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1.
Small ; : e2401537, 2024 Jun 01.
Article En | MEDLINE | ID: mdl-38822716

Metallic 1T-MoS2 with high intrinsic electronic conductivity performs Pt-like catalytic activity for hydrogen evolution reaction (HER). However, obtaining pure 1T-MoS2 is challenging due to its high formation energy and metastable properties. Herein, an in situ SO4 2--anchoring strategy is reported to synthesize a thin layer of 1T-MoS2 loaded on commercial carbon. Single Pd atoms, constituting a substantial loading of 7.2 wt%, are then immobilized on the 1T-phase MoS2 via Pd─S bonds to modulate the electronic structure and ensure a stable active phase. The resulting Pd1/1T-MoS2/C catalyst exhibits superior HER performance, featuring a low overpotential of 53 mV at the current density of 10 mA cm-2, a small Tafel slope of 37 mV dec-1, and minimal charge transfer resistance in alkaline electrolyte. Moreover, the catalyst also demonstrates efficacy in acid and neutral electrolytes. Atomic structural characterization and theoretical calculations reveal that the high activity of Pd1/1T-MoS2/C is attributed to the near-zero hydrogen adsorption energy of the activated sulfur sites on the two adjacent shells of atomic Pd.

2.
J Am Chem Soc ; 146(23): 16039-16051, 2024 Jun 12.
Article En | MEDLINE | ID: mdl-38832517

Efficient methane photooxidation to formic acid (HCOOH) has emerged as a sustainable approach to simultaneously generate value-added chemicals and harness renewable energy. However, the persistent challenge lies in achieving a high yield and selectivity for HCOOH formation, primarily due to the complexities associated with modulating intermediate conversion and desorption after methane activation. In this study, we employ first-principles calculations as a comprehensive guiding tool and discover that by precisely controlling the O2 activation process on noble metal cocatalysts and the adsorption strength of carbon-containing intermediates on metal oxide supports, one can finely tune the selectivity of methane photooxidation products. Specifically, a bifunctional catalyst comprising Pd nanoparticles and monoclinic WO3 (Pd/WO3) would possess optimal O2 activation kinetics and an intermediate oxidation/desorption barrier, thereby promoting HCOOH formation. As evidenced by experiments, the Pd/WO3 catalyst achieves an exceptional HCOOH yield of 4.67 mmol gcat-1 h-1 with a high selectivity of 62% under full-spectrum light irradiation at room temperature using molecular O2. Notably, these results significantly outperform the state-of-the-art photocatalytic systems operated under identical condition.

3.
Angew Chem Int Ed Engl ; : e202403186, 2024 Jun 20.
Article En | MEDLINE | ID: mdl-38900647

Here, we report CdS quantum dot (QD) gels, a three-dimensional network of interconnected CdS QDs, as a new type of direct hydrogen atom transfer (d-HAT) photocatalyst for C-H activation. We discovered that the photoexcited CdS QD gel could generate various neutral radicals, including α-amido, heterocyclic, acyl, and benzylic radicals, from their corresponding stable molecular substrates, including amides, thio/ethers, aldehydes, and benzylic compounds. Its C-H activation ability imparts a broad substrate and reaction scope. The mechanistic study reveals that this reactivity is intrinsic to CdS materials, and the neutral radical generation did not proceed via the conventional sequential electron transfer and proton transfer pathway. Instead, the C-H bonds are activated by the photoexcited CdS QD gel via a d-HAT mechanism. This d-HAT mechanism is supported by the linear correlation between the logarithm of the C-H bond activation rate constant and the C-H bond dissociation energy (BDE) with a Brønsted slope α = 0.5. Our findings expand the currently limited direct hydrogen atom transfer photocatalysis toolbox and provide new possibilities for photocatalytic C-H activation.

4.
Eye Vis (Lond) ; 11(1): 23, 2024 Jun 17.
Article En | MEDLINE | ID: mdl-38880890

BACKGROUND: Diabetic retinopathy (DR) and diabetic macular edema (DME) are major causes of visual impairment that challenge global vision health. New strategies are needed to tackle these growing global health problems, and the integration of artificial intelligence (AI) into ophthalmology has the potential to revolutionize DR and DME management to meet these challenges. MAIN TEXT: This review discusses the latest AI-driven methodologies in the context of DR and DME in terms of disease identification, patient-specific disease profiling, and short-term and long-term management. This includes current screening and diagnostic systems and their real-world implementation, lesion detection and analysis, disease progression prediction, and treatment response models. It also highlights the technical advancements that have been made in these areas. Despite these advancements, there are obstacles to the widespread adoption of these technologies in clinical settings, including regulatory and privacy concerns, the need for extensive validation, and integration with existing healthcare systems. We also explore the disparity between the potential of AI models and their actual effectiveness in real-world applications. CONCLUSION: AI has the potential to revolutionize the management of DR and DME, offering more efficient and precise tools for healthcare professionals. However, overcoming challenges in deployment, regulatory compliance, and patient privacy is essential for these technologies to realize their full potential. Future research should aim to bridge the gap between technological innovation and clinical application, ensuring AI tools integrate seamlessly into healthcare workflows to enhance patient outcomes.

5.
Ann Acad Med Singap ; 53(3): 187-207, 2024 Mar 27.
Article En | MEDLINE | ID: mdl-38920245

Introduction: Automated machine learning (autoML) removes technical and technological barriers to building artificial intelligence models. We aimed to summarise the clinical applications of autoML, assess the capabilities of utilised platforms, evaluate the quality of the evidence trialling autoML, and gauge the performance of autoML platforms relative to conventionally developed models, as well as each other. Method: This review adhered to a prospectively registered protocol (PROSPERO identifier CRD42022344427). The Cochrane Library, Embase, MEDLINE and Scopus were searched from inception to 11 July 2022. Two researchers screened abstracts and full texts, extracted data and conducted quality assessment. Disagreement was resolved through discussion and if required, arbitration by a third researcher. Results: There were 26 distinct autoML platforms featured in 82 studies. Brain and lung disease were the most common fields of study of 22 specialties. AutoML exhibited variable performance: area under the receiver operator characteristic curve (AUCROC) 0.35-1.00, F1-score 0.16-0.99, area under the precision-recall curve (AUPRC) 0.51-1.00. AutoML exhibited the highest AUCROC in 75.6% trials; the highest F1-score in 42.3% trials; and the highest AUPRC in 83.3% trials. In autoML platform comparisons, AutoPrognosis and Amazon Rekognition performed strongest with unstructured and structured data, respectively. Quality of reporting was poor, with a median DECIDE-AI score of 14 of 27. Conclusion: A myriad of autoML platforms have been applied in a variety of clinical contexts. The performance of autoML compares well to bespoke computational and clinical benchmarks. Further work is required to improve the quality of validation studies. AutoML may facilitate a transition to data-centric development, and integration with large language models may enable AI to build itself to fulfil user-defined goals.


Machine Learning , Humans , Lung Diseases/diagnosis , ROC Curve , Brain Diseases/diagnosis , Area Under Curve
7.
Anal Chim Acta ; 1309: 342698, 2024 Jun 22.
Article En | MEDLINE | ID: mdl-38772661

BACKGROUND: The lateral flow immunoassay (LFIA) is widely employed as a point-of-care testing (POCT) technique. However, its limited sensitivity hinders its application in detecting biomarkers with low abundance. Recently, the utilization of nanozymes has been implemented to enhance the sensitivity of LFIA by catalyzing the oxidation of 3,3',5,5'-tetramethylbenzidine (TMB). The catalytic performance of nanozymes plays a crucial role in influencing the sensitivity of LFIA. RESULTS: The Cornus officinalis Sieb. et Zucc-Pd@Pt (CO-Pd@Pt) nanozyme with good peroxidase-like activity was synthesized herein through a facile one-pot method employing Cornus officinalis Sieb. et Zucc extract as a reducing agent. The morphology and composition of the CO-Pd@Pt nanozyme were characterized using TEM, SEM, XRD, and XPS. As a proof of concept, the as-synthesized CO-Pd@Pt nanozyme was utilized in LFIA (CO-Pd@Pt-LFIA) for the detection of human chorionic gonadotropin (hCG). Compared to conventional gold nanoparticles-based LFIA (AuNPs-LFIA), CO-Pd@Pt-LFIA demonstrated a significant enhancement in the limit of detection (LOD, 0.08 mIU/mL), which is approximately 160 times lower than that of AuNPs-LFIA. Furthermore, experiments evaluating accuracy, precision, selectivity, interference, and stability have confirmed the practical applicability of CO-Pd@Pt-LFIA for hCG content determination. SIGNIFICANCE: The present study presents a novel approach for the synthesis of bimetallic nanozymes through environmentally friendly methods, utilizing plant extracts as both protective and reducing agents. Additionally, an easily implementable technique is proposed to enhance signal detection in lateral flow immunoassays.


Palladium , Platinum , Palladium/chemistry , Platinum/chemistry , Immunoassay/methods , Humans , Metal Nanoparticles/chemistry , Limit of Detection , Peroxidase/chemistry , Peroxidase/metabolism , Benzidines/chemistry , Catalysis , Oxidation-Reduction
8.
J Colloid Interface Sci ; 667: 136-146, 2024 Aug.
Article En | MEDLINE | ID: mdl-38636215

Breaking through the limitations of lithium-ion transmission is imperative for high-power rechargeable batteries. As a promising anode material for fast-charging lithium-ion batteries (LIBs), niobium pentoxide (Nb2O5) has garnered considerable research attention due to its exceptional rate performance, stable lithium storage performance and high safety attributes. Nevertheless, the limited intrinsic conductivity of Nb2O5, coupled with its structural degradation during the cycling process, imposes constraints on its viability as a commercially viable electrode material. Herein, a ruthenium (Ru) doping method is employed to regulate the oxygen defects and the interlayer spacing of the tetragonal Nb2O5 (M-Nb2O5), offering superior reaction kinetics, higher stability for lithium storage sites and more unobstructed lithium-ion transport channels. Ru-doped Nb2O5 (RNO) manifests excellent electrochemical properties, including remarkable rate capacity (166 mAh/g at 80C), reversible capacity (246.98 mAh/g at 0.5C), improved initial Coulombic efficiency (95.77 % compared to 81.44 % of the pure sample) and cycling stability (maintaining a capacity of 113.5 mAh/g at 10C for 2,000 cycles). The enhancement mechanism of Ru doping on the structural stability and ion transport kinetics in tetragonal Nb2O5 is comprehensively elucidated through diverse electrochemical analyses and in-situ techniques.

9.
PLOS Digit Health ; 3(4): e0000341, 2024 Apr.
Article En | MEDLINE | ID: mdl-38630683

Large language models (LLMs) underlie remarkable recent advanced in natural language processing, and they are beginning to be applied in clinical contexts. We aimed to evaluate the clinical potential of state-of-the-art LLMs in ophthalmology using a more robust benchmark than raw examination scores. We trialled GPT-3.5 and GPT-4 on 347 ophthalmology questions before GPT-3.5, GPT-4, PaLM 2, LLaMA, expert ophthalmologists, and doctors in training were trialled on a mock examination of 87 questions. Performance was analysed with respect to question subject and type (first order recall and higher order reasoning). Masked ophthalmologists graded the accuracy, relevance, and overall preference of GPT-3.5 and GPT-4 responses to the same questions. The performance of GPT-4 (69%) was superior to GPT-3.5 (48%), LLaMA (32%), and PaLM 2 (56%). GPT-4 compared favourably with expert ophthalmologists (median 76%, range 64-90%), ophthalmology trainees (median 59%, range 57-63%), and unspecialised junior doctors (median 43%, range 41-44%). Low agreement between LLMs and doctors reflected idiosyncratic differences in knowledge and reasoning with overall consistency across subjects and types (p>0.05). All ophthalmologists preferred GPT-4 responses over GPT-3.5 and rated the accuracy and relevance of GPT-4 as higher (p<0.05). LLMs are approaching expert-level knowledge and reasoning skills in ophthalmology. In view of the comparable or superior performance to trainee-grade ophthalmologists and unspecialised junior doctors, state-of-the-art LLMs such as GPT-4 may provide useful medical advice and assistance where access to expert ophthalmologists is limited. Clinical benchmarks provide useful assays of LLM capabilities in healthcare before clinical trials can be designed and conducted.

10.
Sci Rep ; 14(1): 8724, 2024 04 16.
Article En | MEDLINE | ID: mdl-38622152

The objective of this study is to define structure-function relationships of pathological lesions related to age-related macular degeneration (AMD) using microperimetry and multimodal retinal imaging. We conducted a cross-sectional study of 87 patients with AMD (30 eyes with early and intermediate AMD and 110 eyes with advanced AMD), compared to 33 normal controls (66 eyes) recruited from a single tertiary center. All participants had enface and cross-sectional optical coherence tomography (Heidelberg HRA-2), OCT angiography, color and infra-red (IR) fundus and microperimetry (MP) (Nidek MP-3) performed. Multimodal images were graded for specific AMD pathological lesions. A custom marking tool was used to demarcate lesion boundaries on corresponding enface IR images, and subsequently superimposed onto MP color fundus photographs with retinal sensitivity points (RSP). The resulting overlay was used to correlate pathological structural changes to zonal functional changes. Mean age of patients with early/intermediate AMD, advanced AMD and controls were 73(SD = 8.2), 70.8(SD = 8), and 65.4(SD = 7.7) years respectively. Mean retinal sensitivity (MRS) of both early/intermediate (23.1 dB; SD = 5.5) and advanced AMD (18.1 dB; SD = 7.8) eyes were significantly worse than controls (27.8 dB, SD = 4.3) (p < 0.01). Advanced AMD eyes had significantly more unstable fixation (70%; SD = 63.6), larger mean fixation area (3.9 mm2; SD = 3.0), and focal fixation point further away from the fovea (0.7 mm; SD = 0.8), than controls (29%; SD = 43.9; 2.6 mm2; SD = 1.9; 0.4 mm; SD = 0.3) (p ≤ 0.01). Notably, 22 fellow eyes of AMD eyes (25.7 dB; SD = 3.0), with no AMD lesions, still had lower MRS than controls (p = 0.04). For specific AMD-related lesions, end-stage changes such as fibrosis (5.5 dB, SD = 5.4 dB) and atrophy (6.2 dB, SD = 7.0 dB) had the lowest MRS; while drusen and pigment epithelial detachment (17.7 dB, SD = 8.0 dB) had the highest MRS. Peri-lesional areas (20.2 dB, SD = 7.6 dB) and surrounding structurally normal areas (22.2 dB, SD = 6.9 dB) of the retina with no AMD lesions still had lower MRS compared to controls (27.8 dB, SD = 4.3 dB) (p < 0.01). Our detailed topographic structure-function correlation identified specific AMD pathological changes associated with a poorer visual function. This can provide an added value to the assessment of visual function to optimize treatment outcomes to existing and potentially future novel therapies.


Macular Degeneration , Humans , Cross-Sectional Studies , Prospective Studies , Macular Degeneration/diagnostic imaging , Tomography, Optical Coherence , Fluorescein Angiography , Structure-Activity Relationship
12.
Nat Commun ; 15(1): 1010, 2024 Feb 03.
Article En | MEDLINE | ID: mdl-38307902

The reaction system of hydrogen peroxide (H2O2) catalyzed by nanozyme has a broad prospect in antibacterial treatment. However, the complex catalytic activities of nanozymes lead to multiple pathways reacting in parallel, causing uncertain antibacterial results. New approach to effectively regulate the multiple catalytic activities of nanozyme is in urgent need. Herein, Cu single site is modified on nanoceria with various catalytic activities, such as peroxidase-like activity (POD) and hydroxyl radical antioxidant capacity (HORAC). Benefiting from the interaction between coordinated Cu and CeO2 substrate, POD is enhanced while HORAC is inhibited, which is further confirmed by density functional theory (DFT) calculations. Cu-CeO2 + H2O2 system shows good antibacterial properties both in vitro and in vivo. In this work, the strategy based on the interaction between coordinated metal and carrier provides a general clue for optimizing the complex activities of nanozymes.


Antioxidants , Oxidants , Antioxidants/pharmacology , Copper , Hydrogen Peroxide , Hydroxyl Radical , Anti-Bacterial Agents/pharmacology , Peroxidase
13.
Int J Nurs Pract ; : e13251, 2024 Feb 20.
Article En | MEDLINE | ID: mdl-38379023

AIMS: We aim to review the experiences and needs of postpartum Chinese women undergoing 'confinement' or 'doing-the-month' a postpartum practice after childbirth. METHODS: A meta-synthesis was reported in alignment with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement. Ten electronic databases were searched for eligible primary qualitative or mixed-methods studies in English and Chinese from their inception until December 2021. Two reviewers independently reviewed the methodological quality of the included studies using the 10-item Critical Appraisal Skills Program (CASP) qualitative checklist, with discrepancies resolved through discussions. The meta-synthesis was conducted based on the two-step approach by Sandelowski and Barroso. RESULTS: Four themes were meta-synthesized from 13 studies: 'confinement' as an essential practice; physical and psychological stressors during 'confinement'; coping strategies by postpartum women; and needs for family, social, and professional support in enhancing satisfaction with 'confinement'. The review showed that 'confinement' remains a significant practice shaped by socio-cultural and health constructs. CONCLUSION: This review suggested re-evaluating the 'confinement' practice and promoting evidence-based care to improve maternal well-being. Nurses and midwives should be cognisant of such postpartum customs and adopt non-judgemental attitudes as early as the prenatal period to provide culturally sensitive care.

14.
Cell Rep Med ; 5(2): 101419, 2024 Feb 20.
Article En | MEDLINE | ID: mdl-38340728

Federated learning (FL) is a distributed machine learning framework that is gaining traction in view of increasing health data privacy protection needs. By conducting a systematic review of FL applications in healthcare, we identify relevant articles in scientific, engineering, and medical journals in English up to August 31st, 2023. Out of a total of 22,693 articles under review, 612 articles are included in the final analysis. The majority of articles are proof-of-concepts studies, and only 5.2% are studies with real-life application of FL. Radiology and internal medicine are the most common specialties involved in FL. FL is robust to a variety of machine learning models and data types, with neural networks and medical imaging being the most common, respectively. We highlight the need to address the barriers to clinical translation and to assess its real-world impact in this new digital data-driven healthcare scene.


Machine Learning , Medicine , Humans , Neural Networks, Computer
15.
J Emerg Med ; 66(2): 184-191, 2024 Feb.
Article En | MEDLINE | ID: mdl-38369413

BACKGROUND: The adoption of point-of-care ultrasound (POCUS) has greatly improved the ability to rapidly evaluate unstable emergency department (ED) patients at the bedside. One major use of POCUS is to obtain echocardiograms to assess cardiac function. OBJECTIVES: We developed EchoNet-POCUS, a novel deep learning system, to aid emergency physicians (EPs) in interpreting POCUS echocardiograms and to reduce operator-to-operator variability. METHODS: We collected a new dataset of POCUS echocardiogram videos obtained in the ED by EPs and annotated the cardiac function and quality of each video. Using this dataset, we train EchoNet-POCUS to evaluate both cardiac function and video quality in POCUS echocardiograms. RESULTS: EchoNet-POCUS achieves an area under the receiver operating characteristic curve (AUROC) of 0.92 (0.89-0.94) for predicting whether cardiac function is abnormal and an AUROC of 0.81 (0.78-0.85) for predicting video quality. CONCLUSIONS: EchoNet-POCUS can be applied to bedside echocardiogram videos in real time using commodity hardware, as we demonstrate in a prospective pilot study.


Echocardiography , Point-of-Care Systems , Humans , Prospective Studies , Pilot Projects , Ultrasonography , Emergency Service, Hospital
16.
Biosens Bioelectron ; 249: 116002, 2024 Apr 01.
Article En | MEDLINE | ID: mdl-38215639

The development of nanomaterials that mimic oxidase-like activities has recently attracted an increasing amount of attention. Obtaining highly active and cost-effective oxidase mimics has posed a significant challenge in this area of research. In this study, we successfully synthesized nickel-doped ferrous disulfide nanocubes (Ni-FeS2) via a facile one-step method. Characterization by scanning electron microscopy (SEM) and transmission electron microscopy (TEM) revealed that Ni was predominantly distributed within the surface layer of the Ni-FeS2 nanocubes. The incorporation of nickel in density functional theory (DFT) calculations effectively reduced the d-band center of Fe, resulting in weakened adsorption to intermediates and thereby enhancing its catalytic efficiency. Moreover, we developed a novel approach based on Ni-FeS2 (the Ni-FeS2 method) for detecting reducing substances, which exhibited good sensitivity toward ascorbic acid (AA), glutathione (GSH), and cysteine (Cys). Remarkably, the established Ni-FeS2 method was successfully employed for in vitro assessment of total antioxidant capacity (TAC) in cellular and organ samples, thereby enabling discrimination between normal, senescent, and malignant cells as well as distinguishing among healthy liver tissue, cancerous liver tissue, and metastatic organs.


Antioxidants , Biosensing Techniques , Iron , Sulfides , Oxidoreductases , Nickel , Glutathione
17.
West J Emerg Med ; 25(1): 9-16, 2024 Jan.
Article En | MEDLINE | ID: mdl-38205979

Introduction: Identification of patients not meeting catheterization laboratory activation criteria by electrocardiogram (ECG) but who would benefit from early coronary intervention remains challenging in the emergency department (ED). The purpose of this study was to evaluate whether emergency physician (EP)-performed point-of-care transthoracic echocardiography (POC TTE) could help identify patients who required coronary intervention within this population. Methods: This was a retrospective observational cohort study of adult patients who presented to two EDs between 2018-2020. Patients were included if they received a POC TTE and underwent diagnostic coronary angiography within 72 hours of ED presentation. We excluded patients meeting catheterization laboratory activation criteria on initial ED ECG. Ultrasound studies were independently reviewed for presence of regional wall motion abnormalities (RWMA) by two blinded ultrasound fellowship-trained EPs. We then calculated test characteristics for coronary intervention. Results: Of the 221 patient encounters meeting inclusion criteria, 104 (47%) received coronary intervention or coronary artery bypass grafting (CABG) referral. Overall prevalence of RWMA on POC TTE was 35% (95% confidence interval [CI] 29-42%). Presence of RWMA had 38% (95% CI 29-49%) sensitivity and 68% (95% CI 58-76%) specificity for coronary intervention/CABG referral. Presence of "new" RWMA (presence on EP-performed POC TTE and prior normal echocardiogram) had 43% (95% CI 10-82%) sensitivity and 93% (95% CI 66-100%) specificity for coronary intervention/CABG referral. The EP-performed POC TTE interpretation of RWMA had 57% (95% CI 47-67%) sensitivity and 96% (95% CI 87-100%) specificity for presence of RWMA on subsequent cardiology echocardiogram during the same admission. Conclusion: Presence of RWMA on EP-performed POC TTE had limited sensitivity or specificity for coronary intervention or referral to CABG. The observed specificity appeared to trend higher in subjects with a prior echocardiogram demonstrating absence of RWMA, although a larger sample size will be required to confirm this finding. The EP-performed POC TTE RWMA had high specificity for presence of RWMA on subsequent cardiology echocardiogram. Further evaluation of the diagnostic performance of new RWMA on EP-performed POC TTE with a dedicated cohort is warranted.


Acute Coronary Syndrome , Physicians , Adult , Humans , Acute Coronary Syndrome/diagnostic imaging , Cohort Studies , Echocardiography , Electrocardiography
18.
Nat Prod Res ; : 1-13, 2024 Jan 08.
Article En | MEDLINE | ID: mdl-38189427

Bioactivity-guided purification obtained polysaccharide BP-S1 from seeds of Brucea javanica. The results showed that BP-S1 was a homogenous polysaccharide with molecular weight of 45.7 kDa, mainly composed of arabinose and glucose in the ratio of 1.0:1.0 and the backbone of BP-S1 was deduced to be →3,4)-α-Glup-(1→ with branches of →2)-α-Arap-(1→and α-Arap-(1→, and the possible repetitive units were speculated according to result of methylation and 2D-NMR. Moreover, BP-S1 is a periodic rope-like structure. Functional analysis revealed that BP-S1 inhibited complement activation on the classic and alternative pathways with values of CH50 0.073 ± 0.012 mg/mL and AP50 0.097 ± 0.004 mg/mL, respectively. In mechanism study, using complement component depleted-sera methods indicated that BP-S1 selectively interacted with C3 and C4 components.

19.
Ophthalmol Retina ; 8(1): 32-41, 2024 Jan.
Article En | MEDLINE | ID: mdl-37648064

PURPOSE: To evaluate the relationship between specific monocular and binocular visual function (VF) assessments with binocularly performed activities of daily living task tests (ADLTTs) in patients with age-related macular degeneration (AMD) and healthy controls. DESIGN: Prospective case-control cohort study. SUBJECTS: Thirty-six AMD patients and 36 controls. METHOD: Visual field assessments included monocular and binocular best-corrected visual acuity (BCVA), contrast sensitivity (CS), and monocular microperimetry testing for mean macula sensitivity, mean retina sensitivity (MRS), fixation area, and fixation distance from fovea (FDF). Age-related macular degeneration lesion area and sensitivity were measured on OCT and microperimetry, respectively. Participants performed 4 validated ADLTTs with binocular BCVA: (1) reading; (2) item-search; (3) money-counting; and (4) multi-step drink-making tasks. MAIN OUTCOME MEASURES: Spearman correlations and multivariate regression analysis, adjusted for age, sex, and potential correlation between the 2 eyes, were used to assess the relationship between monocular and binocular VF assessments, and ADLTT performance in both groups. RESULTS: Age-related macular degeneration patients had poorer VF (BCVA, CS, mean macula sensitivity, and MRS) compared with healthy controls. Monocular BCVA in both better- and worse-vision eyes was moderately correlated with the binocular reading speed and money-counting tasks in participants with AMD. In AMD, monocular worse eye CS, MRS, AMD lesion area on OCT, and lesion sensitivity on microperimetry showed moderate correlations to various ADLTTs, such as reading, money-counting, and drink-making. Similar findings were found in our AMD cohort on multivariate regression analysis. Fewer significant correlations were observed for the better-vision eye, whereas no correlations were observed for healthy controls between VF parameters and ADLTTs. In contrast, significant associations were observed between binocular BCVA and CS with binocular ADLTTs (reading and item-search tasks) but not in AMD patients. CONCLUSION: Although monocular BCVA remains the most common measure of VF, CS and microperimetry testing also show significant correlations with ADLTTs performance in AMD patients, and should be considered as complimentary VF-outcome measures in both clinical and research settings. Unlike healthy subjects, AMD patients do not rely on binocular VF for ADLTT function, with the worse-vision eye impacting binocular ADLTT function more than the better-vision eye. Therefore, the worse-vision eye should not be neglected during the management of AMD. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.


Activities of Daily Living , Macular Degeneration , Humans , Visual Acuity , Case-Control Studies , Vision, Binocular , Macular Degeneration/diagnosis
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