-
Optometry and Vision Science : Official... Aug 2019This study reports prevalence data combined independently for accommodative dysfunction, convergence insufficiency, visual field loss, and visual acuity loss in patients... (Meta-Analysis)
Meta-Analysis
SIGNIFICANCE
This study reports prevalence data combined independently for accommodative dysfunction, convergence insufficiency, visual field loss, and visual acuity loss in patients with traumatic brain injury in the absence of eye injury.
OBJECTIVE
The objective of this study was to conduct a systematic review and meta-analysis to determine the prevalence rates of accommodative dysfunction, convergence insufficiency, visual field loss, and visual acuity loss in TBI patients without concomitant eye injury.
DATA SOURCES
The data sources used in this study were PubMed, EMBASE, EBSCO, and Cochrane Library.
STUDY APPRAISAL AND SYNTHESIS METHODS
Publications reporting the prevalence of diagnosed accommodative dysfunction, convergence insufficiency, visual field loss, or visual acuity loss to the level of legal blindness in TBI patients of any age were included. Univariate metaregression analyses and subgroup analyses were performed to account for statistical heterogeneity.
RESULTS
Twenty-two eligible publications were identified across the four visual conditions. Random-effects models yielded combined prevalence estimates: accommodative dysfunction (42.8; 95% confidence interval [CI], 31.3 to 54.7), convergence insufficiency (36.3%; 95% CI, 28.2 to 44.9%), visual field loss (18.2%; 95% CI, 10.6 to 27.1%), and visual acuity loss (0.0%; 95% CI, 0.0 to 1.1%). Metaregression and subgroup analyses revealed that visual field loss was significantly more prevalent in moderate to severe (39.8%; 95% CI, 29.8 to 50.3%) compared with mild TBI (6.6%; 95% CI, 0 to 19.5%).
CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS
This study demonstrates that accommodative dysfunction, convergence insufficiency, and visual field loss are common sequelae of TBI. Prospective longitudinal research with rigorous and uniform methodology is needed to better understand short- and long-term effects of TBI on the vision system.
Topics: Accommodation, Ocular; Brain Injuries, Traumatic; Humans; Ocular Motility Disorders; Vision Disorders; Visual Acuity; Visual Fields
PubMed: 31343512
DOI: 10.1097/OPX.0000000000001407 -
Schizophrenia Research Dec 2017Patients with schizophrenia show impairments in processing of biological motion. This is especially important since deficits in domains of social cognition has been... (Meta-Analysis)
Meta-Analysis Review
CONTEXT
Patients with schizophrenia show impairments in processing of biological motion. This is especially important since deficits in domains of social cognition has been associated with functional outcome and everyday functioning in this population.
OBJECTIVES
We conducted a systematic review and meta-analysis of studies which have used point-light displays to present whole-body motion to patients with schizophrenia and healthy controls, to evaluate the magnitude of differences between these groups in biological motion processing.
METHOD
Firstly, relevant publications were identified by a systematic search of Google Scholar and PubMed databases. Secondly, we excluded non-relevant studies for the meta-analysis according to our exclusion criteria. Effect sizes were expressed as standardized mean difference (SMD).
RESULTS
15 papers reporting results of 14 different experiments with 571 patients and 482 controls were included in the meta-analysis. The results for the general biological motion perception analysis revealed that patients with schizophrenia (compared with healthy controls) present reduced biological motion processing capacity with the effect size (SMD) of 0.66 (95% CI, -0.79 to -0.54; p<0.001). The results for the specific biological motion-based tasks were also statistically significant with SMD of 0.72 for Basic Biological Motion task (95% CI: -0.94 to -0.51; p<0.001) and SMD of 0.61 for Emotion in Biological Motion task, (95% CI: -0.79 to -0.43; p<0.001) respectively.
CONCLUSION
The findings from our meta-analysis highlight abnormalities in general and specific domains of biological motion perception in schizophrenia patients as compared with healthy controls.
Topics: Humans; Motion Perception; Perceptual Disorders; Schizophrenic Psychology; Social Perception
PubMed: 28285029
DOI: 10.1016/j.schres.2017.03.013 -
Ophthalmic & Physiological Optics : the... Jul 2016The aim of this study was to systematically review the literature to investigate the link (if any) between vision and dizziness. (Review)
Review
PURPOSE
The aim of this study was to systematically review the literature to investigate the link (if any) between vision and dizziness.
METHODS
Medline, CINAHL, AMED, Web of Science and The Cochrane Library were searched with keywords chosen to find articles which investigated the causes of dizziness and considered vision as a possible trigger. Citation chaining of all included papers was performed in addition to the hand searching of all reference lists. Unpublished literature was identified using www.opengrey.eu. The review considered studies involving adults which link, measure or attempt to improve any aspect of vision in relation to dizziness.
RESULTS
Nine thousand six hundred and eighty one possible references were found, and the abstracts were screened independently by two reviewers to determine if they should be included in the study. Thirteen papers were found which investigated whether dizziness was linked to an assessment of vision. Visual impairment measures were crude and typically self-report, or Snellen visual acuity with little or no measurement details. Five studies found an independent link between dizziness and vision, five found a weak association (typically finding a link when univariate analyses were used, but not when multivariate analyses were used), and three found no association. Studies finding a strong link were usually cross-sectional with a large study population whereas those finding a weak association had relatively small numbers of participants. Studies which did not find an association used a broad definition of dizziness that included the term light-headedness, an unreliable Rosenbaum near visual acuity chart or an unusual categorisation of visual acuity.
CONCLUSIONS
This review suggests that dizziness (although likely not 'light-headedness') is linked with poor vision although further studies using more appropriate measures of vision are recommended.
Topics: Dizziness; Humans; Vision, Low; Visual Acuity
PubMed: 27255594
DOI: 10.1111/opo.12299 -
European Journal of Ophthalmology Jun 2017Over 8 million cataract surgeries are performed in the United States and the European Union annually, with many patients choosing to pay out of pocket for premium... (Review)
Review
PURPOSE
Over 8 million cataract surgeries are performed in the United States and the European Union annually, with many patients choosing to pay out of pocket for premium options including premium intraocular lens implants (IOLs) or laser-assisted cataract surgery (LACS). This report provides a systematic review evaluating patient-centered and visual quality outcomes comparing standard monofocal IOLs to premium cataract surgery options.
METHODS
PubMed and EMBASE were searched for publications published between January 1, 1980, and September 18, 2016, on multifocal, accommodative, and toric IOLs, monovision, and LACS, which reported on 1) dysphotopsias, 2) contrast sensitivity, 3) spectacle independence, 4) vision-related quality of life or patient satisfaction, and 5) IOL exchange.
RESULTS
Multifocal lenses achieved higher rates of spectacle independence compared to monofocal lenses but also had higher reported frequency of dysphotopsia and worse contrast sensitivity, especially with low light or glare. Accommodative lenses were not associated with reduced contrast sensitivity or more dysphotopsia but had only modest improvements in spectacle independence compared to monofocal lenses. Studies of monovision did not target a sufficiently myopic outcome in the near-vision eye to achieve the full potential for spectacle independence. Patients reported high levels of overall satisfaction regardless of implanted IOL. No studies correlated patient-reported outcomes with patient expectations.
CONCLUSIONS
Studies are needed to thoroughly compare patient-reported outcomes with concomitant patient expectations. In light of the substantial patient costs for premium options, patients and their surgeons will benefit from a better understanding of which surgical options best meet patients' expectations and how those expectations can be impacted by premium versus monofocal-including monovision-options.
Topics: Accommodation, Ocular; Cataract Extraction; Contrast Sensitivity; Eyeglasses; Humans; Lens Implantation, Intraocular; Lenses, Intraocular; Patient Satisfaction; Prosthesis Design; Quality of Life; Visual Acuity
PubMed: 28574135
DOI: 10.5301/ejo.5000978 -
Canadian Journal of Ophthalmology.... Apr 2020To examine and compare the rates of dry eye after various refractive surgeries, including laser-assisted in situ keratomileusis (LASIK), photorefractive keratectomy... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To examine and compare the rates of dry eye after various refractive surgeries, including laser-assisted in situ keratomileusis (LASIK), photorefractive keratectomy (PRK), femtosecond lamellar extraction (FLEx), and small incision lenticule extraction (SMILE).
DESIGN
Systematic review and meta-analysis.
METHODS
This systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines. Databases searched included MEDLINE (Ovid), Embase, Cochrane Library, Cumulative Index of Nursing and Allied Health Literature, Web of Science, ProQuest Dissertations and Theses, and ClinicalTrials.gov. Meeting abstracts from European Society of Cataract and Refractive Surgeons, American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology, and Canadian Ophthalmological Society were also examined. Articles underwent 3 stages of screening before data extraction and meta-analysis.
RESULTS
In total, 3232 studies were found; 261 remained after title screening, 92 remained after abstract screening, and 14 studies progressed to data extraction. Meta-analysis indicated a significant reduction in tear break-up time (TBUT) with LASIK (standardized mean difference [SMD] = -0.3; confidence interval [CI]: -0.53 to -0.08) and FLEx (SMD = -1.09; CI: -1.44 to -0.74), and a nonsignificant reduction in TBUT with SMILE (SMD = -0.34; CI: -0.95 to 0.27) and PRK (SMD = -0.11; CI: -0.29 to 0.08). Meta-analysis also indicated a significant reduction in tear production with LASIK (SMD = -0.23; CI: -0.46 to -0.01), and a nonsignificant reduction in tear production with SMILE (SMD = 0.04; CI: -0.28 to 0.36), FLEX (SMD = -0.05; CI: -0.37 to 0.28), and PRK (SMD = -0.07; CI: -0.32 to 0.19).
CONCLUSIONS
Overall, a significant reduction in postoperative tear production as well as TBUT time was seen with LASIK, and a nonsignificant reduction in postoperative tear production and TBUT was seen with SMILE, FLEx, and PRK. Ultimately, more high-quality randomized controlled trials are required to make concrete conclusions about dry eye parameters after refractive surgery.
Topics: Corneal Surgery, Laser; Dry Eye Syndromes; Humans; Tears; Visual Acuity
PubMed: 31712000
DOI: 10.1016/j.jcjo.2019.07.005 -
American Journal of Ophthalmology Jan 2023To compare the efficacy and safety of ultrathin Descemet stripping (automated) endothelial keratoplasty (UT-DS(A)EK) versus Descemet membrane endothelial keratoplasty... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To compare the efficacy and safety of ultrathin Descemet stripping (automated) endothelial keratoplasty (UT-DS(A)EK) versus Descemet membrane endothelial keratoplasty (DMEK) for the treatment of Fuchs endothelial dystrophy (FED) and bullous keratopathy (BK).
DESIGN
Systematic review and meta-analysis.
METHODS
Literature containing DMEK and UT-DSAEK were searched in the Cochrane Database of Systematic Reviews, PubMed, EMBASE, LILACS, and through manual reference searching. Studies were included that measured the outcome of interventions-including best corrected visual acuity (BCVA), endothelial cell density (ECD), and postoperative complications, especially graft detachment with the need of re-bubbling, graft rejection, graft failure, and postoperative elevated intraocular pressure (IOP)-in patients with FED and BK. Included outcomes were pooled as standardized mean differences (SMD) or risk ratios (RR) using random effects models. Inter-study heterogeneity was assessed using the Q-test and I statistic.
RESULTS
Seven (of 163) studies met all the inclusion and exclusion criteria. Meta-analysis showed a significantly better BCVA 12 months postoperatively, but an increased re-bubbling rate in eyes after DMEK compared with eyes after UT-DS(A)EK (BCVA: SMD = 0.50 [95% CI 0.27-0.74] and re-bubbling rate: RR = 0.33 [95% CI 0.16-0.67]). All other parameters did not differ significantly between both interventions, although estimates were imprecise (graft failure: RR = 0.65 [95% CI 0.18-2.30], graft rejection: RR = 1.40 [95% CI 0.27-7.30], and postoperative intraocular pressure elevation: RR = 1.14 [95% CI 0.60-2.18]). Postoperative SMDs of ECD could not be evaluated due to significant heterogeneity between studies.
CONCLUSIONS
Although the improvement in BCVA was higher after UT-DS(A)EK than after conventional DS(A)EK, the BCVA after DMEK was still superior. The complication rates were comparable for both procedures, except for the higher rate of re-bubbling after DMEK.
Topics: Humans; Cell Count; Corneal Edema; Descemet Membrane; Descemet Stripping Endothelial Keratoplasty; Endothelium, Corneal; Fuchs' Endothelial Dystrophy; Retrospective Studies; Visual Acuity
PubMed: 36220351
DOI: 10.1016/j.ajo.2022.09.013 -
Eye & Contact Lens Jan 2016The aim of this review is to evaluate the ocular safety of orthokeratology (OrthoK) treatment of myopia correction and retardation. (Review)
Review
OBJECTIVES
The aim of this review is to evaluate the ocular safety of orthokeratology (OrthoK) treatment of myopia correction and retardation.
DATA SOURCES
Clinical studies published in English and Chinese were identified from MEDLINE, EMBASE CNKI, CQVIP, and WANFANG DATA (all from 1980 to April 2015). The reference lists of the studies and the Science Citation Index were also searched.
SELECTION CRITERIA
Relevant clinical studies including case series, case reports, patient/practitioner surveys, retrospective and prospective cohort studies, and clinical trials were all included in the review. The material of OrthoK lenses was limited to gas-permeable lens.
MAIN RESULTS
This review incorporated a total of 170 publications, including 58 English and 112 Chinese literature. The risk of microbial keratitis in overnight OrthoK was similar to that of other overnight modality. The most common complication was corneal staining. Other clinically insignificant side effects included epithelial iron deposit, prominent fribrillary lines, and transient changes of corneal biomechanical properties. There was no long-term effect of OrthoK on corneal endothelium.
CONCLUSIONS
There is sufficient evidence to suggest that OrthoK is a safe option for myopia correction and retardation. Long-term success of OrthoK treatment requires a combination of proper lens fitting, rigorous compliance to lens care regimen, good adherence to routine follow-ups, and timely treatment of complications.
Topics: Child; Child, Preschool; Clinical Studies as Topic; Contact Lenses; Corneal Diseases; Eye Infections; Humans; Myopia; Orthokeratologic Procedures; Visual Acuity
PubMed: 26704136
DOI: 10.1097/ICL.0000000000000219 -
Neuroscience and Biobehavioral Reviews Aug 2015There is increasing interest in the understanding of emotion recognition deficits in temporal lobe epilepsy (TLE), the most common form of focal epilepsies. There are... (Review)
Review
There is increasing interest in the understanding of emotion recognition deficits in temporal lobe epilepsy (TLE), the most common form of focal epilepsies. There are conflicting reports about impairments for different emotions in right and left temporal lobe epilepsy patients. A systematic review and a narrative synthesis was conducted for studies investigating emotion recognition (ER) in TLE. Embase, MEDLINE, PsychINFO and Pubmed were searched from 1990 to March 2015 and reference lists were reviewed. 996 citations were identified and 43 studies were finally included. ER deficits are consistently observed across studies. A fear recognition deficit is always reported, followed by deficits in sadness and disgust recognition. Deficits are observed across visual and auditory domains. Conflicting evidence is present concerning the severity of ER deficits in right and left TLE. Studies on anterior temporal lobectomy report data similar to that observed in pre-surgical patients. Current evidence supports the conclusion that recognition of negative emotions is commonly impaired in TLE, particularly for fear, and in the visual domain. Future work should focus on more ecologically valid test, on longitudinal studies to assess the role of anterior temporal lobectomy, and to correlate ER measures to social functioning in everyday life.
Topics: Adult; Auditory Perception; Emotions; Epilepsy, Temporal Lobe; Facial Expression; Facial Recognition; Fear; Female; Humans; Male; Middle Aged; Recognition, Psychology
PubMed: 25999121
DOI: 10.1016/j.neubiorev.2015.05.009 -
Ophthalmic Epidemiology Jun 2023In response to the recommendations of the World Health Organization (WHO) World report on vision, the WHO is developing a Package of Eye Care Interventions (PECI) to... (Review)
Review
BACKGROUND
In response to the recommendations of the World Health Organization (WHO) World report on vision, the WHO is developing a Package of Eye Care Interventions (PECI) to support the integration of eye care into health systems within countries. This study was done to systematically review clinical practice guidelines (CPGs) related to age-related macular degeneration (AMD) to provide evidence-based recommendations.
METHODS
All AMD-related CPGs published between 2010 and 2020 were reviewed and evaluated using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool.
RESULTS
Of 3778 CPGs identified, 48 underwent full-text screening and eight underwent quality appraisal. Five National Institute for Health and Care Excellence (NICE, UK) guidelines for AMD were finally selected for data extraction. Intravitreal anti-vascular endothelial growth factor (VEGF) treatment was strongly recommended for advanced, active neovascular AMD based on high-quality evidence. Photodynamic therapy and laser photocoagulation were not recommended as an adjunct to anti-VEGF therapy as first-line treatment for AMD. Recommendations on other interventions, including epiretinal brachytherapy, miniature lens system implantation, and limited macular translocation, were weak and evidence mostly came from low-quality case series studies. Hence these interventions were recommended to be used only with special arrangements or research. Existing evidence on treating geographic atrophy was limited, an implantable miniature telescope might be an effective intervention to improve vision but was still under investigation.
DISCUSSION
Current CPGs recommend anti-VEGF therapy for patients with late active neovascular AMD, while other interventions should be used with caution and further researches are warranted.
Topics: Humans; Angiogenesis Inhibitors; Vascular Endothelial Growth Factor A; Visual Acuity; Wet Macular Degeneration; Geographic Atrophy
PubMed: 35417274
DOI: 10.1080/09286586.2022.2059812 -
Journal of Refractive Surgery... Apr 2016To assess possible differences in clinical outcomes when small-incision lenticule extraction (SMILE) and femtosecond laser-assisted LASIK (FS-LASIK) are used to correct... (Comparative Study)
Comparative Study Meta-Analysis Review
PURPOSE
To assess possible differences in clinical outcomes when small-incision lenticule extraction (SMILE) and femtosecond laser-assisted LASIK (FS-LASIK) are used to correct myopia.
METHODS
A systematic review and meta-analysis. A systematic literature search was performed using Cochrane Collaboration methodology to identify randomized controlled trials and appropriate comparative studies comparing SMILE and FS-LASIK for myopia.
RESULTS
The authors identified 11 studies from a review of 102 articles, involving a total of 1,101 eyes, of which 532 eyes (48.32%) underwent SMILE and 569 eyes (51.68%) underwent FS-LASIK. No significant difference between the two procedures was evident in terms of final refractive spherical equivalent (P = .72), the proportion of eyes losing one or more lines of corrected distance visual acuity after surgery (P = .69), or the proportion of eyes achieving an uncorrected distance visual acuity of 20/20 or better (P = .35) and a refractive spherical equivalent within ±1.00 diopter of the target values (P = .70). The tear break-up time was longer in the SMILE group than the FS-LASIK group at 1 (P = .004) and 6 (P = .02) months after surgery. Corneal sensitivity was higher in the SMILE group than in the FS-LASIK group at 1 week (P < .00001) and 1 (P < .0001), 3 (P < .00001), and 6 (P < .003) months after surgery.
CONCLUSIONS
SMILE and FS-LASIK were comparable in terms of both safety and efficacy. SMILE may create fewer dry eye symptoms than FS-LASIK. Corneal sensitivity was greater after SMILE than FS-LASIK.
Topics: Corneal Stroma; Humans; Keratomileusis, Laser In Situ; Myopia; Refraction, Ocular; Surgical Flaps; Visual Acuity
PubMed: 27070233
DOI: 10.3928/1081597X-20151111-06