Mesopic Conditions Research Articles

Visual performance of four types of diffractive multifocal intraocular lenses and a review of articles.

To compare the clinical outcomes of a variety of multifocal intraocular lenses (MIOLs) in patients diagnosed with presbyopia or cataracts. This clinical trial study included 141 patients (282 eyes) with different MIOLs implantation. The Symfony (60 eyes), the ReSTOR (100 eyes), the AT LISAtri (60 eyes), and the PanOptix (62 eyes) intraocular lenses were evaluated in this prospective interventional study. The near, intermediate, and distant visual acuities, contrast sensitivity, and defocus curve were measured as valid criteria. To statistically analyze the results, we used the Statistical Package for Social Science software, the non-parametric Wilcoxon signed-rank t, the one-way analysis of variance and the Tukey's post-hoc test in our analysis. Moreover, we conducted a detailed literature search on the PubMed database in English about MIOLs, in total 59 studies were included in this review article. The four approaches did not show any significant difference in the best-corrected distance visual acuity (P>0.05). The defocus curves at the contrast of 100% showed that trifocal IOLs had better intermediate performance than the bifocal IOL (P<0.05). There were no statistically significant differences between AT LISAtri and PanOptix lenses for visual acuity at all distances. The eyes with PanOptix, Symfony, and AT LISAtri IOL showed better contrast sensitivity than those ReSTOR at spatial frequencies of 1, 3, and 6 cpd in photopic and mesopic conditions (P<0.001). All four groups of the multifocal lenses were satisfying in terms of distance and near vision. Also, the group of trifocal lenses led to satisfactory outcomes in intermediate vision, without degradation in quality of vision.

Is soft toric contact lenses fitting a feasible option to improve optical quality and visual performance in corneal ectasia?

ObjectivesTo assess the feasibility of fitting soft toric contact lenses (STCL) in corneal ectasias and their impact on optical quality and visual performance. MethodsA total of 22 eyes were fitted with a molded STCL: 11 eyes/9 subjects with corneal ectasia and 11 healthy eyes/11 subjects. Wavefront aberrations were analyzed using a Hartmann-Shack aberrometer. Visual performance was measured under photopic (85 cd/m 2) and mesopic (≤3 cd/m 2) conditions. High-(96 %) and low- (10 %) contrast VA (HCVA and LCVA respectively) were assessed using the ETDRS charts and contrast sensitivity (CS) using the Pelli-Robson chart. ResultsAfter STCL fitting in the ectatic corneas, oblique astigmatism increased 0.15±0.17 μm and 0.34 ± 0.36 μm for 3 mm- and mesopic pupil diameters, respectively.Mean defocus decreased 1.41 ± 0.36 μm and 2.17 ± 0.85 μm for the same pupil diameters. More positive values of vertical coma were found with a change of 0.05 ± 0.06 μm and 0.12 ± 0.10 μm for 3 mm and mesopic pupil diameters, respectively. Comparing changes between both groups, with a 3 mm pupil aperture, statistically significant differences (p < 0.05) were detected in oblique astigmatism, defocus, vertical secondary trefoil and horizontal secondary coma. In the group with corneal ectasia, photopic HCVA and LCVA improved 0.09 ± 0.11 logMAR and 0.12 ± 0.15 logMAR respectively. In mesopic conditions, HCVA, LCVA and CS improved 0.11 ± 0.12 logMAR, 0.18 ± 0.15 logMAR and 0.11 ± 0.07 log. units, respectively. ConclusionsThe analyzed molded soft toric contact lens is a feasible option for good vision in corneal ectasia with moderate irregularity and negative vertical coma.

Long-Term Visual Function Effects of Pan-Retinal Photocoagulation in Diabetic Retinopathy and Its Impact in Real Life.

PurposeTo address the long-term visual function after bilateral pan-retinal photocoagulation (PRP) and its impact in real life, namely on visual field (VF) legal criteria to drive. To determine potential predictors related to clinical factors and treatment strategies.Patients and MethodsObservational cross-sectional study. Eyes from diabetic patients diagnosed with diabetic retinopathy who underwent bilateral PRP, with or without macular treatments and with visual acuity legal criteria for non-professional driving were randomly assigned. Main outcomes were: demographic and clinical data including best corrected visual acuity; binocular visual field (EBST-Esterman Binocular Suprathreshold Test, Humphrey analyzer3®); contrast sensitivity (CS-Metrovision-MonPack3®); light scattering in the retina (HD Analyzer, Visiometrics®).ResultsSeventy-one diabetic patients included (44 men and 27 women), with a mean age of 62.2±11.8 years. PRP was performed, on average, 9.7±6.9 years before the study. The average EBST Score was 85.8±17.0 and the average CS (2–5cpd) was 19.5±2.9 dB in photopic and 14.2±4.1 dB in mesopic conditions. Through a multivariate regression model, after adjusting to the clinical and demographic factors as possible confounders, we found that treatment factors associated with worse results were the use of Argon laser for the EBST Score, the very confluent PRP for the number of non-viewed points in the central 30°x20° of the EBST and the presence of macular treatments for the CS tests. According to Portuguese law, 79% (n=56) of patients had minimal EBST amplitudes for non-professional driving.ConclusionThe functional results achieved in our sample are compatible with an active life, allowing most of the patients included to overcome the requirements of Portuguese legislation for driving light vehicles, namely at the level of the binocular visual field. These results highlight the role of PRP in the treatment of diabetic retinopathy in an era with evolving less aggressive laser options.

Visual Performance of Center-distance Multifocal Contact Lenses Fit Using a Myopia Control Paradigm.

The purpose of this study was to examine the visual performance of center-distance MFCLs in nonpresbyopic adults under different illumination and contrast conditions compared with a single-vision contact lens (SVCL). Twenty-five adult subjects were fit with three different lenses (CooperVision Biofinity D MFCL +2.50 add, Visioneering Technologies NaturalVue MFCL, CooperVision Biofinity sphere). Acuity and reading performance were evaluated. A statistically significant difference in high-contrast distance acuity was observed (Biofinity, -0.18 ± 0.06; Biofinity MFCL, -0.14 ± 0.08; NaturalVue MFCL, -0.15 ± 0.03; repeated-measures [RM] ANOVA, P = .02). Under mesopic, high-contrast conditions, MFCLs performed worse than SVCLs (Biofinity, -0.05 ± 0.091; Biofinity MFCL, +0.03 ± 0.09; NaturalVue MFCL, +0.05 ± 0.091; RM-ANOVA, P < .0001). Under low-contrast conditions, MFCLs performed one line worse in photopic lighting and two lines worse under mesopic conditions (RM-ANOVA, P < .0001). Glare reduced acuity by 0.5 logMAR for all lenses (RM-ANOVA, P < .001). A statistically significant difference in near acuity was observed (RM-ANOVA, P = .02), but all lenses achieved acuity better than -0.1 logMAR (Biofinity, -0.16 ± 0.06; Biofinity MFCL, -0.17 ± 0.04; NaturalVue MFCL, -0.13 ± 0.08). Reading performance in words per minute (wpm) was worse with MFCLs (Biofinity MFCL, 144 ± 22 wpm; NaturalVue MFCL, 150 ± 28 wpm) than with SVCLs (156 ± 23 wpm; RM-ANOVA, P = .02) regardless of letter size (RM-ANOVA, P = .13). No difference in acuity between the MFCLs was detected (RM-ANOVA: all, P > .05). Multifocal contact lenses perform similarly to SVCLs for high-contrast targets and display reduced low-contrast acuity and reading speed. Practitioners should recognize that high-contrast acuity alone does not describe MFCL visual performance.

Effect of the EVO+ Visian Phakic Implantable Collamer Lens on Visual Performance and Quality of Vision and Life

To assess the effect of EVO+ (V5) Visian implantable collamer lens implantation on mesopic visual performance, quality of vision (QoV), and quality of life (QoL). Prospective interventional case series. Thirty-six eyes of 36 participants who underwent EVO+ implantation for myopia were evaluated preoperatively and at postoperative visits at 1 week and 1, 3, and 6 months. Visual acuity (VA) and mesopic contrast sensitivity (CS) with and without halogen- and xenon-type glare sources were evaluated at each visit. Subjective QoV was assessed with the QoV questionnaire and QoL assessed with the Quality of Life Impact of Refractive Correction (QIRC) questionnaire at each visit. Ring-shaped dysphotopsia was also assessed at each postoperative visit. Linear, cumulative link and logit mixed models were fitted to analyze the effect of the EVO+. Following EVO+ implantation, VA significantly (P ≤ .012) improved at the 4 postoperative visits. Mesopic CS progressively improved at 1, 3, and 6 months postoperatively (P ≤ .012). Halogen glare CS decreased at 1 week and halogen and xenon glare CS improved at 6 months (P ≤ .016). Photostress recovery time after halogen glare improved at 3 and 6 months (P ≤ .004). QoV scores improved at 1 week and 3 and 6 months (P ≤ .001). QIRC scores improved postoperatively (P < .001). Ring-shaped dysphotopsia decreased at 3 and 6 months (P ≤ .007). EVO+ implantation provides good mesopic visual performance, QoV, and QoL during up to 6 months follow-up. Some activities performed under mesopic conditions with glare sources may be affected during the first postoperative week. Ring-shaped dysphotopsia is negligibly bothersome 6 months after surgery.

Altered visual processing in the mdx52 mouse model of Duchenne muscular dystrophy

The mdx52 mouse model of Duchenne muscular dystrophy (DMD) is lacking exon 52 of the DMD gene that is located in a hotspot mutation region causing cognitive deficits and retinal anomalies in DMD patients. This deletion leads to the loss of the dystrophin proteins, Dp427, Dp260 and Dp140, while Dp71 is preserved. The flash electroretinogram (ERG) in mdx52 mice was previously characterized by delayed dark-adapted b-waves. A detailed description of functional ERG changes and visual performances in mdx52 mice is, however, lacking. Here an extensive full-field ERG repertoire was applied in mdx52 mice and WT littermates to analyze retinal physiology in scotopic, mesopic and photopic conditions in response to flash, sawtooth and/or sinusoidal stimuli. Behavioral contrast sensitivity was assessed using quantitative optomotor response (OMR) to sinusoidally modulated luminance gratings at 100% or 50% contrast. The mdx52 mice exhibited reduced amplitudes and delayed implicit times in dark-adapted ERG flash responses, particularly in their b-wave and oscillatory potentials, and diminished amplitudes of light-adapted flash ERGs. ERG responses to sawtooth stimuli were also diminished and delayed for both mesopic and photopic conditions in mdx52 mice and the first harmonic amplitudes to photopic sine-wave stimuli were smaller at all temporal frequencies. OMR indices were comparable between genotypes at 100% contrast but significantly reduced in mdx52 mice at 50% contrast. The complex ERG alterations and disturbed contrast vision in mdx52 mice include features observed in DMD patients and suggest altered photoreceptor-to-bipolar cell transmission possibly affecting contrast sensitivity. The mdx52 mouse is a relevant model to appraise the roles of retinal dystrophins and for preclinical studies related to DMD.

Pupil size differences between female and male patients after cataract surgery

PurposeTo evaluate the changes in pupil diameter in women and men after cataract surgery. The correlation of pupillary changes with the variables age and anterior chamber depth will be analyzed. MethodsThe values of 109 randomized eyes who underwent cataract surgery were obtained and divided into two groups, 71 women and 38 men. Pupil diameter was measured preoperatively and 3-months postoperatively using the pupillometer software of the Topolyzer Vario (Wavelight Laser Technologie AG). Anterior chamber depth was obtained with Pentacam® (Oculus). Differences in pupillary diameters were investigated and correlations with age and anterior chamber depth were analyzed. ResultsFor mesopic pupils, the male group had greater reduction in their postoperative pupillary diameter, −0.56 mm (−12.4%), than the female group, −0.38 mm (−8.2%), P = 0.025. Photopic postoperative pupils reduced to a lesser extent, yet more in men than in women (−0.11mm [−4.5%] vs. −0.04 [−1.6%], P = 0.048). Weak significant negative correlation was found between photopic pupillary changes in women with age (r = −0.24, P = 0.041), and positive correlation for mesopic pupillary changes in men with age (r = +0.34, P = 0.039). ConclusionsPatients experience pupil reduction after cataract surgery in general, but more in men than in women and for both photopic and mesopic lighting conditions. The differences are statistically significant and have moderate clinical relevance. Concerning pupillary changes, weak but opposite sign correlations were found between male/female gender and age.Trial registration number at ClinicalTrials.gov Identifier: NCT04286646.

Phentolamine Mesylate Ophthalmic Solution Provides Lasting Pupil Modulation and Improves Near Visual Acuity in Presbyopic Glaucoma Patients in a Randomized Phase 2b Clinical Trial.

PurposePhentolamine mesylate ophthalmic solution (PMOS), applied to the eye topically, was shown previously to have beneficial effects in patients with dim light vision disturbances (DLD), including decreased pupil diameter (PD), improved best-corrected distance visual acuity (BCDVA), as well as lower intraocular pressure (IOP). The ORION-1 trial evaluated the long-term safety and efficacy of PMOS in a glaucomatous, presbyopic population.Patients and MethodsIn this randomized, double-masked, multi-center, placebo-controlled, multiple-dose Phase 2b trial, 39 patients with elevated IOP were randomized to receive one evening dose of study medication or placebo for 14 days. The primary outcome measure was mean change in diurnal IOP, and the key secondary outcome measures included changes in PD, distance-corrected near visual acuity (DCNVA), and conjunctival hyperemia.ResultsUse of 1% PMOS did not lead to a statistically significant decrease in diurnal IOP compared to placebo (P = 0.89) but trended toward a greater decrease in patients with lower IOP baselines. PMOS produced a statistically significant mean 20% PD reduction under both photopic and mesopic conditions that was sustained for 36 hours post-dosing. A statistically significant number of patients with PMOS compared to placebo demonstrated ≥1 line of improvement in photopic DCNVA at day 8 (P = 0.0018), day 15 (P = 0.0072), and day 16 (P = 0.0163), with a trend for 2- and 3-line improvements at all time points. There was no statistical difference in conjunctival hyperemia compared to placebo.ConclusionAlthough mean IOP was not lowered significantly, daily evening dosing of 1% PMOS was found to be well tolerated with no daytime conjunctival redness and demonstrated improvement in DCNVA with sustained PD reduction in a glaucomatous and presbyopic population. Smaller pupil size can have beneficial effects in improving symptoms of presbyopia and DLD, which will be the focus of further studies.

Use of automated quantitative pupillometric evaluation for monitoring the severity of diabetic retinopathy.

We aimed to evaluate the use of automated quantitative static and dynamic pupillometry in screening patients with type 2 diabetes mellitus and different stages of diabetic retinopathy. 155 patients with type 2 diabetes mellitus (diabetes mellitus group) were included in this study and another 145 age- and sex-matched healthy individuals to serve as the control group. The diabetes mellitus group was divided into three subgroups: diabetes mellitus without diabetic retinopathy (No-diabetic retinopathy), nonproliferative diabetic retinopathy, and proliferative diabetic retinopathy. Static and dynamic pupillometry were performed using a rotating Scheimpflug camera with a topography-based system. In terms of pupil diameter in both static and dynamic pupillometry (p<0.05), statistically significant differences were observed between the diabetes mellitus and control groups and also between the subgroups No-diabetic retinopathy, nonproliferative diabetic retinopathy, and proliferative diabetic retinopathy subgroups. But it was noted that No-diabetic retinopathy and nonproliferative diabetic retinopathy groups have showed similarities in the findings derived from static pupillometry under mesopic and photopic conditions. The two groups also appeared similar at all points during the dynamic pupillometry (p>0.05). However, it could be concluded that the proliferative diabetic retinopathy group was significantly different from the rest of the subgroups, No-diabetic retinopathy and nonproliferative diabetic retinopathy groups, in terms of all the static pupillometry measurements (p<0.05). The average speed of dilation was also significantly different between the diabetes mellitus and control groups and among the diabetes mellitus subgroups (p<0.001). While weak to moderate significant correlations were found between all pupil diameters in static and dynamic pupillometry with the duration of diabetes mellitus (p<0.05 for all), the HbA1c values showed no statistically significant correlations with any of the investigated static and dynamic pupil diameters (p>0.05 for all). This study revealed that the measurements derived from automated pupillometry are altered in patients with type 2 diabetes mellitus. The presence of nonproliferative diabetic retinopathy does not have a negative effect on pupillometry findings, but with proliferative diabetic retinopathy, significant alterations were observed. These results suggest that using automated quantitative pupillometry may be useful in verifying the severity of diabetic retinopathy.

Screening of pediatric eye disease at home by using camera of mobile phone

The simplest method of screening eye pathology in infant is red reflex examination. Present, absence or change of red reflex is key point in early detection of eye pathology. Objective – establish possibility using of mobile phone camera for eye pathology screening at home.Materials and methods. 750 children were included in research. Patient parents allowed photo their child before ophthalmology exam. First step was taking photo on parent’s mobile telephone in playing room from different distance and lighting. Second step was photo in exam room in mesopic condition in 1, 2 and 4 m distance with using maximum zoom and then ophthalmologic exam. After that, all photos was analysed by next signs: present or absence of red reflex, intensive of red reflex, present or absence pathology shadow, in case of red reflex changing, distance where changing is best viewed, comparison photo with result of ophthalmology exam. Results. After analysing photos all children was divided in three groups depending on red reflex chan-ging. In the first group red reflex was even without additional shadow, same in both eye. In this group after ophthalmology exam ametropy low level and eyelid pathology was diagnosed. In the second group red reflex was irregular by colour with additional light shadow or different intensity of red reflex in both eye. Ametropy high level was diagnosed in this group. In the third group we observed absence or colour change of red reflex. Cataract, congenital glaucoma, retinoblastoma, retinal and choroidal coloboma, Coats retinitis was diagnosed. Changing of red reflex possible to find on all photos from different distance, but the most informative was photo that was done from 1 m in mesopic condition. Conclusion. By equability and colour changing of red reflex on photo, all children may divided in three groups: 1 – children require only prophylactic ophthalmology exam, 2 – children require additional ophthalmology exam, 3 – children require immediate ophthalmology exam.

Pinhole Pupilloplasty for Higher Order Aberrations: Assessment of Visual Quality and Depth of Focus

To evaluate visual quality and depth of focus under photopic and mesopic light conditions of patients treated with pinhole pupilloplasty (PPP) for corneal higher order aberrations. This was a prospective, noncomparative, interventional series and PPP was performed with a single-pass four-throw procedure in 14 eyes of 14 patients. After PPP, patients were analyzed with the Clinical Trial Suite machine (M & S Technologies, Inc) that offers a standardized method of recording visual quality. The luminance levels of 85 and 3 cd/m2 were set for photopic and mesopic lighting conditions, respectively, and uncorrected and corrected distance visual acuity were recorded for distance (4 m), intermediate (66 cm), and near (44 cm). Low contrast acuity (LCA) at 10% and mesopic contrast sensitivity function (CSF) with glare on and off at four spatial frequencies of 1.5, 3, 6, and 12 cycles per degree (cpd) and defocus curve were assessed. Under photopic and mesopic conditions, a significant difference was observed postoperatively in uncorrected and corrected distance visual acuity for distance, intermediate, and near. The defocus curve demonstrated extended depth of focus that ranged from +1.50 to -2.50 diopters and LCA at 10% demonstrated significant improvement for all cases. For mesopic CSF, a significant improvement was noted at spatial frequencies of 3 and 6 cpd with glare on. With glare off, an improvement was seen at spatial frequencies of 1.5, 3, and 6 cpd, but not at 12 cpd. Early results demonstrate that PPP provides improved visual quality and extended depth of focus and can be a useful option in cases with higher order aberrations. [J Refract Surg. 2020;36(12):812-819.].

Comparison of Post-Cataract Surgery Visual Outcomes and Quality of Life in Patients Bilaterally Implanted with Multifocal Intraocular Lenses.

IntroductionThe present study compared visual outcomes in eyes with bilateral implantation of two multifocal intraocular lenses (MFIOLs)—the Eyecryl™ ACTV diffractive multifocal IOL (group 1) and AcrySof® IQ ReSTOR® multifocal IOL (group 2).MethodsThis was a prospective, two-group observational longitudinal study of 118 eyes from 59 patients conducted at Laxmi Eye Institute, Panvel, India. We evaluated the patients at 1, 3, and 6 months. We assessed visual acuity, contrast sensitivity, higher-order aberrations, reading speed, defocus curve, stereopsis, quality of life (QOL), and adverse events in these participants.ResultsThe median (interquartile range) best-corrected distance visual acuity was 0.18 (0, 0.18) in group 1 and 0.18 (0, 0.18) in group 2 at 1, 3, and 6 months; the difference was not statistically significant (p = 0.48). The binocular defocus curve in both groups showed two peaks at 0.0 to −0.5 D and at −2.5 D. The mean (95% confidence interval) critical print size was significantly different between groups 1 and 2 at low illumination (0.918 [0.905, 0.931] vs 1.154 [1.128, 1.180]; p = 0.004). Contrast sensitivity was significantly better in group 1 under mesopic conditions but not under scotopic conditions. Though total QOL did not differ significantly between groups, the psychosocial quality of life was significantly better in group 1. About 23% of patients in group 2 reported unwanted images, compared with 0% in group 1 (p = 0.01).ConclusionWe found that the Eyecryl and AcrySof groups were comparable for best-corrected visual acuity, photopic contrast sensitivity, defocus curve, reading parameters, stereopsis, and quality of vision. However, the Eyecryl group had better mesopic contrast and a lower proportion of unwanted images. Psychosocial quality of life was significantly better in the Eyecryl group; however, satisfaction was similar between groups. The cost of one of the lenses is less than the other. Thus, individuals with limited resources may opt for the Eyecryl™ ACTV, with similar visual outcomes.

Quantitative Assessment of the Pupil: An Underrecognized Yet Important Factor Related to Orbital Blowout Fracture Repair.

To investigate dynamic pupil changes after orbital blowout fracture repair. To compare postoperative changes in under photopic and mesopic pupil size and center position after orbital blowout fracture repair surgery. The study evaluated 19 eyes. Pupils were imaged for pupil size and center position before and 3 months after orbital blowout fracture repair surgery. Pupil size changes were measured, and the correlation between preoperative and postoperative pupil centroid shift was evaluated. After repair, operative eyes exhibited a growth of 9.3% ± 8.6% in pupil size, and contralateral eyes showed a growth of 8.6% ± 8.2% (P = 0.011, P = 0.007). Similar findings were noted in mesopic conditions. Under mesopic conditions, the pupil of operative eyes in medial orbital wall fracture deviated 0.030 ± 0.019 mm towards the nasal side along the X-axis (P = 0.031). The postoperative orbital floor fracture group demonstrated statistical significance at a spatial frequency of 5 (P = 0.041). Orbital blowout fracture repair surgery affects pupil size and center position.

Visual function, ocular surface integrity and symptomatology of a new extended depth-of-focus and a conventional multifocal contact lens

PurposeTo evaluate visual function, ocular surface integrity and dry eye symptoms with an extended depth-of-focus (EDOF) design and a conventional multifocal (MF) contact lens (CL) after 15 days of wear. MethodsA crossover single mask randomised clinical trial was conducted including 30 presbyopes who used an EDOF and a conventional MF CL (Biofinity MF) for 15 days each. Defocus curves, depth-of-focus range, contrast sensitivity (CS) under photopic and mesopic conditions (with and without glare) and subjective perception of halos and glare were evaluated. The ocular surface was evaluated through non-invasive Keratograph tear breakup time (NIKBUT), averaged tear breakup time (NIKBUT-avg), tear meniscus height (TMH), bulbar and limbal redness, and conjunctival and corneal staining. Dry eye symptoms were assessed with the OSDI questionnaire. ResultsNo statistically significant differences were found for defocus curves or depth-of-focus between the two CLs (both p > 0.05). Subjective perception of halos and glare was not significantly different between CLs. Statistically significant differences were observed for CS under mesopic conditions for low spatial frequencies (p = 0.008). None of the CL produced significant changes in NIKBUT, NIKBUT-avg, TMH or redness. No change in conjunctival staining was observed in 76.7 % and 73.3 % of participants for EDOF and Biofinity MF, respectively. No change in corneal staining was observed in 86.7 % and 83.3 % of participants for EDOF and Biofinity MF, respectively. No changes were observed in the symptomatology measured with OSDI questionnaire (p > 0.05). ConclusionsBoth CL for presbyopia offer good visual quality, preserve the ocular surface integrity and provide the patient with similar symptomatology levels after 15 days of lens wear.

Visual performance and patient satisfaction following the implantation of a novel trifocal supplementary intraocular lens.

To evaluate the visual quality, visual performance, and patient satisfaction after the implantation of the last generation supplementary intraocular lens (1stQ AddOn Trifocal) for achieving near vision spectacle-independence in pseudophakic patients who had primary monofocal capsular bag implantation. Patients who underwent monofocal lens surgery in the past year, and who expressed their explicit desire to become spectacle-independent were included in this prospective observational study. Uncorrected and corrected distance, intermediate and near visual acuities (CDVA, UDVA, DCIVA, UIVA, CNVA, and UNVA), refractive outcomes, lens positioning, contrast sensitivity and patient satisfaction were assessed 6 months postoperatively. About 28 eyes of 18 patients were evaluated. No intra- or postoperative complications (iris chafing, iris capture, interlenticular opacification, IOL-dislocation, etc.) could be observed. The postoperative mean UDVA and CDVA were 0.05 ± 0.08 and 0.01 ± 0.03 (logMAR), respectively. The mean UNVA improved from the preoperative 0.50 ± 0.23 to 0.02 ± 0.05 (logMAR), postoperatively (p = 0.0104). The postoperative mean UIVA and DCIVA were 0.06 ± 0.020 and 0.01 ± 0.00 (logMAR), respectively. Twenty-five eyes (89%) had a residual spherical equivalent within 1.0 D from the target refraction, emmetropia. Contrast sensitivity measured in photopic and mesopic conditions were statistically indifferent from the preoperative curves. All patients had better visual function and quality scores compared to the preoperative responses. The highest improvement could be achieved in near vision activities, dependency, and limitation of social functioning. The 1stQ AddOn Trifocal lens represents a safe and effective option for pseudophakic patients aiming for high quality, spectacle-free vision.

Association between central retinal thickness and low luminance visual acuity in early age-related macular degeneration.

To examine whether central retinal thickness (CRT) is related to mesopic visual acuity (VA) and low luminance deficit (LLD, difference between photopic and mesopic VA) in eyes with early and intermediate age-related macular degeneration (AMD). In a cross-sectional study, 50 pseudophakic subjects older than 63 years were divided into three groups (no AMD, early AMD and intermediate AMD). Spectral domain optical coherence tomography (SD-OCT) was used to measure CRT in the 1 mm-central-area. Best-corrected distance VA was measured under photopic or mesopic luminance conditions and LLD calculated. Subjects were stratified by VA impairment to compare CRTs across these groups. Relationships were examined by stepwise multiple linear regression. No significant differences in mean CRT, photopic and mesopic VA or LLD were detected between the groups no AMD, early AMD and intermediate AMD. However, mean CRTs were 20 microns and 18 microns thicker in the eyes with impaired mesopic VA (> 0.3 logMAR) and impaired LLD (⩾ 0.3 logMAR) compared to the eyes with non-impaired VA or LLD respectively (both p < 0.01). CRT and mesopic pupil size were independent predictors of mesopic VA (p = 0.001). CRT emerged as the only independent predictor of LLD (p = 0.004). Increased CRT was linked to worse retinal function when measured under mesopic conditions in eyes without AMD and eyes with early to intermediate AMD. SD-OCT imaging combined with VA measurements under low luminance conditions could be a useful tool to detect early AMD.

The Effect of Blue-blocking Lenses on Photostress Recovery Times.

The selective reduction in visible wavelengths transmitted through commercially available blue-blocking lenses (BBLs) is known to influence the appearance and contrast detection of objects, particularly at low light levels. This influence may impair the human retinal receptor response time to dynamic light changes during photostress events. This study aimed to assess whether BBLs selectively affect photostress recovery times (PSRTs) for chromatic and achromatic stimuli of different Weber contrasts that were viewed on a dark black background. Photostress recovery times were measured in 12 younger participants (18 to 39 years old) with no history of ocular disease or abnormal vision. Photostress recovery times were evaluated for four brands of BBLs, which were compared with a control lens. In these experiments, after exposure to an intense light source for 5 seconds, the time taken to recover vision and correctly identify a computer-generated letter stimulus viewed under low and high luminance levels was determined, which means perception is likely to be governed by mesopic and photopic conditions. Across conditions, the letter stimulus was achromatic and chromatic and could differ in luminance contrast. Under photopic stimulus conditions, although reducing luminance contrast increased PSRTs, BBLs had no significant effect on PSRTs relative to control lens. However, under mesopic stimulus conditions, BBLs significantly affect PSRTs for both achromatic (F2.006,8.02 = 61.95, P < .0001) and chromatic stimuli (F3,16 =139.01, P < .0001), particularly for blue targets, which had considerably longer PSRTs (38.40 seconds). The brand of BBL was also shown to selectively affect PSRTs, with those with transmittance profiles that block the most blue light having longer PSRTs. The present study suggests that, although the color and contrast of the target stimuli affected recovery times, the difference in recovery times between different types of BBLs was noticed only under low-light-level stimulus conditions.

Central and peripheral motion perception under mesopic conditions in older adults

Central and peripheral motion perception under mesopic conditions in older adults

Threshold versus intensity functions in two-colour automated perimetry.

Two-colour computerised perimetry is a technique developed for assessing cone- and rod-function at fixed background luminances in retinal disease. However, the state of adaptation during testing is unknown but crucial in the interpretation of results. We therefore aimed to determine the adaptational state of rod- and cone-mechanisms in two-colour perimetry. Sensitivity to 480nm (blue) and 640nm (red) Goldmann size V targets was determined for 10 normal subjects aged 16 to 46years at 17 locations in the central 60 degrees of the visual field under scotopic conditions and then from -1.5 log cd m-2 to 2 log cd m-2 (white background) in 0.5 log unit steps. Data were fitted with threshold versus intensity (tvi) functions of the form logT=logT0 + log ((A+A0 )/A0 )n . No clear rod-cone break was observed for 640nm stimuli. For 480nm stimuli, transition from rod-detection to cone-detection occurred at mesopic illumination levels, where rod adaptation approached Weber behaviour. Cone detection mechanisms did not display Weber-like adaptation until the background luminance approached 1 log cd.m-2 . Diseases resulting in a "filter effect" - including disorders of the photoreceptors - are therefore predicted to affect sensitivity when rod function is probed with short-wavelength targets under scotopic conditions, but less so under mesopic conditions. Filter effects are similarly anticipated to affect cone function measured using long-wavelength targets under mesopic conditions (e.g., during microperimetry), but less so under photopic conditions. Asymmetries in adaptation in automated two-colour perimetry are predicted to artefactually favour the detection of losses in rod sensitivity under scotopic conditions and cones under mesopic conditions.

Factors Affecting Contrast Sensitivity in Intermittent Exotropia.

Purpose To determine whether contrast sensitivity (CS) can represent photophobia in intermittent exotropia (IXT) by comparing the CS test with and without glare stimulus, and to analyze the factors of IXT affecting CS.Methods We retrospectively reviewed the medical records of 107 patients with basic-type IXT. We compared CS under mesopic and photopic conditions, with and without glare. We compared the difference in CS before and after glare (ΔCS) between mesopic and photopic conditions, and compared CS with glare between patients with and without photophobia. The correlations between the clinical features of IXT and CS were analyzed.Results There was no significant reduction in CS at all spatial frequencies by glare stimulus. ΔCS was greater at high spatial frequencies under photopic conditions than under mesopic conditions. The group with subjective photophobia showed lower CS at 10.2 cpd under mesopic conditions with glare. CS showed a negative correlation with stereopsis under both mesopic and photopic conditions, and a positive correlation with fusional ability at low and intermediate spatial frequencies under mesopic conditions. ΔCS was smaller at intermediate spatial frequencies with better fusional ability, greater at high spatial frequencies with photophobia, and greater at intermediate spatial frequencies with a higher frequency of exotropia.ConclusionsThe CS test could not represent photophobia in IXT. However, CS tended to decrease with glare stimulus, and CS under mesopic conditions with glare was worse when accompanied by photophobia. Moreover, a poorer degree of stereopsis was associated with lower CS, and better fusional ability was associated with higher CS under mesopic conditions. Therefore, the CS test can be considered helpful in evaluating sensory function in IXT.