Classification of congenital cataracts based on multidimensional phenotypes and its association with visual outcomes

●AIM:To establish a classification for congenital cataracts that can facilitate individualized treatment and help identify individuals with a high likelihood of different visual outcomes.●METHODS:Consecutive patients diagnosed with congenital cataracts and undergoing surgery between January 2005 and November 2021 were recruited.Data on visual outcomes and the phenotypic characteristics of ocular biometry and the anterior and posterior segments were extracted from the patients’medical records.A hierarchical cluster analysis was performed.The main outcome measure was the identification of distinct clusters of eyes with congenital cataracts.●RESULTS:A total of 164 children(299 eyes)were divided into two clusters based on their ocular features.Cluster 1(96 eyes)had a shorter axial length(mean±SD,19.44±1.68 mm),a low prevalence of macular abnormalities(1.04%),and no retinal abnormalities or posterior cataracts.Cluster 2(203 eyes)had a greater axial length(mean±SD,20.42±2.10 mm)and a higher prevalence of macular abnormalities(8.37%),retinal abnormalities(98.52%),and posterior cataracts(4.93%).Compared with the eyes in Cluster 2(57.14%),those in Cluster 1(71.88%)had a 2.2 times higher chance of good best-corrected visual acuity[<0.7 logMAR;OR(95%CI),2.20(1.25–3.81);P=0.006].●CONCLUSION:This retrospective study categorizes congenital cataracts into two distinct clusters,each associated with a different likelihood of visual outcomes.This innovative classification may enable the personalization and prioritization of early interventions for patients who may gain the greatest benefit,thereby making strides toward precision medicine in the field of congenital cataracts.

OCTA characteristics in non-arteritic central retinal artery occlusion and correlation with visual acuity

AIM:To observe the retinal and choroidal circulations in patients with non-arteritic permanent central retinal artery occlusion(NA-CRAO)via optical coherence tomography angiography(OCTA)and analyze their correlation with visual acuity.METHODS:Sixty-two eyes with clinically confirmed acute NA-CRAO were included in the study and divided into:A type(mild n=29),B type(moderate n=27)and C type(severe n=6)based on the degree of visual loss,retinal edema,and arterial blood flow delay in fundus fluorescence angiography(FFA).Contralateral healthy eyes were used as the control group.Best-corrected visual acuity(BCVA),slit lamp microscopy,indirect ophthalmoscopy,fundus color photography,OCTA,and FFA were performed.Spearman’s correlation analysis was used to determine the correlations between retinal and choroidal vessels and visual acuity.RESULTS:There were no statistically significant differences in age,gender,and intraocular pressure among the three types and the control group(P>0.05).Vessel density in deep capillary plexus(VD-DCP)significantly decreased(P<0.05)in all three types of NA-CRAO patients compared to the control group.Vessel density in superficial vascular plexus(VD-SVP)significantly decreased(P<0.05)in type A patients and choriocapillaris flow area significantly decreased(P<0.05)in type B and type C patients compared to the control group;while outer retinal flow areas significantly increased in the type A(P<0.05)and decreased in type C patients(P<0.05).The retinal thickness significantly increased in type C group(P<0.05).The VD-SVP at fovea in the type A was significantly lower than both of type B and C.The VD-SVP at nasal parafovea in type A and B was significantly lower than type C(P<0.05).The logMAR BCVA of type A was significantly better than that of type B and C groups(P<0.05).Spearman’s correlation analysis showed that the logMAR BCVA was positively correlated with VD-SVP at fovea(r=0.679,P=0.031)and nasal parafovea(r=0.826,P=0.013).CONCLUSION:OCTA is valuable for assessing retinal ischemia,and evaluating visual impairment.Deep retinal vasculature is commonly affected in all NA-CRAO types.VDSVPs at fovea and nasal parafovea can serve as reliable markers of visual impairment in NA-CRAO.

Values of macular ganglion cell-inner plexiform layer and 10-2 visual field measurements in detecting and evaluating glaucoma

AIM:To assess the performance of macular ganglion cell-inner plexiform layer thickness(mGCIPLT)and 10-2 visual field(VF)parameters in detecting early glaucoma and evaluating the severity of advanced glaucoma.METHODS:Totally 127 eyes from 89 participants(36 eyes of 19 healthy participants,45 eyes of 31 early glaucoma patients and 46 eyes of 39 advanced glaucoma patients)were included.The relationships between the optical coherence tomography(OCT)-derived parameters and VF sensitivity were determined.Patients with early glaucoma were divided into eyes with or without central 10°of the VF damages(CVFDs),and the diagnostic performances of OCT-derived parameters were assessed.RESULTS:In early glaucoma,the mGCIPLT was significantly correlated with 10-2 VF pattern standard deviation(PSD;with average mGCIPLT:β=-0.046,95%CI,-0.067 to-0.024,P<0.001).In advanced glaucoma,the mGCIPLT was related to the 24-2 VF mean deviation(MD;with average mGCIPLT:β=0.397,95%CI,0.199 to 0.595,P<0.001),10-2 VF MD(with average mGCIPLT:β=0.762,95%CI,0.485 to 1.038,P<0.001)and 24-2 VF PSD(with average mGCIPLT:β=0.244,95%CI,0.124 to 0.364,P<0.001).Except for the minimum and superotemporal mGCIPLT,the decrease of mGCIPLT in early glaucomatous eyes with CVFDs was more severe than that of early glaucomatous eyes without CVFDs.The area under the curve(AUC)of the average mGCIPLT(AUC=0.949,95%CI,0.868 to 0.982)was greater than that of the average circumpapillary retinal nerve fiber layer thickness(cpRNFLT;AUC=0.827,95%CI,0.674 to 0.918)and rim area(AUC=0.799,95%CI,0.610 to 0.907)in early glaucomatous eyes with CVFDs versus normal eyes.CONCLUSION:The 10-2 VF and mGCIPLT parameters are complementary to 24-2 VF,cpRNFLT and ONH parameters,especially in detecting early glaucoma with CVFDs and evaluating the severity of advanced glaucoma in group level.

Changes in visual performance after implantation of different intraocular lenses

AIM:To evaluate the trending visual performance of different intraocular lenses(IOLs)over time after implantation.METHODS:Ninety-one patients received cataract surgery with implantations of monofocal(Mon)IOLs,segmental refractive(SegRef)IOLs,diffractive(Dif)IOLs,and extendeddepth-of-focus(EDoF)IOLs were included.The aberrations and optical quality collected with iTrace and OQAS within postoperative 6mo were followed and compared.RESULTS:Most of the visual parameters improved over the postoperative 6mo.The postoperative visual acuity(POVA)of the Mon IOL,SegRef IOL,and EDoF IOL groups achieved relative stability in earlier states compared with the Dif IOL group.Nevertheless,the overall visual performance of the 3 IOLs continued to upturn in small extents within the postoperative 6mo.The optical quality initially improved in the EDoF IOL group,then in the Mon IOL,SegRef IOL,and Dif IOL groups.POVA and objective visual performance of the Mon IOL and EDoF IOL groups,as well as POVA and visual quality of the Dif IOL group,improved in the postoperative 1mo and stabilized.Within the postoperative 6mo,gradual improvements were observed in the visual acuity and objective visual performance of the SegRef IOL group,as well as in the postoperative optical quality of the Dif IOL group.CONCLUSION:The visual performance is different among eyes implanted with different IOLs.The findings of the current study provide a potential reference for ophthalmologists to choose suitable IOLs for cataract patients in a personalized solution.

Systematic bibliometric and visualized analysis of research hotspots and trends on the application of artificial intelligence in glaucoma from 2013 to 2022

AIM:To conduct a bibliometric analysis of research on artificial intelligence(AI)in the field of glaucoma to gain a comprehensive understanding of the current state of research and identify potential new directions for future studies.METHODS:Relevant articles on the application of AI in the field of glaucoma from the Web of Science Core Collection were retrieved,covering the period from January 1,2013,to December 31,2022.In order to assess the contributions and co-occurrence relationships among different countries/regions,institutions,authors,and journals,CiteSpace and VOSviewer software were employed and the research hotspots and future trends within the field were identified.RESULTS:A total of 750 English articles published between 2013 and 2022 were collected,and the number of publications exhibited an overall increasing trend.The majority of the articles were from China,followed by the United States and India.National University of Singapore,Chinese Academy of Sciences,and Sun Yat-sen University made significant contributions to the published works.Weinreb RN and Fu HZ ranked first among authors and cited authors.American Journal of Ophthalmology is the most impactful academic journal in the field of AI application in glaucoma.The disciplinary scope of this field includes ophthalmology,computer science,mathematics,molecular biology,genetics,and other related disciplines.The clustering and identification of keyword nodes in the co-occurrence network reveal the evolving landscape of AI application in the field of glaucoma.Initially,the hot topics in this field were primarily“segmentation”,“classification”and“diagnosis”.However,in recent years,the focus has shifted to“deep learning”,“convolutional neural network”and“artificial intelligence”.CONCLUSION:With the rapid development of AI technology,scholars have shown increasing interest in its application in the field of glaucoma.Moreover,the application of AI in assisting treatment and predicting prognosis in glaucoma may become a future research hotspot.However,the reliability and interpretability of AI data remain pressing issues that require resolution.

DPT‐tracker:Dual pooling transformer for efficient visual tracking

Transformer tracking always takes paired template and search images as encoder input and conduct feature extraction and target‐search feature correlation by self and/or cross attention operations,thus the model complexity will grow quadratically with the number of input images.To alleviate the burden of this tracking paradigm and facilitate practical deployment of Transformer‐based trackers,we propose a dual pooling transformer tracking framework,dubbed as DPT,which consists of three components:a simple yet efficient spatiotemporal attention model(SAM),a mutual correlation pooling Trans-former(MCPT)and a multiscale aggregation pooling Transformer(MAPT).SAM is designed to gracefully aggregates temporal dynamics and spatial appearance information of multi‐frame templates along space‐time dimensions.MCPT aims to capture multi‐scale pooled and correlated contextual features,which is followed by MAPT that aggregates multi‐scale features into a unified feature representation for tracking prediction.DPT tracker achieves AUC score of 69.5 on LaSOT and precision score of 82.8 on Track-ingNet while maintaining a shorter sequence length of attention tokens,fewer parameters and FLOPs compared to existing state‐of‐the‐art(SOTA)Transformer tracking methods.Extensive experiments demonstrate that DPT tracker yields a strong real‐time tracking baseline with a good trade‐off between tracking performance and inference efficiency.

A language to analyze, describe, and explore collections of visual art

A vast quantity of art in existence today is inaccessible to individuals.If people want to know the different types of art that exist,how individual works are connected,and how works of art are interpreted and discussed in the context of other works,they must utilize means other than simply viewing the art.Therefore,this paper proposes a language to analyze,describe,and explore collections of visual art(LadeCA).LadeCA combines human interpretation and automatic analyses of images,allowing users to assess collections of visual art without viewing every image in them.This paper focuses on the lexical base of LadeCA.It also outlines how collections of visual art can be analyzed,described,and explored using a LadeCA vocabulary.Additionally,the relationship between LadeCA and indexing systems,such as ICONCLASS or AAT,is demonstrated,and ways in which LadeCA and indexing systems can complement each other are highlighted.

Stabilization and visual analysis of video-recorded sailing sessions

One common way to aid coaching and seek to improve athletes’performance is by recording training sessions for posterior analysis.In the case of sailing,coaches record videos from another boat,but usually rely on handheld devices,which may lead to issues with the footage and missing important moments.On the other hand,by autonomously recording the entire session with a fixed camera,the analysis becomes challenging owing to the length of the video and possible stabilization issues.In this work,we aim to facilitate the analysis of such full-session videos by automatically extracting maneuvers and providing a visualization framework to readily locate interesting moments.Moreover,we address issues related to image stability.Finally,an evaluation of the framework points to the benefits of video stabilization in this scenario and an appropriate accuracy of the maneuver detection method.

Macular Perfusion Changes and Ganglion Cell Complex Loss in Patients with Silicone Oil-related Visual Loss

Objective The aim of this study was to investigate macular perfusion changes and ganglion cell complex(GCC)loss in patients with unexplained visual loss following vitrectomy and silicone oil(SO)tamponade,and to evaluate the correlation between retinal blood flow and GCC loss using optical coherence tomography angiography(OCTA)and optical coherence tomography(OCT).Methods This retrospective study included seven eyes(seven patients)with unexpected visual loss after vitrectomy and SO tamponade.OCTA was used to evaluate the alterations in retinal vessel density(VD)in the superficial capillary plexus(SCP),deep capillary plexus(DCP),and radial peripapillary capillary plexus(RPCP).OCT was used to measure the thickness of GCC and retinal nerve fiber layer(RNFL).Medical records of patients were reviewed.Results Quantitative analysis of OCTA images revealed a significant reduction in SCP VD in the affected eyes compared with the controls(all sections P<0.05).No difference was found in GCC thickness,but FLV(focal loss volume)and GLV(global loss volume)were significantly higher in the affected eyes(both P<0.001).SCP VD was inversely correlated with FLV and GLV.Conclusions Silicone oil-related severe visual loss was associated with superficial retinal microvasculature damage and ganglion cell apoptosis.

Retinal detachment repair through multifocal intraocular lens-overcoming visualization challenge of the peripheral retina

Sir Nicholas Harold Lloyd Ridley has revolutionized the practice of ophthalmology by performing the firstintraocular lens （IOL） implantation in 1949. His scientific achievement was acknowledged thirty years later, which led to US Food and Drug Administration approval in 1981. Although the basic principles of IOL implantation have not changed since, many efforts have been invested in perfecting IOL design during the past decades.

Visual performance after conventional LASIK and wavefront-guided LASIK with iris-registration:results at 1 year

AIM:To compare visual performance of wavefrontguided laser in situ keratomileusis(LASIK) with iris-registration(Wg-LASIK group) and conventional LASIK(LASIK group) one year after surgery and analyze the correlation between wavefront aberrations and visual performance.·METHODS:Eight hundred and fifty-two myopic eyes of 430 patients were enrolled in this prospective study and divided into two groups:Wg-LASIK group(436eyes) and LASIK group(416 eyes).A Wavescan Wavefront aberrometer was used to analyze Zernike coefficients and the root-mean-square(RMS) of higher order aberrations,and Optec 6500 visual function instrument was used to measure contrast sensitivity(CS)before and 3,6,12 months after surgery.·RESULTS:The mean spherical equivalent(SE) in WgLASIK group was significantly better than those in LASIK group one year after surgery(P =0.024).Wg-LASIK eyes showed better CS values than LASIK eyes at all spatial frequencies with and without glare after surgery(P all【0.01).Moreover,the increase of higher RMS(RMSh),coma,RMS3,RMS4,RMS5 in Wg-LASIK group were significantly lower than those in LASIK group 1 year after surgery(P all 【0.05).The increase of coma,spherical aberration(SA),RMS3 and RMS4 in Wg-LASIK and coma and RMS3 in LASIK group were negatively correlated with reduction of contrast sensitivity 1 year after surgery.·CONCLUSION:A significant better visual performance is got in Wg-LASIK group compared with LASIK group 1year after surgery,and the Wg-LASIK is particularly suitable for eyes with high-magnitude RMSh.

Visual function and vision-related quality of life after vitrectomy for idiopathic macular hole: a 12mo followup study

· AIM: To investigate the visual function and the relationship with vision-related quality of life(VRQOL)after macular hole repair surgery.· METHODS: Prospective case series. Thirty-six consecutive eyes in 36 patients who underwent pars plana vitrectomy(PPV) and internal limiting membrane(ILM) peeling were included. The 25-item National Eye Institute Visual Function Questionnaire(VFQ-25) was answered by the participants before and 3 and 12 mo after operation. Follow-up visits examinations included best-corrected visual acuity(BCVA), clinical examination,and central macular thickness(CMT) measured by optical coherence tomography(OCT).·RESULTS: Macular-hole closure was achieved in 35 of36 eyes(97.2%). At baseline and months 3 and 12, the log MAR BCVAs(mean±SD) were 1.15±0.47, 0.68±0.53(P 【0.0001 versus baseline), and 0.55 ±0.49(P 【0.001 versus baseline, P =0.273 versus month 3), respectively; the CMTs(μm) were 330 ±81, 244 ±62(P 【0.001 versus baseline), and 225±58(P 【0.001 versus baseline, P =0.222 versus month 3), respectively; the median preoperative VFQ-25 composite score of 73.50(63.92-81.13) increased postoperatively to 85.50(80.04-89.63) at 3mo(P 【0.001)and 86.73(82.50-89.63) at 12mo(P 【0.001) respectively.The improved BCVA was correlated with improvements in five subscales(r =-0.605 to-0.336, P 【0.001 to P =0.046) at 12 mo.· CONCLUSION: PPV with ILM peeling improved anatomic outcome, visual function, and VRQOL. Theimproved BCVA was an important factor related to the improved VRQOL.

Effects of disparity distribution on visual comfort for multiple objects of stereoscopic images

With the development of stereoscopic technology, more attention is attracted on the stereoscopic three-dimensional(S3 D) content and service, and researches on images and videos have emerged in large numbers. This paper focuses mainly on visual comfort affected by characteristics of disparity for multiple objects. To find the relationship between disparity distribution and visual comfort perception, several subject evaluation experiments are done. The study contains two spatial distribution types of disparity: 1) only one of the foreground objects has zero disparity; 2) one of the foreground objects has positive disparity, while the other one has negative disparity. The experimental results and relative regression analysis provide appropriate relationship between disparity distribution and visual comfort for both conditions, which is significant to meet the applicant field in S3 D content acquisition, display adjustment and quality evaluation.

Human melanopsin-AAV2/8 transfection to retina transiently restores visual function in rd1 mice

AIM： To explore whether ectopic expression of human melanopsin can effectively and safely restore visual function in rd1 mice.· METHODS： Hematoxylin-eosin staining of retinal sections from rd1 mice was used to detect the thickness of the outer nuclear layer to determine the timing of surgery. We constructed a human melanopsinAAV2/8 viral vector and injected it into the subretinal space of rd1 mice. The Phoenix Micron IV system was used to exclude the aborted injections, and immunohistochemistry was used to validate the ectopic expression of human melanopsin. Furthermore, visual electrophysiology and behavioral tests were used to detect visual function 30 and 45 d after the injection. The structure of the retina was compared between the human melanopsin-injected group and phosphate buffer saline（PBS）-injected group.·RESULTS： Retinas of rd1 mice lost almost all of their photoreceptors on postnatal day 28（P28）. We therefore injected the human melanopsin-adeno-associated virus（AAV） 2/8 viral vector into P30 rd1 mice. After excluding aborted injections, we used immunohistochemistry of the whole mount retina to confirm the ectopic expression of human melanopsin by co-expression of human melanopsin and YFP that was carried by a viral vector. At30 d post-injection, visual electrophysiology and the behavioral test significantly improved. However,restoration of vision disappeared 45 d after human melanopsin injection. Notably, human melanopsin-injected mice did not show any structural differences in their retinas compared with PBS-injected mice.·CONCLUSION： Ectopic expression of human melanopsin effectively and safely restores visual function in rd1

Decoding brain responses to pixelized images in the primary visual cortex: implications for visual cortical prostheses

Visual cortical prostheses have the potential to restore partial vision. Still limited by the low-resolution visual percepts provided by visual cortical prostheses, implant wearers can currently only ＂see＂ pixelized images, and how to obtain the specific brain responses to different pixelized images in the primary visual cortex（the implant area） is still unknown. We conducted a functional magnetic resonance imaging experiment on normal human participants to investigate the brain activation patterns in response to 18 different pixelized images. There were 100 voxels in the brain activation pattern that were selected from the primary visual cortex, and voxel size was 4 mm × 4 mm × 4 mm. Multi-voxel pattern analysis was used to test if these 18 different brain activation patterns were specific. We chose a Linear Support Vector Machine（LSVM） as the classifier in this study. The results showed that the classification accuracies of different brain activation patterns were significantly above chance level, which suggests that the classifier can successfully distinguish the brain activation patterns. Our results suggest that the specific brain activation patterns to different pixelized images can be obtained in the primary visual cortex using a 4 mm × 4 mm × 4 mm voxel size and a 100-voxel pattern.

Long-term outcomes of penetrating keratoplasty in keratoconus: analysis of the factors associated with final visual acuities

AIM:To investigate the long-term results of penetrating keratoplasty(PK)in patients with keratoconus(KC)and to evaluate factors that might influence the final visual outcome.METHODS:We retrospectively reviewed the data of all patients with clinical KC who had undergone PK by a single corneal surgeon in a single center from May 1980to December 2005.The age of the patients,preoperative best-corrected visual acuity(BCVA),corneal thickness,death to preservation time,and preservation to transplantation time were recorded.Additionally,postoperative complications such as graft rejection,development of glaucoma and specular microscopy were checked during the follow-up.RESULTS:Sixty-nineeyesfrom69patientswerefinally included.The follow-up period was 8.64±6.13y.Graft rejection occurred in 4 eyes of 69 cases(5.8%),and the time to graft rejection was 2.1±1.3y.A Kaplan-Meier survival analysis showed that the estimated cumulative probability of graft rejection at 6,13,and 17y after PK were 95.6%,90.0%,and 78.8%,respectively.When we evaluated factors that might influence final BCVA in eyes,no disparity donor-host trephine size(same graft size)as well as higher spherical equivalent,and average Kvalue were associated with higher final BCVA.(P=0.006,0.051,0.092,and 0.021 in eyes with follow-up【8y;P=0.068,0.065,and 0.030 in eyes with follow-up≥8y,respectively).CONCLUSION:The long-term results of PK in patients with KC were favorable with a high percentage of good BCVA.Less myopic change and low average K-reading,as well as a surgical technique using the same size donor-recipient button may provide better visual outcomes particularly in patients with KC.

Visual impact of sub-Tenon anesthesia during combined phacoemulsification and vitrectomy surgery

AIM:To investigate the visual impact of sub-Tenon anesthesia during combined phacoemulsification and vitrectomy surgery.METHODS:In this prospective case series, consecutive patients who underwent combined phacoemulsification and pars plana vitrectomy(PPV) under sub-Tenon anesthesia between October 2008 and September 2009 were enrolled. The patients were asked whether they could see the light of the operating microscope or not between various surgical steps with their contralateral eye being covered.RESULTS:A total of 163 eyes of 163 patients were enrolled in this study. After their contralateral eyes were covered, 152(93.3%) patients said that they could not see any light at least during one of the surgical steps. All eyes recovered to at least light perception on the first postoperative day. The incidence of no light perception during the surgery was not related to demographic factors, including age, gender, or type of ocular diseases.CONCLUSION:The incidence of no light perception during combined phacoemulsification and vitrectomy under sub-Tenon anesthesia was high in our study.Patients should be duly informed about this temporary but potential intraoperative event.

Postnatal development of NADPH-diaphorase expression in the visual cortex of the golden hamster

Nitric oxide is an important neuromodulator in the brain and is involved in the development of visual system. But it is not clear how nitric oxide and nitric oxide synthase （NOS） are involved in the developing visual cortex of rodents. Thus we examined the expression of NOS activity in the postnatal developing visual cortex of the golden hamster by using histochemical technique for NADPH-diaphorase （NADPH-d）. A heavily stained NADPH-d band was observed in the neuropil of the visual cortex. This NADPH-d band initially appeared in the cortical plate from the day of birth （P0） to postnatal day 4 （P4）. From P7 to P21, this band was confined to area 17 and migrated to the deeper layers Ill IV and V VI before it eventually disappeared at P28. Such developmental trends of the band correlated well with the process of formation and establishment of the geniculo-cortical projection patterns. Thus, the areal specific development of the band suggests that NOS is closely related to the cortical differentiation and synaptic formation of the primary visual cortex. On the other hand, monocular eye enucleation on P1 could not alter the appearance of this NADPH-d positive band, indicating a non-activity dependant role of NOS. In addition, differences in the laminar distributions and developmental sequence between the heavily and lightly stained NADPH-d positive neurons during development suggest that they play different roles in the development.

Comparison of corneal biomechanical properties in normal tension glaucoma patients with different visual field progression speed

AIM：To compare the corneal biomechanical properties difference by ocular response analyzer（ORA） in normal tension glaucoma（NTG） patients with different visual field（VF） progression speed. METHODS：NTG patients with well-controlled Goldmann applanation tonometer（GAT） who routinely consulted Kitasato University Hospital Glaucoma Department between January 2010 and February 2014 were enrolled.GAT and ORA parameters including corneal compensated intraocular pressure（lOPcc）,Goldmann estimated intraocular pressure（lOPg）,corneal hysteresis（CH）,corneal resistance factor（CRF） were recorded.VF was tested by Swedish interactive threshold algorithm（SITA）-standard 30-2 fields.All patients underwent VF measurement regularly and GAT did not exceed 15 mm Hg at any time during the 3y follow up.Patients were divided into four groups according to VF change over 3y,and ORA findings were compared between the upper 25th percentile group（slow progression group） and the lower 25th percentile group（rapid progression group）.RESULTS：Eighty-two eyes of 56 patients were studied.There were 21 eyes（21 patients） each in rapid and slow progression groups respectively.GAT,lOPcc,lOPg,CH,CRF were 12.1＋1.4 mm Hg,15.8±1.8 mm Hg,12.8±2.0 mm Hg,8.4±1.1 mm Hg,7.9±1.3 mm Hg respectively in rapid progression group and 11.5±1.3 mm Hg,13.5±2.1 mm Hg,11.2±1.6 mm Hg,9.3±1.1 mm Hg,8.2±0.9 mm Hg respectively in slow progression group（P=0.214,〈0.001,0.007,0.017,0.413,respectively）.In bivariate correlation analysis,lOPcc,lOPcc-GAT and CH were significant correlated with m△MD（r =-0.292,-0.312,0.228 respectively,P =0.008,0.004,0.039 respectively）.CONCLUSION：Relatively rapid VF progression occurred in NTG patients whose lOPcc are rather high,CH are rather low and the difference between lOPcc and GAT are relatively large.Higher lOPcc and lower CH are associated with VF progression in NTG patients.This study suggests that GAT measures might underestimate the IOP in such patients.

Visual function alterations in essential tremor: A case report

Our purpose is to report alterations in contrast sensitivity function(CSF)and in the magno,parvo and koniocellular visual pathways by means of a multichannel perimeter in case of an essential tremor(ET).A complete evaluation of the visual function was performed in a 69-year old patient,including the analysis of the chromatic discrimination by the Fansworth–Munsell 100 hue test,the measurement of the CSF by the CSV-1000E test,and the detection of potential alteration patterns in the magno,parvo and koniocellular visual pathways by means of a multichannel perimeter.Visual acuity and intraocular pressure(IOP)were within the ranges of normality in both eyes.No abnormalities were detected in the fundoscopic examination and in the optical coherence tomography(OCT)exam.The results of the color vision examination were also within the ranges of normality.A signi¯cant decrease in the achromatic CSFs for right eye(RE)and left eye(LE)was detected for all spatial frequencies.The statistical global values provided by the multichannel perimeter confirms that there were significant absolute sensitivity losses compared to the normal pattern in RE.In the LE,only a statistically significant decrease in sensitivity was detected for the blue-yellow(BY)channel.The pattern standard deviation(PSD)values obtained in our patient indicated that there were significant localized losses compared to the normality pattern in the achromatic channel of the RE and in the red-green(RG)channel of the LE.Some color vision alterations may be present in ET that cannot be detected with conventional color vision tests,such as the FM 100 Hue.