Predicting visual acuity in Bietti crystalline dystrophy: evaluation of image parameters

Background To analyze multiple imaging modalities in patients with Bietti crystalline dystrophy (BCD) and to investigate which factors from these modalities are associated with best corrected visual acuity (BCVA). Methods In this retrospective study, 40 eyes from 22 patients with BCD were included and were separated into group 1 (BCVA ≤20/200) and group 2 (BCVA > 20/200). Data including BCVA and characteristic findings from near-infrared reflectance (NIR) imaging, fundus autofluorescence (FAF), and spectral domain-optic coherence tomography (SD-OCT) were analyzed and compared. The outcome measures of multimodal imaging were evaluated for correlation with BCVA. Results NIR is a good diagnostic tool for detecting either crystalline or sclerotic vessels in BCD. Patients in group 1 tended to have a thinner choroid (P = 0.047) with ellipsoid zone (EZ) disruption (P = 0.011). Calculation of the area under the curve indicated that EZ disruption detected on SD-OCT could be a good predictor of legal blindness in BCD. Conclusion For the diagnosis of BCD, NIR could be a good diagnostic tool. Of the studied imaging modalities, we found that EZ disruption at the fovea were strongly associated with legal blindness, which could be easily assessed by SD-OCT.

Choroba Stargardta funkcjonalnie – o sposobach radzenia sobie z niepełnosprawnością wzroku w stopniu znacznym

Visual disability affects about 2 million Poles. This group includes people who have been diagnosed with Stargardt’s disease. This disease occurs in the general population with a frequency of one in 10,000. It leads to legal blindness with visual acuity lower than 5%. Visual disturbances in this disease may occur in children, i.e. 7–12 years of age, as well as in adolescents and adults. People suffering from this disease experience a significant reduction in visual acuity, difficulty in recognizing colors, impaired depth vision, difficulties with accommodation, impaired central vision and often severe photophobia. The aim of the research was to collect information about the assistive technologies used by people with Stargardt’s disease and to identify their ability to move independently despite a significant reduction in visual acuity. The research results show that most of the 102 surveyed people use various types of assistive technology and experience significant visual impairment. At the same time, a significant part of this group declares that despite the inability to read the black print text, they can still move quite freely.

Intermediate uveitis associated with MS

Uveitis is a major cause of visual impairment and blindness among working-age adults, accounting for 10% of legal blindness in the United States. Among people with MS, the prevalence of uveitis is 10 times higher than among the general population, and because MS and uveitis share similar genetic risk factors and immunologic effector pathways, it is not clear whether uveitis is one of the manifestations of MS or a coincident disorder. This uncertainty raises several diagnostic and management issues for clinicians who look after these patients, particularly with regard to recognizing visual symptoms resulting from demyelination, intraocular inflammation, or the visual complications of disease modifying drugs for MS, e.g., fingolimod. Likewise, management decisions regarding patients with uveitis are influenced by the risk of precipitating or exacerbating episodes of demyelination, e.g., following anti–tumor necrosis factor biologic therapy, and other neurologic complications of immunosuppressive treatments for uveitis. In this review, we explore the similarities in the pathophysiology, clinical features, and treatment of patients with uveitis and MS. Based on the latest evidence, we make a set of recommendations to help guide neurologists and ophthalmologists to best manage patients affected by both conditions.

An Investigation into the Prevalence of Behavioral and Environmental Determinants of Cataract

Accounting for 51% of legal blindness in the world and 27% in Qatar, cataract remains the most prevelant cause of visual imapairments. Cataract involves the clouding of the eye lens, which reduces the light that reaches the retina and ultimately reduces vision. There are existing medical procedures for cataract, however these are deemed invasive and unaffordable. Scientists and public specialists agree that preventing cataract formation is the key to allevating worl blindness levels. Our objectives are: -To determine factors that inrease risk of developing cataract. -To discover the link between day-to-day activities of individuals in earlier life and the development of catarct in later life. -To compile a list of ways to prevent formation of cataract.

Predicting Visual Acuity in Bietti Crystalline Dystrophy: Evaluation of Image Parameters

Background: To analyze multiple imaging modalities in patients with Bietti crystalline dystrophy (BCD) and to investigate which factors from these modalities are associated with best corrected visual acuity (BCVA).Methods: In this prospective observational study, the eyes were separated into group 1 (BCVA £ 20/200) and group 2 (BCVA > 20/200). Data including BCVA and characteristic findings from near-infrared reflectance (NIR) imaging, fundus autofluorescence (FAF), and spectral domain-optic coherence tomography (SD-OCT) were analyzed and compared. The outcome measures of multimodal imaging were evaluated for correlation with BCVA.Results: NIR is a good diagnostic tool for detecting either crystalline or sclerotic vessels in BCD. Patients in group 1 tended to have a thinner choroid (P = 0.047) with ellipsoid zone (EZ) disruption (P = 0.011). Calculation of the area under the curve indicated that EZ disruption detected on SD-OCT could be a good predictor of legal blindness in BCD.Conclusion: For the diagnosis of BCD, NIR could be a good diagnostic tool. Of the studied imaging modalities, we found that EZ disruption at the fovea were strongly associated with legal blindness, which could be easily assessed by SD-OCT.Trial registration: Retrospectively registered.

Optogenetic therapy: High spatiotemporal resolution and pattern recognition compatible with vision restoration in non-human primates

Restoring vision using optogenetics is an ideal medical application because the eye offers a direct window to access and stimulate the pathological area: the retina. Optogenetic therapy could be applied to diseases with photoreceptor degeneration such as retinitis pigmentosa. Here, we select the specific optogenetic construct that is now used in the clinical trial and assess the opsin functional efficacy on non-human primate’s retinal ganglion cells (RGCs).We chose the microbial opsin ChrimsonR and showed that the vector AAV2.7m8 produced greater transfection in RGCs compared to AAV2, and that ChrimsonR attached to tdTomato (ChR-tdT) is more efficiently expressed than ChrimsonR. The 600 nm light activates the RGCs transfected with the vector AAV2.7m8-ChR-tdT from an irradiance of 1015 photons.cm-2.s-1. Vector doses of 5.1010 and 5.1011 vg/eye transfect up to 7000 RGCs/mm2 in the perifovea, with no significant immune reaction. Furthermore, using a multielectrode array we recorded RGCs responses starting from 1ms stimulus duration. Using the recorded activity we were able to decode stimulus information and estimate a theoretical visual acuity of 20/249, above legal blindness. Altogether, our results pave the way for the ongoing clinical trial with the AAV2.7m8-ChrimsonR-tdT vector for vision restoration in patients affected by retinitis pigmentosa.One Sentence SummaryWe select here the vector and genetic construct best suited to provide vision restoration in patients suffering from retinopathies, we demonstrate temporal resolution compatible with high dynamic visual scenes and a visual acuity above legal blindness.

The Effect of an Innovative Vision Simulator (OrCam) on Quality of Life in Patients with Glaucoma

Purpose:The aim of this study was to determine the impact of OrCam on vision-related quality of life of patients with legal blindness and end-stage glaucoma. OrCam is a device comprised of a camera and earpiece attached to the user’s eyeglass that translates written text to speech.Methods:In this prospective, observational study, a total of 27 participants were recruited and tested. All participants were legally blind. Participants were provided with the OrCam device during the study period and trained how to operate it. National Eye Institute Visual Functioning Questionnaire-25 (NEI-VFQ-25) and other questionnaires were given to participants at the baseline visit and at the end of the 4-week study for comparison. Additional questions were surveyed weekly during the study to monitor progress.Results:At the final visit after 1 month, most participants, 74.1% ( n = 20/27), reported an increase in their overall quality of life. Participants were highly satisfied with the device; 88.9% ( n = 24/27) reported being “very satisfied” or “satisfied” with the device. The NEI-VFQ-25 near vision subscale score improved from 29.9 to 37.2 ( p = .045).Discussion:OrCam allowed participants with legal blindness to read independently when in controlled settings, subsequently improving their quality of life. However, users had more difficulty using the device when the location of text was not readily apparent (e.g., street signs, billboards), and users with some degree of vision had an easier time aligning the device with the text.Implications for practitioners:This device may offer participants with visual impairments the opportunity to read independently.

Reports from Parents about Medical and Low Vision Services for Their Children with Albinism: An Analysis

Introduction The purpose of this study was to gain information from parents in the United States about their children with albinism. The article focuses on information and services related to medical care and low vision care. Methods An online questionnaire was used to collect data, and parents had opportunities to submit additional information. One hundred ninety-two families, representing 223 children with albinism from 40 U.S. states, completed surveys. Results A snapshot of the data indicates that for 8.6 out of 10 families, there were no known relatives with the condition; 55.8% of the children had visual acuities that met the criteria for legal blindness in the United States; and 48% of the children using optical devices had received clinical low vision evaluations by optometrists or ophthalmologists who specialized in low vision. Implications for practitioners The data gathered suggest recommendations for medical service providers, including clinical low vision specialists who perform evaluations for improving the functional use of vision.

Participant Experiences in an Employment Mentoring Program for College Students with Visual Impairments

Introduction Mentors can help college graduates with visual impairments (that is, those with blindness or low vision) prepare for and seek employment in their chosen fields by serving as role models and sharing their experiences with mentees. Identifying mentoring activities and discussions most valued by mentees with visual impairments will facilitate the design of future mentoring programs. Methods A nationwide mentoring program for college students with legal blindness was implemented using an experimental longitudinal research design. Career mentors with legal blindness worked with mentees to develop knowledge and skills related to securing employment. Data included engagement in job-seeking activities, most helpful aspects of the mentoring relationship, and a participant evaluation of the program. Results Most mentees indicated that program activities and discussions related to visual impairment (for instance, disclosure and accommodation planning) and field-specific issues (such as career exploration and professional development) were of greatest value. Participants evaluated the program positively. Discussion Mentees valued knowledge, support, encouragement, and career guidance provided by mentors. Mentors valued the opportunity to contribute to the growth of young professionals with visual impairments. Implications for practitioners Students with visual impairments find value in specific aspects of mentoring relationships, and mentors are eager to work with students seeking employment. Topics and activities for future mentoring programs should include disclosure, accommodations, blindness skills, and job-search skills. Level of visual impairment and the career field should both be considered when pairing mentors with students with visual impairments preparing for employment.