Vision

14 pages, 549 KiB

Open AccessArticle

The Relationship Between Anxiety Sensitivity, Emotional States, and Dry Eye Disease Symptom Severity: A Cross-Sectional Study

by Marko Toth, Nataša Jokić-Begić and Sandro Krašić

Vision 2025, 9(2), 36; https://doi.org/10.3390/vision9020036 (registering DOI) - 18 Apr 2025

Abstract

Dry eye disease (DED) is often comorbid with psychiatric conditions and psychological disturbances like anxiety and depression. The psychological symptoms are mostly considered to be a consequence of DED or a side-effect of medication. However, the possible psychological etiology of DED is seldom [...] Read more.

Dry eye disease (DED) is often comorbid with psychiatric conditions and psychological disturbances like anxiety and depression. The psychological symptoms are mostly considered to be a consequence of DED or a side-effect of medication. However, the possible psychological etiology of DED is seldom explored. This study explores the relationship between anxiety sensitivity (AS), unpleasant emotional states, and the severity of DED symptoms in a healthy general population sample in Croatia. A total of 766 adults (62.27% females) aged between 18 and 88 years completed an online survey consisting of the Ocular Surface Disease Index (OSDI), Anxiety Sensitivity Index (ASI), and Depression Anxiety Stress Scales (DASS21) together with socio-demographic data. The results revealed significant positive correlations between ASI, emotional states, and OSDI (r = 0.25–0.29, p < 0.01). Mediation analysis showed that DASS21 significantly mediates the relationship between ASI and OSDI (B = 0.1, CI = [0.004, 0.2]). Highly anxiety sensitive people are more sensitive to DED symptoms, which additionally increases in a state of emotional stress. Thus, DED symptoms are perceived more intensely and frequently than in less sensitive people. Understanding these associations is crucial for comprehensive DED management, indicating potential benefits from addressing psychological health in DED patients and eye health in psychiatric patients. Full article

18 pages, 755 KiB

Open AccessReview

Novel Therapeutic Approaches for Treatment of Diabetic Retinopathy and Age-Related Macular Degeneration

by Deokho Lee, Soo Jin Kim and Junyeop Lee

Vision 2025, 9(2), 35; https://doi.org/10.3390/vision9020035 - 17 Apr 2025

Viewed by 161

Abstract

Retina, a light-sensitive layer of tissue of the eye, requires high levels of oxygen for its physiology. Retinal ischemia occurs due to inadequate supply of blood to the retina and choroid. Retinal ischemia is implicated in the development or progression of many ocular [...] Read more.

Retina, a light-sensitive layer of tissue of the eye, requires high levels of oxygen for its physiology. Retinal ischemia occurs due to inadequate supply of blood to the retina and choroid. Retinal ischemia is implicated in the development or progression of many ocular diseases, such as diabetic retinopathy (DR) and age-related macular degeneration (AMD). To date, anti-vascular endothelial growth factor (VEGF) treatment has been widely used to manage neovascular diseases associated with retinal ischemia. Nonetheless, a substantial number of patients with DR or AMD still suffer from incomplete response and adverse effects related to its therapy with limitations. Therefore, research scientists have been developing and finding novel treatments to protect against or prevent vision loss in those diseases. In this review article, we summarize the recent novel therapeutic approaches for the treatment of ischemic retinopathy (e.g., cell therapy, advanced molecular targeting, or drug delivery). This summary enables further research to obtain more solid evidence of novel effective drug development in retinal ischemic diseases. Full article

(This article belongs to the Special Issue Retinal and Optic Nerve Diseases: New Advances and Current Challenges)

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26 pages, 3351 KiB

Open AccessArticle

Reconciling the Neurophysiological and Cognitive Theories of Stimulus–Response Spatial Compatibility Effects: A Visual–Motor Dissociation Approach

by Elton H. Matsushima and Jose Antonio Aznar-Casanova

Vision 2025, 9(2), 34; https://doi.org/10.3390/vision9020034 - 17 Apr 2025

Viewed by 84

Abstract

This study investigated the differential impact of two visual dimensions (direction and spatial location) in two spatial Stroop tasks, where the relevant dimension for the response varied. Three studies compared the interactions between spatial compatibility and congruence effects on reaction time performances to [...] Read more.

This study investigated the differential impact of two visual dimensions (direction and spatial location) in two spatial Stroop tasks, where the relevant dimension for the response varied. Three studies compared the interactions between spatial compatibility and congruence effects on reaction time performances to infer how the dorsal pathway (DP) and ventral pathway (VP) of visual processing interfered with one another in processing relevant and irrelevant spatial information. This allowed us to bridge neurophysiological mechanisms with dual-process models of spatial compatibility. The participants responded from an avatar’s perspective, manipulated through rotations relative to the forward position, along with independent rotations of the avatar’s screen and keyboard. The results revealed two distinct response patterns: in the Direction Stroop, the performance was influenced equally by the relevant direction (VP) and the automatic processing of irrelevant location (DP); in the Location Stroop, the VP exerted minimal interference on the DP. Furthermore, the Only Keyboard rotation disrupted hand–eye coordination, modulating the DP interference on the VP in the Direction Stroop. These findings provide insights into the functional interaction of these visual pathways and their contributions to spatial compatibility effects, along with evidence for the dual-process model of spatial compatibility. Some issues about the separation of visual pathways are discussed based on our results. Full article

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11 pages, 1764 KiB

Open AccessArticle

Coherent Interpretation of Entire Visual Field Test Reports Using a Multimodal Large Language Model (ChatGPT)

by Jeremy C. K. Tan

Vision 2025, 9(2), 33; https://doi.org/10.3390/vision9020033 - 11 Apr 2025

Viewed by 185

Abstract

This study assesses the accuracy and consistency of a commercially available large language model (LLM) in extracting and interpreting sensitivity and reliability data from entire visual field (VF) test reports for the evaluation of glaucomatous defects. Single-page anonymised VF test reports from 60 [...] Read more.

This study assesses the accuracy and consistency of a commercially available large language model (LLM) in extracting and interpreting sensitivity and reliability data from entire visual field (VF) test reports for the evaluation of glaucomatous defects. Single-page anonymised VF test reports from 60 eyes of 60 subjects were analysed by an LLM (ChatGPT 4o) across four domains—test reliability, defect type, defect severity and overall diagnosis. The main outcome measures were accuracy of data extraction, interpretation of glaucomatous field defects and diagnostic classification. The LLM displayed 100% accuracy in the extraction of global sensitivity and reliability metrics and in classifying test reliability. It also demonstrated high accuracy (96.7%) in diagnosing whether the VF defect was consistent with a healthy, suspect or glaucomatous eye. The accuracy in correctly defining the type of defect was moderate (73.3%), which only partially improved when provided with a more defined region of interest. The causes of incorrect defect type were mostly attributed to the wrong location, particularly confusing the superior and inferior hemifields. Numerical/text-based data extraction and interpretation was overall notably superior to image-based interpretation of VF defects. This study demonstrates the potential and also limitations of multimodal LLMs in processing multimodal medical investigation data such as VF reports. Full article

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15 pages, 3569 KiB

Open AccessArticle

Cup and Disc Segmentation in Smartphone Handheld Ophthalmoscope Images with a Composite Backbone and Double Decoder Architecture

by Thiago Paiva Freire, Geraldo Braz Júnior, João Dallyson Sousa de Almeida and José Ribamar Durand Rodrigues Junior

Vision 2025, 9(2), 32; https://doi.org/10.3390/vision9020032 - 11 Apr 2025

Viewed by 66

Abstract

Glaucoma is a visual disease that affects millions of people, and early diagnosis can prevent total blindness. One way to diagnose the disease is through fundus image examination, which analyzes the optic disc and cup structures. However, screening programs in primary care are [...] Read more.

Glaucoma is a visual disease that affects millions of people, and early diagnosis can prevent total blindness. One way to diagnose the disease is through fundus image examination, which analyzes the optic disc and cup structures. However, screening programs in primary care are costly and unfeasible. Neural network models have been used to segment optic nerve structures, assisting physicians in this task and reducing fatigue. This work presents a methodology to enhance morphological biomarkers of the optic disc and cup in images obtained by a smartphone coupled to an ophthalmoscope through a deep neural network, which combines two backbones and a dual decoder approach to improve the segmentation of these structures, as well as a new way to combine the loss weights in the training process. The models obtained were numerically evaluated through Dice and IoU measures. The dice values obtained in the experiments reached a Dice of 95.92% and 85.30% for the optical disc and cup and an IoU of 92.22% and 75.68% for the optical disc and cup, respectively, in the BrG dataset. These findings indicate promising architectures in the fundus image segmentation task. Full article

(This article belongs to the Section Retinal Function and Disease)

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12 pages, 3181 KiB

Open AccessArticle

Artificial Intelligence vs. Human Cognition: A Comparative Analysis of ChatGPT and Candidates Sitting the European Board of Ophthalmology Diploma Examination

by Anna P. Maino, Jakub Klikowski, Brendan Strong, Wahid Ghaffari, Michał Woźniak, Tristan Bourcier and Andrzej Grzybowski

Vision 2025, 9(2), 31; https://doi.org/10.3390/vision9020031 - 9 Apr 2025

Viewed by 276

Abstract

Background/Objectives: This paper aims to assess ChatGPT’s performance in answering European Board of Ophthalmology Diploma (EBOD) examination papers and to compare these results to pass benchmarks and candidate results. Methods: This cross-sectional study used a sample of past exam papers from 2012, 2013, [...] Read more.

Background/Objectives: This paper aims to assess ChatGPT’s performance in answering European Board of Ophthalmology Diploma (EBOD) examination papers and to compare these results to pass benchmarks and candidate results. Methods: This cross-sectional study used a sample of past exam papers from 2012, 2013, 2020–2023 EBOD examinations. This study analyzed ChatGPT’s responses to 440 multiple choice questions (MCQs), each containing five true/false statements (2200 statements in total) and 48 single best answer (SBA) questions. Results: ChatGPT, for MCQs, scored on average 64.39%. ChatGPT’s strongest metric performance for MCQs was precision (68.76%). ChatGPT performed best at answering pathology MCQs (Grubbs test p < 0.05). Optics and refraction had the lowest-scoring MCQ performance across all metrics. ChatGPT-3.5 Turbo performed worse than human candidates and ChatGPT-4o on easy questions (75% vs. 100% accuracy) but outperformed humans and ChatGPT-4o on challenging questions (50% vs. 28% accuracy). ChatGPT’s SBA performance averaged 28.43%, with the highest score and strongest performance in precision (29.36%). Pathology SBA questions were consistently the lowest-scoring topic across most metrics. ChatGPT demonstrated a nonsignificant tendency to select option 1 more frequently (p = 0.19). When answering SBAs, human candidates scored higher than ChatGPT in all metric areas measured. Conclusions: ChatGPT performed stronger for true/false questions, scoring a pass mark in most instances. Performance was poorer for SBA questions, suggesting that ChatGPT’s ability in information retrieval is better than that in knowledge integration. ChatGPT could become a valuable tool in ophthalmic education, allowing exam boards to test their exam papers to ensure they are pitched at the right level, marking open-ended questions and providing detailed feedback. Full article

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17 pages, 2231 KiB

Open AccessArticle

Brain Functional Connectivity During First- and Third-Person Visual Imagery

by Ekaterina Pechenkova, Mary Rachinskaya, Varvara Vasilenko, Olesya Blazhenkova and Elena Mershina

Vision 2025, 9(2), 30; https://doi.org/10.3390/vision9020030 - 6 Apr 2025

Viewed by 167

Abstract

The ability to adopt different perspectives, or vantage points, is fundamental to human cognition, affecting reasoning, memory, and imagery. While the first-person perspective allows individuals to experience a scene through their own eyes, the third-person perspective involves an external viewpoint, which is thought [...] Read more.

The ability to adopt different perspectives, or vantage points, is fundamental to human cognition, affecting reasoning, memory, and imagery. While the first-person perspective allows individuals to experience a scene through their own eyes, the third-person perspective involves an external viewpoint, which is thought to demand greater cognitive effort and different neural processing. Despite the frequent use of perspective switching across various contexts, including modern media and in therapeutic settings, the neural mechanisms differentiating these two perspectives in visual imagery remain largely underexplored. In an exploratory fMRI study, we compared both activation and task-based functional connectivity underlying first-person and third-person perspective taking in the same 26 participants performing two spatial egocentric imagery tasks, namely imaginary tennis and house navigation. No significant differences in activation emerged between the first-person and third-person conditions. The network-based statistics analysis revealed a small subnetwork of the early visual and posterior temporal areas that manifested stronger functional connectivity during the first-person perspective, suggesting a closer sensory recruitment loop, or, in different terms, a loop between long-term memory and the “visual buffer” circuits. The absence of a strong neural distinction between the first-person and third-person perspectives suggests that third-person imagery may not fully decenter individuals from the scene, as is often assumed. Full article

(This article belongs to the Special Issue Visual Mental Imagery System: How We Image the World)

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15 pages, 6945 KiB

Open AccessArticle

Gaze Error Estimation and Linear Transformation to Improve Accuracy of Video-Based Eye Trackers

by Varun Padikal, Alex Plonkowski, Penelope F. Lawton, Laura K. Young and Jenny C. A. Read

Vision 2025, 9(2), 29; https://doi.org/10.3390/vision9020029 - 3 Apr 2025

Viewed by 86

Abstract

Eye tracking technology plays a crucial role in various fields such as psychology, medical training, marketing, and human–computer interaction. However, achieving high accuracy over a larger field of view in eye tracking systems remains a significant challenge, both in free viewing and in [...] Read more.

Eye tracking technology plays a crucial role in various fields such as psychology, medical training, marketing, and human–computer interaction. However, achieving high accuracy over a larger field of view in eye tracking systems remains a significant challenge, both in free viewing and in a head-stabilized condition. In this paper, we propose a simple approach to improve the accuracy of video-based eye trackers through the implementation of linear coordinate transformations. This method involves applying stretching, shearing, translation, or their combinations to correct gaze accuracy errors. Our investigation shows that re-calibrating the eye tracker via linear transformations significantly improves the accuracy of video-based tracker over a large field of view. Full article

(This article belongs to the Section Visual Neuroscience)

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15 pages, 2174 KiB

Open AccessArticle

Exploring Attention in Depth: Event-Related and Steady-State Visual Evoked Potentials During Attentional Shifts Between Depth Planes in a Novel Stimulation Setup

by Jonas Jänig, Norman Forschack, Christopher Gundlach and Matthias M. Müller

Vision 2025, 9(2), 28; https://doi.org/10.3390/vision9020028 - 3 Apr 2025

Viewed by 73

Abstract

Visuo-spatial attention acts as a filter for the flood of visual information. Until recently, experimental research in this area focused on neural dynamics of shifting attention in 2D space, leaving attentional shifts in depth less explored. In this study, twenty-three participants were cued [...] Read more.

Visuo-spatial attention acts as a filter for the flood of visual information. Until recently, experimental research in this area focused on neural dynamics of shifting attention in 2D space, leaving attentional shifts in depth less explored. In this study, twenty-three participants were cued to attend to one of two overlapping random-dot kinematograms (RDKs) in different stereoscopic depths in a novel experimental setup. These RDKs flickered at two different frequencies to evoke Steady-State Visual Evoked Potentials (SSVEPs), a neural signature of early visual stimulus processing. Subjects were instructed to detect coherent motion events in the to-be-attended-to plane/RDK. Behavioral data showed that subjects were able to perform the task and selectively respond to events at the cued depth. Event-Related Potentials (ERPs) elicited by these events—namely the Selection Negativity (SN) and the P3b—showed greater amplitudes for coherent motion events in the to-be-attended-to compared to the to-be-ignored plane/RDK, indicating that attention was shifted accordingly. Although our new experimental setting reliably evoked SSVEPs, SSVEP amplitude time courses did not differ between the to-be-attended-to and to-be-ignored stimuli. These results suggest that early visual areas may not optimally represent depth-selective attention, which might rely more on higher processing stages, as suggested by the ERP results. Full article

(This article belongs to the Section Visual Neuroscience)

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14 pages, 2108 KiB

Open AccessArticle

Tear Film Changes and Ocular Symptoms Associated with Soft Contact Lens Wear

by Eduardo Insua Pereira, Madalena Lira and Ana Paula Sampaio

Vision 2025, 9(2), 27; https://doi.org/10.3390/vision9020027 - 1 Apr 2025

Viewed by 94

Abstract

Discomfort is one of the leading causes associated with contact lens dropout. This study investigated changes in the tear film parameters induced by lens wear and their relationship with ocular symptomology. Thirty-four lens wearers (32.9 ± 9.1 years, 7 men) and thirty-three non-lens [...] Read more.

Discomfort is one of the leading causes associated with contact lens dropout. This study investigated changes in the tear film parameters induced by lens wear and their relationship with ocular symptomology. Thirty-four lens wearers (32.9 ± 9.1 years, 7 men) and thirty-three non-lens wearers (29.4 ± 6.8 years, 12 men) participated in this clinical setting. Subjects were categorised into asymptomatic (n = 11), moderate (n = 15), or severe symptomatic (n = 8). Clinical evaluations were performed in the morning, including blink frequency and completeness, pre-corneal (NIBUT) and pre-lens non-invasive break-up (PL-NIBUT), lipid interference patterns, and tear meniscus height. Contact lens wearers had a higher percentage of incomplete blinks (37% vs. 19%, p < 0.001) and reduced tear meniscus height compared to controls (0.24 ± 0.08 vs. 0.28 ± 0.10 mm, p = 0.014). PL-NIBUT was shorter than NIBUT (7.6 ± 6.2 vs. 10.7 ± 9.3 s. p = 0.002). Significant statistical differences between the groups were found in the PL-NIBUT (p = 0.01) and NIBUT (p = 0.05), with asymptomatic recording higher times than symptomatic. Long-term use of silicone–hydrogel lenses can affect tear stability, production, and adequate distribution through blinking. Ocular symptomology correlates with tear stability parameters in both lens wearers and non-wearers. Full article

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19 pages, 646 KiB

Open AccessReview

Emerging Treatments for Persistent Corneal Epithelial Defects

by Jeonghyun (Esther) Kwon, Christie Kang, Amirhossein Moghtader, Sumaiya Shahjahan, Zahra Bibak Bejandi, Ahmad Alzein and Ali R. Djalilian

Vision 2025, 9(2), 26; https://doi.org/10.3390/vision9020026 - 1 Apr 2025

Viewed by 145

Abstract

Persistent corneal epithelial defects (PCEDs) are a challenging ocular condition characterized by the failure of complete corneal epithelial healing after an insult or injury, even after 14 days of standard care. There is a lack of therapeutics that target this condition and encourage [...] Read more.

Persistent corneal epithelial defects (PCEDs) are a challenging ocular condition characterized by the failure of complete corneal epithelial healing after an insult or injury, even after 14 days of standard care. There is a lack of therapeutics that target this condition and encourage re-epithelialization of the corneal surface in a timely and efficient manner. This review aims to provide an overview of current standards of management for PCEDs, highlighting novel, emerging treatments in this field. While many of the current non-surgical treatments aim to provide lubrication and mechanical support, novel non-surgical approaches are undergoing development to harness the proliferative and healing properties of human mesenchymal stem cells, platelets, lufepirsen, hyaluronic acid, thymosin ß4, p-derived peptide, and insulin-like growth factor for the treatment of PCEDs. Novel surgical treatments focus on corneal neurotization and limbal cell reconstruction using novel scaffold materials and cell-sources. This review provides insights into future PCED treatments that build upon current management guidelines. Full article

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29 pages, 3715 KiB

Open AccessReview

μετὰ τὰ ϕυσικά: Vision Far Beyond Physics

by Liliana Albertazzi

Vision 2025, 9(2), 25; https://doi.org/10.3390/vision9020025 - 26 Mar 2025

Viewed by 254

Abstract

Vision Science is an area of study that focuses on specific aspects of visual perception and is conducted mainly in the restricted and controlled context of laboratories. In so doing, the methodological procedures adopted necessarily reduce the variables of natural perception. For the [...] Read more.

Vision Science is an area of study that focuses on specific aspects of visual perception and is conducted mainly in the restricted and controlled context of laboratories. In so doing, the methodological procedures adopted necessarily reduce the variables of natural perception. For the time being, it is extremely difficult to perform psychophysical, neurophysiological, and phenomenological experiments in open scenery, even if that is our natural visual experience. This study discusses four points whose status in Vision Science is still controversial. Namely, the copresence of distinct visual phenomena of primary and secondary processes in natural vision; the role of visual imagination in seeing; the factors ruling the perception of global ambiguity and enigmatic and emotional atmosphere in the visual experience of a scene; and if the phenomena of subjective vision are considered, what kind of new laboratories are available for studying visual perception in open scenery. In the framework of experimental phenomenology and the use of pictorial art as a complement and test for perceptual phenomena, a case study from painting showing the copresence of perceptual and mental visual processes is also discussed and analyzed. This has involved measuring color and light in specific zones of the painting chosen for analysis, relative to visual templates, using Natural Color System notation cards. Full article

(This article belongs to the Section Visual Neuroscience)

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Vision, Volume 9, Issue 2 (June 2025) – 12 articles

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