Corrigendum: The impact of patient-reported visual disturbance on dynamic visual acuity in myopic patients after corneal refractive surgery.

[This corrects the article DOI: 10.3389/fnins.2023.1278626.].

The impact of corneal higher-order aberrations on dynamic visual acuity post cataract surgery.

Purpose: To explore the influence of corneal higher-order aberrations (HOAs) on dynamic visual acuity (DVA) post cataract surgery. Methods: A total of 27 patients with 45 eyes following cataract surgery were included in this study. The postoperative monocular object-moving DVA at the velocity of 20, 40, and 80 degrees per second (dps) were examined at 1 month. The total corneal HOAs were measured with Scheimpflug-based corneal topography. The correlation between postoperative DVA and HOAs was analyzed. Results: Significant difference was shown among DVA at different velocities (P < 0.001). The 20 dps DVA was significantly better than 40 (P < 0.001) and 80 (P < 0.001) dps DVA. No significant difference was observed between 40 and 80 dps DVA (P = 0.420). The vertical coma and the root mean square (RMS) of coma (RMScoma) were statistically correlated with 80 dps DVA (P < 0.05). The vertical trefoil, RMStrefoil and total RMSHOA were statistically correlated with 40 and 80 dps DVA (P < 0.05). The spherical aberration was not significantly associated with postoperative DVA (P > 0.05 for all velocites). The multivariate linear regression model revealed that age was a significant influential factor for 20 dps DVA (P = 0.002), and RMStrefoil (4 mm) and age were significantly associated with 40 and 80 dps DVA (P ≤ 0.01). Conclusion: The research demonstrated that larger corneal HOAs, especially coma and trefoil aberrations were significantly associated with worse high-speed DVA, but not spherical aberration post cataract surgery.

Dynamic Visual Acuity, Vestibulo-Ocular Reflex, and Visual Field in National Football League (NFL) Officiating: Physiology and Visualization Engineering for 3D Virtual On-Field Training.

The ability to make on-field, split-second decisions is critical for National Football League (NFL) game officials. Multiple principles in visual function are critical for accuracy and precision of these play calls, including foveation time and unobstructed line of sight, static visual acuity, dynamic visual acuity, vestibulo-ocular reflex, and sufficient visual field. Prior research has shown that a standardized curriculum in these neuro-ophthalmic principles have demonstrated validity and self-rated improvements in understanding, confidence, and likelihood of future utilization by NFL game officials to maximize visual performance during officiating. Virtual reality technology may also be able to help optimize understandings of specific neuro-ophthalmic principles and simulate real-life gameplay. Personal communication between authors and NFL officials and leadership have indicated that there is high interest in 3D virtual on-field training for NFL officiating. In this manuscript, we review the current and past research in this space regarding a neuro-ophthalmic curriculum for NFL officials. We then provide an overview our current visualization engineering process in taking real-life NFL gameplay 2D data and creating 3D environments for virtual reality gameplay training for football officials to practice plays that highlight neuro-ophthalmic principles. We then review in-depth the physiology behind these principles and discuss strategies to implement these principles into virtual reality for football officiating.

Influence of trajectory and contrast on dynamic visual acuity in elite team sports players.

Dynamic visual acuity (DVA) is considered an essential component for studying the visual function, especially in challenging environments like team sports. Beyond frequent comparative studies, much information is still lacking about the mechanisms underlying DVA and possible differences in stimulus presentation. It is crucial to understand the performance of DVA under different conditions of contrast and trajectories to achieve more specific data and better ecological validity of measurements. Fifty-five top professional male Spanish athletes, including 23 soccer, 14 basketball, and 18 water polo players were selected. Static visual acuity (SVA) was evaluated at 5 m. DVA was determined at 2 m under combined conditions of velocity (52°/s), three trajectories (horizontal, diagonal 45° and 135°) and two contrasts (99.7% and 13%). Significant differences in most DVA conditions measurements show that the best scores correspond to horizontal, over diagonal trajectories, and high contrast. The correlation between SVA and DVA showed a different relationship depending on the contrast conditions. Professional soccer, basketball, and water polo players have similar characteristics with reference to all the DVA evaluated conditions.

Efficacy of vestibular rehabilitation program in children with balance disorders and sensorineural hearing loss.

OBJECTIVE: Asses the efficacy of a Vestibular-balance rehabilitation program to minimize or reverse balance disability in children with sensorineural hearing loss. METHOD: Forty-five hearing-impaired children with balance deficits (i.e., variable degrees of sensorineural hearing loss or auditory neuropathy). Thirty-five were rehabilitated with cochlear implants, and ten with hearing aids. Their age ranged from 4 to 10 years old. A Pre-rehab evaluation was done using questionnaires, neuromuscular evaluation, vestibular and balance office testing, and vestibular lab testing (using cVEMP and caloric test). Customized balances, as well as vestibular rehabilitation exercises, have been applied for three months. That was followed by post-rehab assessment, including the Arabic DHI questionnaire, PBS, BESS, HTT, and DVA test. RESULTS: There was a statistically significant difference in all measured parameters (including the Arabic DHI questionnaire, PBS, BESS, HTT, and DVA test) after rehabilitation. CONCLUSIONS: Vestibular-balance rehabilitation intervention positively impacts vestibular and balance functions in hearing-impaired children.

[Dynamic visual acuity screening test results analysis of 25 patients with peripheral vertigo].

Objective:To observe the results of dynamic visual acuity screening tests in patients with peripheral vertigo and explore its clinical significance. Methods:The number of 48 healthy volunteers were enrolled as control group and 25 peripheral vertigo patients as experimental group. In the experimental group, there are 12 patients with vestibular neuritis, 1 patient with Hunt syndrome, 5 patients with sudden deafness with vertigo and 7 patients with bilateral vestibular dysfunction. Horizontal and vertical dynamic visual acuity screening tests were performed on them. The number of lost rows of horizontal and vertical dynamic visual acuity was compared between the control group and the experimental group to figure out if there is a statistical difference. The number of lost rows of horizontal and vertical dynamic visual acuity was compared within the experimental group to figure out if there is a statistical difference. The two groups of 18 cases of unilateral vestibular function decline and 7 cases of bilateral vestibular function decline in the experimental group were compared with the control group, and figure out if there is a statistical difference. Results:The median number of lost rows of horizontal dynamic visual acuity in 48 healthy volunteers was 1.5 and median number of lost rows of vertical dynamic visual acuity was 1.0 in the control group. The median number of lost rows of horizontal dynamic visual acuity of 26 healthy volunteers was 6 and median number of lost rows of vertical dynamic visual acuity was 5 in the experimental group. Compared to the experimental group, the number of lost rows both have statistical significance in horizontal and vertical dynamic visual acuity（P<0.01）. The comparison of horizontal and vertical lost rows within the test group also have statistical significance（P<0.01）. Twenty five patients with exceptional vestibular disease in the experimental group were divided into unilateral vestibular function reduction group（n=18） and bilateral vestibular function reduction group（n=7）. Compared with the control group, there was significant differences in the number of horizontal and vertical lost rows（P<0.01） within the three groups. After pairwise comparison, the number of lost rows of horizontal and vertical in the control group was significantly lower than that in the unilateral vestibular function reduction group and the bilateral vestibular function reduction group（P<0.01）. There was a highly significant correlation between the number of horizontally lost rows of DVA and the mean vHIT values of bilateral horizontal semicircular canals in 25 patients（P<0.01）; and a highly significant correlation between the number of vertically lost rows of DVA and the mean vHIT values of vertical semicircular canals in 4 groups bilaterally（P<0.01）. Conclusion:The Dynamic Visual Acuity Screening Test is a useful addition to existing tests of peripheral vestibular function, particularly the vHIT test, and provides a rapid assessment of the extent of 2 Hz VOR impairment in patients with reduced vestibular function.

Relationship between dynamic visual acuity and static visual acuity, refractive error, and binocular vision in elite soccer players.

CLINICAL RELEVANCE: In many sports, dynamic visual acuity is used. In order to improve dynamic visual acuity, it is important to understand the aspects of the visual system that can cause compromise. BACKGROUND: To investigate the parameters of the visual system that may influence dynamic visual acuity in professional soccer players. METHODS: In 2022, 40 professional players were analysed. Screening consisted of a survey, the measurement refractive error, and static and dynamic visual acuity and the binocular vision parameters. All athletes were men with a mean age of 24.9 ± 4.8 years. RESULTS: The mean refractive error was -0.29 ± 0.61D, and 22.5% of athletes are myopic only and 7.5% hyperopic. Static visual acuity was R: -0.037 ± 0.094 LogMAR , L: -0.036 ± 0.098 LogMAR. Dynamic visual acuity was 0.154 ± 0.118 LogMAR . There is a positive and moderate correlation between monocular static visual acuity and dynamic visual acuity, with r = 0.524 (r2 = 0.275 , p < 0.001) for the right eye and r = 0.553 (r2 = 0.306, p < 0.001) for the left eye. For the component of astigmatism (J = 0) and for stereopsis in distance vision, the correlation was, r = -0.472 (r2 = 0.223, p = 0.002) and r = -0.467 (r2 = 0.218, p = 0.002), respectively. CONCLUSION: Athletes with lower static visual acuity in distance vision, or with worse stereopsis in distance vision or more myopic astigmatism, have lower dynamic visual acuity than other athletes.

Validation of the DYOP visual acuity test

Purpose: The dynamic optotype (DYOP) visual acuity (VA) test is based on motion detection rather than element resolution and has been proposed for routine clinical assessment. This investigation examined the validity, inter- and intra-session repeatability and subjective preference for the DYOP versus a static letter chart and examined its utility in detecting astigmatic defocus. Methods: VA of 103 participants was measured three times with the letter and DYOP charts and repeated within two weeks in 75 participants who also rated their subjective experience. The VA of 29 participants was measured using DYOP, letter, Landolt C, and Tumbling E charts, with habitual correction and astigmatism induced with +1.00, +2.00 or +3.00 cylinders at 45, 60, 90 and 180°. Results: The charts differed by a mean of 0.02 logMAR, with 81% of the measurements within one line of acuity. Inter-session, intraclass correlation coefficients, within-subject SD and repeatability were 0.03 logMAR, 0.95, 0.11 and 0.30 versus 0.01 logMAR, 0.92, 0.15 and 0.42 for the DYOP and letter charts, respectively. The DYOP was significantly more frustrating (1.79 vs.1.36), with 59% preferring the letter chart. The DYOP was least affected by induced astigmatism. Conclusions: The DYOP and letter charts differed significantly in their mean values with wide limits of agreement. DYOP had better within-subject SD and narrower limits of agreement between sessions, though clinically insignificant, and performed significantly worse for the detection of uncorrected astigmatism. Thus, it is difficult to recommend this test for the clinical determination of refractive error. (AU)

The impact of patient-reported visual disturbance on dynamic visual acuity in myopic patients after corneal refractive surgery.

Purpose: To investigate the impact of patient-reported visual disturbance on dynamic visual acuity in myopic patients after corneal refractive surgery. Methods: This is a prospective nonrandomized study. Adult myopic patients receiving bilateral laser-assisted sub-epithelial keratomileusis (LASEK), femtosecond laser-assisted in situ keratomileusis (FS-LASIK), or small incision lenticule extraction (SMILE) with Plano target were included. Eight types of patient-reported visual disturbance were evaluated regarding frequency, severity and bothersome and dynamic visual acuity (DVA) of 40 and 80 degrees per second (dps) was measured postoperatively at 3 months. Results: The study enrolled 95 patients with an average age of 27.6 ± 6.4 years. The most frequently reported visual disturbance was the fluctuation in vision (70.5%), followed by glare (66.3%) and halo (57.4%). Postoperative DVA at 80 dps was significantly associated with the total score of haloes (p = 0.038) and difficulty in judging distance (p = 0.046). Significant worse postoperative DVA at 40 dps was observed in patients with haloes than those without (p = 0.024). The DVA at 80 dps for patients without haloes or difficulty in judging distance was significantly better than that with the symptoms (haloes, p = 0.047; difficulty in judging distance, p = 0.029). Subgroup analysis by surgical procedures demonstrated that the significant difference in DVA between patients with and without visual disturbance was only observed in patients receiving FS-LASIK. Conclusion: Postoperatively, myopic patients undergoing corneal refractive surgery with haloes or difficulty in judging distance have significantly worse low and high-speed DVA than those without the symptoms. The present study provided the basis for postoperative guidance in daily tasks involving dynamic vision when patients have visual disturbances.

Enhancement of dynamic visual acuity using transcranial alternating current stimulation with gamma burst entrained on alpha wave troughs.

BACKGROUND: Cross-frequency phase-amplitude coupling (PAC) of cortical oscillations is observed within and across cortical regions during higher-order cognitive processes. Particularly, the PAC of alpha and gamma waves in the occipital cortex is closely associated with visual perception. In theory, gamma oscillation is a neuronal representation of visual stimuli, which drives the duty cycle of visual perception together with alpha oscillation. Therefore, it is believed that the timing of entrainment in alpha-gamma PAC may play a critical role in the performance of visual perception. We hypothesized that transcranial alternating current stimulation (tACS) with gamma waves entrained at the troughs of alpha waves would enhance the dynamic visual acuity (DVA). METHOD: We attempted to modulate the performance of DVA by using tACS. The waveforms of the tACS were tailored to target PAC over the occipital cortex. The waveforms contained gamma (80 Hz) waves oscillating at either the peaks or troughs of alpha (10 Hz) waves. Participants performed computerized DVA task before, immediately after, and 10 min after each stimulation sessions. EEG and EOG were recorded during the DVA task to assess inter-trial phase coherence (ITPC), the alpha-gamma PAC at occipital site and the eye movements. RESULTS: tACS with gamma waves entrained at alpha troughs effectively enhanced DVA, while the tACS with gamma waves entrained at alpha peaks did not affect DVA performance. Importantly, analyses of EEG and EOG showed that the enhancement of DVA performance originated solely from the neuromodulatory effects, and was not related to the modulation of saccadic eye movements. Consequently, DVA, one of the higher-order cognitive abilities, was successfully modulated using tACS with a tailored waveform. CONCLUSIONS: Our experimental results demonstrated that DVA performances were enhanced when tACS with gamma bursts entrained on alpha wave troughs were applied over the occipital cortex. Our findings suggest that using tACS with tailored waveforms, modulation of complex neuronal features could effectively enhance higher-order cognitive abilities such as DVA, which has never been modulated with conventional noninvasive brain stimulation methods.

Functional and anatomical alterations in bilateral vestibulopathy: A multimodal neuroimaging study and clinical correlation.

Object: To study multimodal neuroimaging study including resting state functional MRI (rs-fMRI), anatomical connectivity and brain morphology in patients with bilateral vestibulopathy (BVP) and relationship with clinical correlation. Methods: Thirteen patients with BVP (7 women; mean age ± SD = 63.5 ± 14.7 years, 22-80 years) and eighteen age and gender-matched controls were compared rs-fMRI and anatomical MRI. Also, we analyzed the relationship between multimodal neuroimaging and Dizziness Handicap Inventory score (DHI), Vestibular Disorders Activities of Daily Living Scale (VDRL), Geriatric Depression Scale (GDS) and Hospital Anxiety and Depression Scale (HADS). Results: Compared with controls, BVP patients showed decreased functional connectivity among the key nodes of the salience network, auditory (including vestibular) network, bilateral posterior parahippocampal gyri, bilateral paracingulate gyri, and right frontoparietal network, and the anatomical connectivity in the right cerebellum, corpus callosum tapetum, and left fornix. BVP patients showed decreased gray matter volume in the bilateral parahippocampal gyri, right precentral gyrus, anterior cingulate gyrus, and right middle temporal gyrus and increased gray matter volume in the right superior frontal gyrus compared with controls. Correlation analyses showed rs-fMRI and clinical variables showed no significant result. DHI correlated negatively with anatomical connectivity in the bilateral frontal parahippocampal cingulum, corpus callosum, right inferior fronto-occipital fasciculus, bilateral fornix, and gray matter volumes in the bilateral middle occipital gyri, right superior occipital gyrus, left angular gyrus, and right cuneus in BVP. VADL correlated negatively with Anatomical connectivity in the corpus callosum, bilateral fornix, bilateral cerebellum, bilateral superior and anterior thalamic radiation, right inferior fronto-occipital fasciculus, bilateral fronto-parietal cingulum, right dentatoruburothalamic tract and gray matter volumes in the right angular gyri, bilateral parahippocampal gyri, right middle temporal gyrus, right cuneus, bilateral inferior occipital gyri, left middle occipital gyrus, right superior frontal gyrus, left fusiform gyrus, bilateral caudate, left cerebellar crus, and bilateral calcarine gyri in BVP. Conclusions: This study identified reductions in the volume of the hippocampus and alterations in functional and anatomical connectivity that concurs with previously established characteristics of BVP. The degree of disability can be inferred from the change in the connectivity and volume between vestibular cortical areas and their network.

Dynamic visual acuity as a biometric for astronaut performance and safety.

Astronauts are exposed to an austere and constantly changing environment during space travel. To respond to these rapid environmental changes, high levels of dynamic visual acuity (DVA) are required. DVA is the ability to visualize objects that are in motion, or with head movement and has previously been shown to decrease significantly following spaceflight. Decreased DVA can potentially impact astronauts while performing mission critical tasks and drive space motion sickness. In this paper, we suggest that DVA assessment during spaceflight and during G-transitions should be considered to help further understand the vestibulo-ocular impacts of interplanetary spaceflight and ensure mission performance including potential manned missions to Mars.

The impact of different corneal refractive surgeries on binocular dynamic visual acuity.

Purpose: To investigate the influence of different corneal refractive surgeries on dynamic visual acuity (DVA), and explore its potential influence factors. Methods: This was a prospective non-randomized study. Adult myopic patients undergoing bilateral laser-assisted sub-epithelial keratomileusis (LASEK), femtosecond laser-assisted in situ keratomileusis (FS-LASIK), or small incision lenticule extraction (SMILE) with Plano refraction target were enrolled. Uncorrected and corrected distance visual acuity (UDVA/CDVA), manifest refraction and binocular optotype-moving DVA of 40 and 80 degrees per second (dps) were evaluated pre-operatively and post-operatively up to 3 months. Results: The study included 264 eyes of 132 subjects, with an average age of 27.0 ± 6.7 years, and females accounted for 59% of the participants. Significant improvement was observed at the 3-month visit for 40 dps (SMILE, P = 0.001; LASEK, P = 0.006; FS-LASIK, P = 0.010) and 80 dps (SMILE, P = 0.011; LASEK, P = 0.025; FS-LASIK, P = 0.012) DVA. Adjusting for pre-operative DVA, there was no significant difference in DVA among groups at 3 months post-operatively (P > 0.05 for multiple comparisons). Overall, multiple linear models demonstrated that post-operative DVA at 3 months was correlated with pre-operative DVA (40 dps, ß = 0.349, P = 0.001; 80 dps, ß = 0.447, P < 0.001), pre-operative spherical equivalent (40 dps, ß = 0.311, P = 0.003; 80 dps, ß = 0.261, P = 0.009) and post-operative UDVA (40 dps, ß = -0.224, P = 0.024; 80 dps, ß = -0.188, P = 0.05). Conclusion: Dynamic visual acuity at 3 months post-operatively of the three corneal refractive surgeries was better than that before the surgery in adult myopic patients, and there was no significant difference among different surgical techniques. Post-operative DVA at 3 months was found correlated with pre-operative DVA, pre-operative SE, and post-operative UDVA. With further improvement, DVA could be a promising functional visual indicator for myopic patients undergoing refractive surgeries.

Binocular dynamic visual acuity in dry eye disease patients.

Purpose: To investigate binocular dynamic visual acuity (DVA) for patients with dry eye disease (DED). Methods: The prospective study included DED patients. The binocular DVA at 40 and 80 degrees per second (dps), Ocular Surface Disease Index (OSDI), tear meniscus height (TMH), tear film break-up time first (TBUTF), corneal fluorescein staining (CFS), eyelid margin abnormalities and meibomian gland (MG) abnormalities morphology and function were evaluated. A deep learning model was applied to quantify the MG area proportion. The correlation between DVA and DED parameters was analyzed. Results: A total of 73 DED patients were enrolled. The age, OSDI, CFS, MG expressibility, secretion quality, and eyelid margin abnormalities were significantly positively correlated with the DVA for 40 and 80 dps (all P < 0.05). The MG area proportion in the upper eyelid was negatively correlated with DVA at 40 dps (R = -0.293, P < 0.001) and at 80 dps (R = -0.304, P < 0.001). Subgroup analysis by MG grade demonstrated that the DVA of patients with severe MG dropout (<25% of the total area) was significantly worse than other mild and moderate groups, both in 40 and 80 dps (all P < 0.05). The patients with CFS showed worse 40 (P < 0.001) and 80 dps (P < 0.001) DVA than the patients without CFS. Conclusion: Binocular DVA is significantly associated with DED symptoms and signs. The DED patients with CFS and severe MG dropout and dysfunction have worse DVA.

Dynamic Visual Acuity After Small Incision Lenticule Extraction for Myopia Patients.

In the present study we compared dynamic visual acuity (DVA) of 84 eyes (for 42 adults with myopia; M age = 28.4, SD = 6.6 years; males = 38.1%, females = 61.9%) at 40 and 80 degree per second (dps) before surgery with eyeglass corrections and after a surgical procedure - a small incision lenticule extraction (SMILE). Participants underwent binocular SMILE surgery with plano refraction targets. Their eyeglass-corrected binocular DVA at 40 and 80 dps was evaluated preoperatively, and their uncorrected binocular DVA was assessed post-operatively at 1 week, 1 month and 3 months. The mean logMAR (logarithm of the minimum angle of resolution) uncorrected and corrected distance visual acuities (UDVA and CDVA) were -0.09 and -0.11 respectively, 3 months postoperatively. The mean preoperative eyeglass-corrected DVAs at 40 and 80 dps were 0.141 and 0.184, respectively, and significant improvements were observed for 40 dps and 80 dps DVAs 3 months postoperatively. Pearson's correlations were statistically significant between the postoperative DVAs at 3 months and for both the preoperative DVA and postoperative UDVA at both 40 dps and 80 dps. The change in the DVAs at 3 months were significantly associated with the preoperative DVAs at 40 dps and 80 dps. In conclusion, myopic patients' DVAs significantly improved following SMILE in comparison to corrected preoperative visual acuity when wearing eyeglasses. The post-SMILE DVA was associated with both the preoperative DVA and the postoperative UDVA.

Validation of the DYOP visual acuity test.

PURPOSE: The dynamic optotype (DYOP) visual acuity (VA) test is based on motion detection rather than element resolution and has been proposed for routine clinical assessment. This investigation examined the validity, inter- and intra-session repeatability and subjective preference for the DYOP versus a static letter chart and examined its utility in detecting astigmatic defocus. METHODS: VA of 103 participants was measured three times with the letter and DYOP charts and repeated within two weeks in 75 participants who also rated their subjective experience. The VA of 29 participants was measured using DYOP, letter, Landolt C, and Tumbling E charts, with habitual correction and astigmatism induced with +1.00, +2.00 or +3.00 cylinders at 45, 60, 90 and 180°. RESULTS: The charts differed by a mean of 0.02 logMAR, with 81% of the measurements within one line of acuity. Inter-session, intraclass correlation coefficients, within-subject SD and repeatability were 0.03 logMAR, 0.95, 0.11 and 0.30 versus 0.01 logMAR, 0.92, 0.15 and 0.42 for the DYOP and letter charts, respectively. The DYOP was significantly more frustrating (1.79 vs.1.36), with 59% preferring the letter chart. The DYOP was least affected by induced astigmatism. CONCLUSIONS: The DYOP and letter charts differed significantly in their mean values with wide limits of agreement. DYOP had better within-subject SD and narrower limits of agreement between sessions, though clinically insignificant, and performed significantly worse for the detection of uncorrected astigmatism. Thus, it is difficult to recommend this test for the clinical determination of refractive error.

Comparisons of visual outcomes between bilateral implantation and mix-and-match implantation of three types intraocular lenses.

PURPOSE: To compare binocular static visual acuity (SVA), stereopsis, contrast sensitivity (CS) and dynamic visual acuity (DVA) of 5 combinations of bifocal intraocular lenses (IOLs), trifocal IOLs and extended-depth-of-focus (EDOF) IOLs in age-related cataract patients. METHODS: Two hundred and ninety-two eyes of 146 patients who underwent cataract surgery in the ophthalmology department of the First Affiliated Hospital of Chongqing Medical University were involved. Subgroups included group MM (33patients, bilaterally bifocal IOL, ZMB00), group TT (31patients, bilaterally trifocal IOL, AT LISA tri839MP), group XX (34patients, bilaterally EDOF IOL, ZXR00), group MX (25patients, bifocal IOL, ZMB00 + EDOF IOL, ZXR00) and group TX (23patients, trifocal IOL, AT LISA tri839MP + EDOF IOL, ZXR00). The uncorrected SVAs (UDVA, UIVA and UNVA), uncorrected DVAs (UDDVA, UIDVA and UNDVA), near and distance stereopsis, and CS were assessed 3 months postoperatively. RESULTS: Subgroups of TT, XX, MX and TX showed better UIVA than MM (bP = 0.039, 0.021, 0.035 and 0.037, respectively). MX showed better UNVA than MM and TX (bP = 0.031 and 0.013, respectively). MX group had the optimal outcomes of both near and distance stereopsis. In the UDDVA, XX group and MX group showed better outcomes than TX group at 24 fps (frames per second) (bP = 0.019 and 0.023, respectively). XX group and MX group showed optimal outcomes at all speeds of UIDVA (P = 0.001, 0.005, 0.003 and 0.005, respectively). As the speed increased, the XX group and the MX group showed better UNDVA than the MM group and the TT group (P = 0.019, 0.002 and 0.003, respectively). CONCLUSIONS: Mix-and-match implantation of bifocal IOLs and EDOF IOLs provides excellent and stable binocular visual outcomes including SVA, stereopsis and DVA in distant and near distances.

Comparison of dynamic visual acuity after implantation of toric bifocal or trifocal intraocular lens in age-related cataract patients: a randomized controlled trial.

Purpose: To investigate the dynamic visual acuity (DVA) after implantation of toric bifocal or trifocal intraocular lens in age-related cataract patients. Methods: This was a prospective randomized controlled trial. Of one hundred and twenty-four patients enrolled and randomized to receive unilateral phacoemulsification and toric trifocal (939 M/MP, Carl Zeiss Meditec AG, Jena, Germany) or toric bifocal (909 M, Carl Zeiss Meditec AG, Jena, Germany) intraocular lenses (IOL) implantation, ninety-nine patients completed the follow-up and were included in final analysis. Postoperatively, uncorrected and corrected distance (UDVA and CDVA), intermediate (UIVA and DCIVA) and near (UNVA and DCNVA) static visual acuity, manifest refraction and uncorrected and corrected distance DVA (UDDVA and CDDVA) at 20, 40 and 80 degrees per second (dps) were evaluated at one week, one month and three months. Results: Three months postoperatively, the UDVA were 0.13 ± 0.11 and 0.14 ± 0.13 in the toric trifocal and bifocal IOL group, respectively. Significant better UIVA (trifocal, 0.17 ± 0.13 vs. bifocal, 0.23 ± 0.13, p = 0.037) and DCIVA (trifocal, 0.16 ± 0.11 vs. bifocal, 0.20 ± 0.12, p = 0.048) were observed in patients implanting toric trifocal than bifocal IOL at three months postoperatively. Patients implanted with toric bifocal IOL obtained better CDDVA at 80 dps (0.5607 ± 0.2032) than the trifocal group (0.6573 ± 0.2450, p = 0.039) at three months. Postoperative UDDVA and CDDVA at 20, 40 and 80 dps were significantly associated with age (p < 0.05, respectively) and postoperative static visual acuity (p < 0.05, respectively). Conclusion: Toric trifocal IOL provides better static intermediate visual acuity, and toric bifocal IOL implantation provides better distance dynamic visual acuity at high speed.

A Cross-Sectional Study on the Effect of Chronic Noise Exposure on the Vestibular Function of Traffic Policemen and Automobile Drivers.

Introduction: Noise is a preventable occupational hazard for certain professions like automobile drivers and traffic police personnel. The harmful auditory effects of noise are well known. However, little is known about the status of the vestibular function in chronic noise exposure without noise induced hearing loss. Our objective was to assess the vestibular function in chronic noise exposure. Methodology: : The study was conducted with a sample size of 242 (chronic noise exposure group - 121, group without chronic noise exposure - 121). Noise estimation was carried out across various traffic intersections to assess the noise exposure levels of the exposed group. All participants underwent a detailed vestibular evaluation in the clinical vestibulometry laboratory. Results: There was no difference in nystagmus, saccades, caloric function between the two groups. The latency and amplitude of vestibular evoked myogenic potentials (VEMP) were similar in both the groups. However, dynamic posturography showed a significant difference in the Adaptation test between the two groups (P < 0.05). We also found a statistically significant difference between the static and dynamic subjective visual vertical (SVV) and the dynamic visual acuity (DVA) between the two groups (P < 0.05). Conclusion: We did not find any clinical evidence of vestibular dysfunction in the noise exposed group. However, the statistical significance of SVV and DVA as seen in this study needs to be evaluated further as an early marker for vestibular dysfunction. It remains to be seen whether the statistically significant prolongation is reversible after the noise exposure is withdrawn.

Dynamic Visual Acuity Results in Otolith Electrical Stimulation in Bilateral Vestibular Dysfunction.

(1) Background. Patients with bilateral vestibular disease (BVD) experience oscillopsia with a detriment to visual acuity (VA). This VA is driven mainly by the VOR that has two components: rotational and translational. VA can be tested by using dynamic visual acuity (DVA) on a treadmill because both systems are activated. The aim of this study is to compare VA before and after chronic electrical stimulation of the otolith organ. (2) Materials and Method. Five patients suffering from bilateral vestibular dysfunction (BVD), previously implanted with a new vestibular implant prototype, were included in this study with the aim to check VA with and without vestibular implant use (W and W/O) in static, 2 km/h and 4 km/h walking situations. DVAtreadmill was measured on a treadmill with a dynamic illegible E (DIE) test in static and dynamic conditions (while walking on the treadmill at 2 and 4 km/h). The DVA score was registered in a logarithm of the minimum angle of resolution (LogMAR) for each speed. In addition, every patient completed the oscillopsia severity questionnaire (OSQ) and video head impulse test (vHIT) before and after activation of the vestibular implant. (3) Results. The analysis shows a significant difference in OSQ scores and DVA with an improvement in dynamic conditions. Organized corrective saccades during the use of a vestibular implant with no changes in gain were also detected in the video head impulse tests (vHIT). (4) Conclusion. The vestibular implant with otolithic stimulation offers changes in the response of DVA, which makes this paper one of the first to address the possible restoration of it. It is not possible to rule out other contributing factors (presence of covert saccades, somatosensory system, …). More work seems necessary to understand the neurophysiological basis of these findings, but this implant is added as a therapeutic alternative for the improvement of oscillopsia.