Klinische Monatsblatter fur Augenheilkunde最新文献

Background: Reading is a cognitively challenging skill that is used frequently in daily life, involving various visual factors. Previous studies have shown the impact of visual impairments on reading. The implementation of augmented reality (AR) is relatively new in ophthalmology. Studies have applied AR Head Mounted Displays (HMD) in vision enhancing systems for older drivers or as an instrument to compensate for metamorphopsia; however, the usability of an AR-HMD in ophthalmologic research has received little attention. The aim of this study was to assess the usability of AR-HMD for reading studies.

Patients and methods: Participants were randomly assigned to read aloud four of five texts with a similar level of reading skill as fast and accurately as possible, as displayed either on a PC monitor or on the Varjo XR4 AR HMD. Each test consisted of two reading blocks: a pilot for the participant to get familiar with the setup and the test with the recorded reading performance (4 blocks, 2 × 2). Reading speed (words/min) were recorded in both displays and eye movements were tracked for the reading experiment in the PC. At the end of the study, participants were asked about comfort, the adjustment of the AR-HMD and challenges experienced during the experiment.

Results: All participants (n = 31) successfully completed all blocks. There was no significant difference in the speed at which participants read the pilot and test reading texts in either device; however, there was a significant difference between the reading speeds assessed with the PC and with the AR HMD (p = 0.003). The average saccade amplitude and average peak velocity were strongly correlated. Individual mean saccade amplitudes ranged from 1.47° to 1.65° and the mean of the mean fixation durations were calculated at 276 - 288 ms. Common complaints with the AR HMD included its weight and tightness and some participants reported an unnatural visual experience during use.

Conclusions: This study demonstrated the potential usability of an AR HMD device for reading experiments. Future uses of AR-HMD could leverage its advanced technical capabilities (eye and head tracking) for complex visual behavioral studies, realistic simulation of ophthalmic diseases, and objective assessment of driving capability in real-world scenarios.

Background: Acute syphilitic posterior placoid chorioretinitis (ASPPC) is a pathognomonic manifestation of ocular syphilis. Although formerly considered as being uncommon, its incidence appears to be increasing in recent years. Advances in multimodal imaging, particularly spectral domain optical coherence tomography (SD-OCT), have provided new insights into its pathophysiology and natural course.

Case series: We present three cases of ASPPC with multimodal imaging and long-term follow-up. Clinical history, fundus findings, fluorescein and indocyanine green angiography, fundus autofluorescence and SD-OCT were reviewed. All patients exhibited systemic symptoms prior to ocular involvement and presented with bilateral uveitis, vitritis, and placoid yellowish macular lesions. SD-OCT demonstrated granular RPE thickening, ellipsoid zone disruption, followed by RPE-nodular elevations. These findings likely reflect an inflammatory response in the choroid and choriocapillaris, causing vascular alterations and metabolic impairment of the RPE and the outer retina. With appropriate systemic antibiotic therapy, OCT findings progressively normalised in parallel with gradual visual acuity improvement over 1 - 2 months.

Conclusions: These cases illustrate the characteristic clinical features of ASPPC and highlight the role of SD-OCT in both diagnosis and follow-up. Prompt recognition of ocular syphilis remains crucial and particularly rewarding for the ophthalmologist, who is often the first to recognise ocular syphilis, thereby preventing life-threatening systemic complications and achieving successful treatment of ocular manifestation.