Wayfinding and Glaucoma: A Virtual Reality Experiment.

PurposeWayfinding, the process of determining and following a route between an origin and a destination, is an integral part of everyday tasks. The purpose of this study was to investigate the impact of glaucomatous visual field loss on wayfinding behavior using an immersive virtual reality (VR) environment.MethodsThis cross-sectional study included 31 glaucomatous patients and 20 healthy subjects without evidence of overall cognitive impairment. Wayfinding experiments were modeled after the Morris water maze navigation task and conducted in an immersive VR environment. Two rooms were built varying only in the complexity of the visual scene in order to promote allocentric-based (room A, with multiple visual cues) versus egocentric-based (room B, with single visual cue) spatial representations of the environment. Wayfinding tasks in each room consisted of revisiting previously visible targets that subsequently became invisible.ResultsFor room A, glaucoma patients spent on average 35.0 seconds to perform the wayfinding task, whereas healthy subjects spent an average of 24.4 seconds (P = 0.001). For room B, no statistically significant difference was seen on average time to complete the task (26.2 seconds versus 23.4 seconds, respectively; P = 0.514). For room A, each 1-dB worse binocular mean sensitivity was associated with 3.4% (P = 0.001) increase in time to complete the task.ConclusionsGlaucoma patients performed significantly worse on allocentric-based wayfinding tasks conducted in a VR environment, suggesting visual field loss may affect the construction of spatial cognitive maps relevant to successful wayfinding. VR environments may represent a useful approach for assessing functional vision endpoints for clinical trials of emerging therapies in ophthalmology

Macular Pigment and Visual Function in Patients With Glaucoma: The San Diego Macular Pigment Study.

PurposeAlthough recent studies have shown that macular pigment (MP) is significantly lower in glaucoma patients, this relationship merits further investigation.MethodsThis cross-sectional study included 85 glaucoma patients and 22 controls. All subjects had standard automated perimetry (SAP) and retinal nerve fiber layer (RNFL) thickness measurements. Intake of lutein (L) and zeaxanthin (Z) was estimated using a novel dietary screener. The Heidelberg Spectralis dual-wavelength autofluorescence (AF) technology was employed to study the relationship between MP and glaucoma. The association between MP volume and glaucoma was investigated using linear regression models accounting for potential confounding factors.ResultsGlaucoma patients had significantly worse SAP mean deviation (MD) and lower RNFL thickness in the study eye compared to control subjects (P < 0.001 for both). MP (volume) was comparable between groups (P = 0.436). In the univariable model, diagnosis of glaucoma was not associated with MP volume (R2 = 1.22%; P = 0.257). Dietary intake of L and Z was positively and significantly related to MP in the univariable (P = 0.022) and multivariable (P = 0.020) models.ConclusionsThese results challenge previous studies that reported that glaucoma is associated with low MP. Dietary habits were found to be the main predictor of MP in this sample. Further research is merited to better understand the relationship between glaucoma, MP, and visual performance in these patients

Protected areas: A focus on Brazilian freshwater biodiversity

Brazil has a variety of aquatic ecosystems and rich freshwater biodiversity, but these components have been constantly damaged by the expansion of unsustainable activities. An array of different conservation strategies is needed, especially the creation of protected areas (PAs, hereafter). However, Brazil's PAs are biased towards terrestrial ecosystems and we argue that current PAs have limited efficacy in the protection of freshwater biodiversity. New PAs should better consider aquatic environments, covering entire basins, rivers and other freshwater habitats. We recommend ways to implement these PAs and provide guidance to avoid social impacts. Freshwater systems in Brazil provide essential goods and services but these ecosystems are being rapidly degraded and will be lost if not adequately protected. © 2018 The Authors. Diversity and Distributions Published by John Wiley & Sons Lt

Macular Pigment and Visual Function in Patients With Glaucoma: The San Diego Macular Pigment Study.

PurposeAlthough recent studies have shown that macular pigment (MP) is significantly lower in glaucoma patients, this relationship merits further investigation.MethodsThis cross-sectional study included 85 glaucoma patients and 22 controls. All subjects had standard automated perimetry (SAP) and retinal nerve fiber layer (RNFL) thickness measurements. Intake of lutein (L) and zeaxanthin (Z) was estimated using a novel dietary screener. The Heidelberg Spectralis dual-wavelength autofluorescence (AF) technology was employed to study the relationship between MP and glaucoma. The association between MP volume and glaucoma was investigated using linear regression models accounting for potential confounding factors.ResultsGlaucoma patients had significantly worse SAP mean deviation (MD) and lower RNFL thickness in the study eye compared to control subjects (P < 0.001 for both). MP (volume) was comparable between groups (P = 0.436). In the univariable model, diagnosis of glaucoma was not associated with MP volume (R2 = 1.22%; P = 0.257). Dietary intake of L and Z was positively and significantly related to MP in the univariable (P = 0.022) and multivariable (P = 0.020) models.ConclusionsThese results challenge previous studies that reported that glaucoma is associated with low MP. Dietary habits were found to be the main predictor of MP in this sample. Further research is merited to better understand the relationship between glaucoma, MP, and visual performance in these patients

Results of the univariable and multivariable linear regression models for explaining fear of falling in glaucoma patients^*.

<p>Results of the univariable and multivariable linear regression models for explaining fear of falling in glaucoma patients^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0187220#t002fn002" target="_blank">*</a>}.</p

Patient performing the test on the virtual reality environment, while standing on the force platform and wearing the head-mounted goggles.

<p>Patient performing the test on the virtual reality environment, while standing on the force platform and wearing the head-mounted goggles.</p

The 16-item University of Illinois at Chicago fear of falling measure scoring questionnaire.

<p>The 16-item University of Illinois at Chicago fear of falling measure scoring questionnaire.</p

Demographic and clinical characteristics of glaucoma and control subjects included in the study evaluating the relationship between fear of falling and postural reactivity.^*.

<p>Demographic and clinical characteristics of glaucoma and control subjects included in the study evaluating the relationship between fear of falling and postural reactivity.^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0187220#t001fn002" target="_blank">*</a>}.</p