IMI Pathologic Myopia
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GUIDE for the Evaluation of VISUAL Impairment
International Society for Low vision Research and Rehabilitation GUIDE for the Evaluation of VISUAL Impairment Published through the Pacific Vision Foundation, San Francisco for presentation at the International Low Vision Conference VISION-99. TABLE of CONTENTS INTRODUCTION 1 PART 1 – OVERVIEW 3 Aspects of Vision Loss 3 Visual Functions 4 Functional Vision 4 Use of Scales 5 Ability Profiles 5 PART 2 – ASSESSMENT OF VISUAL FUNCTIONS 6 Visual Acuity Assessment 6 In the Normal and Near-normal range 6 In the Low Vision range 8 Reading Acuity vs. Letter Chart Acuity 10 Visual Field Assessment 11 Monocular vs. Binocular Fields 12 PART 3 – ESTIMATING FUNCTIONAL VISION 13 A General Ability Scale 13 Visual Acuity Scores, Visual Field Scores 15 Calculation Rules 18 Functional Vision Score, Adjustments 20 Examples 22 PART 4 – DIRECT ASSESSMENT OF FUNCTIONAL VISION 24 Vision-related Activities 24 Creating an Activity Profile 25 Participation 27 PART 5 – DISCUSSION AND BACKGROUND 28 Comparison to AMA scales 28 Statistical Use of the Visual Acuity Score 30 Comparison to ICIDH-2 31 Bibliography 31 © Copyright 1999 by August Colenbrander, M.D. All rights reserved. GUIDE for the Evaluation of VISUAL Impairment Summer 1999 INTRODUCTION OBJECTIVE Measurement Guidelines for Collaborative Studies of the National Eye Institute (NEI), This GUIDE presents a coordinated system for the Bethesda, MD evaluation of the functional aspects of vision. It has been prepared on behalf of the International WORK GROUP Society for Low Vision Research and Rehabilitation (ISLRR) for presentation at The GUIDE was approved by a Work Group VISION-99, the fifth International Low Vision including the following members: conference. -
Vision Rehabi I Itation for Patients with Age Related Macular Degeneration
Vision rehabi I itation for GARY S. RUBIN patients with age related macular degeneration Epidemiology of low vision The over-representation of macular degeneration patients in the low-vision clinic is The epidemiology of vision impairment is dealt reflected in the chief complaints of those with in detail elsewhere.1 However, there is one referred for rehabilitation. A study of 1000 particularly salient factor that bears emphasis. consecutive patients seen at the Wilmer Low The prevalence of vision impairment increases Vision clinic indicated that 64% listed 'reading' dramatically with advancing age. Statistics as their chief complaint, while other activities compiled in the UK by the Royal National were identified by fewer than 8% of patients. Institute for the Blind2 indicate that there were Undoubtedly the bias towards reading approximately 1.1 million blind or partially problems results partly from the nature of the sighted persons in 1996, of whom 82% were 65 low-vision services offered. Those served by a years of age or older. Thus it is not surprising to community-based programme that includes learn that the major causes of vision impairment home visits might be more likely to report are age-related eye diseases. Fig. 1 illustrates the problems with activities of daily living, while a distribution of causes of vision impairment blind rehabilitation centre would be more likely 5 from three recent studies?- Approximately to address mobility issues. Nevertheless, most equal percentages are attributed to macular macular degeneration patients are referred to degeneration and cataract, with smaller hospital or optometry clinic services, and as percentages for glaucoma, diabetic retinopathy their overwhelming concern is with reading, and optic neuropathies. -
Bass – Glaucomatous-Type Field Loss Not Due to Glaucoma
Glaucoma on the Brain! Glaucomatous-Type Yes, we see lots of glaucoma Field Loss Not Due to Not every field that looks like glaucoma is due to glaucoma! Glaucoma If you misdiagnose glaucoma, you could miss other sight-threatening and life-threatening Sherry J. Bass, OD, FAAO disorders SUNY College of Optometry New York, NY Types of Glaucomatous Visual Field Defects Paracentral Defects Nasal Step Defects Arcuate and Bjerrum Defects Altitudinal Defects Peripheral Field Constriction to Tunnel Fields 1 Visual Field Defects in Very Early Glaucoma Paracentral loss Early superior/inferior temporal RNFL and rim loss: short axons Arcuate defects above or below the papillomacular bundle Arcuate field loss in the nasal field close to fixation Superotemporal notch Visual Field Defects in Early Glaucoma Nasal step More widespread RNFL loss and rim loss in the inferior or superior temporal rim tissue : longer axons Loss stops abruptly at the horizontal raphae “Step” pattern 2 Visual Field Defects in Moderate Glaucoma Arcuate scotoma- Bjerrum scotoma Focal notches in the inferior and/or superior rim tissue that reach the edge of the disc Denser field defects Follow an arcuate pattern connected to the blind spot 3 Visual Field Defects in Advanced Glaucoma End-Stage Glaucoma Dense Altitudinal Loss Progressive loss of superior or inferior rim tissue Non-Glaucomatous Etiology of End-Stage Glaucoma Paracentral Field Loss Peripheral constriction Hereditary macular Loss of temporal rim tissue diseases Temporal “islands” Stargardt’s macular due -
Central Serous Choroidopathy
Br J Ophthalmol: first published as 10.1136/bjo.66.4.240 on 1 April 1982. Downloaded from British Journal ofOphthalmology, 1982, 66, 240-241 Visual disturbances during pregnancy caused by central serous choroidopathy J. R. M. CRUYSBERG AND A. F. DEUTMAN From the Institute of Ophthalmology, University of Nijmegen, Nijmegen, The Netherlands SUMMARY Three patients had during pregnancy visual disturbances caused by central serous choroidopathy. One of them had a central scotoma in her first and second pregnancy. The 2 other patients had a central scotoma in their first pregnancy. Symptoms disappeared spontaneously after delivery. Except for the ocular abnormalities the pregnancies were without complications. The complaints can be misinterpreted as pregnancy-related optic neuritis or compressive optic neuropathy, but careful biomicroscopy of the ocular fundus should avoid superfluous diagnostic and therapeutic measures. Central serous choroidopathy (previously called lamp biomicroscopy of the fundus with a Goldmann central serous retinopathy) is a spontaneous serous contact lens showed a serous detachment of the detachment of the sensory retina due to focal leakage neurosensory retina in the macular region of the from the choriocapillaris, causing serous fluid affected left eye. Fluorescein angiography was not accumulation between the retina and pigment performed because of pregnancy. In her first epithelium. This benign disorder occurs in healthy pregnancy the patient had consulted an ophthal- adults between 20 and 45 years of age, who present mologist on 13 June 1977 for exactly the same with symptoms of diminished visual acuity, relative symptoms, which had disappeared spontaneously http://bjo.bmj.com/ central scotoma, metamorphopsia, and micropsia. after delivery. -
Kanazawa University
Introduction of Kanazawa University 1 Where is Kanazawa University?? Kanazawa Ishikawa Pref. Japan 2 BASIC INFORMATION The origin of NATIONAL 1862 KU, Smallpox Legal Status: Vaccination Center authorized National University by the Kaga Domain, was opened in 1862. 3Colleges, 5Graduate Schools 10,328 Covering almost all area of Number of Students Undergraduate 7,932 disciplines Graduate 2,319; Other 77 2,723 534 Million USD Number of Staffs Budget Teaching Staff 1,207 Administrative Staff 1,516 *All numbers as of 2014, unless otherwise noted 3 BASIC INFORMATION 194 522 Number of Partner Institutions Number of University-Level:135 International Students Department-Level:59 (as of Oct.1,2014) (as of Oct.1,2014) 235 106,981 times Number of Research Paper Citations Students Sent Abroad (2013) 20th in Japan (2003-2013) Number of 796 research projects TOP500 awarded Grants-in-Aid for ACADEMIC RANKING OF Scientific Research by MEXT. WORLD UNIVERSITIES 2014 4 14th in Japan *All numbers as of 2014, unless otherwise noted UNDERGRADUATE GRADUATE 3 Colleges 16 Schools 5 Graduate Schools Humanities Education (Master’s Course only) Law Economics Human and Human and Socio‐Environment Studies Teacher Education Social Sciences Regional Development Natural Science and Engineering Studies International Studies Medical Science (includes Pharmacy and Mathematics and Physics Health Sciences) Chemistry Law School (Professional Degree Course only) Mechanical Engineering Science and Engineering Electrical and Computer Engineering Environmental Design Natural System Medical, Medicine Pharmaceutical Pharmacy and Health Pharmaceutical Sciences 5 Sciences Health Sciences KU HAS BEEN SELECTED FOR TOP GLOBAL UNIVERSITY PROJECT BY JAPANESE GOVERNMENT On September 26, 2014, Ministry of Education, Culture, Sports, Science and Technology (MEXT) selected 37 universities for the ‘TOP GLOBAL UNIVERSITY PROJECT’ including KU. -
Dominant Optic Atrophy
Lenaers et al. Orphanet Journal of Rare Diseases 2012, 7:46 http://www.ojrd.com/content/7/1/46 REVIEW Open Access Dominant optic atrophy Guy Lenaers1*, Christian Hamel1,2, Cécile Delettre1, Patrizia Amati-Bonneau3,4,5, Vincent Procaccio3,4,5, Dominique Bonneau3,4,5, Pascal Reynier3,4,5 and Dan Milea3,4,5,6 Abstract Definition of the disease: Dominant Optic Atrophy (DOA) is a neuro-ophthalmic condition characterized by a bilateral degeneration of the optic nerves, causing insidious visual loss, typically starting during the first decade of life. The disease affects primary the retinal ganglion cells (RGC) and their axons forming the optic nerve, which transfer the visual information from the photoreceptors to the lateral geniculus in the brain. Epidemiology: The prevalence of the disease varies from 1/10000 in Denmark due to a founder effect, to 1/30000 in the rest of the world. Clinical description: DOA patients usually suffer of moderate visual loss, associated with central or paracentral visual field deficits and color vision defects. The severity of the disease is highly variable, the visual acuity ranging from normal to legal blindness. The ophthalmic examination discloses on fundoscopy isolated optic disc pallor or atrophy, related to the RGC death. About 20% of DOA patients harbour extraocular multi-systemic features, including neurosensory hearing loss, or less commonly chronic progressive external ophthalmoplegia, myopathy, peripheral neuropathy, multiple sclerosis-like illness, spastic paraplegia or cataracts. Aetiology: Two genes (OPA1, OPA3) encoding inner mitochondrial membrane proteins and three loci (OPA4, OPA5, OPA8) are currently known for DOA. Additional loci and genes (OPA2, OPA6 and OPA7) are responsible for X-linked or recessive optic atrophy. -
2. Law of Property and Obligation
DEvELOP雁NTS刀¥r2003-ACADEMIC SOC盟丁田S 119 2. Law of Property and Obligation I. Japan Association of Private Law held its 67th General Meeting at Kansai University on October 12 and 1 3, 2003. Symposium : Contemporary Problems on Nonprofits Organizations Chaired by Seiichi Yamada (Professor, Kobe University) and Hiroto Dogauchi (Professor, University of Tokyo). ( 1) "Introduction" Yoshihisa Nomi (Professor, University of Tokyo). (2) "The Regime of Charitable Corporations in Japan: An Analysis of the Structure of the Problem" Hiroyasu Nakata (Professor, Hitotsubashi University). (3) "Governance of Nonprofit Organizations" 120 WASEDA BULLET餌OF CO耀ARATlvE LAw Vb1.23 Hiroyuki Kansa㎞(Professor,Ga㎞shuin University). (4) “The Legislation for Phvate Nonprofit Co耳)orations” Takako Ame血ya(Professor,Shoin University)。 (5)“Reconside血g theMeaning ofLegalEntity” Y6shihisa Nomi(Professor,University ofTokyo)。 (6)“ProlegomenatoRethinldngofMeaningofFreedomofAssociation in Civil Law” Atsushi Omura(Professor,University ofTokyo)。 (7)“A Case Study in a Real Market(“IBO-NO-ITO”of Handmade SOMENIndustry):Meaning ofMutual Bene且tOrganization” Hisakazu Hirose(Professor,University of Tokyo). WorkshOμ (1)“The Relation ofI両ury to Damages in the Law ofTorts” KenMizuno(Professor,GakushuinUniversity). (2)“TheRefomoftheJapaneseLaw ConcemingtheRegistrationof I㎜ovables” Katsuhiko Shitinohe(Professor,Keio University). Re口ort: First Section (1)“Reconst皿ction ofThe Theory ofNon-Genuine Joint Liability” Miki Hirabayashi(AssociateProfessor,KanazawaUniversity). (2)“The Defaulting -
Japanese Universities That Offer Teacher-Training Programs
Japanese Universities that Offer Teacher-Training Programs Hokkaido University of Education – http://www.hokkyodai.ac.jp Hirosaki University - http://www.hirosaki-u.ac.jp/kokusai/index.html Iwate University – http://iuic.iwate-u.ac.jp/ Miyagi University of Education – http://www.miyakyo-u.ac.jp Fukushima University – http://www.fukushima-u.ac.jp/ Ibaraki University – http://www.ibaraki.ac.jp/ University of Tsukuba – www.kyouiku.tsukuba.ac.jp www.intersc.tsukuba.ac.jp Utsunomiya University – http://www.utsunomiya-u.ac.jp/ Gunma University – http://www.gunma-u.ac.jp Saitama University – http://www.saitama-u.ac.jp Chiba University – http://www.chiba-u.ac.jp Tokyo University of Foreign Studies – http://www.tufs.ac.jp Tokyo Gakugei University – http://www.u-gakugei.ac.jp/ Yokohama National University – http://www.ynu.ac.jp/english/ Niigata University – http://www.niigata-u.ac.jp/ Joetsu University of Education – http://www.juen.ac.jp/ Akita University – http://www.akita-u.ac.jp/english/ Toyama University – http://www.u-toyama.ac.jp Kanazawa University – http://www.kanazawa-u.ac.jp/e/index.html University of Fukui – http://www.u-fukui.ac.jp University of Yamanashi – http://www.yamanashi.ac.jp/ Shinshu University – http://www.shinshu-u.ac.jp/english/index.html Gifu University – https://syllabus.gifu-u.ac.jp/ Shizuoka University – http://www.shizuoka.ac.jp/ Aichi University of Education – http://www.aichi-edu.ac.jp/ http://www.aichi-edu.ac.jp/cie/ 1 Mie University – http://www.mie-u.ac.jp Shiga University – http://www.shiga-u.ac.jp/ -
Optic Neuritis – More Than a Loss of Vision
CLINICAL PRACTICE Edward R Chu Celia S Chen MBBS, is resident medical officer, MBBS, MPHC, FRANZCO, is a consultant ophthalmologist Department of Ophthalmology, Flinders and Senior Lecturer, Department of Ophthalmology, Flinders Medical Centre and Flinders University, Medical Centre and Flinders University, South Australia. South Australia. [email protected] Optic neuritis More than a loss of vision Optic neuritis (ON) is the presence of an acute Background inflammation of the optic nerve that results in painful loss of Optic neuritis is an acute inflammation of the optic nerve that vision. It is the most commonly encountered optic neuropathy results in painful loss of vision. Patients often present to a general in general practice,1–4 and is often associated with multiple practitioner, and early recognition is important as treatment may 3,4 improve the speed of vision recovery. sclerosis (MS). Studies show that in about 15–20% of MS cases, ON was the presenting symptom and more than half of Objective people with MS experience at least one episode of ON during This article provides information on the signs and symptoms of optic their disease.5,6 The risk of developing MS can be stratified by neuritis and discusses appropriate referral, investigations appropriate imaging investigations at the diagnosis of ON. and management. Therefore, early recognition is important to ensure timely Discussion referral, investigation and treatment; prompt treatment can Optic neuritis is the presenting symptom in up to one-fifth of people hasten visual recovery. with multiple sclerosis. Diagnosis of optic neuritis is based on history and examination, therefore obtaining pertinent information Epidemiology and performing proper ophthalmic examination is essential. -
Patchy Scotoma Observed in Chorioretinal Patchy Atrophy of Myopic Macular Degeneration
Retina Patchy Scotoma Observed in Chorioretinal Patchy Atrophy of Myopic Macular Degeneration Jung Lo,1,2 Linda Yi-Chieh Poon,2 Yi-Hao Chen,2 Hsi-Kung Kuo,2 Yung-Jen Chen,2 Wei-Yu Chiang,1,2 and Pei-Chang Wu1,2 1Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan 2Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan Correspondence: Pei-Chang Wu, PURPOSE. To investigate the retinal sensitivity of highly myopic eyes with chorioretinal Department of Ophthalmology, patchy atrophy (PA) using microperimetry. Kaohsiung Chang Gung Memorial Hospital and Chang Gung University METHODS. Fifty-two eyes of 32 patients with high myopia were prospectively included. College of Medicine, Kaohsiung, Twenty-two eyes of 16 patients had PA lesions; eyes without PA were analyzed as controls. Taiwan; Testing points on microperimetry in eyes with PA were designated as 3 zones: zone 1 as [email protected]. the PA lesion including its borders; zone 2 including testing points adjoining PA; zone 3 Received: April 5, 2019 including all other testing points. Accepted: November 15, 2019 RESULTS. In the PA group, the mean retinal sensitivity in zone 1 was 2.1 ± 2.8 dB, zone Published: February 13, 2020 2 = 8.3 ± 4.3 dB, and zone 3 = 9.4 ± 4.1 dB. Sensitivity in zone 1 was significantly Citation: Lo J, Poon LY-C, Chen Y-H, reduced than zones 2 and 3 (P < 0.001). The mean retinal sensitivity in the PA group et al. -
Classification of Visual Field Abnormalities in the Ocular Hypertension Treatment Study
CLINICAL SCIENCES Classification of Visual Field Abnormalities in the Ocular Hypertension Treatment Study John L. Keltner, MD; Chris A. Johnson, PhD; Kimberly E. Cello, BSc; Mary A. Edwards, BSc; Shannan E. Bandermann, MA; Michael A. Kass, MD; Mae O. Gordon, PhD; for the Ocular Hypertension Treatment Study Group Objectives: (1) To develop a classification system for Main Outcome Measures: A 97% interreader hemi- visual field (VF) abnormalities, (2) to determine inter- field agreement. reader and test-retest agreement, and (3) to determine the frequency of various VF defects in the Ocular Hy- Results: The average hemifield classification agree- pertension Treatment Study. ment (between any 2 of 3 readers) for 5018 hemifields was 97% and 88% for the 1266 abnormal VFs that were Methods: Follow-up VFs are performed every 6 months reread (agreement between the first and second and are monitored for abnormality, indicated by a glau- classifications). Glaucomatous patterns of loss (partial coma hemifield test result or a corrected pattern SD arcuate, paracentral, and nasal step defects) composed outside the normal limits. As of January 1, 2002, 1636 the majority of VF defects. patients had 2509 abnormal VFs. Three readers inde- pendently classified each hemifield using a classifica- Conclusion: The Ocular Hypertension Treatment tion system developed at the VF reading center. A Study classification system has high reproducibility and subset (50%) of the abnormal VFs was reread to evalu- provides a possible nomenclature for characterizing VF ate test-retest reader agreement. A mean deviation was defects. calculated separately for the hemifields as an index to the severity of VF loss. -
Mapping the Binocular Scotoma in Macular Degeneration
Journal of Vision (2021) 21(3):9, 1–12 1 Mapping the binocular scotoma in macular degeneration Smith-Kettlewell Eye Research Institute, San Francisco, Cécile Vullings CA, USA Smith-Kettlewell Eye Research Institute, San Francisco, Preeti Verghese CA, USA When the scotoma is binocular in macular degeneration where cortical processes perceptually complete missing (MD), it often obscures objects of interest, causing information by extrapolating the background (Zur & individuals to miss information. To map the binocular Ullman, 2003), although this challenge has not been scotoma as precisely as current methods that map the addressed under binocular viewing and it is unclear monocular scotoma, we propose an iterative eye-tracker how the nature of the stimulus affects this phenomenon method. Study participants included nine individuals (Cohen, Lamarque, Saucet, Provent, Langram, & with MD and four age-matched controls. We measured LeGargasson, 2003). the extent of the monocular scotomata using a scanning The binocular scotoma results from an overlap of the laser ophthalmoscope/optical coherence tomography two monocular scotomata and determines functional (SLO/OCT). Then, we precisely mapped monocular and vision in the real world. The residual vision outside binocular scotomata with an eye tracker, while fixation the scotoma along with factors, such as where it is was monitored. Participants responded whenever they placed with respect to the eccentric fixation locus, detected briefly flashed dots, which were first presented on a coarse grid, and then at manually selected points to determines performance in tasks including eye-hand refine the shape and edges of the scotoma. Monocular coordination (e.g. Verghese, Tyson, Ghahghaei, & scotomata measured in the SLO and eye tracker are Fletcher, 2016), navigation (e.g.