Acuity Testing Research Articles

Dynamics of retinal perfusion parameters in patients with post-COVID syndrome

BACKGROUND: A major current health issue is the rehabilitation of patients who previously had a coronavirus infection (COVID-19), as well as the treatment of patients with post-COVID syndrome. For a long time after COVID-19, patients may have complaints, including vision-related ones. One of the theories is that this may be due to long-term persistent microcirculatory retinal changes.
 AIM: To assess the long-term dynamics of retinal microcirculation changes in patients with post-COVID syndrome and to evaluate the relationship of these parameters with visual functions.
 MATERIALS AND METHODS: The main group consisting of 41 patients (82 eyes) was divided into groups depending on the severity of COVID-19: mild, moderate and severe. The control group included 13 people (26 eyes) who did not have COVID-19 to the time of the examination. All patients underwent an ophthalmological examination, including low-contrast visual acuity testing and optical coherence tomography-angiography. Vessel density (VD) was examined within the superficial capillary plexus (SCP), deep capillary plexus (DCP), and radial peripapillary capillaries (RPC). The following structural indicators were also measured: the retinal thickness, the retinal nerve fiber layer thickness and the ganglion cell complex. All patients were examined twice: 6 weeks after COVID-19 and in 27 weeks (6 months after the first visit).
 RESULTS: Patients who went through moderately severe and severe COVID-19 showed a significant decrease in low-contrast visual acuity in comparison to the control group at Visit 1 (p .001 in both cases), which totally recovered to the Visit 2. In the same group of patients, there was a significant decrease in VD SCP (p .001) and VD DCP (p .001) in comparison to the control group, and these parameters significantly decreased at visit 2 (p .001 in both cases). In the group of patients with moderate COVID-19, there was also a decrease in VD SCP and VD DCP in comparison to the control group (p .001 in both cases), while the indicators remained stable during 6 months of follow-up (p = .082). There were no significant changes in VD RPC and main morphometric parameters during 6 months of follow-up.
 CONCLUSIONS: In patients with COVID-19 from moderate severity to severe, there is a significant decrease in contrast sensitivity, which is temporary and fully recovers after 6 months. In patients with severe COVID-19, there was a negative dynamic of retinal perfusion during 6 months, both in deep and superficial capillary plexuses. Patients with post-COVID syndrome, or those who have had COVID-19 and present with visual complaints, need a deep ophthalmological examination including optical coherence tomography-angiography, with a possible involvement of related specialists.

Chinese expert consensus on the visual acuity testing for infants and preverbal children (2023)

Abnormal visual experience in the first 3 years of life may lead to permanent visual impairment without early screening and timely intervention. It is of great clinical significance to evaluate the visual acuity of infants and preverbal children with suspected visual abnormality. However, the evaluation is difficult due to the inability of these children to express their complaints and the lack of unified standards. In order to promote the standardization of the visual acuity testing in infants and preverbal children, including the screening and follow-up examinations, a consensus has been reached by the Chinese Association for Pediatric Ophthalmology and Strabismus along with the Pediatric Ophthalmology and Strabismus Group of Chinese Ophthalmologist Association, based on the research results of evidence-based medicine.

Quantification of expected information gain in visual acuity and contrast sensitivity tests

We make use of expected information gain to quantify the amount of knowledge obtained from measurements in a population. In the first application, we compared the expected information gain in the Snellen, ETDRS, and qVA visual acuity (VA) tests, as well as in the Pelli–Robson, CSV-1000, and qCSF contrast sensitivity (CS) tests. For the VA tests, ETDRS generated more expected information gain than Snellen. Additionally, the qVA test with 15 rows (or 45 optotypes) generated more expected information gain than ETDRS, whether scored with VA threshold alone or with both VA threshold and VA range. Regarding the CS tests, CSV-1000 generated more expected information gain than Pelli–Robson, and the qCSF test with 25 trials generated more expected information gain than CSV-1000, whether scored with AULCSF or with CSF at six spatial frequencies. The active learning-based qVA and qCSF tests have the potential to generate more expected information gain than traditional paper chart tests. Although we have specifically applied it to compare VA and CS tests, expected information gain is a general concept that can be used to compare measurements in any domain.

Comparison of cataract patients with regular corneal astigmatism after implantation of extended range-of-vision and bifocal toric intraocular lenses.

To compare the postoperative visual acuity and visual quality between extended range-of-vision and multifocal toric intraocular lens (IOLs) after implantation in cataract patients with regular corneal astigmatism. Department of Ophthalmology, the Second Hospital of Jilin University, Changchun, Jilin Province, China. Retrospective and single-center study. The study involved implanting the Tecnis Symphony (ZXR00IOL) or the bifocal toric (ZMTIOL) in patients undergoing cataract surgery. Three months after surgery, lens performance was evaluated using distance, intermediate, and near visual acuity tests, defocus curves, the modulation transfer function (MTF), a visual function index questionnaire (VF-14), and the adverse optical interference phenomena. The 3-month postoperative follow-up found that both groups had good corrected distance vision. The ZMT group had better-uncorrected distance visual acuity and near visual acuity (p < 0.05). However, the ZXR group showed better uncorrected intermediate visual acuity (p < 0.05) and visual continuity. Overall astigmatism in the postoperative ZMT group was significantly lower than that in the pre-operative group (p < 0.05). The ZMT group had lower total high-order aberrations (tHOs), higher MTF values, and higher VF-14 scores (p < 0.05). Finally, the ZXR group exhibited reduced halo and glare phenomena (p < 0.05). We found that ZMT can effectively correct a corneal astigmatism of 1.0-1.5 D and ZXR can improve patient outcomes regarding subjective optical quality and range of vision. These findings have the potential to improve future astigmatism treatment options.

Testing for visual deficits by the police among road users in Germany

The Professional Association of Ophthalmologists (BVA) estimates that at least 100,000s of traffic accidents with 10,000s of injuries and fatalities are caused by known and unknown visual disorders on German roads every year. Until now, however, the police have not had the opportunity to check for potential visual disorders on the spot in cases of conspicuous driving. In apilot project of the police with the Eye Hospital of the Hannover Medical School (MHH), the aim was for the first time to extend the existing tests of the police by adapted "car-side" vision tests. On-site evaluation of eye motility, pupil size and light reaction of car drivers as well as an orienting visual acuity test and an orienting confrontation visual field was performed. The practical performance of all examination modalities was previously coordinated and trained. The scope and type of individual examinations for estimating visual ability of car drivers were described and standardized. In addition to the visual characteristics, more familiar neurological tests, such as walking along astraight line were also recorded. The combined test evaluation results in an objective basis for the official decision of an immediate temporary withdrawal of the driving license, if necessary, and the initiation of further measures, such as an ophthalmological examination. With these innovations, the Lower Saxony police have revised their training concept for checking driving ability and issued it for implementation at the beginning of 2022, including the vision tests recommended by ophthalmologists. In the meantime, around 150 officers have been trained in Lower Saxony and are now authorized to carry out qualified driving ability tests. In this respect, alarge number of corresponding traffic examinations have already been carried out and the continued driving of road users with significant visual deficits has been prevented. In this pilot project, the aim was for the first time to expand the common testing procedures of the traffic police for the detection of drivers who are dangerous to traffic, in addition to screening for alcohol, drugs and neurological deficits, to include specific tests for the detection of visual deficits. The corresponding training of police officers has been carried out across the board in Lower Saxony and Hamburg, and the measures are currently being applied as needed during traffic controls. In the future, the tested characteristics will be evaluated in aweighted score and will provide an objective basis for the police to decide whether to stop the driver in cases of deficits.

Is there value in measuring near visual acuity during occlusion therapy for amblyopia?

ABSTRACT Introduction: The purpose of this study was to investigate near and distance visual acuity (VA) prior to, during and on completion of occlusion therapy for amblyopia. Method: Fifty-four patients aged 4–7 years (mean 4.9; ±0.44) with untreated strabismic, anisometropic or mixed amblyopia were recruited to the study following refractive adaptation where applicable. All patients underwent conventional occlusion (patching). Uniocular near and distance VA was tested using age and ability appropriate Crowded LogMAR VA tests prior to, during and upon conclusion of occlusion therapy. Results: In amblyopic eyes, there was no significant difference between near and distance VA prior to occlusion therapy with LogMAR Crowded (p = .66; mean distance VA at 3 m = 0.6 LogMAR; mean near VA at 40 cm = 0.58 LogMAR), or with LogMAR Crowded Kay Picture test (p = .78, mean distance VA at 3 m = 0.44 LogMAR; mean near VA at 33 cm = 0.46 LogMAR;). No significant difference was found between near and distance VA at any visit during occlusion therapy, or on completion of occlusion therapy with LogMAR Crowded (p = .86, mean final distance VA at 3 m = 0.266 LogMAR; mean final near VA at 40 cm = 0.25 LogMAR) or LogMAR Crowded Kay Pictures (p = .74, mean final distance VA at 3 m = 0.16 LogMAR; mean final near VA at 33 cm = 0.16 LogMAR). There was no significant difference in the VA of the fellow (non-amblyopic) eyes prior to and on completion of occlusion therapy with LogMAR Crowded at distance (3 m) or near (40 cm) (p = .05, p = .40 respectively); or with LogMAR Crowded Kay Pictures at distance (3 m) or near (33 cm) (p = .89, p = .35 respectively). Discussion: Improvement in VA of amblyopic eyes did not significantly differ between near and distance testing proximites at any point during the course of occlusion therapy for amblyopia in our study. These findings may aid clinicians with appropriate test selection and help with clinical time pressures. Where patient concentration does not allow for uniocular distance vision, uniocular near vision may be used to diagnose amblyopia, and vice versa. This could prevent delay in the treatment of amblyopia.

Increasing depth of focus with allogeneic presbyopic inlays: 3-year results.

To demonstrate the safety and efficacy of allogenic corneal inlays designed to increase the depth of focus (DoF) in treated eyes. Medipol University Hospital, Istanbul, Turkey. Prospective case series. This study includes 50 eyes of 25 patients with a follow-up of 3 years. Emmetropic patients with presbyopia had implantation of allogenic corneal inlays in the nondominant eye. The uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and uncorrected near visual acuity (UNVA) were evaluated in all eyes. A subjective visual acuity test system (Multifocal Lens Analyzer 3.0 application) was used to analyze the DoF by measuring the defocus curves. No significant difference between the treated and fellow eyes in UDVA and CDVA was found, whereas UNVA was significantly better in the treated eyes ( P = .20, P = .07, P < .01, respectively). Comparing to the preoperative CDVA, there was a 1-line decrease in CDVA in 6 (%24) patients. The mean defocus curves reveal a DoF of 1.1 diopters (D) for the untreated eye at the logMAR = 0.2 threshold. By contrast, the mean DoF of the treated eye and binocularly was 2.8 D. The areas under the curve were significantly better in the near, intermediate, and total distances in the treated eyes, whereas it was better for the far distances in the untreated eyes. All values were significant ( P = .023 total, P < .01 others). Allogenic presbyopic inlay implantation may be safe and provided a clinically and statistically significant increase in the DoF leading to good far, intermediate, and near-visual acuity in emmetropic presbyopic patients.

Refractive Outcomes of Cataract Surgery in Patients With Intrastromal Femtosecond Laser Treatment of Presbyopia (INTRACOR).

To evaluate the outcomes of cataract surgery with intraocular lens (IOL) implantation in patients who underwent intrastromal femtosecond laser treatment of presbyopia (INTRACOR). This was an interventional case series of 8 patients (10 eyes) who presented for cataract surgery 6.1 ± 3.2 years (mean ± standard deviation [SD]) after INTRACOR (Technolas Perfect Vision GmbH) treatment. A monofocal IOL was implanted in 9 eyes (7 patients) and a small-aperture IOL was implanted in 1 eye. The IOL power was calculated without adjustments using biometry obtained after the INTRACOR treatment. For additional calculations, keratometry obtained before the INTRACOR treatment was used. Postoperative examinations included visual acuity testing, manifest refraction, defocus curve, ocular biometry, corneal tomography, aberrometry, anterior segment optical coherence tomography, and slit-lamp examination. After the cataract surgery, the mean ± SD uncorrected distance visual acuity was 0.37 ± 0.17 logMAR, the corrected distance visual acuity was 0.10 ± 0.10 logMAR, and the manifest refraction spherical equivalent, adjusted to infinity, was +0.39 ± 0.63 diopters (D). Intermediate and near visual acuity, both uncorrected and distance-corrected, and distance-corrected defocus curves varied considerably among patients. Using biometry performed after INTRACOR, the traditional IOL power calculation formulas produced hyperopic outcomes, with the mean ± SD prediction error ranging from +0.72 ± 0.34 to +0.96 ± 0.41 D. Although the mean ± SD prediction error decreased (range: -0.34 ± 0.56 to -0.15 ± 0.53 D) when using keratometry obtained before INTRACOR, the accuracy remained low due to high variability. In patients with cataract who had previous INTRACOR treatment, IOL power calculation could be inaccurate, with a tendency toward hyperopic outcomes. These results require confirmation in more extensive studies. [J Refract Surg. 2023;39(10):676-682.].

A Comparative Study of Manual and Digital Methods and Stereopsis Assessment in Young Adults

Reduced stereopsis or depth perception may be the early indicator of abnormal motor functions in people therefore, the stereopsis test is considered ideal for visual screening. It can accomplish the need for the assessment of stereopsis by using a cost-effective smartphone application. Objective: To compare the stereo acuity values of manual and digital stereopsis tests by using the Random Dot Stereo Acuity test with Lea Symbols (Manual) and the SAT App for Android (Digital). Methods: A comparative cross-sectional study was carried out in the Eye department at The University of Lahore Teaching Hospital from February 2023 to May 2023. A total of 62 subjects aged 15-35 years were included in our study, out of which 31 were emmetropes and 31 were ametropes. Screening of subjects was done which included torch light examination and basic refraction. Manually stereopsis was measured using Random Dot stereo acuity test with Lea symbols and digitally it was measured by SAT application. Results: The mean ± SD stereo acuity value of the manual test (N=62) was 60.5242 ± 36.47607 seconds of arc and the mean stereo acuity value of the digital test (N=62) was 70.0968 ± 28.29569 seconds of arc. P-value was 0.006 which confirmed that our results were statistically significant. Conclusions: Our study highlighted the comparison of digital and manual stereopsis tests. We obtained different stereo acuity values from both tests on the same individuals. Hence, the manual test gave better values of stereopsis than the digital test.

Visual results and subjective satisfaction after implantation of two different trifocal diffractive intraocular lenses models (AcrySof IQ PanOptix and AT LISA tri 839 MP).

This study aimed to compare visual results following the implantation of two distinct diffractive trifocal IOLs utilizing various vision evaluation techniques and subjective satisfaction. The study included 32 eyes receiving AcrySof IQ PanOptix implantation and 32 receiving AT LISA tri 839 MP. Post-operative examination at one year included uncorrected visual acuity (UCVA), distance-corrected visual acuity (DCVA) at 4 m, 80 cm, 60 cm, and 40 cm, Contrast sensitivity under photopic and mesopic conditions, and a questionnaire on subjective quality of vision, optical phenomena, and spectacle independence. The two groups were similar in baseline demographics, pre-operative visual, biometric data (except for axial length), and surgical paraments. The PanOptix outperformed the AT LISA tri in the intermediate range when using the standard visual acuity testing (UCVA: 0.23 ± 0.14 logMAR vs. 0.31 ± 0.17 logMAR, p = 0.04; BCVA: 0.21 ± 0.12 vs. 0.28 ± 0.14, p = 0.03) and in the intermediate and far range when using the interactive computer program (intermediate: UNVA "E" optotype test: 0.05 ± 0.12 vs. 0.12 ± 0.13, p = 0.03; Far: UNVA "E" optotype: 0.07 ± 0.12 vs. 0.13 ± 0.10, p = 0.05). In addition, the PanOptix group had higher contrast sensitivity under photopic and mesopic conditions with and without glare at all spatial frequencies. There was no difference in subjective outcomes between the groups. Patients who received PanOptix IOL had better visual outcomes for intermediate and far with higher contrast sensitivity under various conditions. Based on patients ' needs and demands, these results could support discussion when tailoring the optimal multifocal IOl.

Evolution of schooling drives changes in neuroanatomy and motion characteristics across predation contexts in guppies

One of the most spectacular displays of social behavior is the synchronized movements that many animal groups perform to travel, forage and escape from predators. However, elucidating the neural mechanisms underlying the evolution of collective behaviors, as well as their fitness effects, remains challenging. Here, we study collective motion patterns with and without predation threat and predator inspection behavior in guppies experimentally selected for divergence in polarization, an important ecological driver of coordinated movement in fish. We find that groups from artificially selected lines remain more polarized than control groups in the presence of a threat. Neuroanatomical measurements of polarization-selected individuals indicate changes in brain regions previously suggested to be important regulators of perception, fear and attention, and motor response. Additional visual acuity and temporal resolution tests performed in polarization-selected and control individuals indicate that observed differences in predator inspection and schooling behavior should not be attributable to changes in visual perception, but rather are more likely the result of the more efficient relay of sensory input in the brain of polarization-selected fish. Our findings highlight that brain morphology may play a fundamental role in the evolution of coordinated movement and anti-predator behavior.

Screen Time at 6 Years Old and Visual Function in Early Adolescence.

Excessive screen time has been linked to adverse health outcomes in children, including vision-related problems such as myopia. However, very few studies have evaluated the effect of moderate screen exposure on the development of visual functions. This study aimed to examine the association between screen time during middle childhood and color discrimination, contrast sensitivity, and short-range visual acuity in 12-year-old children (n = 305) from the mother-child PELAGIE cohort (France) for the whole sample and for boys and girls separately. Visual functions were assessed using the Freiburg Acuity and Contrast Test and an adapted version of the Cambridge Color Test. Screen exposure was documented using a parent self-report questionnaire. Regression models showed that screen exposure at 6 years of age was significantly associated with higher contrast sensitivity across the entire sample at 12 years of age. However, when controlling for covariates, this association remained statistically significant in girls only. Sex-stratified analyses also showed that moderate screen exposure was linked to improved tritan-axis color vision in boys only. These findings suggest that moderate screen exposure in middle childhood is not harmful to visual function development and as such, provide new insights into the impact of digital technology on children's visual health and development.

Validation of the Waterloo Differential Visual Acuity Test (WatDAT) and Comparison With Existing Pediatric Tests of Visual Acuity.

The new Waterloo Differential Acuity Test (WatDAT) is designed to allow recognition visual acuity (VA) measurement in children before they can typically undertake matching tests. The study purpose was to validate WatDAT in adults with normal and reduced VA. Eighty adults (18 to <40 years of age) participated (32 normal VA, 12 reduced VA, and 36 simulated reduced VA). Monocular VA was measured on two occasions in random order for WatDAT (versions with 3 and 5 distractors for Faces and Patti Pics house among circles), Lea Symbols, Kay Pictures and Patti Pics matching tests, Teller Acuity Cards, Cardiff Acuity Test, and Early Treatment Diabetic Retinopathy Study (ETDRS) letter chart. Pediatric tests were validated against ETDRS using limits of agreement (LoA), sensitivity, and specificity. The LoA for repeatability were also determined. WatDAT showed minimal bias compared with ETDRS, and LoAs, which were similar to pediatric matching tests (0.241-0.250). Both preferential looking tests showed higher bias and LoAs than ETDRS. Matching tests showed good agreement with ETDRS, except for Kay Pictures and Lea Uncrowded test, which overestimated VA. WatDAT showed high sensitivity (>0.96) and specificity (>0.79), which improved with criterion adjustment and were significantly higher than for the preferential looking tests. LoA for repeatability for WatDAT 3 Faces and WatDAT 5 Faces were comparable with the ETDRS. WatDAT demonstrates good agreement and repeatability compared with the gold-standard ETDRS letter chart, and performed better than preferential looking tests, the alternative until a child can undertake a matching VA test. Good validity of the Waterloo Differential Acuity Test was demonstrated in adults as a first step to showing its potential for detecting childhood visual disorders.

Improving Access to Eye Care in Rural Communities: PocDoc's Web-Based Visual Acuity Screening Tool.

Objective: Visual acuity (VA) testing is crucial for early intervention in cases of visual impairment, especially in rural health care. This study aimed to determine the potential of a web-based VA test (PocDoc) in addressing the unique health care needs of rural areas through the comparison in its effectiveness against the conventional VA test in identifying visual impairment among an Indian rural population. Methods: Prospective comparative study conducted in December 2022 at a tertiary referral eye care center in central India. We evaluated all patients with the PocDoc VA tests using three device types, and the conventional VA test. Bland-Altman plot (BAP) compared PocDoc and conventional VA tests. Fisher's exact tests evaluated associations between categorical parameters. Kruskal-Wallis tests followed by post hoc Dunn's tests identified association between categorical parameters and numerical parameters. Results: We evaluated 428 patients (792 measurements of VA) with mean age 36.7 (±23.3) years. PocDoc resulted in slightly worse VA scores (mean logMAR: 0.345) than conventional (mean logMAR: 0.315). Correlation coefficient between the conventional and PocDoc logMAR VA values was rho = 0.845 and rho2 = 0.7133 (p = 6.617 × 10-215; adjusted p = 2.205 × 10-214). Most data points fell within the interchangeable range of ±0.32 on BAP. Difference between the two methods increased with higher logMAR values, indicating poorer agreement for worse VA scores. Conclusions: Identifying and addressing the unique health care needs of rural populations is critical, including access to appropriate and effective VA testing methods. Validating and improving VA testing methods can ensure early intervention and improve the quality of life for individuals with visual impairment.

Formulating a Novel Physical Equation to Quantify Interocular Visual Acuity Influence

ABSTRACT The limitation of conventional visual acuity assessment, which primarily focuses on individual eye performance (monocular visual acuity tests). This study addresses this limitation by emphasizing the importance of binocular vision, where both eyes work together. Binocular vision provides numerous advantages, such as improved depth perception, a wider field of view, reduced visual fatigue, and binocular summation. The article introduces a new mathematical model based on the physics of constructive interference in light waves and the anatomy of visual nerves. This model yields an equation that quantifies how weakness in one eye affects the visual acuity of the other. By analyzing the correlation between the rates of visual weakness in each eye and the corresponding distances, utilizing the Snellen 6-meter test, valuable insights are gained into the complex interplay between eye deficiencies and their collective impact on overall visual acuity. The equations derived from this study can have significant implications for eye care professionals, clinicians, and patients, contributing to a more comprehensive understanding of visual impairments and enriching the field of optics and vision science.

Retina disease prediction using modified convolutional neural network based on Inception‐ResNet model with support vector machine classifier

AbstractArtificial intelligence and deep learning have aided ocular disease through experiments including automatic illness recognition from images of the iris, fundus, or retina. Automated diagnosis systems (ADSs) provide services for the benefit of humanity and are essential in the early detection of harmful diseases. In fact, early detection is essential to avoid total blindness. In real life, several diagnostic tests such as visual ocular tonometry, retinal exam, and acuity test are performed, but they are conclusively time demanding and stressful for the patient. To consume time and detect the retinal disease earlier, an efficient prediction method is designed. In this proposed model, the first process is data collection that consists of a retinal disease dataset for testing and training. The second process is pre‐processing, which executes image resizing and noise filter for feature extraction. The third step is feature extraction, which extracts the image's form, size, color, and texture for classification with CNN based on Inception‐ResNet V2. The classification process is done by using the SVM with the extracted features. The prediction of diseases is classified such as normal, cataract, glaucoma, and retinal disease. The suggested model's performance is assessed using performance indicators such as accuracy, error, sensitivity, precision, and so forth. The suggested model's accuracy, error, sensitivity, and precision are 0.96, 0.962, 0.964, and 0.04, respectively, higher than existing techniques such as VGG16, Mobilenet V1, ResNet, and AlexNet. Thus, the proposed model instantly predicts retinal disease.

Retinal vascular and structural recovery analysis by optical coherence tomography angiography after endoscopic decompression in sellar/parasellar tumors

We assessed the potential retinal microcirculation alterations for postoperative visual recovery in sellar/paraseller tumor patients with Optical Coherence Tomography Angiography (OCT-A). Two hundred ten eyes with sellar/parasellar tumor for which preoperative and postoperative (3 months) MRI Scans, Visual Acuity Test, Optical Coherence Tomography (OCT), OCT-A and, Visual Field Test data were available, besides 92 healthy eyes were evaluated. In the preoperative phase, significant reductions were observed in retinal vascular densities in various regions, including the Superficial Retinal Capillary Plexus (SRCP) (whole: p < 0.001, fovea: p = 0.025, parafovea: p < 0.001), Deep Retinal Capillary Plexus (DRCP) (whole: p < 0.001, fovea: p = 0.003, parafovea: p < 0.001), Peripapillary Vascular Density (PVD) (whole: p = 0.045, peripapillary: p < 0.001, nasal: p < 0.001, inferior: p < 0.001, temporal: p < 0.001), and Retinal Nerve Fiber Layer (RNFL) (nasal: p = 0.024, inferior: p < 0.001, temporal: p < 0.001, superior: p < 0.001) compared to the healthy control group. After surgery, the postoperative data of patients without chiasmal distortion were compared to their preoperative data. In the postoperative evaluation, significant increases were observed in vascular densities in patients without chiasmal distortion in the SRCP (whole: p < 0.001, parafovea: p = 0.045), DRCP (whole: p = 0.007, fovea: p = 0.006, parafovea: p = 0.040), PVD (peripapillary: p = 0.010, inferior: p < 0.001, temporal: p < 0.001, superior: p < 0.001), and RNFL (nasal: p = 0.011, inferior: p = 0.034, temporal: p = 0.046, superior: p = 0.011). Furthermore, significant associations were observed in the ROC analysis between the postoperative Visual Field Mean Deviation (VFMD) and SRCP (whole AUC = 0.793, p < 0.001, cut-off = 51.45, parafovea AUC = 0.820, p < 0.001, cut-off = 53.95), DRCP (whole AUC = 0.818, p < 0.001, cut-off = 55.95, parafovea AUC = 0.820, p < 0.001, cut-off = 59.05), PVD (temporal AUC = 0.692, p < 0.001, cut-off = 55.10), and RNFL (whole AUC = 0.690, p = 0.001, cut-off = 119.5, inferior AUC = 0.712, p < 0.001, cut-off = 144.75). These findings indicate a potential role of pre and post-operative OCT-A measurements in the assessment of surgical timing and postoperative visual recovery in patients with or without optic chiasm distortion.

Poster Session: Retinal Changes Associated with Football-Related Concussions and Head Impacts.

This pilot study explored the sensitivity of retinal markers to CNS sequelae of concussive and subconcussive head hits. Three groups of college athletes were assessed at pre-season, post-season and 4-months later: Football players with a concussion history (FB+C) (n = 9), players without a concussion history (FB-C) (n = 11), and non-contact athletes (swimmers, track & field; Non-FB) (n = 12). Measures included optical coherence tomography (OCT), OCT angiography, electroretinography, and visual acuity testing. Head impacts during the season were tracked with in-helmet accelerometers. At pre-season, FB+C demonstrated thicker macular central subfields (CSF) (Hedge's g (effect size) = 1.05, p = 0.02) and retinal nerve fiber layers (RNFL) (g = 0.81, p = 0.08), relative to other athletes. Differences in CSF thickness were also observed at post-season and follow-up (gs > 1.00, ps < 0.04), reflecting their non-short-term nature. RNFL was thicker in FB+C at post-season (g = 0.93, p = 0.06) but not later. Total head impacts during the season correlated with increases in CSF thickness from baseline to follow-up only (r = -0.53, p = 0.02). High intensity head impacts in particular correlated with increases in cup-to-disc ratio at post-season and follow-up (rs > 0.53, ps < 0.03). These data suggest that concussion history is associated with retinal changes that are not short-term, and that severe head impacts are associated with acute changes whose duration is not yet known.

Anisometropia and Amblyopia Outcomes in Early Versus Late Resolution of Congenital Nasolacrimal Duct Obstruction in Older Infants.

Congenital nasolacrimal duct obstruction is a known risk factor for amblyopia and anisometropia. The purpose of this study was to investigate whether the rate of anisometropia and amblyopia development differed based on the age at CNLDO resolution in older infants. This retrospective chart review at a single tertiary children's hospital from 2007 to 2017 compared early versus late spontaneous resolution (cutoff 12 months) and intervention (cutoff 15 months) groups presenting at ≥9 months of age, comparing visual outcomes, including anisometropia (≥1 D of sphere or cylinder) and amblyopia (≥2 levels difference in Teller acuity or optotype testing). Parents/guardians were contacted by phone for missing data on spontaneous resolution or intervention status. A total of 462 patients were included (152 early; 310 late group). The early group presented at a median age of 12.0 (interquartile range: 10.0, 13.0) months, while the late group presented at 21.0 (interquartile range: 15.0, 32.0) months. Unilateral disease occurred in 62% and 59%, respectively. Anisometropia was seen in (12/102) 12% of early versus (25/243) 10% of late patients (p = 0.686, 95% CI: -0.059, 0.088), and amblyopia in (4/131) 3% of early versus (14/286) 5% of late patients (p = 0.322, 95% CI: -0.061, 0.018). In patients presenting <24 months without undergoing surgery, spontaneous resolution occurred in 76% between 12 and 24 months (n = 41). Anisometropia and amblyopia rates did not significantly differ between early and delayed intervention for congenital nasolacrimal duct obstruction in this retrospective cohort presenting beyond 9 months of age to a children's hospital. This study found frequent late spontaneous resolution.

Efficacy οf Wet Age-related Macular Degeneration Treatment οn Reading: A Pilot Study Using Eye-movement Analysis.

Functional vision, as evaluated with silent passage reading speed, improves after anti-vascular endothelial growth factor (anti-VEGF) treatment in patients with wet age-related macular antidegeneration (wAMD), reflecting primarily a concomitant reduction in the number of fixations. Implementing eye movement analysis when reading may better characterize the effectiveness of therapeutic approaches in wAMD. This study aimed to evaluate silent reading performance by means of eye fixation analysis before and after anti-VEGF treatment in wAMD patients. Sixteen wAMD patients who underwent anti-VEGF treatment in one eye and visual acuity (VA) better than 0.5 logMAR served as the AMD group. Twenty adults without ocular pathology served as the control group. Central retinal thickness and near VA were assessed at baseline and 3 to 4 months after their first visit. Reading performance was evaluated using short passages of 0.4-logMAR print size. Eye movements were recorded using EyeLink II video eye tracker. Data analysis included computation of reading speed, fixation duration, number of fixations, and percentage of regressions. Frequency distributions of fixation durations were analyzed with ex-Gaussian fittings. In the AMD group, silent reading speed in the treated eye correlated well with central retinal thickness reduction and improved significantly by an average of 15.9 ± 28.5 words per minute (P = .04). This improvement was accompanied by an average reduction of 0.24 ± 0.38 in fixations per word (P = .03). The corresponding improvement in monocular VA was not statistically significant. Other eye fixation parameters did not change significantly after treatment. No statistically significant differences were found in the control group. Visual acuity tests may underestimate the potential therapeutic effects after anti-VEGF treatment in patients with relatively good acuity who are being treated for wAMD. Evaluating silent reading performance and eye fixation parameters may better characterize the effectiveness of therapeutic approaches in wAMD patients.