Visual Acuity does not Moderate Effect Sizes of Higher-Level Cognitive Tasks.

Background/study contextDeclining visual capacities in older adults have been posited as a driving force behind adult age differences in higher-order cognitive functions (e.g., the "common cause" hypothesis of Lindenberger & Baltes, 1994, Psychology and Aging, 9, 339-355). McGowan, Patterson, and Jordan (2013, Experimental Aging Research, 39, 70-79) also found that a surprisingly large number of published cognitive aging studies failed to include adequate measures of visual acuity. However, a recent meta-analysis of three studies (La Fleur and Salthouse, 2014, Psychonomic Bulletin & Review, 21, 1202-1208) failed to find evidence that visual acuity moderated or mediated age differences in higher-level cognitive processes. In order to provide a more extensive test of whether visual acuity moderates age differences in higher-level cognitive processes, we conducted a more extensive meta-analysis of topic.MethodsUsing results from 456 studies, we calculated effect sizes for the main effect of age across four cognitive domains (attention, executive function, memory, and perception/language) separately for five levels of visual acuity criteria (no criteria, undisclosed criteria, self-reported acuity, 20/80-20/31, and 20/30 or better).ResultsAs expected, age had a significant effect on each cognitive domain. However, these age effects did not further differ as a function of visual acuity criteria.ConclusionThe current meta-analytic, cross-sectional results suggest that visual acuity is not significantly related to age group differences in higher-level cognitive performance-thereby replicating La Fleur and Salthouse (2014). Further efforts are needed to determine whether other measures of visual functioning (e.g., contrast sensitivity, luminance) affect age differences in cognitive functioning

Loss of Foveal Cone Structure Precedes Loss of Visual Acuity in Patients With Rod-Cone Degeneration.

PurposeTo assess the relationship between cone spacing and visual acuity in eyes with rod-cone degeneration (RCD) followed longitudinally.MethodsHigh-resolution images of the retina were obtained using adaptive optics scanning laser ophthalmoscopy from 13 eyes of nine RCD patients and 13 eyes of eight healthy subjects at two sessions separated by 10 or more months (mean 765 days, range 311-1935 days). Cone spacing Z-score measured as close as possible (average <0.25°) to the preferred retinal locus was compared with visual acuity (letters read on the Early Treatment of Diabetic Retinopathy Study [ETDRS] chart and logMAR) and foveal sensitivity.ResultsCone spacing was significantly correlated with ETDRS letters read (ρ = -0.47, 95%CI -0.67 to -0.24), logMAR (ρ = 0.46, 95%CI 0.24 to 0.66), and foveal sensitivity (ρ = -0.30, 95%CI -0.52 to -0.018). There was a small but significant increase in mean cone spacing Z-score during follow-up of +0.97 (95%CI 0.57 to 1.4) in RCD patients, but not in healthy eyes, and there was no significant change in any measure of visual acuity.ConclusionsCone spacing was correlated with visual acuity and foveal sensitivity. In RCD patients, cone spacing increased during follow-up, while visual acuity did not change significantly. Cone spacing Z-score may be a more sensitive measure of cone loss at the fovea than visual acuity in patients with RCD

Primary radiotherapy in progressive optic nerve sheath meningiomas: a long-term follow-up study

Background/aims: To report the outcome of primary radiotherapy in patients with progressive optic nerve sheath meningioma (ONSM). Methods: The clinical records of all patients were reviewed in a retrospective, observational, multicentre study. Results: Thirty-four consecutive patients were included. Twenty-six women and eight men received conventional or stereotactic fractionated radiotherapy, and were followed for a median 58 (range 51–156) months. Fourteen eyes (41%) showed improved visual acuity of at least two lines on the Snellen chart. In 17 (50%) eyes, the vision stabilised, while deterioration was noted in three eyes (9%). The visual outcome was not associated with age at the time of radiotherapy (p=0.83), sex (p=0.43), visual acuity at the time of presentation (p=0.22) or type of radiotherapy (p=0.35). Optic disc swelling was associated with improved visual acuity (p<0.01) and 4/11 patients with optic atrophy also showed improvement. Long-term complications were dry eyes in five patients, cataracts in three, and mild radiation retinopathy in four. Conclusion: Primary radiotherapy for patients with ONSM is associated with long-term improvement of visual acuity and few adverse effects.Peerooz Saeed, Leo Blank, Dinesh Selva, John G. Wolbers, Peter J.C.M. Nowak, Ronald B. Geskus, Ezekiel Weis, Maarten P. Mourits, Jack Rootma

Dysflective cones: Visual function and cone reflectivity in long-term follow-up of acute bilateral foveolitis.

PURPOSE:Confocal adaptive optics scanning laser ophthalmoscope (AOSLO) images provide a sensitive measure of cone structure. However, the relationship between structural findings of diminished cone reflectivity and visual function is unclear. We used fundus-referenced testing to evaluate visual function in regions of apparent cone loss identified using confocal AOSLO images. METHODS:A patient diagnosed with acute bilateral foveolitis had spectral-domain optical coherence tomography (SD-OCT) (Spectralis HRA + OCT system [Heidelberg Engineering, Vista, CA, USA]) images indicating focal loss of the inner segment-outer segment junction band with an intact, but hyper-reflective, external limiting membrane. Five years after symptom onset, visual acuity had improved from 20/80 to 20/25, but the retinal appearance remained unchanged compared to 3 months after symptoms began. We performed structural assessments using SD-OCT, directional OCT (non-standard use of a prototype on loan from Carl Zeiss Meditec) and AOSLO (custom-built system). We also administered fundus-referenced functional tests in the region of apparent cone loss, including analysis of preferred retinal locus (PRL), AOSLO acuity, and microperimetry with tracking SLO (TSLO) (prototype system). To determine AOSLO-corrected visual acuity, the scanning laser was modulated with a tumbling E consistent with 20/30 visual acuity. Visual sensitivity was assessed in and around the lesion using TSLO microperimetry. Complete eye examination, including standard measures of best-corrected visual acuity, visual field tests, color fundus photos, and fundus auto-fluorescence were also performed. RESULTS:Despite a lack of visible cone profiles in the foveal lesion, fundus-referenced vision testing demonstrated visual function within the lesion consistent with cone function. The PRL was within the lesion of apparent cone loss at the fovea. AOSLO visual acuity tests were abnormal, but measurable: for trials in which the stimulus remained completely within the lesion, the subject got 48% correct, compared to 78% correct when the stimulus was outside the lesion. TSLO microperimetry revealed reduced, but detectible, sensitivity thresholds within the lesion. CONCLUSIONS AND IMPORTANCE:Fundus-referenced visual testing proved useful to identify functional cones despite apparent photoreceptor loss identified using AOSLO and SD-OCT. While AOSLO and SD-OCT appear to be sensitive for the detection of abnormal or absent photoreceptors, changes in photoreceptors that are identified with these imaging tools do not correlate completely with visual function in every patient. Fundus-referenced vision testing is a useful tool to indicate the presence of cones that may be amenable to recovery or response to experimental therapies despite not being visible on confocal AOSLO or SD-OCT images

Photometric compliance of tablet screens and retro-illuminated acuity charts as visual acuity measurement devices

Mobile technology is increasingly used to measure visual acuity. Standards for chart-based acuity tests specify photometric requirements for luminance, optotype contrast and luminance uniformity. Manufacturers provide some photometric data but little is known about tablet performance for visual acuity testing. This study photometrically characterised seven tablet computers (iPad, Apple inc.) and three ETDRS (Early Treatment Diabetic Retinopathy Study) visual acuity charts with room lights on and off, and compared findings with visual acuity measurement standards. Tablet screen luminance and contrast were measured using nine points across a black and white checkerboard test screen at five arbitrary brightness levels. ETDRS optotypes and adjacent white background luminance and contrast were measured. All seven tablets (room lights off) exceeded the most stringent requirement for mean luminance (≥ 120 cd/m2) providing the nominal brightness setting was above 50%. All exceeded contrast requirement (Weber ≥ 90%) regardless of brightness setting, and five were marginally below the required luminance uniformity threshold (Lmin/Lmax ≥ 80%). Re-assessing three tablets with room lights on made little difference to mean luminance or contrast, and improved luminance uniformity to exceed the threshold. The three EDTRS charts (room lights off) had adequate mean luminance (≥ 120 cd/m2) and Weber contrast (≥ 90%), but all three charts failed to meet the luminance uniformity standard (Lmin/Lmax ≥ 80%). Two charts were operating beyond manufacturer’s recommended lamp replacement schedule. With room lights on, chart mean luminance and Weber contrast increased, but two charts still had inadequate luminance uniformity. Tablet computers showed less inter-device variability, higher contrast, and better luminance uniformity than charts in both lights-on and lights-off environments, providing brightness setting was &gt;50%. Overall, iPad tablets matched or marginally out-performed ETDRS charts in terms of photometric compliance with high contrast acuity standards

Visual pathway function and structure in Wolfram syndrome: Patient age, variation and progression

Background/aimsTo report alterations in visual acuity and visual pathway structure over an interval of 1–3 years in a cohort of children, adolescents and young adults who have Wolfram syndrome (WFS) and to describe the range of disease severity evident in patients with WFS whose ages differed by as much as 20 years at first examination.MethodsAnnual, prospective ophthalmological examinations were performed in conjunction with retinal nerve fibre layer (RNFL) analysis. Diffusion tensor MRI-derived fractional anisotropy was used to assess the microstructural integrity of the optic radiations (OR FA).ResultsMean age of the 23 patients with WFS in the study was 13.8 years (range 5–25 years). Mean log minimum angle resolution visual acuity was 0.66 (20/91). RNFL thickness was subnormal in even the youngest patients with WFS. Average RNFL thickness in patients with WFS was 57±8 µ or ~40% thinner than that measured in normal (94±10 µ) children and adolescents (P&lt;0.01). Lower OR FA correlated with worse visual acuity (P=0.006). Subsequent examinations showed declines (P&lt;0.05) in visual acuity, RNFL thickness and OR FA at follow-up intervals of 12–36 months. However, a wide range of disease severity was evident across ages: some of the youngest patients at their first examination had deficits more severe than the oldest patients.ConclusionThe genetic mutation of WFS causes damage to both pregeniculate and postgeniculate regions of the visual pathway. The damage is progressive. The decline in visual pathway structure is accompanied by declines of visual function. Disease severity differs widely in individual patients and cannot be predicted from their age.</jats:sec

Dynamic Visual Acuity

We present a review on the visual ability to discriminate ¿ ne details of moving objects (DVA: Dynamic Visual Acuity), showing the most relevant differences, which have been attributed to this visual capacity in comparison to SVA (static visual acuity). It is known that the correlation between SVA and DVA is low. Moreover, when DVA is measured, not only the minimum spatial separation that the visual system can resolve is evaluated, but also the functionality of the oculomotor system. Therefore, assessing DVA also involves measuring the ability of the eye to actively seek information. Nowadays, it is known that DVA is one of the best indicators of success in certain sports specialties (table tennis, baseball, etc...) and that it negatively correlates with accident rates in traf¿ c scenarios. The investigated factors that produce a signi¿ cant reduction in dynamic spatial resolution are: the speed of the stimulus, affecting both vertical and horizontal trajectories; the stimulus exposure time; ambient illumination; reduction in contrast and subject age. Moreover, it has been veri¿ ed that this visual capacity is likely to improve with training.Postprint (published version

Initial Findings on Visual Acuity Thresholds in an African Elephant (\u3cem\u3eLoxodonta africana\u3c/em\u3e)

There are only a few published examinations of elephant visual acuity. All involved Asian elephants (Elephas maximus) and found visual acuity to be between 8′ and 11′ of arc for a stimulus near the tip of the trunk, equivalent to a 0.50 cm gap, at a distance of about 2 m from the eyes. We predicted that African elephants (Loxodonta africana) would have similarly high visual acuity, necessary to facilitate eye-trunk coordination for feeding, drinking and social interactions. When tested on a discrimination task using Landolt-C stimuli, one African elephant cow demonstrated a visual acuity of 48′ of arc. This represents the ability to discriminate a gap as small as 2.75 cm in a stimulus 196 cm from the eye. This single-subject study provides a preliminary estimate of the visual acuity of African elephants

Prevelence and causes of visual impairment and blindness in older adults in an area of India with a high cataract surgical rate.

BACKGROUND: The cataract surgical rate (CSR) in Gujarat, India is reported to be above 10,000 per million population. This study was conducted to investigate the prevalence and causes of vision impairment/blindness among older adults in a high CSR area. METHODS: Geographically defined cluster sampling was used in randomly selecting persons >or= 50 years of age in Navsari district. Subjects in 35 study clusters were enumerated and invited for measurement of presenting and best-corrected visual acuity and an ocular examination. The principal cause was identified for eyes with presenting visual acuity < 20/32. RESULTS: A total of 5158 eligible persons were enumerated and 4738 (91.9%) examined. Prevalence of presenting visual impairment < 20/63 to 20/200 in the better eye was 29.3% (95% confidence interval [CI]: 27.5-31.2) and 13.5% (95% CI: 12.0-14.9) with best correction. The prevalence of presenting bilateral blindness (< 20/200) was 6.9% (95% CI: 5.7-8.1), and 3.1% (95% CI: 2.5-3.7) with best correction. Presenting and best-corrected blindness were both associated with older age and illiteracy; gender and rural/urban residence were not significant. Cataract in one or both eyes was the main cause of bilateral blindness (82.6%), followed by retinal disorders (8.9%). Cataract (50.3%) and refractive error (35.4%) were the main causes in eyes with vision acuity < 20/63 to 20/200, and refractive error (86.6%) in eyes with acuity < 20/32 to 20/63. CONCLUSIONS: Visual impairment and blindness is a significant problem among the elderly in Gujarat. Despite a reportedly high CSR, cataract remains the predominant cause of blindness

Retrospective, controlled observational case study of patients with central retinal vein occlusion and initially low visual acuity treated with an intravitreal dexamethasone implant

Background Patients with initially low visual acuity were excluded from the therapy approval studies for retinal vein occlusion. But up to 28 % of patients presenting with central retinal vein occlusion have a baseline BCVA of less than 34 ETDRS letters (0.1). The purpose of our study was to assess visual acuity and central retinal thickness in patients suffering from central retinal vein occlusion and low visual acuity (<0.1) in comparison to patients with visual acuity (≥0.1) treated with Dexamethasone implant 0.7 mg for macular edema. Methods Retrospective, controlled observational case study of 30 eyes with macular edema secondary to central retinal vein occlusion, which were treated with a dexamethasone implantation. Visual acuity, central retinal thickness and intraocular pressure were measured monthly. Analyses were performed separately for eyes with visual acuity <0.1 and ≥0.1. Results Two months post intervention, visual acuity improved only marginally from 0.05 to 0.07 (1 month; p = 0,065) and to 0.08 (2 months; p = 0,2) in patients with low visual acuity as compared to patients with visual acuity ≥0.1 with an improvement from 0.33 to 0.47 (1 month; p = 0,005) and to 0.49 (2 months; p = 0,003). The central retinal thickness, however, was reduced in both groups, falling from 694 to 344 μm (1 month; p = 0.003,) to 361 μm (2 months; p = 0,002) and to 415 μm (3 months; p = 0,004) in the low visual acuity group and from 634 to 315 μm (1 month; p < 0,001) and to 343 μm (2 months; p = 0,001) in the visual acuity group ≥0.1. Absence of visual acuity improvement was related to macular ischemia. Conclusions In patients with central retinal vein occlusion and initially low visual acuity, a dexamethasone implantation can lead to an important reduction of central retinal thickness but may be of limited use to increase visual acuity