Disk halo size measured in individuals with monofocal versus diffractive multifocal intraocular lenses

PURPOSE: To compare disk halo size in response to a glare source in eyes with an aspheric apodized diffractive multifocal intraocular lens (IOL) or aspheric monofocal IOL. SETTING: Rementeria Ophthalmological Clinic, Madrid, Spain. DESIGN: Prospective randomized masked study. METHOD: Halo radius was measured using a vision monitor (MonCv3) with low-luminance optotypes in eyes that had cataract surgery and bilateral implantion of an Acrysof Restor SN6AD1 multifocal IOL or Acrysof IQ monofocal IOL 6 to 9 months previously. The visual angle subtended by the disk halo radius was calculated in minutes of arc (arcmin). Patient complaints of halo disturbances were recorded. Monocular uncorrected distance visual acutity (UDVA) and corrected distance visual acuity (CDVA) were measured using high-contrast (96%) and low-contrast (10%) logMAR letter charts. RESULTS: The study comprised 39 eyes of 39 subjects (aged 70 to 80 years); 21 eyes had a multifocal IOL and 18 eyes a monofocal IOL. The mean halo radius was 35 arcmin larger in the multifocal IOL group than the monofocal group (P<.05). Greater halo effects were reported in the multifocal IOL group (P<.05). The mean monocular high-contrast UDVA and low-contrast UDVA did not vary significantly between groups, whereas the mean monocular high-contrast CDVA and low-contrast CDVA were significantly worse at 0.12 logMAR and 0.13 logMAR in the multifocal than in the monofocal IOL group, respectively (P <.01). A significant positive correlation was detected by multiple linear regression between the halo radius and low-contrast UDVA in the multifocal IOL group (r = 0.72, P<.001). CONCLUSIONS: The diffractive multifocal IOL gave rise to a larger disk halo size, which was correlated with a worse low-contrast UDVA.

A model for the time-order error in contrast discrimination.

Trials in a temporal two-interval forced-choice discrimination experiment consist of two sequential intervals presenting stimuli that differ from one another as to magnitude along some continuum. The observer must report in which interval the stimulus had a larger magnitude. The standard difference model from signal detection theory analyses poses that order of presentation should not affect the results of the comparison, something known as the balance condition (J.-C. Falmagne, 1985, in Elements of Psychophysical Theory). But empirical data prove otherwise and consistently reveal what Fechner (1860/1966, in Elements of Psychophysics) called time-order errors, whereby the magnitude of the stimulus presented in one of the intervals is systematically underestimated relative to the other. Here we discuss sensory factors (temporary desensitization) and procedural glitches (short interstimulus or intertrial intervals and response bias) that might explain the time-order error, and we derive a formal model indicating how these factors make observed performance vary with presentation order despite a single underlying mechanism. Experimental results are also presented illustrating the conventional failure of the balance condition and testing the hypothesis that time-order errors result from contamination by the factors included in the model.

Fixed vs. variable noise in 2AFC contrast discrimination: lessons from psychometric functions.

Recent discussion regarding whether the noise that limits 2AFC discrimination performance is fixed or variable has focused either on describing experimental methods that presumably dissociate the effects of response mean and variance or on reanalyzing a published data set with the aim of determining how to solve the question through goodness-of-fit statistics. This paper illustrates that the question cannot be solved by fitting models to data and assessing goodness-of-fit because data on detection and discrimination performance can be indistinguishably fitted by models that assume either type of noise when each is coupled with a convenient form for the transducer function. Thus, success or failure at fitting a transducer model merely illustrates the capability (or lack thereof) of some particular combination of transducer function and variance function to account for the data, but it cannot disclose the nature of the noise. We also comment on some of the issues that have been raised in recent exchange on the topic, namely, the existence of additional constraints for the models, the presence of asymmetric asymptotes, the likelihood of history-dependent noise, and the potential of certain experimental methods to dissociate the effects of response mean and variance.

The transducer model for contrast detection and discrimination: formal relations, implications, and an empirical test.

The transducer function mu for contrast perception describes the nonlinear mapping of stimulus contrast onto an internal response. Under a signal detection theory approach, the transducer model of contrast perception states that the internal response elicited by a stimulus of contrast c is a random variable with mean mu(c). Using this approach, we derive the formal relations between the transducer function, the threshold-versus-contrast (TvC) function, and the psychometric functions for contrast detection and discrimination in 2AFC tasks. We show that the mathematical form of the TvC function is determined only by mu, and that the psychometric functions for detection and discrimination have a common mathematical form with common parameters emanating from, and only from, the transducer function mu and the form of the distribution of the internal responses. We discuss the theoretical and practical implications of these relations, which have bearings on the tenability of certain mathematical forms for the psychometric function and on the suitability of empirical approaches to model validation. We also present the results of a comprehensive test of these relations using two alternative forms of the transducer model: a three-parameter version that renders logistic psychometric functions and a five-parameter version using Foley's variant of the Naka-Rushton equation as transducer function. Our results support the validity of the formal relations implied by the general transducer model, and the two versions that were contrasted account for our data equally well.

Contrast sensitivity evaluation with filter contact lenses in patients with retinitis pigmentosa: a pilot study

Purpose: the aim of this pilot study was to test whether retinitis pigmentosa patients would benefit from filter contact lenses as an effective optical aid against glare and photophobia. Methods: fifteen subjects with retinitis pigmentosa were enrolled in this study. All of them were evaluated with filter soft contact lenses (MaxSight), filter glasses (CPF 527) and without filters (control). All patients were assessed for the three aid conditions by means of best corrected visual acuity (BCVA), contrast sensitivity (without glare and with central and peripheral glare)(CSV-1000) and a specific subjective questionnaire about quality of vision. Results: BCVA was slightly better with filters than without filter but the differences were not statistically significant. Contrast sensitivity without glare improved significantly with the contact lenses (p<0.05). The central glare had significant differences for the frequencies of 3 cpd and 18 cpd between the contact lens filter and the control group (p=0.021 and p=0.044, respectively). For the peripheral glare contrast sensitivity improved with contact lens versus control group for highest frequencies, 12 and 18 cpd (p<0.001 and p=0.045, respectively). According to the questionnaire the contact lens filter gave them more visual comfort than the glasses filter under the scenarios of indoors glare, outdoors activities and indoors comfort. Conclusion: the filter contact lenses seem to be a good option to improve the quality of vision of patients with retinitis pigmentosa.

Impaired Mesopic Visual Acuity in Eyes with Early Age-Related Macular Degeneration

Purpose.: To determine photopic and mesopic distance high-contrast visual acuity (HC-VA) and low-contrast visual acuity (LC-VA) in eyes with early age-related macular degeneration (AMD). Methods.: Measurements were made in 22 subjects with early AMD and 28 healthy control subjects. Inclusion criteria included a photopic HC-VA of 20/25 or better. Distance VA was measured using HC (96%) and LC (10%) Bailey-Lovie logMAR letter charts under photopic (85 cd/m2) and mesopic (0.1–0.2 cd/m2) luminance conditions. Results.: Mean mesopic distance HC-VA and LC-VA were significantly worse (0.1 logMAR and 0.28 logMAR, respectively) in the early AMD group than in the control group. Under mesopic conditions, the mean difference between LC-VA and HC-VA was significantly greater in the early AMD (0.45 logMAR) than the control group (0.27 logMAR). Mean differences between mesopic versus photopic HC-VA and mesopic versus photopic LC-VA were significantly greater in the early AMD than the control group (0.13 and 0.32 logMAR of difference between the means, respectively). Sensitivity and specificity were significantly greater for mesopic LC-VA than for mesopic HC-VA (Receiver Operating Characteristics, area under the curve [AUC], 0.94 ± 0.030 and 0.76 ± 0.067, respectively). AUC values for photopic HC-VA and LC-VA were below 0.70. Conclusions.: Visual acuity testing under low luminance conditions emerged as an optimal quantitative measure of retinal function in early AMD.