Vision (Switzerland)最新文献

Introduction: Low vision affects more than visual acuity; it substantially disrupts daily functioning and may contribute to long-term cognitive, emotional, and social consequences. When medical or surgical treatment options are no longer effective, structured low-vision rehabilitation becomes essential, providing strategies and tools that support functional adaptation and promote independence. This review aims to map the current outcomes of rehabilitation services, identify gaps in existing research, and highlight opportunities for further study. Methods: An article search was conducted via PubMed, Scopus, PsycInfo, and Google Scholar. Then, title, abstract, and full-text screenings for inclusion were performed by all the authors independently, and disagreements were resolved through discussion. The relevant outcomes from the eligible publications were extracted by four authors and then cross-checked by the other authors. The results are presented via the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews checklist. Results: A total of 13 studies met the inclusion criteria. Most were randomized controlled trials (n = 10,77%), with the majority conducted in the United States and the United Kingdom. Study populations consisted of adults aged 18 years and older. Across the included studies, low-vision rehabilitation interventions particularly visual training, magnification-based programs, and multidisciplinary approaches, were associated with significant improvements in visual function, activities of daily living, and vision-related quality of life. Conclusions: Low vision rehabilitation interventions demonstrate clear benefits for visual acuity, contrast sensitivity, reading speed, and functional independence. However, substantial gaps remain, including limited evidence on long-term outcomes, inconsistent assessment of psychosocial influences, and underrepresentation of diverse populations. Standardized outcome measures and long-term, inclusive research designs are needed to better understand the sustained and equitable impact of low-vision rehabilitation.

Dynamic drawing has emerged as a strategy to communicate tactical diagrams, yet its effectiveness remains uncertain and appears to depend on individual differences. This study investigated how the memorization and visual processing of tactical soccer scenes are influenced by drawing format (static drawing vs. dynamic drawing) and moderated by visuospatial abilities (VSA) and expertise. Expert (N = 57) and novice (N = 54) participants were randomly assigned to one of two conditions. In the static drawing condition, participants viewed a pre-drawn, completed tactical diagram accompanied by an oral explanation. In the dynamic drawing condition, they observed the coach drawing the diagram in real time while delivering the same explanation. VSA was first assessed using a control test. Then, in the main test, participants memorized and reproduced the tactical scene while their eye movements were recorded using an eye tracker. Key findings revealed a three-way interaction, highlighting the occurrence of an expertise reversal effect: high VSA novices performed better with dynamic drawing, whereas low VSA experts benefited more from static drawing, showing distinct visual processing patterns across groups. Overall, the results highlight the need to tailor drawing strategies to individual characteristics, particularly VSA and expertise, to optimize visual attention and tactical memorization.

The aim of this study was to evaluate the performance and safety of T2769 (Thealoz^® Total), a preservative-free eye drop combining 0.15% sodium hyaluronate, 3% trehalose, and 2.45% N-acetylaspartyl-glutamate (NAAGA), in contact lens wearers with dry eye symptoms and discomfort. This prospective, single-arm investigation enrolled 34 adult contact lens wearers with Ocular Surface Disease Index (OSDI) scores ≥ 18 and Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8) scores ≥ 12. Patients instilled one drop of T2769 three to six times daily for 36 days. Performance assessments included CLDEQ-8, ocular discomfort and symptoms, OSDI, soothing sensation, and ocular signs. Safety assessments included adverse events (AEs), far BCVA, and ocular tolerance. CLDEQ-8 improved from the baseline at Day 36 (-12.6 ± 5.0; p < 0.001) and as early as D15, with similar improvements in ocular discomfort, OSDI, and total symptom score. Soothing sensation was judged important by 79.4% of patients at D36. Ocular surface staining, tear break-up time, and the Schirmer test improved at D15 and D36, while conjunctival hyperaemia improved in 82.4% of patients at D36. Two non-serious treatment-related AEs (photophobia and blurred vision) occurred in one patient. BCVA was unchanged, and tolerance was rated very satisfactory/satisfactory. In conclusion, T2769 was safe and effective for reducing contact lens-associated dry eyes and discomfort.

Background/Objectives: Early detection and timely treatment of amblyopia require reliable visual acuity testing in toddlers; however, conventional Landolt ring charts often show poor testability in 2-3-year-old children. Therefore, we aimed to verify the practicality of a new Child-Friendly Minimum-Separable (CFMS) chart for 2-3-year-old children by comparing cooperation rates with the standard Landolt ring visual acuity chart. Methods: A prospective pilot study was conducted on 20 children aged 2 years (30.6 ± 3.2 months) and 20 children aged 3 years (41.8 ± 3.9 months). Right-eye visual acuity was tested in random order using the Landolt ring (four options, 3/5 considered correct) and the CFMS chart (two options, 3/3 considered correct). Test cooperation rates and visual acuity were analyzed. Results: In the 2-year-olds, the cooperation rate was 15% and 75% for the Landolt ring and CFMS chart, respectively (p = 0.0005). Twelve children refused to cooperate with the Landolt ring but cooperated with the CFMS chart; the reverse did not occur. In the 3-year-olds, the cooperation rate was 60% and 90% for the Landolt ring and CFMS chart, respectively (p = 0.031); six children cooperated only with the CFMS chart. The odds ratio for cooperation per additional month of age was 1.34 (95% confidence interval [CI]: 1.12-1.59; p = 0.001) and 1.24 (95% CI: 1.03-1.50; p = 0.026) for the Landolt ring and CFMS chart, respectively. Conclusions: Compared to the Landolt ring, the CFMS chart significantly improves cooperation rates for visual acuity testing in 2-3-year-old children, especially among 2-year-olds.

Background: To evaluate the short-term effects of a dietary supplement containing curcumin, bromelain, glucosamine, chondroitin sulphate, sodium hyaluronate, type II collagen, and vitamin C on symptomatic vitreous floaters (SVFs) following Nd:YAG laser capsulotomy. Methods: Forty eyes with SVFs on the first postoperative day were randomized into a control group (standard topical therapy, n = 20) and a treatment group (oral supplement plus standard therapy, n = 20). Outcomes included best-corrected visual acuity (BCVA), contrast sensitivity (CS), and subjective scores from a non-standardized questionnaire on floater perception (QS1), interference with daily activities (QS2), and foreign body sensation (QS3). Objective evaluation was performed using two novel ultrasound-based methods: mean number of vitreous peaks (MVP) from A-scans and mean grey intensity (MGI) from B-scan images processed with ImageJ. Results: At 2 months, the treatment group showed greater improvement in CS (Δ = 0.26 LogCS, CI, 0.14-0.38; p < 0.01), QS1 (Δ = 1.10; 95% CI, 0.60-1.60; p < 0.01), QS2 (Δ = 0.90; 95% CI, 0.40-1.40; p < 0.01), QS3 (Δ = 0.90; 95% CI, 0.44-1.36; p < 0.01), MVP (Δ = 1.10; 95% CI, 0.60-1.60; p < 0.01), and MGI (Δ = 12.89 units; 95% CI, 7.84-17.93; p < 0.01). BCVA was comparable between groups (p = 0.478). Conclusions: Short-term dietary supplementation with vitreous-specific nutrients is well tolerated and associated with improvements in reducing SVFs and foreign body sensations after Nd:YAG capsulotomy and may represent a promising non-invasive therapeutic option.

This study investigated the functional visual impact of simulated astigmatic blur using cylindrical powers of 0.50 D, 1.00 D, and 2.00 D, applied in against-the-rule (ATR), with-the-rule (WTR), and oblique (OBL) axes, in adults aged 18 to 35 years with no known ocular disease. Forty-five young adults were randomly divided into three groups (n = 15). Binocular best-corrected visual acuity (distance and near) was recorded in logMAR using the ETDRS acuity chart at 5 m and 40 cm, supported by acuity optotypes displayed in a Bailey-Lovie chart format. Depth-fusion and disparity discrimination were measured using polarized stereopsis thresholds with the Randot^® Stereo Test from Stereo Optical Company, Inc. Reading performance was quantified as a continuous binocular rate metric (words per minute) using the validated Portuguese digital reading curve provided by the MNREAD iPad App by Precision Vision at 40 cm. The results were preserved verbatim as follows: Distance and near BCVA were significantly affected by ATR astigmatisms (-0.50 + 1.00 90°, -1.00 + 2.00 90°), WTR astigmatisms (-0.25 + 0.50 180°, -0.50 + 1.00 180°, -1.00 + 2.00 180°), and OBL astigmatisms (OD: -0.25 + 0.50 45°, OS: -0.25 + 0.50 135°; OD: -0.50 + 1.00 45°, OS: -0.50 + 1.00 135°; OD: -1.00 + 2.00 45°, OS: -1.00 + 2.00 135°). Stereopsis was significantly influenced by high-power OBL astigmatism (-1.00 + 2.00). Reading rate was also negatively impacted by OBL astigmatisms ≥1.00 D. Simulated astigmatism of different powers and axes reduced high-contrast distance and near BCVA, stereopsis, and reading speed in adults aged 18-35 years. Higher-power astigmatism, particularly along oblique axes, caused the most significant functional impairment.

Background: Trabeculectomy remains gold-standard surgical approach for intraocular pressure (IOP) control in glaucoma, yet its impact on optic nerve head (ONH) morphology and retinal microvasculature has not been fully clarified. This study aimed to investigate structural and vascular changes of the ONH and macula after trabeculectomy using spectral-domain optical coherence tomography (SD-OCT) and OCT angiography (OCTA).

Methods: In this retrospective study, data from 22 patients with primary open-angle glaucoma who underwent uncomplicated trabeculectomy were reviewed. The fellow eye served as control. Structural parameters, including Bruch's membrane opening (BMO), maximum cup depth (MCD), and cup area, were measured with SD-OCT. Vessel density (VD) of the optic disc, peripapillary retina, and macular superficial (SCP) and deep (DCP) capillary plexuses were analyzed with OCTA. Preoperative and two-month postoperative data were compared using paired statistical tests.

Results: Mean IOP decreased from 23.1 ± 3.9 mmHg to 13.2 ± 3.2 mmHg (p < 0.001). Significant postoperative reductions were observed in BMO (-5 ± 6%, p = 0.004), MCD (-31 ± 8%, p < 0.001), and cup area (-44 ± 18%, p < 0.001). RNFL thickness and ONH vascular parameters remained stable. In contrast, DCP vessel density increased in the foveal (p = 0.002) and parafoveal (p = 0.023) regions, while SCP density showed no significant change.

Conclusions: Trabeculectomy was associated with measurable reversal of optic disc cupping, indicating partial structural recovery of the ONH following IOP reduction. The selective improvement in deep retinal vessel density suggests a layer-specific microvascular response. These findings provide further insight into the interplay between mechanical and vascular mechanisms in glaucoma and may inform postoperative monitoring strategies.

Ocular surface (OS) and dry eye (DE) symptoms are frequent ophthalmic complaints influenced by climate and pollution related with acute and chronic ocular surface symptoms. This study assessed their association with environmental conditions in São Paulo metropolitan area (2016-2020), including air temperature, humidity, atmospheric pressure, ozone (O₃), particulate matter (PM), using IQVIA eye drop sales data and Google search trends. Sympathomimetic decongestant sales correlated with higher temperature (r = 0.434, p = 0.0021), UV radiation (r = 0.643, p < 0.0001), and ozone (r = 0.491, p = 0.0004). Artificial tears and lubricants correlated with ozone (r = 0.452, p = 0.0012) and with searches for "red eye" (r = 0.505, p = 0.0005) and "stye" (r = 0.599, p < 0.0001). To address multicollinearity, Principal Component Analysis (PCA) was applied, with the first two components (PC1 and PC2) explaining 87.3% of variance. Regression models using these components were significant for decongestant sales and "stye" searches. Eye drop sales and search trends thus emerge as potential indicators of OS and DE symptoms, reflecting environmental conditions and informing prevention strategies.

This retrospective study evaluated changes in ocular characteristics and retinal pigment epithelium (RPE) and photoreceptor ellipsoid zone (EZ) depletion rates before and after intravitreal pegcetacoplan initiation in clinical practice. A total of 168 eyes from 110 patients with GA secondary to age-related macular degeneration (AMD) who received at least 3 pegcetacoplan injections were included. Data was collected from 5 years before to 9 months after pegcetacoplan initiation. RPE and EZ depletion areas were measured using an automated artificial intelligence (AI) algorithm on optical coherence tomography (OCT) images. At baseline, 76 eyes (45.2%) had concurrent neovascular AMD (nAMD), with mean RPE and EZ depletion areas of 3.3 mm² and 4.9 mm², respectively. By pegcetacoplan initiation, these increased to 8.6 mm² and 11.2 mm², respectively, with 151 eyes (89.9%) having concurrent nAMD and 155 eyes (92.3%) having subfoveal GA. Pre-treatment to post-treatment RPE and EZ square root depletion rates decreased from 0.25 mm/year to 0.096 mm/year, and 0.26 mm/year to 0.049 mm/year, respectively. Mean best-recorded visual acuity (BRVA) worsened by 0.05 logMAR annually before and after treatment. These real-world findings align with data from the pegcetacoplan phase 3 trials, showing reduced RPE and EZ depletion rates without changes in rates of BRVA loss. Additional studies are warranted.

This study evaluates the ability of the QuickSee Free (QSF) portable autorefractor (PlenOptika) to detect and measure refractive error compared to subjective clinical refractometry (SCR) in a Brazilian adult population in a low-resource setting in Amazonas. A total of 100 participants aged 18-65 years underwent visual acuity screening and autorefraction with and without cycloplegia using the QSF, alongside a complete ophthalmic examination including SCR. Refractive error measurements included spherical component (SC), cylindrical component (CC), cylindrical axis (CA), spherical equivalent (SE), and vector powers (MV90 and MV135). Accuracy was assessed for hyperopia ≥ +2.00 D, myopia ≤ -0.75 D, astigmatism ≥ 1.00 DC, and anisometropia ≥ 1.00 D using receiver operating characteristic (ROC) curve analysis. The area under the curve for detecting significant refractive errors ranged from 0.538 to 0.930. The mean difference between QSF without cycloplegia and SCR was -1.08 ± 1.17 D for SC and -1.15 ± 1.15 D for SE (p < 0.0001), and with cycloplegia, it was -0.81 ± 1.07 D and -0.83 ± 1.02 D, respectively. The QSF exhibited a moderate negative bias for both SC and SE with and without cycloplegia, underestimating these values, but it showed good predictability for detecting refractive errors in a low-resource setting.