OBJECTIVE

Despite being a preventable and treatable condition, central microbial keratitis (CMK) and its complications remain to be a significant cause of vision loss in our country. This study presents the demographic profile, risk factors, etiologies, treatments, and outcomes of CMK in the Philippines.

The study was a two-center, prospective, non-randomized clinical study involving the patients of the External Disease and Cornea Clinics of two tertiary eye referral centers in the Philippines. It was conducted as the Philippine leg of the Asia Cornea Society Infectious Keratitis Study (ASCIKS).1 Patients with a clinical diagnosis of CMK rendered by a cornea specialist, and who signed the consent form, were recruited into the study. They underwent uniform sample collection and culture techniques as described in the ACSIKS. All patients were followed-up for 6 months. Data collected included demographics, risk factors, culture results, management, and treatment outcomes. Descriptive statistics and frequency were used to analyze the data.

A total of 348 patients diagnosed with CMK were included. Trauma (65.5%) among the middle-aged (42.9 ± 17.9 years) male population was the most significant risk factor for development of CMK, followed by contact lens wear (12.9%), prior ocular surgery (6.0%), and ocular surface diseases (3.4%). Bacterial keratitis (53.2%) was still the most common etiology of CMK, followed by fungal keratitis (27.0%), Acanthamoeba keratitis (5.7%), and viral keratitis (2.0%). Aspergillus species (18.3%) were the most common microbial isolates. Pseudomonas species (13.9%) were the most common bacterial isolates. The median time from onset of symptoms to consultation with the study centers was 2 weeks. Medical treatment was enough to treat the infection in 34.8% of cases. Surgical intervention was necessitated in 22.6% with evisceration/enucleation done in 1 out of 3 patients who had surgery.

Bacterial infection remains the most common cause of CMK in the Philippines, followed by fungal infection. Significant risk factors include trauma and contact lens wear. Aspergillus species and Pseudomonas species were the most common fungal and bacterial isolates, respectively. Despite medical treatment, almost a quarter of the cases still required surgical intervention.

Three different preclinical evaluation methods of MTF through-frequency response, MTF through-focus-response and expected visual acuity were used to compare and analyze the imaging differences of IOLs with four different optical designs. The research work could be used in the simultaneous vision IOLs in the optical design stage and verify the optical quality of the IOLs, the results can predict the visual representation of the patients better. The evaluation results can provide reference for IOL manufacturers and users in product design, development, validation and application selection.
Humans ; Prosthesis Design ; Lenses, Intraocular ; Vision, Ocular ; Visual Acuity

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social communication and repetitive behaviors. With the rapid development of computer vision, visual behavior analysis aided diagnosis of ASD has got more and more attention. This paper reviews the research on visual behavior analysis aided diagnosis of ASD. First, the core symptoms and clinical diagnostic criteria of ASD are introduced briefly. Secondly, according to clinical diagnostic criteria, the interaction scenes are classified and introduced. Then, the existing relevant datasets are discussed. Finally, we analyze and compare the advantages and disadvantages of visual behavior analysis aided diagnosis methods for ASD in different interactive scenarios. The challenges in this research field are summarized and the prospects of related research are presented to promote the clinical application of visual behavior analysis in ASD diagnosis.
Humans ; Autism Spectrum Disorder/diagnosis* ; Vision, Ocular ; Behavior

OBJECTIVES: To study the virtual reality-pattern visual evoked potential (VR-PVEP) P100 waveform characteristics of monocular visual impairment with different impaired degrees under simultaneous binocular perception and monocular stimulations. METHODS: A total of 55 young volunteers with normal vision (using decimal recording method, far vision ≥0.8 and near vision ≥0.5) were selected to simulate three groups of monocular refractive visual impairment by interpolation method. The sum of near and far vision ≤0.2 was Group A, the severe visual impairment group; the sum of near and far vision <0.8 was Group B, the moderate visual impairment group; and the sum of near and far vision ≥0.8 was Group C, the mild visual impairment group. The volunteers' binocular normal visions were set as the control group. The VR-PVEP P100 peak times measured by simultaneous binocular perception and monocular stimulation were compared at four spatial frequencies 16×16, 24×24, 32×32 and 64×64. RESULTS: In Group A, the differences between P100 peak times of simulant visual impairment eyes and simultaneous binocular perception at 24×24, 32×32 and 64×64 spatial frequencies were statistically significant (P<0.05); and the P100 peak time of normal vision eyes at 64×64 spatial frequency was significantly different from the simulant visual impairment eyes (P<0.05). In Group B, the differences between P100 peak times of simulant visual impairment eyes and simultaneous binocular perception at 16×16, 24×24 and 64×64 spatial frequencies were statistically significant (P<0.05); and the P100 peak time of normal vision eyes at 64×64 spatial frequency was significantly different from the simulant visual impairment eyes (P<0.05). In Group C, there was no significant difference between P100 peak times of simulant visual impairment eyes and simultaneous binocular perception at all spatial frequencies (P>0.05). There was no significant difference in the P100 peak times measured at all spatial frequencies between simulant visual impairment eyes and simultaneous binocular perception in the control group (P>0.05). CONCLUSIONS VR-PVEP can be used for visual acuity evaluation of patients with severe and moderate monocular visual impairment, which can reflect the visual impairment degree caused by ametropia. VR-PVEP has application value in the objective evaluation of visual function and forensic clinical identification.
Humans ; Evoked Potentials, Visual ; Vision, Ocular ; Vision, Binocular/physiology* ; Vision Disorders/diagnosis* ; Virtual Reality

OBJECTIVE: To observe the effect of acupoint thread METHODS: A total of 60 children with refractive amblyopia were randomized into an observation group (30 cases, 2 cases dropped off) and a control group (30 cases, 1 case dropped off). In the control group, comprehensive therapy of eye covering of intact side and family refined performance was adopted. On the basis of the treatment in the control group, acupoint thread RESULTS: After treatment, the corrected vision was increased compared before treatment in the both groups ( CONCLUSION Acupoint thread
Acupuncture Points ; Amblyopia/therapy* ; Child ; Humans ; Retina ; Vision, Ocular ; Visual Acuity

Optogenetics ; Vision, Ocular

PURPOSE: To compare the classification and severity of congenital color vision deficiency using a Nagel anomaloscope and Farnsworth Munsel 100-hue Test (FM 100-hue).METHODS: A total of 394 eyes of 197 patients diagnosed with congenital color vision deficiency were included. Examinations using a Nagel anomaloscope and FM 100-hue were performed, and color vision abnormalities were classified as a protan color defect or deutan color defect by each test, and the degrees of color vision abnormalities were compared.RESULTS: The tests showed 64.3% (p < 0.001) agreement in the classification of color vision deficiencies. The Nagel anomaloscope was able to classify all cases, whereas 143 eyes (36.3%) could not be classified using the FM 100-hue test. In the case of the same type of color vision abnormality in both eyes, 196 cases (99.5%) using the Nagel anomaloscope and 111 cases (56.3%) using the FM 100-hue were observed. Regarding the degree of color defect, there was a moderate positive correlation between the two tests (r = 0.43; p < 0.001). There were no significant differences in the total error scores between mild anomalous trichromacy and severe anomalous trichromacy as assessed using FM 100-hue (p = 0.087).CONCLUSIONS: The Nagel anomaloscope was a more appropriate test for discerning the degree of color defect and binocular classification. In severity assessments, there was a moderate positive correlation between the two test methods. However, there were no significant differences in the total error scores between mild anomalous trichromacy and severe anomalous trichromacy as assessed using FM 100-hue. Therefore, it was difficult to perform severity classification using the Nagel anomaloscope based on the total error score of the FM 100-hue test.
Classification ; Color Vision Defects ; Color Vision ; Humans ; Telescopes

OBJECTIVE: To compare the visual, refractive, and patient-reported outcomes of eyes implanted with one of 3 trifocal intraocular lenses (IOLs). METHODS: This is a cross-sectional, comparative, non-interventional study wherein subjects implanted with FineVision Micro F, AT LISA tri 839MP or AcrySof IQ PanOptix trifocal IOL after phacoemulsification were recruited. Manifest refraction, uncorrected and corrected visual acuity (VA) at distance, intermediate and near vision, contrast sensitivity, modulated transfer function (MTF) values and questionnaire answers were compared among the 3 groups using analysis of variance (ANOVA). RESULTS: Fifty-seven (57) eyes were included in the study: 21 eyes with FineVision (group A), 21 eyes with LISA tri (group B), and 15 eyes with PanOptix IOL (group C). The post-operative mean manifest spherical equivalent was -0.01D, -0.07D, and 0.05D, respectively (p=0.083). Uncorrected distance VA and best-corrected distance VA were similar among the groups. Groups A and C had better uncorrected and corrected intermediate VA at 80 cm and at 60 cm compared to group B. Group A had significantly better uncorrected near visual acuity than groups B and C (p=0.032). Mesopic contrast sensitivity testing showed group C had higher contrast sensitivities without glare in at the spatial frequency of 6 CPD (p=0.038) and with glare at 3 CPD (p=0.039) and at 12 CPD (p=0.009). MTF average height analysis showed that the group A had significantly superior resolution in far targets compared to groups B and C (p=0.001). At near targets, groups A and C had better resolutions compared to group B (p=0.017). There was no significant difference in patient satisfaction for far, intermediate and near VA among the groups. CONCLUSION: Eyes implanted with any of the 3 trifocal IOL designs achieved excellent uncorrected and bestcorrected distance, intermediate and near vision. FineVision and PanOptix provided significantly better intermediate vision than LISA tri at both 80 cm and 60 cm testing distance. FineVision had better near visual outcomes than PanOptix and LISA tri. Patient satisfaction was high in all 3 trifocal IOLS
Lenses, Intraocular ; Vision, Ocular

PURPOSE: We report a case of homonymous quadrantanopia caused by occipital lobe ulegyria. CASE SUMMARY: A 23-year-female was referred to our clinic because of a visual field defect incidentally discovered during preoperative evaluation for refractive surgery at another clinic. However, she did not report any symptoms. She had no systemic diseases. Visual acuity was 20/20 in both eyes, and the color vision test was normal. Both pupils exhibited normal responses to light and near stimulations. In fundus examinations, the right optic disc was normal and the left contained drusen. Automated perimetry revealed right lower homonymous quadrantanopia with macular sparing. Brain magnetic resonance imaging revealed areas of ulegyria involving the left occipital lobe, consistent with the visual field defect. A follow-up visual field test performed 5 months later yielded the same result. CONCLUSIONS: Neuroimaging should be performed in patients with homonymous visual field defects to determine the location and etiology of the brain lesions. Occipital lobe ulegyria can cause homonymous quadrantanopia in the absence of any neurological problem.
Brain ; Brain Injuries ; Color Vision ; Follow-Up Studies ; Hemianopsia ; Humans ; Magnetic Resonance Imaging ; Neuroimaging ; Occipital Lobe ; Pupil ; Refractive Surgical Procedures ; Visual Acuity ; Visual Field Tests ; Visual Fields

PURPOSE: Horizontal visual field defects are generally caused by lesions before the optic chiasm, but we report a case with bilateral inferior altitudinal defects secondary to bilateral occipital lobe infarction. CASE SUMMARY: A 57-year-old male with a history of diabetes and hypertension presented with a month of blurring in the inferior visual field. His corrected visual acuity was 1.0 in the right eye and 0.63 in the left eye, and the intraocular pressure was normal in each eye. Pupillary response, ocular movement, and color vision tests were normal in both eyes. There was no specific finding of the optic disc and macula on fundus examination. Visual field examination revealed an inferior congruous homonymous hemianopia with horizontal meridian sparing and a left incongruous homonymous quadrantanopia. Optical coherence tomography for peripapillary retinal nerve fiber layer thickness revealed a mild decrease in the inferior disc of both eyes. Brain magnetic resonance imaging confirmed the presence of an acute infarction confined with upper medial calcarine fissures of bilateral occipital lobe and the right splenium of the corpus callosum, which were consistent with inferior altitudinal hemianopia and left superior incongruous quadrantanopia, respectively. Brain magnetic resonance angiography showed multiple stenosis of bilateral posterior cerebral arteries. CONCLUSIONS: The altitudinal visual field defects could be caused by the occipital lesion medial to the calcarine fissure, and unusual visual defects could be due to a combination of multiple lesions.
Brain ; Color Vision ; Constriction, Pathologic ; Corpus Callosum ; Hemianopsia ; Humans ; Hypertension ; Infarction ; Infarction, Posterior Cerebral Artery ; Intraocular Pressure ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Nerve Fibers ; Occipital Lobe ; Optic Chiasm ; Posterior Cerebral Artery ; Retinaldehyde ; Tomography, Optical Coherence ; Visual Acuity ; Visual Fields