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At least 595 records · Page 33Linked to original sources
PubMed2004

Quality of vision after AMO Array multifocal intraocular lens implantation.

PURPOSE: To evaluate safety and efficacy of Array SA40N multifocal intraocular lens (IOL) (AMO) implantation in cataract surgery. SETTING: Helsinki University Eye Hospital, Helsinki, Finland. METHODS: In this prospective randomized comparative trial, 80 patients scheduled for cataract surgery were selected based on preoperative counseling and randomized to have multifocal or monofocal IOL implantation. Fifty-three eyes of 35 patients received a multifocal IOL and 67 eyes of 40 patients, a monofocal IOL. The incidence of complications and visual outcome in the multifocal and monofocal IOL groups were compared. Quality of vision was measured by comparing the severity of visual symptoms (glare, halos, and cataract symptoms score), changes in functional impairment measured by a 7-item visual function test (VF-7), changes in global measures of vision (trouble and satisfaction with vision), and range of accommodation and contrast sensitivity. RESULTS: Intraoperative and postoperative complications and adverse events were few and required no further surgical intervention. Both distance and near visual acuities were significantly better in the multifocal group than in the monofocal group; the difference was most prominent in distance corrected near acuity (P<.001). Thirty-five eyes (67.3%) in the multifocal group and 10 eyes (14.9%) in the monofocal group achieved a distance corrected near acuity of J6 (20/40) or better; 30 eyes (56.6%) and 19 eyes (28.4%), respectively, achieved a best corrected distance acuity of 20/20 or better. Glare symptoms decreased postoperatively in both groups but were slightly more common in the multifocal group. In contrast, halos were significantly more common at 1 month in the multifocal group (P<.001). Contrast sensitivity values were slightly lower with multifocal IOLs at almost all spatial frequencies, but the difference was not significant. The change in the quality of life postoperatively, measured with the VF-7, was significant and identical in both groups. CONCLUSIONS: Pseudophakic eyes with multifocal IOLs had better distance and near acuity and range of accommodation than eyes with a monofocal IOL. Slightly lower contrast sensitivity and increased perception of halos by subjects with the multifocal IOL appear to be an acceptable compromise to enhanced near and distance vision.

Accommodation, Ocular↗
PubMed2005

Discriminative power of reading tests to differentiate visual impairment caused by cataract and age-related macular degeneration.

PURPOSE: To determine whether preoperative reading tests can be used for differentiating visual impairments with regard to the diagnosis of cataract and age-related macular degeneration (ARMD). SETTING: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. METHODS: Reading performance of patients with nuclear cataract, posterior subcapsular cataract, and ARMD were evaluated with respect to reading acuity, maximum reading speed, and critical print size; normal-sighted participants were tested as controls. A multivariate discriminant analysis of the 4 groups (100 eyes of 100 participants) was performed to evaluate how many patients could be correctly diagnosed by significant differences in the tested reading parameters. Subsequently, the nuclear cataract and posterior subcapsular cataract patients were compared with cataract patients with coexisting ARMD. RESULTS: Distance visual acuity was comparable in the nuclear cataract, posterior subcapsular cataract, and ARMD groups (P>.05). Reading acuity was significantly reduced in posterior subcapsular cataract and ARMD patients compared with nuclear cataract patients and controls (P<.0001). No significant difference in maximum reading speed was found between the nuclear cataract patients and the controls (P = .07), whereas the maximum reading speed of the posterior subcapsular cataract and ARMD patients was significantly reduced (P<.0001). In the discriminant analysis, it was possible to assign the correct diagnosis to 72% of the nuclear cataract patients, 76% of the posterior subcapsular cataract patients, 72% of the ARMD patients, and 92% of the controls. Comparing the reading performance of nuclear cataract and posterior subcapsular cataract patients and cataract patients with coexisting ARMD showed that reading performance was significantly impaired in the comorbid patients (nuclear cataract and ARMD, P<.001; posterior subcapsular cataract and ARMD, P<.05). CONCLUSION: The high discriminant accuracy shows that this standardized reading test system is a valuable diagnostic tool for evaluating functional visual impairments when distance visual acuity alone cannot elucidate the origin of functional impairment. Considering the significant discrepancies in reading performance among patients with nuclear cataract, posterior subcapsular cataract, and ARMD, reading tests may relevantly improve the clinical evaluation of patients with visual loss, even of patients with ocular comorbidity.

Aged↗
PubMed2006

Capabilities of potential vision test measurements: clinical evaluation in the presence of cataract or macular disease.

PURPOSE: To determine the usefulness of a battery of potential vision tests (PVTs) including potential acuity meter (PAM), laser interferometer (LI), critical flicker/fusion frequency (CFF), superilluminated pinhole at distance (SPH(d)) and near (SPH(n)), and optimal reading speed (ORS) by their independence of the effects of cataracts and sensitivity to macular disease (MD). SETTING: Department of Optometry, University of Bradford, Bradford and Leeds General Infirmary, Leeds, United Kingdom. METHODS: Potential vision test measurements were determined in 76 patients with age-related cataract and no other eye disease, 52 patients with MD and clear ocular media, and 28 patients with normal, healthy eyes. RESULTS: Potential vision tests were independent of the degrading effects of cataract up to a visual acuity (VA) level of 20/200 or worse (CFF), 20/125 (ORS and SPH), and 20/40 (PAM and LI). A high degree of association was found between PVT scores and distance VA in the MD group for SPH(d) (r2 = 0.93), SPH(n) (r2 = 0.89), and PAM (r2 = 0.71). A moderate correlation was found for LI (r2 = 0.55), CFF (r2 = 0.50), and ORS (r2 = 0.45). CONCLUSIONS: Potential acuity meter and LI showed very limited independence to moderate/dense cataracts and inaccurate predictions in patients with MD. Superilluminated pinhole was relatively unaffected by moderate/dense cataract and yet provided accurate predictions in the presence of MD and clear ocular media. Critical flicker/fusion frequency showed the greatest ability to bypass cataracts, although its ability to predict VA in patients with early MD was limited. The ORS was relatively unaffected by moderate/dense cataract, but its poor ability to predict VA in MD may limit its clinical suitability as a PVT.

Aged↗
PubMed2005

Symptomatic Arnold-Chiari malformation and cranial nerve dysfunction: a case study of applied kinesiology cranial evaluation and treatment.

OBJECTIVE: To present an overview of possible effects of Arnold-Chiari malformation (ACM) and to offer chiropractic approaches and theories for treatment of a patient with severe visual dysfunction complicated by ACM. CLINICAL FEATURES: A young woman had complex optic nerve neuritis exacerbated by an ACM type I of the brain. INTERVENTION AND OUTCOME: Applied kinesiology chiropractic treatment was used for treatment of loss of vision and nystagmus. After treatment, the patient's ability to see, read, and perform smooth eye tracking showed improvement. CONCLUSION: Further studies into applied kinesiology and cranial treatments for visual dysfunctions associated with ACM may be helpful to evaluate whether this single case study can be representative of a group of patients who might benefit from this care.

Adult↗
PubMed2006

Complications of temporomandibular joint arthroscopy: a retrospective analytic study of 670 arthroscopic procedures.

PURPOSE: Temporomandibular joint (TMJ) arthroscopy has been considered a safe surgical procedure in the treatment of TMJ derangement. However, it is not exempt from complications. This study evaluates the complications of arthroscopy in patients with internal derangement of TMJ. PATIENTS AND METHODS: Five hundred consecutive patients (670 joints) with TMJ derangement who underwent arthroscopy between 1995 and 2004 were retrospectively analyzed. All the patients were classified as II to V in the Wilkes classification. Lysis and lavage, electrocautery of the posterior ligament, injection of corticoids, injection of ethanolamine, myotomy of lateral pterygoid muscle attachments, myotomy and electrocautery, motor debridement, injection of sodium hyaluronate, and meniscal suture were performed in different patients. RESULTS: Complications were recognized during or immediately after the surgery. They were observed in 5 of 341 (1.26%) arthroscopies of the right TMJ and 4 of 329 (1.21%) arthroscopies of the left TMJ. A 1.34% complication rate was found in the whole series. No blood clots within the external auditory canal were observed. Bleeding within the superior TMJ space was observed in 57 cases (8.5%), 36 of them in the right TMJ and 21 in the left TMJ, but they were not considered as true complications. Lacerations of the external auditory canal were found in 2 cases (0.3%), with no cases of perforation of the tympanic membrane. Lesion of the auriculotemporal nerve was observed in a case. Paresia of the facial nerve was found in 4 cases (0.6%). Alteration of visual accuracy of the ipsilateral eye was also observed in a patient immediately after the surgery. CONCLUSION: Special care must be taken to reduce complications within the upper joint space by means of an adequate instrumentation and by paying attention to essential points of the arthroscopic technique.

Arthroscopy↗
PubMed2005

Vision abnormalities in young children exposed prenatally to organic solvents.

Despite an accumulating body of evidence demonstrating that the visual system is an important target for organic solvent toxicity in adults, little attention has been paid to the visual functioning of children with prenatal exposure to organic solvents. The present study aimed to: (1) determine prospectively whether prenatal solvent exposure increases the risk of visual deficits in infants and (2) assess the relationship between estimates of exposure level and integrity of visual responses. A sample of 21 infants born to women who were occupationally exposed to solvents during pregnancy was compared with 27 non-exposed age-matched control infants. All mothers were recruited from Motherisk, an antenatal counseling service in Toronto, Canada. Contrast sensitivity and grating acuity were assessed using a sweep visual evoked potential (VEP) technique whereas chromatic- and achromatic mechanisms were assessed using a transient VEP technique. Exposure level was estimated from questionnaire data obtained during pregnancy. Testers were masked to exposure status. Results showed a significant reduction in contrast sensitivity in the low and intermediate spatial frequency range in solvent-exposed infants compared to controls (p<0.001). With respect to grating acuity, there was a significant effect of exposure level, with children in the high exposed having reduced grating acuity compared with children in the low exposed group (p<0.025) and controls (p=0.02). Regarding color vision, 26.3% of infants in the exposed group versus 0% of the controls produced abnormal VEP responses to the red-green onset stimulus (p<0.01), but not to either blue-yellow or achromatic stimuli. No differences were found with respect to latency or amplitude of chromatic and achromatic response. These findings suggest that prenatal solvent exposure is associated with selective visual deficits, including reduced contrast sensitivity and abnormal red-green vision. Increasing levels of exposure may lead to further visual deficits affecting grating acuity. These findings support the need for a re-evaluation of current occupational exposure standards for pregnant women.

Adult↗
PubMed2007

Vesicular glutamate transport at a central synapse limits the acuity of visual perception in zebrafish.

The neural circuitry that constrains visual acuity in the CNS has not been experimentally identified. We show here that zebrafish blumenkohl (blu) mutants are impaired in resolving rapid movements and fine spatial detail. The blu gene encodes a vesicular glutamate transporter expressed by retinal ganglion cells. Mutant retinotectal synapses release less glutamate, per vesicle and per terminal, and fatigue more quickly than wild-type in response to high-frequency stimulation. In addition, mutant axons arborize more extensively, thus increasing the number of synaptic terminals and effectively normalizing the combined input to postsynaptic cells in the tectum. This presumably homeostatic response results in larger receptive fields of tectal cells and a degradation of the retinotopic map. As predicted, mutants have a selective deficit in the capture of small prey objects, a behavior dependent on the tectum. Our studies successfully link the disruption of a synaptic protein to complex changes in neural circuitry and behavior.

Animals↗
PubMed2007

The blu Blur: mutation of a vesicular glutamate transporter reduces the resolution of zebrafish vision.

Vesicular transporters mediate the packaging of neurotransmitters into synaptic vesicles and can therefore control the amount of neurotransmitter released into the synaptic cleft. In this issue of Neuron, Smear et al. demonstrate that mutation of a vesicular glutamate transporter (Vglut) found in the retinal ganglion cells (RGCs) of zebrafish alters both the synaptic transmission and connectivity between RGCs and their targets, limiting the transfer of visually evoked activity from RGCs and degrading behaviors that depend on high-acuity vision.

Animals↗
PubMed2004

Functional visual loss.

Functional visual loss is a common problem encountered in practice. It must be recognized that this problem occurs in patients who have organic illness. Manual perimetry is the most effective method for evaluating functional visual loss, and the presence of a central scotoma in a functional visual field strongly suggests that organic pathology is present. Neuropsychological and psychiatric intervention can be useful in treating these patients.

Humans↗
PubMed2004

Sleep disturbances in young subjects with visual dysfunction.

PURPOSE: To determine whether the type of ophthalmic disease is predictive of sleep and wakefulness disturbances in young subjects with visual dysfunction. DESIGN: Prospective cohort study. PARTICIPANTS AND CONTROLS: Twenty-five subjects (ages 12-20) were recruited from the Missouri School for the Blind. Twelve controls with normal sight were recruited from a residential school. METHODS: Daily activity was monitored for 14 days using wrist actigraphy. Sleep and wakefulness measures were derived from actigraphy records by automated analysis. Visually impaired subjects were prospectively stratified by presence or absence of optic nerve disease. MAIN OUTCOME MEASURES: Daytime napping and regularity of awakening time (wake-up time instability). RESULTS: Subjects with optic nerve disease napped in the daytime significantly more than other visually impaired children or normal sighted controls: 28.1+/-4.0 minutes per day (mean +/- standard error) versus 11.9+/-2.4 minutes per day in equally visually impaired subjects with intact optic nerve function versus 6.2+/-2.2 minutes per day in subjects with normal sight (P<0.0001). These subjects also showed significantly more variable awakening times than the other groups. Logistic regression revealed that subjects with optic nerve disease are 9.1 times more likely to demonstrate daily napping of more than 20 minutes per day than equally blind subjects without optic nerve disease (95% confidence interval [CI] = 1.4-58.7, P = 0.02). Blind subjects with optic nerve disease are 21.3 times more likely than children with normal sight to nap more than 20 minutes on average per day (95% CI = 1.2-378, P = 0.04). CONCLUSIONS: Optic nerve disease is predictive of increased daytime napping in young visually impaired subjects, suggesting that the nature and presence of ophthalmic disease affect the probability of concomitant sleep timing disorders.

Adolescent↗
PubMed2004

Comparison of preschool vision screening tests as administered by licensed eye care professionals in the Vision In Preschoolers Study.

PURPOSE: To compare 11 preschool vision screening tests administered by licensed eye care professionals (LEPs; optometrists and pediatric ophthalmologists). DESIGN: Multicenter, cross-sectional study. PARTICIPANTS: A sample (N = 2588) of 3- to 5-year-old children enrolled in Head Start was selected to over-represent children with vision problems. METHODS: Certified LEPs administered 11 commonly used or commercially available screening tests. Results from a standardized comprehensive eye examination were used to classify children with respect to 4 targeted conditions: amblyopia, strabismus, significant refractive error, and unexplained reduced visual acuity (VA). MAIN OUTCOME MEASURES: Sensitivity for detecting children with > or =1 targeted conditions at selected levels of specificity was the primary outcome measure. Sensitivity also was calculated for detecting conditions grouped into 3 levels of importance. RESULTS: At 90% specificity, sensitivities of noncycloplegic retinoscopy (NCR) (64%), the Retinomax Autorefractor (63%), SureSight Vision Screener (63%), and Lea Symbols test (61%) were similar. Sensitivities of the Power Refractor II (54%) and HOTV VA test (54%) were similar to each other. Sensitivities of the Random Dot E stereoacuity (42%) and Stereo Smile II (44%) tests were similar to each other and lower (P<0.0001) than the sensitivities of NCR, the 2 autorefractors, and the Lea Symbols test. The cover-uncover test had very low sensitivity (16%) but very high specificity (98%). Sensitivity for conditions considered the most important to detect was 80% to 90% for the 2 autorefractors and NCR. Central interpretations for the MTI and iScreen photoscreeners each yielded 94% specificity and 37% sensitivity. At 94% specificity, the sensitivities were significantly better for NCR, the 2 autorefractors, and the Lea Symbols VA test than for the 2 photoscreeners for detecting > or =1 targeted conditions and for detecting the most important conditions. CONCLUSIONS: Screening tests administered by LEPs vary widely in performance. With 90% specificity, the best tests detected only two thirds of children having > or =1 targeted conditions, but nearly 90% of children with the most important conditions. The 2 tests that use static photorefractive technology were less accurate than 3 tests that assess refractive error in other ways. These results have important implications for screening preschool-aged children.

Amblyopia↗
PubMed2004

The impact of visual impairment on self-reported visual functioning in Latinos: The Los Angeles Latino Eye Study.

OBJECTIVE: To assess the association between presenting binocular visual acuity (VA) and self-reported visual function as measured by the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). DESIGN: A population-based, prevalence study of eye disease in Latinos 40 years and older residing in La Puente, California (Los Angeles Latino Eye Study [LALES]). PARTICIPANTS: Six thousand three hundred fifty-seven Latinos 40 years and older from 6 census tracts in La Puente. METHODS: All participants completed a standardized interview, including the NEI-VFQ-25 to measure visual functioning, and a detailed eye examination. Two definitions of visual impairment were used: (1) presenting binocular distance VA of 20/40 or worse and (2) presenting binocular distance VA worse than 20/40. Analysis of variance was used to determine any systematic differences in mean NEI-VFQ-25 scores by visual impairment. Regression analyses were completed (1) to determine the association of age, gender, number of systemic comorbidities, depression, and VA with self-reported visual function and (2) to estimate a visual impairment-related difference for each subscale based on differences in VA. MAIN OUTCOME MEASURES: The NEI-VFQ-25 scores in persons with visual impairment. RESULTS: Of the 5287 LALES participants with complete NEI-VFQ-25 data, 6.3% (including 20/40) and 4.2% (excluding 20/40) were visually impaired. In the visually impaired participants, the NEI-VFQ-25 subscale scores ranged from 46.2 (General Health) to 93.8 (Color Vision). In the regression model, only VA, depression, and number of comorbidities were significantly associated with all subscale scores (R(2) ranged from 0.09 for Ocular Pain to 0.33 for the composite score). For 9 of 11 subscales, a 5-point change was equivalent to a 1- or 2-line difference in VA. Relationships were similar regardless of the definition of visual impairment. CONCLUSION: In this population-based study of Latinos, the NEI-VFQ-25 was sensitive to differences in VA. A 5-point difference on the NEI-VFQ-25 seems to be a minimal criterion for a visual impairment-related difference. Self-reported visual function is essentially unchanged if the definition of visual impairment includes or excludes a VA of 20/40.

Adult↗
PubMed2004

Impact of diabetes on glaucoma screening using frequency-doubling perimetry.

PURPOSE: To determine whether diabetes is a potential source of abnormal test results in glaucoma screening by use of frequency-doubling perimetry. DESIGN: Observational case series. PARTICIPANTS AND CONTROLS: Twenty-five patients with diabetes and 25 nondiabetic normal controls, all without cataract or glaucoma. METHODS: Frequency-doubling perimetry using the C-20-5 screening mode was performed in 1 randomly selected eye of each participant. Abnormal test results were immediately repeated to reduce artifacts caused by test inexperience. Frequency-doubling technology (FDT) results were assigned a numerical score between 0 (normal) and 87 (no stimuli detected). MAIN OUTCOME MEASURE: Abnormal FDT test scores. RESULTS: Overall, 7 of 25 (28%) patients with diabetes and 1 of 25 (4%) normal controls had an abnormal test; the 1 normal subject with an abnormal test was subsequently determined to have an abnormal glucose tolerance test. Four of the 7 patients with diabetes with abnormal FDT tests had no evidence of diabetic retinopathy on clinical examination. Patients with diabetes had higher test scores than normal controls (8.9+/-16.9 vs. 1.0+/-4.4, P = 0.028) and had longer test times than normal controls (66.4+/-35.5 seconds vs. 48.3+/-11.2 seconds, P = 0.019). CONCLUSIONS: Frequency-doubling perimetry is abnormal in some patients with diabetes, including some patients with diabetes without clinical evidence of diabetic retinopathy. Abnormal FDT testing in diabetic eyes may not represent glaucomatous visual field loss. Diabetes may be a source of "false-positive" test results when this technology is used for glaucoma screening.

Adult↗