Visual Function In Patients Research Articles

Micropulse Laser versus Eplerenone for Chronic Central Serous Chorioretinopathy: A 12-Month Comparison.

To compare the long-term efficacy of navigated subthreshold micropulse laser (NSML) and continuous oral eplerenone (EPL) in chronic central serous chorioretinopathy (cCSC). This retrospective observational study included 44 eyes with cCSC (EPL: n = 26; NSML: n = 18). Best-corrected visual acuity (BCVA), central macular thickness (CMT), subretinal fluid (SRF) height, and subfoveal choroidal thickness (SFCT) were evaluated over 12months. Both groups showed significant improvements in BCVA and CMT (p < 0.05). Complete SRF resolution was achieved in both groups by 12months, with NSML showing faster resolution (2.77 ± 1.43 vs. 6.34 ± 2.17months, p < 0.001). The EPL group demonstrated significant SFCT reduction at 6 and 12months (p = 0.001), while the NSML group showed no significant SFCT changes (p > 0.05). Both NSML and EPL improved retinal morphology and visual function in patients with cCSC. NSML achieved faster SRF resolution, while EPL resulted in more significant choroidal thickness reduction. These findings suggest distinct mechanisms of action: NSML primarily affects the retinal pigment epithelium, while EPL modulates choroidal vasculature. Treatment choice may depend on individual patient characteristics and treatment goals.

In Vitro and In Vivo Methods for Studying Retinal Ganglion Cell Survival and Optic Nerve Regeneration.

Glaucoma is marked by a progressive degeneration of the optic nerve and delayed loss of retinal ganglion cells (RGCs), the projection neurons of the eye. Because RGCs are not replaced and because surviving RGCs cannot regenerate their axons, the visual loss in glaucoma is largely irreversible. Here we describe methods to evaluate treatments that may be beneficial for treating glaucoma using in vitro cell culture models (immunopanning to isolate neonatal RGCs, dissociated mature retinal neurons, retinal explants) and in vivo models that test potential treatments or investigate underlying molecular mechanisms in an intact system. Potentially, the use of these models can help investigators continue to improve treatments to preserve RGCs and restore visual function in patients with glaucoma.

Ten-year trends of delayed sequential bilateral cataract surgery (DSBCS) in Sweden: a register-based study.

To study the trend of delayed sequential bilateral cataract surgery (DSBCS) in Sweden in the past decade. This register-based cohort study utilized data from the Swedish National Cataract Register (NCR) from 2010 through 2019. Register files from patients who underwent cataract surgery in both eyes during the study period were linked using their social security numbers. Bilateral surgeries on different days were classified as DSBCS. The study investigated the association between DSBCS within 3months and several variables with stratification and multivariate logistic regression. The following variables were used: operation year, region, private or public unit, age, sex, indication for surgery, type of intraocular lens (IOL), preoperative visual acuity, ocular comorbidity, posterior capsule rupture and perioperative difficulties. During the study period, 368,106 patients underwent DSBCS, of which 62.6% (n = 230,331) had bilateral surgery within 3months. The median time between the surgeries was 61days (interquartile range 26-161days), showing regional variations. Better visual acuity in the fellow eye, presence of ocular comorbidity, various perioperative events and complications were associated with longer time to surgery of the second eye. Conversely, cataract surgery in more recent years, private clinic, increasing age, anisometropia and multifocal IOL were associated with shorter timespan between surgeries. The majority of DSBCS were conducted within a 3-month timeframe, with the interval between surgeries decreasing throughout the study period. Several rational factors were associated with the time difference, in addition to regional variations. Many patients would probably benefit from less time between the surgeries, and we encourage a clinical practice taking the whole patient's visual function into account.

Evaluation of the relationship between the real-time changes of macular structure and visual function in patients with rhegmatogenous retinal detachment after silicone oil tamponade

PurposeTo evaluate the relationship between the real-time changes of macular structure and visual function in rhegmatogenous retinal detachment (RRD) patients. MethodsForty-six patients were enrolled in this retrospective study. The best corrected visual acuity (BCVA) and macular structural changes were analyzed within 3 months after silicone oil tamponade. ResultsThe mean final BCVA was significantly better than the preoperative BCVA (P = 0.002). The parafoveal thickness became thinner, the proportion of subretinal fluid (SRF) decreased, and the proportion of intact external limiting membrane (ELM) increased within 3 months postoperatively. The recovery stage and the integrity of ELM in the SRF (-) group were significantly faster than that in the SRF (+) group (all P < 0.05). The central foveal thickness (CFT), the inferior and temporal thickness of the parafovea, and the integrity of the ELM were significantly correlated with BCVA at each time point (all P < 0.05). Long duration of preoperative RRD, thinner CFT at 1 month postoperatively, and without integrity of ELM at 3 months postoperatively were associated with poor final BCVA recovery (R2 = 0.462). ConclusionsThe macular microstructural tended to restore integrity within 3 months. The presence of SRF in macula delayed the recovery of RRD patients but did not affect the visual function.

A chart-based test of contrast sensitivity in noise: reference ranges, effects of age and optical abnormality

ABSTRACT Clinical relevance Contrast sensitivity plays an important role in the comprehensive assessment of visual function; however, measurement with standard eye charts can be affected by age and optical abnormality. Background This study describes a novel chart-based test of letter contrast sensitivity (CS) in luminance noise (the Illinois Eye and Ear Noise CS test), defines normal reference ranges, estimates test-retest repeatability, and assesses the effects of age and simulated optical abnormalities. Methods Seventy-five individuals with normal visual function (age 18–85 years) participated. Subjects identified letter optotypes that spanned a broad contrast range (0.9% to 59.6%) printed in a book-based test. Letters were presented against a grey background (no-noise condition) and in luminance noise that consisted of light and dark checks (noise condition). A subset of 10 subjects repeated the test to define short-term variability and performed the test under three additional conditions: simulated cataract, +2.00D defocus, and low room illuminance. Results In the no-noise condition, CS was independent of age (mean log CS of 1.74) until approximately 54 years, and declined for older subjects (CS loss of 0.1 log unit/decade). CS measured in noise was independent of age across the range of ages tested (mean log CS of 0.91). The 95% limits of agreement for test-retest repeatability was 0.19 log units. Simulated cataract, +2.00D defocus, and reduced illumination significantly reduced CS in the no-noise condition (F = 102.6, p < 0.001), whereas these optical manipulations did not significantly affect CS in noise (F = 2.58, p = 0.074). Conclusions Measurements of CS in luminance noise may be valuable, as these measures are largely independent of age and certain forms of optical degradation. CS measurements in noise may provide useful insight into visual function in patients who have combined neural and optical abnormality, as noise minimises CS loss from optical defects.

Effects of retinopathy on visual function in type 2 diabetes mellitus

Objective: To study the influence of the severity of diabetic retinopathy (DR) on the visual function of patients with type 2 diabetes, to provide scientific basis for the early prevention and control of DR. Methods: This study was designed as a cross-sectional study, recruiting already-diagnosed type 2 diabetes patients in four community health service centers in Guizhou Province between February and September 2022. Employing the Chinese version of the Visual Function Index-14 (VF-14), assess the participants' near vision, visual adaptation, subjective visual perception, and stereo vision, with higher scores indicating poorer visual function. Categorize the severity of each eye's damage into no diabetic retinopathy (DR), mild non-proliferative diabetic retinopathy (NPDR), moderate NPDR, severe NPDR, and proliferative diabetic retinopathy (PDR), and use a 5-level DR grading system to evaluate the overall severity of diabetic retinopathy in both eyes. Employing linear regression analysis to investigate the linear relationship between DR and visual function index. Local weighted regression evaluates the nonlinear relationship between the DR composite score and the scores of visual function, with a steeper slope indicating poorer visual function for that level. Results: A total of 542 patients with type 2 diabetes were investigated, including 244 (45.02%) males, 298 (54.98%) females, and 162 (29.89%) patients with DR. After adjusting for confounders, compared with those without DR, patients with binocular DR Had overall scores (β=0.136, P=0.003), near vision (β=0.163, P<0.001), visual adaptation (β=0.092, P=0.042), subjective vision (β=0.120, P=0.009) and stereo vision (β=0.094, P=0.044) were higher than those without DR. There were no differences in visual functions between DR And monocular DR. The local weighted regression curve showed that near vision (slope: 23.78) and overall score (slope: 58.37) increased sharply from mild to moderate NPDR in both eyes. Visual adaptation (slope: 5.37, 7.72), subjective vision (slope: 6.53, 7.93), stereovision (slope: 0.74, 0.91) increased slowly in mild to moderate NPDR in both eyes and in moderate to severe NPDR/PDR in both eyes. Conclusion: Binocular DR is associated with impaired visual function, but there is no difference between monocular DR And non-DR visual function. The early damage of DR To visual function is mainly manifested in near vision. In the prevention and control of DR, more attention should be paid to visual function, especially the change of near vision, and retinal damage should not be assessed solely by visual status.

The reduction of LEDD leads to visual dysfunction in patients with PD after STN-DBS: a randomized clinical trial

Background: Medication adjustment after deep brain stimulation (DBS) of the subthalamic nucleus (STN) in patients with Parkinson’s disease (PD) may influence visual function. However, no clinical trials have been designed specifically to investigate this effect. Objectives: To compare the effects of levodopa equivalent daily dose (LEDD) reduction and non-reduction on visual function in patients with Parkinson’s disease (PD) following STN-DBS. Methods: This was a multi-center, prospective, randomized, double-blinded clinical trial. A total of 208 patients with Parkinson’s disease were referred for DBS between June 2019 and July 2021 and analyzed between June 2023 and July 2023. STN-DBS was performed, and the LEDD was reduced in one study arm but not in the other. The primary outcome measure was visual impairment in Parkinson’s disease questionnaire (VIPD-Q) with or without LEDD reduction 12 months postoperatively, and the secondary outcomes included retinal nerve fiber layer (RNFL) thickness, vessel density, eye-tracking system results, contrast sensitivity and visual field. Results: During the short-term follow-up, DBS implantation and stimulation did not significantly affect visual function (VIPD-Q, baseline vs. 1 month, 9.269±8.385 vs. 8.938±7.666, Mann–Whitney U tests; P=0.6746). In the long-term follow-up, the reduction group demonstrated a significant decline in visual function, RNFL thickness, and vessel density after STN-DBS compared with the control group without STN-DBS (P&lt;0.001). Conclusions: Visual dysfunction, particularly a thinner RNFL and lower vessel density, is related to LEDD reduction after STN-DBS. Prolonged administration of dopamine-mimetic drugs prevents visual symptoms. Thus, physicians should consider LEDD adjustment when patients report visual dysfunction before surgery or severe visual symptoms after STN-DBS.

The incidence, monitoring coverage and clinical characteristics of hydroxychloroquine retinopathy in the United Kingdom

BackgroundRetinal monitoring is recommended for hydroxychloroquine users to detect pre-symptomatic retinopathy and preserve visual function. However, the incidence of hydroxychloroquine retinopathy and monitoring coverage in the U.K. are incompletely characterised. Moreover, the visual benefits of monitoring for retinopathy – recommended for over 70,000 long-term hydroxychloroquine users in the U.K. - remain unproven.MethodsA national, prospective observational study was undertaken with the British Ophthalmological Surveillance Unit (BOSU). Newly diagnosed cases of hydroxychloroquine retinopathy in the U.K. were reported and data captured using a standardised questionnaire over 3.5 years (July 2018–Dec 2021). The frequency of retinopathy and coverage of monitoring amongst long-term users was estimated. Visual function was compared between asymptomatic individuals detected on monitoring and those presenting with visual symptoms. The clinical characteristics, dosing and management of reported cases were captured.ResultsThe annualised number of incident cases of hydroxychloroquine retinopathy was 29–57, with an annualised frequency of 0.04–0.08% amongst long-term users (~1 in 1247–2625). The coverage of monitoring was approximately 2.6–5.5%. Visual acuity (0.1 vs. 0.22 logMAR; p = 0.007) and visual field mean deviation (−3.73 dB vs. −8.69 dB; p = 0.017) were better preserved in asymptomatic individuals compared to those presenting with visual symptoms.ConclusionThese data support the efficacy of monitoring in the preservation of visual function in patients with hydroxychloroquine retinopathy at diagnosis. The overall population coverage of monitoring was low, consistent with the high proportion of symptomatic patients at diagnosis. This study presents a method for evaluating the yield of monitoring for hydroxychloroquine retinopathy in the U.K.

Evaluation of the ocular surface with keratograph 5M analysis after scleral buckle surgery in patients with retinal detachment

ABSTRACT Background This study aims to evaluate the ocular surface health with oculus keratograph 5M (Oculus, Wetzlar, Germany) in patients, 4–6 weeks after the SB surgery. Research design and methods Adult patients with RRD who underwent SB surgery were enrolled. Subjects with the existence of any concomitant ophthalmologic diseases or topical medications that can affect the ocular surface were excluded. The ophthalmic examination and corneal imaging with oculus keratograph 5M were conducted 4–6 weeks after the surgery, following discontinuation of all topical medications. The ocular surface parameters were compared between the surgical and other eyes. Results The results showed a statistically significant difference in the ocular surface profile, including the tear meniscus height (TMH), Non-invasive keratograph breakup time (NIKBUT), Meibography, and Redness scores, between the surgical eye and the other eye four to six weeks after the procedure. Conclusion In this study, we showed convincing evidence of the role of keratography imaging in the objective evaluation of the ocular surface 4–6 weeks after SB surgery. We depicted that SB surgery disturbs the ocular surface homeostasis significantly, which can cause ocular discomfort as well as decrease visual function in patients in the post-up periods.

Prospective comparison of minimally invasive glaucoma surgery techniques for goniotomy in primary congenital glaucoma: Optimizing intraocular pressure control

BackgroundA family of less invasive glaucoma procedures has been developed to provide moderate reductions in intraocular pressure and medication burden in eyes with therapeutic needs that may not warrant the risks associated with trabeculectomy and tube shunt implantation. This study aims to compare the effectiveness and clinical outcomes of pediatric goniotomy using minimally invasive glaucoma surgery techniques to manage primary congenital glaucoma. Materials and methodsUsing a computer-generated set of random numbers, the patients were randomized into three groups: Kahook blade group, microvitreoretinal blade group, and 23G needle group. Each group contained 22 eyes. All patients underwent anesthesia for intraocular pressure measurement, corneal diameter evaluation, and fundoscopy. Preoperative intraocular pressure at presentation and postoperative intraocular pressure were recorded during a one-year follow-up period. Outcome measures included decreases in corneal diameter from preoperative size, mean postoperative reduction in intraocular pressure for each minimally invasive glaucoma surgery technique and absence of intraoperative or postoperative complications. Surgical success was defined as a postoperative intraocular pressure of ≤20 mmHg without antiglaucoma medications or reoperation, based on the last recorded intraocular pressure during postoperative follow-up. ResultsA total of 66 eyes were diagnosed with primary congenital glaucoma and underwent goniotomy surgeries during the study period in 2022. The majority (89%) were bilateral cases. Among the patients, there were 26 males and 9 females, which makes up an 8: 2 male-to-female ratio, with an average age range of 2 months to 2 years. After a one-year postoperative follow-up, a significant reduction in intraocular pressure was achieved of ≤18 mmHg. In terms of surgical success with minimally invasive glaucoma surgery techniques, goniotomy with a 23-gauge needle had the most postoperative intraocular pressure, followed by the microvitreoretinal blade and the Kahook blade. On average, the 23-gauge needle had a corneal diameter of 13.8 mm, while the microvitreoretinal blade was 13.9 mm and the Kahook blade recorded 14 mm. ConclusionsGoniotomy using minimally invasive glaucoma surgery techniques has been proven to be an effective surgical technique for the management of childhood glaucoma among Nigerian patients. A reduction in postoperative intraocular pressure, corneal diameter, and absence of complications provide clinical evidence of successful glaucoma management and preservation of outcomes of visual function in patients. Level of evidenceLevel 1 (Prospective study)

Organic photovoltaic biomaterial with fullerene derivatives for near-infrared light sensing in neural cells.

Retinal degenerative diseases, which can lead to photoreceptor cell apoptosis, have now become the leading irreversible cause of blindness worldwide. In this study, we developed an organic photovoltaic biomaterial for artificial retinas, enabling neural cells to detect photoelectric stimulation. The biomaterial was prepared using a conjugated polymer donor, PCE-10, and a non-fullerene receptor, Y6, both known for their strong near-infrared light absorption capabilities. Additionally, a fullerene receptor, PC61BM, was incorporated, which possesses the ability to absorb reactive oxygen species. We conducted a comprehensive investigation into the microstructure, photovoltaic properties, and photothermal effects of this three-component photovoltaic biomaterial. Furthermore, we employed Rat adrenal pheochromocytoma cells (PC-12) as a standard neural cell model to evaluate the in vitro photoelectric stimulation effect of this photovoltaic biomaterial. The results demonstrate that the photovoltaic biomaterial, enriched with fullerene derivatives, can induce intracellular calcium influx in PC-12 cells under 630 nm (red light) and 780 nm (near-infrared) laser irradiation. Moreover, there were lower levels of oxidative stress and higher levels of mitochondrial activity compared to the non-PC61BM group. This photovoltaic biomaterial proves to be an ideal substrate for near-infrared photoelectrical stimulation of neural cells and holds promise for restoring visual function in patients with photoreceptor apoptosis.

Impact of Online Video Game-Based Dichoptic Training on Binocular Vision Rehabilitation in Post-surgical Patients with Intermittent Exotropia.

Dichoptic training has emerged as a promising rehabilitation approach for improving binocular visual function in patients with strabismus. A prospective observational study design was employed to assess the effectiveness of online video game-based dichoptic training in rehabilitating binocular visual function in patients who had undergone anoperation for intermittent exotropia. A total of 64 patients who had undergone anoperation for intermittent exotropia were recruited and divided into the training group and the control group based on whether they would receive the dichoptic training. The dichoptic training was conducted for 3 months in the training group and the control group would not accept any form of orthoptic therapy. Assessments of binocular visual functions and deviation were conducted at baseline, 3-month and 6-month follow-up. Twenty-nine participants in the training group (mean 9.69 ± 2.66years old) and 26 participants in the control group (mean 8.41 ± 2.64years old) completed follow-up. At both 3- and 6-month follow-ups, the training group showed superior distance stereopsis compared to the control group, with near stereopsis only showing significant difference at the 6-month follow-up. Additionally, the training group exhibited significantly less distance exo-deviation drift than the control group at these times, and no significant difference was observed in near exo-deviation drift between the groups. The control group had a significantly higher rate of suboptimal surgical outcomes at both the 3- and 6-month follow-up. However, no significant differences were observed in simultaneous perception and fusion functions between the two groups. Online video game-based dichoptic training has the potential to become a novel postoperative rehabilitation strategy for patients with intermittent exotropia.

Visual dysfunction and neurodegeneration caused by severe inflammatory optic neuropathy after coil embolization of a paraclinoid aneurysm: illustrative case.

Visual impairment due to delayed optic neuropathy is a rare complication of the endovascular treatment of paraclinoid aneurysms. An inflammatory response induced in the treated aneurysm wall is a known mechanism underlying this pathophysiology. The authors describe a case with severe and progressive optic neuropathy leading to neuronal degeneration and severe visual dysfunction. A 42-year-old female with a history of surgical clipping for a paraclinoid aneurysm presented with a recurrence. Although the patient was unaware of any visual dysfunction, a preoperative ophthalmological examination revealed mild inferior quadrantanopia in the left eye. The coil embolization procedure was uneventful; however, the following day, the patient experienced progressive visual impairment, which worsened despite the initiation of steroid therapy. Ophthalmological examination revealed a severe decrease in visual acuity and further deterioration of the visual field. Magnetic resonance imaging showed remarkable swelling and edema of the left optic nerve adjacent to the treated aneurysm. Despite continued steroid therapy, the patient's visual function did not recover well due to subsequent optic nerve degeneration. Optic neuropathy after endovascular procedures can lead to severe visual dysfunction. Careful management is essential, particularly when treating a symptomatic paraclinoid aneurysm, even if symptoms are only apparent on detailed examination.

Severity of Disorganization of Retinal Layers and Visual Function Impairment in Diabetic Retinopathy

To evaluate best-corrected visual acuity (BCVA), retina sensitivity (RS), and fixation impairment by microperimetry (MP) due to the presence and severity of disorganization of retinal inner and outer layers (DRIL/DROL) and ischemia in OCT/OCT angiography (OCTA) in diabetic retinopathy (DR). Retrospective case-control study. Seventy-six eyes (65 patients) with DR were analyzed. Major exclusion criteria were: center-involving diabetic macular edema (DME), significant media opacity, nondiabetic macular pathology, and active proliferative DR. Patients with DRIL and DROL within central 3 mm were enrolled as cases. Patients with DR and no retina disorganization were considered as controls. A detailed grading of MP and OCT/OCTA images using Image J software, and specific Image Manipulation Program was applied to colocalize the presence of retina disorganization and RS. Best-corrected visual acuity and RS were correlated with the disorganization of retina layers' characteristics and grading (grade 1-DRIL; grade 2-DROL; grade 3-DROL plus, with involvement of the ellipsoid zone). The same procedure of colocalization was applied to the vascular layers on OCTA using MATLAB. Correlation between BCVA and MP parameters with disorganization of retina layers grading and OCTA parameters. Best-corrected visual acuity, mean RS within 1 mm and central 3 mm (overall RS [oRS]), perfusion density, vessel density, and geometric perfusion deficit in intermediate and deep capillary plexuses were lower in cases versus controls (P < 0.001). Mean RS within 1 mm (21.4 decibels [dB] ± 2.4 vs. 13.8 dB ± 5.4, P= 0.002), oRS (22.0 dB ± 2.1 vs. 14.4 dB ± 4.6, P < 0.001), and BCVA (76.1 ± 7.4 vs. 61.2 ± 20.4 ETDRS letters; P= 0.02), had a significant decrease from grade 1 to grade 3 retina disorganization. Choriocapillaris flow voids (CC-FVs) increased from grade 1 to grade 3 (DROL plus) (P= 0.004). Overall retina sensitivity and CC-FV were identified as significant predictors of retina disorganization grade with an adjusted coefficient of determination, R2= 0.45. Cases had more dense scotomas (P= 0.03) than controls with a positive correlation between the worsening of fixation stability and the severity of DRIL/DROL (P= 0.04). Microperimetry and BCVA documented a reduction in visual function in patients with DR and disorganization of retina layers at different grades, with greater functional impairment when outer retina layers and photoreceptors are involved. The severity of retina disorganization and the presence of ischemia could serve as a potential biomarker of functional impairment. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Results of Quantitative and Qualitative Assessment of Color Vision in Patients with Congenital Partial Atrophy of the Optic Nerve

Background. Congenital partial atrophy of the optic nerve is one of the main causes of blindness and low vision in patients with fundus pathology, and the study of color vision is important in diagnosis and monitoring visual functions in patients with this disease.Purpose: to study the possibilities of using the own developed method of quantitative and qualitative assessment of color vision in patients with partial optic nerve atrophy.Materials and methods. 55 patients aged from 8 to 20 years with congenital partial atrophy of the optic nerve (PAON) with a typical fundus pattern and EFI indicators for this disease were observed. The control group included 116 people of the same age without fundus pathology and with normal visual acuity. To study color vision in both groups, the classic FarnsworthMunsell Dichotomous D15 Test and the own developed method for quantitative and qualitative assessment of color vision were used.Results. The method developed by us made it possible to identify color perception disorders of varying severity in the majority (about 90 %) of patients with PAON. In the control group, no color perception disorders were detected in more than 70 % of the subjects. Quantitative assessment of color vision conducted using the method developed by us demonstrates significantly higher indicators of the total error of perception of color tones in patients with PAON (35.6 ± 3.2 degrees for a better-seeing eye and 39.9 ± 3.3 degrees for a worse-seeing eye) in comparison with the subjects of the control group (6.2 ± 1.1 degrees for a better-seeing eye and 7.5 ± 1.3 degrees for a worse-seeing eye). The severity of color perception disorders in patients with PAON does not depend on age, but has a significant inverse relationship with visual acuity. In the group of patients with PAON, when examining both better-seeing eye and worse-seeing eye, perception disorders of all color tones are detected with a slight predominance of disorders of perception of red, green and blue. The method developed by us has sufficiently higher sensitivity and specificity in comparison with the classic Farnsworth-Mansell D-15 test.Conclusion. The method developed by us makes it possible to effectively carry out a quantitative and qualitative assessment of the state of color perception in patients with PAON.

Анализ эффективность применения антиангиогенной терапии в комплексном лечении пациентов с диабетическим макулярным отеком

Currently, priority in the treatment of diabetic macular edema (DME) with use from inhibitors of vascular endothelial growth factor (VEGF), the effectiveness of this method has been proven by multicenter researches. The aim of our research is investigation the effectiveness of usage for antiangiogenic therapy in the complex treatment of patients with diabetic macular edema. Material and methods. We analysed with refractory laser photocoagulation resistant DME in 61 eyes of 49 patients for effectiveness of this drug. Ophthalmological examinations in patients (visometry, biomicroscopy, non-contact tonometry, optical coherence tomography (OCT), refractometry and color photographing of fundus) were performed the day after the injection, then on the 2nd, 4th, 8th, 12th , 16th, 20th and 24th week and next every 3 months until the end of the observation period. Results and conclusion. The competent use of drugs from this group in compliance with the developed schemes and techniques for intravitreal injection, well-defined indications for repeated injections, as well as compact dynamic monitoring of patients can become the key to success in maintaining and improving visual functions in patients with diabetic macular edema (DME). Keywords: diabetic macular edema (DME), vascular endothelial growth factor (VEGF), visual acuity, ophthalmoscopy, optical coherence tomography (OCT)

Short term effects of extremely low irradiance photobiomodulation on retinal function, in age related macular degeneration.

recently much studies evidenced the potential role of photo-biomodulation (PBM) in patients affected by Age-related Macular Degeneration (AMD). We designed a new wearable device for self-medication that employs the same broadband red light described in literature, but with extremely low irradiance. to demonstrate the safety and effectiveness of low-fluence light stimulations emitted by a LED source with appropriate wavelengths through our new device in improving short-term visual function in patients affected by severe non neovascular AMD. we prospectively enrolled patients affected by severe non-neovascular AMD with a relative sparing of the foveal region. All the patients were randomly assigned in placebo or in treatment group. The treatment consisted of 10 sessions of 10-min each, using the new device comprised of micro-LEDs that emitted light onto an amorphous support assembled within Metallic eyeglasses. The placebo group blindly underwent the same number of PBM sessions with the micro-LED turned off. Before and after each placebo/treatment sessions all the patients received: optical coherence tomography (OCT), Best-Corrected Visual Acuity (BCVA) and Microperimetry (MP). no significant differences in the anatomical parameters were observed in the two groups. The MP mean sensitivity and the central visual function both far and near significantly improved in the treated group (respectively p < 0.001, p < 0.001). our pivotal demonstrated that the LED PBM delivered through our new device is a safe and effective tool for improving short-term visual function in patients affected by severe non-neovascular AMD.

Potential therapeutic agent for the treatment of retinal detachment: Artificial interphotoreceptor matrix

Retinal detachment (RD) is a common ophthalmic emergency that presents as a separation and gap between the retinal neuroepithelium and the pigment epithelium that supplies the retina. Treatment for RD is primarily focused on surgically reattaching the retina as soon as possible. Nevertheless, the recovery of visual function in patients undergoing surgical retina reattachment of the retina is insufficient. Previous studies' findings revealed that photoreceptor cell death was not sufficiently prevented by surgically reattaching the retina. Besides, intervention with the retinal microenvironment has been proposed as a ground-breaking opinion in the treatment of RD to further preserve the patient's visual function. Further, traditional vitrectomy invariably replaces the interphotoreceptor matrix (IPM) in its original physiological form with leftover fluid in the possible interstitial space of the subretinal cavity. As a result, the leftover fluid might cause oxidative stress and inflammatory reactions that can hinder the functional recovery and nutrition delivery of retinal photoreceptor cells. In this context, the present hypotheses pioneered an artificial interphotoreceptor matrix (AIPM) as a secure and economical solution. In this article, we explain how surgical procedures and gas–liquid exchange will temporarily replace the natural IPM with AIPM in the subretinal cavity. Also, a cocktail of medications to suppress oxidative stress and inflammatory reactions as well as prevent apoptosis will be present in the AIPM. Under comprehensive consideration, we summarized the evidence that is currently available in the field, including several studies that showed potentially useful medications in RD examinations. We evaluated the experimental and anticipated outcomes to construct an AIPM and validate it. In conclusion, we offer an evaluation, viewpoint, and discussion of the substantial significance of AIPM as well as potential clinical applications.

TRNS boosts visual perceptual learning in participants with bilateral macular degeneration.

Perceptual learning (PL) has shown promise in enhancing residual visual functions in patients with age-related macular degeneration (MD), however it requires prolonged training and evidence of generalization to untrained visual functions is limited. Recent studies suggest that combining transcranial random noise stimulation (tRNS) with perceptual learning produces faster and larger visual improvements in participants with normal vision. Thus, this approach might hold the key to improve PL effects in MD. To test this, we trained two groups of MD participants on a contrast detection task with (n = 5) or without (n = 7) concomitant occipital tRNS. The training consisted of a lateral masking paradigm in which the participant had to detect a central low contrast Gabor target. Transfer tasks, including contrast sensitivity, near and far visual acuity, and visual crowding, were measured at pre-, mid and post-tests. Combining tRNS and perceptual learning led to greater improvements in the trained task, evidenced by a larger increment in contrast sensitivity and reduced inhibition at the shortest target to flankers' distance. The overall amount of transfer was similar between the two groups. These results suggest that coupling tRNS and perceptual learning has promising potential applications as a clinical rehabilitation strategy to improve vision in MD patients.

Liberty® by Medicontur, a Complex in Structure, Hydrophilic Intraocular Lens in the Correction of Eyes with Preoperative Myopia

A retrospective analysis of visual function in patients with preoperatively diagnosed myopia, after implantation of Liberty® intraocular lens, including the influence of some factors like a kind of surgery, values of angle alpha and kappa, pupil size, values of higher order aberrations generated by the lens on visual acuity to far and near distances was done. Lens removal and Liberty® implantation was done 47 eyes, including in 13 patients in both eyes. In 7 eyes, it was a toric lens. A mean preoperative value of myopia was -6.72 Dsph. Cataract removal accounted for 55% of all procedures performed, the rest being Refractive Lens Exchange. Preoperative pupil size was between 3.6 and 6,4 mm. The average postoperative visual acuity to far distances was 0.13 (logMar), and to near distances was 0.51 (Snellen). Rare cases of insufficient quality of vision to intermediate distances, when the postoperative pupil size was greater than 4 mm, resolved after increasing light intensity in the room. A bigger values of higher order aberrations corresponded with lower values of preoperative visual acuity to far distances. A bigger values of angle alpha corresponded with lower values of postoperative visual acuity to far distances, which were significantly higher in cataract group. Visual acuity to far distances was also better in eye with bigger pupil size. A specific structure of the lens allows patients to see good to the near distances, even if the light intensity not perfect.