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Vision, Volume 7, Issue 2 (June 2023) – 19 articles

Cover Story (view full-size image): This review on biomechanics related to ocular structures focuses on the cornea and its role in glaucoma. It discusses two devices, the Ocular Response Analyzer (ORA) and the Corvis ST Dynamic Scheimpflug Analyzer, which are used to evaluate the connection between ocular biomechanics and intraocular pressure (IOP) in patients with glaucoma. The text also highlights the importance of corneal and scleral stiffness in the progression of glaucoma, explores various parameters that are measured using the Corvis ST, and discusses the creation of algorithms to calculate biomechanically compensated IOP. In addition, the review touches on the significance of hysteresis in glaucoma and the effect of increased ocular structure stiffness on the pathobiology of the disease. View this paper
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10 pages, 1417 KiB  
Article
Effect of Contact Lens Design on Objective Visual Acuity-Based Parameters in Pre-Presbyopic Patients in Photopic and Mesopic Lighting Conditions
by Orit Sztrigler-Cohen, Nogah Bromberger, Yonina Thee, Rivkah Lender and Hadas Ben-Eli
Vision 2023, 7(2), 46; https://doi.org/10.3390/vision7020046 - 18 Jun 2023
Cited by 1 | Viewed by 1251
Abstract
Presbyopia is often corrected by progressive soft contact lenses (CL), and the resulting visual acuity-based parameters can be affected by the lens design and pupil size under different lighting conditions. In this study, we examined the effect of CL design (spheric vs. aspheric) [...] Read more.
Presbyopia is often corrected by progressive soft contact lenses (CL), and the resulting visual acuity-based parameters can be affected by the lens design and pupil size under different lighting conditions. In this study, we examined the effect of CL design (spheric vs. aspheric) on objective parameters of visual acuity-based parameters under mesopic vs. photopic lighting conditions. In a prospective, double-blind study, pre-presbyopic and presbyopic patients were fitted with spheric (Dispo Silk; 8.6 base curve, 14.2 diameter) and aspheric (Dispo Aspheric; 8.4 base curve, 14.4 diameter) CLs. The low contrast (10%) and high contrast (100%) visual acuity (VA), amplitude of accommodation (AA) (push-away method, Diopters) and distance contrast sensitivity (CS) (FACT chart, cycles per degree (CPD)) were measured with both types of CLs under mesopic and photopic lighting conditions. The eye with the better visual acuity was tested and analyzed. Thirteen patients (age range: 38–45 years) were included. The mean CS was significantly better with spheric compared to aspheric lenses for low spatial frequencies (3 CPD: 81.69 ± 7.86, 67.62 ± 5.67, respectively; p < 0.05), though there was no significant difference for lower or higher spatial frequencies (1.5, 6, 12, 18 CPD). The low-contrast (10%) and high-contrast (100%) VAs were not different between the two lens designs. However, there were significant differences between near VA, distance low-contrast VA and AA obtained under mesopic (dim) vs. photopic (bright) conditions with the aspheric design correction modality. In conclusion, photopic lighting conditions improved both the visual acuity and measured amplitude of accommodation with both lens designs, though the amplitude of accommodation was significantly higher with aspheric lenses. However, contrast sensitivity demonstrated the superiority of the spheric lens at a 3 CPD spatial frequency. This suggests that the ideal lens differs from patient to patient, depending on the visual demands. Full article
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9 pages, 405 KiB  
Article
Safety and Efficacy of Prostaglandin Analogues in the Immediate Postoperative Period after Uneventful Phacoemulsification
by Eleftherios Anastasopoulos, Spyridon Koronis, Artemis Matsou, Maria Dermenoudi, Nikolaos Ziakas and Argyrios Tzamalis
Vision 2023, 7(2), 45; https://doi.org/10.3390/vision7020045 - 16 Jun 2023
Viewed by 1182
Abstract
Prostaglandin analogues (PGAs) have been associated with the development of pseudophakic macular edema (PME) in complicated cataract cases, but evidence on their effects in uncomplicated phacoemulsification remains controversial. This two-arm, prospective, randomised study included patients with glaucoma or ocular hypertension under PGA monotherapy [...] Read more.
Prostaglandin analogues (PGAs) have been associated with the development of pseudophakic macular edema (PME) in complicated cataract cases, but evidence on their effects in uncomplicated phacoemulsification remains controversial. This two-arm, prospective, randomised study included patients with glaucoma or ocular hypertension under PGA monotherapy who were scheduled for cataract surgery. The first group continued PGA use (PGA-on), while the second discontinued PGAs for the first postoperative month and reinitiated use afterwards (PGA-off). Topical non-steroidal anti-inflammatory drugs (NSAIDs) were routinely administered to all patients during the first postoperative month. The patients were followed up for three months and the primary outcome was PME development. Secondary outcomes were corrected distance visual acuity (CDVA), central and average macular thickness (CMT and AMT), and intraocular pressure (IOP). The analysis included 22 eyes in the PGA-on group and 33 eyes in the PGA-off group. No patient developed PME. CDVA was not significantly different between the two groups (p = 0.83). CMT and AMT showed a small but statistically significant increase until the end of follow-up (p < 0.001). Mean IOP values had no significant differences between the groups at each visit (p > 0.05). At the end of follow-up, the IOP values were significantly lower than baseline in both groups (p < 0.001). In conclusion, PGA administration with concomitant topical NSAIDs appears to be a safe practice in the early postoperative period of uncomplicated phacoemulsification. Full article
(This article belongs to the Section Visual Neuroscience)
13 pages, 3003 KiB  
Article
Vision in the Vertical Axis: How Important Are Visual Cues in Foraging and Navigation?
by Jessica L. Campbell and Theresa Burt de Perera
Vision 2023, 7(2), 44; https://doi.org/10.3390/vision7020044 - 06 Jun 2023
Viewed by 1041
Abstract
In both terrestrial and aquatic environments, a large number of animal behaviors rely on visual cues, with vision acting as the dominant sense for many fish. However, many other streams of information are available, and multiple cues may be incorporated simultaneously. Being free [...] Read more.
In both terrestrial and aquatic environments, a large number of animal behaviors rely on visual cues, with vision acting as the dominant sense for many fish. However, many other streams of information are available, and multiple cues may be incorporated simultaneously. Being free from the constraints of many of their terrestrial counterparts, fish have an expanded range of possible movements typified by a volume rather than an area. Cues such as hydrostatic pressure, which relates to navigation in a vertical plane, may provide more salient and reliable information to fish as they are not affected by poor light conditions or turbidity. Here, we tested banded tetra fish (Astyanax fasciatus) in a simple foraging task in order to determine whether visual cues would be prioritized over other salient information, most notably hydrostatic pressure gradients. We found that in both vertical and horizontal arrays there was no evidence for fish favoring one set of cues over the other, with subjects making choices at random once cues were placed into conflict. Visual cues remained as important in the vertical axis as they were in the horizontal axis. Full article
(This article belongs to the Special Issue Vision in Aquatic Environment)
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11 pages, 1898 KiB  
Article
Dexamethasone Modulates the Dynamics of Wnt Signaling in Human Trabecular Meshwork Cells
by Chi Zhang, Elizabeth Tannous, Alseena Thomas, Natalia Jung, Edmond Ma and Jie J. Zheng
Vision 2023, 7(2), 43; https://doi.org/10.3390/vision7020043 - 25 May 2023
Cited by 1 | Viewed by 1220
Abstract
Trabecular meshwork (TM) tissue is highly specialized, and its structural integrity is crucial for maintaining homeostatic intraocular pressure (IOP). The administration of glucocorticoids, such as dexamethasone (DEX), can perturb the TM structure and significantly increase IOP in susceptible individuals, resulting in ocular diseases [...] Read more.
Trabecular meshwork (TM) tissue is highly specialized, and its structural integrity is crucial for maintaining homeostatic intraocular pressure (IOP). The administration of glucocorticoids, such as dexamethasone (DEX), can perturb the TM structure and significantly increase IOP in susceptible individuals, resulting in ocular diseases such as steroid-induced glaucoma, a form of open-angle glaucoma. Although the exact mechanism involved in steroid-induced glaucoma remains elusive, increasing evidence suggests that DEX may act through various signaling cascades in TM cells. Despite uncertainty surrounding the specific process by which steroid-induced glaucoma occurs, there is growing evidence to indicate that DEX can impact multiple signaling pathways within TM cells. In this study, we examined the impact of DEX treatment on the Wnt signaling pathway in TM cells, given that Wnt signaling has been reported to play a crucial role in regulating extracellular matrix (ECM) levels in the TM. To further elucidate the role of Wnt signaling in the glaucomatous phenotype, we examined mRNA expression patterns between Wnt signaling markers AXIN2 and sFRP1 and DEX-mediated induction of myocilin (MYOC) mRNA and protein levels over 10 days in DEX-treated primary TM cells. We observed a sequential pattern of peak expression between AXIN2, sFRP1, and MYOC. Based on the study, we propose that sFRP1 upregulation could be a result of a negative feedback mechanism generated by stressed TM cells to suppress abnormal Wnt signaling activities. Full article
(This article belongs to the Special Issue Recent Advances in Glaucoma: Diagnosis and Treatment)
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12 pages, 12007 KiB  
Case Report
Amblyopia Treatment through Immersive Virtual Reality: A Preliminary Experience in Anisometropic Children
by Ainhoa Molina-Martín, Luis Leal-Vega, Dolores de Fez, Elena Martínez-Plaza, María Begoña Coco-Martín and David P. Piñero
Vision 2023, 7(2), 42; https://doi.org/10.3390/vision7020042 - 19 May 2023
Cited by 2 | Viewed by 1547
Abstract
The use of digital devices provides a wide range of possibilities for measuring and improving visual function, including concepts such as perceptual learning and dichoptic therapy. Different technologies can be used to apply these concepts, including, in recent years, the introduction of virtual [...] Read more.
The use of digital devices provides a wide range of possibilities for measuring and improving visual function, including concepts such as perceptual learning and dichoptic therapy. Different technologies can be used to apply these concepts, including, in recent years, the introduction of virtual reality (VR) systems. A preliminary experience in treating anisometropic amblyopia through an immersive VR device and using prototype software is described. A total of 4 children were treated by performing 18 office-based sessions. Results showed that distance VA in amblyopic eyes remained constant in two subjects, whereas the younger subjects improved after the training. Near VA improved in three subjects. All subjects showed an increase in the stereopsis of at least one step, with three subjects showing a final stereopsis of a 60 s arc. A total of three subjects showed an increase of approximately 0.5 CS units for the spatial frequency of 3 cpd after the training. Results from this pilot study suggest that visual training based on perceptual learning through an immersive VR environment could be a viable treatment for improving CS, VA, and stereopsis in some children with anisometropic amblyopia. Future studies should support these preliminary results. Full article
(This article belongs to the Section Visual Neuroscience)
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10 pages, 227 KiB  
Article
Clinical Outcomes of Descemet’s Membrane Endothelial Keratoplasty without Routine Prophylactic Peripheral Iridotomy
by Ritika Mukhija, Gabriella Quiney and Mayank A. Nanavaty
Vision 2023, 7(2), 41; https://doi.org/10.3390/vision7020041 - 19 May 2023
Cited by 1 | Viewed by 968
Abstract
Objectives: To analyze the outcomes and complications of Descemet‘s membrane endothelial keratoplasty (DMEK) performed without prophylactic peripheral iridotomy (PI). Methods: Design: Retrospective study. Setting: Institutional, tertiary care eye hospital. Study Population: All patients who underwent DMEK or DMEK combined with phacoemulsification (DMEK [...] Read more.
Objectives: To analyze the outcomes and complications of Descemet‘s membrane endothelial keratoplasty (DMEK) performed without prophylactic peripheral iridotomy (PI). Methods: Design: Retrospective study. Setting: Institutional, tertiary care eye hospital. Study Population: All patients who underwent DMEK or DMEK combined with phacoemulsification (DMEK triple) for Fuchs endothelial dystrophy, using a standardized protocol between August 2016 and July 2021, were included. Previous glaucoma surgery, laser PI, aphakia, or complicated pseudophakia were excluded. Main outcome measures: Primary outcomes: Incidence of pupillary block (PB). Secondary outcomes: Graft detachment (GD), rebubbling rates, uncorrected (UCDVA) and best corrected logMAR distance visual acuity (BCDVA), and endothelial cell loss (ECL) at six months. Data were analyzed using the chi-square test and stepwise backward regression analysis. Results: 104 eyes of 72 patients were included. Four eyes (3.8%) developed PB; in two of these cases, standard protocol was not followed. Overall minor GD occurred in 43.2% (n = 45); significant GD was present only in 7 eyes (6.6%). Overall slit lamp rebubbling rate was 30% (n = 35), though only four patients were rebubbled in theatre (3.8%). PB, GD, and rebubbling rates did not vary with the surgeon, surgery, or tamponade (air or SF6 gas). UCDVA, BCDVA, and ECL at 6 months were 0.29 ± 0.31, 0.20 ± 0.28, and 40.46 ± 20.36%, respectively. Conclusions: Compared to previously reported outcomes of DMEK with PI, our results of PI less DMEK using a standardized protocol have a similar incidence of pupillary block, graft detachment, and rebubbling, with comparable visual acuity and endothelial cell loss. Full article
10 pages, 618 KiB  
Article
Agreement between Two Devices for Measuring Pupil Diameter in Patients Implanted with Multifocal Intraocular Lenses
by Joaquín Fernández, Noemí Burguera, Carlos Rocha-de-Lossada, Marina Rodríguez-Calvo-de-Mora and Manuel Rodríguez-Vallejo
Vision 2023, 7(2), 40; https://doi.org/10.3390/vision7020040 - 09 May 2023
Viewed by 1441
Abstract
The purpose of this study was to evaluate the agreement between three methods for measuring pupil size in patients implanted with multifocal intraocular lenses (MIOLs): Keratograph 5M (K5M), Pentacam AXL Wave (PW), and a simple hand ruler. Sixty-nine subjects implanted with MIOLs and [...] Read more.
The purpose of this study was to evaluate the agreement between three methods for measuring pupil size in patients implanted with multifocal intraocular lenses (MIOLs): Keratograph 5M (K5M), Pentacam AXL Wave (PW), and a simple hand ruler. Sixty-nine subjects implanted with MIOLs and measured at the three-month follow-up visit were included in this retrospective analysis. K5M and PW were used to measure the photopic (PP) and mesopic (MP) pupil sizes, and a hand ruler was used to measure the pupil under environmental light conditions (135 lux). The Bland–Altman method with its limits (LoAs) was used to assess the agreement. The median PP was 2.8, 2.95, and 3 mm for K5M, PW, and the ruler, respectively (p < 0.05). Differences in PP were statistically significant for all paired comparisons (p < 0.0005) except between PW and the ruler (p = 0.44). The LoAs for the difference in PP between K5M and PW was 0.63 mm. The mean difference for MP between K5M and PW was 0.04 mm (p = 0.34) with LoAs of 0.72 mm. MP measured with K5M and PW could be considered interchangeable, although a correction of −0.3 mm (IC95%: −0.23 to −0.39) should be applied to PP measured with PW to attain the K5M mean. Full article
(This article belongs to the Special Issue Pupillometry)
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9 pages, 252 KiB  
Brief Report
Combat Sports as a Model for Measuring the Effects of Repeated Head Impacts on Autonomic Brain Function: A Brief Report of Pilot Data
by Christopher Kirk and Charmaine Childs
Vision 2023, 7(2), 39; https://doi.org/10.3390/vision7020039 - 04 May 2023
Cited by 1 | Viewed by 1847
Abstract
Automated pupil light reflex (PLR) is a valid indicator of dysfunctional autonomic brain function following traumatic brain injury. PLR’s use in identifying disturbed autonomic brain function following repeated head impacts without outwardly visible symptoms has not yet been examined. As a combat sport [...] Read more.
Automated pupil light reflex (PLR) is a valid indicator of dysfunctional autonomic brain function following traumatic brain injury. PLR’s use in identifying disturbed autonomic brain function following repeated head impacts without outwardly visible symptoms has not yet been examined. As a combat sport featuring repeated ‘sub-concussive’ head impacts, mixed martial arts (MMA) sparring may provide a model to understand such changes. The aim of this pilot study was to explore which, if any, PLR variables are affected by MMA sparring. A cohort of n = 7 MMA athletes (age = 24 ± 3 years; mass = 76.5 ± 9 kg; stature = 176.4 ± 8.5 cm) took part in their regular sparring sessions (eight rounds × 3 min: 1 min recovery). PLR of both eyes was measured immediately pre- and post-sparring using a Neuroptic NPi-200. Bayesian paired samples t-tests (BF10 ≥ 3) revealed decreased maximum pupil size (BF10 = 3), decreased minimum pupil size (BF10 = 4) and reduced PLR latency (BF10 = 3) post-sparring. Anisocoria was present prior to sparring and increased post-sparring, with both eyes having different minimum and maximum pupil sizes (BF10 = 3–4) and constriction velocities post-sparring (BF10 = 3). These pilot data suggest repeated head impacts may cause disturbances to autonomic brain function in the absence of outwardly visible symptoms. These results provide direction for cohort-controlled studies to formally investigate the potential changes observed. Full article
(This article belongs to the Special Issue Pupillometry)
12 pages, 595 KiB  
Article
Eye Movement Latency Coefficient of Variation as a Predictor of Cognitive Impairment: An Eye Tracking Study of Cognitive Impairment
by Megan Polden and Trevor J. Crawford
Vision 2023, 7(2), 38; https://doi.org/10.3390/vision7020038 - 01 May 2023
Viewed by 1548
Abstract
Studies demonstrated impairment in the control of saccadic eye movements in Alzheimer’s disease (AD) and people with mild cognitive impairment (MCI) when conducting the pro-saccade and antisaccade tasks. Research showed that changes in the pro and antisaccade latencies may be particularly sensitive to [...] Read more.
Studies demonstrated impairment in the control of saccadic eye movements in Alzheimer’s disease (AD) and people with mild cognitive impairment (MCI) when conducting the pro-saccade and antisaccade tasks. Research showed that changes in the pro and antisaccade latencies may be particularly sensitive to dementia and general executive functioning. These tasks show potential for diagnostic use, as they provide a rich set of potential eye tracking markers. One such marker, the coefficient of variation (CV), is so far overlooked. For biological markers to be reliable, they must be able to detect abnormalities in preclinical stages. MCI is often viewed as a predecessor to AD, with certain classifications of MCI more likely than others to progress to AD. The current study examined the potential of CV scores on pro and antisaccade tasks to distinguish participants with AD, amnestic MCI (aMCI), non-amnesiac MCI (naMCI), and older controls. The analyses revealed no significant differences in CV scores across the groups using the pro or antisaccade task. Antisaccade mean latencies were able to distinguish participants with AD and the MCI subgroups. Future research is needed on CV measures and attentional fluctuations in AD and MCI individuals to fully assess this measure’s potential to robustly distinguish clinical groups with high sensitivity and specificity. Full article
(This article belongs to the Section Visual Neuroscience)
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8 pages, 1045 KiB  
Case Report
Postural and Proprioceptive Deficits Clinically Assessed in Children with Reading Disabilities: A Case-Control Study
by Franck Scheveig and Maria Pia Bucci
Vision 2023, 7(2), 37; https://doi.org/10.3390/vision7020037 - 27 Apr 2023
Cited by 1 | Viewed by 1179
Abstract
Several studies have reported motor deficiencies in children with dyslexia, in line with the cerebellar deficit theory. In the present study, we explored whether tests used by physiotherapists during clinical evaluation were able to report motor deficits in a group of fifty-six dyslexic [...] Read more.
Several studies have reported motor deficiencies in children with dyslexia, in line with the cerebellar deficit theory. In the present study, we explored whether tests used by physiotherapists during clinical evaluation were able to report motor deficits in a group of fifty-six dyslexic children (mean age 10.9 ± 0.2 years old) compared to a group of thirty-eight non-dyslexic children (mean age 11.2 ± 0.4 years old). The occurrence of instability on an unstable support; spinal instability in the sagittal, frontal and horizontal plane; head-eye discoordination; and poor eye stability were clinically assessed in the two groups of children. All such measures were found to be significantly more frequent in dyslexic than in non-dyslexic children (p < 0.001, p < 0.05, p < 0.001 and p < 0.001, respectively, for occurrence of instability on an unstable support, spinal instability, head-eye discoordination and poor eye stability). These results, firstly, confirmed the poor motor control of dyslexic children, suggesting deficient cerebellar integration. Secondly, for the first time, we reported that simple tests that can be done by pediatricians and/or during a clinical routine evaluation could be useful to discriminate children with reading difficulties. The tests used in this study could be a reference for a first exploration of motor deficiencies in children with dyslexia that can be easily assessed by clinicians and/or physiotherapists. Full article
(This article belongs to the Special Issue Eye and Head Movements in Visuomotor Tasks)
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14 pages, 4497 KiB  
Review
Ocular Biomechanics and Glaucoma
by Rodrigo Brazuna, Ruiz S. Alonso, Marcella Q. Salomão, Bruno F. Fernandes and Renato Ambrósio, Jr.
Vision 2023, 7(2), 36; https://doi.org/10.3390/vision7020036 - 23 Apr 2023
Cited by 2 | Viewed by 2096
Abstract
Biomechanics is a branch of biophysics that deals with mechanics applied to biology. Corneal biomechanics have an important role in managing patients with glaucoma. While evidence suggests that patients with thin and stiffer corneas have a higher risk of developing glaucoma, it also [...] Read more.
Biomechanics is a branch of biophysics that deals with mechanics applied to biology. Corneal biomechanics have an important role in managing patients with glaucoma. While evidence suggests that patients with thin and stiffer corneas have a higher risk of developing glaucoma, it also influences the accurate measurement of intraocular pressure. We reviewed the pertinent literature to help increase our understanding of the biomechanics of the cornea and other ocular structures and how they can help optimize clinical and surgical treatments, taking into consideration individual variabilities, improve the diagnosis of suspected patients, and help monitor the response to treatment. Full article
(This article belongs to the Special Issue Recent Advances in Glaucoma: Diagnosis and Treatment)
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2 pages, 438 KiB  
Editorial
Development, Progression and Management of Contact Lenses and Eye Care—Editorial Letter
by Nir Erdinest
Vision 2023, 7(2), 35; https://doi.org/10.3390/vision7020035 - 22 Apr 2023
Cited by 1 | Viewed by 2171
Abstract
The world of contact lenses comprises a considerable segment of the ophthalmology field [...] Full article
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13 pages, 679 KiB  
Review
Circulating Biomarkers to Predict Diabetic Retinopathy in Patients with Diabetic Kidney Disease
by Jonny, Laurencia Violetta, Arief S. Kartasasmita, Rudi Supriyadi and Coriejati Rita
Vision 2023, 7(2), 34; https://doi.org/10.3390/vision7020034 - 09 Apr 2023
Cited by 3 | Viewed by 2320
Abstract
The purpose of this review is to outline the currently available circulating biomarkers to predict diabetic retinopathy (DR) in patients with diabetic kidney disease (DKD). Studies have extensively reported the association between DR and DKD, suggesting the presence of common pathways of microangiopathy. [...] Read more.
The purpose of this review is to outline the currently available circulating biomarkers to predict diabetic retinopathy (DR) in patients with diabetic kidney disease (DKD). Studies have extensively reported the association between DR and DKD, suggesting the presence of common pathways of microangiopathy. The presence of other ocular complications including diabetic cataracts may hinder the detection of retinopathy, which may affect the visual outcome after surgery. Unlike DKD screening, the detection of DR requires complex, costly machines and trained technicians. Recognizing potential biological markers related to glycation and oxidative stress, inflammation and endothelial dysfunction, basement membrane thickening, angiogenesis, and thrombosis as well as novel molecular markers involved in the microangiopathy process may be useful as predictors of retinopathy and identify those at risk of DR progression, especially in cases where retinal visualization becomes a clinical challenge. Further investigations could assist in deciding which biomarkers possess the highest predictive power to predict retinopathy in clinical settings. Full article
(This article belongs to the Section Retinal Function and Disease)
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10 pages, 559 KiB  
Article
The Most-Cited Articles on Retinoblastoma: A Fifty-Year Perspective
by Rachel Shemesh, Hunter Sandler, Sarah Dichter, Ido Didi Fabian, Eedy Mezer and Tamara Wygnanski-Jaffe
Vision 2023, 7(2), 33; https://doi.org/10.3390/vision7020033 - 04 Apr 2023
Cited by 1 | Viewed by 1363
Abstract
Purpose: To summarize the characteristics and trends of interest in retinoblastoma (Rb) in the last 50 years. Methods: The Web of Science Database was used to find all studies focused on Rb published from 1970 to 2018. The term “retinoblastoma” was used to [...] Read more.
Purpose: To summarize the characteristics and trends of interest in retinoblastoma (Rb) in the last 50 years. Methods: The Web of Science Database was used to find all studies focused on Rb published from 1970 to 2018. The term “retinoblastoma” was used to search for the 100 most cited records. Results: The mean number of citations was 153.55 ± 88.9. The majority were from the United States (US) (n = 68). Drs. Shields authored 38% of the papers. The number of citations per year was positively correlated with the number of authors, r = 0.26 (p = 0.008). The number of patients was significantly associated with the number of citations per year (p = 0.012). Although papers on radiotherapy were the most common, publications about intra-arterial chemotherapy (IAC) were associated with 88.3% more citations per year (p = 0.031) and papers on intravenous chemotherapy (IVC) were associated with 40.3% more citations per year (p= 0.04). Review and meta-analysis studies had a higher median of citations (10.5) than interventional (6.4) or observational (5.2) studies. Conclusions: This study compiles a comprehensive analysis of the most-cited articles on Rb. Studies with a higher number of citations per year were associated with IAC, which emphasizes the significance of the advances in Rb treatments that allow for the saving of eyes and vision as well as lives. Review studies had more citations than observational or interventional studies. More citations were associated with a larger number of authors or more reported patients per paper. These findings highlight the importance of collaborations to achieve relevant, high-quality research of Rb. Full article
(This article belongs to the Section Retinal Function and Disease)
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22 pages, 792 KiB  
Review
Toxic External Exposure Leading to Ocular Surface Injury
by Steven H. Rauchman, Brandon Locke, Jacqueline Albert, Joshua De Leon, Morgan R. Peltier and Allison B. Reiss
Vision 2023, 7(2), 32; https://doi.org/10.3390/vision7020032 - 03 Apr 2023
Cited by 3 | Viewed by 5167
Abstract
The surface of the eye is directly exposed to the external environment, protected only by a thin tear film, and may therefore be damaged by contact with ambient particulate matter, liquids, aerosols, or vapors. In the workplace or home, the eye is subject [...] Read more.
The surface of the eye is directly exposed to the external environment, protected only by a thin tear film, and may therefore be damaged by contact with ambient particulate matter, liquids, aerosols, or vapors. In the workplace or home, the eye is subject to accidental or incidental exposure to cleaning products and pesticides. Organic matter may enter the eye and cause infection. Ocular surface damage can trigger a range of symptoms such as itch, discharge, hyperemia, photophobia, blurred vision, and foreign body sensation. Toxin exposure can be assessed clinically in multiple ways, including via measurement of tear production, slit-lamp examination, corneal staining, and conjunctival staining. At the cellular level, environmental toxins can cause oxidative damage, apoptosis of corneal and conjunctival cells, cell senescence, and impaired motility. Outcomes range from transient and reversible with complete healing to severe and sight-compromising structural changes. Classically, evaluation of tolerance and safety was carried out using live animal testing; however, new in vitro and computer-based, in silico modes are superseding the gold standard Draize test. This review examines how environmental features such as pollutants, temperature, and seasonality affect the ocular surface. Chemical burns to the eye are considered, and approaches to protect the ocular surface are detailed. Full article
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15 pages, 989 KiB  
Article
Effectiveness of Topical Cyclosporin-A 0.1% Compared to Combined Topical Cyclosporin-A 0.1% with Topical Sodium Hyaluronate on Interleukin-6 Levels in the Tears of Patients with Dry Eye Disease
by Desti Priani, Habibah S. Muhiddin, Junaedi Sirajuddin, Hasnah B. Eka, Burhanuddin Bahar and Agussalim Bukhari
Vision 2023, 7(2), 31; https://doi.org/10.3390/vision7020031 - 03 Apr 2023
Cited by 1 | Viewed by 1654
Abstract
Introduction: Pro-inflammatory cytokines are important contributors to dry eye disease (DED). The cytokine interleukin (IL)-6 has become a therapeutic target in several DED drug studies. This randomized controlled trial aimed to determine the effectiveness of topical cyclosporin-A 0.1% compared to the combination of [...] Read more.
Introduction: Pro-inflammatory cytokines are important contributors to dry eye disease (DED). The cytokine interleukin (IL)-6 has become a therapeutic target in several DED drug studies. This randomized controlled trial aimed to determine the effectiveness of topical cyclosporin-A 0.1% compared to the combination of topical cyclosporin-A 0.1% and sodium hyaluronate in reducing tear IL-6 levels in DED patients. Methods: The participants were 20 patients, each with two eyes, who had moderate-to-severe DED. Before and after treatment, the clinical degree of DED was examined in each group, using ocular surface disease index (OSDI) scores, tear break-up time (TBUT), fluorescent tests, and Schirmer I tests. In addition, tear samples were taken to examine IL-6 levels through the ELISA method. The results were analyzed using the t-test, Wilcoxon test, and Mann–Whitney test. The correlation between tear IL-6 levels and the severity of DED was analyzed using the Spearman correlation test. Results: The study showed a significantly lower tear IL-6 level, OSDI score, and degree of ocular staining after either topical cyclosporin-A 0.1% or a combination of topical cyclosporin-A 0.1% and sodium hyaluronate (all values p < 0.05). Conclusions: The combination therapy was superior in reducing tear IL-6 levels. In addition, a correlation existed between tear IL-6 levels and the severity of DED based on the TBUT, although it was weak and not statistically significant. Full article
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12 pages, 1765 KiB  
Article
Nature in the Heart and Mind of the Beholder: Psycho-Emotional and EEG Differences in Perception of Virtual Nature Due to Gender
by Artem Davidov, Olga Razumnikova and Maxim Bakaev
Vision 2023, 7(2), 30; https://doi.org/10.3390/vision7020030 - 03 Apr 2023
Cited by 2 | Viewed by 1591
Abstract
Natural environment experiences in virtual reality (VR) can be a feasible option for people unable to connect with real nature. Existing research mostly focuses on health and emotional advantages of the “virtual nature” therapy, but studies of its neuropsychological effects related to visual [...] Read more.
Natural environment experiences in virtual reality (VR) can be a feasible option for people unable to connect with real nature. Existing research mostly focuses on health and emotional advantages of the “virtual nature” therapy, but studies of its neuropsychological effects related to visual perception are rare. In our experiment, 20 subjects watched nature-related video content in VR headsets (3D condition) and on a computer screen (2D condition). In addition to the gender factor, we considered the individual Environmental Identity Index (EID) and collected the self-assessment of the emotional state per the components of Valence, Arousal, and Dominance in each experimental condition. Besides the psychometric data, we also registered brainwave activity (EEG) and analyzed it with the 7 frequency bands. For EID, which was considerably higher in women, we found significant positive correlation with Valence (i.e., beneficial effect of the natural stimuli on the psycho-emotional status). At the same time, the analysis of the EEG data suggests a considerable impact of the VR immersion itself, with higher relaxation alpha effect in 3D vs. 2D condition in men. The novel and most pronounced effect of the gender factor was found in the relation between the EID and the EEG powers in the high-frequency bands—that is, positive correlation of these variables in women (0.64 < Rs < 0.74) but negative correlation in men (−0.66 < Rs < −0.72). Our results imply individually different and gender-dependent effects of the natural stimulus in VR. Correspondingly, the video and VR content development should consider this and aim to provide a user characteristics-tailored experience. Full article
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18 pages, 2385 KiB  
Article
Ultrafast Image Categorization in Biology and Neural Models
by Jean-Nicolas Jérémie and Laurent U. Perrinet
Vision 2023, 7(2), 29; https://doi.org/10.3390/vision7020029 - 24 Mar 2023
Cited by 2 | Viewed by 1181
Abstract
Humans are able to categorize images very efficiently, in particular to detect the presence of an animal very quickly. Recently, deep learning algorithms based on convolutional neural networks (CNNs) have achieved higher than human accuracy for a wide range of visual categorization tasks. [...] Read more.
Humans are able to categorize images very efficiently, in particular to detect the presence of an animal very quickly. Recently, deep learning algorithms based on convolutional neural networks (CNNs) have achieved higher than human accuracy for a wide range of visual categorization tasks. However, the tasks on which these artificial networks are typically trained and evaluated tend to be highly specialized and do not generalize well, e.g., accuracy drops after image rotation. In this respect, biological visual systems are more flexible and efficient than artificial systems for more general tasks, such as recognizing an animal. To further the comparison between biological and artificial neural networks, we re-trained the standard VGG 16 CNN on two independent tasks that are ecologically relevant to humans: detecting the presence of an animal or an artifact. We show that re-training the network achieves a human-like level of performance, comparable to that reported in psychophysical tasks. In addition, we show that the categorization is better when the outputs of the models are combined. Indeed, animals (e.g., lions) tend to be less present in photographs that contain artifacts (e.g., buildings). Furthermore, these re-trained models were able to reproduce some unexpected behavioral observations from human psychophysics, such as robustness to rotation (e.g., an upside-down or tilted image) or to a grayscale transformation. Finally, we quantified the number of CNN layers required to achieve such performance and showed that good accuracy for ultrafast image categorization can be achieved with only a few layers, challenging the belief that image recognition requires deep sequential analysis of visual objects. We hope to extend this framework to biomimetic deep neural architectures designed for ecological tasks, but also to guide future model-based psychophysical experiments that would deepen our understanding of biological vision. Full article
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13 pages, 1898 KiB  
Article
Identifying Meibomian Gland Dysfunction Biomarkers in a Cohort of Patients Affected by DM Type II
by Alessandro Abbouda, Antonio Florido, Filippo Avogaro, John Bladen and Enzo Maria Vingolo
Vision 2023, 7(2), 28; https://doi.org/10.3390/vision7020028 - 24 Mar 2023
Viewed by 2229
Abstract
(1) Background: Meibomian gland dysfunction (MGD) among patients with diabetes mellitus (DM) is a common manifestation of dry eye syndrome (DES). (2) Methods: The purpose of this study is to identify clinical parameters and biomarkers useful to improve the follow-up and the treatment [...] Read more.
(1) Background: Meibomian gland dysfunction (MGD) among patients with diabetes mellitus (DM) is a common manifestation of dry eye syndrome (DES). (2) Methods: The purpose of this study is to identify clinical parameters and biomarkers useful to improve the follow-up and the treatment of these patients. We have used an ocular surface disease index (OSDI) questionnaire, Schirmer test I/II, tear film break-up time (TF-BUT), fluorescein plus lissamine green staining, Marx’s line (ML), and meibomian gland (MGs) morphology using Sirius® Topographer (CSO, Costruzione Strumenti Oftalmici, Florence, Italy). Blood sample analysis included glucose, glycated hemoglobin, lipid profile, cortisol, dehydroepiandrosterone sulfate (DHEA-S), androstenedione (ASD) and testosterone. (3) Results: Cortisol and ASD were positively correlated with an increase of MG tortuosity, and an Increased level of triglycerides was associated with a reduction of MGs length. DHEAS levels lowered with age and were associated with ocular surface staining. (4) Conclusions: Future studies, perhaps including meibum lipid analysis and tear cytokine levels, may also further elucidate the connection between these parameters, MG architecture and function. Full article
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