Comparison of sweep visual evoked potential of visual acuity and Snellen visual acuity in healthy and amblyopic children / Comparação da acuidade visual por potenciais evocados visuais de varredura e pelo teste de Snellen em crianças saudáveis e ambliópicas

ABSTRACT Purpose: To evaluate the visual acuity of healthy and amblyopic children using sweep visual evoked potential and compare the results with those of Snellen visual acuity testing. Methods: A total of 160 children aged 6-17 years were included in the study. Of these, 104 (65%) were aged 7-17 years old, able to verbally communicate, and did not have any systemic or ocular pathology (Group 1). Group 2 included 56 (35%) children aged 6-17 years, able to verbally communicate, and had strabismus or anisometropic amblyopia whose best corrected visual acuity was between 0.1 and 0.8. All subjects underwent a detailed ophthalmological examination and sweep visual evoked potential measurement. Demographic characteristics, ocular findings, best corrected visual acuity, and sweep visual evoked potential results were recorded. Results: In Group 1, the mean and maximum visual acuity values for sweep visual evoked potential were lower than the Snellen best corrected visual acuity (p<0.001, for both, respectively). Bland-Altman analysis revealed that in Group 1, the distribution of the differences between the Snellen best corrected visual acuity and mean sweep visual evoked potential visual acuity was ±0.11 logMAR, and the distribution of the differences between the Snellen best corrected visual acuity and maximum sweep visual evoked potential visual acuity was ±0.023 logMAR. In Group 2, the mean and maximum sweep visual evoked potential visual acuity were lower than the Snellen best corrected visual acuity (p<0.001 and p=0.009, respectively). Bland-Altman analysis revealed that the distribution of the differences between the Snellen best corrected visual acuity and mean sweep visual evoked potential visual acuity was ±0.16 logMAR, and the distribution of the differences between the Snellen best corrected visual acuity and maximum sweep visual evoked potential visual acuity was ±0.19 logMAR. Conclusions: Sweep visual evoked potential visual acuity measurements have comparable results with Snellen visual acuity measurements. This technique is an objective and reliable method for evaluating visual acuity in children.

RESUMO Objetivo: Avaliar a acuidade visual através de po­tenciais evocados visuais de varredura em crianças saudáveis e ambliópicas, comparando-a com a acuidade visual pelo teste de Snellen. Métodos: Foram incluídas no estudo 160 crianças com idades entre 6 e 17 anos. Desse total, 104 crianças (65%) estavam entre 7 e 17 anos de idade, eram capazes de comunicação verbal e não tinham nenhuma patologia ocular ou sistêmica (Grupo 1). O grupo 2 incluiu 56 crianças verbais (35%) com idades entre 6 e 17 anos e portadoras de estrabismo ou ambliopia anisometrópica, com a melhor acuidade visual corrigida entre 0,1 e 0,8. Todos os pacientes foram submetidos a um exame oftalmológico detalhado e a uma medição do potencial evocado visual por varredura. Registraram-se as características demográficas, os achados oculares, a melhor acuidade visual corrigida e os resultados do potencial evocado visual por varredura. Resultados: No Grupo 1, os valores médios e máximos da acuidade visual pelo potencial evocado visual por varredura mostraram-se menores que a melhor acuidade visual corrigida medida através do teste de Snellen (p<0,001 para ambas as medições). Uma análise de Bland-Altman revelou que no grupo 1, a distribuição das diferenças entre a melhor acuidade visual corrigida pelo teste de Snellen e a média do potencial evocado visual por varredura foi de ± 0,11 logMAR, enquanto a distribuição das diferenças entre a melhor acuidade visual corrigida pelo teste de Snellen e o valor máximo do potencial evocado visual por varredura foi de ± 0,023 logMAR. No Grupo 2, os valores médio e máximo do potencial evocado visual por varredura mostraram-se menores que a melhor acuidade visual corrigida pelo teste de Snellen (respectivamente, p<0,001 e p=0,009). A análise de Bland-Altman revelou que a distribuição das diferenças entre a melhor acuidade visual corrigida pelo teste de Snellen e a média do potencial evocado visual por varredura foi de ± 0,16 logMAR, enquanto a distribuição das diferenças entre a melhor acuidade visual corrigida pelo teste de Snellen e o valor máximo do potencial evocado visual por varredura foi de ± 0,19 logMAR. Conclusões: As medidas da acuidade visual através do potencial evocado visual por varredura mostram resultados comparáveis às medidas da acuidade visual pelo teste de Snellen. Essa técnica é um método objetivo e confiável de se avaliar a acuidade visual em crianças.

Predicción del Síndrome Informático Visual mediante la adicción a videojuegos en estudiantes chinos y españoles / Prediction of computer vision syndrome by video game addiction in Chinese and Spanish students

Introducción: El uso de los videojuegos, por la extensión que ha llegado a alcanzar durante la pandemia de la COVID-19, es una variable relevante de estudio, especialmente por sus interacciones con aspectos de la salud mental y visual. Objetivo: predecir el nivel de Síndrome informático visual a partir de un índice optimizado sobre el nivel de adicción en estudiantes universitarios de dos poblaciones: española y china. Material y Métodos: Se administró un cuestionario online con tres instrumentos validados: un cuestionario para evaluar el juego con videojuegos (CHCVI), un cuestionario para evaluar la adicción a los videojuegos (CERV) y un cuestionario para detectar el síndrome visual por ordenador (CSQ). Los tres cuestionarios se aplicaron a una muestra de 253 estudiantes, tanto de universidades chinas como españolas. Para establecer las predicciones, se construyeron índices robustos basados en el análisis factorial de los instrumentos administrados. Finalmente, se aplicó una regresión logística para obtener un modelo matemático útil para predecir el Síndrome Informático Visual. Resultados: Los resultados mostraron un mayor síndrome informático visual y apetito por los videojuegos en los estudiantes españoles, y menores puntuaciones de síndrome informático visual pero una mayor alteración de la vida cotidiana en los estudiantes chinos debido a este tipo de ocio. Además, se comprobó que los estudiantes de la muestra china tenían un menor riesgo de padecer el síndrome informático visual, y que tener mayores niveles de adicción implicaba 1,4 veces más probabilidades de sufrir dicho síndrome. Conclusiones: Los presentes hallazgos demuestran una relación hasta ahora inexplorada entre la adicción a los videojuegos y los síntomas visuales relacionados con el abuso del ocio electrónico.

Introduction: The use of video games, due to the extent that it has reached during the COVID-19 pandemic, is a relevant study variable especially because of its interactions with aspects of mental and visual health. Objective: to predict the occurrence of computer vision syndrome according to the level of addiction to video games in university undergraduates during a particular period of uncertainty due to health and mobility restrictions imposed by governments as a result of the COVID-19 pandemic. Material and Methods: To accomplish this objective, an online questionnaire was administered with three validated instruments: a questionnaire to assess playing video games (CHCVI), a questionnaire to evaluate video games addiction (CERV), and a questionnaire to detect computer vision syndrome (CSQ). The three questionnaires were applied to a sample of 253 students from both Chinese and Spanish universities. To establish the predictions, robust indexes were constructed based on the Factor Analysis of the instruments administered. Finally, logistic regression was applied to predict computer vision syndrome. Results: The results showed greater computer vision syndrome and appetite for video games in Spanish students, and lower computer vision syndrome scores but a greater alteration of daily life in chinese students due to this type of leisure. Moreover, it was found that students from the Chinese sample entailed a lower risk of suffering from computer vision syndrome, and that having higher levels of addiction involved 1,4 times more likelihood of suffering from such syndrome. Conclusions: The present findings demonstrate a previously unexplored relationship between video games addiction and visual symptoms related to screen exposure.

Validación del instrumento "Computer Vision Syndrome Questionnaire (CVS-Q)" para la evaluación del síndrome visual informático en personal de salud de Lima

Objetivos: Determinar la validez y confiabilidad del instrumento "Computer Vision Syndrome Questionnaire (CVS-Q)" en la medición del Síndrome Visual Informático en personal de salud de Lima. Material y métodos: Estudio observacional, descriptivo y de corte transversal, de tipo evaluación de cuestionario, realizado en 82 trabajadores de salud. La validez de contenido se evaluó mediante juicio de expertos con método estadístico de V de Aiken; Validez de constructo, mediante análisis factorial; validez discriminante, a través de la curva operador-receptor (ROC) contrastada con el cuestionario CSSV17; confiabilidad de consistencia interna, con alfa de Cronbach; confiabilidad test - re-test (con 7 días de diferencia); con Rho de Spearman y Coeficiente de Correlación Intraclase (CCI), con intervalos de confianza (IC) del 95%. Se empleó para el procesamiento el software SPSS versión 20.0 para Windows con licencia de prueba. Resultados: El V de Aiken obtuvo un valor de 100%. El análisis factorial extrajo 3 componentes principales que explicaron el 69,455% de la varianza total. El área bajo la curva ROC fue 0,889 [(0,845-0,934); IC=0,95] (p=0,000), sensibilidad 72,22% y especificidad 100%. El alfa de Cronbach fue 0,939, Rho de Spearman 0,884 (p=0,000) y CCI 0,856 [(0,777 - 0,907); IC=0,95] (p=0,000). Conclusiones: El Cuestionario CVS-Q es válido y confiable para ser aplicado sobre el grupo ocupacional de profesionales de la salud con buenas propiedades psicométricas.

SUMMARY Objectives: To determine the validity and reliability of the instrument "Computer Vision Syndrome Questionnaire (CVS-Q)" in the measurement of the Computer Visual Syndrome in health personnel in Lima. Methods: A quantitative, observational, descriptive, cross-sectional and questionnaire study was carried out in 82 health workers. Content validity was evaluated by expert judgment with the Aiken V statistical method; construct validity, through factor analysis; discriminant validity, through the receiver operating characteristic curve (ROC) curve contrasted with the CSSV17 questionnaire; internal consistency reliability, with Cronbach's alpha; reliability test - re-test (7 days apart); with Spearman's Rho and Interclass Correlation Coefficient (ICC) with 95% CI. The SPSS software version 20.0 for Windows with a trial license was used for its processing. Results: The V of Aiken obtained a value of 100%. The factor analysis extracted 3 main components that explain 69.455% of the total variance. The area under the ROC curve was 0.889 [(0.845-0,934); CI=0.95] (p=0.000), sensitivity 72.2% and specificity 100%. Cronbach's alpha was 0.939, Spearman's Rho 0.884 (p=0.000) and ICC 0.856 [(0.777 - 0.907); CI=0.95] (p=0.000). Conclusions: The CVS-Q questionnaire is valid and reliable to be applied in the health professionals' occupational group with good psychometric properties.

Brazilian guidelines on the frequency of ophthalmic assessment and recommended examinations in healthy children younger than 5 years / Diretrizes brasileiras sobre avaliação oftalmológica de crianças saudáveis menores de 5 anos: exames recomendados e frequência

ABSTRACT Purpose: To provide guidance on the frequency and components of eye examinations for healthy children aged 0 to 5 years. Methods: These guidelines were developed based on the medical literature and clinical experience of an expert committee. PubMed/Medline searches were performed, with selected publications not restricted to systematic reviews, randomized controlled trials, or observational studies. The Grading of Recommendations Assessment, Development, and Evaluation profile was applied when suitable, and for issues without scientific evidence, recommendations were based on expert consensus. Recommendations by the American Academy of Pediatrics, American Association of Pediatric Ophthalmology and Strabismus, American Academy of Ophthalmology, Royal College of Ophthalmologists, and Canadian Ophthalmological Society were also reviewed. The final guideline document was approved by the Brazilian Pediatric Ophthalmology Society and by the Brazilian Pediatric Society. Results: Newborns must undergo the red reflex test and inspection of the eyes and adnexa by a pediatrician within 72 hours of life. The red reflex test should be repeated by the pediatrician during childcare consultations at least three times per year during the first 3 years of life. If feasible, a comprehensive ophthalmologic examination may be performed between 6 and 12 months of age. Until 36 months of age, the pediatrician should assess the infant's visual development milestones, age-appropriate assessment of visual function, ocular fixation, and eye alignment. At least one comprehensive ophthalmologic examination should be performed at 3 to 5 years of age. The examination should minimally include inspection of the eyes and adnexa, age-appropriate visual function assessment, evaluations of ocular motility and alignment (cover tests), cycloplegic refraction, and dilated fundus. Conclusions: Guidelines concerning the frequency of ophthalmic assessment are important tools for directing physicians regarding best practices that avoid treatable vision problems that affect children's development, school, and social performance and cause unnecessary permanent vision loss.

RESUMO Objetivo: Fornecer orientações sobre a frequência e os componentes dos exames oftalmológicos para crianças saudáveis de 0 a 5 anos. Métodos: Essas diretrizes foram desenvolvidas com base em revisão bibliográfica e experiência clínica de um comitê de especialistas. Foram realizadas buscas PubMed/Medline; documentos selecionados não se restringiram a revisões sistemáticas, ensaios clínicos randomizados e estudos observacionais. Quando adequado, o perfil GRADE foi aplicado para graduá-los e o consenso de especialistas foi usado nos tópicos sem evidência científica. Também foram revisadas as recomendações pela Academia Americana de Pediatria, Associação Americana de Oftalmologia Pediátrica e Estrabismo, Academia Americana de Oftalmologia, Royal College of Ophthalmologist e Sociedade Canadense de Oftalmologia. O documento final foi aprovado pela Sociedade Brasileira de Oftalmologia Pediátrica e Sociedade Brasileira de Pediatria. Resultados: Os recém-nascidos devem ser submetidos ao teste do reflexo vermelho e inspeção dos olhos e anexos pelo pediatra dentro de 72 horas de vida ou antes da alta da maternidade. O teste do reflexo vermelho deve ser repetido pelo pediatra durante as consultas de puericultura pelo menos três vezes ao ano durante os primeiros 3 anos de vida. Se factível, um exame oftalmológico completo pode ser feito entre 6 a 12 meses de vida. Até os 36 meses de idade, os marcos visuais, função visual apropriada para a idade, fixação e alinhamento ocular também devem ser avaliados pelo pediatra ou médico da família. Pelo menos um exame oftalmológico completo deve ser realizados entre 3 e 5 anos de idade. O exame deve conter pelo menos inspeção dos olhos e anexos, avaliação da função visual apropriada para a idade, avaliação da motilidade e alinhamento ocular (testes de cobertura), refração sob cicloplegia e avaliação do fundo de olho dilatado. Conclusões: As diretrizes sobre a frequência da avaliação oftalmológica são ferramentas importantes para orientar os médicos sobre a melhor prática a fim de evitar problemas visuais tratáveis na infância, que poderiam comprometer seu desenvolvimento social, escolar e global, além de causar perda permanente da visão.

Epidemiology of myopia and unaided visual impairment of primary and secondary school students of Han and minorities in Mangshi City in Yunnan / 中国学校卫生

Objective@#To investigate the prevalence and associated factors of unaided visual impairment and myopia among primary and secondary school students in Yunnan Province, and to provide scientific basis for myopia prevention.@*Methods@#The study was conducted among primary and secondary school students in Mangshi, Yunnan Province from March to August, 2014. All the 7 681 subjects underwent detailed eye examinations and a questionnaire survey. Myopia was defined as spherical equivalent value of less than -0.5 diopters. Unaided visual impairment was analyzed on the basis of the better and the worse-seeing eye, respectively.@*Results@#The prevalence of myopia and high myopia were 39.1% and 0.6%. The prevalence of unaided visual impairment was 11.4% based on the worse-seeing eye. Refractive errors accounted for 87.3% of the participants with unaided visual impairment. Prevalence of myopia was higher in girls than in boys (χ2=29.74, P<0.01), but there was no gender difference in high myopia (P=0.19). The prevalence of myopia and high myopia increased significantly with increasing age (χ2=351.23, 22.56, P<0.01). Besides, prevalence of myopia was 63.7% in Dai nationality students and 36.6% in Yi nationality students (χ2=78.14, P<0.01), which was higher than other ethnic minorities. After adjusting for the effects of sex, age and ethnicity, the presence of myopia was associated with increasing height (OR=1.02, 95%CI=1.01-1.03), computer use (OR=1.17, 95%CI=1.03-1.32), having a myopic father (OR=1.56, 95%CI=1.24-1.94), having a myopic mother (OR=1.33, 95%CI=1.08-1.63) and more time reading(OR=1.18, 95%CI=1.09-1.28). High myopia was found to be more prevalent in children who had a myopic father (OR=3.98, 95%CI=1.72-9.22) and using computers (OR=2.31, 95%CI=1.17-4.57).@*Conclusion@#Myopia and unaided visual impairment is prevalent in school students in rural China (Yunnan), though the prevalence is relatively lower compared with other areas in China. Attention should be paid to the formulation and input of primary eye care policies.

Clinical study of Xiaoyaosan and Shengmaiyin combined with conventional western medicine in the treatment of xerophthalmia / 国际中医中药杂志

Objective To evaluate the effect of Xiaoyaosan and Shengmaiyin combined with conventional western medicine for xerophthalmia.Methods A total of 76 xerophthalmia patients who met the criteria were divided into two groups according to random number table,with 38 cases in each group.The control group was treated with routine western medicine,while the observation group was treated with Xiaoyaosan combined with Shengmaiyin on the basis of the control group.Both groups were treated for 4 weeks.Before and after treatment,the symptoms were scored,and the tear film stability was evaluated according to the results of fluorescent test (FL),breakup time of tear film (BUT) and schirmer Ⅰ test (SIT).The contents of IL-1β,IL-6 and TNF-α in tear were detected by ELISA,and the clinical efficacy was evaluated.Results The total effective rate was 92.9％ (65/70) in the observation group and 76.4％ (55/72) in the control group,and there was significant difference between the two groups (Z=-2.991,P=0.002).After treatment,the SIT (6.9 ± 0.8 mm vs.4.3 ± 0.5 mm,t=3.751),BUT (10.5 ± 1.6 s vs.6.4 ± 0.8 s,t=4.228) in the observation group were significantly higher than those in the control group (P＜0.05).The FL score (0.9 ± 0.1 vs.1.4 ± 0.2,t=3.208) in the observation group was significantly lower than that of the control group (P＜0.05).The scores of aningeresting,foreign body sensation,visual fatigue,photophobia and visual blur in the observation group were significantly lower than those in the control group (t were 3.559,4.015,4.119,3.983,4.120,all Ps＜0.05).The levels of IL-1β,IL-6 and TNF-α in tear were significantly lower than those in control group (t were 11.887,8.028,8.112,all Ps＜0.001).Conclusions The Xiaoyaosan combined with Shengmaiyin can improve tear film stability,relieve local ocular surface inflammation and improve clinical symptoms in patients with xerophthalmia.

A need for standardization in visual acuity measurement / Medida da acuidade visual e necessidade de padronização

ABSTRACT Standardization of terminologies and methods is increasingly important in all fields including ophthalmology, especially currently when research and new technology are rapidly driving improvements in medicine. This review highlights the range of notations used by vision care professionals around the world for vision measurement, and the challenges resulting from this practice. The global community is urged to move toward a uniform standard.

RESUMO Nos tempos atuais, quando a pesquisa e a tecnologia estão avançando rapidamente, as melhorias na medicina, a padronização de terminologias e métodos está se tornando cada vez mais importante em todos os campos, incluindo a oftalmologia. Os profissionais de cuidados da visão em todo o mundo usam várias notações para a medição da visão. Nesta revisão, os autores destacam os desafios enfrentados por essa abordagem. A comunidade global precisa adotar um padrão uniforme.

Development of the Portuguese version of a standardized reading test: the Radner-Coimbra Charts / Desenvolvimento da versão portuguesa do teste padronizado de leitura: tabelas Radner-Coimbra

ABSTRACT Purpose: To develop 27 short sentence optotypes for the Portuguese version of the Radner Reading Charts. Methods: Thirty-four Portuguese sentences were constructed following the concept of the Radner Reading Charts to obtain highly comparable sentences in terms of lexical difficulty, syntactical complexity, word length, number of syllables, and position of words. A long text (106 words) at the 5th grade reading level was also tested to assess the validity of the reading speeds obtained with the short sentences. The short sentences and long text were tested in 50 volunteers with similar educational backgrounds (mean age 30.98 years ± 6.99 years, range 19-47 years). Reading speeds were measured with a stop-watch and reported as words per minute (wpm). The reading time for each of the short sentences to be selected for the chart was defined as falling within the range of the mean ± 0.40 × standard deviation (SD). Results: The overall mean reading speed for each of the short sentences was 235.43 ± 36.39 wpm. The 27 sentences with a mean between 220.8 and 250.0 wpm (overall mean ± 0.40 × SD) were selected for construction of the reading charts. The mean reading speed for the long text was 212.42 ± 26.20 wpm. Correlation between the selected short sentences and long text was high (r =0.86). Reliability analysis yielded an overall Cronbach's alpha coefficient of 0.97. Conclusions: The 27 short Portuguese sentences were highly comparable in terms of syntactical structure, number, position and length of words, lexical difficulty, and reading length. This reading test can overcome the limitations of the current tests for homogeneity and comparability, reducing subjectivity in the evaluation of the functional outcomes of medical and surgical ophthalmologic treatments.

RESUMO Objetivo: Desenvolver 27 frases-optotipo para a versão em português das tabelas de leitura de Radner. Métodos: Trinta e quatro frases em português foram elaboradas de acordo com o conceito das tabelas de leitura de Radner, de forma a obter frases-optotipo, altamente comparáveis em termos dificuldade lexical, complexidade sintática, tamanho das palavras, número de sílabas e posição das palavras. Foi também avaliado um texto longo (106 palavras) ao nível do 5o ano de escolaridade para determinar a validade dos resultados obtidos com as frases curtas. As frases curtas e o texto longo foram testados em 50 voluntários de nível acadêmico semelhante e média de idades de 30,98 anos ± 6,99 (intervalo de 19-47 anos). A velociade de leitura foi medida com cronômetro, de forma a obter o número de palavras por minuto (wpm). O intervalo válido para tempo de leitura das frases curtas foi definido como a média ± 0,40 x desvio padrão (SD). As frases mais semellhantes foram estatisticamente selecionadas para a construção das tabelas de leitura Radner-Coimbra. Resultados: A velocidade média de leitura obtida com as frases curtas foi 235,43 ± 36,39 wpm. As frases com velocidade média entre 220,8 e 250,0 palavras por minuto (média ± 0,40 x SD) foram selecionadas. Vinte e sete frases cumpriram este critério. A velocidade média de leitura do texto longo foi 212,42 ± 26,20 wpm. A correlação entre as frases curtas selecionadas e o texto longo foi alta (r=0,86). A análise de fiabilidade originou um coeficiente alfa de Cronbach de 0,97. Conclusões: As 27 frases em português são altamente semelhantes em termos de estrutura sintática, número, posição e comprimento das palavras, dificuldade lexical e duração da leitura. Este teste permite ultrapassar as limitações dos testes existentes em termos de homogeneidade e comparabilidade, reduzindo a subjetividade na avaliação dos resultados de terapêuticas médicas e cirúrgicas.

Application of optic coherent tomography in assessing visual performance of idiopathic macular epiretinal membrane patients / 天津医药

Objective To investigate the correlation between retinal deformation degree and retina thickness (RT) detected by optic coherent tomography (OTC) in patients with idiopathic macular epiretinal membrane (IMEM). Methods The 66 eyes (56 patients) with IMEM diagnosed by OCT were retrospectively analyzed in this study. After best corrected visual acuity (BCVA), ocular fundus and OCT examination, patients were divided into three groups (mild, medium and severe) according to retinal deformation degrees. The RT value was measured manually. Results There were significant differences in RT values between mild, moderate and severe groups:(311.95 ±51.78) μm, (447.13±41.95) μm and (560.00± 58.23) μm (P<0.05). The values of BCVA were 0.78±0.16, 0.38±0.12 and 0.27±0.14 for mild, moderate and severe groups, there were significant differences between them (P<0.05). There was no significant correlation between RT and BCVA in mild group (r=-0.352,P=0.128). There was negative correlation between RT and BCVA in medium group and serious group (r=-0.768 and-0.482,P<0.05). Conclusion The retinal deformation degree and RT are two objective indicators to assess visual performance in patients of IMEM. When RT is more than 400 μm, it can be used as objective criteria for surgical intervention.

Objective quantitative assessment of visual quality with a double-pass instrument for myopic foveoschisis patients / 中华眼底病杂志

Objective To objectively quantitative assess the visual quality in patients with myopic foveoschisis (MF) using a double-pass optical quality analysis system (OQASⅡ).Methods Sixty-two subjects participated in this cross-sectional,observational study,who were divided into three groups based on the pathologic conditions including myopic fovcoschisis group (MFG),myopic control group (MCG) and normal control group (NCG).Measurements with OQAS Ⅱ were performed for the modulation transfer function cut off frequency (MTFcut-off),the Strehl ratio (SR) and the objective scatter index (OSI).Visual data were analyzed using ANOVA and Pearson's correlation accompanied by logMAR BCVA and axial length (AL).Results The mean values for MTFcut-off,SRand OSIof MFG,MCGand NCG were 18.18±4.81,0.13± 0.03,3.50±0.44;22.87±2.66,0.14±0.02,2.42±0.29;33.68±4.70,0.23±0.02,1.68±0.20 respectively,and statistical difference were proved except SR between MFG and MCG,or BCVA between MCG and NCG (P＜ 0.05).LogMAR BCVA and AL have negative correlations to MTF cut-off (r =-0.928,-0.658;P＜0.05) and SR (r=-0.577,-0.893;P＜0.05) with high coefficients in MFG.Log MAR BCVA has negative correlations to MTF cut-off and SR (r=-0.659,-0.806;P＜0.05) in MCG.Log MAR BCVA has negative correlations to MTF cut-off and SR (r=-0.606,-0.602;P＜0.05) and positively correlated to OSI (r=0.561,P＜0.05) in NCG.Conclusions The mean value of BCVA,MTF cut-off,SR,OSI of myopic foveoschisis patients were lower than those myopic patients without foveoschisis and normal people.there exists a significant negative correlation between Log MAR BCVA,AL to MTF cut-off and SR.Compared with myopic and normal subjects,myopic foveoschisis have lower BCVA,MTF cut off,SR but higher OSI.

Visual performance: validation of the inventory of visual efficiency in students / Desempenho visual: validação do inventário de eficiência visual em estudantes

Purpose: Translate and adapt the COVD-QoL questionnaire to Portuguese language and culture and assess the psychometric properties of the translated questionnaire. Methods: The questionnaire was adapted according to the methodology recommended by the literature. The final version of visual symptoms and quality of life questionnaire adapted to Portuguese (QSL-QOL) was applied in 130 volunteers, aged 18 to 30 years and 36 subjects completed the questionnaire at two different times. Results: The results showed good internal consistency for the full version with 30 items (α = 0.894) and for the short version with 19 items (0.858). The test re-test revealed an average of differences between the first and second evaluation of 0,917 points (SD = ± 4.813) which indicates a minimum bias between the two applications. Conclusions: The Portuguese version of COVD-QoL showed good psychometric properties and has been shown to be applicable to the Portuguese population, to evaluate visual discomfort associated with near vision in higher education students.

Objetivo:Traduzir e adaptar transculturalmente o questionário COVD-QoL para a língua portuguesa e avaliar as propriedades psicométricas do questionário traduzido.Métodos:O questionário foi adaptado segundo a metodologia recomendada pela literatura. A versão final do questionário de sintomas e eficiência visual adaptado à língua portuguesa (IEV – Inventário de eficiência visual) foi aplicada em 130 indivíduos, com idades compreendidas entre os 18 e os 30 anos e 36 sujeitos responderam ao questionário em dois momentos distintos.Resultados:Os resultados evidenciam uma boa consistência interna tanto para a versão completa, com 30 itens (α = 0,894) como para a versão curta, com 19 itens (0,858). O teste reteste revelou uma média de diferenças entre a primeira e a segunda avaliação de 0,917 pontos (SD=±4,813) o que indica um viés mínimo entre as duas administrações.Conclusão:O questionário traduzido, apresentou boas propriedades psicométricas e demonstrou ser aplicável à população portuguesa, para se avaliar a eficiência visual associada à visão de perto, em estudantes do ensino superior.

Influence of different corneal limbal incision on the surface astigmatism after phacoemulsification on corneal / 中国基层医药

Objective To observe the effect of limbal incision before and after phacoemulsification corneal astigmatism degree.Methods 46 patients with cataract (76 eyes) were randomly divided into two groups.23 cases (40 eyes) in group A received a temporal clear corneal incision phacoemulsification.23 cases (36 eyes) in group B received the upper clear corneal incision cataract ultrasound breast surgery.Results In group A,preoperative corrected visual acuity was (0.13 ±0.10)D,after 3 months of corrected visual acuity was (0.79 ± 0.13)D.In group B,preoperative corrected visual acuity was (0.14 ± 0.11)D,after 3 months of corrected visual acuity was (0.76 ± 0.15)D,the patients after 3 months corrected visual acuity was significantly improved than before treatment (t =4.127,P ＜0.01),the postoperative visual acuity was not statistically significant(t =0.605,P ＞ 0.05).Two groups postoperative corneal anterior surface,surface astigmatism values were gradually reduced,3 months after operation in group A after corneal anterior surface,surface astigmatism value were (0.45 ± 0.24) D,(0.09 ± 0.06) D ; those in B group were (0.52 ± 0.25) D,(0.09 ± 0.07) D,which were significantly lower than 1 week after operation and postoperation(t =2.232,2.128,all P ＜ 0.05).The remaining time two groups of corneal astigmatism value had no significant difference (P ＞ 0.05).Conclusion Temporal clear corneal incision phacoemulsification recovery of visual acuity is better,and less than the above changes of corneal astigmatism corneal incision operation.

Quality of vision in refractive and cataract surgery, indirect measurers: review article / Qualidade visual em cirurgia refrativa e catarata, medidores indiretos: artigo de revisão

Visual acuity is the measurement of an individual's ability to recognize details of an object in a space. Visual function measurements in clinical ophthalmology are limited by factors such as maximum contrast and so it might not adequately reflect the real vision conditions at that moment as well as the subjective aspects of the world perception by the patient. The objective of a successful vision-restoring surgery lies not only in gaining visual acuity lines, but also in vision quality. Therefore, refractive and cataract surgeries have the responsibility of achieving quality results. It is difficult to define quality of vision by a single parameter, and the main functional-vision tests are: contrast sensitivity, disability glare, intraocular stray light and aberrometry. In the current review the different components of the visual function are explained and the several available methods to assess the vision quality are described.

Qualidade Visual é a medida da capacidade individual de reconhecer detalhes de um objeto no espaço. Medições de função visual na clínica oftalmológica são limitadas por vários fatores, tal como máximo contraste e assim podem não refletir adequadamente as condições visuais reais, bem como os aspectos subjetivos da percepção do mundo pelo paciente. O sucesso em uma cirurgia está não apenas em restaurar linhas de visão, mas sim qualidade visual. Portanto, as cirurgias refrativas e de catarata têm a responsabilidade de alcançar resultados de qualidade. É difícil definir qualidade visual por um único parâmetro, sendo os principais testes de função visual: sensibilidade ao contraste; glare; dispersão intraocular da luz e aberrometria. Nesta revisão os diferentes componentes da função visual são explicados e os diversos métodos disponíveis para se avaliar a qualidade de visão são descritos.

Implantação do exame do reflexo vermelho em crianças da região do Hospital das Clínicas da Faculdade de Medicina de Botucatu - SP - Brasil / Implementation of red reflex exam in children in the area of Botucatu Medical School Clinical Hospital - São Paulo, Brazil

OBJETIVO: Descrever a implantação do teste de reflexo vermelho nas 30 cidades de inserção do Hospital das Clínicas da Faculdade de Medicina de Botucatu, HC/FMB/UNESP (480.337 habitantes), a criação de um centro para referência de crianças com reflexo vermelho alterado ou duvidoso, a Triagem do reflexo vermelho e outro para o tratamento da catarata infantil, o Centro de tratamento da catarata infantil. MÉTODOS: O exame do reflexo vermelho foi divulgado em 30 cidades da região de Botucatu. Foram realizadas palestras aos municípios, convocados pelo Departamento Regional de Saúde VI do estado de São Paulo (DRS VI). Foram distribuídos 109 "pen torch ophthalmoscope", às maternidades e Unidades Básicas de Saúde (UBSs) das cidades. A Triagem do reflexo vermelho recebeu os casos de reflexo vermelho alterado ou duvidoso e estabeleceu o diagnóstico oftalmológico. O Centro de tratamento da catarata infantil realizou o exame pré-operatório, o tratamento cirúrgico e o acompanhamento das crianças com catarata. RESULTADOS: Após um ano de funcionamento a Triagem do reflexo vermelho atendeu 29 crianças, 17 do sexo masculino e 12 do feminino, com idade média e desvio padrão (dp) de 10,09 ± 20,35 meses (7 dias - 98 meses). 16 pacientes foram encaminhados com reflexo vermelho alterado, idade média e dp de 13,17 ± 24,14 meses (7 dias - 98 meses), a alteração foi confirmada em todos os casos, 13 deles apresentavam catarata. Em 13 encaminhamentos com reflexo duvidoso, idade média e dp de 6,29 ± 14,46 meses (7 dias - 98 meses), a alteração não se confirmou. A incidência de alterações do reflexo vermelho encontradas foi de 9,2/10.000 nascidos vivos e a incidência the catarata foi de 7,9/10.000 nascidos vivos. CONCLUSÃO: Descrevemos a implantação do Teste do reflexo vermelho na Região de Botucatu, a criação da Triagem do reflexo vermelho e do Centro de tratamento da catarata infantil e dificuldades encontradas.

PURPOSE: To describe the implantation of the red reflex test in 30 cities in the area of Botucatu Medical School Clinical Hospital, (480,337 inhabitants) and the creation of a reference Center for children with red reflex changes, the Red reflex screening and another Center for treatment of childhood cataract. METHODS: The red reflex exam was released in 30 cities of the surrounding Botucatu area, lectures were done in the cities invited to participate by the Regional Department of Health.109 pen torch ophthalmoscopes were distributed to the hospital maternities and primary care units. The Red reflex screening attended cases of altered or doubtful red reflex and established the diagnosis. The Center for treatment of childhood cataract performed the preoperative examination, surgical treatment and follow-up of children with cataracts. RESULTS: After one year the Red reflex screening attended 29 children, 17 males and 12 females, mean age and pattern deviation (PD) of 10.09 ± 20.35 months (7 days - 98 months old). 16 patients were referred with altered red reflex, with a mean age and pattern deviation of 13.17 ± 24.14 months (7 days - 98 months old). The alteration was confirmed in all of these cases. 13 children had cataract. In 13 children with doubtful exam, with a mean age and PD of 6.29 ± 14.46 months (7 days - 54 months old), the alteration was not confirmed in any of these patients. The incidence of negative red reflex found among newborns was 9.2/10,000 and the incidence cataracts in this same group was 7.9/10,000. CONCLUSION: We described the implantation of the red reflex exam in the Botucatu area, and the creation of a reference Center for eye examination of children with changes in the red reflex, and the creation of a reference Center for treatment of childhood cataract and difficulties.

Confiabilidade da avaliação da visão funcional para crianças com baixa visão de dois a seis anos: em busca de evidências / Reliability of functional vision assessment in children with low vision from 2 to 6 years old: searching for evidences

OBJETIVOS: Avaliar a confiabilidade interexaminadores, fazer o teste-reteste e verificar a consistência interna da avaliação da visão funcional para crianças com baixa visão de dois a seis anos de idade (AVIF-2 a 6 anos). MÉTODOS: Foram testados sete domínios: fixação visual, seguimento visual, campo visual de confrontação, coordenação olho-mão, visão de contraste, deslocamento no ambiente e visão de cores, em 40 crianças, 20 com baixa visão e 20 sem alterações visuais. A consistência interna foi examinada para o teste de todas as crianças e a confiabilidade interexaminadores e teste-reteste para 12 delas. RESULTADOS: Seis domínios apresentaram ao teste-reteste coeficiente de correlação intraclasse com valores de 0,5361 a 1,000. Para o domínio deslocamento no ambiente esse coeficiente foi de 0,37. Na confiabilidade interexaminadores, somente o campo visual de confrontação apresentou valor abaixo do esperado (0,3901). O coeficiente kappa ponderado obteve resultados que variaram de -0,087 a 1,000. O valor do alfa de Cronbach variou de 0,584 (no deslocamento no ambiente) a 0,973 (na visão de contraste). CONCLUSÃO: A AVIF-2 a 6 anos apresentou bons índices de confiabilidade, mas a confiabilidade dos domínios, quando analisados isoladamente, precisa ser aprimorada.

PURPOSE: The functional vision assessment (AVIF-2 to 6 years) for low vision children with ages from 2 to 6 years old was analyzed. The inter-rater, test-retest and the internal consistency were verified for reliability. METHODS: The test, composed by seven domains (visual fixation, visual following, visual field confrontation, eye-hand coordination and surrounding locomotion, contrast vision and color vision discrimination), was applied to 40 children, 20 with low vision and 20 without low vision. The inter-rater and test-retest reliability were analyzed with 12 children and the internal consistency with 40 children. RESULTS: Concerning test-retest reliability, six domains exhibited intra-class correlation coefficients ranging from 0.5361 to 1.000. For the movement within surroundings category, this coefficient was 0.37. For inter-rater reliability, only the category of confrontation visual field was bellow expectations (0.3901). The weighted kappa coefficient exhibited values ranged from -0.087 to 1.000. Cronbach's alfa ranged from 0.584 (movement within surroundings) to 0.973 (contrast sensitivity). CONCLUSION: AVIF-2 to 6 years presented good reliability indexes, however a few items within the domains need minor adjustments in order to improve scores' consistency of some items.

Comparação do teste modificado de fixação preferencial com o convencional em pacientes com estrabismo / Comparison of the modified fixation preference test with the conventional test in strabismic patients

OBJETIVO: Comparar a acurácia do teste de fixação preferencial quando o paciente olha e toca o objeto alvo ao invés de apenas olhá-lo, como convencionalmente descrito. MÉTODOS: Estudo piloto transversal e prospectivo, incluindo 40 pacientes estrábicos, com desvios maiores que 10 dioptrias prismáticas entre 7 e 30 anos. RESULTADOS: O teste modificado mostrou sensibilidade de 93% (IC 95%=68,53 -98,73%) e especificidade de 77% (IC 95%=57,95 - 88,97%). O teste convencional apresentou sensibilidade de 93% (IC 95%=68,53 - 98,73%) e especificidade 46% (IC 95%= 28,76 - 64,54%). CONCLUSÕES: Estes resultados sugerem que a modificação no teste de fixação preferencial, solicitando que o paciente toque o objeto alvo, possa reduzir os resultados falsos positivos do teste.

PURPOSE: To compare the accuracy of the fixation preference test performed with the patient touching and looking at the fixation target, to the conventional method test done with the patient only looking at it. METHODS: A pilot transversal and prospective study was done with 40 strabismic patients with deviations greater than 10 prism diopters, from 7 to 30 years old. RESULTS: The modified test had a sensitivity of 93% (IC 95%=68.53 - 98.73%) and specificity of 77% (IC 95%=57.95 - 88.97%); while the conventional test had a sensitivity of 93% (IC 95%=68.53 - 98.73%) and a specificity of 46% (IC 95%=28.76 - 64.54%). CONCLUSIONS: Our results suggest that the modification of the fixation preference test by asking the patient to touch the fixation target might reduce the number of false positive results of the test.

Medida da visão em candelas: description of a psychophysical technique to quantify luminous intensity / descrição de uma técnica psicofísica para quantificar intensidade luminosa / Vision measurement in candelas

OBJETIVO: Desenvolver um método e um dispositivo para quantificar a visão em candela (cd). Os estudos de medida da visão são importantes para todas as ciências visuais. MÉTODOS: É um estudo teórico e experimental. Foram descritos os detalhes do método psicofísico e da calibração do dispositivo. Foram realizados testes preliminares em voluntários. RESULTADOS: É um teste psicofísico simples e com resultado expresso em unidades do sistema internacional de medidas. Com a descrição técnica será possível reproduzir o experimento em outros centros de pesquisa. CONCLUSÃO: Os resultados aferidos em intensidade luminosa (cd) são uma opção para estudo visual. Esses resultados possibilitarão extrapolar medidas para modelos matemáticos e para simular efeitos individuais com dados aberrométricos.

PURPOSE: To develop a method and a device for vision measurement in candela (cd). Vision measurement studies are important to all visual sciences. METHODS:It is a theoretical and experimental study. The details of psychophysical method and device calibration were described. Preliminary tests were performed on volunteers. RESULTS:It is a simple psychophysical test and results are expressed in International System of Units. With this technical description it will be possible to reproduce the experiment in others research centers. CONCLUSION: The results measured in luminous intensity (cd) are an option for visual studies. These results allow to extrapolate measurements for mathematical models and to simulate data for individual aberrometry effects.

Confiabilidade da previsão da acuidade visual pós-operatória de catarata mediante medição da acuidade visual pré-operatória utilizando o retinômetro Heine Lambda 100 / Reliability of predictable postoperative visual acuity of cataracts as measured by Heine Lambda 100 retinometer preoperatively

Objetivo: Utilizar o retinômetro de Heine Lambda 100 para avaliar a relação da acuidade visual obtida no pré-operatório de cirurgia de catarata com a acuidade visual obtida 3 meses no pós-operatório com correção óptica, bem como, sua correlação com a classificação morfológica dominante da catarata e com a intensidade da opacificação quando do tipo nuclear. Métodos: Trata-se de um estudo prospectivo realizado no Hospital Oftalmológico Visão Laser, em Santos, envolvendo 121 olhos de 70 pacientes avaliados de abril a julho 2009, submetidos à cirurgia de catarata sob a técnica de facoemulsificação com implante de lente intraocular. No período pré-operatório, foi realizado o retinômetro de Heine sob midríase e seu resultado foi comparado à melhor acuidade visual pós-operatória do terceiro mês e correlacionado com a classificação morfológica da catarata, quando do tipo nuclear, sendo denominado satisfatório aquele resultado que não variou mais do que duas linhas na tabela de Snellen. Resultados: Os resultados satisfatórios em nosso estudo foram de 86,78 por cento, apresentando resultados de acuidade visual com retinômetro de Heine igual ao resultado da acuidade visual pós-operatória em 34,7 por cento. A opacidade predominantemente nuclear N1+ tem um porcentual de acerto maior do que N2+ e N3+ (50 por cento, 31,3 por cento e 26,7 por cento, respectivamente). Em relação ao total de olhos, observamos um teste extremamente significante (p<0,0001). Conclusão: O retinômetro de Heine hipoestimou ou manteve a acuidade visual pós-operatória corrigida após 3 meses dos pacientes submetidos à facectomia, na maioria dos casos. Ao correlacionar com a classificação morfológica da catarata, observamos que, quanto maior a opacidade do cristalino do tipo nuclear, maior a hipoestimação da acuidade visual.

Purpose: To assess the relationship between potential visual acuity obtained before cataract surgery using Heine Lambda 100 retinometer with best corrected visual acuity 3 months postoperatively, as well as its correlation with the morphological pattern of the dominant cataract and the intensity of nuclear opacification. Methods: Prospective study executed in the Ophthalmology Hospital Laser Vision in Santos of 121 eyes of 70 patients who underwent cataract surgery (phacoemulsification with intraocular lens implantation), from April to July, 2009. In the preoperative period, Heine retinometer test was performed under mydriasis and its results were compared to postoperative best corrected visual acuity three months after surgery and correlated with the morphological classification of cataracts, being considered a satisfactory result those who did not vary more than two lines in Snellen chart. Results: The satisfactory cases found in our study were 86.78 percent, with results of visual acuity with Heine retinometer equal to the postoperative visual acuity in 34.7 percent of the cases. Predominant nuclear opacity N1+ has a higher reliability than N2+ and N3+ (50 percent, 31.3 percent and 26.7 percent, respectively). Regarding all studied eyes, statistical significance was noted (p<0.0001). Conclusion: In most cases Heine retinometer underestimated or maintained best corrected visual acuity 3 months postoperatively in patients who underwent cataract surgery. With respect to the morphological classification of cataracts, the higher the opacity of the nuclear lens, the greater the visual acuity underestimation.

Evaluation of visual performance and patient satisfaction with pseudophakic monovision technique / Avaliação do desempenho visual e satisfação do paciente com a técnica de monovisão pseudofácica

PURPOSE: To evaluate the distance, intermediate and near visual acuity of patients with bilateral cataract operated on both eyes corrected for distance in one eye and for near in the fellow eye, as well as, their stereo acuity and their general satisfaction. SETTINGS: Hospital de Olhos de São Paulo and Complexo Hospitalar Padre Bento - Guarulhos - São Paulo - Brazil. METHODS: This is a prospective study of 76 eyes of 38 patients with bilateral cataract aiming to become spectacle free after surgery. The patients were operated on both eyes; the first eye was corrected for distance and the fellow eye for near vision. The refractive error was programmed between -0.5 D and +0.5 D in the first eye and -2.00 D in the second eye. Patients with preoperative corneal astigmatism equal or higher than 1.0 D were excluded from the study. The uncorrected and best-corrected distant visual acuity (UCDVA, BCDVA) were tested, as well as the uncorrected near visual acuity (UCNVA) and collected at the 3 postoperative months. The Titmus test was performed at the last follow-up. Finally, the modified questionnaire VF-7 was applied and the patient was required to choose, regarding their general satisfaction, between very satisfied, satisfied, or unsatisfied. RESULTS: All patients achieved uncorrected distant visual acuity 20/40 or better (mean SE 0.625 D) and uncorrected near visual acuity J3 or better (mean SE -2.0 D), and intermediate visual acuity J3 in 90%. The Titmus test revealed an average of 197" of arc with reduction of stereo acuity in most of patients as expected and 97.3% of patients demonstrated to be satisfied or very satisfied with this technique. CONCLUSION: It consists in a viable technique for correction of near, intermediate and distant vision on cataract surgery as demonstrated by the high rate of satisfaction (97.3%) by the modified VF-7 questionnaire, especially when the patient has no access to a multifocal intraocular lens.

OBJETIVO: Avaliar a acuidade visual para longe, perto e intermediária dos pacientes operados de catarata bilateral em ambos os olhos corrigidos para longe em um olho e para perto no olho contralateral, bem como sua acuidade estereoscópica e sua satisfação geral. LOCAL: Hospital de Olhos de São Paulo e Complexo Hospitalar Padre Bento - Guarulhos - São Paulo - Brasil. MÉTODOS: Este é um estudo prospectivo com 76 olhos de 38 pacientes com catarata bilateral e desejo de ficar independente de óculos após a cirurgia. Os pacientes foram operados em ambos os olhos; o primeiro olho foi corrigido para longe e o contralateral para perto. O erro refrativo programado foi entre -0,5 D e +0,5 D para o primeiro olho e -2,0 D no segundo. Pacientes com astigmatismo corneao pré-operatório igual ou maior que 1,0 D foram excluídos do estudo. A acuidade visual sem correção e melhor acuidade visual para longe foram testadas, bem como, a acuidade visual sem correção para perto, e coletadas no terceiro mês pós-operatório. O teste de Titmus foi realizado na última visita. Finalmente, o questionário modificado VF-7 foi aplicado e ao paciente foi solicitado escolher, em relação à satisfação geral entre satisfeito, muito satisfeito ou insatisfeito. RESULTADOS: Todos pacientes atingiram acuidade visual sem correção para longe de 20/40 ou melhor (EE médio de 0,625 D) e acuidade visual para perto sem correção de J3 ou melhor (EE médio de -2,0 D), e acuidade visual intermediária de J3 em 90%. O teste de Titmus revelou uma redução média de 197" de arco na maioria dos pacientes como esperado e 97,3% dos pacientes demonstraram estar satisfeitos ou muito satisfeitos com esta técnica. CONCLUSÃO: Esta técnica consiste em uma opção viável para correção da acuidade visual de perto, longe e intermediária na cirurgia de catarata como demonstrado pela alta taxa de satisfação (97,3%) através do questionário VF-7, especialmente quando o paciente não tem ..

VISIÓN 2020: El Derecho a la Visión / VISION 2020: The right to vision

VISIÓN 2020: El Derecho a la Visión, es una iniciativa conjunta de la Organización Mundial de la Salud (OMS) y la Agencia Internacional para la Prevención de la Ceguera (IAPB - por sus siglas en inglés), con una coalición de entidades internacionales, instituciones de atención oftalmológica, organizaciones no gubernamentales y corporaciones. VISIÓN 2020 tiene como meta eliminar la ceguera evitable en todo el mundo para el año 2020, con el fin de dar a todos y en particular, a los innecesariamente ciegos, el derecho a la visión.

VISION 2020: The Right to Vision is a joint initiative of the World Health Organization (WHO) and the International Agency for the Prevention of Blindness (IAPB), with a coalition of international entities, eye care institutions, non-governmental organizations and corporations. VISION 2020 aims to eliminate avoidable blindness worldwide by 2020, in order to give everyone, and particularly the needlessly blind, the right to vision.