Acuity Testing Research Articles

Does multidimensional daily information predict the onset of myopia? A 1-year prospective cohort study

PurposeThis study aimed to develop an interpretable machine learning model to predict the onset of myopia based on individual daily information.MethodThis study was a prospective cohort study. At baseline, non-myopia children aged 6–13 years old were recruited, and individual data were collected through interviewing students and parents. One year after baseline, the incidence of myopia was evaluated based on visual acuity test and cycloplegic refraction measurement. Five algorithms, Random Forest, Support Vector Machines, Gradient Boosting Decision Tree, CatBoost and Logistic Regression were utilized to develop different models and their performance was validated by area under curve (AUC). Shapley Additive exPlanations was applied to interpret the model output on the individual and global level.ResultOf 2221 children, 260 (11.7%) developed myopia in 1 year. In univariable analysis, 26 features were associated with the myopia incidence. Catboost algorithm had the highest AUC of 0.951 in the model validation. The top 3 features for predicting myopia were parental myopia, grade and frequency of eye fatigue. A compact model using only 10 features was validated with an AUC of 0.891.ConclusionThe daily information contributed reliable predictors for childhood’s myopia onset. The interpretable Catboost model presented the best prediction performance. Oversampling technology greatly improved model performance. This model could be a tool in myopia preventing and intervention that can help identify children who are at risk of myopia, and provide personalized prevention strategies based on contributions of risk factors to the individual prediction result.

A pilot clinical study of complex rhegmatogenous retinal detachment treatment via foldable capsular buckle scleral buckling

BackgroundTo evaluate the feasibility of and identify problems in treating complex rhegmatogenous retinal detachment using foldable capsular buckle scleral buckling.MethodsThis prospective clinical study enrolled five patients with complex rhegmatogenous retinal detachment treated with foldable capsular buckle scleral buckling at the 988th Hospital of People’s Liberation Army Joint Logistic Force, China. During the 24-week follow-up period, the patients underwent measurements of their best-corrected visual acuity, slit-lamp examination, indirect ophthalmoscopy, and visual field testing. Additionally, B-ultrasound and fundus photography of the patients’ retinal reattachments helped evaluate the treatment’s post-surgery efficacy. We determined the safety of foldable capsular buckle scleral buckling based on infection, eye pain, diplopia, elevated intraocular pressure, and other postoperative severe complications.ResultsAll five patients’ complex rhegmatogenous retinal detachments were successfully treated and evaluated via B-ultrasound and fundus photography after surgery. Visual acuity was enhanced in four patients 24 weeks after surgery, while the remaining patients developed diplopia after surgery. No other complications were observed.ConclusionThis pilot study preliminarily determined that foldable capsular buckle scleral buckling is feasible for efficient and safe treatment of complex rhegmatogenous retinal detachment. These results support this surgery as a potential and novel alternative to current extraocular procedures for treating complex rhegmatogenous retinal detachment.Trial registrationThe prospective observational clinical study protocol was approved by the Institutional Review Board and Ethics Committee and registered at the clinical research center in the 988th Hospital of People’s Liberation Army Joint Logistic Force, China (9,882,019,000).

Revealing the influence of bias in a letter acuity identification task: A noisy template model

In clinical testing of visual acuity, it is often assumed that performance reflects sensory abilities and observers do not exhibit strong biases for or against specific letters, but this assumption has not been extensively tested. We re-analyzed single-letter identification data as a function of letter size, spanning the resolution threshold, for 10 Sloan letters at central and paracentral visual field locations. Individual observers showed consistent letter biases across letter sizes. Preferred letters were named much more often and others less often than expected (group averages ranged from 4% to 20% across letters, where the unbiased rate was 10%). In the framework of signal detection theory, we devised a noisy template model to distinguish biases from differences in sensitivity. When bias varied across letter templates the model fitted very well - much better than when sensitivity varied without bias. The best model combined both, having substantial biases and small variations in sensitivity across letters. The over- and under-calling decreased at larger letter sizes, but this was well-predicted by template responses that had the same additive bias for all letter sizes: with stronger inputs (larger letters) there was less opportunity for bias to influence which template gave the biggest response. The neural basis for such letter bias is not known, but a plausible candidate is the letter-recognition machinery of the left temporal lobe. Future work could assess whether such biases affect clinical measures of visual performance. Our analyses so far suggest very small effects in most settings.

Frequency of visual involvement in a 10-year interdisciplinary cohort of patients with giant cell arteritis

We present the largest study of the frequency and nature of visual complications in a cohort of 350 patients consecutively diagnosed with giant cell arteritis (GCA). All individuals were assessed using structured forms and diagnosed using imaging or biopsy. A binary logistic regression model was used to analyse data for predicting visual loss. Visual symptoms occurred in 101 (28.9%) patients, with visual loss in one or both eyes in 48 (13.7%) patients. Four patients had binocular visual loss. Anterior ischaemic optic neuropathy (N=31), retinal artery obstruction (N=8) and occipital stroke (N=2) were the main causes of visual loss. Of the 47 individuals who had repeat visual acuity testing at 7 days, three individuals had improvement to 6/9 or better. After introducing the fast-track pathway, the frequency of visual loss decreased from 18.7% to 11.5%. Age at diagnosis (odds ratio (OR) 1.12) and headache (OR 0.22) were significant determinants of visual loss in a multivariate model. Jaw claudication trended to significance (OR 1.96, p=0.054). We recorded a visual loss frequency of 13.7% in the largest cohort of patients with GCA examined from a single centre. Although improvement in vision was rare, a dedicated fast-track pathway reduced visual loss. Headache could result in earlier diagnosis and protect against visual loss.

Optical coherence tomography findings due to structural changes of the choroid and retina in Behçet's uveitis

Aims: To evaluate the change in central macular and retinal nerve fiber layer (RNFL) thickness by using optical coherence tomography (OCT) and choroidal thickness by using enhanced depth imaging optical coherence tomography (EDI-OCT) in posterior uveitis of Behcet’s disease, to compare these results with the healthy population and to investigate the relationship between these parameters and Behcet’s disease duration, the number of ocular attacks and visual acuity. Methods: Sixteen patients with the active phase and 33 patients with the inactive phase of Behcet’s disease, were followed up at Uvea Clinic in Ulucanlar Eye Training and Research Hospital, and 35 healthy cases were enrolled in this prospective study. All the individuals underwent visual acuity testing, intraocular pressure measurement, biomicroscopy, and fundus examinations. By using OCT and EDI-OCT central macular, RNFL thicknesses and subfoveal, at nasal 500 µm, nasal 1000 µm, temporal 500 µm, and temporal 1000 µm choroidal thicknesses were measured in all cases. The results of Behcet’s patients and healthy subjects were compared and the relationship between these parameters and Behcet’s disease duration, the number of ocular attacks, and visual acuity were assessed. Results: Five patients (31,3%) were female, 11 (68,8%) were male in the active group and 8 patients (24,2%) were female and 25 (75,8%) were male in the inactive group. In active patients central macular and RNFL thicknesses were significantly thicker than inactive patients and the control group (p=0,000). In inactive patients with Behcet’s disease duration and the number of ocular attacks RNFL thickness was getting thinner than in active patients (p=0,023, p=0,007). In active, inactive patients and healthy subjects subfoveal choroidal thicknesses were 449,31±111,36, 318,21±94,81 and 364,34±82,88 µm respectively; at nasal 500 µm choroidal thicknesses were 437,44±105,51, 308,33±95,36 and 355,97±83,81 µm respectively; at nasal 1000 µm choroidal thickness were 418,25±112,71, 286,33±96,06 and 337,26±87,11 µm respectively; at temporal 500 µm choroidal thickness were 429,44±102,98, 305,67±88,56 and 360,51±83,78 µm respectively; at temporal 1000 µm, choroidal thickness were 407,44±102,64, 299,73±76,30 and 360,71±86,67 µm respectively. In active patients subfoveal, at nasal 500 and 1000 µm choroidal thickness was significantly thicker than inactive patients and control group (p<0,01), in inactive patients at temporal 500 and 1000 µm choroidal thickness were significantly thinner than control subjects (p<0,05). Conclusion: By using OCT and EDI-OCT, in patients with active phase of Behcet’s disease central macular, RNFL, and choroidal thicknesses were found significantly thicker than inactive and control subjects. In inactive patients, choroidal thicknesses were significantly thinner than in healthy cases. In this study, the results showed that OCT and EDI-OCT findings were found to be beneficial in ocular Behcet’s disease diagnosis and follow-up period.

Accuracy of Mobile-Based Vision Chart in Clinical Practice during the COVID-19 pandemic

ABSTRACT Purpose The accuracy of mobile-based visual acuity testing in clinical practice is debatable. This study aimed to analyze the accuracy of mobile-based distant vision chart in comparison to the standard chart projector. Methods In this cross-sectional study, monocular distant best-corrected visual acuity (BCVA) in 571 eyes of 288 subjects was measured twice, using the Tumbling E vision chart by standard chart projector and repeated using mobile-based vision chart application with screen mirroring on a 22-inch monitor. The decimal results of BCVA were compared to analyze the accuracy of the mobile-based chart in comparison to the standard vision chart projector. Results The mean age of the studied patients was 29 ± 14 years. The most frequent refractive error was hyperopia (35.4%), followed by emmetropia (26.7%), myopia (22.9%), and astigmatism (14.9%). The mean BCVA in decimal form was 0.9 ± 0.2 and 0.91 ± 0.26 by the standard and mobile-based charts, respectively. An excellent agreement was reported between both tests as the intraclass correlation coefficient (ICC) was 0.976, with a confidence interval (CI) of 0.965–0.982. Bland–Altman analysis revealed that most visual acuity differences between both methods lie on the equality line or within the allowed difference zone. Conclusions The mobile-based vision chart is an economical, accessible, and accurate way for distant vision assessment, and its results are comparable to the standard chart projector in clinical practice.

Überblick und Handlungsleitfaden bei visuellen Störungen im Zusammenhang mit Kiefer- und Haltungsstörungen

Purpose. The human system consists of various subsystems. These are anatomically and functionally connected and form a structural unit. As a result, disorders in one subsystem can also affect other subsystems and the human system as a whole. Material and Methods. Using literature review and practi- cal experience, an overview of visual disorders associated with jaw and posture disorders is presented. These are visual acuity differences, spherical and astigmatic anisometropia, and binocular disorders. Visual disorders may be primary or secondary. Therefore, to determine visual asymmetry, testing for visual acuity and ametropias, as well as for sym- metric eye movement, convergence, and binocular function are useful. Results. Visual disorders with jaw and postural disorders can be transmitted by disorders of the nerve pathways (afferent as well as efferent disorders), muscles and skeleton. Therefore, an interdisciplinary assessment/diagnosis and selection of care and appropriate management is important. Conclusion. Optometrists must recognize visual disorders as- sociated with postural disorders in order to provide thorough history and treatment. Keywords symmetry, asymmetry, jaw disorders, postural disorders, binocular disorders

Forensic Study on Objective Evaluation of Visual Acuity of Ametropia with the Event-related Potential P3.

In this study, we aimed to assess the characteristics of the P3 component from an event-related potential (ERP) that was induced by visual acuity (VA) processing. Furthermore, we sought to provide electrophysiological evidence for the objective evaluation of VA. We recruited 32 participants with myopia-related ametropia. They reported no other ocular diseases and had an uncorrected VA of 4.0 in both eyes. We used the block letter "E" at different visual angles and orientations as the graphic stimuli. The oddball paradigm, consisting of 4 modules, was used for ERP analysis. The standard stimuli of each module were identical, with a visual angle of 1°15'. The visual angles of the target stimuli were 1°15', 55', 24', and 15'. The VA test was performed on each eye separately for all participants, and all characteristics of the P3 component were analyzed. There was no significant difference in the P3 peak letencies between the target stimulation angle 1°15' group and the 55' group, or between the target stimulation angle 24' group and the 15' group. There was a significant difference in the P3 peak letencies between the target stimulation angle 1°15' group and the 24' group as well as the 15' group. There was a significant difference in the P3 peak letencies between the target stimulation angle 55' group and the 24' group as well as the 15' group. No significant differences were observed in the P3 amplitude between modules. In the oddball paradigm, P3 elicitation indicated a cognitive response to the target stimuli. These data showed that the characteristics of P3 can be used as an objective evaluation of VA.

The Effect of Vestibular Rehabilitation on Balance and Quality of Life in Patients with Bilateral Vestibular Hypofunction.

This study aims to investigate the effectiveness of vestibular rehabilitation on balance, dynamic visual acuity, and quality of life in patients with bilateral vestibular hypofunction (BVH). 20 patients diagnosed by videonystagmography were included in the study. Balance tests, Visual Analogue Scale (VAS), testing of Dynamic Visual Acuity (DVA), Dizziness Handicap Inventory (DHI), Computer-modified Clinical Test of Sensory Interaction in Balance (m-CTSIB), and Limits of Stability Test were applied before and 3 and 6months after the treatment. Physiotherapy sessions were given at two-week intervals. According to the development of the patients, they were asked to perform a home exercise program with 10 repetitions 3 times a day. After 6months of vestibular rehabilitation, improvements in balance and quality of life parameters were observed in the patients. VAS, DVA, DHI, all static balance parameters except Romberg, Semi-tandem eyes open were significant (p < 0.005). In computerized M-CTSIB, while no significant results were obtained on the hard surface with the eyes open (p = 0.126), statistically significant improvement was observed on the hard surface with the eyes closed and on a foam surface with eyes open and close. LOS results showed significant improvement in velocity, reaching the endpoint, and maximal deviation in all directions except the right posterior. While significant results were found in the right, posterior, left anterior, and left posterior directions in the reaction time section, there was no statistical significance in any of the direct control sections (p < 0.005). Trial registration number:NCT05231109, Date of registration:27/01/2022 (Retrospectively registered).

Integration of the Expanded Disability Status Scale with ambulation, visual and cognitive tests improves disability assessment (P13-3.003)

<h3>Objective:</h3> Aim of our study was to estimate the difference between the Expanded Disability Status Scale (EDSS) obtained during routine visits, or after specific tests. <h3>Background:</h3> The EDSS is usually calculated through a neurological examination with self-reported performance. This may lead to incorrect assessment of Functional System scores (FSs). <h3>Design/Methods:</h3> We enrolled 670 MS patients that underwent a regular neurology consultation, and visual evaluation using optotype tables, ambulation evaluation with a rodometer, and cognitive assessment with the Brief International Cognitive assessment for MS (BICAMS). We calculated a new integrated EDSS (iEDSS) using the refined values of the FS and compared it to the standard EDSS. <h3>Results:</h3> Visual, cerebral and ambulation FSs were significantly higher compared with the self-reported counterpart [+1.169 (95%CI 1.077, 1.262; p&lt;0.001), +0.727 (95%CI 0.653, 0.801; p&lt;0.001) and +0.822 (95%CI 0.705, 0.939; p&lt;0.001), respectively]. Mean iEDSS was higher than EDSS (+0.642; p&lt;0.001). Visual acuity tests worsened the EDSS in 31% of cases, cognitive tests in 10%, ambulation measurement in 35%, all three measurements in 59% of cases. <h3>Conclusions:</h3> Objective measurement of FSs results in a more accurate EDSS score in almost two-thirds of cases. This could lead to a more thorough evaluation of patients in the transition or progressive phase. <b>Disclosure:</b> Dr. Sacca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Sacca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Almirall. Dr. Sacca has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Argenx. Dr. Sacca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Avexis. Dr. Sacca has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Sacca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lexeo therapeutics. Dr. Sacca has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Sacca has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Sacca has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Sacca has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Takeda. Mr. Carotenuto has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Merk, Novartis, Roche and Almirall. The institution of Mr. Carotenuto has received research support from ALMIRALL. The institution of Mr. Carotenuto has received research support from Carotenuto Antonio. Marcello Moccia, 2019 has nothing to disclose. Roberta Lanzillo has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck, Biogen. Roberta Lanzillo has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen, Roche, Novartis. Dr. Petracca has nothing to disclose. Dr. Brescia Morra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Brescia Morra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NOVARTIS. Dr. Brescia Morra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BIOGEN. Dr. Brescia Morra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ROCHE. Dr. Brescia Morra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TEVA. Dr. Brescia Morra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ALMIRALL. Dr. Brescia Morra has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for MERK. Dr. Brescia Morra has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for MERK. The institution of Dr. Brescia Morra has received research support from FISM. Dr. Brescia Morra has a non-compensated relationship as a PI with FISM that is relevant to AAN interests or activities. Cinzia Valeria Russo has nothing to disclose.

A 3-month comparison study of subjective and objective visual quality of small incision lenticule extraction and transepithelial photorefractive keratectomy in patients with low and moderate myopia.

To compare the subjective and objective visual quality between small incision lenticule extraction (SMILE) and transepithelial photorefractive keratectomy (tPRK) in patients with low and moderate myopia. Patients undertaking SMILE or tPRK for the correction of low and moderate myopia were consecutively recruited in this prospective cohort study with a 3-month follow-up period. Objective evaluation [visual acuity test, manifest refraction, wavefront aberrations, the total cut-off value of the total modulation transfer function (MTFcut-off), and Strehl ratio (SR)] and subjective evaluation of visual quality (quality-of-life questionnaire) were conducted before surgery and at days 1, 7, 30, and 90 after surgery. A total of 47 patients (94 eyes) with SMILE and 22 patients (22 eyes) with tPRK were enrolled. The uncorrected visual acuity (UCVA) was better in SMILE patients on day 7 after surgery (1.13±0.13 vs 0.99±0.17, t=4.85, P<0.001) but was comparable at days 30 and 90. At day 90, the SMILE group had a lower spherical equivalent (SE) than the tPRK group (0.04±0.31 vs 0.19±0.43, t=2.08, P=0.042). Total higher order aberrations (HOAs) were induced in both surgical types, which were more evident in the tPRK group with 3-mm pupil diameter (0.16±0.07 vs 0.11±0.05, t=4.27, P<0.001) and 5-mm pupil diameter (0.39±0.17 vs 0.36±0.11, t=2.33, P=0.022). The MTFcut-off and SR showed a trend of improvement in both SMILE and tPRK patients but were statistically better in the SMILE group with both pupil diameters. There was a significant improvement of contrast sensitivity (CS) over baseline levels at the spatial frequency of 18 cycles/degree (c/d) in the SMILE group (F=2.72, P=0.033) and at 3 c/d (F=3.03, P=0.031), 12 c/d (F=3.72, P=0.013), and 18 c/d (F=4.62, P=0.004) in the tPRK group. The subjective quality of life questionnaire showed a steady improvement in the SMILE group (F=8.31, P<0.001) but not the tPRK group. SMILE and tPRK are both safe and effective ways to correct low and moderate myopia. A generally better and quicker recovery of visual quality favors the application of SMILE in qualified patients.

Evaluation of an Eye-Tracking-Based Method for Assessing the Visual Performance with Progressive Lens Designs

Due to the lack of sensitivity of visual acuity (VA) measurement to quantify differences in visual performance between progressive power lenses (PPLs), in this study, we propose and evaluate an eye-tracking-based method to assess visual performance when wearing PPLs. A wearable eye-tracker system (Tobii-Pro Glasses 3) recorded the pupil position of 27 PPL users at near and distance vision during a VA test while wearing three PPL designs: a PPL for general use (PPL-Balance), a PPL optimized for near vision (PPL-Near), and a PPL optimized for distance vision (PPL-Distance). The participants were asked to recognize eye charts at both near and distance vision using centered and oblique gaze directions with each PPL design. The results showed no statistically significant differences between PPLs for VA. However, significant differences in eye-tracking parameters were observed between PPLs. Furthermore, PPL-Distance had a lower test duration, complete fixation time, and number of fixations at distance evaluation. PPL-Near has a lower test duration, complete fixation time, and number of fixations for near vision. In conclusion, the quality of vision with PPLs can be better characterized by incorporating eye movement parameters than the traditional evaluation method.

Visual Acuity Assessment: A Comprehensive Survey of Methods

This review paper focuses on the various methods and tools available for measuring visual acuity, a crucial aspect of visual function that is used to diagnose and monitor a wide range of ocular disorders. The paper provides an overview of the basic principles of visual acuity measurement and examines the most used techniques, including Snellen charts, the Rossano-Weiss test electronic Measurement of Visual Acuity (eMOVA)test, and paper-based tests (PBVA). The strengths and weaknesses of each method are discussed, along with the factors that can affect the accuracy and reliability of visual acuity measurements. The paper also considers recent developments in visual acuity testing, such as the use of Natural Language Processing, Machine Learning along with smartphone apps, and explores their potential benefits and limitations. As a whole, this review paper provides a comprehensive and up-to-date analysis of the different approaches to measuring visual acuity and highlights the importance of careful consideration of the choice of the test method in clinical practice.

Retinal displacement following successful pars plana vitrectomy for rhegmatogenous retinal detachment

Background The appearance of hyperfluorescent lines next to the retinal blood vessels after successful retinal detachment (RD) surgery was explained by the occurrence of retinal displacement. This can attribute to the metamorphopsia experienced by some patients after their surgeries. Patients and methods A prospective interventional study was performed that included 30 eyes of 30 patients with primary rhegmatogenous RD, who had undergone successful RD surgery via pars plana vitrectomy and silicone oil tamponade. The entire patients had preoperative and postoperative fundus autofluorescence and optical coherence tomography. They were followed up for 3 months after surgery with testing of the best-corrected visual acuity and Amsler grid testing. Results The mean age of the included group was 53.7±9.2 years, and 17 (56.7%) patients were males. The most frequent tear site was upper temporal (43.3%), followed by multiple peripheral (23.33%), upper nasal (13.3%), lower temporal (13.3%), and the least was lower nasal (6.7%). Retinal displacement was detected by hyperfluorescent lines adjacent to the retinal blood vessels in the fundus autofluorescence imaging in 16 eyes (53.3% with 95% confidence interval: 36.7–70.0%). Patients with retinal displacement were significantly younger than patients without (P=0.019). The presence of proliferative vitreoretinopathy was significantly related to the occurrence of displacement (P=0.028). Metamorphopsia was significantly more frequent among patients with displacement (P&lt;0.001). Conclusion Retinal displacement had a high possibility to occur after successful repair of primary rhegmatogenous RD. Young patients and patients with proliferative vitreoretinopathy are at a higher risk for displacement.

Topographic patterns of retinal lesions in multiple evanescent white dot syndrome.

To demonstrate different topographic distributions of multiple-evanescent white dot syndrome (MEWDS) and secondaryMEWDS disease and to describe possible associations. Clinical evaluation and multimodal retinal imaging in 27 subjects with MEWDS (29 discrete episodes of MEWDS). Ophthalmic assessment included best-corrected visual acuity testing and multimodal retinal imaging with OCT, blue-light autofluorescence, fluorescein and indocyanine green angiography, fundus photography, and widefield pseudocolor and autofluorescence fundus imaging. The topographic distribution of MEWDS lesions was centered on or around the optic disc (n = 17, 59%), centered on the macula (n = 7, 24%), sectoral (n = 2, 7%), or was indeterminate (n = 3, 10%). The MEWDS episodes either occurred in the absence ('primary MEWDS'; n = 14, 48%) or presence of concurrent chorioretinal pathology ('secondary MEWDS'; n = 15, 52%). In patients with the latter, MEWDS lesions were often centered around a coexisting chorioretinal lesion. The majority of patients in both groups experienced resolution of their symptoms and retinal changes on multimodal imaging by 3months. Distinct distributions of MEWDS lesions were identified. MEWDS may occur in tandem with other chorioretinal pathology, which may impact the topography of MEWDS lesions.

Performance of a Smart Device over 12-Months for Home Monitoring of Patients with Intermediate Age-Related Macular Degeneration.

To determine the 12-month compliance with and retention of home monitoring (HM) with Melbourne Rapid Fields (MRFh) for patients with intermediate age-related macular degeneration (iAMD) and compare visual acuity (VA) and retinal sensitivity (RS) results to clinical measures. Participants were recruited to a 12-month HM study with weekly testing of vision with MRFh. Inclusion criteria were a diagnosis of iAMD, understand English instructions, VA ≥ 20/40, and access to an iPad. Supervised in-clinic testing of high contrast VA (HVA, ETDRS), low-luminance VA (LLVA, ETDRS with ND2 filter), and RS (Macular Integrity Assessment, MAIA, and MRF in-clinic, MRFc) was conducted every 6-months. A total of 54 participants (67 ± 6.8 years) were enrolled. Compliance to weekly HM was 61% and study retention at 12-months was 50% of those with uptake (n = 46). No difference was observed between MRFc and MRFh across all RS and VA outcomes (p > 0.05). MRFh RS was higher than MAIA (29.1 vs. 27.1 dB, p < 0.001). MRFh HVA was not different from ETDRS (p = 0.08), but LLVA was 9 letters better (81.5 vs. 72.4 letters, p < 0.001). Over 12-months, MRFh yields a moderate level of compliance with (61%) and retention (50%) of weekly testing. Further studies are required to assess the ability of MRFh to detect early progression to nAMD.

Design and Validation of a Novel Smartphone-Based Visual Acuity Test: The K-VA Test.

Visual acuity (VA) testing is a critical screening examination for the assessment of visual function. This study describes the development and validation of a smartphone-based VA test: the K-VA test. A total of 171 patients with various ocular diseases were examined in our outpatient unit at Aristotle University of Thessaloniki, School of Medicine in Greece. Participants underwent VA examination using the standard Early Treatment Diabetic Retinopathy Study (ETDRS)charts and the K-VA smartphone-based test. The K-VA test was performed by participants themselves. The Bland-Altman method was employed to assess the agreement between the ETDRS charts and the new test for the examination of VA at 1m and 40cm. Test-retest reliability was also calculated. A questionnaire regarding the participants' feedback on the K-VA test was completed. No significant bias wasobserved between the gold standard ETDRS charts and the K-VA test measurements. The mean difference (95% limits of agreement, LoA) between the K-VA test at 1m and the ETDRS chart at 4m was -0.006 (95% LoA -0.129 to 0.117) logarithm of the minimal angle of resolution (logMAR). The agreement of the K-VA test at 40cm with thenear ETDRS chart was also high with a mean difference of -0.007 (95% LoA -0.105 to 0.090) logMAR. Test-retest reliability was found to be high with a mean difference of 0.003 (95% LoA -0.045 to 0.033) logMAR and 0.005 (95% LoA -0.065 to 0.076) logMAR for theK-VA testat 1m and 40cm, respectively. A total of 97 participants answered the questionnaire and 71 (73.2%) stated that the test was easy to very easy to use for self-performance. The study demonstrated that the K-VA application performed well compared with the ETDRS charts and provides reliable and repeatable measurements of VA across a wide range of VA.

Effective Detection of Amblyopia Risk Factor Using Smart Phone Eye Testing Application

Amblyopia also called as lazy eye. In this disease there is week communication between human eyes with human brain. Due to this reason one of the eye is not working properly compare to other eye. Amblyopia starts in early childhood, and most of the children are loss his vision. In the world 3 to 4 child’s are affected of amblyopia risk factors out of 100 children. If we give the early treatment on affected eye may be prevents long-term vision problems. This problem is focus in mind and author is doing study to accurately identify children at risk for amblyopia by using existing application from smartphone platforms. This study is not replace the advice of doctors on any condition.&#x0D; Keywords: Amblyopia Risk Factor, Visual Acuity Test,

Visual Results of Intravitreal Bevacizumab (Avastin) Treatment for Branch Retinal Vein Occlusion a Multi Center Study

Objective: To evaluate the visual outcomes in patients with branch retinal vein obstruction after intravitreal bevacizumab (Avastin) injection. Study Location and Duration:, Department of Ophthalmology Abaseen hospital and Khyber medical center Peshawar from January 2019 to January 2022 both department conducted this multi-center study. Methodology: Patients with BRVO received at least one intravitreal Bevacizumab (Avastin) injection of 1.25 mg in 0.05 ml. Snellen visual acuity tests, Fundus Fluorescein Angiography (FFA), and Optical Coherence Tomography were used to assess the patients (OCT). A complete eye exam was conducted before treatment began, and monthly follow-up examinations were scheduled for the following six months. Results: The total number of patients and eyes was 78, with a mean age of 60. (SD 15.1). The average number of Intravitreal bevacizumab (Avastin) injections administered to patients was four (SD 1.40) per eye. There were no negative consequences observed. Before treatment, the average central macular thickness was 568 microns, but after three months it was only 370 microns (p0.001), and by six months it had decreased to 290 microns. Three months later, the average acuity was much better than at the start (p=0.001), with log MAR = 0.30 (SD 0.22). During the most recent 6-month follow-up, the mean visual acuity was log MAR = 0.40 (SD 0.23), better than the baseline value (p 0.001). Overall, 44 eyes showed an improvement in their vision. Conclusion: Intravitreal Bevacizumab intravitreally for branch retinal vein occlusion improves vision. Bevacizumab intravitreally enhances visual acuity, macular edema, and ischemia. Bevacizumab reduces the risk of vision-threatening vitreous hemorrhage and neovascularization. Hence, Bevacizumab improves vision and treats branch retinal vein occlusion effectively. Keywords: Intravitreal Bevacizumab (Avastin), Branch Retinal Vein Occlusion (BRVO), Visual Acuity Improvement, Macular Ischemia Relief. Retinal Neovascularization Reduction

A study on disability glare vision in young adult subjects

The full assessment of the visual system must include the evaluation of the optical quality of the eye and neural visual functions. The objective evaluation of the retinal image quality is often carried out by computing the point spread function (PSF) of the eye. The central part of the PSF is associated with optical aberrations and the peripheral areas with scattering contributions. In that sense, visual acuity and contrast sensitivity function tests can be considered the perceptual neural response to those contributions characterizing the eye’s PSF. However, in natural viewing conditions, visual acuity tests may provide good vision while contrast sensitivity tests can reveal visual impairment in glare vision conditions, such as exposure to bright light sources or night driving conditions. Here we present an optical instrument for the study of disability glare vision under extended Maxwellian illumination to assess the contrast sensitivity function under glare conditions. The limit of the Total Disability Glare threshold, tolerance, and glare adaptation will be investigated as a function of the angular size of the glare source (GA) and the contrast sensitivity function in young adult subjects.