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Purpose: We investigated personality traits and symptoms of anxiety and depression in patients with primary vitreous floaters. Methods: A U.K. sample of adult patients (> 18 years old) with vitreous floaters of a minimum of three months severe enough to seek a consultation was assessed for personality traits (The Big Five Inventory (BFI)), symptoms of depression (Patient Health Questionnaire-9), and symptoms of anxiety (Generalized Anxiety Disorder Questionnaire-7). Results: 149 patients participated in the study. Compared to the general population, our sample had a significantly increased score in the domain of BFI-neuroticism (3.27 vs 2.97, ρ < 0.0001, d = 0.38) and reduced score in the domain of extraversion (2.97 vs 3.24, ρ < 0.0001, d = 0.33). Female patients scored significantly higher than male patients on BFI-neuroticism (ρ = 0.01), and on BFI-agreeableness (ρ = 0.01). Age was positively correlated with BFI-Conscientiousness (r = 0.19, ρ = 0.02) and with BFI-Agreeableness (r = 0.20, ρ = 0.01). 36% of our sample had moderate to severe symptoms of depression, and 43% had moderate to severe symptoms of anxiety. Conclusions: Our study highlights the underlying psychological traits of patients with severe vitreous floaters and particular mental health needs that deserve further consideration by ophthalmological and vision science clinicians. [ABSTRACT FROM AUTHOR]

Purpose: Automated measurement algorithm software is not routinely available in optical coherence tomography angiography (OCTA) devices and manual measurement of choroidal neovascular membrane (CNVM) size is necessary. Our aim was to determine intra- and inter-rater agreement of inflammatory CNVM manual measurements obtained with OCTA. Methods: OCTA (Triton® Topcon Corporation) images in patients with inflammatory CNVM were imported into ImageJ software v1.50 (NIH image). Two experienced observers performed manual area and perimeter measurements independently, and one of the observers performed the same measurements twice. Agreement was evaluated with intraclass correlation coefficients (ICC) and concordance correlation coefficients (CCC). Bland-Altman plots were plotted to graphically assess concordance. Statistical analysis was performed using STATA v13.0. Results: Sixteen eyes of 16 subjects, with a mean age of 39.0 ± 16.6 years (range 13–71), were included. Mean CNVM area and perimeter was 124.83 ± 117.80 and 4.20 ± 2.00 mm, respectively. Intra-rater ICC for both area and perimeter measured was 0.99 (95% confidence interval (CI) 0.99–0.99). Inter-rater ICC for area and perimeter measured was 0.95 (95%CI 0.87–0.98) and 0.81 (95%CI 0.17–0.94), respectively. Intra-rater CCC for both area and perimeter measured was 0.99 (95%CI 0.99–0.99). Inter-rater CCC for both area and perimeter measured was 0.91 (95%CI 0.81–0.99) and 0.66 (95%CI 0.44–0.88), respectively. Conclusions: Inflammatory CNVM manual measurement showed high intra-rater agreement and moderate inter-rater agreement. Repeatability and reproducibility studies are essential in manual analysis to establish thresholds that can distinguish measurements variation from true clinical change. An automatic algorithm may be helpful to accurately grade lesions and monitor disease activity and response to treatment. [ABSTRACT FROM AUTHOR]

Dear Editor, In discussion with colleagues around the world, we have identified a critical gap of guidance for clinicians to communicate with patients and their families about how to minimize exposure whilst undertaking crucial eye care services during the current COVID-19 pandemic. We at the Vision Academy [[1]], with support from Bayer, have compiled a guidance document that explains how to adapt clinic practices to minimize risk of exposure of patients and medical staff, and to prioritize those with the greatest treatment need [[2]]. Informing patients and families about what to expect at the next appointment Before the appointment, the clinic may reach out to inquire about the patient's current health status. [Extracted from the article]

Purpose: To review the current literature on the psychological impact of anti-VEGF treatments for wet age-related macular degeneration (wAMD), in terms of patients' experiences of receiving these treatments, and the impact of these treatments for patients' mental health and quality of life. Methods: We critically analyzed current literature evaluating psychological impact of anti-VEGF treatments for wAMD. Primary searches of PubMed, Science Direct, and Web of Science were conducted in July and August of 2015. We reviewed all papers on the topic published until August 5, 2015. Results: Our literature search found 14 papers addressing the psychological impact of anti-VEGF treatments for wAMD. Results highlighted potential anxieties and experiences of pain caused by receiving regular intravitreal injections. A positive visual outcome of anti-VEGF therapy is associated with positive vision-related QOL outcomes, although such association seems to be dependent on improvements on visual acuity. In the literature reviewed, patients receiving anti-VEGF treatments showed a prevalence rate of depression between 20 and 26 %. Conclusions: Although anti-VEGF treatments can cause some anxiety and being experienced as a stressful event, especially in the beginning of the treatment, preliminary findings suggest a potential benefit for long-term vision-related quality of life. Further longitudinal and qualitative research should bring more evidence on the positive and negative effects of these treatments on patients' long-term mental health. [ABSTRACT FROM AUTHOR]

Purpose: Many eye diseases require on-going assessment for optimal management, creating an ever-increasing burden on patients and hospitals that could potentially be reduced through home vision monitoring. However, there is limited evidence for the utility of current applications and devices for this. To address this, we present a new automated, computer tablet-based method for self-testing near visual acuity (VA) for both high and low contrast targets. We report on its reliability and agreement with gold standard measures. Methods: The Mobile Assessment of Vision by intERactIve Computer (MAVERIC) system consists of a calibrated computer tablet housed in a bespoke viewing chamber. Purpose-built software automatically elicits touch-screen responses from subjects to measure their near VA for either low or high contrast acuity. Near high contrast acuity was measured using both the MAVERIC system and a near Landolt C chart in one eye for 81 patients and low contrast acuity using the MAVERIC system and a 25 % contrast near EDTRS chart in one eye of a separate 95 patients. The MAVERIC near acuity was also retested after 20 min to evaluate repeatability. Results: Repeatability of both high and low contrast MAVERIC acuity measures, and their agreement with the chart tests, was assessed using the Bland-Altman comparison method. One hundred and seventy-three patients (96 %) completed the self- testing MAVERIC system without formal assistance. The resulting MAVERIC vision demonstrated good repeatability and good agreement with the gold-standard near chart measures. Conclusions: This study demonstrates the potential utility of the MAVERIC system for patients with ophthalmic disease to self-test their high and low contrast VA. The technique has a high degree of reliability and agreement with gold standard chart based measurements. [ABSTRACT FROM AUTHOR]

Purpose: To investigate whether macular pigment optical density (MPOD) is related to dark adaptation in healthy subjects. Methods: Dark adaptation was measured after a minimum 30 % pigment bleach in 33 subjects (aged 15-68), using a white 1° stimulus presented 11° below fixation on a cathode ray tube monitor. The luminance range of the monitor was extended using neutral density filters. A heterochromatic flicker photometry based instrument (MPS 9000) was used to measure MPOD. Results: The average MPOD for the whole group was 0.37 ±0.21 optical density units. Subjects with lighter irides had on average 40 % lower MPOD compared to those with darker irides (0.3 ± 0.20 vs 0.5 ± 0.19). Group mean MPOD was weakly associated with second ( r = 0.32, p = 0.07) and third rod-mediated recovery rates ( r = 0.31, p = 0.08) and with the rod threshold ( r = −0.24, p = 0.18) 30 min after the onset of bleach. MPOD was unrelated to cone time constant ( r = −0.02, p = 0.91), cone threshold ( r = −0.01, p = 0.96), rod-cone break ( r = 0.13, p = 0.45) or the rod-rod break ( r = 0.11, p = 0.52). The second rod-mediated recovery rate (S2) for the lower 10th percentile of MPOD ( n = 4) was 0.18 log cd.m.min and 0.24 log cd.m.min for the upper 10th percentile ( n = 4). The two groups were significantly different ( t = −2.67, p = 0.037). Conclusions: We report a statistically significant difference between subjects falling in the 10th percentile extremes of MPOD and rod-mediated but not cone-mediated sensitivity recovery. Further investigation into the relationship between MPOD and rod function is warranted, particularly extending the work to encompass those with low MPOD and poor night vision. [ABSTRACT FROM AUTHOR]

Purpose: To assess repeatability of visual function measures in patients with early, intermediate or late age-related macular degeneration (AMD) without active neovascular disease in the study eye, but active neovascular AMD in the fellow eye. Methods: One hundred subjects from an ongoing trial were screened for this study in which their LogMAR acuity, contrast sensitivity and reading performance were assessed using standardised protocols by trained optometrists. The same measures were repeated one month later and repeatability of the visual functions assessed. Results: Data from 83 subjects satisfied inclusion criteria for analysis. Coefficient of repeatability was 14.9 letters for LogMAR visual acuity , 7.2 letters for Pelli Robson contrast sensitivity, 0.72 for LogMAR reading acuity, 110.4 words/ min for reading speed and 0.67 for LogMAR critical print size. Intraclass correlation coefficients allowed comparison between measures and were found to be 0.96 for LogMAR visual acuity, 0.93 for contrast sensitivity, 0.75 for LogMAR reading acuity, 0.79 for reading speed and 0.74 for LogMAR critical print size. Coefficients of variation were 9.4 %, 10.7 %, 48.4 %, 28.4 % and 31.8 % respectively. Conclusions: We found coefficients of repeatability that concurred with previous studies demonstrating variability of visual functions in patients with AMD. In addition, we found intraclass correlation coefficients to be better with visual acuity and contrast sensitivity than with measures of reading performance. [ABSTRACT FROM AUTHOR]

Purpose: To characterize the rate of rod-mediated sensitivity decline with age using a PC-driven cathode ray tube (CRT) monitor. To provide data regarding the repeatability of the technique. Methods: Dark adaptation was monitored for 30 min following a minimum 30 % pigment bleach, using a white 1° stimulus (modulated at 1 Hz), presented 11° below fixation on a CRT monitor. Thirty-three subjects with no ocular pathology and normal fundus photographs were divided into two groups: older (≥45, n = 16) and younger (<45, n = 17). Results: Rod recovery was assessed using component S2 of dark adaptation. S2 was significantly slower in the older (0.19 ± 0.03 log cd.m.min) compared with the younger group (0.23 ± 0.03 log cd.m.min, t = −4.05, p < 0.0003), despite no difference in visual acuity and fundus appearance. Faster rates of S2 recovery were correlated with lower threshold at 30 min (T) ( r = −0.49). Correlation coefficients between first and second measurements for S2 and T were 0.49 ( p < 0.009) and 0.84 ( p < 0.0001) respectively. The coefficient of repeatability was 0.07 log cd.m.min for S2 and 0.35 log cd.m for T. The coefficients of variation for S2 and T were 15 % and 10 % respectively. Conclusions: Dark adaptation is slowed in normal ageing. CRT-based dark adaptometry is easily implemented and highly repeatable. The technique described in this article would be useful for documenting visual changes in future clinical trials assessing retinal health in the older eye with and without ocular pathology. [ABSTRACT FROM AUTHOR]

Background. This study explores the relative influence of fibrosis and pearl-type posterior capsule opacification (PCO) on visual function. It also examines the relevance of analyzing different central areas of posterior capsule on visual function. Methods. Thirty-eight eyes of 33 patients had their vision tested and posterior capsules photographed digitally. Each patient then underwent Nd:YAG laser capsulotomy. Patients returned 1 week later for repeat vision tests and photography. Analyses of areas of pearls and fibrosis were performed using the EPCO software system. The difference in these values before and after Nd:YAG laser capsulotomy was compared to change in vision for each patient. The effect of analyzing the central 1.5-, 2.5- and 3.5-mm zones was studied. Results. Stepwise multiple linear regression analysis shows that improvements in distance and near acuity are most strongly related to the central 1.5–2.5 mm of fibrosis and the central 3.5 mm of pearls. Improvements in contrast sensitivity are most strongly related to the central 1.5 mm of both fibrosis and pearls. Conclusion. In the assessment of PCO, the location and morphology of opacification correlate with visual function. Central fibrosis and paraxial pearls are important determinants of visual dysfunction. [ABSTRACT FROM AUTHOR]

Abstract Background. There are no prospective controlled trials comparing methods of capsulotomy or patterns of capsulotomy openings in similarly graded opacified posterior capsules. This paper aims to investigate the effect of various forms of posterior capsular opacification (PCO) capsulotomy openings on visual function Methods. Thirty-six eyes of 34 patients had vision tested and posterior capsules were digitally photographed. Each patient then underwent Nd:YAG laser capsulotomy. Patients returned 1 week later for repeat vision tests and photography. Analyses of areas of pearls and fibrosis were performed using the EPCO software system. Analyses of size and shape of capsulotomy was also done with image analysis software. The capsulotomy characteristics were analysed with respect to improvements in vision, taking into consideration the PCO scores. Results. No correlation was found between capsulotomy dimensions and visual function improvement, even when PCO details were included in the analyses. Neither capsulotomy area, eccentricity, nor shape irregularity in the ranges measured was found to correlate significantly with eventual visual outcome in terms of contrast sensitivity, near and distance visual acuity, or glare readings. Conclusion. Performing a small capsulotomy (at least 1.5 mm in diameter), even if decentred up to 1 mm, may allow for satisfactory visual performance as long as the aperture is clear and not obscured by residual strands. [ABSTRACT FROM AUTHOR]