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Article ; Online: Peripheral Binocular Imbalance in Anisometropic and Strabismic Amblyopia.

Wiecek, Emily / Kosovicheva, Anna / Ahmed, Zain / Nabasaliza, Amanda / Kazlas, Melanie / Chan, Kimberley / Hunter, David G / Bex, Peter J

Investigative ophthalmology & visual science

2024 Volume 65, Issue 4, Page(s) 36

Abstract: Purpose: Individuals with amblyopia experience central vision deficits, including loss of visual acuity, binocular vision, and stereopsis. In this study, we examine the differences in peripheral binocular imbalance in children with anisometropic ... ...

Abstract	Purpose: Individuals with amblyopia experience central vision deficits, including loss of visual acuity, binocular vision, and stereopsis. In this study, we examine the differences in peripheral binocular imbalance in children with anisometropic amblyopia, strabismic amblyopia, and typical binocular vision to determine if there are systematic patterns of deficits across the visual field. Methods: This prospective cohort study recruited 12 participants with anisometropic amblyopia, 10 with strabismic amblyopia, and 10 typically sighted controls (age range, 5-18 years). Binocular imbalance was tested at 0°, 4°, and 8° eccentricities (4 angular locations each) using band-pass filtered Auckland optotypes (5 cycles per optotype) dichoptically presented with differing contrast to each eye. The interocular contrast ratio was adjusted until the participant reported each optotype with equal frequency. Results: Participants with anisometropic and strabismic amblyopia had a more balanced contrast ratio, or decreased binocular imbalance, at 4° and 8° eccentricities as compared with central vision. Participants with strabismic amblyopia had significantly more binocular imbalance in the periphery as compared with individuals with anisometropic amblyopia or controls. A linear mixed effects model showed a main effect for strabismic amblyopia and eccentricity on binocular imbalance across the visual field. Conclusions: There is evidence of decreased binocularity deficits, or interocular suppression, in the periphery in anisometropic and strabismic amblyopia as compared with controls. Notably, those with strabismic amblyopia exhibited more significant peripheral binocular imbalance. These variations in binocularity across the visual field among different amblyopia subtypes may necessitate tailored approaches for dichoptic treatment.
MeSH term(s)	Humans ; Amblyopia/physiopathology ; Vision, Binocular/physiology ; Male ; Female ; Child ; Prospective Studies ; Adolescent ; Strabismus/physiopathology ; Visual Acuity/physiology ; Visual Fields/physiology ; Child, Preschool ; Anisometropia/physiopathology ; Anisometropia/complications ; Depth Perception/physiology
Language	English
Publishing date	2024-04-23
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	391794-0
ISSN	1552-5783 ; 0146-0404
ISSN (online)	1552-5783
ISSN	0146-0404
DOI	10.1167/iovs.65.4.36
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Article ; Online: Vergence, accommodation, and visual tracking in children and adolescents evaluated in a multidisciplinary concussion clinic.

Wiecek, Emily K / Roberts, Tawna L / Shah, Ankoor S / Raghuram, Aparna

Vision research

2021 Volume 184, Page(s) 30–36

Abstract: Many patients with concussion experience visual symptoms following injury that lead to a diagnosis of convergence insufficiency, accommodative insufficiency, or saccadic dysfunction. However, these diagnostic categories are based on aggregates of ... ...

Abstract	Many patients with concussion experience visual symptoms following injury that lead to a diagnosis of convergence insufficiency, accommodative insufficiency, or saccadic dysfunction. However, these diagnostic categories are based on aggregates of clinical tests developed from a non-concussed population and therefore may not accurately describe visual deficits in the concussed population. Thus, we sought to understand individual metrics of visual dysfunction in chronically symptomatic post-concussion patients. This retrospective cross-sectional study included patients examined at the multidisciplinary concussion clinic (MDCC) at Boston Children's Hospital over four years. Patients aged 5-21 years who had a complete assessment of eye alignment, vergence, accommodation, and visual tracking, and had visual acuity better than or equal to 20/30 in each eye were included. Patients with history of amblyopia, strabismus, or ocular pathology were excluded. Chart review yielded 116 patients who met inclusion criteria (median age 15 years, 64% female). The majority of patients (52%) experienced a single concussion and most were sports-related (50%). Clinical data show vergence, accommodation, or visual tracking deficits in 95% of patients. A receded near point of convergence (NPC, 70/116) and reduced accommodative amplitude (63/116) were the most common deficits. Both NPC and accommodative amplitude were significantly correlated with one another (r = -0.5) and with measures of visual tracking (r = -0.34). Patients with chronic post-concussion symptoms show deficits in individual metrics of vergence, accommodation and visual tracking. The high incidence of these deficits, specifically NPC and accommodative amplitude, highlights the need for a detailed sensorimotor evaluation to guide personalized treatment following concussion.
MeSH term(s)	Accommodation, Ocular ; Adolescent ; Child ; Convergence, Ocular ; Cross-Sectional Studies ; Female ; Humans ; Male ; Retrospective Studies ; Vision, Binocular
Language	English
Publishing date	2021-04-07
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	200427-6
ISSN	1878-5646 ; 0042-6989
ISSN (online)	1878-5646
ISSN	0042-6989
DOI	10.1016/j.visres.2021.03.002
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Article ; Online: Clinical Update on Metamorphopsia: Epidemiology, Diagnosis and Imaging.

Hanumunthadu, Daren / Lescrauwaet, Benedicte / Jaffe, Myles / Sadda, Srinivas / Wiecek, Emily / Hubschman, Jean Pierre / Patel, Praveen J

Current eye research

2021 Volume 46, Issue 12, Page(s) 1777–1791

Abstract: ... ...

Abstract	Purpose
MeSH term(s)	Fovea Centralis/diagnostic imaging ; Humans ; Tomography, Optical Coherence/methods ; Vision Disorders/diagnosis ; Vision Disorders/epidemiology ; Visual Acuity ; Visual Field Tests/methods
Language	English
Publishing date	2021-05-17
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	82079-9
ISSN	1460-2202 ; 0271-3683
ISSN (online)	1460-2202
ISSN	0271-3683
DOI	10.1080/02713683.2021.1912779
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Article ; Online: Longitudinal Change of Refractive Error in Retinopathy of Prematurity Treated With Intravitreal Bevacizumab or Laser Photocoagulation.

Wiecek, Emily / Akula, James D / Vanderveen, Deborah K / Mantagos, Iason S / Wu, Carolyn / Curran, Amber-Lee / De Bruyn, Hanna / Peterson, Bridget / Fulton, Anne B

American journal of ophthalmology

2022 Volume 240, Page(s) 252–259

Abstract: Purpose: To compare progression of myopia and refractive error in former premature infants with retinopathy of prematurity (ROP) treated using intravitreal bevacizumab (IVB) or laser.: Design: Retrospective clinical cohort study.: Methods: We ... ...

Abstract	Purpose: To compare progression of myopia and refractive error in former premature infants with retinopathy of prematurity (ROP) treated using intravitreal bevacizumab (IVB) or laser. Design: Retrospective clinical cohort study. Methods: We identified premature infants with ROP treated using IVB from 2011 to 2020 and compared their longitudinal cycloplegic refraction data to that of infants with ROP treated using laser during the same timeframe. A subset of infants treated using IVB also underwent additional treatment using laser. We included cycloplegic refractions from 789 cumulative visits over a median 3.2 years. We used a linear mixed-effects model with a log decay function to evaluate how refraction changed with age after treatment. Results: In aggregate, the model estimated a significant (P < .001) trend in refraction-from slight hyperopia to relatively more myopic states. However, progression in laser-treated eyes was significantly (P < .001) more rapid, regardless of treatment with IVB. The number of laser spots resulted in increased myopic progression by approximately 0.16 diopters per 100 laser spots. Both ROP stage and zone had a significant effect on myopic progression, with more severe disease resulting in faster myopic progression. Random effects, including individual subject variation with nested variance for left and right eye, accounted for 86.4% of the remaining variance not explained by age and treatment. Conclusions: Laser treatment for severe ROP increases the trend to severe myopia. In our sample, IVB did not affect myopic progression but did substantially reduce the amount of consequent laser required to treat ROP. The effect of laser persists after accounting for differences in ROP stage and zone.
MeSH term(s)	Angiogenesis Inhibitors/therapeutic use ; Bevacizumab/therapeutic use ; Cohort Studies ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Intravitreal Injections ; Laser Coagulation/methods ; Mydriatics/therapeutic use ; Myopia/surgery ; Refractive Errors ; Retinopathy of Prematurity/diagnosis ; Retinopathy of Prematurity/drug therapy ; Retinopathy of Prematurity/surgery ; Retrospective Studies
Chemical Substances	Angiogenesis Inhibitors ; Mydriatics ; Bevacizumab (2S9ZZM9Q9V)
Language	English
Publishing date	2022-03-31
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	80030-2
ISSN	1879-1891 ; 0002-9394
ISSN (online)	1879-1891
ISSN	0002-9394
DOI	10.1016/j.ajo.2022.03.020
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Article ; Online: Metamorphopsia and letter recognition.

Wiecek, Emily / Dakin, Steven C / Bex, Peter

Journal of vision

2014 Volume 14, Issue 14, Page(s) 1

Abstract: Acuity is the most commonly used measure of visual function, and reductions in acuity are associated with most eye diseases. Metamorphopsia--a perceived distortion of visual space--is another common symptom of visual impairment and is currently assessed ... ...

Abstract	Acuity is the most commonly used measure of visual function, and reductions in acuity are associated with most eye diseases. Metamorphopsia--a perceived distortion of visual space--is another common symptom of visual impairment and is currently assessed qualitatively using Amsler (1953) charts. In order to quantify the impact of metamorphopsia on acuity, we measured the effect of physical spatial distortion on letter recognition. Following earlier work showing that letter recognition is tuned to specific spatial frequency (SF) channels, we hypothesized that the effect of distortion might depend on the spatial scale of visual distortion just as it depends on the spatial scale of masking noise. Six normally sighted observers completed a 26 alternate forced choice (AFC) Sloan letter identification task at five different viewing distances, and the letters underwent different levels of spatial distortion. Distortion was controlled using spatially band-pass filtered noise that spatially remapped pixel locations. Noise was varied over five spatial frequencies and five magnitudes. Performance was modeled with logistic regression and worsened linearly with increasing distortion magnitude and decreasing letter size. We found that retinal SF affects distortion at midrange frequencies and can be explained with the tuning of a basic contrast sensitivity function, while object-centered distortion SF follows a similar pattern of letter object recognition sensitivity and is tuned to approximately three cycles per letter (CPL). The interaction between letter size and distortion makes acuity an unreliable outcome for metamorphopsia assessment.
MeSH term(s)	Adult ; Contrast Sensitivity/physiology ; Humans ; Middle Aged ; Pattern Recognition, Visual/physiology ; Spatial Behavior/physiology ; Vision Disorders/physiopathology ; Visual Acuity/physiology ; Young Adult
Language	English
Publishing date	2014-12-01
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2106064-2
ISSN	1534-7362 ; 1534-7362
ISSN (online)	1534-7362
ISSN	1534-7362
DOI	10.1167/14.14.1
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Article ; Online: Association between post-concussion symptoms and oculomotor deficits among adolescents.

Gowrisankaran, Sowjanya / Shah, Ankoor S / Roberts, Tawna L / Wiecek, Emily / Chinn, Ryan N / Hawash, Karameh K / O'Brien, Michael J / Howell, David R / Meehan, William P / Raghuram, Aparna

Brain injury

2021 Volume 35, Issue 10, Page(s) 1218–1228

Abstract: Purpose: To examine the association between Post-Concussion Symptom Scale (PCSS) scores, Convergence Insufficiency Symptom Survey (CISS) scores, and oculomotor deficits post-concussion.: Methods: Records of adolescent patients examined in a ... ...

Abstract	Purpose: To examine the association between Post-Concussion Symptom Scale (PCSS) scores, Convergence Insufficiency Symptom Survey (CISS) scores, and oculomotor deficits post-concussion. Methods: Records of adolescent patients examined in a multidisciplinary concussion clinic between July 2014 and May 2019 were reviewed. PCSS and CISS scores, results of eye examination and oculomotor assessment, concussion history, and demographics were abstracted. Results: One hundred and forty patient records (median age, 15.3 years; 52 males, presented 109 days (median) from their most recent concussion) met inclusion criteria. Mean total scores on PCSS and CISS were 46.67 ± 25.89 and 27.13 ± 13.22, respectively, and were moderately correlated with each other (r = 0.53, Conclusion: High PCSS scores may indicate an accommodation deficit and thus prompt an oculomotor assessment in patients following a concussion. Using the CISS and a detailed oculomotor assessment may reveal underlying oculomotor deficits, which may benefit from treatment.
MeSH term(s)	Adolescent ; Athletic Injuries ; Brain Concussion/complications ; Eye Movements ; Humans ; Male ; Neuropsychological Tests ; Post-Concussion Syndrome/diagnosis ; Post-Concussion Syndrome/epidemiology
Language	English
Publishing date	2021-08-12
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	639115-1
ISSN	1362-301X ; 0269-9052
ISSN (online)	1362-301X
ISSN	0269-9052
DOI	10.1080/02699052.2021.1959065
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Article ; Online: Spatial-frequency dependent binocular imbalance in amblyopia.

Kwon, MiYoung / Wiecek, Emily / Dakin, Steven C / Bex, Peter J

Scientific reports

2015 Volume 5, Page(s) 17181

Abstract: While amblyopia involves both binocular imbalance and deficits in processing high spatial frequency information, little is known about the spatial-frequency dependence of binocular imbalance. Here we examined binocular imbalance as a function of spatial ... ...

Abstract	While amblyopia involves both binocular imbalance and deficits in processing high spatial frequency information, little is known about the spatial-frequency dependence of binocular imbalance. Here we examined binocular imbalance as a function of spatial frequency in amblyopia using a novel computer-based method. Binocular imbalance at four spatial frequencies was measured with a novel dichoptic letter chart in individuals with amblyopia, or normal vision. Our dichoptic letter chart was composed of band-pass filtered letters arranged in a layout similar to the ETDRS acuity chart. A different chart was presented to each eye of the observer via stereo-shutter glasses. The relative contrast of the corresponding letter in each eye was adjusted by a computer staircase to determine a binocular Balance Point at which the observer reports the letter presented to either eye with equal probability. Amblyopes showed pronounced binocular imbalance across all spatial frequencies, with greater imbalance at high compared to low spatial frequencies (an average increase of 19%, p < 0.01). Good test-retest reliability of the method was demonstrated by the Bland-Altman plot. Our findings suggest that spatial-frequency dependent binocular imbalance may be useful for diagnosing amblyopia and as an outcome measure for recovery of binocular vision following therapy.
MeSH term(s)	Adolescent ; Adult ; Amblyopia/physiopathology ; Female ; Humans ; Male ; Middle Aged ; Photic Stimulation ; Vision, Binocular/physiology ; Visual Acuity ; Young Adult
Language	English
Publishing date	2015-11-25
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/srep17181
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Article ; Online: End COVID-19 in low- and middle-income countries.

Mobarak, Ahmed Mushfiq / Miguel, Edward / Abaluck, Jason / Ahuja, Amrita / Alsan, Marcella / Banerjee, Abhijit / Breza, Emily / Chandrasekhar, Arun G / Duflo, Esther / Dzansi, James / Garrett, Denise / Goldsmith-Pinkham, Paul / Gonsalves, Gregg S / Hossain, Muhammad Maqsud / Jakubowski, Aleksandra / Kang, Gagandeep / Kharel, Arjun / Kremer, Michael / Meriggi, Niccolo /

Nekesa, Carol / Olken, Benjamin A / Omer, Saad B / Qadri, Firdausi / Rees, Helen / Salako, Babatunde / Voors, Maarten / Warren, Shana / Więcek, Witold

Science (New York, N.Y.)

2022 Volume 375, Issue 6585, Page(s) 1105–1110

MeSH term(s)	Biomedical Research ; COVID-19/economics ; COVID-19/epidemiology ; COVID-19/prevention & control ; COVID-19 Vaccines/administration & dosage ; COVID-19 Vaccines/supply & distribution ; Cell Phone Use ; Communicable Disease Control ; Developing Countries ; Humans ; India/epidemiology ; Masks ; Vaccination Coverage ; Vaccination Hesitancy
Chemical Substances	COVID-19 Vaccines
Language	English
Publishing date	2022-03-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	128410-1
ISSN	1095-9203 ; 0036-8075
ISSN (online)	1095-9203
ISSN	0036-8075
DOI	10.1126/science.abo4089
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Article ; Online: A statistical analysis of metamorphopsia in 7106 amsler grids.

Wiecek, Emily / Lashkari, Kameran / Dakin, Steven C / Bex, Peter

Ophthalmology

2014 Volume 122, Issue 2, Page(s) 431–433

MeSH term(s)	Aged ; Aged, 80 and over ; Central Serous Chorioretinopathy/diagnosis ; Diabetic Retinopathy/diagnosis ; Epiretinal Membrane/diagnosis ; Female ; Geographic Atrophy/diagnosis ; Humans ; Macular Edema/diagnosis ; Male ; Middle Aged ; Models, Statistical ; Retrospective Studies ; Vision Disorders/diagnosis ; Vision Tests/instrumentation ; Vision Tests/statistics & numerical data ; Wet Macular Degeneration/diagnosis
Language	English
Publishing date	2014-10-22
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	392083-5
ISSN	1549-4713 ; 0161-6420
ISSN (online)	1549-4713
ISSN	0161-6420
DOI	10.1016/j.ophtha.2014.09.006
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Article ; Online: Metamorphopsia and interocular suppression in monocular and binocular maculopathy.

Wiecek, Emily / Lashkari, Kameran / Dakin, Steven C / Bex, Peter

Acta ophthalmologica

2014 Volume 93, Issue 4, Page(s) e318–20

MeSH term(s)	Epiretinal Membrane/physiopathology ; Geographic Atrophy/physiopathology ; Humans ; Retinal Diseases/physiopathology ; Surveys and Questionnaires ; Vision Disorders/physiopathology ; Vision, Binocular/physiology ; Vision, Monocular/physiology ; Wet Macular Degeneration/physiopathology
Language	English
Publishing date	2014-10-01
Publishing country	England
Document type	Letter
ZDB-ID	2408333-1
ISSN	1755-3768 ; 1755-375X
ISSN (online)	1755-3768
ISSN	1755-375X
DOI	10.1111/aos.12559
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