EFFECT OF METHOTREXATE THERAPY ON VISUAL FUNCTIONS

Impact of visual function on computer task accuracy and reaction time in a cohort of patients with age-related macular degeneration

Background: Effects of pressure changes especially by long term stay in high altitude area are well known but effect of high atmospheric pressure on ocular tissue is not studied in detail. This study intends to find out the effect of long term exposure to high pressure due to diving on certain parameters of ocular functions Material and Methods: Single centre study performed during 2010–11, for a group of retired naval divers (actively diving) (52 eyes) and a control group of non-divers (retired surface naval personal) (52 eyes). Both groups were matched for age, sex baseline visual status and various parameter related to diving and their detailed ophthalmologic examination was carried out which consisted of testing of visual acuity, IOP, contrast sensitivity, color vision and visual fields. Results: Mean IOP was higher in the diver group (Diver group: 17.04 mm Hg, Control group: 14.81 mm Hg,p > 0.05) and it was statistically significant. There was a high frequency of red-green axis color vision defects (30.7 %) in the diver group. Visual field assessment also showed some difference in both groups but no conclusive pattern could be determined. No significant difference in visual acuity and contrast sensitivity were found between the two groups. Conclusions: There is a definite effect of long term diving on ocular tissue and visual functions. Mean IOP was found high in the diving group and color vision defects were also found more commonly in divers group though no significant difference in visual acuity and contrast sensitivity was found between the two groups.

目的 应用计算机图像分析软件评价后发性白内障(posterior capsule opacification,PCO)的形态,以探讨不同类型、部位PCO对最佳矫正视力(best corrected visual acuity,BCVA)、对比敏感度(contrast sensitivity,CS)和眩光敏感度glare sensitivity,GS)的影响.方法 收集拟行激光后囊切开术的PCO患者61例(67眼),充分散瞳,行详细眼科检查后,应用裂隙灯照相获取PCO后照法照片,使用PCO计算机分析软件(FOCOman软件)对其进行形态学分析.同时分别测量所有患者激光后囊切开术术前及术后1周BCVA、CS、GS.分析不同类型、不同部位PCO对BCVA、CS、GS的影响.结果 珍珠型PCO的BCVA、各频段CS和CS均低于纤维型PCO,且两者之间的差异有统计学意义(P<0.05).其中,4.0 mm珍珠型PCO在低、中频段CS和中频段GS均低于中央2.0 mm珍珠型PCO,差异有统计学意义(P<0.05);中央2.0 mm纤维型PCO在中、高频段CS和低、中频段GS均低于中央4.0 mm纤维型PCO,差异有统计学意义(P<0.05).中央2.0 mm珍珠型PCO时BCVA的影响最为显著:中央4.0 mm珍珠型PC0对CS和GS的影响最为显著.结论 珍珠型PCO对BCVA、各频段CS和GS的彩响大于纤维型PCO.珍珠型PCO在中央4.0 mm区对视功能的影响大于中央2.0 mm区:纤维型PCO在中央2.0 mm区对视功能的影响大于中央4.0 mm区。

To determine the role of vision and visual attention factors in automobile crash involvement. Drivers aged 65 to 84 years were identified during the baseline interview (1993-1995) of the Salisbury Eye Evaluation (SEE) Study. Crash involvement through December 1997 was determined from Maryland State motor vehicle records. Vision tests at baseline included distance acuity at normal and low luminance, contrast sensitivity, glare sensitivity, stereoacuity, and visual fields. Visual attention was evaluated with the Useful Field of View Test (UFOV; Visual Awareness, Chicago, IL). Survival analysis was used to determine the relative risk of a crash as a function of demographic variables, miles driven, vision, and visual attention. One hundred twenty (6.7%) of the 1801 drivers were involved in a crash during the observation interval. Glare sensitivity and binocular field loss were significant predictors of crash involvement (P < 0.05). For those with moderate or better vision (<3 letters for glare sensitivity and <20 points missed for binocular visual fields) increased glare sensitivity or reduced visual fields were, paradoxically, associated with a reduction in crash risk, whereas for those with poorer levels of vision, increased glare sensitivity or reduced visual fields were associated with increased crash risk. Worse UFOV score was associated with increased crash risk. Glare sensitivity, visual field loss, and UFOV were significant predictors of crash involvement. Acuity, contrast sensitivity, and stereoacuity were not associated with crashes. These results suggest that current vision screening for drivers' licensure, based primarily on visual acuity, may miss important aspects of visual impairment.

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

The visual acuity of the patient with ethambutol optic neuropathy will recover within 3 to 4 months after discontinuing the drug. We studied the extent of the recovery of other visual functions. Thirty-six axial type ethambutol optic neuropathy patients, who visited our neuro-ophthalmology clinic from January, 1990, to December, 1993, were included in this study. Fifteen patients (29 eyes) regained their visual acuity to better than 1.0. The average follow-up period following the recovery is 21.7 months. Pattern reversal VEP, Farnsworth-Munsell 100-Hue color vision test, critical flicker frequency (CFF), visual field perimetry, contrast sensitivity and edge-light pupil cycle time were assessed for every affected eye. Latency (P100) of visually evoked potential was delayed in 34.5% (10/29) of eyes. In color vision, 48.3% (14/29) of eyes had deutan or tritan defect. An abnormality of red CFF with value lower than 31 Hz was revealed 51.7% (15/29) eyes. In the visual field, 58.6% (17/29) of eyes had paracentral scotoma, arcuate scotoma, or enlargement of physiologic blind spot. Contrast sensitivity was depressed in 62.1% (18/29) of eyes, mainly at middle and low spatial frequency. Pupil cycle time was prolonged in 72.4% (21/29) of eyes. Aside from visual acuity, other visual functions of the recovered ethambutol optic neuropathy patients were incomplete. The extent of recovery of the visual function is as follows: visual acuity-VEPs-color sense-CFF-visual field-contrast sensitivity-pupil cycle time.

The aim of the present study was to evaluate whether Zen meditation (a mindfulness-based practice) stimulates visual function and increases retinal and retinal nerve fiber layer (RNFL) thickness. This cross-sectional controlled study included 36 eyes of 18 meditators and 76 eyes of 38 age- and sex-matched healthy non-meditators. The average response of both eyes in each subject was analyzed. All subjects underwent evaluation of high and low contrast visual acuity (using ETDRS charts), contrast sensitivity vision (CSV) using the Pelli Robson chart and CSV 1000E test, color vision (using the Farnsworth and L’Anthony desaturated D15 color tests), stereoscopic vision using the TNO test, and retinal and RNFL thickness using optical coherence tomography (OCT). Differences in visual function and RNFL thickness were compared between groups. Our results indicated that meditators exhibited significantly better visual acuity with the three contrast levels used and significantly better contrast sensitivity vision (CSV 1000E) than healthy non-meditators (p ≤ 0.05). Retinal and RNFL structural measurements did not differ significantly between groups. Ganglion cell layer thickness was moderately correlated with visual acuity, CSV, color vision, and stereoscopic vision (p ≤ 0.05; r > 0.6). In conclusion, visual function was enhanced in meditators without significant alterations in the retinal morphologic structure. Further studies are needed to determine whether there is a causal association between mindfulness and visual function improvement.

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.

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Purpose. To compare contrast sensitivity, acquired color vision deficiency, and reading ability in patients with glaucoma at different stages of the disease and to establish correlations between visual field parameters and visual function scores. Methods. This prospective cross-sectional study included 121 glaucoma patients. Subjects with a diagnosis of chronic open angle glaucoma were recruited and classified according to Hodapp-Parrish-Anderson criteria. Patients with severe visual field defects were excluded because they were older, which could bias the interpretation of visual function tests. Contrast sensitivity was measured using the Pelli-Robson Chart and the CSV1000E test. Chromatic vision was evaluated using the Farnsworth-panel D15 and the L'Anthony D15 tests of Vision Color Recorder software. Reading ability was measured using Radner-Vissum test. Results. Contrast sensitivity (with photopic and mesopic luminance with glare) differed significantly between patients with early and moderate visual field defects (p < 0.05). Reading ability scores and results of the chromatic vision tests did not differ significantly between the two groups. Significant and moderate Spearman correlations between visual field indexes and contrast sensitivity tests were detected. Conclusions. Contrast sensitivity was significantly worse in patients with moderate glaucoma compared to those with early-stage glaucoma. Evaluation of visual function in clinical practice provides important information to address a glaucoma patient's vision complaints.

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.

Optic nerve sheath fenestration for idiopathic intracranial hypertension: A seven year review of visual outcomes in a tertiary centre

Growing evidence emphasizes the importance of xanthophyll carotenoids and omega-3 fatty acids in eye health. However, the beneficial effects of such supplementation have not been thoroughly discussed among adults with high screen exposure. Current trial evidence on lutein bioavailability is contradictory, and the interactions of dietary intervention with host-related factors remain elusive. This study aims to investigate the comparative effectiveness of supplementation with macular xanthophylls and omega-3 fatty acids on macular pigment optical density (MPOD) and visual function, access the bioavailability of free lutein and lutein ester, and explore the complex interplay between genetic variations, intestinal microbiota, and the dietary intervention in Chinese adults with long-term exposure to digital devices. The Lutein, Zeaxanthin, and Omega-3 (LZO) clinical trial is a 24-week multicenter, randomized, double-blind, placebo-controlled trial of 600 participants recruited from research centers, universities, and communities. Individuals are eligible to participate if they are aged over 18 years and use digital devices for over 8 h daily in the last 2 years, and will be randomized to six arms. A total of three visits will be scheduled at baseline, 12 and 24 weeks. The primary outcome is the change in MPOD over the 24-week intervention. The secondary outcomes are changes in visual function (visual acuity, best-corrected visual acuity, contrast and glare sensitivity, critical flicker fusion, reaction time, visuognosis persistence, symptoms and signs of dry eye, retinal thickness, and optical quality), and changes in serum lutein and zeaxanthin concentrations, and erythrocyte membrane omega-3 fatty acids. Genetic variations will be determined using genome-wide genotyping at baseline. 16S rRNA gene sequencing will be utilized to assess microbiome compositional changes before and after intervention. The trial is anticipated to establish early interventions to prevent photochemical ocular damage and delay the onset of vision impairment in young adults with long-term repeated exposure to screen-based electronic devices, and provide valuable insights for the development of precision nutrition strategies for maintaining eye health. www.clinicaltrials.in.th, Identifier, TCTR20220904002.

Standards for building elements recommend a minimum luminance contrast of 30%. The basis of this value and the metric originally used is not known. To begin to provide an evidence base for the specification of minimum contrast in building elements. Subjects with and without a vision impairment were characterized by visual acuity, contrast sensitivity, visual fields and color vision. On an iPad they rated the visibility, as a function of contrast, of simulated door frames, door handles, light switches and stair nosings as "not visible at all", "poorly visible", "easily visible" and "extremely easily visible". The contrasts for each level of visibility were highly correlated with visual acuity and contrast sensitivity. A principal component analysis also verified the importance of visual acuity, contrast sensitivity and visual fields in rating visibility of simulations of building elements. The required contrast for door handles, light switches and stair nosings to attain the same ratings of visibility were very similar but less contrast was required for door frames. 30% Michelson contrast for building elements renders building elements only poorly visible for those with severe vision impairments. 65% luminance contrast is necessary for all elements to be "easily visible". Some increase (not a decrease) on the present 30% requirement and encouragement to exceed this requirement would seem appropriate. The use of simulated objects facilitates a systematic examination of the effect of contrast, but the applicability of the results to real-life remains to be demonstrated.

To evaluate the clinical profile, response to dexamethasone treatment and visual function outcome in Indian patients with acute optic neuritis. We conducted an observational study of patients with acute optic neuritis who were treated with intravenous dexamethasone (100 mg in 250 ml of 5% dextrose over 1-2 hours daily, for three consecutive days) and had completed at least two years of follow-up. Parameters assessed included visual acuity, contrast sensitivity, color vision, visual fields, relative afferent pupillary defect (RAPD) and visually evoked potentials. Out of 40 patients studied, 26 patients (33 eyes) had all visual function parameters assessed. Twenty three patients (28 eyes) had completed two years of follow-up and were included for statistical analysis. Improvement in visual acuity was statistically significant for distance after 24 hours of the first dose (P = < 0.001) and for near vision after 24 hours of the second dose (P = 0.006); improvement in color and contrast sensitivity was statistically significant 24 hours after the third dose (P = < 0.001 for color vision and P = 0.013 for contrast sensitivity). Significant improvement in RAPD and visual fields were seen by 1 month (P = 0.005). Recurrence was seen in 4 eyes of 4 patients. No serious side effects were observed. At two years, 82.14% (23 out of 28) eyes had visual acuity > 20/40. Treatment with intravenous pulsed dexamethasone led to rapid recovery of vision in acute optic neuritis, without any serious side effects.