Vision (Switzerland)最新文献

Eye tracking can provide quantitative indices of visual exploration and cognitive processing during radiographic image interpretation. This study examined eye-movement patterns and pupil dynamics and their associations with task performance while fifth-year dental students interpreted a single mixed-dentition panoramic radiograph under free-viewing conditions. Task performance was defined as the number of correctly identified pre-specified items (three radiographic findings plus two interpretive items: dental age estimation and the presence/absence of congenital anomalies). Eye-movement patterns were classified into four groups: clockwise (R, 29.6%), counterclockwise (L, 44.4%), saccadic (S, 16.7%), and concentrated (C, 9.3%). Clockwise scan paths were associated with higher task scores and more globally distributed fixations than other patterns (p < 0.001). Linear mixed-effects modeling suggested that task scores increased up to 120 s of viewing time, whereas longer viewing times were not associated with further improvements. Furthermore, ordinal logistic regression analysis revealed that higher task scores were significantly associated with a smaller mean pupil area across the entire viewing time, combined with a larger pupil area specifically during fixations, suggesting more selective allocation of cognitive resources. These findings indicate associations between global scan structure, time allocation, pupil dynamics, and task performance in this single-image setting. Generalization to overall diagnostic competence or other radiographs requires replication using multiple panoramic images and a broader range of verified findings.

Head-mounted ("virtual reality") perimeters (HMPs), based on standard consumer electronic hardware, are a cheaper alternative to standard automated perimetry. They have not been validated in patients with inherited retinal disease (IRDs), yet. We evaluated the Iowa-HMP in a first pilot study. It consists of a legacy smartphone, a headset, and freely available, open-source software. We used the 10-2 grid, the ZEST algorithm, and a background of 10 cd/m² to measure central visual fields in one normal subject, and in patients with occult macular dystrophy (n = 2), Stargardt's disease (n = 3) and retinitis pigmentosa (n = 6). Results were compared with those from an Octopus 900 perimeter. The typical patterns of visual field loss were clearly discernible, but head-mounted perimeters generally have a limited dynamic range. Within the dynamic range of the Iowa-HMP (14 to 30 dB Octopus sensitivity), the Limits of Agreement (Bland-Altman) were ±7.5 dB. The Iowa-HMP had a diagnostic sensitivity of 0.67 for detecting locations with low perimetric sensitivity (<14 dB in the Octopus perimetry) with a diagnostic specificity of 0.95. Although the Iowa-HMP cannot be directly compared to standard perimetry in IRDs, open software greatly facilitates research in this area.

Background: Using a cross-sectional design, this study assessed and compared myopia knowledge among parents and teachers of schoolchildren aged 6-15 years in Beirut, Lebanon.

Methods: Two cross-sectional surveys were conducted between October 2022 and February 2024 among parents (n = 1256) and teachers (n = 366) of children aged 6-15 years. Using validated online Google Form questionnaires, data were collected on demographics, awareness, risk factors, and myopia knowledge, and analyzed with Statistical Package for the Social Sciences version 28 (SPSS v28) through descriptive statistics and logistic regression.

Results: Findings showed that 78.3% of parents and 79.5% of teachers had poor knowledge of myopia. Among teachers, better knowledge was linked to being male, having a family history of myopia, positive attitudes toward eyeglasses use, and attending regular or occasional eye care visits (all statistically significant). Among parents, higher knowledge was associated with having previously heard of myopia, higher income and education levels, and a family history of myopia, while parents of private-school children were less knowledgeable. Odds ratios below 1 indicate lower odds of good myopia knowledge relative to the reference category.

Conclusions: Both groups showed inadequate knowledge, underscoring the urgent need for targeted educational interventions to improve myopia awareness and prevention.

Purpose: To evaluate demographic representation in AI-generated and search-engine-sourced images of North American ophthalmologists, overall and stratified by subspecialty, and compare these with actual demographic data. Methods: This cross-sectional analysis examined 2000 images (1000 AI-generated and 1000 search-engine-sourced) across ten North American ophthalmology subspecialties. Images were sourced from four AI platforms (DALL·E 3, Firefly, Midjourney, Grok-2) and four search engines (Google, Bing, DuckDuckGo, Yahoo!). Using a standardized framework, reviewers assessed gender, race, age group, and professional attire. Pearson chi-squared tests were used to compare image sets with actual demographic data from the Association of American Medical Colleges and Canadian Institute for Health Information. Results: AI-generated images depicted 69% men compared to 64% in search-engine-sourced images (p = 0.047), though both were lower than the actual proportion of male ophthalmologists in North America (71-73%, p < 0.001). White individuals were overrepresented in AI-generated images (81%) relative to both search-engine-sourced images (74%, p = 0.001) and actual demographic data (69%, p < 0.001). Younger individuals (under 50 years) were significantly overrepresented in both image sets, with 82% in AI-generated images and 73% in search-engine-sourced images, compared to only 45-46% in actual demographic data (p < 0.001 for both). AI-generated images also depicted ophthalmologists with significantly more stereotypical medical accessories, including stethoscopes (17% vs. 2%, p < 0.001), glasses (45% vs. 30%, p < 0.001), and white coats (68% vs. 53%, p < 0.001), compared to search-engine-sourced images. Conclusions: AI-generated images diverge from actual demographics, presenting a younger, more stereotypical workforce that paradoxically aligns closer to gender parity than reality.

Background: Large language models (LLMs) and vision-language models (VLMs) have recently been applied to ophthalmology for patient education, diagnosis, and surgical decision support. Their ability to generate, interpret, and synthesize medical information positions them as promising assistive tools in glaucoma care. This scoping review aims to consolidate current evidence on the applications of LLMs and VLMSs in glaucoma, summarizing their tasks, inputs, performance metrics, and limitations to guide future clinical and research developments. Methods: A systematic search was conducted in PubMed, Scopus, Web of Science, arXiv, and IEEE Xplore from 2014 to July 2025. Eligible studies included original research and research letters employing LLMs or VLMs/MM-LLMs in any glaucoma-related application, including diagnostic reasoning, image interpretation, patient education, or surgical decision support. Screening and full-text review were independently performed by two reviewers following PRISMA-ScR methodology, with discrepancies resolved by consensus. Results: In total, 316 records were identified across five databases, with 27 studies meeting the inclusion criteria. The selected studies focused on three main domains: patient education (n = 11), diagnosis and risk prediction (n = 10), and surgical management (n = 6). Conclusions: Current LLMs serve best as assistive rather than autonomous tools in glaucoma care. They demonstrate strong potential in patient communication and text-based clinical decision support but remain constrained by variable accuracy, limited multimodal integration, and a lack of ophthalmology-specific fine-tuning. Future research should focus on developing domain-trained and retrieval-augmented LLMs, enhancing multimodal (text-image) fusion, ensuring readability adaptation for patients, and establishing ethical and regulatory frameworks for clinical implementation.

We report a novel phenomenon in which dynamic changes in luminance are perceived as changes in transparency rather than as changes in surface lightness. Participants viewed an achromatic disc on a uniform gray background and indicated whether the observed change was best described in terms of lightness or transparency. In Experiment 1, transparency-change responses were more frequent at low contrast and were strongly biased toward sequences in which contrast decreased over time, revealing a pronounced asymmetry between decreasing and increasing contrast trajectories. Experiment 2 introduced a size manipulation, such that the disc either expanded or contracted during the luminance modulation. Transparency-change responses were highest when contrast decreased and the disc expanded, indicating that spatial expansion further amplifies transparency-related interpretations of the disc's surface appearance. Overall, the results reveal a systematic asymmetry in how contrast-change direction shapes visual appearance, consistent with a forward bias in the processing of continuously changing visual signals. When contrast dynamically approached the background level, perceptual representations appeared to be weighted toward the upcoming low-contrast state, enhancing impressions of increasing transparency. These findings demonstrate that even minimal displays lacking traditional geometric cues to transparency can evoke strong transparency impressions, driven by predictive weighting of spatiotemporal contrast trajectories rather than by static image properties alone.

Background: Orientation discrimination tasks provide a core measure of visual sensitivity and are widely used to study how perceptual performance varies with stimulus uncertainty and visual field location. Here, we examined how external noise, retinal eccentricity, and individual perceptual efficiency shape orientation discrimination thresholds.

Methods: Forty-two adults (mean age = 32.35 years, SD = 7.23) completed a two-alternative forced-choice task judging the orientation (clockwise vs. counterclockwise) of briefly presented Gabor patches under varying levels of external noise (low, medium, high) and eccentricity (0°, 5°, 10°). Orientation offsets ranged from -8° to +8°. Thresholds were estimated using psychometric functions and analyzed via rm ANOVA, linear mixed-effects models, and supervised machine learning.

Results: Accuracy declined with increasing noise (ω² = 0.48, p < 0.001) and improved with larger orientation offsets (ω² = 0.62, p < 0.001). Thresholds increased with both noise (ω² = 0.31, p = 0.002) and eccentricity (ω² = 0.27, p = 0.003). Signal-to-noise efficiency was the strongest predictor (β = -0.72, p < 0.001); age alone was nonsignificant, but its interaction with eccentricity showed selective peripheral declines. Mixed-effects models confirmed spatial effects (β = 0.058, p < 0.001) and residual between-subject variability (σ² = 0.14). Predictive models generalized well (R² = 0.54).

Conclusions: Orientation discrimination is shaped by both stimulus-level difficulty and individual differences in perceptual efficiency, which account for variability in sensitivity across visual conditions. Age-related differences emerge primarily under spatial load and depend on interactions between observer traits and task demands.

Background and objectives: Primary open-angle glaucoma (POAG) is one of the leading ocular diseases leading to irreversible blindness and is often asymptomatic until advanced cases. While intraocular pressure reduction remains the cornerstone of treatment, neuroprotective strategies targeting retinal ganglion cell metabolism are actively investigated. Niacinamide (nicotinamide, vitamin B3), a precursor of NAD+, has shown neuroprotective potential in preclinical models. This exploratory study evaluated the short-term functional, structural, and electrophysiological effects of oral niacinamide supplementation in POAG.

Materials and methods: In this interventional study, patients with POAG received oral niacinamide 500 mg daily for six months. Visual field (VF) global and localized sensitivity (Mean Deviation [MD], Pattern Standard Deviation [PSD]), Optic Coherence Tomography (OCT)-derived peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell complex (GCC), and Visual evoked potentials (VEP) latency parameters (P2 1.4 Hz, P100 1°, and P100 15') were assessed at baseline and at six months. Because both eyes from some participants were included, primary longitudinal inference was based on clustered analyses using generalized estimating equations and linear mixed-effects models to account for inter-eye correlation. Eye-level paired analyses were used for exploratory comparison. Change-change relationships across modalities were explored using Spearman correlation.

Results: After accounting for inter-eye correlation, no statistically significant change in MD was detected (mean ΔMD +0.43 dB; GEE p = 0.099; LME p = 0.101), and PSD remained stable. RNFL thickness showed a small decrease (-1.26 µm; GEE p = 0.046), while GCC did not change significantly. VEP P100 latencies remained stable, whereas P2 latency showed a small increase (+3.9 ms; GEE p = 0.039). Correlation analysis revealed a moderate association between changes in GCC and MD (ρ = 0.44), suggesting concordance between macular structural stability and global visual field performance.

Conclusions: When inter-eye correlation is appropriately accounted for, six months of niacinamide supplementation in POAG is associated with overall functional, structural, and electrophysiological stability, without evidence of clinically meaningful improvement or progression. These findings support short-term safety and highlight the importance of clustered analytical approaches and macular-centered biomarkers in future glaucoma neuroprotection trials.

The objective of this study was to compare subjective manifest refraction with wavefront-based automated refraction using iTrace (ray tracing) and LadarWave (Hartmann-Shack) in eyes implanted with two enhanced monofocal intraocular lenses (IOLs) and a standard aspheric monofocal IOL, emphasizing agreement and refractive variability across optical designs. This retrospective cohort included 84 eyes from 42 patients implanted with Tecnis Eyhance (DIB00), RayOne EMV (RAO200E), or Tecnis ZCB00 IOLs. Postoperative evaluation (1-3 months) included uncorrected and corrected distance visual acuity and subjective manifest refraction, followed by automated refraction with iTrace and LadarWave. Outcomes were sphere, cylinder, and spherical equivalent (SE). Agreement was assessed using mean signed difference, mean absolute error, root mean square error, Bland-Altman limits of agreement, proportions within clinically relevant thresholds, and vector astigmatism (J0, J45). Linear mixed-effect modeling evaluated SE differences across methods and IOL types while accounting for within-subject correlation. Subjective SE differed among IOLs (p = 0.027), with RAO200E more myopic than ZCB00 (-0.20 ± 0.32 D vs. -0.08 ± 0.44 D, p = 0.035). Automated refraction showed greater variability and poorer agreement in enhanced monofocal IOLs, particularly for cylinder and SE, with wider limits of agreement and fewer eyes within ±0.50 D compared with ZCB00. In mixed-effect contrasts (three-method repeated-measures model), iTrace and LadarWave showed a consistent myopic bias versus manifest refraction in DIB00 and RAO200E, whereas in ZCB00 the iTrace-manifest difference was not significant and LadarWave retained a significant myopic bias. Enhanced monofocal IOLs exhibit reduced agreement between wavefront-based automated and subjective manifest refraction compared with a standard aspheric monofocal IOL. Manifest refraction remains essential for postoperative assessment, and automated measurements should be interpreted as complementary, particularly in IOL designs that modify aberrations.

This paper proposes E-MOTE (Emotion-aware Teacher Education Framework), an ethically grounded conceptual model aimed at enhancing teacher education through the integrated use of the Facial Action Coding System (FACS), Artificial Intelligence (AI), and Virtual Reality (VR). As a conceptual and design-oriented proposal, E-MOTE is presented as a structured blueprint for future development and empirical validation, not as an implemented or evaluated system. Grounded in neuroscientific and educational research, E-MOTE seeks to strengthen teachers' emotional awareness, teacher noticing, and social-emotional learning competencies. Rather than reporting empirical findings, this article offers a theoretically structured framework and an operational blueprint for the design of emotion-aware teacher training environments, establishing a structured foundation for future empirical validation. E-MOTE articulates three core contributions: (1) it clarifies the multi-layered construct of emotion-aware teaching by distinguishing between emotion detection, perception, awareness, and regulation; (2) it proposes an integrated AI-FACS-VR architecture for real-time and post hoc feedback on teachers' perceptual performance; and (3) it outlines a staged experimental blueprint for future empirical validation under ethically governed conditions. As a design-oriented proposal, E-MOTE provides a structured foundation for cultivating emotionally responsive pedagogy and inclusive classroom management, supporting the development of perceptual micro-skills in teacher practice. Its distinctive contribution lies in proposing a shift from predominantly macro-behavioral simulation toward the deliberate cultivation of perceptual micro-skills through FACS-informed analytics integrated with AI-driven simulations.