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Prolactinomas are benign tumors that make up the majority of all pituitary adenoma cases and present most commonly in women. Prolactinomas presenting in adolescents and children, however, are extremely rare. We report a case of a 17-year-old male who presented with a six-month history of headaches and a previously unrecognized visual field deficit on examination. Neuroimaging revealed a large suprasellar tumor with imaging, more characteristic of a craniopharyngioma or suprasellar low-grade glioma impinging, on the left intracranial optic nerve causing right-sided hemianopsia. Due to the extensive mass effect and bitemporal hemianopsia on examination, the decision to proceed with initial surgical debulking was made following informed consent. A subtotal resection was performed where the pathology was consistent with a prolactinoma that correlated with markedly elevated prolactin (PRL) levels obtained pre and post-operatively that have not resulted until five days post procedure. The patient was subsequently treated with dopamine agonist (DA) cabergoline therapy and is now five-years disease-free with normal neurological examination and no residual tumor on neuroimaging. DA therapy has shown high clinical efficacy and should be considered prior to any surgical intervention; however, extensive mass effect may appropriate surgical debulking to increase therapy efficacy. Our case highlights an atypical appearance of a giant prolactinoma that may mimic other more common suprasellar tumors, a presentation associated with unrecognized visual field deficits, and the importance of rapid turnaround testing for serum PRL that may aid in the upfront diagnosis and management of prolactinomas.

PurposeTo investigate differences across the visual field (VF) in the rate of glaucomatous progression, the likelihood of defect in four disease severity cross-sections, and comparisons of subgroups in each of between 12 demographic, comorbid, and clinical variables.MethodsTwo long-term glaucoma clinical trials used Humphrey Field Analyzer 24-2 VFs to calculate pointwise deviations from age-matched normal controls. Slopes of glaucomatous progression over time were calculated per participant using linear mixed models. Pointwise differences between subgroups in slopes and cross-sectional categories were tested, adjusting for multiple comparisons using false discovery rate (FDR) and Q values.ResultsPointwise data were available for 1118 patients who had 15,073 VFs. On average, defects were seen at all VF points. Of the 12 variables, six had average pointwise slopes where Subgroup 1 had significantly faster progression than Subgroup 2 at all or many of the 52 VF points: participants who were older (≥65 vs. younger), 52/52; were male, 13/52; had diabetes, 29/52; had hypertension, 46/52; had a larger cup-to-disc ratio (≥0.7), 36/52; or had larger differences in absolute mean deviation (MD) between eyes (>3 dB), 52/52. Cross-sectional patterns at MD severity of -12 to -6.1 dB showed strong midline effects for gender and other patterns for hypertension, cup-to-disc ratio, absolute difference in MD between eyes, and disc notching.ConclusionsThe approach used provides new longitudinal and cross-sectional insights into variation across the VF associated with demographic, comorbid, and clinical variables.Translational relevanceThis exploration and characterization of variable effects in the setting of pointwise VF testing may enable clinicians to anticipate patterns of VF loss based on demographic, comorbid, and clinical associations.

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Background: The aim of this study was to determine if the rise in new surgical procedures for glaucoma is changing the baseline features of patients. Methods: In this retrospective study, we reviewed the baseline features of patients undergoing their first glaucoma surgery in 2011 and 2021, collecting data regarding intraocular pressure (IOP), visual field (VF) parameters, stage of disease, and the type of surgery. Results: In the study, 455 patients were included in the analysis. From these, 230 eyes had glaucoma surgery performed in 2011 (Group A) and 225 eyes in 2021 (Group B). When considering the baseline features, Group A was older than Group B (72.7 ± 10.7 and 70 ± 12.4 years; p = 0.02, respectively), and showed a significantly more advanced VF mean defect (−16.4 ± 8.8 and −13.8 ± 8.7 dB; p < 0.01, respectively) and a higher IOP (25.9 ± 6.6 and 24.9 ± 7.8 mmHg; p = 0.02, respectively). Overall, severe VF damage at the time of surgery was more frequent in Group A (74.3%) than in Group B (60.8%) (p < 0.01). The overall number of traditional glaucoma surgeries was 211 in 2011, reducing to 94 ten years later, with similar severe pre-operative VF defects. In 2021, minimally invasive bleb surgery (MIBS) represented 58% of all surgeries. Conclusions: In the last ten years, patients receiving glaucoma surgery for the first time were younger, had less severe disease, and a more contained IOP. The baseline feature modifications were probably related to the diffusion of new procedures, especially MIBS, which allowed for treating patients at an earlier stage, reserving traditional procedures for advanced cases.

The ability to make on-field, split-second decisions is critical for National Football League (NFL) game officials. Multiple principles in visual function are critical for accuracy and precision of these play calls, including foveation time and unobstructed line of sight, static visual acuity, dynamic visual acuity, vestibulo-ocular reflex, and sufficient visual field. Prior research has shown that a standardized curriculum in these neuro-ophthalmic principles have demonstrated validity and self-rated improvements in understanding, confidence, and likelihood of future utilization by NFL game officials to maximize visual performance during officiating. Virtual reality technology may also be able to help optimize understandings of specific neuro-ophthalmic principles and simulate real-life gameplay. Personal communication between authors and NFL officials and leadership have indicated that there is high interest in 3D virtual on-field training for NFL officiating. In this manuscript, we review the current and past research in this space regarding a neuro-ophthalmic curriculum for NFL officials. We then provide an overview our current visualization engineering process in taking real-life NFL gameplay 2D data and creating 3D environments for virtual reality gameplay training for football officials to practice plays that highlight neuro-ophthalmic principles. We then review in-depth the physiology behind these principles and discuss strategies to implement these principles into virtual reality for football officiating.

The aim of the study was to explore the functional impairments and related factors in older adults with moderate to advanced stages of glaucoma. Nineteen patients with glaucoma and 19 participants with no ocular disease performed step test and balance control tasks with analysis of overall stability index and fall risk index. Monocular and binocular Humphrey Visual Field tests were used to estimate visual field defect severity. The International Physical Activity Questionnaire was used to measure physical activity level. Patients with glaucoma showed poorer values for most of the mobility and balance control parameters with medium and large effect sizes (0.3–0.5). Mobility scores in patients were partly associated with their monocular visual field defect (rs =.507, p <.05). Low physical activity was identified as a risk factor for falls (rs = −.453, p <.05) and postural instability (rs = −.457, p <.05). Functional declines in dynamic tasks were not related to glaucoma severity. Older adults with glaucoma display impairment with mobility and balance control compared to controls, associated with the degree of monocular visual field loss and lower daily physical activity. [ABSTRACT FROM AUTHOR]

Abstract Purpose: Assessment of the pattern visual evoked potential (PVEP) responses in different areas of visual fields in individuals with normal vision. Methods: This study was conducted on 80 eyes of normal subjects aged 18–35 years. All participants underwent refraction and visual acuity examination. Visual evoked potential (VEP) responses were recorded in different areas of field. The repeated measure test was used to compare the P100 latency and amplitude of PVEP among different areas. Results: The repeated measures analysis of variance showed a statistically significant difference among different areas in terms of amplitude and latency of P100 (P = 0.002 and P < 0.001, respectively). According to the results, the highest and lowest amplitude of P100 was observed in inferior-nasal and superior areas, respectively. The highest and lowest latency of P100 was related to the temporal and inferior-nasal areas, respectively. Conclusion: This study partially revealed the details of local PVEP distribution in the visual field and there was a significant difference in the amplitude and latency of PVEP wave in different areas of the visual field.

This is a case of ezetimibe-induced concentric field loss, dyschromatopsia, and nyctalopia in a patient with no prior history of retinal dystrophy or drug hypersensitivity. A 55-year-old Caucasian woman presents with a 1-year history of increasing concentric visual field loss, nyctalopia, photophobia, and colour vision impairment. These symptoms correlated with the commencement of ezetimibe therapy 10 mg daily for hypercholesterolaemia. She demonstrated repeatable bilateral visual field constriction on 30-2 Humphrey visual filed testing and colour vision impairment on Ishihara plates (OD: 1/17, OS: 1/17). Biochemical and radiological screening for carcinoma-associated retinopathy was unremarkable. A working diagnosis of drug-induced rod-cone dysfunction was made. Her visual symptoms and field changes completely resolved 3 months after cessation of ezetimibe therapy. This case suggests that ezetimibe is a potential cause of rod-cone dysfunction and should be considered as a differential in patients with new unexplained visual symptoms.

Timely treatment is essential in the management of glaucoma. However, subjective assessment of visual field (VF) progression is not recommended, because it can be unreliable. There are two types of artificial intelligence (AI) strong and weak (machine learning). Weak AIs can perform specific tasks. Linear regression is a method of weak AI. Using linear regression in the real-world clinic has enabled analyzing and predicting VF progression. However, caution is still required when interpreting the results, because whenever the number of VF data sets investigated is small, the predictions can be inaccurate. Several other non-ordinal, or modern AI methods have been constructed to improve prediction accuracy, such as clustering and more modern AI methods of Analysis with Non-Stationary Weibull Error Regression and Spatial Enhancement (ANSWERS), Variational Bayes Linear Regression (VBLR), Kalman Filter and sparse modeling (The least absolute shrinkage and selection operator regression: Lasso). It is also possible to improve the prediction performance using retinal thickness measured with optical coherence tomography by using machine learning methods, such as multitask learning. [ABSTRACT FROM AUTHOR]

Purpose: To estimate the diagnostic accuracy of circumpapillary retinal nerve fibre layer (RNFL) thickness and macular ganglion cell layer–inner plexiform layer (GCL‐IPL) thickness measurements to discriminate an abnormal visual function (i.e. abnormal age‐based visual acuity and/or visual field defect) in children with a newly diagnosed brain tumour. Methods: This cross‐sectional analysis of a prospective longitudinal nationwide cohort study was conducted at four hospitals in the Netherlands, including the national referral centre for paediatric oncology. Patients aged 0–18 years with a newly diagnosed brain tumour and reliable visual acuity and/or visual field examination and optical coherence tomography were included. Diagnostic accuracy was evaluated with sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Results: Of 115 patients included in the study (67 [58.3%] male; median age 10.6 years [range, 0.2–17.8 years]), reliable RNFL thickness and GCL‐IPL thickness measurements were available in 92 patients (80.0%) and 84 patients (73.0%), respectively. The sensitivity for detecting an abnormal visual function was 74.5% for average RNFL thickness and 41.7% for average GCL‐IPL thickness at a specificity of 44.5% and 82.9%, respectively. The PPV and NPV were 33.0% and 82.6% for the average RNFL thickness and 57.1% and 82.2% for the average GCL‐IPL thickness. Conclusion: An abnormal visual function was discriminated correctly by using the average RNFL thickness in seven out of ten patients and by using the average GCL‐IPL thickness in four out of ten patients. The relatively high NPVs signified that patients with normal average RNFL thickness and average GCL‐IPL thickness measurements had a relative high certainty of a normal visual function. [ABSTRACT FROM AUTHOR]

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Three‐dimensional gaze estimation aims to reveal where a person is looking, which plays an important role in identifying users' point‐of‐interest in terms of the direction, attention and interactions. Appearance‐based gaze estimation methods could provide relatively unconstrained gaze tracking from commodity hardware. Inspired by medical perimetry test, we have proposed a multiscale framework with visual field analysis branch to improve estimation accuracy. The model is based on the feature pyramids and predicts vision field to help gaze estimation. In particular, we analysis the effect of the multiscale component and the visual field branch on challenging benchmark datasets: MPIIGaze and EYEDIAP. Based on these studies, our proposed PerimetryNet significantly outperforms state‐of‐the‐art methods. In addition, the multiscale mechanism and visual field branch can be easily applied to existing network architecture for gaze estimation. Related code would be available at public repository https://github.com/gazeEs/PerimetryNet. [ABSTRACT FROM AUTHOR]

Glaucoma usually does not show any symptoms and may not be noticed until it reaches the advanced stage. In our study, demographic and clinical findings of patients who were diagnosed with glaucoma incidentally and were not aware of their disease and any symptoms are presented. Our study group consisted of people who did not have any symptoms and only wanted to receive an eye health report. Additional tests (visual field examination, retinal nerve fiber layer (RNFL) analysis, central corneal thickness etc.) for the diagnosis of glaucoma were planned for all participants over the age of 18 with suspected glaucoma (intraocular pressure >21mmHg, optic nerve changes (cup/disc (c/d) ratio of 0.6 and above, c/d asymmetry greater than 0.2 between optic discs, peripapillary atrophy, optic disc hemorrhage etc.) in routine examinations. The diagnosis and classification of glaucoma was defined according to the International Society for Geographical and Epidemiological Ophthalmology Classification. Glaucoma was diagnosed in 51 eyes of 35 out of 1024 patients, including 24 male patients and 11 female patients. The mean age of the patients was 62.31±12.392 years. There was 14 patients in primary open-angle glaucoma, 10 patients in pseudoexfoliation glaucoma, 6 patients in normotensive glaucoma, 1 patient with chronic angle-closure glaucoma, 1 patient with pigmentary glaucoma, 1 patient with angle-recession glaucoma, 1 patient with steroid-related glaucoma, and 1 patient with vitreoretinal surgery-related glaucoma. The mean visual acuity (VA) was 0.6 and above in all types except the patient who had the vitrectomy surgery. Primary open-angle glaucoma was the most common in incidentally diagnosed glaucoma patients. The presence of a high VA before symptoms develop in patients with glaucoma indicates the importance of early diagnosis in the prognosis of the disease. [ABSTRACT FROM AUTHOR]

To identify visual field (VF) worsening from longitudinal OCT data using a gated transformer network (GTN) and to examine how GTN performance varies for different definitions of VF worsening and different stages of glaucoma severity at baseline. Retrospective longitudinal cohort study. A total of 4211 eyes (2666 patients) followed up at the Johns Hopkins Wilmer Eye Institute with at least 5 reliable VF results and 1 reliable OCT scan within 1 year of each reliable VF test. For each eye, we used 3 trend-based methods (mean deviation [MD] slope, VF index slope, and pointwise linear regression) and 3 event-based methods (Guided Progression Analysis, Collaborative Initial Glaucoma Treatment Study scoring system, and Advanced Glaucoma Intervention Study [AGIS] scoring system) to define VF worsening. Additionally, we developed a "majority of 6" algorithm (M6) that classifies an eye as worsening if 4 or more of the 6 aforementioned methods classified the eye as worsening. Using these 7 reference standards for VF worsening, we trained 7 GTNs that accept a series of at least 5 as input OCT scans and provide as output a probability of VF worsening. Gated transformer network performance was compared with non–deep learning models with the same serial OCT input from previous studies—linear mixed-effects models (MEMs) and naive Bayes classifiers (NBCs)—using the same training sets and reference standards as for the GTN. Area under the receiver operating characteristic curve (AUC). The M6 labeled 63 eyes (1.50%) as worsening. The GTN achieved an AUC of 0.97 (95% confidence interval, 0.88–1.00) when trained with M6. Gated transformer networks trained and optimized with the other 6 reference standards showed an AUC ranging from 0.78 (MD slope) to 0.89 (AGIS). The 7 GTNs outperformed all 7 MEMs and all 7 NBCs accordingly. Gated transformer network performance was worse for eyes with more severe glaucoma at baseline. Gated transformer network models trained with OCT data may be used to identify VF worsening. After further validation, implementing such models in clinical practice may allow us to track functional worsening of glaucoma with less onerous structural testing. Proprietary or commercial disclosure may be found after the references. [ABSTRACT FROM AUTHOR]

Copyright of Die Ophthalmologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: This study aimed to investigate whether intravitreal aflibercept was safe and effective in patients with acute nonarteritic anterior ischemic optic neuropathy (NAION). Methods: This was a chart study of 25 individuals with acute NAION (25 eyes). An intravitreal injection of 2 mg/0.05 mL of aflibercept was administered to fifteen participants. The remaining ten patients in the control group were given standard care. The researchers measured the initial visual acuity, retinal nerve fiber layer thickness (RNFLT), and automated perimetry. During the follow-up period, the researchers measured the final visual acuity, RNFLT, automated perimetry, and side effects. Results: Visual acuity and visual field assessment were significantly improved in the study group, and optical coherence tomography testing demonstrated significant disc edema resolution. The therapy results differed significantly between the two groups regarding visual outcomes (F = 0.027, p = 0.039) and RNFLT decrease (F = 5.507, p = 0.003). However, the difference in visual field alterations was not significant (F = 0.724, p = 0.387). Conclusions: Intravitreal injection of aflibercept can significantly improve visual acuity and resolve disc edema in patients with acute NAION. Intravitreal aflibercept may be an alternative treatment for acute NAION. However, a large series investigation is needed to assess the long-term therapeutic benefit and safety of intravitreal aflibercept in patients with acute NAION. [ABSTRACT FROM AUTHOR]

Introduction: A significant number of Restitution Training (RT) paradigms claim to ameliorate visual field loss after stroke by re-activating neuronal connections in the residual visual cortex due to repeated bright light-stimulation at the border of the blind and intact fields. However, the effectiveness of RT has been considered controversial both in science and clinical practice for years. The main points of the controversy are (1) the reliability of perimetric results which may be affected by compensatory eye movements and (2) heterogeneous samples consisting of patients with visual field defects and/or visuospatial neglect. Methods: By means of our newly developed and validated Virtual Reality goggles Salzburg Visual Field Trainer (SVFT) 16 stroke patients performed RT on a regular basis for 5 months. By means of our newly developed and validated Eye Tracking Based Visual Field Analysis (EFA), we conducted a first-time full eye-movementcontrolled perimetric pre-post intervention study. Additionally, patients subjectively rated the size of their intact visual field. Results: Analysis showed that patients' mean self-assessment of their subjective visual field size indicated statistically significant improvement while, in contrast, objective eye tracking controlled perimetric results revealed no statistically significant effect. Discussion: Bright-light detection RT at the blind-field border solely induced a placebo effect and did not lead to training-induced neuroplasticity in the visual cortex of the type needed to ameliorate the visual field size of stroke patients. [ABSTRACT FROM AUTHOR]

Objective: It is believed that postural balance problems may contribute to the development of adolescent idiopathic scoliosis (AIS). Vision provides proprioceptive input by supplying information about body positions. Considering the fundamental role of vision in postural control, this study aims to investigate the relationship between AIS and the volume of the eye-moving muscles and the visual field. Materials and Methods: This prospective cross-sectional study included a total of 47 female individuals, with 24 having AIS and 23 being healthy participants. Magnetic resonance imaging was used to calculate the volumes of the medial rectus (MR) and lateral rectus (LR) muscles in both groups. Additionally, the visual field test was conducted to determine the pattern standard deviation (PSD) and mean deviation (MD) values for the left and right eyes of individuals in both groups. Results: The mean age of AIS patients with a major curvature of 48.50 degrees and a Lenke Type-1 curve was similar to that of asymptomatic individuals. The volume values of the MR muscle on both sides were lower in the AIS group compared to the control group (p<0.05). Significant differences were found in the PSD values of the visual field test within the AIS group (p<0.01). However, there was no significant difference in the MD values between the left and right eyes of the two groups (p>0.05). Conclusion: It is important to consider the presence of visual sensory defects in individuals with AIS. It is unknown whether AIS causes visual impairment or vice versa. Therefore, further comprehensive studies are needed. [ABSTRACT FROM AUTHOR]

Purpose: Craniopharyngiomas (CP) are benign tumours of the sellar region. Hypopituitarism, visual deficits, hypothalamic damage with consequent obesity and related increased cardiovascular risk, are complications due to the tumour itself or secondary to treatment strategy. We retrospectively correlated visual field status with clinical, neuroradiological, histopathological features and management strategy, in a single-centre cohort of patients with CP. Methods: Thirty-four patients (16 M; median age 27.2 ± 21.8 yrs) with CP were included. We evaluated visual field status, assessed by means of standard automated perimetry and expressed as mean deviation (MD), at last follow-up visit (median 14 ± 11.7 yrs). MD has been correlated with clinical, radiological, histological data and treatment modalities. Results: In univariate analysis worst eye MD was significantly associated with panhypopituitarism (p 0.010). In multivariable linear regression, panhypopituitarism (p 0.008), CP recurrence (p 0.020) and DI (p 0.004) were found to be the main independent predictors of a worse visual field outcome. When stratifying patients according to the degree of visual field impairment (MD < −12 dB Vs MD > −12 dB), the main independent predictors of worse visual field outcome were older age at diagnosis (p 0.010), CP histological subtype (p 0.004), invasiveness (p 0.04), CP recurrence (p 0.035), DI (p 0.002) and weight at last follow-up (p 0.012). Conclusion: In CP patients the long-term ophthalmological impairment is frequent, especially at older age, and strictly related to tumour invasiveness and recurrence, and associated to pituitary disfunction and obesity. [ABSTRACT FROM AUTHOR]

One of the essential needs of humans that is influenced by architectural geometry is visibility in indoor areas. Prayer hall geometry dominates the mosque typology and morphology. The spatial–volumetric shapes of interior prayer halls affect worshipers' visual comfort and spirituality. In this study, a new integrative framework is developed to quantitatively describe various mosque typo-morphologies affecting the visual comfort of worshipers, including spaciousness and consciousness, to obtain prayer hall typo-morphological patterns that may provide higher levels of visual comfort. Spatial and volumetric metrics from various prayer hall vantage points are used in this study. A two-dimensional isovist (VGA) map in depthmapX.10 collects spatial metrics, while the grasshopper script in Rhinoceros-7 collects 3D isovist volumetric metrics. The findings confirm the feasibility of creating a prominent area in barrier-free mosque layout designs centered on a central domed roof form. [ABSTRACT FROM AUTHOR]

PrecisModerate to substantial agreement between 10-2 and 24-2C perimetry for detecting central field defects suggests that adding central test points to the 24-2 protocol may improve efficiency of visual field (VF) testing for glaucoma management.PurposeThe purpose of this study was to assess agreement between Humphrey Visual Field Analyzer 10-2 and 24-2C test protocols for detecting glaucomatous defects in the central 10 degrees of the visual field (CVFDs).Materials and methodsVFs from 165 eyes of 18 healthy individuals, 12 glaucoma suspects and 62 glaucoma patients who completed 10-2 and 24-2C VF testing protocols within 6 months were included. CVFDs on 10-2 and 24-2C (within the central 22 points) test grids required a cluster of 3 contiguous points with P

PrecisA lower baseline corneal hysteresis and a decrease in corneal resistance factor (CRF) over time are associated with higher risk of visual field progression in glaucomatous and glaucoma suspect eyes.PurposeThe aim was to investigate the longitudinal change in CRF and cornea hysteresis (CH) as risk factors for visual field progression.Materials and methodsIn this prospective observational cohort study, 72 eyes of 48 glaucoma or glaucoma suspect patients were followed for an average of 4.5 years. Baseline and follow-up CH and CRF measurements were performed with the Ocular Response Analyzer (Reichert Ophthalmic Instruments Inc., Depew, N.Y.). Evaluation of rates of visual field change during follow-up was performed using visual field mean deviation. Univariable and multivariable linear mixed models assessed the relationship of visual field progression with baseline CRF and CH as well as with changes in CRF and CH.ResultsThe mean baseline CH was 9.0 (95% confidence interval: 8.6-9.4)  mm Hg and the mean baseline CRF was 9.3 (95% confidence interval: 8.8-9.9) mm Hg. There was no statistically significant difference in average CH and CRF measurements over time. In multivariable modeling adjusting for age, race, and mean intraocular pressure during follow-up, each 1 mm Hg lower in baseline CH and 1 mm Hg decrease in CRF over time were associated with a 0.12 (P=0.042) and 0.14 dB/year (P=0.007) faster rate of visual field mean deviation loss, respectively. Similar findings were found in glaucoma eyes but not found in glaucoma suspect eyes.ConclusionVisual field progression was associated with a lower baseline CH and a decrease in CRF over time. Assessment of corneal resistance and elasticity at baseline and during follow-up examinations should be considered to identify those eyes at highest risk of visual field progression.

Low-tension glaucoma can sometimes be difficult to diagnose, particularly if patients do not have a classic presentation. This case series shows the value of Humphrey visual field (HVF) 10-2 tests to identify deficits in central vision. Case 1 describes a female in her mid-60s who presented complaining of a “blind spot” in her right eye. While a HVF 24-2 suggested her test was “within normal limits,” an HVF 10-2 showed an unusually shaped scotoma in her right eye that matched her visual complaint. Case 2 describes a male in his mid-60s who was referred to the glaucoma service by a retina specialist. He complained of a “blind spot” in his left eye and was revealed to have a focal central scotoma on his HVF 10-2 test. Both patients presented with normal intraocular pressures, and both had been cleared by retina specialists and neuro-ophthalmologists. Both patients were then diagnosed with low-tension glaucoma, and treatment to date has been successful in slowing vision loss.

Ploysai Rujkorakarn,1– 3 Michael J Margolis,1,2 Diana Morvey,1,2 Yujia Zhou,1,2 C Stephen Foster1,2,4 1Massachusetts Eye Research and Surgery Institution, Waltham, MA, USA; 2The Ocular Immunology and Uveitis Foundation, Waltham, MA, USA; 3Suddhavej Hospital Department of Ophthalmology, Mahasarakham University, Maha Sarakham, Thailand; 4Department of Ophthalmology, Harvard Medical School, Cambridge, MA, USACorrespondence: C Stephen Foster, Massachusetts Eye Research and Surgery Institution, 1440 Main St. &num;201, Waltham, MA, 02451, USA, Tel +1 781 891-6377, Fax +1 781 647-1430, Email sfoster@mersi.comPurpose: To assess the possible correlation of anti-retinal antibody titers and number of anti-retinal antibodies with outcome measurements including visual acuity, subjective vision loss, visual field, and electroretinography in patients with autoimmune retinopathy.Design: Single-center, retrospective cross-sectional study.Patients and Methods: Patients with autoimmune retinopathy who underwent anti-retinal antibody testing at least twice during their follow-up were enrolled. Anti-retinal antibody titers and numbers were grouped as improved, stable, or worsened. Outcomes included Snellen visual acuity, patient-reported vision loss, Humphrey visual field mean deviations, and electroretinography parameters.Results: Thirty-one eyes among 16 patients with autoimmune retinopathy were included. Between-group analyses of visual acuity, subjective vision loss, visual field, and electroretinography outcomes did not reveal any significant differences by anti-retinal antibody titer or number group at a 95% confidence interval.Conclusion: Changes in anti-retinal antibody titers or numbers were not associated with any vision outcome. Repeated anti-retinal antibody testing may be unnecessary after diagnosis of autoimmune retinopathy and detection of an anti-retinal antibody.Keywords: autoimmune retinopathy, anti-retinal antibody, visual field, electroretinography, outcome measurements

Objectives:To evaluate the effectiveness of optic nerve sheath fenestration (ONSF) on visual functions in patients with increased intracranial pressure (İİP).Materials and Methods:The medical records of 24 eyes of 17 patients who had İİP due to idiopathic intracranial hypertension, cerebral venous sinus thrombosis, or intracranial cyst and underwent ONSF surgery to prevent visual loss were evaluated. Pre- and postoperative visual acuity, optic disc images, and visual field findings were reviewed.Results:The mean age of the patients was 30.4±8.5 years, and 88.2% were female. The patients’ mean body mass index was 28.67±6.1 kg/m2. The mean follow-up time was 24±12.1 months (range: 3-44). At postoperative 3 months, the mean best-corrected distance visual acuity had improved in 20 eyes (83.3%) and stabilized in 4 eyes (16.7%) compared to preoperative values. In visual field mean deviation, an improvement was observed in 10 eyes (90.9%), while 1 eye (9.1%) eye remained stable. Optic disc edema decreased in all patients.Conclusion:This study indicates that ONSF has beneficial effects on visual function in patients with rapidly progressive visual loss caused by increased intracranial pressure.

Abstract Background Visual field (VF) testing in combination with a specialized VF analysis software is critical for characterizing and monitoring visual loss in glaucoma. Although performing glaucoma progression analysis requires original VF data rather than printouts or image files, extent of VF data transfer between referring and referred ophthalmologists is unclear. Here, we surveyed glaucoma specialists who belong to the Japan Glaucoma Society (JGS). Methods An internet survey of daily practice patterns regarding electronic VF data transfer at the time of glaucoma referrals (referring/referred) was sent to all 50 JGS board members. The survey consisted with 11 questionnaires, and the response rate was 100%. Results The respondents included 33 university hospital ophthalmologists (66%) (Q1), and those scattered throughout Japan (Q2). All respondents used Humphrey Visual Filed Analyzer (HFA) (Q3) and at least one of a VF progression analysis software (Q4). Ten respondents (20%) actively transferred electronic VF data, while 40 (80%) did not (Q5). The major reasons for not actively transferring data electronically were that there was no support for data transfer by neighboring (n = 26, 65%) and/or own (25, 63%) institutes (Q6). All 40 inactive respondents responded that electronic data transfer is ideal (Q7). All 10 active respondents transferred data using USB flash memory (Q8). Of the 10 active respondents, seven (70%) reported that the percentage of referral letters accompanying electronic VF data in a format that allows for progression analysis from the beginning was less than 25% (Q9). When the referral letters did not accompany the electronic VF data, four (40%) reported that they further requested the data transfer in

AIM: To compare the visual function of low-vision patients with primary retinal pigmentosa(RP)before and after wearing amber filter.METHODS: Self-control before and after study. A total of 30 patients(60 eyes)with low vision who were diagnosed with primary RP in the ophthalmology clinic of Xi'an No.1 Hospital from August 2021 to March 2022 were collected. The uncorrected distance visual acuity(UCDVA), best-corrected distance visual acuity(BCDVA), uncorrected near visual acuity(UCNVA), best-corrected near visual acuity(BCNVA), visual field and Farnsworth-Munsell(FM)-100 color visions were recorded before and after wearing amber filter. The contrast sensitivity(CS)in three visual environments including bright room, darkroom and darkroom with glare was measured and recorded respectively, and the changes of those parameters were analyzed before and after wearing filter.RESULTS: UCDVA and BCDVA after wearing the filter were better than those before wearing(t=-2.32, P

Face mask-wearing practices and their impact on the visual field bear particular importance in the coronavirus disease 2019 (COVID-19) pandemic era. This case series examines 10 participants with no history of ocular impairment or visual field defects who underwent age-corrected visual field testing in both eyes with different types of face masks. Wearing duckbill N95 masks was consistently associated with increased accuracy errors in the inferior altitudinal visual field when compared to wearing surgical masks or no masks. These findings support public health guidance that has previously attributed the risks of falls and accidents to face mask wearing.

Purpose The aim of this study was to describe the demographic and clinical characteristics of a large cohort of patients with retinitis pigmentosa (RP) in Egypt. Patients and methods An extensive electronic medical record search was performed to gather data on all patients with RP who were evaluated at two major referral hospitals: Ain Shams University Hospital and Watany Eye Hospital, Cairo, Egypt during a 7-year period from January 2015 to October 2022. The age at last visit, sex, family history, history of parental consanguinity, status of the fundus, lens, and macula, visual acuity, visual field, and electroretinogram (ERG) data were recorded. Results The study included 766 patients with nonsyndromic RP. They were diagnosed based on either clinical examination alone or clinical examination and superadded investigations in the form of any of the following: color fundus photography, fundus autofluorescence, fundus fluorescein angiography, optical coherence tomography, and/or electrophysiological studies such as full-field and pattern ERG. The mean age at the last visit was 39.6±17.3 years, and 57.9% of the patients were males. Cataract was found in 343 (44.8%) patients, of whom 178 (51.9%) patients underwent cataract surgery. ERG was reduced in 12.9% and abolished in 87.1% of the patients. The foveal area was preserved in five (4.9%) patients, atrophic in 72 (69.9%), edematous in 13 (12.6%), and revealed an epiretinal membrane in 37 (35.9%) patients. A hyperautofluorescent ring was present in 87.5% of the patients. Conclusions Cataract was a significant comorbidity in patients with RP, and atrophic macula was the most prevalent among the macular status changes. RP is the subject of clinical intervention trials, and population-based epidemiological data can guide genetic testing and provide more candidates for possible gene therapy and other new treatment modalities.

The extended use of ethambutol beyond 2 months for treating tuberculosis has increased risk of optic neuropathy. We performed a systematic review of studies evaluating optic neuropathy in extended ethambutol use since 2010 and compared the outcome with a similar systematic review (1965–2010) by Ezer et al. Literature search was conducted in PubMed, Medline, EMBASE, and Cochrane databases. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Main outcome measures were visual acuity, color vision, visual field defects, optical coherence tomography (OCT), and visual evoked potential (VEP). The JBI Critical Appraisal Checklists were used for quality assessment. Twelve studies were selected (out of 639 studies) for analysis of ethambutol optic neuropathy. Visual acuity improvement after stopping ethambutol was statistically significant. Similar improvement was not noted for other outcome measures. On comparing the results of this review with those by Ezer et al., significant improvement was noted in visual acuity, color vision, and visual field defects. Moreover, more patients reported increased optic nerve toxicity, color vision defects, and visual field defects in the present review. Hence, we conclude that the extended use of ethambutol beyond 2 months results in significant optic nerve toxicity. Further randomized controlled trials with different populations are needed to understand the magnitude of this issue.

Glaucoma is one of the most common reasons for blindness worldwide, especially in elderly people. Glaucoma can be monitored using visual field (VF) tests. Therefore, predicting the future VF to monitor progression of glaucoma is important. In this paper, we proposed a deep learning model to predict future VF based on previous VF and optical coherence tomography (OCT) images (including thickness map, vertical tomogram, and horizontal tomogram). The image data were analyzed using a ResNet-50 model. Image features and previous VFs were combined, and a long short-term memory (LSTM) network was used to predict future VF. A weighted method was used to detect noisy data. The proposed method was improved when applying weighted loss. The mean absolute error (MAE) was 3.31 ± 1.37, and the root mean square error (RMSE) was 4.58 ± 1.77. The model showed high performance when combining VF data and OCT image data. Furthermore, the model was useful for detecting and re-weighting noisy data.

Perimetry and optical coherence tomography (OCT) are both used to monitor glaucoma progression. However, combining these modalities can be a challenge due to differences in data types. To overcome this, we have developed an autoencoder data fusion (AEDF) model to learn compact encoding (AE-fused data) from both perimetry and OCT. The AEDF model, optimized specifically for visual field (VF) progression detection, incorporates an encoding loss to ensure the interpretation of the AE-fused data is similar to VF data while capturing key features from OCT measurements. For model training and evaluation, our study included 2504 longitudinal VF and OCT tests from 140 glaucoma patients. VF progression was determined from linear regression slopes of longitudinal mean deviations. Progression detection with AE-fused data was compared to VF-only data (standard clinical method) as well as data from a Bayesian linear regression (BLR) model. In the initial 2-year follow-up period, AE-fused data achieved a detection F1 score of 0.60 (95% CI: 0.57 to 0.62), significantly outperforming (p < 0.001) the clinical method (0.45, 95% CI: 0.43 to 0.47) and the BLR model (0.48, 95% CI: 0.45 to 0.51). The capacity of the AEDF model to generate clinically interpretable fused data that improves VF progression detection makes it a promising data integration tool in glaucoma management.

Word reading requires a range of spatial attention processes, such as orienting to a specific word and selecting it while ignoring other words. This study investigated whether deficits of these spatial attention processes can show dissociations after hemispheric lesions. Thirty-nine patients with left or right focal epilepsy and 66 healthy participants had to read aloud four-letter words presented in the left and right visual hemifields. There were three successive blocks of presentation: in the unilateral block, a single word was presented in one of the visual hemifields; in the bilateral block, two words were presented simultaneously, one in each visual hemifield; in the cued block, two words were also presented, but only the cued word had to be reported. Twenty-one patients, twelve with a left and nine with a right hemisphere lesion, showed a word reading deficit. Four had specific difficulties in the cued block, suggesting an attentional selection reading deficit. Twelve patients had an asymmetric reading deficit, suggesting an attention orientation or a visual field deficit. Five patients had more complex deficits. The visual field presentation procedure may help to reveal different types of reading disorders in patients with epilepsy and to dissociate orienting and selecting deficits.

A timely detection of visual hemifield deficits (VHFDs; hemianopias or quadrantanopias) is critical for both the diagnosis and treatment of stroke patients. The present study determined the sensitivity and specificity of four qualitative visual field tests, including face description, confrontation tests (finger wiggle), and kinetic boundary perimetry, to screen large and dense VHFDs in right-brain-damaged (RBD) stroke patients. Previously, the accuracy of qualitative visual field tests was examined in unselected samples of patients with heterogeneous aetiology, in which stroke patients represented a very small fraction. Building upon existing tests, we introduced some procedural ameliorations (incl. a novel procedure for kinetic boundary perimetry) and provided a scoresheet to facilitate the grading. The qualitative visual field tests’ outcome of 67 consecutive RBD stroke patients was compared with the standard automated perimetry (SAP; i.e., reference standard) outcome to calculate sensitivity and specificity, as well as positive and negative predictive values (PPV and NPV), both for each individual test and their combinations. The face description test scored the lowest sensitivity and NPV, while the kinetic boundary perimetry scored the highest. No test returned false positives. Combining the monocular static finger wiggle test (by quadrants) and the kinetic boundary perimetry returned the highest sensitivity and specificity, in line with previous studies, but with higher accuracy (100% sensitivity and specificity). These findings indicate that the combination of these two tests is a valid approach with RBD stroke patients, prompting referral for a formal visual field examination, and representing a quick, easy-to-perform, and inexpensive tool for improving their care and prognosis.

The aim of this study was to compare the effectiveness of trabeculectomy (TE) and deep sclerectomy (DS) in lowering intraocular pressure (IOP) and thereby preserving visual field and peripapillary retinal nerve fiber layer (RNFL) tissue in primary open-angle glaucoma (POAG) cases. IOP, number of IOP-lowering medications, visual acuity, mean defect of standard automated perimetry, and mean peripapillary RNFL thickness were retrospectively collected and followed up for 3 years after surgery. TE was performed in 104 eyes and DS in 183 eyes. Age, gender, laterality, IOP, number of medications, visual acuity, perimetry mean defect, and peripapillary RNFL thickness were equally distributed at baseline. Mean IOP decreased from 23.8 ± 1.4 mmHg and 23.1 ± 0.4 mmHg to 13.4 ± 0.6 mmHg (p < 0.001) and 15.4 ± 0.7 mmHg (p = 0.001) in the TE and DS groups, respectively. Mean defect remained stable (TE: −11.5 ± 0.9 dB to −12.0 ± 1.1 (p = 0.090); DS: −10.5 ± 0.9 dB to −11.0 ± 1.0 dB (p = 0.302)), while mean peripapillary RNFL thickness showed further deterioration during follow-up (TE group: 64.4 ± 2.1 μm to 59.7 ± 3.5 μm (p < 0.001); DS group: 64.9 ± 1.9 μm to 58.4 ± 2.1 μm (p < 0.001)). Both TE and DS were comparably effective concerning postoperative reduction in IOP and medication. However, glaucoma disease further progressed during follow-up.

A longitudinal ophthalmic dataset was used to investigate multi-modal machine learning (ML) models incorporating patient demographics and history, clinical measurements, optical coherence tomography (OCT), and visual field (VF) testing in predicting glaucoma surgical interventions. The cohort included 369 patients who underwent glaucoma surgery and 592 patients who did not undergo surgery. The data types used for prediction included patient demographics, history of systemic conditions, medication history, ophthalmic measurements, 24-2 VF results, and thickness measurements from OCT imaging. The ML models were trained to predict surgical interventions and evaluated on independent data collected at a separate study site. The models were evaluated based on their ability to predict surgeries at varying lengths of time prior to surgical intervention. The highest performing predictions achieved an AUC of 0.93, 0.92, and 0.93 in predicting surgical intervention at 1 year, 2 years, and 3 years, respectively. The models were also able to achieve high sensitivity (0.89, 0.77, 0.86 at 1, 2, and 3 years, respectively) and specificity (0.85, 0.90, and 0.91 at 1, 2, and 3 years, respectively) at an 0.80 level of precision. The multi-modal models trained on a combination of data types predicted surgical interventions with high accuracy up to three years prior to surgery and could provide an important tool to predict the need for glaucoma intervention.

The present study demonstrates that spatial attention modulates temporal order perception differently in the perifoveal and peripheral regions, with a more pronounced effect in the left peripheral visual field, suggesting a dissociation in attentional systems for event timing at the sub‐second level. [ABSTRACT FROM AUTHOR]

Disc hemorrhage (DH) is often associated with glaucoma progression. A vertically asymmetrical pattern is typical of glaucoma progression, but it remains unclear whether the association between DH and glaucoma progression differs between the superior and inferior hemiretinas. We compared the thickness changes of the macular ganglion cell complex (GCC) in the hemiretinas of normal-tension glaucoma patients with or without DH, as well as between hemiretinas positive and negative for DH, during five years. Both the superior and inferior hemiretinas in the DH-positive group had a more negative GCC thickness slope in association with more DH counts compared to those in the DH-negative group. Conversely, only the inferior hemiretina exhibited a significant relationship between GCC thickness slope and DH counts when hemiretinas positive and negative for DH in the DH-positive group were compared. In the superior hemifield, the slope of the total deviation changes in the DH-positive hemifield of the DH-positive group was more negative compared to that of the DH-negative group. The association between DH and glaucoma progression in the macular GCC may be stronger in the inferior hemiretina, suggesting that more attention should be paid to DH in the inferior disc area as a sign of glaucoma progression. [ABSTRACT FROM AUTHOR]

Background: Current guidelines suggest high-dose steroids as first-line treatment for dysthyroid optic neuropathy (DON). When steroids fail, decompressive surgery is mandatory. Methods: We conducted a single-center, retrospective cohort study in a tertiary care combined Thyroid-Eye clinic in Milan, Italy. We studied 88 orbits of 56 patients that were submitted to surgical orbital decompression to treat DON from 2005 to 2020. Of these, 33 orbits (37.5%) underwent surgery as first-line treatment for DON whereas the other 55 (62.5%) were decompressed after being unresponsive to very high-dose steroids. Previous orbital surgery, concurrent neurological or ophthalmologic diseases, or incomplete follow-up were considered as exclusion criteria from this study. Surgery was considered successful if no further decompression was needed to preserve vision. Pinhole best corrected visual acuity (p-BCVA), color sensitivity, automated visual field, pupil reflexes, optic disk and fundus appearance, exophtalmometry, and ocular motility were studied before and after surgery (1 week, 1, 3, 6, and 12 months). Activity of Graves' Orbitopathy (GO) was graded using a clinical activity score (CAS). Results: Surgery was successful in 77 orbits (87.5%). The remaining 11 orbits (12.5%) needed further surgery to treat DON definitively. All parameters of visual function improved significantly at follow-up and GO inactivated (CAS <3) within 1 month. At 3 months, all 77 responding orbits had p-BCVA >0.63 whereas all of the 11 non-responding orbits had p-BCVA ≤0.63. Visual field parameters and color sensitivity were not associated with response to surgery. High-dose steroid treatment before surgery was associated with a better response rate (96% vs. 73%; p = 0.004). Balanced decompression was associated with a higher response rate compared with medial wall decompression (96% vs. 80%; p = 0.04). A significant inverse correlation was observed between final p-BCVA and the patient's age (r = −0.42; p = 0.0003). Conclusions: Surgical decompression was found to be a very effective treatment for DON. In this study, all clinical parameters improved after surgery and further intervention was rarely needed. [ABSTRACT FROM AUTHOR]

Human visual performance typically declines with eccentricity; the neural bases of this effect exist at multiple stages of the visual system. Visual performance also varies with polar angle: it is better along the horizontal than vertical meridian, and along the lower than upper vertical meridian. Polar angle asymmetries exist at multiple stages of the visual system: in the density of photoreceptors and midget retinal ganglion cells, and in the distribution of tissue representing the visual field in visual cortex. Each subsequent stage explains more of the perceptual variability. Polar angle asymmetries are rooted in the asymmetric distribution of tissue in visual cortex, but asymmetric differences in neural tuning properties (spatial frequency tuning, orientation tuning, and receptive field size) likely play a key role in the perceptual asymmetries. Human visual performance changes with visual field location. It is best at the center of gaze and declines with eccentricity, and also varies markedly with polar angle. These perceptual polar angle asymmetries are linked to asymmetries in the organization of the visual system. We review and integrate research quantifying how performance changes with visual field location and how this relates to neural organization at multiple stages of the visual system. We first briefly review how performance varies with eccentricity and the neural foundations of this effect. We then focus on perceptual polar angle asymmetries and their neural foundations. Characterizing perceptual and neural variations across and around the visual field contributes to our understanding of how the brain translates visual signals into neural representations which form the basis of visual perception. [ABSTRACT FROM AUTHOR]

Birds of prey rely on vision to execute flight manoeuvres that are key to their survival, such as intercepting fast-moving targets or navigating through clutter. A better understanding of the role played by vision during these manoeuvres is not only relevant within the field of animal behaviour, but could also have applications for autonomous drones. In this paper, we present a novel method that uses computer vision tools to analyse the role of active vision in bird flight, and demonstrate its use to answer behavioural questions. Combining motion capture data from Harris' hawks with a hybrid 3D model of the environment, we render RGB images, semantic maps, depth information and optic flow outputs that characterise the visual experience of the bird in flight. In contrast with previous approaches, our method allows us to consider different camera models and alternative gaze strategies for the purposes of hypothesis testing, allows us to consider visual input over the complete visual field of the bird, and is not limited by the technical specifications and performance of a head-mounted camera light enough to attach to a bird's head in flight. We present pilot data from three sample flights: a pursuit flight, in which a hawk intercepts a moving target, and two obstacle avoidance flights. With this approach, we provide a reproducible method that facilitates the collection of large volumes of data across many individuals, opening up new avenues for data-driven models of animal behaviour. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the intereye correlations between and differences in the rates of visual field (VF) progression in eyes with bilateral open-angle glaucoma. Study design: Retrospective, longitudinal, observational study. Methods: Patients with bilateral open-angle glaucoma with 8 or more reliable 30 − 2 standard automated perimetry tests over a period of more than 2 years were enrolled. The rate of change of the MD (MD slope) was used as the indicator for the rates of VF progression. Descriptive statistics of the absolute intereye difference in the MD slope values were computed. Factors associated with a large intereye difference (> 0.42 dB/year) were explored. Results: One hundred eighty-eight eyes from 94 patients (56 women) were enrolled. A significant intereye correlation of the rates of visual field progression (P =.002) was found. The mean ± standard deviation and median intereye differences of the MD slope values were 0.29 ± 0.31 and 0.18 dB/year (range: 0–1.41), respectively. The 5th, 10th, 25th, 75th, 90th, and 95th percentiles of intereye differences were 0.01, 0.02, 0.08, 0.42, 0.72, and 0.91 dB/year, respectively. Older age and slower progression were significantly associated with large intereye difference. Conclusion: A significant intereye correlation in the rate of VF progression was found in eyes with bilateral open-angle glaucoma. We showed the distributions and associated factors of intereye differences in VF progression. These data may be used for improving the estimation of rates of VF progression. [ABSTRACT FROM AUTHOR]

Humans employ visually-guided actions during a myriad of daily activities. These ubiquitous but precise manual actions rely on synergistic work between eye and hand movements. During this close cooperation between hands and eyes, the hands persist in sight in a way which is unevenly distributed across our visual field. One common assertion is that most hand actions occur in the lower visual field (LVF) because the arms are anatomically lower than the head, and objects typically rest on waist-high table surfaces. While experimental work has shown that humans are more efficient at reaching for and grasping targets located below their visual midline (Goodale and Danckert, Exp Brain Res 137:303–308, 2001), there is almost no empirical data detailing where the hands lie in the visual fields during natural hand actions. To build a comprehensive picture of hand location during natural visually guided manual actions, we analyzed data from a large-scale open-access dataset containing 100 h of non-scripted manual object interactions during domestic kitchen tasks filmed from a head-mounted camera. We found a clear vertical visual asymmetry with hands located in the lower visual scene (LVS) in more than 70% of image frames, particularly in ipsilateral space. These findings provide the first direct evidence for the established assumption that hands spend more time in the lower than in the upper visual field (UVF). Further work is required to determine whether this LVF asymmetry differs across the lifespan, in different professions, and in clinical populations. [ABSTRACT FROM AUTHOR]

Background: To investigate the long‐term visual field (VF) outcome and baseline factors associated with functional sequelae in patients who experienced an episode of acute primary angle closure (APAC) and underwent subsequent lens extraction. Methods: Fifty patients (50 eyes) who experienced an APAC episode and underwent subsequent lens extraction at Chonnam National University Hospital were enrolled in this retrospective study. Patients underwent VF examinations after 1 year of an acute episode. They were classified into two groups based on whether they had significant VF defects or not. Demographic data were recorded, and baseline anterior‐segment OCT (AS‐OCT) images were analysed. Multivariate logistic regression analysis was performed to assess baseline risk factors for presence of VF defects. Results: Twenty‐five (50%) eyes were found to have varied degree of VF defects after 1 year of an acute episode. Longer duration between the symptom onset and IOP lowering (p = 0.005), a higher presenting IOP (p = 0.014), and flat iris curvature (p = 0.037) at baseline AS‐OCT measurement were significant predictors of VF loss. The area under the receiver operating characteristic curve (AUC) revealed that combination of these three potential baseline factors could predict the long‐term VF outcome (AUC = 0.921). Conclusions: Patients exhibiting a long duration between symptom onset and IOP lowering, a high presenting IOP, and flat iris curvature were at a higher risk of visual impairment after an episode of APAC. The eyes with such features may require more careful follow‐up after an episode of APAC. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to compare the patterns of visual field (VF) defects in primary angle-closure glaucoma (PACG) to control groups of eyes with high-tension glaucoma (HTG) and normal-tension glaucoma (NTG). Methods: Forty-eight eyes with PACG were enrolled, and control eyes with HTG and NTG matched for age, sex, and mean deviation of VF defect were selected. VF tests were performed using the 24-2 program of the Humphrey field analyzer. VF defects were classified into six patterns with the Ocular Hypertension Treatment Study classification system and were categorized into three stages (early, moderate, and advanced). Each hemifield was divided into five regions according to the Glaucoma Hemifield Test (GHT). The mean total deviation (TD) of each GHT region was calculated. Results: Compared with HTG and NTG groups, the partial arcuate VF defects were more common in the PACG group. In the PACG group, the nasal GHT region in the inferior hemifield had the worst mean TD (−8.48 ± 8.62 dB), followed by the arcuate 1 (−7.81 ± 7.91 dB), arcuate 2 (−7.46 ± 7.43 dB), paracentral (−7.19 ± 7.98 dB), and central (−5.14 ± 6.24 dB) regions; the mean TD of the central region was significantly better than those for all other regions (all p < 0.05). A similar trend was observed in the superior hemifield in the PACG group but not the VF hemifields of the HTG and NTG groups. Conclusion: Patterns of VF defect in PACG patients differ from those with HTG and NTG. This discrepancy might be due to the differences in the pathogenic mechanisms of glaucomatous optic neuropathy. [ABSTRACT FROM AUTHOR]

Diagnosing glaucoma accurately in patients with high myopia is difficult because of the clinical features that resemble glaucomatous optic neuropathy. Patients may establish visual field defects that imitate glaucoma, and conventional imaging technology is less informative in disease identification and monitoring due to the absence of myopic normative data. These facts highlight the critical importance of determining the underlying pathology associated with myopia and primary open-angle glaucoma in future studies. This review discusses the intricate relationship between myopia and glaucoma and the challenges of current testing protocols and treatment strategies. [ABSTRACT FROM AUTHOR]

To investigate the natural history of PRPF31-related retinitis pigmentosa (RP11). We identified individuals with RP11 and collected retrospective data from disease onset to present date including genetics, demographic data, Goldmann visual field areas, and visual acuity measurements. Visual fields were evaluated as summed squared degrees and best-corrected visual acuity was converted to logMAR. We performed linear mixed model regression analysis to evaluate annual disease progression, and survival analysis to evaluate the age of legal blindness. We included 46 subjects with RP11. Median age of disease onset was 10 years (range 5–65). Follow-up spanned from 0 to 36 years with a median of 8 years. Median Goldmann visual field areas decreased by 10.0% per year (95% CI 7.5%−12.4%) with target IV4e, 7.9% (95% CI 4.5% − 11.2%) with target III4e, and 9.3% (95% CI: 7.0% −11.5%) when combining target sizes. Individuals with RP11 maintained good visual acuity until late stage of disease. Legal blindness was reached at a median age of 57 years (95% CI 50–75 years). PRPF31 variants cause autosomal dominant retinitis pigmentosa that most commonly manifests in childhood with a variable disease progression. Visual field area deteriorates faster than visual acuity and was the major cause of legal blindness in our study population. This study characterizes disease progression in retinitis pigmentosa caused by PRPF31-variants and demonstrates the importance of differentiation between specific genotypes when counselling patients and conducting natural history studies of RP. [ABSTRACT FROM AUTHOR]

To search findings that can explain the heterogeneity between Resistant and Responsive patients with birdshot chorioretinopathy. This was a retrospective observational case series on "Responsive" versus "Resistant" birdshot chorioretinopathy One-hundred-eighty and Ninety-nine patients were included in the Responsive and Resistant groups respectively. Multivariate analysis of paraclinical variables at the first visit demonstrated that mean deviation (p =.04), pattern standard deviation (p <.001), optic nerve head leakage (p =.012), large vessel leakage and staining (p =.01), and macular small vessel leakage (p =.03) were statistically significantly different between the two groups; however, at the visit preceding successful therapy, only macular small vessel leakage (p =.01) was statistically significantly different between the two groups.Small vessel leakage in the macular area and/or optic nerve head leakage at the earliest visit might be risk factors for resistant birdshot chorioretinopathy. [ABSTRACT FROM AUTHOR]