Abstract: Between 2011 and 2013, two large-scale cohort epidemiology studies were launched in Shanghai: the SCALE study, which aimed to provide ocular public health services to cover the entire youth population in Shanghai, and the SCES, which was based on sample surveys and aimed to provide information on the prevalence and incidence of visual impairment and different types of refractive errors. A total of 910,245 children and adolescents were finally enrolled in the SCALE study; three possible methods for monitoring refractive error without mydriasis were tested, and the agreement between the refractive outcomes of three commonly used autorefractors were examined to ensure the accuracy of the results of the SCALE study. A total of 8,627 children were enrolled in the SCES, and the baseline prevalence of different refractive errors, different behaviors associated with 1 year myopic shifts, and the different patterns of 2-year myopia progression between internal migrant and local resident school children have been analyzed. In some subset samples of the SCALE study and the SCES, several refraction components such as choroidal thickness (ChT) and crystalline lens power were also measured, to further elucidate the relationships between the refraction components and myopia as well as the mechanism of myopia incidence and development. The three methods used in Shanghai to prevent and intervene with childhood myopia: increasing outdoor time, low concentration atropine, and use of orthokeratology lens are also addressed in this review.
Background: To compare objective electrophysiological contrast sensitivity function (CSF) in patients implanted with either multifocal intraocular lenses (MIOLs) or monofocal intraocular lenses (IOLs) by pattern reversal visual evoked potentials (prVEP) measurements.
Methods: Fourty-five cataract patients were randomly allocated to receive bilaterally: apodized diffractive-refractive Alcon Acrysof MIOL (A), full diffractive AMO Tecnis MIOL (B) or monofocal Alcon Acrysof IOL (C). Primary outcomes: 1-year differences in objective binocular CSF measured by prVEP with sinusoid grating stimuli of 6 decreasing contrast levels at 6 spatial frequencies. Secondary outcomes: psychophysical CSF measured with VCTS-6500, photopic uncorrected distance (UDVA), and mesopic and photopic uncorrected near and intermediate visual acuities (UNVA and UIVA respectively).
Results: Electrophysiological CSF curve had an inverted U-shaped morphology in all groups, with a biphasic pattern in Group B. Group A showed a lower CSF than group B at 4 and 8 cpd, and a lower value than group C at 8 cpd. Psychophysical CSF in group A exhibited a lower value at 12 cpd than group B. Mean photopic and mesopic UNVA and UIVA were worse in monofocal group compared to the multifocal groups. Mesopic UNVA and UIVA were better in group B.
Conclusions: Electrophysiological CSF behaves differently depending on the types of multifocal or monofocal IOLs. This may be related to the visual acuity under certain conditions or to IOL characteristics. This objective method might be a potential new tool to investigate on MIOL differences and on subjective device-related quality of vision.
Background: With the arrival of a new standardized tool and considering the multiple disadvantages of the actual method used for assesses lighting needs, the goal of the study was to compare the actual lighting assessment method used by the clinicians working in a rehabilitation center with the use of the LuxIQTM. As reading is found to be the main difficulty mentioned by the majority of the clients at the rehabilitation centre and that past studies have shown the impact of lighting on improving reading speed and deceasing print size, the hypothesis stated that the use of the standardized tool would be statistically significantly superior than the use of the standard method on the variables on reading speed, print size, ocular fatigue, application of the recommendations and satisfaction of the length of time read.
Methods: Three clinicians proceeded to home lighting assessments for 28 participants aged from 19 to 100 years (mean =75, SD =27) old diagnosed with age-related macular degeneration or glaucoma. The study evaluated and compared pre and post results between the two methods.
Results: The intervention did not have a statistically significant impact on any of the variables mentioned. The lighting assessment itself, with either the standard method or using the LuxIQ, statistically significantly decreased print size for reading (P<0.001, ω2 =0.47).
Conclusions: Lighting has a significant impact on reading print size. Participants value the assessment but encounter various obstacles that prevent them from applying the lighting recommendations. Considering the positive impact of lighting, finding a solution so participants may profit from the benefits of this intervention is crucial.
Abstract: Complications of myopia have become an important public health issue with serious socio-economic burdens. Prevention and treatment are both important. The Taiwan Student Vision Care Program (TSVCP) promoted by Ministry of Education (MOE) has been carried out for 3 decades in Taiwan. The myopia prevalence has increased rapidly to a high level and therefore myopia prevention has continued to be the most important item in the program. Therefore, TSVCP aims to decrease the prevalence of myopia, in order to decrease the high myopia related blindness in the future. Recently, outdoor activity has been found to be an important protective factor for myopia and was implemented in TSVCP since 2010. Afterwards, the nationwide vision impairment rate (uncorrected vision 20/25 or less) of elementary school students declined unprecedentedly and continuously in recent years. Evidence-based protective and risk factors for myopia are now clearer. Widespread acknowledgement of myopic disease, preventing the onset of myopia, prompt diagnosis, and early treatment to control progression are all important.
Background: The usage of the light emitting diode (LED) has been increasingly applied in the illumination setting and electronic equipment. However, the effect of LED lights on the retina remains unclear. In this study, we observed and analyzed the impact of white LED lights at different intensities on the function and morphology of rat retinas.
Methods: Thirty-six Sprague-Dawley rats weighing 150–180 g were randomly divided into six groups (n=6 in each group) including a normal control (NC) group, 4 white LED groups at different light intensities (4,000, 6,000, 7,000, and 10,000 lux), and an ultraviolet B (UVB) lighting group (302 nm, 1,000 μw/cm2). After 24 hours of continuous illumination, full-field flash electroretinogram (FERG) and pathological examination were performed in each group.
Results: As revealed by FERG, the impairment of retinal function gradually worsened with the increase of LED light intensity. In contrast, the UVB group had the most severe retinal function impairment. Particularly, the functional damage of rod cells and inner nuclear layer cells was the main FERG finding in each group. In the NC group, the retina had typical morphologies featured by well-defined structures, clearly visible border between the inner and outer segments, and neatly arranged inner and outer nuclear layer cells. After 24 hours of illumination, the inner and outer parts of the retina in the 4,000 lux group were still neatly arranged, along with a clear border; however, the inner and outer nuclear layers were randomly arranged, and some irregular nuclei and cells were lost. The damage of the internal and external retinal segments and the internal and external nuclear layers became more evident in the 6,000 lux group, 7,000 lux group, and 10,000 lux group. The UVB group had a more obviously disordered arrangement of inner and outer nuclear layers and loss of cells.
Conclusions: Continuous exposure to white LED light can cause structural and functional damage to rat retinas, and such damage is related to the intensity of illumination. Therefore, the risk of retinal damage should be considered during LED illumination, and proper LED illumination intensity may help to maintain eye health.
Abstract: Congenital ptosis is an abnormally low position of the upper eyelid, with respect to the visual axis in the primary gaze. It can be present at birth or manifest itself during the first year of life and can be bilateral or unilateral. Additionally, it may be an isolated finding or part of a constellation of signs of a specific syndrome or systemic associations. Depending on how much it interferes with the visual axis, it may be considered as a functional or a cosmetic condition. In childhood, functional ptosis can lead to deprivation amblyopia and astigmatism and needs to be treated. However, even mild ptosis with normal vision can lead to psychosocial problems and correction is also advised, albeit on a less urgent basis. Although, patching and glasses can be prescribed to treat the amblyopia, the mainstay of management is surgical. There are several types of surgical procedure available depending on the severity and etiology of the droopy eyelid. The first part of this paper will review the different categories of congenital ptosis, including more common associated syndromes. The latter part will briefly cover the different surgical approaches, with emphasis on how to choose the correct condition. In spite of many complex factors inherent to the treatment of congenital ptosis, the overall outcomes are quite satisfactory, and most surgeons feel that ptosis management can be both challenging and rewarding at the same time.
Abstract: Several factors drive the need for increased efficiency in telemedicine screening programs directed toward diabetic retinopathy: continually increasing prevalence of diabetes worldwide, growing awareness among physicians and patients of the importance of early detection of retinal damage, and emerging technology in artificial intelligence that enables rapid identification of vision-threatening fundus features. In this context, optimizing workflows in teleretinopathy programs becomes a priority. Recent work has revealed opportunities for improvement in areas of logistics, in particular in finding the best way to get diabetic patients in front of screening cameras as conveniently as possible, as this improves compliance and, ultimately, achieves the widest reach for detection programs. The present review discusses particular aspects of mobile screening programs in which specialized retinal cameras are deployed in a van or similar type of vehicle so that they can reach patients anywhere in order to reduce barriers to access. The rationale for implementing such programs and practical considerations are presented, along with a view toward future expansion of screening and integration with artificial intelligence platforms. Lacking standardization of format and quality control among smartphone-linked approaches at present, translation of eye clinic-based photographic techniques to community-based screening offers a means of expanding the scope of impactful screening programs without the need for adoption of significantly new technology.
Abstract: The objective of the paper is to provide a general view for automatic cup to disc ratio (CDR) assessment in fundus images. As for the cause of blindness, glaucoma ranks as the second in ocular diseases. Vision loss caused by glaucoma cannot be reversed, but the loss may be avoided if screened in the early stage of glaucoma. Thus, early screening of glaucoma is very requisite to preserve vision and maintain quality of life. Optic nerve head (ONH) assessment is a useful and practical technique among current glaucoma screening methods. Vertical CDR as one of the clinical indicators for ONH assessment, has been well-used by clinicians and professionals for the analysis and diagnosis of glaucoma. The key for automatic calculation of vertical CDR in fundus images is the segmentation of optic cup (OC) and optic disc (OD). We take a brief description of methodologies about the OC and disc optic segmentation and comprehensively presented these methods as two aspects: hand-craft feature and deep learning feature. Sliding window regression, super-pixel level, image reconstruction, super-pixel level low-rank representation (LRR), deep learning methodologies for segmentation of OD and OC have been shown. It is hoped that this paper can provide guidance and bring inspiration to other researchers. Every mentioned method has its advantages and limitations. Appropriate method should be selected or explored according to the actual situation. For automatic glaucoma screening, CDR is just the reflection for a small part of the disc, while utilizing comprehensive factors or multimodal images is the promising future direction to furthermore enhance the performance.
