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1.
Lasers Med Sci ; 39(1): 154, 2024 Jun 11.
Article En | MEDLINE | ID: mdl-38862806

PURPOSE: To investigate the diagnostic ability of retinal superficial vasculature evaluation by optic coherence tomography angiography (OCTA) combined with visual field (VF) testing for early primary open-angle glaucoma (POAG). PATIENTS AND METHODS: In this cross-sectional study, 84 participants were included, including 11 in the ocular hypertension (OHT) group, 11 in the preperimetric POAG (pre-POAG) group, 29 in the early POAG group and 33 in the control group. All participants underwent 6 × 6 mm2 scans of macula and optic nerved head by optic coherence tomography (OCT) and OCTA, along with white-on-white and blue-on-yellow VF testing by static automated perimetry. The ability of diagnosing early glaucoma by either various examinations separately or combination of examinations in both terms of function and structure was studied using the receiver operating characteristic (ROC) curve and the area under the curve (AUC). RESULTS: The superficial retinal vessel densities (VD) in peri-nasal, para-temporal, peri-temporal and peri-inferior regions around the macula, as well as vessel area densities (VAD) in all peripapillary regions, were significantly different among the four groups, with lower VD or VAD in the early POAG patients compared to the normal individuals. The diagnostic ability of peripapillary superficial retinal VAD alone or VF testing alone was limited for early POAG only. However, the combination of these two was more effective in distinguishing normal individuals from OHT subjects or pre-POAG patients without VF defects, with better performance than the combination of peripapillary retinal nerve fiber layer (RNFL) thickness and VF indicators. CONCLUSIONS: Peripapillary retinal vessel densities were generally lower in early POAG patients compared to normal individuals. The combination of peripapillary superficial retinal VAD by OCTA with white-on-white VF testing improved the ability to distinguish POAG patients at early stage without function impairment, which may help in providing reference and guidance for the following-up and treatment of suspected POAG patients.


Glaucoma, Open-Angle , Microvessels , Retinal Vessels , Tomography, Optical Coherence , Visual Field Tests , Humans , Glaucoma, Open-Angle/physiopathology , Glaucoma, Open-Angle/diagnosis , Glaucoma, Open-Angle/diagnostic imaging , Cross-Sectional Studies , Male , Middle Aged , Visual Field Tests/methods , Female , Tomography, Optical Coherence/methods , Microvessels/diagnostic imaging , Retinal Vessels/diagnostic imaging , Retinal Vessels/physiopathology , Aged , ROC Curve , Visual Fields/physiology , Adult , Optic Disk/blood supply , Optic Disk/diagnostic imaging , Early Diagnosis
2.
Transl Vis Sci Technol ; 13(6): 5, 2024 Jun 03.
Article En | MEDLINE | ID: mdl-38869357

Purpose: Bioptic telescopic spectacles can allow individuals with central vision impairment to obtain or maintain driving privileges. The purpose of this study was to (1) compare hazard perception ability among bioptic drivers and traditionally licensed controls, (2) assess the impact of bioptic telescopic spectacles on hazard perception in drivers with vision impairment, and (3) analyze the relationships among vision and hazard detection in bioptic drivers. Methods: Visual acuity, contrast sensitivity, and visual field were measured for each participant. All drivers completed the Driving Habits Questionnaire. Hazard perception testing was conducted using commercially available first-person video driving clips. Subjects signaled when they could first identify a traffic hazard requiring a change of speed or direction. Bioptic drivers were tested with and without their bioptic telescopes in alternating blocks. Hazard detection times for each clip were converted to z-scores, converted back to seconds using the average response time across all videos, and then compared among conditions. Results: Twenty-one bioptic drivers and 21 normally sighted controls participated in the study. The hazard response time of bioptic drivers was improved when able to use the telescope (5.4 ± 1.4 seconds vs 6.3 ± 1.8 seconds without telescope); however, it remained significantly longer than for controls (4.0 ± 1.4 seconds). Poorer visual acuity, contrast sensitivity, and superior visual field sensitivity loss were related to longer hazard response times. Conclusions: Drivers with central vision loss had improved hazard response times with the use of bioptic telescopic spectacles, although their responses were still slower than normally sighted control drivers. Translational Relevance: The use of a bioptic telescope by licensed, visually impaired drivers improves their hazard detection speed on a video-based task, lending support to their use on the road.


Automobile Driving , Contrast Sensitivity , Telescopes , Visual Acuity , Humans , Automobile Driving/psychology , Male , Female , Visual Acuity/physiology , Middle Aged , Adult , Contrast Sensitivity/physiology , Visual Perception/physiology , Visual Fields/physiology , Visually Impaired Persons/psychology , Eyeglasses , Aged , Surveys and Questionnaires , Reaction Time/physiology , Accidents, Traffic/prevention & control
3.
J Vis ; 24(6): 11, 2024 Jun 03.
Article En | MEDLINE | ID: mdl-38869372

Microsaccades-tiny fixational eye movements-improve discriminability in high-acuity tasks in the foveola. To investigate whether they help compensate for low discriminability at the perifovea, we examined microsaccade characteristics relative to the adult visual performance field, which is characterized by two perceptual asymmetries: horizontal-vertical anisotropy (better discrimination along the horizontal than vertical meridian) and vertical meridian asymmetry (better discrimination along the lower than upper vertical meridian). We investigated whether and to what extent microsaccade directionality varies when stimuli are at isoeccentric locations along the cardinals under conditions of heterogeneous discriminability (Experiment 1) and homogeneous discriminability, equated by adjusting stimulus contrast (Experiment 2). Participants performed a two-alternative forced-choice orientation discrimination task. In both experiments, performance was better on trials without microsaccades between ready signal onset and stimulus offset than on trials with microsaccades. Across the trial sequence, the microsaccade rate and directional pattern were similar across locations. Our results indicate that microsaccades were similar regardless of stimulus discriminability and target location, except during the response period-once the stimuli were no longer present and target location no longer uncertain-when microsaccades were biased toward the target location. Thus, this study reveals that microsaccades do not flexibly adapt as a function of varying discriminability in a basic visual task around the visual field.


Photic Stimulation , Saccades , Visual Fields , Humans , Saccades/physiology , Visual Fields/physiology , Male , Adult , Female , Young Adult , Photic Stimulation/methods , Fixation, Ocular/physiology , Orientation/physiology , Discrimination, Psychological/physiology , Fovea Centralis/physiology
4.
J Vis ; 24(6): 3, 2024 Jun 03.
Article En | MEDLINE | ID: mdl-38837169

The primary symptom of visual snow syndrome (VSS) is the unremitting perception of small, flickering dots covering the visual field. VSS is a serious but poorly understood condition that can interfere with daily tasks. Several studies have provided qualitative data about the appearance of visual snow, but methods to quantify the symptom are lacking. Here, we developed a task in which participants with VSS adjusted parameters of simulated visual snow on a computer monitor until the simulation matched their internal visual snow. On each trial, participants (n = 31 with VSS) modified the size, density, update speed, and contrast of the simulation. Participants' settings were highly reliable across trials (intraclass correlation coefficients > 0.89), and they reported that the task was effective at stimulating their visual snow. On average, visual snow was very small (less than 2 arcmin in diameter), updated quickly (mean temporal frequency = 18.2 Hz), had low density (mean snow elements vs. background = 2.87%), and had low contrast (average root mean square contrast = 2.56%). Our task provided a quantitative assessment of visual snow percepts, which may help individuals with VSS communicate their experience to others, facilitate assessment of treatment efficacy, and further our understanding of the trajectory of symptoms, as well as the neural origins of VSS.


Visual Fields , Humans , Adult , Male , Female , Visual Fields/physiology , Young Adult , Photic Stimulation/methods , Middle Aged , Contrast Sensitivity/physiology , Perceptual Disorders/physiopathology , Perceptual Disorders/etiology , Visual Perception/physiology , Computer Simulation , Vision Disorders/physiopathology
5.
PLoS One ; 19(5): e0302459, 2024.
Article En | MEDLINE | ID: mdl-38809939

Saccadic eye movements enable us to search for the target of interest in a crowded scene or, in the case of goal-directed saccades, to simply bring the image of the peripheral target to the very centre of the fovea. This mechanism extends the use of the superior image processing performance of the fovea over a large visual field. We know that visual information is processed quickly at the end of each saccade but estimates of the times involved remain controversial. This study aims to investigate the processing of visual information during post fixation oscillations of the eyeball. A new psychophysical test measures the combined eye movement response latencies, including fixation duration and visual processing times. When the test is used in conjunction with an eye tracker, each component that makes up the 'integrated saccade latency' time, from the onset of the peripheral stimulus to the correct interpretation of the information carried by the stimulus, can be measured and the discrete components delineated. The results show that the time required to process and encode the stimulus attribute of interest at the end of a saccade is longer than the time needed to carry out the same task in the absence of an eye movement. We propose two principal hypotheses, each of which can account for this finding. 1. The known inhibition of afferent retinal signals during fast eye movements extends beyond the end point of the saccade. 2. The extended visual processing times measured when saccades are involved are caused by the transient loss of spatial resolution due to eyeball instability during post-saccadic oscillations. The latter can best be described as retinal image smear with greater loss of spatial resolution expected for stimuli of low luminance contrast.


Fixation, Ocular , Reaction Time , Saccades , Visual Perception , Humans , Saccades/physiology , Adult , Male , Female , Reaction Time/physiology , Visual Perception/physiology , Fixation, Ocular/physiology , Young Adult , Photic Stimulation , Visual Fields/physiology , Time Factors
6.
BMC Ophthalmol ; 24(1): 209, 2024 May 10.
Article En | MEDLINE | ID: mdl-38724962

BACKGROUD: The aim of this study was to investigate the associations between fluctuation in blood pressure (BP), ocular perfusion pressure (OPP) and visual field (VF) progression in normal-tension glaucoma (NTG). METHODS: This prospective, longitudinal study included 44 patients with NTG. Only newly diagnosed NTG patients who had not been treated with a glaucoma medication were included. Patients were examined every year for 7 years. Intraocular pressure (IOP), heart rate (HR), systolic BP (SBP), diastolic BP (DBP), ocular perfusion pressure (OPP), and diastolic ocular perfusion pressure (DOPP) were measured at the same time. Ophthalmic examinations, including perimetry, were performed also. Initial VF were compared with follow-up data after 7 years. RESULTS: After 7 years of follow-up, 9 of the 44 patients showed VF progression. The standard deviation (SD) of SBP and OPP were significantly associated with VF progression (P = 0.007, < 0.001, respectively). Multiple regression analysis showed that VF progression was significantly associated with SD of OPP (odds ratio, OR = 2.012, 95% CI = 1.016-3.985; P = 0.045). CONCLUSIONS: Fluctuation in OPP was associated with VF progression in patients with NTG.


Blood Pressure , Disease Progression , Intraocular Pressure , Low Tension Glaucoma , Visual Fields , Humans , Low Tension Glaucoma/physiopathology , Visual Fields/physiology , Male , Female , Intraocular Pressure/physiology , Prospective Studies , Middle Aged , Blood Pressure/physiology , Follow-Up Studies , Aged , Visual Field Tests , Adult
7.
Neuropsychologia ; 199: 108907, 2024 Jul 04.
Article En | MEDLINE | ID: mdl-38734179

Studies of letter transposition effects in alphabetic scripts provide compelling evidence that letter position is encoded flexibly during reading, potentially during an early, perceptual stage of visual word recognition. Recent studies additionally suggest similar flexibility in the spatial encoding of syllabic information in the Korean Hangul script. With the present research, we conducted two experiments to investigate the locus of this syllabic transposition effect. In Experiment 1, lexical decisions for foveal stimulus presentations were less accurate and slower for four-syllable nonwords created by transposing two syllables in a base word as compared to control nonwords, replicating prior evidence for a transposed syllable effect in Korean word recognition. In Experiment 2, the same stimuli were presented to the right and left visual hemifields (i.e., RVF and LVF), which project both unilaterally and contralaterally to each participant's left and right cerebral hemisphere (i.e., LH and RH) respectively, using lateralized stimulus displays. Lexical decisions revealed a syllable transposition effect in the accuracy and latency of lexical decisions for both RVF and LVF presentations. However, response times for correct responses were longer in the LVF, and therefore the RH, as compared to the RVF/LH. As the LVF/RH appears to be selectively sensitive to the visual-perceptual attributes of words, the findings suggest that this syllable transposition effect partly finds its locus within a perceptual stage of processing. We discuss these findings in relation to current models of the spatial encoding of orthographic information during visual word recognition and accounts of visual word recognition in Korean.


Reaction Time , Reading , Humans , Female , Male , Young Adult , Reaction Time/physiology , Functional Laterality/physiology , Pattern Recognition, Visual/physiology , Photic Stimulation , Adult , Visual Fields/physiology , Language
8.
Invest Ophthalmol Vis Sci ; 65(5): 33, 2024 May 01.
Article En | MEDLINE | ID: mdl-38771569

Purpose: This study explored early (contrast discrimination) and intermediate (global form perception) visual processing in primary subtypes of glaucoma: primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG). We aimed to understand early and intermediate visual processing in POAG and PACG, matched for similar visual field defect severity. Methods: Early visual processing was measured using a contrast discrimination task described by Porkorny and Smith (1997), and intermediate processing using a global form perception task using glass pattern coherence thresholds. Thresholds were determined centrally and at a single midperipheral location (12.5°) in a quadrant without visual field defects. Controls were tested in corresponding quadrants to individuals with glaucoma. Results: Sixty participants (20 POAG, 20 PACG, and 20 age-matched controls), aged 50 to 77 years, were included. Visual field defects were matched between POAG and PACG, with mean deviation values of -6.53 ± 4.46 (range: -1.5 to -16.85) dB and -6.2 ± 4.24 (range: -1.37 to -16.42) dB, respectively. Two-Way ANOVA revealed significant differences in thresholds between the glaucoma groups and the control group for both contrast discrimination and global form perception tasks, with higher thresholds in the glaucoma groups. Post hoc analyses showed no significant contrast discrimination difference between POAG and PACG, but POAG had significantly higher thresholds than PACG for form perception. Conclusions: In form perception, POAG showed slightly worse performance than PACG, suggesting that individuals with POAG may experience more severe functional damage than PACG of similar visual field severity.


Contrast Sensitivity , Form Perception , Glaucoma, Angle-Closure , Glaucoma, Open-Angle , Visual Fields , Humans , Glaucoma, Open-Angle/physiopathology , Glaucoma, Angle-Closure/physiopathology , Middle Aged , Aged , Male , Female , Visual Fields/physiology , Contrast Sensitivity/physiology , Form Perception/physiology , Intraocular Pressure/physiology , Sensory Thresholds/physiology , Visual Field Tests
9.
J Vis ; 24(5): 7, 2024 May 01.
Article En | MEDLINE | ID: mdl-38771584

This study aimed to investigate the impact of eccentric-vision training on population receptive field (pRF) estimates to provide insights into brain plasticity processes driven by practice. Fifteen participants underwent functional magnetic resonance imaging (fMRI) measurements before and after behavioral training on a visual crowding task, where the relative orientation of the opening (gap position: up/down, left/right) in a Landolt C optotype had to be discriminated in the presence of flanking ring stimuli. Drifting checkerboard bar stimuli were used for pRF size estimation in multiple regions of interest (ROIs): dorsal-V1 (dV1), dorsal-V2 (dV2), ventral-V1 (vV1), and ventral-V2 (vV2), including the visual cortex region corresponding to the trained retinal location. pRF estimates in V1 and V2 were obtained along eccentricities from 0.5° to 9°. Statistical analyses revealed a significant decrease of the crowding anisotropy index (p = 0.009) after training, indicating improvement on crowding task performance following training. Notably, pRF sizes at and near the trained location decreased significantly (p = 0.005). Dorsal and ventral V2 exhibited significant pRF size reductions, especially at eccentricities where the training stimuli were presented (p < 0.001). In contrast, no significant changes in pRF estimates were found in either vV1 (p = 0.181) or dV1 (p = 0.055) voxels. These findings suggest that practice on a crowding task can lead to a reduction of pRF sizes in trained visual cortex, particularly in V2, highlighting the plasticity and adaptability of the adult visual system induced by prolonged training.


Magnetic Resonance Imaging , Neuronal Plasticity , Visual Cortex , Visual Fields , Humans , Male , Female , Visual Cortex/physiology , Adult , Visual Fields/physiology , Magnetic Resonance Imaging/methods , Young Adult , Neuronal Plasticity/physiology , Photic Stimulation/methods
10.
Retina ; 44(6): 982-990, 2024 Jun 01.
Article En | MEDLINE | ID: mdl-38767849

PURPOSE: To evaluate macular sensitivity using microperimetry in patients with proliferate diabetic retinopathy following vitrectomy and to investigate the relationship between the sensitivity and foveal microstructures with optical coherence tomography/angiography. METHODS: Eighty-four eyes of 84 patients with proliferative diabetic retinopathy, who were indicated for vitrectomy, had no intraocular surgery history 3 months preoperatively, and were able to ensure fundus examination after the vitrectomy, were included. A logMAR best-corrected visual acuity, macular sensitivity of microperimetry, macular retinal thickness, and macular vessel perfusion using optical coherence tomography/angiography were examined at 1 week, 1 month, and 3 months postoperatively. RESULTS: The logMAR best-corrected visual acuity and mean macular sensitivity of patients with proliferative diabetic retinopathy improved postoperatively (P < 0.05). There was a significant correlation between best-corrected visual acuity and mean sensitivity (P < 0.05). Postoperative mean macular sensitivity was significantly correlated with outer retinal thickness in the 0 to 6 mm macular area (P < 0.05) and also significantly correlated with deep capillary plexus perfusion (P < 0.05). Fixation stability and mean macular sensitivity did not show any correlation with glycated hemoglobin, triglyceride, serum total cholesterol, carbamide, and creatinine and duration of diabetes mellitus (P > 0.05). CONCLUSION: Postoperative mean macular sensitivity was significantly correlated with outer retinal thickness and deep capillary plexus perfusion for patients with proliferative diabetic retinopathy. The authors found that the visual performance of patients can be evaluated by the outer retinal thickness and deep capillary plexus perfusion, so optical coherence tomography/angiography examination can be an important prognostic factor for visual performance in patients.Clinical Trial Registration: This trial is registered with the Chinese Clinical Trial Registry (http://www.chictr.org.cn; Registration No.: ChiCTR2100043399).


Diabetic Retinopathy , Fluorescein Angiography , Macula Lutea , Tomography, Optical Coherence , Visual Acuity , Visual Field Tests , Vitrectomy , Humans , Diabetic Retinopathy/physiopathology , Diabetic Retinopathy/surgery , Diabetic Retinopathy/diagnosis , Vitrectomy/methods , Male , Female , Tomography, Optical Coherence/methods , Visual Acuity/physiology , Middle Aged , Visual Field Tests/methods , Fluorescein Angiography/methods , Macula Lutea/blood supply , Macula Lutea/diagnostic imaging , Aged , Adult , Visual Fields/physiology , Retinal Vessels/physiopathology , Retinal Vessels/diagnostic imaging , Postoperative Period
11.
PLoS Comput Biol ; 20(5): e1012127, 2024 May.
Article En | MEDLINE | ID: mdl-38820562

Neurons in the primary visual cortex respond selectively to simple features of visual stimuli, such as orientation and spatial frequency. Simple cells, which have phase-sensitive responses, can be modeled by a single receptive field filter in a linear-nonlinear model. However, it is challenging to analyze phase-invariant complex cells, which require more elaborate models having a combination of nonlinear subunits. Estimating parameters of these models is made additionally more difficult by cortical neurons' trial-to-trial response variability. We develop a simple convolutional neural network method to estimate receptive field models for both simple and complex visual cortex cells from their responses to natural images. The model consists of a spatiotemporal filter, a parameterized rectifier unit (PReLU), and a two-dimensional Gaussian "map" of the receptive field envelope. A single model parameter determines the simple vs. complex nature of the receptive field, capturing complex cell responses as a summation of homogeneous subunits, and collapsing to a linear-nonlinear model for simple type cells. The convolutional method predicts simple and complex cell responses to natural image stimuli as well as grating tuning curves. The fitted models yield a continuum of values for the PReLU parameter across the sampled neurons, showing that the simple/complex nature of cells can vary in a continuous manner. We demonstrate that complex-like cells respond less reliably than simple-like cells. However, compensation for this unreliability with noise ceiling analysis reveals predictive performance for complex cells proportionately closer to that for simple cells. Most spatial receptive field structures are well fit by Gabor functions, whose parameters confirm well-known properties of cat A17/18 receptive fields.


Computational Biology , Models, Neurological , Neural Networks, Computer , Neurons , Visual Cortex , Animals , Neurons/physiology , Visual Cortex/physiology , Visual Cortex/cytology , Computational Biology/methods , Photic Stimulation , Visual Fields/physiology , Cats , Primary Visual Cortex/physiology
12.
Brain Behav ; 14(5): e3525, 2024 May.
Article En | MEDLINE | ID: mdl-38773793

INTRODUCTION: Visual field defects (VFDs) represent a debilitating poststroke complication, characterized by unseen parts of the visual field. Visual perceptual learning (VPL), involving repetitive visual training in blind visual fields, may effectively restore visual field sensitivity in cortical blindness. This current multicenter, double-blind, randomized, controlled clinical trial investigated the efficacy and safety of VPL-based digital therapeutics (Nunap Vision [NV]) for treating poststroke VFDs. METHODS: Stroke outpatients with VFDs (>6 months after stroke onset) were randomized into NV (defective field training) or Nunap Vision-Control (NV-C, central field training) groups. Both interventions provided visual perceptual training, consisting of orientation, rotation, and depth discrimination, through a virtual reality head-mounted display device 5 days a week for 12 weeks. The two groups received VFD assessments using Humphrey visual field (HVF) tests at baseline and 12-week follow-up. The final analysis included those completed the study (NV, n = 40; NV-C, n = 35). Efficacy measures included improved visual area (sensitivity ≥6 dB) and changes in the HVF scores during the 12-week period. RESULTS: With a high compliance rate, NV and NV-C training improved the visual areas in the defective hemifield (>72 degrees2) and the whole field (>108 degrees2), which are clinically meaningful improvements despite no significant between-group differences. According to within-group analyses, mean total deviation scores in the defective hemifield improved after NV training (p = .03) but not after NV-C training (p = .12). CONCLUSIONS: The current trial suggests that VPL-based digital therapeutics may induce clinically meaningful visual improvements in patients with poststroke VFDs. Yet, between-group differences in therapeutic efficacy were not found as NV-C training exhibited unexpected improvement comparable to NV training, possibly due to learning transfer effects.


Stroke Rehabilitation , Stroke , Virtual Reality , Visual Fields , Visual Perception , Humans , Double-Blind Method , Male , Female , Middle Aged , Aged , Visual Fields/physiology , Stroke/complications , Stroke/therapy , Stroke/physiopathology , Visual Perception/physiology , Stroke Rehabilitation/methods , Stroke Rehabilitation/instrumentation , Learning/physiology , Vision Disorders/etiology , Vision Disorders/rehabilitation , Vision Disorders/therapy , Vision Disorders/physiopathology
13.
J Glaucoma ; 33(6): 381-386, 2024 Jun 01.
Article En | MEDLINE | ID: mdl-38722193

PRCIS: A review of the literature found that certain types of exercise and physical activity result in transient reductions in intraocular pressure and may have a beneficial effect on glaucoma severity and progression. INTRODUCTION: Glaucoma is the most common cause of irreversible vision loss worldwide. Raised intraocular pressure (IOP) is the most important risk factor for the disease. Exercise is known to result in changes in IOP. The purpose of this review was to investigate the effect of exercise on IOP and glaucoma. METHODS: A comprehensive search of multiple literature databases was performed. Medline, EMBASE, and Cochrane libraries were used to search for the relevant terms. 16 original studies were selected for the review. RESULTS: Exercise of varying intensity and type has differing effects on IOP. Moderate-intensity aerobic exercise results in transient reductions in IOP, while high-intensity resistance exercise and weight-lifting lead to transient elevations in IOP. There is evidence to suggest that exercise and higher levels of fitness may be protective against the development of glaucoma. In addition, increased daily physical activity may be associated with less visual field progression in patients with glaucoma. While secondary causes of glaucoma are included in some of the studies discussed in this review, the findings are largely applicable to primary open angle glaucoma. CONCLUSION: Exercise may be a beneficial lifestyle modification in the management of glaucoma; however, further longitudinal studies are required to validate this.


Exercise , Glaucoma , Intraocular Pressure , Humans , Intraocular Pressure/physiology , Exercise/physiology , Glaucoma/physiopathology , Visual Fields/physiology , Glaucoma, Open-Angle/physiopathology , Tonometry, Ocular
14.
Photodiagnosis Photodyn Ther ; 47: 104197, 2024 Jun.
Article En | MEDLINE | ID: mdl-38723758

BACKGROUND: Diabetic retinopathy (DR) is a common complication of diabetes mellitus (DM) and is a leading cause of vision loss. Early detection of DR-related neurodegenerative changes is crucial for effective management and prevention of vision loss in diabetic patients. METHODS: In this study, we employed spectral-domain polarization-sensitive optical coherence tomography (SD PS-OCT) to assess retinal nerve fiber layer (RNFL) changes in 120 eyes from 60 types 1 DM patients without clinical DR and 60 age-matched healthy controls. Visual field testing was performed to evaluate mean sensitivity (MS) and mean defect (MD) as indicators of visual function. RESULTS: SD PS-OCT measurements revealed significant reductions in RNFL birefringence, retardation, and thickness in type 1 DM patients compared to healthy controls. Visual field testing showed decreased MS and increased MD in DM patients, indicating functional impairment correlated with RNFL alterations. CONCLUSION: Our findings demonstrate early neurodegenerative changes in the RNFL of type 1 DM patients without clinical DR, highlighting the potential of SD PS-OCT as a sensitive tool for early detection of subclinical DR-related neurodegeneration. These results underscore the importance of regular ophthalmic screenings in diabetic patients to enable timely intervention and prevent vision-threatening complications.


Diabetes Mellitus, Type 1 , Diabetic Retinopathy , Nerve Fibers , Tomography, Optical Coherence , Visual Fields , Humans , Tomography, Optical Coherence/methods , Male , Female , Visual Fields/physiology , Adult , Nerve Fibers/pathology , Diabetes Mellitus, Type 1/complications , Optic Nerve/diagnostic imaging , Optic Nerve/pathology , Middle Aged , Case-Control Studies
15.
J AAPOS ; 28(3): 103933, 2024 Jun.
Article En | MEDLINE | ID: mdl-38729256

PURPOSE: To assess the feasibility and performance of Vivid Vision Perimetry (VVP), a new virtual reality (VR)-based visual field platform. METHODS: Children 7-18 years of age with visual acuity of 20/80 or better undergoing Humphrey visual field (HVF) testing were recruited to perform VVP, a VR-based test that uses suprathreshold stimuli to test 54 field locations and calculates a fraction seen score. Pearson correlation coefficients were calculated to evaluate correlation between HVF mean sensitivity and VVP mean fraction seen scores. Participants were surveyed regarding their experience. RESULTS: A total of 37 eyes of 23 participants (average age, 12.9 ± 3.1 years; 48% female) were included. All participants successfully completed VVP testing. Diagnoses included glaucoma (12), glaucoma suspect (7), steroid-induced ocular hypertension (3), and craniopharyngioma (1). Sixteen participants had prior HVF experience, and none had prior VVP experience, although 7 had previously used VR. Of the 23 HVF tests performed, 9 (39%) were unreliable due to fixation losses, false positives, or false negatives. Similarly, 35% of VVP tests were unreliable (as defined by accuracy of blind spot detection). Excluding unreliable HVF tests, the correlation between HVF average mean sensitivity and VVP mean fraction seen score was 0.48 (P = 0.02; 95% CI, 0.09-0.74). When asked about preference for the VVP or HVF examination, all participants favored the VVP, and 70% were "very satisfied" with VVP. CONCLUSIONS: In our cohort of 23 pediatric subjects, VVP proved to be a clinically feasible VR-based visual field testing, which was uniformly preferred over HVF.


Feasibility Studies , Virtual Reality , Visual Acuity , Visual Field Tests , Visual Fields , Humans , Visual Field Tests/methods , Child , Female , Male , Pilot Projects , Adolescent , Visual Fields/physiology , Visual Acuity/physiology , Glaucoma/diagnosis , Glaucoma/physiopathology , Reproducibility of Results , Vision Disorders/diagnosis , Vision Disorders/physiopathology , Ocular Hypertension/diagnosis , Ocular Hypertension/physiopathology
16.
Curr Biol ; 34(11): 2474-2486.e5, 2024 Jun 03.
Article En | MEDLINE | ID: mdl-38772362

ON and OFF thalamic afferents from the two eyes converge in the primary visual cortex to form binocular receptive fields. The receptive fields need to be diverse to sample our visual world but also similar across eyes to achieve binocular fusion. It is currently unknown how the cortex balances these competing needs between receptive-field diversity and similarity. Our results demonstrate that receptive fields in the cat visual cortex are binocularly matched with exquisite precision for retinotopy, orientation/direction preference, orientation/direction selectivity, response latency, and ON-OFF polarity/structure. Specifically, the average binocular mismatches in retinotopy and ON-OFF structure are tightly restricted to 1/20 and 1/5 of the average receptive-field size but are still large enough to generate all types of binocular disparity tuning. Based on these results, we conclude that cortical receptive fields are binocularly matched with the high precision needed to facilitate binocular fusion while allowing restricted mismatches to process visual depth.


Primary Visual Cortex , Vision, Binocular , Animals , Cats/physiology , Vision, Binocular/physiology , Primary Visual Cortex/physiology , Visual Fields/physiology , Visual Cortex/physiology , Vision Disparity/physiology
17.
Harefuah ; 163(5): 298-304, 2024 May.
Article He | MEDLINE | ID: mdl-38734943

INTRODUCTION: Glaucoma is a progressive optic neuropathy and is the leading cause of preventable irreversible blindness worldwide. Glaucoma causes progressive visual field loss and can have significant implications on the patient's quality of life. Lowering intraocular pressure (IOP) is the only treatment proven to prevent vision loss from glaucoma. It is achieved using medication, laser treatment and surgery. The treatment paradigm of glaucoma has been one whereby surgical intervention has been left for advanced cases due to a variety of reasons, mainly concerning safety and long term success. The past two decades have seen a paradigm shift towards earlier IOP lowering interventions using a wide array of different technologies in the laser and surgical spaces. This review aims to understand the background to this paradigm shift, its necessity, and its potential impact on the vision and life of glaucoma patients.


Glaucoma , Intraocular Pressure , Laser Therapy , Quality of Life , Humans , Glaucoma/therapy , Glaucoma/surgery , Intraocular Pressure/physiology , Laser Therapy/methods , Blindness/etiology , Blindness/prevention & control , Visual Fields/physiology , Disease Progression , Optic Nerve Diseases/etiology , Optic Nerve Diseases/therapy
18.
Am J Ophthalmol ; 259: 7-14, 2024 Mar.
Article En | MEDLINE | ID: mdl-38708401

Purpose: To evaluate the diagnostic accuracy of retinal nerve fiber layer thickness (RNFLT) by spectral-domain optical coherence tomography (OCT) in primary open-angle glaucoma (POAG) in eyes of African (AD) and European descent (ED). Design: Comparative diagnostic accuracy analysis by race. Participants: 379 healthy eyes (125 AD and 254 ED) and 442 glaucomatous eyes (226 AD and 216 ED) from the Diagnostic Innovations in Glaucoma Study and the African Descent and Glaucoma Evaluation Study. Methods: Spectralis (Heidelberg Engineering GmbH) and Cirrus (Carl Zeiss Meditec) OCT scans were taken within one year from each other. Main Outcome Measures: Diagnostic accuracy of RNFLT measurements. Results: Diagnostic accuracy for Spectralis-RNFLT was significantly lower in eyes of AD compared to those of ED (area under the receiver operating curve [AUROC]: 0.85 and 0.91, respectively, P=0.04). Results for Cirrus-RNFLT were similar but did not reach statistical significance (AUROC: 0.86 and 0.90 in AD and ED, respectively, P =0.33). Adjustments for age, central corneal thickness, axial length, disc area, visual field mean deviation, and intraocular pressure yielded similar results. Conclusions: OCT-RNFLT has lower diagnostic accuracy in eyes of AD compared to those of ED. This finding was generally robust across two OCT instruments and remained after adjustment for many potential confounders. Further studies are needed to explore the potential sources of this difference.


Glaucoma, Open-Angle , Intraocular Pressure , Nerve Fibers , Optic Disk , ROC Curve , Retinal Ganglion Cells , Tomography, Optical Coherence , Visual Fields , White People , Humans , Glaucoma, Open-Angle/ethnology , Glaucoma, Open-Angle/diagnosis , Tomography, Optical Coherence/methods , Nerve Fibers/pathology , Retinal Ganglion Cells/pathology , Female , Male , Middle Aged , Intraocular Pressure/physiology , Visual Fields/physiology , White People/ethnology , Reproducibility of Results , Aged , Optic Disk/pathology , Optic Disk/diagnostic imaging , Optic Nerve Diseases/diagnosis , Optic Nerve Diseases/ethnology , Black or African American/ethnology , Area Under Curve , Sensitivity and Specificity
19.
PLoS One ; 19(5): e0303400, 2024.
Article En | MEDLINE | ID: mdl-38739635

Visual abilities tend to vary predictably across the visual field-for simple low-level stimuli, visibility is better along the horizontal vs. vertical meridian and in the lower vs. upper visual field. In contrast, face perception abilities have been reported to show either distinct or entirely idiosyncratic patterns of variation in peripheral vision, suggesting a dissociation between the spatial properties of low- and higher-level vision. To assess this link more clearly, we extended methods used in low-level vision to develop an acuity test for face perception, measuring the smallest size at which facial gender can be reliably judged in peripheral vision. In 3 experiments, we show the characteristic inversion effect, with better acuity for upright faces than inverted, demonstrating the engagement of high-level face-selective processes in peripheral vision. We also observe a clear advantage for gender acuity on the horizontal vs. vertical meridian and a smaller-but-consistent lower- vs. upper-field advantage. These visual field variations match those of low-level vision, indicating that higher-level face processing abilities either inherit or actively maintain the characteristic patterns of spatial selectivity found in early vision. The commonality of these spatial variations throughout the visual hierarchy means that the location of faces in our visual field systematically influences our perception of them.


Facial Recognition , Visual Fields , Humans , Visual Fields/physiology , Female , Male , Adult , Facial Recognition/physiology , Young Adult , Photic Stimulation , Visual Perception/physiology , Visual Acuity/physiology , Face/physiology
20.
Vestn Oftalmol ; 140(2. Vyp. 2): 34-42, 2024.
Article Ru | MEDLINE | ID: mdl-38739129

PURPOSE: This study analyzes changes in light sensitivity in each test point of the visual field in patients with different stages of glaucoma. MATERIAL AND METHODS: The data of a prospective analytical case-control study were analyzed. All patients underwent assessment of retinal light sensitivity and its variability in 54 points corresponding to the 24-2 program. Mean light sensitivity values were calculated in each point. Intergroup analysis was performed to evaluate changes in light sensitivity in each point. RESULTS: The range of light sensitivity decrease in the early glaucoma group compared to the control group was from 1.5 to 3.6 dB. The range of light sensitivity decrease in the moderate glaucoma group compared to the control group was from 2.1 to 11.5 dB, and compared to the early glaucoma group - from -0.9 to 7.9 dB. The most frequent decrease in light sensitivity was detected in the nasal sector and along the horizontal line in the upper half of the visual field. This trend persisted within the central 10 degrees of the visual field. The range of light sensitivity decrease in the advanced glaucoma group compared to the control group was from 14.1 to 28.0 dB, and compared to the early glaucoma group - from 11.35 to 26.08 dB, compared to the moderate glaucoma group - from 9.1 to 23.5 dB. The most frequent and severe decrease in light sensitivity was detected in the paracentral zone in the lower half of the visual field. CONCLUSION: The study analyzed the trends in the development of glaucoma from the early to the advanced stage. The most frequent and severe defect in light sensitivity in cases of verified advanced glaucoma was found in the lower half of the visual field. Points No. 32, 33 and 40 can be indicated as the area of interest in assessing the progression of glaucoma, as they were found to have the most profound changes in light sensitivity as glaucoma progressed.


Disease Progression , Glaucoma , Visual Field Tests , Visual Fields , Humans , Visual Fields/physiology , Glaucoma/physiopathology , Glaucoma/diagnosis , Male , Female , Middle Aged , Visual Field Tests/methods , Prospective Studies , Aged , Case-Control Studies , Light
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