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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)

Background There is a clinical need to identify diagnostic parameters that objectively quantify and monitor the effective visual ability of patients with homonymous visual field defects (HVFDs). Visual processing speed (VPS) is an objective measure of visual ability. It is the reaction time (RT) needed to correctly search and/or reach for a visual stimulus. VPS depends on six main brain processing systems: auditory-cognitive, attentional, working memory, visuocognitive, visuomotor, and executive. We designed a new assessment methodology capable of activating these six systems and measuring RTs to determine the VPS of patients with HVFDs. Methods New software was designed for assessing subject visual stimulus search and reach times (S-RT and R-RT respectively), measured in seconds. Thirty-two different everyday visual stimuli were divided in four complexity groups that were presented along 8 radial visual field positions at three different eccentricities (10o, 20o, and 30o). Thus, for each HVFD and control subject, 96 S- and R-RT measures related to VPS were registered. Three additional variables were measured to gather objective data on the validity of the test: eye-hand coordination mistakes (ehcM), eye-hand coordination accuracy (ehcA), and degrees of head movement (dHM, measured by a head-tracker system). HVFD patients and healthy controls (30 each) matched by age and gender were included. Each subject was assessed in a single visit. VPS measurements for HFVD patients and control subjects were compared for the complete test, for each stimulus complexity group, and for each eccentricity. Results VPS was significantly slower (p Conclusions Measurement of VPS by this new assessment methodology could be an effective tool for objectively quantifying the visual ability of HVFD patients. Future research should evaluate the effectiveness of this novel method for measuring the impact that any specific neurovisual rehabilitation program has for these patients.

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).

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.

In this work, we developed a wearable system using a commercial stereoscopic head-mounted display. We compared depth first-then contour (df-tc) and contour first-then depth (cf-td) algorithms in terms of images processed per second rate versus the window size and sweep values. Likewise, we performed a comparison of several edge detection methods in the same terms. The developed technical aid was clinically tested. We evaluated the preferred walking speed and the walking speed with and without the devices during three test circuits. For comparative analysis of anxiety levels, we recorded patients’ heart rate data before, during and after the test. The system has proven its potential for enhancing the patients’ mobility and reducing the level of anxiety related to movement activities.

Grey seal (Halichoerus grypus) populations declined dramatically in U.S. waters during the nineteenth and twentieth centuries, but have rebounded in recent decades as a result of legal protection. In the Gulf of Maine, increasing grey seal populations have the potential to impact commercially important groundfish species such as cod and haddock, but the potential also exists for more complex ecological interactions to occur given the recent increase of spiny dogfish (Squalus acanthias), another potential groundfish predator. Specifically, seal predation on dogfish could free groundfish species from additional predation pressure. Little quantitative data exists on intraguild predation rates by grey seals on spiny dogfish, in part because of the limitations of current methods of food habits analysis for grey seals. We report the development, validation, and field testing of a non-invasive genetic method for the detection of spiny dogfish in grey seal diets using DNA collected from seal feces. Our method amplified spiny dogfish DNA from 10 of 10 positive control scats from a captive seal with a known diet, and amplified spiny dogfish DNA from 0 of 10 negative control scats. We field tested the method on 20 scats from wild seals and detected spiny dogfish in two of the samples. All positive amplifications were sequenced to verify the species identify, and all were spiny dogfish. Our method has the potential to provide valuable information about changing predator prey dynamics in the Gulf of Maine and elsewhere.

Osteoporosis is considered a generalised skeletal disorder in which there is impaired bone resistance, which predisposes the individual to a greater risk of fracture. The aim of this cross-sectional study was to collect and present data on the main clinical characteristics of patients who consult medical internists in Spain. Understanding these characteristics can help in implementing action plans to improve these patients' care more effectively and efficiently.Through an analysis of the Osteoporosis in Internal Medicine (OSTEOMED) registry, this study presents the main clinical characteristics of patients with osteoporosis who attended internal medicine consultations in 23 Spanish hospital centres between 2012 and 2017. We analysed the reasons for the consultations, the densitometric values, the presence of comorbidities, the prescribed treatment and other lifestyle-related factors.In total, 2024 patients with osteoporosis were assessed (89.87% women, 10.13% men). The patients' mean age was 64.1±12.1 years (women, 64.7±11.5 years; men, 61.2±14.2 years). There was no significant difference between the sexes in their history of recent falls (9.1% and 6.7%); however, there were significant differences in the daily intake of calcium from milk products (553.8±332.6mg for women vs. 450.2±303.3mg for men; p.001) and in the secondary causes of osteoporosis (13% of men vs. 6.5% of women; p.001). In the sample, there were 404 fractures (20%), with a notable number of confirmed vertebral fractures (17.2%, 35.6% in men vs. 15.2% in women; p.001). A large portion of the patients did not undergo the indicated treatment and presented low levels of physical activity and sun exposure. A significant percentage of the patients presented associated comorbidities, the most common of which were hypertension (32%) and dyslipidaemia (28%).These results define the profile of patients with osteoporosis who attend internal medicine consultations in Spain. The results also show the multisystemic character of this condition, which, along with its high prevalence, determine that the specific internal medicine consultations dedicated to managing the condition are the appropriate place for caring for these patients.

Osteoporosis is considered a generalised skeletal disorder in which there is impaired bone resistance, which predisposes the individual to a greater risk of fracture. The aim of this cross-sectional study was to collect and present data on the main clinical characteristics of patients who consult medical internists in Spain. Understanding these characteristics can help in implementing action plans to improve these patients' care more effectively and efficiently.Through an analysis of the Osteoporosis in Internal Medicine (OSTEOMED) registry, this study presents the main clinical characteristics of patients with osteoporosis who attended internal medicine consultations in 23 Spanish hospital centres between 2012 and 2017. We analysed the reasons for the consultations, the densitometric values, the presence of comorbidities, the prescribed treatment and other lifestyle-related factors.In total, 2024 patients with osteoporosis were assessed (89.87% women, 10.13% men). The patients' mean age was 64.1±12.1 years (women, 64.7±11.5 years; men, 61.2±14.2 years). There was no significant difference between the sexes in their history of recent falls (9.1% and 6.7%); however, there were significant differences in the daily intake of calcium from milk products (553.8±332.6mg for women vs. 450.2±303.3mg for men; P.001) and in the secondary causes of osteoporosis (13% of men vs. 6.5% of women; P.001). In the sample, there were 404 fractures (20%), with a notable number of confirmed vertebral fractures (17.2%, 35.6% in men vs. 15.2% in women; P.001). A large portion of the patients did not undergo the indicated treatment and presented low levels of physical activity and sun exposure. A significant percentage of the patients presented associated comorbidities, the most common of which were hypertension (32%) and dyslipidaemia (28%).These results define the profile of patients with osteoporosis who attend internal medicine consultations in Spain. The results also show the multisystemic character of this condition, which, along with its high prevalence, determine that the specific internal medicine consultations dedicated to managing the condition are the appropriate place for caring for these patients.

We aimed to study the relationship between the ischemic core’s (IC) radiological hypodensity and the risk of parenchymal haematoma after endovascular therapy (EVT) in acute ischemic stroke (AIS) presenting > 4.5 h from onset. We studied AIS patients with a proximal anterior circulation occlusion > 4.5 h from symptoms onset treated with primary EVT. The IC regions of interest (ROI) were manually delineated on pretreatment CT within the affected hemisphere and their specular ROIs on the unaffected side. IC hypodensity ratio was calculated by dividing mean Hounsfield Unit (HU) value from all ROIs in affected/unaffected hemisphere. Primary endpoint: parenchymal hematoma (PH) type hemorrhagic transformation. Secondary: poor long-term clinical outcome. From May 2015 to November 2018, 648 consecutive AIS patients received reperfusion therapies and 107 met all inclusion criteria. PH after EVT was diagnosed in 33 (31%) patients. In bivariate analyses, IC hypodensity ratio (p 4.5 h-window AIS patients treated with primary EVT, although it was not independently associated with a worse clinical outcome., This research has been partially funded by the INVICTUS PLUS Research Network in Cerebrovascular Diseases from the Instituto Carlos III, Ministery of Science, Madrid, Spain (Code RD16/0019) and by the Research Project FIS PI 16/01396 (PI Dr Arenillas), Ministery of Science, Madrid, Spain. Beatriz Gómez-Vicente received a research contract by the Junta de Castilla y León, Spain.

[Background and Purpose]: We aimed to evaluate the impact of brain atrophy on long-term clinical outcome in patients with acute ischemic stroke treated with endovascular therapy, and more specifically, to test whether there are interactions between the degree of atrophy and infarct volume, and between atrophy and age, in determining the risk of futile reperfusion., [Methods]: We studied consecutive patients with acute ischemic stroke with proximal anterior circulation intracranial arterial occlusions treated with endovascular therapy achieving successful arterial recanalization. Brain atrophy was evaluated on baseline computed tomography with the global cortical atrophy scale, and Evans index was calculated to assess subcortical atrophy. Infarct volume was assessed on control computed tomography at 24 hours using the formula for irregular volumes (A×B×C/2). Main outcome variable was futile recanalization, defined by functional dependence (modified Rankin Scale score >2) at 3 months. The predefined interactions of atrophy with age and infarct volume were studied in regression models., [Results]: From 361 consecutive patients with anterior circulation acute ischemic stroke treated with endovascular therapy, 295 met all inclusion criteria. Futile reperfusion was observed in 144 out of 295 (48.8%) patients. Cortical atrophy affecting parieto-occipital and temporal regions was associated with futile recanalization. Total global cortical atrophy score and Evans index were independently associated with futile recanalization in an adjusted logistic regression. Multivariable adjusted regression models disclosed significant interactions between global cortical atrophy score and infarct volume (odds ratio, 1.003 [95%CI, 1.002–1.004], P, [Conclusions]: A higher degree of cortical and subcortical brain atrophy is associated with futile endovascular reperfusion in anterior circulation acute ischemic stroke. The impact of brain atrophy on insufficient clinical recovery after endovascular reperfusion appears to be independently amplified by age and by infarct volume., This study has been partially funded by the Spanish Ministry of Science, via FIS projects PI13/02544 and PI16/01396, and through the INVICTUS PLUS research network RD16/0019.

We report outcomes of 228 consecutive patients with total joint arthroplasty using the Arpe® prosthesis, among which 216 trapeziometacarpal joints in 199 patients had a minimum of 10 years follow-up. The cumulative survival rate of the 216 implants at 10 years using the Kaplan–Meyer method was 93%. Two hundred joints were functional and painless. We found good integration and positioning of the components in 184 (93%) of the joints. Sixteen prostheses failed. We conclude that this implant has acceptable long-term survival rate and restores good hand function. We also report our methods to improve implant survival and to decrease the risk of component malpositioning, and failure rate. Level of evidence: II

To evaluate the efficacy of a reading rehabilitation program (RRP) in patients with central visual loss (CVL) and assess the impact of the RRP on the quality of life (QoL).The RRP included four in-office and 39 in-home training sessions over 6 weeks. Reading speed, duration, and font size were evaluated during each in-office session. The subjective perception of the QoL was assessed before and after the RRP using the short version of a questionnaire (World Health Organization Quality of Life). A control group who received advice about ocular conditions and low-vision aids also was included.Seventeen patients with Stargardt's disease (STGD), 11 with adult-onset foveomacular vitelliform dystrophy (AFVD), and eight with myopic macular degeneration (MMD) were included. The control group included five patients each with STGD, AFVD, and MMD. The respective mean corrected distance visual acuities (VAs) in patients with STGD, AFVD, MMD, and the control group were 0.57 ± 0.38, 0.51 ± 0.38, 0.49 ± 0.24, and 0.55 ± 0.25 logarithm of the minimum angle of resolution; the mean corrected near VAs were 0.89 ± 0.20, 1.08 ± 0.17, 0.99 ± 0.34, and 1.18 ± 0.37 (M notation) using low-vision aids. The reading speed, duration, and font size improved in all groups. The RRP groups obtained (p ≤ 0.01) greater improvements than the control group in each reading performance variable assessed. Patients with STGD obtained greater improvements in the subjective evaluation; the control group did not obtain noteworthy improvement in any domain.The RRP improved reading performance in patients with CVL and positively impacted the subjective perception of the QoL.

PURPOSE The aim of this study was to assess the intersession and interobserver reliability of central corneal thickness (CCT) measurements using a posterior-segment spectral domain optical coherence tomography (SD-OCT). METHODS Sixty patients were examined with a posterior-segment SD-OCT system (Topcon 3D-OCT). To analyze intersession reproducibility, 1 examiner measured CCT in 60 eyes 2 times 1 week apart, and to study interobserver reproducibility, a second examiner obtained another measurement during the first session. Within-subject reproducibility, coefficient of reproducibility (CR), and intraclass correlation coefficients (ICC) were calculated. Agreement between Topcon 3D OCT and ultrasound pachymetry (USP) was also assessed. RESULTS Posterior-segment SD-OCT showed an intersession reproducibility of 12.7 μm (CR = 2.4%) and an excellent ICC (0.96). No systematic difference between sessions was found (average difference, 1.7 μm; P = 0.15). We found no significant bias between observers (mean difference, -1.5 μm; P = 0.29). The interobserver reproducibility was 16.4 μm (CR = 3.1%), and the ICC was 0.94. Topcon 3D OCT CCT values were lower than USP readings (mean difference, 7.6 ± 8.1 μm; 95% confidence interval, 9.9-5.3 μm; P < 0.001). CONCLUSIONS With a commercially available retinal SD-OCT system, reliable intersession and interobserver CCT measurements can be feasibly obtained. The criteria for a significant change, which would be the one exceeding the reproducibility, indicate that intersession and interobserver variations in CCT of more than 13 and 16 μm, respectively, may reflect true corneal change with this particular device. These estimates should help investigators and clinicians differentiate actual CCT modification from measurement random error. The slight CCT underestimation with respect to USP is within the range of other OCT devices.

PURPOSE: The aim of this study was to assess the random error of the thinnest point and midperipheral pachymetry with a combined Placido-scanning-slit system (Orbscan II) in the intermediate-term follow-up of excimer laser keratorefractive surgery for treating myopia. METHODS: Sixty-five patients who had undergone aspheric surface ablation for treating myopia with a minimum follow-up of 6 months, and showed no biomicroscopically detectable corneal haze, were subjected to 5 consecutive topographic examinations. All eyes underwent a complete ophthalmic examination before the surgery. The within-subject SD (Sw), repeatability (2.77 × Sw), coefficient of repeatability (2.77 × Sw/mean), and intraclass correlation coefficients of pachymetry at the thinnest point and in each 4 quadrants at a 6-mm diameter were calculated. RESULTS: The patients had a mean age of 31.9 ± 6.2 years, and the average follow-up was for 7.5 ± 2.6 months. The mean ablation depth for myopia was 63.6 ± 23.6 μm. The average pachymetry for the thinnest point and midperipheral superior, inferior, nasal, and temporal locations was 456.9, 602.0, 595.5, 609.7, and 566.1 μm, respectively. The repeatability (and coefficient of repeatability) for the thinnest point and midperipheral superior, inferior, nasal, and temporal locations was 26.5 (5.8%), 37.9 (6.3%), 31.0 (5.2%), 30.5 (5.0%), and 35.4 μm (6.2%), respectively. The intraclass correlation coefficients were 0.96, 0.88, 0.89, 0.97, and 0.91 for each location, respectively. CONCLUSIONS: This study provides the repeatability of the thinnest and midperipheral pachymetry using the combined Placido-scanning-slit system in transparent corneas after laser keratorefractive surgery for treatment of myopia. The test-retest reliability provided here will help differentiate real corneal thickness change from measurement noise. For this, only pachymetric changes >6% are likely to be real and therefore useful when evaluating postoperative keratectasia suspects.

To assess early variations in central and paracentral corneal epithelial and non-epithelial thicknesses after uneventful clear corneal incision phacoemulsification.Twenty patients with a senile cataract underwent coaxial phacoemulsification through a 2.75-mm-wide corneal incision created at 180° in a prospective cohort pilot study. Corneal sublayer thickness measurements were obtained with Fourier-domain optical coherence tomography (FD-OCT, Cirrus HD-OCT, Carl Zeiss Meditec, Inc., Dublin, CA) before and after 1 week and 1 month postoperatively. Central measurements were performed in the middle of the FD-OCT scan and in the 3-mm corneal diameter (paracentral 180° and 0° locations). Epithelial, non-epithelial and total corneal pachymetry were measured at the central and paracentral locations.No significant changes in epithelial thickness were seen 1 week postoperatively. However, 1 month postoperatively, the central, 180°, and 0° paracentral epithelial thicknesses (52.7 ± 3.8, 53.1 ± 5.4, and 52.7 ± 5.3 µm, respectively) decreased significantly (p 0.01) compared to preoperatively (57.2 ± 4.8, 58.0 ± 5.7, 56.6 ± 5.3 µm, respectively). The 1-week central, 180°, and 0° paracentral non-epithelial corneal thicknesses (515.5 ± 39.6, 534.3 ± 45.6, and 521.3 ± 36.9 µm) were significantly (p 0.01) higher than preoperatively (486.2 ± 34.7, 498.2 ± 33.8, 497.5 ± 32.3 µm, respectively). The non-epithelial corneal thickness increase was significantly (p = 0.02) greater after 1 week in the central (29.3 ± 17.2 µm) and the 180° paracentral (36.1 ± 28.7 µm) locations than at the 0° paracentral location (23.8 ± 16.5 µm).Immediate postoperative corneal edema following phacoemulsification irregularly affects the cornea at the sublayer level. The initial central and paracentral non-epithelial thickening is compensated by subsequent central and paracentral epithelial thinning. These initial changes occurred more markedly closest to the main incision over the entrance pupil, which may have visual implications.

The Tup1-Ssn6 corepressor complex in Saccharomyces cerevisiae represses the transcription of a diverse set of genes. Chromatin is an important component of Tup1-Ssn6-mediated repression. Tup1 binds to underacetylated histone tails and requires multiple histone deacetylases (HDACs) for its repressive functions. Here, we describe physical interactions of the corepressor complex with the class I HDACs Rpd3, Hos2, and Hos1. In contrast, no in vivo interaction was observed between Tup-Ssn6 and Hda1, a class II HDAC. We demonstrate that Rpd3 interacts with both Tup1 and Ssn6. Rpd3 and Hos2 interact with Ssn6 independently of Tup1 via distinct tetratricopeptide domains within Ssn6, suggesting that these two HDACs may contact the corepressor at the same time.

A new tannin-based coagulant was synthesized by polymerization with formaldehyde and diethanolamine from tannin extract from Quebracho colorado (Schinopsis balansae). The resulting coagulant is a feasible treatment agent for dye removal in aqueous solutions for up to nine types of dyes. Specifically, Alizarin Violet 3R was selected as a model compound for evaluating the influence of several operating variables, such as pH, temperature, stirring rate and period, or initial dye content. The coagulant is fully working in a wide range of operating variables, and the entire system (dye-coagulant) can be modeled according to adsorption-like coagulation models, such as Freundlich or Gu and Zhu.

Purpose: To evaluate the patient-reported outcomes (PRO) in age-related macular degeneration (AMD) patients by using instruments for eliciting health status and vision specific issues. Methods: PRO were assessed using the 25-item National Eye Institute Visual Function Questionnaire (NEIVFQ-25) and the Short-Form General Health Survey (SF-12). Results: The mean age and corrected distance visual acuity (CDVA) in the better eye of the AMD patients were 82.53 ± 5.17 years and 0.82 ± 0.43 logMAR, respectively. The overall NEIVFQ-25 composite score was 57.89. SF-12 physical and mental component summary scores were 37.28 and 57.25, respectively. There were significant correlations (p ≤ 0.05) between CDVA and the following NEIVFQ-25 subscales: general (r = -0.73), near (r = -0.40) and distance vision (r = -0.60), role limitations (r = -0.40), social function (r = -0.48) and mental health (r = -0.38). Conclusions: Visual function is severely affected in AMD patients. It hampers their daily living without, however, deeply disturbing their social function. This may help them retain adequate mental health despite their poor physical status.

PURPOSE To assess the repeatability, intersession and interobserver reproducibility, and agreement of central corneal thickness (CCT) measurements obtained by scanning-slit topography (SST) and noncontact specular microscopy (NCSM) after advanced surface ablation (ASA). METHODS To analyze repeatability, one examiner measured 63 post-myopic ASA eyes five times successively using both techniques randomly. To calculate interobserver reproducibility a second examiner obtained another CCT measurement in a random fashion. To study intersession reproducibility, the first operator obtained CCT measurements from another 24 eyes during two sessions 1 week apart. RESULTS With regard to intrasession repeatability, SST and NCSM within-subject standard deviation (S(w)) and intraclass correlation coefficient (ICC) were 7.35 and 3.81 μm, and 0.97 and 0.99, respectively. For interobserver reproducibility, SST measurement variability showed correlation with CCT magnitude (r(s) = -0.38; P = 0.002), whereas NCSM did not. NCSM S(w) and ICC were 3.83 μm and 0.99, respectively. For intersession reproducibility, no difference in CCT measurements was found for any technique; S(w) and ICC estimates for SST and NCSM were 12.2 and 8.37 μm, and 0.94 and 0.95, respectively. We found a tendency for the difference (mean SST-NCSM = 13.39 μm) to increase in thicker corneas (r(s) = 0.45, P = 0.001). CONCLUSIONS Both noncontact pachymetry techniques provided highly repeatable and quite reproducible CCT measurements in post-ASA patients having no clinically significant corneal haze, except for SST interobserver reproducibility, which decreased in thinner corneas. However, the techniques were not interchangeable. The estimates provided should help clinicians differentiate real CCT change from noncontact pachymetry measurement variability after ASA.

The aim of the chapter is to review the most recent advances in electro-optical technologies applied to visually disabled people. The World Health Organization (WHO) estimates that the number of people in the world with some kind of visual impairment is 285 million, with 246 million of these persons in a partially sighted or Low Vision (LV) condition. The top three causes of visual impairment are uncorrected refractive errors, cataracts and glaucoma, followed by age-related macular degeneration. On the other hand, Head Mounted Displays or electro-optical materials used in liquid crystal or electrochromic devices can be used in technical aids for LV. In this chapter, the authors review how disabled people receive real world information using these new technologies, how the recently developed electro-optical technical aids can improve visual perception, and how these LV aids do work, from a technological point of view.

Purpose To assess the intrasession and intersession precision of ocular, corneal, and internal higher-order aberrations (HOAs) measured using an integrated topographer and Hartmann-Shack wavefront sensor (Topcon KR-1W) in refractive surgery candidates. Setting IOBA-Eye Institute, Valladolid, Spain. Design Evaluation of diagnostic technology. Methods To analyze intrasession repeatability, 1 experienced examiner measured eyes 9 times successively. To study intersession reproducibility, the same clinician obtained measurements from another set of eyes in 2 consecutive sessions 1 week apart. Ocular, corneal, and internal HOAs were obtained. Coma and spherical aberrations, 3rd- and 4th-order aberrations, and total HOAs were calculated for a 6.0 mm pupil diameter. Results For intrasession repeatability (75 eyes), excellent intraclass correlation coefficients (ICCs) were obtained (ICC >0.87), except for internal primary coma (ICC = 0.75) and 3rd-order (ICC = 0.72) HOAs. Repeatability precision (1.96 × S w ) values ranged from 0.03 μm (corneal primary spherical) to 0.08 μm (ocular primary coma). For intersession reproducibility (50 eyes), ICCs were good (>0.8) for ocular primary spherical, 3rd-order, and total higher-order aberrations; reproducibility precision values ranged from 0.06 μm (corneal primary spherical) to 0.21 μm (internal 3rd order), with internal HOAs having the lowest precision (≥0.12 μm). No systematic bias was found between examinations on different days. Conclusions The intrasession repeatability was high; therefore, the device's ability to measure HOAs in a reliable way was excellent. Under intersession reproducibility conditions, dependable corneal primary spherical aberrations were provided. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.

Purpose To assess the intrasession and intersession precision of higher-order aberrations (HOAs) measured using a commercial Hartmann-Shack wavefront sensor (Zywave; Bausch & Lomb) in refractive surgery candidates. Design Prospective, experimental study of a device. Methods To analyze intrasession repeatability, 1 experienced examiner measured 30 healthy eyes 5 times successively. To study intersession reproducibility, the same clinician obtained measurements from another 30 eyes in 2 consecutive sessions at the same time of day 1 week apart. Results For intrasession repeatability, excellent intraclass correlation coefficients (ICCs) were obtained for total ocular aberrations, total HOAs, and second-order terms (ICC, > 0.94). The ICCs for third-order terms also were high (ICCs, > 0.87); however, fourth-order ICCs varied from 0.71 to 0.90 (Z 4 0 = 0.90); and fifth-order ICCs were less than 0.85. For intersession reproducibility, only total ocular aberrations, total ocular HOAs, second-order terms, Z 4 0 , Z 3 1 , and Z 3− 3 had ICCs of 0.90 or more. Bland-Altman analysis showed that the limits of agreement (were clinically too wide for most higher-order Zernike terms, especially for the third-order terms (> 0.21 μm). Conclusions Total ocular aberrations, total HOAs, and second-order terms can be measured reliably by Zywave aberrometry without anatomic recognition. Third-order terms and Z 4 0 are repeatable, but not as reproducible between visits. Fourth-order terms, except for Z 4 0 , and fifth-order terms are not sufficiently reliable for clinical decision making or treatment. Because the variability of Zywave can be a major limitation of a truly successful wavefront-guided excimer laser procedure, surgeons should consider treating HOA magnitudes that are more than the intrasession repeatability values (2.77 × S w ) as those presented in this study.

Purpose To assess intraobserver and interobserver reliability of central corneal thickness (CCT) measurements using optical low-coherence reflectometry (OLCR) technology and its agreement with spectral-domain optical coherence tomography (SD-OCT). Setting Rio Hortega University Hospital, Valladolid, Spain. Design Evaluation of diagnostic technology. Methods To analyze OLCR intraobserver repeatability, 1 examiner obtained 4 successive measurements. To study interobserver reproducibility, a different examiner obtained another CCT measurement. To determine agreement with SD-OCT, the first examiner also obtained CCTs. Intraobserver and interobserver within-subject standard deviation (S w ), coefficient of variation (CV w ), and limits of agreement (LoA) were obtained for OLCR reliability analysis; for study agreement, data were analyzed using the paired-sample t test and the LoA were calculated. Results For OLCR intraobserver repeatability, the S w and precision (1.96×S w ) were 2.33 and 4.56 μm, respectively. The intraobserver CV w was 0.42%. For interobserver reproducibility, the S w and precision were 11.59 and 22.71 μm, respectively; the CV w was 2.10%. The mean difference between observers was −1.35 μm (95% confidence interval [CI], −3.97 to 1.26). The width of the LoA was 45.27 μm. The mean CCT difference between OLCR and SD-OCT was 5.68±11.46 μm (95% CI, 8.29-3.08 μm; P =.0001), and the width of the LoA was 44.93 μm. Conclusions Optical low-coherence reflectometry technology provided reliable intraobserver and interobserver CCT measurements. Although OLCR underestimated the pachymetry by less than 6 μm compared with SD-OCT, its interchangeability fell within the range of interobserver reproducibility. Both noncontact pachymetry measurements seem to be clinically useful and may be used interchangeably with minimum calibration adjustment. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.

Purpose To describe the diagnosis and management of Coats disease in a patient with Fanconi anemia. Methods Case report. Results A 12-year-old girl with Fanconi anemia developed Coats disease. Retinal vasculature anomalies are present in both diseases; however, differential diagnosis in this case could be based on the presence of telangiectasias, which are typical of Coats disease, and the absence of perivascular sheathing, usually described in the uncommon retinal manifestations of Fanconi anemia. The stage 4 Coats disease was managed with intravitreal bevacizumab injections and later pars plana vitrectomy with silicone oil tamponade surgery, which prevented enucleation despite visual loss. Conclusions Patients with Fanconi anemia can have retinal vasculature anomalies that are not necessarily related to this systemic anomaly. In this case, the retinal alterations were related to advanced Coats disease stage, which was successfully treated, and enucleation of the affected eye was not necessary.