| 1. |
- Miranda, Antonio Miguel, et al.
(författare)
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Eye movements, convergence distance and pupil-size when reading from smartphone, computer, print and tablet
- 2018
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Ingår i: Scandinavian Journal of Optometry and Visual Science. - : The Norwegian Association of Optometry. - 1891-0882 .- 1891-0890. ; 11:1, s. 1-5
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated the use of eye-tracking glasses to monitor visual behaviour when reading from electronic devices and paper in free-viewing conditions. The Tobii-Pro-Glasses were used to monitor 20 subjects with normal vision during reading tasks. Reading was performed in a smartphone, computer, paper and tablet. Texts from the IReST-test were read in devices in a random order. Participants read one text in each device and then repeated the same task 1 hour later; in total each participant read eight different texts. The sequence for the devices was randomized. We found differences between devices for saccade amplitude, fixation duration, convergence distance and pupil size. Reading speed between computer and tablet was slightly different (8 words-per-minute) and pupil size reduced up to 20% in electronic devices compared to print. Behavioural changes observed whilst reading from different devices may reflect an attempt from readers to optimize performance. The need to maintain visual performance under different visual condition may lead to increased visual symptoms. Eye-tracking glasses could be a valuable tool to investigate visual aspects of digital strain.
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| 2. |
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| 3. |
- Baskaran, Karthikeyan, Senior Lecturer, 1983-, et al.
(författare)
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Reading performance in Portuguese children from second to tenth grade with the MNREAD reading acuity test
- 2023
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Ingår i: Journal of Optometry. - : Elsevier. - 1888-4296. ; 16:4, s. 261-267
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Tidskriftsartikel (refereegranskat)abstract
- PurposeTo assess reading performance and report normative values for normal sighted Portuguese schoolchildren using the Portuguese version of the MNREAD reading acuity chart.MethodsChildren in the 2nd, 4th, 6th, 8th, and 10th grade in Portugal were recruited for this study. One hundred and sixty-seven children from 7 to 16 years of age participated. The Portuguese version of the printed MNREAD reading acuity chart was used to measure reading performance in these children. The non-linear mixed effects model with negative exponential decay function was used to compute maximum reading speed (MRS) and critical print size (CPS) automatically. Reading acuity (RA) and reading accessibility index (ACC) were computed manually.ResultsThe mean MRS in words-per-minute (wpm) for the 2nd grade was 55 wpm (SD = 11.2 wpm), 104 wpm (SD = 27.9) for the 4th grade, 149 wpm (SD = 22.5) for 6th grade, 172 wpm (SD = 24.6) for 8th grade and 180 wpm for the 10th grade (SD = 16.8). There was a significant difference in MRS between school grades (p < 0.001). Participants’ reading speed increased by 14.5 wpm (95% CL: 13.1–15.9) with each year of increase in age. We found a significant difference between RA and school grades, but not for CPS.ConclusionsThis study provides normative reading performance values for the Portuguese version of the MNREAD chart. The MRS increased with increasing age and school grade, while RA shows initial improvement from early school years and gradually stabilizes in the more mature children. Normative values for the MNREAD test can now be used to determine reading difficulties or slow reading speed in, for example, children with impaired vision.
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| 4. |
- Baskaran, Karthikeyan, Senior Lecturer, 1983-, et al.
(författare)
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Scoring reading parameters : An inter-rater reliability study using the MNREAD chart
- 2019
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Ingår i: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 14:6, s. 1-14
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Tidskriftsartikel (refereegranskat)abstract
- Purpose First, to evaluate inter-rater reliability when human raters estimate the reading performance of visually impaired individuals using the MNREAD acuity chart. Second, to evaluate the agreement between computer-based scoring algorithms and compare them with human rating. Methods Reading performance was measured for 101 individuals with low vision, using the Portuguese version of the MNREAD test. Seven raters estimated the maximum reading speed (MRS) and critical print size (CPS) of each individual MNREAD curve. MRS and CPS were also calculated automatically for each curve using two different algorithms: the original standard deviation method (SDev) and a non-linear mixed effects (NLME) modeling. Intra-class correlation coefficients (ICC) were used to estimate absolute agreement between raters and/or algorithms. Results Absolute agreement between raters was ‘excellent’ for MRS (ICC = 0.97; 95%CI [0.96, 0.98]) and ‘moderate’ to ‘good’ for CPS (ICC = 0.77; 95%CI [0.69, 0.83]). For CPS, inter-rater reliability was poorer among less experienced raters (ICC = 0.70; 95%CI [0.57, 0.80]) when compared to experienced ones (ICC = 0.82; 95%CI [0.76, 0.88]). Absolute agreement between the two algorithms was ‘excellent’ for MRS (ICC = 0.96; 95%CI [0.91, 0.98]). For CPS, the best possible agreement was found for CPS defined as the print size sustaining 80% of MRS (ICC = 0.77; 95%CI [0.68, 0.84]). Absolute agreement between raters and automated methods was ‘excellent’ for MRS (ICC = 0.96; 95% CI [0.88, 0.98] for SDev; ICC = 0.97; 95% CI [0.95, 0.98] for NLME). For CPS, absolute agreement between raters and SDev ranged from ‘poor’ to ‘good’ (ICC = 0.66; 95% CI [0.3, 0.80]), while agreement between raters and NLME was ‘good’ (ICC = 0.83; 95% CI [0.76, 0.88]). Conclusion For MRS, inter-rater reliability is excellent, even considering the possibility of noisy and/or incomplete data collected in low-vision individuals. For CPS, inter-rater reliability is lower. This may be problematic, for instance in the context of multisite investigations or follow-up examinations. The NLME method showed better agreement with the raters than the SDev method for both reading parameters. Setting up consensual guidelines to deal with ambiguous curves may help improve reliability. While the exact definition of CPS should be chosen on a case-by-case basis depending on the clinician or researcher’s motivations, evidence suggests that estimating CPS as the smallest print size sustaining about 80% of MRS would increase inter-rater reliability.
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| 5. |
- Baskaran, Karthikeyan, Senior Lecturer, 1983-, et al.
(författare)
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Scoring reading parameters: an inter-rater reliability study using the MNREAD test
- 2017
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Konferensbidrag (refereegranskat)abstract
- Aim: Estimating MNREAD parameters such as Critical Print Size (CPS) and Maximum Reading Speed (MRS) - using the time taken to read blocks of text - often requires subjective analysis of the reading profile. Depending on the rater, parameters may be over- or under-estimated, resulting in difficult or even impossible between-study comparisons. The aim of this project was to evaluate the inter-rater reliability of MNREAD parameters in subjects with visual impairment. Methods: Reading times for the Portuguese version of the MNREAD chart from 32 subjects, reading binocularly were analyzed. Reading speed was computed by a single experimenter (AFM) using reading time and number of errors. Based on reading speeds, three experimented raters (AFM, AC and KB) computed MRS and CPS using the following method. CPS was defined as the print size at which subsequent smaller print sizes were read at 1.96 x standard deviation slower than the mean of the preceding print sizes; MRS was estimated as the mean reading speed for sentences in print larger than the CPS. Inter-rater reliability was assessed using intra-class correlation (ICC) coefficient for both MRS and CPS for all three raters. Results: Near acuity range was 0.14-1.9 logMAR. The average measure ICC for CPS was 0.896 with a 95% CI from 0.814 to 0.946 (p< 0.001). The average measure ICC for MRS was 0.984 with a 95% CI from 0.970 to 0.992 (p< 0.001). Conclusion: A high degree of reliability was found between the three raters for both CPS and MRS. Even though some small variability exists this may be due to raters’ high-level experience with MNREAD data. Future directions will involve: 1) including more raters with various level of experience in MNREAD rating; 2) investigating the degree of inter-rater reliability for raters using different estimation methods.
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| 6. |
- Baskaran, Karthikeyan, Senior Lecturer, 1983-, et al.
(författare)
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Swedish version of the Massof activity inventory to measure vision-related activity difficulties among patients with nAMD
- 2024
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Ingår i: Acta Ophthalmol, vol 102, issue S279: Special Issue:Abstracts from the 2023 European Association for Vision and Eye Research Festival, 26‐28 October 2023, Valencia. - : John Wiley & Sons.
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Konferensbidrag (refereegranskat)abstract
- Aims/Purpose: The aim of this study was to assess vision-related activity difficulties among patients with neovascular AMD using a Swedish version of the mass of activity inventory (MAI). Methods: Participants were patients diagnosed with neovascular AMD receiving treatment for the disease in a hospital in southeast Sweden. Participants completed the Swedish version of the MAI questionnaire. MAI can be used to measure the overall visual ability and visual ability in 4 functional domains: reading, mobility, visual motor function and visual information processing. Best corrected distance and near visual acuity (VA) were also measured. Results: Among the 196 participants (mean age=78.5 years, SD=7.67, 66% female) the median VA in the better seeing eye was 0.18 logMAR (IQR=?0.34), and in the worse eye was 0.54 logMAR (IQR=0.98). The median visual ability for all participants was 1.92 logits (IQR=2.69). There was a significant negative correlation between distance VA in the better eye and visual ability (rho=0.4025, p<0.01). Using ROC curves, we tested the capacity of the MAI to detect cases of any vision impairment (VA worse than 0.3 logMAR in the better seeing eye), the area under the curve (AUC) was 0.717 (95% CI=0.643 - 0.791 p<0.001). When we tested for detection of moderate vision impairment (VA worse than 0.5 logMAR in the better seeing eye) the AUC was 0.738 (95% CI=0.648 - 0.829 p?<0.001). Conclusions: The results indicate that the Swedish version of the MAI produce measures of visual ability that are consistent with clinical measures among patients with nAMD. The Swedish version of the MAI can be used as outcome measure in interventions for people with nAMD.References1. Macedo, A.F. et al. Predictors of problems reported on the EQ-5D-3L dimensions among people with impaired vision in northern Portugal. Health Qual Life Outcomes 2022; 20: 132.
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| 7. |
- Demir, Pelsin, 1994-, et al.
(författare)
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All retinas are not created equal : Fovea‐to‐macula thickness ratio and foveal microvasculature in healthy young children
- 2022
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Ingår i: Ophthalmic & physiological optics. - : John Wiley & Sons. - 0275-5408 .- 1475-1313. ; 42:3, s. 644-652
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Markers for the relationships between structural and microvasculature measures given by optical coherence tomography angiography are necessary to increase the diagnostic and prognostic value of this technique. The aim of this study was to investigate relationships between structural and microvasculature measures around the fovea in healthy eyes of healthy children.Methods: Observational cross-sectional study involving children aged 8–17 years, born at full-term, with no eye disease. The better of two 3 × 3 mm macular scans obtained with a Cirrus 5000HD-OCT was analysed. Images were corrected for lateral magnification errors. Vessel density and perfusion were measured with ImageJ/Fiji software for the superficial capillary plexus. Structural measures including foveal and macular thicknesses were performed manually.Results: The sample included 86 participants, 51 (59%) females. Mean age was 12.4 years (SD = 2.5); mean best-corrected acuity was −0.10 logMAR (SD = 0.09); mean refractive error was +0.59 D (SD = 1.3) and mean axial length was 23.1 mm (SD = 0.86). Mean area of the foveal avascular zone (AFAZ) was 0.20 mm2 (SD = 0.88); median fovea-to-macula thickness ratio (FMTR) was 0.63 (IQR = 0.08); mean central vessel density was 12.42 mm−1 (SD = 2.78) and mean central perfusion was 38.66% (SD = 3.83). AFAZ was correlated with central vessel density (p < 0.001), perfusion (p < 0.001), foveal thickness (p < 0.001) and FMTR (p < 0.001). Central vessel density was correlated with foveal thickness (p < 0.001) and FMTR, (p = 0.01). Central perfusion was correlated with foveal thickness (p < 0.001) and FMTR, (p = 0.003).Conclusion: In this study, foveal thickness, FMTR and foveal microvasculature measurements were correlated. Clinicians need to be aware that shallow foveal pits and persistent foveal microvasculature are likely to occur in optical coherence tomography angiography images. In healthy eyes from healthy children, an atypical high FMTR and a small AFAZ may be associated with incomplete foveal development. The mechanism and functional implications of this remain unknown.
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| 8. |
- Demir, Pelsin, 1994-, et al.
(författare)
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Comparison of an open view autorefractor with an open view aberrometer in determining peripheral refraction in children
- 2023
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Ingår i: Journal of Optometry. - : Elsevier. - 1888-4296. ; 16:1, s. 20-29
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Tidskriftsartikel (refereegranskat)abstract
- PurposeThe aim of this study was to compare central and peripheral refraction using an open view Shin-Nippon NVision-K 5001 autorefractor and an open view COAS-HD VR aberrometer in young children.MethodsCycloplegic central and peripheral autorefraction was measured in the right eye of 123 children aged 8 to 16 years. Three measurements each were obtained with both Shin-Nippon NVision-K 5001 autorefractor and COAS-HD VR aberrometer along the horizontal visual field up to 30° (nasal and temporal) in 10° steps. The refraction from the autorefractor was compared with aberrometer refraction for pupil analysis diameters of 2.5-mm and 5.0-mm.ResultsThe Shin-Nippon was 0.30 D more hyperopic than COAS-HD VR at 2.5-mm pupil and 0.50 D more hyperopic than COAS-HD VR at 5-mm pupil for central refraction. For both pupil sizes, the 95% limits of agreement were approximately 0.50 D for central refraction, and limits were wider in the nasal visual field compared to the temporal visual field. The mean difference for both J0 and J45 were within 0.15 D and the 95% limits of agreement within 0.90 D across the horizontal visual field.ConclusionDefocus components were similar between the Shin-Nippon autorefractor and the COAS-HD VR aberrometer with a 2.5-mm pupil for most visual field angles. However, there was a significant difference in defocus component between the Shin-Nippon autorefractor and the COAS-HD VR aberrometer with a 5.0-mm pupil, wherein the autorefractor measured more hyperopia. The astigmatic components J0 and J45 were similar between instruments for both central and peripheral refraction.
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| 9. |
- Demir, Pelsin, 1994-
(författare)
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Prevalence of refractive errors and incidence of myopia in Swedish schoolchildren
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- PurposeThe aim of this thesis was to investigate the prevalence, incidence, and risk factors for myopia development in a cohort of Swedish schoolchildren. The specific goals were: - to recruit a cohort of children aged 8 to 16 years and to follow the cohort over a period of 24 months with regular study visits; - to investigate the predictive value of relative peripheral error and other optical parameters for the prevalence and incidence of myopia; - to determine and investigate the predictive value of genetic and environmental factors, and structural characteristics of the eye to the incidence of myopia.MethodsThis was a longitudinal study with a follow-up period of 2-years conducted at Linnaeus University in Kalmar. All participants underwent eye examinations and completed questionnaires at regular intervals during the follow-up period. Data analysis was performed assuming hypotheses such as: - myopia development is associated with genetic factors and environmental factors (Papers I and IV); - changes in refractive error over time are explained by multiple genetic and environmental factors (Paper IV) - instruments with different measurement principles can lead to different refraction results (Paper II); - there is a relationship between refractive error and the characteristics of the choroid (Exploratory study, not published) and the characteristics of the microvasculature of the retina (Paper III).ResultsA total of 128 children (70 females and 58 males) participated in this study with mean age of 12.0 years (SD=2.4). Paper I: based on cycloplegic SER of the right eye, the distribution of refractive errors was: hyperopia 48.0% (CI95=38.8-56.7), emmetropia 42.0% (CI95=33.5-51.2) and myopia 10.0%. (CI95=4.4-14.9). Participants with two myopic parents had higher myopia and increased axial length than those with one or no myopic parents. Paper II: The Shin-Nippon was 0.30 D more hyperopic than COAS-HD VR at 2.5-mm pupil and 0.50 D more hyperopic than COAS-HD VR at 5-mm pupil for central refraction. Paper III: The sample included 86 out of the 128 participants, 51 (59%) females. The area of the foveal avascular zone (AFAZ) was correlated with central vessel density, perfusion, foveal thickness and with fovea-to-macula thickness ratio. Paper IV: The cumulative incidence of myopia during the two-years was 5.5%, incidence rate of myopia was 3.2 cases per 100 person-years. Cox regression revealed that the probability of myopic shift reduced with “age” and increased with “axial length/corneal-curvature ratio”. Myopic children at the baseline and children with two myopic parents showed a significant faster-paced SER change over time.ConclusionThe prevalence and incidence of myopia in Sweden was lower than expected when compared with countries in East Asia. Genetic factors such as parental myopia remains a critical factor to consider when predicting myopia onset and progression. Children born full-term and visual acuity within the normal range can have very different retinal microvasculature at the centre of the macula that may influence refractive error development. Future studies are necessary to find out possible relationships between vasculature, structural changes and refractive error development. In addition, more studies involving children from different ethnicities and incorporating longer follow-up period are necessary to increase our understanding of the incidence of myopia in Swedish schoolchildren.
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| 10. |
- Demir, Pelsin, 1994-, et al.
(författare)
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Refractive error, axial length, environmental and hereditary factors associated with myopia in Swedish children
- 2021
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Ingår i: Clinical and experimental optometry. - : Taylor & Francis Group. - 0816-4622 .- 1444-0938. ; 104:5, s. 595-601
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Tidskriftsartikel (refereegranskat)abstract
- Clinical relevance: Investigation of refractive errors amongst Swedish schoolchildren will help identify risk factors associated with myopia development.Background: Genetic and hereditary aspects have been linked with the development of myopia. Nevertheless, in the case of ‘school myopia’ some authors suggest that environmental factors may affect gene expression, causing school myopia to soar. Additional understanding about which environmental factors play a relevant role can be gained by studying refractive errors in countries like Sweden, where prevalence of myopia is expected to be low.Methods: Swedish schoolchildren aged 8-16 years were invited to participate. Participants underwent an eye examination, including cycloplegic refraction and axial length (AL) measurements. Predictors such as time spent in near work, outdoor activities and parental myopia were obtained using a questionnaire. Myopia was defined as spherical equivalent refraction (SER) ≤ −0.50D and hyperopia as SER ≥ +0.75D.Results: A total of 128 children (70 females and 58 males) participated in this study with mean age of 12.0 years (SD = 2.4). Based on cycloplegic SER of the right eye, the distribution of refractive errors was: hyperopia 48.0% (CI95 = 38.8-56.7), emmetropia 42.0% (CI95 = 33.5-51.2) and myopia 10.0%. (CI95 = 4.4-14.9). The mean AL was 23.1 mm (SD = 0.86), there was a correlation between SER and AL, r = −0.65 (p < 0.001). Participants with two myopic parents had higher myopia and increased axial length than those with one or no myopic parents. The mean time spent in near work, outside of school, was 5.3 hours-per-day (SD = 3.1), and mean outdoor time reported was 2.6 hours-per-day (SD = 2.2) for all the participants. The time spent in near work and outdoor time were different for different refractive error categories.Conclusion: The prevalence of myopia amongst Swedish schoolchildren is low. Hereditary and environmental factors are associated with refractive error categories. Further studies with this sample are warranted to investigate how refractive errors and environmental factors interact over time.
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