Analysis of Visual Acuity, Contrast Sensitivity and Color Perception in Multiple Sclerosis Patients

BackgroundAlzheimer’s Disease (AD) can cause degeneration in the retina and optic nerve either directly, as a result of amyloid beta deposits, or secondarily, as a result of the degradation of the visual cortex. These effects raise the possibility that tracking ophthalmologic changes in the retina can be used to assess neurodegeneration in AD. This study aimed to detect retinal changes and associated functional changes in three groups of patients consisting of AD patients with mild disease, AD patients with moderate disease and healthy controls by using non-invasive psychophysical ophthalmological tests and optical coherence tomography (OCT).MethodsWe included 39 patients with mild AD, 21 patients with moderate AD and 40 age-matched healthy controls. Both patients and controls were ophthalmologically healthy. Visual acuity, contrast sensitivity, colour perception, visual integration, and choroidal thicknesses were measured. In addition, OCT and OCT angiography (OCTA) were applied.FindingsVisual acuity, contrast sensitivity, colour perception, and visual integration were significantly lower in AD patients than in healthy controls. Compared to healthy controls, macular thinning in the central region was significant in the mild AD patients, while macular thickening in the central region was found in the moderate AD group. The analysis of macular layers revealed significant thinning of the retinal nerve fibre layer, the ganglion cell layer and the outer plexiform layer in AD patients relative to controls. Conversely, significant thickening was observed in the outer nuclear layer of the patients. However, mild AD was associated with significant thinning of the subfovea and the nasal and inferior sectors of the choroid. Significant superonasal and inferotemporal peripapillary thinning was observed in patients with moderate disease.ConclusionsThe first changes in the mild AD patients appear in the psychophysical tests and in the central macula with a decrease in the central retinal thickness. When there was a disease progression to moderate AD, psychophysical tests remained stable with respect to the decrease in mild AD, but significant thinning in the peripapillary retina and thickening in the central retina appeared. The presence of AD is best indicated based on contrast sensitivity.

Introduction: Optic neuritis (ON) is an inflammation of the optic nerve that can occur alone or in association with neurological inflammatory or infectious disorders, or local or systemic inflammatory diseases. Vision function will return to near normal in weeks or months regardless of treatment, but it will be hastened with corticosteroid treatment. Objective: To determine the clinical features of ON patients and difference of visual acuity, contrast sensitivity and color vision before and after steroid therapy.Methods: Analytical descriptive research with retrospective data collection based on medical records of patients visiting Prof. dr. I. G. N. G. Ngoerah General Hospital in 2021-2022. Statistical analysis regarding comparation of variables before and after treatment used Wilcoxon test. Results: There were 14 patients with equal percentage of males and females, 15-40 years old (64.3%), bilateral cases (57.1%), and atypical neuritis (92.9%). The chief complaint was blurred vision (57.1%) and onset was less than one week (57.1%). Baseline visual acuity log MAR 2,00±0,51, contrast sensitivity and color vision were mostly not evaluable, respectively 57.1% and 85.7%. After steroid therapy, visual acuity reached log MAR 0,93±1,05, contrast sensitivity and color vision reached normal, both 35.7%. Conclusion: The NO patients had an equal percentage of males and females, aged 15-40 years, with bilateral atypical neuritis type. There were differences in visual acuity, contrast sensitivity, and color vision before and after steroid therapy. Whereas clinical features were better after steroid therapy. Keyword: optic neuritis, visual acuity, steroid

Abstracts

Estudio longitudinal de la función visual en pacientes con esclerosis múltiple remitente-recurrente con y sin antecedentes de neuritis óptica

Purpose : To report visual acuity, contrast sensitivity and color vision prior to, 1 year after, 2 years after and 3 years after iodine-125 brachytherapy for choroidal and ciliary body melanoma (CCM).Design : Prospective interventional case series.Participants : Thirty-seven patients (37 eyes) with CCM.Methods : Patients had best-corrected Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity, Pelli-Robson contrast sensitivity and Hardy-Rand-Rittler color vision measurement; comprehensive ophthalmology examination; optical coherence tomography; and ultrasonography at baseline prior to, 1 year after, 2 years after and 3 years after I-125 brachytherapy.Main Outcome Measures : Visual acuity, contrast sensitivity and color vision prior to, 1 year after, 2 years after and 3 years after brachytherapy.Results :Nineteen (19) men and 18 women with mean age of 58 years (SD 13, range 30-78) prior to, 1 year after, 2 yearsafter and 3 years after brachytherapy had mean best-corrected visual acuity of 77 letters (20/32), 65 letters (20/50), 56letters (20/80) and 47 letters (20/125); contrast sensitivity of 30, 26, 22 and 19 letters; color vision of 26, 20, 17 and 14test figures, respectively. Decrease in visual acuity, contrast sensitivity and color vision was statistically significant frombaseline at 1 year, 2 years, and 3 years after brachytherapy. Decreased acuity at 3 years was associated with mid-choroidand macula melanoma location, ≥ 4.1 mm melanoma height, radiation maculopathy and radiation optic neuropathy.Conclusion : 1, 2 and 3 years after brachytherapy, eyes with CCM had significantly decreased visual acuity, contrast sensitivity and color vision.

Glare visual acuity and contrast sensitivity are important indicators of visual quality. Studies have shown that the glare visual acuity and contrast sensitivity in dry eye patients tend to degenerate, further affecting their quality of life. The objective of this study was to investigate the effect of notch filters on glare VA and contrast sensitivity in patients with dry eye or with dry eye syndrome. 36 subjects in the 20‒65 age group were diagnosed as having dry eye disease or perceived dry eye syndromes themselves who were included after the initial screening with the OSDI questionnaire, and one was subsequently excluded as they had undergone retinal detachment surgery. Finally, 35 subjects (14 male and 21 female) with a mean age of 40.66 ± 15.62years participated in this study. All subjects wore their habitual prescriptions and four different filter lenses (namely 480, 620, dual 480 & 620 notch filter, and FL-41 tinted lens), and measured the parameters of glare visual acuity and contrast sensitivity using CSV-1000 and sine wave contrast test (SWCT), respectively. Student t-test and Repeated measurement analysis (R-ANOVA) were utilized by using SPSS 26.0 software. A dual-wavelength 480 & 620nm optical notch filter had a significant anti-glare effect decreasing glare disabilities or discomfort, and leading to better visual quality, the same effect was also shown on a 480nm notch filter lens. All participants showed a significant difference among the baseline, three notch filters (480nm, 620nm, dual-wavelength 480 & 620nm), and FL-41 tinted lens were used on SWCT_A (1.5cpd, F = 3.054, p = 0.019) and SWCT_E (18cpd, F = 2.840, p = 0.049); but did not show statistical different on SWCT_B (3cpd, F = 0.333, p = 0.771), SWCT_C (6cpd, F = 1.779, p = 0.159), and SWCT_D (12cpd, F = 1.447, p = 0.228). The baseline showed the best visual performance on CS at a low spatial frequency (SWCT_A, 1.5cpd), any filter might reduce the contrast sensitivity at low spatial frequencies in the clinical trial, whereas 480nm notch filter showed the best effectiveness on CS at a high spatial frequency (SWCT_E, 18cpd), the FL-41 lens that also filters out the 480nm band does not achieve the same effect. Moreover, patients with dry eye or those older than 40years old preferred optical multilayer notch filters to FL-41 tinted lenses. The 480- & 620-nm dual-wavelength and 480-nm single-wavelength notch filters have the best effect on the glare visual acuity and contrast sensitivity (CS) at high spatial frequencies in dry eye patients. The 620-nm notch filter performs better in CS at low and mid-low spatial frequencies; the FL-41 tinted lens performs poorly for glare VA and CS spatial frequencies examination. Patients with glare disabilities or CS disturbance at high spatial frequencies may choose a 480-nm notch filter lens, and patients who have CS disturbance at low spatial frequencies may consider a 620-nm notch filter for the prescription.

Blue-Blocking IOLs: A Complete Review of the Literature

Objective: To identify cutpoints for visual measures at baseline and 1 month predictive of abnormal 6-month vision that could be used as eligibility criteria in a clinical trial to test potential neuroprotection or myelin repair agents in patients with optic neuritis. To determine whether moderate-to-severe dysfunction in one or more visual measures at baseline or 1 month correlates with having major vision loss at 6 months. Methods: We used the Optic Neuritis Treatment Trial database to evaluate various cutpoints for baseline and 1-month vision levels that predicted abnormal 6-month vision. For selected cutpoints, we computed a 95% CI for positive predictive value and the required sample size if the cutpoint was to be used for clinical trial eligibility. We evaluated whether the degree of visual loss at baseline, 1 month, or change in visual function from baseline to 1 month correlated with 6-month visual acuity, contrast sensitivity, or threshold visual field. Results: The best cutpoints for baseline and 1 month were visual acuity ≤ 20/50, contrast sensitivity p = 0.01). A trial could require as few as 100 subjects for an outcome variable of one or more abnormal measures. Cutpoints at 1 month were highly predictive of abnormal 6-month vision, but the proportion of patients who would be eligible for a trial would be small. Conclusion: Provided data can be used either for the clinician to counsel patients on expected visual outcome or for designing studies to test therapies that might reduce the amount of permanent optic nerve damage due to optic neuritis in high-risk patients.

Optic neuritis is an inflammatory condition affecting the optic nerve. It presents with sudden diminution of vision, also affecting colour vision, contrast sensitivity and stereoacuity. Steroids are given in optic neuritis to reduce inflammation of optic nerve. The aim of this study was to compare the visual functions in patients with optic neuritis before and after treatment with steroid therapy. This prospective study was conducted from November 2021 to October 2022 in the Department of Ophthalmology of a tertiary-level hospital. Thirty-seven eyes affected by optic neuritis of were included in the study. All the patients were given IV methylprednisolone for 3 consecutive days followed by oral prednisolone for 11 days in tapering doses. Visual functions such as visual acuity, colour vision, contrast sensitivity and stereoacuity at presentation and after treatment were compared. Among 37 eyes, 24 (64.86%) had best corrected visual acuity <1/60-perception of light at presentation, improving after six weeks with 21 (56.76%) achieving visual acuity 6/6-6/18. At presentation, only 1 (2.71%) had normal colour vision while at six weeks, 9 (24.32%) had normal colour vision. Contrast sensitivity could not be assessed in 29 (78.37%) cases at presentation due to poor vision, which reduced to 12 (32.43%) at six weeks. None had good stereoacuity at presentation; however, 6 (16.22%) had good stereoacuity after six weeks. The study showed that steroid therapy improved visual functions in patients with optic neuritis.

Visual Performance of AcrySof ReSTOR Apodized Diffractive IOL: A Prospective Comparative Trial

To compare intraocular straylight measurements and contrast sensitivity after wavefront-guided LASIK (WFG LASIK) in one eye and wavefront-guided photorefractive keratectomy (WFG PRK) in the fellow eye for myopia and myopic astigmatism correction. A prospective, randomized study of 22 eyes of 11 patients who underwent simultaneous WFG LASIK and WFG PRK (contralateral eye). Both groups were treated with the NIDEK Advanced Vision Excimer Laser System, and a microkeratome was used for flap creation in the WFG LASIK group. High and low contrast visual acuity, wavefront analysis, contrast sensitivity, and retinal straylight measurements were performed preoperatively and at 3, 6, and 12 months postoperatively. A third-generation straylight meter, C-Quant (Oculus Optikgeräte GmbH), was used for measuring intraocular straylight. Twelve months postoperatively, mean uncorrected distance visual acuity was -0.06 +/- 0.07 logMAR in the WFG LASIK group and -0.10 +/- 0.10 logMAR in the WFG PRK group. Mean preoperative intraocular straylight was 0.94 +/- 0.12 logs for the WFG LASIK group and 0.96 +/- 0.11 logs for the WFG PRK group. After 12 months, the mean straylight value was 1.01 +/- 0.1 log s for the WFG LASIK group and 0.97 +/- 0.12 log s for the WFG PRK group. No difference was found between techniques after 12 months (P = .306). No significant difference in photopic and mesopic contrast sensitivity between groups was noted. Intraocular straylight showed no statistically significant increase 1 year after WFG LASIK and WFG PRK. Higher order aberrations increased significantly after surgery for both groups. Nevertheless, WFG LASIK and WFG PRK yielded excellent visual acuity and contrast sensitivity performance without significant differences between techniques.

: The building blocks of effective sports vision are visual acuity and contrast sensitivity. Proper measurement of these spatial vision attributes is necessary for repeatability in the clinic or in the laboratory. The most repeatable method of testing visual acuity is with logMAR charts-either the Bailey-Lovie chart or the Early Treatment Diabetic Retinopathy Study chart. The Pelli-Robson and the Mars are the most repeatable contrast sensitivity tests. Athletes may or may not demonstrate superior visual acuity and contrast sensitivity compared with age-matched nonathlete populations, and the optical quality of their eyes may be similar. Dynamic visual acuity in athletes and their performance are typically superior to those of nonathletes. How these differences relate to on-field performance is not known. Other changes to the visual system because of refractive surgery or contact lens wear may increase higher order aberrations and reduce low-contrast visual acuity. The ability to improve already-normal visual acuity is unclear although contrast sensitivity can improve with fast-paced video games. Tinted contact lenses help reduce discomfort glare and speed up adaptation but do not have an appreciable effect on visual acuity and contrast sensitivity. The use of valid and repeatable visual acuity and contrast sensitivity tests is essential for measuring the differences in visual performance among athletes and nonathletes. The development of a standardized dynamic visual acuity test is needed as are well-controlled scientific studies to evaluate the benefits of sports vision training.

Visual Impairment in Elderly Patients Receiving Long-term Hemodialysis

To determine the association between performance on selected tasks of everyday life and impairment in visual acuity and contrast sensitivity. Visual acuity and contrast sensitivity were obtained on a population-based sample of 2520 older African American and white subjects. Performance was assessed on mobility, daily activities with a strong visual component, and visually intensive tasks. Disability was defined as performance less than 1 SD below the mean. Receiver operating characteristic curve analyses were used to evaluate the sensitivity and specificity of thresholds in acuity and contrast loss for determining disability. Both visual acuity and contrast sensitivity loss were associated with decrements in function. The relationship of function to the vision measures was mostly linear, therefore, receiver operating characteristic curves were not helpful in identifying cutoff points for predicting disabilities. For mobility tasks, most persons were not disabled until they had significant acuity loss (logMAR visual acuity >1.0 or <20/200) or contrast sensitivity loss (0.9 log units contrast sensitivity). For heavily visually intensive tasks, like reading, visual acuity worse than 0.2 logMAR (20/30) or contrast sensitivity worse than 1.4 log units was disabling. Both contrast sensitivity and visual acuity loss contribute independently to deficits in performance on everyday tasks. Defining disability as deficits in performance relative to a population, it is possible to identify visual acuity and contrast loss where most are disabled. However, the cutoff points depend on the task, suggesting that defining disability using a single threshold for visual acuity or contrast sensitivity loss is arbitrary.

We evaluated the effect of ginkgo biloba extract on visual field defect and contrast sensitivity in a Chinese cohort with normal tension glaucoma. In this prospective, randomized, placebo-controlled crossover study, patients newly diagnosed with normal tension glaucoma, either in a tertiary glaucoma clinic (n = 5) or in a cohort undergoing routine general physical examinations in a primary care clinic (n = 30), underwent two 4-week phases of treatment, separated by a washout period of 8 weeks. Randomization determined whether ginkgo biloba extract (40 mg, 3 times per day) or placebo (identical-appearing tablets) was received first. Primary outcomes were change in contrast sensitivity and mean deviation on 24-2 SITA standard visual field testing, while secondary outcomes included IOP and self-reported adverse events. A total of 35 patients with mean age 63.7 (6.5) years were randomized to the ginkgo biloba extract-placebo (n = 18) or the placebo-ginkgo biloba extract (n = 17) sequence. A total of 28 patients (80.0%, 14 in each group) who completed testing did not differ at baseline in age, sex, visual field mean deviation, contrast sensitivity, IOP, or blood pressure. Changes in visual field and contrast sensitivity did not differ by treatment received or sequence (P > 0.2 for all). Power to have detected a difference in mean defect as large as previously reported was 80%. In contrast to some previous reports, ginkgo biloba extract treatment had no effect on mean defect or contrast sensitivity in this group of normal tension glaucoma patients. (http://www.chictr.org number, ChiCTR-TRC-08000724).