Acuity Measurements Research Articles

Evaluating a web-based visual acuity and refractive error self-assessment tool in myopic children.

Demands for myopia management are rising. A web-based tool that allows home-performed self-assessments of visual acuity (VA) and refractive error may enable hybrid care pathways and aid in identifying those with deteriorating visual performance. The tool has been validated in adult populations, but has yet to be evaluated in children. This study compared home-performed VA and refraction self-assessments to conventional measurements obtained at the clinic in a population of myopic children. Myopic children aged ≥6 years old were invited to perform web-based eye tests at home, assisted by a parent. At two myopia control clinics, they also underwent measurements of VA using a Snellen chart and refractive error using cycloplegic autorefraction. Agreement between the tests, repeatability of the web-based test and associations between clinical characteristics and web-based test accuracy were evaluated. A total of 147 children were enrolled, of whom 116 (51% male; mean age 13 ± 3 years; mean spherical equivalent refraction (SEQ) -5.58 ± 3.05) performed the web-based tests at home. Overall, the home-performed VA self-assessment and the Snellen chart assessment at the clinic agreed well (mean difference 0.03 ± 0.11 logMAR). A significant proportional bias was identified (β 0.65, p < 0.001), indicating underestimated web-based VA scores when the child's vision declined. The sensitivity to detect VA poorer than 0.10 logMAR was 94%; the specificity was 71%. The web-based refractive error algorithm measured more myopia progression compared to clinic observations (mean difference SEQ 0.40 ± 0.51 dioptres). Age, sex or use of atropine drops were not significantly associated with test accuracy. The web-based test for self-assessing vision, performed at home by children with assistance from their parents, yielded VA scores with a precision similar to Snellen chart testing conducted in a clinical setting. However, the web-based refractive error algorithm overestimated myopia progression and requires recalibration for this specific age group.

Prospective validation of a virtual post-operative clinic in vitreoretinal surgery.

To evaluate the clinical efficacy and safety of asynchronous virtual post-operative assessments following vitreoretinal surgery and procedures compared to traditional face-to-face assessments in a high-volume tertiary eye centre. Prospective comparative clinical series study of patients who had undergone vitreoretinal surgery or post-laser retinopexy. Patients received both virtual and face-to-face assessments. The virtual assessment included clinical questions, visual acuity measurement, and virtual retinal imaging using ultra-wide field (UWF) imaging and macular optical coherence tomography (OCT). Face-to-face assessments involved standard clinical examinations. We included 142 patients undergoing a variety of vitreoretinal procedures. We showed comparable results between virtual and face-to-face assessments in both, post-operative and post-laser treatments. UWF imaging with macular OCT demonstrated potential for effective virtual post-operative assessment. The virtual assessment has a sensitivity of 91% and specificity of 100% for detecting retinal detachments with 100% specificity and 100% sensitivity for detecting new retinal tears or insufficient laser treatment. The implementation of asynchronous virtual post-operative assessments following a variety of vitreoretinal procedures is a promising alternative to traditional face-to-face assessments. Virtual assessments using UWF imaging and macular OCT showed high sensitivity and specificity. Virtual post-operative clinics offer the potential to improve patient access and decrease the clinical burden, especially with the continuing evolution of telemedicine technologies and imaging modalities.

Analysis of macular thickness and peripapillary retinal nerve fiber layer thickness in various ABO and Rh blood groups

PurposeTo determine the association between ABO and Rh blood groups with retinal structural indices including macular thickness and peripapillary retinal nerve fiber layer (RNFL) thickness.MethodsThis cross-sectional study was conducted using convenience sampling in a tertiary referral eye hospital in Tehran, Iran. Study participants were referred to the hospital laboratory to test their blood group. Ocular examinations were performed including measurement of visual acuity, auto-refraction, subjective refraction, and slit-lamp biomicroscopy. Retinal imaging was carried out using Spectral-domain OCT under dilated papillary conditions.ResultsThree hundred and twenty-eight individuals were recruited in this study. Of these, 219 (60.7%) were female and the mean age of the participants was 63.29 ± 5.57 years (range: 56 to 83 years). According to the multiple linear regression model, the global peripapillary RNFL thickness [coefficient: -3.05 (95% CI: -5.30 to -0.74); P = 0.010] and peripapillary RNFL thickness in the superior [coefficient: -4.65 (95% CI: -8.40 to -0.89), P < 0.001] and inferior [coefficient: -4.00 (95% CI: -7.81 to -0.19); P = 0.040] quadrants were significantly thinner in individuals with blood type B compared to those with other ABO blood groups. The average [coefficient: 12.69 (95% CI: 4.12–21.64); P = 0.004) and central [coefficient: 16.21 (95%: 6.44–25.97); P = 0.001) macular thicknesses were significantly thicker in AB group compared to other blood groups. The average macular thickness was significantly thinner in Rh + compared to the Rh- group [coefficient: -8.33 (95% CI: -15.4 to -1.25); P = 0.021].ConclusionRetinal structural indices may be related to blood groups implying a genetic linkage. Considering the lack of consistency among various studies, larger trials are needed to explore the effect of ABO and Rh grouping on peripapillary RNFL and macular thicknesses.

Visual Outcomes of Cataract Surgery in Patients with Previous History of Implantable Collamer Lens.

Background/Objectives: This retrospective case series analyzed visual outcomes in patients with a prior history of implantable collamer lens (ICL) implantation who underwent cataract extraction (CE). A secondary aim was to investigate the relationship between vault height and the rate of cataract development. Methods: Visual acuity and refraction measurements were collected after CE at one week, one month and six months. Vault height measurements were correlated to the time until symptomatic cataracts were removed. Results: A total of 44 eyes were analyzed at six months after CE with efficacy and safety indexes of 1.20 ± 1.11 and 1.50 ± 1.06, respectively. In addition, 70% of eyes had a post-operative uncorrected distance visual acuity (UDVA) within one line of pre-operative corrected distance visual acuity (CDVA). Refractive predictability at six months demonstrated that 43% and 69% of eyes were within ±0.25 D and ±0.50 D of SEQ target, respectively. Astigmatism measured by refractive cylinder was ≤0.25 D in 17% and ≤0.50 D in 34% of eyes pre-operatively compared to 40% and 60% of eyes, respectively, at six months post-operatively. Vault heights one week after ICL (p < 0.0081) and one week before CE (p < 0.0154) demonstrated a positive linear regression with the time until CE. Conclusions: This sample population achieved favorable visual outcomes six months after CE, similar to six months after ICL implantation. Patients with a history of ICL implantation will similarly have a good visual prognosis after CE.

SING IMT in pseudophakic eyes: Results of the first experiences

PurposeTo evaluate the feasibility and outcomes of implanting the Smaller-Incision New-Generation Implantable Miniature Telescope (SING IMT) in pseudophakic patients affected by late-stage dry AMD. SubjectsFive pseudophakic patients’ eyes with stable dry AMD were suitable for SING IMT implantation. Four eyes were excluded because of previous YAG laser capsulotomy. Patients underwent preoperative assessments, including visual acuity measurements and OCT scans. MethodsSurgical procedures were performed under peribulbar anesthesia, with careful IOL removal and SING IMT implantation. Postoperative follow-up was conducted at regular intervals to monitor visual acuity, device positioning and complications. ResultsPostoperative outcomes demonstrated improvements in visual acuity for most patients with an average gain in CDVA (Corrected Distance Visual Acuity) and CNVA (Corrected Near Visual Acuity) of 16,8 ± 10,2 and 13,8 ± 7,4 ETDRS letters, respectively. Limited complications have been observed. In one case, we observed dislocation of the device into the vitreous chamber, which we managed through vitrectomy and scleral fixation of the SING IMT using GoreTex suture. ConclusionsDespite being traditionally contraindicated for pseudophakic patients, SING IMT implantation in selected cases yielded favorable outcomes, indicating potential benefits for this population. Further research with larger sample sizes and longer follow-up periods is warranted to refine patient selection criteria and optimize surgical techniques.

Natural History of Visual Acuity and Microperimetry-Based Functional Outcome Measures of the Macula in Patients with Geographic Atrophy: A Retrospective Chart Review Study in Germany.

Background/Objectives: Geographic atrophy (GA) is an advanced form of age-related macular degeneration (AMD) leading to the progressive and irreversible loss of visual function. Characteristics of GA include atrophic lesions resulting from the loss of photoreceptors, retinal pigment epithelium, and choriocapillaris. During GA progression, atrophic lesions typically advance from the macular periphery to the center, affecting foveal light sensitivity and visual acuity. This study analyzed changes in light sensitivity and visual acuity during the natural course of GA progression using the topographic analysis of structural and functional changes based on Early Treatment Diabetic Retinopathy Study (ETDRS) charts, multimodal imaging, and microperimetry assessment. Methods: Medical chart data of GA patients between 2014 and 2022 from the Internationale Innovative Ophthalmochirurgie GbR (I.I.O.) research center (Düsseldorf, Germany) were retrospectively analyzed. All patient eyes fulfilling the phase 3 OAKS study inclusion criteria were included and followed up for 60 months. The imputation of missing measurements and dropouts was performed by linear mixed models. Results: A total of 20 GA eyes from 13 GA patients were included in the study. At the index, 53.8% of patients had bilateral GA, with 70.0% of the eyes showing multifocal GA and 30.0% subfoveal encroachment (SFE). A total of 35.0% of the eyes had 2-5, and 15.0% over 20, areas of atrophy. Over time, the GA lesion size increased from 6.4 mm2 to 11.8 mm2 (1.08 mm2/year). After an average observation time of 2.9 years, 78.6% of the initially unaffected study eyes developed SFE. The percentage of study eyes without visual impairment decreased from 55.0% to 30.0%, with mean normal-luminance best-corrected visual acuity (NL-BCVA) reducing from 63.7 to 55.7 ETDRS letters. The share of absolute scotoma points in microperimetry assessment increased from 15.7% to 43.5% while overall average macular sensitivity declined from 15.7 dB to 7.4 dB. Conclusions: The substantial deterioration of macular outcomes and visual function was comprehensively detected. The results were a documentation of structural and functional aspects of the natural progression of GA for a 60-month follow-up, providing a typical outline for AMD patients with GA.

Ethnicity and outcomes for patients with gastrointestinal disorders attending an emergency department serving a multi-ethnic population

BackgroundEthnic inequalities in acute health acute care are not well researched. We examined how attendee ethnicity influenced outcomes of emergency care in unselected patients presenting with a gastrointestinal (GI) disorder.MethodsA descriptive, retrospective cohort analysis of anonymised patient level data for University Hospitals of Leicester emergency department attendees, from 1 January 2018 to 31 December 2021, receiving a diagnosis of a GI disorder was performed. The primary exposure of interest was self-reported ethnicity, and the two outcomes studied were admission to hospital and whether patients underwent clinical investigations. Confounding variables including sex and age, deprivation index and illness acuity were adjusted for in the analysis. Chi-squared and Kruskal–Wallis tests were used to examine ethnic differences across outcome measures and covariates. Multivariable logistic regression was used to examine associations between ethnicity and outcome measures.ResultsOf 34,337 individuals, median age 43 years, identified as attending the ED with a GI disorder, 68.6% were White. Minority ethnic patients were significantly younger than White patients. Multiple emergency department attendance rates were similar for all ethnicities (overall 18.3%). White patients had the highest median number of investigations (6, IQR 3–7), whereas those from mixed ethnic groups had the lowest (2, IQR 0–6). After adjustment for age, sex, year of attendance, index of multiple deprivation and illness acuity, all ethnic minority groups remained significantly less likely to be investigated for their presenting illness compared to White patients (Asian: aOR 0.80, 95% CI 0.74–0.87; Black: 0.67, 95% CI 0.58–0.79; mixed: 0.71, 95% CI 0.59–0.86; other: 0.79, 95% CI 0.67–0.93; p < 0.0001 for all). Similarly, after adjustment, minority ethnic attendees were also significantly less likely to be admitted to hospital (Asian: aOR 0.63, 95% CI 0.60–0.67; Black: 0.60, 95% CI 0.54–0.68; mixed: 0.60, 95% CI 0.51–0.71; other: 0.61, 95% CI 0.54–0.69; p < 0.0001 for all).ConclusionsSignificant differences in usage patterns and disparities in acute care outcomes for patients of different ethnicities with GI disorders were observed in this study. These differences persisted after adjustment both for confounders and for measures of deprivation and illness acuity and indicate that minority ethnic individuals are less likely to be investigated or admitted to hospital than White patients.

Cross-sectional study of cognitive impairment and visual impairment among the elderly population in residential care in India: the Hyderabad Ocular Morbidity in Elderly Study (HOMES)

ObjectiveTo report the relationship between visual impairment (VI) and cognitive impairment (CI) among the older population living in residential care homes in Hyderabad, India.Study designCross-sectional study.Setting41 homes for the aged...

Intra-operative Intravitreal Bevacizumab For Patients With Diabetic Macular Edema Undergoing Phacoemulsification with Foldable IOL Implantation

Objective: To assess the efficacy of Intra-operative Intravitreal Bevacizumab in treating Diabetic Macular Edema in patients undergoing Phacoemulsification with Foldable intraocular lens (IOL) Implantation, in comparison to a control group.Methodology: This experimental study was performed in department of Ophthalmology, Madinah Teaching Hospital, Faisalabad from 5th October to 2022 – 5th March 2023. Sixty patients (30 in each group) were enrolled in the study. Patients in group “A” received Intravitreal Bevacizumab immediately after phacoemulsification with foldable IOL implantation.Whereas Intravitreal Bevacizumab was not given to patients in group B (control group). Best Corrected Visual Acuity (BCVA) and macular thickness using optical coherence tomography (OCT) were recorded within a timeframe of 7-30 days prior to surgery, as well as at 1 and 3 months after the surgery for comparison between the two study groups. Results: The study comprised 60 patients, with a mean age of 56.43 ± 5.90 years, representing both genders. Among the participants, males were predominant, accounting for 32 (53.3%) individuals, while females constituted 28 (46.7%) of the sample. The baseline best-corrected visual acuity (BCVA) measurements between group A and group B were 0.22 ± 0.68 and 0.21 ± 0.07, respectively. There was no statistically significant difference observed between the two groups (P = 0.677). However, significant disparities in BCVA were observed after one- and three-months post-surgery, favoring group A.Similarly, mean optical coherence tomography (OCT) at baseline was 271.09 ± 26.87 in group A and 307.57 ± 32.81 in group B, with no significant difference (P = 0.771). Nonetheless, significant differences in OCT were noted after one- and three-months post-surgery, with group A demonstrating superior results. These findings underscore the beneficial impact of intra-operative Bevacizumab in improving both BCVA and OCT outcomes post-surgery. Conclusion: The administration of intravitreal bevacizumab during phacoemulsification has been shown to yield notable improvements in Best Corrected Visual Acuity (BVCA) and Optical Coherence Tomography (OCT) among those with diabetes with macular edema who are undergoing cataract surgery.

Retrospective investigation of improvements in functional vision for adolescent students with cerebral vision impairments in a specialist residential school and college setting

Cerebral and/or cortical vision impairment (CVI) is the leading cause of childhood vision impairment in the Global North. Previous studies have demonstrated that the functional vision of children with CVI can develop over time, but evidence for the effectiveness of interventions is still in its infancy. In this study, we retrospectively reviewed student records from a specialist residential school and college in the United Kingdom that had implemented an evidence-based approach to assessment and intervention for adolescent students with CVI called the CVI Range. The outcome of CVI Range assessments were recorded annually over a 5-year period, and potential predictor variables such as measures of visual acuity and presence of conditions such as cerebral palsy and seizure disorders were recorded as part of standard practice within the service. A total of 73 annual assessments were analysed from a total of 24 students between the ages of 9 and 25 years old. We used a mixed model for repeated measures approach to reveal a significant fixed effect of time on functional vision that equated to a linear increase of 0.78, 95% CI [0.60, 0.97] in CVI Range Rating 2 for each year of participation on the programme. The mixed effects models also revealed significant interindividual differences in functional vision, which could be partly explained by a significant negative effect of acuity and by a joint positive effect of nystagmus and time, but not by age. These findings demonstrated that significant improvements in functional vision are still possible for students with CVI long after the accepted sensitive period of neuroplasticity in the visual cortex. Further studies incorporating research designs appropriate for evaluating complex interventions are required to determine which individual and contextual characteristics are valid and reliable predictors of improvements in functional vision for young people with CVI.

Evaluation of Intrascleral Lakes after Phaco-Viscocanalostomy using Anterior Segment Optical Coherence Tomography.

This study aimed to investigate the results of combined phacoemulsification and viscocanalostomy (phaco-VC) in a six-month follow-up and its relationship with intrascleral lake (IL) using anterior segment optical coherence tomography (AS-OCT) in patients with primary open-angle glaucoma (POAG). In total, 36 eyes with POAG eligible for phaco-VC were enrolled in this prospective observational study. All patients underwent AS-OCT evaluation and ophthalmologic examination including Goldman tonometry, cup-disc ratio assessment, best corrected visual acuity (BCVA) measurement, and antiglaucoma medication(s) prior to surgery and one, three, and six months after the surgery. The width, length, area, and circumference of the ILs were evaluated using AS-OCT at each follow-up. A total of 36 eyes of 34 patients with POAG were investigated in this study. According to the results, the mean age of the patients was 70.09 8.73 years, and the majority of the cases were male (n = 23; 63.9%). The mean preoperative intraocular pressure (IOP) was 20.11 7.22 mmHg on 2.47 1.1 medications, and the mean postoperative IOP reduced to 11.11 2.58 mmHg on 0.11 medications, which was statistically significant (P 0.001). ILs were detectable in all cases which resulted in a 100% qualified success rate. The reduction in the width, area, and circumference of the IL was significant during the six-month follow-up. The relationship between IOP changes and IL parameters on AS-OCT was not significant. This study evaluated the associations between IL changes and IOP reduction after phaco-VC. A six-month follow-up showed a notable reduction in the IL, but unexpectedly, IOP control did not decline. A reduction in IL diameter, when there is sufficient IOP control, indicates that there may be various IOP lowering mechanisms through VC other than the IL diameters. Further evaluation of VC focusing on long-term changes in IL and Schlemm's canal diameter is necessary to explain the precise mechanisms of lowering the IOP.

Efficacy and safety of hyperbaric oxygen therapy monitored by fluorescein angiography in patients with retinal artery occlusion

AimsTo assess the efficacy and safety of a standardised hyperbaric oxygen therapy protocol (HBOT) monitored by fluorescein angiography (FA) in patients with retinal artery occlusion (RAO).MethodsIt is a prospective, non-comparative,...

Assessment of the Retinal Ganglion Cell Layer after Uncomplicated Cataract Surgery.

(1) Background: This research aimed to evaluate the changes in ganglion cell layer thickness (GCLT) after uncomplicated cataract surgery in patients without previous ocular pathology and the impact of the appearance of cystoid macular edema on the GCLT and visual acuity. (2) Methods: The evaluation of 174 patients was performed with the indication of uncomplicated cataract surgery. The variables analyzed were demographic data, best-corrected visual acuity (BCVA), cataract type and OCT (Optical Coherence Tomography) measurements of central macular thickness (CMT), and the presence of cysts and GCLT preoperatively and one day, one and three months after surgery. (3) Results: There was a relationship between the postoperative increase in retinal GCLT and BCVA after uncomplicated cataract surgery. The presence of microcysts reduced the thickness of the GCL, which is significantly related to the loss of BCVA. The appearance of cystoid macular edema one month after surgery was also related to the preoperative CMT. There was a statistically significant decrease in preoperative GCL but a statistically significant increase in preoperative CMT in patients with microcysts one-month post-surgery. (4) Conclusions: There is a relationship between postoperative retinal GCLT and BCVA after uncomplicated cataract surgery. The presence of microcysts significantly reduces the thickness of the GCL, which is significantly related to the loss of BCVA.

Effects of physical activity patterns on myopia among children and adolescents: A latent class analysis.

The daily physical activity (PA) patterns of children and adolescents are intricate and ambiguous, with varying effects on myopia resulting from different combinations of PA. This study aims to scrutinize the spectrum of PA patterns among children and adolescents and assess their impact on myopia. Data sourced from the 2014 National Student Physical Fitness Survey (Tianjin segment) encompassed PA records and visual acuity measurements of participants. Latent Class Analysis and a generalized linear model were employed to investigate the relationship between PA categories and visual acuity across different educational stages. The study comprised 6465 primary and middle school students, among whom 50.13% were male. PA patterns were categorized into high (27.16%), medium (29.88%) and low visual acuity regulation groups (13.97%) and the nonmainstream group (28.99%). Following adjustments for sex, age, region and BMI, the medium visual acuity regulation group exhibited a lower risk of myopia (OR = 0.617, 95% CI = 0.424-0.897, p = 0.012; OR = 0.654, 95% CI = 0.438-0.976, p = 0.038) compared to the nonmainstream group among junior and senior middle school students. The efficacy of diverse PA patterns in mitigating myopia risk varies across educational stages and is influenced by sex-specific factors. It is imperative to advance myopia management strategies by emphasizing tailored PA interventions, discerning between PA patterns and delivering timely guidance and interventions tailored to distinct educational stages and sexes.

Self-assessment of Visual Acuity Using a Smartphone Application

Purpose: We evaluated the accuracy and usefulness of self-assessment of visual acuity (VA) using a smartphone application for Korean users and explored its potential application in screening eye diseases.Methods: In total, 52 participants aged ≥ 20 years were included in the study. Of these participants, 31 used Jin Yong-Han’s VA chart and the smartphone application to measure their distant visual acuity (DVA), whereas 21 used Han Chun-Seok’s near visual acuity chart and the application to measure their near visual acuity (NVA). The results and time required for VA measurement using both methods were compared. VA was converted to logarithm of the minimum angle of resolution (logMAR) for analysis. The voice recognition rate of the application for numbers 2-9 was assessed.Results: The mean NVA was 0.29 ± 0.28 using Han’s chart and 0.30 ± 0.43 using the application with no significant difference (&lt;i&gt;p&lt;/i&gt; = 1.00). The mean DVA was 0.19 ± 5.89 using Jin's chart and 0.20 ± 0.27 using the application with no significant difference (&lt;i&gt;p&lt;/i&gt; = 0.19). The average time spent for measuring NVA and DVA was 19 seconds (s) using Han’s and Jin's charts, whereas it was 42 and 38 s for measuring NVA and DVA using the application. The voice recognition rate of the application was 87% on average for numbers 2-9, with the highest rate for number 7 (79%) and the lowest rate for number 4 (91%).Conclusions: Self-assessment of VA using a smartphone application exhibited similar results to conventional VA measurement methods. Although the measurement time varied, DVA and NVA could be measured at home using a smartphone, and would be particularly useful for those who have difficulty visiting a hospital.

Assessment of refractive errors, amblyopia, strabismus, and low vision among hearing-impaired and deaf students in Kermanshah

Background and AimRefractive errors, amblyopia, strabismus, and low vision are more common among children with hearing impairments in comparison with their hearing peers. Neglecting visual disorders can pose educational and social problems for these children. The present study aimed to assess the prevalence of refractive errors, amblyopia, strabismus, and low vision among hearing-impaired and deaf students in Kermanshah.Materials and methodsA total of 79 deaf and hearing impaired students within the age range of 7–20 years (mean age of 15.01 ± 2.72) underwent optometric examinations, including autorefractometry, retinoscopy, ophthalmoscopy, slit lamp, visual acuity measurement, and cover-uncover test. Those who needed further evaluation were referred to the Ophthalmology Clinic of Imam Khomeini Hospital.ResultsRegarding the prevalence of refractive errors, 32 (40.5%) subjects had one or a combination of refractive errors, the most common of which was astigmatism (36.7%), followed by amblyopia (15.1%). The most common type of strabismus was latent strabismus (heterophoria) (88.6%), followed by exophoria (81%). Moreover, 3 (3.7%) cases had nystagmus. A significant difference was observed between the prevalence of amblyopia and the degree of hearing loss (P = 0.026), and no significant difference was detected in other cases.ConclusionAs evidenced by the obtained results, refractive errors, amblyopia, strabismus, and low vision are more prevalent among deaf and hearing-impaired children compared to normal children because deaf and hearing-impaired children are not able to convey their vision problems and need to compensate for their poor hearing with an enhanced sense of sight, inattention to these disorders can present these children with serious educational and social problems. Therefore, eye screening examinations are of paramount importance in deaf and hearing-impaired children.

Sense of ownership influence on tactile perception: Is the predictive coding account valid for the somatic rubber hand Illusion?

According to the predictive coding account, the attenuation of tactile perception on the hand exposed to the visuo-tactile Rubber Hand Illusion (vtRHI) relies on a weight increase of visual information deriving from the fake hand and a weight decrease of tactile information deriving from the individual’s hand. To explore if this diametrical modulation persists in the absence of vision when adopting the somatic RHI (sRHI), we recorded tactile acuity measures before and after both RHI paradigms in 31 healthy individuals, hypothesizing a weight decrease for somatosensory information deriving from the hand undergoing the illusion and a weight increase for those deriving from the contralateral hand in the sRHI. Our results showed a significant overall decrease in tactile acuity on the hand undergoing the illusion whilst no changes emerged on the contralateral hand during sRHI. Since the sRHI was not accompanied by the hand spatial remapping, despite the generation of the feeling of ownership toward the fake hand, we hypothesized spatial remapping might play a pivotal role in determining sensory information weight attribution.

Prevalence and characteristics of amblyopia, strabismus, and refractive errors among patients aged 3–16 years in Shanghai, China: a hospital-based population study

BackgroundFunctional visual impairments in children are primarily caused by amblyopia or strabismus. This study aimed to determine the prevalence and clinical profile of amblyopia and strabismus among individuals aged 3–16 years in Shanghai, China.MethodsFrom February 2023 to February 2024, this hospital-based, cross-sectional study included data of children who visited the Ophthalmology Department of Shanghai General Hospital. Comprehensive ocular examinations included visual acuity measurement after cycloplegic refraction, slit lamp examination, cover test, and dilated fundus examination. Descriptive statistics were performed to estimate the proportion and clinical characteristics of amblyopia and strabismus.ResultsA total of 920 children were enrolled in our study. Among them, 223 (24.24%) children were identified as amblyopia. Unilateral amblyopia occupied 57.85%, and bilateral amblyopia occupied 42.15%. Most participants were within the age range of 5–10 years (75.97% for unilateral amblyopia, and 70.21% for bilateral amblyopia). Anisometropia was the primary cause of unilateral amblyopia (68.99%). Most amblyopic children have high hyperopia (38.76% for unilateral amblyopia, and 39.89% for bilateral amblyopia). 30 (3.26%) children were diagnosed with strabismus, and 19 (63.3%) of them were aged 5–10 years. Seven of the children had both strabismus and amblyopia.ConclusionThe proportion of patients with amblyopia and strabismus was determined as 24.24% and 3.26% in our study. Anisometropia was the leading cause of unilateral amblyopia, whereas high hyperopia was a crucial refractive error in the amblyopic population. These findings shed light on further longitudinal studies targeting the age-related changes in amblyopia, strabismus and refraction errors. Therefore, efforts should be made to manage uncorrected refractive errors, amblyopia, and strabismus among children in Shanghai.

Measure to improve: a pilot study of Birthrate Plus in the Netherlands

Background/Aims Evidence-based standards are an important means for ensuring safe and effective care for birthing women. The provision of one-to-one care for women in labour is one such standard, which should be the norm in Dutch maternity care. However, no audit measures of this standard are available. This study examined the use of Birthrate Plus, a validated instrument for the measurement of patient acuity. This tool has the added benefit of allowing measurement of birth characteristics in relation to staffing numbers, providing a basis for auditing the standard of one-to-one care for women in labour in hospitals in the Netherlands. Methods This pilot study used the Birthrate Plus tool to retrospectively examine birth characteristics and staffing levels in a 4-month period, in five hospitals in the Netherlands. Results The review of 11 582 patient cases found that most births in the sample were classified as occurring in the higher acuity levels of Birthrate+ tool. Examination of staffing levels showed that when comparing actual staffing levels with recommended levels, hospitals had a shortfall of between 47% and 64%. Conclusions The Birthrate Plus tool could be useful in auditing staffing levels in Dutch maternity care. Analysis of the data provided by hospitals in the sample showed that none were able to meet the Dutch standard of providing consistent one-one-one care.

Objective acuity measures for infusion therapy staffing: A predictive model approach—Phase I.

e13553 Background: Acuity is a measure of the complexity of patient care and an estimate of nursing workload. The use of acuity tools is shown to improve care standards, nurse satisfaction and productivity. Existing acuity tools have barriers to adoption, including increased nursing workload, estimate variations among different nurses and clinical care settings, and poor understanding of validity of acuity measures. We aim to build a predictive model for prospectively determining acuity levels and staffing requirements in infusion therapy to address these gaps. This project will be implemented with a phased approach. Here we describe Phase I, to establish a standard measure and documentation process for acuity, then collect and analyze a large data set to quantify the relationship of acuity scores to selected patient characteristics. Methods: A US Oncology Network nursing committee developed evidence-based guidelines for acuity measurement and documentation in August 2023. Nine sites from four independent, community oncology practices were selected to perform acuity rating and documentation using the developed guidelines. Multiple training sessions on the guidelines were conducted with nurses from selected sites. Nurses documented acuity scores (level 1~6) and start time for patients’ infusion visits in the EHR 8/30/2023 – 11/30/2023. Acuity documentation rates were calculated and provided to each site weekly to gain feedback and engagement. Acuity scores were extracted from the electronic health record using natural language processing. Structured data on potential predictors including patient demographics, performance status, lab, and treatment-related information were also collected. Results: A total of 14,610 infusion room visits (5,139 distinct patients) with documented acuity scores were reported. The acuity documentation rate from each site was consistent by week and ranged 60 – 96%. Table reports prevalence of select features by acuity score. Conclusions: An operational workflow was successfully implemented to collect and analyze acuity scores and relevant features. Features of interest include chemotherapy Cycle 1 Day 1, five or more drugs and highly emetogenic treatment. In Phase II, the collected acuity scores and clinical features will be used to build a predictive model to objectively estimate acuity. Phase III will focus on the deployment of the predictive model to oncology practices. [Table: see text]