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Bayesian optimization (BO) is commonly used to optimize the hyperparameters of transfer learning models to improve the model’s performance significantly. In BO, the acquisition functions direct the hyperparameter space exploration during the optimization. However, the computational cost of evaluating the acquisition function and updating the surrogate model can become prohibitively expensive due to increasing dimensionality, making it more challenging to achieve the global optimum, particularly in image classification tasks. Therefore, this study investigates and analyses the effect of incorporating metaheuristic methods into BO to improve the performance of acquisition functions in transfer learning. By incorporating four different metaheuristic methods, namely Particle Swarm Optimization (PSO), Artificial Bee Colony (ABC) Optimization, Harris Hawks Optimization, and Sailfish Optimization (SFO), the performance of acquisition function, Expected Improvement (EI), was observed in the VGGNet models for visual field defect multi-class classification. Other than EI, comparative observations were also conducted using different acquisition functions, such as Probability Improvement (PI), Upper Confidence Bound (UCB), and Lower Confidence Bound (LCB). The analysis demonstrates that SFO significantly enhanced BO optimization by increasing mean accuracy by 9.6% for VGG-16 and 27.54% for VGG-19. As a result, the best validation accuracy obtained for VGG-16 and VGG-19 is 98.6% and 98.34%, respectively.

To report non-organic visual loss (NOVL) following cataract surgery with multifocal intraocular lens (IOL) implantation. After reviewing consecutive cases of NOVL diagnosed by a single neuro-ophthalmologist over a one year period, two patients reported herein attributed their visual symptoms to cataract surgery and multifocal IOL implantation. In both patients variability was noted in visual function and kinetic perimetry demonstrated non-organic visual field loss. Initially, refractive surgeons considered lens exchange, which was avoided after neuro-ophthalmic evaluation in both cases. This report should alert cataract and refractive surgeons to the possibility of NOVL as an explanation for dissatisfaction after cataract surgery with multifocal IOL implantation.

Background/Objectives: The imo Vifa® is reportedly useful for diagnosing functional visual field loss; however, its potential for detecting malingering is unclear. Here, we intentionally simulated monocular visual field defects under bilateral randomized visual field testing conditions using the imo Vifa® in healthy participants and compared their resulting defect phenotypes. Methods: Twenty participants (mean age, 37.3 ± 12.4 years; 12 orthoptists, 1 physician, and 7 administrative staff members) without ocular disease were enrolled. Four types of monocular visual field defects were simulated: right eye nasal hemianopia, left eye temporal hemianopia, right eye centripetal visual field constriction, and left eye central scotoma. Bilateral randomized visual field testing was performed using the AIZE-rapid mode with the 24-2 and 24plus(1) programs. Results: Accurate simulation of the intended defects was challenging. Orthoptists produced left homonymous hemianopia for right nasal hemianopia and left temporal hemianopia. Regarding right nasal hemianopia, many office workers generated patterns resembling right homonymous hemianopia-like, whereas for left temporal hemianopia, noncertified orthoptists produced patterns similar to those of left homonymous hemianopia-like. Considering the right centripetal constriction, all orthoptists produced the intended centripetal constriction, whereas non-orthoptists generated right homonymous hemianopia-like or patchy patterns. Orthoptists produced central scotomas or patchy patterns for the left central scotoma, whereas non-orthoptists generated left homonymous hemianopia-like patterns. Conclusions: Creating targeted monocular abnormalities during bilateral randomized visual field testing was challenging. Differences in the participants’ understanding of visual field testing influenced the resulting patterns. In future research, having participants create monocular visual field defects under occlusion conditions would be necessary.

PurposeAccurate objective assessment of visual acuity is crucial, particularly in cases of suspected malingering, or when the patient’s inability to cooperate makes standard psychophysical acuity tests unreliable. The P300 component of the event-related potentials offers a potential solution and even allows for the use of standard optotypes like the Landolt C. However, low-vision patients with large eccentric visual field defects often struggle to locate the Landolt C gap quickly enough for a P300 to be reliably produced.MethodsAddressing this challenge, we introduce a novel optotype (the “FreiBurger”) with a critical detail that extends through the optotype’s center. Two experiments, with 16 and 12 participants, respectively, were conducted. In the first, psychophysical acuity estimates were obtained with both the FreiBurger and the Landolt C. In the second, we tested the performance of the FreiBurger, relative to the Landolt C, in eliciting a P300 with undegraded vision, simulated low vision, and in a simulated combination of low vision and visual field constriction.ResultsComparable psychophysical acuity values (average difference 0.03 logMAR) were obtained for both optotypes. In the P300 recordings, both optotypes produced similar P300 responses under conditions of undegraded vision and low vision. However, with the combination of low vision and constricted visual field, the P300 could only be reliably obtained with the FreiBurger, while the amplitude was drastically reduced with the Landolt C (9.1 µV vs. 2.2 µV; p < 0.0005).ConclusionThe new optotype extends the applicability of P300-based acuity estimation to the frequently encountered combination of low vision and constricted visual field, where Landolt C optotypes fail. Although impairments were simulated in the present study, we assume that the advantages of the new optotype will also manifest in patients with such impairments. We furthermore expect the advantages to apply to time-sensitive psychophysical examinations as well.

Purpose: Glaucoma influences vision-related quality of life (VRQoL) of an individual in various ways. There are very limited studies on the Indian population and the northern part of India. Therefore, we conducted the present study to evaluate VRQoL in glaucoma patients as well as the association between the severity of glaucoma and VRQoL. Methods: An institution-based, cross-sectional, analytical study was conducted from August 2022 to October 2022 involving 190 participants (95 glaucoma patients and 95 controls). The glaucoma quality of life-15 (GQL-15) questionnaire was explained in their vernacular language by the interviewer. The scoring was given according to the validated scoring algorithm for the questionnaire. Results: Mean GQL score in the control group was 19.66 ± 5.5 and in glaucoma cases was 32.8 ± 10.2, whereas the mean score of mild glaucoma cases was 22.3 ± 4.83, moderate glaucoma cases was 36.3 ± 4.09, and severe glaucoma cases was 47.24 ± 3.03. Therefore, as the severity of glaucoma increases, the GQL score also increases, indicating poorer quality of life. Visual field loss was strongly positively correlated (correlation coefficient = 0.759, P < 0.01) with the GQL-15 score, while a weaker positive correlation was found with best corrected visual acuity (BCVA), cup disc ratio, and duration of treatment. Conclusion: Besides controlling or reducing intraocular pressure (IOP) to the target level, the goal of glaucoma treatment should be to provide an individual with good functional vision to maintain an acceptable quality of life. It would also help in providing patients with the best possible treatment, not only in terms of good vision but also in maintaining or improving their overall quality of life.

BackgroundTo quantify the degree of ganglion cell degeneration through spectral domain optical coherence tomography (SD-OCT) in adult patients with post-stroke homonymous visual field defect.MethodsFifty patients with acquired visual field defect due to stroke (mean age = 61 years) and thirty healthy controls (mean age = 58 years) were included. Mean deviation (MD) and pattern standard deviation (PSD), average peripapillary retinal nerve fibre layer thickness (pRNLF-AVG), average ganglion cell complex thickness (GCC-AVG), global loss volume (GLV) and focal loss volume (FLV) were measured. Patients were divided according to the damaged vascular territories (occipital vs. parieto-occipital) and stroke type (ischaemic vs. haemorrhagic). Group analysis was conducted with ANOVA and multiple regressions.ResultspRNFL-AVG was significantly decreased among patients with lesions in parieto-occipital territories compared to controls and to patients with lesions in occipital territories (p = .04), with no differences with respect to stroke type. GCC-AVG, GLV and FLV differed in stroke patients and controls, regardless of stroke type and involved vascular territories. Age and elapsed time from stroke had a significant effect on pRNFL-AVG and GCC-AVG (p < .01), but not on MD and PSD.ConclusionsReduction of SD-OCT parameters occurs following both ischaemic and haemorrhagic occipital stroke, but it is larger when the injury extends to parietal territories and increases as time since stroke increases. The size of visual field defect is unrelated to SD-OCT measurements. Macular GCC thinning appeared to be more sensitive than pRNFL in detecting retrograde retinal ganglion cell degeneration and its retinotopic pattern in stroke.

PurposeTo evaluate the relationship between the 24-h variability of blood pressure (BP), ocular perfusion pressure (OPP), intraocular pressure (IOP), and visual field (VF) defect in thyroid-associated orbitopathy (TAO).MethodsThirty patients (60 eyes) with TAO were clinically examined in the Eye Hospital of Wenzhou Medical University. Patients were divided into two groups: one with VF defect (A) and the other without (B). Clinical parameters measured include 24-h IOP, 24-h blood pressure, orbital computed tomography (CT) scan, optical coherence tomography (OCT), and VFs. The pulse pressure (PP), mean arterial pressure (MAP), mean ocular perfusion pressure (MOPP), and 24-h fluctuations were calculated by formula.ResultsThe MOPP and MAP fluctuation were greater in group A than B (p < 0.05) and had significant negative correlation to mean deviation (MD) of VF (R = − 0.434 P = 0.001*). There was no statistical difference in the muscle index, medial rectus muscle thickness, and blood pressure between two groups. Although there were no significant differences in the mean IOP and IOP fluctuation between two groups, the incidence of IOP abnormalities has higher trend in group A. Patients with 24-h IOP fluctuation ≥8 mmHg and the mean IOP > 21 mmHg in the group A were more than group B.ConclusionsDysthyroid optic neuropathy (DON) might have multiple pathogenic mechanisms. In this study, 24-h MOPP fluctuation and medial rectus maximal diameter were all the risk factors for DON. Higher mean IOP and 24-h IOP fluctuation might be risk factors for DON.

This study aimed to characterize the clinical presentation, ophthalmologic findings, and final diagnoses of patients with primary intracranial mass lesions who initially presented with visual symptoms. We conducted a retrospective observational case series at the Neuro-ophthalmology Department of Chi Mei Medical Center, Taiwan, analyzing adult patients who presented with visual disturbances between January 2021 and August 2023 and were subsequently diagnosed with intracranial mass lesions. Demographic characteristics, ophthalmologic findings, imaging results, treatment modalities, and visual outcomes were analyzed. Thirteen patients were included (six men; mean age: 45.2 ± 13.1 years). Blurred vision (61.5%) was the most frequent presenting symptom. Visual field defects (76.9%) and optic disc pallor (53.9%) were common findings. Pituitary adenoma was the most predominant tumor type (38.5%). The results indicate that visual symptomatology may represent an early manifestation of primary intracranial mass lesions. Prompt neuroimaging and multidisciplinary management are essential for achieving timely diagnosis and optimal clinical outcomes.

Homonymous hemianopia (HH) is a visual field defect in which the same side of both eyes is blind. In this paper, we propose an out-of-visual-field information compensation system for HH patients using an optical see-through head-mounted display. In the proposed system, in order to reduce the obstruction in the remaining visual field, indicators are placed at the boundary between the remaining visual field and the defective part to notify the HH patient about the events occurring at the blinded side of the visual field. Two different kinds of indicators, namely brightness-based and flicker-based, are designed to visualize the spatial information of the events. We conducted experiments with simulated HH participants to verify the effectiveness of the proposed system and compare the two designed indicators, as well as an existing method that makes use of the overlay overview window. The experimental results proved that the proposed system can react more intuitively and is faster than the existing method in the part near the central visual field. Moreover, it can alleviate the obstruction problem of the existing method.

BackgroundOptic disc drusen (ODD) can cause retinal nerve fibre layer (RNFL) defects with progressive visual field (VF) loss. Microvascular changes are discussed as a cause. We measured the vessel density (VD) of the optic disc in ODD using optical coherence tomography angiography and compared it with a normal population. Another intent was to determine the sensitivity and correlations in comparison with functional (VF) and structural parameters (RNFL, minimum rim width (MRW), ganglion cell complex (GCC)).MethodsWe analysed the VD of 25 patients with ODD and an age-matched control population including 25 healthy participants using AngioVue (Optovue, Fremont, CA, USA). We obtained data about RNFL, GCC, Bruch’s membrane opening MRW (Spectralis HRA & OCT; Heidelberg Engineering, Germany) and VF (standard automated perimetry; SITA 24-2). Low image quality and pathologies interfering with the diagnostics were excluded. Parametric data were analysed using the t-test and non-parametric values using the Mann-Whitney U test. Linear regression analysis was used to determine correlations using the Bravais-Pearson test.ResultsThe VD was significantly reduced in the ODD group especially the peripapillary capillary VD (n=45 vs 50 eyes; mean 43.15% vs 51.70%). Peripapillary RNFL thickness correlated with the VD significantly (r=0.902 (n=44), 0.901 (n=44), 0.866 (n=45)). The RNFL analysis showed a reduction in ODD, especially the superior hemisphere (mean 107 µm, 129 µm; 49 vs 50 eyes). The GCC was significantly lower in the ODD group (n=38 vs 40; mean 87 µm vs 98 µm). Positive correlation between the VD and the GCC was significant (n=37, r=0.532). There is a significant negative correlation (n=19; r=−0.726) between the VD and the pattern standard deviation (PSD).ConclusionThis study reveals significant peripapillary microvascular changes in patients with ODD correlating with the RNFL and GCC reduction. There is a negative correlation between the PSD and the VD.