The theory of critical flicker fusion frequency and its application in cataracts

Background:Due to media opacity,it is usually difficult to accurately evaluate the postoperative visual acuity in cataracts patients.As a small and portable tool,the critical flicker fusion frequency(CFF)device reflects the temporal resolution of visual function and has been widely used in clinical research.However,poor understanding of the technique and equipment limitations have restricted its clinical application in China.Main text:There was a decrease in the CFF value in various ophthalmic diseases,indicating that the CFF is sensitive to detect visual functional changes.A number of studies have shown that the CFF test can accurately distinguish patients with simple cataracts from those with cataracts combined with fundus disease,and,as a visual test,it can more accurately predict postoperative visual acuity without being affected by media opacity.This study comprehensive reviews the basic principles of CFF and its application in ophthalmology,especially in cataracts.Conclusions:As one of the tools for dynamic visual function detection,the CFF test could help doctors to assess the possible presence of fundus disease in cataracts patients,especially in eyes with dense cataracts,and more precisely provide a reasonable visual prognosis than other available visual tests.

The clinical application of critical flicker fusion frequency in demyelinating optic neuritis

Purpose:To investigate the application of critical flicker fusion frequency(CFF)in demyelinating optic neuritis(DON).Methods:A cross-sectional study.A total of 127 eyes in 69 DON patients and 63 eyes in 33 healthy control(HC)groups were included between January 2021 to September 2021 from Department of Ophthalmology,PLA General Hospital.Patients underwent best-corrected visual acuity(BCVA),visual field,optical coherence tomography(OCT),flash visual evoked potential(F-VEP),and CFF examinations.The affected eyes were divided into aquaporins 4(AQP4-),myelin oligodendrocyte glycoprotein(MOG-),and double negative DON according to serum antibody;mild,moderate,severe degree visual impairment according to BCVA
0.5,0.1-0.5,<0.1;and 4 groups:<1,1~<3,3~<6 and>6 months according to time interval from onset to CFF examination.One-way ANOVA was used to perform above subgroup analysis.The correlations between CFF and F-VEP peak time,peak value,BCVA and mean visual filed defect(MD)were analyzed in order via Pearson correlation analysis.Results:he trichromatic values of red,green,and yellow in DON affected eyes were 21.83±9.03,23.66±10.21,24.09±10.77 Hz,respectively,which was significantly reduced compared with the HC group(t=-14.82,-14.22,-14.00;P<0.001).The subgroup analysis showed no significant difference between different antibody subtypes(P=0.914<0.848<0.604),whereas,a significant decrease of CFF trichromatic value was found in severe visual acuity impairment group(P<0.001).There was a significant difference in CFF-trichromatic values at different time points(P<0.001),to be specific,CFF fluctuated under 20Hz within 3 months after onset and tended to be stable around 24-28Hz.Correlation analysis showed that the peak time of F-VEP(r=-0.486,-0.515,-0.526;P<0.001),BVCA(r=-0.640,-0.659,-0.642;P<0.001),were negatively correlated with CFF trichromatic values,MD and CFF were positively correlated(r=0.486,0.453,0.476;P=0.003,0.006,0.004).Conclusions:A significant decrease of CFF value was found in DON-affected eyes,and it has a good correlation with BCVA,MD and latency of F-VEP,and can better reflect the impairment of visual function.

Maintenance time of sedative effects after an intravenous infusion of diazepam: A guide for endoscopy using diazepam

AIM: To examine whether the sedative effects assessed by psychomotor tests would depend on the cytochrome P450 (CYP ) 2C19 genotypes after an infusion regimen of diazepam commonly used forgastrointestinal endoscopy in Japan. METHODS: Fifteen healthy Japanese volunteers consisting of three different CYP2C19 genotype groups underwent a critical ? icker fusion test, an eye movement analysis and a postural sway test as a test for physical sedative effects, and a visual analog scale (VAS) symptom assessment method as a test for mental sedative effects during the 336 h period after the intravenous infusion of diazepam (5 mg). RESULTS: The physical sedative effects assessed by the critical flicker test continued for 1 h (t values of 5 min, 30 min and 60 min later: 4.35, 5.00 and 3.19, respectively) and those by the moving radial area of a postural sway test continued for 3 h (t values of 5 h, 30 h, 60 min and 3 h later: -4.05, -3.42, -2.17 and -2.58, respectively), which changed significantly compared with the baseline level before infusion (P < 0.05). On the other hand, the mental sedative effects by the VAS method improved within 1 h. The CYP2C19 genotype-dependent differences in the postinfusion sedative effects were not observed in any of the four psychomotor function tests. CONCLUSION: With the psychomotor tests, the objective sedative effects of diazepam continued for 1 h to 3 h irrespective of CYP2C19 genotype status and the subjective sedative symptoms improved within 1 h. Up to 3 h of clinical care appears to be required after the infusion of diazepam, although patients feel subjectively improved.

Reducing the Effects of Driving Fatigue with Magnetic Stimulation

The purpose of this study was to assess the effects of reducing driving fatigue with magnitopuncture stimuli on Dazhui (DU14) point and Neiguan (PC6) points using heart rate (HR), reaction time (RT) testing, critical flicker fusion frequency (CFF) and subjective evaluation. Twenty healthy subjects were randomly divided into two groups: A-group (study group) and B-group (control group). All subjects were required to be well rested before the experiment. The subjects were engaged in high speed driving at a constant vehicle velocity of 80 km/h continuously for three hours on a test course simulating an expressway. During the driving magnitopunctures were applied to the Dazhui (DU14) point and Neiguan (PC6) points for the A-group when the subject performed the task for two and half hours, and for the B-group magnitopunctures were applied to non-acupuncture points at the same time session. In this study RT exbited a significant delay in B-group (P<0.01) but no found in A-group after the driving task. CFF and subjective evaluation also exhibited significant differences between the two groups after the driving task (P<0.05). The findings showed that magnitopuncture stimuli on Dazhui (DU14) point and Neiguan (PC6) points could reduce the effects of driving fatigue.