Search Results (1,859)

Background: Ocular trauma is a significant cause of monocular visual impairment and potential psychological morbidity. This study aimed to determine the prevalence of anxiety, depression, and post-traumatic stress disorder (PTSD) in patients with mechanical ocular trauma and to investigate the predictive value of baseline clinical characteristics, specifically initial visual acuity. Methods: This retrospective study included 58 adult patients treated for mechanical ocular trauma. Sociodemographic data, injury mechanisms, and clinical variables, including initial visual acuity (LogMAR), ocular trauma score, and number of ocular surgeries, were analyzed. Psychological status was assessed using the Beck Depression Inventory, Beck Anxiety Inventory, and a PTSD checklist. Multivariate logistic regression and correlation analyses were performed to identify predictors of severe PTSD. Results: The cohort was predominantly male (86.2%) with a mean age of 42.5 years. Severe or very severe PTSD symptoms were identified in 35.1% of patients. Analysis revealed a significant positive correlation between initial visual acuity and PTSD scores (r = 0.273, p = 0.038). In the logistic regression model, initial visual acuity (LogMAR) demonstrated the highest odds ratio for severe PTSD in the multivariable model; however, this association did not reach statistical significance (OR = 2.164, 95% CI: 0.720–6.508, p = 0.169) and should therefore be interpreted as an exploratory trend rather than a confirmed predictor. Conclusions: Greater visual loss at the time of injury showed the strongest, although non-significant, association with subsequent PTSD symptom severity. These findings suggest that patients with severe initial visual impairment following ocular trauma may benefit from early psychological screening and timely mental health referral, warranting confirmation in larger prospective studies. Full article

Background: Dynamic visual acuity (DVA) is functionally distinct from static visual acuity (SVA), though SVA is often used clinically as a reference. Methods: To identify EEG biomarkers for DVA, we presented participants with a high-contrast checkerboard moving horizontally at speeds ranging from 4°/s to 30°/s, engaging motion-sensitive pathways while preserving spatial detail. Six EEG features—ERPs (N200 and P300), TRCA, Hjorth activity, mean curve length, and Tsallis entropy—were extracted from eight occipito-parietal channels and evaluated for speed sensitivity. Results: Hjorth activity and Tsallis entropy showed consistent monotonic trends with respect to speed. Hjorth activity exhibited the strongest univariate correlation (r = 0.88, p < 0.05). In a Lasso regression model using all speed-sensitive features, the predicted speed correlated with actual speed at r = 0.588, with TRCA-weighted features retained for their multivariate contribution. Notably, Hjorth activity peaked at PO7/PO8 (3.558 and 1.478 µV² at 30°/s), aligning with V5/MT+ activation. Conclusion: Given its high sensitivity, neuroanatomical plausibility, and simplicity, Hjorth activity is recommended as a primary candidate for EEG-based DVA biomarker development. This study provides a foundation for objective neurophysiological evaluation of dynamic vision. Full article

Bivalves possess a diverse array of photoreceptive organs that are significant for their evolutionary success and systematic classification. Giant clams are the largest bivalve mollusks, with mantle tissue permanently extended in nature to maintain symbiosis with zooxanthellae and perceive environmental cues. Eyes serve as critical sensory organs for these organisms, yet the structural and functional characteristics of tridacnine eyes remain inadequately understood. This study systematically investigated the ocular traits and visual resolution of three ecologically distinct giant clam species (Tridacna crocea, T. squamosa, T. maxima) using morphometric analysis, hematoxylin-eosin (HE) staining, transmission electron microscopy (TEM), and grating stimulation assays. Significant interspecific differences were observed in eye count, diameter, and pupil-to-eye ratio (PER): T. maxima exhibited the highest mean eye count (221 ± 8), T. squamosa the largest mean eye diameter (0.490 ± 0.082 mm), and T. crocea the highest mean PER (0.363 ± 0.041). Eyes were numerically symmetric on the left and right mantles but positionally asymmetric, showing random distribution patterns along the mantle margin without fixed corresponding locations across species. All three species possessed typical pinhole eyes lacking lenses and retinas, primarily composed of filler cells, receptor cells, and sparse neurons, with symbiotic zooxanthellae distributed in the surrounding mantle tissue. Grating stimulation assays revealed resolvable stripe periods of 5.82–11.64° (T. crocea), 8.62–13.16° (T. squamosa), and 10.15–12.26° (T. maxima), confirming T. crocea as the species with the highest visual resolution. These ocular variations are inferred to reflect adaptive evolution driven by ecological niches and habitat-specific factors (water depth or light intensity), while the simplified pinhole morphology is consistent with their sedentary lifestyle and metabolic dependence on symbiotic zooxanthellae. These ocular variations provide potential morphological markers for the systematic classification of Tridacninae and offer valuable insights for researchers studying the evolutionary plasticity of bivalve visual systems. Full article

Background: To develop and validate an automated visual acuity (VA) testing system integrating artificial intelligence (AI)–driven speech and image recognition technologies, enabling self-administered, clinic-based VA assessment; Methods: The system incorporated a fine-tuned Whisper speech-recognition model with Silero voice activity detection and pose estimation through facial landmark and ArUco marker detection. A state-driven interface guided users through sequential testing with and without a pinhole. Speech recognition was enhanced using a local Singaporean English dataset. Laboratory validation assessed speech and pose recognition performance, while clinical validation compared automated and manual VA testing at a tertiary eye clinic; Results: The fine-tuned model reduced word error rates from 17.83% to 9.81% for letters and 2.76% to 1.97% for numbers. Pose detection accurately identified valid occluder states. Among 72 participants (144 eyes), automated unaided VA showed good agreement with manual VA (ICC = 0.77, 95% CI 0.62–0.85), while pinhole VA demonstrated moderate agreement (ICC = 0.63, 95% CI 0.25–0.83). Automated testing took longer (132.1 ± 47.5 s vs. 97.1 ± 47.8 s; p < 0.001), but user experience remained positive (mean Likert scale score 4.3 ± 0.8); Conclusions: The AI-based automated VA system delivered accurate, reliable, and user-friendly performance, supporting its feasibility for clinical implementation. Full article

Pathologic myopia has become a major global cause of blindness, making timely surgical management for myopic traction maculopathy (MTM) increasingly important. This study aimed to identify prognostic factors associated with functional and anatomical outcomes following surgery for MTM and to determine the optimal timing for intervention. This retrospective study included 33 eyes from 28 patients with MTM without full-thickness macular hole who underwent pars plana vitrectomy with internal limiting membrane peeling and gas tamponade. Better preoperative best-corrected visual acuity (BCVA) and lower foveal height were associated with better postoperative BCVA, whereas longer axial length, higher MTM, and higher Atrophy–Traction–Neovascularization (ATN) classification grade were correlated with thinner postoperative central foveal thickness. Foveal detachment (FD), ellipsoid zone (EZ) disruption, and advanced MTM grade were associated with poorer functional and anatomical outcomes. Postoperative visual outcomes should be interpreted with caution, as they may have been influenced by lens-related factors, including combined cataract surgery, post-vitrectomy cataract progression, and posterior capsule opacity. Nonetheless, consistent anatomical improvement was observed, supporting early surgical consideration in eyes with MTM showing progressive macular traction or EZ disruption, even in the absence of FD. These findings highlight the importance of serial OCT monitoring and individualized surgical timing based on preoperative assessments. Full article

Background: Novel approaches such as video games represent a promising tool in increasing visual acuity (VA) in children with amblyopia. The aim was to determine the effectiveness of video game-based interventions (VGBIs) in increasing VA in children with amblyopia. Secondarily, to estimate safety, satisfaction, and compliance with VGBIs. Methods: According to the PRISMA guidelines, a systematic review with meta-analysis (SRMA) was conducted, including studies retrieved from PubMed Medline, SCOPUS, WOS, CINAHL, and PEDro without publication date and language restrictions. We included randomized controlled trials (RCTs) and pilot RCTs, comprising children with amblyopia, that compared the effectiveness of VBGI vs. others in improving VA. Pooled effect was estimated with the Cohen’s standardized mean difference (SMD) and its 95% confidence interval (95%CI). Results: Twenty-one RCTs, providing data from 1515 children, were included. VGBIs are effective (SMD = 0.38; 95%CI 0.08 to 0.68; p = 0.013) in increasing VA. Subgroup analyses suggested that non-immersive video games are the most appropriate for improving VA (SMD = 0.35; 95%CI 0.02 to 0.68; p = 0.039) and that VGBI is more effective than patching therapy, especially in combination with patching therapy (SMD = 0.63; 95%CI 0.29 to 0.97; p < 0.001). Conclusion: This SRMA, including a large number of RCTs to date, demonstrates that VGBI is effective in improving VA in children with amblyopia. Full article

Background: This study evaluated morphological and functional differences among eyes with retinitis pigmentosa (RP) classified according to fundus autofluorescence (FAF) patterns. Methods: A total of 146 eyes from 73 patients with RP were analysed. Based on FAF imaging, eyes were classified as having regular hyperautofluorescent rings (n = 23), irregular rings (n = 76), or absent rings (n = 47). Participants underwent best-corrected visual acuity (BCVA), contrast sensitivity, 10–2 and 30–2 static perimetry, multifocal electroretinography (mfERG), and optical coherence tomography (OCT). FAF morphometrics included ring diameters and area. Results: Eyes with a regular FAF ring demonstrated significantly better visual function than those with irregular or absent rings, including higher BCVA (p < 0.001 and p = 0.001) and greater contrast sensitivity (both p < 0.001). The mfERG amplitude density in the first ring was higher in regular than irregular FAF patterns (p = 0.034). Eyes with irregular FAF showed more advanced visual field loss, with lower mean deviation on 10–2 (p = 0.042) and 30–2 perimetry (p = 0.027). In the regular-ring group, the ellipsoid zone was predominantly intact (p = 0.012). The hyperautofluorescent ring area correlated positively with mfERG amplitude density in the first and second rings (Rs = +0.573, p = 0.016; Rs = +0.736, p = 0.001) and with macular volume (Rs = +0.667, p = 0.003). Conclusions: FAF patterns reflect central retinal functional and structural impairment in RP. Therefore, incorporating FAF imaging into the diagnostic algorithm is valuable for monitoring disease progression. Full article

Clinical Relevance and Background: Motion sickness is a common manifestation of autonomic dysfunction. Increasingly induced by modern technology, such as virtual reality (VR), it presents a pressing challenge that warrants investigation. However, the relationship between binocular function, visual perception, and motion sickness remains largely unexplored. Therefore, this study investigated the correlations between binocular visual functions, visual perception, and motion sickness susceptibility in adults. Methods: Adults aged 20 to 25 years were recruited. Based on a background and motion sickness susceptibility questionnaire, participants were divided into two groups: the Sick Tendency (ST) group (n = 21) and the Normal group (n = 33). Clinical assessments included habitual distance prescription and visual acuity (VA), phoria, fixation disparity (FD), positive/negative fusional vergence (PFV/NFV), vertical fusional vergence (VFV), positive/negative relative accommodation (PRA/NRA), accommodative facility (AF), vergence facility (VF), stereopsis, contrast sensitivity (CS), near point of convergence (NPC), and near point of accommodation (NPA). Additionally, motor-free visual perception test (MVPT), peripheral awareness (PA), and body balance (center of pressure) were assessed. Results: The ST group exhibited significantly higher distance NFV, distance VFV, and near PFV. Conversely, their NPA, stereopsis, and body balance (center of pressure) were significantly poorer than those of the Normal group. These deficits may be attributed to the accommodation–convergence conflict. Conclusions: Motion sickness susceptibility is closely associated with specific binocular functions. Individuals susceptible to motion sickness exhibit poorer postural stability, likely due to diminished stereopsis and accommodative amplitude (NPA). Future research should further investigate the underlying mechanisms and their clinical implications. Full article

Background/Objectives: Refractory macular holes (MHs) that persist after conventional internal limiting membrane (ILM) peeling pose a significant surgical challenge. In this study, we analyzed the anatomical and functional outcomes of epiretinal human amniotic membrane (hAM) transplantation in patients with MHs. Methods: This retrospective study included 10 eyes of 10 patients with refractory MHs. All patients underwent 25-gauge pars plana vitrectomy, epiretinal cryopreserved hAM transplantation, and C3F8 gas tamponade. The large hAM graft was placed over the macula with the stromal side facing the retina. Preoperative and postoperative best-corrected visual acuity (BCVA), optical coherence tomography (OCT) findings, and MH dimensions were recorded. Results: The mean follow-up period was 7 months (range: 3–14 months). The mean preoperative minimum linear diameter and base diameter of the MHs were 715 ± 212 μm and 1114 ± 258 μm, respectively. Anatomical closure was achieved in all patients (100%). Postoperative OCT revealed rearrangement of the inner and other retinal layers in 7 out of 10 patients (70%), with partial restoration of the outer retinal layers. The mean logMAR BCVA improved significantly from 1.60 ± 0.37 preoperatively to 1.00 ± 0.45 postoperatively (p < 0.001). No graft dislocation, rejection, or other significant complications were observed. Conclusions: Our preliminary results suggest that epiretinal human amniotic membrane transplantation is a feasible and promising surgical technique for achieving anatomical closure and functional improvement in refractory macular holes in which conventional ILM peeling has failed. Full article

Background/Objectives: Enhanced monofocal and non-diffractive extended depth-of-focus (EDoF) intraocular lenses (IOLs) aim to improve intermediate vision while maintaining contrast sensitivity. However, direct comparative evidence under both photopic and mesopic conditions remains limited. This study prospectively compared the visual performance of two enhanced monofocal IOLs (Tecnis^® Eyhance^™ and ISOPure^®) and one non-diffractive EDoF IOL (AcrySof^® IQ Vivity^™). Methods: Sixty patients undergoing bilateral cataract surgery were implanted with one of three IOL groups (n = 20 each). Patients were assigned to one of three IOL groups based on preoperative consultation and clinical indications. One month postoperatively, monocular corrected distance (CDVA), distance-corrected intermediate (DCIVA), and near visual acuity (DCNVA) were measured under photopic and mesopic conditions. Photopic defocus curves, contrast sensitivity under photopic and mesopic conditions and correlation between pupil diameter and visual acuities were also assessed. Results: Baseline characteristics were comparable among groups. Under photopic conditions, Vivity^™ achieved significantly better UDVA, DCIVA and DCNVA than both Eyhance^™ and ISOPure^®. Under mesopic conditions, distance acuity did not differ significantly, but Vivity™ showed superior DCIVA and DCNVA. Defocus curves demonstrated a broader functional range of vision with Vivity™, while Eyhance^™ and ISOPure^® showed nearly overlapping profiles. Contrast sensitivity was similar among all IOLs under both lighting conditions, with no statistically significant differences. Conclusions: The non-diffractive EDoF AcrySof^® IQ Vivity^™ provided a wider and more functional depth-of-focus than the enhanced monofocal lenses evaluated, without compromising contrast sensitivity. Eyhance^™ and ISOPure^® offered comparable performance, with good distance vision and modest depth-of-focus extension. All three IOLs maintained CS levels comparable to those typically reported for standard monofocal IOLs under both photopic and mesopic illumination, indicating no clinically relevant contrast penalty. Full article

Background/Objectives: Macular Telangiectasia Type 2 (MacTel type 2) is a rare, progressive retinal disease that can lead to central vision loss. Optical coherence tomography (OCT) plays a crucial role in the early diagnosis, monitoring, and prognostic assessment of this condition. This narrative review aims to summarize the clinical features, OCT findings, and current management strategies for MacTel type 2. Methods: A literature search of PubMed, MEDLINE, and Google Scholar was performed for articles published from October 1993 to September 2025 using keywords related to MacTel type 2, OCT, clinical features, and treatment. All relevant clinical studies, including observational studies, clinical trials, and case series, were considered. The literature was screened independently by two authors, and a total of 69 articles were included. Results: Characteristic OCT findings include foveal cavitation, hyperreflective middle retinal layers, inner and outer retinal cavities, ellipsoid zone disruption, and retinal pigment clumps. Central macular thickness is consistently reduced, and structural biomarkers identified on OCT correlate with visual acuity decline. Treatment strategies vary by disease stage: non-proliferative MacTel type 2 currently has no universally effective therapy, although neuroprotective interventions such as ciliary neurotrophic factor (CNTF) show promising results. Proliferative MacTel type 2 is primarily managed with anti-vascular endothelial growth factor therapy (anti-VEGF), demonstrating functional and anatomical improvements. Conclusions: OCT provides essential structural evaluation for monitoring MacTel type 2, while treatment approaches remain stage-dependent. Emerging therapies, including CNTF implants and novel anti-VEGF agents, hold potential for improving outcomes. Full article

Background/Objectives: Hydroxychloroquine (HCQ) is used to manage various autoimmune diseases, including systemic lupus erythematosus. The prolonged use of HCQ is associated with retinopathy and irreversible visual loss due to retinal toxicity. Despite adherence to dosage regimens, patients may develop functional rather than structural changes, without detectable abnormalities on routine examination using visual acuity and optical coherence tomography (OCT). The study aimed to detect early signs of retinopathy in patients with autoimmune diseases treated with HCQ. Methods: This cross-sectional study included patients (n = 36) with autoimmune diseases who were treated with HCQ. The control group (n = 35) comprised healthy volunteers matched for age and sex. All participants were screened using colour vision tests (Ishihara, Konan ColourDX high definition [HD]), and retinal thickness was evaluated using OCT. Results: Our findings suggest a significant reduction in the contrast threshold of the L and M-cone photoreceptors compared with that of the control using Konan ColourDX HD. The OCT measurements revealed no statistically significant difference in retinal thickness between patients and controls; however, the contrast sensitivity test showed a significant reduction at all spatial frequencies (p < 0.0001). Conclusions: The current study suggests that the Konan ColourDX cone contrast test HD and contrast sensitivity testing may be valuable for periodic monitoring of patients receiving HCQ, potentially enabling earlier detection of toxicity. However, longitudinal studies with larger cohorts are needed to confirm these findings and to further establish the clinical value of these functional visual tests. Full article

Background/Objectives: The purpose of this study was to evaluate the efficacy and safety of oral eplerenone in patients with acute and chronic central serous chorioretinopathy (CSCR). Methods: In this prospective study, 43 patients with CSCR and subretinal fluid on optical coherence tomography (OCT) at baseline were divided either to oral eplerenone (n = 23) or observation (n = 20). All subjects underwent best-corrected visual acuity (BCVA) measurement, OCT, and fluorescein angiography (FA) at baseline. The changes in BCVA and subretinal resolution (SRF) were examined at 1, 6, and 12 months after the initiation of treatment. Potential adverse events were recorded. Results: At month 6, SRF resolution was observed in 78.3% and 45% of the patients in the eplerenone and control groups, respectively (p = 0.024). However, there was a recurrence of fluid in three patients in the eplerenone group and in four patients in the control group. Therefore, at month 12, 65.2% of the patients in the eplerenone group and 25% in the control group had SRF resolution (p = 0.008). There was a statistically significant improvement in BCVA at 6 months (p < 0.001) and 12 months (p < 0.001) in the eplerenone group, while in the control group, there was an improvement in BCVA at 6 months (p = 0.079) and 12 months (p = 0.259), which did not reach statistical significance. Regarding adverse events, no ocular nor systemic adverse events were reported during the follow-up period, apart from dry mouth in 7 out of 23 patients (30.4%) taking eplerenone. Conclusions: Oral eplerenone was found to be a safe and effective treatment alternative for the management of CSCR in both acute and chronic cases, providing SRF resolution in approximately 65% of patients with significant improvement in visual acuity at the 12^th month of follow-up. Full article

Background: The implantable miniature telescope is used to provide functional vision for patients with advanced AMD. However, despite the considerable cost of the device, there are strict criteria to be met for this procedure, since the patients require challenging neuroadaptation afterward, which sometimes fails and leads to the necessity of device explantation. Visual outcomes also depend on the stability of the microtelescope; tilts cause unwanted optical aberrations and can lead to device luxation, with sight-threatening complications. Case report: This case presents a novel technique for fixing the ophthalmic telescope device SING-IMT™. A 76-year-old female with pre-operative visual acuity of 15 letters on the ETDRS scale underwent surgery on her left eye. The superior haptic was fixed at the 12 o’clock position with a Prolene 5-0 suture, achieving good postoperative stability. The implant was stable throughout the entire observation period. Conclusions: Implant stability is crucial for maximizing visual potential in patients with advanced AMD selected for the procedure, since visual acuity in the peripheral retina, where the perceived image eventually lands, is much lower than the macula. Therefore, there is a need to standardize surgical approaches and use objective follow-up measures to assess long-term patient satisfaction. Full article

Background: Minimally invasive glaucoma surgery, often performed with phacoemulsification (PHACO-MIGS), for the management of primary open angle glaucoma (POAG), has good clinical outcomes and safety profiles. However, few studies have comprehensively evaluated the impact of PHACO-MIGS on patients’ quality of life (QoL). We determined the post-operative effectiveness of PHACO-MIGS on glaucoma-specific QoL domains in mild–moderate POAG patients. Methods: In this prospective study, adults aged ≥ 21 years with mild–moderate POAG in one eye scheduled for PHACO-MIGS at the Singapore National Eye Centre were administered a digital patient-reported outcome measure (PROM) that utilizes computerized adaptive testing (CAT) to precisely estimate glaucoma-specific QoL across 12 different domains (GlauCAT^TM), pre-surgery and at 6 months post-surgery. The 12 domains included the following: Visual Symptoms (VSs), Ocular Comfort Symptoms (OSs), Emotional (EM), Activity Limitation (AL), Driving (DV), Lighting (LT), Mobility (MB), Treatment Convenience (TCV), Concerns (CNs), Social (SC), General Convenience (GCV), and Economic (EC). Clinical variables collected included intraocular pressure (IOP), better eye visual acuity (VA), visual field deficit (VFD) and number of glaucoma drops prescribed. Linear mixed models were utilized to determine the within-group changes in each domain, adjusted for relevant clinical, treatment and sociodemographic variables. Results: Of the 83 patients (mean age ± SD: 70.84 ± 6.70 years; 65.1% male; 90.4% Chinese), 61 (73.5%) underwent PHACO-MIGS with Hydrus^® Microstent, and 22 (26.5%) with iStent^® inject. Mean (SD) improvements in VA and IOP were observed post-surgery (0.11 [0.15] LogMAR units and 1.35 [4.20] mmHg, respectively), while VFD and the average number of anti-glaucoma medications prescribed decreased by 0.90 (2.97) dB and 1.30 (0.11) drops (all p < 0.05). Compared to pre-operative scores, four GlauCAT^TM domains [VSs (13.04%, p < 0.001; ES: 0.84), OSs (6.42%, p < 0.001; ES: 0.52), CNs (7.53%, p = 0.002; ES: 0.51), and GCV (6.34%, p = 0.004; ES: 0.45)] showed significant improvements post-surgery. The improvements across these four domains were driven primarily by a reduction in IOP and improvements in VA. Conclusions: Using a novel and AI-driven QoL PROM, we found significant post-operative improvements in Visual and Ocular Comfort Symptoms, Convenience, and Concerns in patients with POAG undergoing combined PHACO-MIGS, driven by improvements in IOP and VA post-surgery. Full article