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Abstract Background Urban air pollution resulting from economic growth as well as urbanization impacts the health of inhabitants. This study aims to examine the spatial distribution of particulate matter (PM10) and the risk of exposure for the population in the Klang Valley, an urban conglomeration centred in Kuala Lumpur, Malaysia. Methods The inverse distance weighted (IDW) interpolation technique in the ArcGIS platform was used to map the air quality from five air monitoring stations. Spatial statistics of the Global Moran’s I Spatial Autocorrelation and Optimized Hot Spot Analysis were used to estimate the spatial clustering of PM10. The population-weighted exposure level (PWEL) technique was used to calculate the population density susceptible to PM10 and the AirQ+ model was applied to estimate the proportion of the adult population at risk of chronic bronchitis due to long-term exposure to PM10 concentrations in the Klang Valley. Results The highest annual mean PM10 concentrations at the Klang station ranged between 80 and 100 μg/m3 from 2000 to 2009 and exceeded the New Malaysia Ambient Air Quality Standard (NMAAQS) and the World Health Organization Air Quality Guidelines (WHOAQG) levels of 40 and 20 μg/m3, respectively. The Moran's I results indicated that the statistically significant clusters of high PM10 in Klang present a health risk to the local community. The PWEL results showed that levels of PM10 in Petaling Jaya exceeded the WHOAQG limits, potentially posing a health risk to the high-density population. The AirQ+ model found Klang to be a significantly high-risk area for chronic bronchitis among the adult population with 804,240 people (with a relative risk of 1.85) in 2009. Conclusion These high-risk values are due to rapid urbanization and high motor vehicle usage in the Klang Valley and therefore the impact of PM10 on the population needs to be reduced. This situation should be taken seriously by the Department of Environment and Kuala Lumpur City Hall in addressing air pollution issues through stricter rules on emissions and implementing low-carbon policies to improve the well-being of residents.

Future workforce skills are dominated by a good understanding of technology and engineering, and problem-solving skills. Therefore, the importance of science, technology, engineering, mathematics (STEM) education is globally recognized. Among the STEM-related subjects, mathematics is known as a challenging subject. Mathematics learning during pandemic Covid 19 becomes more challenging when students are encouraged to self-learn at home. An appropriate combination of pedagogy and technology such as artificial intelligence (AI) will benefit mathematical learning. Therefore, this study is to investigate the effectiveness of an AI-based learning aid for a mathematics topic, which is differentiation. An artificial intelligence-based learning aid known as the “Smart Differentiation System” or known as SDS in short, is developed to allow students to cross-check differentiation solutions in solving differential equations. An AI technique called Self-Adaptive Ensemble Based Differential Evolution (SAEDE) is integrated into the development of the Smart Differentiation System. Smart Differentiation System is developed based on the Agile model. A multiple-choice questionnaire is used to collect data from the target group of respondents regarding their problems in learning mathematics and feedback about the Smart Differentiation System. Based on the results, 86.7% of the respondents agreed that the use of Smart Differentiation System as a learning aid in the classroom is more fun and exciting and 80% agreed that Smart Differentiation System is acceptable and can be used by secondary school students in learning mathematics. In conclusion, the learning aid has determined the effectiveness of the AI-based learning aid especially in helping students to perform self-learning in mathematics.

Machine learning has been the topic of interest in research related to early detection of breast cancer based on mammogram images. In this study, we compare the performance results from three (3) types of machine learning techniques: 1) Naïve Bayes (NB), 2) Neural Network (NN) and 3) Support Vector Machine (SVM) with 2000 digital mammogram images to choose the best technique that could model the relationship between the features extracted and the state of the breast (‘Normal’ or ‘Cancer’). Grey Level Co-occurrence Matrix (GLCM) which represents the two dimensions of the level variation gray in the image is used in the feature extraction process. Six (6) attributes consist of contrast, variance, standard deviation, kurtosis, mean and smoothness were computed as feature extracted and used as the inputs for the classification process. The data has been randomized and the experiment has been repeated for ten (10) times to check for the consistencies of the performance of all techniques. 70% of the data were used as the training data and another 30% used as testing data. The result after ten (10) experiments show that, Support Vector Machine (SVM) gives the most consistent results in correctly classifying the state of the breast as ‘Normal’ or ‘Cancer’, with the accuracy of 99.4%, in training and 98.76% in testing. The SVM classification model has outperformed NN and NB model in the study, and it shows that SVM is a good choice for determining the state of the breast at the early stage. ABSTRAK: Pembelajaran mesin telah menjadi topik yang diminati dalam penyelidikan yang berkaitan dengan pengesanan awal kanser payudara berdasarkan imej mamogram. Dalam kajian ini, kami membandingkan hasil prestasi dari tiga (3) jenis teknik pembelajaran mesin: 1) Naïve Bayes (NB), 2) Neural Network (NN) dan 3) Support Vector Machine (SVM) dengan 2000 imej digital mammogram hingga teknik terbaik yang dapat memodelkan hubungan antara ciri yang diekstraksi dan keadaan payudara ('Normal' atau 'Cancer') dapat diperoleh. Grey Level Co-occurrence Matrix (GLCM) yang mewakili dua dimensi variasi tahap kelabu pada gambar digunakan dalam proses pengekstrakan ciri. Enam (6) atribut terdiri dari kontras, varians, sisihan piawai, kurtosis, min dan kehalusan dihitung sebagai fitur yang diekstrak dan digunakan sebagai input untuk proses klasifikasi. Eksperimen telah diulang selama sepuluh (10) kali untuk memeriksa kesesuaian prestasi semua teknik. 70% data digunakan sebagai data latihan dan 30% lagi digunakan sebagai data ujian. Hasil setelah sepuluh (10) eksperimen menunjukkan bahawa, Support Vector Machine (SVM) memberikan hasil yang paling konsisten dalam mengklasifikasikan keadaan payudara dengan betul sebagai 'Normal' atau 'Kanser', dengan akurasi 99.4%, dalam latihan dan 98.76% dalam ujian. Model klasifikasi SVM telah mengungguli model NN dan NB dalam kajian ini, dan ia menunjukkan bahawa SVM adalah pilihan yang baik untuk menentukan keadaan payudara pada peringkat awal.

Kajian ini mencadangkan sistem yang lebih mudah dan berkesan untuk penilaian prestasi guru-guru di sekolah menggunakan Sistem Sokongan Keputusan (Decision Support System, DSS) yang dipanggil Key Performance Indicator-Monitoring Tool (KPI-MT). Antara muka sistem ini telah dibangunkan dengan menggunakan perisian Macromedia Dreamweaver, manakala PHP Hypertext Preprocessor (PHP) versi 5.2.9 digunakan sebagai bahasa skrip dan MySQL versi 5.0 sebagai sistem pengurusan pangkalan data. DSS dalam sistem KPI-MT juga turut menggunakan kaedah jumlah wajaran (Weighted Sum Method, WSM) untuk mengira markah keseluruhan guru-guru dan juga untuk menentukan sama ada prestasi guru dalam tahun itu adalah sangat baik, baik, sederhana, kurang memuaskan atau lemah. Dengan sistem KPI-MT, pengetua sekolah boleh memantau prestasi guru bermula dari tahun pertama perkhidmatan guru di sekolah. Untuk memastikan bahawa keseluruhan sistem yang dibangunkan memenuhi keperluan sekolah dan untuk melihat sama ada antaramuka yang dibina adalah mesra pengguna atau tidak, satu kajian kebolehgunaan telah dijalankan. Kajian ini dijalankan dengan menggunakan kaji selidik dengan set soalan kepada sepuluh responden dan data yang dikumpul dianalisis dengan menggunakan Statistical Package For Social Science (SPSS) versi 21.0. Keputusan menunjukkan bahawa pengguna yang kebanyakannya guru-guru dan bakal guru berpuas hati dengan sistem KPI-MT kerana mudah untuk digunakan, dimana mereka tidak memerlukan bantuan teknikal untuk mengendalikan sistem ini. Dengan ciri-ciri tambahan yang terdapat pada prototaip KPI-MT ini, seperti paparan graf dan keupayaan untuk memantau prestasi guru-guru setiap tahun, maka adalah dilihat bahawa prototaip ini berpotensi untuk menggantikan sistem KPI yang sedia ada di sekolah bagi membantu pihak pengurusan sekolah terutamanya pengetua, untuk menilai dan memantau prestasi guru dengan lebih baik dan efisyen. This study suggests a simpler and more effective system for teacher performance evaluation in schools using a Decision Support System (DSS) called Key Performance Indicators Monitoring Tool (KPI-MT). The system interface was developed using Macromedia Dreamweaver, while PHP Hypertext Preprocessor (PHP) version 5.2.9 is used as a scripting language and MySQL version 5.0 as the database management system. DSS in KPI-MT system use a weighted sum method (WSM) to calculate an overall score of teachers, and also to determine whether the performance of teachers in that year was very good, good, fair, poor, or weak. With KPI-MT system, school principals can monitor teacher’s performance from the first year of their service at schools. To ensure that the whole system was developed to meet the needs of the school and to see whether the interface is user-friendly or not, a usability study was conducted. The study was conducted using a survey with ten sets of questions and the data collected were analyzed using Statistical Package for Social Sciences (SPSS) version 21.0. The results show that users who are mainly teachers and prospective teachers, are satisfied with KPI-MT system which is easy to use, where they do not require technical assistance to operate the system. With additional features on the KPI-MT prototype, such as the display of graphs and the ability to monitor the performance of teachers every year, it is seen that the prototype has potentials to replace the KPI system existing at the school to assist the school management especially the principals, in assessing and monitoring teacher’s performance efficiently.

Early childhood is a significant period when transitions take place in children. This period is a hot topic among researchers who pursue this domain across different scientific disciplines. Many studies addressed social, scientific, medical, and technical topics during early childhood. Researchers also utilized different analysis measures to conduct experiments on the different types of data related to the early childhood to produce research articles. This paper aims to review and analyze the literature related to early childhood in addition to the data analyses and the types of data used. The factors that were considered to boost the understanding of contextual aspects in the published studies related to early childhood were considered as open challenges, motivations, and recommendations of researchers who aimed to advance the study in this area of science. We systematically searched articles on topics related to early childhood, the data analysis approaches used, and the types of data applied. The search was conducted on five major databases, namely, ScienceDirect, Scopus, Web of Science, IEEE Xplore, and PubMed from 2013 to September 2017. These indices were considered sufficiently extensive and reliable to cover our field of the literature. Articles were selected on the basis of our inclusion and exclusion criteria (n = 233). The first portion of studies (n = 103/233) focused on the different aspects related to the development of children in early age. They discussed different topics, such as the body growth development of children, psychology, skills, and other related topics that overlap between two or more of the previous topics or do not fall into any of the categories but are still under development. The second portion of studies (n = 107/233) focused on different aspects associated with health in early childhood. A number of topics were discussed in this regard, such as those related to family health, medical procedures, interventions, and risk that address the health-related aspects, in addition to other related topics that overlap between two or more of the previous topics or do not fall into any of the categories but are still under health. The remaining studies (n = 23/233) were categorized to the other main category because they overlap between the previous two major categories, namely, development and health, or they do not fall into any of the previous main categories. Early childhood is a sensitive period in every child's life. This period was studied using different means of data analysis and with the aid of different data types to produce different findings from the previous studies. Research areas on early childhood vary, but they are equally significant. This paper emphasizes the current standpoint and opportunities for research in this area and boosts additional efforts toward the understanding of this research field.

Breast cancer continues to be a significant public health problem in the world. Early detection is the key for improving breast cancer prognosis. Mammography has been one of the most reliable methods for early detection of breast carcinomas. However, it is difficult for radiologists to provide both accurate and uniform evaluation for the enormous mammograms generated in widespread screening. Breast cancer computer aided diagnosis (CAD) systems can provide such help and they are important and necessary for breast cancer control. Micro calcifications and masses are the two most important indicators of malignancy, and their automated detection is very valuable for early breast cancer diagnosis. Since masses are often indistinguishable from the surrounding parenchymal, automated mass detection and classification is even more challenging. This research presents algorithms for building a classification system or CAD, especially to obtain the different characteristics of mass and micro calcification using association technique based on classification. Starting with an individual-specific deformable of 3D breast model, this modelling framework will be useful for tracking visible tumors between mammogram images, as well as for registering breast images taken from different imaging modalities. From the results, the classifier developed able to perform well by successfully classifying the cancer and non-cancer (normal) images with the accuracy of 97%. Apart from that, by applying color map to the final results of segmentation provides a more interesting display of information and gives more direction to the purpose of image processing, which distinguishes between cancerous and non-cancerous tissues.

Este estudo tem como objetivo verificar a perspectiva dos familiares acompanhantes sobre o atendimento psicológico recebido na rede hospitalar. Trata-se de uma pesquisa de campo de natureza qualitativa com análise descritiva. Como instrumento de coleta de dados, foi utilizado um questionário de opinião sobre o acolhimento e satisfação do atendimento psicológico recebido em hospitais pelo familiar acompanhante da pessoa hospitalizada. Outros aspectos gerais sobre os cuidados recebidos no ambiente hospitalar também foram investigados. Os resultados evidenciaram que o familiar acompanhante qualifica como satisfatórias as seguintes categorias: 1) às disposições hospitalares e equipe médica; 2) o cumprimento do seu papel enquanto familiar acompanhante; e 3) o atendimento psicológico recebido.

Purpose: To describe the ocular clinical and imaging findings of a patient with isolated vitreous metastasis, confirmed by vitreous biopsy, from an anaplastic lymphoma kinase (ALK)-positive metastatic lung cancer., Methods: Case report., Results: A 47-year-old woman with a history of metastatic ALK-positive lung cancer was referred by her oncologist because of unilateral blurred vision over 4 weeks. The fundus examination showed vitreous opacities with clumps of nonpigmented cells, without vasculitis or retinitis, whereas optical coherence tomography showed hyperreflective deposits on the inner retinal surface with no retinal involvement. Diagnostic vitrectomy revealed neoplastic cells with ALK mutation., Conclusion: This is the first report that documents a case of isolated vitreous metastasis from ALK-positive lung cancer in a patient under targeted therapy to treat metastatic lung cancer. We emphasize the importance of multimodal imaging, diagnostic vitrectomy, and a pathologist's cooperation to provide essential information about diagnosis and effective treatment.

Introduction: Tuberous sclerosis complex (TSC) is a rare hereditary phakomatosis. The clinical features can include benign growths in the central nervous system, tumors of various visceral organs, and retinal or optic disc astrocytic hamartomas in the nerve fiber layer. Here we present the case of a child with known TSC developing Coats-like manifestations., Case Description: A 22-month-old girl with known TSC and retinal hamartoma followed since birth presented for the development of exotropia and leukocoria in the left eye. Fundus examination of the left eye showed blurred optic disc, macular star, and yellow retinal exudation in the temporal area. In addition, the left eye showed marked retinal vascular tortuosity and telangiectasias. The patient underwent brain and orbit magnetic resonance imaging, revealing heterotopic gray matter nodulations along ependyma of both lateral ventricles, with partial calcification, and a posterior flattening of the left eye., Conclusion: This report shows a rare case of Coats-like disease in a child with tuberous sclerosis. In case of presence of Coats' manifestations associated with atypical retinal or systemic findings, genetic diseases should be considered in the differential diagnosis.

This study aimed to genetically and clinically characterize a unique cohort of 25 individuals from 21 unrelated families with autosomal recessive nanophthalmos (NNO) and posterior microphthalmia (MCOP) from different ethnicities. An ophthalmological assessment in all families was followed by targeted MFRP and PRSS56 testing in 20 families and whole-genome sequencing in one family. Three families underwent homozygosity mapping using SNP arrays. Eight distinct MFRP mutations were found in 10/21 families (47.6%), five of which are novel including a deletion spanning the 5' untranslated region and the first coding part of exon 1. Most cases harbored homozygous mutations (8/10), while a compound heterozygous and a monoallelic genotype were identified in the remaining ones (2/10). Six distinct PRSS56 mutations were found in 9/21 (42.9%) families, three of which are novel. Similarly, homozygous mutations were found in all but one, leaving 2/21 families (9.5%) without a molecular diagnosis. Clinically, all patients had reduced visual acuity, hyperopia, short axial length and crowded optic discs. Retinitis pigmentosa was observed in 5/10 (50%) of the MFRP group, papillomacular folds in 12/19 (63.2%) of MCOP and in 3/6 (50%) of NNO cases. A considerable phenotypic variability was observed, with no clear genotype-phenotype correlations. Overall, our study represents the largest NNO and MCOP cohort reported to date and provides a genetic diagnosis in 19/21 families (90.5%), including the first MFRP genomic rearrangement, offering opportunities for gene-based therapies in MFRP-associated disease. Finally, our study underscores the importance of sequence and copy number analysis of the MFRP and PRSS56 genes in MCOP and NNO.

Background: Oral propranolol reduces retinopathy of prematurity (ROP) progression, although not safely. Propranolol 0.1% eye micro-drops administered to newborns with stage 2 ROP are well-tolerated, but not sufficiently effective. Methods: A multi-center open-label trial was conducted to assess the safety and efficacy of propranolol 0.2% eye micro-drops in newborns with stage 1 ROP. The progression of the disease was evaluated with serial ophthalmologic examinations. Hemodynamic, respiratory, biochemical parameters, and propranolol plasma levels were monitored. Demographic and perinatal characteristics, co-morbidities and co-intervention incidences, together with ROP progression, were compared with a historical control group in the same centers participating in the trial. Results: Ninety-eight newborns were enrolled and compared with the historical control group. Populations were not perfectly homogeneous (as demonstrated by the differences in the Apgar score and the different incidence rate in surfactant administration and oxygen exposure). The progression to ROP stage 2 or 3 plus was significantly lower than the incidence expected on the basis of historical data (Risk Ratio 0.521, 95% CI 0.297- 0.916). No adverse effects related to propranolol were observed and the mean propranolol plasma level was significantly lower than the safety cut-off of 20 ng/mL. Unexpectedly, three newborns treated with oral propranolol before the appearance of ROP, showed a ROP that was unresponsive to propranolol eye micro-drops and required laser photocoagulation treatment. Conclusion: Propranolol 0.2% eye micro-drops were well-tolerated and appeared to reduce the ROP progression expected on the basis of a comparison with a historical control group. Propranolol administered too early appears to favor a more aggressive ROP, suggesting that a β-adrenoreceptor blockade is only useful during the proliferative phase. Further randomized placebo-controlled trials are required to confirm the current results. Clinical Trial Registration   The trial was registered at ClinicalTrials.gov with Identifier NCT02504944 and with EudraCT Number 2014-005472-29.

Context: Intelligent wheelchair technology has recently been utilised to address several mobility problems. Techniques based on brain-computer interface (BCI) are currently used to develop electric wheelchairs. Using human brain control in wheelchairs for people with disability has elicited widespread attention due to its flexibility., Objective: This study aims to determine the background of recent studies on wheelchair control based on BCI for disability and map the literature survey into a coherent taxonomy. The study intends to identify the most important aspects in this emerging field as an impetus for using BCI for disability in electric-powered wheelchair (EPW) control, which remains a challenge. The study also attempts to provide recommendations for solving other existing limitations and challenges., Methods: We systematically searched all articles about EPW control based on BCI for disability in three popular databases: ScienceDirect, IEEE and Web of Science. These databases contain numerous articles that considerably influenced this field and cover most of the relevant theoretical and technical issues., Results: We selected 100 articles on the basis of our inclusion and exclusion criteria. A large set of articles (55) discussed on developing real-time wheelchair control systems based on BCI for disability signals. Another set of articles (25) focused on analysing BCI for disability signals for wheelchair control. The third set of articles (14) considered the simulation of wheelchair control based on BCI for disability signals. Four articles designed a framework for wheelchair control based on BCI for disability signals. Finally, one article reviewed concerns regarding wheelchair control based on BCI for disability signals., Discussion: Since 2007, researchers have pursued the possibility of using BCI for disability in EPW control through different approaches. Regardless of type, articles have focused on addressing limitations that impede the full efficiency of BCI for disability and recommended solutions for these limitations., Conclusions: Studies on wheelchair control based on BCI for disability considerably influence society due to the large number of people with disability. Therefore, we aim to provide researchers and developers with a clear understanding of this platform and highlight the challenges and gaps in the current and future studies., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Purpose: To describe a novel macular phenotype that is associated with normal visual function., Design: Retrospective, observational case series., Participants: Thirty-six affected individuals from 23 unrelated families., Methods: This was a retrospective study of patients who had a characteristic macular phenotype. Subjects underwent a full ocular examination, electrophysiologic studies, spectral-domain optical coherence tomography (OCT), and fundus autofluorescence imaging. Genomic analyses were performed using haplotype sharing analysis and whole-exome sequencing., Main Outcome Measures: Visual acuity, retinal features, electroretinography, and whole-exome sequencing., Results: Twenty-six of 36 subjects were female. The median age of subjects at presentation was 15 years (range, 5-59 years). The majority of subjects were asymptomatic and presented after a routine eye examination (22/36 subjects) or after screening because of a positive family history (13/36 subjects) or by another ophthalmologist (1/36 subjects). Of the 3 symptomatic subjects, 2 had reduced visual acuity secondary to nonorganic visual loss and bilateral ametropic amblyopia with strabismus. Visual acuity was 0.18 logarithm of the minimum angle of resolution (logMAR) or better in 30 of 33 subjects. Color vision was normal in all subjects tested, except for the subject with nonorganic visual loss. All subjects had bilateral symmetric multiple yellow dots at the macula. In the majority of subjects, these were evenly distributed throughout the fovea, but in 9 subjects they were concentrated in the nasal parafoveal area. The dots were hyperautofluorescent on fundus autofluorescence imaging. The OCT imaging was generally normal, but in 6 subjects subtle irregularities at the inner segment ellipsoid band were seen. Electrophysiologic studies identified normal macular function in 17 of 19 subjects and normal full-field retinal function in all subjects. Whole-exome analysis across 3 unrelated families found no pathogenic variants in known macular dystrophy genes. Haplotype sharing analysis in 1 family excluded linkage with the North Carolina macular dystrophy (MCDR1) locus., Conclusions: A new retinal phenotype is described, which is characterized by bilateral multiple early-onset yellow dots at the macula. Visual function is normal, and the condition is nonprogressive. In familial cases, the phenotype seems to be inherited in an autosomal dominant manner, but a causative gene is yet to be ascertained., (Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Purpose: To review the anatomic and visual outcomes of a series of children diagnosed with Coats' disease and treated on the basis of intraoperative fluorescein angiography (FA) findings., Design: Retrospective case series., Participants: Twenty-five children 2 to 15 years of age diagnosed with early Coats' disease and treated after intraoperative FA., Methods: Retrospective review of patients who underwent treatment for stage 2 Coats' disease in a tertiary center in the United Kingdom between 2007 and 2012. The children underwent treatment to the telangiectatic vessels and associated areas of retinal nonperfusion identified on intraoperative FA performed with a wide-angle retinal camera (RetCam II)., Main Outcome Measures: Anatomic and structural assessment of the retina after treatment, visual acuity (VA), and complications related to treatment., Results: Twenty children with Coats' disease who underwent intraoperative RetCam FA and retinal ablative treatment and who had more than 3 months of follow-up were identified from clinical records. All had unilateral disease. Six eyes were classified as stage 2a, and 14 eyes were classified as stage 2b. The median duration of follow-up was 21 months (mean, 26 months). Fifteen eyes needed 1 treatment to stabilize the disease, and 5 eyes needed a second treatment. None of the patients demonstrated progression of the disease to a more severe stage. Twelve eyes had a final VA of 0.4 logarithm of the minimum angle of resolution (logMAR) or better, 6 patients had VA between 0.4 and 1.0 logMAR, and 2 patients had VA worse than 1.0 logMAR., Conclusions: The treatment of retinal telangiectasia and areas of retinal nonperfusion identified by wide-angle intraoperative FA in children with stage 2 Coats' disease led to good anatomic outcome, with preservation of VA in most cases., (Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Purpose: To assess the diagnostic validity of morphometric examination of the optic disc and retinal nerve fiber layer (RNFL) thickness to detect permanent structural changes after retrobulbar optic neuritis (ON)., Design: Evaluation of a diagnostic test., Participants: Twenty-five patients with a history of retrobulbar ON and 29 disease-free controls., Methods: The optic discs were evaluated by means of confocal scanning laser ophthalmoscopy (Heidelberg Retinal Tomograph [HRT III]), and RNFL thickness by means of scanning laser polarimetry (GDx), and optical coherence tomography (OCT). Vision function was assessed in all subjects by testing visual acuity, contrast sensitivity, color vision, visual field (VF), and visual evoked potentials (VEPs). Statistical comparisons were made between the affected (ON) and unaffected eyes (non-ON) of the patients with ON, and between these eyes and control eyes (Mann-Whitney test and Wilcoxon's test). Receiver operating characteristic (ROC) curves, and sensitivity and specificity in discriminating ON from control eyes, were calculated for the significant parameters. Correlations between the tests were calculated by means of Spearman's correlation coefficient., Main Outcome Measures: We compared OCT, GDx, HRT, and visual testing results in ON eyes versus control eyes., Results: All of the visual function test parameters and RNFL thickness (GDx and OCT) were significantly different between the ON eyes and both the non-ON and control eyes (P<0.01), and there were significant differences in some GDx parameters between the non-ON and control eyes. There were no significant differences in the HRT parameters. The ROC curves indicated that the greatest diagnostic validity was associated with the GDx nerve fiber indicator (AUC, 0.92; sensitivity, 0.80; specificity, 0.97 using a cutoff point of 20.5 between ON and non-ON eyes), and OCT temporal thickness (AUC, 0.92; sensitivity, 0.72; specificity, 0.95 using a cutoff point of 51.5 microm)., Conclusions: When investigating permanent damage after ON, RNFL thickness is a promising biomarker. The GDx and OCT are reliable, noninvasive, user-friendly devices; both show good diagnostic validity and good correlations with functional tests in discriminating affected from unaffected eyes. Retinal nerve fiber layer thinning in non-ON eyes should be further studied as a possible subclinical indicator of disease., (Copyright 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)