Acuity Measurements Research Articles

Comparative analysis of visual and cognitive performance in esports athletes and soccer players

ABSTRACT Clinical relevance Assessing visual and cognitive performance in athletes is important for optimising training strategies and preventing visual strain in both esports and traditional sports. Background This study compared visual acuity, refractive error, binocular functions, and cognitive perception measures between esports and soccer players to optimise visual performance strategies. Methods Twenty-eight male esports athletes and 38 male soccer players were assessed. Visual acuity was measured using an ETDRS chart, and refractive error was assessed with retinoscopy. Phoria was evaluated with the Modified Thorington Technique at distance and near. Fusional vergence ranges and vergence facility were measured using prism bars and a prism flipper. Monocular accommodative facility at near was tested with ± 2.00D flipper lenses. Stereopsis was assessed using the Randot Stereo Test. Perception span, multiple object tracking, and visual reaction time, were evaluated using the Senaptec Sensory Station. Results Soccer players had significantly better visual acuity than esports athletes. For the right eye, the soccer group had an average decimal visual acuity of 1.1 ± 0.2 compared to 0.9 ± 0.1 in the esports group (p < 0.001). Refractive error analysis showed that esports athletes had more myopia (M =-0.67 ± 1.70D) and higher astigmatism (J0 = 0.47 ± 0.53D) than soccer players (M = 0.6 ± 1.06D, J0 = 0.09 ± 0.43D; p < 0.001). Soccer players demonstrated better negative fusional vergence at distance (p = 0.049) and superior near-accommodative facility (12.4 ± 4.2 cpm vs. 9.4 ± 5.2 cpm; p = 0.025). Soccer players also outperformed esports athletes in multiple object tracking (1811.3 ± 391.3 vs. 1523.4 ± 528.7; p = 0.013). No significant differences were observed in stereopsis or other binocular vision parameters. Conclusion Soccer players showed superior visual acuity and performance in tasks such as negative fusional vergence and near-accommodative facility compared to esports players. Esports athletes had more myopia and astigmatism, indicating a need for targeted visual interventions.

Microseconds-level coding for echo delay in the auditory brainstem of an FM-echolocating bat.

Echolocating big brown bats (Eptesicus fuscus) detect changes in ultrasonic echo delay with an acuity as sharp as 1 microsecond (μs) or less. How this perceptual feat is accomplished in the nervous system remains unresolved. Here, we examined the precision of latency registration (latency jitter) in neural population responses as a possible mechanism underlying the bat's hyperacuity. We recorded local field potentials in the cochlear nucleus and inferior colliculus of anesthetized big brown bats to sequences of sounds consisting of a simulated frequency modulated broadcast followed, at various echo delays, by a four-echo cascade. Latencies of the first negative response peak to the broadcast and to the first echo in the cascade were shorter in the cochlear nucleus than in the inferior colliculus, but latency jitter of this peak was comparable in both brainstem nuclei. Mean latency jitter, averaged over all stimulus conditions, was 51 μs in the cochlear nucleus and 56 μs in the inferior colliculus. Latency jitter to the successive echoes in the echo cascades was larger, with means of 125 μs and 111 μs, respectively. These values are lower than values commonly reported for single-neuron latency variability in bats and other mammals, and they approach within an order of magnitude the big brown bat's psychophysical performance. Latency jitter for synchronized population responses on a scale of microseconds reduces the gap between neurophysiological and behavioral measures of acuity. Further systems level analysis is necessary for understanding neural mechanisms of perception. XXXX XXXX.

Visual outcome after monocular implantation of extended depth of focus intraocular lens in a patient with iridodialysis: a case report and literature review

BackgroundIridodialysis, the separation of the iris root from the ciliary body, typically results from trauma and can lead to significant visual impairment. This case report is novel as it demonstrates the successful management of iridodialysis using an extended depth of focus intraocular lens in a patient with a slightly irregular pupil.Case presentationA 34-year-old Hispanic man presented with reduced vision and pain in his right eye following blunt trauma from a nail at work. Examination revealed a small temporal corneal stromal scar, traumatic posterior subcapsular cataract, two inferior iridodialysis defects, and a superiorly displaced dyscoric oval pupil. Snellen uncorrected distance visual acuity was 20/400. The patient opted for an extended depth of focus intraocular lens implantation to meet his visual demands for distance and intermediate vision without glasses. Cataract surgery with capsular tension ring, extended depth of focus intraocular lens implantation, iridodialysis repair, and suture pupilloplasty were performed uneventfully. At 1 month postoperatively, uncorrected distance visual acuity improved to 20/40, while uncorrected intermediate visual acuity and uncorrected near visual acuity were 20/20. A central, relatively round, and slightly inferiorly peaked pupil was achieved. A steroid response intraocular pressure rise at postoperative month 2 required intraocular pressure-lowering medications, and symptomatic posterior capsular opacity developed at 8 months postoperatively. At 11 months postoperatively, selective laser trabeculoplasty and laser capsulotomy were performed. At 4-year follow-up, visual acuity measurements remained stable, and intraocular pressure was normal without any medication. The patient was satisfied with the visual and cosmetic outcomes.ConclusionThis case demonstrates that extended depth of focus intraocular lenses can be a viable option for patients with slightly irregular pupils following suture repair of the iris and pupil. The successful visual and cosmetic outcomes in this patient suggest that extended depth of focus intraocular lenses may be considered in similar complex cases, providing a balance of near, intermediate, and distance vision without significant visual disturbances.

Vision impairment in school students: Results of a school-based study in Qatar

Background: Pediatric vision impairment (VI) has profound implications for a child's development, intellectual skills, and quality of life. The aim of this study was to assess the prevalence of VI among primary and preparatory school students in Qatar. Methods: A school-based cross-sectional study was conducted among students in grades 1, 3, 5, 7, and 9 in Qatar. School nurses conducted visual acuity (VA) measurement using a Snellen chart placed 6 meters away, with an E symbol, in which the 6/6 line is the standard for normal vision. Each student's information was recorded in their electronic health records (government schools, GSs) or in Excel sheets (private schools, PSs). Results: Three hundred and thirty schools participated in this survey, with 99,379 students divided into 45,670 from GSs and 53,709 from PSs. The prevalence of abnormal VA among students was 10.4% in GSs and 12.6% in PSs. There was no significant association between VI and gender or nationality, although VI was higher in grades 5, 7, and 9 but not statistically significant. Furthermore, the proportion of visually impaired students diagnosed with refractive errors and wearing glasses or contact lenses during vision measurement was 14.7% in GSs and 27% in PSs. Conclusion: The study provides comprehensive and baseline data on VI among the school children of Qatar. The vision screening helped in the early detection of VI in one-tenth of the affected students. However, urgent interventions are needed to enhance screening strategies for future studies on the causes of VI.

Refractive Profiles in Children Receiving School-Based Eye Exams Following Vision Screening from a Large School-Based Vision Program in 2016 to 2022

ABSTRACT Purpose To describe refractive error findings and associated factors in students who received school-based eye exams following vision screenings. Methods Cross-sectional study of pre-kindergarten through 12th grade students who failed vision screening and underwent a school-based eye exam in the Northeast region of the United States during 2016–2022. Non-cycloplegic autorefraction and visual acuity measurements were used to categorize refractive error by type and severity. Main outcomes included any refractive error (at least −0.50D myopia, +0.50 hyperopia, 1.00D astigmatism, or 1.00D anisometropia), clinically significant refractive error (CSRE; more severe refractive error with decreased vision), and refractive amblyopia risk (RAR). Multivariable mixed-effects logistic regression was used to determine student- and school-level characteristics associated with refractive error outcomes. Results Of 103,159 included students who failed screening, 95,875 (92.9%) were analyzed. Overall prevalence of any refractive error was 94.2%, with 81.7% having CSRE. Pre-kindergarten & kindergarten students had the highest prevalence of CSRE (85.7%), which dropped to 77.0% by 3rd and 4th grade before rising with each higher grade level thereafter. Prevalence of RAR was 60.9% overall and highest in pre-kindergarten and kindergarten students (73.8%). Myopia was the most prevalent refractive error, followed by astigmatism, anisometropia, then hyperopia. The odds of hyperopia, astigmatism, and anisometropia decreased with higher grade level. Conclusion Over 80% of students who failed vision screening at a large school-based vision program had CSRE, and over 60% had RAR. Pre-kindergarten and kindergarten students had an especially high prevalence of RAR. Refractive error remained common in every grade level.

Retinal Function in Advanced Multiple Sclerosis.

People with multiple sclerosis (pwMS) experience autoimmunity-mediated inflammation and neurodegeneration throughout the central nervous system. There remains a need for clinically accessible, reliable functional markers of neurodegeneration in MS. Previous research has described changes to electroretinography (ERG)-derived measures of retinal bipolar cell function in pwMS early in the disease course. We, therefore, investigated ERG as a potential outcome measure in individuals with more advanced disease. This cross-sectional observational study included pwMS with Expanded Disability Status Scale (EDSS) scores of ≥3.0 and healthy control (HC) participants who underwent ERG, optical coherence tomography, high- and low-contrast visual acuity measurement, and an ophthalmological examination. ERG findings in MS eyes with and without previous optic neuritis (MS +ON; MS -ON) were compared with those in HC eyes. Effects of EDSS, disease duration, ON, and treatment status on selected ERG outcomes were measured. Additional exploratory analyses assessed potential influences of MS phenotype and disease status (clinically active, radiologically active, and disease progression). Delays to two ERG peak times (dark-adapted 3.0 b-wave; light-adapted flicker) were recorded in MS +ON and MS -ON eyes. No influences of EDSS score, disease duration, previous ON, or treatment status were observed. Exploratory analyses were consistent with no effects of MS phenotype or disease status. ERG findings are abnormal in individuals with moderate-severe disability caused by MS; however, these findings are not distinct from those observed earlier in the disease course. Although bipolar dysfunction appears to be common in pwMS throughout the disease course, ERG is likely not useful in monitoring or prognostication of MS.

Is Patching After Age 4 Beneficial for Children Born with a Unilateral Congenital Cataract?

The goal of these analyses is to provide evidence that can help parents and health care providers determine whether or not to continue occlusion therapy once a reliable measure of optotype acuity can be obtained in children who are born with a unilateral congenital cataract. Data from the Infant Aphakia Treatment Study (IATS) are used in a cohort design. 105 children who participated in the IATS and did not have a vision-threatening adverse event. We assessed the relationship between visual acuity at age 10.5 years and average daily hours of patching reported by caregivers on quarterly 48-hour recall interviews and annual 7-day patching diaries obtained between 48 and 60 months of age. Monocular visual acuity was assessed at the clinic visit closest to 48 months of age using the Amblyopia Treatment Study-HOTV protocol. Final visual acuity was measured at age 10.5 years using the E-ETDRS testing protocol. Visual acuity measurements obtained at age 4 were reliable, with a single measure intraclass correlation coefficient of 0.83 (95% CI 0.78,0.88) and were predictive of those obtained at age 10.5 (rSpearman = 0.83 (p<0.01)). Forty percent (n=48) of the children, the visual acuity measured at age 10.5 years was within +0.15 logMAR of the measurement obtained at age 4. The amount of patching that was received between the 4th and 5th birthdays was unrelated to changes in visual acuity. These analyses suggest that optotype acuity measures obtained early in the 5th year of life are reliable and are predictive of final visual outcomes. Additionally, our results suggest that less aggressive patching protocols, or discontinuing patching altogether, may be justified in some children, particularly those with poor vision, once optotype acuity can be measured. However, the potential impact of latent nystagmus on uniocular visual acuity measurement and the effect of patching on the child's quality of life, family relationships, and binocular visual field need to be considered before discontinuing occlusion therapy.

Effects of visual neuroplasticity training on visual perception, visual quality, and macular blood flow in patients with strabismus.

To observe the effects of visual neuroplasticity training on visual perception, visual quality, and macular blood flow in patients with concomitant strabismus postoperatively. In total, 108 patients underwent binocular strabismus correction operation, and some patients underwent neuroplasticity training. All patients underwent clinical ophthalmic examination, including measurement of best-corrected visual acuity, spherical equivalent, axis length, optical coherence tomography angiography, optical quality analysis system, and visual perception examinations. A total of 78 patients received neuroplasticity training for 1 month postoperatively, and 30 patients did not receive training. All patients underwent a visual perception examination preoperatively and at 1 day, 1 week, and 1 month postoperatively. Macular blood flow and visual quality were examined preoperatively and at 1 month postoperatively. Postoperative visual perception was better than preoperative visual perception ( P < 0.05). After neuroplasticity training, the visual perception of the trained subjects was better than that of the untrained subjects ( P < 0.05), and the blood flow in the macular area of the trained patients was lower than that of the untrained subjects ( P < 0.05). The visual quality of the untrained subjects was lower than that of the trained patients ( P < 0.05). Visual inspection system could accurately evaluate binocular visual perception in patients with concomitant strabismus. After surgical alignment of the strabismus patient, training can stimulate and integrate the formation of stereovision in a short period of time, maintain the visual quality of patients after surgery, and provide conditions for the formation of binocular visual signals and binocular stereovision, but in the short term, it will lead to the decrease of macular blood vessel density and perfusion density. However, the long-term effects of training have not been proven.

Discriminating Diseases Mimicking Normal-Tension Glaucoma (NTG) from NTG.

Background/Objectives: The aim of this study was to identify the most reliable ocular exam and establish a threshold for deciding whether to perform neuroimaging in order to screen for diverse diseases other than normal-tension glaucoma (NTG). A retrospective, observational, comparative study was used. Methods: In total, 106 individuals with atypical features of NTG who underwent glaucoma assessments and contrast-enhanced MRI of the brain or orbit were included. The criteria for atypical NTG included the following: (1) unilateral normal-tension glaucoma, (2) visual field (VF) damage inconsistent with optic disc appearance, (3) fast VF progression, (4) worsening of visual acuity, (5) optic disc pallor, (6) scotoma restricted by a vertical line, and (7) central scotoma. Glaucoma evaluations included measurements of visual acuity, intraocular pressure, central corneal thickness, axial length, cup-disc ratio, retinal nerve fiber layer (RNFL) thickness, ganglion cell-inner plexiform layer (GCIPL) thickness, mean deviation (MD), and visual field index (VFI). Statistical analyses involved independent t-tests, receiver operating characteristic (ROC) curves, and area under the curve (AUC) in order to differentiate neuro-ophthalmological conditions from NTG, compare the diagnostic power of each factor, and determine the cut-off value. Results: Relatively fewer diagnoses of non-glaucomatous diseases were associated with unilateral NTG, the worsening of VA, and central scotoma. Factors such as rapid visual field progression, optic disc pallor, and scotoma restricted by a vertical line had a relatively higher diagnostic rate of non-glaucomatous diseases. There were significant differences in average RNFL and GCIPL thicknesses at the nasal quadrant between NTG and NTG-mimicking conditions. Only the GCIPL thickness at the nasal quadrant had reliable power for discriminating between neuro-ophthalmological disease and NTG. For the GCIPL thickness at the nasal quadrant, the AUC was 0.659, and the cut-off value was 65.75. Conclusions: When deciding whether to proceed with imaging, such as carrying out an MRI test, for NTG patients with atypical NTG characteristics, it would be advisable to consider the nasal sector cut-off value of GCIPL thickness.

The effect of central and peripheral luminance on visual acuity.

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

A Vibrotactile Belt for Measuring Vibrotactile Acuities on the Human Torso Using Coin Motors.

Accurate measurement of the vibrotactile acuities of the human torso is the key to designing effective torso-worn vibrotactile displays for healthcare applications such as navigation aids for visually impaired persons. Although efforts have been made to measure vibrotactile acuities, there remains a lack of systematic studies addressing the spatial, temporal, and intensity-related aspects of vibrotactile sensitivity on the human torso. In this work, a torso-worn vibrotactile belt consisting of two crossed coin motor arrays was designed and a psychophysical study was carried out to measure the spatial, temporal, and intensity-related vibrotactile acuities of a set of human subjects wearing the designed belt. The objective parameters of vibrational intensity and the timing latency of the coin motor were also determined before measuring the vibrotactile acuities. The experimental results indicated that the tested coin motor was able to generate a median number of five and six available just-noticeable differences in intensity and duration, respectively. Among the four parameters of vibrational intensity, the perceived intensity was the most relevant to vibrational displacement. The spatial acuities measured as the degree of two-point spatial thresholds (TPTs) showed less individual difference than the distance TPTs. The results from the current work provide valuable guidance for the design of a comfortable torso-worn vibrotactile display using coin motors.

Elevated Serum Levels of Osteopontin in Patients with Psoriasis: Is It Associated with Ocular Comorbidities?

Introduction: Psoriasis is a chronic inflammatory disease affecting 2%-3% of the global population via immune-mediated mechanisms. Osteopontin plays a crucial role in T-helper 1 and T-helper 17-mediated illnesses, including psoriasis. Ocular complications in psoriasis have been reported and their assessment is of importance. Osteopontin is normally expressed constitutively in ocular structures and is linked to ocular homeostasis. Objective: This study aimed to clarify the role of osteopontin (OPN) in psoriasis (PS) and its correlation with disease severity and ocular manifestations. Methods: A case-control study involving 40 psoriatic patients and an equal number of age and sex-matched healthy subjects was conducted. We used the psoriasis area severity index (PASI) to assess disease severity and performed a comprehensive ophthalmological examination. Additionally, we measured serum osteopontin levels using Enzyme-Linked Immunosorbent Assay (ELISA) in both groups. Results: A significant elevation in serum OPN levels in psoriatic patients compared to controls was found (P=0.00). Furthermore, there was a highly significant positive correlation between serum OPN levels and patient age, disease duration, and PASI scores. Notably, a higher prevalence of ocular complications, including blepharitis, corneal affection, conjunctivitis, keratoconjunctivitis sicca, and cataract, in psoriatic patients compared to controls was observed. Importantly, significant associations between serum OPN levels and the presence of cataracts and intraocular pressure (IOP) were identified. Additionally, significant correlations between serum OPN levels and measures of visual acuity and ocular surface health were found. Conclusions: Osteopontin is considered a marker of psoriasis severity and is associated with ocular comorbidities in psoriasis.

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

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

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

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

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

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

The Short-term Effect of Caffeine Consumption on Reading Performance

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

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

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

Smartphone Proprioception for Ankle Navigation (SPAN): Reliability and Effect of Position Exposure Time

This study investigated ankle discriminative acuity and performance and measurement consistency for tests undertaken with different joint position exposure times (PETs). Twenty-four participants were tested using a novel Smartphone Proprioception for Ankle Navigation (SPAN) under four PETs, i.e., 0.25s, 0.5s, 0.75s and 1s, delivered in a random sequence, and then re-tested within one week. The results indicated a PET main effect (F = 10.12, p = 0.004, partial ƞ2 = 0.14), and limb preference main effect (F = 5.39, p = 0.03, partial ƞ2 = 0.19), without significant interactions (p > 0.05). Ankle proprioception improved with prolonged PET, with the non-dominant side outperforming the dominant side. A PET of 0.25s showed good to excellent reliability, with intraclass correlation coefficients (ICCs) of 0.897 (95%CI: 0.761, 0.955) and 0.885 (95%CI: 0.736, 0.951), with standard errors of measurements (SEM) between 0.030 and 0.035, and minimum detectable change at 90% (MDC90) between 0.070 and 0.082, compared to poor to moderate reliability at the other three longer PETs (ICCs =0.352–0.736). The findings suggested the prolongation of PET can improve ankle proprioceptive performance but can amplify the inter-occasion variability, likely due to increased cognitive analysis with longer stimulus sampling. SPAN may thus be a cost-effective and accessible apparatus for clinical practice.

Radial polarisation patterns identify macular damage: a machine learning approach

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

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

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