Patients with Low vision are known to experience difficulties in executing activities of daily living and visual search due to reduction in vision. There is a need to translate clinical parameters into a real world that is relevant so as to understand the patient's functional vision; this can be possible with virtual reality (VR). This prospective study included 53 normal and 30 low vision subjects older than 18 years of age in a tertiary care center. The low vision subjects were further classified into peripheral field loss (PFL) and central field loss (CFL). A VR bank environment was developed with multiple tasks that aimed at assessing reading for distance and near, identification of objects against various contrast levels and mobility. Based on the normative data obtained a scoring system was developed to quantify the visual performance between normal and low vision subjects. A significant difference was found in the performance between the normal and low vision subjects in the VR environment. The overall VR performance score was lower in subjects with PFL 56.65 (IQR 19.4) than CFL 63.25 (IQR 10.83); however, both of them were lower compared with normal subjects 87 (IQR 4.6) p < 0.001. These findings suggest that performance of low vision subjects was worse than normal subjects in VR environment and it is important to plan and prioritize assessment and rehabilitation interventions for low vision subjects with a more holistic performance based approach.
Purpose: To evaluate affected choroidal regions and corresponding retinal changes in acute and recurrent central serous chorioretinopathy using swept-source optical coherence tomography. Methods: The foveal and subfoveal choroidal thicknesses were measured with swept-source optical coherence tomography. The retina was divided into five zones on the swept-source optical coherence tomography image based on baseline choroidal thickness being <100, 100–199, 200–299, 300–399 and ⩾400 μm. The retinal and choroidal thicknesses in the same five regions were evaluated during follow-up. The measurements were then compared between baseline (when central serous chorioretinopathy was active) and follow-up (after complete resolution of disease). Results: At baseline, in the acute group, the mean outer retinal layer thickness was significantly higher in areas with thicker choroid and lower in areas with thinner choroid. No such change was noticed in the recurrent group. In the acute group, the overall retinal thickness from baseline to follow-up decreased from 269.84 to 251.9 µm, ganglion cell layer thickness decreased from 107.14 to 101.28 µm, retinal nerve fibre layer thickness decreased from 56.96 to 49.33 µm, and no significant difference was noted in choroidal thickness. In the recurrent group, choroidal thickness significantly increased from 254.58 to 262.55 µm and ganglion cell layer decreased from 103.43 to 94.01 µm. No significant difference was noted in overall retina and retinal nerve fibre layer. Reduction in choroidal and retinal layer thicknesses was better in eyes which underwent laser treatment than the observation group. Conclusion: Swept-source optical coherence tomography might serve as an important non-invasive tool for both evaluating the extent of pathology and to predict the recurrence rate.
Background: To compare vision-related quality of life (VRQOL) between acute and chronic Central serous chorioretinopathy (CSC) and correlate this with Cohen's Perceived Stress Scale (PSS) questionnaire. Methods: Patients who were diagnosed with both acute and chronic CSC were recruited in this study. Visionrelated quality of life (VRQOL) was assessed with Rasch revised National Eye Institute Visual Functioning Questionnaire 25 (NEI-VFQ25) and perceived stress with Cohen's PSS questionnaire in 118 subjects with either acute or chronic CSC. The quality of life score was compared between patients with acute and chronic CSC. Correlations between the functional score and visual acuity (VA), stage of CSC, and stress were studied. Results: There was no significant difference in VRQOL between Acute and Chronic CSC. In Acute CSC, affected eye VA correlated significantly with near vision question of the visual function subscale. Better eye VA correlated significantly with distance vision, social function, role limitation and dependency of the socioeconomic subscale. In chronic CSC, affected eye VA correlated with social function question of the socioemotional subscale and the better eye VA correlated with driving and distance vision of the visual function subscale. No other significant correlations with VA were noted. No correlations were observed between outcome of Cohen's PSS questionnaire and NEI-VFQ25 scores of acute and chronic CSC. Conclusion: The VRQOL is similar between acute and chronic CSC. Perceived stress was not found to influence the VRQOL in CSC.
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