Purpose: To describe clinical visual outcomes, spectacle independence, and patient satisfaction after cataract surgery with blending implantation of ReSTOR (Alcon laboratories) multifocal intraocular lenses. Material and Methods: A single-arm, non-randomized prospective study assessed patients undergoing cataract surgery with ReSTOR® +2.50 intraocular lens in the dominant eye and +3.00 add in the fellow eye between January 2015 to January 2020. Results: In total, 47 patients (94 eyes) were enrolled, 28 women and 19 men. The average age at surgery time was 64 ±8 years, average postoperative follow-up was 45.4 ±7.0 months, with a minimum of 18.9 months. Postoperative binocular uncorrected distance visual acuity (UDVA) was on average 0.07 logMar (Snellen 20/24), uncorrected binocular intermediate visual acuity at 65 cm was 0.07 logMar (20/24), uncorrected binocular near visual acuity at 40 cm was 0.06 logMar (20/23). Contrast sensitivity under photopic and scotopic conditions, with and without glare, remained at the upper limit of normality. 98% of patients were quite satisfied or very satisfied. 87% did not require glasses for any activities, either at distant vision, nor at near vision. Conclusions: Cataract surgery with ReSTOR® IOL blended vision showed medium-term satisfactory visual results, achieving spectacle independence and a high level of satisfaction.

• MeSH
• citlivost na kontrast MeSH
• extrakce katarakty * metody   MeSH
• fakoemulzifikace metody   MeSH
• implantace nitrooční čočky metody   MeSH
• katarakta komplikace   terapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nitrooční čočky MeSH
• prospektivní studie MeSH
• senioři MeSH
• spokojenost pacientů MeSH
• vidění binokulární MeSH
• zraková ostrost MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH

Nearby flanking objects degrade visual resolution. If the flankers are similar to the acuity target, this influence is called crowding (CW), whereas if the flanking stimuli are simple bars then the phenomenon is known as contour interaction (CI). The aim of this study was to compare the influence of the number and position of flankers on foveal CW and CI to investigate possible differences in mechanism of these two effects. Five normal observers viewed single, foveally presented Sloan letters surrounded by 1, 2 or 4 flankers (either a Sloan letter or one-stroke-width bars), presented at several edge-to-edge separations. Single flankers were presented in the right, left, top or bottom position, 2 flankers were placed equally to the right and left or top and bottom of the central target, and 4 flankers were equally spaced in all four directions. Percent correct letter identification was determined for each type, number, position and separation of flankers and confusion matrices were constructed for separations equal to 20% and 100% letter width. Increasing the number of flankers caused an increase in the magnitude of both phenomena. CW showed a greater magnitude than CI for higher numbers of flankers. Analysis of confusion matrices suggests that in addition to the edge-to-edge interaction that appears to mediate CI, letter substitution and feature pooling contribute significantly to CW when higher numbers of flankers are presented. Foveal CW is more strongly influenced by an increase in the number of flankers than CI, which can be explained by the presence of additional interaction effects.

• MeSH
• fovea centralis * MeSH
• lidé MeSH
• nahuštění v prostoru MeSH
• rozpoznávání obrazu MeSH
• vnímání tvaru * MeSH
• zraková ostrost MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Úvod: Autoři posuzovali vývoj nitroočních změn u diabetiků 1. typu (T1DM) od počátku choroby směřující až k diabetologické retinopatii (DR). Motto: „Musí existovat mezistupeň mezi fyziologickým nitroočním nálezem a vlastní diabetickou retinopatií“, (prof. Jan Vavřinec). Metodika: Na Oční klinice Fakultní nemocnice Královské Vinohrady v Praze proběhla dvouletá studie (2018–2019). Jednalo se o 54 nemocných ve věku 17–42 let, detekce T1DM se pohybovala mezi 1. a 14. rokem života, s délkou jeho trvání 12–35 let. Jednotliví pacienti byli vždy vyšetření současně třemi metodami: CS (citlivost na kontrast), SD-OCT (spektrální optická koherenční tomografie) a OCT-A (optická koherenční tomografie – angiografie). Jednorázově a komplexně jsme vyšetřili 106 očí. Výsledky: Prokázali jsme, že existuje mezistupeň mezi fyziologickým nálezem na sítnici a DR, a to tzv. diabetická preretinopatie (DpR). Následné přerozdělení sledovaných do dvou podskupin DpR jsme odvodili od velikosti foveální avaskulární zóny (FAZ), buď s její menší plochou nebo s větší plochou určující mikrovaskularitu centrální části sítnice. K těmto hodnotám byly přiřazeny výsledky obou dalších metod. U SD-OCT byla určena hloubka foveoly (rozdíl mezi centrální tloušťkou sítnice a průměrnou tloušťkou sítnice), která byla ovlivněna zvýšenou kubaturou makulární oblasti. U všech nemocných byla v průměru 10,3 μm3. Sítnice v centrální oblasti byla signifikantně zesílena oproti zdravé populaci na hladině významnosti p ≤ 0,001. Vlastní DpR jsme rozdělili na obraz: DpR1 u 26,5 % očí – stav s průměrně mělčí foveou jen o 21,5 μm pod úrovní okolní sítnice a průměrně užší FAZ: 0,165 mm2 a s výraznějším poklesem CS; DpR2 u 40,5 % očí – stav s průměrně hlubší foveolou o 42 μm, tedy výrazněji a průměrně rozsáhlejší FAZ: 0,325 mm2 s nižším poklesem CS. Současně byly zaznamenány další změny microvaskularity jako jsou poruchy ve smyslu neperfuze v centrální části sítnice různého stupně. Tento nález se významně odlišoval od změn, u již vzniklé (neproliferativní DR) NPDR u 36 % očí, kdy byl zjištěn zásadní pokles CS při normální zrakové ostrosti 4/4 ETDRS. Byly stanoveny statistické rozdíly u CS mezi DpR1 a DpR2 a NPDR: vždy p ≤ 0,001. Průměrná hloubka foveoly byla u NPDR: 29,5 μm. NPDR měla nejrozsáhlejší průměrnou FAZ: 0,56 mm2. Také podstatné byly nejvýraznější změny neperfuze a hlavně přítomnost mikroaneurysmat. Závěr: Tyto tři neinvazní metody napomáhaly sledovat dynamiku vývoje očních změn u T1DM kvalitněji než stanovení zrakové ostrosti a oftalmoskopické vyšetření. Zvýšená kubatura sítnice vyvolala hypoxii světločivých buněk s následným dvojím autoregulačním mechanismem podmiňujícím dva typy diabetické preretinopatie před vznikem DR.

Aim: The authors assessed the development of intraocular changes in type 1 diabetes (T1DM) from the onset of the disease leading to diabetic retinopathy (DR). The quote: “There must be an intermediate stage between the physiological intraocular finding and the diabetic retinopathy itself “, (prof. Jan Vavřinec). Methods: A two-year study (2018 and 2019) was conducted at the Department of Ophthalmology of the Teaching Hospital Kralovske Vinohrady in Prague (Czech Republic). There were 54 patients aged 17–42 years, the detection of T1DM ranged between the 1st and 14th year of life, with a duration of 12–35 years. Individual patients were always examined simultaneously by three methods: CS (contrast sensitivity), SD-OCT (spectral domain optical coherence tomography) and OCT-A (optical coherence tomography-angiography). We examined 106 eyes once and in a comprehensive manner. Results: We have shown that there is an intermediate stage between the physiological finding on the retina and DR, so-called diabetic pre-retinopathy (DpR). Subsequent redistribution of the observed into two DpR subgroups was derived from the size of the FAZ, either with its smaller area or with a larger area determining the microvascularity of the central area of the retina. The results of both other methods were assigned to these values. For SD-OCT, the depth of the fovea (the difference between the central retinal thickness and the total average retinal thickness) was determined, which was affected by the increased the macular cubature. In all patients it was on average 10.3 μm3. The retina in the central area was significantly strengthened compared to the healthy population at the level of significance p ≤ 0,001. We divided the actual DpR into an image: DpR1 in 26.5 % of eyes – condition with an average shallower fovea only by 21.5 μm below the level of the surrounding retina and an average narrower FAZ: 0.165 mm2 and with a more significant decrease in CS; DpR2 in 40.5 % of eyes – condition with average deeper fovea by 42 μm, i.e., more significantly and average larger FAZ: 0.325 mm2 with lower decrease of CS. At the same time, other changes in microvascularity were noted, such as disorders in the sense of non-perfusion in the central part of the retina of various degrees. This finding differed significantly from changes in already established (non-proliferative) NPDR in 36 % of eyes, when a significant decrease in CS with normal visual acuity was found 4/4 ETDRS. Statistical differences in CS between DpR1 and DpR2 and NPDR were determined – always p ≤ 0.001. The average depth of the fovea was NPDR: 29.5 μm. NPDR had the largest average FAZ: 0.56 mm2. Also significant were the most significant changes in non-perfusion and especially the presence of microaneurysms. Conclusions: These three non - invasive methods helped to monitor the dynamics of the development of ocular changes in T1DM of better quality than the determination of visual acuity and ophthalmoscopic examination. Increased retinal volume induced hypoxia of visual cells with subsequent dual autoregulatory mechanism conditioning two types of diabetic pre-retinopathy before the onset of DR.

• MeSH
• citlivost na kontrast MeSH
• diabetes mellitus 1. typu komplikace   MeSH
• diabetická retinopatie * diagnóza   etiologie   patofyziologie   MeSH
• dospělí MeSH
• komplikace diabetu MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• optická koherentní tomografie metody   MeSH
• retrospektivní studie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH

Nearby flanking bars degrade letter identification and resolution, a phenomenon known as contour interaction. However, many previous studies found that the relationship between foveal letter identification and flanker separation is non-monotonic, with an upturn in performance at very small target-to-flanker separations. Here, we replicate this observation and show that a similar upturn occurs also for targets presented at 5 deg in the inferior field, if the target-to-flanker separation is sufficiently small. The presence and magnitude of the observed performance upturn depends on the flanking-bar width, being more evident for narrower compared to wider flanking bars. We interpret our results to indicate that neural interactions between nearby contours reduce performance when the target and flanking bars form discrete neural images. At sufficiently small separations, the images of the target and flanking bars can not be distinguished and performance is governed by the contrast of the target in the blended neural image.

• MeSH
• analýza rozptylu MeSH
• citlivost na kontrast fyziologie   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• nahuštění v prostoru MeSH
• senioři MeSH
• světelná stimulace MeSH
• vnímání tvaru fyziologie   MeSH
• zraková ostrost fyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

• Klíčová slova
• intraokulární rozptyl, optotypy,
• MeSH
• citlivost na kontrast MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• oči - fyziologické jevy * MeSH
• optometrie metody   přístrojové vybavení   MeSH
• ostré světlo MeSH
• senioři MeSH
• statistika jako téma MeSH
• věkové faktory MeSH
• výzkum MeSH
• zraková ostrost * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• senioři MeSH

• Klíčová slova
• ACUVUE, ACUVUE OASYS,
• MeSH
• citlivost na kontrast MeSH
• kontaktní čočky trendy   MeSH
• oči - fyziologické jevy MeSH
• ostré světlo škodlivé účinky   MeSH
• zraková ostrost MeSH
• zrakové testy * MeSH

SIGNIFICANCE: Both foveal and peripheral contour interactions are based on, as yet, unexplained neural mechanisms. Our results show that, unlike foveal contour interaction, peripheral contour interaction cannot be explained on the basis of the antagonistic structure of neural receptive fields. PURPOSE: Foveal contour interaction is markedly reduced for mesopic compared with photopic targets. This finding is consistent with an explanation based on the antagonistic structure of neural receptive fields. However, no reduction was found for low-luminance targets in the periphery, possibly because the luminances used previously remained substantially above peripheral scotopic detection thresholds. In this study, we compared foveal and peripheral contour interactions for long-wavelength photopic and mesopic targets, which would be expected to significantly elevate the peripheral retinal detection threshold. METHODS: Five normal observers viewed a randomly selected Sloan letter surrounded by four flanking bars at several edge-to-edge separations (min arc). Photopic and mesopic stimuli were viewed foveally and at 6° peripherally through a selective red filter that ensured that mesopic targets were within 1 log unit of detection threshold at both retinal locations. RESULTS: Whereas the magnitude of foveal contour interaction was substantially less at mesopic compared with photopic luminance (20 vs. 46% reduction of percent correct, on average), no significant difference was observed in peripheral contour interaction, which had average mesopic and photopic magnitudes of 38 and 40%. Moreover, confusion matrices representing photopic and mesopic contour interaction differed in the fovea but not in the periphery. The extent of contour interaction did not change with luminance at either retinal location. CONCLUSIONS: Our results indicate that, although the characteristics of foveal contour interaction can be accounted for by the antagonistic structure of neural receptive fields, the same mechanism is not compatible with the characteristics of peripheral contour interaction.

• MeSH
• dospělí MeSH
• fovea centralis fyziologie   MeSH
• lidé MeSH
• senzorické prahy fyziologie   MeSH
• světlo MeSH
• vidění barevné fyziologie   MeSH
• vnímání tvaru fyziologie   MeSH
• zraková pole fyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH

SIGNIFICANCE: Contour interaction describes an impairment of visual acuity produced by nearby flanking features, which exerts a significant impact in many clinical tests of visual acuity. Our results indicate that the magnitude of interaction depends either on the flanker contrast energy (i.e., the product of flanker contrast and width) or the flanker contrast alone, depending on the contrast energy of the flankers. PURPOSE: The discrimination of acuity targets is impaired by the presence of nearby flanking contours, a phenomenon known as contour interaction. METHODS: In this study, we measured percent correct identification for threshold size, high-contrast Sloan letters at the fovea and at 5° in the inferior visual field for different combinations of flanking-bar width, and Weber contrast corresponding to specific fixed values of contrast energy (width × contrast, in %-min arc). RESULTS: For flanking bars with low-contrast energy, contour interaction exhibited no systematic dependence on the flanking-bar width. However, when the flanking bars had higher contrast energy, narrower high-contrast bars produced significantly greater contour interaction than wider bars of lower contrast. CONCLUSIONS: The results are consistent with the interpretation that contour interaction depends primarily on the contrast energy of flanking contours when their contrast energy is low. As the contrast energy of the flanking contours increases, the magnitude of contour interaction depends on the flanker contrast. For high-contrast flanking contours, the magnitude of contour interaction saturates when the width of the flanking contours is approximately 20% of letter size.

• MeSH
• citlivost na kontrast fyziologie   MeSH
• dospělí MeSH
• fovea centralis MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• vnímání tvaru fyziologie   MeSH
• zraková ostrost fyziologie   MeSH
• zraková pole fyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

• MeSH
• lidé MeSH
• ortodontisté MeSH
• percepce MeSH
• včely MeSH
• vnímání tvaru MeSH
• Check Tag
• lidé MeSH

PURPOSE: To compare the visual and refractive outcomes obtained with the implantation of a rotationally asymmetric refractive multifocal IOL after femtosecond laser-assisted cataract surgery (FLACS) and conventional lens extraction (CLE). METHODS: A total of 78 eyes of 58 patients that had undergone conventional phacoemulsification (36 eyes, CLE group) or FLACS (37 eyes, FLACS group) with the implantation of the toric multifocal IOL LU-313 MF30T (Oculentis, Germany) were enrolled in this retrospective study. Mean age was 57.0 years at the time of surgery, ranging from 44 to 69 years. Visual and refractive outcomes were evaluated during a 12-month follow-up. Likewise, contrast sensitivity was assessed at the end of the follow-up. RESULTS: Significant improvements were observed in both groups in uncorrected distance (UDVA) and near visual acuity (UNVA) at 1 month postoperatively (p < 0.001). Differences between groups in these parameters as well as in sphere and cylinder did not reach statistical significance during the whole follow-up (p ≥ 0.079), except for UNVA only at 12 months postoperatively (p = 0.018). Concerning corrected near visual acuity, only significant differences between groups were found preoperatively (p = 0.020). Furthermore, only a minimal but significant difference between groups was found at 12 months postoperatively in contrast sensitivity for the spatial frequency of 18 cycles/° (p = 0.029). CONCLUSIONS: The rotationally asymmetric toric multifocal IOL LU-313 MF 30T provides good visual rehabilitation for near and distance vision after presbyopic lens extraction in eyes with preexisting astigmatism, independently whether the cataract surgery is performed with the FLACS or conventional technique.

• MeSH
• citlivost na kontrast MeSH
• dospělí MeSH
• fakoemulzifikace * metody   MeSH
• implantace nitrooční čočky * MeSH
• lidé středního věku MeSH
• lidé MeSH
• multifokální intraokulární čočky * MeSH
• refrakce oka * MeSH
• retrospektivní studie MeSH
• senioři MeSH
• zraková ostrost MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH