Acuity Measurements Research Articles

The effect of central and peripheral luminance on visual acuity.

Lighting conditions significantly influence visual acuity (VA), visual function, and quality of life. Previous research highlighted a correlation between luminance and VA but left a gap in understanding the impact of surrounding luminance. This study focused on investigating the effects of both central and peripheral luminance on VA. This study aimed to investigate the influence of both central and surrounding luminance on VA through distance VA measurements. A dual-component lighting system was utilized, comprising a self-illuminated ETDRS chart and a skyLED system for consistent surrounding illumination. Two experimental setups were conducted: the first varied the central luminance (25 ± 2-341 ± 10 cd/m²), while the second maintained a constant central luminance (150 ± 5 cd/m²) and varied the surrounding luminance (4 ± 2 cd/m² OFF-105 ± 10 cd/m² ON). Sixty-six participants with refractive errors between 0.0 D and -2.75 D were tested under various lighting conditions. Both uncorrected refractive error (URE) and corrected refractive error (CRE) eyes were evaluated. Paired t-tests were used to evaluate the statistical significance of differences in VA scores. Experiment 1 demonstrated a significant increase in VA scores, with mean improvements of -0.120 LogMAR for URE eyes and -0.073 LogMAR for CRE eyes as chart luminance increased from 26 cd/m² to 153 cd/m². Experiment 2 further showed a notable improvement in VA scores under varied surrounding luminance conditions, with mean improvements of - 0.118 LogMAR for URE eyes and -0.073 LogMAR for CRE eyes as luminance increased from 4 cd/m² to 102 cd/m². This study emphasizes the significant impact of both central and peripheral luminance on VA. The introduction of the skyLED lighting system underlines the importance of optimal lighting for visual performance.

Web-based vs. conventional: a comprehensive analysis of visual acuity assessment using the PocDoc tool in a tertiary eye care centre.

Visual acuity (VA) represents a fundamental measure of visual function. The significant prevalence of underdiagnosed ocular disorders underscores the importance of effective VA assessment. This study evaluates the efficacy of a web-based VA assessment tool ("PocDoc") versus conventional VA testing. Prospective observational study including 353 participants recruited from various eye clinics in a tertiary referral centre. Age, diagnosis, and VA related information (i.e. VA measurements from PocDoc and conventional VA test [Snellen chart], test type, etc) were collected. Spearman's rank correlation, Intraclass Correlation, and Bland-Altman plot compared outcomes of both tests. One-way ANOVA and paired-T test were used to compare means. Most patients were males (59.2%) with a mean age of 52.2 ± 20.6 years. PocDoc had moderate positive correlation to conventional testing (rho = 0.50, p < 0.001). PocDoc led to higher logMAR scores compared to conventional testing (mean logMAR 0.19 and 0.13 respectively, p < 0.01). Moreover, PocDoc demonstrated a sensitivity of 82.8% and specificity of 79% for detecting visual impairment. The discrepancy between PocDoc and conventional VA testing increased with higher logMAR values, indicating greater inconsistency between the tests for patients with poorer VA. Age, test type, and disease type contributed to this variability. The concordance between PocDoc and conventional testing for VA measurement across various ages and conditions makes it a suitable screening tool. Future technological inventions should consider age, test type, and disease type as critical factors related to the level of agreement and correlation between digital and conventional VA testing methods.

One-Year Visual and Refractive Outcomes of SmartPulse® Technology in Transepithelial Photorefractive Keratectomy for Myopic and Astigmatic Patients.

Background/Objectives: This study aims to evaluate the efficacy, safety, and predictability of Transepithelial Photorefractive Keratectomy (TPRK) using the SmartPulse® technology excimer laser for the correction of myopia and myopic astigmatism, assessing visual and refractive outcomes over a one-year follow-up period. Methods: This retrospective cohort study analyzed data from patients who underwent TPRK at the Ophthalmology Department-"Victor Babes" University of Medicine and Pharmacy in Timisoara (Romania), between January 2019 and June 2023. The procedure was performed using the SmartPulse® Technology of the SmartSurfACE AMARIS 750S excimer laser (SCHWIND eye-tech-solutions, Kleinostheim, Germany). Preoperative assessments included visual acuity, refraction, and corneal measurements, with postoperative evaluations conducted for up to 12 months. Results: This study included 92 eyes from 46 patients (mean age 29.02 years, 63% male). At 12 months post-op, 100% achieved UDVA 20/25 or better, with an efficacy index of 1.01. Refractive accuracy was 96% within ±0.50 D of the target and astigmatism ≤ 0.50 D in 99% of eyes. The safety index was 1.01. Corneal haze occurred in 8.70% of eyes and was effectively managed with dexamethasone drops. Conclusions: TPRK with the SmartPulse® technology excimer laser demonstrated high efficacy and safety in correcting myopia and myopic astigmatism, achieving stable visual outcomes over one year. The procedure also showed excellent predictability with a low incidence of complications, supporting its use as a reliable refractive surgery option.

Comparative analysis of pre-operative findings and post-operative outcomes in primary and secondary macular holes at a tertiary eye hospital in South India

PurposeThis study aimed to compare demographics, clinical characteristics, and post-surgical outcomes between idiopathic and secondary full-thickness macular holes (MHs).MethodsA retrospective analysis of 348 eyes from 339 patients treated between June 2017 and December 2023 was conducted. The study included both idiopathic and secondary MHs, excluding cases where surgery was not performed or lacked sufficient follow-up. Demographic data, visual acuity (VA), ocular characteristics, and optical coherence tomography measurements were analyzed.ResultsIdiopathic MHs were identified in 308 eyes (89%), and secondary MHs in 40 eyes (11%). Idiopathic MH patients were older (mean age: 68.26 vs. 60.13 years; p = 0.001) and more commonly female (63% vs. 40%; p = 0.005). Post-surgical closure was achieved in 86% of all MHs, with a median VA improvement of 15 ETDRS letters (3 Snellen lines). However, secondary MHs had a lower closure rate (67% vs. 89%, p = 0.001) and less VA improvement (2 lines vs. 3 lines, p = 0.001) compared to idiopathic MHs. Significant differences in maximal basal diameter and diameter hole index were noted between the groups.ConclusionsSecondary MHs, accounting for 11% of surgical cases, show poorer anatomical and visual outcomes than idiopathic MHs. Despite lower success rates, early surgical intervention in secondary MHs is recommended to enhance outcomes. Differentiating between idiopathic and secondary MHs is crucial for optimal management.

The Short-term Effect of Caffeine Consumption on Reading Performance

Objective: Caffeine, a widely consumed psychoactive substance, is recognized for its cognitive-enhancing effects, notably enhancing performance on tasks requiring narrative comprehension, where it has been shown to boost both acuity and speed. This study investigates the impact of caffeine intake on reading acuity and evaluates changes in reading speed post-caffeine consumption. Material and Methods: Employing a cross-sectional design, nineteen participants with distance best-corrected vision of 6/6 or better (equivalent to logMAR 0.00 or better) (mean age=22.5±1.00 years old) and near vision of 0.1 logMAR (N5) were recruited. Baseline measurements of reading acuity and speed were taken using the article sourced from Perpustakaan Tun Abdul Razak (PTAR) and Buari-Chen Malay Reading Chart (BCMRC) before coffee consumption, respectively. Participants consumed 200 mg of Nescafe Gold (caffeine) before the subsequent assessment. The time taken to read the reading materials was recorded, alongside any errors. Results: While reading speed significantly increased post-caffeine consumption (t=-7.536, p-value&lt;0.001), reading acuity remained unaffected (t=-0.378, p-value=0.705). These results suggest a moderate dose of 200 mg of caffeine can enhance reading speed without compromising acuity in young adults.Conclusion: This indicates that caffeine mainly affects the rate of reading, while it does not alter the reading acuity of individuals.

Rheumatic fever and long-term use of benzathine penicillin as possible risk factors for extensive macular atrophy with pseudodrusen in a Brazilian cohort

BackgroundAlthough there has been a large increase in the number of extensive macular atrophy with pseudodrusen (EMAP) cases, the basic aspects of this disease remain unknown. Brazilian patients have a common past history of rheumatic fever (RF) and/or benzathine penicillin (BP) treatment possibly related to the disease. We analyzed how RF and BP might be correlated with EMAP in Brazilian patients.DesignObservational, retrospective, case-control study.MethodsThe databases of three private eye clinics in Brazil were searched for patients with an EMAP-like appearance. Each patient was asked about a previous history of RF and/or long-term use of BP. Patients underwent best-corrected visual acuity (BCVA) measurement, color fundus imaging, fundus autofluorescence (FAF) imaging, optical coherence tomography (OCT) imaging, and electroretinography (ERG). The following characteristics were analyzed: subretinal drusenoid deposits (SDD), pigment mottling, retinal pigment epithelial/basement membrane (RPE/BM) separation, outer retinal or RPE atrophy, and identification of a paving stone-like appearance. The choroidal thickness was measured using enhanced depth imaging OCT. The central atrophic area was measured manually on ultra-wide-field FAF.ResultsA total of 154 eyes of 77 patients (women, 66.2%; mean age, 58.6 years) with EMAP were included; 90.9% of patients were diagnosed with RF; 94.8% had been treated with BP and treatment was started at an average age of 7.3 years (mean duration, 11.8 years). The treatment duration was significant for the area of atrophy (P = 0.027) in which each 1-year increase in treatment duration led to an average reduction of 6.91 mm2 in area. The age at diagnosis of RF was significant (P = 0.026) for SDD. The increase of 1 year in the diagnosis of RF (late disease) led to a reduction of 24% in the chance of central SDD being present. On OCT, 65.5% eyes had SDD and more than 70% had a split RPE/BM and outer retinal or RPE atrophy. The choroidal thickness in patients with EMAP was significantly (P < 0.001) thinner than the control group. The ERG was abnormal in all eyes.ConclusionThese findings may suggest a relation between RF and EMAP in Brazilian patients. Patients with EMAP should be questioned about a history of RF.

Radial polarisation patterns identify macular damage: a machine learning approach

ABSTRACT Clinical relevance Identifying polarisation-modulated patterns may be an effective method for both detecting and monitoring macular damage. Background The aim of this work is to determine the effectiveness of polarisation-modulated patterns in identifying macular damage and foveolar involvement using a methodology that involved feature selection, Naïve Bayes supervised machine learning, cross validation, and use of an interpretable nomogram. Methods A cross-sectional study involving 520 eyes was undertaken, encompassing both normal and abnormal cases, including those with age-related macular disease, diabetic retinopathy or epiretinal membrane. Macular damage and foveolar integrity were assessed using optical coherence tomography. Various polarisation-modulated geometrical and optotype patterns were employed, along with traditional methods for visual function measurement, to complete perceptual detection and identification measures. Other variables assessed included age, sex, eye (right, left) and ocular media (normal, pseudophakic, cataract). Redundant variables were removed using a Fast Correlation-Based Filter. The area under the receiver operating characteristic curve and Matthews correlation coefficient were calculated, following 5-fold stratified cross validation, for Naïve Bayes models describing the relationship between the selected predictors of macular damage and foveolar involvement. Results Only radially structured polarisation-modulated patterns and age emerged as predictors of macular damage and foveolar involvement. All other variables, including traditional logMAR measures of visual acuity, were identified as redundant. Naïve Bayes, utilising the Fast Correlation-Based Filter selected features, provided a good prediction for macular damage and foveolar involvement, with an area under the receiver operating curve exceeding 0.7. Additionally, Matthews correlation coefficient showed a medium size effect for both conditions. Conclusions Radially structured polarisation-modulated geometric patterns outperform polarisation-modulated optotypes and standard logMAR acuity measures in predicting macular damage, regardless of foveolar involvement.

Microperimetry Sensitivity Correlates to Structural Macular Changes in Adolescents with Achromatopsia Unlike Other Visual Function Tests.

Objectives: Achromatopsia (ACHM) is a rare autosomal, recessively inherited disease that is characterized by cone dysfunction, for which several gene therapies are currently on trial. The aim of this study was to find correlations between the morphological macular changes identified using optical coherence tomography (OCT) and some visual functional parameters. Visual acuity (VA), contrast sensitivity (CS), and macular sensitivity obtained by means of microperimetry were assessed. Methods: Adolescents with ACHM underwent macular microperimetry (S-MAIA device) in mesopic condition, macular OCT, best corrected visual acuity (BCVA), low luminance visual acuity (LLVA), near vision acuity (NVA), and CS measurement. Results: Eight patients (15 eyes) with ACHM were analyzed. The mean age was 17 ± 2.7 years, and genetic variants involved the CNGA3 gene (37.5%) and CNGB3 gene (62.5%). OCT staging significantly correlated with microperimetry sensitivity parameters, namely the sensitivity of the central foveal point (p = 0.0286) and of the first and second perifoveal rings (p = 0.0008 and p = 0.0014, respectively). No correlations were found between OCT staging and VA measurements, nor with CS value. Conclusions: Among the extensive evaluated visual function tests, only microperimetry sensitivity showed a correlation with morphological macular changes identified at OCT. Microperimetry sensitivity may thus represent a useful visual function tool in natural ACHM history studies considering the upcoming research on gene therapies for the treatment of ACHM.

Photobiomodulation Therapy for Serous Pigment Epithelium Detachment in Chronic Central Serous Chorioretinopathy

PURPOSE: To report a case of giant pigment epithelium detachment (PED) secondary to chronic central serous chorioretinopathy (cCSC) successfully treated with photobiomodulation (PBM). METHODS: Case report. RESULTS: A 55-year-old man complained a worsening of vision in the left eye (LE) over the last 18 months. A complete ophthalmological evaluation encompassing best corrected visual acuity (BCVA) measurement, spectral-domain optical coherence tomography (SD-OCT), fundus autofluorescence (FAF), fluorescein angiography (FA) and microperimetry (MP) was performed. SD-OCT showed several small PEDs around the macula in the right eye and a giant macular serous PED with subretinal fluid (SRF) in the LE. FA disclosed multiple hyperfluorescent roundish areas in the posterior pole bilaterally, with a macular pooling in the LE. A diagnosis of cCSC was made, and patient underwent PBM with one session for week for four weeks, followed by one session bi-weekly for two months. SD-OCT of the LE showed a gradual flattening of the macular PED at 3 months, with a complete regression of the latter and of the SRF at 6- and 12-month follow up with no residual signs of chorioretinal atrophy on FAF. BCVA improved from 20/80 at baseline to 20/25 at the last follow up, and this functional improvement was further confirmed by MP. CONCLUSIONS: PBM can be considered a safe and effective treatment strategy for the management of cCSC with SRF and serous PED.

Validation of a French Version of the Visual Function and Corneal Health Status Instrument and Correlation With Vision and Glare Measurements in Fuchs Endothelial Corneal Dystrophy.

To validate a French version of the Visual Function and Corneal Health Status (V-FUCHS) instrument in Fuchs endothelial corneal dystrophy (FECD) and to correlate questionnaire scores with objective measurements of best-corrected visual acuity (BCVA) and intraocular straylight. The original V-FUCHS 15-item instrument was designed to assess VA and glare in patients with FECD. It was translated from English to French and back translated to English by independent translators. The questionnaire was administered on 2 occasions (4 weeks apart), and BCVA, modified Krachmer grade, and straylight were measured. Construct validity, internal consistency, test-retest reliability, and predictive validity were assessed. A total of 159 subjects, aged 41 to 86 years, were prospectively recruited from July 2019 to October 2020 and classified into 6 groups: mild, moderate, or advanced FECD; unilateral or bilateral Descemet membrane endothelial keratoplasty for FECD; and healthy controls (n = 35). Construct validity was confirmed by item response theory model. Cronbach alpha demonstrated excellent internal consistency (VA: 0.91, glare: 0.88), and intraclass correlations showed good test-retest reliability (VA: 0.75 and glare: 0.82). Significant correlations were observed between both VA and glare factors and the modified Krachmer grade, BCVA, and straylight. The proposed French version of the V-FUCHS instrument provides a valid and reliable tool for the assessment of visual disability in patients with FECD. This questionnaire bridges the gap between self-reported FECD symptoms and objective clinical measurements, which may prove useful to optimize the timing of surgery and to assess postoperative improvement in symptoms.

Improvement in Central Serous Chorioretinopathy in Renal Transplant Recipients Following Hemodialysis: Case Report

Introduction: This case report describes an elderly man experienced recurrent central serous chorioretinopathy (CSCR) for several years following a kidney transplant. Despite various treatments, his subretinal fluid was unexpectedly absorbed following hemodialysis after the loss of graft kidney function. Optical coherence tomography (OCT) imaging and best-corrected visual acuity (BCVA) measures were taken. The patient has been followed for approximately 10 years. Conclusion: Hemodialysis should be considered early if there is persistent and refractory serous retinal detachment despite reducing or discontinuing glucocorticoid therapy and in the presence of decreased glomerular filtration rate.

Clinical validation of a cross-platform digital visual acuity measurement system

Clinical validation of a cross-platform digital visual acuity measurement system

Prevalence of Age-related Macular Degeneration among Elderly Bulgarian Population

Age-related macular degeneration (AMD) is the leading cause of blindness worldwide in an older patient population with the highest risk of disease development in individuals older than 65 years. This study aims to estimate the prevalence of AMD and its stages among the elderly population of Sofia city. An observational study among elderly Sofia citizens, held as prophylactic ophthalmological examinations was performed. The participants underwent full ophthalmic examination including autorefractometry, noncontact tonometry, best-corrected visual acuity measurement, biomicroscopy, and indirect ophthalmoscopy through a dilated pupil. Optical coherent tomography was performed in cases with difficulties to determine the stage of AMD or when the visual acuity did not correspond to the ophthalmoscopy findings. All participants were asked to fill in informed consent and a specifically structured questionnaire based on the modified Wolffson LVQOL questionnaire that was previously used in the study in Eastern Bulgaria (in 2014 by Nencheva). Overall 700 patients, with a median age of 74 years (69 to 96 years) met the inclusion criteria and were enrolled in the study. The prevalence of AMD, early, intermediate and late AMD was estimated as 26.1%, 14%, 6.6%, and 5.6%, respectively. Age was strongly associated with the prevalence of AMD and its stages. The ageing of the population in Bulgaria and worldwide and the large proportion of elderly persons, affected by AMD, emphasize the necessity of regular ophthalmological examinations of that part of the population. The timely diagnosis and treatment are very important for diminishing of blindness and visual impairment.

A comprehensive dataset of pattern electroretinograms for ocular electrophysiology research

The Pattern Electroretinogram (PERG) is an essential tool in ophthalmic electrophysiology, providing an objective assessment of the central retinal function. It quantifies the activity of cells in the macula and the ganglion cells of the retina, assisting in the differentiation of macular and optic nerve conditions. In this study, we present the IOBA-PERG dataset, an extensive collection of 1354 transient PERG responses accessible on the PhysioNet repository. These recordings were conducted at the Institute of Applied Ophthalmobiology (IOBA) at University of Valladolid, over an extended period spanning nearly two decades, from 2003 to 2022. The dataset includes 336 records, ensuring at least one PERG signal per eye. The dataset thoughtfully includes demographic and clinical data, comprising information such as age, gender, visual acuity measurements, and expert diagnoses. This comprehensive dataset fills a gap in ocular electrophysiological repositories, enhancing ophthalmology research. Researchers can explore a broad range of eye-related conditions and diseases, leading to enhanced diagnostic accuracy, innovative treatment strategies, methodological advancements, and a deeper understanding of ocular electrophysiology.

Automated visual acuity estimation by optokinetic nystagmus using a stepped sweep stimulus.

To describe an automatic system for objective measurement of visual acuity (VA) using optokinetic nystagmus (OKN). This pilot study tested the system's sensitivity and specificity for detecting reduced VA in healthy adults by comparing VA-OKN to VA with an Early Treatment of Diabetic Retinopathy Study (ETDRS) chart (VA-ETDRS). Adult participants (age 30 ± 12 years) with either reduced VA (n = 11, VA-ETDRS > 0.20 logMAR) or normal VA (n = 12, VA-ETDRS ≤ 0.20 logMAR) completed monocular VA-OKN measurements in each eye. The VA-OKN stimulus was an array of drifting (5°/s) vanishing discs presented in descending/ascending size order (0.00-1.00 logMAR in 0.10 steps). The stimulus was stepped every 2 s, and 10 sweeps were shown per eye (five ascending and five descending). Eye-tracking data determined when OKN activity ceased (descending sweep) or began (ascending sweep), which was used to determine VA-OKN for each sweep. The estimates were averaged across sweeps to produce an automated VA-OKN. The automated sweeps were then provided in randomised order to a reviewer blinded to the VA-ETDRS findings who determined a final VA-OKN for an eye. A single randomly selected eye from each observer was used for analysis. The sensitivity and specificity of VA-OKN using the same 0.20 logMAR threshold as VA-ETDRS was 100%. Comparisons between the VA-OKN and VA-ETDRS measures were made for participants in the reduced VA group. There was no significant difference between VA-OKN and VA-ETDRS (p = 0.55) and the two measures produced comparable values (r2 = 0.84, 95% limits of agreement = 0.19 logMAR, intra-class correlation coefficient = 0.90 [95% CI:0.68-0.97]). Visual acuity using optokinetic nystagmus correctly identified a VA deficit in adults and for those with a VA deficit, VA-OKN was strongly correlated with the gold-standard clinical measure of VA. OKN is a promising method which has the potential for use in cognitively impaired adults and pre-verbal children.

Diurnal changes of corneal epithelial and stromal thickness maps and visual quality in mild form of Fuchs' endothelial corneal dystrophy.

To investigate the functional and structural daily variations in eyes with a mild form of Fuchs' endothelial corneal dystrophy (FECD). This prospective study included 30 eyes with the mild form of FECD. Subjects underwent functional and structural testing at 8 AM, 2 PM, and 8 PM. Testing included measurement of uncorrected distance visual acuity (UDVA), best corrected twilight vision (TV), and contrast sensitivity function (CSF) testing (Vista Vision Far-Pola, DMD MedTech charts). Corneal epithelial and stromal parameters were evaluated with anterior segment optical coherence tomography (AngioVue, AvantiRTVue-XR; Optovue, CA, USA). UDVA, TV, and CSF for spatial frequencies B, C, and F showed significant changes during the day, with the lowest values in the morning (P < 0.0001 for UDVA, P = 0.0109 for TV, and P < 0.0001, P = 0.0126, and P = 0.0471 for the three spatial frequencies, respectively). There was no significant change in epithelial parameters between visits. Central corneal thickness showed significant decrease during the day (P < 0.0001), as did the central stromal thickness on the 5- and 7-mm maps (P = 0.0002 and P < 0.0001, respectively), stromal thickness in the superior section of the 5-mm map (P = 0.0107), stromal thickness in the inferior section of the 7-mm map (P = 0.0002), and minimal stromal thickness on both maps (P < 0.0001). A significant negative correlation was found between central stromal thickness and TV, implying that simultaneous evaluation of corneal layers and visual quality may be useful in assessing FECD.

SING IMT removal for unsatisfied patients: step-by-step surgery for a safe explant.

To report three cases of Smaller-Incision New-Generation Implantable Miniature Telescope (SING-IMG) explantation and three-piece acrylic intraocular lens (IOL) implantation in patients affected by late-stage dry AMD. This is a single-center cohort study. Three patients with stable dry AMD previously implanted with SING-IMT failed to adapt to the device requesting its explantation. Surgical procedures were performed under peribulbar anesthesia, with careful removal of the SING-IMT telescope through a sclero-corneal tunnel of 8 mm and implantation of a three-piece acrylic IOL. Patients underwent pre and postoperative assessments, including visual acuity measurements, endothelial cell count and intraocular pressure. Patients were followed postoperatively for at least 6 months, with particular attention to IOL stability and posterior capsule integrity. Postoperative assessments demonstrated positive outcomes, revealing no IOL dislocation or posterior capsular opacification after 6 months. Endothelial cell count diminished. Best-corrected visual acuity (BCVA) returned to values before SING-IMT implantation. In our small cohort, SING-IMT explantation appeared to be a safe option. Despite promising visual outcomes, some patients might not adapt to SING-IMT. Further studies are needed to evaluate criteria to predict telescope adaptation.

Are Peripapillary Hyperreflective Ovoid Mass-like Structures with an Elevated Optic Disc Still a Diagnosis Dilemma?

ObjectiveTo identify clinical characteristics that would help make or rule out the diagnosis of Idiopathic intracranial hypertension (IIH) in patients referred for papilledema (PE) with peripapillary hyperreflective ovoid mass-like structures (PHOMS) DesignA retrospective cohort study SubjectsAll patient referred for PE excluding PE with Frisén grade ≥ 3, optic neuritis, ischemic optic neuropathy, compressive optic neuropathy. Patients were divided into 2 groups:Group1= isolated PHOMSGroup2= PHOMS associated with IIH MethodsWe analyzed the location of PHOMS based on OCT-EDI and calculated their volume Main outcome MeasuresP RNFL,GCC, PHOMS’ volume Results154 patients (308 eyes) were included, mean age was 29 with female predominance (78%). PHOMS were associated to these etiologies : IIH(38.3%) isolated (35.7%), posterior uveitis (11%),optic disc drusen (ODD)(10%), and tilted optic disc (5%). An MRI was obtained in 83.1% of cases. More than half of the MRIs were interpreted as consistent with IIH. However, only 39.7% of these patients had confirmed IIH with 44.5% of sensitivity and 55.5% of sensibility. PHOMS were overrepresented in the nasal region (95.5%).The location of PHOMS in the superior and/ or inferior quadrant was significantly associated to IIH or optic dusc drusen, while their presence in the temporal or nasal sector was strongly associated to isolated lesions. PHOMS mean and median volume were 1.66 μm3 and 1.50 μm3 respectively. There was a significant difference in PHOMS volume with higher volume in IIH patients (p=0.0037). Follow up of these patients at 3 and 6 months demonstrated no significant changes in visual function, as per visual field mean deviation, and visual acuity measurements as well as Ganglion cell layer (GCL).Mean pRNFL, showed a decrease of -4.225 μm at 3 months and of –6.489 μm at 6 months, when compared to initial measurement independing of the etiology. ConclusionIsolated PHOMS should be considered as a distinct entity. In asymptomatic patients, PHOMS should be carefully studied. Nasal or temporal location, small volume, stable aspect over the course of weeks or months, are so suggestive of this entity. This strategy would considerably reduce the impact on patients’ anxiety and morbidity.

Diagnostic Performance of the Offline Medios Artificial Intelligence for Glaucoma Detection in a Rural Tele-Ophthalmology Setting

PurposeThis study assesses the diagnostic efficacy of offline Medios Artificial Intelligence (AI) glaucoma software in a primary eyecare setting, using non-mydriatic fundus images from Remidio's Fundus-on-Phone (FOP NM-10). AI results were compared with tele-ophthalmologists' diagnoses and with a glaucoma specialist's assessment for those participants referred to tertiary eyecare hospital. DesignProspective, cross-sectional study Participants303 participants from 6 satellite vision centers of a tertiary eye hospital MethodsAt the vision center, participants underwent comprehensive eye evaluations, including clinical history, visual acuity measurement, slit lamp examination, intraocular pressure measurement, and fundus photography using the FOP NM-10 camera. Medios AI-Glaucoma software analysed 42-degrees disc-centric fundus images, categorizing them as normal, glaucoma, or suspect. Tele-ophthalmologists who were glaucoma fellows with a minimum of 3 years of ophthalmology and 1 year of glaucoma fellowship training, masked to AI results, remotely diagnosed subjects based on the history and disc appearance. All participants labelled as disc suspects or glaucoma by AI or tele-ophthalmologists underwent further comprehensive glaucoma evaluation at the base hospital, including clinical examination, Humphrey visual field analysis (HFA), and Optical Coherence Tomography (OCT). AI and tele-ophthalmologist diagnoses were then compared with a glaucoma specialist's diagnosis. Main Outcome MeasuresSensitivity and Specificity of Medios AI ResultsOut of 303 participants, 299 with at least one eye of sufficient image quality were included in the study. The remaining 4 participants did not have sufficient image quality in both eyes. Medios AI identified 39 participants (13%) with referable glaucoma. The AI exhibited a sensitivity of 0.91 (95% CI: 0.71 - 0.99) and specificity of 0.93 (95% CI: 0.89 - 0.96) in detecting referable glaucoma (definite perimetric glaucoma) when compared to tele-ophthalmologist. The agreement between AI and the glaucoma specialist was 80.3%, surpassing the 55.3.% agreement between the tele-ophthalmologist and the glaucoma specialist amongst those participants who were referred to the base hospital. Both AI and the tele-ophthalmologist relied on fundus photos for diagnoses, while the glaucoma specialist's assessments at the base hospital were aided by additional tools such as HFA and OCT. Furthermore, AI had fewer false positive referrals (2 out of 10) compared to the tele-ophthalmologist (9 out of 10). ConclusionMedios offline AI exhibited promising sensitivity and specificity in detecting referable glaucoma from remote vision centers in southern India when compared with teleophthalmologists. It also demonstrated better agreement with glaucoma specialist’s diagnosis for referable glaucoma participants.

The mediational role of hearing acuity in the association between personality and memory: Evidence from the health and retirement study and the English Longitudinal Study of Ageing

ObjectivesPersonality traits (i.e., the enduring patterns of thoughts, feelings, and behaviors) are associated with cognition across adulthood. There is interest in identifying potential mechanisms to explain this association, but none has focused on sensory function. Therefore, the present study examined whether an objective measure of hearing acuity mediates the association between personality and memory. MethodsParticipants were from the Health and Retirement Study (HRS, N = 5497, 60 % women, Mean age = 65.66, SD = 9.00) and the English Longitudinal Study of Ageing (ELSA, N = 4706, 57 % women, Mean age = 64.47, SD = 7.59). In the HRS, participants had data on personality and demographic variables in 2012/2014, hearing acuity in 2016/2018, and memory in 2020. In ELSA, participants had data on personality and demographic variables measured in 2010/2011, hearing acuity in 2014/2015, and memory in 2018/2019. ResultsIn both HRS and ELSA, higher hearing acuity partially mediated the association between lower neuroticism (4 % and 5 % proportion effect mediated), higher conscientiousness (6 % and 15 %) and higher openness (3 % and 7 %) and better memory performances at follow-up. ConclusionsThe present study provides novel evidence that hearing acuity mediates the association between personality and cognition.