Vision

17 pages, 749 KiB

Open AccessEditor’s ChoiceArticle

Impact of Visual Input and Kinesiophobia on Postural Control and Quality of Life in Older Adults During One-Leg Standing Tasks

by Paul S. Sung and Dongchul Lee

Vision 2025, 9(1), 24; https://doi.org/10.3390/vision9010024 - 20 Mar 2025

Cited by 4 | Viewed by 970

Abstract

Visual conditions significantly influence fear of movement (FOM), which is a condition that impairs postural control and quality of life (QOL). This study examined how visual conditions influence sway velocity during repeated one-leg standing tasks and explored the potential relationship between postural control, [...] Read more.

Visual conditions significantly influence fear of movement (FOM), which is a condition that impairs postural control and quality of life (QOL). This study examined how visual conditions influence sway velocity during repeated one-leg standing tasks and explored the potential relationship between postural control, FOM, and QOL in older adults with and without FOM. Thirty-seven older adults with FOM and 37 controls participated in the study. Postural sway velocity was measured across three repeated trials under visual conditions in both anteroposterior (AP) and mediolateral (ML) directions. The groups demonstrated significant interaction under visual conditions (F = 7.43, p = 0.01). In the eyes-closed condition, the FOM group exhibited faster ML sway velocity than the control group, with significant differences across all three trials. There was a significant interaction between sway direction and vision (F = 27.41, p = 0.001). In addition, the FOM demonstrated strong negative correlations with several QOL measures on social functioning (r = −0.69, p = 0.001) and role limitations due to emotional problems (r = −0.58, p = 0.001) in the FOM group. While FOM influenced sway velocity during balance tasks, visual input emerged as a key determinant of postural control. The FOM group demonstrated a heightened reliance on vision, suggesting an increased need for vision-dependent strategies to maintain balance. Full article

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24 pages, 377 KiB

Open AccessEditor’s ChoiceReview

Syndromic Retinitis Pigmentosa: A Narrative Review

by Márta Janáky and Gábor Braunitzer

Vision 2025, 9(1), 7; https://doi.org/10.3390/vision9010007 - 20 Jan 2025

Cited by 2 | Viewed by 3678

Abstract

Retinitis pigmentosa (RP) encompasses inherited retinal dystrophies, appearing either as an isolated eye condition or as part of a broader systemic syndrome, known as syndromic RP. In these cases, RP includes systemic symptoms impacting other organs, complicating diagnosis and management. This review highlights [...] Read more.

Retinitis pigmentosa (RP) encompasses inherited retinal dystrophies, appearing either as an isolated eye condition or as part of a broader systemic syndrome, known as syndromic RP. In these cases, RP includes systemic symptoms impacting other organs, complicating diagnosis and management. This review highlights key systemic syndromes linked with RP, such as Usher, Bardet–Biedl, and Alström syndromes, focusing on genetic mutations, inheritance, and clinical symptoms. These insights support clinicians in recognizing syndromic RP early. Ocular signs like nystagmus and congenital cataracts may indicate systemic disease, prompting genetic testing. Conversely, systemic symptoms may necessitate eye exams, even if vision symptoms are absent. Understanding the systemic aspects of these syndromes emphasizes the need for multidisciplinary collaboration among ophthalmologists, pediatricians, and other specialists to optimize patient care. The review also addresses emerging genetic therapies aimed at both visual and systemic symptoms, though more extensive studies are required to confirm their effectiveness. Overall, by detailing the genetic and clinical profiles of syndromic RP, this review seeks to aid healthcare professionals in diagnosing and managing these complex conditions more effectively, enhancing patient outcomes through timely, specialized intervention. Full article

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

12 pages, 243 KiB

Open AccessEditor’s ChoiceReview

Digital Applications for Videoterminal-Associated Dry Eye Disease

by Maria Angela Romeo, Giulia Coco, Andrea Taloni, Giovanna Carnovale-Scalzo, Vincenzo Scorcia and Giuseppe Giannaccare

Vision 2024, 8(4), 67; https://doi.org/10.3390/vision8040067 - 28 Nov 2024

Cited by 1 | Viewed by 2678

Abstract

Dry eye disease (DED) has become increasingly prevalent in the digital era, largely due to prolonged screen exposure. The excessive use of digital devices contributes to inappropriate blink frequency and dynamics, leading to ocular surface dryness and discomfort. Additionally, digital screen use has [...] Read more.

Dry eye disease (DED) has become increasingly prevalent in the digital era, largely due to prolonged screen exposure. The excessive use of digital devices contributes to inappropriate blink frequency and dynamics, leading to ocular surface dryness and discomfort. Additionally, digital screen use has broader implications for systemic health, including visual strain, headaches, and disrupted circadian rhythms caused by blue light exposure. Previous studies have shown that prolonged screen time correlates with altered blink frequency and increased symptom severity in DED patients, exacerbating the imbalance in tear film production and evaporation. Blinking dynamics, particularly blink rate and completeness, are crucial in maintaining ocular surface moisture. Incomplete blinking impairs meibomian gland function, reducing lipid secretion, which is essential for preventing tear evaporation. Raising patient awareness through educational material, ergonomic adjustments, and blinking exercises has been shown to mitigate these effects. Digital tools that provide targeted educational interventions can be particularly effective in improving blink dynamics and overall ocular comfort. This study evaluates the efficacy of digital applications in optimizing blinking dynamics and enhancing tear film stability. The findings suggest that these innovations improve patient outcomes by encouraging healthier eye care practices. However, further research is needed to assess their long-term impact across diverse populations. Full article

11 pages, 622 KiB

Open AccessEditor’s ChoiceArticle

Measuring the Pupillary Light Reflex Using Portable Instruments in Applied Settings

by Nicola S. Gray, Menna Price, Jennifer Pink, Chris O’Connor, Ana Antunes and Robert J. Snowden

Vision 2024, 8(4), 60; https://doi.org/10.3390/vision8040060 - 1 Oct 2024

Cited by 3 | Viewed by 2746

Abstract

The early components of the pupillary light reflex (PLR) are governed by the parasympathetic nervous system. The use of cheap, portable pupillometry devices may allow for the testing of parasympathetic-system health in field settings. We examined the reliability of two portable instruments for [...] Read more.

The early components of the pupillary light reflex (PLR) are governed by the parasympathetic nervous system. The use of cheap, portable pupillometry devices may allow for the testing of parasympathetic-system health in field settings. We examined the reliability of two portable instruments for measuring the PLR and their sensitivity to individual differences known to modulate the PLR. Parameters of the PLR were measured in a community sample (N = 108) in a variety of field settings. Measurements were taken using a commercial pupillometer (NeuroLight, IDMED) and an iPhone using the Reflex Pro PLR analyser (Brightlamp). The parameters of baseline pupil diameter, constriction latency, amplitude and relative amplitude of constriction, and constriction velocity were measured. Individual differences related to age, levels of anxiety, and post-traumatic stress disorder (PTSD) symptomology were assessed. Some measures could not be attained using the iPhone under these field conditions. The reliability of the measures was high, save for the measurement of contraction latency which was particularly unreliable for the iPhone system. The parameters of the PLR showed the same internal relationships as those established in laboratory-based measurements. Age was negatively correlated with all the reliable PLR parameters for both systems. Effects of anxiety and PTSD symptomology were also apparent. The study demonstrated that a hand-held portable infrared pupillometer can be used successfully to measure the PLR parameters under field settings and can be used to examine individual differences. This may allow these devices to be used in workplaces, sports fields, roadsides, etc., to examine parasympathetic activity where needed. Full article

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11 pages, 1897 KiB

Open AccessEditor’s ChoiceArticle

Colour Vision Changes across Lifespan: Insights from FM100 and CAD Tests

by Renārs Trukša, Sergejs Fomins, Zane Jansone-Langina and Laura Tenisa

Vision 2024, 8(3), 53; https://doi.org/10.3390/vision8030053 - 6 Sep 2024

Cited by 2 | Viewed by 2979

Abstract

(1) Background: in this research study, colour vision was evaluated in individuals aged 19 to 70 years with and without red–green colour vision disorders. (2) Methods: study participant colour vision was assessed with anomaloscope, HRR, FM100 hue, and CAD tests. (3) Results: No [...] Read more.

(1) Background: in this research study, colour vision was evaluated in individuals aged 19 to 70 years with and without red–green colour vision disorders. (2) Methods: study participant colour vision was assessed with anomaloscope, HRR, FM100 hue, and CAD tests. (3) Results: No significant correlation was found between participant age and chromatic sensitivity of the red–green colour opponent channel. However, a decrease in blue–yellow colour opponent channel chromatic sensitivity was confirmed with the FM100 hue test and CAD test. Analysis of FM100 hue test error scores across age groups revealed a decline in chromatic sensitivity in the short-wave region of visible light with increasing age. Comparison of the colour-deficient individual results of the CAD and anomaloscope tests confirmed that CAD test sensitivity and specificity reaches 100%. However, some individuals with deutan-type deficits were misclassified as having protan-type deficits. This study confirmed the effectiveness of the FM100 test in identifying individuals with moderate to severe colour vision deficits, with sensitivity and specificity rates of 81.25% and 95.38%. (4) Conclusions: It was found that the FM100 hue test effectively identifies individuals with moderate and severe red–green colour vision deficiencies. On the other hand, individuals with mild colour vision deficiencies may go undetected with the FM100 hue test. Full article

(This article belongs to the Special Issue Selected Papers from the 4th International Symposium on Visual Physiology, Environment, and Perception (VisPEP 2024))

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25 pages, 8852 KiB

Open AccessEditor’s ChoiceArticle

Diabetic Retinopathy Features Segmentation without Coding Experience with Computer Vision Models YOLOv8 and YOLOv9

by Nicola Rizzieri, Luca Dall’Asta and Maris Ozoliņš

Vision 2024, 8(3), 48; https://doi.org/10.3390/vision8030048 - 23 Aug 2024

Cited by 8 | Viewed by 3572

Abstract

Computer vision is a powerful tool in medical image analysis, supporting the early detection and classification of eye diseases. Diabetic retinopathy (DR), a severe eye disease secondary to diabetes, accompanies several early signs of eye-threatening conditions, such as microaneurysms (MAs), hemorrhages (HEMOs), and [...] Read more.

Computer vision is a powerful tool in medical image analysis, supporting the early detection and classification of eye diseases. Diabetic retinopathy (DR), a severe eye disease secondary to diabetes, accompanies several early signs of eye-threatening conditions, such as microaneurysms (MAs), hemorrhages (HEMOs), and exudates (EXs), which have been widely studied and targeted as objects to be detected by computer vision models. In this work, we tested the performances of the state-of-the-art YOLOv8 and YOLOv9 architectures on DR fundus features segmentation without coding experience or a programming background. We took one hundred DR images from the public MESSIDOR database, manually labelled and prepared them for pixel segmentation, and tested the detection abilities of different model variants. We increased the diversity of the training sample by data augmentation, including tiling, flipping, and rotating the fundus images. The proposed approaches reached an acceptable mean average precision (mAP) in detecting DR lesions such as MA, HEMO, and EX, as well as a hallmark of the posterior pole of the eye, such as the optic disc. We compared our results with related works in the literature involving different neural networks. Our results are promising, but far from being ready for implementation into clinical practice. Accurate lesion detection is mandatory to ensure early and correct diagnoses. Future works will investigate lesion detection further, especially MA segmentation, with improved extraction techniques, image pre-processing, and standardized datasets. Full article

(This article belongs to the Special Issue Selected Papers from the 4th International Symposium on Visual Physiology, Environment, and Perception (VisPEP 2024))

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14 pages, 19268 KiB

Open AccessEditor’s ChoiceTechnical Note

A New Model of a Macular Buckle and a Refined Surgical Technique for the Treatment of Myopic Traction Maculopathy

by Barbara Parolini

Vision 2024, 8(3), 42; https://doi.org/10.3390/vision8030042 - 3 Jul 2024

Cited by 5 | Viewed by 3019

Abstract

Myopic traction maculopathy (MTM) affects 20% of eyes with pathologic myopia (PM). The MTM Staging System (MSS), published in 2020, describes the nomenclature of MTM as well as a proposal of pathogenesis, natural evolution, and prognosis. A study of customized treatment for each [...] Read more.

Myopic traction maculopathy (MTM) affects 20% of eyes with pathologic myopia (PM). The MTM Staging System (MSS), published in 2020, describes the nomenclature of MTM as well as a proposal of pathogenesis, natural evolution, and prognosis. A study of customized treatment for each stage of MTM has been published previously and suggested to treat maculoschisis and detachment by placing a macular buckle (MB) behind the macula to push the sclera towards the retina, selecting pars plana vitrectomy (PPV) only in cases where a macular hole is associated with MTM. We hereby describe a new model of a macular buckle, known as NPB, and an NPB loading device, with the aim to standardize the surgical technique and render it more user friendly, efficient, and safe. Macular buckle is an effective and safe procedure to treat maculoschisis and macular detachment in MTM. We recommend using it as a unique and first-line treatment. Full article

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

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13 pages, 754 KiB

Open AccessEditor’s ChoiceReview

Eyes on Memory: Pupillometry in Encoding and Retrieval

by Alex Kafkas

Vision 2024, 8(2), 37; https://doi.org/10.3390/vision8020037 - 14 Jun 2024

Cited by 4 | Viewed by 2463

Abstract

This review critically examines the contributions of pupillometry to memory research, primarily focusing on its enhancement of our understanding of memory encoding and retrieval mechanisms mainly investigated with the recognition memory paradigm. The evidence supports a close link between pupil response and memory [...] Read more.

This review critically examines the contributions of pupillometry to memory research, primarily focusing on its enhancement of our understanding of memory encoding and retrieval mechanisms mainly investigated with the recognition memory paradigm. The evidence supports a close link between pupil response and memory formation, notably influenced by the type of novelty detected. This proposal reconciles inconsistencies in the literature regarding pupil response patterns that may predict successful memory formation, and highlights important implications for encoding mechanisms. The review also discusses the pupil old/new effect and its significance in the context of recollection and in reflecting brain signals related to familiarity or novelty detection. Additionally, the capacity of pupil response to serve as a true memory signal and to distinguish between true and false memories is evaluated. The evidence provides insights into the nature of false memories and offers a novel understanding of the cognitive mechanisms involved in memory distortions. When integrated with rigorous experimental design, pupillometry can significantly refine theoretical models of memory encoding and retrieval. Furthermore, combining pupillometry with neuroimaging and pharmacological interventions is identified as a promising direction for future research. Full article

(This article belongs to the Special Issue Pupillometry)

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13 pages, 4536 KiB

Open AccessEditor’s ChoiceCommunication

Dynamic Visual Acuity, Vestibulo-Ocular Reflex, and Visual Field in National Football League (NFL) Officiating: Physiology and Visualization Engineering for 3D Virtual On-Field Training

by Joshua Ong, Nicole V. Carrabba, Ethan Waisberg, Nasif Zaman, Hamza Memon, Nicholas Panzo, Virginia A. Lee, Prithul Sarker, Ashtyn Z. Vogt, Noor Laylani, Alireza Tavakkoli and Andrew G. Lee

Vision 2024, 8(2), 35; https://doi.org/10.3390/vision8020035 - 17 May 2024

Cited by 1 | Viewed by 3446

Abstract

The ability to make on-field, split-second decisions is critical for National Football League (NFL) game officials. Multiple principles in visual function are critical for accuracy and precision of these play calls, including foveation time and unobstructed line of sight, static visual acuity, dynamic [...] Read more.

The ability to make on-field, split-second decisions is critical for National Football League (NFL) game officials. Multiple principles in visual function are critical for accuracy and precision of these play calls, including foveation time and unobstructed line of sight, static visual acuity, dynamic visual acuity, vestibulo-ocular reflex, and sufficient visual field. Prior research has shown that a standardized curriculum in these neuro-ophthalmic principles have demonstrated validity and self-rated improvements in understanding, confidence, and likelihood of future utilization by NFL game officials to maximize visual performance during officiating. Virtual reality technology may also be able to help optimize understandings of specific neuro-ophthalmic principles and simulate real-life gameplay. Personal communication between authors and NFL officials and leadership have indicated that there is high interest in 3D virtual on-field training for NFL officiating. In this manuscript, we review the current and past research in this space regarding a neuro-ophthalmic curriculum for NFL officials. We then provide an overview our current visualization engineering process in taking real-life NFL gameplay 2D data and creating 3D environments for virtual reality gameplay training for football officials to practice plays that highlight neuro-ophthalmic principles. We then review in-depth the physiology behind these principles and discuss strategies to implement these principles into virtual reality for football officiating. Full article

(This article belongs to the Special Issue Eye and Head Movements in Visuomotor Tasks)

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12 pages, 256 KiB

Open AccessEditor’s ChoiceReview

Corneal Nerve Assessment by Aesthesiometry: History, Advancements, and Future Directions

by Jordan R. Crabtree, Shadia Tannir, Khoa Tran, Charline S. Boente, Asim Ali and Gregory H. Borschel

Vision 2024, 8(2), 34; https://doi.org/10.3390/vision8020034 - 12 May 2024

Cited by 7 | Viewed by 2875

Abstract

The measurement of corneal sensation allows clinicians to assess the status of corneal innervation and serves as a crucial indicator of corneal disease and eye health. Many devices are available to assess corneal sensation, including the Cochet–Bonnet aesthesiometer, the Belmonte Aesthesiometer, the Swiss [...] Read more.

The measurement of corneal sensation allows clinicians to assess the status of corneal innervation and serves as a crucial indicator of corneal disease and eye health. Many devices are available to assess corneal sensation, including the Cochet–Bonnet aesthesiometer, the Belmonte Aesthesiometer, the Swiss Liquid Jet Aesthesiometer, and the newly introduced Corneal Esthesiometer Brill. Increasing the clinical use of in vivo confocal microscopy and optical coherence tomography will allow for greater insight into the diagnosis, classification, and monitoring of ocular surface diseases such as neurotrophic keratopathy; however, formal esthesiometric measurement remains necessary to assess the functional status of corneal nerves. These aesthesiometers vary widely in their mode of corneal stimulus generation and their relative accessibility, precision, and ease of clinical use. The development of future devices to optimize these characteristics, as well as further comparative studies between device types should enable more accurate and precise diagnosis and treatment of corneal innervation deficits. The purpose of this narrative review is to describe the advancements in the use of aesthesiometers since their introduction to clinical practice, compare currently available devices for assessing corneal innervation and their relative limitations, and discuss how the assessment of corneal innervation is crucial to understanding and treating pathologies of the ocular surface. Full article

19 pages, 4185 KiB

Open AccessEditor’s ChoiceReview

Visual Deficits and Diagnostic and Therapeutic Strategies for Neurofibromatosis Type 1: Bridging Science and Patient-Centered Care

by Kiyoharu J. Miyagishima, Fengyu Qiao, Steven F. Stasheff and Francisco M. Nadal-Nicolás

Vision 2024, 8(2), 31; https://doi.org/10.3390/vision8020031 - 9 May 2024

Cited by 3 | Viewed by 3688

Abstract

Neurofibromatosis type 1 (NF1) is an inherited autosomal dominant disorder primarily affecting children and adolescents characterized by multisystemic clinical manifestations. Mutations in neurofibromin, the protein encoded by the Nf1 tumor suppressor gene, result in dysregulation of the RAS/MAPK pathway leading to uncontrolled cell [...] Read more.

Neurofibromatosis type 1 (NF1) is an inherited autosomal dominant disorder primarily affecting children and adolescents characterized by multisystemic clinical manifestations. Mutations in neurofibromin, the protein encoded by the Nf1 tumor suppressor gene, result in dysregulation of the RAS/MAPK pathway leading to uncontrolled cell growth and migration. Neurofibromin is highly expressed in several cell lineages including melanocytes, glial cells, neurons, and Schwann cells. Individuals with NF1 possess a genetic predisposition to central nervous system neoplasms, particularly gliomas affecting the visual pathway, known as optic pathway gliomas (OPGs). While OPGs are typically asymptomatic and benign, they can induce visual impairment in some patients. This review provides insight into the spectrum and visual outcomes of NF1, current diagnostic techniques and therapeutic interventions, and explores the influence of NF1-OPGS on visual abnormalities. We focus on recent advancements in preclinical animal models to elucidate the underlying mechanisms of NF1 pathology and therapies targeting NF1-OPGs. Overall, our review highlights the involvement of retinal ganglion cell dysfunction and degeneration in NF1 disease, and the need for further research to transform scientific laboratory discoveries to improved patient outcomes. Full article

(This article belongs to the Section Visual Neuroscience)

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8 pages, 491 KiB

Open AccessEditor’s ChoiceReview

Uncovering the Role of the Early Visual Cortex in Visual Mental Imagery

by Nadine Dijkstra

Vision 2024, 8(2), 29; https://doi.org/10.3390/vision8020029 - 2 May 2024

Cited by 9 | Viewed by 3901

Abstract

The question of whether the early visual cortex (EVC) is involved in visual mental imagery remains a topic of debate. In this paper, I propose that the inconsistency in findings can be explained by the unique challenges associated with investigating EVC activity during [...] Read more.

The question of whether the early visual cortex (EVC) is involved in visual mental imagery remains a topic of debate. In this paper, I propose that the inconsistency in findings can be explained by the unique challenges associated with investigating EVC activity during imagery. During perception, the EVC processes low-level features, which means that activity is highly sensitive to variation in visual details. If the EVC has the same role during visual mental imagery, any change in the visual details of the mental image would lead to corresponding changes in EVC activity. Within this context, the question should not be whether the EVC is ‘active’ during imagery but how its activity relates to specific imagery properties. Studies using methods that are sensitive to variation in low-level features reveal that imagery can recruit the EVC in similar ways as perception. However, not all mental images contain a high level of visual details. Therefore, I end by considering a more nuanced view, which states that imagery can recruit the EVC, but that does not mean that it always does so. Full article

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

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14 pages, 2167 KiB

Open AccessEditor’s ChoiceArticle

Less Is More: Higher-Skilled Sim Racers Allocate Significantly Less Attention to the Track Relative to the Display Features than Lower-Skilled Sim Racers

by John M. Joyce, Mark J. Campbell, Fazilat Hojaji and Adam J. Toth

Vision 2024, 8(2), 27; https://doi.org/10.3390/vision8020027 - 29 Apr 2024

Cited by 1 | Viewed by 2378

Abstract

Simulated (sim) racing is an emerging esport that has garnered much interest in recent years and has been a relatively under-researched field in terms of expertise and performance. When examining expertise, visual attention has been of particular interest to researchers, with eye tracking [...] Read more.

Simulated (sim) racing is an emerging esport that has garnered much interest in recent years and has been a relatively under-researched field in terms of expertise and performance. When examining expertise, visual attention has been of particular interest to researchers, with eye tracking technology commonly used to assess visual attention. In this study, we examined the overt visual attention allocation of high- and low-skilled sim racers during a time trial task using Tobii 3 glasses. In the study, 104 participants were tested on one occasion, with 88 included in the analysis after exclusions. Participants were allocated to either group according to their fastest lap times. Independent t-tests were carried out with sidak corrections to test our hypotheses. Our results indicate that when eye tracking metrics were normalised to the lap time and corner sector time, there was a difference in the relative length of overt attention allocation (fixation behaviour) as lower-skilled racers had significantly greater total fixation durations in laps overall and across corner sectors when normalised (p = 0.013; p = 0.018). Interestingly, high- and low-skilled sim racers differed in where they allocated their attention during the task, with high-skilled sim racers allocating significantly less overt attention to the track relative to other areas of the display (p = 0.003). This would allow for higher-skilled racers to obtain relatively more information from heads-up display elements in-game, all whilst driving at faster speeds. This study provides evidence that high-skilled sim racers appear to need significantly less overt attention throughout a fast lap, and that high- and low-skilled sim racers differ in where they allocate their attention while racing. Full article

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13 pages, 1552 KiB

Open AccessEditor’s ChoiceArticle

A Pilot Study to Improve Cognitive Performance and Pupil Responses in Mild Cognitive Impaired Patients Using Gaze-Controlled Gaming

by Maria Solé Puig, Patricia Bustos Valenzuela, August Romeo and Hans Supèr

Vision 2024, 8(2), 25; https://doi.org/10.3390/vision8020025 - 24 Apr 2024

Cited by 2 | Viewed by 2487

Abstract

Mild cognitive impairment (MCI) may progress to severe forms of dementia, so therapy is needed to maintain cognitive abilities. The neural circuitry for oculomotor control is closely linked to that which controls cognitive behavior. In this study, we tested whether training the oculomotor [...] Read more.

Mild cognitive impairment (MCI) may progress to severe forms of dementia, so therapy is needed to maintain cognitive abilities. The neural circuitry for oculomotor control is closely linked to that which controls cognitive behavior. In this study, we tested whether training the oculomotor system with gaze-controlled video games could improve cognitive behavior in MCI patients. Patients played a simple game for 2–3 weeks while a control group played the same game using a mouse. Cognitive improvement was assessed using the MoCA screening test and CANTAB. We also measured eye pupil and vergence responses in an oddball paradigm. The results showed an increased score on the MoCA test specifically for the visuospatial domain and on the Rapid Visual Information Processing test of the CANTAB battery. Pupil responses also increased to target stimuli. Patients in the control group did not show significant improvements. This pilot study provides evidence for the potential cognitive benefits of gaze-controlled gaming in MCI patients. Full article

(This article belongs to the Section Visual Neuroscience)

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19 pages, 1705 KiB

Open AccessEditor’s ChoiceArticle

An Insight into Knowledge, Perspective, and Practices of Indian Optometrists towards Childhood Myopia

by Archana Naik, Siddharth K. Karthikeyan, Jivitha Jyothi Ramesh, Shwetha Bhaskar, Chinnappa A. Ganapathi and Sayantan Biswas

Vision 2024, 8(2), 22; https://doi.org/10.3390/vision8020022 - 16 Apr 2024

Cited by 6 | Viewed by 4103

Abstract

The current understanding of clinical approaches and barriers in managing childhood myopia among Indian optometrists is limited. This research underscores the necessity and relevance of evidence-based practice guidelines by exploring their knowledge, attitude, and practice towards childhood myopia. A self-administered internet-based 26-item survey [...] Read more.

The current understanding of clinical approaches and barriers in managing childhood myopia among Indian optometrists is limited. This research underscores the necessity and relevance of evidence-based practice guidelines by exploring their knowledge, attitude, and practice towards childhood myopia. A self-administered internet-based 26-item survey was circulated online among practicing optometrists in India. The questions assessed the demographics, knowledge, self-reported clinical practice behavior, barriers, source of information guiding their management, and extent of adult caregiver engagement for childhood myopia. Of 393 responses, a significant proportion of respondents (32.6–92.4%) were unaware of the ocular complications associated with high myopia, with less than half (46.5%) routinely performing ocular biometry in clinical practice. Despite the growing awareness of emerging myopia management options, the uptake remains generally poor, with single-vision distance full-correction spectacles (70.3%) being the most common mode of vision correction. Barriers to adopting optimal myopia care are medicolegal concerns, absence of clinical practice guidelines, and inadequate consultation time. Own clinical experience and original research articles were the primary sources of information supporting clinical practice. Most (>70%) respondents considered involving the adult caregiver in their child’s clinical decision-making process. While practitioners’ awareness and activity of newer myopia management strategies are improving, there is plenty of scope for its enhancement. The importance of evidence-based practice guidelines and continuing education on myopia control might help practitioners enhance their clinical decision-making skills. Full article

(This article belongs to the Special Issue New Horizons in Myopia Management: Bridging Epidemiology and Clinical Innovation)

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17 pages, 2188 KiB

Open AccessEditor’s ChoiceArticle

Enhancement of the Inner Foveal Response of Young Adults with Extended-Depth-of-Focus Contact Lens for Myopia Management

by Ana Amorim-de-Sousa, Rute J. Macedo-de-Araújo, Paulo Fernandes, José M. González-Méijome and António Queirós

Vision 2024, 8(2), 19; https://doi.org/10.3390/vision8020019 - 14 Apr 2024

Cited by 1 | Viewed by 2433

Abstract

Background: Myopia management contact lenses have been shown to successfully decrease the rate of eye elongation in children by changing the peripheral refractive profile of the retina. Despite the efforts of the scientific community, the retinal response mechanism to defocus is still unknown. [...] Read more.

Background: Myopia management contact lenses have been shown to successfully decrease the rate of eye elongation in children by changing the peripheral refractive profile of the retina. Despite the efforts of the scientific community, the retinal response mechanism to defocus is still unknown. The purpose of this study was to evaluate the local electrophysiological response of the retina with a myopia control contact lens (CL) compared to a single-vision CL of the same material. Methods: The retinal electrical activity and peripheral refraction of 16 eyes (16 subjects, 27.5 ± 5.7 years, 13 females and 3 males) with myopia between −0.75 D and −6.00 D (astigmatism < 1.00 D) were assessed with two CLs (Filcon 5B): a single-vision (SV) CL and an extended-depth-of-focus (EDOF) CL used for myopia management. The peripheral refraction was assessed with an open-field WAM-5500 auto-refractometer/keratometer in four meridians separated by 45° at 2.50 m distance. The global-flash multifocal electroretinogram (gf-mfERG) was recorded with the Reti-port/scan21 (Roland Consult) using a stimulus of 61 hexagons. The implicit time (in milliseconds) and response density (RD, in nV/deg²) of the direct (DC) and induced (IC) components were used for comparison between lenses in physiological pupil conditions. Results: Although the EDOF decreased both the HCVA and the LCVA (one and two lines, respectively; p < 0.003), it still allowed a good VA. The EDOF lens induced a myopic shift in most retinal areas, with a higher and statistically significant effect on the nasal retina. No differences in the implicit times of the DC and IC components were observed between SV and EDOF. Compared with the SV, the EDOF lens showed a higher RD in the IC component in the foveal region (p = 0.032). In the remaining retinal areas, the EDOF evoked lower, non-statistically significant RD in both the DC and IC components. Conclusions: The EDOF myopia control CL enhanced the response of the inner layers of the fovea. This might suggest that, besides other mechanisms potentially involved, the central foveal retinal activity might be involved in the mechanism of myopia control with these lenses. Full article

(This article belongs to the Special Issue New Horizons in Myopia Management: Bridging Epidemiology and Clinical Innovation)

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22 pages, 8733 KiB

Open AccessEditor’s ChoiceArticle

The Neural Basis of a Cognitive Function That Suppresses the Generation of Mental Imagery: Evidence from a Functional Magnetic Resonance Imaging Study

by Hiroki Motoyama and Shinsuke Hishitani

Vision 2024, 8(2), 18; https://doi.org/10.3390/vision8020018 - 10 Apr 2024

Cited by 1 | Viewed by 2470

Abstract

This study elucidated the brain regions associated with the perception-driven suppression of mental imagery generation by comparing brain activation in a picture observation condition with that in a positive imagery generation condition. The assumption was that mental imagery generation would be suppressed in [...] Read more.

This study elucidated the brain regions associated with the perception-driven suppression of mental imagery generation by comparing brain activation in a picture observation condition with that in a positive imagery generation condition. The assumption was that mental imagery generation would be suppressed in the former condition but not in the latter. The results show significant activation of the left posterior cingulate gyrus (PCgG) in the former condition compared to in the latter condition. This finding is generally consistent with a previous study showing that the left PCgG suppresses mental imagery generation. Furthermore, correlational analyses showed a significant correlation between the activation of the left PCgG and participants’ subjective richness ratings, which are a measure of the clarity of a presented picture. Increased activity in the PCgG makes it more difficult to generate mental imagery. As visual perceptual processing and visual imagery generation are in competition, the suppression of mental imagery generation leads to enhanced visual perceptual processing. In other words, the greater the suppression of mental imagery, the clearer the presented pictures are perceived. The significant correlation found is consistent with this idea. The current results and previous studies suggest that the left PCgG plays a role in suppressing the generation of mental imagery. Full article

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

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14 pages, 309 KiB

Open AccessEditor’s ChoiceReview

Transepithelial Photorefractive Keratectomy—Review

by Christopher Way, Mohamed Gamal Elghobaier and Mayank A. Nanavaty

Vision 2024, 8(1), 16; https://doi.org/10.3390/vision8010016 - 21 Mar 2024

Cited by 10 | Viewed by 4851

Abstract

The type and nature of refractive surgery procedures has greatly increased over the past few decades, allowing for almost all patient populations to be treated to extremely high satisfaction. Conventional photorefractive keratectomy involves the removal of the corneal epithelium through mechanical debridement or [...] Read more.

The type and nature of refractive surgery procedures has greatly increased over the past few decades, allowing for almost all patient populations to be treated to extremely high satisfaction. Conventional photorefractive keratectomy involves the removal of the corneal epithelium through mechanical debridement or dilute alcohol instillation. An improvement to this method utilises laser epithelial removal in a single-step process termed transepithelial photorefractive keratectomy (transPRK). We explore the history of transPRK from its early adoption as a two-step process, identify different transPRK platforms from major manufacturers, and describe the role of transPRK in the refractive surgery armamentarium. This is a narrative review of the literature. This review finds that TransPRK is a safe and effective procedure that works across a variety of patient populations. Though often not seen as a primary treatment option when compared to other corneal-based procedures that offer a faster and more comfortable recovery, there are many scenarios in which these procedures are not possible. These include, but are not limited to, cases of corneal instability, previous refractive surgery, or transplant where higher-order aberrations can impair vision in a manner not amenable to spectacle or contact lens correction. We discuss refinements to the procedure that would help improve outcomes, including optimising patient discomfort after surgery as well as reducing corneal haze and refractive regression. Full article

20 pages, 4100 KiB

Open AccessEditor’s ChoiceProtocol

Automated Analysis Pipeline for Extracting Saccade, Pupil, and Blink Parameters Using Video-Based Eye Tracking

by Brian C. Coe, Jeff Huang, Donald C. Brien, Brian J. White, Rachel Yep and Douglas P. Munoz

Vision 2024, 8(1), 14; https://doi.org/10.3390/vision8010014 - 18 Mar 2024

Cited by 10 | Viewed by 3953

Abstract

The tremendous increase in the use of video-based eye tracking has made it possible to collect eye tracking data from thousands of participants. The traditional procedures for the manual detection and classification of saccades and for trial categorization (e.g., correct vs. incorrect) are [...] Read more.

The tremendous increase in the use of video-based eye tracking has made it possible to collect eye tracking data from thousands of participants. The traditional procedures for the manual detection and classification of saccades and for trial categorization (e.g., correct vs. incorrect) are not viable for the large datasets being collected. Additionally, video-based eye trackers allow for the analysis of pupil responses and blink behaviors. Here, we present a detailed description of our pipeline for collecting, storing, and cleaning data, as well as for organizing participant codes, which are fairly lab-specific but nonetheless, are important precursory steps in establishing standardized pipelines. More importantly, we also include descriptions of the automated detection and classification of saccades, blinks, “blincades” (blinks occurring during saccades), and boomerang saccades (two nearly simultaneous saccades in opposite directions where speed-based algorithms fail to split them), This is almost entirely task-agnostic and can be used on a wide variety of data. We additionally describe novel findings regarding post-saccadic oscillations and provide a method to achieve more accurate estimates for saccade end points. Lastly, we describe the automated behavior classification for the interleaved pro/anti-saccade task (IPAST), a task that probes voluntary and inhibitory control. This pipeline was evaluated using data collected from 592 human participants between 5 and 93 years of age, making it robust enough to handle large clinical patient datasets. In summary, this pipeline has been optimized to consistently handle large datasets obtained from diverse study cohorts (i.e., developmental, aging, clinical) and collected across multiple laboratory sites. Full article

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23 pages, 2831 KiB

Open AccessEditor’s ChoiceReview

Angioid Streaks Remain a Challenge in Diagnosis, Management, and Treatment

by Georgios Tsokolas, Charalambos Tossounis, Straton Tyradellis, Lorenzo Motta, Georgios D. Panos and Theo Empeslidis

Vision 2024, 8(1), 10; https://doi.org/10.3390/vision8010010 - 5 Mar 2024

Cited by 3 | Viewed by 3440

Abstract

Aim: Angioid streaks (ASs) are a rare retinal condition and compromise visual acuity when complicated with choroidal neovascularization (CNV). They represent crack-like dehiscences at the level of the Bruch’s membrane. This objective narrative review aims to provide an overview of pathophysiology, current [...] Read more.

Aim: Angioid streaks (ASs) are a rare retinal condition and compromise visual acuity when complicated with choroidal neovascularization (CNV). They represent crack-like dehiscences at the level of the Bruch’s membrane. This objective narrative review aims to provide an overview of pathophysiology, current treatment modalities, and future perspectives on this condition. Materials and Methods: A literature search was performed using “PubMed”, “Web of Science”, “Scopus”, “ScienceDirect”, “Google Scholar”, “medRxiv”, and “bioRxiv.” Results: ASs may be idiopathic, but they are also associated with systemic conditions, such as pseudoxanthoma elasticum, hereditary hemoglobinopathies, or Paget’s disease. Currently, the main treatment is the use of anti-vascular endothelial growth factors (anti-VEGF) to treat secondary CNV, which is the major complication observed in this condition. If CNV is detected and treated promptly, patients with ASs have a good chance of maintaining functional vision. Other treatment modalities have been tried but have shown limited benefit and, therefore, have not managed to be more widely accepted. Conclusion: In summary, although there is no definitive cure yet, the use of anti-VEGF treatment for secondary CNV has provided the opportunity to maintain functional vision in individuals with AS, provided that CNV is detected and treated early. Full article

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

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13 pages, 1383 KiB

Open AccessEditor’s ChoiceReview

Astigmatism Management in Modern Cataract Surgery

by Royce B. Park and Ahmad A. Aref

Vision 2024, 8(1), 9; https://doi.org/10.3390/vision8010009 - 27 Feb 2024

Cited by 3 | Viewed by 3863

Abstract

Astigmatism management is a frequently encountered challenge in the world of modern cataract surgery. This review article investigates the importance of astigmatic correction and seeks to uncover the critical components of preoperative evaluation. With the rapid growth of new technologies and techniques, this [...] Read more.

Astigmatism management is a frequently encountered challenge in the world of modern cataract surgery. This review article investigates the importance of astigmatic correction and seeks to uncover the critical components of preoperative evaluation. With the rapid growth of new technologies and techniques, this article aims to also catalogue and clarify the multitude of astigmatism treatment options available for the cataract surgeon. Full article

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13 pages, 416 KiB

Open AccessEditor’s ChoiceArticle

The Influence of Tear Film Quality on Visual Function

by Snježana Kaštelan, Ksenija Gabrić, Maša Mikuličić, Danijela Mrazovac Zimak, Mirela Karabatić and Antonela Gverović Antunica

Vision 2024, 8(1), 8; https://doi.org/10.3390/vision8010008 - 26 Feb 2024

Cited by 4 | Viewed by 3245

Abstract

Background: The prevalence of dry eye disease (DED) is increasing globally, resulting in a variety of eye symptoms characterized by discomfort and visual disturbances. The accurate diagnosis of the disease is often challenging and complex, requiring specialized diagnostic tools. This study aimed to [...] Read more.

Background: The prevalence of dry eye disease (DED) is increasing globally, resulting in a variety of eye symptoms characterized by discomfort and visual disturbances. The accurate diagnosis of the disease is often challenging and complex, requiring specialized diagnostic tools. This study aimed to investigate the impact of tear film instability on visual function and to evaluate the value of post-blink blur time (PBBT) as an alternative method for assessing tear film stability. Methods: The study included 62 subjects: 31 with subjective symptoms of DED (Group A) and a control group consisting of 31 healthy participants (Group B). Symptoms were assessed using the standard Schein questionnaire, supplemented with additional questions. PBBT was measured using standard Snellen charts to investigate a potential association between PBBT and tear film dysfunction. Additional clinical assessments included tear film break-up time (TBUT). Results: Statistically significant differences were observed in the average values of PBBT and TBUT between the examined groups. The average PBBT was 8.95 ± 5.38 s in the group with DED and 14.66 ± 10.50 s in the control group, p < 0.001. Group A exhibited an average TBUT of 4.77 ± 2.37 s, while Group B had a TBUT of 7.63 ± 3.25 s, p < 0.001. Additionally, a strong positive correlation was identified between PBBT and TBUT values (r = 0.455; p < 0.001). Conclusions: The research confirms that tear film stability has an important role in the refraction of light and the maintenance of optical quality of vision. PBBT could potentially function as an objective and clinically significant screening test for DED. Full article

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11 pages, 1091 KiB

Open AccessEditor’s ChoiceArticle

Kinematic Assessment of Fine Motor Skills in Children: Comparison of a Kinematic Approach and a Standardized Test

by Ewa Niechwiej-Szwedo, Taylor A. Brin, Benjamin Thompson and Lisa W. T. Christian

Vision 2024, 8(1), 6; https://doi.org/10.3390/vision8010006 - 17 Feb 2024

Cited by 3 | Viewed by 3212

Abstract

Deficits in fine motor skills have been reported in some children with neurodevelopmental disorders such as amblyopia or strabismus. Therefore, monitoring the development of motor skills and any potential improvement due to therapy is an important clinical goal. The aim of this study [...] Read more.

Deficits in fine motor skills have been reported in some children with neurodevelopmental disorders such as amblyopia or strabismus. Therefore, monitoring the development of motor skills and any potential improvement due to therapy is an important clinical goal. The aim of this study was to test the feasibility of performing a kinematic assessment within an optometric setting using inexpensive, portable, off-the-shelf equipment. The study also assessed whether kinematic data could enhance the information provided by a routine motor function screening test (the Movement Assessment Battery for Children, MABC). Using the MABC-2, upper limb dexterity was measured in a cohort of 47 typically developing children (7–15 years old), and the Leap motion capture system was used to record hand kinematics while children performed a bead-threading task. Two children with a history of amblyopia were also tested to explore the utility of a kinematic assessment in a clinical population. For the typically developing children, visual acuity and stereoacuity were within the normal range; however, the average standardized MABC-2 scores were lower than published norms. Comparing MABC-2 and kinematic measures in the two children with amblyopia revealed that both assessments provide convergent results and revealed deficits in fine motor control. In conclusion, kinematic assessment can augment standardized tests of fine motor skills in an optometric setting and may be useful for measuring visuomotor function and monitoring treatment outcomes in children with binocular vision anomalies. Full article

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12 pages, 933 KiB

Open AccessEditor’s ChoiceArticle

Mimicking Facial Expressions Facilitates Working Memory for Stimuli in Emotion-Congruent Colours

by Thaatsha Sivananthan, Steven B. Most and Kim M. Curby

Vision 2024, 8(1), 4; https://doi.org/10.3390/vision8010004 - 30 Jan 2024

Viewed by 2544

Abstract

It is one thing for everyday phrases like “seeing red” to link some emotions with certain colours (e.g., anger with red), but can such links measurably bias information processing? We investigated whether emotional face information (angry/happy/neutral) held in visual working memory (VWM) enhances [...] Read more.

It is one thing for everyday phrases like “seeing red” to link some emotions with certain colours (e.g., anger with red), but can such links measurably bias information processing? We investigated whether emotional face information (angry/happy/neutral) held in visual working memory (VWM) enhances memory for shapes presented in a conceptually consistent colour (red or green) (Experiment 1). Although emotional information held in VWM appeared not to bias memory for coloured shapes in Experiment 1, exploratory analyses suggested that participants who physically mimicked the face stimuli were better at remembering congruently coloured shapes. Experiment 2 confirmed this finding by asking participants to hold the faces in mind while either mimicking or labelling the emotional expressions of face stimuli. Once again, those who mimicked the expressions were better at remembering shapes with emotion-congruent colours, whereas those who simply labelled them were not. Thus, emotion–colour associations appear powerful enough to guide attention, but—consistent with proposed impacts of “embodied emotion” on cognition—such effects emerged when emotion processing was facilitated through facial mimicry. Full article

(This article belongs to the Special Issue What We Bring to the Perceptual Table: Perceiver-Based Factors in Visual Perception)

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12 pages, 589 KiB

Open AccessEditor’s ChoiceArticle

Treatment of Rapid Progression of Myopia: Topical Atropine 0.05% and MF60 Contact Lenses

by Nir Erdinest, Maya Atar-Vardi, Naomi London, David Landau, David Smadja, Eran Pras, Itay Lavy and Yair Morad

Vision 2024, 8(1), 3; https://doi.org/10.3390/vision8010003 - 19 Jan 2024

Cited by 6 | Viewed by 3500

Abstract

This retrospective study evaluates the effectiveness of combining 0.05% atropine with MF60 contact lenses in managing rapid myopia progression in children over one year. The study involved three groups: the treatment group (TG) with 15 children (53% male, average age 12.9 ± 1.04), [...] Read more.

This retrospective study evaluates the effectiveness of combining 0.05% atropine with MF60 contact lenses in managing rapid myopia progression in children over one year. The study involved three groups: the treatment group (TG) with 15 children (53% male, average age 12.9 ± 1.04), the MF group (MF) with 12 children (50% male, average age 12.8 ± 0.8) using only MF60 lenses, and the control group (CG) with 14 children (43% male, average age 12.1 ± 0.76). Baseline myopia and axial length (AL) were similar across groups, with the TG, MF, and CG showing −4.02 ± 0.70 D, −4.18 ± 0.89 D, −3.86 ± 0.99 D, and 24.72 ± 0.73 mm, 24.98 ± 0.70 mm, 24.59 ± 1.02 mm, respectively. Prior to the study, all groups exhibited significant myopia and AL progression, with no previous myopia control management. The treatment involved daily 0.05% atropine instillation, the use of MF60 lenses and increased outdoor activity. Biannual cycloplegic refraction and slit lamp evaluations confirmed no adverse reactions. After one year, the TG showed a significant reduction in myopia and AL progression (−0.43 ± 0.46 D, p < 0.01; 0.22 ± 0.23 mm, p < 0.01), whereas the CG showed minimal change (−1.30 ± 0.43 D, p = 0.36; 0.65 ± 0.35 mm, p = 0.533). The MF group also exhibited a notable decrease (−0.74 ± 0.45 D, p < 0.01; 0.36 ± 0.23 mm). Increased outdoor activity during the treatment year did not significantly impact myopia control, suggesting its limited additional effect in this cohort. The study concludes that the combination of 0.05% atropine and peripheral defocus soft contact lenses effectively controls myopia progression in children. Full article

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