Acuity Status Research Articles

A Comparative Study on Visual Health and Physical Activity of Chinese and Japanese Children Aged 6-12 Years.

In this study, we compare the visual acuity levels and physical activity participation of Chinese and Japanese children. We collected data on static visual acuity, kinetic visual acuity, axial length, intensity, frequency, duration, amount, and physical activity items of 431 children aged 6-12 years from Chinese and Japanese schools in the same city. Our analysis examined the relationships involving age, visual function indicators, ocular biometric parameters, and extracurricular physical activity. We found the myopia rate higher in Chinese children than in Japanese children, increasing with age except in grade 4; kinetic visual acuity in Chinese children was lower than in Japanese children (p<.01). The axial length becomes longer with age in both groups, with Chinese children having a longer axial length than Japanese children. The amount of physical activity in Chinese and Japanese children aged 6-12 years fluctuates. The frequency, duration, and physical activity items are lower in Chinese children than Japanese (p<.01). Chinese and Japanese children's overall static visual acuity development level shows a decreasing trend, and Japanese children have better kinetic visual acuity and physical activity participation than Chinese children. Physical activity could have an impact on visual acuity.

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

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. 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 3months postoperatively. 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). 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.

Dynamic Visual Acuity Test To Denote Visuomotor Changes In Adolescents Participating In High Impact Sports

Repetitive head impacts (RHI), independent of concussion, can have a negative influence on the visual system but data are sparse in adolescent contact athletes. PURPOSE: Evaluate the effect of repetitive head impacts influence on adolescent football players oculomotor and vision throughout the mid-point of a single contact season using a dynamic visual acuity (DVA) task. METHODS:4 NIAA Varsity and JV football high school players (all males) with ≤20/20 static visual acuity with or without corrective lenses participated in this study. Student-athletes were evaluated prior (PRE) to the start of the season and in the middle (MID) of the season. The football players all wore instrumented mouthguards to track head impacts during each practice and game. Every participant completed 120 randomized trials of smooth pursuit (SPEM) (30°/s) and saccadic (90°/s) eye movements at (PRE) and (MID) of the season. All participants eye movements were tracked by (500 Hz; Eyelink SR research, Ottawa, CN) while their heads were stable in a chin rest 150 cm away from a 26° monitor. Participants were tasked to determine the orientation of Landolt-C’s openings (left, right, up, down) that moved across the monitor (horizontally left to fight) using a keypad. Depending on the correct/incorrect responses during the smooth pursuit and saccadic trials, the size of the C’s would either increase or decrease in size (2-up, 1-down staircase). Between each trial, a retinal flush image was presented for 2 ms before the appearance of a fixation cross. Smoot pursuit eye movement (SPEM) gain, and vision alongside saccadic peak velocity were evaluated at each time point. RESULTS: No significant difference was noted at PRE (1.09 ± 0.04) to MID (1.07 ± 0.08; p = 0.33, Cohen’s d = 0.32) for SPEM gain and for saccadic peak velocity (PRE = 386.70 ± 36.94 m/s, MID = 397.20 ± 2.12 m/s; p = 0.935, Cohen’s d = 0.33). Similarly, no difference was noted for SPEM Vision at PRE (20/32) and MID (20/32; p = 0.71) and for saccades (PRE = 20/40, MID = 20/40; p = 0.935). Participants had ≤20/20 static visual acuity at both time points. CONCLUSIONS: Oculomotor control and vision do not decline in the presence of RHI from the beginning to the middle of a contact football season in adolescents. Additional data are needed given the strength of the effect size.

Profile of Visual Impairment in Older Adult Patients Attending Primary Eye Care Optometry Clinic: A Retrospective Study

With an aging population, prevalence of visual impairment (VI) is expected to increase as well. A retrospective study was conducted involving the files of older adult patients aged 60 years and above from the Primary Eye Care (PEC) Optometry Clinic Universiti Kebangsaan Malaysia (UKM). This study was aimed to determine the prevalence and causes of VI among older adults. This retrospective study was conducted by reviewing files of older adult patients aged 60 years and above who had visited PEC Optometry Clinic UKM from 2009 to 2019. Socio-demographic, health status, status of visual acuity (VA), refractive error, prevalence and causes of VI before and after refractive correction were analysed by using descriptive statistic. Habitual distance VA was measured monocularly using the Snellen chart and recorded in decimal unit. The mean habitual distance VA in the better eye was 0.72+0.31, ranging from 0.41 to 1.03 while the mean VA after subjective refraction in the better eye was 0.88+0.28 which ranging from 0.60 to 1.16. The prevalence of VI based on habitual VA were 16.0%. The main cause of VI based on habitual VA was cataract (53.4%). The refractive status after subjective refraction showed highest percentage of hyperopia (41.9%), followed by emmetropia (32.4%) and myopia (25.7%). The findings of this study emphasise the importance of increased patient education and further expansion of optometric services are required to reduce avoidable blindness.

The incidence of falls after first and second eye cataract surgery: a longitudinal cohort study.

ObjectiveTo compare fall incidence, and visual acuity and refractive status, before surgery and after first and second eye cataract surgery.Design, settingProspective observational study in eight tertiary referral ophthalmology clinics in public hospitals in Sydney, Melbourne, and Perth.ParticipantsPeople aged 65 years or more referred for bilateral age‐related cataract surgery during 2013–16, followed for maximum of 24 months after study entry or until six months after second eye surgery, whichever was shorter.Main outcome measuresPrimary outcome: age‐ and sex‐adjusted incidence of falls. Secondary outcomes: visual acuity and refractive error.ResultsThe mean age of the 409 included participants was 75.4 years (SD, 5.4 years); 220 were women (54%). Age‐ and sex‐adjusted fall incidence prior to surgery was 1.17 (95% CI, 0.95–1.43) per year, 0.81 (95% CI, 0.63–1.04) per year after first eye surgery, and 0.41 (95% CI, 0.29–0.57) per year after second eye surgery. For the 118 participants who underwent second eye surgery and participated in all follow‐up visits, age‐ and sex‐adjusted incidence before (0.80 [95% CI, 0.55–1.15] falls per year) and after first eye surgery (0.81 [95% CI, 0.57–1.15] falls per year) was similar, but was lower after second eye surgery (0.32 [95% CI 0.21–0.50] falls per year). Mean habitual binocular visual acuity (logMAR) was 0.32 (SD, 0.21) before surgery, 0.15 (SD, 0.17) after first eye surgery, and 0.07 (SD, 0.15) after second eye surgery.ConclusionsFirst eye surgery substantially improves vision in older people with cataract, but second eye surgery is required to minimise fall incidence. Timely cataract surgery for both eyes not only optimises vision in older people with cataract, but also reduces their risk of injury from falls.

Relationship between dynamic visual acuity and multiple object tracking performance.

We assessed the association between measures of dynamic visual acuity and a multiple object tracking task in physically active young adults. Ninety-four young adults performed the dynamic visual acuity and multiple object tracking tasks. Dynamic visual acuity was measured for horizontal and random walk motion paths at four target speeds (5, 10, 20, and 30°/s). For the multiple object tracking task, participants had to track three out of eight balls for 10 s, and the object speed was adjusted by a staircase procedure. We found that multiple object tracking performance was associated with better identification of horizontally and randomly moving targets in the dynamic visual acuity test (p < .001, r = -.35 [-.52, -.16]; and p < .001, r = -.52 [-.65, -.35]; respectively). This effect was consistent across all target speeds (all p-values<0.05). However, static visual acuity did not correlate with any measure of dynamic visual acuity or multiple object tracking (p > 0.170 in all cases). This study provides novel insights into the association between the ability to identify horizontally and randomly moving targets and track multiple objects. Future studies are needed to determine the potential utility of dynamic visual acuity for talent identification and predicting sports performance in real-game situations.

Сравнительная оценка результатов комбинированного применения различных методов лечения: кросслинкинга роговицы, имплантации интрастромальных роговичных колец-сегментов и трансэпителиальной топографической фоторефрактивной кератэктомии при лечении кератоконуса

Purpose. Comparative evaluation of the results of combined use of corneal cross-linking (CXL) and implantation of intrastromal corneal ring segments (ICRS) followed by transepithelial topographic photorefractive keratectomy (ТE-topoPRK) in the treatment of keratoconus. Material and methods. The study had been conducted at the National Centre of Ophthalmology named after acad. Zarifa Aliyeva. Within the frames of the first stage of the study during 2016–2019 years: 48 patients (48 eyes) have been operated only with using CXL (first group); 48 patients (48 eyes) – with using only ICRS (second group); and 48 patients (48 eyes) – with using of combination of CXL and ICRS (ICRS first, then CXL after 24 hours) for treatment of keratoconus of II–III stages due to Amsler M. classification. After 8 months, all patients (144 eyes) underwent the second stage of treatment using ТE-topoPRK. Results. Visual acuity and corneal status 8 months later after CXL, ICRS and the combination of CXL with ICRS generally changed significantly, which confirms the achievement of the expected effect. Comparing the studied parameters after the operation in the groups of patients operated on by the CXL, ICRS methods and their combination, a significant difference was revealed only in the value of NCVA (0.22±0.04, 0.46±0.03 и 0.52±0.04; р&lt;0.05). Conclusion. The combined two-stage (with the interval of 8 months) treatment of keratoconus by implantation of intrastromal corneal rings with simultaneous corneal crosslinking followed by topographic photorefractive keratectomy is more effective than the use of these operations without combinations. Key words: crosslinking, corneal segments, keratoconus, topographic photorefractive keratectomy

A retrospective study of the prevalence and management of complications of proliferative diabetic retinopathy and its visual outcome in patients in a tertiary care hospital

To provide the prevalence of complications of proliferative diabetic retinopathy (PDR) in patients visiting the retina clinic in Dr. B. R. Ambedkar Medical College and Hospital and to evaluate their visual acuity (VA) status. A retrospective study in which the chart review was done of the patients diagnosed with PDR, attending the retina clinic in Dr. B.R. Ambedkar Medical College and Hospital. Patients with a diagnosis of type 1 or 2 diabetes with a clinical diagnosis of active PDR in any or both eyes, who had long term follow-up for up to at least 5 years were included. Evaluating the prevalence of the complications of PDR, presenting VA of people with PDR, short-term outcomes at 6 months and 5 years are the main outcomes of the study. The most common complication of PDR was diabetic macular edema (DME). Eyes receiving treatment early in the disease course (i.e. baseline VA 6/18 or better) had significantly better VA outcomes at 5 years versus eyes treated at a later stage (i.e. baseline VA &amp;#60;6/18 - ≥3/60). The treatment of patients with VA &amp;#60;3/60 can also lead to significant improvement in visual outcome. Our results suggest that early diagnosis and treatment of patients with PDR is of utmost importance in preventing severe vision loss due to advanced diabetic eye disease. People with diabetes in India need to be made aware of annual screening and treatment of their eyes to avoid vision impairment and blindness.

The efficacy of exergaming in patients with knee osteoarthritis: A randomized controlled clinical trial.

Exergaming, one of the most recognized virtual rehabilitation tools, has been shown to be useful for promoting physical activity and enhancing postural stability for neurologic conditions. However, studies with exergaming programs for patients with knee osteoarthritis (OA) are limited. We aimed to investigate the effects of exergaming given by visual and auditory stimulated assisted joint training device in addition to the conventional physiotherapy program on pain intensity, range of motion (ROM), functional status, kinesiophobia, proprioceptive acuity, muscle strength, and postural stability in patients with knee OA. Randomized controlled clinical trial. Sixty patients (47 female, 13 male) with knee osteoarhritis aged 40-65years (57.36±7.26) who were at stage of two to three according to the Kellegren Lawrence radiological evaluation were included in the study. The patients were randomly divided into two groups as study group (conventional physiotherapy+exergaming) and control group (conventional physiotherapy). Electrotherapy and exercise program were applied to both of the groups along 5days a week for 6weeks but exergaming only applied to study group. ROM, pain intensity, proprioceptive acuity, kinesiophobia, muscle strength, and postural stability of the patients were evaluated at the beginning and end of the treatment. In the intra-group analyses of all the assessments of the patients, there was a significant difference in the positive direction in both groups, except for the postural stability values. In the intra-group analyses of postural stability, there was a significant increase only in the study group. In comparison between the groups, proprioceptive acuity, ROM, functional status, and postural stability scores were significantly increased in the study group according to the control group; pain and kinesiophobia decreased significantly. In this study, the exergaming accompanied with conventional physiotherapy programs resulted more positive improvements on pain, ROM, postural stability, kinesiophobia, proprioceptive acuity, and functional status in patients with knee OA compared to the conventional physiotherapy program alone.

The incidence of myopia and myopic progression from 2019 to 2020 in school-age children in Zhuozhou

Objective: To analyze the changes in refractive status and prevalence of myopia in 6-to 14-year-old children at 2 time points in Zhuozhou, Hebei Province. Methods: In the current cohort study, the visual acuity and refractive status of primary and secondary school students aged 6 to 14 years were examined from June to August 2019 and reexamined from June to August 2020. A total of 30 412 subjects with examination data were enrolled, including 15 861 males (52.2%) and 14 551 females (47.8%), with an average age of (10.0±2.7) years. The participants underwent autorefraction without cycloplegia and a naked eye visual acuity test with a standard logarithmic visual acuity chart. Myopia was screened by the standard of equivalent spherical refraction less than -0.75 diopter (D). The categorical data were analyzed by the Chi-square or Fisher's exact test. Clopper-Pearson was used to estimate the 95% confidence intervals for the incidence of myopia. Results: After the 1-year interval, the change of equivalent spherical refraction was(-0.67±1.11) D and(-0.76±1.11) D, respectively, in male and female participants, and their visual acuity decreased by 0.11±0.19 and 0.12±0.21, respectively. There were significant inter-group differences in the annual change of spherical power in different age groups (χ²=276.23, P<0.001). The naked eye visual acuity reduction was greatest in the 10-year-old students. The incidence of myopia was 42.2% (95% confidence intervals of 41.47% to 42.93%) during the 1-year follow-up period. The incidence of myopia was highest at the age of 14 (52.0% in males and 54.2% in females) and lowest at the age of 6 (31.0% in males and 33.1% in females). Conclusions: The 1-year follow-up revealed an obvious myopic shift in the refractive status of school students in Zhuozhou, with their naked eye visual acuity decreased. The incidence of myopia was higher in females than that in males.

Outcomes Of IABP Vs Impella As A Bridge To Cardiac Transplantation - Analysis Of National United Network For Organ Sharing Database

<h3>Introduction</h3> Temporary mechanical circulatory support technology has advanced vastly in the last decade. United Network for Organ Sharing (UNOS) heart transplant allocation system was updated in 2018 to accommodate the new Era. Among patients requiring temporary mechanical circulatory support as a bridge to transplantation, device choice relies on patient, practitioner, and institutional factors. To date, there is limited outcome data to contrast the different mechanical circulatory support platforms. <h3>Objective</h3> We aim to compare heart transplant survival in those bridged with intra-aortic balloon pump (IABP) vs Impella mechanical support. <h3>Methods</h3> Using the national UNOS database, we studied heart transplantation recipients listed on the new UNOS allocation system (oct 18^th 2018) and then compared survival of those bridged with IABP vs Impella to transplantation as status 2. The last date of follow up was Sep 4^th 2020. Cohort demographics, serum biochemistry, hemodynamic measurements, and organ support interventions were collected. Wilcoxon-Mann-Whitney test was used for continuous variables, Chi-square test for categorical variables, and Log-rank test for survival analysis. <h3>Results</h3> A total of 1721 patients (1524 IABP, 197 Impella) met our criteria, in whom, there was no difference between IABP vs Impella groups in age, BMI, or waiting list time (Table 1). We found that Impella was used more often in males (74% vs 88%, p <0.01) and Hispanics (9% vs 15% p <0.01). Clinical data are summarized in Table 1. Impella was associated with more mechanical ventilation (4 vs 16%, p <0.01), dialysis (3 vs 10%, p <0.01), and vasoactive medication support (79 vs 89%). Plasma free hemoglobin > 50 mg/dL was noted in 13.3% of the Impella group. Median survival (figure 1) was similar between IABP vs Impella (181 vs 183 days, p=0.92). <h3>Conclusion</h3> There was no observed difference in waiting time nor post-transplant survival between IABP vs Impella groups, however, the latter group was in more critical condition, and from that perspective, Impella seems to be an effective platform to bridge higher acuity status 2 patients.

Barriers for the uptake of cataract surgery: A rural community-based study

Background: Cataract is the leading cause of blindness. Various national programmes have been undertaken to reduce its prevalence. Several barriers in the rural community and individuals exist which decreases the uptake of cataract surgery. Knowledge of factors would help in improving surgical uptake in rural patients and a decrease in blindness rate.Aim: This study aimed to evaluate the factors preventing cataract surgery acceptance in rural patients.Setting: An observational cross-sectional study was conducted between June 2019 to December 2019 in eye screening camps in rural areas of south Karnataka, India.Methods: An observational cross-sectional study was conducted between June 2019 and December 2019. A total of 4114 patients were screened at camps, out of which 500 patients above the age of 50 years, diagnosed with cataracts but had refused cataract surgery earlier, were included. Data were collected on demography, visual acuity, cataract or lens status, source of information on cataract surgery in camps, reasons for refusal of cataract surgery previously. Barriers to cataract surgery uptake (CSU) were classified as attitudinal, social, economical and psychological factors and reasons for uptake of cataract surgery in the current visit were recorded in the form of a questionnaire and analysed.Results: The mean age of the participants was 65.8 years. The male to female ratio was 1.1:1. The prevalence of cataract blindness in our study population was 11.5%, which was significant (p = 0.000). Announcements and pamphlets were the most common source of information on cataract surgery in camps. Significant barriers to CSU were attitudinal factors, mainly the ability to manage daily work (66.4%) with cataract; one eye had an adequate vision (57.4%). The next common barrier was an economic factor as they waited for a camp to avail themselves of free service (61.5%). The least common barriers were female gender (13.2%), fear related to surgery (11.8%), old age (9.6%), God’s will/fate (6.2%), lack of transport (5.4%). The critical factors in CSU in the camps were a provision of free surgery, accessible transport, the camp being conducted closer to their home and motivation by the health workers.Conclusion: Although economic barriers were efficiently taken care of by the government through national programmes, attitudinal barriers seem to be the most important barriers to achieve the goal of reducing blindness because of cataract in rural population.

Binocular Dynamic Visual Acuity in Eyeglass-Corrected Myopic Patients

Current clinical visual assessment mainly focuses on static vision. However, static vision may not sufficiently reflect real-life visual function as moving optotypes are frequently observed daily. Dynamic visual acuity (DVA) might reflect real-life situations better, especially when objects are moving at high speeds. Myopia impacts static uncorrected distance visual acuity, conveniently corrected with eyeglasses. However, due to peripheral defocus and prism effects, eyeglass correction might affect DVA. The present research demonstrates a standard method to examine eyeglass-corrected DVA in myopia patients, and aimed to explore the influence of eyeglass correction on DVA. Initially, standard subjective refraction was performed to provide the eyeglass prescription to correct the refractive error. Then, binocular distance vision-corrected DVA was examined using the object-moving DVA protocol. Software was designed to display the moving optotypes according to the preset velocity and size on a screen. The optotype was the standard logarithmic visual chart letter E and moves from the middle of the left to the right side horizontally during the test. Moving optotypes with randomized opening direction for each size are displayed. The subjects were required to identify the opening direction of the optotype, and the DVA is defined as the minimum optotype that subjects could recognize, calculated according to the algorithm of logarithmic visual acuity. Then, the method was applied in 181 young myopic subjects with eyeglass-corrected-to-normal static visual acuity. Dominant eye, cycloplegic subjective refraction (sphere and cylinder), accommodation function (negative and positive relative accommodation, binocular cross-cylinder), and binocular DVA at 40 and 80 degrees per second (dps) were examined. The results showed that with increasing age, DVA first increased and then decreased. When myopia was fully corrected with eyeglasses, a worse binocular DVA was associated with more significant myopic refractive error. There was no correlation between the dominant eye, accommodation function, and binocular DVA.

Binocular Dynamic Visual Acuity in Eyeglass-corrected Myopic Patients.

Current clinical visual assessment mainly focuses on static vision. However, static vision may not sufficiently reflect real-life visual function as moving optotypes are frequently observed daily. Dynamic visual acuity (DVA) might reflect real-life situations better, especially when objects are moving at high speeds. Myopia impacts static uncorrected distance visual acuity, conveniently corrected with eyeglasses. However, due to peripheral defocus and prism effects, eyeglass correction might affect DVA. The present research demonstrates a standard method to examine eyeglass-corrected DVA in myopia patients, and aimed to explore the influence of eyeglass correction on DVA. Initially, standard subjective refraction was performed to provide the eyeglass prescription to correct the refractive error. Then, binocular distance vision-corrected DVA was examined using the object-moving DVA protocol. Software was designed to display the moving optotypes according to the preset velocity and size on a screen. The optotype was the standard logarithmic visual chart letter E and moves from the middle of the left to the right side horizontally during the test. Moving optotypes with randomized opening direction for each size are displayed. The subjects were required to identify the opening direction of the optotype, and the DVA is defined as the minimum optotype that subjects could recognize, calculated according to the algorithm of logarithmic visual acuity. Then, the method was applied in 181 young myopic subjects with eyeglass-corrected-to-normal static visual acuity. Dominant eye, cycloplegic subjective refraction (sphere and cylinder), accommodation function (negative and positive relative accommodation, binocular cross-cylinder), and binocular DVA at 40 and 80 degrees per second (dps) were examined. The results showed that with increasing age, DVA first increased and then decreased. When myopia was fully corrected with eyeglasses, a worse binocular DVA was associated with more significant myopic refractive error. There was no correlation between the dominant eye, accommodation function, and binocular DVA.

Developing dynamic defocus curve for evaluating dynamic vision accommodative function

BackgroundTo assess dynamic visual acuity (DVA) under different defocus statuses and explore the assessment of dynamic vision accommodation.MethodsTwenty subjects (6 males and 14 females) aged 18 to 35 were recruited. Nonmydriatic subjective refraction (sphere and cylinder) and accommodative tests including negative relative accommodation (NRA), positive relative accommodation (PRA), binocular cross cylinder (BCC) and accommodative facility using a flipper were performed. Binocular static visual acuity (SVA) and DVA at 40 degrees per second (dps) were measured under different defocus statuses (+1.5D to -4D in -0.5D steps) based on the refractive error fully corrected. Static and dynamic defocus curves were plotted. The area under the curve (AUC) and corrected dynamic vision accommodation (CDVAc) were calculated.ResultsThe study showed that the dynamic defocus curve fitted the cubic curve properly (p<0.001). DVA was significantly worse than SVA at all defocused statuses (p<0.001), and the difference was more significant at greater defocus diopters. Single factor analysis indicated that CDVAc was significantly correlated with NRA-PRA (p=0.012) and AUCdynamic (p<0.001). Significant associations were observed between AUCdynamic and PRA (p=0.013) as well as NRA-PRA (p=0.021). Meanwhile, DVA was positively correlated with PRA at 0D, -1.0D, -1.5D, -2.5D and -3.0D (p<0.05) and with NRA-PRA at 0D, -1.0D, -1.5D, -2.0D and -2.5D (p<0.05). Multiple factor regression analysis indicated that CDVAc (0D ~ -3.5D) and SVA (+1.5D ~ +1.0D & -2.5D ~ -4.0D) were significant influential factors for defocused DVA (p<0.05).ConclusionsOur study demonstrated that DVA had a defocus curve similar to that of SVA. CDVAc was feasible for the assessment of dynamic vision accommodative function. The dynamic defocus curve test could efficiently be applied in the evaluation of dynamic visual performance under different defocus statuses.

Anisometropic Amblyopia: Analysis of treatment results with patching of dominant eye and refraction with active visual therapy (AVT) in school age children.

Objectives: To analyse the results of Active Visual Therapy with patching and refraction in anisometropic amblyopia in school age children from age 7-15 years. Study Design: Analytical study. Setting: Department of Ophthalmology, DHQ KDA Teaching Hospital Kohat. Period: January 2016 to December 2018. Material &amp; Methods: The school age children suffering from anisometropic amblyopia with age range from 7-15 years. Proper documentation proforma was designed for record and follow up of patients. Informed consents were taken from parents of patients and they were specially trained for compliance. Total 41 patients were included comprising 28(68.29%) male and 13(31.70%) female with age range of 7-15 years. Anterior and posterior segments were properly examined. Best corrected visual therapy was recorded. Difference of two or more lines on snellen chart between the two eyes was considered to be anisometropic amblyopia. Before treatment 14(34.14%) patients had BCVA of 6/24, 8(19.51%) patients had 6/36, 10(24.39%) patients had 6/60 and 9(21.95%) patients had CF. Out of 41 patients 29(70.73%) patients were hypermetropic while 12(29.26%) were myopic. The refractive error of amblyopic eyes in spherical equivalent was from + 7 to – 5 diopters. Proper refractive correction was done. Patching of the normal eye was advised for three hours per day at the dose of one week per year of age. The amblyopic eye was exposed to active visual therapy with video games with computer and smart phones. The patients were examined after each three months and improvement in visual acuity and change in refraction was addressed. Results were analysed on the basis of pretreatment and post treatment visual acuity. Finally T-test for regression and co-relation was applied on the post treatment status of visual acuity of 6/24, 6/36, 6/60 and Counting finger with pretreatment status of visual acuity of 6/24, 6/36, 6/60 and Counting finger showing P = 0.005 which is less than 0.05 and is statistically significant. Results: Cumulatively after treatment out of 41 patients 10(24.39%) had best corrected visual acuity 6/6, 6(14.63%) had 6/9, 7(17.07%) had 6/12, 7(17.07%) had 6/18, 4(9.75%) had 6/24, 5(12.19%) had 6/60 and 2(4.87%) had best corrected visual acuity of CF. Conclusion: Patching of dominant eye and refraction with Active Visual Therapy of amblyopic eye is effective in treatment of anisometropic amblyopia.

Foveal Thickness Fluctuation in Anti-VEGF Treatment for Branch Retinal Vein Occlusion: A Long-term Study

Branch retinal vein occlusion (BRVO) causes macular edema (ME), which can be controlled with anti-VEGF treatments. However, these treatments are not curative, necessitating additional anti-VEGF treatments at recurrence. Long-term results, optimal anti-VEGF treatment regimens, and the comprehensive effects of ME recurrence are largely unknown. Thus, we aimed to examine the effects of foveal thickness (FT) fluctuation (FTF) on the visual and morphologic outcomes of anti-VEGF treatments for BRVO-ME administered via a pro re nata regimen. A retrospective, observational case series. This study analyzed 309 treatment-naïve patients (309 eyes) with BRVO-ME between 2012 and 2021 at a multicenter retinal practice. The FT was assessed using OCT at each study visit. We evaluated the logarithm of the minimal angle of resolution (logMAR) best corrected visual acuity (BCVA) and the defect length of the foveal ellipsoid zone (EZ) band using OCT. At baseline, the mean logMAR BCVA was 0.30 ± 0.30 and the mean FT was 503 ± 162 μm. The number of anti-VEGF injections for BRVO-ME was 5.8 ± 4.6 during the mean follow-up period (50.6 ± 22.2 months). At the final examination, the mean logMAR BCVA and FT values were significantly improved compared with those at the baseline. Multiple regression analyses showed that age, baseline logMAR BCVA, and FTF were significantly associated with the final logMAR BCVA (β= 0.20, 0.35, and 0.30, respectively). Foveal thickness fluctuation (divided into groups 0-3 in ascending order of FTF) was significantly associated with logMAR BCVA and the defect length of the foveal EZ band at the final examination. The defect lengths of the foveal EZ band were longitudinally shortened in groups 0 and 1 and were slightly prolonged in groups 2 and 3. The logMAR BCVA showed improvements in groups 0 and 1 and worsened slightly in groups 2 and 3. Foveal thickness fluctuation was significantly associated with visual acuity and foveal photoreceptor status. Thus, the morphologic and functional prognoses of eyes with BRVO may improve with the identification of the characteristics of eyes with greater FTF and consequently controlling the FTF more strictly.

Vision-related quality of life and visual ability in patients with autosomal dominant optic atrophy.

The purpose of the study was to evaluate vision-related quality of life and visual ability in patients with OPA1 autosomal dominant optic atrophy (ADOA). This cross-sectional, observational study included 145 participants with a mutation in the OPA1 gene associated with ADOA, 63 mutation-free first-degree relatives and 92 healthy subjects unrelated to the families. Participants underwent a clinical eye examination, and adult participants completed the National Eye Institute Visual Function Questionnaire (NEI-VFQ-39), while children completed the Cardiff Visual Ability Questionnaire for Children (CVAQC). In adults with ADOA, both mean visual acuity (VA) and mean contrast sensitivity (CS) were significantly inferior to both first-degree relatives and unrelated controls (p < 0.001). In children with ADOA, mean VA was significantly lower compared with first-degree relatives (p = 0.0052), whereas CS was not (0.127). Adults with ADOA scored lower than both comparator groups on composite score (p < 0.001), general health subscale (p = 0.0075) and all vision-related subscales (p < 0.001) except the ocular pain subscale (p = 0.2). In children with ADOA, the median CVAQC logit score was significantly lower compared with first-degree relatives (p = 0.037). The science lessons subscale was significantly lower for children with ADOA compared with first-degree relatives (p = 0.046), as well as the language lessons subscale (p = 0.038). For adults, composite score and subscale scores were significantly associated with both VA, CS and fixation status. OPA1 mutation is associated with lower quality of life and visual ability in patients with ADOA compared with both first-degree relatives and unrelated controls. VA, CS and fixation status affect quality of life in patients with ADOA.

Effects of Vision Therapy on Bilateral Amblyopia Unresponsive to Conventional Treatment: A Retrospective Comparative Study

Background: In this study we aim to determines the effect of our vision therapy program for 7- to 10-year-old patients who exhibit bilateral amblyopia that is no longer responsive to conventional treatment. Methods: Children with bilateral amblyopia between the ages of 7 and 10 treated with vision therapy at the China Medical University Hospital between 2016 and 2019 were retrospectively reviewed. Age and visual acuity-matched bilateral amblyopes are included as a control group. The visual acuity for both groups showed no improvement for more than 3 months with part-time patching and full refraction correction. The initial and final visual acuity, stereopsis, and refractive status were analyzed. Results: Here, 15 cases were included as the treatment group and 16 cases as a control group. At the endpoint, the study group shows a significant improvement in BCVA, with a mean of 0.32 ± 0.15 logMAR (3 lines improvement) versus 0.003 ± 0.19 logMAR (nearly no improvement) for the control group (p < 0.001). The benefits of treatment are most obvious in the first 3 months after treatment (p < 0.001) and last until the end point. Stereoacuity also improves from 190.00 ± 163.34 to 85.00 ± 61.24 arc seconds, which is a 55.26% improvement. Conclusions: Vision therapy, comprising orthoptic therapy, perceptual learning and dichoptic training, is a successful program for increasing visual acuity and stereoacuity in 7- to 10-year-old children with bilateral amblyopia that is unresponsive to conventional treatment.

Световая чувствительность зрительной системы как функциональный биомаркер нейрональных повреждений при рассеянном склерозе у пациентов с перенесенным острым ретробульбарным оптическим невритом и без него

Цель исследования — оценка контрастно-цветовой чувствительности в центральной области поля зрения, контрастно-частотной чувствительности и динамической остроты зрения у здоровых испытуемых, в больных и здоровых глазах при рассеянном склерозе (РС) у пациентов с перенесенным ретробульбарным оптическим невритом (РБН) и без него. Материал и методы. Исследование зрительных функций проведено в 150 глазах 114 здоровых испытуемых, 49 глазах 36 пациентов с РС, перенесших острый РБН, и 43 глазах 29 пациентов с РС без перенесенного РБН. У всех испытуемых перед исследованием показателей световой чувствительности проводились определение статической остроты зрения, рефракции и офтальмоскопия глазного дна. Результаты и заключение. На основании анализа показателей контрастно-цветовой чувствительности, контрастно-частотной чувствительности и динамической остроты зрения проведена оценка изменений световой чувствительности больных и здоровых глаз у пациентов с РС с перенесенным РБН и без него. Выявлено, что световая чувствительность снижена во вторых — здоровых глазах при РС с перенесенным монокулярным РБН и что снижение световой чувствительности в глазах при РС с перенесенным РБН более глубокое. Световая чувствительность остается сниженной, несмотря на восстановление статической остроты зрения после перенесенного РБН. Различия показателей cветовой чувствительности зрительной системы используются для обсуждения связи острой демиелинизирующей оптической нейропатии с нейрональными повреждениями и характером течения рассеянного склероза. Обсуждается также возможность использования данных о снижении световой чувствительности для ранней диагностики и оценки нейрональных нарушений в зрительной системе при РС.