PURPOSE: A recent study suggested that updated spectacles could increase fall rate in frail older people. The authors hypothesized that the increased risk may be due to changes in spectacle magnification. The present study was conducted to assess the effects of spectacle magnification on step negotiation. METHODS: Adaptive gait and visual function were measured in 10 older adults (mean age, 77.1 +/- 4.3 years) with the participants' optimal refractive correction and when blurred with +1.00, +2.00, -1.00, and -2.00 DS lenses. Adaptive gait measurements for the leading and trailing foot included foot position before the step, toe clearance of the step edge, and foot position on the step. Vision measurements included visual acuity, contrast sensitivity, and stereoacuity. RESULTS: The blur lenses led to equal decrements in visual acuity and stereoacuity for the +1.00 and -1.00 DS and the +2.00 and -2.00 DS lenses. However, they had very different effects on step negotiation compared with the optimal correction. Positive-blur lenses led to an increased distance of the feet from the step, increased vertical toe clearance and reduced distance of the leading heel position on the step. Negative lenses led to the opposite of these changes. CONCLUSIONS: The step negotiation changes did not mirror the effects of blur on vision, but were driven by the magnification changes of the lenses. Steps appear closer and larger with positive lenses and farther away and smaller with negative ones. Magnification is a likely explanation of the mobility problems some older adults have with updated spectacles and after cataract surgery.

PURPOSE: To examine foveal structure in amblyopia using spectral-domain optical coherence tomography (SD-OCT). DESIGN: Prospective, cross-sectional study. PARTICIPANTS AND CONTROLS: Two subject groups were recruited to the study: 85 amblyopes (34 adults, 51 children) and 110 visually normal controls (44 adults, 66 children). METHODS: A detailed eye examination, including an SD-OCT scan, was performed in all participants. A total of 390 eyes of 195 subjects were imaged using a 3-dimensional (3D) macula scan covering a nominal 6 x 6-mm area with a resolution of 256 x 256 (65,536 axial scans). Data from the B-scans bisecting the fovea both horizontally and vertically were fitted with a mathematical model of the fovea to determine a range of foveal parameters. MAIN OUTCOME MEASURES: Foveal thickness, foveal pit depth, and foveal pit slope. RESULTS: Bilateral differences between the eyes of amblyopes compared with visually normal controls were found. The difference between foveal structure in amblyopic participants relative to structure in subjects with normal vision persisted even when variables such as age, ethnicity, axial length, and sex were taken into account. Amblyopes showed increased foveal thickness (+8.31 mum; P = 0.006) and a reduction in pit depth in the horizontal meridian (-10.06 mum; P = 0.005) but not in the vertical meridian (P = 0.082) when compared with subjects with normal vision. Foveal pit slopes were found to be approximately 1 degree flatter in the nasal (P = 0.033) and temporal (P = 0.014) meridians in amblyopes, but differences between amblyopes and controls in the superior (P = 0.061) and inferior (P = 0.087) meridians did not reach statistical significance. No statistically significant interocular differences were found in the foveal structure between amblyopic and fellow eyes. CONCLUSIONS: Differences were found in the foveal structure in both eyes of amblyopes compared with subjects with normal vision. These differences consisted of increased foveal thickness, reduced pit depth when measured along the horizontal meridian, and flattening of the nasal and temporal sides of the foveal pit.

Objetivos: determinar a acuidade visual de resolução de grades (AV) durante o primeiro ano de vida por meio dos registros dos potenciais visuais evocados de varredura em grupos de crianças nascidas prematuramente (RNPT) e a termo (RNT); comparar os valores finais da AV no grupo RNPT em relação à idade gestacional e ao desenvolvimento neuropsicomotor e comparar as curvas de desenvolvimento visual entre os grupos RNPT e RNT. Casuística e métodos: Estudo realizado em 25 RNT e 36 RNPT acompanhados em ambulatório e submetidos a avaliações oftalmológica e neuropediátrica. O grupo RNPT foi dividido em subgrupos com relação a idade gestacional e desenvolvimento neuropsicomotor. Para a medida da AV foi utilizado o aplicativo NuDIVA (\"Digital Infant Visual Assessment\") calculando-se a AV em logaritmo do mínimo ângulo de resolução (logMAR) através de curva de regressão linear, relacionando-se a amplitude do potencial do segundo harmônico à freqüência espacial linear. Na análise estatística utilizou-se método de Fischer, teste t, análise de variância (ANOVA) e teste para comparação entre retas de regressão linear simples. O nível de significância foi fixado em 0,05. Resultados: Estrabismo foi detectado em cinco crianças, todas do grupo RNPT, quatro delas com alteração neurológica (p=0,07). Erros de refração com necessidade de prescrição óptica foi encontrado em seis crianças, todas do grupo RNPT (p=0,07). A medida da AV foi obtida com sucesso em 96,4% dos casos, sendo ao final do primeiro ano de vida significativamente inferior nos RNPT com alteração neurológica (p<0,05). A medida da AV estimada ao nascimento foi maior em todos os RNPT com relação aos RNT (p<0,05) porém a velocidade de aquisição da AV foi maior no grupo RNT (p<0,05). Conclusões: A AV pôde ser facilmente determinada durante o primeiro ano de vida tanto em RNPT quanto em RNT sendo seus valores semelhantes, com exceção dos RNPT que apresentaram alteração neurológica. Todos os RNPT apresentaram desenvolvimento visual semelhante, porém, significativamente inferior ao encontrado para os RNT / Purpose: Determine the grating visual acuity (VA) of a group of preterm infants using sweep visual evoked potentials (sweep-VEP). Compare the development of VA of these infants to that of normal full-term infants, with respect to: gestational age, neuropsychomotor development and visual development. Methods: The study was conducted on 25 preterm and 36 full-term infants, with follow-up ophthalmologic and neuropediatric evaluations. The preterm infants were divided into subgroups in accordance with their gestational age and neurological development. VA was assessed using the Digital Infant Visual Assessment (NuDiva) sweep-VEP system, expressed in logMAR, and threshold grating acuities were estimated using the VEP second harmonic amplitudes, determined by a linear regression line drawn through the highest spatial frequency peak and the spatial frequency at which signal amplitude reaches the noise level. Statistical analysis was performed using the Fisher, Student-t test, analysis of variance (ANOVA) and comparison by simple linear regression test between the two groups. The significance level was 0.05. Results: Strabismus was detected in five preterm infants; four of these had neurological alterations (p=0.07). Prescription for refractive errors was necessary in six preterm infants (p=0.07). Grating VA was assessable in 96.4% of the infants; preterm infants with neurological alterations had significantly lower grating VA (p<0.05) at the end of the first year. Early VA scores were higher in all of the preterm infants compared to the full term infants (p<0,05) but at the end of the first year of life the VA was improving at a higher rate in the full term group (p<0.05)

Objetivos: determinar a acuidade visual de resolução de grades (AV) durante o primeiro ano de vida por meio dos registros dos potenciais visuais evocados de varredura em grupos de crianças nascidas prematuramente (RNPT) e a termo (RNT); comparar os valores finais da AV no grupo RNPT em relação à idade gestacional e ao desenvolvimento neuropsicomotor e comparar as curvas de desenvolvimento visual entre os grupos RNPT e RNT. Casuística e métodos: Estudo realizado em 25 RNT e 36 RNPT acompanhados em ambulatório e submetidos a avaliações oftalmológica e neuropediátrica. O grupo RNPT foi dividido em subgrupos com relação a idade gestacional e desenvolvimento neuropsicomotor. Para a medida da AV foi utilizado o aplicativo NuDIVA (\"Digital Infant Visual Assessment\") calculando-se a AV em logaritmo do mínimo ângulo de resolução (logMAR) através de curva de regressão linear, relacionando-se a amplitude do potencial do segundo harmônico à freqüência espacial linear. Na análise estatística utilizou-se método de Fischer, teste t, análise de variância (ANOVA) e teste para comparação entre retas de regressão linear simples. O nível de significância foi fixado em 0,05. Resultados: Estrabismo foi detectado em cinco crianças, todas do grupo RNPT, quatro delas com alteração neurológica (p=0,07). Erros de refração com necessidade de prescrição óptica foi encontrado em seis crianças, todas do grupo RNPT (p=0,07). A medida da AV foi obtida com sucesso em 96,4% dos casos, sendo ao final do primeiro ano de vida significativamente inferior nos RNPT com alteração neurológica (p<0,05). A medida da AV estimada ao nascimento foi maior em todos os RNPT com relação aos RNT (p<0,05) porém a velocidade de aquisição da AV foi maior no grupo RNT (p<0,05). Conclusões: A AV pôde ser facilmente determinada durante o primeiro ano de vida tanto em RNPT quanto em RNT sendo seus valores semelhantes, com exceção dos RNPT que apresentaram alteração neurológica. Todos os RNPT apresentaram desenvolvimento visual semelhante, porém, significativamente inferior ao encontrado para os RNT / Purpose: Determine the grating visual acuity (VA) of a group of preterm infants using sweep visual evoked potentials (sweep-VEP). Compare the development of VA of these infants to that of normal full-term infants, with respect to: gestational age, neuropsychomotor development and visual development. Methods: The study was conducted on 25 preterm and 36 full-term infants, with follow-up ophthalmologic and neuropediatric evaluations. The preterm infants were divided into subgroups in accordance with their gestational age and neurological development. VA was assessed using the Digital Infant Visual Assessment (NuDiva) sweep-VEP system, expressed in logMAR, and threshold grating acuities were estimated using the VEP second harmonic amplitudes, determined by a linear regression line drawn through the highest spatial frequency peak and the spatial frequency at which signal amplitude reaches the noise level. Statistical analysis was performed using the Fisher, Student-t test, analysis of variance (ANOVA) and comparison by simple linear regression test between the two groups. The significance level was 0.05. Results: Strabismus was detected in five preterm infants; four of these had neurological alterations (p=0.07). Prescription for refractive errors was necessary in six preterm infants (p=0.07). Grating VA was assessable in 96.4% of the infants; preterm infants with neurological alterations had significantly lower grating VA (p<0.05) at the end of the first year. Early VA scores were higher in all of the preterm infants compared to the full term infants (p<0,05) but at the end of the first year of life the VA was improving at a higher rate in the full term group (p<0.05)