Vision (Switzerland)最新文献

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.

Deep learning for glaucoma screening often relies on high-resolution clinical images and convolutional neural networks (CNNs). However, these methods face significant performance drops when applied to noisy, low-resolution images from portable devices. To address this, our work investigates ensemble methods using multiple Transformer architectures for automated glaucoma detection in challenging scenarios. We use the Brazil Glaucoma (BrG) and private D-Eye datasets to assess model robustness. These datasets include images typical of smartphone-coupled ophthalmoscopes, which are often noisy and variable in quality. Four Transformer models-Swin-Tiny, ViT-Base, MobileViT-Small, and DeiT-Base-were trained and evaluated both individually and in ensembles. We evaluated the results at both image and patient levels to reflect clinical practice. The results show that, although performance drops on lower-quality images, ensemble combinations and patient-level aggregation significantly improve accuracy and sensitivity. We achieved up to 85% accuracy and an 84.2% F1-score on the D-Eye dataset, with a notable reduction in false negatives. Grad-CAM attention maps confirmed that Transformers identify anatomical regions relevant to diagnosis. These findings reinforce the potential of Transformer ensembles as an accessible solution for early glaucoma detection in populations with limited access to specialized equipment.

Models suggest social anxiety is characterized by negative processing biases. Negative biases also arise from negative mood, i.e., state affect. We examined how social anxiety influences emotional processing and whether state affect, or mood, modified the relationship between social anxiety and perceptual bias. We quantified bias by determining the point of subjective equality, PSE, the face judged equally often as happy and as angry. We found perceptual bias depended on social anxiety and state affect. PSE was greater in individuals high (mean PSE: 8.69) versus low (mean PSE: 3.04) in social anxiety. The higher PSE indicated a stronger negative bias in high social anxiety. State affect modified this relationship, with high social anxiety associated with stronger negative biases, but only for individuals with greater negative affect. State affect and trait anxiety interacted such that social anxiety status alone was insufficient to fully characterize perceptual biases. This raises several issues such as the need to consider what constitutes an appropriate control group and the need to consider state affect in social anxiety. Importantly, our results suggest compensatory effects may counteract the influences of negative mood in individuals low in social anxiety.

We provide an automated characterization of human retinal cells, i.e., RPE's based on the non-invasive AO-TFI retinal imaging and PR's based on the non-invasive AO-FI retinal imaging on a large-scale study involving 171 confirmed healthy eyes from 104 participants of 23 to 80 years old. Comprehensive standard checkups based on SD-OCT and Fondus imaging modalities were carried out by Ophthalmologists from the Luzerner Kantonsspital (LUKS) to confirm the absence of retinal pathologies. AO imaging imaging was performed using the Cellularis^® device and each eye was imaged at various retinal eccentricities. The images were automatically segmented using a dedicated software and RPE and PR cells were identified and morphometric characterizations, such as cell density and area were computed. The results were stratified based on various criteria, such as age, retinal eccentricity, visual acuity, etc. The automatic segmentation was validated independently on a held-out set by five trained medical students not involved in this study. We plotted cell density variations as a function of eccentricity from the fovea along both nasal and temporal directions. For RPE cells, no consistent trend in density was observed between 0° to 9° eccentricity, contrasting with established histological literature demonstrating foveal density peaks. In contrast, PR cell density showed a clear decrease from 2.5° to 9°. RPE cell density declined linearly with age, whereas no age-related pattern was detected for PR cell density. On average, RPE cell density was found to be ≈6313 cells/mm² (±σ=757), while the average PR cell density was calculated as ≈10,207 cells/mm² (±σ=1273).