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Background: Treatment of amblyopia in esotropic subjects with accommodative component currently consists of optical correction and subsequent occlusion, or penalisation, of the dominant eye. This treatment obtains a good outcome in visual acuity but poor outcomes in binocular vision. An intervention protocol that could improve the outcome of conventional treatment is presented. Methods: A retrospective study in subjects with amblyopia associated with both fully accommodative and partially accommodative esotropia is presented. Subjects were refracted under cycloplegia and treated with occlusion (passive therapy). Subjects who did not achieve orthotropia through optical correction (partially accommodative esotropia) performed an active therapy (full‐time prismatic correction and subsequent fusional vergence therapy or surgery in larger angles > 12 prism dioptres). After treatment, the subjects were examined by a masked optometrist in an external ophthalmology clinic. Results: Twenty‐six subjects (12 males and 14 females) aged from six to 13 years (median 8.50; interquartile range [IQR] 3) were included. Median age of detection was three years (IQR 1). All the subjects were hyperopic. In the baseline, median best‐corrected visual acuity of the amblyopic eye was 0.40 logMAR (IQR 0.30) and 0.00 logMAR (IQR 0.01) in the dominant eye. After the treatment, the median best‐corrected visual acuity in the amblyopic eye was 0.06 logMAR (IQR 0.08). These differences were statistically significant (p

Purpose To characterize the fixation and macular integrity of subjects with multiple sclerosis (MS) with and without previous optic neuritis (ON) using microperimetry (MP). Methods Fifty-five eyes of MS patients, subdivided into three groups (28 eyes without ON, 16 with previous ON, and 11 eyes with previous ON in the contralateral eye), and 43 healthy eyes were enrolled (January–November 2018). All cases were evaluated using the MAIA microperimeter (Centervue), analyzing the following parameters: average macular threshold (AT), fixation indexes (P1 and P2), bivariate contour ellipse area (BCEA) for 95% and 63% of points, and horizontal (H) and vertical (V) axes of the ellipse of fixation. Results All MS groups showed a significant reduced AT compared with the control group (p 0.05). Mean AT was correlated with the examination time in all three groups (between ρ = − 0.798 p

This study enrolled 61 volunteers (102 eyes) classified into subjects < 50 years (group 1) and subjects ≥ 50 years (group 2). Dysfunctional Lens Index (DLI); opacity grade; pupil diameter; and corneal, internal, and ocular higher order aberrations (HOAs) were measured with the i-Trace system (Tracey Technologies). Mean DLI was 8.89 ± 2.00 and 6.71 ± 2.97 in groups 1 and 2, respectively, being significantly higher in group 1 in all and right eyes (both p < 0.001). DLI correlated significantly with age (Rho = −0.41, p < 0.001) and pupil diameter (Rho = 0.20, p = 0.043) for all eyes, and numerous internal and ocular root-mean square HOAs for right, left, and all eyes (Rho ≤ −0.25, p ≤ 0.001). Mean opacity grade was 1.21 ± 0.63 and 1.48 ± 1.15 in groups 1 and 2, respectively, with no significant differences between groups (p ≥ 0.29). Opacity grade significantly correlated with pupil diameter for right and all eyes (Rho ≤ 0.33, p ≤ 0.013), and with some ocular root-mean square HOAs for right and all eyes (Rho ≥ 0.23, p ≤ 0.020). DLI correlates with age and might be used complementary to other diagnostic measurements for assessing the dysfunctional lens syndrome. Both DLI and opacity grade maintain a relationship with pupil diameter and internal and ocular HOAs, supporting that the algorithms used by the device may be based, in part, on these parameters. This research was funded by European Union-NextGenerationEU (E.M.-P.) and by the Ministry of Economy, Industry and Competitiveness of Spain within the program Ramón y Cajal, RYC-2016-20471 (D.P.P.).

The goal of this study was to analyze the agreement between the Medmont E300 and the Visionix VX120+ systems in terms of non-invasive tear break-up time (NIBUT) and tear meniscus height (TMH) measurements. A total of 60 eyes (30 healthy subjects) were enrolled. NIBUT and TMH were evaluated with Medmont E300; first NIBUT, NIBUT50%, and TMH were evaluated with Visionix VX120+. Both evaluations were performed in a random order by the same clinician for right, left, and both eyes. The Medmont E300 provided significantly higher NIBUT than Visionix VX120+ for first NIBUT in right, left, and both eyes (p ≤ 0.003) and NIBUT50% in left and both eyes (p ≤ 0.042). The TMH measured with VX120+ was significantly higher than with Medmont E300 considering both eyes (p = 0.037). No significant correlations were found between both devices for either NIBUT (p ≥ 0.11) or TMH (p ≥ 0.09). Passing–Bablok regression analyses revealed poor agreement between devices for NIBUT and TMH outcomes. VX120+ is expected to provide substantial lower first NIBUT values than the NIBUT measured by Medmont E300. Clinicians should consider not using both instruments as interchangeable for dry eye diagnosis. The author D.P.P. has been supported by the Ministry of Economy, Industry and Competitiveness of Spain within the program Ramón y Cajal, RYC-2016-20471. This research received no external funding. E.M.P. has been supported by European Union-NextGenerationEU.

Purpose: To compare the sagittal height (SH) measurements and best fit sphere (BFS) scleral curvature obtained with two different diagnostic technologies. Methods: Prospective, nonrandomized, and comparative study analyzing 23 healthy eyes of 23 patients (age, 14–52 years) was conducted. A complete eye examination was performed including a corneoscleral topographic analysis with the Scheimpflug camera–based system Pentacam (Oculus GmbH, Wetzlar, Germany) and afterward with the Fourier domain profilometer Eye Surface Profiler (ESP) (Eaglet-Eye, Houten, the Netherlands). Differences between devices in temporal SH (TSH), nasal SH (NSH), and mean SH (MSH) measurements at 13- and 15-mm chord length and in scleral BFS were analyzed. Results: Statistically significant differences were found in TSH, NSH, and MSH obtained with Pentacam and ESP (P≤0.017), with a range of agreement from 0.21 to 1.28 mm, and a clear trend of the Pentacam system to provide higher SH measurements. Significant differences were found between Pentacam scleral BFS and ESP outer BFS (P

Producción Científica, The easy access to electronic devices for users has resulted in the development of a vast range of programs and applications for visual evaluation and diagnosis that can be downloaded to any device. Some of them are based on tasks and stimuli that depend on luminance. The aim of the present study was to evaluate differences in luminance reproduction between electronic devices and their implications for contrast reproduction. A total of 20 Galaxy Tab A devices with 8-bit graphics processing units were evaluated. Characterization of every screen was performed obtaining the response curve for the achromatic stimulus. Mean, maximum and minimum luminance, standard deviation and coefficient of variation were obtained to assess differences between devices. Variation of luminance with increasing digital level was observed in all devices following a gamma distribution. Comparison between devices for mean results showed that some of them differed by as much as 45 cd/m2. The coefficient of variation varied from ~5 to 9%. Mean percentage of differences in luminance between devices reached 30%. In conclusion, differences in luminance reproduction between devices were present, even considering devices from the same manufacturing batch. It cannot be assumed that the characterization of one device can be extrapolated to other devices. Every device used for research purposes should be individually characterized to ensure the correct reproduction. For clinical purposes, limitations should be considered by visual specialists., Ministerio de Economía, Industria y Competitividad - program Ramón y Cajal (RYC-2016-20471), Centro para el Desarrollo Tecnológico Industrial y el Fondo Europeo de Desarrollo Regional (IDI-20180123)

Producción Científica, The authors of this study evaluated the potential benefit on visual performance of a novel 3 week visual rehabilitation program based on the use of Gabor patches in patients undergoing bilateral cataract surgery with the implantation of two models of trifocal diffractive intraocular lens (IOL). A total of 30 patients were randomly assigned to two groups: a study group (15 patients) that used a videogame based on Gabor patches and a placebo group (15 patients) that used a videogame without specific stimuli for improving visual performance. No statistically significant differences between groups were found in distance, intermediate, and near post-training visual acuity (p ≥ 0.15). Significantly better distance contrast sensitivity (CS) was found for the spatial frequencies of 6 (p = 0.02) and 12 cpd (p = 0.01) in the study group. Likewise, significantly better values of near CS were found in the study group compared to the placebo group for the spatial frequency of 1.5 cpd (p = 0.02). In conclusion, a 3 week visual rehabilitation program based on the use of Gabor patches in the immediate postoperative period after the bilateral implantation of trifocal diffractive IOLs seems to be beneficial for improving both distance and near visual performance achieved with the implant, Ministerio de Economía, Industria y Competitividad - FEDER (EXP 00106153/IDI-20180123), Ministerio de Economía, Industria y Competitividad - program Ramón y Cajal (RYC-2016-20471)

Multifocal intraocular lenses (IOLs) are currently usually implanted for the treatment of cataracts because they have been proved to be superior to monofocal IOLs with respect to spectacle independence. In turn, they are associated with a higher prevalence of dysphotopsia symptoms that is one of the most common causes of patient dissatisfaction. Neuroadaptation seems to play a major role in the optimal adaptation to multifocal IOLs. In this context, the development of strategies that facilitate the neuroadaptation process to multifocality might be an effective strategy to reduce patients’ dissatisfaction. Video games have been proved to be effective for the improvement of visual acuity and for the promotion of neuroplasticity in elderly subjects and other populations with cortical-related visual impairment. This narrative review highlights the physiological potential of video games as a perceptual strategy to improve visual acuity and promote neuroplasticity in patients using multifocal IOLs, although research is still needed to confirm these benefits in this specific population, with only one comparative study to this date providing evidence of them. Coco-Martin MB, Maldonado-López MJ, Molina-Martín A and Piñero DP are supported by CDTI (Centro para el Desarrollo Tecnológico Industrial, Ministry of Economy and Competitiveness of Spain) by means of the program PID (“Proyectos de Investigación y Desarrollo”); The author Piñero DP has been also supported by the Ministry of Economy, Industry and Competitiveness of Spain within the program Ramón y Cajal (RYC-2016-20471); Valenzuela PL is supported by a contract granted by University of Alcalá (FPI2016).

This retrospective study was conducted to evaluate the efficacy of the combined treatment of occlusion and active vision therapy in a total of 27 amblyopic children, including 14 strabismic and 13 anisometropic cases. For such purpose, changes in distance and near visual acuity as well as in the binocular function was evaluated during a two-year follow-up. In both amblyopia groups, significant improvements were found in distance and near visual acuity in the non-dominant eye (p < 0.001). In the strabismic amblyopia group, the percentage of patients with binocular function score (BF) > 3.3 decreased significantly from a baseline value of 64.3% to a two-year follow-up value of 7.1% (p < 0.001). In the anisometropic amblyopia group, this percentage also decreased significantly from a baseline value of 15.4% to a two-year follow-up value of 0.0% (p < 0.001). No recurrences were observed in the anisometropic amblyopia group, whereas recurrence occurred in two cases of the strabismic amblyopia group after finishing the vision rehabilitation process. In conclusion, the combined approach of the treatment evaluated is efficacious for providing an improvement in visual acuity and binocular function in both anisometropic and strabismic amblyopia, which was maintained over time. The author David P Piñero has been supported by the Ministry of Economy, Industry and Competitiveness of Spain within the program Ramón y Cajal, RYC‐2016‐20471.

Purpose: To analyze and characterize the pattern of visual working distance (WD) and mobile phone usage distance (MPD) in a large population, analyzing the differences in these parameters according to the job profile. Methods: Cross-sectional study consisting of a screening campaign evaluating the visual status of professionals from seven different environments. A total of 454 participants with a mean age of 41.5 years (range, 22–64 years) were revised. The screening campaign consisted of several rapid tests performed in a single session in the usual work environment of each participant, including measurement of WD, arm length, and MPD (VisionApp, VisionApp Solutions S.L.). Results: WD was significantly longer than MPD (82.5 ± 150.6 vs. 31.9 ± 6.3 cm, p < .001), whereas no significant differences were found between arm length (74.3 ± 4.8 cm) and WD (p = .493). WD was below 80 cm in 89.6% (407/454) of participants, whereas MPD was below 40 cm in 89.0% (404/454). No significant correlation was found between WD and MPD (r = 0.126, p = .117). Statistically significant differences were detected among job profile subgroups in WD (p < .001), with military personnel showing significantly longer WD than other professionals (p ≤ 0.018). Significant differences were also found between job profile subgroups in MPD (p = .006), with shorter MPDs for shoe factory professionals compared to sellers (p = .046). Conclusions: WD and MPD vary significantly among individuals, but always showing a shorter MPD. WD varies significantly also according to the job profile, being necessary to consider this information when selecting the most optimal optical aid in each case, especially for the compensation of presbyopia. The author Fernando Soler received an unrestricted grant from Johnson and Johnson Surgical Vision for the performance of this study. The author David P Piñero has been supported by the Ministry of Economy, Industry and Competitiveness of Spain within the program Ramón y Cajal, [RYC-2016-20471].

The main objective of the current study was to investigate further the relationship of the overall length of the eye with a great variety of anterior segment parameters, including scleral geometry. A total of 64 eyes of 32 participants with ages from 12 to 52 years were included in this prospective non-randomized single-center study. All participants underwent a complete eye examination, including an analysis of corneo-scleral shape with a Fourier-domain profilometer. A strong negative correlation was found between axial length and temporal-nasal ocular sagittal height difference for different chord lengths. For the right eye, a consistent and stable linear model was obtained to predict the axial length from the spherical equivalent, the corneal diameter, the high-order aberrations root mean square, and the minimum sagittal height for 13- and 14-mm chord. For the left eye, a model was obtained to predict the axial length from the spherical equivalent and the mean corneal curvature, including other parameters such as corneal diameter or high-order aberrations, depending on the chord length, considered for estimating the sagittal height values. More studies with larger samples are needed to confirm these preliminary outcomes. This article is funded by the Project UAIND18-06B of the University of Alicante within the program “Ayudas destinadas a la formación predoctoral en colaboración con empresas 2018” supported by the Vicerrectorado de Investigación y Transferencia de Conocimiento. The author David P Piñero was also supported by the Ministry of Economy, Industry and Competitiveness of Spain within the program Ramón y Cajal, RYC-2016-20471.

Purpose: To evaluate the intrasession repeatability of corneal, limbal and scleral measurements obtained by an experienced operator with a Fourier transform profilometer in healthy eyes. Methods: Prospective, single-center study including 35 eyes of 35 participants with ages ranging from 13 to 52 years. All patients underwent three consecutive corneoscleral topographic evaluations with the Eye Surface Profiler (ESP) system (Eaglet Eye b.v.). Intrasession repeatability was analyzed for different geometric and sagittal height variables using the following parameters: the within-subject standard deviation (Sw) of the three consecutive measurements, intrasubject precision (1.96 × Sw), coefficient of variation (CV) and the intraclass correlation coefficient (ICC). Results: Inner best fit sphere (BFS) showed good repeatability, with ICC of 0.844. Higher variability was observed for the repeated measurements of limbus and outer BFS, with ICCs of 0.636 and 0.739, respectively. For mean corneal and scleral radius, ICCs were 0.933 and 0.888, respectively. The repeatability of all sagittal height data was good for all chords evaluated (11–15 mm), with Sw values from 0.02 to 0.11 mm, and ICCs from 0.568 to 0.909. A significant positive correlation was found between the magnitude of temporal-nasal sagittal height difference for all measured chords and its Sw associated. Conclusion: The ESP system can provide consistent measurements of sagittal height data for different chord diameters as well as for mean corneal and scleral radius in healthy eyes. Best fit approaches for limbal and scleral areas were less repeatable, although within a clinically acceptable range. This article is funded by the Project UAIND18−06B of the University of Alicante within the program “Ayudas destinadas a la formación predoctoral en colaboración con empresas 2018″ supported by the Vicerrectorado de Investigación y Transferencia de Conocimiento. The author David P Piñero has been also supported by the Ministry of Economy, Industry and Competitiveness of Spain within the program Ramón y Cajal, RYC-2016-20471.

Purpose To evaluate the intrasession repeatability for non-invasive break-up time (NIBUT) and tear meniscus height (TMH) measurements provided by a new multi-diagnostic platform, and to assess the interobserver reproducibility of TMH measures. Methods Twenty-one healthy eyes of 21 patients (age, 23–65 years) were enrolled. A complete eye examination was performed in all cases with the VX120+ device (Visionix-Luneau Technologies), including an analysis with the new Dry Eye module, performing three consecutive measurements. The within-subject standard deviation (Sw) and Bland–Altman plots were used to assess intersession repeatability. Differences between examiners for TMH were also analysed. Results No statistically significant differences were found between repeated measures of NIBUT (time associated with the first break) and TMH (p > 0.05). However, significant differences were found for NIBUT50% (time associated with half of breaks of the tear film) (p

Amparo Gil-Casas,1,2 David P Piñero-Llorens,2 Ainhoa Molina-Martin2 1Clínica Optométrica, Fundació Lluís Alcanyís, University of Valencia, Valencia, Spain; 2Optics and Visual Perception Group (GOPV), Department of Optics, Pharmacology, and Anatomy, University of Alicante, Alicante, SpainCorrespondence: Ainhoa Molina-MartinDepartment of Optics, Pharmacology, and Anatomy, University of Alicante, Carretera San Vicente del Raspeig, San Vicente del Raspeig, 03690, Alicante, SpainTel +34 965 903-400Email ainhoa.molina@ua.esPurpose: Oculomotor disorders have been reported in multiple sclerosis (MS) in up to 80% of cases. There have been studies evaluating binocular vision in several neurological diseases, but not in MS. Considering that a high percentage of eye-movement anomalies have been reported, the aim of this study was to analyze binocular vision in these subjects.Methods: A total of 59 participants with MS — 21 with monocular optic neuritis, eleven with binocular optic neuritis, and 27 without optic neuritis — and 26 age-matched controls were enrolled. Binocular vision was analyzed using near point of convergence (NPC), positive and negative fusional vergence for far and near distance, measurement of heterophoria at both distances with cover and modified Thorington tests, and random-dot stereoscopy.Results: The percentage of subjects with abnormal NPC values was highest in the MS group, followed by the MSONm (MS with optic neuritis in one eye), MSONb (MS with optic neuritis in both eyes), and control groups. MS patients showed an esophoric trend at near distance. Positive fusional vergence showed no significant differences between control and MS groups, but higher variability in recovery was found in MS groups. Negative fusional vergence at near distance showed significant differences between the control group and the two MS groups, with optic neuritis for both break-point and recovery values. A high percentage of patients with MS had alterations on stereopsis.Conclusion: Alterations in binocular vision were present in MS, with divergence at near distance and stereopsis the most affected parameters. Likewise, MS patients with optic neuritis showed worse binocular vision.Keywords: multiple sclerosis, binocular vision, near point of convergence, heterophoria, fusional vergences, stereopsis

In recent years, virtual reality (VR) has emerged as a new safe and effective tool for neurorehabilitation of different childhood and adulthood conditions. VR-based therapies can induce cortical reorganization and promote the activation of different neuronal connections over a wide range of ages, leading to contrasted improvements in motor and functional skills. The use of VR for the visual rehabilitation in amblyopia has been investigated in the last years, with the potential of using serious games combining perceptual learning and dichoptic stimulation. This combination of technologies allows the clinician to measure, treat, and control changes in interocular suppression, which is one of the factors leading to cortical alterations in amblyopia. Several clinical researches on this issue have been conducted, showing the potential of promoting visual acuity, contrast sensitivity, and stereopsis improvement. Indeed, several systems have been evaluated for amblyopia treatment including the use of different commercially available types of head mounted displays (HMDs). These HMDs are mostly well tolerated by patients during short exposures and do not cause significant long-term side effects, although their use has been occasionally associated with some visual discomfort and other complications in certain types of subjects. More studies are needed to confirm these promising therapies in controlled randomized clinical trials, with special emphasis on the definition of the most adequate planning for obtaining an effective recovery of the visual and binocular function. All authors have been supported by CDTI (Centro para el Desarrollo Tecnológico Industrial, Ministry of Economy and Competitiveness of Spain) by means of the PID program (Proyectos de Investigación y Desarrollo) in the context of the Project NEIVATECH (Neuroplasticity through Virtual Reality for Amblyopia) (application number: 111705). David P. Piñero was supported by the Ministry of Economy, Industry and Competitiveness of Spain, through the program Ramón y Cajal, RYC-2016-20471.

Multiple sclerosis (MS) is an acquired demyelinating and inflammatory neurodegenerative disease affecting the central nervous system (CNS). Clinical and subclinical ocular disturbances occur in almost all patients with MS. The objective of this narrative review was to collect and summarize the available scientific information on oculomotor, accommodative and binocular alterations that have been reported in MS. A systematic search strategy with the following descriptors was carried out: multiple sclerosis, ocular motility disorders, internuclear ophthalmoplegia, nystagmus, vergences, fixation, pupil reflex, accommodation and stereopsis. According to the search, some oculomotor alterations were found to be commonly reported in MS, such as alterations in saccades and nystagmus. In contrast, accommodative, vergence and stereopsis alterations have not been comprehensively studied despite their relevance, with only minimal evidence showing a potential negative impact of the disease on these aspects. In conclusion, oculomotor impairment is a common component of disability in MS patients and should be considered when managing this type of patients. More research is still needed to know the real impact of this disease on binocular vision and accommodation. The author David P Piñero has been also supported by the Ministry of Economy, Industry and Competitiveness of Spain within the program Ramón y Cajal, [RYC-2016-20471].

Purpose: To evaluate different intraocular lens (IOL) designs and to determine whether extended depth of focus (EDOF) lenses provide a higher depth of field (DOF) than the rest considering both subjective and objective measurements. Methods: A total of 100 eyes undergoing cataract surgery were divided into six groups depending on the IOL implanted: bifocal designs were Tecnis ZMB and ZLB (Abbott Laboratories, Illinois, USA), trifocal designs were Finevision (PhysIOL, Liège, Belgium) and AT LISA Tri (Carl Zeiss Meditec., Jena, Germany) and EDOF designs were Symfony (Abbott Laboratories, Illinois, USA) and MiniWell (SIFI MedTech, Catania, Italy). Subjective DOF was obtained from defocus curves for the range of vergences which provide a VA over 0.1 LogMAR and 0.2 LogMAR. Aberrometry was measured and Visual Strehl Optical Transference Function (90%) was used to quantify objectively the DOF. Results: Symfony IOL group showed better subjective and objective DOF compared to the rest of IOL groups, with statistically significant differences (p

Background: The objective of this study was to compare the central corneal curvature and astigmatism measurements obtained with three different systems in healthy eyes and to assess the level of interchangeability between them. Methods: This was a comparative study examining 30 healthy eyes of 30 patients (age 15–53 years). A complete eye examination was performed in all cases including analysis of anterior corneal curvature and astigmatism with three devices: the colour‐LED topography system Cassini (i‐Optics) (CAS), the Scheimpflug‐based system Pentacam (Oculus Optikgeräte) (PTC) and the optical biometer IOL‐Master 500 (Carl Zeiss Meditec) (IOLM). Differences between devices in terms of curvature in the flattest (flat K) and steepest meridians (steep K) as well as in the magnitude (AST) and power vector components of astigmatism (J0 and J45) were evaluated. The interchangeability between devices was evaluated with the Bland–Altman method. Results: Statistically significant differences between devices were found in steep K and flat K (p

Purpose To evaluate the intrasession repeatability of anterior corneal topographic and aberrometric measurements provided by a color-LED topographer as well as their interchangeability with those provided by a Scheimpflug-based system in healthy eyes. Methods Thirty-five healthy eyes of 35 patients (age, 16–66 years) were enrolled. A complete eye examination was performed in all cases including a complete corneal analysis with the Scheimpflug-based system Pentacam (Oculus Optikgeräte) (one measurement) and the Cassini system (i-Optics) (three consecutive measurements). Intrasession repeatability of the Cassini measurements was assessed with the within-subject standard deviation (Sw) and the intraclass correlation coefficient (ICC). The Bland-Altman analysis was used to evaluate the agreement between both devices. Results Mean Sw for keratometric readings was 0.02 mm (ICC ≥ 0.992), ranging between 0.16 and 0.05 D (ICC 0.930–0.978) for anterior and total astigmatic measurements. Mean Sw for asphericity and corneal diameter were 0.06 (ICC 0.926) and 0.03 mm (IC 0.997), respectively. Aberrometric parameters showed ICCs ≥ 0.816, except for Z42 (ICC 0.741) and Z44 (ICC 0.544). When comparing devices, statistically significant differences were found for most of topographic and aberrometric data (p ≤ 0.044). Likewise, ranges of agreement between devices were clinically relevant (keratometry > 0.06 mm; total astigmatic components > 0.69 D; asphericity 0.35; second-, third-, and fourth-order Zernike terms, more than 0.20, 0.13, and 0.01 μm, respectively). Conclusions Consistent anterior corneal topographic, total corneal astigmatic, and aberrometric measurements are obtained with color-LED topography in healthy eyes, which are not interchangeable with those provided by the Scheimpflug-based topography. The author David P Piñero has been supported by the Ministry of Economy, Industry and Competitiveness of Spain within the program Ramón y Cajal, RYC-2016-20471.

Purpose To establish normative values of retinal sensitivity and parameters describing the fixation pattern using macular analyzer integrity assessment (MAIA) microperimetry (Centervue, Padova, Italy) in adults and children. Methods A sample of 237 eyes of 237 healthy subjects aged between 10 and 70 years (mean age 30.63 ± 16.23 years) was evaluated using the MAIA microperimeter. The following parameters provided by the MAIA device were evaluated: average threshold (AT), macular integrity, fixation indexes (P1% and P2%), bivariate contour ellipse area (BCEA) for 95% and 63% of points, and horizontal (H) and vertical (V) axes of the ellipse of fixation. Differences between different age-related groups were evaluated. Correlation of microperimetric parameters with age was also assessed. Results Median retinal sensitivity of the overall sample was 32.90 dB (interquartile range 1.80 dB). Median P1 and P2 values were 98.00% (6.00) and 100.00% (1.00), respectively. Median BCEA for 95% and 63% of points were 2.40°2 (4.50) and 0.30°2 (0.50), respectively. Median H and V were 0.90° (0.80) and 0.90° (0.70), respectively. Age was significantly correlated with the following parameters in subjects from 21 to 70 years of age (pConclusions Retinal sensitivity in healthy eyes tends to decrease with age as well as the stability of the pattern of fixation. A normative database in terms of retinal sensitivity threshold and fixation performance can be established in this type of eyes.

Microperimetry (MP) is a technology that allows the study of retinal sensitivity at different foveal and parafoveal areas as well as eye fixation. It is a technique of functional evaluation, providing a direct correlation between anatomical and functional outcomes. There are a great variety of studies which evaluate the repeatability or reliability of measurements obtained with this technology and also describe and explore different clinical applications. MP has been shown to be useful in the characterization of sensory and motor conditions, such as amblyopia or nystagmus. Concerning ocular pathology, several studies have confirmed the usefulness of MP for evaluating and analyzing different retinal pathological conditions, such as age-related macular degeneration or glaucoma, and for analyzing the effect of different medical or surgical treatments for these conditions. MP has also been shown to be useful for visual training or rehabilitation in some specific cases.

Objective: To assess the usefulness of microperimetry (MP) as an additional objective method for characterizing the fixation pattern in nystagmus. Design: Prospective study. Participants: Fifteen eyes of 8 subjects (age, 12–80 years) with nystagmus from the Lluís Alcanyís Foundation (University of Valencia, Spain) were included. Methods: All patients had a comprehensive ophthalmologic examination including a microperimetric examination (MAIA, CenterVue, Padova, Italy). The following microperimetric parameters were evaluated: average threshold (AT), macular integrity index (MI), fixating points within a circle of 1° (P1) and 2° of radius (P2), bivariate contour ellipse area (BCEA) considering 63% and 95% of fixating points, and horizontal and vertical axes of that ellipse. Results: In monocular conditions, 6 eyes showed a fixation classified as stable, 6 eyes showed a relatively unstable fixation, and 3 eyes showed an unstable fixation. Statistically significant differences were found between the horizontal and vertical components of movement (p = 0.001), as well as in their ranges (p < 0.001). Intereye comparison showed differences between eyes in some subjects, but only statistically significant differences were found in the fixation coordinates X and Y (p < 0.001). No significant intereye differences were found between microperimetric parameters. Between monocular and binocular conditions, statistically significant differences in the X and Y coordinates were found in all eyes (p < 0.02) except one. No significant differences were found between MP parameters for monocular or binocular conditions. Strong correlations of corrected distance visual acuity (CDVA) with AT (r = 0.812, p = 0.014), MI (r = –0.812, p = 0.014), P1 (r = 0.729, p = 0.002), horizontal diameter of BCEA (r = –0.700, p = 0.004), and X range (r = –0.722, p = 0.005) were found. Conclusions: MP seems to be a useful technology for the characterization of the fixation pattern in nystagmus, which seems to be related to the level of visual acuity achieved by the patient.

Purpose: To evaluate the reliability and intersession agreement of measurements of retinal sensitivity as well as of the fixation pattern obtained in healthy eyes with a microperimeter integrating the mechanism of the scanning laser ophthalmoscope (SLO) with the static perimetry. Methods: This study included a sample of 44 healthy eyes of 44 subjects of a mean age of 27.0 ± 8.5 years. In all cases, microperimetric exams with the MAIA system (Centervue, Padova, Italy) were performed in three different sessions to evaluate the intersession repeatability. The consistency of measurements was analyzed by using the Friedman test and by analyzing the correlation between consecutive measurements. Agreement between the first and third sessions was assessed by using the Passing–Bablok regression analysis. The following parameters were analyzed: average threshold (AT), macular integrity (MI) index, fixation indexes P1 and P2, bivariate contour ellipse area (BCEA), major and minor axes of the ellipse and high preferred retinal locus position (PRLh). Results: Not statistically significant differences were found in the evaluated parameters between the three sessions (p ≥ 0.193). The correlation between consecutive measurements was moderate to strong for all parameters evaluated (r ≥ 0.49, p

Purpose. To evaluate the usefulness of microperimetry in the early detection of the ocular anomalies associated with the use of hydroxychloroquine.Methods. Prospective comparative case series study comprising 14 healthy eyes of 7 patients (group A) and 14 eyes of 7 patients under treatment with hydroxychloroquine for the treatment of rheumatologic diseases and without fundoscopic or perimetric anomalies (group B). A comprehensive ophthalmological examination including microperimetry (MP) and spectral-domain optical coherence tomography was performed in both groups.Results. No significant differences were found in mean MP foveal sensitivity between groupsP=0.18. However, mean MP overall sensitivity was significantly higher in group A (29.05±0.57 dB versus group B,26.05±2.75 dB;P<0.001). Significantly higher sensitivity values were obtained in group A in comparison to group B for the three eccentric loci evaluatedP<0.001.Conclusion. Microperimetry seems to be a useful tool for the early detection of retinal damage in patients treated with hydroxychloroquine.