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  • 1.
    Alhamami, Mastour
    et al.
    Indiana University, USA.
    Elsner, Ann
    Indiana University, USA;Aeon Imaging, USA.
    Malinovsky, Victor
    Indiana University, USA.
    Clark, Christopher
    Haggerty, Bryan
    Indiana University, USA.
    Ozawa, Glen
    University of California, USA.
    Cuadros, Jorge A
    University of California, USA ; EyePACS, USA.
    Baskaran, Karthikeyan
    Indiana University, USA.
    Gast, Thomas
    Indiana University, USA;Aeon Imaging, USA.
    Litvin, Taras
    University of California, USA.
    Muller, Matthew
    Aeon Imaging, USA.
    Brahm, Shane
    Indiana University, USA.
    Young, Stuart
    Indiana University, USA.
    Miura, Masahiro
    Tokyo Medical University Ibaraki Medical Center, Japan.
    Comparison of Cysts in Red and Green Images for Diabetic Macular Edema2017Inngår i: Optometry and Vision Science, ISSN 1040-5488, E-ISSN 1538-9235, Vol. 94, nr 2, s. 137-149Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To investigate whether cysts in diabetic macular edema are better visualized in the red channel of color fundus camera images, as compared with the green channel, because color fundus camera screening methods that emphasize short-wavelength light may miss cysts in patients with dark fundi or changes to outer blood retinal barrier.

    Methods: Fundus images for diabetic retinopathy photoscreening were acquired for a study with Aeon Imaging, EyePACS, University of California Berkeley, and Indiana University. There were 2047 underserved, adult diabetic patients, of whom over 90% self-identified as a racial/ethnic identify other than non-Hispanic white. Color fundus images at nominally 45 degrees were acquired with a Canon Cr-DGi non-mydriatic camera (Tokyo, Japan) then graded by an EyePACS certified grader. From the 148 patients graded to have clinically significant macular edema by the presence of hard exudates in the central 1500 [mu]m of the fovea, we evaluated macular cysts in 13 patients with cystoid macular edema. Age ranged from 33 to 68 years. Color fundus images were split into red, green, and blue channels with custom Matlab software (Mathworks, Natick, MA). The diameter of a cyst or confluent cysts was quantified in the red-channel and green-channel images separately.

    Results: Cyst identification gave complete agreement between red-channel images and the standard full-color images. This was not the case for green-channel images, which did not expose cysts visible with standard full-color images in five cases, who had dark fundi. Cysts appeared more numerous and covered a larger area in the red channel (733 +/- 604 [mu]m) than in the green channel (349 +/- 433 [mu]m, p < 0.006).

    Conclusions: Cysts may be underdetected with the present fundus camera methods, particularly when short-wavelength light is emphasized or in patients with dark fundi. Longer wavelength techniques may improve the detection of cysts and provide more information concerning the early stages of diabetic macular edema or the outer blood retinal barrier.

  • 2.
    Arthur, Edmund
    et al.
    Indiana University, USA.
    Young, Stuart B.
    Bowersox Vision Center, Shelbyville, USA.
    Elsner, Ann E.
    Indiana University, USA.
    Baskaran, Karthikeyan
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO).
    Papay, Joel A.
    Indiana University, USA.
    Muller, Matthew S.
    Aeon Imaging, LLC, Bloomington, USA.
    Gast, Thomas J.
    Indiana University, USA;Aeon Imaging, LLC, Bloomington, USA.
    Haggerty, Bryan P.
    Indiana University, USA.
    Clark, Christopher A.
    Indiana University, USA.
    Malinovsky, Victor E.
    Indiana University, USA.
    Brahm, Shane G.
    Peter Christensen Health Center, Lac Du Flambeau, USA.
    Litvin, Taras V.
    University of California, USA.
    Ozawa, Glen Y.
    University of California Berkeley, USA.
    Cuadros, Jorge A.
    University of California Berkeley, USA.
    Central Macular Thickness in Diabetic Patients: A Sex-based Analysis2019Inngår i: Optometry and Vision Science, ISSN 1040-5488, E-ISSN 1538-9235, Vol. 96, nr 4, s. 266-275Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    SIGNIFICANCE The pathological changes in clinically significant diabetic macular edema lead to greater retinal thickening in men than in women. Therefore, male sex should be considered a potential risk factor for identifying individuals with the most severe pathological changes. Understanding this excessive retinal thickening in men may help preserve vision. PURPOSE The purpose of this study was to investigate the sex differences in retinal thickness in diabetic patients. We tested whether men with clinically significant macular edema had even greater central macular thickness than expected from sex differences without significant pathological changes. This study also aimed to determine which retinal layers contribute to abnormal retinal thickness. METHODS From 2047 underserved adult diabetic patients from Alameda County, CA, 142 patients with clinically significant macular edema were identified by EyePACS-certified graders using color fundus images (Canon CR6-45NM). First, central macular thickness from spectral domain optical coherence tomography (iVue; Optovue Inc.) was compared in 21 men versus 21 women without clinically significant macular edema. Then, a planned comparison contrasted the greater values of central macular thickness in men versus women with clinically significant macular edema as compared with those without. Mean retinal thickness and variability of central macular layers were compared in men versus women. RESULTS Men without clinically significant macular edema had a 12-μm greater central macular thickness than did women (245 ± 21.3 and 233 ± 13.4 μm, respectively; t40 = −2.18, P = .04). Men with clinically significant macular edema had a 67-μm greater central macular thickness than did women (383 ± 48.7 and 316 ± 60.4 μm, P < .001); that is, men had 55 μm or more than five times more (t20 = 2.35, P = .02). In men, the outer-nuclear-layer thickness was more variable, F10,10 = 9.34. CONCLUSIONS Underserved diabetic men had thicker retinas than did women, exacerbated by clinically significant macular edema.

  • 3.
    Baskaran, Karthikeyan
    et al.
    Linnéuniversitetet, Fakultetsnämnden för naturvetenskap och teknik, Institutionen för naturvetenskap, NV.
    Rosen, R.
    Lewis, Peter
    Linnéuniversitetet, Fakultetsnämnden för naturvetenskap och teknik, Institutionen för naturvetenskap, NV.
    Unsbo, P.
    Gustafsson, Jörgen
    Linnéuniversitetet, Fakultetsnämnden för naturvetenskap och teknik, Institutionen för naturvetenskap, NV.
    Benefit of Adaptive Optics Aberration Correction at Preferred Retinal Locus2012Inngår i: Optometry and Vision Science, ISSN 1040-5488, E-ISSN 1538-9235, Vol. 89, nr 9, s. 1417-1423Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE.: To investigate the effect of eccentric refractive correction and full aberration correction on both high- and low-contrast grating resolution at the preferred retinal locus (PRL) of a single low-vision subject with a long-standing central scotoma. METHODS.: The subject was a 68-year-old women with bilateral absolute central scotoma due to Stargardt disease. She developed a single PRL located 25 degrees nasally of the damaged macula in her left eye, this being the better of the two eyes. High- (100%) and low-contrast (25 and 10%) grating resolution acuity was evaluated using four different correction conditions. The first two corrections were solely refractive error corrections, namely, habitual spectacle correction and full spherocylindrical correction. The latter two corrections were two versions of adaptive optics corrections of all aberrations, namely, habitual spectacle correction with aberration correction and full spherocylindrical refractive correction with aberration correction. RESULTS.: The mean high-contrast (100%) resolution acuity with her habitual correction was 1.06 logMAR, which improved to 1.00 logMAR with full spherocylindrical correction. Under the same conditions, low-contrast (25%) acuity improved from 1.30 to 1.14 logMAR. With adaptive optics aberration correction, the high-contrast resolution acuities improved to 0.89/0.92 logMAR and the low-contrast acuities improved to 1.04/1.06 logMAR under both correction modalities. The low-contrast (10%) resolution acuity was 1.34 logMAR with adaptive optics aberration correction; however, with purely refractive error corrections, she was unable to identify the orientation of the gratings. CONCLUSIONS.: Correction of all aberrations using adaptive optics improves both high- and low-contrast resolution acuity at the PRL of a single low-vision subject with long-standing absolute central scotoma

  • 4.
    Baskaran, Karthikeyan
    et al.
    Linnéuniversitetet, Fakultetsnämnden för naturvetenskap och teknik, Institutionen för naturvetenskap, NV.
    Theagarayan, Baskar
    Linnéuniversitetet, Fakultetsnämnden för naturvetenskap och teknik, Institutionen för naturvetenskap, NV.
    Carius, Staffan
    Linnéuniversitetet, Fakultetsnämnden för naturvetenskap och teknik, Institutionen för datavetenskap, fysik och matematik, DFM.
    Gustafsson, Jörgen
    Linnéuniversitetet, Fakultetsnämnden för naturvetenskap och teknik, Institutionen för naturvetenskap, NV.
    Repeatability of Peripheral Aberrations in Young Emmetropes2010Inngår i: Optometry and Vision Science, ISSN 1040-5488, E-ISSN 1538-9235, Vol. 87, nr 10, s. 751-759Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE.: The purpose of this study is to assess the intrasession repeatability of ocular aberration measurements in the peripheral visual field with a commercially available Shack-Hartmann aberrometer (complete ophthalmic analysis system-high definition-vision research). The higher-order off-axis aberrations data in young healthy emmetropic eyes are also reported.

    METHODS.: The aberrations of the right eye of 18 emmetropes were measured using an aberrometer with an open field of view that allows peripheral measurements. Five repeated measures of ocular aberrations were obtained and assessed in steps of 10 degrees out to +/-40 degrees in the horizontal visual field (nasal + and temporal -) and -20 degrees in the inferior visual field. The coefficient of repeatability, coefficient of variation, and the intraclass correlation coefficient were calculated as a measure of intrasession repeatability.

    RESULTS.: In all eccentric angles, the repeatability of the third- and fourth-order aberrations was better than the fifth and sixth order aberrations. The coefficient of variation was <30% and the intraclass correlation coefficient was >0.90 for the third and fourth order but reduced gradually for higher orders. There was no statistical significant difference in variance of total higher-order root mean square between on- and off-axis measurements (p > 0.05). The aberration data in this group of young emmetropes showed that the horizontal coma (C13) was most positive at 40 degrees in the temporal field, decreasing linearly toward negative values with increasing off-axis angle into the nasal field, whereas all other higher-order aberrations showed little or no change.

    CONCLUSIONS.: The complete ophthalmic analysis system-high definition-vision research provides fast, repeatable, and valid peripheral aberration measurements and can be used efficiently to measure off-axis aberrations in the peripheral visual field

  • 5.
    Baskaran, Karthikeyan
    et al.
    Linnéuniversitetet, Fakultetsnämnden för naturvetenskap och teknik, Institutionen för naturvetenskap, NV.
    Unsbo, Peter
    Biomedical and X-Ray Physics.
    Gustafsson, Jörgen
    Linnéuniversitetet, Fakultetsnämnden för naturvetenskap och teknik, Institutionen för naturvetenskap, NV.
    Influence of age on peripheral ocular aberrations.2011Inngår i: Optometry and Vision Science, ISSN 1040-5488, E-ISSN 1538-9235, Vol. 88, nr 9, s. 1088-1098Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE.: To compare peripheral lower and higher order aberrations across the horizontal (±40°) and inferior (-20°) visual fields in healthy groups of young and old emmetropes. METHODS.: We have measured off-axis aberrations in the groups of 30 younger (24 ± 3 years) and 30 older (58 ± 5 years) emmetropes. The aberrations of OD were measured using the COAS-HD VR Shack-Hartmann aberrometer in 10° steps to ±40° horizontally and -20° inferiorly in the visual field. The aberrations were quantified with Zernike polynomials for a 4 mm pupil diameter. The second-order aberration coefficients were converted to their respective refraction components (M, J45, and J180). Mixed between-within subjects, analysis of variance were used to determine whether there were significant differences in the refraction and aberration components for the between-subjects variable age and the within-subjects variable eccentricity. RESULTS.: Peripheral refraction components were similar in both age groups. Among the higher order coefficients, horizontal coma (C3) and spherical aberration (C4) varied mostly between the groups. Coma increased linearly with eccentricity, at a more rapid rate in the older group than in the younger group. Spherical aberration was more positive in the older group compared with the younger group. Higher order root mean square increased more rapidly with eccentricity in the older group. CONCLUSIONS.: Like the axial higher order aberrations, the peripheral higher order aberrations of emmetropes increase with age, particularly coma and spherical aberration.

  • 6.
    Lewis, Peter
    et al.
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO).
    Baskaran, Karthikeyan
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO).
    Rosen, Robert
    Royal Institute of Technology KTH.
    Lundström, Linda
    Royal Institute of Technology KTH.
    Unsbo, Peter
    Royal Institute of Technology KTH.
    Gustafsson, Jörgen
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO).
    Objectively Determined Refraction Improves Peripheral Vision2014Inngår i: Optometry and Vision Science, ISSN 1040-5488, E-ISSN 1538-9235, Vol. 91, nr 7, s. 740-746Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose. The purpose of this study was twofold: to verify a fast, clinically applicable method for determining off-axis refraction and to assess the impact of objectively obtained off-axis refractive correction on peripheral low-contrast visual acuity. Methods. We measured peripheral low-contrast resolution acuity with Gabor patches both with and without off-axis correction at 20 degrees in the nasal visual field of 10 emmetropic subjects; the correction was obtained using a commercial open-field Hartmann-Shack wavefront sensor, the COAS-HD VR aberrometer. Off-axis refractive errors were calculated for a 5-mm circular pupil inscribed within the elliptical wavefront by COAS using the instruments' inbuilt "Seidel sphere" method. Results. Most of the subjects had simple myopic astigmatism, at 20 degrees in the nasal visual field ranging from -1.00 to -2.00 DC, with axis orientations generally near 90 degrees. The mean uncorrected and corrected low-contrast resolution acuities for all subjects were 0.92 and 0.86 logMAR, respectively (an improvement of 0.06 logMAR). For subjects with a scalar power refractive error of 1.00 diopters or more, the average improvement was 0.1 logMAR. The observed changes in low-contrast resolution acuity were strongly correlated with off-axis astigmatism (Pearson r = 0.95; p < 0.0001), the J(180) cross-cylinder component (Pearson r = 0.82; p = 0.0034), and power scalar (Pearson r = -0.75; p = 0.0126). Conclusions. The results suggest that there are definite benefits in correcting even moderate amounts of off-axis refractive errors; in this study, as little as -1.50 DC of off-axis astigmatism gave improvements of up to a line in visual acuity. It may be even more pertinent for people who rely on optimal peripheral visual function, specifically those with central visual field loss; the use of open-field aberrometers could be clinically useful in rapidly determining off-axis refractive errors specifically for this patient group who are generally more challenging to refract.

  • 7.
    Lewis, Peter
    et al.
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO).
    Venkataraman, Abinaya Priya
    Royal Institute of Technology.
    Lundström, Linda
    Royal Institute of Technology.
    Contrast sensitivity in eyes with central scotoma: effect of stimulus drift2018Inngår i: Optometry and Vision Science, ISSN 1040-5488, E-ISSN 1538-9235, Vol. 95, nr 4, s. 354-361Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Significance

    In the field of visual rehabilitation of patients with central visual field loss, knowledge on how peripheral visual function can be improved is essential. This study presents measurements of peripheral dynamic contrast sensitivity (with optical correction) for off-axis viewing angles in subjects with central visual field loss.

    Purpose

    Subjects with central visual field loss (CFL) rely on a peripheral preferred retinal locus (PRL) for many visual tasks. It is therefore important to ascertain that contrast sensitivity (CS) is maximized in the PRL. This study evaluates the effect of stimulus motion, in combination with optical correction, on CS in subjects with CFL.

    Methods

    The off-axis refractive errors in the PRL of five young CFL subjects were measured with a COAS open-view Hartmann-Shack aberrometer. Low-contrast (25% and 10%) and high-contrast resolution acuity for stationary gratings was assessed with and without optical correction. High-contrast resolution was also measured for gratings drifting at 7.5 Hz (within a fixed Gaussian window). Furthermore, resolution CS was evaluated for both stationary and moving gratings with optical correction for a total of 2-3 spatial frequencies per subject.

    Results

    High-contrast resolution acuity was relatively insensitive to stimulus drift motion of 7.5 Hz, whereas CS for gratings of 0.5 cycles per degree improved with drift for all subjects. Furthermore, both high- and low-contrast static resolution improved with optical correction.

    Conclusions

    Just as for heathy eyes, stimulus motion of 7.5 Hz enhances CS for gratings of low spatial frequency also in the PRL of eyes with CFL. Concurrently, high contrast resolution is unaffected by the 7.5 Hz drift, but improves with off-axis optical correction. This highlights the importance of providing optimal refractive correction for subjects with CFL, and that stimulus motion can be used to further enhance CS at low spatial frequencies.

  • 8. Lundström, Linda
    et al.
    Gustafsson, Jörgen
    Högskolan i Kalmar, Naturvetenskapliga institutionen.
    Unsbo, Peter
    Visual Evaluation of Eccentric Refractive Correction2007Inngår i: Optometry and Vision Science, ISSN 1040-5488, E-ISSN 1538-9235, Vol. 84, nr 11, s. 1046-1052Artikkel i tidsskrift (Fagfellevurdert)
  • 9.
    Macedo, António Filipe
    et al.
    University of Minho, Portugal.
    Nascimento, Sérgio Miguel Cardoso
    University of Minho, Portugal.
    Gomes, Augusto Oliveira Silva
    University of Porto, Portugal.
    Puga, André Texieira
    University of Porto, Portugal.
    Fixation in Patients with Juvenile Macular Disease2007Inngår i: Optometry and Vision Science, ISSN 1040-5488, E-ISSN 1538-9235, Vol. 84, nr 9, s. 852-858Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose. The instability of fixation with central scotoma has been mainly studied in patients with age-related macular diseases (MDs). However, early macular lesions can lead to different characteristics of fixation. The aim of this work was to study fixation in patients with juvenile MD.

    Methods. Eye movements of 10 patients and 10 controls were monitored during fixation. Visual fields were assessed by static perimetry to determine the extent of the field defects. Eye movements were separated into saccades and drifts, with fixation stability assessed by bivariate contour ellipse area (BCEA). To quantify the number and location of preferred retinal loci (PRL), the kernel density estimator and expectation maximization for mixtures of gaussians were used.

    Results. Patients have worse fixation stability than controls and large BCEAs resulted in more than one PRL. It was found that central field defects (10°) have negative correlation with the size of BCEA. In addition, the meridian of saccades during fixation was correlated with the meridian inter-PRL.

    Conclusions. Patients with juvenile MDs have large BCEAs, frequently associated with two PRL. Similar results had been found for patients with age-related MDs. Also, the meridian of involuntary saccades during fixation was found to be correlated with the location of PRLs, suggesting a useful role of these movements in alternating between them.

  • 10.
    Price, Holly
    et al.
    Anglia Ruskin University, UK ; Vision Cooperative Research Centre, Australia.
    Allen, Peter M.
    Anglia Ruskin University, UK ; Vision Cooperative Research Centre, Australia.
    Radhakrishnan, Hema
    Vision Cooperative Research Centre, Australia ; University of Manchester, UK.
    Calver, Richard
    Anglia Ruskin University, UK ; Vision Cooperative Research Centre, Australia.
    Rae, Sheila
    Anglia Ruskin University, UK ; Vision Cooperative Research Centre, Australia.
    Theagarayan, Baskar
    Anglia Ruskin University, UK.
    Sailoganathan, Ananth
    Anglia Ruskin University, UK ; National Institute of Ophthalmic Sciences, Malaysia.
    O'Leary, Daniel J.
    Anglia Ruskin University, UK ; Cardiff Metropolitan University, UK.
    The Cambridge anti-myopia study: variables associated with myopia progression2013Inngår i: Optometry and Vision Science, ISSN 1040-5488, E-ISSN 1538-9235, Vol. 90, nr 11, s. 1274-1283Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: To identify variables associated with myopia progression and to identify any interaction between accommodative function, myopia progression, age, and treatment effect in the Cambridge Anti-Myopia Study.

    METHODS: Contact lenses were used to improve static accommodation by altering ocular spherical aberration, and vision training was performed to improve dynamic accommodation. One hundred forty-two subjects, aged 14-21 years, were recruited who had a minimum of -0.75D of myopia. Subjects were assigned to contact lens treatment only, vision training only, contact lens treatment and vision training, or control group. Spherical aberration, lag of accommodation, accommodative convergence/accommodation (AC/A) ratio, accommodative facility, ocular biometry, and refractive error were measured at regular intervals throughout the 2-year trial.

    RESULTS: Ninety-five subjects completed the 24-month trial period. There was no significant difference in myopia progression between the four treatment groups at 24 months. Age, lag of accommodation, and AC/A ratio were significantly associated with myopia progression. There was a significant treatment effect at 12 months in the contact lens treatment group in younger subjects, based on a median split, aged under 16.9 years (p = 0.005). This treatment effect was not maintained over the second year of the trial. Younger subjects experienced a greater reduction in lag of accommodation with the treatment contact lens at 3 months (p = 0.03), compared to older contact lens treatment and control groups. There was no interaction between AC/A ratio and contact lens treatment effect.

    CONCLUSIONS: Age, lag of accommodation, and AC/A ratio were significantly associated with myopia progression. Although there was no significant treatment effect at 24 months, an interaction between age and contact lens treatment suggests younger subjects may be more amenable, at least in the short term, to alteration of the visual system using optical treatments.

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