Quantitative Assessment of the Retina Using OCT and Associations with Cognitive Function.

PURPOSE: To determine the association of retinal thickness with cognitive function in Japanese persons. DESIGN: Cross-sectional, population-based survey. PARTICIPANTS: A total of 1293 Japanese persons aged 65 to 86 years who resided in the Saku area in the Japan Public Health Center-Based Prospective Study participated in the eye and mental health screening. METHODS: Participants underwent comprehensive ophthalmic assessment, including fundus photography, measurement of intraocular pressure, and determination of refraction status. We assessed the thickness of the macular retinal nerve fiber layer (mRNFL), ganglion cell-inner plexiform layer (GC-IPL), and ganglion cell complex (GCC, which includes the retinal nerve fiber layer and GC-IPL), and the full thickness in the macula and peripapillary retinal nerve fiber layer (ppRNFL) using spectral-domain (SD) OCT. Cognitive tests consisted of the Mini-Mental State Examination, Wechsler Memory Scale Revised logical memory I/II subtest, clock drawing test, and Clinical Dementia Rating Scale. These were used to designate the participants in the following 3 groups: Normal, those with mild cognitive impairment (MCI), and those with dementia. Multivariable logistic regression models were used to analyze associations between retinal thickness and cognitive function after adjusting potential confounding factors. MAIN OUTCOME MEASURES: Association of retinal thickness with cognitive function. RESULTS: Among the 1293 potential subjects, 114 were excluded for a diagnosis of depression, 64 were excluded for retinal disease, and 140 were excluded for scanning errors or suboptimal OCT images. The remaining 975 participants (mean age, 73.2 years) were included in this analysis. Significant differences were found in the 3 groups in all layers and GCC thickness, but not in ppRNFL thickness. After adjusting for age, sex, educational status, and refraction, full macular thickness and GCC thickness were inversely associated with the presence of dementia, but ppRNFL thickness was not. Furthermore, GC-IPL, GCC, and full macular thicknesses were all associated with the presence of dementia in the inferior sectors. CONCLUSIONS: Macular thickness was associated with the presence of dementia, but ppRNFL was not. Our results suggest that OCT measurements of the macula could be superior to those of the ppRNFL in assessing neurodegenerative changes and a potentially useful diagnostic biomarker of cognitive function.

"Cannot see? Use your strengths!" A randomized controlled trial of strengths intervention for improving self-esteem among visually impaired individuals.

OBJECTIVE: To evaluate the association between strengths use and self-esteem among visually impaired individuals in Study 1 and reveal the causal effect of a strengths intervention in Study 2. DESIGN: A prospective cross-sectional design in Study 1 and a randomized controlled, open-label, parallel-group comparative design in Study 2. SETTING: Several welfare institutions for visually impaired individuals in the Kanto area of Japan. SUBJECTS: In Study 1, 59 participants with visual impairments (mean age = 49.34 ± 4.89 years, range = 22-82 years) were recruited. In Study 2, participants (mean age = 41.36 ± 12.09 years, range = 22-61 years) were recruited and randomly assigned to an intervention (n = 11) or wait-list control group (n = 11). INTERVENTION: A strengths intervention was performed in Study 2. MAIN MEASURES: In Study 1, we examined the association between Strengths Use Scale and Rosenberg Self-Esteem Scale scores. In Study 2, the primary outcome was the difference in change in Rosenberg Self-Esteem Scale scores from baseline to one-month follow-up between the groups. RESULTS: In Study 1, simple and multiple regression analyses revealed that the Rosenberg Self-Esteem Scale score was significantly associated with the Strengths Use Scale score (ß = 0.60, P < 0.001; ß = 0.55, P < 0.001, respectively). In Study 2, we found a significant between-groups difference in the improvement in Rosenberg Self-Esteem Scale scores from baseline to one-month follow-up (F(1, 19) = 18.61, P < 0.001). CONCLUSION: Utilizing psychological strengths might improve self-esteem among visually impaired individuals.

Analysis of the association between the severity of ocular and systemic pain.

PURPOSE: To evaluate the relationship between the severity of ocular and systemic pain. METHODS: A cross-sectional study was conducted in patients with ocular pain symptoms who were observed in Keio University Hospital between April 2017 and September 2018. Evaluations consisted of the Dry Eye-Related Quality of Life Score (DEQS), Short-Form McGill Pain Questionnaire (SF-MPQ), visual analog scale (VAS), and ophthalmologic examination, including tear breakup time measurement and Schirmer I test. The revised Asia Dry Eye Society Dry Eye Disease (DED) diagnostic criteria were used. RESULTS: The present study involved 41 participants (31 women; mean age, 57.6 ±â€¯17.5 years). Thirteen participants had aqueous-deficient DED, 18 participants had short tear break-up time DED, and 10 participants had no DED. Multivariate regression analysis revealed that the DEQS was significantly associated with both the SF-MPQ total (Coefficient score ß = 0.92, p < 0.01) and the VAS (ß = 0.25, p = 0.01). In addition, correlation analysis revealed that the DEQS had a significant positive linear correlation with both the SF-MPQ total (Spearman correlation score rs = 0.70, p < 0.01) and the VAS (rs = 0.66, p < 0.01). CONCLUSIONS: The findings of the present study suggested that the ocular pain score was significantly associated with systemic pain score. Participants with higher systemic pain scores have an increased risk of having ocular pain.

Patients' satisfaction and subjective happiness after refractive surgery for myopia.

PURPOSE: The purpose of this study was to assess patients' satisfaction and change in subjective happiness after laser-assisted in situ keratomileusis (LASIK). PATIENTS AND METHODS: This was a retrospective cross-sectional study of 307 patients (mean age, 34.3 years; range, 20-63 years) who underwent bilateral LASIK surgery and ocular examinations, including subjective refraction and visual acuity axial length measurements at Minamiaoyama Eye Clinic. Patients also completed questionnaires on their satisfaction with the surgery, and on the subjective happiness scale (SHS) within 1 month before and 1 month after surgery. A multiple regression analysis was performed to determine the independent predictors of the SHS score. RESULTS: In total, 91.2% of the patients were satisfied with surgery (very satisfied: n=155; satisfied: n=125). The SHS score increased postoperatively from 5.2±0.9 to 5.3±0.9 (P<0.001). The multiple regression analysis revealed that the preoperative SHS score (ß=0.77; P<0.001) and satisfaction with surgery (ß=-0.11; P=0.05) were predictors of postoperative SHS score. CONCLUSION: LASIK may contribute to increased patient happiness.

Value of considering psychological strengths in patients with eye pain.

PURPOSE: To characterize the possibility of strength intervention to improve eye-related quality of life and satisfaction with life of a patient who experienced eye pain and dissatisfaction with the outcomes of ocular surgery. OBSERVATION: A young female patient who underwent LASIK surgery and experienced dissatisfaction with the outcome claimed that she had eye pain and had lost her strengths and self-confidence, having lower quality of life despite the successful surgery. We performed strength intervention in an attempt to improve her psychological condition. After the intervention, her quality of life and satisfaction with life improved, although her near vision remained unchanged. CONCLUSIONS AND IMPORTANCE: This case report emphasized the importance of considering positive psychological aspects when dealing with patients who are dissatisfied with the outcomes of ocular surgery. Ophthalmologists should proactively consider their patients' psychological strengths as part of the diagnosis in order to improve their patients' quality of life.

Strengths use as a secret of happiness: Another dimension of visually impaired individuals' psychological state.

It is well recognized that visual impairments (VI) worsen individuals' mental condition. However, little is known about the positive aspects including subjective happiness, positive emotions, and strengths. Therefore, the purpose of this study was to investigate the positive aspects of persons with VI including their subjective happiness, positive emotions, and strengths use. Positive aspects of persons with VI were measured using the Subjective Happiness Scale (SHS), the Scale of Positive and Negative Experience-Balance (SPANE-B), and the Strengths Use Scale (SUS). A cross-sectional analysis was utilized to examine personal information in a Tokyo sample (N = 44). We used a simple regression analysis and found significant relationships between the SHS or SPANE-B and SUS; on the contrary, VI-related variables were not correlated with them. A multiple regression analysis confirmed that SUS was a significant factor associated with both the SHS and SPANE-B. Strengths use might be a possible protective factor from the negative effects of VI.