Outcomes of Patients With Acute Vogt–koyanagi–harada Disease Treated With Intravenous Corticosteroid Pulse Followed by the Slow Tapering of Oral Corticosteroid Therapy

Purpose We investigated the treatment outcomes of patients with acute Vogt–Koyanagi–Harada (VKH) disease and assessed the differences between patients with no inflammation worsening and those with persistent or worsening inflammation. Potential factors responsible for eyes with low visual outcomes were also investigated.Methods We retrospectively reviewed the clinical records of patients with acute VKH disease who first visited us between 2009 and 2018 and were followed up for >300 days. Clinical characteristics, treatments, and posttreatment conditions were assessed. Patients were classified into no inflammation worsening (acute–resolved [AR]) and inflammation worsening (chronic–recurrent [CR]) groups based on conditions after 6 months from disease onset.Results This study assessed 62 eyes from 31 patients (mean age: 52.8 years). One patient was treated with topical treatment alone and showed poor visual outcomes. In total, 30 patients were treated with methylprednisolone pulse followed by the slow tapering of oral prednisolone; 73% of them developed AR and 27% CR. Although the total prednisolone dose was higher in patients with CR disease, no significant difference was noted in the final best-corrected visual acuity (BCVA). Among the patients receiving systemic steroid, five eyes had a final BCVA of ≤0.5 due to anisometropic amblyopia, diabetic maculopathy, pre-existing macular hole, epiretinal membrane, and ellipsoid zone loss. Conclusions Patients with acute VKH disease treated with corticosteroid pulse followed by the slow tapering of prednisolone appear to demonstrate good visual outcomes, including patients with CR; most eyes with low visual outcomes have pre-existing conditions that explain low vision.

Low vision impairs implicit sensorimotor adaptation in response to small errors, but not large errors

Successful goal-directed actions require constant fine-tuning in response to errors introduced by changes in the body and environment. This implicit adaptive process has been assumed to operate in a statistically optimal fashion, reducing its sensitivity to errors when sensory uncertainty is high. However, recent work has shown that visual uncertainty attenuates implicit adaptation for small errors, but not large errors, a result that is at odds with an optimal integration hypothesis. This error size interaction has motivated a new hypothesis that sensory uncertainty impacts the distribution of the perceived error locations but not the system's sensitivity to errors. To examine these competing hypotheses, previous studies have experimentally manipulated uncertainty. But it is unknown which hypothesis best describes motor adaptation to sensory uncertainty experienced during daily life. To address this question, we recruited individuals with low vision due to diverse clinical conditions impacting visual uncertainty and matched controls. The groups were tested on visuomotor tasks designed to isolate implicit adaptation and maintain tight control over the error size. In two experiments, low vision was associated with attenuated implicit adaptation only for small errors, but not for large errors. Taken together with prior work in which visual uncertainty was experimentally manipulated, these results support the notion that increasing sensory uncertainty increases the likelihood that errors are mis-localized but does not affect error sensitivity, offering a novel account for the motor learning deficits seen in low vision.

Usability and Accessibility of the ArtontheBrain™ Virtual Recreation Activity for Older Adults With Low Vision Due to Age-Related Macular Degeneration

Experiencing visual art can inspire, be an overall positive leisure activity, and has been linked to improved cognition, especially in older adults. Access to artwork in a museum environment can comprise a variety of barriers, including difficulties linked to its visual experience for persons that are visually impaired. The present study explored the barriers and facilitators experienced by 15 older adults (age 65 to 93) living with age-related macular degeneration when using an iPad to access ArtontheBrain™, a virtual art museum recreation experience created by members of this team. Using the Concurrent Think Aloud method, participants were asked to continuously comment on their experiences with the application while being audio/video recorded. Indeed, codes were determined by identifying frequently stated and emphasized ideas or behaviors of participants using the ArtontheBrain™ application. Transcripts underwent thematic analysis and indicated that the main access barriers were linked to control of the contrast, magnification, and the tactile interface on the tablet device. The learn and play activities as well as the text-to-speech feature were identified as facilitators for ArtontheBrain™ engagement. The present findings should also be considered in the larger context of application development, as this study provides insight pertaining to the needs of low vision individuals regarding usability and accessibility.

Vitrectomy in Myopic Maculopathy

Myopia is one of the most important causes of low vision in the world. While high myopia causes pathological changes in many tissues in the eye, it also causes degenerative changes in the retina. This review mentions the vitreoretinal surgical approach, difficulties in surgery, and new developments in maculopathies due to pathological myopia.

Strategies of planning online scientific projects for blind and visually impaired students

The paper describes distance learning opportunities for blind and visually impaired students. The research aims at analyzing various tools and techniques that are necessary for their participation in online scientific projects and conferences. Methodology includes analysis of pedagogical studies, the survey carried out during International Conference for Students at Samara State Technical University, examination of educational activities performed for blind and visually impaired students all over the world, in particular the experience of American Foundation for the Blind. The findings show that distance learning programmes for blind and visually impaired people are becoming popular in many countries, but in Russia there are only a few of them. The authors prove the necessity of doing research in this sphere. It is recommended that more distance learning opportunities are created for such students at Russian universities. The analysis shows that it is even easier to plan the inclusion of blind and visually impaired students in the online scientific events that are not new and have already been held for wider public. The authors conclude that it is essential to adapt the existing system of distance learning using special tools and techniques, which are described in the article. These are accessible platforms, software used with assistive technologies, keyboard controls, audio description, smartphone apps, etc. Special emphasis is laid upon planning webinars for blind and low vision participants. This research can serve as a guide for making online scientific events accessible for all people.

Congenital Blindness and Psychosis: A Literature Review

Low vision has been declared by the World Health Organization (WHO) to be one of the major ophthalmologic problems requiring global attention. Low-vision patients experience a reduced vision-related quality of life due to impaired visual function. However, this condition that interfere their daily life could also make a significant effect on their mental health. Therefore, the final goal of low-vision rehabilitation is to improve the daily quality of life. However, the absence of vision at birth appears to protect against psychosis, whereas later-life visual loss appears to predispose to the development of psychotic symptoms. Thus, our purpose in this literature review is to learn how the onset of visual loss may affect patient's mental health.