Perception of first-order grating acuity and second-order spatial contrast sensitivity in anisometropia amblyopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To study the perception of first-order grating acuity and second-order spatial contrast sensitivity in patients with monocular anisometropia amblyopia.METHODS:A total of 715 children(715 eyes)diagnosed as monocular anisometropia amblyopia in our hospital from January 2018 to December 2022 were collected as amblyopia group, and 745 children(745 eyes)with normal corrected visual acuity were collected. The best corrected visual acuity(BCVA), first-order grating acuity and/or second-order spatial contrast sensitivity were measured, repectively. The perception ability of amblyopia patients to first-order grating acuity and second-order spatial contrast sensitivity were analyzed.RESULTS:There were significant differences between amblyopia group and normal control group in the perception of first-order grating acuity(11.58±6.10 vs. 20.27±3.47, P<0.001)and second-order spatial contrast sensitivity(0.33±0.16 vs 0.12±0.04, P<0.001). And there were significant differences between mild-to-moderate amblyopia and severe amblyopia patients in first-order grating acuity(12.10±6.23 vs. 8.13±3.70, P<0.001)and second-order spatial contrast sensitivity(0.32±0.16 vs. 0.37±0.17, P<0.05).CONCLUSION: The first-order and second-order visual pathway of the cerebral cortex in children with monocular anisometropia amblyopia have different degrees of damage. The injury of severe amblyopia is more serious than that of mild-to-moderate amblyopia.

Efectividad del tratamiento con atropina versus oclusiones en pacientes con ambliopía refractiva moderada unilateral

Objetivo: Comparar la efectividad del tratamiento de atropina versus oclusión ocular en pacientes con ambliopía refractiva moderada unilateral. Métodos: Se realizó un estudio descriptivo, longitudinal y prospectivo de una serie de casos que acudieron a la consulta de Oftalmología Pediátrica del Instituto Cubano de Oftalmología Ramón Pando Ferrer durante el período comprendido de septiembre del 2019 a septiembre de 2021. La muestra quedó conformada por 44 pacientes, los cuales se dividieron de forma aleatoria en dos grupos de estudio, 22 casos al grupo de oclusiones e igual número al grupo de atropina, que cumplían los criterios de inclusión. Se analizaron las variables edad, sexo, defecto refractivo, agudeza visual mejor corregida, sensibilidad al contraste y estereopsis. Resultados: Predominó el astigmatismo hipermetrópico en ambos grupos de estudio. La media de la agudeza visual mejor corregida inicial en ambos grupos fue de 0,4 LogMAR y mejoró a 0,1 LogMAR al finalizar el tratamiento. La media de la sensibilidad al contraste inicial fue de 1,48 (±19,75) para el grupo de oclusiones y de 1,47 (±20,5) para el grupo atropina, al finalizar alcanzaron 1,59 (±10,1) y 1,57 (±10,0) por orden de mención. La estereopsis inicial fue subnormal en ambos grupos, al finalizar el tratamiento fue normal en el 77,3 % grupo oclusión y el 68,2 % grupo atropina. Conclusiones: La efectividad del tratamiento en pacientes con ambliopía refractiva moderada unilateral con atropina es similar a la que se alcanza con la aplicación de la oclusión ocular.

Objective: To compare the effectiveness of atropine treatment versus ocular occlusion in patients with unilateral moderate refractive amblyopia. Methods: A descriptive, longitudinal and prospective study of a series of cases that attended the Pediatric Ophthalmology office of the Ramón Pando Ferrer Cuban Institute of Ophthalmology during the period from September 2019 to September 2021 was carried out. The sample consisted of 44 patients, who were randomly divided into two study groups, 22 cases to the occlusion group and the same number to the atropine group, who met the inclusion criteria. The variables age, gender, refractive defect, best corrected visual acuity, contrast sensitivity and stereopsis were analyzed. Results: Hypermetropic astigmatism predominated in both study groups. Average initial best-corrected visual acuity in both groups was 0.4 LogMAR and improved to 0.1 LogMAR at the end of treatment. Average initial contrast sensitivity was 1.48 (±19.75) for the occlusion group and 1.47 (±20.5) for the atropine group, at completion reaching 1.59 (±10.1) and 1.57 (±10.0) in order of mention. Initial stereopsis was subnormal in both groups, at the end of treatment it was normal in 77.3 % occlusion group and 68.2 % atropine group. Conclusions: The effectiveness of treatment in patients with unilateral moderate refractive amblyopia with atropine is similar to that achieved with the application of ocular occlusion.

Multifocal versus modified monovision corrections: A non-dispensing comparison of visual assessment in presbyopic neophytes

Purpose: To compare the visual performance of two simultaneous?vision soft multifocal contact lenses and to compare multifocal contact lens and its modified monovision counterpart in presbyopic neophytes. Methods: A double?masked, prospective, comparative study was conducted on 19 participants fitted with soft PureVision2 multifocal (PVMF) and clariti multifocal (CMF) lenses in random order. High? and low?contrast distance visual acuity, near visual acuity, stereopsis, contrast sensitivity, and glare acuity were measured. The measurements were conducted using multifocal and modified monovision design with one brand and then repeated with another brand of lens. Results: High?contrast distance visual acuity showed a significant difference between CMF (0.00 [?0.10–0.04]) and PureVision2 modified monovision (PVMMV; ?0.10 [?0.14–0.00]) correction (P = 0.003) and also between CMF and clariti modified monovision (CMMV; ?0.10 [?0.20–0.00]) correction (P = 0.002). Both modified monovision lenses outperformed CMF. The current study did not show any statistically significant difference between contact lens corrections for low?contrast visual acuity, near visual acuity, and contrast sensitivity (P > 0.01). Stereopsis at near distance was significantly lower with both modified monovision (PVMMV: 70 [50–85]; P = 0.007, CMMV: 70 [70–100]; P = 0.006) and with CMF (50 [40–70]; P = 0.005) when compared to spectacles (50 [30–70]). Glare acuity was significantly lower with multifocal (PVMF: 0.46 [0.40–0.50]; P = 0.001, CMF: 0.40 [0.40–0.46]; P = 0.007) compared with spectacles (0.40 [0.30–0.40]), but no significant difference was noted between the multifocal contact lenses (P = 0.033). Conclusion: Modified monovision provided superior high?contrast vision compared to multifocal correction. Multifocal corrections performed better for stereopsis when compared to modified monovision. In parameters like low?contrast visual acuity, near acuity, and contrast sensitivity, both the corrections performed similarly. Both multifocal designs showed comparable visual performances.

Dual visual impairment and contrast sensitivity among community-dwelling older adults: a cross-sectional study from the PrevQuedas Brazil trial / Duplo déficit visual e sensibilidade ao contraste em idosos da comunidade: estudo transversal do PrevQuedas Brasil

OBJECTIVE: To investigate the importance of improving visual assessment for community-dwelling older adult fallers. METHODS: Cross-sectional study with eligible older adults (> 60 years old) living in the community and who suffered at least one fall in the last 12 months from the PrevQuedas Brasil clinical trial. Sociodemographic data, information on previous falls, physical and functional assessment (BOMFAQ and FES-I) were collected. We evaluated impairments in visual acuity and contrast sensitivity using the Snellen E chart and low-contrast visual acuity tests, respectively. Dual visual impairment refers to the presence of both impairments. For statistical analysis we compared the participants in relation to the number of falls (single fallers or recurrent fallers) using Chi-square or Fisher's exact test and the significance level was <0.05 for all analyses. RESULTS: Visual acuity, low contrast sensitivity, and dual visual impairment were associated with recurrent falls (OR 1.85); visual impairment was more prevalent among the oldest old. Approximately 90% of the participants reported using glasses, and 63.80% used multifocal lenses. Dual impairment was identified in 143 (20.30%) participants. In multivariate logistic regression, the predictive variables for recurrent falls were low contrast sensitivity (95%CI 1.15­2.47), dual visual impairment (95%CI 1.16­2.83), and self-perceived fall risk (95%CI 1.16­2.46) which was measured using the Falls Efficacy Scale-International. CONCLUSION: Older adults with dual visual impairment are more likely to suffer recurrent falls. Low contrast sensitivity is crucial for fall risk assessment

OBJETIVO: Este estudo investiga a importância de avaliar a visão de idosos caidores na comunidade. METODOLOGIA: Estudo transversal com idosos elegíveis (> 60 anos) residentes na comunidade e que sofreram pelo menos uma queda nos últimos 12 meses do ensaio clínico PrevQuedas Brasil. Foram coletados dados sociodemográficos, informações sobre quedas pregressas, exames físicos e funcionais (BOMFAQ e FES-I). Avaliamos os comprometimentos da acuidade visual e da sensibilidade ao contraste por meio da Tabela E de Snellen e testes de acuidade visual de baixo contraste, respectivamente. O duplo déficit visual refere-se à presença de ambas as deficiências. Para análise estatística comparamos os idosos com relação ao número de quedas (caidores únicos ou caidores recorrentes) usando Qui-quadrado ou Teste exato de Fisher e o nível de significância foi <0.05 para todas as análises. RESULTADOS: Baixa acuidade visual, baixa sensibilidade ao contraste e duplo déficit visual foram associados a quedas recorrentes com odds ratio ­ OR 1,85, frequentemente mais prevalente entre os idosos longevos. Cerca de 90,00% dos idosos relataram usar óculos e 63,80% usavam lentes multifocais. O duplo déficit visual foi identificado em 143 (20,30%) participantes. Nos modelos de regressão logística multivariados, verificamos que as variáveis preditoras para queda recorrente foram a baixa sensibilidade ao contraste (intervalo de confiança ­ IC95% 1,15­2,47), duplo déficit (IC95% 1,16­2,83) e a autopercepção do risco de cair (IC95% 1,16­2,46) medido pela Falls Efficacy Scale-International. CONCLUSÃO: Idosos com baixa sensibilidade ao contraste e duplo déficit visual têm maiores chances de sofrerem múltiplas quedas quando comparados com idosos que possuem apenas baixa acuidade visual. Assim, a baixa sensibilidade ao contraste é essencial na avaliação do risco de quedas dos idosos

Comparison of Contrast Sensitivity and Central Corneal Thickness in Primary Open Angle Glaucoma Suspects and Visually Normal Participants

@#Introduction: Glaucoma causes a reduction of contrast sensitivity (CS) while thinner central corneal thickness is (CCT) associated with the risk of glaucoma. Thus, in glaucoma suspect patients, CS and CCT measurements may better evaluate and monitor the disease. The purpose of this study was to compare CS and CCT between a Primary Open Angle Glaucoma (POAG) suspect group and a normal group of similar age. Methods: CS was measured with the Pelli-Robson CS chart, while CCT was measured with a hand-held pachymeter. In total, 115 glaucoma suspects and 102 normal participants were included. Results: There was a significant effect of the clinical condition on CS [F(1,209)=5.409, p=0.02]. The effect of age on CS was also significant [F(3,209)=20.419, p<0.001]. The interaction between age and clinical condition was not statistically significant [F(3,209)=0.815, p=0.49]. CS of POAG suspects was significantly lower than that of the normal group for the younger age groups (40 to 59 years old) but not for the older age groups (50 to 80 years old). There was no significant effect of clinical condition on CCT [F(3,209)=0.754, p=0.39]. However, there was a significant effect of age on CCT [F(3,209)=3.789, p=0.01]. Conclusion: Contrast sensitivity measurement is potentially useful to be integrated with routine investigations for POAG suspect patients, especially those who are younger than 60 years old. Measurements of central corneal thickness alone may not be able to differentiate between POAG suspects and visually normal individuals.

Comparison of visual function before and after wearing amber filter in low vision patients with primary retinitis pigmentosa / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the visual function of low-vision patients with primary retinal pigmentosa(RP)before and after wearing amber filter.METHODS: Self-control before and after study. A total of 30 patients(60 eyes)with low vision who were diagnosed with primary RP in the ophthalmology clinic of Xi'an No.1 Hospital from August 2021 to March 2022 were collected. The uncorrected distance visual acuity(UCDVA), best-corrected distance visual acuity(BCDVA), uncorrected near visual acuity(UCNVA), best-corrected near visual acuity(BCNVA), visual field and Farnsworth-Munsell(FM)-100 color visions were recorded before and after wearing amber filter. The contrast sensitivity(CS)in three visual environments including bright room, darkroom and darkroom with glare was measured and recorded respectively, and the changes of those parameters were analyzed before and after wearing filter.RESULTS: UCDVA and BCDVA after wearing the filter were better than those before wearing(t=-2.32, P&#x0026;#x003C;0.001; t=-6.77, P&#x0026;#x003C;0.001), while there was no statistically significant difference in UCNVA and BCNVA before and after wearing filter. The visual field index(VFI)after wearing filter was lower than that before wearing(t=8.62, P&#x0026;#x003C;0.001), and the mean defect(MD)of visual field was greater than that before wearing(t=7.73, P&#x0026;#x003C;0.001). FM100 color chess test showed that both total error score(TES)and partial error score(PES)in multiple regions were higher than those before wearing filter(P&#x0026;#x003C;0.001). After wearing, the CS of each frequency band in the environment of bright room and darkroom with glare was higher than that before wearing(P&#x0026;#x003C;0.001), and there was no statistically significant difference in each frequency band before and after wearing amber filter under the environment of darkroom without glare.CONCLUSION: Patients with low vision of primary RP showed improved UCDVA and BCDVA, but unchanged UCNVA and BCNVA after wearing amber filter, while the visual field and color discrimination were worse than those before wearing filter. The CS of the bright room and darkroom with glare environment was improved than before wearing filter, while there were no significant changes in CS under darkroom without glare.

Normative database for Spaeth Richman contrast sensitivity test for Indian eyes

Purpose: To ascertain normative database of contrast sensitivity (CS) using Spaeth/Richman CS test (SPARCS) in the Indian population. Methods: This cross?sectional study enrolled 200 healthy individuals, and CS was tested in both eyes of each participant using SPARCS. A detailed ocular examination was done before enrollment to rule out pathologies that may affect CS. A practice test was performed in the right eye (OD), followed by uniocular testing in each eye and a final binocular test. Results: Data of 400 eyes of 200 subjects who fulfilled the inclusion criteria was evaluated. The average age of subjects was 46.57 ± 16.77 years (range 21–79 years), with a slight female preponderance (53%, n = 106). A statistically significant decline in average SPARCS scores was noted with increasing age (P < 0.05), ranging from 86.68 (20–29 years age group) to 67.44 (70–79 years age group). Higher scores were noted in binocular testing than uniocular testing (Interclass correlation coefficient [ICC] = 0.83; P < 0.001). Females achieved statistically significant higher total scores in uniocular SPARCS testing (both OD and OS), but there was no significant difference noted between the two genders in binocular testing. Correlation between practice and main tests was statistically Significant with an interclass correlation coefficient of 0.54 (P < 0.001). Conclusion: Normative database for SPARCS was established for Indian eyes, with a decreasing trend noted in peripheral as well as central CS scores with increasing age.

Sensibilidad al contraste y aberrometría ocular en pacientes operados de miopía con técnicas de superficie / Contrast Sensitivity and Ocular Aberrometry in Patients Operated on for Myopia with Surface Techniques

Objetivo: Determinar el cambio de la sensibilidad al contraste en pacientes operados de miopía con técnicas de superficie y su relación con la aberrometría ocular. Métodos: Se realizó un estudio experimental con 324 ojos de 162 pacientes miopes atendidos en la consulta de Cirugía Refractiva del Instituto Cubano de Oftalmología "Ramón Pando Ferrer" en el período de enero 2019 y marzo de 2020 y que fueron operados de cirugía refractiva con láser de excímero, técnicas de superficie y perfil de ablación asférico. La sensibilidad al contraste fue la variable principal de comparación entre ambas técnicas quirúrgicas. Se formaron dos grupos de pacientes, cuya asignación fue secuencial, al primer grupo, se le realizó la técnica quirúrgica PRK-MMC (81) y al segundo LASEK-MMC (81) con un seguimiento de 3 meses. Resultados: Predominaron las mujeres con miopía leve y edades entre 21 y 28 años. A los tres meses la sensibilidad al contraste, agudeza visual sin corrección, equivalente esférico y el valor cuadrático medio total mejoraron de manera significativa, mostrando una relación positiva con la sensibilidad al contraste en ambos grupos, sin diferencias entre ellos. Conclusiones: La sensibilidad al contraste mejora con técnicas de superficie y posee una relación positiva y significativa con los resultados visuales, refractivos y aberrométricos. El estudio de las aberraciones oculares proporciona un arma fundamental para valorar la calidad óptica del ojo humano, información que permite conocer la calidad visual que se puede esperar en los pacientes evaluados(AU)

Objective: To determine the change in contrast sensitivity in patients operated on for myopia with surface techniques and its relationship with ocular aberrometry. Methods: An experimental study was carried out with 324 eyes of 162 myopic patients treated at the Refractive Surgery Clinic of the Cuban Institute of Ophthalmology "Ramón Pando Ferrer" between January 2019 and March 2020 who underwent refractive surgery with excimer laser and surface techniques and aspheric ablation profile. Contrast sensitivity was the main variable of comparison between both surgical techniques. Two groups of patients were sequentially assigned, the first group underwent PRK-MMC (81) and the second LASEK-MMC (81) with a 3-month follow-up. Results: Women with mild myopia and ages between 21 and 28 years predominated. After 3 months contrast sensitivity, uncorrected visual acuity, spherical equivalent and total average square value improved significantly, showing a positive relationship with contrast sensitivity in both groups, with no differences between them. Conclusions: Contrast sensitivity improves with surface techniques and has a positive and significant relationship with visual, refractive and aberrometric outcomes. The study of ocular aberrations provides a fundamental tool to assess the optical quality of the human eye, information that allows us to know the vision quality that can be expected in the patients evaluated(AU)

Comparison of clinical outcomes of trifocal intraocular lens (AT LISA, Eyecryl SERT trifocal) versus extended depth of focus intraocular lens (Eyhance, Eyecryl SERT EDOF)

Purpose: To compare four different types of intra ocular lenses (IOLs), namely, AT LISA, Eyecryl SERT trifocal, Eyhance, Eyecryl SERT extended depth of focus (EDOF) with respect to their clinical outcomes. Methods: This is a retrospective comparative study in which patients who underwent surgery and one of the four types of IOL were implanted. Postoperative evaluation was recorded at one month, postoperatively. The monocular uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) (6 m), uncorrected intermediate visual acuity (UIVA) (60 cm), distance-corrected intermediate visual acuity (CIVA), uncorrected near visual acuity (UNVA) (40 cm), and corrected near visual acuity (CNVA) were assessed postoperatively on post operative day 30, for all four IOL groups. Defocus curve and contrast sensitivity were also compared. Results: With regards to UDVA and CDVA, P value was not statistically significant. (P = 0.534 and 0.421, respectively). EDOF group of IOLs had statistically significant better UIVA and CIVA than trifocal IOL group. (P < 0.001, 0.012, <0.001) and EDOF group had statistically significant worse P value pertaining to UNVA and CNVA (P < 0.001, 0.070, <0.001, 0.190). Pertaining to contrast sensitivity, EDOF group had better contrast sensitivity than Trifocal IOL group (P < 0.001). Conclusion: All four IOLs compared in this study had good comparable distant visual acuity. Near visual acuity was better with AT LISA and Eyecryl SERT trifocal IOL while intermediate vision was better with Eyhance and Eyecryl SERT EDOF IOL. Contrast sensitivity was better in EDOF IOLs than in both trifocal IOLs

Effects on ocular aberration and contrast sensitivity after implantation of spherical and aspherical monofocal intraocular lens - A comparative study

Purpose: Phacoemulsification with intraocular lens (IOL) implantation is the standard of care for cataractous eyes. Monofocal IOLs are spherical or aspheric. The aspheric design of IOLs reduces the spherical and higher-order aberrations and impacts contrast sensitivity post cataract surgery. There are some studies, but data in the Indian setting with the IOLs we used is lacking. We aimed to compare the effect of implantation of spheric and aspheric foldable intraocular lenses on postoperative quality of vision, spherical aberration, and contrast sensitivity. Methods: This prospective observational study was conducted at a tertiary care hospital with an ophthalmology specialty, data collection from January 2017 to May 2018 in 100 patients. Patients meeting the inclusion criteria were selected. Their preoperative and postoperative data were collected and divided into groups based on whether spherical or aspheric IOL was implanted after cataract surgery. Variables assessed were visual acuity on days 7 and 30, spherical aberrations, and contrast sensitivity was assessed at 1?month postoperative. Results: The mean age of the patients in this study was 64 ± 8 years with a majority of patients (60%) being females. There is no significant difference in postoperative visual acuity between the two groups. Internal SA was significantly lower (~50%) in eyes implanted with aspheric IOLs (P value = 0.004, 0.0001) compared with the spherical group. Contrast sensitivity of patients of the aspheric group was significantly better (P value <0.05). Conclusion: The optical design of the aspheric IOLs reduced spherical aberrations and increased contrast sensitivity.

The effectiveness of laser vitreolysis for vitreous floaters in posterior vitreous detachment

Purpose: To determine the effectiveness of laser vitreolysis in terms of contrast sensitivity function (CSF) and vision?related quality of life (VRQol) for symptomatic floaters due to posterior vitreous detachment (PVD). Materials: This is an interventional study that involved 57 eyes of 45 patients with symptomatic floaters for more than 3 months. Patients underwent one to three sessions of vitreolysis via Neodymiun?doped Yttrium Aluminum Garnet (Nd:YAG) laser. We examined the CSF using the computer programs Freiburg Acuity and Contrast Test (FrACT) and VRQoL survey using the National Eye Institute Visual Function Questionnaire?25 (NEI VFQ?25) before, and 1 month after, vitreolysis. Results: Twelve patients had both eyes lasered and 33 patients had one eye lasered. The mean CSF improved from 3.20 ± 0.85%W to 2.64 ± 0.63%W 1 month after vitreolysis. Each use of the laser showed a significant mean difference in CSF (%W) as analyzed by paired t?test before and after the first laser (0.29 ± 0.49%W [P ? 0.001]); after the first and second laser (0.35 ± 0.53%W [P = 0.01]); and after second and third laser (0.21 ± 0.31%W [P = 0.02]). There was improvement in the median of four subscales in NEI VFQ?25 scores post treatment: general vision (z = ?3.30, P = 0.001), near activity (z = 3.396, P = 0.001, distance activity (z = ?2.788, P = 0.005), and mental health (z = ?2.219, P = 0.026). The mean scores increased to 79.55 ± 9.45 from the baseline 75.06 ± 9.69 (P ? 0.001). No adverse events were recorded 1 month after the laser treatments. Conclusion: Vitreolysis by Nd:YAG laser improved the CFS and VRQoL in symptomatic PVD patients.

Assessing contrast sensitivity change in retinal diseases with use of yellow-amber NoIR glasses

Purpose: The purpose of this study was to assess change of contrast sensitivity (CS) in subjects having retinal diseases with yellow?amber no infrared (NoIR) glasses used as low vision aid (LVA). Methods: We examined CS in 82 low vision (LV) subjects having retinal diseases with Pelli Robson Chart at 1 m distance before and after wearing yellow?amber NoIR glasses. We also found type of retinal affection and macular optical coherence tomography (OCT) features. Results: The distance and near best?corrected visual acuity (BCVA) was, respectively, 0.68 ± 0.17 (median = 0.70) and 0.72 ± 0.25 (median = 0.70) logmar units. The pre?LVA CS was 0.52 ± 0.29 (median = 0.3) and post? LVA was 0.52 ± 0.28 (median = 0.45) logunits (mean reduction = ?0.002 ± 0.24; Median reduction = 0; P = 0.909). The pre?LVA and post?LVA CS showed a negative correlation with logmar distance BCVA [r = ?0.090; P = 0.317 and r = ?0.152; P = 0.090 respectively]. The pre?LVA and post?LVA CS showed a negative correlation with logmar near BCVA [r = ?0.114; P = 0.207 and r = ?0.054; P = 0.549 respectively]. The CS did not improve in subjects having macular degeneration, pathological myopia, hereditary maculopathy, and diabetic retinopathy. The macular OCT features like fluid, exudates, scars, drusens, traction, and hole did not significantly influence CS both at pre?LVA and post?LVA stage. Conclusion: This is the first study with yellow?amber NoIR glasses which blocks “both ultraviolet and infrared light.” The subjects having macular degeneration, pathological myopia, hereditary maculopathy, and diabetic retinopathy did not improve in CS with filters. The correlation values showed that filters may improve CS in subjects having good baseline BCVA.

The Effect of Monochromatic Aberrations of the Cornea on Contrast Sensitivity under Photopic and Mesopic Conditions

Purpose: Vision is one of the most important senses. The first stage of vision is the creation of the observed object抯 image on the retina. The quality of the retinal image is affected by several factors, such as diffraction, sampling on the retina, chromatic aberration, scattering and higher order aberrations. The measurement of the quality is achieved both with subjective (visual acuity, contrast sensitivity) and objective methods (PSF, MTF, Strehl ratio, RMS). The purpose of this project is the measurement of higher order aberrations of the anterior corneal surface (with a Placido corneal topographer) and of the contrast sensitivity (with a Pelli Robson optotype). Then, we will try to find if there is a correlation between them.Methods and Materials: 20 persons participated in this survey, divided in two groups of 10 persons each. The first group (group 1) included subjects up to 39 years old and the second group (group 2) from 40 years and up. The participants didn抰 have any pathological problems, except lower order refractive errors. Both eyes of each individual were included in the procedure. First, the higher order aberrations of the anterior corneal surface were measured, with the implementation of a Placido corneal topographer. This was followed by a measurement of the contrast sensitivity. The whole procedure took place under two lighting conditions, both photopic and mesopic. The examination presentation of the higher order aberrations is performed with the use of Zernike polynomials.Results: The results of the measuring procedure showed that for the first group, under photopic conditions (luminance 32.70 cd/m2) the mean value (� standard deviation) for the higher order aberrations RMS and decimal logarithm contrast sensitivity was 0.073 � 0.018?m and 1.54 � 0,16 (contrast 2.88 � 1.24%) respectively. For the second group the corresponding values were 0.080 � 0.036?m and 1.59 � 0.16 (contrast 2.57 � 1.24%). Accordingly, under mesopic conditions (luminance 1.14 cd/m2) the values for the first group were 0.252 � 0.064 ?m and 1.27 � 0.15 (contrast 5.37 � 2.06%), while for the second were 0.253 � 0.069?m and 1.32 � 0.12 (contrast 4.79 � 1.35%). Spherical aberration and coma (horizontal and vertical) were also measured for both groups under photopic and mesopic conditions. The results showed that for the first group, under photopic conditions, RMS for coma and spherical aberration is 0.033 � 0.014 ?m and 0.022 � 0.011 ?m respectively, while for the second group 0.041 � 0.027 ?m and 0.024 � 0.008 ?m. Under mesopic conditions, the relevant results are 0.139 � 0.065 ?m and 0.124 � 0.035?m for the first group and 0.149 � 0.066 ?m and 0.107 � 0.038 ?m for the second group.Finally, we should mention here that the equivalent defocus error corresponding to the higher order aberration RMS was estimated. The results for all the participants (without age separation), are 0.23 � 0.09D (photopic conditions) and 0.28 � 0.07D (mesopic conditions).Conclusions: From the statistical analysis of the results we conclude that there exists a symmetry between left and right eyes regarding higher order aberrations. Furthermore, it seems that age is not a significant factor for differences on the magnitude of higher order aberrations both under photopic and mesopic conditions as well. Similar conclusions are also reached for the contrast sensitivity measurements. In addition, we have observed that a correlation exists between the higher order aberrations of the anterior corneal surface and the contrast sensitivity, for both photopic and mesopic conditions. Correlation also exists between coma and contrast only under photopic conditions. But there is no significant correlation between spherical aberration and contrast. The age difference of these two groups has not an effect on the results. Finally, the equivalent defocus is too small, both for photopic and mesopic conditions and between each other, in order to be clinically significant.

Evaluation of contrast sensitivity in non-high-risk proliferative diabetic retinopathy treated with panretinal photocoagulation with and without intravitreal injections of ranibizumab / Avaliação da sensibilidade ao contraste em retinopatia diabética proliferativa de não alto risco tratada com panfotocoagulação retiniana com ou sem injeções intravítrea de ranibizumabe

ABSTRACT Purpose: To evaluate contrast sensitivity in non-high-risk, treatment-naïve proliferative diabetic retinopathy patients treated with panretinal photocoagulation and intravitreal injections of ranibizumab) versus panretinal photocoagulation alone. Methods: Sixty eyes of 30 patients with bilateral proliferative diabetic retinopathy were randomized into two groups: one received panretinal photocoagulation and ranibizumab injections (study group), while the other received panretinal photocoagulation alone (control group). All eyes were treated with panretinal photocoagulation in three sessions according to the Early Treatment Diabetic Retinopathy Study guidelines. Contrast sensitivity measurements were performed under photopic conditions (85 cd/m2) with the Visual Contrast Test Sensitivity 6500 chart, allowing for the evaluation of five spatial frequencies with sine wave grating charts: 1.5, 3.0, 6.0, 12.0, and 18.0 cycles per degree (cpd). Outcomes were measured in contrast sensitivity threshold scores among and within groups, from baseline to 1, 3, and 6 months. Results: Fifty-eight eyes (28 in the study group and 30 in the control group) reached the study endpoint. A comparative analysis of changes in contrast sensitivity between the groups showed significant differences mainly in low frequencies as follows: at month 1 in 1.5 cpd (p=0.001) and 3.0 cpd (p=0.04); at month 3 in 1.5 cpd (p=0.016), and at month 6 in 1.5 cpd (p=0.001) and 3.0 cpd (p=0.026) in favor of the study group. Conclusions: In eyes of patients with non-high-risk proliferative diabetic retinopathy, panretinal photocoagulation treatment with ranibizumab appears to cause less damage to contrast sensitivity compared with panretinal photocoagulation treatment alone. Thus, our evaluation of contrast sensitivity may support the use of ranabizumab as an adjuvant to panretinal photocoagulation for the treatment of proliferative diabetic retinopathy.

RESUMO Objetivos: Avaliar a sensibilidade ao contraste em pacientes virgens de tratamento com retinopatia diabética proliferativa de não alto risco, submetidos a panfotocoagulação retiniana com injeções intravítreas de ranibizumabe versus pan­fotocoagulação isolada. Métodos: Sessenta olhos de 30 pa­cientes foram randomizados em dois grupos: um submetido a panfotocoagulação com injeções de ranibizumabe (grupo estudo), e o outro submetimedo a panfotocoagulação isolada (grupo controle). Todos olhos foram tratados em 3 sessões de laser, seguindo recomendação do Early Treatment Diabetic Retinopathy Study (ETDRS). Avaliação da sensibilidade ao contraste foi realizada sob condições fotópicas (85 cd/m2) com tabela Visual Contrast Test Sensitivity 6500, permitindo avaliação de cinco frequências espaciais medidas com redes senoidais: 1.5, 3.0, 6.0, 12.0 e 18.0 ciclos por grau de ângulo visual (cpd). Foram realizadas medidas dos limiares de sensibilidade ao contraste intra e entre grupos na visita inicial, no 1º, 3º, e 6º mês de seguimento. Resultados: Cinquenta e oito olhos, 28 do grupo estudo e 30 do grupo controle, atingiram o término do estudo. Análise comparativa da SC entre os grupos mostrou diferença estatisticamente significante, nas baixas frequências espaciais, no 1º mês em 1.5 cpd (p=0,001) e 3.0 cpd (p=0,04), no 3º mês em 1.5 cpd (p=0,016) e no 6º mês em 3.0 cpd (p=0,026) a favor do grupo estudo. Conclusão: O tratamento com panfotocoagulação associada a injeção de ranibizumabe parece causar menos danos a sensibilidade ao contraste quando comparada com panfotocoagulação isolada em olhos com retinopatia diabética proliferativa de não alto risco. Dessa forma, os resultados apresentados podem justificar a associação do ranibizumabe à panfotocoagulação nestes pacientes.

Binocular summation in comitant exotropia: Change after surgery

Purpose: To assess the change in binocular summation (BiS) in comitant exotropia (XT) after strabismus surgery. Methods: This is a prospective study on 20 patients who underwent surgery for comitant XT over a one year period. Patients with sensory exotropia and nystagmus were excluded. Best?corrected visual acuity (VA) and contrast sensitivity (CS) of both eyes separately and together (binocularly) were recorded. BiS score was calculated as binocular score minus better eye score. BiS score at the end of 3 months was compared with the preoperative data. Results: The mean ± SD of BiS score increased from 2.95 ± 0.88 to 4.55 ± 0.68 (P?value < 0.0001) for VA (on ETDRS letters) and from 2.75 ± 0.44 to 4.5 ± 0.76 (P?value < 0.001 for CS (on Pelli–Robson chart) after surgery. Conclusion: There is significant improvement in BiS in XT after strabismus surgery. Authors recommend its inclusion in evaluation of functional outcome of XT surgery

Do automotive window films affect drivers' safety by decreasing vision sensitivity? A Cross-sectional study / Películas automotivas e perda de acuidade visual? Estudo transversal

ABSTRACT Objective: To measure visual acuity in high contrast and low contrast sensitivities in different grades of visible light transmission films in three different positions (front, lateral and rear windows). Methods: Forty-four healthy volunteers between 30-75 y-o, with BCVA better than 0,5, were tested in the 5 following vehicles with different grades of visible light transmission films. Vehicle 1: 75% in the front and 70% in the lateral and rear windows; Vehicle 2: 70% in the front and lateral windows and 28% in the rear; Vehicle 3: 70% in the front, 28% in the lateral and 15% rear; Vehicle 4: 35% in all 3 windows; Vehicle 5: 50% in the front, 20% in the lateral and 15% in the rear. Descriptive statistics were used and the average of the 3 measurements of VA was considered. Wilcoxon Test was applied to compare the average visual acuity in each vehicle and position. P value<0.05 was considered statistically significant. Results: According to the Brazilian Traffic Regulations for driving in categories C/D/E, when low contrast was tested in the front window, all visible light transmissions were borderline, in the lateral window they were all outside the limit, while in the rear window for both low and high contrast, all visible light transmissions tested were outside the limit and also borderline for driving in categories A/B, with the exception of the vehicle with visible light transmission of 35%. Conclusion: Visual acuity is affected, especially in the rear window, by the use of automotive films. The study is an alert that window films is a possible cause of accidents and may contribute to the revision of traffic regulations worldwide.

RESUMO Objetivo: Medir a acuidade visual em alto e baixo contraste nas diversas graduações de transparência de filmes em três janelas de veículos: frontal, lateral e traseira. Métodos: Foram avaliados 44 voluntários saudáveis entre 30 e 75 anos, com acuidade visual melhor corrigida acima de 0,5, em cinco veículos, sendo: veículo 1, com 75% de transparência frontal e 70% na lateral e traseira; veículo 2, com 70% na frontal e na lateral e 28% na traseira; veículo 3, com 70% na frontal, 28% na lateral e 15% na traseira; veículo 4, com 35% nas três janelas; e veículo 5, com 50% na frontal, 20% na lateral e 15% na traseira. Foi realizada estatística descritiva utilizando a média de três medidas consecutivas, com teste de Wilcoxon para comparar a média de acuidade visual em cada janela, e foi considerado estatisticamente significativo quando valor de p<0,05. Resultados: Todas as transparências testadas nos vidros reduziram a acuidade visual em situação de baixo contraste para níveis limítrofes na janela frontal e níveis ilegais na lateral para conduzir veículos nas categorias C/D/E. Na janela traseira, tanto em alto quanto em baixo contraste, todas as transparências mostraram redução da acuidade visual para níveis ilegais para categorias C/D/E e limítrofes para as categorias A/B, exceto na transparência de 35%. Conclusão: A acuidade visual é reduzida pelo uso dos filmes automotivos, especialmente na janela traseira. Condutores de veículos com filmes devem ser alertados pelo risco aumentado de acidentes. Esse dado científico propõe revisões nas regulações de tráfego mundiais.

Visual function and visual quality in diabetic macular edema treated by Conbercept / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the visual function and visual quality of patients with diabetic macular edema treated with conbercept injection.<p>METHODS: The average change of contrast sensitivity(CS), best corrected visual acuity(BCVA), central retinal thickness(CRT)and NEIVFQ-25 score were observed for 3mo after intravitreal injection of conbercept in 43 eyes of 38 patients with diabetic macular edema.<p>RESULTS: The mean CS increased from(1.060±0.14)units to(1.47±0.31)units at 12wk after intravitreal injection of conbercept(<i>P</i><0.05). The average LogMAR BCVA decreased significantly from 0.535±3.32 to 0.333±0.11 at 12wk(<i>P</i><0.05), and the average CRT decreased significantly from 369.45±36.42μm to 226.53±39.48μm at 12wk(<i>P</i><0.05). There is not a correlation between the changes in CRT and BCVA and the improvement of CS. The NEIVFQ-25 score improved in 30 cases(79%)from baseline to 12wk. 6 cases(16%)had no change in the NEIVFQ-25 score, and 2 cases(5%)declined in the NEIVFQ-25 score.<p>CONCLUSION: The treatment of conbercept injection for diabetic retinal macular edema can significantly improve the visual function and the quality of life.

Clinical value of transabdominal ultrasonography versus transvaginal ultrasonography in the early diagnosis of ectopic pregnancy / 中国基层医药

Objective:To investigate the clinical value of transabdominal ultrasonography versus transvaginal ultrasonography in the early diagnosis of ectopic pregnancy. Methods:A total of 100 patients with suspected early ectopic pregnancy who received treatment in Luanping Shengjian Hospital between April 2019 and April 2021 were included in this study. All of them underwent transabdominal and transvaginal ultrasonography. Surgical pathological results were used as the gold standard to analyze the diagnostic efficacy of the two examination methods. The detection rate of ectopic pregnancy by ultrasonography was compared between the two examination methods.Results:Early ectopic pregnancy was detected in 59 cases by transabdominal ultrasonography, among which seven cases were misdiagnosed and 10 cases were missed. Early ectopic pregnancy was detected in 60 cases by transvaginal ultrasonography, among which one case was misdiagnosed and three cases were missed. The sensitivity, specificity and accuracy of transvaginal ultrasonography in the early detection of ectopic pregnancy were 95.2%, 97.4% and 96.0%, respectively, which were significantly higher than those of transabdominal ultrasonography (83.9%, 81.6%, 83.0%, χ2 =4.21, 5.03, 8.99, P = 0.040, 0.025, 0.003). Transvaginal ultrasonography showed that detection rates of accessory mass, yolk sac, embryo, intrauterine pseudopregnancy sac, pelvic effusion and original vascular fluctuation were 88.7%, 50.0%, 24.2%, 22.6%, 12.9%, 87.1%, respectively, which were significantly higher than those of transabdominal ultrasonography (64.5%, 19.4%, 4.8%, 4.8%, 1.6%, 56.5%, χ2 = 10.13, 12.85, 9.36, 8.25, 5.87, 14.37, P = 0.001, < 0.001, = 0.002, = 0.004, = 0.015, < 0.001). Conclusion:Transvaginal ultrasonography is superior to transabdominal ultrasonography in the early detection of ectopic pregnancy and has a higher detection rate of sonographic manifestation than transabdominal ultrasonography.

Macular functional changes after vitrectomy with internal limiting membrane peeling and air filling for myopic foveoschisis by microperimetry / 中华眼底病杂志

Objective:To observe the changes of macular visual function after myopic foveoschisis (MF) and pars plana vitrectomy (PPV) combined with internal limiting membrane peeling and air filling.Methods:A single-center, retrospective study. From October 2018 to October 2019, 29 MF inpatients (32 eyes) in Tianjin Eye Hospital were included in this study. There were 3 males (4 eyes) and 26 females (28 eyes). The age was 63.00±3.45 years old. Equivalent spherical lens degree was -14.16±2.54 D, and axial length was 29.14±1.04 mm. Among them, 3 patients (3 eyes) had lamellar macular holes. All eyes underwent standard pars plana three-channel 25G PPV combined with internal limiting membrane peeling and air filling. Before surgery and at 1, 3, and 6 months after surgery, macular microperimetry was performed with a macular integrity assessment instrument, and the mean retinal sensitivitie (MS) within 10° of the macula, fovea 2° and 4° fixation rates (P1, P2), 63% and 95% bivariate contour ellipse area (BCEA) were recorded. The comparison of MS, P1, P2, 63%BCEA and 95%BCEA at different times before and after surgery was performed by paired t test; the comparison of fixation stability rate was performed by χ 2 test. Results:Compared with before surgery, there were significant differences in the improvement of MS in affected eyes at 1, 3 and 6 months after surgery ( t=-2.208, -3.435,-4.919; P=0.038, 0.002, 0.000). In the pairwise comparison at different times after surgery, only 6 months after surgery and 1 month after surgery were significantly different ( P=0.036). Compared with the preoperative P1, P2, 63%BCEA and 95%BCEA, the P1 and P2 of the eyes gradually increased after surgery, while the 63%BCEA and 95%BCEA gradually decreased, however, the difference was not statistically significant (P1: t=-1.595,-1.698,-1.966; P=0.125, 0.104, 0.062. P2: t=-1.622,-1.654,-1.707; P=0.119, 0.112, 0.102. 63%BCEA: t=1.410, 1.409, 1.553; P=0.172, 0.173, 0.135. 95%BCEA: t=1.412, 1.408, 1.564; P=0.172, 0.173, 0.132). Six months after surgery, all the eyes underwent anatomical repositioning of the macular area, and no serious complications such as full-thickness macular hole and macular hole retinal detachment were found. Conclusions:PPV with internal limiting membrane peeling and air filling is an effective and safe method for MF, and the macular function improved significantly within 6 months postoperatively.

Subjective visual quality, reading fluency and patient satisfaction with the extended depth of focus IOL / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the subjective visual quality, reading fluency and patient satisfaction after a unilateral or bilateral implantation of the Tecnis Symfony extended depth of focus intraocular lens(IOL)with cataract.<p>METHODS: The retrospective analysis on the 48 patients(71 eyes)with cataract phacomulsification surgery in our hospital, which were randomly divided into two groups. The bilateral group with 23 patients(46 eyes)bilateral implanted the Symfony extended depth of focus IOL, the unilateral group with 25 patients(25 eyes)implanted the Symfony IOL in one eye and an aspherical monofocal IOL in the other eye. The uncorrected distance visual acuity(UDVA), uncorrected intermediate distance visual acuity(UIVA), uncorrected near distance visual acuity(UNVA), and best corrected distance visual acuity(BCVA)were measured 3, 6mo after surgery. The contrast sensitivity, reading fluency, reading speed, patient satisfaction and the occurrence of complications were also observed.<p>RESULTS: In the unilateral group, there were no significant differences in the UDVA and BCVA between an eye with the Symfony IOL and an eye with monofocal IOL 3mo after surgery(P>0.05). After 6mo of surgery, UDVA were significantly better than pre-operation in two groups, average visual acuity of LogMAR was under 0.1. There were no significant differences in UDVA, BCVA, UIVA and UNVA between two groups(P>0.05). The patients'far, intermediate, and near distances satisfaction were higher after 3mo of surgery. There were no statistically significant differences in spatial frequency contrast sensitivity between the two groups under photopic/mesopic conditions and mesopic with glare 6mo after surgery. The scores of satisfactions for reading fluency were better in the bilateral group than in the unilateral group(P>0.05). After 6mo, the reading speed of binocular group was slightly higher than the unilateral group(P<0.05), but there was no significant difference between two groups(P >0.05).<p>CONCLUSION:The Symfony extended depth of focus IOL provides good far, intermediate, and near visual acuity in the bilateral group and the unilateral group, while maintaining the same level of visual quality. In both groups over 90% patients were spectacle independent. Symfony IOL has widely adaptability and highly predictability, patients can obtain better satisfactions for reading fluency and reading speed. It is more suitable for intermediate vision.