Dynamic text presentation on smart glasses: A pilot evaluation in age-related macular degeneration

We suggest a low-vision reading aid based on user-customized text presented on a head-mounted display (HMD), and make an initial comparison to optical aids in participants with age-related macular degeneration (AMD). Biomimetic scrolling, a novel method of text presentation which mimics the natural movements of the eye while reading, was previously invented: while the user maintains a steady gaze, text is scrolled horizontally across the display in a series of pauses and steps that resemble the natural fixations and saccades of reading. This method, along with rapid serial visual presentation, continuous scrolling, and static text, was presented on smart glasses to 23 participants with macular disease. Reading speed and subjective preference of the smart glasses was compared to reading text printed on paper using the participants’ habitual optical reading aid. Reading using smart glasses, the mean (±standard error) maximum reading speed was 122 ± 15 words per minute (wpm), compared to 74 ± 9 wpm using each participants’ habitual optical magnifier. This is a statistically significant difference as confirmed by a paired-sample t-test, t(17) = –4.61, p < .001. In total, 70% of the participants preferred reading from the smart glasses compared to reading from paper, and 84% found doing so easier. Data from this small patient cohort with AMD have demonstrated enhanced reading performance using dynamic text presented on a spectacle type HMD-device. Loss of reading ability marks a major decline in quality of life and independent functioning. Dynamic text presentation, including biomimetic scrolling, on smart glasses could improve reading performance for the visually impaired.

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The Experience of a Randomized Clinical Trial of Closed-Circuit Television versus Eccentric Viewing Training for People with Age-Related Macular Degeneration

Journal of Visual Impairment & Blindness ◽

10.1177/0145482x1711100405 ◽

2017 ◽

Vol 111 (4) ◽

pp. 354-368 ◽

Cited By ~ 2

Author(s):

Susan J. Leat ◽

Francie Fengqin Si ◽

Deborah Gold ◽

Dawn Pickering ◽

Keith Gordon ◽

...

Keyword(s):

Visual Acuity ◽

Macular Degeneration ◽

Vision Loss ◽

Low Vision ◽

Reading Speed ◽

Optical Devices ◽

Reading Performance ◽

Age Related Macular Degeneration ◽

Eccentric Viewing ◽

Age Related

Introduction In addition to optical devices, closed-circuit televisions (CCTVs) and eccentric viewing training are both recognized interventions to improve reading performance in individuals with vision loss secondary to age-related macular degeneration. Both are relatively expensive, however, either in the cost of the device or in the amount of time personnel need to provide training. In this randomized trial, we compared the effectiveness of these two interventions. Methods Participants with age-related macular degeneration and visual acuity between 6/48 (20/160) and 6/120 (20/400) first received basic low vision care, including optical devices. At the subsequent baseline visit, they undertook a battery of measures including logMAR visual acuity; reading speed and accuracy for text in 1.3M and 1M fonts; reading information on medicine bottles, utility bills, and food packages; the NEI-VFQ; the Geriatric Depression Scale; and a reading inventory questionnaire. They were then randomized to either obtaining a CCTV for home use or eccentric viewing training over the following six weeks. Results Recruitment was more difficult than expected for this population. Of 145 patients referred, 29 met the inclusion-exclusion criteria, 14 were willing to enroll, and 10 completed the trial. For the primary outcome (reading speed for 1.3M print), there was a significant improvement between baseline and outcome for the CCTV group (p = 0.005), but not for the eccentric viewing training group (p = 0.28), and the CCTV group showed significantly greater change (p = 0.04). There was a nonsignificant improvement in reading speed for 1M text and a decrease in the amount of time taken to read utility bill information in the CCTV group. There was a significant improvement in near visual acuity with current glasses with eccentric viewing training. The other measures did not reach statistical significance. Discussion Randomized clinical trials for low vision rehabilitation, particularly in the elderly population with vision loss, are challenging, but such trials are important for the allocation of resources. This trial showed early indications of more impact on reading performance from CCTV than eccentric viewing training.

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Assessment of Online Patient Education Materials Designed for People with Age-Related Macular Degeneration

10.21203/rs.3.rs-50520/v3 ◽

2020 ◽

Author(s):

Jennifer K Fortuna ◽

Anne Riddering ◽

Linda Shuster ◽

Cassie Lopez-Jeng

Keyword(s):

Health Literacy ◽

Patient Education ◽

Macular Degeneration ◽

Reading Ability ◽

Reading Speed ◽

Reading Level ◽

Age Related Macular Degeneration ◽

Age Related ◽

The Mean ◽

Readability Level

Abstract Background Age-related macular degeneration (AMD) is a chronic eye condition that leads to permanent vision loss in the central visual field. Difficulty reading is one of the most common complaints from patients with this condition. Reading comprehension may be poorer due to slower reading speed, increased demands of decoding and poorer quality of visual input. The internet has become the most widely accessible source of patient education materials (PEMs). Optical devices improve access to text, but they do not promote processing and understanding of written patient education materials. Methods Online PEMs were sourced from websites of national organizations providing patient education materials designed for people with AMD. The Flesch-Kincaid Grade Level formula and the Suitability Assessment of Materials instrument were used to assess the readability and suitability of PEMs. Descriptive statistics were used to compare online PEMs by organization based on national guidelines for readability level (≤ sixth grade) and the recommended suitability score (≥ 70%) for superior material. Results One hundred online PEMs were evaluated from websites of 16 professional organizations. The mean readability level was 9.3 (range 5.0-16.6). The mean suitability score was 53% (range 18%-78%). Only six (6%) of PEMs met the recommended readability level and suitability score. Conclusion The majority of online PEMs included in this study were written at a reading level considerably higher than the average U.S. adults reading ability. To promote health literacy, the readability of PEMs must match the reading capacity of the target audience. Existing guidelines for promoting health literacy should consider how age and visual impairment create additional barriers to processing and understanding of written health information. Additional research is needed to determine optimal design characteristics of PEMs for people with AMD. Future studies should also explore the effectiveness of PEMs that have been modified based on evidence-based guidelines for patients with low health literacy and low vision.

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Maximum Reading Speed in Patients With Geographic Atrophy Secondary to Age-Related Macular Degeneration

Investigative Opthalmology & Visual Science ◽

10.1167/iovs.18-24238 ◽

2018 ◽

Vol 59 (4) ◽

pp. AMD195 ◽

Cited By ~ 3

Author(s):

Rohit Varma ◽

Eric H. Souied ◽

Adnan Tufail ◽

Elizabeth Tschosik ◽

Daniela Ferrara ◽

...

Keyword(s):

Macular Degeneration ◽

Reading Speed ◽

Geographic Atrophy ◽

Age Related Macular Degeneration ◽

Age Related

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Effect of Ranibizumab Treatment in Cases of Choroidal Neovascular Membranes Secondary to Pathological Myopia versus Age-Related Macular Degeneration

QJM ◽

10.1093/qjmed/hcaa058.011 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

M S Abdaltawab ◽

Z F Ismail ◽

W M A Ebeid ◽

S M Fawzy

Keyword(s):

Visual Acuity ◽

Macular Degeneration ◽

Age Related Macular Degeneration ◽

Intravitreal Injections ◽

P Value ◽

Newly Diagnosed ◽

Pathological Myopia ◽

Age Related ◽

Significant Difference ◽

The Mean

Abstract Aim of the Work The aim of this work is to compare the response of treatment with ranibizumab in terms of visual acuity in cases of CNV secondary to pathological myopia versus CNV secondary to age-related macular degeneration. Methods This prospective, comparative study included ten eyes newly diagnosed as having CNV secondary to pathological myopia, and 10 eyes newly diagnosed as having subfoveal active CNV secondary to AMD. All patients had 3 monthly intravitreal Injections of 0.50 mg (in 0.05 ml of solution) ranibizumab with monthly evaluation of best corrected visual acuity (BCVA) by Landolt C chart, and also calculated in Logarithm of Minimum Angle of Resolution (Log MAR). Results pretreatment there was no significant difference between the two groups as the mean VA (Log Mar) was 1.31 ± 0.2 in AMD group and 1.17 ± 0.3 in MCNV group of P value = 0.431 and also post three IVI of ranibizumab showed no significant difference between the two groups as the mean VA (Log Mar) was 1.22 ± 0.2 for AMD and 1.22 ± 0.5 for MCNV of P value = 0.635. Conclusion there was no significant difference in BCVA between AMD and MCNV groups after three intravitreal injections of ranibizumab.

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Development of an ultra-sensitive human IL-33 biomarker assay for age-related macular degeneration and asthma drug development

Journal of Translational Medicine ◽

10.1186/s12967-021-03189-3 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Elaine Mai ◽

Joyce Chan ◽

Levina Goon ◽

Braeden K. Ego ◽

Jack Bevers ◽

...

Keyword(s):

Macular Degeneration ◽

Inflammatory Diseases ◽

Interleukin 1 ◽

Age Related Macular Degeneration ◽

Reduced Form ◽

Enzyme Linked Immunosorbent Assay ◽

Interleukin 33 ◽

Age Related ◽

Significant Difference ◽

High Concentrations

Abstract Background Over the past decade, human Interleukin 33 (hIL-33) has emerged as a key contributor to the pathogenesis of numerous inflammatory diseases. Despite the existence of several commercial hIL-33 assays spanning multiple platform technologies, their ability to provide accurate hIL-33 concentration measurements and to differentiate between active (reduced) and inactive (oxidized) hIL-33 in various matrices remains uncertain. This is especially true for lower sample volumes, matrices with low hIL-33 concentrations, and matrices with elevated levels of soluble Interleukin 1 Receptor-Like 1 (sST2), an inactive form of ST2 that competes with membrane bound ST2 for hIL-33 binding. Results We tested the performance of several commercially available hIL-33 detection assays in various human matrices and found that most of these assays lacked the sensitivity to accurately detect reduced hIL-33 at biologically relevant levels (sub-to-low pg/mL), especially in the presence of human sST2 (hsST2), and/or lacked sufficient target specificity. To address this, we developed and validated a sensitive and specific enzyme-linked immunosorbent assay (ELISA) capable of detecting reduced and total hIL-33 levels even in the presence of high concentrations of sST2. By incorporating the immuno-polymerase chain reaction (iPCR) platform, we further increased the sensitivity of this assay for the reduced form of hIL-33 by ~ 52-fold. Using this hIL-33 iPCR assay, we detected hIL-33 in postmortem human vitreous humor (VH) samples from donors with age-related macular degeneration (AMD) and found significantly increased hIL-33 levels when compared to control individuals. No statistically significant difference was observed in aqueous humor (AH) from AMD donors nor in plasma and nasosorption fluid (NF) from asthma patients compared to control individuals. Conclusions Unlike existing commercial hIL-33 assays, our hIL-33 bioassays are highly sensitive and specific and can accurately quantify hIL-33 in various human clinical matrices, including those with high levels of hsST2. Our results provide a proof of concept of the utility of these assays in clinical trials targeting the hIL-33/hST2 pathway.

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Efficacy Comparison of Intravitreal Anti-VEGF Therapy for Three Subtypes of Neovascular Age-Related Macular Degeneration: A Systematic Review and Meta-Analysis

Journal of Ophthalmology ◽

10.1155/2018/1425707 ◽

2018 ◽

Vol 2018 ◽

pp. 1-10 ◽

Cited By ~ 4

Author(s):

Jianqing Li ◽

Jiayi Xu ◽

Yiyi Chen ◽

Jiaju Zhang ◽

Yihong Cao ◽

...

Keyword(s):

Systematic Review ◽

Macular Degeneration ◽

Meta Analysis ◽

Age Related Macular Degeneration ◽

Cochrane Library ◽

Anti Vegf ◽

Age Related ◽

Significant Difference ◽

The Mean

Purpose. Intravitreal antivascular endothelial growth factor (anti-VEGF) therapy has been widely used for the treatment of neovascularization (NV) secondary to age-related macular degeneration (AMD). This study aimed to compare the efficacy among different subtypes of neovascular age-related macular degeneration (nAMD). Methods. PubMed, Embase, and the Cochrane Library were searched for eligible studies. We performed meta-analysis using Review Manager 5.3 and Stata/SE 12.0. Results. A total of 24 studies met our inclusion criteria and were included in the systematic review. At 3 months, the mean logarithm of the minimum angle of resolution (logMAR) improvements were −0.09, −0.18, and −0.23 for type 1, 2, and 3, respectively, while the mean macular thickness (MT) changes were −104.83, −130.76, and −196.29 μm. At 12 months, the mean changes in Early Treatment of Diabetic Retinopathy Study (ETDRS) letters were 6.38, 8.12, and 9.37, while the MT decrease was 126.51, 126.52, and 139.85 μm, respectively. However, statistically significant difference was only found between type 1 and 3 in vision improvement, both in the short term (p=0.0002) and long term (p=0.01). Conclusions. The reactivity to VEGF inhibitors varied among different subtypes of nAMD. The efficacy of intravitreal anti-VEGF therapy in type 3 nAMD was statistically better than type 1 when considering vision improvement at 3 and 12 months. Thus, the lesion subtype is a predictor for the treatment outcome which can help guide prognosis.

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Intravitreal bevacizumab treatment for neovascular age-related macular degeneration and thromboembolic events

European Journal of Ophthalmology ◽

10.1177/1120672118823128 ◽

2019 ◽

Vol 30 (1) ◽

pp. 66-71

Author(s):

Orly Weinstein ◽

Muhammad Abu Tailakh ◽

Tova Lifshitz ◽

Victor Novack ◽

Jaime Levy

Keyword(s):

Acute Coronary Syndrome ◽

Macular Degeneration ◽

Intravitreal Bevacizumab ◽

Age Related Macular Degeneration ◽

Thromboembolic Events ◽

Coronary Syndrome ◽

Intravitreal Bevacizumab Injection ◽

Age Related ◽

Significant Difference ◽

Bevacizumab Injection

Background: Systemic complications of intravitreal anti-vascular endothelial growth factor agents are relatively uncommon but highly significant. Objectives: Primary objective: To assess the risk for thromboembolic events following intravitreal bevacizumab injection in neovascular age-related macular degeneration patients by a large population-based study. Secondary objective: To analyze the association between injection frequency and the risk for thromboembolic events, the time interval between the injection and the thromboembolic events, and the influence of chronic diseases on complications rate. Design: A retrospective cohort study. Methods: Consecutive neovascular age-related macular degeneration patients receiving intravitreal bevacizumab at Soroka University Medical Center from December 2005 to December 2013 were included. Thromboembolic events analyzed included acute coronary syndrome, acute myocardial infarction, stroke, deep vein thrombosis, and pulmonary embolism. The thromboembolic event rate was compared 2 years prior and 2 years after the initial intravitreal bevacizumab injection. Results: A total of 2102 patients were included. Acute coronary syndrome and stroke rate were higher 2 years after intravitreal bevacizumab (p = 0.03 and p = 0.01, respectively). No statistical significant difference was found for the rest of thromboembolic events. Patients older than 80 years and patients receiving less than six intravitreal bevacizumab injections were more likely to experience stroke. Patients with known cardiovascular risk factors before starting injections did not develop significant more thromboembolic events. Conclusion: In our study population, patients treated with intravitreal bevacizumab were significantly more likely to experience stroke during 2 years after first injection.

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