Translational Vision Science & Technology最新文献

Purpose: Uncorrected refractive error (URE) is the leading cause of vision impairment, especially in rural, underserved areas. We previously evaluated the accuracy of a smartphone app for measuring spherical equivalent refraction. In this study, we evaluated the benefits of vision correction based on the prescription given by the app.

Methods: The app estimates myopic refractive error by measuring the far point distances for reading 20/20 Tumbling E letters. Trial lenses rounded to 0.25 diopter (D) were fitted to 100 patients (myopic refractive error, astigmatism < 1.5 D) visiting MCM Eye Unit in Addis Ababa, Ethiopia. The age range of the participants was 10 to 68 years (mean = 31.3 ± 13.0 years). The refraction measurement and visual acuity (VA) tests were all performed without cycloplegia.

Results: The range of spherical equivalent refractive error was -0.5 D to -6 D (interquartile range [IQR] = -2.25 D to -0.95 D), and the range of astigmatism was 0 to -1.25 D (IQR = -0.5 D to 0 D), according to subjective refraction performed by a study optometrist. On average, the uncorrected VA of the 200 eyes was 0.57 ± 0.32 logMAR. With the spherical equivalent correction based on the refraction app, their VA was improved significantly to 0.03 ± 0.09 logMAR-more than 5 lines of improvement, on average.

Conclusions: This study indicates that using the app to determine the spherical equivalent prescription for vision correction addresses the URE problem, whereas its effect for prominent astigmatism is yet to be evaluated.

Translational relevance: This approach, which requires minimal training, has potential in fighting avoidable blindness in underserved areas lacking optometry services, such as remote Sub-Saharan Africa.

Purpose: Multi-variant alleles causing retinitis pigmentosa (RP) are extremely rare. This study aimed to explore the pathogenicity and function of a multi-variant allele of RPE65 associated with retinitis pigmentosa.

Methods: Ophthalmic evaluations were performed. Targeted next-generation sequencing was performed for the proband, and Sanger sequencing was conducted in the family members. In silico molecular genetics and bioinformatics analyses were performed. Wild-type RPE65 and variant plasmids were constructed and transferred into HEK293T cells. The expression levels, protein stability, and protein ubiquitination levels were measured.

Results: A 9-year-old genotypic female showed signs of RP. Five missense variants were identified in the RPE65 exonic region of the proband. Four missense variants, c.1154C>T (p.T385D), c.571A>G (p.N191D), c.490A>C (p.K164Q), and c.480G>C (p.L160F), were arranged in the same allele, whereas the variant c.16G>A (p.E6K) was found on the other allele. c.490A>C, c.480G>C, and c.16G>A were novel variants. In vitro, variant proteins c.1154C>T, c.571A>G, c480G>C, and c.16G>A and the multi-variant allele exhibited decreased expression levels and decreased protein stability but increased ubiquitination levels.

Conclusions: The multi-variant allele and RPE65 c.16G>A may cause RP. The novel variants (RPE65 c.16G>A and RPE65 c.480G>C) and the previously reported variants (RPE65 c.1154C>T and RPE65 c.571A>G) led to protein degradation and reduced the stability of RPE65, which appeared to be associated with the proteasome-ubiquitin pathway.

Translational relevance: Accurately assessing multi-variant alleles is important but challenging, and this study explored the pathogenicity and function of a multi-variant allele of RPE65.

Purpose: To investigate whether an anti-interleukin-6 (IL-6) receptor antibody (MR16-1) can prevent retinal and optic nerve dysfunction, as well as myelitis, in a mouse model of myelitis induced by immunization with aquaporin-4 (AQP4) peptide.

Methods: Mice immunized with AQP4 peptide received MR16-1 or vehicle. Retinal function was assessed by electroretinography (ERG), including b-wave, a-wave, and positive scotopic threshold response (pSTR) amplitudes. Histologic analysis evaluated inflammatory cell infiltration and aberrant Müller cell activation (punctate pattern of glial fibrillary acidic protein staining). Blood-retinal barrier (BRB) integrity was assessed using Evans blue dye, IgG leakage, and transendothelial electrical resistance (TEER) in primary mouse retinal microvascular endothelial cells (mRMECs) exposed to mouse serum.

Results: AQP4 peptide immunization led to reductions in ERG b-wave and pSTR amplitudes and increased inflammatory cell infiltration, Müller cell alteration, and retinal vascular permeability. MR16-1 treatment significantly mitigated these changes, suppressing reductions in pSTR and b-wave amplitude, preventing inflammation and aberrant Müller cell activation, and reducing vascular leakage. The improvement of a-wave amplitude was not significant. Serum from MR16-1-treated mice did not reduce mRMEC TEER, while serum from AQP4 peptide-immunized mice reduced it.

Conclusions: IL-6 receptor blockade with MR16-1 has the potential to suppress AQP4 peptide immunization-related retinal and optic nerve dysfunction and pathology, likely by protecting BRB integrity and suppressing inflammation. These findings support the therapeutic potential of IL-6 inhibition in preserving visual function in neuromyelitis optica spectrum disorder (NMOSD).

Translational relevance: IL-6 receptor blockade may be a viable strategy for preventing visual impairment in patients with NMOSD.

Purpose: The purpose of this study is to quantify the effect of monofocal intraocular lens (IOL) turbidity on visibility threshold and spatial pattern detection threshold with an infrared (IR)-two-photon (2P) approach, and visible light.

Methods: Three observers were tested with pulsed IR (1045 nm) and visible lights (522.5 nm) using visibility threshold and spatial pattern detection threshold methods on two clear control IOLs and 11 explanted opacified IOLs, using our 2P microperimetry setup. IOL power and straylight were measured. Data from the clear IOLs served as control.

Results: Control IOLs (20 D) had a mean straylight of 0.57 ± 0.05 logs and opacified IOLs (18.9-21.8 D) had a mean straylight of 2.16 ± 0.37 logs. Most threshold measurements differed significantly between clear and opacified IOLs. For IR, slopes of linear regression of straylight vs. visibility threshold and spatial pattern detection threshold ratios were similar (0.78 vs. 0.93 logs-1; P = 0.8531). For visible light, the visibility threshold ratio slope was lower than the spatial pattern detection threshold ratio (2.97 vs. 4.53 logs-1; P = 0.0008). IR measurements showed significantly less dependence on straylight than visible light for both visibility threshold and spatial pattern detection threshold (P < 0.00001).

Conclusions: We found that 2P measurements yield lower variability and reduced straylight dependence compared with visible light with either the spatial pattern detection threshold or visibility threshold methods.

Translational relevance: Regardless of spatial pattern detection threshold or visibility threshold methods, two-photon microperimetry is less affected by increased opacity and may yield consistent threshold ratio results.

Purpose: Mesopic microperimetry is a promising tool to evaluate retinal function in clinical trials. Although visual function (VF), the ability to perform vision-related tasks, relates strongly to visual acuity (VA) in patients with age-related macular degeneration, the relationship between mesopic microperimetry and VF remains unclear.

Methods: A cross-sectional study in patients with age-related macular degeneration was performed. VF was measured by questionnaire using a subset of the National Eye Institute 25-Item Visual Function Questionnaire. The macular integrity assessment microperimeter, was used with a 4-2 staircase strategy with a 10° diameter circular grid containing 37 loci. Three interpretations of the retinal sensitivity data were calculated: the mean of the 37 thresholds (mean sensitivity [MS]), the percent-reduced threshold (PRT), and the log-transformed candela mean (MS cd log). MS, PRT, and MS cd log were tested via stepwise hierarchical linear regression and R2.

Results: We analyzed data from 102 patients (64 females [61%]; mean age, 71.8 ± 11.2 years). VF was explained best by VA (MS; R2 VA = 0.38, MS cd log; R2 VA = 0.38, PRT; R2 VA = 0.39). All retinal sensitivities contributed significantly to total R2. In the MS cd log model (total adjusted R2 = 0.52) the combined contribution of variance explained by VA and MS cd log was 46% (partial adjusted R2 = 0.46).

Conclusions: Mesopic microperimetry is associated with VF but VA provides a more meaningful estimation of this same construct. These results suggest that VA provides stronger evidence of clinical efficacy.

Translational relevance: This study relates functional tests to daily vision-related functioning.

Purpose: A novel strip-scanning method for optical coherence tomography angiography (OCTA) is presented and its utility is demonstrated for efficient widefield OCTA mosaicking.

Methods: An analytical expression for strip-scanned OCTA mosaicking efficiency is derived. Strip-scanned OCTA with simultaneous retinal tracking is used for multi-volume motion-corrected OCTA mosaicking at capillary resolution.

Results: As the mosaic field-of-view increases, strip-scanning reduces OCTA mosaicking workload by asymptotically achieving a two-fold gain in mosaicking efficiency and by scaling pairwise registrations linearly. Motion-corrected widefield retinal OCTA mosaicking at capillary resolution is demonstrated across a 35-degree × 45-degree field-of-view using strip-scanned OCTA.

Conclusions: Strip-scanned OCTA improves widefield OCTA mosaicking efficiency.

Translational relevance: Strip-scanning increases OCTA mosaicking efficiency for visualizing capillaries across wide fields-of-view to aid in retinal vascular disease detection and monitoring.

Purpose: The purpose of this study was to evaluate the effectiveness of an augmented-reality (AR) head-mounted display (HMD) in patients with glaucomatous tunnel vision.

Methods: Fifteen patients with glaucoma with a central visual field (VF) of less than 20 degrees in radius in their better eye and 15 healthy controls were enrolled. Patients completed visual function (kinetic VF, contrast sensitivity [CS], and visual acuity [VA]), visual search, and mobility tests with and without the device. For initial validation of the performance-based tests and the device, a perforated eye mask was used to simulate the peripheral field loss (PFL) in healthy controls.

Results: The VF area of the better eye significantly increased when patients used the device (P <0.001). Better-eye CS improved with the device in both normal (P < 0.001) and contrast modes (P = 0.014). Better-eye VA did not significantly improve with device use. Similar results were observed in patients' worse eyes. A significant reduction in average search time was observed when patients used the device (P = 0.001), whereas the task scores did not significantly change. The average walking time was prolonged with device use (P = 0.001), whereas obstacle avoidance scores showed no significant differences. Comparable test results were demonstrated in both healthy controls and subjects with simulated PFLs.

Conclusions: The AR HMD significantly improved the VF, CS, and visual search performance of patients with glaucomatous tunnel vision, but it did not improve patients' VA and mobility performance.

Translational relevance: These findings provide evidence for the potential of AR-based devices in vision rehabilitation and may offer insights for the future optimization of such technologies.

Purpose: To evaluate anterior chamber angle (ACA) parameter changes and their correlation with intraocular pressure (IOP) in primary versus secondary intraocular lens (IOL) implantation following congenital cataract (CC) surgery, using swept-source anterior segment optical coherence tomography (SS-ASOCT).

Methods: Preoperative and postoperative (1 and 6 months) SS-ASOCT images from 89 eyes of 64 patients undergoing CC surgery were analyzed. ACA parameters (AOD500, ARA500, TISA500, TIA500) were measured. Generalized estimating equations assessed ACA parameter changes, and multivariable analysis determined relationships between ACA parameters and IOP.

Results: Compared to normal eyes, aphakic eyes showed larger AOD500 and ARA500 but smaller TISA500 (P < 0.05). After IOL implantation, both primary and secondary pseudophakic eyes (P-PsE and S-PsE) exhibited significant postoperative reductions in ARA500 and TISA500 (P < 0.05), mainly in the nasal angle. Multivariable analysis revealed corneal thickness positively correlated with IOP in both groups, while nasal AOD500 (β = -0.685, P < 0.05) and nasal TIA500 (β = -0.109; P < 0.001) showed negative associations in S-PsE. Angle abnormalities were identified during the annotation of images, associated with poorer visual outcomes.

Conclusions: Significant postoperative reductions in ARA500 and TISA500 occurred in both primary and secondary IOL implantation for CC, predominantly in the nasal angle. Although overall angle parameters were comparable, S-PsEs uniquely demonstrated IOP correlations with pupil diameter and nasal angle, suggesting distinct IOP regulation mechanisms.

Translational relevance: SS-ASOCT-derived nasal anterior chamber angle metrics may provide an accessible biomarker for monitoring angle remodeling and intraocular pressure regulation following congenital cataract surgery.

Purpose: This study aimed to assess the role of novel lipid-related indices in patients with nonarteritic anterior ischemic optic neuropathy (NAION) and investigate the correlation between these indices and NAION severity.

Methods: All participants underwent comprehensive ocular examinations and serum lipid analysis. Novel lipid-related indices, including the atherogenic index of plasma (AIP), non-high-density lipoprotein cholesterol (HDL-C)/HDL-C ratio, and triglyceride glucose (TyG) index, were calculated using traditional lipid parameters and subsequently compared between patients with NAION and control participants. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive values of these indices. Correlations between novel lipid-related indices and NAION severity were also investigated.

Results: Forty-four patients with NAION and 42 control participants were included in this study. The levels of AIP and TyG were significantly elevated in patients with NAION compared to control participants, whereas the traditional lipid parameters in both groups remained within normal limits. The areas under the ROC curves for AIP and TyG were 0.725 and 0.758, respectively. Additionally, no significant correlations were observed among AIP, TyG, best-corrected visual acuity, peripapillary retinal nerve fiber layer thickness, and mean deviation on visual field test.

Conclusions: Elevated levels of AIP and TyG were observed in patients with NAION in this study, suggesting that AIP and TyG may serve as systemic metabolic risk markers significantly associated with NAION.

Translational relevance: The findings of this study help us better understand the underlying mechanisms of NAION and improve its diagnosis and management.