Diagnostic values of questionnaires of Convergence Insufficiency Symptom Survey and College of Optometrists Vision Development Quality of Life in the screening of convergence insufficiency

AIM:To compare and analyse the diagnostic efficacy of the College of Optometrists Vision Development Quality of Life Questionnaire(COVD-QOL)and the Convergence Insufficiency Symptom Survey(CISS)in detecting convergence insufficiency and to compare their diagnostic value in clinical applications.METHODS:Using the diagnostic test method,62 adult patients with convergence insufficiency(age:24.74±3.75y)and 62 normal participants(age:23.61±3.13y)who visited the Optometry Clinic of West China Hospital of Sichuan University from April 2021 to January 2023 were included.All subjects completed the CISS and COVD-QOL.Statistical analysis of the sensitivity and specificity of the CISS and COVD-QOL and comparison and joint experimental analysis of their diagnostic efficacy were performed.RESULTS:The sensitivity of the CISS and COVD-QOL for convergence insufficiency was 64.5%and 71.0%,respectively,while the specificity was 96.8%and 67.7%,respectively.Compared to the CISS alone,the combination of the CISS and COVD-QOL demonstrated lower sensitivity and specificity.The areas under the receiver operating characteristic curve of CISS,COVD-QOL and CISS combined with COVD-QOL were 0.806,0.694 and 0.782,respectively.CONCLUSION:Considering the low sensitivity of the CISS and the low specificity of the COVD-QOL,it is recommended to supplement these questionnaires with other screening tests for the detection of convergence insufficiency.

The Evaluation of Vision Related Quality of Life in Patients with Retinitis Pigmentosa after Suprachoroidal Umbilical Cord Derived Mesenchymal Stem Cell Treatment

Background: The aim of this study was to evaluate vision related quality of life (VRQoL) in patients with retinitis pigmentosa (RP) after suprachoroidal umbilical cord derived mesenchymal stem cell (UC-MSC) treatment. Methods: The patients were evaluated regarding to the VRQoL before the treatment and at the end of the first year. The study was performed in an affiliated hospital of a university between 2018 and 2020. The patients were operated by a single surgeon and evaluated at baseline and at first, sixth and twelfth month after stem cell implantation. To assess patients’ subjective visual situation, we used Impact of Vision Impairment (IVI) Profile 28-item questionnaire. It basically evaluated vision-related activities in three subscales: “reading and accessing information”, “mobility and independence” and “emotional well-being”. This test is established to assess VRQoL in low vision patients. Results: A total of 123 people, ranging in age from 18 to 48 years, participated in the study and 43.9% (n = 54) were women. The study patients were followed up for one year and the questionnaire was filled by patients at baseline and one year after surgery. In all groups, no difficulty was observed in understanding the questionnaire. The results showed significant improvements in VRQoL after stem cell treatment (p < 0.05). The analysis of each subscale score including “reading and accessing information”, “mobility and independence” and “emotional well-being” before and after treatment showed significant improvements in all subscale scores (p < 0.05). Conclusions: IVI 28 item questionnaire seems to be an effective test for the assessment of VRQoL in low vision patients. The suprachoroidal implantation of UC-MSC for the treatment of RP can improve the quality of life of these patients.

Early visual function outcomes of topography-guided FS-LASIK and SMILE in treatment of myopia and myopic astigmatism

AIM: To compare the quality outcomes of vision at early phase after topography-guided femtosecond laser-assisted in situ keratomileusis(FS-LASIK-CV) and small incision lenticule extraction(SMILE) in treatment of myopia and myopic astigmatism.METHODS: Retrospective comparative analysis of 49 patients that underwent FS-LASIK(n=23) or SMILE(n=26) procedure for myopia and myopic astigmatism between April and September in 2019. Pre-and postoperative uncorrected visual acuity(UCVA), spherical equivalent refraction(SEQ), cylindrical refraction, contrast sensitivity function(CSF), and corneal higher-order aberrations(HOAs) were evaluated. Independent t-test was used for inter-group comparison, while repeated measures ANOVA was used to analyze changes at different time points. RESULTS: In both groups, 100% of the eyes obtained a UCVA of 20/20 or better at 1 wk, 1, and 3 mo postoperatively. At 1 d and 3 mo postoperatively, UCVA was better in FS-LASIKCV group than in SMILE group. At 1 wk postoperatively, SEQ was lower in SMILE group than in FS-LASIK-CV group(P=0.006). At 3 mo postoperatively, the SEQ reached target refraction in both groups. The residual astigmatism was reduced in both groups without intergroup difference(P>0.05). At 3 mo postoperatively, the spherical aberration and coma under 6 mm pupil size were higher than preoperative levels in both groups(P<0.05). However, the increase in the corneal HOAs in the FS-LASIK-CV group was less than the SMILE group(P<0.05). At 3 mo postoperatively, the log CS were better than preoperative levels under scotopic conditions without glare and scotopic conditions with glare in both groups(P<0.05). At 1 and 3 mo postoperatively, under scotopic conditions without glare and scotopic conditions with glare, FS-LASIK-CV group showed more improvement in log CS at two spatial frequencies(12.0 c/d and 18.0 c/d;P<0.05).CONCLUSION: Both FS-LASIK-CV and SMILE demonstrate to be safe, effective, and predictable in treatment of myopia and myopic astigmatism. Early postoperative improvement in UCVA and CSF at high spatial frequency under scotopic conditions were better after FS-LASIK-CV than SMILE.

Multifocal and extended depth of focus intraocular lenses

Advances in intraocular lens(IOL)design have rendered cataract surgery a refractive procedure.Newer IOL types include bifocal,trifocal and extended depth of focus(EDOF)IOLs.Their basic difference nestles in the number of focal points that each lens provides,which in turn leads to different visual outcomes.Familiarity of surgeons with the various characteristics of each lens is of utmost importance for accurate IOL selection to match each patient’s needs.In this review,we aim to compare the clinical outcomes after implantation of multifocal and EDOF IOLs in terms of distance,intermediate and near vision,contrast sensitivity,and reading performance.Finally,we discuss the defocus curve and the optical and photic phenomena associated with each type of IOL.