Prediction of acute methanol poisoning prognosis using machine learning techniques.

Methanol poisoning is a global public health concern, especially prevalent in developing nations. This study focuses on predicting the severity of methanol intoxication using machine learning techniques, aiming to improve early identification and prognosis assessment. The study, conducted at Loghman Hakim Hospital in Tehran, Iran. The data pertaining to individuals afflicted with methanol poisoning was retrieved retrospectively and divided into training and test groups at a ratio of 70:30. The selected features were then inputted into various machine learning methods. The models were implemented using the Scikit-learn library in the Python programming language. Ultimately, the efficacy of the developed models was assessed through ten-fold cross-validation techniques and specific evaluation criteria, with a confidence level of 95%. A total number of 897 patients were included and divided in three groups including without sequel (n = 573), with sequel (n = 234), and patients who died (n = 90). The two-step feature selection was yielded 43 features in first step and 23 features in second step. In best model (Gradient Boosting Classifier) test dataset metric by 32 features younger age, higher methanol ingestion, respiratory symptoms, lower GCS scores, type of visual symptom, duration of therapeutic intervention, ICU admission, and elevated CPK levels were among the most important features predicting the prognosis of methanol poisoning. The Gradient Boosting Classifier demonstrated the highest predictive capability, achieving AUC values of 0.947 and 0.943 in the test dataset with 43 and 23 features, respectively. This research introduces a machine learning-driven prognostic model for methanol poisoning, demonstrating superior predictive capabilities compared to traditional statistical methods. The identified features provide valuable insights for early intervention and personalized treatment strategies.

Effectiveness and Safety of Non-Invasive Neuromodulation for Vision Restoration: A Systematic Review and Meta-Analysis.

We carried out a systematic review and meta-analysis to determine the effectiveness and safety of non-invasive electrical stimulation (NES) for vision restoration. We systematically searched for randomised controlled trials (RCTs) comparing NES with sham stimulation, for vision restoration between 2000 and 2022 in CENTRAL, MEDLINE, EMBASE, and LILACS. The main outcomes were as follows: visual acuity (VA); detection accuracy; foveal threshold; mean sensitivity as the parameter for the visual field; reading performance; contrast sensitivity (CS); electroencephalogram; quality of life (QoL), and safety. Two reviewers independently selected studies, extracted data, and evaluated the risk of bias using the Cochrane risk of bias 2.0 tool. The certainty in the evidence was determined using the GRADE framework. Protocol registration: CRD42022329342. Thirteen RCTs involving 441 patients with vision impairment indicate that NES may improve VA in the immediate post-intervention period (mean difference [MD] = -0.02 logMAR, 95% confidence intervals [CI] -0.08 to 0.04; low certainty), and probably increases QoL and detection accuracy (MD = 0.08, 95% CI -0.25 to 0.42 and standardised MD [SMD] = 0.09, 95% CI -0.58 to 0.77, respectively; both moderate certainty). NES likely results in little or no difference in mean sensitivity (SMD = -0.03, 95% CI -0.53 to 0.48). Compared with sham stimulation, NES increases the risk of minor adverse effects (risk ratio = 1.24, 95% CI 0.99 to 1.54; moderate certainty). The effect of NES on CS, reading performance, and electroencephalogram was uncertain. Our study suggests that although NES may slightly improve VA, detection accuracy, and QoL, the clinical relevance of these findings remains uncertain. Future research should focus on improving the available evidence's precision and consistency.

Prevalence of computer vision syndrome: A systematic review and meta-analysis

Purpose This review aimed to estimate the prevalence of computer vision syndrome (CVS) in the general population and subgroups. Methods A search was conducted in the following the databases: PubMed, SCOPUS, EMBASE, and Web of Science until February 13, 2023. We included studies that assessed the prevalence of CVS in any population. The Joanna Briggs Institute's critical appraisal tool was used to evaluate the methodological quality. A meta-analysis of the prevalence of CVS was done using a random-effects model, assessing the sources of heterogeneity using subgroup and meta-regression analyses. Results A total of 103 cross-sectional studies with 66 577 participants were included. The prevalence of CVS was 69.0% (95% CI: 62.3 to 75.3; I2: 99.7%), ranging from 12.1 to 97.3% across studies. Point prevalence was higher in women than in men (71.4 vs. 61.8%), university students (76.1%), Africa (71.2%), Asia (69.9%), contact lens wearers (73.1% vs. 63.8%) in studies conducted before the COVID-19 pandemic (72.8%), and in those that did not use the CVS-Q questionnaire (75.4%). In meta-regression, using the CVS-Q scale was associated with a lower prevalence of CVS. Conclusion Seven out of ten people suffer from CVS. Preventive strategies and interventions are needed to decrease the prevalence of this condition which can affect productivity and quality of life. Future studies should standardize a definition of CVS. (AU)

Oral Health Status and Oral Health-Related Behaviours of Hong Kong Students with Vision Impairment.

This cross-sectional epidemiological study aimed to describe dental caries and oral hygiene conditions among visually impaired students in Hong Kong. Students aged 6-21 years from two specialised schools for those with vision impairment were invited. Information on sociodemographic background and oral health-related behaviours was collected through an online parent-reported questionnaire. Dental caries and oral hygiene were assessed using the Decayed, Missing and Filled Teeth (DMFT) index and the Visible Plaque Index (VPI), respectively. Chi-square, Mann-Whitney U and Kruskal-Wallis H tests were conducted to analyse the association between students' background and oral health status. A total of 73 participants were recruited, of whom 57.5% were male. Their mean (SD) age was 12.9 (4.7) years. Their mean DMFT score (SD) was 1.0 (1.8), and 43.8% had caries experience. The mean VPI (SD) was 0.76 (0.30). Their caries experience was significantly associated with their snacking habits (p = 0.013). Male participants had poorer oral hygiene than females (p = 0.048). In summary, dental caries is prevalent among visually impaired students in Hong Kong and their oral hygiene condition is unsatisfactory. Caries experience is significantly associated with snacking frequency, whereas oral hygiene is associated with gender. More specially designed preventive oral health measures should be provided for visually impaired students and their caretakers.

Visual stimulation in the neonatal intensive care unit: A systematic literature review.

We aimed to systematically categorize evidence on the types of early visual stimulation applied to preterm infants (PTIs) admitted to neonatal intensive care units (NICUs), aiming to improve visual function parameters. This study was conducted according to PRISMA and registered in PROSPERO with CRD42022333753. Last search was conducted on March 15, 2023, in four different databases. Articles written in English, Portuguese, Spanish, or Italian, and available in full text were included. Two independent authors performed study selection, data extraction, and bias risk assessment. If there was any disagreement, a third author was contacted. A total of eight studies were included. From these, 62.5% presented a low risk of bias. 100% used a multisensory intervention, which included visual stimulation. In 50%, visual intervention consisted of black and white stimulation cards placed inside the incubator for three minutes. The outcomes showed positive benefits in visual function parameters and other reported clinical benefits in breastfeeding and neuromuscular development. This review demonstrated there is still scarce literature on the effects of early visual stimulation on purely visual functional outcomes, although the existing findings are promising. Parental involvement has been generating unquestionable benefits for the binomial mother-infant and gaining greater acceptance by health professionals.

Advanced Visualization Engineering for Vision Disorders: A Clinically Focused Guide to Current Technology and Future Applications.

Head-mounted visualization technology, often in the form of virtual, augmented, and mixed reality (VAMR), has revolutionized how visual disorders may be approached clinically. In this manuscript, we review the available literature on VAMR for visual disorders and provide a clinically oriented guide to how VAMR technology has been deployed for visual impairments. The chief areas of clinical investigation with VAMR are divided include (1) vision assessment, (2) vision simulation, and (3) vision rehabilitation. We discuss in-depth the current literature of these areas in VAMR and upcoming/future applications to combat the detrimental impact of visual impairment worldwide.

Prevalence of computer vision syndrome: A systematic review and meta-analysis.

PURPOSE: This review aimed to estimate the prevalence of computer vision syndrome (CVS) in the general population and subgroups. METHODS: A search was conducted in the following the databases: PubMed, SCOPUS, EMBASE, and Web of Science until February 13, 2023. We included studies that assessed the prevalence of CVS in any population. The Joanna Briggs Institute's critical appraisal tool was used to evaluate the methodological quality. A meta-analysis of the prevalence of CVS was done using a random-effects model, assessing the sources of heterogeneity using subgroup and meta-regression analyses. RESULTS: A total of 103 cross-sectional studies with 66 577 participants were included. The prevalence of CVS was 69.0% (95% CI: 62.3 to 75.3; I2: 99.7%), ranging from 12.1 to 97.3% across studies. Point prevalence was higher in women than in men (71.4 vs. 61.8%), university students (76.1%), Africa (71.2%), Asia (69.9%), contact lens wearers (73.1% vs. 63.8%) in studies conducted before the COVID-19 pandemic (72.8%), and in those that did not use the CVS-Q questionnaire (75.4%). In meta-regression, using the CVS-Q scale was associated with a lower prevalence of CVS. CONCLUSION: Seven out of ten people suffer from CVS. Preventive strategies and interventions are needed to decrease the prevalence of this condition which can affect productivity and quality of life. Future studies should standardize a definition of CVS.

Saccadic movements during an exploratory visual search task in patients with glaucomatous visual field loss

ABSTRACT Purpose: To evaluate the saccadic movements of patients with visual field loss due to primary open-angle glaucoma. Methods: Thirteen patients with good visual acuity (0.2 logMAR or better) (seven patients with primary open-angle glaucoma 65 ± 13 years) and six controls (51 ± 6 years) yielded a comprehensive ophthalmological examination, including Humphrey Visual Field tests (SITA-Standard 24-2), and performed a monocular, exploratory digital visual search task that quantifies the duration for finding the number "4" on a random array of digits distributed on the screen. After individual adjustments of the angle and distance positioning, the screen was spatially matched with the 24-2 visual field, and divided into five areas for analysis. During the task, saccades were simultaneously recorded in the same eye with a video-based eye tracker. Results: The patients with primary open-angle glaucoma showed a significantly higher number of saccades/screen (median ± interquartile range, 59.00 ± 29.00 vs. 32.50 ± 19.75 saccades (p=0.027) and visual search time per screen (38.50 ± 60.14 vs. 23.75 ± 8.90 seconds (p=0.035) than the controls did. Although the univariate analysis indicated a significant correlation with visual field mean deviation (coefficient=26.19 (p=0.02), only the visual search time/screen was significantly associated with the number of saccades/screen in the multivariate regression model (coefficient=0.55 (p<0.001). Overall, no significant correlation was observed between the sectorial number of saccades and the sensitivity of the five visual field areas. Conclusions: The patients with primary open-angle glaucoma show impaired search performance and showed a higher number of saccades needed to find stimuli when performing the exploratory visual task.

Immune-related visual dysfunction in thyroid eye disease: a combined orbital and brain neuroimaging study.

OBJECTIVES: To investigate the pathological interplay between immunity and the visual processing system (VPS) in thyroid eye disease (TED). METHODS: A total of 24 active patients (AP), 26 inactive patients (IP) of TED, and 27 healthy controls (HCs) were enrolled. Orbital magnetic resonance imaging (MRI) and resting-state functional MRI (rs-fMRI) were conducted for each participant. Multiple MRI parameters of the intraorbital optic nerve (ON) were assessed. The amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo) were calculated. Correlation analyses were carried out on the above parameters and clinical characteristics. RESULTS: Visual functioning scores differentiated between the AP and IP groups. The ON subarachnoid space and ON sheath diameter were significantly higher in AP than in IP. Six vision-related brain regions were identified in TED patients compared with HCs, including right calcarine (CAL.R), right cuneus (CUN.R), left postcentral gyrus (PoCG.L), right middle temporal gyrus (MTG.R), left superior frontal gyrus (SFG.L), and left caudate (CAU.L). The brain activity of MTG.R, SFG.L, and CAU.L differentiated between the AP and IP groups. The correlation analysis revealed a close association among the vision-related brain regions, MRI parameters of ON, and clinical characteristics in AP and IP, respectively. CONCLUSIONS: Combined orbital and brain neuroimaging revealed abnormalities of the VPS in TED, which had a close correlation with immune statuses. Vision-related brain regions in TED might be possibly altered by peripheral immunity via a direct or indirect approach. CLINICAL RELEVANCE STATEMENT: The discovery of this study explained the disparity of visual dysfunction in TED patients with different immune statuses. With the uncovered neuroimaging markers, early detection and intervention of visual dysfunction could be achieved and potentially benefit TED patients. KEY POINTS: • Patients with different immune statuses of thyroid eye disease varied in the presentation of visual dysfunction. • The combined orbital and brain neuroimaging study identified six altered vision-related brain regions, which had a significant correlation with the MRI parameters of the intraorbital optic nerve and immunological characteristics. • Peripheral immunity might possibly give rise to alterations in the central nervous system part of the visual processing system via a direct or indirect approach.

Síndrome de Balint y trombosis de senos venosos cerebrales: reporte de caso / Balint syndrome and cerebral venous sinus thrombosis: Case report

Introducción: El síndrome de Balint es un trastorno neurológico infrecuente, de etiología diversa, cuya presentación incluye la triada clásica de: simultagnosia, ataxia óptica y apraxia oculomotora, síntomas secundarios asociados a lesiones parieto-occipitales, con pronóstico variable según la etiología que se encuentre. A continuación, se reporta un caso secundario a una trombosis de senos venosos. Presentación del caso: Mujer de 66 años que ingresa a urgencias por cefalea aguda asociada a síntomas neurológicos progresivos con compromiso visual. Presentó tensión arterial elevada, simultagnosia, ataxia óptica y apraxia oculomotora. Los estudios imagenológicos reportaron hemorragia subaracnoidea por trombosis de seno sigmoideo izquierdo, por lo que se inició anticoagulación, antihipertensivo, con adecuada evolución del cuadro clínico. Discusión: A pesar de que el síndrome de Balint es un trastorno poco común, de etiología diversa, con escasos reportes a escala global, el caso comentado concordó con las características descritas en la literatura. El abordaje de la paciente en su atención inicial permitió la sospecha diagnóstica oportuna y la indicación de ayudas diagnósticas imagenológicas pertinentes. Tales ayudas soportaron un manejo temprano y la adecuada evolución y resolución del cuadro, en el contexto de la asociación del síndrome a una trombosis de senos venosos cerebrales (una etiología infrecuente). Conclusión: Mediante una historia clínica completa y minuciosa, junto a un adecuado examen neurológico, es posible hacer un acercamiento diagnóstico temprano que permita generar la sospecha del síndrome de Balint y la solicitud temprana de imágenes diagnósticas que orienten en el estudio de su etiología y manejo oportuno, con mejores desenlaces en el paciente.

Introduction: Balint Syndrome is a rare neurological disorder with multiple etiologies. The physical signs include a classic triad (simultagnosia, optic ataxia, and oculomotor apraxia). These symptoms are associated with parieto-occipital lesions, and the prognosis depends on the etiology. This article reports a case secondary to venous sinus thrombosis. Presentation of the case: A 66-year-old woman presented to the emergency room with acute headache associated with progressive neurological symptoms and visual impairment. She had high blood pressure, simultanagnosia, optic ataxia, and oculomotor apraxia. Imaging studies revealed subarachnoid hemorrhage due to thrombosis of the left sigmoid sinus, for which anticoagulation and antihypertensive therapy were started. The patient had a favorable clinical outcome. Discussion: Although Balint syndrome is a rare disorder of diverse etiology with few clinical cases reported globally, the case discussed here was consistent with the characteristics described in the literature. The patient's initial assessment allowed for timely diagnostic suspicion and appropriate imaging studies, which supported early management and the appropriate evolution and resolution of the condition, given the association of the syndrome with an uncommon cause as cerebral venous sinus thrombosis. Conclusion: A complete and thorough medical history, along with a proper neurological exam, can lead to an early diagnostic approach that raises suspicion of Balint's syndrome and prompts timely imaging studies to guide the investigation of its etiology and management, ultimately leading to better outcomes for the patient.

Towards identifying gaps in employment integration of people living with vision impairment: A scoping review.

BACKGROUND: The high rate of unemployment among individuals with vision impairment remains a pressing issue, even with the implementation of disability laws and coordinated effort to foster inclusive workplace. Employment integration challenges persist for people with vision impairment due to inaccessible job markets and workplaces. OBJECTIVE: To create new knowledge from previous studies related to employment among people with vision impairment and to understand what has been explored and identify the gaps in employment integration. METHOD: A comprehensive search of six databases was conducted utilizing both index terms and keywords. The title and abstract of identified studies were screened, followed by a full-text screening using pre-set criteria. Only available peer-reviewed studies with a focus on employment and vision impairment were included, irrespective of location and publication year. RESULT: Of 2264 studies screened, only 43 studies were eligible for review and data extraction. Using thematic analysis, 8 key themes emerged: social support, disability rights and service systems, transition strategies and challenges, career, employment integration, employment environment, adaptive potential, and employment sustainability. These studies considered the perspectives of people living with vision impairment, rehabilitation practice, and employers. Identified gaps include transition strategies, workplace participation, the perception of colleagues, and work evolution. CONCLUSION: The primary focus of studies was on the individual factors that impact workplace integration; work environment impact was not explored in depth. The need to examine the readiness of the work environment is also importance because environmental factors can be modified according to the functional needs of people with vision impairment.

Reading Difficulties in Parkinson's Disease: A Stepped Care Model for Neurovisual Rehabilitation.

BACKGROUND: People with Parkinson's disease (PD) frequently experience reading difficulties. Little is known about what functional impairments distinguish people with PD with and without reading difficulties and how these should guide rehabilitation. OBJECTIVE: To provide concrete advice for an efficient stepped care model for reading difficulties in PD, based on extensive functional assessments. METHODS: This study included 74 people with PD in a neurovisual rehabilitation setting who underwent assessment of visual, visuoperceptual, and cognitive functions. Outcomes were compared between those with frequent (RD+; N = 55) and infrequent reading difficulties (RD-; N = 19). Aids and advice provided during rehabilitation were registered. RESULTS: Only a few functions appeared to distinguish RD+ and RD-. Visual functions (i.e., contrast sensitivity, g = 0.76; reading acuity, g = 0.66; visual acuity, g = 0.54) and visuoperceptual functions (i.e., visual attention, g = 0.58, visual motor speed, g = 0.56) showed significant worse scores in RD+ compared to RD-. Aids and advice applied consisted mainly of optimizing refraction, improving lighting, and optimizing text size and spacing. CONCLUSION: The test battery showed significant differences between RD+ and RD-on only a few tests on visual and visuoperceptual functions. The applied aids and advice matched well with these impairments. Therefore, we recommend a stepped care model, starting with a short test battery on these functions. If this battery indicates functional impairments, this can be followed by standard aids and advice to improve reading. Only in case of insufficient effect additional testing should take place.

The utility and reliability of the PreViAs questionnaire forthe assessment of vision in Turkish neonates and infants. / Utilidad y confiabilidad del cuestionario PreViAs para la evaluación de la visión en neonatos y lactantes turcos.

Introduction: Evaluating the visual functions of children with an easy-to-use and evidence-based method during the preverbal period will enable early diagnosis and intervention of visual impairments. The aim of this study is to determine the utility and reliability of the Turkish version of the Preverbal Visual Assessment (PreViAs) questionnaire, which was developed to evaluate the visual functioning of preverbal infants. Population and Methods: The PreViAs questionnaire was administered to primary caregivers of term infants under 24 months of age, and their responses were recorded. Results: Data from the 278 participating infants were analyzed to assess the internal consistency of the PreViAs questionnaire. Results showed a high level of consistency with Cronbach's alpha value of 0.958 for the total score, suggesting strong internal coherence. In addition, the Cronbach's alpha values for each domain were 0.890, 0.913, 0.951, and 0.922 for visual attention, visual communication, visual processing, and visual-motor coordination, respectively, indicating good internal consistency for each subdomain. Conclusion: The Turkish version of the PreViAs questionnaire is useful and reliable for assessing functional vision during the preverbal period.

Introducción. La evaluación de la visión en los niños durante el periodo preverbal, con un método fácil de usar y basado en la evidencia, permitiría el diagnóstico temprano y la intervención en los trastornos visuales. El objetivo del estudio fue determinar la utilidad y confiabilidad de la versión en idioma turco del cuestionario Preverbal Visual Assessment (PreViAs), desarrollado para evaluar la visión en niños preverbales. Población y métodos. El cuestionario PreViAs se administró a los cuidadores primarios de niños nacidos de término, antes de los 24 meses de edad. Se registraron sus respuestas. Resultados. Se analizaron los datos de 278 participantes para evaluar la consistencia interna del cuestionario PreViAs. Se encontró un alto nivel de consistencia con un alfa de Cronbach de 0,958 para el puntaje total, lo que sugiere una fuerte coherencia interna. Los valores del alfa de Cronbach para cada dominio fueron: 0,890 ­ 0,913 ­ 0,951 y 0,922 para la atención visual, la comunicación visual, el procesamiento visual y la coordinación visomotora respectivamente; esto indica una buena consistencia interna para cada subdominio. Conclusión. La versión en idioma turco del cuestionario PreViAs es útil y confiable para evaluar la visión durante el periodo preverbal.

Oculomotor screening and neuro-visual rehabilitation following pediatric brain tumor resection.

Visual difficulties are common after brain tumors, despite a lack of visual complaints at diagnosis. These include difficulties with eye movements, visual coordination, vergence, accommodation, and photophobia, in addition to more obvious problems such as visual field defects.This case report presents the results of a thorough neuro-visual evaluation in a boy with sequelae after a brain tumor including intermittent double vision that was not explained by routine visual examination. Subjective complaints included poor reading perseverance, intermittent blurred and double vision, headache around the eyes when performing near activities, less efficient eye movement behavior in reading tasks, and increased sensitivity to visual motion. The patient participated in a multidisciplinary visual rehabilitation program that included reading glasses with prism compensation and tinted glasses, as well as training with the aim of improving eye teaming, near vision functions, and perseverance in eye movements.The patient responded quickly to the vision therapy program, with positive changes after just four weeks. Repeated neuro-visual evaluations over eight months showed remarkable improvements that were stable over time. This encouraging case report supports the notion that neuro-visual evaluation and rehabilitation should be included in the follow-up of patients after brain tumors.

Knowledge and experience of paramedics concerning patients with hearing and visual disability.

BACKGROUND: A 2017 nationwide disability survey conducted by the General Authority of Statistics in Saudi Arabia, a sample representing the whole population living in Saudi Arabia, reported that approximately 5% and 2% of the Saudi population suffers from visual or hearing impairments, respectively. Patients with these disabilities find it difficult to convey their medical history and chief complaints to paramedics, causing communication breakdowns that can lead to misinterpretation of patient history, leave medical problems unaddressed, and reduce patient engagement and autonomy. We aimed to assess paramedics' knowledge, attitude, and level of confidence when managing patients with visual or hearing problems. METHODS: Descriptive cross-sectional design was used to report the knowledge and experience of paramedics towards patients with hearing/vision disabilities in Saudi Arabia. A validated questionnaire was distributed to our study sample of paramedics in Riyadh, Saudi Arabia between 01, July 2020 and 31, December 2020. Ethical approval was obtained from King Abdullah International Medical Research Center. RESULTS: Ninety-seven participants completed the survey. Male paramedics accounted for 77% of the study participants; 24% were Saudi Red Crescent employees, and 57% were 20-25 years old. Most participants encountered 1-5 cases of patients with hearing disability (55%) as well as patients with visual disability (48%) during their career. Taking medical history was a challenge indicated by 42% of the participants, and 30% reported difficulties in explaining procedures. Of the participants, 44% were confident in handling patients with hearing or visual impairment. There was a strong association between participants who indicated higher confidence levels and those who had obtained specific training for patients with hearing or visual impairments. CONCLUSION: Assisting patients with hearing or visual impairments is challenging, especially during an emergency. We recommend programs that provide specific training in handling hearing or visually impaired patients to close the communication gap in emergent medical situations handled by paramedics or other emergency medicine doctors and nurses.

The effects of abnormal visual experience on neurodevelopmental disorders.

Normal visual development is supported by intrinsic neurobiological mechanisms and by appropriate stimulation from the environment, both of which facilitate the maturation of visual functions. However, an offset of this balance can give rise to visual disorders. Therefore, understanding the factors that support normal vision during development and in the mature brain is important, as vision guides movement, enables social interaction, and allows children to recognize and understand their environment. In this paper, we review fundamental mechanisms that support the maturation of visual functions and discuss and draw links between the perceptual and neurobiological impairments in autism spectrum disorder (ASD) and schizophrenia. We aim to explore how this is evident in the case of ASD, and how perceptual and neurobiological deficits further degrade social ability. Furthermore, we describe the altered perceptual experience of those with schizophrenia and evaluate theories of the underlying neural deficits that alter perception.

The integrity of psychophysical visual function in non-immunocompromised PLHIV (NIPLHIV) without retinitis on antiretroviral therapy (ART).

Purpose: The present study investigated the integrity of contrast sensitivity (CS), colour vision, and pattern evoked vision potentials (VEP) in non-immunocompromised people living with HIV (NIPLHIV) without retinitis. Methods: All participants were visually asymptomatic and no history of ocular disorders, with CD4 counts above 350 cells/mm3, low viral loads and on ART. Thirty NIPLHIV and 30 age-matched HIV negative control groups underwent F100 hue colour assessment, Pelli-Robson contrast sensitivity assessment and pattern-reversal VEP. Results: The median F100 total error scores for NIPLHIV and controls was 33 (IQR: 28;41) and 28 (IQR: 26;48.50) respectively, this was statistically different (p= 0.020). The median P100 amplitude for NIPLHIV was 5.75 µV (IQR: 4.4;8.85) and 4.05 µV (IQR: 3.2;5.8) for controls, this was statistically different (p=0.045). The mean LogCS score 1.83±0.14 and the median P100 peak latency was 105.45 msec (IQR: 102.98;108.98) for NIPLHIV. Higher CD4+ counts were significantly associated with having higher F100 total error scores (OR=0.995; p=0.018), lower P100 amplitudes (OR=1.007; p=0.010) and higher P100 latencies (OR=0.994; p=0.011). Conclusion: Contrast sensitivity function, colour vision, and VEP were uncompromised in NIPLHIV. Associations between CD4 counts with F100 total error scores and P100 latency may aid in the surveillance of vision of NIPLHIV.

The Impact of Visual Impairment on Healthcare Use among Four Medical Institution Types: A Nationwide Retrospective Cohort Study in Korea.

PURPOSE: The aim of this study was to determine the effect of visual impairment (VI) onset on the use of healthcare services across four types of institutions in South Korea. MATERIALS AND METHODS: We utilized data from the National Health Insurance Service database from 2006 to 2015 for 714 persons who experienced VI onset in 2009-2012 and for 2856 matched persons for a 1:4 ratio of matching controls. We compared trends in healthcare use and expenditures for eye diseases at clinics, hospitals, general hospitals, and tertiary teaching hospitals using 3 years of data prior to and after the onset of VI. RESULTS: The inpatient and outpatient healthcare expenditures of individuals with VI were higher than those without VI, peaking at the pre-VI onset period in tertiary teaching hospitals. During the pre-VI onset period, the proportion of healthcare expenditures attributed to eye diseases ranged 11%-40.8% among individuals with VI, but 1.9%-11% among individuals without VI at the four types of institutions. The differences in healthcare use between the pre- and post-VI periods were primarily observed in tertiary teaching hospitals for inpatient care. There was a peak in utilization of outpatient care in the year preceding VI onset at tertiary teaching hospitals, clinics, and hospitals, but there was a decrease in outpatient care over time during the post-VI period. CONCLUSION: Our findings suggest economic burden of healthcare in tertiary teaching hospitals during pre-VI onset period and a potential lack of regular management and continuity of care in post-VI periods.

Evaluation of oral health education programs for oral health of individuals with visual impairment: An umbrella review.

AIM: To exemplify, summarize and critically appraise the systematic reviews (SRs) that evaluated different oral health education (OHE) interventions in individuals with visual impairment (VI). METHODOLOGY: Six electronic databases were searched for SRs evaluating OHE programs in individuals with VI. The internal validity of the included SRs was evaluated using the Assessing the Methodological Quality of Systematic Reviews-2 (AMSTAR-2) tool. The degree of overlap of the primary studies in the included SRs was calculated using the "corrected covered area (CCA)" approach. RESULTS: Seven SRs were included in this umbrella review that included 30 primary studies with a CCA of 26% (very high overlap). Six of the included SRs were assessed to have critically low confidence in the results, whereas only one had moderate confidence. CONCLUSIONS: A combination of various OHE methods for individuals with VI might be better than using one method alone to improve oral hygiene. There is no conclusive evidence that one OHE method is superior to others. However, the evidence of OHE in improving the outcomes related to dental trauma or caries is inconclusive. Furthermore, it appears that most of the evaluations of oral health programs come from limited parts of the world, and data from many other regions is lacking.

Association between Visual Impairment and Nutritional Risk among Older Adults with Diabetes: A Population-Based Cross-Sectional Study.

PURPOSE: Despite the high prevalence of visual impairment caused by diabetic retinopathy and nutritional problems among older adults with diabetes, evidence regarding factors related to nutritional risk in this population is limited. Therefore, this study aimed to identify the correlates of nutritional risk among older adults with diabetes, focusing on visual impairment. METHODS: This study was a secondary data analysis of the 2020 National Survey of Older Koreans aged 65 years and above. The sample comprised 2,376 older adults with diabetes, and complex sample ANOVA and Rao-Scott chi-square tests were used to compare the groups according to visual impairment. Complex-sample logistic regression analyses were conducted to verify the association between visual impairment and nutritional risk. RESULTS: Older adults with diabetes, who also have severe visual impairment, are more likely to have nutritional risk status than those without impairment after controlling for covariates (odds ratio [OR] = 2.44, 95% confidence interval [CI] 1.16~5.13). Among the covariates, depression (OR = 3.58, 95% CI 2.60~4.94), dependent activities of daily living status (OR = 2.79, 95% CI 1.60~4.86), and experience of hospitalization during the past year (OR = 2.51, 95% CI 1.57~4.03) were strongly associated with nutritional risk. CONCLUSION: Severe visual impairment increases the nutritional risk among older adults with diabetes. Therefore, it is essential to prevent visual impairment due to exacerbation of diabetes through appropriate management. Additionally, tailored nutritional interventions for visually impaired older adults with diabetes that consider visual characteristics are required.