Visual Psychophysics / Physiological Optics 106 Retinal
Transcription
Visual Psychophysics / Physiological Optics 106 Retinal
ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics 106 Retinal Alterations In Aging and Disease Sunday, May 03, 2015 8:30 AM–10:15 AM Exhibit Hall Poster Session Program #/Board # Range: 87–94/A0247–A0254 Organizing Section: Visual Psychophysics / Physiological Optics Contributing Section(s): Low Vision, Multidisciplinary Ophthalmic Imaging Program Number: 87 Poster Board Number: A0247 Presentation Time: 8:30 AM–10:15 AM Characterization of Human Photoreceptor Packing Arrangement as a Function of Retinal Eccentricity using an Adaptive Optics Scanning Laser Ophthalmoscope (AO-SLO) Elaine M. Wells-Gray1, Susanna C. Finn3, Cherry Greiner2, Stacey S. Choi1, Nathan Doble1. 1College of Optometry, Ohio State University, Columbus, OH; 2InfraredX, Burlington, MA; 3University of Massachusetts Lowell, Lowell, MA. Purpose: The human photoreceptor mosaic has been well characterized through histological measurements from excised retina. In vivo measurements of cone photoreceptor packing have been reported by several research groups out to retinal eccentricities of 15°. Reports of rod properties in vivo are not so common. The aim of this study was to examine the packing arrangement of cone and rod photoreceptors in vivo at greater eccentricities than have currently been reported. Methods: An adaptive optics scanning laser ophthalmoscope (AOSLO) was used to image two human control subjects at the foveal center and 4 temporal retinal (TR) eccentricities extending out to 25°. Both subjects had low refractive error without any history of retinal disease and were imaged over a dilated pupil diameter of 7.2 mm. The AO system employed a Shack-Hartmann wavefront sensor and a 97 actuator deformable mirror to measure and correct for the ocular aberrations. The imaging wavelength was 680 nm with a field of view of 0.9° x 1° on the retina. The frame acquisition rate was 30 Hz and the confocal pinhole diameter was set to 1 Airy disk. In the subsequent post-processing, individual frames underwent strip-wise registration to remove eye motion and were then averaged to increase the signal-to-noise ratio. At each retinal location, the cone and rod spacing were measured. Results: The cone mosaic was clearly imaged at the fovea, 4, 8, and 13° TR in both subjects, and at 25° TR in subject 2. Mean cone spacing was 3.43 ± 0.44 mm, 9.01 ± 0.62 mm, 14.1 ± 1.86 mm, 18.1 ± 0.50 mm, and 19.7 mm, for fovea, 4°, 8°, 13°, and 25° TR respectively. The spacing increased sharply when moving out from the fovea, but then tapered beyond 8° TR. Rod photoreceptors were clearly visible at 4, 8, and 13° TR in both subjects, with mean spacing of 3.18 ± 0.03 mm, 3.31 ± 0.25 mm, and 3.82 ± 0.06 mm respectively. The visibility of the rod mosaic especially at the higher eccentricities was found to be highly sensitive to the plane of focus. Conclusions: Results for both cone and rod photoreceptor spacing as a function of retinal eccentricity show good agreement with known distributions established by histology. This data can serve as a benchmark against which diseased retinas (e.g., age-related macular degeneration and retinitis pigmentosa) can be compared. Commercial Relationships: Elaine M. Wells-Gray, None; Susanna C. Finn, None; Cherry Greiner, None; Stacey S. Choi, None; Nathan Doble, None Support: NIH Grant EY020901, Department of Defense (DoD) Telemedicine and Advanced Technology Research Center (TATRC) W81XWH-10-1-0738 Program Number: 88 Poster Board Number: A0248 Presentation Time: 8:30 AM–10:15 AM Assessing cone mosaic disruption in patients with X-linked cone dysfunction Emily J. Patterson1, James Tee2, 6, Jay Neitz3, Christopher S. Langlo4, Alfredo Dubra5, 1, Maureen Neitz3, Adam M. Dubis2, 6, Alison J. Hardcastle2, Michel Michaelides2, 6, Joseph Carroll1, 4. 1 Ophthalmology, Medical College of Wisconsin, Milwaukee, WI; 2 Institute of Ophthalmology, University College London, London, United Kingdom; 3Department of Ophthalmology, University of Washington, Seattle, WA; 4Cell Biology, Neurobiology, and Anatomy, Medical College of Wisconsin, Milwaukee, WI; 5Biophysics, Medical College of Wisconsin, Milwaukee, WI; 6Moorfields Eye Hospital, London, United Kingdom. Purpose: Cone dysfunction syndromes are typically associated with reduced color vision and have been linked to the OPN1LW and OPN1MW genes on the X chromosome. How mutations in these genes affect cone photoreceptor integrity remains an important question as we seek to elucidate a deeper understanding of the genotype-phenotype relationship in these conditions. Here we used adaptive optics scanning light ophthalmoscopy (AOSLO) to characterize cone structure in subjects with mutations in the OPN1LW and OPN1MW genes. Methods: Six males (aged 11-37 years) with OPN1LW and OPN1MW mutations were recruited. All subjects were dichromatic (5 protanopic, 1 deuteranopic). Images of the cone mosaic were obtained using AOSLO (both confocal and non-confocal splitdetection). Cone density was measured at parafoveal regions of interest (ROIs) using semi-automated cone-counting software and compared to published normative data. In five subjects, we compared cone density across the confocal and non-confocal split-detection modalities. Confocal cone density was assessed over time for two subjects (follow up = 2 or 4 years). Results: Three subjects had the previously reported LIAVA haplotype encoded by either the OPN1LW or OPN1MW gene, while two others had an insertion in exon 2 of the OPN1LW gene resulting in a 32bp repeat. The final subject had no OPN1LW gene, and one of his two OPN1MW genes encoded either the LIAVA or MIAVA haplotype. Subjects showed variable reduction in cone density compared to normal observers using both confocal (range = 26-90%) and split detection (range = 7-87%) images. In most ROIs, we observed greater cone density using split-detection rather than confocal images (p = .70), indicating that the low cone density in confocal images was due partly to altered cone reflectivity, rather than complete loss of cones. No change in cone density was observed for the two subjects for whom serial images were acquired (p = .30 and .42). Conclusions: There is striking variability in the cone mosaic phenotype in individuals with OPN1LW and OPN1MW mutations. The combined use of confocal and split-detection AOSLO imaging allows for a more thorough assessment of residual cone structure in these patients. It remains to be seen whether the variable degree of cone loss observed here correlates with variable functional deficits. Commercial Relationships: Emily J. Patterson, None; James Tee, None; Jay Neitz, None; Christopher S. Langlo, None; Alfredo Dubra, Canon USA Inc (P); Maureen Neitz, None; Adam M. Dubis, None; Alison J. Hardcastle, None; Michel Michaelides, None; Joseph Carroll, None Support: NIH (P30EY001931, R01EY017607, P30EY001730, R01EY009303), National Institute for Health Research Biomedical Research Centre at Moorfields Eye Hospital, Fight For Sight (UK), Moorfields Eye Hospital Special Trustees (UK), Moorfields Eye Charity (UK), Foundation Fighting Blindness (USA), The Wellcome Trust. MM is supported by an FFB Career Development Award. ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Program Number: 89 Poster Board Number: A0249 Presentation Time: 8:30 AM–10:15 AM Recovery of cone photoreceptors at the macula after concussion of the retina Atsushi Hayashi, Mitsuya Otsuka, Masaaki Ishida, Toshihiko Oiwake. Ophthalmology, University of Toyama, Toyama, Japan. Purpose: To examine changes in cone photoreceptors at the macula after concussion of the retina with an adaptive optics (AO) fundus camera. Methods: Two patients after blunt injury who visited Toyama University Hospital were included in this study. Patient#1 was 16 years old female and patient#2 was 27 years old male. They were followed more than 3 months and underwent comprehensive ophthalmic examinations and AO fundus camera (rtx1™, Imagine Eyes, France) examination during the follow-up. Cone densities at 500 mm and 1000mm from the foveal center of the injured eyes were obtained with AOdetect software. OCT images were compared to the AO images. Results: Cone densities of the patient#1were increased from 3984 /mm2 to 16317 /mm2 at 500mm, and 3803 /mm2 to 9766 /mm2 at 1000mm during 6 months after the injury. Cone densities of the patient #2 were also increased from 4044/mm2 to 9533 /mm2 at 500mm, and 1285 /mm2 to 6686 /mm2 at 1000mm during 3 months after the injury. Visual acuity was improved to 1.0 at 3 months in both patients. OCT images showed irregular inner segment ellipsoid line and cone outer segment tip line at the macula. Conclusions: This is the first report to show the recovery of cone densities after concussion of the retina. Even though visual acuity and OCT images recovered with time, cone densities at the macula remained reduced. Commercial Relationships: Atsushi Hayashi, None; Mitsuya Otsuka, None; Masaaki Ishida, None; Toshihiko Oiwake, None Program Number: 90 Poster Board Number: A0250 Presentation Time: 8:30 AM–10:15 AM Cone density loss on adaptive optics in early macular telangiectasia type 2 Julie Jacob1, Valérie Krivosic2, Michel Paques3, Ramin Tadayoni2, Alain Gaudric2. 1Ophthalmology, University Hospitals Leuven, Leuven, Belgium; 2Ophtalmologie, Hôpital Lariboisière, Paris, France; 3Imaging, Hôpital des Quinze-Vingts, Paris, France. Purpose: To study whether cone photoreceptors are early impaired in the progression of Macular telangiectasia type 2 (MacTel 2) disease. MacTel2 is a macular neurodegenerative disease characterized by progressive loss of Müller cells, intraretinal capillary proliferation and ultimately loss of central photoreceptors. Early dysfunction or loss of cone photoreceptors in the course of MacTel2 is debated. We studied cone density, using flood illumination adaptive optics (AO) in early-stage MacTel2. Methods: Design: Eight patients with early signs of MacTel2 and 8 healthy volunteers underwent multimodal retinal imaging including infrared reflectance scanning laser ophthalmoscopy, OCT, fluorescein angiography and flood-illumination AO (rtx 1, Imagine Eyes, France). Cone mosaic was studied in 5 sampling windows ranging from 2° to 7° from the foveal center. Main Outcome Measure: Structural appearance of cones; cone density, spacing and hexagonal arrangement. Results: Cone density values in the 10 MacTel2 eyes were inferior to normal at all eccentricities from 2° to 7° (p<0.0001). Mean cone spacing values were larger than normal at all eccentricities (p<0.0001) and mean percentage of hexagonally organized cone photoreceptors was lower at all eccentricities from 2° to 7° (p<0.0001). This difference was more pronounced on the temporal side of the fovea (p<0.0001) but also significant in nasal and was not limited to the area of capillary anomalies. AO images in MacTel2 patients showed an irregular patchy disturbance of the cone mosaic corresponding to some fragmentation of the Cone Outer Segment Tips (COST) line (or Interdigitation zone) on OCT. The Inner/outer segment (IS/OS) line (or ellipsoid zone) remained intact. Conclusions: Adaptive optics showed that in early MacTel2 the cone mosaic is altered in the macular area. The cone density was inferior to normal even outside the telangiectasia, although the IS/OS line remained intact on OCT. However OCT showed fragmentation of the COST line, which correlated with decreased cone density. These findings do not indicate that the loss of cone density is causative of the disease but that it might be secondary to Müller’s cell and rod loss in this area. However cone density assessment could become a useful parameter to follow the progression of the disease. Cone density values in the 10 Mac Tel eyes were significantly inferior to normal values at all eccentricities from 2° to 7° (p<0.0001). Commercial Relationships: Julie Jacob, Bayer (R), Novartis (R); Valérie Krivosic, None; Michel Paques, Imagine Eyes (C), The Agence Nationale de la Recherche (F); Ramin Tadayoni, None; Alain Gaudric, None Clinical Trial: NCT01546181 Program Number: 91 Poster Board Number: A0251 Presentation Time: 8:30 AM–10:15 AM Visual function and retinal structure in suspected carriers of choroideremia Erle Hortense Veim, Rigmor C. Baraas, Stuart J. Gilson. Optometry and Visual Science, Buskerud and Vestfold University College, Kongsberg, Norway. Purpose: To investigate visual function and retinal structure in suspected carriers of choroideremia using clinical methods, and highresolution imaging techniques. Methods: Three symptomatic suspected carriers of choroideremia from one family aged 24, 59 and 62 yo and nine healthy age-matched controls with normal logMAR letter acuity and no observed ocular abnormalities, were included in the study. The youngest carrier was examined two-years ago and re-examined this year. Visual field and dark adaptation were examined with standard Humphrey VFA. Images of retinal layers and the cone mosaic of the fovea, para- and perifoveal regions were obtained with the Heidelberg Spectralis OCT and the Kongsberg Adaptive Optics Ophthalmoscope II, respectively. ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics The subject’s eye was dilated and accommodation suspended with Cyclopentolate 1% prior to imaging. Results: All the carriers had normal logMAR letter acuity. A ringshaped visual field loss and poorer rod dark adaptation was observed in all three carriers (mean deviation >12.02 dB difference and >0.4 log units difference, respectively, as compared with age-matched controls). OCT showed intact retinal layers in the central 5 deg of the 24 yo and the central 2–3 deg of the 59 yo and 62 yo carrier. Beyond this point the layers of outer and inner segments, external limiting membrane and outer nuclear layer merged in to one. Foveal retinal thinning was observed in the 24 yo and 59 yo as compared with age-matched controls, but not in the 62 yo. All three have patches of pigmentary abnormalities in the periphery. The 24 yo showed a marked change over a two-year periode. The region of intact retinal layers was 1 deg smaller and foveal and parafoveal retinal layers were nearly 20 um thinner than two years ago. Her patches of pigmentary abnormalities seemed unchanged. Visual sensitivity (mean deviation) was reduced by 2 dB. AO images revealed reduced cone density as compared with normal controls and loss of reflective cones beyond the central parts corresponding with findings on OCT images. Conclusions: Changes in retinal structure in female carriers of choroideremia progress over time and are clearly visible both in OCT and AO images. Loss of sensitivity is seen both with standard visual field testing and dark adaptation. The latter indicates a greater loss of rods in peripheral parts. Commercial Relationships: Erle Hortense Veim, None; Rigmor C. Baraas, None; Stuart J. Gilson, None mm2 (range 4670-8775 cells/mm2) for healthy controls. This gives a mean cone:GC ratio of 2.15:1 for glaucoma patients and 1.15:1 for healthy controls. PGRA, but not cone density, was reduced in the scan locations of the maximum visual field loss in glaucoma patients (mean cone:GC ratio 4.59:1). Conclusions: The number of cones does not differ in glaucoma patients compared to age-matched normal controls, despite large differences in ganglion cell density. Since large inter-individual differences in GC density exist even in normal subjects [2], cone:GC ratio may prove to be a useful indicator of GC loss from baseline in glaucoma. References: 1. Drasdo N, Fowler CW. Non-linear projection of the retinal image in a wide-angle schematic eye. Br J Ophthalmol 1974;58:709-714. 2. Curcio CA, Allen KA. Topography of ganglion cells in human retina. J Comp Neurol 1990;300:5-25. Program Number: 92 Poster Board Number: A0252 Presentation Time: 8:30 AM–10:15 AM Determining the cone:ganglion cell ratio in glaucoma using psychophysical measures of retinal ganglion cell density and in vivo imaging of the retinal cone mosaic by a modified Heidelberg Retina Angiograph (HRA2) Juliane Matlach1, Padraig Mulholland1, Marketa Cilkova1, Reena Chopra1, Nilpa Shah1, Tony Redmond2, Steven C. Dakin3, David F. Garway-Heath1, Roger S. Anderson4, 1. 1NIHR Biomedical Research Centre, Moorfields Eye Hospital & UCL Institute of Ophthalmology, London, United Kingdom; 2Optometry and Vision Sciences, Cardiff University, Cardiff, United Kingdom; 3School of Optometry, University of Auckland, Auckland, New Zealand; 4Vision Science Research Group, University of Ulster, Coleraine, United Kingdom. Purpose: To determine the parafoveal cone:ganglion cell (GC) density ratio in glaucoma patients compared to age-matched normal controls using a modified Heidelberg Retina Angiograph (HRA2) to image cones and localized measurements of peripheral grating resolution acuity (PGRA) to estimate GC density. Methods: A group of glaucoma patients with early to moderate visual field loss and healthy age-matched controls underwent in vivo cone imaging at 4 retinal locations at 6° eccentricity using a modified HRA2 (scan angle of 3°). Retinal cones were identified and counted using custom software. PGRA measurement was performed at the same retinal locations and converted to GC density. PGRA values were converted to minimum angle of resolution (MAR) and GC density was calculated using the equation MAR = 0.93/√D. A conversion factor [1] was used to calculate the number of ganglion cells per square millimetre of the retina. Results: The mean cone count within the 3° window was 4545 (6678 cells/mm2, range 6235-7287 cells/mm2) for glaucoma patients and 4808 (7064 cells/mm2, range 6601-8007 cells/mm2) for healthy controls. Mean ganglion cell density was 3110 cells/mm2 (range 420-5634 cells/mm2) for glaucoma patients compared to 6139 cells/ Figure shows the location of the cone images with a retinal eccentricity of approximately 6 degrees. Figure is an example of an image of the retinal cone mosaic of a glaucoma patient using the modified HRA2. Commercial Relationships: Juliane Matlach, None; Padraig Mulholland, None; Marketa Cilkova, None; Reena Chopra, None; Nilpa Shah, None; Tony Redmond, Heidelberg Engineering (F); Steven C. Dakin, None; David F. Garway-Heath, Carl Zeiss Meditec (C), Carl Zeiss Meditec (F), Heidelberg Engineering (F), OptoVue (F), Topcon (F); Roger S. Anderson, Heidelberg Engineering (F) Support: Supported by Hirsch Award from Fight for Sight UK, Technical assistance Heidelberg Engineering GmbH, Dr. Werner Jackstädt-Stiftung (J Matlach), ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Program Number: 93 Poster Board Number: A0253 Presentation Time: 8:30 AM–10:15 AM Age related changes of longitudinal chromatic aberration on Color Visual Acuity Yoshiki Tanaka1, Sho Yokoyama2, Hideki Nakamura2, Kazuo Ichikawa1, Shoko Tanabe1, Kato Yukihito3, Rie Horai3, Kiyoshi Tanaka4. 1Vision Laboratory, Chukyo Eye Clinic, Nagoya, Japan; 2 JCHO Chukyo Hospital, Nagoya, Japan; 3Chukyo Eye Clinic, Nagoya, Japan; 4Shinshu University, Nagano, Japan. Purpose: To study the age related changes of longitudinal chromatic aberration (LCA) on color visual acuity (CVA). Methods: Eight normal eyes of 8 subjects were enrolled in this study. All the subjects had no ocular disease or color anomaly. The mean age was 34.3±6.3 years old (27~47). The mean spherical equivalent was -2.28±2.33D. They had best corrected visual acuity of 20/13 or above. We utilized a laptop personal computer and a Liquid Crystal Display (ColorEdge CG245W, EIZO Corp., Ishikawa, JPN) to display the Ladnolt rings. The Landolt rings were colored with four colors (R: Red, GY: Green-Yellow, BG: Blue-Green, BP: Blue-Purple) in the 15 colors (Chroma 6) of NEW COLOR TEST (Lanthony). The dominant-wavelength values were R: 607 [nm], GY: 566 [nm], BG: 488[nm], BP: 440[nm]. The background was colored with white point D65 (achromatic color). The luminance of the background and the Landolt ring color was equiluminance (30 [cd/ m2]) based on colorimetry. The CVAs of four colors were measured by 0.5D increments using addition lenses from +1.0 to -2.0D with the best correction. The visual distance was 3 [m]. This experiment was conducted in a dark room. The LCA was the delta between the R (long-wavelength) and BP (short-wavelength) with the use of the addition lens with which was obtained best visual acuity. Results: Figure 1 shows the results of CVA for each addition lens. The addition lens which obtained the best CVA were R: 0D (best correction), GY, BG, BP: -0.5D. Figure 2 shows the results of agerelated changes of LCA. The LCA and age showed the significant positive correlation (r=0.766, p=0.0310). Conclusions: Our study shows that LCA can be evaluated by CVA numerically and subjectively. We expect that LCA evaluated by CVA can be useful data to attain best corrected visual acuity in infant, because the LCA was high in young subjects. Figure 1. CVA for each addition lens (+1.0 ~-2.0) in four colors (R: Red, GY: Green-Yellow, BG: Blue-Green, GY: Green-Yellow, BP: Blue-Purple). Figure 2. Age-related changes of chromatic aberration. The chromatic aberration means the delta of the addition lens which obtains best visual acuity by the most positive side of the lens between the visual acuity of Red and Blue-Purple. Commercial Relationships: Yoshiki Tanaka, None; Sho Yokoyama, None; Hideki Nakamura, None; Kazuo Ichikawa, None; Shoko Tanabe, None; Kato Yukihito, None; Rie Horai, None; Kiyoshi Tanaka, None Program Number: 94 Poster Board Number: A0254 Presentation Time: 8:30 AM–10:15 AM Cone-weighted chromatic pupillometry as an outcome measure for clinical trials in Usher syndrome patients Ieva Sliesoraityte1, Saddek Mohand-Said1, Konstantin E. Kotliar3, Ana Fakin2, Jose A. Sahel1. 1Centre Hospitalier National dïOphtalmologie, Paris, France; 2UCL Institute of Ophthalmology, Ocular Biology, Moorfields Eye Hospital, London, United Kingdom; 3 FH Aachen University of Applied Sciences, Juelich, Germany. Purpose: Progressive dysfunction of photoreceptors, particularly cones, leads to severe visual impairment in Usher syndrome patients. Reliable cone functional estimates are of key importance for measuring safety and efficacy outcomes in clinical trials. The aim of this study was to evaluate the cone-weighted chromatic pupillometry potential to be used as a standard outcome measure in Usher syndrome patient clinical trials. Methods: The prospective case series study enrolled 50 Usher syndrome patients. All patients underwent in-depth phenotypic examination and were found to carry at least one mutation. Monocular pupil diameter was recorded (Neurolight®, IDMed, Marseilles, France) in response to red (640 nm) light stimuli for varied intensity levels (ranging from 1000 cd/m2 to 0.001cd/m2). Raw data were exported and analyzed off-line using MATLAB software. Data were fitted using the sigmoid Naka-Rushton function. Repeatability and reproducibility was evaluated. Mean response amplitudes were analyzed and compared to the clinical phenotype. Results: The mean cone-weighted response amplitude was 75±20μm in Usher syndrome patients. Lower cone-weighted responses were related to the reduced b-wave amplitude in full field scotopic electroretinogram (ERG) (r=0,49;p<0.001) and decreased P1N1 peaks in mfERG (r=0.60;p<0.001). Cone-weighted responses were measurable in all cases, even with non-recordable scotopic ERG and mfERG. Higher cone-weighted responses were positively associated with preserved kinetic visual field area (r=0,63;p<0.001), although they were not correlated with best- corrected visual acuity. Higher ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics cone-weighted response amplitudes were observed in cases with a preserved inner/outer segment in optical coherence tomography (r=0,54;p<0.001) and increased cone density in adaptive optics (r=0,56;p<0.001). Repeatability and reducibility were 98% and 95%, respectively. Conclusions: Cone-weighted chromatic pupillometry responses are repeatable and reproducible, with a significant correlation potential for cone-related phenotype measures in Usher syndrome patients. Cone-weighted chromatic pupillometry could be used as a standard outcome measure to assess safety and efficacy in clinical trials, particularly in advanced Usher syndrome cases. Commercial Relationships: Ieva Sliesoraityte, None; Saddek Mohand-Said, None; Konstantin E. Kotliar, None; Ana Fakin, None; Jose A. Sahel, None Support: ERAREl N°58: Eur-USH Clinical Trial: NCT01954953 135 Binocular vision, refraction and development Sunday, May 03, 2015 1:30 PM–3:15 PM Exhibit Hall Poster Session Program #/Board # Range: 523–542/A0255–A0274 Organizing Section: Visual Psychophysics / Physiological Optics Contributing Section(s): Anatomy/Pathology, Clinical/ Epidemiologic Research, Eye Movements/Strabismus/Amblyopia/ Neuro-Ophthalmology, Multidisciplinary Ophthalmic Imaging Program Number: 523 Poster Board Number: A0255 Presentation Time: 1:30 PM–3:15 PM Effects of mercury exposure on the visual functions of children from Amazonian riverine villages Joyce D. Freitas1, Eliza Lacerda1, Dario Rodrigues1, Daniela Bonci3, Maria Izabel Côrtez4, Tereza Cristina Corvelo1, 2, Dora F. Ventura3, Luiz Carlos L. Silveira1, 2, Maria da Conceição Pinheiro1, Givago S. Souza1, 2. 1Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Brazil; 2Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil; 3Instituto de Psicologia, Universidade de São Paulo, São Paulo, Brazil; 4Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Amapá, Macapá, Brazil. Purpose: The purpose of the present study was to investigate the color vision of children living in riverine communities located in the Tapajós river basin, in order to evaluate the impacts of mercury exposure earlier in the developing nervous system. We compared the results with those from children living in the Tocantins river basin, considered to be a region without mercury exposure. Methods: One hundred and seventy eight children, 7-14 years old, were studied. They lived in three riverine communities from two different river basins of the Brazilian Amazon: Barreiras and São Luiz do Tapajós from the Tapajós river, and Limoeiro do Ajuru from the Tocantins river. We quantified their mercury hair concentration using atomic absorption spectrophotometry and evaluated their color vision using the Lanthony D-15 desaturated test (D-15d). We applied the Vingrys and King-Smith (1988) vector analysis to estimate the angle and magnitude of the hue ordering error (C-Index). KruskalWallis test and Dunn post-hoc test was applied to compare the data from each children population. Results: Children from Tapajós river basin had 10 times higher mercury exposure than children Tocantins river basin (p < 0.05). Most of children from Tocantins river basin showed Lanthony D-15d C-index between 1 and 4 and error angle between +45o and +900 (normal trichromats), while a few of them had error angle between -750 and -900 (blue-yellow color deficiency). In Barreiras, there was a large cluster of children with C-index between 1 and 3, error angle between +45o and +900, and two smaller clusters, one with radius between 1 and 4 and angle between +150 and -300 (red-green color deficiency) and another with radius between 1 and 3 and angle between -750 and -90). In São Luiz do Tapajós, there were three well distinct groups with C-index between 1-4: error angle between +450 and +900, +150 and -300, and -750 and -90o. In São Luiz do Tapajós, the results of color vision defects were associated to mercury hair concentration higher than 1.15 ppm. Conclusions: We found that in the village with higher mercury exposure, the color vision deficits were associated with the level of mercury exposure. Continuous monitoring of children performance in color vision tests can be important to understand the effects of long term, low levels of mercury exposure in the developing visual nervous system. Commercial Relationships: Joyce D. Freitas, None; Eliza Lacerda, None; Dario Rodrigues, None; Daniela Bonci, None; Maria Izabel Côrtez, None; Tereza Cristina Corvelo, None; Dora F. Ventura, None; Luiz Carlos L. Silveira, None; Maria da Conceição Pinheiro, None; Givago S. Souza, None Support: CAPES, CNPq, FINEP IBN-Net. DFV, LCLS, and MCNP are CNPq research fellows. Program Number: 524 Poster Board Number: A0256 Presentation Time: 1:30 PM–3:15 PM Small Fluctuations in Limbal Thickness are Associated with Blood Glucose Values in Young Healthy Subjects Wendy W. Harrison, Vladimir Yevseyenkov, Catherine Dee, Kristen Davison, Robert Cook, M. Brayden Lundquist, Todd Albrecht, Brady Haslam, Julie Welch. Optometry, Midwestern Univ Arizona Coll of Optometry, Glendale, AZ. Purpose: Previously our group has reported in cross sectional data that limbal thickness (LT) values are positively associated with blood glucose (BG) measures in low myope controls (under-5.50D). This association is absent in patients with diabetes of the same Rx range and higher myopes with thinner scleras. The timeline of these structural changes and the mechanism behind this remains unclear. Here we follow up with a longitudinal pilot study. It seeks to both confirm that these short term fluctuations in LT with BG changes occur within individuals and to learn more about the scale of these differences. Methods: Eighteen 24-32 years old were recruited for this portion of the study. There were 2 high myopes, 9 low myopes, and 6 essential emmetropes. OCT of the temporal sclera at the limbus was performed (Heidelberg Spectralis SD-OCT AS module lens) and LT was measured on the more myopic eye. BG was taken directly before. Two measurements of LT and BG were taken at different times of day but within the same week. The differences between the measures were evaluated. Results: Within individuals, short term differences in BG were positively associated with differences in LT (p<0.03), 78% of patients exhibited this trend. Of the 4 who did not; 2 are the high myopes and a third is a -5D myope. This furthers the data that high myopes may not experience these same fluctuations in LT with BG changes due to scleral differences. This new data is in-line with the cross sectional results previously gathered. The scale of the LT fluctuations was highly variable between subjects but typically small, 7 ± 30 microns. Conclusions: These results confirm short term structural changes at the limbus, which are tied to systemic BG values and measurable with AS-OCT in low myopes. Evaluation of these changes in vascular conditions such as diabetes as well as higher myopia is warranted as a follow up to this work. It appears that higher myopes with thinner scleras may not exhibit this trend. Further investigation into the mechanism at a more detailed level would aid in this analysis. ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Commercial Relationships: Wendy W. Harrison, None; Vladimir Yevseyenkov, None; Catherine Dee, None; Kristen Davison, None; Robert Cook, None; M. Brayden Lundquist, None; Todd Albrecht, None; Brady Haslam, None; Julie Welch, None Program Number: 525 Poster Board Number: A0257 Presentation Time: 1:30 PM–3:15 PM The effect of a cycloplegic agent on the objectively and subjectively determined refraction Arne Ohlendorf, Alexander Leube, Siegfried Wahl. Ophthalmic Research Institute, ZEISS Vision Science Lab, Tuebingen, Germany. Purpose: To study changes in subjective and objective refraction due to relaxed accommodation caused by an cycloplegic agent in myopes and non-myopes. Methods: 18 subjects with a mean age of 27.1 ± 3.5 years participated in the study. Refractive errors of their right eye were measured subjectively and objectively before and after a cycloplegic agent (three times one drop of 1% cycloplentolat with 10 minutes between application) was administered. Subjective refraction was performed by the same investigator, using a trial frame, trial lenses and a 4mm artificial pupil. Objective refraction was measured with the i.Profiler plus (ZEISS, Germany) before and after cycloplegia and data were analyzed for a pupil diameter of 4mm. Results: Objectively and subjectively determined refractions were analyzed for changes in the power vectors M, J0, J45 and the blur strength B (difference in power matrix between post- and precycloplegic refraction). Using the objective refraction method, more hyperopic refractions were observed for M and B in myopes (n=10; delta M 0.44D ± 0.38D, p<0.01 and B 0.49 ± 0.34D, p<0.01) and non-myopes (n=8; delta M 1.12D ± 0.62D, p<0.01 and B 1.14 0.61, p<0.01). Changes in objectively determined J0 and J45 were minor and lacked statistical significance, in both groups. Also, subjectively measured refraction showed a significant shift towards more hyperopia in non-myopes (delta M 0.84D ± 0.68D, p<0.05 and B 0.89 ± 0.62, p<0.001), while J0 and J45 were unaffected. In myopes, blur strength B showed significant changes, again towards hyperopia (0.36 ± 0.24, p<0.01), while changes in power vectors M, J0 and J45 lacked statistical significance. Conclusions: Mean spherical equivalent and blur strength shifted positively after cycloplegia when refraction was assessed subjectively and objectively for the same pupil size. The cycloplegic effect of the drug should be taken into account when interpreting refraction measurements for the prescription of spectacles, planning a wavefront-guided laser ablation or cataract surgery. Possible influence of changes in axial length or choroidal thickness may account for the observed differences but were not investigated in the current course of the study. Commercial Relationships: Arne Ohlendorf, ZEISS Vision International GmbH (E); Alexander Leube, None; Siegfried Wahl, ZEISS Vision International GmbH (E) Program Number: 526 Poster Board Number: A0258 Presentation Time: 1:30 PM–3:15 PM Factors affecting the calibration of white light eccentric photorefraction Yun Chen, Frank Schaeffel. Institute for Opthalmic Research, University Hospital Tubingen, Tubingen, Germany. Purpose: Infrared eccentric photorefraction is widely used to measure refractive errors in animal models and humans(Schaeffel et al. 1993).If photorefraction is performed by a flash of white light LEDs,a separate analysis of the R G and B channel of the video camera could provide longitudinal chromatic aberration.It is unknown how variations in fundal reflectance due to macular pigment,as well as higher order aberrations affect the calibration of photorefraction. Methods: Calibration of white light photorefraction was done simultaneously in the R G and B by trial lenses (-4D~+4D) in 12 eyes of young Caucasian subjects.Pupil size was controlled (5mm). Calibration occured under 3 conditions:1)in the fovea, 2)10 degrees off-axis in the temporal retina,3) in the fovea but after 10mins of previous exposure to bright light.The luminance to pixel response of the video camera was determined in white light.Higher order aberrations were measured with WASCA wavefront Analyzer (Carl Zeiss Meditec AG,Germany).MPOD was measured by the MPOD Tinsley(UK).Ocular parameters were correlated with the calibration factors (converting the brightness slope in the pupil into refractive error;Schaeffel et al 1993).Paired t-tests were used to comparing differences in calibration factors. Results: The luminance to pixel response function of the video system could not explain the interocular variance of the conversion factors.As previously found,calibration factors were highly variable among subjects and even much more variable than what is typical in infrared light, from 3.8 to 13.8 in condtion1, 2.38.0 in 2, and 7.6-16.0 in 3. There were a number of significant correlations:calibration factors fovea to temporal retina,calibration factors to spherical aberration,and even to the foveal refractive error. Furthermore,calibration factors were highly correlated to MPOD in G and B in the fovea but not at 10 degree temporal retina. Exposure to bright light increase conversion factors. Conclusions: The following ocular parameters determined the calibration of white light photorefraction:MPOD, refractive error, previous history of light exposure and spherical aberration. While the effect of the first 3 correlations may ultimately trace back to variations in fundal reflectance, the correlation to spherical aberration is unexpected and requires further studies. These factors have to be controlled before polychromatic photorefraction can be used to measure LCA. Commercial Relationships: Yun Chen, None; Frank Schaeffel, None Program Number: 527 Poster Board Number: A0259 Presentation Time: 1:30 PM–3:15 PM Variability in autorefraction for subjects with and without Down syndrome Jason D. Marsack, Julia Benoit, Heather A. Anderson. Optometry, University of Houston, Houston, TX. Purpose: Patients with Down syndrome (DS) have a high incidence of refractive error and corneal distortion, and a relationship between DS and keratoconus is reported in the literature. Objective measures of refractive error, such as autorefraction, provide a starting point for subjective refraction and may more heavily influence prescribing decisions for this group given the difficulty of performing subjective refraction. This study compares variability in repeated measures of autorefraction in patients with and without DS. Methods: Grand Seiko autorefraction was performed binocularly on 140 DS subjects (age range: 8 to 55, mean: 25±9 yrs) and 138 control subjects (age range: 7 to 59, mean: 25±10 yrs). Subjects where at least 3 repeated measures were recorded in both eyes (DS: 112 and control: 136) were included in further analysis. Each refraction was converted to power vector notation (M J0 J45). The dioptric distance between each refraction pairing for each eye of each subject was calculated for the total (square root of the sum of the squares of ΔM, ΔJ0 and ΔJ45) and astigmatic (square root of the sum of the squares of ΔJ0 and ΔJ45) components of the refraction. The mean total and astigmatic variability in refraction for each eye was calculated as the mean dioptric distance between all 3 comparisons. Right and left ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics eyes were pooled and the mean total and astigmatic variability was calculated within each group. Results: DS eyes exhibited a significantly greater mean total dioptric distance in refraction (+0.66D ± 0.67D) than control eyes (+0.20D ± 0.17D)(t=10.07, p<.001) with 96.7% of control eyes ≤ 0.50D, compared to only 59.4% of DS eyes. No control eye had mean total dioptric distance over 1.50D, whereas 8.9% of DS eyes exceeded that benchmark. When only the astigmatic component is considered, DS eyes exhibited a significantly greater mean astigmatic dioptric distance in refraction (+0.41D ± 0.40D) than control eyes (+0.13D ± 0.13D)(t=9.97, p<.001), with 98.16% of control eyes ≤ 0.50D, compared to 77.7% of DS eyes. No control eye had mean astigmatic dioptric distance over 1.27D, whereas 6.25% of DS eyes exceeded that benchmark. Conclusions: Refractive variability with autorefraction in DS was 3.3x (total) and 3.15x (astigmatic) the levels observed in controls, indicating greater potential uncertainty in the starting point for subjective refraction for this population. Commercial Relationships: Jason D. Marsack, None; Julia Benoit, None; Heather A. Anderson, None Support: NIH EY024590 Program Number: 528 Poster Board Number: A0260 Presentation Time: 1:30 PM–3:15 PM Variability of simulated keratometry measures in subjects with and without Down syndrome Ayeswarya Ravikumar, Jason D. Marsack, Heather A. Anderson. College of Optometry, University of Houston, Houston, TX. Purpose: Individuals with Down syndrome (DS) are known to have steeper corneas and greater astigmatism as compared to the general population. In addition, their corneas demonstrate distortion characteristics similar to keratoconus which could result in increased variability in clinical measurements. This study investigates the variability of corneal astigmatism magnitude, steep keratometry (K) power and the flat K orientation of subjects with and without DS obtained with the Zeiss Atlas corneal topographer. Methods: Corneal topography was obtained on 140 DS subjects and 138 controls (age range=7 to 59 years). Subjects with three corneal topography measures per eye were analyzed for this study (DS: n=108 (216 eyes), controls: n=133 (266 eyes)). Corneal astigmatism (calculated as the difference between steep and flat keratometry powers), steep K power and the flat K orientation was obtained. Variability of each parameter for the DS and control groups was defined as the group mean standard deviation of the three measures. For flat K orientation comparisons, only eyes with >0.50 DC of astigmatism were included (201 and 220 for DS and control eyes respectively). T-tests were performed to compare the mean standard deviations between DS and control eyes for each parameter. Results: Average variability in corneal astigmatism magnitude in DS eyes (0.30 ± 0.39DC, range 0 to 2.83 DC with 65.3% ≤ 0.25 DC and 87.0% ≤ 0.50 DC) was significantly greater (p <0.001) than control eyes (0.09 ± 0.06 DC, range 0 to 0.50 DC (100%)). Average variability in steep K power in DS eyes (0.33 ± 0.43D, range 0 to 3.75D with 60.65% ≤ 0.25 D and 83.80% ≤ 0.50 D) was significantly greater (p <0.001) than control eyes (0.09 ± 0.09 D, range 0 to 1.00D with 99.25% ≤ 0.50D). Average variability in flat K orientation in DS eyes (5.62 ± 5.89 degrees, range 0 to 60 degrees with 86.07% ≤ 10.00 degrees) was significantly greater (p <0.001) than control eyes (3.16 ± 3.01 degrees, range 0 to 30 degrees and 96.82% ≤ 10 degrees). Conclusions: DS eyes showed more variability compared to controls for all parameters. Although differences were statistically significant, on average 86% of DS eyes had variability of astigmatism magnitude and steep K power ≤ 0.50 D and variability of flat K orientation ≤ 10 degrees, indicating tolerable clinical variability for the majority of the group. Commercial Relationships: Ayeswarya Ravikumar, None; Jason D. Marsack, None; Heather A. Anderson, None Support: NIHEY024590 Program Number: 529 Poster Board Number: A0261 Presentation Time: 1:30 PM–3:15 PM Binocularity mitigates the impact of night myopia Emmanuel Chirre1, Christina Schwarz2, Pedro M. Prieto1, Pablo Artal1. 1Laboratorio de Optica, Universidad de Murcia, Murcia, Spain; 2Center for Visual Science, University of Rochester, Rochester, NY. Purpose: Night myopia, the myopic shift occurring at low luminance, has been studied during decades. In most cases, the experiments were performed monocularly with scarce data available under natural binocular viewing conditions. We used a new openview binocular sensor to study binocular accommodation responses under natural viewing conditions to evaluate the effect of binocularity on night myopia. Methods: The instrument is a Hartmann-Shack based sensor to measure refraction, aberrations, pupil diameter and the relative position of both eyes simultaneously in real time (25Hz) with an invisible infrared (1050nm) beam. Subjects unobtrusively observe a 1.3 degree high-contrast black Snellen E letter on white background displayed on an LCD monitor at 2.75 meters. Seven young subjects participated in the study: age 28.7±2.69 years; spherical refractive error was -0.11±0.32 D and -0.24±0.33 D, and astigmatism was -0.46±0.19 D and -0.31±0.14 D for the left and right eye respectively. Accommodation error, high-order aberrations, inter-pupillary distance and pupil size were measured simultaneously in both eyes at 7 different luminance levels ranging from 180 to 0.0005 cd/m2. Measurements were performed both monocularly (with the fellow eye covered) and binocularly. Results: The average values of myopic shift when measured monocularly were -0.51±0.57 D and -0.47±0.55 D for each eye. In binocular vision, these values were reduced to -0.27±0.32 D and -0.26±0.32 D for the left and right eyes respectively. Both the magnitude and variability of the defocus shift were larger in the monocular cases. The average pupil size was smaller in the binocular case for most luminances. A shorter relative inter-pupillary distance in monocular viewing revealed the presence of dark-vergence that is correlated to the myopic shifts. Conclusions: Myopic shifts occurring at low luminance are smaller under binocular conditions than when measured monocularly. Darkvergence occurred under monocular conditions and may have a larger impact on vision. Natural binocular viewing reduces myopic shifts at low luminance and can mitigate the visual impact of night myopia. Commercial Relationships: Emmanuel Chirre, None; Christina Schwarz, None; Pedro M. Prieto, None; Pablo Artal, None Support: Spain grants FIS2013-41237-R & FIS2010-14926 Program Number: 530 Poster Board Number: A0262 Presentation Time: 1:30 PM–3:15 PM Binocular Vision, Reading Ability and Associated Symptoms in School Children Ida Henrysson, Baskar Theagarayan. Department of Medicine and Optometry, Linnaeus University, Bergen, Norway. Purpose: The purpose of this study was to investigate relationship between binocular vision, reading ability and any associated symptoms in School Children. Methods: The study was conducted in a School in western Sweden. A sample of 54 Children aged between 10 and 12 years were ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics invited to participate in this study. A consent form and a letter with information was sent to their parents. Children with at least 20/25 and N6 visual acuity and good Stereopsis were included. After receiving consent forms, 27 Children participated in all the measurements. Amplitude of accommodation was measured using push-up method both monocularly and binocularly. Accommodative facility was measured using ± 2.00 D flippers at 40 cm both monocularly and binocularly. Near point of convergence was measured using a Royal Air Force (RAF) ruler and both break and recovery points were documented. All the Children performed a group of reading ability tests to detect whether they have any reading difficulties. A questionnaire called “The College of Optometrists in Vision Development Quality of Life (COVD-QOL)” was filled by their parents together with their Children. A score of 20 or more is considered as symptomatic. Results: Mean amplitude of accommodation was OD 10.8 ± 4.0 D, OS 11.8 ± 4.1 D and OU 14.2 ± 3.7 D. Amplitude of accommodation was low in terms of Hofstetter’s formula. Based on age, 59% of the Children were below expected value. The accommodative facility was lower than expected, with mean values of OD 5.5 ± 4.0 cpm, OS 5.5 ± 4.0 cpm and OU 5.0 ± 3.5 cpm. Mean near point of convergence was 6.0 ± 5.4 cm for break and 6.6 ± 5.9 cm for recovery. In the reading ability tests all the Children had normal values. Three Children received ≥ 20 points on the symptom questionnaire COVD-QOL, which is considered to be high. All of these three Children had values below normal limits for the amplitude of accommodation and/or the accommodative facility. Regression analysis showed no significant correlation between binocular vision tests, reading ability and symptom score (r < 0.6; p > 0.05). Conclusions: Amplitude of accommodation and accommodative facility was lower than expected values for their age. Near point of convergence values reached the expected normal level. There was no significant correlation between binocular vision tests, reading ability and associated symptoms in this sample of Swedish Children. Commercial Relationships: Ida Henrysson, None; Baskar Theagarayan, None Program Number: 531 Poster Board Number: A0263 Presentation Time: 1:30 PM–3:15 PM The evidence base underlying symptoms of ocular discomfort in emmetropic school children Barbara M. Junghans1, 2, Serap Azizoglu2, Ayla Barutchu2, Sheila G. Crewther2. 1School of Optometry and Vision Science, Univ of New South Wales, UNSW Sydney, NSW, Australia; 2School of Psychological Science, La Trobe University, Melbourne, VIC, Australia. Purpose: To examine whether reports of ocular discomfort by school children with emmetropic refractions are primarily related to binocular vision anomaly(s) (BVA). Also, to investigate whether the Convergence Insufficiency Symptom Survey (CISS) can be utilized to identify suspect BVA and separate accommodative and/or convergence anomalies. Methods: Children aged 8 to 16 years in grades 3 to year 10, were recruited from a private school in Melbourne, Australia for a basic vision screening. Tests included visual acuity for distance and near, non cycloplegic retinoscopy and subjective refraction, stereopsis and cover test. Those children classified as emmetropic and without ametropia, astigmatism, anisometropia, amblyopia, strabismus, ADHD or learning difficulties, also underwent a further detailed binocular vision assessment including a battery of accommodation and convergence tests and completed the CISS. Results: Of the 247 primary and middle school students screened (participation 72.6% of all enrolled, mean age 11.5 ± 2.2), 74.5% (n=184) emmetropes were included for binocular vision assessment. In those who had their binocular vision assessed, 54.3% (n=100) had normal binocular vision (NBV) and the remainder (45.7%, n=84) were suspected on standard clinical tests of having a BVA (35.7% convergence anomaly, 10.7% accommodation anomaly and 53.6% mixed anomaly). BVA groups including accommodative dysfunction had significantly higher symptom survey scores (p<0.01) compared to the NBV group. Results of the 15 question survey revealed 4 redundant questions. The remaining 11 questions were further analysed using factor analysis, whereby two major factors were extracted from the CISS variance, one associated with ocular discomfort and the other relating to cognitive consequences. Conclusions: This study suggests that it is common in a nonselected group of emmetropic school children to find children with suspected BVA who warrant referral based on binocular vision signs and symptoms. Also, this study suggests that the CISS is useful in identifying BVA, and is sensitive to convergence and accommodation anomalies. Commercial Relationships: Barbara M. Junghans, None; Serap Azizoglu, None; Ayla Barutchu, None; Sheila G. Crewther, None Program Number: 532 Poster Board Number: A0264 Presentation Time: 1:30 PM–3:15 PM The Relation Between Convergence Insufficiency and Astigmatism Amy Davis, John D. Twelker, Joseph M. Miller, Erin M. Harvey. Ophthalmology and Vision Science, University of Arizona, Tucson, AZ. Purpose: To determine if children with moderate/high astigmatism have an increased rate of convergence insufficiency compared to children with no/low astigmatism. Methods: Subjects were 3rd-8th grade Tohono O’odham students who have a high prevalence of astigmatism. An eye examination including subjective refinement of Retinomax (Nikon, Inc.) cycloplegic autorefraction was performed on each student. Spectacle correction was prescribed for students with a significant refractive error (>1D myopia, >1D astigmatism, >2.5D hyperopia, >1.5D anisometropia). Hyperopic correction was reduced by 1/3 or by 1.00D whichever was greater. Cover testing at distance and near, near point of convergence, positive and negative fusional vergence at near (fusional convergence and divergence amplitudes), accommodative amplitude (Donder’s pushup method), and symptoms (Convergence Insufficiency Symptom Survey (CISS)) testing was conducted while students wore spectacle correction (if prescribed). Students with an exodeviation at near at least 4∆ greater than at far, a receded NPC (6 cm or greater), and insufficient positive fusional vergence at near (PFV) (convergence amplitudes) (i.e., failing Sheard’s criterion (PFV less than twice the near phoria) or minimum PFV of < 15∆ base-out blur or break), and a CISS score of > 16 were classified as having convergence insufficiency. Astigmatism was categorized by magnitude in the most astigmatic eye (<1D, 1 to <3D, ≥3D). Chisquare analysis was conducted to determine the relation between convergence insufficiency and astigmatism magnitude. Results: The final sample included 484 Tohono Oodham students ages 8.26 to 15.87 years. Prevalence of convergence insufficiency was 6.2% (30/484). Astigmatism <1.00D was present in 43.8% (212/484), >1D to <3D was present in 26.0% (126/484) and > 3D was present in 30.2% (146/484). There was no significant relation between presence of convergence insufficiency and magnitude of astigmatism (p=0.30, see Table and Graph). Conclusions: The prevalence of convergence insufficiency is consistent with reports from other samples, although this finding should be interpreted with caution as the present sample was not ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics population-based. The results suggest that children with moderate to high astigmatism are not at an increased risk for convergence insufficiency. Commercial Relationships: Amy Davis, None; John D. Twelker, None; Joseph M. Miller, None; Erin M. Harvey, None Support: NIH EY13153, Research to Prevent Blindness Program Number: 533 Poster Board Number: A0265 Presentation Time: 1:30 PM–3:15 PM Comparison of best-corrected vs uncorrected performance on the Beery VMI Developmental Test of Visual Perception in astigmatic children Tina K. Green1, Amy Davis1, Mabel Crescioni1, Irene Campus1, Kathleen Mohan1, John D. Twelker1, Joseph M. Miller1, 2, Erin M. Harvey1, 2. 1Ophthalmology and Vision Science, University of Arizona, Tucson, AZ; 2College of Public Health, Tucson, AZ. Purpose: To compare performance of astigmatic students on the Beery VMI Developmental Test of Visual Perception while wearing best correction and while uncorrected. Methods: Subjects were third through eighth grade Tohono O’odham students, who have a high prevalence of astigmatism. An eye examination which included measurement of refractive error (subjectively refined cycloplegic autorefraction) was performed on each student. The Beery VMI Developmental Test of Visual Perception was administered on two separate dates once with best correction and once uncorrected. Order of testing was randomly selected. Testing was conducted binocularly. Standardized testing forms were used and administration and scoring was conducted per the BEERY VMI Manual. Raw scores were converted to age based standardized score (mean = 100, SD = 10). Students were categorized as having moderate (1 to < 3D) or high (>/= 3D) astigmatism based on astigmatism magnitude in their least astigmatic eye. Repeated measures analysis of variance compared performance with correction vs. without correction across astigmatism groups while controlling for test order. Results: The final sample included 195 students (109 moderate astigmats, 86 high astigmats). There was a significant effect of correction, with students scoring better with than without the spectacles (97.82 (SD 12.2) vs 95.01 (SD 14.25), p = 0.006). There was no significant effect of astigmatism magnitude. However, there was a significant interaction between correction and testing order. For students who completed the test with their correction first, there was no significant difference between performance when corrected and when uncorrected (98.75 (SD 11.12) vs. 99.09, (SD 12.14)). For students who completed the test uncorrected first, performance when corrected (97.00, SD 12.74) was significantly better than when uncorrected (91.43, SD 15.04, p < 0.001). Conclusions: The results indicate that uncorrected refractive error, particularly astigmatism, may significantly reduce scores on the BEERY VMI Developmental Test of Visual Perception. However, when correction was worn, average scores in the astigmatic sample approached the standardized score mean of 100. Strategies students developed while performing the test first with their best-correction may have improved performance when uncorrected. Commercial Relationships: Tina K. Green, None; Amy Davis, None; Mabel Crescioni, None; Irene Campus, None; Kathleen Mohan, None; John D. Twelker, None; Joseph M. Miller, None; Erin M. Harvey, None Support: NIH/NEI Grant EY13153 (EH) and funds from Research to Prevent Blindness Program Number: 534 Poster Board Number: A0266 Presentation Time: 1:30 PM–3:15 PM A research based novel method for vergence rehabilitation Zoi Kapoula1, Aurelien Morize1, François Daniel1, Fabienne Jonqua1, Christophe Orssaud2, Dominique Bremond-Gignac3. 1CNRS, Paris, France; 2HEGP, Paris, France; 3Université de Picardie, Paris, France. Purpose: About 30% of population may experience problems of binocular vision related to vergence insufficiency. Rehabilitation of vergence is mostly based on push-up exercises or use of prisms. We have developed a real space visual-acoustic rehabilitation device (patent US 8851669). We aim to validate its clinical efficiency. Methods: Nineteen students (20 to 27 years old) underwent ophthalmologic and orthoptic examination; 8 of them were diagnosed for vergence disorders (high CISS scores, see CITT study 2009). All subjects performed a vergence test with video-oculography (Eyee See Cam). Subjects with vergence disorders performed 5 sessions of vergence rehabilitation 30 min each, over 5 weeks. The vergence test was repeated 1 month after the rehabilitation. Subjects were seated in front of the trapezoid tablet composed of LEDs along the median plane. Vergence test: twenty convergence and twenty divergence eye movements were randomly interleaved starting always from an LED at 40 cm and going to an LED at 20cm or 150 cm. Vergence rehabilitation protocol: convergence trials always started by fixating (for 1000 – 1600 ms) an LED at 150 cm; the target LED was presented at 90cm or 23 cm for 1300 ms after stepping for 200 ms at a distance 20% shorter (double step paradigm); the two types of trials were randomly interleaved. Subjects performed a total of 2200 movements. Results: In healthy latency was 194 vs 203ms for convergence vs divergence; the gain was 0.97 vs 0.76, and mean velocity 26°/s vs 16°/s. Subjects with vergence disorders showed lower gain (0.71 vs 0.54), significantly higher variability for convergence gain, and significantly lower mean velocity (22°/s vs 13°/s). After the ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics 5 sessions of rehabilitation we observed: significant reduction of latency (dropping to 155ms vs 181ms for convergence and divergence); the gain increased significantly for convergence (1.0) and to a less extent for divergence (0.85). Moreover, variability of latency, gain and mean velocity decreased significantly, to values even lower than those from healthy subjects. The CISS decreased significantly. Conclusions: This research based device allows objective evaluation of vergence disorders and efficient rehabilitation, leading to normalization of vergence. The efficiency is due to regular and frequent timing of vergence trials with a double step paradigm, a widely established method for saccade adaptation in research that we now extend for clinical use in patients. Commercial Relationships: Zoi Kapoula, None; Aurelien Morize, None; François Daniel, None; Fabienne Jonqua, None; Christophe Orssaud, None; Dominique Bremond-Gignac, None Program Number: 535 Poster Board Number: A0267 Presentation Time: 1:30 PM–3:15 PM Adaptation of phoria and accommodation in the presence of prism in young children Yifei Wu1, Vidhyapriya Sreenivasan1, Erin Babinsky2, T R. Candy1. 1School of Optometry, Indiana University Bloomington, Bloomington, IN; 2Universitat Pompeu Fabra, Barcelona, Spain. Purpose: Young children have reduced interpupillary distance and hyperopic refraction relative to adults, leading to decreased convergence and increased accommodation demands. Children with typical amounts of hyperopia accommodate to achieve clear retinal images, at the same time generating convergence through neural coupling. It is known that adults demonstrate vergence adaptation to a variety of visual stimuli. Henson and North (1980) reported adults showing average adaptation of 72% to a 6pd demand after 3.5 mins. Do young children also show adaptation to their immature demands? Methods: Purkinje image tracking and eccentric photorefraction were used to record eye alignment and accommodation in adults and young children (3.25 - 5 yrs). Participants viewed a naturalistic target at 95cm binocularly (bi) for 15 secs, followed by 15 secs of monocular (mo) viewing. Each heterophoria was derived from the difference between these two alignments. Additional vergence demand was introduced by holding a 2 MA base out prism (10pd in adults; 6pd in kids) in front of one eye for an extended period of time (~2.5-3.5 mins). The heterophoria measurements were repeated during this period. Adaptation was defined as the percentage of the additional prism that was compensated for by changes in phoria position. Results: 90% of adults maintained fusion when viewing through prisms and on average adapted to 52% of the additional demand (range 39%- 72%). 86% of young children also fused and on average adapted to 55% of the additional demand (range 38% - 67%). When comparing accommodation during the adaptation period with baseline, accommodation was somewhat increased in the beginning of the adaptation (0.25±0.13D bi, 0.02±0.09D mo in adults; 0.28±0.18D bi, 0.25±0.18D mo in kids) and greater still at the end of adaptation (0.31±0.19D bi, 0.14±0.27D mo in adults; 0.33±0.13D bi, 0.15±0.14D mo in kids). Conclusions: Young children and adults showed heterophoria adaptation to a 2 MA demand at a 95cm distance. Changes in accommodation responses during the adaptation were significantly smaller than the changes in phoria. In typically developing children who experience changing visual demands, this adaptation might help maintain eye alignment. Its role in clinical abnormalities is yet to be determined. Commercial Relationships: Yifei Wu, None; Vidhyapriya Sreenivasan, None; Erin Babinsky, None; T R. Candy, None Support: NIH Grant R01EY014660, P30EY019008, Fight for Sight for VS Program Number: 536 Poster Board Number: A0268 Presentation Time: 1:30 PM–3:15 PM Relationship between working distance and lag of accommodation in myopic and emmetropic children Bjorn Drobe1, 2, Xinjie Mao3, 2, Yuwen Wang3, 2, Zuopao Zhou3, 2, Xianling Yang3, 2, Hao Chen3, 2. 1R&D Optics, Essilor International, Wenzhou, China; 2WEIRC, WMU-Essilor International Research Centre, Wenzhou, China; 3School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, China. Purpose: To evaluate the relationship between habitual working distance and lag of accommodation in young myopic and emmetropic Chinese children. Methods: Working distance and lag of accommodation were measured in 24 emmetropic (E: +0.16±0.24 D) and 66 myopic (M: -1.93±0.83 D) Chinese children aged from 7 to 11 (E: 9.6±0.9 y.o., M: 8.6±0.6 y.o.). Myopes were equipped with their best distance correction in spectacles. Near vision posture was recorded continuously at 10 Hz during one reading and one writing task on a desk by means of a Fastrack (Polhemus, USA) electromagnetic motion tracking system. Working distance was defined as the distance between the base of the nose and the center of each line and averaged for the whole duration of the task. Before posture measurements, accommodative response was measured at 33 cm using a Grand Seiko WAM-5500 (Grand Seiko, Hiroshima, Japan) openfield autorefractor and lag of accommodation calculated based on the average of three consecutive readings. Results: Emmetropic children were reading at closer distance than myopic children (E: 263±56 mm, M: 291±57 mm, p=0.04) while both groups were writing at similar distances (E: 223±66 mm, M: 228±61 mm, p=0.79). Adjusting data for height did not change those results. Lags of accommodation were of similar amount in both groups (E: 1.19±0.32 D, M: 1.36±0.46 D, p=0.12). In emmetropic children, working distance was positively correlated with lag of accommodation for both reading (r=0.50, p=0.02) and writing (r=0.54, p=0.01) tasks. In myopic children however, those parameters were not correlated for any of the two tasks (p>0.10). Conclusions: Emmetropic children with higher lags of accommodation had greater working distances compared to children with lower lags. This relationship was not observed in myopic children. As lag increases with decreasing distance, it is possible that emmetropic children adjust their posture to keep an acceptable level of retinal blur depending on their initial lag of accommodation while in myopes decreased blur sensitivity may disrupt this relationship. Commercial Relationships: Bjorn Drobe, Essilor Int, (E); Xinjie Mao, Essilor Int. (F); Yuwen Wang, Essilor Int. (F); Zuopao Zhou, Essilor Int. (F); Xianling Yang, Essilor Int. (F); Hao Chen, Essilor Int. (F) Support: International S&T Cooperation Program of China (Grant No. 2014DFA30940) ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Program Number: 537 Poster Board Number: A0269 Presentation Time: 1:30 PM–3:15 PM Myopes’ ability to discriminate and detect blur Fuensanta A. Vera-Diaz1, Guido Maiello4, 3, Kristen L. Kerber1, Frank Thorn2, Peter Bex3. 1Primary Care, New England College of Optometry, Boston, MA; 2Vision Science, New England College of Optometry, Boston, MA; 3Psychology, North Eastern University, Boston, MA; 4UCL Department of Ophthalmology, University College London, London, United Kingdom. Purpose: Animal studies show that retinal defocus causes abnormal eye growth and myopia. Although some studies indicate larger blur detection thresholds in myopes, this finding is not consistent. We hypothesize that it is an impaired ability to discriminate blur (difficulty interpreting small changes in blur) and greater variability in their response to blur that is associated with myopia. Methods: Continuous images (16deg diameter @ 40cm) of “dead leaves” stimuli were presented in four quadrants, each with a different level of Gaussian blur. Using a spatial 4AFC psychophysical paradigm, observers were required to decide which quadrant of the image was blurriest. For the blur discrimination condition, six different blur levels were used: 0.4, 0.8, 1.6, 3.4, 6.8 and 13.6 arc min. Thirty-seven young (22-31yrs) healthy adults participated, reliable psychophysical data was obtained for n=35 (n=21 myopes). Subjects had best corrected VA 0.0 LogMAR (20/20) or better in each eye and no binocular or accommodative dysfunction. Refractive error was determined by binocular subjective refraction that followed a vision screening and objective refraction. Subjects were classified into: Emmetropes (SE OU +0.50 to -0.25D); Myopes (SE -0.50 to -9.00D); or Hyperopes (SE +0.75 to +6.00D). Results: No differences were found in the blur detection task between refractive groups (p=0.5) and there was no correlation between amount of refractive error and blur detection thresholds (R2=0.1, p=0.8). Blur discrimination thresholds were lower for myopes than emmetropes at discriminating for higher (≥1.6 arc min) levels of pedestal blur (p<0.05). There was a correlation between blur discrimination thresholds and amount of refractive error for those higher levels of pedestal blur (R2=0.32, p=0.05). Conclusions: Contrary to our hypothesis, myopes were better than emmetropes at discriminating blur, and no different at detecting blur. These data suggests that myopes learn to discriminate blur and even when corrected their perception of blur is different than in emmetropes. Commercial Relationships: Fuensanta A. Vera-Diaz, None; Guido Maiello, None; Kristen L. Kerber, None; Frank Thorn, None; Peter Bex, None Program Number: 538 Poster Board Number: A0270 Presentation Time: 1:30 PM–3:15 PM Myopes’ ability to accurately accommodate to blur cues in virtual 3D images Kristen Kerber1, Guido Maiello3, 2, Frank Thorn1, Peter J. Bex2, Fuensanta A. Vera-Diaz1. 1The New England College of Optometry, Boston, MA; 2Psychology, Northeastern University, Boston, MA; 3 UCL Institute of Ophthalmology, University College London, London, United Kingdom. Purpose: Defocus blur affects refractive error development. Various human studies report decreased ability to accurately accommodate in myopic adults and children compared to emmetropes, however other studies have found no differences. We hypothesize that myopes have a decreased ability to accurately accommodate, but only when certain 3D cues to accommodation are not available to them. Methods: Binocular accommodative responses were measured using a PowerRefractor while subjects wore shutter glasses and viewed naturalistic images on a 3D display. Stimuli were “dead leaves” images that capture the spatial characteristics of real world images. Subjects viewed five types of images, each randomly presented five times at 40cm for 5 sec, with various cues to accommodation: (1) flat [2D], (2) blur gradient, (3) disparity gradient, (4) size gradient, (5) all cues. Subjects were instructed to fixate on a central green dot at all times. Thirty-eight young (22 to 31 years) healthy adults participated; reliable data was obtained for 21 (n=10 myopes). Refractive error was determined by binocular subjective refraction that followed a vision screening and objective refraction. Results: Myopes show less stable accommodation responses than emmetropes, which are significantly more variable when viewing 2D flat images (Wilcoxon, p=0.01), but become as stable as emmetropes’ responses when 3D and blur cues are available. Accommodation response latencies appear larger in myopes for all conditions, particularly for the “size” and “disparity” conditions. A positive correlation was found between amount of myopia and accommodation response latency when size and/or disparity cues were available (R2>0.4). The amplitude of accommodation was not significantly different between the refractive groups for any condition, although myopes appear to accommodate more (smaller lags) for all conditions. Conclusions: Our results indicate larger variability in accommodation responses in myopes when viewing flat images. Only when additional cues are added (disparity, blur, size), do myopes’ accommodation responses stabilize. In addition, the time lag to achieve adequate accommodation is larger for myopes. Inaccuracies of accommodation when viewing 2D images (typical of indoor activities) may cause long-term blur on the retina, which may impede precise emmetropization. Commercial Relationships: Kristen Kerber, None; Guido Maiello, None; Frank Thorn, None; Peter J. Bex, None; Fuensanta A. Vera-Diaz, None Program Number: 539 Poster Board Number: A0271 Presentation Time: 1:30 PM–3:15 PM Approximating Spectacle Wear Time Through the Use of a Temperature Sensor Matthew J. Lentsch, Jason D. Marsack, Heather A. Anderson. College of Optometry, University of Houston, Houston, TX. Purpose: This study aims to determine if temperature sensors mounted on spectacles can accurately indicate wear time. Methods: Fifty adults wore a temperature sensor on their spectacle temple for at least 10 hours for one week. Sensors were mounted with adhesive or custom silicone sleeves (randomized) and recorded temperatures every five minutes. Subjects documented wear time on log sheets. Mean temperatures indicating spectacle wear were determined by comparing subject logs to temperature recordings. Wear time was then approximated based on temperature data alone by two strategies: 1) filtering for each individual’s mean (± 1.5 sd) ON temperatures and 2) filtering for the group’s mean (± 3.4°C) ON temperature. Wear time was also approximated by two masked examiners independently analyzing temperature vs time plots with data viewing software. Approximated wear time was compared to subject reported wear time and percent error calculated for each approximation method. Results: ON/OFF temperatures differed significantly (p < .0001) and varied with gender (p=0.04), but not mount type (p = 0.18) (repeated measures ANOVA). Wear time approximations were within 80% agreement of subject reported wear time in 82-86% of subjects ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics for the two examiners and in 76-82% of subjects for temperature filtering strategies. For subjects with <80% agreement, the magnitude of errors were smaller for examiners than temperature filtering strategies. Conclusions: Wear time was better approximated by examiners than current temperature filtering strategies and demonstrated good ability of sensors to quantify spectacle wear time. Analytical software will be developed, incorporating examiner criteria, to automate calculation of wear time from temperature plots. Commercial Relationships: Matthew J. Lentsch, None; Jason D. Marsack, None; Heather A. Anderson, None Support: NIH Grant EY024590, NIH EY0070088, NIH EY07551 Program Number: 540 Poster Board Number: A0272 Presentation Time: 1:30 PM–3:15 PM The long-term changes in axial length and refraction and the characteristics of Fourier domain-OCT in children with syndrome of myelinated retinal nerve fibers, axial myopia and amblyopia Yang Shen, Ling Sun, Peijun Yao, Jooyeon Son, Mi Tian, Xingtao Zhou. Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China. Purpose: To investigate the long-term changes in axial length and refraction and the characteristics of Fourier domain-optical coherence tomography in children with syndrome of myelinated retinal nerve fibers (MRFN), axial myopia and amblyopia. Methods: Ten children (4.40±2.22 years, 4 boys and 6 girls) with the syndrome of MRNF, axial myopia and amblyopia were recruited in this prospective self-controlled study. Each eye underwent routine ophthalmic examinations, including axial length (AL), cycloplegic refraction, best-corrected distance visual acuity (BDVA), simultaneous perception, cover test, corneal curvature, anterior segment and fundus examinations. Spectacles or rigid gas permeable contact lenses (RGP) were used for refractive correction. Part-time occlusion therapy (6-8 hours per day) was employed for amblyopia. Lesion areas and macular thicknesses were examined only on the final visit. Statistical analysis was performed using SPSS 19 software. Cut-off P values were 0.05. Results: The follow-up periods ranged from 1.17 to 9.75 years (mean 4.00±2.40 years). No one dropped out. Two affected eyes had a final BDVA of 20/25; four had 20/60 or better; eight were better than 20/200 and one was worse than 20/200. Nine fellow eyes were 20/25 or better. Six children had normal simultaneous perception. AL and spherical equivalent were both significantly different over time and between groups (P<0.0001), but no time*group interaction effect (P>0.05) was observed. The differences in the corneal curvature, annual mean rate of axial elongation (AMR-AE), annual mean rate of refractive growth (AMR-RG), foveal thickness and parafoveal thickness between the two groups were not significant (P>0.05). The mean perifoveal thickness in the affected eyes was significantly higher than that of the control eyes (P=0.047). In the treatment group, the occlusion dose correlated positively with final BDVA (R=0.764, P=0.016) but did not correlate with the AMR-AE, or AMR-RG (P>0.05). Conclusions: The affected eyes and the fellow eyes show similar developmental processes in AL and refraction. Part-time occlusion therapy may have no effect on axial elongation or refractive growth but may have positive effect on visual improvement. The color fundus photographs on the last visit The affected area revealed by the FD-OCT and the Fundus camera Commercial Relationships: Yang Shen, None; Ling Sun, None; Peijun Yao, None; Jooyeon Son, None; Mi Tian, None; Xingtao Zhou, None ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Program Number: 541 Poster Board Number: A0273 Presentation Time: 1:30 PM–3:15 PM Short-term monocular patching boosts the cortical response to the patched eye Jiawei Zhou1, Daniel Baker3, Mathieu Simard2, Dave SaintAmour2, Robert F. Hess1. 1McGill Vision Research, Department of Ophthalmology, McGill University, Montreal, QC, Canada; 2 Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada; 3Department of Psychology, University of York, Heslington, United Kingdom. Purpose: Ocular dominance is an extensively studied form of neural plasticity. Several recent studies have demonstrated that a degree of eye dominance plasticity occurs in adults after one eye is patched for as little as 2.5 hours. Over these timescales, the patched eye, rather than the unpatched eye, becomes stronger in subsequent binocular viewing. However, little is known about the site and nature of the underlying processes. In this study, we examine the mechanisms underlying this eye dominance plasticity in adults by measuring steady-state visual evoked potentials (SSVEPs) as an index of the neural contrast response in early visual areas. Methods: The experiment consisted of three consecutive stages: a pre-patching EEG recording (14 minutes), a monocular patching stage (2.5 hours) and a post-patching EEG recording (14 minutes; started immediately after the removal of the patch). During the patching stage, a transparent patch (i.e. a diffuser, which transmits light but not pattern) was placed in front of one randomly selected eye. During the EEG recording stage, we measured contrast response functions for each eye to obtain an estimate of the contrastdependence of the patching-induced changes. Results: We found that patching one eye with a diffuser for 2.5 hours in adult humans increased the neural response to stimuli in the patched eye, whilst the responses from the unpatched eye remained the same. Such phenomena occurred under both monocular and dichoptic viewing conditions. Conclusions: We interpret this eye dominance plasticity in adult human visual cortex as homeostatic intrinsic plasticity regulated by an increase of contrast-gain in the patched eye. Commercial Relationships: Jiawei Zhou, None; Daniel Baker, None; Mathieu Simard, None; Dave Saint-Amour, None; Robert F. Hess, None Support: NSERC-46528, CCI-125686 and CIHR-53346 to RFH, a RI-MUHC Postdoctoral award to JZ, and FRSQ Visual Heath Research Network awards to DSA and RFH Program Number: 542 Poster Board Number: A0274 Presentation Time: 1:30 PM–3:15 PM Preventing visuocotical bilirubin induced neurological dysfunction William V. Good1, Chuan Hou1, Vinod Bhutani2, Anthony Norcia3, Ronald Wong2, Kathleen Lewis4, Terri Slagel4. 1Smith-Kettlewell Eye Research Institute, San Francisco, CA; 2Department of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, CA; 3Department of Psychology, Stanford University, Stanford, CA; 4California Pacific Medical Center, San Francisco, CA. Purpose: Controversy exists regarding the spectrum of bilirubininduced neurologic dysfunction (BIND) in neonates, and at what level of bilirubin an infant should be treated to reduce the chances of developing BIND. The goal of this study was to compare sweep visual evoked potential (sVEP) thresholds for 3 measures of vision: contrast sensitivity (CS), vernier acuity (VA), and grating acuity (GA), to an algorithm that predicts risk of BIND based on the hour-specific bilirubin Bhutani nomogram. We hypothesized that infants at higher risk on the algorithm would show worse acuity thresholds. Methods: 90 full-term infants were recruited at birth from the well baby nursery. None had any clinical evidence for hemolysis or other risk factors for developing jaundice. Bilirubin levels were determined by measurements of transcutaneous bilirubin (TcB), total plasma bilirubin (TB), and “free” or unbound bilirubin (UB) levels. At 6 and 12 mos of age, VA, GA, and CS thresholds were measured by a masked observer using the sVEP technique. Neonatal history was tracked prospectively for predischarge TB, use of phototherapy, exposure to anesthesia (none), heart disease (excluded), and thyroid dysfunction. Infants were divided into 4 quartiles, based on their hour-specific TB level. Infants in each quartile were compared to their average acuity thresholds at 6 and 12 mos of age. Results: TB levels ranged from 0.5–21.6 mg/dL (median 7.9). CS and VA (p<0.05 for 6 and 12 mos) were significantly correlated to TB levels overall, but the effect was most pronounced in infants in the top quartile at both 6 and 12 mo of age; i.e., those who have the highest for BIND. GA was not affected by TB level. Conclusions: A reduction in visual sensitivity occurs at 6 mos and persists to 12 mos of age, and correlates with the level of TB in the newborn period for CS and VA measures. Infants whose TB levels were in the highest (4th) quartile on the Bhutani nomogram were significantly more likely to have reductions in visual sensitivity compared to infants in the lower 3 quartiles. These findings suggest that a strategy for managing neonatal jaundice, and for potentially preventing BIND, at least in regards to the visual cortex and related functions. Commercial Relationships: William V. Good, None; Chuan Hou, None; Vinod Bhutani, None; Anthony Norcia, None; Ronald Wong, None; Kathleen Lewis, None; Terri Slagel, None Support: R21EY019996-02 216 IOL optics and visual performance Monday, May 04, 2015 8:30 AM–10:15 AM 702/704/706 Paper Session Program #/Board # Range: 1353–1359 Organizing Section: Visual Psychophysics / Physiological Optics Program Number: 1353 Presentation Time: 8:30 AM–8:45 AM In-vitro assessment of dysphotopsia in IOLs Huawei Zhao1, Mihai State2, Luuk Franssen2, Marrie Van der Mooren2, Henk A. Weeber2, Patricia A. Piers2. 1Abbott Medical Optics Inc., Santa Ana, CA; 2AMO Groningen BV, Groningen, Netherlands. Purpose: Negative dysphotopsia (ND) remains a clinical phenomenon whose understanding is not to date materialized in an ameliorated intraocular lens (IOL) design. In this context, the current study describes the development and initial results of an in-vitro method for measuring dysphotopsia. Methods: For the theoretical evaluation of the photic events, a Zemax Non-Sequential model eye (OpticStudio 14, Zemax LLC) was developed in which the IOL was implemented as a 3D CAD object with a complete geometry (optics, edges, haptic system). The irradiance was mapped on the entire image plane as a function of object angle (0 – 85o), pupil size (3, 6 mm), wavelength and IOL effective position and orientation. Additionally, the image heights of the glare secondary images were computed. For the measurements, an off-axis MTF bench with a 12-bit CCD camera was used (Image Master HR, Trioptics). An anatomical physical eye model with a population average cornea was designed and manufactured. The ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics measurements were performed in photopic light. The measurements output were image frames which were processed off-line by the means of a Matlab script (R2013, The MathWorks Inc.). The figures of merit were frames, average intensities as well as areas under the intensity curves. For benchmarking, both silicone and PMMA IOLs with unfrosted and frosted edges respectively were measured. Finally, IOLs designed to reduce negative dysphotopsia were tested. Results: Both positive dysphotopsia (PD) and ND were captured by simulation and measurement results. All IOLs produced different levels of PD and ND under the conditions tested in this study. PD was observed more for small to medium light incident angles for IOLs without edge frosting and was more visible when the pupil was larger. ND was observed and measured at larger light incident angles and more obvious for smaller pupil sizes. Objective measures show the potential for dysphotopsia occurrences for varying types of lenses. IOLs with optimized geometries were proposed and shown to reduce the incidence of dysphotopsia. Conclusions: The study proposed a dysphotopsia measurement method based on a combined theoretical and experimental approach. This enables a quantitative mapping in order to better understand the origins of the IOL dysphotopsia including how these relate to a given IOL geometry and implantation position. Commercial Relationships: Huawei Zhao, Abbott Medical Optics Inc (E); Mihai State, AMO Groningen BV (E); Luuk Franssen, AMO Groningen BV (E); Marrie Van der Mooren, AMO Groningen BV (E); Henk A. Weeber, AMO Groningen BV (E); Patricia A. Piers, AMO Groningen BV (E) Program Number: 1354 Presentation Time: 8:45 AM–9:00 AM Intraocular lens doublet for full ocular aberrations correction Enrique-Josua Fernandez, Pablo Artal. Physics, Universidad de Murcia, Murcia, Spain. Purpose: Current intraocular lenses (IOLs) are usually based in a single lens design. A proper selection of the lens’ surfaces characteristics allows for adequate defocus, astigmatism and spherical aberration correction. However, with a single lens, perfect image quality cannot be achieved. We explored the potential of an intraocular lens doublet for a more complete correction of the optical aberrations in pseudophakic eyes. Methods: Ray-tracing techniques were used to optimize the optical performance of different configurations of IOL doublets within an eye model. The analysis was performed in white light to consider chromatic aberration correction. The model incorporated chromatic dispersion data from the ocular media and IOL standard materials as acrylics and silicone. Iterative optimization algorithms were applied to design the different doublet configurations to correct for longitudinal chromatic aberration, spherical aberration and peripheral aberrations within 10 degrees of retinal field. Results: Full aberration correction was achieved by combining two materials in one doublet IOL, including off-axis aberrations. Chromatic aberration was typically reduced as much as 95 % compared to the value present phakic eyes. The use of aspheric surfaces permitted to obtain near diffraction-limited image quality on an extended range around the optical axis of 10 degrees. Lateral color and sphero-chromatic aberration were also largely reduced as compared with the phakic normal eye, and also compared with the pseudophakic eye implanted with a standard IOL. A tolerance analysis of the impact of biometrical parameters after surgery was also performed. The benefits in optical quality of the doublet IOL were maintained within a reasonable range of values of decentering and tilt. Conclusions: The potential of an IOL doublet to provide full aberration correction after cataract surgery has been analyzed. By using two materials within an IOL and combining with proper aspheric surfaces, chromatic and peripheral aberrations can be corrected. While an improvement in image quality should provide patients with a better quality of vision, the practical application of doublets IOL should be further explored in terms of manufacturing and surgical limitations. Commercial Relationships: Enrique-Josua Fernandez, None; Pablo Artal, None Support: Programa Jóvenes Líderes en Investigación, Fundación Séneca-Agencia de Ciencia y Tecnología de la Región de Murcia (Spain), (grant 18964/JLI/13); SEIDI, Spain (grant FIS201341237-R); Program Number: 1355 Presentation Time: 9:00 AM–9:15 AM Contrast sensitivity in patients with aspheric profiles in lightadjustable intraocular lenses Eloy A. Villegas1, Lucia Hervella1, José Caballero2, Matthew Haller3, Antonio Benito1, Jose María Marín2, Pablo Artal1. 1Laboratorio de Óptica, Universidad de Murcia, Murcia, Spain; 2Servicio de Oftalmología, Hospital Virgen de la Arrixaca, Murcia, Spain; 3 Calhoun Vision, Inc., Pasadena, CA. Purpose: To assess contrast sensitivity (CS) both with and without the presence of glare, in patients implanted bilaterally with lightadjustable intraocular lenses (LALs).Patients were treated to have one eye set to emmetropia and the contralateral with induced negative spherical aberration (SA) to increase the depth of focus. Methods: Twenty cataract patients were implanted bilaterally with LALs (Calhoun Vision, Pasadena, USA). Two weeks after surgery, the implanted lenses were irradiated with appropriate spatial light intensity profiles to correct for defocus and astigmatism in both eyes and to induce a pre-defined amount of negativeSA in the nondominant eye. After the adjustment procedures, two photo-lockin treatments were performed to ensure the LALs were fixed. Refraction and ocular SA were measured during the entire adjustment process using an adaptive optics instrument (AOneye, Voptica SL, Spain). Visual acuity (VA) and CS were measured both monocularly (each eye separately) and binocularly with and without a glare source surrounding the gratings patch. Results: In the eyes treated with aspheric treatments, the final negative SA ranged between -0.05 and -0.23 microns (for a 4-mm pupil diameter). Mean values of binocular uncorrected decimal VA was around 1.00 at far and intermediate (60 cm) distances and ranged between 1.00 and 0.80 at 40 cm depending on the particular SA. As expected, uncorrected monocular contrast sensitivity was better in the emmetropic eyes than in aspheric eyes at all spatial frequency. Binocular summation improved the CS with respect to the monocular case with emmetropic eyes. Glare had not a measurable impact in the binocular CS. Conclusions: Patients implanted with LALs bilaterally with induced asphericity in one eye showed normal binocular contrast sensitivity. There were not significant differences between the binocular contrast sensitivity measured with and without glare. Commercial Relationships: Eloy A. Villegas, Calhoun Vision, Inc. (F); Lucia Hervella, Calhoun Vision, Inc. (F); José Caballero, Calhoun Vision, Inc. (F); Matthew Haller, Calhoun Vision, Inc. (E); Antonio Benito, Calhoun Vision, Inc. (F); Jose María Marín, Calhoun Vision, Inc. (F); Pablo Artal, Calhoun Vision, Inc. (C), Calhoun Vision, Inc. (F) Support: Supported by the SEIDI, Spain (grants FIS2013-41237-R) & Calhoun Vision ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Program Number: 1356 Presentation Time: 9:15 AM–9:30 AM New Parameter for Predicting the Postoperative IOL Position: Preoperative Lens Equator Depth measured By ThreeDimentional Anterior Segment Optical Coherence Tomography Kyu-yeon Hwang1, Young-Sik Yoo1, Choun-Ki Joo1, Geunyoung Yoon2. 1ophthalmology, the Catholic university of korea, Seoul, Korea (the Republic of); 2Advanced phisiological Optics laboratory, University of Rochester, Rochester, NY. Purpose: We tested the hypothesis that the preoperative crystalline lens equator depth (pre-LED) measured by three-dimensional anterior segment optical coherence tomography (OCT) is an effective predictor of the postoperative anterior chamber depth (post-ACD). Methods: Thirty-nine eyes that underwent phacoemulsification and implantation of a one-piece, plate-haptic Intraocular lens between December 2013 and June 2014 were examined to develop the new algorithm for predicting the post-ACD. The pre-LED was defined as the depth from the back surface of central cornea to the line connecting the intersecting points between the anterior and posterior capsule intraoperatively using 3-D OCT in Catalys (Abbott Medical Optics). The post-ACD was measured by Pentacam (Oculus) in each case at 2 months postoperatively and was analyzed by multiple linear regression for covariance with preoperatively defined variables including the pre-LED, lens thickness, lens vaulting measured by the OCT and the preoperative ACD (pre-ACD) measured by the OCT and Pentacam. Results: The mean pre-ACD, pre-LED, AL, lens thickness and lens vaulting was 2.74±0.50 mm (range, 1.75-3.36); 4.14±0.35 mm (range, 3.36-5.91); 23.97±1.37 mm (range, 21.89-27.63), 4.23±0.46 mm (range, 3.01-5.12) and 1.42±0.27 mm (range, 0.82-1.89). Single regression analysis showed significant correlations between the post-ACD and pre-LED, R2 = 0.468, P<0.001; pre-ACD, R2 = 0.379, P<0.001) Using a new regression formula with the two most significant variables (pre-LED and pre-ACD), the post-ACD can be predicted with an accuracy of 47.3% . In the prospective study, the postoperative ACD was predicted with a correlation coefficient of 0.696. Conclusions: The crystalline lens equator depth may be a promising preoperative parameter to predict the postoperative IOL position. Commercial Relationships: Kyu-yeon Hwang, None; Young-Sik Yoo, None; Choun-Ki Joo, None; Geunyoung Yoon, None Program Number: 1357 Presentation Time: 9:30 AM–9:45 AM Clinical results in 30 eyes with a purkinje based ocular biometer for IOL power calculation Michael C. Mrochen1, 2, Diana Bogusevschi2, Andrew Nolan2, Maria Galligan2, Arthur Cummings2. 1IROC Science, Zurich, Switzerland; 2 R&D, ClearSight Innovations Ltd, Dublin, Ireland. Purpose: Feasibility study on IOL power calculation based on ocular parameters measured by means of a novel Purkinje imaging technique combined with an optical coherence method. Methods: Thirty eyes scheduled for cataract surgery were enrolled into this prospective feasibility study. The study was approved by the local ethic committee and the Irish Medicine Board. Patients were consented in writing before enrolled into the clinical investigation. All eyes underwent pupil dilation to at least 5 mm pupil diameter before the eyes were measured with a standard of care (SOC) corneal tomography (Oculyzer, WaveLight, Erlangen, Germany) and ocular biometry (Biograph, WaveLight, Erlangen, Germany). After that the eyes were measured by means of a prototype ocular biometry device that consists of a Purkinje imaging technique combined with an optical coherence method (ClearSight Innovation Ltd, Dublin, Ireland). The Purkinje imaging technique allows measurements of the corneal anterior and posterior surfaces as well as the lens anterior and poster surfaces. The optical coherence method provides measurements of corneal thickness, anterior chamber depth, lens thickness and axial length. The obtained ocular parameters from each were statistically compared by means of regression analysis, bland altman plots and paired descriptive statistics, where applicable. Results: All correlation coefficients (r) for the ocular parameter: anterior radius of curvatures, posterior radius of curvatures, anterior chamber depth, lens thickness, axial length were found to be r > 0.9 compared with the SOC devices. No significant differences for all mean values were found between the new device and the SOC devices. The SOC ocular biometry device did not provide any measurements of the posterior corneal surface, and anterior and posterior lens. The SOC ocular tomography device provided only anterior and posterior corneal surface measurements and corneal thickness. Conclusions: The results of this initial prospective study demonstrate the feasibility of the new ocular biometry system to provide comparable ocular parameters with SOC devices. However, SOC devices do not provide information about the lens geometry. In contrast, the combined measurements of the new device allow a complete reconstruction of the eye parameter suitable for optical ray tracing to calculate intraocular lens power. Commercial Relationships: Michael C. Mrochen, ClearSight Innovations (I), IROC Science (I); Diana Bogusevschi, ClearSight Innovations (I); Andrew Nolan, ClearSight Innovations (I); Maria Galligan, ClearSight Innovations (I); Arthur Cummings, ClearSight Innovations (I) Clinical Trial: CIV-IE-13-12-011775 Program Number: 1358 Presentation Time: 9:45 AM–10:00 AM Testing vision with radial and angularly segmented multifocal patterns using adaptive optics Maria Vinas, Carlos Dorronsoro, Veronica Gonzalez, Daniel Cortes, Susana Marcos. Visual Optics & Biophotonics Lab, Instituto de Optica, CSIC, Madrid, Spain. Purpose: Multifocal vision corrections are increasingly used solutions to correct for presbyopia, by producing different foci for different distances. We will evaluate the effect of multi-zone multifocal designs (angular & radial, 2-4 zones) on vision, in the presence and absence of natural aberrations. Methods: Perceived visual quality was tested on 8 subjects (age:29±2; spherical error:-1.32±1.00D) with 6 segmented multifocal designs simulated by a phase-only reflective spatial light modulator. A custom-developed Adaptive Optics (AO) system, including a Hartmann-Shack sensor and an electromagnetic deformable mirror, was used to measure and correct the eye’s aberrations (HOA). Light source from a supercontinuum laser was used for wavefront sensing (827nm) and to back-illuminate (555nm) a static natural visual stimulus. The multifocal phase designs had 2 to 4 zones of progressive power (0 to +3D) in either radial or angular configurations. In a psychophysical paradigm the subject judged the better perceived image (first or second) from pairs of images viewed through different multifocal patterns (a total of 240 pairs, randomly presented), providing a weighted response (±10, 5 & 1). The experiment was performed under natural HOA and under AOcorrection. Patterns were graded according to the weighted perceived visual quality responses for far vision. The optical quality of each eye (with/without HOA) with each multifocal pattern was calculated in terms of Visual Strehl (VS). ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Results: 85.76% of the perceptual responses were statistically significant (p<0.05; i.e. higher than chance). On average, radial profiles provided better perceived quality (495±59) than angular profiles (-468±61). However, in the presence of HOA, 2 subjects consistently scored higher the angular patterns, a trend that disappeared upon HOA correction. With HOA correction there was a statistically significant correlation (p<0.05) between optical quality (VS) and perceived quality (scores) in 6/8 subjects. There was a trend for 2-zone patterns to provide better quality (perceived & optical) than 3 and 4 zones, which was statistically significant (p<0.05) with HOA correction. Conclusions: Visual simulation with AO allows identifying the optimal multifocal correction for a patient and the effects of interactions of the natural aberrations. Aberrations play a significant role in perceived visual quality across different multifocal patterns. Commercial Relationships: Maria Vinas, None; Carlos Dorronsoro, None; Veronica Gonzalez, None; Daniel Cortes, None; Susana Marcos, None Support: Spanish Government FIS2011-25637, and FPU Programs; European Research Council ERC-2011-AdG-294099; CSIC JAE Predoctoral Program; Program Number: 1359 Presentation Time: 10:00 AM–10:15 AM Extending depth of focus with a 1 ring diffractive technology Patricia A. Piers1, Carmen Canovas1, Aixa Alarcon1, Henk A. Weeber1, Silvestre Manzanera2, Pablo Artal2. 1Research and Development, Abbott Medical Optics Groningen, Groningen, Netherlands; 2Universidad de Murcia, Laboratorio de Optica, Murcia, Spain. Purpose: To describe a new design to extend depth of focus in the pseudophakic eye and to compare the optical and visual performance provided by this design to that of a monofocal IOL. Methods: The new design consists of an aspheric anterior optic to compensate corneal spherical aberration and a single diffractive ring on the posterior optic. Optical properties of this design and a monofocal lens that compensates for corneal spherical aberration were evaluated in different pre-clinical settings. Through focus MTF for different spatial frequencies and USAF pictures for a 3mm pupil in white light were measured using an optical bench. In addition, best focus contrast sensitivity (CS) was measured in white light in five subjects using a binocular adaptive optics visual simulator (BAOVS) when the phase profile corresponding to each IOL design was induced bilaterally. CS was measured using the q-CSF procedure with a 4.5mm pupil under mesopic conditions, and evaluated at 1.5, 3, 6 and 12 cpd. Results: USAF pictures showed that the new lens design extends depth of focus up to -1.5D in the spectacle plane and that it provides a good image quality over a larger range of defocus than the monofocal design. The area under the MTF (MTFa) integrated up to 50cpmm increased by 26% with respect to the monofocal lens at -1.5D and decreased by 18% for distance vision. However, CS for far was not statistically different between both models for any of the spatial frequencies evaluated, except for the highest spatial frequency evaluated (12cpd was 1.18±0.10 vs 1.06±0.04logCS for the monofocal and new design, respectively). Conclusions: The optical quality and visual performance provided by a new diffractive IOL designed to extend the depth of focus were compared with a monofocal IOL that corrects corneal spherical aberration. Binocular visual simulation and preclinical data showed that the new design improved visual performance at intermediate and provides similar CS to a monofocal IOL at distance. Commercial Relationships: Patricia A. Piers, Abbott Medical Optics (E); Carmen Canovas, Abbott Medical Optics (E); Aixa Alarcon, Abbott Medical Optics (E); Henk A. Weeber, Abbott Medical Optics (E); Silvestre Manzanera, Abbott Medical Optics (F); Pablo Artal, Abbott Medical Optics (C) Support: Eureka Grant for Clear Multifocal Vision 239 Refractive errors and optical aberrations Monday, May 04, 2015 11:00 AM–12:45 PM 702/704/706 Paper Session Program #/Board # Range: 1724–1730 Organizing Section: Visual Psychophysics / Physiological Optics Program Number: 1724 Presentation Time: 11:00 AM–11:15 AM Heritability of ocular, corneal and lens optical aberrations Juan Tabernero1, Lucia Hervella1, Antonio Benito1, Lucia ColodroConde2, Juan Ramón Ordoñana2, Marcos Ruiz-Sánchez3, Jose María Marín3, Pablo Artal1. 1Laboratorio de Optica, Universidad de Murcia, Murcia, Spain; 2Murcia Twin Registry, Area of Psychobiology, Universidad de Murcia, Murcia, Spain; 3Servicio de Oftalmología, Hospital Universitario Arrixaca, Murcia, Spain. Purpose: To estimate the relative contribution of genetic and environmental factors to the variance of ocular, corneal and lens higher order optical aberrations of a population. Methods: Optical aberrations were measured in 116 eyes corresponding to 58 twins; 27 monozygotic (MZ) and 31 dyzogotic (DZ) pairs (age 54 years, SD 6 years). Corneal aberrations were estimated from the elevation data measured with a corneal topographer and using our own developed ray-tracing procedure to express aberrations in Zernike coefficients. Ocular aberrations were measured using a Hartmann-Shack sensort (AOnEye; Voptica SL, Murcia, Spain). Both procedures used the center of the pupil as a reference so that internal aberrations could be estimated by subtraction of corneal to ocular Zernike coefficients. Intraclass Correlation Coefficients (ICC) were used to estimate how strongly aberrations of twins resemble each other and genetic models were fitted to quantify heritability in the selected phenotypes. Results: Spherical Aberration (SA) presented the highest value of the ICC in MZ twins (0.71 right eyes; 0.74 left eyes) while for DZ twins correlations were much lower (0.09 right eyes; 0.15 left eyes). The strong difference between MZ and DZ twins suggested a dominant genetic contribution to the variance of the SA. Corneal SA was also highly correlated in MZ twins (0.64 right eyes; 0.71 left eyes) compared to DZ twins (0.03 right eyes; 0.34 left eyes) and nearly at the same level as the crystalline (internal) SA (0.66 and 0.65 for right and left MZ; 0.14 and 0.41 for right and left DZ). In general, other higher order aberrations presented lower correlations than those of SA for both groups of twins but still the ICC of ocular higher order RMS in MZ twins were systematically higher than in DZ (0.36 and 0.40 for right and left MZ; 0.01 and 0.30 for right and left DZ). Model fitting results yielded heritability estimations for SA ranging between .5 and .7. Conclusions: Variability in the optical aberrations of the components of the eye is far from being randomly generated. Heritability plays an important role to explain a large part of this variance. This is specially the case for SA, while for other aberration terms there was an increase in the contribution of unique random errors and relatively less genetic influence. Whether this genetic basis of the eye’s aberrations is linked or independent to refractive diseases should be subject of further research. ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Commercial Relationships: Juan Tabernero, None; Lucia Hervella, None; Antonio Benito, None; Lucia Colodro-Conde, None; Juan Ramón Ordoñana, None; Marcos Ruiz-Sánchez, None; Jose María Marín, None; Pablo Artal, None Support: European Research Council Advanced Grant ERC-2013AdG-339228 (SEECAT) & SEIDI, Spain (grant FIS2013-41237-R). Program Number: 1725 Presentation Time: 11:15 AM–11:30 AM Measurements of peripheral ocular aberrations under natural viewing conditions Hae Won Jung1, Atanu Ghosh2, Geunyoung Yoon1, 2. 1Optics, University of Rochester, Rochester, NY; 2Flaum Eye Institute, Rochester, NY. Purpose: Previous studies have measured peripheral optics of the human eye with eccentric fixation using commercial devices. These devices required subjects to turn their eyes to measure peripheral aberrations. The goal of the study is to measure wavefront aberrations at peripheral retina with accommodation using a custom built peripheral wavefront sensor which does not require eccentric fixation. Methods: The open view peripheral wavefront sensor can rotate about the pupil center while subjects maintain their natural foveal fixation. Accommodation can be stimulated naturally without visual distraction as wavefront sensing light source is totally invisible (λ=980nm). Wavefront aberrations measured in four myopic subjects (aged from 22 to 28, refractive error: -1 .00 to -4.50D) with their natural pupils at fovea ( 0°) and peripheral retina ( 10° and 20°) with distance (0D) and near target vergence (3D and 5D). During these measurements, subjects were fixating on a high contrast free space target (i.e. Maltese cross) displayed on a micro display. Zernike polynomials up to 10th radial order were fit to the wavefront measurements for a fixed 4 mm pupil. Results: Subjects became more myopic in the periphery with accommodation compared to fovea (mean difference: 0.33 ± 0.54 D and 0.27 ± 0.74 D for 3D stimulus at 10° and 20° eccentricity, respectively; 1.1 ± 0.58 D and 0.83 ± 0.61 D for 5D stimulus at 10° and 20° eccentricity, respectively). Of the higher order aberrations, horizontal coma C (3, 1) had a greater change at 20° eccentricity compared to fovea (mean difference 0.03±01 mm, p=0.02) with accommodation. Accommodation caused greater changes in primary spherical aberration C(4,0) at periphery compared to fovea (mean change: -0.02±0.01 mm, -0.02±0.01 mm and -0.03±0.02 mm at 0°, 10° and 20°, respectively). Higher order RMS increased from fovea to peripheral retina with distance accommodation (mean change: 0.03±0.01mm at 10°, p=0.09 and 0.07±0.01mm at 20°, p=0.01), however there was no significant change in HORMS in periphery with accommodation. Conclusions: Significant myopic shifts observed in the periphery with accommodation compared to fovea that might be associated with biomechanical factors; e.g., changes in retinal curvature or axial elongation during accommodation. Accommodation might have little impact on higher order aberrations in periphery. Commercial Relationships: Hae Won Jung, None; Atanu Ghosh, None; Geunyoung Yoon, None Support: NIH EY014999 Program Number: 1726 Presentation Time: 11:30 AM–11:45 AM Retinal shape modeled from discrete ocular length measurements, biometry and refractive error in healthy Norwegian males Jon B. Gjelle, Elisabeth Bratlie Finstad, Siri Bjørnetun Jacobsen, Stuart J. Gilson, Rigmor C. Baraas. Department of Optometry and Visual Science, Buskerud and Vestfold University College, Kongsberg, Norway. Purpose: Prolate retinal shape as formed by equatorial expansion has been suggested to be a determinant for myopia development. We investigated parameters of retinal shape through modeling of discrete ocular length (OL) measurements by partial coherence interferometry (PCI) and its correlation with spherical equivalent refraction (SER). Methods: Twenty-three healthy males aged 21–38 years, with normal logMAR letter acuity, color vision and no observed ocular abnormalities, were included in the study. In addition to standard biometry, OLs were measured at 22 deg sagittal and transverse of the fovea in the subject’s dominant eye (Zeiss IOLMaster). SER was determined by autorefraction (Nidek AR-1000). The subject’s eye was dilated and accommodation suspended with Cyclopentolate 1% prior to examination. Vitreous depth (VD) and retinal curvature coordinates were determined from individual schematic eye models based on biometry of each subject. 3D retinal models were calculated from retinal curvature coordinates by shape fitting ellipsoids using custom software following a Nelder-Mead simplex algorithm. Results: Ten were emmetropes (EMM, SER: -0.50 to +0.75 D), 7 hyperopes (HYP) and 6 myopes (MYO), 92% being of Caucasian descent. Axial lengths (AL) ranged from 22.60–25.18; VD: 15.65– 19.68, corneal radii (CR): 7.35–8.30 mm and SER: -4.50 – +1.92 D. MYO had significantly larger ALs than both EMM (p=0.004) and HYP (p=0.008) with larger AL/CR ratios than both EMM (p=0.008) and HYP (p<0.001). EMM and HYP showed no significant difference in AL (p=0.587), but EMM had larger AL/CR ratios than HYP (p=0.009). There was no difference in VD between refractive groups (p=0.235). The fitted models revealed an oblate retinal shape for all subjects, with vertical and horizontal asphericity significantly larger than 0 (both p≤0.001). There was no difference in horizontal or vertical asphericity between refractive groups (p=0.305 and p=0.461). Conclusions: A novel 3D model of retinal shape based on discrete OLs from PCI reveal an oblate retinal shape regardless of refractive status. Furthermore, VD did not vary between refractive groups. The results indicate oblate retinal shape as formed by a global expansion, rather than prolate as formed by equatorial expansion, to be associated with myopia for the population studied here. The technique has potential as a clinical method for estimating retinal shape. Commercial Relationships: Jon B. Gjelle, None; Elisabeth Bratlie Finstad, None; Siri Bjørnetun Jacobsen, None; Stuart J. Gilson, None; Rigmor C. Baraas, None Program Number: 1727 Presentation Time: 11:45 AM–12:00 PM Impact of refractive error on the meridional effect in peripheral vision Len Zheleznyak, Atanu Ghosh, Antoine Barbot, Geunyoung Yoon. Flaum Eye Institute, University of Rochester, Rochester, NY. Purpose: Optical blur in the peripheral retina is known to be highly anisotropic due to astigmatic wavefront aberrations and may play a role in emmetropization. In addition, peripheral vision is characterized by the meridional effect, a neural mechanism favoring radially-aligned gratings. The goal of this study was to investigate the impact of refractive error and anisotropic peripheral blur on ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics the meridional effect for neural contrast sensitivity (CS) using an adaptive optics (AO) vision simulator. Methods: An AO vision simulator was used to correct subjects’ wavefront aberrations at 0, 10 and 20 degree temporal retinal eccentricities. CS at 2 cpd was measured with horizontal and vertical grating orientations at each eccentricity in monochromatic light (630 nm). All vision testing was performed with a 5.8 mm artificial pupil using the right eye of 10 cyclopleged subjects (refractive error: -5.5 to +2.0 D). Subjects’ native aberrations were recorded at each eccentricity with a Shack-Hartmann wavefront sensor to quantify the modulation transfer function (MTF). Neural CS was defined as the ratio of the CS divided by the diffraction-limited MTF. Results: With increasing eccentricity, subjects’ native wavefront aberrations led to significantly higher contrast of horizontal gratings as compared to vertical gratings. The average ratio of horizontal to vertical MTF values at 2 cpd at 0, 10 and 20 degrees for emmetropes was 0.99+0.01, 1.22+0.19 and 1.50+0.32 and for myopes was 0.98+0.07, 1.20+0.29 and 1.55+0.39, respectively. The average ratio of horizontal to vertical area under the MTF up to 10 cpd at 0, 10 and 20 degrees for emmetropes was 0.95+0.05, 1.15+0.13 and 1.34+0.27 and for myopes was 0.94+0.18, 1.20+0.36 and 1.64+0.57, respectively. The meridional effect was observed for all subjects, with a greater magnitude at 20 degree eccentricity in the myopic group. The average ratio of horizontal to vertical neural CS at 0, 10 and 20 degrees for emmetropes was 1.04+0.09, 1.39+0.27 and 1.40+0.19 and for myopes was 1.00+0.25, 1.31+0.29 and 1.89+0.89, respectively. Conclusions: The meridional effect was observed in all subjects in the absence of anisotropic blur, however, this effect was greater in myopic subjects. In addition, the change in meridional effect across the retina with respect to native aberrations was significantly correlated with refractive error. Commercial Relationships: Len Zheleznyak, None; Atanu Ghosh, None; Antoine Barbot, None; Geunyoung Yoon, None Support: NIH EY014999, NIH T32 EY007125, Research to Prevent Blindness Program Number: 1728 Presentation Time: 12:00 PM–12:15 PM Extended depth-of-focus contact lenses can slow the rate of progression of myopia Ravi C. Bakaraju1, Pauline Xu1, 2, Xiang Chen2, Martin Ma2, Stephanie Song2, Monica Jong1, 2, Wayne Li2, Serge Resnikoff1, 3, Brien A. Holden1, 3. 1Brien Holden Vision Institute, Sydney, NSW, Australia; 2Brien Holden Vision Institute, Guangzhou, China; 3School of Optometry and Vision Science, UNSW, Sydney, NSW, Australia. Purpose: We investigated the effects of two different, novel design, extended depth-of-focus (EDOF) contact lenses (CL) and a commercially-available single vision control CL on the rate of myopia progression in Chinese children. Methods: A prospective, double-masked, randomized clinical trial was initiated at the BHVI China research clinic in January 2014 to enrol 270 Chinese children, aged 8 to 13 years, with spherical equivalent refractive error between -0.75D and -3.50D. Enrolled patients were randomized into one of the following: a single vision control CL, EDOF1 or EDOF2 prototype CL. The primary outcome measures, cycloplegic autorefraction (AR, Shin-Nippon, Japan) and axial length (AL, Lenstar, Switzerland), were measured at baseline, and were scheduled to be measured every 6 months for at least 3 years. Each group was matched for age, gender, parental myopia, AL and refractive error. Exclusion criteria included previous treatment for myopia and systemic or ocular disease. Results: To date, approximately twenty children in each group have completed the 6 months visit. The mean rate of myopia progression for the control group was AR: -0.49D ± 0.29 and AL: 0.17mm ± 0.09. Statistically significant reduction in the rate of myopia progression (p<0.001) was achieved in children wearing both types of EDOF lenses; EDOF1: AR -0.24D ± 0.28 (51% reduction) and AL 0.07 mm ± 0.08 (58% reduction); EDOF2: AR -0.23D ± 0.28 (53% reduction) and AL 0.08 mm ± 0.09 (53% reduction). The outcome measures obtained with two EDOF lenses were not significantly different between eachother (p>0.05). Conclusions: The EDOF lenses significantly slowed the rate of progression of myopia in children. Longer term results with greater number of participants will be needed to substantiate the results obtained at the 6-month visit. Commercial Relationships: Ravi C. Bakaraju, WO2013/149303 A1, US 2013/0278888 A1 (P); Pauline Xu, Brien Holden Vision Institute (E); Xiang Chen, Brien Holden Vision Institute (E); Martin Ma, Brien Holden Vision Institute (E); Stephanie Song, Brien Holden Vision Institute (E); Monica Jong, Brien Holden Vision Institute (E); Wayne Li, Brien Holden Vision Institute (E); Serge Resnikoff, Brien Holden Vision Institute (C); Brien A. Holden, Brien Holden Vision Institute (E), WO2013/149303 A1 (P) Support: Brien Holden Vision Institute, Australian Government Cooperative Research Centres Grant Scheme and Vision CRC. Clinical Trial: ChiCTR-TRC-14004227 Program Number: 1729 Presentation Time: 12:15 PM–12:30 PM Spherical aberration is a key determinant of refraction at night Norberto Lopez-Gil1, Renfeng Xu2, Arthur Bradley2, Larry N. Thibos2. 1Universidad de Murcia, Murcia, Spain; 2Indiana University, Bloomington, IN. Purpose: For more than 230 years we have known that eyes appear to be more myopic at nighttime. Although spherical aberration has been implicated in this refraction change, its exact role is still unclear. We study if the correction of this refractive change is more closely related to the improvement of the stimulus contrast or its resolution. Methods: Refractive error was determined for a 7mm pupil, objectively by using techniques based on wavefront refraction and subjectively using small bright point stimuli (<1 arc minute, 1000 cd/m2) of an OLED microdisplay. Experimentally, the amount and sign of ocular spherical aberration were controlled. The objective refraction was computed after a through-focus computational paradigm, which determine the correcting lens that would be expected to optimize retinal image quality according to a visual contrast metric (VSOTF) known to be an unbiased predictor of refractive error for conventional letter charts viewed under daylight conditions. Subjective refractions were determined with a through-focus paradigm on paralyzed or presbyopic eyes, for a contrast detection task (increment detection of a point source on a uniform background) and again for a spatial resolution task (minimum separation of two point sources on a black background). Detection refraction was defined as the power of a correcting lens that maximized contrast sensitivity and resolution refraction was defined as the power of a correcting lens that maximized two-point resolution. Results: As the amount of the spherical aberration increases, detection refraction becomes myopic relative to the daylight standard refraction or two-point resolution refraction. Positive spherical aberration usually reproduces the classic astronomer’s observation of night myopia while negative spherical aberration reverses this result (i.e. night hyperopia). Nullifying spherical aberration causes detection, resolution and daylight standard refraction to be nearly the same. The refractive change between resolution and detection ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics refraction ranged from 0.25 to 0.5 D for spherical aberration coefficient C40 = ±0.5 microns (7mm pupil). Conclusions: Night myopia is a phenomenon more closely related to contrast detection than for spatial resolution. The sign and magnitude of night myopia is determined primarily by the sign and magnitude of ocular spherical aberration. These results have clinical implications for optimum correction of the eye for nighttime vision. Commercial Relationships: Norberto Lopez-Gil, Indiana University (P); Renfeng Xu, None; Arthur Bradley, None; Larry N. Thibos, Indiana University (P) Support: Fundación Séneca Grant 15312/PI/10 and Grant ERC2012-StG 309416-SACCO Program Number: 1730 Presentation Time: 12:30 PM–12:45 PM Objective measurements of transverse chromatic aberration across the visual field of the human eye Simon Winter1, Ramkumar Sabesan2, Pavan N. Tiruveedhula2, Claudio Privitera2, Linda Lundstrom1, Austin Roorda2. 1Biomedical & X-Ray Physics, KTH, Royal Institute of Technology, Stockholm, Sweden; 2School of Optometry and Vision Science Graduate Group, University of California, Berkeley, Berkeley, CA. Purpose: The purpose of this study was to use a new image-based technique to make the first-ever objective measures of TCA at different eccentricities within the human visual field. Methods: TCA was measured at visual field angles of 0.5, 2.5, 5, 7.5, 10, 12.5, and 15 degrees from foveal fixation in the right eye of 4 subjects. Interleaved retinal images were taken at wavelengths 543 nm and 842 nm in an adaptive optics scanning laser ophthalmoscope (AOSLO) and were cross-correlated according to methods described in Harmening et al., Biomed Opt Express, 2012. Pupil alignment was controlled with a pupil-camera. To obtain true measures of human eye TCA, the contributions of the AOSLO system TCA were measured using an on-axis aligned model eye and subtracted from the human eye data. Results: The system TCA was stable at around 3 arcmin. On all subjects, it was possible to measure TCA out to 12.5 degrees in the nasal, 10 degrees in the temporal, 12.5 degrees in the inferior, and 15 degrees in the superior visual field. The absolute amount of TCA between green and IR varied somewhat between subjects, but was approximately 4 arcmin at 10 degrees out in the nasal visual field. However, the increase in TCA was found to be linear with a slope close to 0.2 arcmin / degree of visual field angle for all subjects. Translating these results to the visual spectrum would yield a slightly higher slope and larger image shifts, which agree with the theoretical calculations by Thibos, J. Opt. Soc. Am. A, 1987. Conclusions: We have performed the first objective measurement of the TCA of the human eye across the central 30 degrees visual field. The 4 arcmin of TCA at 10 degrees off-axis is very similar to the resolution acuity of 0.5 to 0.7 logMAR at 10 degrees out in the nasal visual field (about 3 to 5 arcmin). Additionally, the measured cone-size at 10 degrees in the subjects of this study was about 1.4 – 1.7 arcmin, which means that the TCA blur covers around 2-3 cones. Therefore, the peripheral TCA can be visually significant. Commercial Relationships: Simon Winter, None; Ramkumar Sabesan, None; Pavan N. Tiruveedhula, None; Claudio Privitera, None; Linda Lundstrom, None; Austin Roorda, University of Rochester, University of Houston (P) Support: EU ITN OpAL - PITN-GA-2010-264605 (SW, LL), The Swedish Research Council - 621-2011-4094 (SW, LL), Burroughs Wellcome Fund Career Award at the Scientific Interfaces (RS), NIH R01EY023591 (PT, CP, AR) 272 Mechanisms of vision loss in early diabetes: Connecting new findings from retinal imaging and functional techniques in patients to basic models - Minisymposium Monday, May 04, 2015 3:45 PM–5:30 PM 702/704/706 Minisymposium Program #/Board # Range: 2089–2093 Organizing Section: Visual Psychophysics / Physiological Optics Contributing Section(s): Multidisciplinary Ophthalmic Imaging, Retina Program Number: 2089 Presentation Time: 3:45 PM–4:05 PM Imaging damage to retinal vessels in diabetic patients Stephen A. Burns. Indiana University, Bloomington, IN. Presentation Description: Diabetic retinopathy has traditionally been staged according to features visible from retinal examination and retinal photography. Adaptive Optics retinal imaging is now allowing us to visualize and charachterize changes that are not readily detected with conventional imaging. This presentation will present change to capillary structure and capillary density, as well as changes to the vascular walls. Commercial Relationships: Stephen A. Burns, AEON Imaging (I), Nidek (C) Support: NEI EY04395; Fight for Sight Program Number: 2090 Presentation Time: 4:05 PM–4:25 PM Retinal pathology in diabetes and systemic comorbidities Jennifer K. Sun. Joslin Diabetes Center, Harvard Medical School, Boston, MA. Presentation Description: High resolution imaging techniques such as adaptive optics scanning laser ophthalmoscopy (AOSLO) and spectral domain optical coherence tomography (SDOCT) allow the assessment and quantification of cellular level changes in the diabetic retina in vivo in the human eye. Thinning and disorganization of the inner neural retinal layers as evaluated by SDOCT may have functional implications for patients both prior to the development of clinically visible vascular lesions and once these lesions have become manifest. AOSLO imaging allows identification of subclinical vascular lesions such as microaneurysms that are too small to be visualized on standard fundus photographs or clinical examination. The combination of these techniques potentially provides the ability to better understand interactions within the neurovascular unit in diabetes. The contribution of other systemic diabetic comorbidities to retinal pathology is also being explored and will be discussed, including available evidence for retinal vascular changes with cardiovascular disease and diabetic nephropathy. Commercial Relationships: Jennifer K. Sun, Boston Micromachines (F), Optovue (F) Support: NIH/NEI R01 EY024702-01; JDRF 3-SRA-2014-264M-R, 17-2011-359; NIDDK 5 P30 DK036836-24 P&F Grant; Eleanor Chesterman Beatson Childcare Ambassador Program Foundation Grant; Massachusetts Lion Eye Research Fund; Boston Micromachines Program Number: 2091 Presentation Time: 4:25 PM–4:45 PM Changes over time in retinal vessels in patients with early diabetes Richard B. Rosen. 1New York Eye and Ear Infirmary, New York, NY; 2 Ophthalmology, Ican School of Medicine at Mount Sinai, New York, NY. ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Presentation Description: Adaptive optics scanning light ophthalmoscopy using an offset pinhole (OP AOSLO) configuration enables non-invasive imaging of the dynamics of retinal microvascular walls, lumen, and blood flow, without the need for any exogenous contrast agent. We used OP AOSLO to survey and monitor subclinical microvascular changes over time in patients with diabetic retinopathy, including capillary perfusion remodeling, loop formation and resolution, microaneurysm expansion and regression. This technique provides a dynamic longitudinal view of the histopathology of aberrant diabetic microvascular development. Commercial Relationships: Richard B. Rosen, None Support: Marrus Family Foundation, Bendheim-Lowenstein Foundation, Wise Foundation, Edith C Blum Foundation, GRF, RPB, Burroughs Wellcome Fund, and NIH grant P30EY001931 Program Number: 2092 Presentation Time: 4:45 PM–5:05 PM Dysregulation of blood flow in the diabetic retina Eric A. Newman. University of Minnesota, Minneapolis, MN. Presentation Description: Activation of the retina by flicker stimulation evokes vasodilation and increased blood flow in the retinal vasculature. This hemodynamic response, termed functional hyperemia, brings added oxygen and glucose to active neurons. Flicker-evoked vasodilation is mediated by neuronal stimulation of retinal glial cells and the release of vasodilating agents, including PGE2 and epoxyeicosatrienoic acids, from the glial cells. Signaling from glial cells to retinal vessels is suppressed by nitric oxide (NO). In patients with diabetic retinopathy flicker-evoked vasodilation and functional hyperemia are substantially reduced, possibly rendering the retina hypoxic. Inducible nitric oxide synthase (iNOS) is upregulated and NO levels are increased in the diabetic retina. Inhibition of iNOS by aminoguanidine reverses the loss of flickerevoked vasodilation in an animal model of diabetic retinopathy, restoring functional hyperemia to normal. Previous work has demonstrated the efficacy of inhibiting iNOS in slowing the progression of diabetic retinopathy. This effect could be due, in part, to the restoration of functional hyperemia. Commercial Relationships: Eric A. Newman, None Support: Fondation Leducq and NIH grant EY004077 Program Number: 2093 Presentation Time: 5:05 PM–5:25 PM Early functional changes in diabetic patients measured with mfERG, contrast sensitivity, and SKILL Card Marcus A. Bearse. UC Berkeley, Berkeley, CA. Presentation Description: Vision and retinal function changes occur early in diabetes, even in the absence of clinical signs and history of diabetic retinopathy. This presentation will discuss our observations of these changes, focusing primarily on local retinal function measured with the multifocal electroretinogram (mfERG), and on vision changes measured by contrast sensitivity and the SmithKettlewell Institute Low Luminance (SKILL) Card. These measures indicate that significant changes are produced by diabetes, and tend to worsen with the onset of clinical diabetic retinopathy. Models based on the mfERG are highly predictive of the appearance of retinopathic lesions. Commercial Relationships: Marcus A. Bearse, None Support: NIH Grant EY021811 277 Psychophysics, visual performance and low vision Monday, May 04, 2015 3:45 PM–5:30 PM Exhibit Hall Poster Session Program #/Board # Range: 2216–2227/B0069–B0080 Organizing Section: Visual Psychophysics / Physiological Optics Contributing Section(s): Low Vision, Retina Program Number: 2216 Poster Board Number: B0069 Presentation Time: 3:45 PM–5:30 PM Independent effects of angular and relative distance magnification on reading speed in normal and low vision subjects Danielle Natale1, Nicole Ross2, 1, Chris Bradley1, Boger Yuval4, David Teitelbaum4, Frank S. Werblin3, Robert W. Massof1. 1Johns Hopkins University, Baltimore, MD; 2Low Vision, New England College of Optometry, Boston, MA; 3University of California, Berkeley, Berkeley, CA; 4Sensics, Inc, Columbia, MD. Purpose: To describe the effects of angular and relative distance magnification on reading speed in normal and low vision subjects. Methods: A head mounted display (HMD) was used to present images in virtual reality of 25 different paragraphs of texts. Each subject then read each of the 25 paragraphs with total magnification ranging from 1x to 25x. Magnification of the text was achieved with all combinations of angular magnification (ranging from 1X to 5X) and relative distance magnification (also ranging from 1X to 5X). The time to read each paragraph was recorded and words per minute reading speeds were calculated for each combination of angular and distance magnification. Results: Angular and relative distance magnifications have independent effects on reading speed. In each normal subject, above the critical print size reading speed declined linearly with the sum of relative distance and angular magnification – not the product. Reading speed declined at a faster rate with increases in angular magnification than with increases in relative distance magnification. In low vision subjects, reading speed increased from threshold with increased angular or relative distance magnification until reading speed reached the ceiling defined by normally sighted subjects and then with further magnification reading speed declined following the normal function. Conclusions: The decline in reading speed as magnification increases cannot be explained by decreased preview area alone because the effects of angular and relative distance magnification on reading speed are additive, not multiplicative. This phenomenon is present in both normal and low vision subjects. One potential explanation for the independent effects on reading rates for the two types of magnification could be that relative distance magnification requires larger head movements with increasing magnification, whereas angular magnification does not, and angular magnification increases the magnification of image motion velocity with head movements, whereas relative distance magnification does not. The results we observed with a HMD, which required head movements to navigate text that extended beyond the field of view, might generalize to other types of movements required to translate text when using conventional low vision devices (e.g., moving the print to read with a microscope or a CCTV or moving the magnifier across the print). Commercial Relationships: Danielle Natale, None; Nicole Ross, None; Chris Bradley, None; Boger Yuval, Sensics Inc (I); David Teitelbaum, Sensics Inc (I); Frank S. Werblin, Visionize (I); Robert W. Massof, Sensics Inc (I) Support: Name: “Next Generation of Low Vision Enhancement” Funding Source: Reader’s Digest Partners for Sight Foundation ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Program Number: 2217 Poster Board Number: B0070 Presentation Time: 3:45 PM–5:30 PM Functional impact of task lighting on reading with low vision Tony A. Succar1, 2, Laura Walker2, 1, karen kendrick1, Andra Mies1, Donald C. Fletcher1, 2. 1Envision Research Institiute, Envison, Inc, Wichita, KS; 2Smith-Kettlewell Eye Research Institute, San Fransisco, CA. Purpose: Individuals with low vision often complain of reading difficulties and increased lighting has been shown to enhance visual acuity (Fletcher et al. ARVO 2014 and ARVO 2015). The purpose of this study was to investigate whether: (1) lighting impacts reading function objectively; and (2) the LuxIQ is a useful or necessary tool for prescribing specific lighting needs. Methods: Reading function of low vision and control subjects was assessed using MNRead Acuity Charts at 40cm under four light settings: ambient room illumination (280 lux), preferred setting and set points at 500 lux below and above the subjects’ preferred setting. Preferred setting was measured as the participants’ subjective light preference when reading their preferred size print on the MNRead chart. Temperature was kept constant at 4500 oK, 575nm. Testing began under ambient illumination and the testing order of the three remaining light settings were randomized for each subject. The LuxIQTM (Jasper Ridge, Inc) was positioned above the MNRead chart and different charts were randomly selected and alternated for each lighting condition. Charts were placed under an opaque cover revealing only the sentence which subjects were required to read. Reading rate was plotted as a function of print size to estimate critical print size and maximum reading rates. Results: In control subjects, the different light settings had little effect on maximum reading rates, and variable effects on critical print sizes. Initial patient data suggests a more consistent impact of lighting on critical print size. Lighting preference may depend on the type of ocular pathology (e.g. Fletcher et. al, ARVO 2015), however this preference does not always confer a functional benefit to reading. The outcome measures presented here will delineate which patients are most likely to benefit from a specific lighting prescription versus simply increasing task lighting to a subjectively comfortable level. Conclusions: Low vision practitioners commonly recommend the use of supplementary localized lighting to enhance near vision tasks. The findings from this study provide guidance as to whether practitioners can benefit low vision patients by providing an objective lighting prescription. Commercial Relationships: Tony A. Succar, None; Laura Walker, None; karen kendrick, None; Andra Mies, None; Donald C. Fletcher, None Support: Envision Pilot Project Award Program Number: 2218 Poster Board Number: B0071 Presentation Time: 3:45 PM–5:30 PM Optimizing the viewing position of words increases reading speed in patients with central vision loss Andrew T. Astle1, Ben S. Webb1, Paul V. McGraw1, Susana T. Chung2. 1 Visual Neuroscience Group, School of Psychology, The University of Nottingham, Nottingham, United Kingdom; 2School of Optometry, University of California, Berkeley, Berkeley, CA. Purpose: Rapid serial visual presentation (RSVP) of words one at a time at the same spatial location increases reading speed in people with normal vision and those with central vision loss by minimizing the need to make inter-word eye movements. Additionally, displaying words such that the optimal viewing-position (OVP), a location between the beginning and middle of a word, lies at fixation increases reading speed in individuals with normal vision. It has recently been suggested that a combination of OVP alignment and highlighting the OVP using a different colored letter leads to improved reading speed in normals (Spritz software). Here we examine whether aligning the OVP of words with fixation, and/or highlighting it, can increase RSVP reading speed in patients with central vision loss. Methods: We measured reading speed for sentences in six patients with central vision loss due to macular disease (age: 50–85, logMAR acuity: 0.22–1.20). Participants fixated a gap between two vertical bars while words were presented at seven different exposure durations using the method of constant stimuli. Thresholds were determined as the duration that corresponded to 80% of correctly identified words. The effect of different combinations of horizontal spatial position and the highlighting of individual letters (using letter color or contrast polarity) on reading speed for sentences and word identification speed for 7 and 9 letter words were investigated for each patient. Results: Word identification speed was not significantly affected by changes in the horizontal spatial position of words or the highlighting of letters. For sentence reading, the mean reading speed when the central letter of words was aligned with fixation (standard RSVP) was 142 words per minute (wpm). When the OVP of words was aligned with fixation, and all letters were the same color, mean reading speed increased to 165 wpm, significantly higher (p = 0.02, Friedman test) than the standard RSVP paradigm. Aligning the OVP at fixation and highlighting the letter at fixation led to a mean reading speed of 124 wpm, which was not statistically different from the reading speed obtained for the standard RSVP condition. Conclusions: Aligning the OVP of words with fixation leads to improved reading ability in patients with central vision loss. Highlighting letters at the OVP location provides no benefit to reading speed. Commercial Relationships: Andrew T. Astle, None; Ben S. Webb, None; Paul V. McGraw, None; Susana T. Chung, None Support: This study was supported by a National Institute for Health Research Post-Doctoral Fellowship (ATA) and a National Institutes of Health research grant R01-EY012810 (STLC). This work presents independent research funded by the NIHR. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health. Program Number: 2219 Poster Board Number: B0072 Presentation Time: 3:45 PM–5:30 PM Assessing Non-standard Vision Function in Early to Intermediate AMD Lori A. Lott1, Marilyn E. Schneck1, 2, Gunilla Haegerstrom-Portnoy1, 2 , Susan Hewlett1, John A. Brabyn1. 1Smith-Kettlewell Eye Research Institute, San Francisco, CA; 2School of Optometry, UC Berkeley, Berkeley, CA. Purpose: It is difficult to predict which patients with early (E) to intermediate (I) age-related macular degeneration (AMD) are at the greatest risk of developing advanced AMD within a reasonable period of time. The goal of this study is to determine whether performance on simple, non-standard vision tests can improve the prediction of AMD progression. This presentation will describe and present data from the baseline session of a longitudinal assessment of vision function in people with E/I AMD. Methods: Participants tested to date (N=48, mean age =72.7 [SD =12.1], range: 56-91 years, 64% female) are patients with E/I AMD, and age-matched controls (C) with no AMD. All eyes have best corrected high contrast acuity ≤0.30 logMAR (20/40 or better). A dilated eye exam and fundus photos are used to confirm AMD status. Each eye is categorized using the clinical classification scale of Ferris et al. (Ophthalmology, 2013): E (medium drusen only), I ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics (large drusen and/or AMD pigmentary abnormalities), and C (no drusen, or small drusen only). In the vision test session, participants are refracted and then tested monocularly on a battery of vision tests with appropriate correction for the 40 cm test distance. The test battery includes: high contrast acuity under conditions of high and low luminance, low contrast acuity at low luminance, contrast sensitivity under conditions of high and low luminance, shape discrimination hyperacuity, reading performance, color vision, flicker modulation sensitivity at a frequency of 14 Hz, and glare recovery. Results: Preliminary results on the sample to date reveal statistically significant differences between early to intermediate AMD participants and controls on all measures, except high contrast acuity measured at high luminance and glare recovery. The E/I group shows greater variability than C, with some AMD patients showing results similar to the C group, and others showing considerably reduced function. The latter are the patients we hypothesize will progress to advanced AMD in a shorter period of time. Conclusions: This ongoing longitudinal study will test the hypothesis that non-standard vision function measures can predict AMD progression. The preliminary data from this baseline sample are promising. Most of the measures tested show sensitivity to E/I AMD, but with sufficient variation within each of the measures to be good candidates for predicting who will develop advanced AMD. Commercial Relationships: Lori A. Lott, None; Marilyn E. Schneck, None; Gunilla Haegerstrom-Portnoy, None; Susan Hewlett, None; John A. Brabyn, None Support: NIH Grant EY023320A Program Number: 2220 Poster Board Number: B0073 Presentation Time: 3:45 PM–5:30 PM Stability of performance of a handheld radial shape discrimination test in patients at risk of developing neovascular AMD Noelia Pitrelli Vazquez1, Simon P. Harding1, 2, Heinrich Heimann2, Paul C. Knox1. 1Eye and Vision Science, University of Liverpool, Liverpool, United Kingdom; 2St Pauls Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom. Purpose: We are currently investigating a handheld Radial Shape Discrimination (hRSD) test (Wang et al, 2013, IOVS 54:5497) as a potential screening test for detecting new neovascular age-related macular degeneration (nvAMD). The stability of performance of the hRSD test over time was assessed in patients at risk of developing nvAMD prior to disease development. Methods: Thirty-three non-diabetic participants (mean±SD age: 77±7 years; range: 60-91 years, 19 female) were recruited from a UK AMD clinic. Participants had nvAMD in one eye (for which they were receiving treatment) and no evidence of nvAMD in their fellow eye (study eye, SE) with a visual acuity of 0.4 logMAR or better in that eye. They performed the hRSD test with the SE, under supervision, on 5 occasions over a period of 5.5±0.8 months. Presence or absence of large drusen (maximum vertical diameter >70mm) and disruption of the ellipsoid zone (EZ) within 1500mm of the foveal centre were assessed on Heidelberg Spectralis OCT at baseline. Results: Group mean (±SD) hRSD thresholds at each time point were -0.54±0.18, -0.57±0.17, -0.56±0.17, -0.56±0.18 and -0.59±0.22 logMAR. A repeated measures ANOVA demonstrated that these thresholds were not statistically significantly different [F(4, 116)=0.56, p=0.694]. Regression analysis of threshold over time showed that the mean slope of individual regression lines was -0.000252±0.001206. The mean (95%CI) difference in hRSD threshold between the first and the last time points was -0.05 (-0.13 to 0.03) logMAR. Presence/absence of large drusen, or disruption to the EZ had no statistically significant effect on hRSD test performance (p=0.10 and p=0.23 respectively). Conclusions: Stability over time prior to the development of the target pathology is an important aspect of a diagnostic test. We have confirmed that hRSD test performance was stable over a period of approximately six months in the fellow (non-nvAMD) eyes of AMD patients and that it remained consistently below the cut-off value for the hRSD test previously suggested to be indicative of disease (-0.37 logMAR). Commercial Relationships: Noelia Pitrelli Vazquez, None; Simon P. Harding, None; Heinrich Heimann, None; Paul C. Knox, None Support: Dunhill Medical Trust Grant R283/0213. Equipment and software supplied by Vital Art & Science Inc. Program Number: 2221 Poster Board Number: B0074 Presentation Time: 3:45 PM–5:30 PM Structural and functional correlation of serial follow-up of patients with scarred choroidal neovascular membrane on Microperimeter .. Aishwarya1, Mathew Kurian Kummelil1, Robert Rosen2, Henk A. Weeber2, Marrie Van der Mooren2, Subhash Chandra3, K Bhujang Shetty1, Rohit Shetty4. 1Cataract and Refractive, Narayana Nethralaya, Bangalore, India; 2Abbott Medical Optics, Groningen, Netherlands; 3 Retina, Narayana Nethralaya, Bangalore, India; 4Refractive Department, Narayana Nethralaya, Bangalore, India. Purpose: To evaluate the long term serial follow up of patients with scarred choroidal neovascular membrane by imaging, using microperimeter (MAIATM), in order to quantify the area covered by the scarred choroidal neovascular membrane and to determine changes in the area of the scar and bivariate contour ellipse area over a period of time. Methods: 8 eyes of 7 patients meeting the inclusion and exclusion criteria were enrolled for the study and followed up for 6 visits at 6 weekly intervals. All patients underwent vision assessment and microperimetry (MAIATM ) at each visit. Serial images were analyzed using custom software for calculating the area of the scar and the changes over the period of time. Results: The analysis revealed average initial scarred choroidal neovascular membrane area to be 92 degrees2 and showed statistically no change over the course of follow up. Similarly, the initial bivariate contour ellipse area (BCEA) was found to be 61degrees2 with no change over time. The structural functional correlation between the scar and the BCEA was studied, and there was no significant correlation between the two. Conclusions: Microperimeter can be used as an assessment tool for serial changes over time in patients with scarred choroidal neovascular membrane. Commercial Relationships: .. Aishwarya, None; Mathew Kurian Kummelil, None; Robert Rosen, Abbott Medical Optics (E); Henk A. Weeber, Abbott Medical Optics (E); Marrie Van der Mooren, Abbott Medical Optics (E); Subhash Chandra, None; K Bhujang Shetty, None; Rohit Shetty, None Support: Funding: Supported by the Ministry of Economic Affairs, Netherlands, Grant OM111018, and by AMO ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Program Number: 2222 Poster Board Number: B0075 Presentation Time: 3:45 PM–5:30 PM Scotopic and Photopic Microperimetry in Patients with Reticular Drusen and Age-related Macular Degeneration Julia S. Steinberg1, Frederick W. Fitzke3, Rolf Fimmers2, Monika Fleckenstein1, Frank G. Holz1, Steffen Schmitz-Valckenberg1. 1 Department of Ophthalmology, University of Bonn, Bonn, Germany; 2 Institute of Biostatistics, University of Bonn, Bonn, Germany; 3 Institute of Ophthalmology, University College London, London, United Kingdom. Purpose: To evaluate retinal function by scotopic and photopic microperimetry patients with age-related macular degeneration (AMD) and a well-demarcated area of RDR (reticular drusen). Methods: A prospective case series of 22 eyes from 18 patients (mean age 74.7 years, range 62-87) was performed. Using combined confocal scanning laser ophthalmoscopy and spectral-domain optical coherence tomography imaging, retinal areas with RDR (category 1), other AMD-related pathologies (category 2) and no visible pathological alterations (category 3) were identified in each eye. Scotopic and photopic microperimetry (MP1S, Nidek Technologies, Padova, Italy) was performed using a grid with 56 stimulus points. A comparison of the mean threshold sensitivities for each category for scotopic and photopic microperimetry was performed. Results: In all eyes, areas of categories 1 and 2 showed a relative and sharply demarcated reduction of scotopic threshold values compared to areas of category 3, while only less pronounced differences were seen for photopic testing. Statistical analysis in the 18 eyes in which the 1.0 log unit neutral density filter was applied revealed a significant difference of scotopic threshold values in areas of category 1 (mean 13.5 ± 3.2 dB), category 2 (mean 7.8 ± 4.4 dB) and category 3 (mean 18.3 ± 2.0 dB) (p = 0.002). For photopic testing, the mean threshold values were 16.8 ± 2.9 dB in category 1, 15.9 ± 5.4 dB in category 2 and 18.4 ± 2.7 in category 3 (p = 0.03). Subtracting the scotopic from the corresponding photopic threshold value for each test point, the mean difference was 3.6 ± 3.0 dB for category 1, 8.1 ± 4.0 dB for category 2 and 0.1 ± 2.3 dB for category 3 (p = 0.002). Conclusions: The results indicate that rod function is more severely affected than cone function in areas with RDR and other AMDrelated pathological alterations. This differential structure-function correlation underscores the functional relevance of RDR in AMD subjects. Commercial Relationships: Julia S. Steinberg, Heidelberg Engineering (F), Optos (F); Frederick W. Fitzke, None; Rolf Fimmers, None; Monika Fleckenstein, Heidelberg Engineering (C), Heidelberg Engineering (F), Heidelberg Engineering (R), Optos (F), US20140303013 A1 (P), Zeiss Meditec (F); Frank G. Holz, Acucela (C), Acucela (F), Alcon (C), Alcon (F), Allergan (C), Allergan (F), Bayer Healthcare (C), Bayer Healthcare (F), Boehringer Ingelheim (C), Genentech (C), Genentech (F), Heidelberg Engineering (C), Heidelberg Engineering (F), Heidelberg Engineering (R), Novartis (C), Novartis (F), Optos (C), Optos (F); Steffen SchmitzValckenberg, Allergan (F), Bayer (F), Bayer (R), Heidelberg Engineering (F), Heidelberg Engineering (R), Novartis (C), Novartis (F), Novatis (R), Optos (F), Optos (R), Roche (C), Roche (F), Zeiss MediTec (F) Support: Gertrud Kusen foundation Program Number: 2223 Poster Board Number: B0076 Presentation Time: 3:45 PM–5:30 PM Mesopic and Scotopic Threshold Sensitivity in Patients with Choroideremia: Relationship with Residual Fundus Autofluorescence Area Ioannis Dimopoulos, Ian M. MacDonald. Ophthalmology and Visual Sciences, University of Alberta, Edmonton, AB, Canada. Purpose: To evaluate retinal sensitivity threshold under mesopic and scotopic conditions in patients with choroideremia and correlate the results with residual fundus autofluorescence area. Methods: 22 eyes of 11 choroideremia subjects with no detectable rod (DA 0.01) or cone (LA 3.0/30Hz) ERG responses were included. Subjects underwent mesopic testing using MAIA custom-grid (121 stimuli) microperimetry (Centervue; Padova, Italy) and scotopic testing using chromatic (white, blue, red) full-field stimulus threshold (FST; Diagnosys LLC). Fundus autofluorescence images (Sonomed Escalon, Inc.) were acquired with a modified fundus camera system (Sonomed Escalon, Inc.) and the area of residual fundus autofluorescence (FAF) in the posterior pole calculated using in-built software (OphthaVisionTM). Mean and maximum microperimetry sensitivity (dB) were correlated with FST (dB) and FAF area (mm2). Rod- and cone-mediation of visual perception was determined based on the difference between blue and red stimulus thresholds (Roman et al. 2005). Results: Residual remaining FAF areas ranged from 1.34 to 13.19 mm2 (mean±SD: 5.9±4.1 mm2). There was a strong correlation of FAF area with white FST threshold (r=-0.82; p<0.001), while no association was observed with maximum or average microperimetry sensitivity (r=0.25 and 0.19, respectively; p>0.1). Microperimetry maximum sensitivity showed a strong ceiling effect (skewness: 0.426; range: 24-28 dB) compared to FST (skewness: 0.005; range: 20.4, 52.5 dB). The majority of eyes (7/8) with residual FAF areas>5mm2 demonstrated rod-mediated perception (blue-red difference>19.3dB). A FAF area<4mm2 was associated with either cone (6/10) or rodmediation (4/10). Mean and maximum microperimetry sensitivity values could not diffentiate between eyes with rod or cone-mediated perception. Conclusions: For the range of FAF area tested, microperimetry mesopic testing showed a strong ceiling effect in terms of average and maximum sensitivity. Progression of RPE degeneration in this choroideremia cohort could be accurately followed by change in scotopic FST threshold. FST allowed quantification of residual rod function in subjects with severe RPE loss. Determining rod or cone mediation of perception in these patients may allow better classification and patient selection for future gene therapy clinical trials. Commercial Relationships: Ioannis Dimopoulos, None; Ian M. MacDonald, None Program Number: 2224 Poster Board Number: B0077 Presentation Time: 3:45 PM–5:30 PM Contrast sensitivity in patients with macular degeneration Robert Rosen1, Jennifer Jayaraj2, Shrikant R. Bharadwaj2, Henk A. Weeber1, Marrie Van der Mooren1, Patricia A. Piers1. 1Abbott Medical Optics, Groningen, Netherlands; 2LV Prasad, Hyderabad, India. Purpose: Age-related macular degeneration (AMD) is a common cause of visual impairment and blindness. It is of great interest to measure contrast sensitivity in patients with AMD, as it has been shown to correlate with e.g. risk of falling independently of acuity. We investigated the use of a quick method to measure the contrast sensitivity function (CSF) in both a group of patients with AMD ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics as well as a control group. In the group with AMD, other clinical measurements were also taken Methods: The study included 12 patients with AMD (acuity 0.5±0.4 logMAR) and 11 healthy volunteers of similar age (0±0.05 logMAR) from Hyderabad, India. The CSF was measured for both groups. The patients with AMD used their preferred retinal locus in the periphery. We used a quick Bayesian method that gave the full CSF curve in less than five minutes, which has earlier been tested for peripheral vision on healthy experienced volunteers. None of the subjects in this study had previous experience with psychophysical tests. Besides the CSF, we also measured visual acuity, visual field, fixation stability, and acquired autoflorescence images of the AMD lesion Results: The CSF could be measured on at least one eye of 10 of the subjects with AMD and all of the healthy volunteers. Two of the subjects with AMD could not see enough of the screen to get meaningful results. The average ± standard deviation of the CSF can be seen in Fig 1. The area under the logarithm of the CSF was significantly smaller for the patients with AMD than for the healthy volunteers (p<0.05, 1.05±0.72 vs 2.1±0.51), with an average individual standard deviation of 0.08 and 0.13 area units respectively. The CSF of the healthy volunteers was similar to that of other healthy subjects. For the patients with AMD, the loss of contrast sensitivity was most pronounced in the lower spatial frequency range. The mean peak of the curve was only 21, whereas it was 89 for the healthy volunteers. Looking at individual spatial frequencies, the difference was significant (p<0.05) at 15 cycles/deg and lower. Conclusions: It is possible to quickly measure the CSF of inexperienced elderly patients with AMD. Their total area under the CSF and peak contrast sensitivity at lower spatial frequencies is significantly lower than that of healthy volunteers. Figure 1. Average and standard deviation of CSF for the patients with AMD and the healthy volunteers Commercial Relationships: Robert Rosen, Abbott Medical Optics (E); Jennifer Jayaraj, None; Shrikant R. Bharadwaj, None; Henk A. Weeber, Abbott Medical Optics (E); Marrie Van der Mooren, Abbott Medical Optics (E); Patricia A. Piers, Abbott Medical Optics (E) Support: Supported by the Ministry of Economic Affairs, Netherlands, Grant OM111018, and by AMO. Program Number: 2225 Poster Board Number: B0078 Presentation Time: 3:45 PM–5:30 PM Precision of contrast sensitivity testing in glaucoma Pradeep Y. Ramulu, Pujan Dave, David S. Friedman. Ophthalmology, Wilmer Eye Inst/Johns Hopkins, Baltimore, MD. Purpose: Contrast sensitivity (CS) is frequently affected in glaucoma, but is not frequently used as part of clinical care. One impediment to the use of contrast sensitivity to monitor disease severity is the high variability of contrast values on repeat testing. Here, we examine test-retest parameters of two contrast sensitivity tests (the MARS contrast sensitivity chart and the Adaptive Sensory Technology quick CSF test) in a group of glaucoma patients with a range of disease severity. Methods: Both CS tests were evaluated in 30 glaucoma patients under the following 4 conditions: right eye, left eye, both eyes, and worse-seeing eye (retested). The MARS test measured CS at a single letter size, with letters read were converted into logCS. The quick CSF test tested contrast sensitivity at varying letter size using a thresholding algorithm. Results were summarized as the area under the contrast/letter size curve (AULCSF), as well as logCS at 3 cycles/ degree (a text size roughly equivalent to the MARS print size). Results: Thirty glaucoma patients completed the testing procedures. Subjects had a mean visual field mean deviation of -12.3 dB in the eyes where CS testing was repeated (SD=8.2 dB, range=-0.1 to -30.9 dB). Mean AULCSF values in retested eyes was 0.77 (0.48), and the mean (SD) test-retest difference in AULCSF was 0.02 (0.09). Bland-Altman plot showed no relationship between the difference in AULCSF and the average AULCSF across the 2 trials (p=0.995), and the coefficient of repeatability for AULCSF was 0.24. Mean test-retest differences in MARS logCS and quick CSF logCS at 3 cpd were 0.12 (.10) and 0.03 (0.15), respectively, with neither value showing a relationship between the difference in logCS and average logCS across the 2 trials (P>0.9 for both). The coefficients of repeatability for MARS log CS and quick CSF logCS at 3 cpd were 0.28 and 0.40, respectively. Conclusions: Precision of contrast sensitivity testing is constant over a wide range of glaucoma damage, suggesting that it may be useful to gauge disease severity, particularly in patients with very advanced disease. AULCSF may be more precise than logCS values calculated from a single letter size, though longitudinal testing will be necessary to determine which contrast sensitivity metrics, if any, are useful in judging progression in eyes with advanced glaucoma. Commercial Relationships: Pradeep Y. Ramulu, None; Pujan Dave, None; David S. Friedman, None Support: Research to prevent blindness; NIH Grant EY022976 Program Number: 2226 Poster Board Number: B0079 Presentation Time: 3:45 PM–5:30 PM Gaze-Directed Magnification: Developing a Head-Mounted, Wide Field, Immersive Electronic Low Vision Aid Frank S. Werblin1, Robert W. Massof2, Nicole C. Ross2, Danielle Natale2, Chris Bradley2, Boger Yuval3, David Teitelbaum3. 1Molecular and Cell Biology, UC Berkeley, Berkeley, CA; 2Low Vision Clinic, Johns Hopkins, Baltimore, MD; 3Sensics, Columbia, MD. Purpose: Design, develop and test a mobile head-mounted electronic low vision enhancement device with immersive wide field of view integrated with a region-of-interest gaze-directed magnification “bubble” locked to the patient’s preferred retinal locus (PRL). Methods: System has 120 degree binocular field of view in HMD with 70 deg binocular overlap. We use two 5 inch 1080p smartphone displays, one for each eye with resolution of 3 arcmin/pixel. The images from a HMD-mounted central field camera resolution of 2 arcmin/pixel and a peripheral field camera resolution of 5 arcmin/ pixel, are “stitched” together to create a panoramic montage. The magnification bubble is positioned and maintained at the patient’s PRL by tracking pupil position. Eye tracker is NTSC miniature IRsensitive video camera placed below each eye illuminated with IR. ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics The display is enriched with edge and contrast enhancement, ambient illumination level control, and additional image remapping. Results: The sensor and processing systems minimize processing delays so that eye tracking and natural image motion with head movements run essentially in real-time. Pupils are tracked at 30 fps (with an angular resolution of 7 arcmin) providing bubble position coordinates within 33 msec (one frame).The magnification bubble is processed within ~10 msec, then rendered into the scene and displayed in the HMD within 16 msec. Therefore, the overall processing for repositioning the bubble in the scene, locked on the PRL, is less than 60 msec, a delay short enough that subjects do not experience motion of the bubble when making saccades. Conclusions: Our proof-of-principle prototype demonstrates that it is feasible to build a wide field of view head-worn low vision enhancement device that can perform gaze-directed image remapping and other forms of real time image processing. Currently, this apparatus is being used to test the visual performance of low vision patients while navigating and viewing with gaze-directed bubble magnification Commercial Relationships: Frank S. Werblin, Visionize LLC (C); Robert W. Massof, None; Nicole C. Ross, None; Danielle Natale, None; Chris Bradley, None; Boger Yuval, Sensics (E); David Teitelbaum, Sensics (E) Program Number: 2227 Poster Board Number: B0080 Presentation Time: 3:45 PM–5:30 PM Layer-specific fMRI subcortical damage in glaucoma and amblyopia patients Wen Wen1, Peng Zhang2, Sheng He3, Xing-Huai Sun1. 1Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, Shanghai, China; 2State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Beijing, China; 3Department of Psychology, University of Minnesota, Minneapolis, MN. Purpose: To segment the layers of subcortical nuclei (LGN, SC) with fMRI, and to investigate selective pathway damage in glaucoma and amblyopia patients. Methods: Eighteen early-stage open-angle glaucoma patients, eighteen adult unilateral amblyopia patients and eighteen controls were enrolled in the study. The M and P stimuli were used to segment the M and P functional layers of LGN. The M stimulus was low spatial frequency sine wave patterns at low luminance contrast, and counter-phase flickering at high temporal frequency. The P stimulus was high spatial frequency, isoluminant red/green square wave patterns, reversing contrast at low temporal frequency. MRI data were collected with 3T scanner (Siemens Verio) and were analyzed using Brainvoyger QX.The M layers of the LGN was identified as voxels showing stronger response to the M stimulus than to the P stimulus, and vice versa for the identification of the P layers. Results: In normal group, the M layers were located more medially, interiorly and anteriorly compare to the location of the P layers, which is consistent with the human LGN anatomy. In glaucoma group, nearly all LGN voxels showed stronger responses to the P stimulus. In the M layers of LGN, a significant interaction was found between the factors of stimuli and groups but there was no interaction between stimuli and groups in the P layers. In amblyopia group, fewer LGN voxels showed strong responses to the P stimulus in the LGNs. In the P layers of LGN, a significant interaction was found between the factors of stimuli and groups but no such interaction in M layers. These results indicate that neuronal responses to the M and P stimuli were selectively reduced in the LGNs of glaucoma patients and amblyopia subjects, that is a greater loss of signals to the M stimulus in the M layers in glaucoma and a greater loss of signals to the P stimulus in the P layers in amblyopia. FMRI signals measured at superior depth showed the same significant interaction as in LGNs of patients. In glaucoma patients, the selective subcortical damage were well correlated with OCT parameters and visual field loss (p<0.05). Conclusions: Using fMRI, we demonstrated clear segregation of M and P divisions in human LGN noninvasively.This fMRI data provide in-vivo and direct evidence to support selective function loss in the two eye diseases and provide a promising paradigm to measure functional defects related to the two parallel pathways. Commercial Relationships: Wen Wen, None; Peng Zhang, None; Sheng He, None; Xing-Huai Sun, None 310 Visual functions in the presence of eye diseases Tuesday, May 05, 2015 8:30 AM–10:15 AM 702/704/706 Paper Session Program #/Board # Range: 2617–2623 Organizing Section: Visual Psychophysics / Physiological Optics Contributing Section(s): Low Vision Program Number: 2617 Presentation Time: 8:30 AM–8:45 AM Novel dual arc stimulus aids sensitive detection of early AMD Humza J. Tahir, Elena Cerio, Neil R. Parry, Jeremiah M. Kelly, David Carden, Tariq M. Aslam, Ian J. Murray. University of Manchester, Manchester, United Kingdom. Purpose: The rate of recovery of rod vision following a bleach is emerging as highly clinically significant. It is systematically slowed in the older eye and in many clinical conditions, notably Age-Related ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Macular Degeneration (AMD). It is not known for certain whether this is a pan-retinal effect or if there are localised regions of impaired rod function. To address this issue a dual arc stimulus was developed that simultaneously samples sensitivity recovery in two retinal locations and we present data for three groups of observers, younger normals (n=13), older normals (n=13) and early AMD patients (AREDS grade 2 or 3, n=47). Methods: Arc-shaped white stimuli were presented on an otherwise black CRT screen at two locations in the inferior visual field. Recovery of sensitivity to the two stimuli was measured concurrently using method of adjustment by alternately presenting them following a localised bleach of at least 80%. Neutral density filters were used to extend the luminance range of the CRT. Data were fitted by non-linear regression to either a seven- or five- parameter model to characterise the dark adaptation curves. Results: The two stimuli produced similar cone recovery curves within each normal age group. Rod recovery slope, S2, was significantly different between the tested locations for the normal age groups (young 6°=-0.21±0.03, 11°=-0.24±0.03, p=0.02; old, 6°=0.18±0.05, 11°=-0.20±0.04, p=0.01) but not for the AMD group (6°=0.10±0.06, 11°=-0.11±0.05, p=0.11). S2 slopes were significantly shallower at both testing locations in the AMD group compared to the age-matched normals (6° p <0.001 and 11° p<0.001). Alpha and beta points were significantly delayed in the AMD group compared to the age-matched normals at both testing locations (α, 6° p=0.035, 11°=0.038 and β, 6° p<0.001, 11° p<0.001). ROC analysis showed testing the extra location enhanced the diagnostic capability of the test in detecting early AMD. Conclusions: The new technique increases the information yield without placing any additional demands on subjects. Previous findings regarding normal dark adaptation across the life span are confirmed. Additional novel data are revealed by the technique showing that the method has the potential to be of clinical benefit in detecting and monitoring early signs of disease of the outer retina, particularly AMD. Commercial Relationships: Humza J. Tahir, None; Elena Cerio, None; Neil R. Parry, None; Jeremiah M. Kelly, None; David Carden, None; Tariq M. Aslam, None; Ian J. Murray, None Support: NRAP and TA’s participation was facilitated by the Manchester Biomedical Research Centre and the Greater Manchester Comprehensive Local Research Network. HJT, ERCD, TA and NRAP were supported by Newtricious R&D B.V. ERCD was also supported by the National Eye Research Centre (NERC). and AOSLO. Cone- and rod-mediated sensitivity was tested using a microperimeter (MP1-S, Nidek) under mesopic and scotopic conditions. Subjects were tested 3 times on different days to assess the repeatability of rod-mediated testing since repeatability of MP1-S scotopic sensitivity has not been reported. MP1-S targets were overlaid on the AOSLO image in which the photoreceptor structure at the MP1-S test locations were examined (Fig.1). Results: Compared to controls, subjects with drusen only showed similar cone- and rod-mediated light sensitivity, whereas those with SDD only showed reduced sensitivity for both cone- and rodmediated vision (Table 1). MP1-S test targets with lower sensitivity corresponded to retinal areas more affected by SDD, as revealed by AOSLO. Mean rod-mediated sensitivity for the entire test region was similar on repeat testing (7.95 dB, 8.83 dB, and 9.39 dB), with correlations ranging from 0.64 to 0.74 (Pearson’s r). The MP1-S’s 20 dB dynamic range of sensitivity creates a ceiling effect for conemediated testing in normal and AMD eyes with drusen only and a floor effect for rod-mediated testing in AMD patients with SDD only. Conclusions: Microperimeters may be useful in assessing SDD’s impact on cone- and rod-mediated vision in patients with AMD. However, further visual function testing in additional patients using instruments with a larger dynamic range is warranted. Program Number: 2618 Presentation Time: 8:45 AM–9:00 AM Mesopic and Scotopic Microperimetry and Multi-Modal Imaging in Eyes with Sub-retinal Drusenoid Deposits (SDD) Yuhua Zhang, Xiaolin Wang, Mark E. Clark, Christine A. Curcio, Cynthia Owsley. Ophthalmology, Univ of Alabama at Birmingham, Birmingham, AL. Purpose: To evaluate the impact of SDD on cone- and rod-mediated vision in patients with age-related macular degeneration (AMD) using mesopic and scotopic microperimetry, and correlate the findings with retinal structures revealed by multimodal imaging including a new generation research adaptive optics scanning laser ophthalmoscope (UAB AOSLO). Methods: Of 8 subjects enrolled, 3 patients had conventional drusen only, 2 patients had SDD only, and all had intermediate AMD (grade 6-7 on the AREDS 9-step severity scale). Three agesimilar adults in good macular health served as controls. SDD and drusen were ascertained by presence in color fundus photographs, infrared, autofluorescence images, optical coherence tomography, Table 1, Mean (standard deviation) cone- and rod-mediated sensitivity (dB) tested at 68 points in the central 10° radius of macula with a Goldman size III target presented for 200 msec using a 4-2 threshold strategy. Commercial Relationships: Yuhua Zhang, None; Xiaolin Wang, None; Mark E. Clark, None; Christine A. Curcio, None; Cynthia Owsley, None Support: This project is funded by EyeSight Foundation of Alabama (YZ), International Retina Research Foundation (YZ), 5R21EY021903 (YZ), R01AG04212 (CO), and R01EY06109 (CC) and institutional support from Research to Prevent Blindness, EyeSight Foundation of Alabama, Buck Trust of Alabama, and NIH P30 EY003039. Fig. 1 A, B, Cone- and rod-mediated light sensitivity. ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Program Number: 2619 Presentation Time: 9:00 AM–9:15 AM Impact of Simulated Micro-Scotomas on Foveal and Non-Foveal RSVP Reading Speed Arunkumar Krishnan, Hope M. Queener, Harold E. Bedell. Optometry, University of Houston - College of Optometry, Houston, TX. Purpose: Reading is impacted negatively in most subjects with central field loss. These subjects typically fixate with a non-foveal preferred retinal locus, which can include areas of localized sensitivity loss, or micro-scotomas. In this study, we simulated microscotomas at the fovea and in the peripheral retina of normal subjects to assess their impact on rapid-serial-visual-presentation (RSVP) reading speed. Methods: A custom MATLAB program using Psychtoolbox-3 simulated 13 x 13 min micro-scotomas that were superimposed on text presented in RSVP format. Reading material included 60-character MNread sentences and 53 ± 8 character sentences, taken from novels. Five naïve subjects with normal vision (ages: 23-31 years) read words presented at or above the critical print size (CPS) at the fovea and at 5 and 10 deg in the inferior visual field. At each eccentricity, critical print size (CPS) was estimated as 0.4 + mean logMAR reading acuity, determined in a preliminary experiment. Text was presented monocularly to the preferred eye on an 85-Hz CRT display as black ‘Courier’ letters on a uniform white background. In different conditions, randomly distributed 13 x 13 min blocks corresponding to 0, 13, 26 and 39% of the text area were set to the background luminance to simulate micro-scotomas. The location of the micro-scotomas was jittered (SDx, SDy = 0.3 deg) across successive words to simulate fixational eye movements. A staircase algorithm was used to estimate the threshold exposure duration for each combination of retinal eccentricity and micro-scotoma density. Reading speed in words per minute (WPM) was determined for each subject from the average of two staircase estimates. Results: Average foveal reading speed with no micro-scotomas was 688 ± 269 WPM. Reading speeds at 5 and 10 deg eccentricity were similar and approximately half of the foveal value. With 39% microscotomas, average RSVP reading speeds decreased at the fovea, 5 and 10 deg locations by approximately 80, 65 and 25%, respectively, from the no-scotoma condition. Conclusions: The impact of simulated micro-scotomas on reading speed for words that scale in size with eccentricity is greater in the central compared to peripheral retina. This outcome can be accounted for by the probability that randomly positioned micro-scotomas “cluster” into groups that approximate individual letter features in size. Commercial Relationships: Arunkumar Krishnan, None; Hope M. Queener, None; Harold E. Bedell, None Support: Student Vision science Grant to advance Research (SVGR - UHCO). We thank Drs. Gordon Legge, Steve Mansfield and Susana Chung for providing the sentences used in this study. Methods: We first estimated the extent of monocular scotoma and the loci of fixation using a scanning laser ophthalmoscope. We also estimated the location of the binocular scotoma using a custom program that projected stimuli on a large screen. Our goal was to train individuals to direct their PRL toward the scotoma, to uncover missing information. The training paradigm involved comparing two stimuli located on opposite sides of the PRL to determine if they were the same or different. One stimulus was hidden behind the individual’s binocular scotoma and the other was clearly visible in the location opposite the scotoma. As the task required knowing the identity of both stimuli, moving the PRL towards the scotoma was the best way to reveal the obscured stimulus. Observers were trained in multiple blocks over two practice sessions. Results: At the start of training, patients initially looked at the visible stimulus (away from the scotoma), but with practice they began to direct their PRL toward the scotoma. The attached figure shows how well participants were able to direct their saccades towards the target, after training and at a 2-month follow-up viist. At the end of training, 4 out of 7 individuals made saccades more than half way toward the hidden target. At the 2-month retention assessment, all observers consistently made saccades toward the the target hidden in the scotoma. Self-reports suggest increased subjective awareness of scotoma location for some, which could explain the high proportion of saccades towards the scotoma. Conclusions: A visual search task designed to direct eye movements toward the scotoma improves both scotoma awareness and eye movement efficiency. Program Number: 2620 Presentation Time: 9:15 AM–9:30 AM Scotoma Awareness and Eye Movement Training in Age-Related Macular Degeneration Preeti Verghese1, Christian P. Janssen1, 2. 1Smith-Kettlewell Eye Res Inst, San Francisco, CA; 2Utrecht University, Utrecht, Netherlands. Purpose: As most individuals with age related macular degeneration are unaware of their scotoma, we seek to: 1. Develop a paradigm to increase scotoma awareness and 2. Train the preferred retinal locus (PRL) to move towards the scotoma to reveal information obscured by the scotoma. ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics capability. Because most low vision patients suffer from impaired acuity and contrast sensitivity, their CSFs will differ from those of people with normal vision. The goal of this study was to test the hypothesis that the CSFs of people with low vision differ from a “normal” CSF only in their horizontal and vertical positions along the spatial frequency (SF) and the contrast sensitivity (CS) axes. Methods: Contrast sensitivity for detecting the presence of a horizontal sinewave grating was measured with a two temporalinterval forced-choice staircase procedure, for a range of SFs spanning 5–6 octaves. CSFs were measured for 23 low-vision eyes (11 with AMD, 5 with Stargardt’s disease and 7 with other pathologies). CSFs were also measured for five adults with normal vision, and the aggregate data were fit with an asymmetric parabolic function. This “normal template”, with the width parameters (shape) of the function constrained, was shifted horizontally and vertically along the SF and CS axes (both in log coordinates) to find the best fit for each of the 23 low-vision CSFs. The low-vision CSFs were also directly fit with best-fitting asymmetric parabolic functions (“freefit”). Results: A comparison of the peak CS, the SF at which peak CS occurs (SFpeak) and the high-frequency cut-off derived from the two fitting methods (template vs. free-fit) reveals that the values are highly correlated (r=0.77 to 0.98) and in good agreement (BlandAltman analysis) with one another, suggesting that the template fit is comparable with the free-fit method in estimating these parameters. The width of the left-half of the low-vision CSFs was 1.72±0.64× [mean±SD] that of the normal’s (p<0.0001) while the width of the right-half of the low-vision CSFs was 0.90±0.15× that of the normal’s (p=0.005), implying that the low-vision CSFs are wider on the left and slightly narrower on the right than a normal CSF. Conclusions: Although the low-vision CSFs are wider than that of a normal CSF, a normal CSF template predicts the peak CS, SFpeak and the high-frequency cut-off of low-vision CSFs reasonably well. Our results suggest that a normal template provides an approximate description of the spatial-pattern detection capability of low vision patients, especially if the emphasis is on the high-SF half of the function. Commercial Relationships: Susana T. Chung, None; Gordon E. Legge, None Support: NIH Research Grants R01-EY012810 and R01-EY017835 The box plots show the distribution of saccade length relative to the target distance from fixation, for each of 7 participants. (Saccades that reach the center of target are denoted by 1, saccades that do not move toward the target by 0.) The upper and lower panels show data at the end of training and at a 2-month retention assessment, respectively. Commercial Relationships: Preeti Verghese, None; Christian P. Janssen, None Support: NIH R01 EY022394; Pacific Vision Foundation Program Number: 2621 Presentation Time: 9:30 AM–9:45 AM Comparing the Shape of the Contrast Sensitivity Functions of Normal and Low Vision Susana T. Chung1, Gordon E. Legge2. 1School of Optometry, University of California, Berkeley, CA; 2Department of Psychology, University of Minnesota, Minneapolis, MN. Purpose: The contrast sensitivity function (CSF) provides a comprehensive description of an individual’s spatial-pattern detection Program Number: 2622 Presentation Time: 9:45 AM–10:00 AM Low Vision Patients Can Transfer Skills They Learned From Virtual Reality to Real Streets Ellen Bowman1, Lei Liu2. 1Vision Science, University of Alabama at Birmingham, Birmingham, AL; 2Optometry, Univeristy of Alabama at Birmingham, Birmingham, AL. Purpose: Virtual reality holds great potential to improve efficiency, affordability and accessibility of low vision rehabilitation. However, whether patients with impaired vision can learn useful skills in a virtual environment and then apply them to solve real world problems has not been tested. Methods: Twelve subjects with vision too poor to use pedestrian signals to make a safe street crossing were trained to use the start (surge) of the traffic in the lanes next to her (near lane) going in the same direct (parallel) to determine the safest time to cross a street within a WALK cycle. A safe surge came a few seconds after the onset of the pedestrian signal, when cars entered the intersection. The subject was asked to say “GO” on the curb when she felt the safest to initiate crossing. The time of the onset of the pedestrian signal, the surge time (first straight-going car passing through the outer boundary of the crosswalk) and the GO time were recorded using ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics stopwatches by two testers. The GO time was converted to a safety score (SS) which was the proportion of remaining “WALK” cycle after GO. SS=0 if GO was in the red cycle. The SS for all subjects was evaluated at 4 real street corners before and after training, at least 3 attempts per corner. A certified orientation & mobility specialist taught the subjects how to use near lane parallel traffic surge. Eight subjects were trained in virtual streets generated by a semi-cave simulator (VS group) and 4 were trained in real streets (RS group). Results: Both groups showed a significant increase in SS after training (0.25 vs. 0.81, t=15.11; p<.0001 for VS; 0.29 vs. 0.76, t=8.48, p<.0001 for RS). Repeated measure ANOVA showed no significant interaction between training effect and group. Before training, VS group said GO 65% of the time in the red cycle (InRed), 17% in the WALK cycle but before surge (BeforeSurge), 1% in the WALK cycle but with less than half the cycle left (SafeLow) and only 17% in the WALK cycle with more than half the cycle left (SafeHigh). After training in virtual streets, the numbers became 3%, 4%, 2% and 91% (Fig. 1). The RS group showed a similar pattern after real street training (Fig. 2). Conclusions: Patients with severely impaired vision can learn important visual skills in a virtual environment and can apply the skills to solve real world problems. The effectiveness of virtual street training can be as good as real street training. Program Number: 2623 Presentation Time: 10:00 AM–10:15 AM Auditory spatial representations of distance are compressed in blind individuals Andrew J. Kolarik1, 2, Brian Moore2, 1, Silvia Cirstea1, Shahina Pardhan1. 1Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, United Kingdom; 2Psychology, Cambridge University, Cambridge, United Kingdom. Purpose: Blind individuals primarily rely on sound for spatial information about their environment in far space. However, it is currently unknown how well they are able to judge the distance of sound sources. We investigated whether lack of visual information, which aids in calibrating audition in far space, leads to poorer estimation of the apparent distance of sounds by blind participants. Methods: Virtualization techniques were used to simulate virtual anechoic and reverberant rooms. Single, unmoving sounds were presented at virtual distances between 1.2 and 13.8 m to 10 blind and 12 normally sighted participants. All had normal hearing. Stimuli were speech, music or noise. Participants were instructed to report the apparent distance of each sound source. Within a series of trials the stimulus type was held constant. Results: For normally sighted participants, perceived distance to farther sounds was underestimated. For blind participants, the distances for closer sounds were overestimated, and those for farther sounds were underestimated. Accuracy of distance judgements was quantified as the mean unsigned error. For both groups, errors increased with increasing virtual distance, and errors were higher for the blind than the sighted group. A mixed-model ANOVA with distance, room reverberation, stimulus and blindness as factors showed main effects of distance and blindness (p<0.05). No other main effects or interactions were significant. Conclusions: Absolute auditory distance judgements are less accurate for blind participants than for normally sighted controls. The internal representation of auditory distance for blind participants is compressed. These findings suggest that accurate calibration and fidelity for sound cues used to perceive auditory distance is compromised as a result of blindness. Commercial Relationships: Andrew J. Kolarik, None; Brian Moore, None; Silvia Cirstea, None; Shahina Pardhan, None Support: MRC grant G0701870 and the Vision and Eye Research Unit (VERU), Postgraduate Medical Institute at Anglia Ruskin University. 320 IOL and Presbyopia Correction Tuesday, May 05, 2015 8:30 AM–10:15 AM Exhibit Hall Poster Session Program #/Board # Range: 2966–2992/D0088–D0114 Organizing Section: Visual Psychophysics / Physiological Optics Contributing Section(s): Cornea, Lens Commercial Relationships: Ellen Bowman, None; Lei Liu, None Clinical Trial: NCT02310880 Program Number: 2966 Poster Board Number: D0088 Presentation Time: 8:30 AM–10:15 AM Alteration in mechanical properties of the lens capsule after cataract surgery Hiroyuki Matsushima, Yoko Katsuki, Koichiro Mukai, Wataru Terauchi, Tadashi Senoo. Ophthalmology, Dokkyo Medical University, Shimotsuga-Gun, Japan. Purpose: To evaluate mechanical properties changes in the rabbit posterior lens capsule over the postoperative course of cataract surgery. Methods: Phacoemulsification was performed for 9-week-old Japanese white rabbits. A capsule tension ring (CTR) and an ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics intraocular lens (IOL: YA-60BB, HOYA) were implanted in the eye (n=3). The lens capsule was extracted in the 4-week postoperative and was fixed by fixture that was placed in normal saline at room temperature. The tensile tester (MINI44, INSTRON) with a rod was used to pierce for measuring the posterior capsule load and displacement to breaking point under the following condition; Gauge Length (1.5 mm), Speed (10 mm/min). The integral load from 1.5 mm to the breaking point in displacement was defined as total deformation energy. For comparison, five capsules, which were extracted immediately after CTR-insertion surgery, were used. Results: The results of the piercing-load measurement are shown for the control group (Fig. 1) and the 4-week postoperative group (Fig.2). For total deformation energy, the control group scored 0.038 Nmm, whereas the 4-week postoperative group scored 0.066 Nmm, significantly higher than the control group (P=0.025). Conclusions: The lens capsule needs more energy for deformation over the postoperative course of cataract surgery. Commercial Relationships: Hiroyuki Matsushima, None; Yoko Katsuki, None; Koichiro Mukai, None; Wataru Terauchi, None; Tadashi Senoo, None Program Number: 2967 Poster Board Number: D0089 Presentation Time: 8:30 AM–10:15 AM Refractive and Corneal Astigmatism in Patients with Monofocal Intraocular Lens Sanjeev Kasthurirangan, Stan Bentow. CLINICAL R&D, Abbott Medical Optics, Milpitas, CA. Purpose: Toric intraocular lenses (IOLs) have led to a renewed interest in understanding posterior corneal astigmatism and its inclusion in the calculation of toric IOL power for implantation. In this study, refractive astigmatism and anterior corneal astigmatism were compared in patients with a monofocal IOL to calculate the magnitude of posterior corneal astigmatism and surgically induced corneal astigmatism. Methods: Corneal astigmatism (CA) and refractive astigmatism (RA) data from a previous multi-center clinical study in which subjects were implanted with a non-toric monofocal IOL or a toric IOL were analyzed. All corneal incisions were restricted to temporal 180 ± 15° in the study. Notably, in the non-toric IOL group, subjects had preoperative anterior CA of 0.75D to 1.50D. In the non-toric IOL group, the difference between postoperative anterior CA and postoperative RA can be attributed to the posterior CA, as the IOL does not have any cylindrical power. Main outcome measures were i) magnitude of posterior corneal astigmatism calculated as postoperative RA minus postoperative CA in the non-toric group (n = 208 eyes) and ii) surgically induced astigmatism (SIA), calculated as postoperative minus preoperative CA of all eyes (n = 535 eyes). Results: The non-toric group had mean ± SD preoperative CA of 0.98 ± 0.32 D, postoperative CA of 0.95 ± 0.45D and postoperative RA of 0.76 ± 0.53 D. Postoperative RA magnitude was statistically significantly different (One-way ANOVA, p < 0.05) for postoperative CA, grouped into “with-the-rule” (vertical steep meridians >60°120°, RA: 0.41 ± 0.33 D), “against-the-rule” (horizontal steep meridians 0°-30° and >150°-180°; RA: 0.98 ± 0.53 D) and “oblique” (steep meridians >30°-60° and >120°-150°; RA: 0.68 ± 0.36 D). ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics The mean posterior CA vector was 0.28D at 179.09°. The J0 vector component of SIA was statistically significantly different (One way ANOVA, p < 0.05) for preoperative CA into “with-the-rule” (SIA J0: 0.00 ± 0.57 D), “against-the-rule” (SIA J0: -0.33 ± 0.60 D) and “oblique” (SIA J0: -0.17 ± 0.55 D). The mean SIA vector was 0.19 D at 90.35°. Conclusions: Generally, “against-the-rule” posterior corneal astigmatism resulted in reduced total refractive astigmatism when anterior corneal astigmatism was “with–the-rule.” Induced SIA was greater when the cataract incision was located along the steep meridian of corneal astigmatism. Commercial Relationships: Sanjeev Kasthurirangan, Abbott Medical Optics (E); Stan Bentow, Abbott Medical Optics (E) Clinical Trial: NCT01098812 Program Number: 2968 Poster Board Number: D0090 Presentation Time: 8:30 AM–10:15 AM Accuracy of Intraoperative Wavefront Aberrometer for Toric IOL in Post Refractive Eyes Undergoing Cataract Surgery Nilufer Yesilirmak, Sotiria Palioura, Vasilios Diakonis, Daniel Waren, Sonia H. Yoo, Kendall Donaldson. Cornea, Bascom Palmer Eye Institute, Miami, FL. Purpose: To compare preoperative toric intraocular lens (IOL) calculater with intraoperative wavefront aberrometry and evaluate the accuracy of intraoperative wavefront aberrometry in post-refractive eyes that underwent cataract surgery with toric IOL. Methods: Ten post-refractive eyes were implanted with toric IOLs by using intraoperative wavefront aberrometry (ORA System, WaveTec Vision) to select the lens power and to guide the final lens orientation. Preoperative IOL power was calculated by IOL Master and toric planner and its prediction error compared with ORA prediction error. Predicted and measured residual refractive error was used to determine the accuracy of ORA System. Results: Mean preoperative keratometric astigmatism was 2.05 ± 0.63 D (range 1.15 to 3.33 D). Mean postop manifest astigmatism was 0.91 ± 0.62 D (range 0.00 to 1.75 D). The mean ORA prediction error (MAVPE) was 0.35 ± 0.24 D, compared to a mean prediction error of 0.97 ± 0.72 for the calculated preoperative lens choice (p < 0.01). The prediction error was ≤ 0.25 D in 50% of eyes with ORA, compared to 20% of eyes with the preoperative lens choice. The prediction error was ≤ 0.75 D in 100% of eyes with ORA, compared to 40% of eyes with the preoperative lens choice. Conclusions: The ORA System is a useful device for selecting of accurate toric IOL power and guiding final lens orientation in postrefractive eyes. Commercial Relationships: Nilufer Yesilirmak, None; Sotiria Palioura, None; Vasilios Diakonis, None; Daniel Waren, None; Sonia H. Yoo, Alcon (C), Allergan (R), AMO (R), Bausch&Lomb (C), Optimedica (C), SLACK (C), Transcend (C), Zeiss (R); Kendall Donaldson, Alcon (C), AMO (C) Program Number: 2969 Poster Board Number: D0091 Presentation Time: 8:30 AM–10:15 AM A novel liquid lens optical component capable of focus and astigmatism correction: application to an innovative phoropter Florent THIEBLEMONT, Hilario GATON, Bruno BERGE, Fannie Castignoles, cécile barnoud, Anaïs curpanen, Nelly GARCIAJALDON, Régis DIMITRIOU, Eric SIMON. Product development, Varioptic, Lyon, France. Purpose: Today the most reliable measurements for eyeglasses prescription rely on the use of a phoropter with an iterative positioning of a set of spherical and cylindrical lenses in front of the eyes. We present the design and the experimental evaluation of a novel compact, portable and low cost system for visual acuity measurement based on a single adaptive-optics component with continuously variable optical power, cylinder power and cylinder axis. Methods: The adaptive-optics component, an 8mm optical aperture diameter liquid lens based on electrowetting, was designed using two encapsulated liquids with different refractive indexes, the interface of which is centered within a conical part. The shape of the liquid interface can be continuously controlled by bias voltages thanks to a multi-electrode design on the conical part, leading to a variable spherical and cylindrical diopter. The novel system for visual acuity measurement consists of two liquid lenses installed on a trial frame, with a driving electronics and a user command interface. The key performances of the system for visual acuity measurement were analyzed using a Shack-Hartmann optical wave-front analyzer. The system was also tested on a few patients to check its operational convenience. Results: The lens with its driver provides a pure spherical power correction from -13D (Diopter) to +15D and a cylinder correction up to -6D with a spherical power included between -6D and +15D. Over this range, an optical power accuracy lower than 0.25D has been demonstrated. The cylinder axis can be controlled with an accuracy better than 3°. The maximal optical wave-front error is below 120nmrms over a 4mm diameter pupil. And the focus control response time is lower than 300ms. Conclusions: The optical performances evaluation has demonstrated the relevance of our system for visual acuity tests. The range of correction should be large enough to examine ametropia on 98% of the worldwide population and an additional fixed lens could be used to measure extreme optical corrections. Moreover the first tests on patients highlight the convenience of the system due to the absence of disruption in the test chart visualization when the optical settings are changed and to the possibility for the patient to tune the settings by himself. Commercial Relationships: Florent THIEBLEMONT, Varioptic (E); Hilario GATON, Varioptic (E); Bruno BERGE, Varioptic (E); Fannie Castignoles, Varioptic (E); cécile barnoud, Varioptic (E); Anaïs curpanen, Varioptic (E); Nelly GARCIA-JALDON, Varioptic (E); Régis DIMITRIOU, Varioptic (E); Eric SIMON, Varioptic (E) Program Number: 2970 Poster Board Number: D0092 Presentation Time: 8:30 AM–10:15 AM Parameters affecting vignetting and negative dysphotopsia in the far peripheral visual field of the pseuodophakic eye Michael Simpson. Optics R&D, Simpson Optics LLC, Arlington, TX. Purpose: As visual angle increases, light becomes increasingly vignetted (blocked) at the edge of an intraocular lens (IOL) for large visual angles, and light that bypasses the IOL completely may also create a second displaced image. These imaging characteristics are likely to be the source of occasional reports of dark shadows in the temporal visual field (negative dysphotopsia), and calculations have been made to estimate the visual angles at which this occurs. Methods: The Zemax raytrace software was used to extend the work reported in J. Opt. Soc. Am. A v31, pp. 2642-2649 (2014), to evaluate visual angles for a range of eye characteristics. The same basic eye was used (Figure 1), but the pupil diameter and ocular distances were varied. The main parameter of interest is simply the percentage of light rays passing through the iris that also pass through the posterior surface of the IOL. A routine was written in Zemax to determine this for collimated light with different input visual angles. Results: Representative plots are given in Fig. 2 for the eye described in Fig. 1. The onset of vignetting varies with various parameters, ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics but the visual angle at which focused light is truncated by the IOL can be as low as 50 degrees. By 75-80 degrees of input visual angle, about half the light is no longer focused by the IOL for any pupil diameter for this example. Vignetting is lower for smaller iris-toIOL separations, calculated separately, but even when this is 0.5 mm about half the energy is obstructed for a visual angle of 85 degrees for larger pupils. Conclusions: The IOL is very much smaller than the natural crystalline lens, and the visual angle at which about 50% of the light is no longer focused by the IOL in a model eye may be a useful parameter for evaluating “dark shadows”. Clinical data for the relevant parameters are rarely reported and difficult to measure, but the visual angle for the strongest shadow, along with the physical characteristics of the eye, could be used to create individual eye models for comparison to clinical date. Any decentrations and tilts of the IOL and the iris should also be included, since these would increase the effect for smaller pupils. Figure 2. Percentage of light transmitted by the IOL for the eye in Figure 1. Commercial Relationships: Michael Simpson, None Figure 1. Schematic eye with 4mm pupil at 4.1 mm from corneal apex, IOL at 5.1 mm, and rays at 80 degrees of visual angle. Program Number: 2971 Poster Board Number: D0093 Presentation Time: 8:30 AM–10:15 AM Higher-order Aberrations after Posterior Chamber Phakic Intraocular lens Implantation Hongting Liu2, 4, Jing Li3, Owhofasa Agbedia4, Jiangxia Wang1, Xinyu Li3, Hujie Wang3, Lei Liu3. 1Biostatistics Department, School of Public Health, Johns Hopkins, Baltimore, MD; 2Visual science and Optometry Center, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning City, China; 3Refractive Surgery Center, Tongji Hospital of Huangzhong Science and Technology University, Wuhan, China; 4Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD. Purpose: To evaluate the changes of higher-order aberrations (HOAs) after implantable collamer lenses implantations (Visian ICL; STAAR Surgical Co, Monrovia, California, USA). Methods: In this prospective study, thirty-three eyes of 20 patients with myopia who had ICL implantation were enrolled. Before surgery and one month after surgery, the wavefront aberration data were obtained with the Hartmann-Shack wavefront sensor (KR-1W aberrometer, Topcon Corp, Tokyo, Japan). For patients with pupil size < 6 mm, the root mean square (RMS) of total ocular HOAs, RMS of third-order aberrations, RMS of fourth-order aberrations were measured and analyzed for 4 mm-pupil diameter. For patients with pupil size ≥ 6 mm, HOAs were calculated for 6 mm-pupil diameter. Visual acuity, refraction, pupil size and intra ocular pressures were also recorded. Results: Significant improvements in visual acuities were found postoperatively, with significant reduction in spherical equivalent (P < 0.001). All HOAs in the 6 mm-pupil group were significantly higher than that of the 4 mm-pupil group, this was observed prior to and after the procedure. After one month of the implantation of ICL, the induction of total ocular HOAs, third-order aberrations, and fourth-order aberrations in 4mm-pupil group were were 0.002 ± 0.061 μm, - 0.004 ± 0.045 μm, and 0.001 ± 0.039 μm, respectively. In the 6-mm pupil group, the induction of total HOAs, third-order aberrations, and fourth-order aberrations were 0.089 ± 0.144 μm, 0.042 ± 0.117 μm, and 0.034 ± 0.060 μm, respectively. The increase in total HOAs and third-order aberrations were not statistically significant after the procedure in ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics both groups (all P > 0.05), however, the increase in fourth-order aberrations was statistically significant in the 6mm-pupil group. Conclusions: ICL implantation results in an improvement in visual acuity with minor increase in HOAs among eyes with 4 mm and 6 mm-pupils. Larger longitudinal studies, with a greater number of subjects are indicated to confirm these findings. Table 1 and Table 2 Figure 1 Commercial Relationships: Hongting Liu, None; Jing Li, None; Owhofasa Agbedia, None; Jiangxia Wang, None; Xinyu Li, None; Hujie Wang, None; Lei Liu, None Program Number: 2972 Poster Board Number: D0094 Presentation Time: 8:30 AM–10:15 AM OCT-based ray tracing on pseudophakic eyes to identify optimal IOL centration Mengchan Sun1, Pablo Pérez-Merino1, Sonia Durán2, Ignacio Jiménez-Alfaro2, Susana Marcos1, 2. 1Consejo Superior de Invest Cient CSIC, Madrid, Spain; 2Fundación Jiménez Díaz, Madrid, Spain. Purpose: Quantitative 3D anterior segment Optical Coherence Tomography (OCT) provides full anatomical information to build customized eye models to identify the IOL centration that would produce best optical quality. Methods: 4 subjects implanted with monofocal aspheric IOLs (Bausch and Lomb, US; Alcon, US) were measured 90 days after cataract surgery. 3-D quantitative anterior segment geometry (corneal topography; anterior chamber depth; IOL tilt & decentration; foveal position) was measured using a custom-developed spectral OCT 840nm; acquisition rate=25,000 A-Scanss; acquisition time =0.72 s; 7(vertical)x15(horizontal)x7mm(axial). Total wave aberrations were measured using custom-developed Laser Ray Tracing at 785nm laser beam sampled 35 positions of a 4-mm pupil. The IOL geometry was characterized ex vivo using profilometry. OCT images were processed and data were exported to ZEMAX to build full OCT-based customized computer eye models. Optical quality was calculated from measured/simulated wave aberrations in terms of Visual Strehl Ratio (VSR), for 4-mm pupils, and estimated for the native tilt & decentration, and simulated decentrations ranging from -2 to +2 mm in 0.1 mm steps in horizontal and vertical meridians, referred to the pupil center. Results: There was a good correspondence between measured and estimated wave aberrations using measured IOL tilt (VSR of 0.3 and 0.2, respectively). VSR varied across IOL decentrations, with a highest mean value of 0.4±0.2. The IOL vertical centrations producing optimal quality were decentered nasally in all cases, ranging from 0.1–1mm. Optimal vertical centration ranged from 0.4-1 mm inferiorly. These positions differed by -0.3 mm horizontally and 0.1 mm vertically on average from native IOL decentration values. Centering the IOL in the estimated optimal location produced an average improvement of 0.08 in VSR with respect to native decentration values and an average improvement of 0.13 in VSR with respect to zero decentration. Conclusions: OCT-based customized eye models predict well optical quality in pseudophakic eyes implanted with state-of-the-art monofocal IOLs. Zero IOL decentration does not produce optical quality. The best IOL decentration can be obtained for each patient based on personalized models, and the achieved improvement may be of clinical relevance. Commercial Relationships: Mengchan Sun, None; Pablo PérezMerino, None; Sonia Durán, None; Ignacio Jiménez-Alfaro, None; Susana Marcos, Patent PCT/ES2012/070185 (P) Support: Support Detail: FIS2011-25637; ERC-2011-AdG-294099; EU Marie Curie FP7-PEOPLE-2010-ITN #26405 Program Number: 2973 Poster Board Number: D0095 Presentation Time: 8:30 AM–10:15 AM Refractive Differences Among Intraocular Lens Formulas and Correlation With Outcomes in the Fellow Eye Steven M. Naids, Sarah E. Brown, Bradford L. Tannen. Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY. Purpose: Partial coherence interferometry (Zeiss IOL Master) selects lens power based on targeted postoperative spherical equivalents. Actual manifest refractive outcomes may differ from the targeted refractive error. Also, error may occur if the same biometry measurements are used in surgical planning of the second eye. This study investigates the accuracy of targeted versus refractive outcomes using SRK/T, SRKII and Holladay formulas, and whether a correlation exists between the first and second eye post-operative spherical equivalent prediction errors. Methods: Retrospective review from January 2013 to September 2014 of 36 eyes of 18 patients that underwent bilateral subsequent phacoemulsification. Biometry from the first surgery was also used for the second eye. All surgeries were performed by the same surgeon, and all patients received an Alcon SN60WF PCIOL. The “refractive difference” was determined by the difference between the predicted and manifest spherical equivalent at one month. Refractive difference was determined for the SRK/T, SRKII, and Holladay formulas using the same IOL power that was implanted. Linear regression was used to investigate the relationship between the error in the first and second eye for each formula. Results: The mean refractive differences at one month for the first and second eye, respectively, for each formula were as follows: SRK/T (0.18+/-0.42, 0.04+/-0.431), SRKII (0.14+/-0.57, -0.001+/- ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics 0.56), Holladay (0.23+/-0.41, -0.02+/-0.46) . While refractive difference in the first eye was not related to the second eye using the SRKT and Holladay formulas (p= 0.280, p=0.140, respectively), refractive difference in the first eye was statistically correlated with that of the second eye using SRKII (p=0.004). Conclusions: The results of this study suggest that the amount of refractive difference at one month after phacoemulsification in the first operative eye has a significant correlation with the second eye when using SRKII. This relationship was not found to exist for SRK/T and Holladay. The mean SRKII refractive differences at one month for both eyes were closer to the targeted spherical equivalent than the other two formulas in this cohort, although results were similar among the formulas. Confirmation of this statistical corelation in a larger study is warranted, and may be a consideration for adjusting the power of the lens used in the second eye using SRKII. Commercial Relationships: Steven M. Naids, None; Sarah E. Brown, None; Bradford L. Tannen, None Program Number: 2974 Poster Board Number: D0096 Presentation Time: 8:30 AM–10:15 AM Correlation between factors related with previous myopic laser in situ keratomileusis and refractive error after intraocular lens implantation Keiichiro Minami1, Yosai Mori1, Shiro Amano1, 2, Kazunori Miyata1, Kazutaka Kamiya3, Kimiya Shimizu3. 1Miyata Eye Hospital, Miyakonojo, Japan; 2Inoue Eye Hospital, Tokyo, Japan; 3 Ophthalmology, Kitasato University, Sagamihara, Japan. Purpose: In eyes after myopic laser in situ keratomileusis (LASIK), power of intraocular lens (IOL) is underestimated by using conventional methods of IOL power calculation. Although plenty of calculation methods have been proposed, regression analysis of IOL power underestimation with respect to LASIK correction was rarely performed. This retrospective study was to evaluate factors related with refractive error after IOL implantation in post- myopic LASIK eyes. Methods: Clinical records of eyes that had previously undergone myopic LASIK and received IOL in cataract surgery were observed. The study comprised of 30 eyes of 20 patients whose mean age was 58.8 years at cataract surgery. Period between LASIK and cataract surgeries was 2 to 13 years (mean: 9.6 years). All target refractions in LASIK were intended to emmetropia. Manifest refractions spherical equivalent (MRSEs) and keratometric refractions (Ks) were recorded before LASIK, and before and 1 month after cataract surgery. Ocular axial length (AXL) was also measured before cataract surgery. Predicted postoperative refraction was obtained by SRK/T and double-K formulas, and the difference from MRSE at 1 month was calculated as refractive error. Correlations between refractive error and, MRSE before LASIK, change in K between before LASIK and cataract surgeries, and AXL were analyzed with linear and multiple regression analyses. Results: MRSE before LASIK was -2 to -13 D (mean: -7.5 D), and change in K was -1.06 to -8.00 D (mean: -4.37 D). Refractive error was 0.03 to 4.99 D (mean: 1.98 D) in the SRK/T, that was significantly correlated with MRSE before LASIK, change in K, and AXL (P < 0.0001, R2 = 0.51, 0.56, 0.52, respectively). Multiple regression analysis showed that refractive error had significant associations with change in K and AXL (P = 0.004 and 0.005, slope = -0.54 and 0.46 D/mm, respectively). In the double-K, significant correlation was found between refractive error and AXL (P = 0.001, slope = 0.38 D/mm). Conclusions: In post-myopic LASIK eyes, refractive error was highly correlated with the amount of myopic correction in SRK/T formula. Significant correlation with AXL were found in both SRK/T and double-K formulas. This result demonstrated that compensation of K values only is not sufficient for IOL power calculation of postLASIK eyes. Commercial Relationships: Keiichiro Minami, None; Yosai Mori, None; Shiro Amano, None; Kazunori Miyata, None; Kazutaka Kamiya, None; Kimiya Shimizu, None Program Number: 2975 Poster Board Number: D0097 Presentation Time: 8:30 AM–10:15 AM Validation of axial length optimization as a way to improve refractive prediction error after cataract surgery Jason R. Mayer, Zachary Landis, Ravi Patel, Christopher Weller, Ingrid U. Scott, Seth Pantanelli. Ophthalmology, Penn State Hershey Eye Center, Hummelstown, PA. Purpose: Wang et al proposed a method of optimizing axial length (AL) in eyes longer than 25.0 mm to reduce the proportion of eyes with hyperopic outcomes. The objective of this study is to compare the accuracy of predicting postoperative refractive error in eyes with AL >25.0 mm undergoing cataract surgery at a large academic center using the IOLMaster AL, 1-center and 2-center optimized ALs. Methods: Retrospective consecutive case series including 50 eyes with an AL >25.0 mm that underwent cataract extraction with intraocular lens (IOL) implantation at Penn State Hershey Eye Center between 12/2013 and 10/2014. Inclusion criteria were (1) biometric measurements by partial coherence interferometry (IOLMaster, Carl Zeiss Meditec, Inc.), (2) no previous ocular surgery or intraoperative or postoperative complications, and (3) postoperative corrected distance visual acuity of 20/30 of better. For each case, an optimized AL was calculated using equations published previously by Wang et al. These optimized ALs were then used to predict the residual refractive error using the Holliday1, SRK/T, Haigis and HofferQ formulas. The refractive prediction error was calculated as the difference between the actual postoperative spherical equivalent and the predicted postoperative spherical equivalent. Mean numerical error (MNE) was calculated for the four formulas using the IOLMaster AL, the 1-center optimized AL, and the 2-center optimized ALs. Results: Table 1 shows the mean numerical errors (MNE), ranges, and proportions of eyes with a hyperopic outcome using the IOLMaster AL, 1-center optimized AL, and 2-center optimized AL. The MNEs using optimized ALs were significantly reduced when compared to MNEs using IOLMaster ALs (all p <0.05). The proportion of eyes with hyperopic outcomes was reduced for all formulas using both the 1-center and 2-center optimized ALs compared to the IOLMaster ALs (all p values <0.05). Conclusions: The accuracy of predicting postoperative spherical equivalent refractive error in axial myopes was significantly improved using optimized AL equations recently proposed by Wang et al. Based on our results, the Holladay1 2-center optimized AL should be used for eyes with an AL >25.0 mm undergoing cataract extraction with IOL implantation since its use was associated with the highest accuracy of postoperative refraction and lower proportion of eyes with hyperopic outcomes. ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics like the MTFa for multiple spatial frequencies and CCC were shown to correlate well with the VA measured clinically. The area under the clinical defocus curve estimates the mean intermediate visual performance well and is well correlated with the AU MTFa. Therefore, these pre-clinical metrics can be used to rank the intermediate visual performance of different IOL models. Commercial Relationships: Aixa Alarcon, AMO (E); Carmen Canovas, AMO (E); Robert Rosen, AMO (E); Henk A. Weeber, AMO (E); Linda Tsai, AMO (E); Kendra Hileman, AMO (E); Patricia A. Piers, AMO (E) Table 1 Commercial Relationships: Jason R. Mayer, None; Zachary Landis, None; Ravi Patel, None; Christopher Weller, None; Ingrid U. Scott, None; Seth Pantanelli, None Program Number: 2976 Poster Board Number: D0098 Presentation Time: 8:30 AM–10:15 AM Pre-clinical metrics to predict visual outcomes in the intermediate range for pseudophakic patients Aixa Alarcon1, Carmen Canovas1, Robert Rosen1, Henk A. Weeber1, Linda Tsai2, Kendra Hileman2, Patricia A. Piers1. 1Abbott Medical Optics, Groningen, Netherlands; 2Abbott Medical Optics, Santa Ana, CA. Purpose: To compare the clinical visual performance in the intermediate range measured in patients implanted with different IOL models to optical bench testing on the same IOLs to determine an optical metric capable of predicting intermediate vision. Methods: Through focus modulation transfer function (MTF) for different spatial frequencies and US Air Force (USAF) pictures for a 3mm pupil in white light were measured using an optical bench for an aspheric monofocal IOL, three multifocal IOLs (MFIOLs) with different add powers (2.75, 3.25 and 4D) and an extended range of vision IOL. Pre-clinical metrics, such as the area under the MTF (MTFa) for multiple spatial frequencies and the cross correlation coefficient (CCC) based on USAF pictures were calculated for each defocus position from -0.5D to -2D in 0.5D steps. Additionally, the area under the MTFa (AU MTFa) over the intermediate defocus range was computed for each IOL. Each pre-clinical metric was compared to the defocus curves measured in patients bilaterally implanted with the same IOL. In all cases, high contrast defocus VA was measured binocularly using the ETDRS chart with best distance correction. Results: MTFa from 0 to 50cpmm and CCC showed very good correlation with the decimal VA measured at each defocus position in the intermediate range (r = 0.89 for both metrics). The average intermediate visual performance, calculated as the area under defocus curves was highly correlated (r= 0.81) with the AU MTFa from 0 to 50cpmm. Both clinical and pre-clinical data show that the monofocal and the MFIOL with the highest add power had lower intermediate performance. MFIOLs with lower add powers showed better intermediate vision, while the extended range of vision IOL had the best visual performance in the intermediate range. Conclusions: Intermediate visual performance in pseudophakic eyes can be predicted by optical bench testing. Pre-clinical metrics Program Number: 2977 Poster Board Number: D0099 Presentation Time: 8:30 AM–10:15 AM A novel method of intraocular lens power selection in cataract surgery using a Markov Chain Monte Carlo Simulator Philip Kurochkin1, Rebecca Weiss1, Roy S. Chuck3, Jonathan Fay3, choul yong2, Jimmy K. Lee3. 1Albert Einstein College of Medicine, Bronx, NY; 2Department of Ophthalmology, Dongguk University, Goyang, Korea (the Republic of); 3Department of Ophthalmology, Montefiore Medical Center, Bronx, NY. Purpose: To evaluate the validity of the FullMonte (FM) intraocular lens (IOL) power computational process and compare its accuracy to four popular formulas. Methods: A retrospective analysis of the first operated eye from 160 patients who underwent cataract surgery with an Acrysof SN60WF IOL (Alcon, Inc) implantation by a single surgeon (JL) was conducted. Biometric data and keratometry obtained by IOLMaster (Carl Zeiss Meditec) as well as pre- and postoperative visual acuities and refractive errors were recorded. Data from the first 80 patients were used to optimize the FM calculator, which was used to get the predicted refraction for the next 80 patients. The absolute difference between predicted refraction and postoperative refraction (spherical equivalent (SE)) was calculated as the prediction error (PE). The PE for Full Monte (FM) was compared to the PE for the Haigis, HofferQ, Holliday1, and SKR/T in the same set of 80 patients. Subset analysis was conducted for long (<26 mm, n=5) and short (<22 mm, n=6) eyes. Repeatability of the FM computing process was also assessed using the intraclass correlation coefficient (ICC). Results: The average preoperative visual acuity and absolute SE was 20/62 and 2.27 diopters. Postoperatively, the average visual acuity was 20/33 and the SE was 0.49 diopters. The average PE for the optimized FM was 0.48 +/- 0.43, for Haigis 0.60 +/- 0.45, for HofferQ 0.52 +/- 0.42, for Holladay 0.50 +/- 0.43, and for SRK/T 0.48 +/- 0.43. For short eyes, the average PE for FM was 0.31 +/- 0.21, for HofferQ 0.44 +/- 0.32, for Holladay 0.52 +/- 0.45, for SRK/T 0.40 +/- 0.42. For long eyes, the average PE for FM was 0.91 +/- 0.53, for HofferQ 0.92 +/- 0.44, for Holladay 0.78 +/- 0.42, for SRK/T 0.46 +/- 0.18. The ICC for Full Monte was 0.69. Conclusions: Markov Chain Monte Carlo estimations are based on raw data simulations of results, and not on formulaic IOL calculations. They are optimized to a particular surgeon’s outcomes and predict future results directly from the data. This study shows that the PE calculated from the Full Monte calculator was not statistically different from current formulas, suggesting that it is at least as accurate as existing popular formulas used in IOL power selection. Subgroup analysis shows a trend toward better predictions by the Full Monte in short eyes and therefore analysis of a larger sample size may prove to be even more useful. Commercial Relationships: Philip Kurochkin, None; Rebecca Weiss, None; Roy S. Chuck, None; Jonathan Fay, None; choul yong, None; Jimmy K. Lee, None ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Program Number: 2978 Poster Board Number: D0100 Presentation Time: 8:30 AM–10:15 AM Correlation between clinical visual acuity and optical/visual metrics at varied defocuses in pseudophakic patients implanted with monofocal and multifocal IOLs Lin He1, Myoung Choi2, Xin Hong2, Ramesh Sarangapani1. 1Global Clinical & Regulatory Affairs, Alcon Laboratories, Novartis, Ft Worth, TX; 2Optics Center of Excellence, Alcon Laboratories, Novartis, Ft Worth, TX. Purpose: Visual acuity and defocus curve are now commonly used as primary clinical endpoints to evaluate the efficacy of newlydeveloped intraocular lenses (IOLs). Simulation of visual acuity and defocus curve can potentially help to screen new IOL designs and estimate their clinical outcomes. Methods: A two-surface reduced model eye was constructed with a corneal surface and an IOL surface. The corneal surface was reconstructed using averaged or individual high-order corneal aberration measured from the clinical studies. The IOL surface was extracted from theoretical design or bench measurement as a grid-sag profile with base curvature subtracted. Both surfaces were scaled and combined at the corneal plane where defocus was defined. One-hundred pupil sizes were randomly sampled from a normal distribution of 3.50±0.80 mm and were used for each iteration of simulation. Point spread function was derived by Fourier transform of the pupil functions. Three metrics, light-in-the-bucket (LIB), Strehl ratio (SRX) and visual Strehl ratio (VSOTF) were calculated at varied defocuses. The LIB metric was further explored using a range of multiples of bucket size (1 multiple of bucket size = 1 Airy disk). Simulation were performed in two Alcon monofocal IOLs and two Alcon multifocal IOLs under monochromatic conditions (λ=550nm) and were linearly correlated with binocular visual acuity from four clinical studies (n=104, 138, 116 and 130). Results: Standard LIB (with 1 multiple of Airy disk size) and SRX have shown good correlation with clinical visual acuity (R2=0.83 and 0.81). Increasing bucket size of LIB to 6 multiples of Airy disk size helped to achieve the best correlation (VA = -0.57 * logLIB – 0.08, R2=0.88, Figure 1). This improvement is more obvious for two diffractive multifocal IOLs with R2 increasing from 0.59 and 0.93 to 0.72 and 0.96. VSOTF has shown slightly worse and less linear correlation (R2=0.70) than LIB and SRX. Conclusions: Two-surface model eye can serve as a useful tool to predict clinical visual acuity. Refining optical/visual metrics (e.g., increase bucket size for LIB metric) can better reflect the optical efficiency of complicated IOL designs and therefore achieve better clinical correlation. Polychromatic and binocular summation will be further implemented to also potentially improve the clinical correlation. Commercial Relationships: Lin He, Alcon Laboratories Inc. (Novartis) (E); Myoung Choi, Alcon Laboratories Inc. (Novartis) (E); Xin Hong, Alcon Laboratories Inc. (Novartis) (E); Ramesh Sarangapani, Alcon Laboratories Inc. (Novartis) (E) Program Number: 2979 Poster Board Number: D0101 Presentation Time: 8:30 AM–10:15 AM Can Aberrometry Provide Rapid and Reliable Measures of Subjective Depth of Focus following Multifocal Intraocular Lens Implantation? Raymond A. Applegate1, Sandeep K. Dhallu2, Amy L. Sheppard2, Toshifumi Mihashi3, Tom Drew2, Sunil Shah4, James S. Wolffsohn2. 1 Visual Optics Inst/Coll of Optometry, University of Houston, Houston, TX; 2Aston University, Birmingham, United Kingdom; 3 Tokyo Institute of Technology, Tokyo, Japan; 4Opthalmology, Birmingham Midland Eye Centre, Birmingham, United Kingdom. Purpose: To determine whether the ‘through-focus’ aberrations of a multifocal and accommodative intraocular lens (IOL) implanted patient can be used to provide rapid and reliable measures of their subjective range of clear vision. Methods: Eyes that had been implanted with a concentric (n = 8), segmented (n = 10) or accommodating (n = 6) intraocular lenses (mean age 62.9 ± 8.9 years; range 46-79 years) for over a year underwent simultaneous monocular subjective (electronic logMAR test chart at 4m with letters randomised between presentations) and objective (Aston open-field aberrometer) defocus curve testing for levels of defocus between +1.50 to -5.00DS in -0.50DS steps, in a randomised order. Pupil size and ocular aberration (a combination of the patient’s and the defocus inducing lens aberrations) at each level of blur was measured by the aberrometer. Visual acuity was measured subjectively at each level of defocus to determine the traditional defocus curve. Objective acuity was predicted using image quality metrics. Results: The range of clear focus differed between the three IOL types (F=15.506, P=0.001) as well as between subjective and objective defocus curves (F=6.685, p=0.049). There was no statistically significant difference between subjective and objective defocus curves in the segmented or concentric ring MIOL group (P>0.05). However a difference was found between the two measures and the accommodating IOL group (P<0.001). Mean Delta logMAR (predicted minus measured logMAR) across all target vergences was -0.06 ± 0.19 logMAR. Predicted logMAR defocus curves for the multifocal IOLs did not show a near vision addition peak, unlike the subjective measurement of visual acuity. However, there was a strong ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics positive correlation between measured and predicted logMAR for all three IOLs (Pearson’s correlation: P<0.001). Conclusions: Current subjective procedures are lengthy and do not enable important additional measures such as defocus curves under differently luminance or contrast levels to be assessed, which may limit our understanding of MIOL performance in real-world conditions. In general objective aberrometry measures correlated well with the subjective assessment indicating the relative robustness of this technique in evaluating post-operative success with segmented and concentric ring MIOL. Commercial Relationships: Raymond A. Applegate, University of Houston (P); Sandeep K. Dhallu, None; Amy L. Sheppard, None; Toshifumi Mihashi, Topcon (F); Tom Drew, None; Sunil Shah, LensAR (F), Lenstec (F), Refocus (F); James S. Wolffsohn, Johnson and Johnson (F) Support: NEI - NIH R01 EY 019105 (PI: RAA), NEI - NIH R01 EY 008520 (PI: RAA), NEI - NIH P30 EY0007551 - Core Grant (PI: LJF), Inovative UK Funding (PI: JW) Program Number: 2980 Poster Board Number: D0102 Presentation Time: 8:30 AM–10:15 AM Correlation between subjective visual performance and throughfocus retinal image quality metrics on presbyopic eyes Eon Kim1, Ravi C. Bakaraju1, Klaus Ehrmann1, 2. 1Brien Holden Vision Institute, Sydney, NSW, Australia; 2School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia. Purpose: To correlate subjective visual performance responses with through-focus retinal image quality (RIQ) metrics obtained on presbyopic participants fitted with single vision (SV) and multifocal (MF) contact lenses. Methods: Thirteen presbyopic participants (50.2 ± 3.5 years, SE: +1.38 to -5.50D) who needed adds of +1.00 or +1.25D were fitted bilaterally with AirOptix Aqua™ SV and AirOptix Aqua™ MF lenses [Alcon, USA]. Using the EyeMapper, a global aberrometer, on-axis ocular wavefront aberration profiles with lenses were captured. Five independent repeats were performed under natural pupils. Additionally, participants pupil sizes were measured at different illumination conditions (scotopic (0 Lux), mesopic (80 Lux) and photopic (300 Lux)) using a custom-built instrument. Post-processing routines in Matlab using the 6th order Zernike polynomial (z1 to z28) obtained from the EyeMapper yielded through-focus retinal image quality metrics (visual Strehl Ratio in the Fourier domain) over natural and mesopic pupil sizes. The participants’ subjective visual performance responses were obtained at far, intermediate and near reading visual distances, separately for each eye when fitted with both SV and MF lenses. Results: Out of twenty-six eyes, approximately 70% of the RIQ plots calculated each over natural and mesopic pupil size correlated with the subjective visual performance response at far, intermediate and near visual distances, for both SV and MF lenses. The shape of the RIQ for most of the SV lenses produced a high peak at far visual distance while MF lens produced gradual increase at far visual distance and plateaued through intermediate and near reading visual distances. Conclusions: Through-focus retinal image quality metrics can be used as a robust indicator to assess the visual performance for presbyopic participants. The interpretation should however be carefully aligned with the objective performance measures like visual acuity and contrast sensitivity. Commercial Relationships: Eon Kim, None; Ravi C. Bakaraju, None; Klaus Ehrmann, None Support: Brien Holden Vision Institute Clinical Trial: ACTRN12613001380785 Program Number: 2981 Poster Board Number: D0103 Presentation Time: 8:30 AM–10:15 AM Psychophysical evaluation of the light sword optical element (LSOE) without axial symmetry for presbyopia compensation Walter Torres1, Alejandro Mira1, John F. Barrera1, Rodrigo Henao1, Andrzej Kolodziejczyk2. 1Physics Institute, Universidad de Antioquia, Medellin, Colombia; 2Faculty of Physics, Warsaw University of Technology, Warsaw, Poland. Purpose: Traditional methods for presbyopia compensation have some limitations for a good correction. For this reason, in last years new optical elements with extended-depth-focus has been proposed for presbyopia correction. In this work it is evaluated the potential application of the LSOE for that purpose, performing subjective test with young people having artificially evoke presbyopia. Methods: A monocular visual simulator has been implemented. The refractive LSOE, with a range of depth-focus [0.00,3.00] D simulating a contact lens was located at a pupil conjugated plane in the optical setup. Visual simulator is composed of three sections: one section for ocular aberrations measurements; other section is a Badal system (BS) to present different defocus conditions to subjects; and the last section contains the device for projecting dynamic stimuli. Visual Acuity (VA) of 10 subjects was measured for different defocus. The subjects had Presbyopia induced using Tropicamide. The psychophysical evaluation was performed by a VA tumbling E test in photopic conditions. For the evaluation, the refraction of the subjects was first corrected using the BS. Later, the VA test was made to defocus from -4D till +1D with step of 1D. At each defocus, two forced choice VA tests were performed, with 48 repetitions each one. Subjects had ages in a range [22, 35] years, with an average of 27.0±4.7 years. They presented a refraction from -1.56 D to +0.66 D (-0.22±0.80 D in average). Further they demonstrated an astigmatism -1.05±0.49 D in average, with a minimum and maximum value -1.79 D and -0.40 D respectively Results: For the naked presbyopic eye, the expected decreasing behavior of VA with the defocus grade was found. The decimal VA goes from a maximum value of 1.16 for far vision condition, until 0.49 for near vision at -2.00 D. When the LSOE was used for correction, a relatively constant VA in the range of [-3.00,0.00] D was obtained, with a mean decimal VA of 0.85±0.08. Conclusions: Due to a relatively constant behavior of VA in the range of the designed optical power of the LSOE, it is possible to remark that it presents adequate features for presbyopia correction. Experiments studying the decentering tolerance of the LSOE and subjective contrast sensitivity measurements can complement the LSOE characterization as a presbyopia corrector element. Commercial Relationships: Walter Torres, None; Alejandro Mira, None; John F. Barrera, None; Rodrigo Henao, None; Andrzej Kolodziejczyk, None Program Number: 2982 Poster Board Number: D0104 Presentation Time: 8:30 AM–10:15 AM Comparison of presbyopia correcting IOL’s profiles with a clinical adaptive optics instrument Bart Jaeken1, Lucia Hervella1, Jose María Marín2, Guillermo M. Perez1, Pablo Artal3. 1R&D, Voptica, Murcia, Spain; 2Arrixaca Hospital, Murcia, Spain; 3Laboratorio de optica, Universidad de Murcia, Murcia, Spain. Purpose: Although there are many types of IOLs to correct presbyopia currently available, their final performance may be strongly patient dependent. Adaptive optics (AO) based visual testing has been proposed to optimize the optical correction before clinical ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics intervention. The validity of this approach is based on laboratory studies (Schwarz et al., ARVO 2014). The aim of this work was to extend this method to the standard clinical practice. Methods: A commercially available clinical AO visual simulator (AOnEye, Voptica SL, Spain) was used. This instrument combines objective wavefront sensing with subjective visual testing for different induced optical phase profiles. Those are generated with a liquid crystal spatial light modulator which is conjugated with the patient’s pupil plane. Visual stimuli are projected by an micro OLED. Through focus visual acuity (VA) was measured (0, 1, 1.5, 2.0 and 3.0 D of object’s vergence). Four different lens profiles were evaluated. Two diffractive multifocal IOLs (bifocal and trifocal) and two IOLs with extended depth of focus (DOF) (mild/strong: sphere +0,75/+1,30; spherical aberration -0,1/-0,4 μm for 4,5 mm pupil). Unpaired t-statistics was used to analyze the difference between the fixation distances. P-values smaller than 0.05 were considered significant. The results were compared with theoretical predictions. Results: The bifocal design showed significant better VA for the two focus distances (0 and 3D). The mean (M) and standard deviation (SD) of VA in decimal at the peaks was 0.81 ± 0.16 and 0.57 ± 0.13 at the other distances. The trifocal design showed no significant difference between the distances (M ± SD: 0.74 ± 0.15). The mild DOF lens showed a plateau at the intermediate values (1, 1.5 and 2D) and a decrease for far and near vision (worst for near). With VA of 0.71 ± 0.11, 0.93 ± 0.23 and 0.46 ± 0.14 for respectively far, intermediate and near. The strong DOF gave an improvement in VA with decreasing distance, with a minimum of 0.46 ± 0.13 at far and a maximum of 0.86 ± 0.15 at near. Both diffractive profiles performed as theoretically predicted. The degradation of far vision for the DOF profiles deviates from the expectations. Conclusions: A clinical AO visual simulator proved to be functional to test presbyopic correcting profiles in prospective cataract patients. This instrument would permit customization/selection of the optimal IOL for each patient. Commercial Relationships: Bart Jaeken, VOPTICA (E), VOPTICA (E); Lucia Hervella, VOPTICA (E), VOPTICA (E); Jose María Marín, None; Guillermo M. Perez, VOPTICA (E), VOPTICA (I); Pablo Artal, VOPTICA (I), VOPTICA (P) Support: SEIDI, Spain (grant FIS2013-41237-R) Program Number: 2983 Poster Board Number: D0105 Presentation Time: 8:30 AM–10:15 AM Analysis of the visual quality with multifocal intraocular lenses before surgery Anna Giner1, Mikel Aldaba1, Sergio O. Luque2, Maria Borrat3, Montserrat Arjona1, Antoni Salvador4, Jaume Pujol1. 1Centre for Sensors, Instruments and Systems Development (CD6), Terrassa, Spain; 210Lens S.L.U., Terrassa, Spain; 3Centre ocular i quirurgic de Terrrassa (COQT), Terrassa, Spain; 4Hospital Universitari Mutua Terrassa, Terrassa, Spain. Purpose: To evaluate the efficacy of a new instrument to predict the visual quality obtained with a multifocal intraocular lens prior to surgery Methods: Non-cyclopegic distance and near visual acuity (VA) and contrast sensitivity (CS) were obtained from 10 different subjects by means of the new instrument VirtIOL. This device projects any IOL behind the pupil plane which is equivalent to perform a virtual IOL implant, while the patient sees any object at a determined distance. There is no magnification effect and the refraction of the IOL is compensated for far vision. The mean ± the standard deviation (SD) in age of the subjects was 67±10years and the mean ± SD decimal best distance corrected visual acuity (BDCVA) was 0.92±0.11 and best distance corrected near visual acuity (BDCNVA) was 0.20±0.10. Before patients were implanted with a bifocal refractive lens (MPlus bifocal: Lentis® MPlus Oculentis®) VA and CS were evaluated through VirtIOL by means of a virtual implant of the same IOL model. Three weeks after surgery, same test were performed. All the patients were corrected for distance vision. A subjective comparison of the vision of a letter and a point light source were done between virtual multifocal implant and post-op vision. The range of the comparison was from 0 to 5, being 0 different and 5 completely the same. Results: The mean absolute difference in BDCVA and BDCNVA between virtual multifocal implant and 3 weeks post-op were 0.10±0.13 and 0.16±0.12 respectively. In terms of CS the mean absolute differences between virtual multifocal implant and real post-op implant were 18.78±12.58 for 3 cycles/0 frequency, 22.22±14.81 for 8 cycles/0 frequency, 7.22±8.69 for 12 cycles/0 frequency and 3.28±3.94 for 18 cycles/0 frequency. Furthermore, the results (mean±SD) of the subjective comparison were 3.20±0.79 and 2.50±0.71 for the letter and the point light source respectively. Conclusions: The new instrument VirtIOL is a useful tool to predict the visual performance of a patient before surgery. Differences found between virtual and real implant are associated with little opacification of the crystalline lens. It is required that the patient has a clear eye at the simulation time as it happens in Refractive Clear Lens Exchange. This was confirmed with one patient, who showed very similar results between virtual multifocal implant and post-op due to the normal transparency of his eye. Commercial Relationships: Anna Giner, None; Mikel Aldaba, None; Sergio O. Luque, 10Lens S.L.U. (I); Maria Borrat, None; Montserrat Arjona, None; Antoni Salvador, None; Jaume Pujol, None Support: PhD Grant DPI2011-30090-C02-01 Program Number: 2984 Poster Board Number: D0106 Presentation Time: 8:30 AM–10:15 AM Binocular vision with rotationally asymmetric multifocal IOLs at different orientations Tjundewo Lawu1, 2, Kazuhiko Ohnuma1, Toru Noda3, Pablo Artal4. 1 Center for Frontier Medical Engineering, Chiba University, Chiba, Japan; 2Research and Development, HOYA Corporation Medical Division, Tokyo, Japan; 3Department of Ophthalmology & NISO, National Hospital Organization Tokyo Medical Center, Tokyo, Japan; 4 Laboratorio de Optica, Universidad de Murcia, Murcia, Spain. Purpose: Rotationally asymmetric multifocal IOL designs induced asymmetric aberrations. This study will investigate the possibility to improve visual outcomes with the binocular combinations of this rotationally asymmetric multifocal IOL with optimal orientation for each eye. Methods: An artificial eye model with the rotationally asymmetric multifocal IOL was used to produce retinal images. We used a 3D display binocular visual simulator to produce a fixed orientation in one eye of the subject, while different orientations were used to simulate for the fellow eye. Calculations were made for object distances at 0.0 D to -3.0 D in 0.25 D steps using the Landolt C optotypes for a 3 mm pupil with induced spherical aberrations. The monocular and binocular logMAR visual acuities (VA) were examined as a function of object distances in nine subjects. Average binocular VA for all object distances were compared to the monocular VA. Results: On average, binocular logMar VA improved by 0.048. The maximum improvement was 0.053 in the orthogonal orientation of the monocular orientation eye. Figure 1 shows the binocular VA differences compared to monocular VA for all measured orientations. ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Conclusions: Binocular VA with the rotationally asymmetric multifocal IOL design improved about half line. Interestingly, it was found that the VA of orthogonal orientation binocularly was better compared to the other orientations. These findings suggest that the use of orthogonal orientation of the rotationally asymmetric multifocal IOL design can be another binocular approach to optimize visual outcomes. Fig. 1. Average binocular VA improvements compared to monocular VA at different orientations. The monocular for reference is illustrated in black, whereas the binocular is shown in red. Commercial Relationships: Tjundewo Lawu, None; Kazuhiko Ohnuma, None; Toru Noda, None; Pablo Artal, None Program Number: 2985 Poster Board Number: D0107 Presentation Time: 8:30 AM–10:15 AM Defocus curve testing of pseudophakic patients: simulations and clinical outcomes. Henk A. Weeber3, Carmen Canovas3, Stan Bentow1, Sanjeev Kasthurirangan1, Eugenia Thomas1, Silvestre Manzanera2, Pablo Artal2, Patricia A. Piers3. 1Abbott Medical Optics, Santa Ana, CA; 2 Laboratorio de Optica, Universidad de Murcia, Murcia, Spain; 3 Abbott Medical Optics, Groningen, Netherlands. Purpose: To compare different methodologies to predict defocus curves of pseudophakic patients, and to compare these predictions with clinically-obtained defocus curves. Methods: The through-focus performance of the pseudophakic eye was evaluated in laboratory and clinical settings. Measurements included computer-simulated defocus curves, through-focus image quality testing on an optical bench, and defocus curves obtained for subjects using an adaptive optics vision simulator (AOVS). The results were compared to available clinically obtained defocus curves of two intraocular lens designs. Results: Predicted visual acuity at distance was better than 0.0 logMAR for the two methods that determined visual acuity (simulations, AOVS). This corresponded with the clinical results. For eyes implanted with an extended range of vision IOL, the simulations and AOVS predicted the clinicallyobtained defocus curve within 0.1 logMAR up to and including 2.0 diopters of defocus. For higher values of defocus, the simulations overestimated the clinically obtained visual acuity, and the AOVS slightly underestimated the clinically obtained visual acuity. Correlation of the image quality on the optical bench and the clinicallyobtained defocus curves varied, depending on the spatial frequency evaluated. Conclusions: Simulation of defocus curves and measurements using an AOVS correspond well with clinicallyobtained defocus curves. Prediction of defocus curves using through-focus image quality measured on an optical bench depends on the spatial frequency content evaluated. Commercial Relationships: Henk A. Weeber, Abbott Medical Opticss (E); Carmen Canovas, Abbott Medical Optics (E); Stan Bentow, Abbott Medical Optics (E); Sanjeev Kasthurirangan, Abbott Medical Optics (E); Eugenia Thomas, Abbott Medical Optics (E); Silvestre Manzanera, Abbott Medical Optics (F); Pablo Artal, Abbott Medical Optics (C), Abbott Medical Optics (F); Patricia A. Piers, Abbott Medical Optics (E) Support: Ministerio de Ciencia e Innovación, Spain (grants FIS201014926 and CSD2007-00013) and Fundación Séneca (Region de Murcia, Spain), grant 4524/GERM/06, and AMO. Program Number: 2986 Poster Board Number: D0108 Presentation Time: 8:30 AM–10:15 AM Early clinical result for restoring accommodation in Asian eyes with LaserACE procedure using the VisioLite Er:YAG laser David H. Ma1, AnnMarie Hipsley2, Chi-Chin Sun4, Mitchell A. Jackson2, 3. 1Department of Ophthalmology, Chang Gung Memorial Hospital, Taipei, Taiwan; 2Ace Vision Group, Inc, Silver Lake, OH; 3 Jacksoneye, Lake Villa, IL; 4Department of Ophthalmology, Chang Gung Memorial Hospital, Kee-Lung, Taiwan. Purpose: To evaluate accommodative benefits for near and intermediate visual performance after bilateral LaserACE procedure in Asian eyes. Methods: This prospective single arm design clinical study evaluated the LaserACE procedure results over 12 months. 20 Subjects ^40 years of age with a demonstrated loss of accommodative function that had good uncorrected distance vision with less than 1.0 D of refractive astigmatism or hyperopia were enrolled. LaserACE surgery was performed using the VisioLite Er:YAG ophthalmic laser system in 4 oblique quandrants on the sclera over the ciliary muscle. The 9-spot matrix microexcisions were made with a hand held probe at 600 um spot size. Primary study targets were binocular defocus curve and unaided near and intermediate visual acuity, with a secondary target of stereoacuity and Patient Reported Outcome Questionnaire. Results: All patients achieved some improvement of near & intermediate vision. An average of 2-4 lines of improvement of reading vision was demonstrated. At Post-operative 1 year, UCIVA was 93% 20/30 or better; 86% 20/25 or better; 80% 20/20 or better; UCNVA was 85% 20/30 or better; 80% 20/25 or better; 46% 20/20 or better. The patients gained an averaged 1.5 D added accommodative reading power after the procedure. No statistically significant change was noted in UCDVA post-operatively, and stereoacuity was unaffected. All patients improved from “very great difficultysome difficulty” pre-operatively to “some difficulty-no difficulty” at post-OP 6 months in the CatQuest 9SF Activities of Daily Living Questionairre. Conclusions: Preliminary results of the Taiwan IRB-monitored clinical trial of the LaserACE procedure appears to show promising results for restoring range of visual performance for near and intermediate visual tasks without compromising distance vision or offending the visual axis. Patient satisfaction was high postoperatively and sustained beyond 1 year in this group of Asian eyes. ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Commercial Relationships: David H. Ma, None; AnnMarie Hipsley, None; Chi-Chin Sun, None; Mitchell A. Jackson, None Support: CGMH XMRPG1A0124 Program Number: 2987 Poster Board Number: D0109 Presentation Time: 8:30 AM–10:15 AM Optical effects of an intracorneal annulus as a treatment for presbyopia Thomas W. Raasch. College of Optometry, Ohio State University, Columbus, OH. Purpose: A potential treatment for presbyopia is the use of an intracorneal annulus, exploiting the pinhole effect to expand the depth of field. The purpose of this study is to examine the effects of an intracorneal annulus on the retinal image and retinal illumination over a range of pupil sizes and visual field angles. Methods: Analytical and numerical methods are used to determine the effects on foveal image quality and on retinal illumination across the visual field. Retinal image characteristics are calculated using analytical formulae. Retinal illumination is calculated using ray tracing techniques. Results: An intracorneal annulus will expand the depth of field by reducing the entrance pupil diameter, thereby improving the clarity of the foveal image for near vision in a presbyopic eye. The opaque band of the annulus occludes at least of portion of the entrance pupil of the eye over a wide range of visual field locations, reducing retinal illumination in an annular ring. Effects depend upon the dimensions and centration of the annulus, anterior chamber depth, and pupil size. In an eye with an extremely small pupil, the reduction in retinal illumination has the potential to produce a relative scotoma. In an eye with a very large pupil and/or a decentered annulus, the retinal image will be formed by ray bundles traversing two paths, i.e. through the center of the annulus and around the outside of the annulus, which may degrade the quality of the retinal image. Conclusions: Used as a treatment for presbyopia, a well-centered intracorneal annulus produces a pinhole effect, expanding the depth of field. When implanted unilaterally, this can be expected to provide a near-emmetropic presbyope a greater degree of spectacle independence by improving the quality of focus at near. This desired effect may be accompanied by undesired consequences if the annulus is decentered, if the entrance pupil of the eye is unusually small, or if it is larger than the outside diameter of the annulus. Commercial Relationships: Thomas W. Raasch, None Program Number: 2988 Poster Board Number: D0110 Presentation Time: 8:30 AM–10:15 AM An Evaluation Of Vitreoretinal Surgery Through A Hydrophobic Small Aperture Intraocular Lens In New Zealand Black Rabbit Eyes Gregory Empey1, Baruch Kuppermann2, Simon R. Bababeygy2, Arlene Gwon2. 1AcuFocus, Irvine, CA; 2UCI, Irvine, CA. Purpose: To evaluate the ease of performing vitreoretinal surgery in eyes implanted with a hydrophobic small aperture intraocular lens (IC-8 IOL, AcuFocus, Irvine). Methods: Single-center, prospective, animal study. Six female New Zealand black rabbits underwent crystalline lens extraction and IC-8 IOL implantation in one eye. In the opposite eye of three rabbits, a control monofocal IOL (BioTech Vision Care) was implanted. In the opposite eye of the remaining 3 rabbits, a Tecnis Multifocal IOL (ZMB00, Abbott, Santa Ana, CA) was implanted. Two weeks post-op, the following vitreoretinal procedures were performed: anterior and posterior vitrectomy, air-fluid exchange, diathermy, simulated epi-retinal membrane peel, simulated endo-retinal laser photocoagulation, and binocular indirect ophthalmoscopic visualization and indirect laser photocoagulation of the retrina. Dilated pupil size varied between 5.0 to 9.5 mm. Procedural ease was rated based on four primary measures of visualization: optical quality, stereopsis, depth perception, and contrast sensitivity. Each measure was rated on a scale of 0 to 4 (4=excellent). Slit-lamp examination was performed to assess ocular status. Results: All procedures and analysis were possible to perform with minor adjustments to technique for the IC-8 IOL eyes. The overall score for ease of performing vitreoretinal procedures in the IC-8 IOL eyes was 3.4 (range 3.0-4.0). Mean scores for ease of performing a vitrectomy procedure was 3.67 (range 3.5-4.0). Mean scores for ease of performing diathermy and simulated epi-membrane peel procedures were both 3.33 (range 3.0-3.5). The ease of performing air-fluid exchange and indirect ophthalmoscopy were rated 3.2 and 3.0 (range 3.0-3.5) respectively. . For the monofocal and multifocal IOL eyes, all scores were 4.0 for all measures. Slit-lamp examination revealed no abnormal findings for any eye involved in this study. Conclusions: Vitreoretinal surgery in eyes implanted with a small aperture IOL can be performed with relative (?)ease and good visibility of all retinal structures. Some minor modifications to technique may be required. Commercial Relationships: Gregory Empey, AcuFocus (E); Baruch Kuppermann, None; Simon R. Bababeygy, None; Arlene Gwon, None Program Number: 2989 Poster Board Number: D0111 Presentation Time: 8:30 AM–10:15 AM Refractive outcomes following pars plana vitrectomy/pars plana lensectomy (PPV/PPL) for retained lens fragments due to complicated cataract surgery Rachel Song, Steven Ness. Boston Medical Center, Boston, MA. Purpose: To study differences in refractive outcomes following PPV/ PPL for retained lens fragments due to complicated cataract surgery based on timing as well as type of intraocular lens (IOL) placed. Methods: A retrospective chart review of 16 eyes was performed. All subjects had at least 6 months of post-surgical follow-up. Predicted refractive outcome (based on preoperative ophthalmic biometry) was compared to the spherical equivalent (SE) of actual postoperative refractive outcome. Actual refractive outcome was based on manifest refraction in subjects with vision better than 20/200 and on autorefraction in subjects with vision 20/200 or worse. Variables studied included the type of IOL placed as well as the timing of lens placement (either at the time of initial cataract surgery or at the time of PPV.) Results: Sixteen eyes were included. 7 of 16 eyes (44%) had an IOL placed during cataract extraction (CE), of which 4 of 7 (57%) had a sulcus intraocular lens (SIOL). Thirty three percent (3 of 9) eyes with IOL placement during PPV/PPL received SIOL. In eyes implanted with an IOL at the time of CE, average actual refractive error was 0.21D more myopic than predicted, as compared to 0.74D more myopic in those eyes implanted with an IOL at the time of PPV/PPL. Among eyes with lens placement at the time of PE, SIOL placement resulted in an average SE difference of -0.64D, while ACIOL placement had an average SE difference of +0.36D. Among eyes with IOL placement at the time of PPV/PPL, SIOL placement resulted in average SE difference of -0.72D, as compared to -0.74D for ACIOL placement. Conclusions: While this study is limited by a small sample size, initial data indicates that IOL placement at the time of PPV/ PPL in cases of retained lens fragment may result in a more myopic postoperative refractive error than expected, and that ACIOL placement at the time of CE may result in an undesirable ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics postoperative hyperopic refraction. Surgeons should consider this data when considering strength of lens to implant. Commercial Relationships: Rachel Song, None; Steven Ness, None Program Number: 2990 Poster Board Number: D0112 Presentation Time: 8:30 AM–10:15 AM Passive Adaptive Contact Lens for Correction of Presbyopia Guoqiang Li1, Thomas F. Mauger2. 1Depts of Ophthal and Vis Sci and ECE, Ohio State University, Columbus, OH; 2Ophthalmology and Visual Science, The Ohio State University, Columbus, OH. Purpose: With aging, the crystalline lens of the human eye loses its ability in accommodation, a natural phenomenon called presbyopia. About 42% of American adults are presbyopic, and the number of cases will keep increasing. To care for the vision of such a large population is of great value. Various nonsurgical (spectacles and contact lenses) and surgical techniques have been used. For spectacle and contact lens correction, it is either based on area division which limits field of view or monovision which loses stereopsis. The best solution should allow natural binocular vision. It would be attractive to develop passive adaptive lenses which generate invariant point spread function across an extended depth of field for correction of presbyopia. Here we show that, by engineering the phase profile of the contact lens using special functions, we are able to correct presbyopia with 20/20 to 20/25 visual acuity for near (40 cm), intermediate (70 cm), and distance (4m) vision while maintain natural binocular vision. Methods: We started the design of the phase function with the Gullstrand model eye in which the object is clearly imaged on the retina without accommodation. We then simulate the effect of passive adaptive wavefront-coding on extension of depth of field for nearand intermediate-vision. In contrast to the binary phase function, for the first time to our knowledge, we are investigating other symmetric and nonsymmetric phase functions for contact lens design. The wavefront coding is optimized by considering the consistency of the modulation transfer function for different object distances, different fields at each object distance, and at different wavelengths. Results: As an example, we have demonstrated the efficacy of the passive adaptive contact lens for correction of presbyopia by optimizing the lens profile using the cubic phase function. For the emmetropic eye with presbyopia (3 mm pupil), the image for near vision is greatly blurred. In contrast, using the passive adaptive wavefront coding technique, all the images through the large depth of field are almost the same, verifying the capability of offering 20/20 vision for all the vision tasks. Conclusions: The passive adaptive contact lens can provide 20/20 to 20/25 visual acuity for all the vision tasks to the prebyopic eyes. This new technique may have the potential to revolutionize the field of vision care. Commercial Relationships: Guoqiang Li, The Ohio State University (P); Thomas F. Mauger, The Ohio State University (P) Support: NIH NEI R01 EY020641 Program Number: 2991 Poster Board Number: D0113 Presentation Time: 8:30 AM–10:15 AM Comparative Assessment of Visual Performance of Multifocal Soft Contact Lenses vs. Monovision Cecile A. Maissa1, Robert Montés-Micó2, Cari Pérez-Vives2, Teresa Ferrer-Blasco2, David Kramer1. 1Alcon Laboratories, Fort Worth, TX; 2Dept. Óptica. Facultad de Física, Universidad de Valencia, Valencia, Spain. Purpose: The purpose of this study was to evaluate the visual performance of DAILIES® Aqua Comfort Plus® (DACP) Multifocal contact lenses compared with monovision correction in a population of established presbyopes. Methods: Soft contact lens wearers presenting with normal corrected vision and established presbyopia (near add ≥+1.50) were randomized into a five (±1) days cross over investigation comparing DACP Multifocal (MF) contact lenses with DACP fitted as monovision (MV). Binocular visual performance was measured in terms of areas of focus for the distance, intermediate and near regions calculated from the defocus curves, stereopsis and contrast sensitivity. To generate defocus curves, binocular visual acuity was measured with the Early Treatment Diabetic Retinopathy Study (ETDRS) high-contrast logMAR chart under photopic conditions (85 cd/m2). Binocular distance contrast sensitivity (CS) was measured using the VCTS test (Vistech Consultants Inc) at five spatial frequencies (1.5, 3, 6, 12 and 18cpd). Stereoacuity was determined with the Howard– Dolman system at a distance of 40 cm. Subjective ratings were recorded on a 10 point scale with extreme anchors (1= poor to 10 = excellent) for the subjects’ vision quality at distance, intermediate, near as well as during computer use or while driving, at night. Results: In this population of established presbyopes, using defocus curves, the area of focus in the intermediate and near vision range with DACP Multifocal was shown to be significantly larger than with monovision (p=0.007 & p<0.0001). This was associated with a wider range of vision with the multifocal correction. Furthermore, DACP Multifocal was also shown to provide a significantly better stereoacuity than monovision (MV: 84.25(12.96) v DACP MF: 27.17(5.75) sec arc p<0.0001). Subjective evaluations were in favor of the DACP MF correction for all items by at least 1 point on average. Conclusions: The area-of-focus metrics used in this study were able to differentiate between multifocal and monovision corrections. DACP Multifocal contact lenses provided better stereoacuity and greater area-of-focus in the intermediate and near zones than monovision. The higher subjective perception associated with the multifocal correction is likely to be due to the lower binocular disruption observed, providing a better real-world visual function. Commercial Relationships: Cecile A. Maissa, Alcon Research Ltd (E); Robert Montés-Micó, Alcon (C), Alcon Research Ltd (F); Cari Pérez-Vives, Alcon (F); Teresa Ferrer-Blasco, Alcon (F); David Kramer, Alcon (E) Support: The study was funded by Alcon Research Ltd Clinical Trial: NCT02235831 Program Number: 2992 Poster Board Number: D0114 Presentation Time: 8:30 AM–10:15 AM Application of Clinically Developed Eye and Vision Models to Presbyopic Contact Lens Design Optimization C. Benjamin Wooley, Tom Karkkainen. Johnson & Johnson Vision Care, Inc, Jacksonville, FL. Purpose: Vision for a contact lens patient is impacted by the geometric and material properties of the contact lens, the physical properties of the eye and the neural/brain system that interprets the images on the retina. Improved vision requires a contact lens design that is optimized by taking advantage of the properties of the eye and brain components of the visual system. The purpose was to create, from clinically measured data, eye and vision models that capture the natural properties of the visual system suitable for optimization of a presbyopic contact lens system. Methods: A system of lenses for presbyopia generally consists of a family of lenses designated for progressively higher add needs (i.e. LOW, MID, and HIGH add lenses) along with a fit guide that recommends how to select lenses. The lenses are often fit as disparate pairs to provide the best binocular vision over the range of visual ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics conditions encountered. Therefore, design optimization requires a Binocular Vision Model (BV) that can predict the quality of vision for patients over a wide range of viewing distances and luminance levels. Vision is optimized by minimizing the equation shown nearby by changing the geometry of the contact lenses and the fit guide to best match the target binocular vision (TargetBV) over a wide range of luminance levels, viewing distance, patient ages, and patient sphere prescriptions. The Binocular Vision Model allows prediction of the quality of vision by correlating properties of a Retinal Image Model with clinical visual response. The Retinal Image Model depends upon the properties of the eye (Eye Model), properties of the contact lens (Contact Lens Model), and the properties of the tear film (Tear Film Model). Each of these models is developed from a combination of J&J Vision Care data, literature data, design data, and in-vitro measurements. Results: A contact lens design optimization method was developed which incorporates a Binocular Vision Model developed from a meta-analysis of data from multiple sources. This model-based design optimization approach was used for vision optimization of a new contact lens product. Conclusions: Optical designs for presbyopic contact lenses developed using the latest physiological and perceptual models provide for potentially improved vision across the full range of viewing conditions and patients. Function to be Minimized Commercial Relationships: C. Benjamin Wooley, Johnson & Johnson Vision Care, Inc (E), Johnson & Johnson Vision Care, Inc (P), Johnson & Johnson, Inc (I); Tom Karkkainen, Johnson and Johnson Vision Care, Inc. (E), Johnson and Johnson Vision Care, Inc. (P), Johnson and Johnson, Inc (I) 338 Exploring the distribution and expression of L-, M- and S-cone photoreceptors - Minisymposium Tuesday, May 05, 2015 11:00 AM–12:45 PM 702/704/706 Minisymposium Program #/Board # Range: 3218–3221 Organizing Section: Visual Psychophysics / Physiological Optics Contributing Section(s): Biochemistry/Molecular Biology Program Number: 3218 Presentation Time: 11:00 AM–11:25 AM S- and M-cone opsin expression and distribution in the mouse retina Edward Pugh. Physiology & Membrane Biology, School of Medicine, UC Davis, Davis, CA. Presentation Description: Mice, like most mammals, express two cone opsins, S-opsin (λmax = 360 nm) and M-opsin (510 nm), which are members of opsin subfamilies (SW1, MW) that diverged by the late Cambrian (500 Mya) and which are homologous to human S-opsin (425 nm) and M/W-opsins (~530 nm, ~555 nm). Mouse cone opsins, like those of many mammals, are expressed in dorso-ventral gradients, with M-opsin much more prevalent in the dorsal retina, and S-opsin in the ventral retina. M-opsin expression is controlled by thryroid hormone (T3), its Trβ2 nuclear receptors and type 3 diodinase. Electroretinography (ERG) and single-cone recordings reveal that most mouse cones co-express S- and M-opsin in a dorso-ventral gradient, though a few cones in the extreme dorsal and ventral retina may express null or functionally negligible amounts of the non-dominant opsin. Mice with S- or M-opsin knocked out express higher levels of the remaining opsin, revealing a normal competition between the mRNAs of S- and M-opsin for access to polyribosomes during translation. Work by Crouch, Rohrer, Baehr and others on mouse models of Leber disease has shown that in the absence of the RPE supply of 11-cis retinal, cone opsins mistraffic, so that normal outer segments are not formed and opsin accumulates in non-outer segment compartments. Recent work by Fu and colleagues has revealed that in the absence of the RPE supply of 11-cis retinal S-opsin is especially susceptible to aggregation and is poorly degraded, and that knocking out S-opsin serves to increase the viability of cones in mouse models of Leber disease, revealing a downside to co-expression. The work on Leber disease models and other recent evidence suggests that during normal biosynthesis in the ER correct folding of cone opsins is abetted by 11-cis retinal, while in the absence of 11-cis retinal misfolded opsins tend to aggregate (S-opsin), and/or overwhelm ER-associated degradation leading to failure to traffick correctly through the Golgi and on to the outer segment. Commercial Relationships: Edward Pugh, None Support: NIH Grant EY02660 Program Number: 3219 Presentation Time: 11:25 AM–11:50 AM Two-photon functional imaging of the photoreceptor mosaic David R. Williams. University of Rochester, Rochester, NY. Presentation Description: This talk will review the topography of the primate photoreceptor mosaic followed by a description of how two-photon imaging can be used to characterize the structure and function of the photoreceptor mosaic in novel ways. Retinal densitometry of single photoreceptors in the living primate eye has provided valuable information about the topography of the cone mosaic based on the selective bleaching of different cone classes with different wavelengths of illumination. In this talk, I will show how high-resolution two-photon fluorescence applied to the living monkey eye provides a new way to reveal cone topography. It allows the in vivo monitoring of a stage or stages in the retinoid cycle following the bleaching of photopigment. Exposure of the retina to femtosecond infrared illumination produces fluorescence, the intensity of which depends on the production of a molecule, possibly retinol, that increases with the fraction of photopigment bleached. Selective bleaching of L and M cones causes their fluorescence to increase, revealing the S cones as a mosaic of relatively dark cones in twophoton images. Commercial Relationships: David R. Williams, Canon, Inc. (F), Canon, Inc. (R), Polgenix, Inc. (F), University of Rochester (P), US patent #6,199,986 (P), US patent #8,226,236 (P) Support: Polgenix, Inc., NIH Grants P30-EY001319, R01EY004367, BRP-EY014375, T32-EY007125, R01-EY009339, R24EY021126, R43-EY020715 Program Number: 3220 Presentation Time: 11:50 AM–12:15 PM Explanatory power and predictions of a labeled line theory of color perception Jay Neitz. University of Washington, Seattle, WA. Presentation Description: Helmholtz was instrumental in developing and promoting trichromatic theory. He was also a proponent of the idea of labeled-lines in which stimulation of each type of color sensor was associated with a specific hue sensation. Currently, Helmholtz’s idea has been replaced with the notion that color vison is based on small-bistratified and midget ganglion cells ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics which perform second-stage processing of outputs from the three cone types. Nonetheless, many vision scientists have assumed a fundamentally labeled-line model with sensations of blue mediated by S-ON small bistratified ganglion cells and sensations of red and green mediated by red-ON and green-ON midget ganglion cells respectively. There were indications at the time of discovery of coloropponent neurons in the early visual pathway—and it has become increasingly clear—that predictions from the physiological properties of the small bistratified and midget ganglion cells do not match human hue perception and our color vision cannot be explained by the activity of these cells. Attempts to reconcile the notion that S-(L+M) and L vs. M ganglion cells serve color perception with the fact that they do not have the required physiological properties have led to suggestions that outputs of these cells are somehow recombined in cortex to produce the appropriate color responses. However, these proposals are vague, producing more questions than answers and the physiological basis of color perception remains a major unsolved problem in vision science. New experimental evidence from the disciplines of genetics, anatomy, physiology and psychophysics indicates that the solution to the problem is twofold. 1) Neither of the ganglion cell types of the standard model are the basis for hue perception—they have other functions in vision. 2) A small subset of midget ganglion cells that have been previously unappreciated form the basis for labeled lines serving sensations or red, green, blue and yellow. The activity of these cells explains many aspects of our vision that were previously mysterious and accurately predicts how genes and environment influence hue perception. Commercial Relationships: Jay Neitz, None Support: NIH Grants EY09303, EY016861 Program Number: 3221 Presentation Time: 12:15 PM–12:40 PM Learning the mosaic: Unsupervised typing of L and M cones from natural image input David H. Brainard. University of Pennsylvania, Philadelphia, PA. Presentation Description: The trichromatic color vision of primates differs from that of its dichromatic ancestors because the cones in the primate retina can express an additional longer-wavelength-sensitive cone photopigment. Thus in primates there are both L- and M-cones, as well as an S cone. Interestingly, the only known difference between primate L- and M-cones is the photopigment they contain; there is no known biochemical marker that allows the post-receptoral visual system to tell whether any particular cone is an L-cone or an M-cone. For color vision to be possible, however, the post-receptoral visual system must process the signals from these two types of cones so as to preserve the separate spectral information carried by each, and it must do so in a manner that preserves this information in a fashion that is consistent in ‘sign’ across the retina and across the two eyes. In the absence of a biochemical marker, how can the post-receptoral visual system learn to do so? In addition, these observations raise the question of how a post-receptoral visual system that evolved in the context of inputs from a dichromatic retina detects the presence of a newly expressed third cone type in the first place. In this talk I will present recent work (Benson, Manning, and Brainard, 2014, PLoS Computational Biology) that approaches these questions from a computational viewpoint. We asked whether there is sufficient information in the initial encoding provided by the trichromatic retina in response to natural image input to accomplish two goals: a) to identify the number of spectral cone types present in the retina and b) to allow identification of the spectral type of each cone. We show that the answer is yes by demonstrating an unsupervised learning algorithm that successfully accomplishes both goals. We used simulations to explore the range of mosaic parameters (L:M cone ratio, separation in lambda-max between L- and M-cones) over which learning is possible and show these to be generally consistent with observed variation in these parameters across trichromatic primates. We also show that it is possible to detect the presence of a fourth retinal cone type and obtain above-chance typing of the cones in a simulated primate tetrachromatic cone mosaic, if mosaic parameters are chosen to optimize the conditions for such learning. Commercial Relationships: David H. Brainard, None Support: Commonwealth Universal Research Enhancement (CURE) program from the Pennsylvania Department of Health and NIH R01 EY10016. 371 Anterior segment optics and visual performance Tuesday, May 05, 2015 3:45 PM–5:30 PM 702/704/706 Paper Session Program #/Board # Range: 3565–3571 Organizing Section: Visual Psychophysics / Physiological Optics Program Number: 3565 Presentation Time: 3:45 PM–4:00 PM OCT-based crystalline lens topography in accommodating eyes Pablo Perez-Merino, Miriam Velasco-Ocana, Eduardo MartinezEnriquez, Susana Marcos. Instituto de Óptica (CSIC), Madrid, Spain. Purpose: To measure anterior and posterior crystalline lens topography in accommodating eyes. To evaluate the relationship between anterior and posterior lens surface shape, cornea and lens shape, and their changes with accommodation. Methods: Custom spectral-domain optical coherence tomography (SD-OCT) provided with automatic quantification and distortion correction algorithms was used to characterize three-dimensionally and in vivo the human crystalline lens in 4 subjects (7 eyes; 31±3 y.o), for accommodative demands between 0 to 6 D, in 1.5 D steps. Anterior segment (cornea and lens) surfaces were fitted to 6th order Zernike polynomials to quantify geometry and biometry (anterior chamber depth (ACD), lens thickness, and corneal and lens radii). Corneal and lens surface elevations were analyzed by means of RMS (high order aberrations (HOAs), astigmatism, coma, trefoil and spherical). Results: Anterior and posterior radii of curvature decreased at rates of 0.61±0.15 and 0.15±0.06 mm/D, ACD decreased 0.04±0.01 mm/D and lens thickness increased 0.05±0.01 mm/D with accommodation demand. Astigmatism was the predominant lens surface aberration (69%-anterior; 56%-posterior). The RMS of HOAs of the posterior lens surface was statistically significant higher than the anterior surface (x2.92; p<0.05). The dominant HOAs of the posterior lens surface were Z33, Z40 and Z42 (accounting for 12%, 14% and 16% of the variance). Astigmatism, coma and trefoil changed with accommodation by a factor of x1.1, x1.3 and x1.4 respectively in both lens surfaces. Spherical aberration showed higher changes with accommodation in the anterior lens surface (x2.5 vs x1.15). The astigmatic angle showed high degree of alignment among corneal and anterior lens surfaces (<13 deg). However, the angle between anterior and posterior lens astigmatism differed by 26 deg. In general, there was slight correlation but not significant between HOAs terms of the anterior and posterior lens surfaces (r=0.38, un-accommodated; r=0.52, 6D accommodation). Fig. 1. 3D full anterior segment image and lens surface elevation maps for S#1(OS). Conclusions: OCT provided with distortion correction is an excellent instrument for evaluating the crystalline lens changes in shape and surface produced by accommodation and for exploring the role of the crystalline lens in the eye’s optics. The increased high order ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics aberrations of the posterior lens surface might be associated to the zonular tension. Commercial Relationships: Pablo Perez-Merino, None; Miriam Velasco-Ocana, None; Eduardo Martinez-Enriquez, None; Susana Marcos, PCT/ES2012/070185 (P) Program Number: 3566 Presentation Time: 4:00 PM–4:15 PM Astigmatism of the isolated human crystalline lens: Surface shape and gradient refractive index contributions Judith Birkenfeld, Alberto De Castro, Susana Marcos. CSIC-Instituto de Optica, Madrid, Spain. Purpose: To estimate the contribution of lens surface shape and lens gradient refractive index (GRIN) to the lens astigmatism in human donor lenses as a function of age. Methods: Thirty-five human donor lenses (age 19-71) were imaged with quantitative custom-developed 3D-spectral optical coherence tomography (840 nm SLD illumination; 12 mm x 12 mm lateral scan, 1668 A-scans x 60 B scans, 6.9 um axial resolution). Laser Ray Tracing was used to measure the lenses’ back focal length (BFL, paraxial and non-paraxial). 3-D lens GRIN (described by a 4-variable model) was reconstructed with an optimization genetic algorithm using OCT optical path differences in 2 lens orientations, using 3-D lens shape, and BFL as input data. Lens surface astigmatism was obtained from ellipsoid fitting to the lens surfaces. Lens astigmatism was estimated by computational ray tracing on the lens, assuming either the reconstructed GRIN lens or an equivalent homogenous Refractive index (EHRIN) lens. Astigmatism magnitude and relative astigmatic angle between lens surfaces, GRIN lens and lens astigmatism were evaluated using power vector notation, and analyzed as a function of age. Results: The astigmatism magnitude in the anterior lens surface decreased with age (slope= -0.005 D/year; r= 0.397, p=0.018), although the posterior surface astigmatism and the (total) lens astigmatism were not age-dependent. Presence of GRIN altered slightly the magnitude (average GRIN-EHRIN magnitude difference: 0.53 D) and the axis of the lens astigmatism (Average GRIN-EHRIN axis difference: 22.17 deg). The total astigmatism of the GRIN lens and the EHRIN lens correlated to the anterior lens surface astigmatism (GRIN: p=3.9E-6 r=0.693; EHRIN: p=4.1E-4, r=0.565). The average relative angle between anterior and posterior surface was 34.08 deg, and had no significant age dependency (r= 0.172, p= 0.32, slope: -0.293). Conclusions: The anterior lens surface astigmatism undergoes changes with age, and has the largest impact on the total lens astigmatism . The GRIN index plays only a minor role in lens astigmatism magnitude and axis. Knowledge of the sources of astigmatism in the lens gives insights in the understanding the optical interactions between ocular components, with impact in the understanding of presbyopia, myopia development and design of new IOLs. Commercial Relationships: Judith Birkenfeld, None; Alberto De Castro, None; Susana Marcos, PCT/ES2012/070185 (P) Support: I-LINK0609, JAE-Predoc 2010, FIS2011-25637, ERC2011-AdG-294099 Program Number: 3567 Presentation Time: 4:15 PM–4:30 PM Finite Element Analysis of Oxidative Stress-Induced Changes in the Mechanical Properties of the Lens Matthew A. Reilly. Biomedical Engineering, University of Texas at San Antonio, San Antonio, TX. Purpose: Age-related changes in lens mechanical properties have been implicated in the pathogenesis of presbyopia. Damage due to oxidative stress has been implicated in the pathogenesis of agerelated nuclear cataract. The present study simulates the accumulation of oxidative damage to the lens with age and how this may result in age-related stiffening of the lens. Methods: A mechanochemical finite element model of the human lens was constructed to simulate the effects of lens transport and biochemical reactions within the lens. Transport and regeneration of glutathione were simulated modeled. Denaturation and crosslinking of crystallins were also modeled. A constitutive model was developed relating crosslink density to elastic modulus. The model was used to simulate the effects of 60 years of aging on the lens’ modulus. Results: The modulus at the center of the lens increased slowly until age 35 after which it increased rapidly (Fig. 1). The modulus near the surface remained relatively constant throughout life. Conclusions: The predictions of this model are in qualitative agreement with the elastic modulus distribution data of Wilde et al. (Exp. Eye Res. 97:36-48, 2012), suggesting that the change in lens properties could be due to oxidative crosslinking. The slow change in modulus with age in the young lens’ nucleus may be due to the relative abundance of native crystallins which are protected from crosslinking. The accumulation of denatured crystallins with age gives rise to an age-related exponential increase in the elastic modulus within the nucleus. Adding additional antioxidants (e.g. ascorbate) and steps to the crystalline denaturation pathway to the model further delays the onset of rapid lens stiffening in the model. Each of these effectively buffer against oxidative stress, thereby shifting the elbow in the curve further to the right on the aging axis. ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Age-related changes in the elastic modulus at the center of the lens due to oxidative stress-induced disulfide bridging. Commercial Relationships: Matthew A. Reilly, None Program Number: 3568 Presentation Time: 4:30 PM–4:45 PM MECHANISM OF ACCOMMODATION: NEW FINDINGS AND THE IMPLICATIONS FOR PRESBYOPIA Mary Ann Croft1, T Michael Nork1, Jared McDonald1, Gregg A. Heatley1, Alexander Katz1, Paul L. Kaufman1, Elke LuetjenDrecoll2. 1Ophthalmology, Univ of Wisconsin-Madison, Madison, WI; 2Anatomy, Institute of Anatomy II, University of Erlangen– Nuremberg, Erlangen, Germany. Purpose: To better understand the accommodative mechanism and presbyopia. Methods: In 10 rhesus monkeys (ages 8-22 yrs), maximum accommodative responses were induced by electrical stimulation of the E-W nucleus. Ultrasound biomicroscopy (UBM; 50 MHz, 35 MHz) images were collected in the region of lens, ciliary muscle (CM), and zonular attachments during the accommodative response. Images were collected before & after lens extraction. Various contrast agents (i.e., triamcinolone, fluorescent microspheres) were used to enhance visualization of the intraocular structures and fluid movements during accommodation. Results: PVZ INS-LE structure (which is attached directly to the posterior lens equator and to the posterior insertion zone of the vitreous zonule) remained straight during the accommodative response (i.e., it did not relax). The anterior end of the PVZ INSLE moved forward during accommodation in the presence or absence of the lens/capsule, pulled/pushed forward by the CM. Intravitreal lacunae could be visualized and the mid-vitreous portion of the lacunae moved posteriorly during accommodation while the peripheral edge of the lacunae adjacent to and interconnected with the vitreous zonule were pulled forward. During accommodation there was fluid flow from the anterior chamber toward the cleft of the anterior hyaloid membrane and then further posteriorly into the cleft between the vitreous zonule and the pars plana. The reverse was true during disaccommodation. These movements declined with age. There was an age-related accumulation of vitreous membranes/fibers in the region of the vitreous zonule, the PVZ INS-LE and the ora serrata. Conclusions: In the young eye, the PVZ INS-LE may act as a “strut” to the posterior lens equator, facilitating accommodative forward movement of the lens equator and thereby facilitating lens thickening. The accommodative posterior/anterior segment fluid flow/exchange represents fluid displacement in response to the lens thickening and CM contraction, and the fluid exchange may allow for the elimination of waste particles/material from the vitreous by transfer to the anterior chamber and then out through the trabecular meshwork. With age, the aggregation of vitreous fibers peripherally may contribute to the posterior restriction of the CM, the vitreous zonule, and the PVZINS LE and thereby dampen the accommodative lens shape change and fluid dynamics. Commercial Relationships: Mary Ann Croft, Alcon (F), Bridge Labs (R), Refocus Group (C), Z-lens LLC (F); T Michael Nork, None; Jared McDonald, None; Gregg A. Heatley, None; Alexander Katz, None; Paul L. Kaufman, Alcon (F), Lens AR (F), Refocus Group (C), Refocus Group (R), Z-Lens LLC (F); Elke LuetjenDrecoll, None Support: NIH Grant Support: NEI (RO1 EY10213 & R21 EY018370 to PLK, Core Grant for Vision Research Grant # P30 EY016665), RPB, NIH Grant # 5P51 RR 000167 to WNPRC, OPREF. Program Number: 3569 Presentation Time: 4:45 PM–5:00 PM Improved phase processing following long-term adaptation to optical aberrations in keratoconus Antoine Barbot1, 2, Ramkumar Sabesan3, Len Zheleznyak1, 2, Krystel R. Huxlin1, 2, Duje Tadin2, 4, Geunyoung Yoon1, 2. 1Flaum Eye Institute, University of Rochester, Rochester, NY; 2Center for Visual Science, University of Rochester, Rochester, NY; 3School of Optometry, University of California, Berkeley, Berkeley, CA; 4Brain and Cognitive Sciences, University of Rochester, Rochester, NY. Purpose: Optical aberrations detrimentally affect both the amplitude and phase relationships between spatial frequencies (SFs) of visual inputs. In addition, long–term presence of optical aberrations progressively alters the way visual information is processed. Here, we investigate the basic neural substrates of altered visual processing resulting from prolonged, chronic exposure to optically degraded retinal image quality by using keratoconus (KC) as a model of longterm adaptation to visual aberrations. Methods: An adaptive optics (AO) vision simulator was first used to measure KC patients’ habitual aberrations with their own corrective, conventional lenses. We then used these measurements to simulate KC optical quality in normal eyes using AO after correcting their native aberrations. Under this identical optically-aberrated condition, we measured tumbling E visual acuity (VA) and contrast sensitivity function (CSF) for KC eyes (n=4) with their habitual aberrations and normal eyes (n=3) with AO-induced KC aberrations, over a 6-mm artificial pupil in white light. Each control subject was tested in both experiments under each KC aberration profile. Results: Under identical, optically-aberrated conditions (average total and higher order RMS errors in KC eyes: 2.72±0.83μm and 1.36±0.29μm, respectively; residual RMS wavefront error of induced KC aberrations in normal eyes: ~0.1μm), we found that the CSF (single SF Gabor stimuli) did not differ between KC and normal eyes. However, KC eyes showed better letter acuity (broadband SF stimuli) than normal eyes under the same conditions. Specifically, neural compensation in KC eyes accounted for ~1.2 line improvement in VA relative to normal eyes and was stronger for advanced KC conditions (~3 lines improvement for more severe cases). This difference in visual performance with broadband SF stimuli indicates that phase information plays an important role in long-term adaptation to visual aberrations. Conclusions: Our results suggest the existence of an adaptive neural compensation mechanism in KC subjects that partially restores the ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics phase congruency across SFs, thus benefiting the processing of optically degraded visual inputs. Altogether, our findings provide fundamental insights into the mechanisms underlying long-term neural adaptation to optical aberrations. Commercial Relationships: Antoine Barbot, None; Ramkumar Sabesan, None; Len Zheleznyak, None; Krystel R. Huxlin, None; Duje Tadin, None; Geunyoung Yoon, None Support: NIH EY014999 Program Number: 3570 Presentation Time: 5:00 PM–5:15 PM Visual acuity evaluation with refractions prescribed by a novel low-cost wavefront aberrometer Eduardo Lage1, 2, Elena Garcia3, Shivang Dave2, 1, Maria C. Ramirez3, Lara M Garcia3, Nicolás Alejandre Alba3, Daryl Lim2, 1, Carlos Dorronsoro4, Susana Marcos4, Nicholas Durr2, 1. 1M+Vision Consortium, MIT, Cambridge, MA; 2Plenoptika Inc., Allston, MA; 3 Department of Ophthalmology, Fundacion Jimenez Diaz, Madrid, Spain; 4Instituto de Optica, CSIC, Madrid, Spain. Purpose: To compare the visual acuity (VA) resulting from eyeglasses prescribed by a novel autorefractor and by subjective refraction. Methods: A total of 81 eyes from 42 patients (mean age 38 ± 13yrs, ametropia range -6.25 to +4.5D spherical equivalent power (SE)) were refracted and their VA tested in a clinical setting (Fundacion Jimenez Diaz, Madrid). Refractions were obtained following a standard non-cycloplegic subjective method and with a second generation autorefractor prototype which is handheld, open-view and binocular. This device is based on a simplified approach to wavefront sensing that does not use a Badal relay lens system. The autorefractor is composed of inexpensive off-the-shelf parts including a 1.3-MP CMOS sensor, a 19-mm focal length lenslet array and an 850-nm laser diode. The subjects hold and look through the device while a dynamic sequence of wavefront images is acquired. This dataset is processed using a custom-developed algorithm that tracks patient-device alignment and accommodation to generate a set of measurements from which the prescription is calculated. Three 10-s videos were recorded for each eye and the results of the two last measurements were averaged to calculate the refraction. VA was measured for prescriptions provided by each method and differences between refraction measurements and VA achieved in each case were evaluated. Results: The average difference between SE measured subjectively and with the prototype was 0.32 ± 0.35D. Refractions obtained from either method were not statistically different (p= 0.96, paired t-test) with a 95% confidence interval of ± 1.0D. The spherical power measured subjectively and with the prototype agreed within 0.25D and 0.5D in 60.5% and 79.0% of the eyes, respectively, while the cylindrical power agreed in 84.0% and 96.4% of the cases for the same thresholds. The average VA achieved with the device and by subjective prescriptions was of 0.000 ± 0.067 and -0.012 ± 0.035 logMar, respectively. Using the prototype refraction, 81.5% of the eyes achieved VA ≥ 20/20 and 98.7% ≥ 20/25. Conclusions: The new prototype provided accurate measurements of refractive errors in a community optometry clinic. Average discrepancies between VA achieved with the device and subjective refraction were smaller than 0.02 logMar (one letter). A low-cost device, such as the one evaluated here, may be beneficial for improving eye care in low-resource settings. Commercial Relationships: Eduardo Lage, MIT (P), Plenoptika, Inc. (S); Elena Garcia, None; Shivang Dave, MIT (P), Plenoptika, Inc. (E); Maria C. Ramirez, None; Lara M Garcia, None; Nicolás Alejandre Alba, None; Daryl Lim, MIT (P), Plenoptika, Inc. (S); Carlos Dorronsoro, MIT (P); Susana Marcos, MIT (P); Nicholas Durr, MIT (P), Plenoptika, Inc. (E) Support: This work has been financially supported by the Comunidad de Madrid through the Madrid-MIT M+Vision Consortium. Program Number: 3571 Presentation Time: 5:15 PM–5:30 PM CLINICAL VALIDATION OF CONTRAST SENSITIVITY MEASURED BY VISUAL SIMULATION FOR PSEUDOPHAKIC PATIENTS Silvestre Manzanera1, Aixa Alarcon2, Carmen Canovas2, Pedro M. Prieto1, Linda Tsai3, Kendra Hileman3, Patricia A. Piers2, Pablo Artal1. 1Laboratorio de Optica, Universidad de Murcia, Murcia, Spain; 2AMO, Groningen, Netherlands; 3AMO, Santa Ana, CA. Purpose: Adaptive optics (AO) vision simulation predicts highcontrast binocular visual acuity following cataract surgery for different IOL designs well (Schwarz, ARVO 2014). The purpose of this study is to compare the clinical contrast sensitivity (CS) measured in patients implanted with different IOL models to those predicted by AO visual simulation for the phase profiles of the same IOLs. Methods: Phase profiles corresponding to five different IOLs (two monofocal IOLs, one aspheric and one spherical, and three diffractive multifocal IOLs) were generated bilaterally in a binocular AO visual simulator. CS was measured in 5 subjects for a 4.5 mm pupil in white light under mesopic conditions using the quick-CSF procedure. In all cases, natural astigmatism and spherical aberration were corrected. The measured CS was compared to the clinical outcomes measured independently in two different clinical trials in pseudophakic patients bilaterally implanted with the same IOL models. In these clinical trials, mesopic CS was measured without glare at 1.5, 3, 6 and 12 c/deg with either a Vector Vision or an Optec 6500 chart. Measurements were performed at 6 months postoperatively with best distance correction in place, according to common clinical practice. Results: CS measured in clinical studies was correlated with CS measured in the AO instrument for the IOL models evaluated (r^2=0.73). This correlation was higher for the lower and higher spatial frequencies than for middle spatial frequencies. When considering different IOL models independently, the correlation between clinical and simulated CS decreased (r^2=0.49) for the monofocal IOL design that corrects for spherical aberration, while the remaining models provided correlated well (r^2>0.8 for all models). Conclusions: AO visual simulation predicts clinical CS following cataract surgery under binocular conditions for refractive and diffractive IOL designs. The correlation was better for high and low spatial frequencies and for multifocal and monofocal spherical designs. These results validate the use of AO instruments as a tool for developing new IOL optics and their impact on the quality of vision. Commercial Relationships: Silvestre Manzanera, Abbott Medical Optics (F); Aixa Alarcon, Abbott Medical Optics (E); Carmen Canovas, Abbott Medical Optics (E); Pedro M. Prieto, Abbott Medical Optics (F); Linda Tsai, Abbott Medical Optics (E); Kendra Hileman, Abbott Medical Optics (E); Patricia A. Piers, Abbott Medical Optics (E); Pablo Artal, Abbott Medical Optics (C), Abbott Medical Optics (F) Support: SEIDI, Spain (grant FIS2013-41237-R) & AMO ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics 382 Psychophysics and vision testing: visual acuity, contrast sensitivity, color vision and visual field Tuesday, May 05, 2015 3:45 PM–5:30 PM Exhibit Hall Poster Session Program #/Board # Range: 3887–3909/D0029–D0051 Organizing Section: Visual Psychophysics / Physiological Optics Contributing Section(s): Anatomy/Pathology, Clinical/ Epidemiologic Research Program Number: 3887 Poster Board Number: D0029 Presentation Time: 3:45 PM–5:30 PM Slope of the psychometric function for low contrast logMAR charts. Andrew Carkeet1, 2, Ian L. Bailey3. 1Optometry and Vision Science, QUT, Kelvin Grove, QLD, Australia; 2QUT, IHBI, Kelvin Grove, QLD, Australia; 3School of Optometry, UC Berkeley, Berkeley, CA. Purpose: Data from acuity charts can be analysed by fitting psychometric functions. While psychometric functions are traditionally used to yield acuity thresholds, the slopes of such psychometric functions can be used to predict the variability of such visual acuity thresholds. This repeated-measures research examined whether high contrast and low contrast acuity charts yield different slopes for their psychometric functions. Methods: Ten participants, 6 female & 4 male, mean age 43 years (SD 18 years), took part in this research. Participants were tested with their preferred eye and wearing their best spectacle correction. Stimuli were Sloan letters presented on an LCD computer monitor, with 9 rows of letters arranged in randomized letter sequences with a standard logMAR chart format. The background had a luminance of 235 cd m-2 and the high and low contrasts were 99.2% and 18.7% Weber contrast. Each participant read 32 charts, 16 at low contrast and 16 at high contrast. For each chart, responses were analysed by probit analysis to generate thresholds and slopes for the psychometric functions. Results: For our participants, the mean high and low contrast visual acuity thresholds (logMAR) were -0.189 0.076 and -0.027 0.079 respectively. Probit sizes were used as a measure of the slopes of the psychometric functions, with smaller probit sizes indicating steeper slopes. Low contrast acuity charts yielded flatter psychometric functions than high contrast acuity charts, indicating a more gradual transition between seeing and non-seeing for the low contrast charts. The difference was statistically significant (F1,9=12.8, p=0.006). The estimates of slope differed slightly, according to whether a lower asymptote of 0.1 (1 in 10 guess rate) or 0.0385 (1 in 26 guess rate) was selected for probit fits. (F1,9=74.1, p<0.001). Probit sizes and inter-subject standard deviations are shown in Table 1. Conclusions: These results indicate that visual acuity measurements are intrinsically more variable with low contrast charts. Previous research has shown that low levels of optical blur also flatten the psychometric function for visual acuity. Monte Carlo modelling based on the probit values shows that stopping patients reading down a low contrast acuity chart, after they’ve made three or more mistakes on a 5-letter row, gives close to optimal precision of acuity measurements. Table 1. Mean probit sizes (logMAR) with inter subject standard deviations. Commercial Relationships: Andrew Carkeet, None; Ian L. Bailey, None Program Number: 3888 Poster Board Number: D0030 Presentation Time: 3:45 PM–5:30 PM Validation of the Dyop™ Visual Acuity Test Paul A. Harris, Erin Keim. Southern College of Optometry, Memphis, TN. Purpose: Sloan and Snellen optotypes are the global eye chart standard for visual acuity testing, but routinely patients struggle with the required endpoint of response confusion. A new Dynamic Optotype, or “Dyop”, using a dynamically sized, rotating, visual arcarea figure to measure acuity was prospectively, clinically compared to Sloan measures of visual acuity under various test conditions. The Dyop has a completely unique endpoint: the rotation animation appears to suddenly stop when threshold is reached. Methods: Acuity was assessed with 162 subjects each randomly with the Dyop test (Konan Medical Chart2020) and Harris StairStep test (M&S Technologies) comparing each with the following strategies: BCVA, UCVA, + Lens (+2, +3, +4) over spectacles. The relationship between Sloan VA/20 and Dyop size in arc-minutes (both log-transformed) was investigated using correlations and repeatedmeasures log-log regression models. Results: There was a strong linear relationship between Sloan and Dyop acuity measures (Pearson r=.94; p<001). In a single predictor model, the Dyop measure explained 89% of the variance in Sloan acuity. An interaction model relaxing the assumption of common slopes by testing condition indicated a significant measure X condition interaction (p=.004), and explained over 91% of the variance in Sloan acuity. Optimal conversion algorithms between Dyop and Sloan measures were developed via regression models. Conclusions: The Dyop is a novel method of measuring visual acuity that is strongly associated with, and may offer a viable alternative to traditional visual acuity methods. Beyond high correlation with standard methods, the Dyop was observed to be advantaged by speed to threshold endpoint, finer acuity granularity compared to the typically used acuity “line” steps, and ease of endpoint interpretation by subjects. Figure 1: Plot of the log of the Dyop size in arc minutes against the log of the Sloan VA/20. Rx Corrected = Dark Gray (x) +2.00 blur = Orange (o) +3.00 blur = Red (+) +4.00 blur = Green (•) ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics to be presented avoiding the glare due to the glossy screen of the iPad tablet. Commercial Relationships: Jae-hyung Kim, None; Sang Yoon Hyun, None; Ju Byung Chae, None; Soolienah Rhiu, None; Hye Jin Lee, None Figure 2: Scatter plots for each of the separate conditions. Correlations were significant to the p <.001 level in all conditions. Pearson correlations for each condition were: Rx Corrected r=.54, +2 blur r=.72, +3 blur r=.72, +4 blur r=.63, overall pooled r=.94. Commercial Relationships: Paul A. Harris, None; Erin Keim, None Program Number: 3889 Poster Board Number: D0031 Presentation Time: 3:45 PM–5:30 PM A pilot trial for visual acuity testing using a random method visual acuity application Jae-hyung Kim1, Sang Yoon Hyun1, Ju Byung Chae1, Soolienah Rhiu2, Hye Jin Lee3. 1Ophthalmology, Chungbuk National University Hospital, Cheongju-si; 2Ophthalmology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea (the Republic of); 3 Ophthalmology, Jeju National University, Jeju, Korea (the Republic of). Purpose: A visual acuity (VA) testing app for the iPad tablet computer using mirroring technique was developed which randomly presented letters categorized by cognoscibility. The aim of this study was to assess whether measurements of distance VA using this application were in agreement with standard clinical tests of VA in adults with normal vision. Methods: Forty-three normally sighted subjects were tested using Early Treatment of Diabetic Retinopathy Study (ETDRS) chart. The logMAR VA results were compared with those from the iPad based application which contains a Snellen chart, a Tumbling E chart, a Landolt C chart and a VA chart consisted with Arabic figures. After a 10-min break, subjects were retested with each test in the same order. Repeatability was assessed by testing the subjects 1-day later with each visual chart. Repeatability and agreement were assessed by determining the 95% limits of agreement (LoA) ± 1.96 SD of the differences between tests. Results: The logMAR VA showed no significant difference between the ETDRS chart and the iPad Snellen chart (P=0.66) and iPad Arabic figure chart (P=0.29). The logMAR VA of the ETDRS chart was significantly better than iPad Tumbling E chart (P<0.01) and iPad Landolt C chart (P<0.01). The subjects showed no chart letter memory of the ETDRS chart (P=0.05), iPad Snellen chart (P=0.62), and iPad Arabic figure chart (P=0.12). The logMAR VA of Tumbling E chart (P=0.03) and Landolt C chart (P=0.001) was significantly better at 10 min. Conclusions: The iPad-based application of VA charts showed similar repeatability and may be a rapid and convenient alternative to some existing measures. Mirroring technique allows the visual chart Program Number: 3890 Poster Board Number: D0032 Presentation Time: 3:45 PM–5:30 PM A Comparative Clinical Evaluation of Two Visual Acuity Testing Systems: ETDRS vs. FrACT Linda Tsai, Eugenia Thomas, Janice Tarrant, Stan Bentow, Sanjeev Kasthurirangan. Clinical R&D, Abbott Medical Optics, Santa Ana, CA. Purpose: Visual acuity (VA) results with physical Early Treatment of Diabetic Retinopathy Study (ETDRS) letter charts are heavily dependent upon the test administrator ability (i.e., better threshold VA with persistent encouragement, accurate recording of correctly read letters). In addition, the risk of subject memorization with physical charts requires the administrator to change charts frequently. The impact of such factors may be reduced with the use of a VA software program that automates testing by allowing the test subject to view randomized optotypes in a staircase size presentation and respond with direct input to the software program, which then determines threshold acuity. This clinical study evaluated results with both test systems. Methods: A total of 25 subjects were evaluated for distance-corrected visual acuity at far, intermediate and near and distance defocus testing from +2.00 diopters (D) to -4.00 D, in 0.5 D increments. Each subject was tested monocularly with a retroilluminated ETDRS chart and a computer-based vision testing software, the Freiburg Visual Acuity and Contrast Test (FrACT). All results were obtained in logMAR format, and analyses were conducted in paired comparisons between the two testing systems. Results: Across all test distances, visual acuity results with FrACT were found to be within 0.05 logMAR of ETDRS chart results. Generally, a difference less than 0.1 logMAR (1 line of Snellen acuity) was found in 80% (20/25) of subjects. ETDRS visual acuities were frequently better than that with FrACT; there was a 0.1 logMAR difference at far and 0.06 logMAR differences at both intermediate and near. With defocus testing, there was a mean difference of 0.05 logMAR across the defocus range, with the greatest differences between -2.00 and -4.00 D (mean of 0.08 logMAR). The mean bestcorrected distance VA (BCDVA) was slightly better than the mean VA with the manifest refraction (0.00 D defocus) in the defocus sequence with both ETDRS (0.02 logMAR) and FrACT (0.03 logMAR). Conclusions: VA test results with the FrACT system were found to be slightly worse than that with the ETDRS letter charts. However, the benefits of automated administration of VA testing with the FrACT system merit further evaluation of test factors that may affect results. Commercial Relationships: Linda Tsai, Abbott Medical Optics (E); Eugenia Thomas, Abbott Medical Optics (E); Janice Tarrant, Abbott Medical Optics (E); Stan Bentow, Abbott Medical Optics (E); Sanjeev Kasthurirangan, Abbott Medical Optics (E) Program Number: 3891 Poster Board Number: D0033 Presentation Time: 3:45 PM–5:30 PM Evaluation of defocus curve performance with two visual acuity testing systems: ETDRS and FrACT Janice Tarrant, Eugenia Thomas, Linda Tsai, Sanjeev Kasthurirangan. Abbott Medical Optics, Milpitas, CA. Purpose: An important clinical method to evaluate multifocal and accommodating intraocular lens performance is the defocus curve ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics test. To have a clear interpretation of the defocus curve data, the test methods used and the metrics obtained from this test should be evaluated relative to other clinical measures. The aim of this study was to compare near visual acuity (VA) and defocus curve measurements with two different methods, standard letter charts (ETDRS) and a computer based technique (FrACT), in nonpresbyopic and presbyopic subjects. Methods: A total of 25 subjects were recruited (22 to 80 years; mean: 46 ± 15 years). Outcome measures included monocular manifest refraction of the right eye, distance corrected intermediate VA (DCIVA) at 66 cm and distance corrected near VA (DCNVA) at 40 cm with both the ETDRS and FrACT systems. Defocus curves (far visual acuity measured through trial lenses from +2.0 D to -4.0 D in 0.5 D steps) were measured with both systems. Near add power at 40 cm and push-down accommodative amplitude (AA) were obtained. Two depth of focus (DOF) metrics from defocus curves were evaluated: a 20/32 VA threshold (DOF-M1) and a 0.2 logMAR loss in VA from the 0.0 D defocus VA (DOF-M2). Age related trends for DCIVA, DCNVA and depth of focus measurements were evaluated through regression analyses and slopes compared. Results: Intermediate VA (DCIVA) declined at about 0.1 logMAR per decade with both ETDRS (-0.367 + 0.009 * age; R2 = 0.51) and FrACT (-0.430 + 0.011 * age; R2 = 0.61). Near VA (DCNVA) declined at 0.14 logMAR per decade with both ETDRS (-0.455 + 0.014 * age; R2 = 0.58) and FrACT (-0.408 + 0.014 * age; R2 = 0.58). Depth of focus metrics (DOF-M1) and (DOF-M2), measured with ETDRS and FrACT, showed a significant relationship with age (p < 0.05 for all regression slopes) and had slopes between -0.6 D and -0.7 D per decade. Similarly, minimum near add declined at 0.6 D per decade (R2 = 0.83). All non-presbyopes accommodated well to the ETDRS chart, but some showed reduced accommodation with the FrACT system, especially through -3.5 D and -4.0 D defocus levels. Conclusions: The ETDRS charts and FrACT computer system measured comparable reductions in intermediate visual acuity and near visual acuity and depth of focus with increasing age. Generally, with each decade increase in age, near vision declined at 0.1 logMAR and depth of focus declined at about 0.6 D. Commercial Relationships: Janice Tarrant, None; Eugenia Thomas, None; Linda Tsai, None; Sanjeev Kasthurirangan, None and an iPad, respectively. The tests were controlled by a 2-down, 1-up staircase procedure with 4 reversals. SDH was estimated using a maximum likelihood fitting procedure. Results obtained from 162 eyes of these 86 subjects with BCVA 20/100 or better were included for linear regression and Bland-Altman analysis to assess the agreement of the self-testing results obtained with these two paradigms. Results: The linear regression of the SDH obtained with the 4AFC mVTTM versus those obtained with 3AFC mVTTM showed that the results of these two paradigms are highly correlated (r = 0.87, p<0.0001). The slope of linear regression is 0.94 (95% confidence interval, 0.85 – 1.02), including slope one, suggesting no significant difference in SDH measurements by these two testing paradigms. The Bland-Altman plot of the difference of 4AFC and 3AFC measurements versus their means showed the mean difference is 0.057 logMAR, indicating that SDH measured by 4AFC paradigm is slightly worse than that by 3AFC paradigm. This bias is significantly different from zero because the 95% confidence interval (0.033 to 0.081 logMAR) of the mean difference doesn’t include zero. Conclusions: The performance of mVTTM employing a 4AFC testing paradigm is comparable to that of mVTTM using a 3AFC testing paradigm. The slight bias of the 4AFC measurements compared to 3AFC supports the hypothesis that the 4AFC paradigm reduces chance level (lucky guesses), so that it reduces the likelihood of overestimating patients’ ability to detect distortion in a shape discrimination task. Program Number: 3892 Poster Board Number: D0034 Presentation Time: 3:45 PM–5:30 PM Comparison of myVisionTrack® Vision Monitor Performance with 3-Alternative Forced-Choice (3AFC) and 4AFC Testing Paradigms for Assessing Shape Discrimination Hyperacuity Michael B. Bartlett1, Gina Mitzel2, Song Zhang3, Yi-Zhong Wang2, 4 1 . Vital Art and Science, LLC, Richardson, TX; 2Retina Foundation of the Southwest, Dallas, TX; 3Clinical Sciences, UT Southwestern Medical Center, Dallas, TX; 4Ophthalmology, UT Southwestern Medical Center, Dallas, TX. Purpose: The myVisionTrack® (mVTTM), a mobile shape discrimination hyperacuity (SDH) test, was originally developed as a spatial 3-alternative forced-choice (3AFC) test (Wang, et al. IOVS 54:5501, 2013). Newer phones and tablets have bigger screens which allow for additional stimulus patterns to be displayed simultaneously. Increasing the number of choices will reduce the chance level and so decrease the likelihood of overestimating the performance in a psychophysical test. To test this hypothesis we compared the 4AFC and 3AFC test paradigms among normal subjects and patients with maculopathy in this study. Methods: A cross-sectional study was conducted with 86 subjects (40 with normal vision and 46 with various types of maculopathy). The 3AFC and 4AFC SDH tests were implemented on an iPod touch ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Commercial Relationships: Michael B. Bartlett, Vital Art and Science, LLC (E), Vital Art and Science, LLC (I), Vital Art and Science, LLC (P), Vital Art and Science, LLC (S); Gina Mitzel, None; Song Zhang, None; Yi-Zhong Wang, Vital Art and Science, LLC (C), Vital Art and Science, LLC (F), Vital Art and Science, LLC (I), Vital Art and Science, LLC (P), Vital Art and Science, LLC (S) Support: NIH Grant 5R44EY020016-03 Program Number: 3893 Poster Board Number: D0035 Presentation Time: 3:45 PM–5:30 PM Objective Alternanting Cover Test technique implemented in a new vision analyzer. Juan Carlos Ondategui Parra, Irene Claramunt, Rosa Borras, Selena Gomez, Jaume Pujol. DAVALOR Research Center (DRC) Universistat Politècnica de Catalunya, Terrassa, Spain. Purpose: To compare the values of near phoria measured with the clinical Alternating Cover Test (CACT) commonly used in clinics, objective method for the patient and subjective method for the examiner, with the objective method using the Alternating Cover Test Technique (OACT) implemented in a prototype of a new fully autonomous and automated vision analyzer (Eye and Vision Analyzer, EVA, DAVALOR, Spain). In this latter one eye movements are recorded while the patient watches a true-3D short video game, with a precise stimulation of accommodation and vergence. Methods: 55 healthy subjects with no previous history of strabismus or amblyopia, no ocular pathology, and no history of eye surgery were enrolled in the study. All eyes achieved a visual acuity equal o higher to 0.00 logMAR. The CACT method was the commonly used in clinics consisting of alternating occlusion of each eye every 2 seconds and measuring the deviation angle with a prism bar in prismatic diopters (PD). The phoria value was defined as the mean value obtained with the maximum and minimal limit technique of the compensation ocular movement. The OACT method was implemented in the prototype of EVA device showing the video game only in one eye during 2 seconds in an alternant manner. The procedure was repeated 5 times. Phoria values were obtained as the deviation angle before the occlusion of the other eye recorded by the eye tracker. All measures were done at near vision (40 cm) and the visual acuity for the test stimuli was 0.2 logMAR. Three measurements were performed for each method. Results: The mean age (mean ± standard deviation) of the sample was 21.5±1.5 years (range: 19 to 24). The mean phoria values obtained were -1.0±3.8 PD for CACT and -2.3±3.4 PD for OACT. The mean value of difference between methods was 1.3±2.2 PD and was statistically significant (p<0.01). The Bland and Altman plot shows a confidence interval at 95% between -5.57 and 3.03 PD. The Pearson Correlation Coefficient between both methods was 0.82 and the Intraclass Correlation Coefficient (ICC) was 0.90, therefore, the strength of agreement is very good. Conclusions: The EVA prototype is a useful device to use the Alternating Cover Test procedure to measure phoria. The results obtained with EVA were similar to the results with the method used commonly in clinics. Despite it is statistically significant; it is not clinically significant, because the difference is lower than 2PD. Commercial Relationships: Juan Carlos Ondategui Parra, DAVALOR (F); Irene Claramunt, DAVALOR (F); Rosa Borras, DAVALOR (F); Selena Gomez, DAVALOR (F); Jaume Pujol, DAVALOR (F) Support: DAVALOR, DPI 2011-30090-C02-01 Program Number: 3894 Poster Board Number: D0036 Presentation Time: 3:45 PM–5:30 PM Objective horizontal heterophoria measurements using a new vision analyzer Jaume Pujol, Rosa Borras, Irene Claramunt, Mireia Sanchez, Alfonso Sanchez-Magan, Juan Carlos Ondategui Parra. Davalor Research Center (DRC) - Universitat Politècnica de Catalunya, Terrassa, Spain. Purpose: To compare the results of two subjective methods commonly used in clinics to measure horizontal heterophoria with an objective method implemented in a prototype of a new fully autonomous and automated vision analyzer (Eye and Vision ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Analyzer, EVA, DAVALOR, Spain), that records eye movements while the patient watches a true-3D short video game Methods: Measurements were performed in a group of 54 young healthy subjects. Monocular visual acuity at far and near distances equal or better than 0.0 logMAR was required. Subjective methods consisted of Von Graefe with a line of letters (VGL) and the Modified Thorington (MT) test. VGL was performed at 40 cm with an increment speed of prismatic diopters (PD) of 2PD/sec and under controlled conditions of ilumination (L≈450 lux). MT was performed at 40 cm with a RAF ruler and spotlight under controlled conditions of ilumination (L≈50 lux). Moreover, accurate instructions about stimulus alignment were given to the patients. Three measurements were performed for each method with an interval of 5 seconds between them. Objective measurements were made using an Alternant Cover Test procedure (OACT) showing the video game only in one eye during 2 seconds and recording the ocular movements. This procedure was also repeated three times. Runtime, including time for instructions, was also measured Results: The mean age of the sample was 21.5±1.5 years (range:19 to 24). The mean horizontal heterophoria values were -6.7±6.0 PD for VGL, -1.0±3.8 PD for MT and -2.0±3.0 PD for OACT. The mean value of differences was -5,6±5,3 PD for VGL vs MT, -4,6±4,6 PD for VGL vs OACT and 0,9±2,8 PD for MT vs OACT. The 95% confidence interval (Bland & Altman plot) was 10,48 for VGL vs MT; 9.83 for VGL vs OACT and 2.52 for TM vs OACT. The Intraclass Coefficient Correlation (ICC) was 61,2% for MT vs OACT; 61.9% for VGL vs OACT and 80.4% for TM vs OACT. The runtime was 137±20 sec for VGL;, 83±13 sec. for MT and 26±5 sec. for OACT Conclusions: The EVA prototype is a useful device to objectively measure horizontal heterophoria using an Alternating Cover Test procedure. Results show a good ICC (>80%) when OACT is compared with MT. Differences between both methods (1PD) are not clinically significant and are within a good confidence interval. VGL shows higher differences and lower ICC when it is compared with OACT and MT. In addition, OACT is more than 3 times faster than MT and more than 5 times faster than VGL Commercial Relationships: Jaume Pujol, DAVALOR (F); Rosa Borras, DAVALOR (F); Irene Claramunt, DAVALOR (F); Mireia Sanchez, DAVALOR (F); Alfonso Sanchez-Magan, DAVALOR (F); Juan Carlos Ondategui Parra, DAVALOR (F) Support: DPI2011-30090-C02-01 Program Number: 3895 Poster Board Number: D0037 Presentation Time: 3:45 PM–5:30 PM A pilot trial for a self-testing application for reading speed Ju Byung Chae1, Sang Yoon Hyun1, Soolienah Rhiu2, Hye Jin Lee3, Jae-hyung Kim1. 1Ophthalmology-Coll of Med, Chungbuk National University Hospital, Cheong-ju, Chung-buk, Korea (the Republic of); 2Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea (the Republic of); 3Department of Ophthalmology, Jeju National University School of Medicine, Jeju, Korea (the Republic of). Purpose: To develop a reading chart app for the iPad tablet computer in the Korean language and to investigate reading speed in a normalsighted population according to age groups. Methods: Sixty-three Korean sentences were selected from textbooks for second grade students in elementary school. Commonly used typeface in everyday printed material, “Batangche” was used. Letter size was presented logMAR 0.0 to 1.0 at 0.1 logMAR steps at a reading distance 40 cm. A 3rd generation retina display iPad was used to present the chart and the sentences were presented randomly for each vision and reading speed was checked twice. Pilot testing followed in 55 normal vision adults under 60 years old of age. The subjects read aloud to prevent them from skipping reading words Results: The average word count for the sentences was 6.5 0.7. The mean reading speed for logMAR 0.5 optotype (point 10) was 133.9 ± 26.1 words per minute (wpm) in 20s (n = 19), 121.1 ± 31.6 in 30s (n = 25), 96.8 ± 17.2 in 40s (n = 6), 67.7 ± 41.9 (n = 5) in 50s. The mean reading speed for logMAR 0.0 optotype (point 3.5) was 121.2 ± 27.2 wpm in 20s, 106.6 ± 34.9 in 30s, 61.4 ± 20.1 in 40s, 43.6 ± 77.2 in 50s. Conclusions: This Korean reading chart app can present a new standard when checking reading speed according to age groups. The app also provides portability and accessibility for this new reading acuity chart. Commercial Relationships: Ju Byung Chae, None; Sang Yoon Hyun, None; Soolienah Rhiu, None; Hye Jin Lee, None; Jaehyung Kim, None Program Number: 3896 Poster Board Number: D0038 Presentation Time: 3:45 PM–5:30 PM Average Precision as a test-retest reliability measure: a quick CSF study on myopia Michael Dorr1, 2, Luis A. Lesmes2, Tobias Elze3, Hui Wang4, 3, ZhongLin Lu5, Peter J. Bex6. 1Technische Universität München, Munich, Germany; 2Adaptive Sensory Technology, Boston, MA; 3Mass Eye and Ear, Boston, MA; 4Jilin University of Finance and Economics, ChangChun City, China; 5Ohio State University, Columbus, OH; 6 Northeastern University, Boston, MA. Purpose: The Contrast Sensitivity Function (CSF) provides a comprehensive assessment of visual sensitivity, but its routine evaluation in clinical care is hampered by practical challenges. We evaluated test-retest reliability (TRR) of an iPad-based quick CSF implementation (Dorr et al., IOVS 2013) in a cohort of myopes and age-matched controls. Methods: We collected repeated measurements of the full CSF on a handheld device at a viewing distance of 60cm from 101 subjects (63 myopes with 33 uncorrected/30 corrected eyes, 38 controls); in each of 50 trials per measurement, a bandpass-filtered Sloan letter was presented for 500ms. Spatial frequency (SF, 24 levels from .64 to 41cpd) and contrast (48 levels from .2 to 100%) were chosen by the quick CSF algorithm to maximize information gain about the CSF. Subjects then indicated their response (10-AFC) on the touch screen. We computed cross-correlation coefficients (CC) and Bland-Altman Coefficients of Repeatability (CoR) for contrast sensitivities at 6 individual SF, CSF Acuity (the SF where sensitivity=0), and the Area under the Log CSF (AULCSF). However, both CC and CoR are vulnerable to artefacts due to test score range and quantization. Therefore, we also computed Average Precision, the area under the Precision-Recall curve that more accurately describes test-retest variance in terms of between-subject variability: how easily can a repeat measurement be identified from the whole population-wide set of measurements, given only the initial measurement? Results: CC ranged from .873 for contrast sensitivity at 1.5cpd to .98 for the AULCSF. CoR were likewise small for AULCSF (.225) and CSF Acuity (.193), and increased for individual contrast sensitivities at higher SF (1.5cpd, CoR=.2; 18cpd, CoR=.308). Precision-Recall scores were worst for low SF (1.5cpd, AveP=.79) and best for AULCSF (AveP=.87). Notably, repeatability as assessed by AveP was better for uncorrected eyes than for corrected eyes, despite much higher Bland-Altman CoR (e.g. uncorrected AULCSF, AveP=.879, CoR=.255; corrected AULCSF, AveP=.829, CoR=.168). Conclusions: Despite very short testing times (2-3 minutes) and without specialized laboratory equipment, the iPad-based quick CSF test reliably assessed the full CSF in myopes and controls. While ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Bland-Altman CoR is routinely used to quantify TRR, its absolute scores cannot be compared across different test measures; Average Precision should be used instead. Commercial Relationships: Michael Dorr, Adaptive Sensory Technology (I), US 14/399,136 (P); Luis A. Lesmes, Adaptive Sensory Technology (E), Adaptive Sensory Technology (I), US 14/399,136 (P); Tobias Elze, None; Hui Wang, None; Zhong-Lin Lu, Adaptive Sensory Technology (I), US 14/399,136 (P); Peter J. Bex, Adaptive Sensory Technology (I), US 14/399,136 (P) Program Number: 3897 Poster Board Number: D0039 Presentation Time: 3:45 PM–5:30 PM Hierarchical Bayesian adaptive estimation of the contrast sensitivity function: Part I – effect of sample size Hairong Gu, Woojae Kim, Fang Hou, Zhong-Lin Lu, Mark Pitt, Jay Myung. Psychology, The Ohio State University, Columbus, OH. Purpose: Lesmes et al (2010) developed a Bayesian adaptive method for accurately and efficiently measuring the contrast sensitivity function (CSF). Kim et al (2013) recently proposed a hierarchical Bayesian extension, dubbed hierarchical adaptive design optimization (HADO), that provides a judicious way to exploit prior information gained from past experiments to achieve even greater efficiency. The purpose of the present study is to evaluate the benefits and validity of HADO in both human and simulated experiments. Methods: We first conducted a 10AFC letter identification experiment with 100 subjects using the quick CSF method of Lesmes et al (2010) and used the data to construct informative priors. We varied the amount of information in the priors by using four different numbers of subjects (5, 12, 30,100) included in the prior construction. We then repeated the experiment with 10 new subjects using the four priors. Performance of the CSF estimation was compared between these different prior conditions, and also against the quick CSF method with a diffuse prior. The same HADO procedure was carried out in Monte Carlo simulations as well to take the effect of sampling error into account. Results: Figure 1 shows root-mean-squared-error (RMSE) plots of the area-under-the-log-CSF (AULCSF) averaged across all 10 subjects as a function of trial number. The results showed that the informative priors increased the efficiency by lowering the RMSE at a certain number of trials. From the diffuse prior, for comparison, the reduction of RMSE for sample size 5 and 12 averaging over the first 10 trials is about 6.47 dB and the reduction for sample size 30 and 100 is about 10.72 dB. The errors decreased for all priors as the trials accumulated, with the differences among them being indistinguishable at trial 50. Essentially the same (but less noisy) pattern of results was obtained in simulated experiments. Conclusions: Using well-informed priors in HADO shows higher efficiency in estimating CSF than using the non-informative, diffuse prior in the standard adaptive method. The advantage is considerable even when a small number of subjects are available for constructing the prior. Increasing the sample size brings further but small advantage, which can still be beneficial in clinical settings. Figure 1: Effect of sample sizes on the estimates of AULCSF. Commercial Relationships: Hairong Gu, None; Woojae Kim, None; Fang Hou, None; Zhong-Lin Lu, Adaptive Sensory Technology, LLC. (I), Adaptive Sensory Technology, LLC. (P); Mark Pitt, None; Jay Myung, None Support: National Institute of Mental Health MH093838 ; National Eye Institute EY021553 Program Number: 3898 Poster Board Number: D0040 Presentation Time: 3:45 PM–5:30 PM Hierarchical Bayesian adaptive estimation of the contrast sensitivity function: Part II — effect of type of prior Mark Pitt, Hairong Gu, Fang Hou, Woojae Kim, Zhong-Lin Lu, Jay Myung. Psychology, Ohio State Univeristy, Columbus, OH. Purpose: The contrast sensitivity function (CSF) characterizes spatial vision in both normal and clinical populations. The quick CSF method (Lesmes, et al, 2010) measures CSF precisely in only a few trials. Kim et al. (2014) introduced a hierarchical Bayesian framework in which adaptive estimation of the CSF can be further accelerated and improved by using prior knowledge (e.g., parameter estimates) from previously tested participants. The current experiment explored how the specification of priors influences adaptive estimation by comparing conditions in which the priors varied from correctly specified to incorrectly specified. Methods: Priors were created from parameter estimates from a study in which the CSF of 100 observers with normal vision were measured using the quick CSF procedure in a 10AFC letter identification task under three viewing conditions: no filter (Normal), weak neutral density filter (ND1, 78.8% attenuation) and strong neutral density filter (ND2, 97.2% attenuation). In the current study, 10 participants were tested with quick CS in the Normal viewing condition three times, each using a different prior: Normal (correctly specified), ND2 (misspecified) and a mixture prior consisting of equal parts Normal, ND1, and ND2. Diffuse priors (no prior knowledge) were used in a control condition. Results: The root mean squared error (RMSE) of the Area Under the log CSF (AULCSF) was calculated across trials for each participant in all conditions using the estimated true AULCSF, obtained after 100 trials in an additional diffuse condition. Aggregate data over the first ten trials showed that, when compared to results in the diffuse condition, estimation error in the ND2 (misspecified) condition decreased by 0.41dB. The Normal (correctly specified) prior condition yielded the greatest improvement (7.80 dB) over the diffuse condition. Surprisingly, the mixture prior showed a significant benefit (4.24 dB drop). Estimates improved for all conditions as trials accumulated, with differences among them being almost indistinguishable by trial 50. Conclusions: Prior knowledge can influence the accuracy and efficiency of adaptive CSF measurement. A correctly specified prior can greatly improve estimation, but a misspecified prior is ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics comparable to a diffuse prior. When the prior is unknown, a mixture prior is a smart choice, providing significant benefit without cost. Commercial Relationships: Mark Pitt, None; Hairong Gu, None; Fang Hou, None; Woojae Kim, None; Zhong-Lin Lu, Adaptive Sensory Technology (S); Jay Myung, None Support: National Institute of Mental Health (MH093838), National Eye Institute (EY021553) Program Number: 3899 Poster Board Number: D0041 Presentation Time: 3:45 PM–5:30 PM A large-sample study for evaluating the precision of the quick CSF method Zhong-Lin Lu1, Fang Hou1, Luis A. Lesmes2, Woojae Kim1, Hairong Gu1, Mark Pitt1, Jay Myung1. 1Psychology, The Ohio State University, Columbus, OH; 2Adaptive Sensory Technology, LLC., Boston, MA. Purpose: The quick CSF method (Lesmes, et al, 2010) applies a Bayesian adaptive algorithm to estimate the contrast sensitivity function (CSF) with high precision and reduced testing time (~5 min). We collected a large dataset of CSF to 1) determine reliability as a function of test duration, 2) evaluate the concordance between estimates against intra- and inter-run variability (via Bayesian confidence and repeated testing, respectively), and 3) conduct a power analysis for detecting CSF change. Methods: CSFs of 112 college students with normal vision were repeatedly assessed using quick CSF with a 10-letter identification task. For each observer, running CSF estimates were calculated for each trial, via bootstrap statistics for the area under the log CSF (AULCSF), computed by resampling from the Bayesian posterior distribution of the CSF. Results: 1) After 6 trials, the AULCSFs from the two repeated measurements were significantly correlated. Pearson’s r increased from 0.22 (p=0.02) to 0.84 (p<0.001) as trial number increased from 6 to 50. The 95% confidence interval of the ratio between the two AULCSFs was [0.94, 1.02] at trial 6 and [0.99, 1] at trial 50. 2) The comparable metrics of intra- and inter-run variability provided by standard deviations of AULCSF estimates were 0.20 and 0.25 log units after 10 trials, 0.13 and 0.16 log units after 20 trials, and 0.07 and 0.09 log units after 50 trials, respectively. 3) From the posterior distributions of the CSFs, we computed the minimum AULCSF difference (MAD) that can be detected by quick CSF with 95% posterior probability as a function of both trial and observer numbers (Figure 1). To detect MADs of 0.2, 0.1 and 0.05 l log units with 25 quick CSF trials, we needed to run 2, 6 and 27 observers, respectively. To detect the same MADs in 50 trials, only 1, 3 and 11 observers were needed. With 20 observers, we needed 5, 11, and 30 trials to detect MADs of 0.2, 0.1 and 0.05 log units, respectively. With 112 observers, we needed only 3, 6 and 12 trials to detect the same MADs, respectively. Conclusions: The quick CSF method is very precise and highly reliable. The high precision and reliability make it possible to use the method to efficiently measure CSF and detect CSF changes with greatly reduced sample size and costs in clinical trials. Figure 1. The minimum AULCSF difference (MAD, in log units) that can be detected by quick CSF as a function of both trial and observer numbers. Commercial Relationships: Zhong-Lin Lu, Adaptive Sensory Technology, LLC. (I), Adaptive Sensory Technology, LLC. (P); Fang Hou, None; Luis A. Lesmes, Adaptive Sensory Technology, LLC. (E), Adaptive Sensory Technology, LLC. (I), Adaptive Sensory Technology, LLC. (P); Woojae Kim, None; Hairong Gu, None; Mark Pitt, None; Jay Myung, None Support: Supported by the National Eye Institute (EY021553 to ZLL) and by the National Institute of Mental Health (MH093838 to JM and MP) Program Number: 3900 Poster Board Number: D0042 Presentation Time: 3:45 PM–5:30 PM Evaluating the sensitivity for detecting contrast sensitivity changes using the quick CSF method Fang Hou1, Luis A. Lesmes2, Woojae Kim1, Hairong Gu1, Mark Pitt1, Jay Myung1, Zhong-Lin Lu1. 1Department of Psychology, the Ohio State University, Columbus, OH; 2Adaptive Sensory Technology, LLC., Boston, MA. Purpose: The contrast sensitivity function (CSF) has shown promise for monitoring the progression of vision loss in eye disease or its remediation with treatment (Barnes, et al., 2004). The quick CSF is a novel Bayesian adaptive method developed to enable the wide, easy application of precise CSF testing. Here, we 1) induced predictable visual changes in a large sample of observers, 2) determined the quick CSF’s sensitivity for detecting CSF changes, and 3) used the large dataset to empirically determine the minimum sample sizes and testing times needed to detect CSF changes. Methods: CSFs of 112 college students with normal vision were assessed by the quick CSF with a 10-letter identification task in low, medium, and high mean luminance conditions: 2.65 (L), 20.2 (M) and 95.4 (H) cd/m2. Visual acuity (VA) was measured using the Snellen eye chart. Data were analyzed using Bayesian and conventional statistics. For each observer, CSF metrics across different luminance conditions were calculated in each trial, via bootstrap statistics for the area under the log CSF (AULCSF), computed by resampling from the Bayesian posterior distribution of the CSF. Results: 1) Average AULCSF values obtained in the L and M conditions were only 38.7% and 72.1% of those obtained in the ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics H condition, while average relative VA values were 95% and 99%. Although both AULCSF (F(2,335)=293, p<0.001) and VA (F(2,332)=5.89, p<0.001) reductions were significant, the magnitudes of AULCSF changes were much greater than those of VA reduction (F(1,443)=461, p<0.001). 2) After 10 trials, we needed only 1, 3, and 17 subjects to reliably (with 95% posterior probability) detect AULCSF changes in comparisons of L-H, L-M, and M-H conditions, respectively; after 25 trials, we needed only 1 subject to detect all the changes. In contrast, we needed 16, 20, and 82 subjects to reliably detect VA changes in those comparisons 3) With 10 subjects, we needed 3, 4, and 11 quick CSF trials to reliably detect AULCSF changes between the L-H, L-M and M-H luminance conditions, respectively. With 25 subjects, we needed only 2, 3, and 7 trials. Conclusions: This assay calibration study demonstrates that the quick CSF method is very sensitive in detecting CSF changes. Whereas the current study uses the quick CSF to detect visual changes modeled by different luminance conditions, future studies will examine the performance of the method in clinical settings. Commercial Relationships: Fang Hou, None; Luis A. Lesmes, Adaptive Sensory Technology, LLC. (E), Adaptive Sensory Technology, LLC. (I), Adaptive Sensory Technology, LLC. (P); Woojae Kim, None; Hairong Gu, None; Mark Pitt, None; Jay Myung, None; Zhong-Lin Lu, Adaptive Sensory Technology, LLC. (I), Adaptive Sensory Technology, LLC. (P) Support: Supported by the National Eye Institute (EY021553 to ZLL) and by the National Institute of Mental Health (MH093838 to JM and MP) in first and second measurement and the limits of agreement as assessed by the Altman and Bland plots. The AULCSF had upper limit of agreement (ULA) -0.18 and lower limit of agreement (LLA) +0.22. The CSF acuity had ULA -7.0 and LLA +10.9 cpd. The t-tests revealed that all parameters, including AULCSF and CS at various cpd, were not significantly different between the first and second sets of measurement (paired t-test p>0.05). However, CSF acuity was significantly higher in the second measurement compared to the first measurement (mean difference 1.95 cpd; paired t-test t-statistic -2.09, p= 0.04). Conclusions: The quick CSF provides contrast sensitivity parameters that are repeatable in groups with normal and mild impaired vision. Program Number: 3901 Poster Board Number: D0043 Presentation Time: 3:45 PM–5:30 PM Repeatability of measurements obtained using the quick CSF method Lilia Babakhan1, Anna Parfenova1, Katherine Ha1, Raymond Maeda1, Steven Thurman2, Aaron Seitz2, Pinakin G. Davey1. 1College of Optometry, Western University of Health Sciences, Burbank, CA; 2 UC Riverside, Riverside, CA. Purpose: Contrast sensitivity is a fundamental measure of visual function, and obtaining quick and reliable estimates of contrast sensitivity is vital in clinical settings. The quick CSF is an adaptive method that uses Bayesian inference and a trial-to-trial information gain strategy to obtain rapid measurements of contrast sensitivity and to produce an estimate of the entire contrast sensitivity function (CSF) (Lesmes et al Journal of Vision 2010, ARVO 2012 and 2013).The purpose of the present study was to evaluate short term repeatability of CSF parameter estimates using the quick CSF method. Methods: Twenty four individuals with normal or mild impaired vision (glaucoma, cataract or age related macular degeneration) participated in the study. Measurements were performed twice with the quick CSF technique in binocular viewing conditions. The CSF was measured with 50 trials and estimates of area under the log CSF (AULCSF), high spatial frequency cutoff (CSF acuity), and contrast sensitivity at 1, 1.5, 3, 6, 12 and 18 cycles per degree (cpd) were obtained (see figure 1). Altman and Bland plots were performed to evaluate the limits of agreement and paired t-tests were performed to assess difference between the first and second measurements. Results: The median age of the study participants was 32 years (range 22-76). The figure 2 provides the contrast sensitivity measures obtained Commercial Relationships: Lilia Babakhan, None; Anna Parfenova, None; Katherine Ha, None; Raymond Maeda, None; ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Steven Thurman, None; Aaron Seitz, None; Pinakin G. Davey, None Support: NIH 1 R01EY023582 Program Number: 3902 Poster Board Number: D0044 Presentation Time: 3:45 PM–5:30 PM Clinical assessment of the Landolt C-CSF test-M&S Smart System Contrast Sensitivity Testing Device Kaydee McCray1, Violeta Paronian1, Aaron Seitz2, Pinakin G. Davey3. 1 Gradutate College of Biomedical Sciences, Western University of Health Sciences, Pomona, CA; 2Psychology, University of CaliforniaRiverside, Riverside, CA; 3College of Optometry, Western University of Health Sciences, Pomona, CA. Purpose: Contrast sensitivity function is decreased in many disease entities notably: cataract, age related macular degeneration and glaucoma. It is also lowered in individuals that undergo keratorefractive surgery procedures. Traditional contrast sensitivity tests printed on charts are limited in the fact that a certain working distance is needed and are prone to degradation due to use. The electronic M&S Smart System contrast sensitivity testing unit provides the flexibility to use at variable distance and provides better resolution capabilities especially at lower contrast due to the visual display system. The purpose of the study was to evaluate the short-term repeatability and use of Landolt C contrast sensitivity function test in ocular healthy and in individuals with decreased visual function. Methods: Twenty six individuals were tested twice using the Landolt C-CSF test of the M&S Smart System contrast sensitivity testing system. The mean age of the study participants was 37.3 years (SD 15). The Landolt C-CSF was performed for 20/20, 20/40 and 20/80 and all measurements were obtained viewing the chart binocularly at a distance of nine feet. Repeatability was assessed using Altman and Bland plots and 95% limits of agreement were calculated. The difference in measurements of first and repeat measurements was assessed using paired samples t-test. Results: Table 1 below provides the mean of first and second measurements of obtained data using the Landolt C contrast sensitivity function test and the limits of agreement at different acuities. Overall the contrast sensitivity peak measured as percent contrast was very repeatable at different visual acuity levels with average difference in percent contrast being not significantly different in all three acuity levels (paired samples t-test p value 0.8, 0.9 and 0.9 respectively). Conclusions: The Landolt C-CSF test of the M&S Smart System contrast sensitivity testing system is repeatable and provides data that can be useful in measuring contrast levels. Further tweaks may be done to provide area under log CSF from the various peak contrast sensitivity tested. Commercial Relationships: Kaydee McCray, None; Violeta Paronian, None; Aaron Seitz, None; Pinakin G. Davey, None Support: NIH Grant 1R01EY023582 Program Number: 3903 Poster Board Number: D0045 Presentation Time: 3:45 PM–5:30 PM Assessment of Evans low contrast sensitivity in measuring log contrast sensitivity Pinakin G. Davey1, Raymond Maeda1, Aaron Seitz2. 1College of Optometry, Western University of Health Sciences, Pomona, CA; 2 Psychology, UC Riverside, Riverside, CA. Purpose: Clinically a quick and reliable estimate of contrast sensitivity levels is desirable to evaluate patients with decreased vision or difficulty of vision in dim illumination. The Evans Low Contrast Test (ELCT) chart presents Sloan Letters optotypes line size of 20/630 (a testing distance of 1m) varying contrast in sets of 3 letters of equal contrast level. All triplets are balanced for letter difficulty and differ in contrast by 0.15 log contrast step. The purpose of this study was to evaluate the short term repeatability of the ELCT in measuring lowest log contrast appreciated in healthy and eyes with ocular pathology. Methods: Study participants were tested at 13 feet in a dark environment and the retro illuminated box provided the background illumination for the ELCT chart. Twenty five study participants with either normal visual function or decreased visual function performed assessment with ELCT twice viewing the chart binocularly. Repeatability was assessed using Altman and Bland plots and 95% limits of agreement were calculated. Difference in measurements was assessed using paired samples t-test. Results: The mean log contrast of attempt 1 and attempt 2 was 2.198 and 2.208 (standard deviation 0.17 and 0.08 respectively). The mean difference between the groups was not statistically significant (paired samples t-test: t statistic =0.36; p value =0.72). The test was easy to perform and the results were obtained in a couple of minutes maximum. Conclusions: The Evans Low Contrast Test provides a quick and easy method of estimating lowest log contrast and may be useful test in identifying decreased contrast sensitivity in individuals with ocular pathology. Commercial Relationships: Pinakin G. Davey, None; Raymond Maeda, None; Aaron Seitz, None Support: NIH1R01EY023582 Program Number: 3904 Poster Board Number: D0046 Presentation Time: 3:45 PM–5:30 PM Assessment of the Impact of congenital dichromacy on the lives of color blind adults Amanda Bastos, Lívia Rego, Daniela Bonci, Dora F. Ventura, Mirella Gualtieri. Experimental Psychology, University of São Paulo, São Paulo, Brazil. Purpose: Congenital color blindness affects 6 to 8% of the male caucasian population. Recent developments point to gene therapy as a possible treatment for this type of impairment. However, little is known regarding the impact of dyschromatopsia on people with congenital color blindness. Questionnaires assessing quality of life in vision research have been effective in revealing the impact of the visual losses. However, issues related to color vision are still largely absent from these instruments.The objective of this work is to evaluate the impact of congenital dyschromatopsia on the life of adults Methods: We investigated different dimensions of the impact of color blindness in everyday life, based on the analysis of the content of interviews - using the Sphinx software (Le Sphinx, UK). Twelve male participants were interviewed (age = 33.6 years old ± 9.9; educational level between undergraduate and graduate school). All participants underwent psychophysical color vision assessment – using the Cambridge Colour Test (Cambridge Research Systems, ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics UK) - as well as genotyping of the opsin genes (Gentra Systems - QUIAGEM, Dusseldorf, Germany). The results were compared to those from a control group for psychophysical assessment and genetics of color vision. (age = 27,1 years old ± 4,7) Results: Dyschromatopsias had direct negative impact on professional daily life activities in 27% of the individuals; 12% of the participants found to be color blind during childhood as a result of self-assessment; 22% considered that their vision was good; 60% revealed that life would be no different if they had no visual defect; 29% depended on someone else in their daily life and 30% would like to undergo treatment for color blindness cure. The psychophysical colour vision results revealed: Protan: 320 ± 129,61; Deutan: 684,45 ± 392,2 Tritan: 76,64 ± 24,3 and control group Protan: 50 ± 26,5 Deutan: 50,2 ± 16,9 e Tritan: 77,5 ± 26,9. Genetic analysis confirmed the psychophysical results Conclusions: Color blindness has an impact on individuals, as revealed by semi-structured interviews. However, the extent of the impact is not homogeneous among subjects most participants had different difficulties in daily life, mostly related to professional activity developed. A questionnaire being designed based on these results might constitute a tool for identifying individuals who are more strongly affected by congenital dyschromatopsia Commercial Relationships: Amanda Bastos, None; Lívia Rego, None; Daniela Bonci, None; Dora F. Ventura, None; Mirella Gualtieri, None Program Number: 3905 Poster Board Number: D0047 Presentation Time: 3:45 PM–5:30 PM Genetic analysis, the Color Assessment and Diagnosis (CAD) test, and the Cambridge Color Test (CCT) yield the same color vision classifications in humans Victoria Honnell2, 1, Daniela Bonci2, Mirella T. Barboni2, Mirella Gualtiere2, Amanda Bastos2, Lívia Rego2, Givago S. Souza2, Malinda E. Fitzgerald3, Luiz Carlos L. Silveira2, Dora F. Ventura2. 1 Neuroscience, Rhodes College, Memphis, TN; 2University of Sao Paulo, Sao Paulo, Brazil; 3Christian Brothers University, Memphis, TN. Purpose: To determine whether the three color vision classification procedures produce identical results in trichromats and dichromats. Methods: Blood samples were analyzed from trichromat (26.5±5.2 years old, 5 males and 14 females) and dichromat (31.1±8.1 years old, 8 males) volunteers living in Sao Paulo, Brazil. The opsin genes, specifically Exon 5, of all subjects were sequenced after DNA extraction and PCR amplification procedures. The amino acids in place 277 and 285 on Exon 5 were identified and the visual pigment alleles were assessed. Each participant was also tested using the Cambridge Colour Test (CCT) and the Colour Assessement Diagnosis test (CAD) using the full assessment protocol (N=26). Results: 26 subjects were evaluated using psychophysical tests and genetic analysis. The subjects that self identified as daltonic (N=8) showed only one M or L allele through the genetic analysis. Seven of the eight dichromat patients were classified as deutan and only one subject was classified as protan by the psychophysical tests, CCT and CAD. Of the eight dichromats that had their genes sequenced, seven were classified as deutan and one was protan. The psychophysical test results match the genetic test results for each daltonic patient. The subjects that self identified as trichromats (N=18) had normal results for the genetic analysis, CCT, and CAD. Conclusions: Equal classifications were obtained with the three methods of color vision classification. This suggests that each testing method in itself is a reliable measure. Commercial Relationships: Victoria Honnell, None; Daniela Bonci, None; Mirella T. Barboni, None; Mirella Gualtiere, None; Amanda Bastos, None; Lívia Rego, None; Givago S. Souza, None; Malinda E. Fitzgerald, None; Luiz Carlos L. Silveira, None; Dora F. Ventura, None Support: MHIRT Grant NIH 2T37 MD001378-13 Program Number: 3906 Poster Board Number: D0048 Presentation Time: 3:45 PM–5:30 PM Neural Compensation for Color Deficiency: Binocular Enhancement of Cone-Specific Color VEPs Jeff C. Rabin, Dan Lam, Andrew Kryder. Optometry, UIW Rosenberg School of Optometry, San Antonio, TX. Purpose: Central nervous system (CNS) degeneration often precedes glaucomatous retinal changes suggesting that glaucoma is a CNS disease. Moreover, preservation of the binocular field in glaucoma as well as cognitive function in Alzheimer’s disease are mediated by CNS control.1,2 Our purpose was to determine if comparable CNS control mechanisms operate developmentally to optimize function in hereditary color vision deficiency (CVD) by comparing binocular to monocular cone specific color VEPs. Methods: Red (L), green (M) and blue (S) cone specific VEPs were recorded in pattern-onset mode with colored checkerboards on a grey background (L&M cone: 1 deg. checks, S cone: 2 deg., 2 onsets/ sec., Diagnosys LLC). Display luminance and CIE chromaticity were transformed to cone contrasts to selectively stimulate L, M and S cones. Subjects included 17 color vision normal (CVN) and 11 hereditary red or green CVDs confirmed to be CVD on a battery of tests. The ratio of binocular VEP amplitude (N1-P1) to mean (RE & LE) monocular amplitude was used to quantify enhancement. Results: CVDs showed binocular facilitation of VEP amplitude (enhancement >2X; mean = 3.1X) for the color corresponding to their CVD. Values exceeded enhancement for other cone types within CVDs (3.1X vs. 1.2X, p<0.003) and compared to CVNs (3.1X vs. 1.2X, p<0.007). Binocular facilitation of CVD VEPs remained high (2.4X) even when quantified as binocular amplitude/higher amplitude from right or left eyes (2.4X vs. 1.1X, p <0.008). Dichromatic CVDs did show an enhancement effect. Conclusions: Hereditary CVDs with anomalous trichromacy show binocular facilitation of VEPs for the color corresponding to their CVD. This suggests neural compensation for CVD similar to preservation of function in glaucoma and Alzheimer’s disease. Other congenital anomalies and rod-cone, macular and/or corneal dystrophies may be subject to neural compensation. Elucidation of underlying mechanisms could lead to new treatments for visually debilitating disease. 1 Crish et. al, PNAS 2010;107:5196–5201. 2Sponsel et. al TVST 2014;1-13. Commercial Relationships: Jeff C. Rabin, None; Dan Lam, None; Andrew Kryder, None Program Number: 3907 Poster Board Number: D0049 Presentation Time: 3:45 PM–5:30 PM Comparison of interpolation algorithms for static visual field data Travis Smith1, Ning Smith2, Richard G. Weleber1. 1Ophthalmology, Oregon Health & Science University, Portland, OR; 2Center for Health Research, Kaiser Permanente, Portland, OR. Purpose: Static perimetry generates 3-D data (x-y test location and z sensitivity value) representing the visual field (VF), sometimes called the hill of vision (HOV), which is often sparsely sampled. Data interpolation produces a finer HOV representation to aid interpretation, visual display, and quantitative analysis. The goal of this study is to compare the accuracy of several scattered data interpolation algorithms and identify the optimal one for VF data. ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Methods: Full-field VF data was analyzed from 129 exams of 10 normal subjects and 10 retinitis pigmentosa (RP) patients that passed quality assessment. Data was acquired with the Octopus 900 with 164 radially oriented, centrally condensed test points using GATEi, target size V, and a 10 cd/m2 background. Repeated exams for each subject were included if obtained within 90 days of the first. Interpolation accuracy was assessed by the root mean square error (RMSE) and mean absolute error (MAE) from leave-one-out cross-validation (LOOCV) after blind spot removal. In LOOCV, each location’s z-value is interpolated from the other 163 points and compared with a target value to produce an error residual; this is repeated for all locations in each exam. Two types of target values were considered: the median z-value at each location across all exams for that eye (Target 1), and the measured z-value itself (Target 2). LOOCV was performed with the 8 nonparametric interpolation methods in the top row of Table 1. Significance was assessed by one-sided paired t-tests with Bonferroni correction. Results: Table 1 summarizes the interpolator performances. Linear radial basis function (RBF) interpolation had the smallest mean RMSE and MAE compared to all other methods for both target types, significant (p<0.006) in each case except those identified by * in Table 1. Linear RBF performance was significantly better in RP patients than in normals in all scenarios. Conclusions: Interpolation of static VF data was most accurate with a linear RBF kernel. Accuracy improved in subjects with visual field loss, likely due to higher spatial correlation in the data. Future work will assess parametric and regularized methods to mitigate overfitting, incorporate a larger number of exams, and analyze the influence of perimetric test grid density and target size on interpolation accuracy. Weleber, AGTC SAB (S), Foundation Fighting Blindness ESAB (F), U.S. patent no. 8657446, Method and apparatus for visual field monitoring, also known as Visual Field Modeling and Analysis (P) Support: Supported by an Unrestricted Grant from Research to Prevent Blindness, Foundation Fighting Blindness, and Hear See Hope Program Number: 3908 Poster Board Number: D0050 Presentation Time: 3:45 PM–5:30 PM Automated static threshold perimetry using a remote eye tracker Pete R. Jones1, 2, Sarah Kalwarowsky1, Gary S. Rubin1, 2, Marko Nardini3, 1. 1Institute of Ophthalmology, UCL, London, United Kingdom; 2NIHR Moorfields Biomedical Research Centre, London, United Kingdom; 3Department of Psychology, Durham University, Durham University, United Kingdom. Purpose: Current methods of Static Threshold Perimetry require (i) an explicit, button-press response (precluding testing of infants) and (ii) expensive, specialised equipment. Here we present a novel measure that addresses these problems by combining a cheap, commercially available, eye tracker (Tobii EyeX: $135), with an ordinary desktop computer. Methods: Luminance detection thresholds were measured monocularly in 7 healthy adults (additional data collection ongoing), using both a Humphrey Field Analyzer [HFA] and an automated remote eyetracking [ARE] procedure (Fig 1A). The eye tracker was used to present stimuli relative to the current point of fixation, and to assess whether the participant made an eye-movement towards the stimulus. In both tests, Goldman III stimuli were arranged on a 24-2 grid, and were presented individually against a 10 cd/m2 white background. Participants completed each test twice (same eye) in order to assess test-retest reliability. Results: The pointwise Coefficient of Repeatability was similar for the two tests (ARE: 8.1 dB. HFA: 6.3 dB). Differences in mean sensitivity to stimuli in the central 10° and those located more peripherally (10—24°) were observed in both the ARE (CI95% = 0.9—2.7 dB) and the HFA (CI95% = 2.3—4.6 dB). Furthermore, as shown in Fig 1B, the ARE was able to differentiate between the blind spot and surrounding retinal locations (t6 = -3.1, p = 0.021). Conclusions: An eye tracker can be used to perform Static Threshold Perimetry based on eye movement responses alone. The ARE was sensitive to normal variations in sensitivity across the healthy eye, and could isolate the blind spot. It may therefore be capable of detecting visual field deficits, including acute scotomas. Its low price and ease of use could make such a test particularly effective as a means of screening infants. Mean RMSE and mean MAE values (both in dB) across all exams for each interpolator analyzed, as assessed by LOOCV. Commercial Relationships: Travis Smith, Foundation Fighting Blindness (F), Hear See Hope (F); Ning Smith, None; Richard G. ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Fig 1. (A) Example trial for the ARE. Here a test point is presented at [-3° -6°], relative to the current point of fixation. Fixation at trial onset was unconstrained. The monitor was a Samsung 305T LCD, gain-corrected in software for uniformity. (B) Mean threshold data from the ARE, computed from 4 participants tested with their left eye. Numbers show the final threshold estimate at each location, in dB (higher = more sensitive). Note that the blind spot was measured in an identical manner to all other points, with no prior assumptions or constraints, in order to simulate an unknown scotoma. Commercial Relationships: Pete R. Jones, None; Sarah Kalwarowsky, None; Gary S. Rubin, None; Marko Nardini, None Support: This work was supported by Fight for Sight, the NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, the Special Trustees of Moorfields Eye Hospital, and the Leverhulme Trust. Program Number: 3909 Poster Board Number: D0051 Presentation Time: 3:45 PM–5:30 PM Influence of visual field threshold fluctuation on high resolution perimetry with 0.5-degree interval Takuya Numata1, Chota Matsumoto1, Sachiko Okuyama1, Fumi Tanabe1, Shigeki Hashimoto1, Mariko Eura1, Tomoyasu Kayazawa2, Sayaka Yamao1, Yoshikazu Shimomura1, Ted Maddess3. 1 Ophthalmology, Kinki Univ Faculty of Medicine, Osaka-Sayama City, Japan; 2Ophthalmology, Kinki University Faculty of Medicine, Nara Hospital, Ikoma, Japan; 3Biology & Environment, Australian National University College of Medicine, Canberra, ACT, Australia. Purpose: It is well known that visual field threshold can fluctuate. The fluctuation is small where the visual field threshold is small, and the fluctuation is large where it is large. The visual field threshold also fluctuates at localized areas such as scotoma. We performed an observational clinical study using high resolution perimetry with 0.5-degree interval to investigate the factors for the visual field threshold fluctuation. Methods: Sixteen eyes of 16 patients with glaucoma (mean age: 63.1 ± 5.9) were studied. Octopus 900 Custom test program was used with target size III and background luminance of 31.4 asb to measure the sensitivity on the upper temporal meridian of 45 degrees from the fixation point to the eccentricity of 30 degrees with the interval of 0.5 degrees. The sensitivity was evaluated 3 times at each point. Visual field threshold was determined by computing the mean sensitivity of the 3 repeats at each test point. The standard deviation was defined as test- retest SD. In order to evaluate local visual field threshold fluctuation at scotoma or else, we also computed Spatial SD along each sample line using a moving window of between 3 and 20 points wide. In addition, we computed the independent variable Spatial Interaction (SI) multiplying visual field threshold by Spatial SD at each point. Using univariate correlation analysis, associations were examined between test- retest SD and visual field threshold, Spatial SD, SI, and the eccentricity. We also did a multivariate regression analysis to look for the independent factors that best determined test- retest SD. Results: Univariate correlation analysis revealed test- retest SD was significantly correlated (p < 0.002) with the eccentricity, visual field threshold, Spatial SD, and SI. Test- retest SD showed strongest correlation with visual field threshold (p < 0.002; r = -0.342) and Spatial SD (p < 0.002; r = 0.452). Multivariate regression analysis showed test- retest SD was affected by visual field threshold (p < 0.01; t-value 5.05) and Spatial SD (p < 0.01; t-value 12.5). Conclusions: Visual field threshold fluctuation was mostly affected by visual field threshold and Spatial SD. Commercial Relationships: Takuya Numata, None; Chota Matsumoto, None; Sachiko Okuyama, None; Fumi Tanabe, None; Shigeki Hashimoto, None; Mariko Eura, None; Tomoyasu Kayazawa, None; Sayaka Yamao, None; Yoshikazu Shimomura, None; Ted Maddess, None 411 Color and neural circuitry Wednesday, May 06, 2015 8:30 AM–10:15 AM 702/704/706 Paper Session Program #/Board # Range: 4012–4017 Organizing Section: Visual Psychophysics / Physiological Optics Program Number: 4012 Presentation Time: 8:30 AM–8:45 AM Retinal Mediator of Uniform Hue Perceptions Nathaniel D. Douda, Jamie K. Opper, Andrew I. Wilson, Katie T. Youngpeter, Vicki J. Volbrecht. Psychology, Colorado State University, Fort Collins, CO. Purpose: Stimuli presented either to the fovea or to the peripheral retina differ in color, yet in everyday living we usually do not view stimuli in isolation as we do in the laboratory. How is color perception determined when a stimulus covers both the fovea and the peripheral retina? Does the fovea determine the overall perception, does the peripheral retina determine the overall perception, or does the overall perception represent an average of the different retinal areas? This study investigated how information from the fovea and peripheral retina are combined to give one uniform perception. Methods: Monochromatic (420-660 nm) circular (1°, 23°) or annular (17° inner diameter, 23° outer diameter) stimuli were equated to 1.3 log td and presented for 500 ms. After 30 min dark adaptation the four observers described their hue perceptions using the “4 + 1” huenaming procedure. Results: Similar to previous findings from our laboratory, the hue perceptions for the 1° foveal stimulus differed from that for the annular stimulus. In particular, the annular stimulus appeared greener across the visible spectrum and more yellow and saturated in the midspectral region of the visible spectrum compared to the foveal stimulus. The hue-naming data were strikingly similar between the annular and 23° circular stimuli. Conclusions: Initial findings indicate that when a stimulus covers both the foveal and peripheral regions of the retina, the peripheral retina determines the overall hue perception of the stimulus. Commercial Relationships: Nathaniel D. Douda, None; Jamie K. Opper, None; Andrew I. Wilson, None; Katie T. Youngpeter, None; Vicki J. Volbrecht, None Support: NSF112771 ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Program Number: 4013 Presentation Time: 8:45 AM–9:00 AM Functional organization of color in the trichromatic cone mosaic Ramkumar Sabesan1, Brian Schmidt2, William S. Tuten1, Alexandra Boehm1, Austin Roorda1. 1School of Optometry and Vision Science Graduate Group, University of California, Berkeley, Berkeley, CA; 2 Graduate program in Neuroscience, University of Washington, Seattle, WA. Purpose: At the scale of single receptors, luminance and color are indistinguishable in the retinal image, yet the visual system is capable of reconstructing fine spatial detail and rich color experience from the external world. The mechanisms by which percepts of color are derived from individual cones and facilitated by the postreceptoral circuitry remain unclear. Our goal was to investigate the contribution of individual cones to color perception and how it depends on the spectral topography of the cone mosaic. Methods: The cone mosaic at 1.5 deg eccentricity was spectrally classified with adaptive optics(AO) imaging and densitometry. Hue percepts were recorded by individually stimulating cones in this region with AO-corrected, cone-sized and retinally-stabilized stimuli at 543nm. The stimuli appeared on a neutral white background. While an entire gamut of hue choices was available, pilot experiments revealed that responses were categorized under only red, green, white and not-seen under these stimulus conditions. Color responses were analyzed for purity, dependence on local cone-type environment and spatial clustering. Results: Purity, defined as the number of responses in the most frequently named color category divided by the total number of trials, was 0.73 on average across cones and departed consistently from random behavior. White was reported 50% of the time across L & M cones. In cases when a color other than white was reported, L-cones signaled red while M-cones signaled green in 90% of trials. Color responses depended significantly on the surrounding cone environment. For L-cones, the proportion of ‘red’ decreased and ‘white’ increased with increasing M+S cones in the surround. For M-cones, the proportion of ‘green’ decreased and ‘white’ increased with increasing L+S cones in the surround. Overall, sub-mosaics of same color responses, consisting of more than one cone, emerged. Conclusions: Color sensations elicited from individual cones were repeatable and showed a strong dependence on cone-type. White reporting cones were situated in a mixed cone-type neighborhood, while color (red/green) reporting cones were situated amidst their same cone-types. Overall, these findings were inconsistent with models of single cone-center opponent midget ganglion cells at the fovea. It rather suggests spatial pooling via cone coupling, correlations between neighboring ganglion cell outputs or convergence elsewhere in the visual pathway. Commercial Relationships: Ramkumar Sabesan, None; Brian Schmidt, None; William S. Tuten, None; Alexandra Boehm, None; Austin Roorda, University of Houston (P), University of Rochester (P) Support: NIH R01EY023591, Burroughs Wellcome Fund Career Award at the Scientific Interface, Fight for Sight Postdoctoral Award, NIH K23EY022412, American Optometric William C. Ezell Fellowship,NIH T32EY07031, NIH T32EY007043 Program Number: 4014 Presentation Time: 9:00 AM–9:15 AM Studying the neural circuitry of blue with single cone stimulation Brian Schmidt1, Ramkumar Sabesan2, William S. Tuten2, 3, Jay Neitz4, Austin Roorda2, 3. 1Graduate Program in Neuroscience, University of Washington, Seattle, WA; 2School of Optometry, University of California, Berkeley, CA; 3Vision Science Graduate Group, University of California, Berkeley, CA; 4Department of Ophthalmology, University of Washington, Seattle, WA. Purpose: More than a half-century of psychophysical experiments have indicated blue-yellow and red-green neural channels are responsible for color perception. Physiological recordings have identified single neurons early in the visual pathway with red-green and blue-yellow responses. However, the cone inputs necessary to produce color sensations as measured psychophysically do not align with the characteristics of opponent cells measured physiologically. To reconcile biology with perception, we measured color percepts elicited by stimulation of identified single cones in a human subject. Methods: An adaptive optics scanning laser ophthalmoscope was used with retinal densitometry to classify (as L, M or S) ~1000 cones in a subject. Using the same system, single cone stimulation (543 nm) was achieved following published methods [Harmening et al. 2014 J Neuroscience]. The subject was instructed to report the sensation elicited by each stimulus using an electronic tablet. Pilot work indicated that, under our experimental conditions, red, green, blue, yellow and white were sufficient color categories to adequately describe the percepts. Results: On a dim white background these single cone conditions did not elicit blue percepts. To encourage blue sensations, we adopted a background dominated by short wavelengths to preferentially hyperpolarize S-cones. Under these conditions, when the flash was detected, the percentage of percepts named blue was 22%, white 60% and red 18%. Stimulation of L-cones rarely resulted in blue percepts (9% of trials). M-cones were significantly more likely to result in blue responses (43% of trials). Finally, when M-cones were targeted, the probability of seeing blue decreased as distance to the nearest S-cone increased. Conclusions: These results provide direct evidence that blue percepts can be driven by stimulation of individual M-cones. The increased likelihood of blue responses with M-cone proximity to S-cones suggests this sensation arises when M-cones sum with S-cones in post-receptoral pathways. Small bistratified ganglion cells, assumed to be the retinal pathway responsible for blue color perception, however, difference S- and M-cone signals, exactly the opposite of the trend found here. Our results are consistent with the existence of alternative neural circuitry in the retina responsible for mediating blue sensations in which outputs of S + M cone signals are differenced from L-cones. Commercial Relationships: Brian Schmidt, None; Ramkumar Sabesan, None; William S. Tuten, None; Jay Neitz, None; Austin Roorda, University of Rochester, University of Houston (P) Support: NIH R01EY023591 to AR, American Optometric William C. Ezell Fellowship and NIH K23EY022412 to WT, Burroughs Wellcome Fund Career Award at the Scientific Interface & Fight for Sight Postdoctoral Award to RS, and Vision Research Training Grant T32EY07031 to BPS ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Program Number: 4015 Presentation Time: 9:15 AM–9:30 AM Six-year follow-up of individuals heterozygous for the T190I mutation in the S-cone-opsin gene (OPN1SW) Lene A. Hagen, Stuart J. Gilson, Rigmor C. Baraas. Department of Optometry and Visual Science, Faculty of Health Sciences, Buskerud and Vestfold University College, Kongsberg, Norway. Purpose: Heterozygotes for the T190I OPN1SW mutation have been reported to have a mild tritan deficiency associated with abnormal S-cone function (Baraas, Hagen et al. 2012). We carried out a followup study to investigate whether there was any deterioration of S-cone function six years after the initial examination. Methods: Females (aged 30–42 yrs) heterozygous for the T190I mutation in the S-cone-opsin gene (OPN1SW) with an associated tritan color-vision-deficiency and healthy color normal controls (aged 30–44 yrs) were included in this study. All participated in the initial study (Baraas, Hagen et al. 2012), and all had normal logMAR letter acuity and no observed ocular abnormalities. Color vision was examined with a battery of standard tests, including Moreland anomaloscopy and Cambridge Colour Test. Achromatic and isolated S-cone spatial acuity were measured in the dominant eye with a Sloan E letter at 90% achromatic contrast and at 23, 46, 69 and 90% S-cone contrast. The Sloan E was presented at 5 deg eccentricity, and fixation was verified by an eye-tracker. Observers were corrected to best logMAR letter acuity and viewed the stimuli monocularly from a distance of 2.3 m. Average luminance of the stimuli was 10 cd m-2. Results: Observers with the T190I mutation showed poorer performance along the tritan axis on standard color tests, whereas normal controls showed no change six years after the initial test. Achromatic acuity ranged from logMAR 0.26–0.44. S-cone spatial acuity increased with increasing cone contrast for all observers, but those with the T190I mutation could not perceive the S-cone stimuli at the lowest cone contrast. Their performance was more than 2 SD poorer than the controls at 46 and 69% and 1–2 SD poorer at 90% cone contrast. Conclusions: Tritan color vision deficiency caused by T190I OPN1SW mutation appears not to be stationary. The results from measurements of S-cone acuity at different levels of cone contrast confirm that the T190I mutation is consistent with a loss of function in a single dose. Commercial Relationships: Lene A. Hagen, None; Stuart J. Gilson, None; Rigmor C. Baraas, None Program Number: 4016 Presentation Time: 9:30 AM–9:45 AM Melanopsin-mediated light adaptation measured from human pupil flicker responses Dingcai Cao, Pablo A. Barrionuevo. Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL. Purpose: Intrinsically photosensitive retinal ganglion cells (ipRGCs) can be activated by intrinsic melanopsin phototransduction as well as by extrinsic inputs from rods and cones. Studying melanopsin-based functions is challenging in humans, due to the difficulty in isolating melanopsin activation from rod and cone inputs. Here we introduced a five-primary photostimulator that can control the excitations of rods, S-, M-, L-cones and melanopsin at a constant light level to allow for assessment of melanopsin-, rod- or cone-mediated light adaptation. Methods: The photostimulator included a bundle of five optic fibers to transmit the lights from the five bright LEDs through a homogenizer and diffuser to achieve a homogeneous field. The lights from 5 LEDs (dominant wavelengths of 456 nm, 488 nm, 540 nm, 592 nm, and 632 nm) were controlled by a laboratory-created board using Pulse Width Modulation dimming. Using a silent substitution method, the photostimulator could generate photoreceptorisolating stimuli that modulated the rod excitations alone (R), cone excitations alone (S-, M- or L), melanopsin excitation alone (I), or any combinations of the photoreceptor signals. We measured human pupil responses with the L, M, S, R, I, L+M, L+M+S, L+M+S+R, L+M+S+R+I modulations (16% contrast, 1 Hz, mean retinal illuminance of 2 Td-20000 Td in a one log unit step), using an EyeLink II Eyetracker (SR Research). For each condition, pupillary response amplitude and phase were derived from Fourier analysis. Results: For all modulation types, the pupil response amplitudes increased with increasing light levels, although the pupil responses were not measurable for the melanopsin modulation at 2 Td due to below melanopsin activation threshold, for the rod modulation at 2000 and 20000 Td due to saturation, and for the S- modulation at 2 and 20 Td due to low contrast sensitivity. The melanopsin-mediated pupil responses had similar phases to rods, L, M, L+M stimuli but was out of phase with the S-cone-mediated response. While the phases with the rod or cone-mediated responses were relatively stable over 2 Td -20000 Td, the phase of melanopsin-mediated responses increases with increasing light levels, suggesting speeding up of the melanopsin phototransduction. Conclusions: Melanopsin displays a unique light adaptation characteristic compared with rod- and cone-mediated light adaptation in pupil flicker responses. Commercial Relationships: Dingcai Cao, None; Pablo A. Barrionuevo, None Support: P30-EY01792 (UIC core grant for vision research) and Unrestricted Departmental Grant from the Research to Prevent Blindness Program Number: 4017 Presentation Time: 9:45 AM–10:00 AM Longitudinal Imaging of Foveal Cone Structure in Congenital Achromatopsia Christopher S. Langlo1, Frederick T. Collison2, Phyllis Summerfelt3, Carol White2, Alfredo Dubra3, 4, William W. Hauswirth5, Gerald A. Fishman2, 6, Joseph Carroll1, 3. 1Cell Biol, Neurobiol, Anatomy, Medical College of Wisconsin, Milwaukee, WI; 2The Pangere Center for Hereditary Retinal Diseases, The Chicago Lighthouse for People Who Are Blind or Visually Impaired, Chicago, IL; 3Ophthalmology, Medical College of Wisconsin, Milwaukee, WI; 4Biophysics, Medical College of Wisconsin, Milwaukee, WI; 5Ophthalmology, University of Florida, Gainesville, FL; 6Ophthalmology and Visual Sciences, The University of Illinois at Chicago, Chicago, IL. Purpose: Achromatopsia (ACHM) is a disorder associated with absent or severely limited function and variably-disrupted structure in cone photoreceptors. In order to monitor the efficacy of gene therapy efforts in this condition, it will be necessary to quantitatively monitor cone structure over time in individual retinas. Here we demonstrate the use of split-detection adaptive optics scanning light ophthalmoscopy (AOSLO) to longitudinally evaluate foveal cone structure in patients with ACHM. Methods: Seven subjects with genetically confirmed ACHM were recruited. Confocal and split-detector AOSLO and SD-OCT imaging were performed at baseline and 9-10 months later. Peak foveal cone density was determined by manually outlining the rod-free zone as seen on confocal imaging – a variably sized area between image sets – and marking cells in that region, then measuring 27x27μm areas centered on each pixel. Results: One subject had outer retinal atrophy in the fovea preventing foveal analysis. Another had a corneal abrasion at the ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics first examination that prevented imaging, though this resolved by the second visit, and in a third subject the foveal center was not captured with the split-detector method at the first visit. The remaining 4 subjects showed little variability of residual foveal cone structure between the baseline and follow up visit. The peak densities at baseline for these subjects were 19,204, 16,460, 8,230, and 21,948 cones/mm2 and 15,089, 19,204, 5,487, and 26,063 cones/ mm2 on follow-up respectively. The change in density between visits corresponded to an average difference of 2.5 cones in the search window. The OCT images showed no change in phenotype between visits based on previously published grading criteria (Sundaram V, et al. Ophthalmology 2014;121:234-245). Conclusions: Due to nystagmus this is a particularly challenging patient population in which to obtain reliable longitudinal measures of cone structure. Despite this, we have demonstrated that we can re-image the exact same photoreceptors over a 9-month follow-up period and that there does not appear to be substantial change in foveal cone structure. The ability to obtain repeated measurements of structure will allow sensitive monitoring of the biological response to treatment in these patients. Commercial Relationships: Christopher S. Langlo, AGTC (F); Frederick T. Collison, AGTC (F), AGTC (R); Phyllis Summerfelt, AGTC (F); Carol White, AGTC (F); Alfredo Dubra, AGTC (F), US Patent 8,226,236 (P); William W. Hauswirth, AGTC (C), AGTC (F), AGTC (P); Gerald A. Fishman, AGTC (F); Joseph Carroll, AGTC (F) Support: NIH Grants R24-EY022023, R01-EY017607, P30EY001931, T32-GM080202; Glaucoma Research Foundation Catalyst for a Cure, Research to Prevent Blindness Career Development Award, Pangere Family Foundation Clinical Trial: NCT01846052 disparity between test and basic objects – stereo-acuity are recorded and presented in tables and diagrams. Given the lack of stereovision it is induced and trained with special exercises. The movements “forward – backward” are trained and the references where a test object must be located may be provided. Significant role is played by two factors: sight shifting from the closer object to the more distant one and its coordination with hand movements. In trainings with the disparity of 6-15 arcminutes (6’-15’) the stereoscopic view corresponding the movement of hand and eyes is gradually accumulated and formed. Trainings increase the stereoacuity. By seeing his/her results and receiving references a trainee corrects the movements of his hand and eyes gradually increasing his/ her stereo-acuity. Results: More than 50 individuals passed the tests, 15 of those were instructed and received the stereovision training. Static stereo-acuity of 35 individuals was up to 2’ and dynamic stereo-acuity was about 4’-6’. They had no complaint of stereoacuity and those values may be considered as sufficient. Out of 15 individuals who had no stereovision only one of them failed to induce it by training in a few months. Tests may be used for the evaluation of acuity of stereovision and stereo-activity of individuals of different occupations, drivers and surgeons inclusive. Conclusions: Evaluation and training of characteristics of stereovision by using an integral model with feedback confirm its high integrity, precision and effectiveness. 423 Visual performance: Normal vision Wednesday, May 06, 2015 8:30 AM–10:15 AM Exhibit Hall Poster Session Program #/Board # Range: 4302–4316/D0236–D0250 Organizing Section: Visual Psychophysics / Physiological Optics Contributing Section(s): Eye Movements/Strabismus/Amblyopia/ Neuro-Ophthalmology, Low Vision Program Number: 4302 Poster Board Number: D0236 Presentation Time: 8:30 AM–10:15 AM Research and Training of Stereovision with Integral Feedback Mecislovas Vrubliauskas4, 1, Igor Rabichev3, 2. 1Aesthetic Dentistry Center Vivadens, Vilnius, Lithuania; 2Center of Investigation and Vision Correction ‘Perception’, Moscow, Russian Federation; 3The department of anatomy and physiology of humans and animals, Moscow State Pedagogical University, Moscow, Russian Federation; 4 VISUS-4D Center, Vilnius, Lithuania. Purpose: Sensorimotor models of visual perception are distinguished for their effectiveness in evaluation and training of stereovision, but they lack integrity, feedback and accuracy. This study researches an integral model and method of stereovision with a feedback which increase the accuracy and effectiveness of measurement, inducing and training of stereovision. Methods: Method and software may test, induce and train the stereovision for people with healthy and disordered binocular vision. It consists of a personal computer, optic system and VISUS4D software. Basic and test - static or dynamic stereo objects are projected on a monitor screen. A basic stereo object is operated by the software and a test object - manually by a tested individual. The scheme of the model is presented in the image. The results of Commercial Relationships: Mecislovas Vrubliauskas, None; Igor Rabichev, None Program Number: 4303 Poster Board Number: D0237 Presentation Time: 8:30 AM–10:15 AM Learning to read using peripheral vision through non-task-based training: prerequisites for learning and its transfer Deyue Yu. College of Optometry, Ohio State University, Columbus, OH. Purpose: Reading speed in peripheral vision can be improved through perceptual learning. Perceptual learning paradigms typically require practicing a demanding task hundreds of trials per day, which can be an impediment to compliance from patients. To minimize training effort, Yu (ARVO 2013) developed a non-taskbased training procedure utilizing stimulus exposure and identity priming. The goal of this study is to identify the factor(s) that determine the effectiveness of non-task-based learning in improving ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics peripheral reading speed. The findings will be of great importance for developing a useful form of low-vision reading rehabilitation. Methods: Twenty-eight normally-sighted young adults were randomly assigned to a no-training control group or one of four training groups that differed with respect to the inclusion of different design components. Pre- and post-tests consisted of measurements of visual-span sizes (number of letters recognized without moving the eyes) and reading speeds using the rapid serial visual presentation method at 10° above and below fixation. Training occurred at 10° below fixation. Three design components were visual exposure to crowded letter (target letter flanked by two other letters on the left and right), visual exposure to uncrowded letter (target letter alone), and identity priming (pre-knowing target letter identity). In five training sessions (1430 trials/session), group A viewed crowded letters, group B viewed crowded letters with identity priming, group C viewed uncrowded letters with identity priming, and group D viewed letters with identity priming under both crowded and uncrowded conditions. Results: Comparisons between different groups revealed an essential role of crowding in ensuring reading-related learning. Groups A, B and D showed significant improvement in visual-span size (gaining 1.2 to 1.4 letters; all p<0.0005). Only stimulus exposures that occurred simultaneously with identity priming enabled learning transfer to the untrained reading task (62% increase for group B and 78% for group D; all p<0.0005). Learning also transferred from the trained (lower) to the untrained (upper) visual field (all p<0.03). Conclusions: Non-task-based training can greatly reduce learning effort. Furthermore, including crowding and identity priming in the training paradigm is the prerequisite for effective learning in improving peripheral reading speed. Commercial Relationships: Deyue Yu, None Program Number: 4304 Poster Board Number: D0238 Presentation Time: 8:30 AM–10:15 AM New postural behaviors related to the use of digital devices involve new characteristics for occupational lenses Damien Paille, Jean-Luc Perrin, Amandine Debieuvre. Vision Science, ESSILOR, Paris, France. Purpose: Since the last decade, we see an explosion in the use of smartphones, tablets, e-book readers and hybrid devices which combine laptop and mobile functions. Those tools, also called “handheld or mobile devices”, can be use everywhere: standing up whilst commuting, sat in a couch, lying in bed... This study aims to investigate the impact of the use of new technology devices on postural behavior in everyday life. Methods: 22 subjects wearing their usual correction were recruited in the experiment. They wore a helmet with 4 reflective markers and were equipped with 4 additional markers (Left and right shoulder, torso and clavicle). Once fitted, they performed a scenario mixing 7 different tasks (weather forecast, writing an email, reading an email, video game, video, searching information, reading a text) on three digital devices (smartphone, tablet and ebook reader) in three different conditions (standing, sitting and lying). Postural data were recorded thanks to a VICON motion tracking system. Subjects were asked to act as they would do in real life during the experiment. For each task, several parameters such as distance between the eyes and the middle of the device, head declination, eye declination, head roll, head in trunk rotation and shift were then computed. Results: During all the tasks, the head stays perpendicular to the trunk (Mean Head in trunk rotation: 0.13±1.4°) with no roll (Mean Head roll: 2.87±1.23°). The middle of the device remains centered on the sagittal plane of the user (Mean head shift: 2.3±2.5°). Contrast analysis showed that eye declination was higher when standing compared to sitting and lying tasks (difference 6.68°, CI(95%) [4.87; 8.50], p<0.01). The distance of use was smaller with smartphones compared to tablets or ebook readers (difference 5.35cm, CI(95%) [3.92; 6.78], p<0.01). Results showed small reading distances with digital devices (smartphones: 33.79cm, tablets: 39.70cm, ebook readers: 38.05cm). Conclusions: The experiment showed that digital device users are adopting rigid postures in front of their devices. Moreover, the distance of use is smaller and eye declination higher with electronic devices compared with traditional paper media. Occupational lenses must thus take into account these new postural behaviors in order to answer all the wearer needs. Commercial Relationships: Damien Paille, ESSILOR (E); JeanLuc Perrin, ESSILOR (E); Amandine Debieuvre, ESSILOR (E) Program Number: 4305 Poster Board Number: D0239 Presentation Time: 8:30 AM–10:15 AM Exploring the role of biological motion in enhancing night-time pedestrian recognition: assessment of eye movements Joanne M. Wood1, Richard Tyrrell2, Alex A. Black1, Philippe F. Lacherez1. 1Queensland University of Technology, Brisbane, QLD, Australia; 2Clemson University, Clemson, SC. Purpose: To examine drivers’ eye movements as they approach pedestrians wearing retroreflective markers in a configuration that conveys biological motion (known as “biomotion”). Methods: Twenty visually normal participants (M=24.35 ± 6.42 years) drove an instrumented vehicle (incorporating a custom-built distance measurement system) around a 1.8 km closed-road circuit at night. Pedestrians wore black clothing and walked in place at two different locations along the course, and faced either towards or away from the roadway. Pedestrians wore two conspicuity treatments – either a standard retroreflective vest or a retroreflective vest with additional retroreflective tape positioned on the extremities in a configuration that conveyed biological motion (biomotion). Participants pressed a response pad when they first recognized that a pedestrian was present and again when they first detected the direction that the pedestrian was walking. Eye movements were recorded (ASL Mobile Eye) to characterize drivers’ fixation behaviours when viewing the pedestrians; the time to first gaze at the pedestrian and response time to first recognize the pedestrian were expressed as time relative to the moment when the pedestrian was first in the drivers’ field of view. Results: Eye movement patterns revealed that the biomotion configuration attracted drivers’ attention significantly sooner compared to the vest (time to first gaze: 1.1 vs 3.5 s). Drivers spent significantly less time fixating on the pedestrian wearing biomotion prior to recognition compared to the vest (3.4 s vs. 6.1 s). As a result the drivers’ response time to first recognize the pedestrian was approximately half that for biomotion compared to the vest (6.4 vs 13.9 s). Consistent with these findings, drivers recognized pedestrians at significantly longer distances when wearing biomotion compared to the vest (331.6 m vs. 185.2 m) and identified the direction of walking at longer distances (220.2 m vs. 87.7 m). Conclusions: At night the biomotion configuration facilitated earlier recognition of pedestrians and identification of their walking direction, thus enhancing drivers’ capacity to avoid pedestrians. Patterns of eye movements reveal the impact of pedestrian conspicuity on drivers’ attention and gaze behaviors at night-time. Commercial Relationships: Joanne M. Wood, None; Richard Tyrrell, None; Alex A. Black, None; Philippe F. Lacherez, None Support: ARC Linkage LP0990292 ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Program Number: 4306 Poster Board Number: D0240 Presentation Time: 8:30 AM–10:15 AM Visual performance and perception with bifocal and trifocal presbyopia corrections simulated using a hand-held simultaneous vision device Carlos Dorronsoro, Jose Ramon Alonso-Sanz, Daniel Pascual, Aiswaryah Radhakrishnan, Miriam Velasco-OCana, Pablo PerezMerino, Susana Marcos. Instituto de Optica, CSIC, Madrid, Spain. Purpose: To evaluate visual performance/perception in patients with simulated multifocal corrections, using a novel hand-held simultaneous vision simulator and clinically-suited visual tests. To identify the optimal multifocal correction in individual patients. Methods: 5 cyclopeged subjects were evaluated with a miniaturized see-thru simultaneous vision simulator. Multifocal corrections are simulated by a tunable lens (Optotune, AG) operating in temporal multiplexing, able to scan through a 3-diopters (D) addition focus range at 50 Hz, giving a static appearance of multifocal retinal images. Evaluation of the lens by HS-aberrometry and laser ray tracing focimetry reveal high linear response of optical power vs voltage (r=0.997), high optical quality (RMS<0.05 μm), and high reproducibility of thru-focus energy distribution. Seven lenses were simulated, with different energy distributions at far (F) intermediate (I; 1.5D add) and near (N; 3D add): 3 monofocal (100F, 100I & 100N), 2 bifocal (50F50N & 70F30N) and 2 trifocal (33F33I33N & 50F20I30N) patterns. With each lens, high contrast visual acuity (VA) was measured at F, I and N distances using randomized optotypes on a high definition display. Also, subjects scored the perceived quality of a real visual scene containing F, I and N targets, and compared visual quality (2AFC) through 60 random pairs of multifocal corrections. Results: Average logMAR VA at F ranged between -0.05 (100F) and 0.52 (100N) for monofocal, and between 0.17 (50F20I30N) and 0.43 (33F33I33N) for multifocal corrections (mean 0.25). VA ranges at N were 0.12 (100N) to 0.61 (100F) with monofocal, and 0.26 (50F50N) to 0.42 (70F30N) with multifocal corrections (mean 0.31). Highest multifocal VA at I (0.25) was found for 33F33I33N. On average across distances the highest VA and perceptual scores were found for 100I. Direct comparisons revealed a systematic preference of 50F50N over 70F30N and 50F20I30N over 33F33I33N. However, consistent intersubject differences occurred in VA and perception with the different multifocal corrections. Conclusions: Temporal multiplexing of a tunable lens provides new ways to simulate multifocal corrections, mimicking existing IOLs/CLs. All multifocal designs outperform monofocal corrections focused at far and near, but not at intermediate distance. Visual quality differed across multifocal designs and patients. Commercial Relationships: Carlos Dorronsoro, PCT/2014ES/070725 (P), PCT/ES2010/070218 (P); Jose Ramon Alonso-Sanz, PCT/2014ES/070725 (P), PCT/ES2010/070218 (P); Daniel Pascual, PCT/2014ES/070725 (P); Aiswaryah Radhakrishnan, None; Miriam Velasco-OCana, None; Pablo Perez-Merino, None; Susana Marcos, PCT/2014ES/070725 (P) Support: FIS2011-25637; ERC-2011-AdG-294099; EU Marie Curie FP7-PEOPLE-2010-ITN #26405 Program Number: 4307 Poster Board Number: D0241 Presentation Time: 8:30 AM–10:15 AM Exposure to green laser decreases driving performance Per G. Soderberg1, Stig Sandberg2, Ulf Hörberg2, Rolf Persson2, Folke Berglund2, Kjell Karlsson2, Johan Öhgren2, Zhaohua Yu1, Ove Steinwall Ove Steinwall2. 1Gullstrand lab, Ophthalmology, Dept. of Neuroscience, Uppsala university, Uppsala, Sweden; 2Laser Systems group, Swedish Defense Research Agency, Linköing, Sweden. Purpose: To determine the impact of 532 nm laser exposure on vision and thereby driving performance. Methods: Ten non-professional drivers aged [24;50] yrs drove a test track through gates of 4 plastic cones with randomly placed openings, allowing free passage. A 532 nm laser beam, 45 mrad divergence, was directed against the advancing test driver every second test drive. Irradiance increased from 2 Wm-2 at the entrance of the test track to 5 Wm-2 at the last gate (MPE = 10 Wm2). The spatial distribution and the irradiance of the beam was verified before and after each test drive. Driving speed was 25 kmhr-1 at the entrance gate and then at the drivers choice. For each driver, the background illuminance varied from daylight to darkness, [1000-0.01 lux]. Altogether, 32 test drives per driver were analyzed. The significance level was set to 0.05. Results: None of the subjects recruited had any ophthalmological disorder before or after test driving. A driver perceives less driving certainty with laser exposure than without as indicated by Wilcoxon’s paired sample test. An analyses of variance supported that laser exposure increases driving time and indicated an interaction between laser exposure and background illumination. A chi2 analysis indicated that laser exposure is associated with more wrong choices of gate and more hits of cones than driving without laser exposure. A descriptive analysis indicated more wrong choice of gate and more hit cones with less background luminance. Sun visor folded down when exposed to laser was advantageous on driving time, number of wrong gates chosen per driver, and accumulated number of cones hit as indicated by paired t-test and chi2 analysis. Conclusions: Exposure to 532 nm laser light while driving below 25 kmh-1 in dark conditions decreases perceived safe driving speed, causes wrong decision of road geometry, increases risk of mispositioning the vehicle, and decreases the subjective perception of controlled driving. Sun visor folded down during green laser exposure improves the driving performance and the perception of driving certainty. Commercial Relationships: Per G. Soderberg, None; Stig Sandberg, None; Ulf Hörberg, None; Rolf Persson, None; Folke Berglund, None; Kjell Karlsson, None; Johan Öhgren, None; Zhaohua Yu, None; Ove Steinwall Ove Steinwall, None Support: Swedish defense research agency (FOI), The Uppsala university/Uppsala Läns Landsting’s ALF Research grants, Synskadades vänner, Uppsala, Kronpricessan Margaretas Arbetsnämnd för synskadade Program Number: 4308 Poster Board Number: D0242 Presentation Time: 8:30 AM–10:15 AM The sensitivity of human infrared vision is age-dependent Katarzyna Komar1, Patrycjusz Stremplewski1, Agnieszka Zielinska1, Grazyna Palczewska2, Krzysztof Palczewski3, Maciej Wojtkowski1. 1 Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, Torun, Poland; 2Department of Medical Devices, Polgenix Inc, Cleveland, OH; 3Department of Pharmacology, Cleveland Center for Membrane and Structural Biology, School of Medicine,, Case Western Reserve University, Cleveland, OH. Purpose: Pulsed IR laser light is detectable by humans and causes sensation of color corresponding to roughly half of the stimulus wavelength. Some authors recently explained this phenomenon as resulting from two-photon isomerization of chromophore in human photoreceptors. Here we describe the effect of age on this phenomenon. Methods: A beam from a laser source emitting a 1040 nm train of 200-fs pulses was coupled into an optical fiber of 2 m or 1 km length ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics to obtain the different pulse lengths, 1 ps or 300 ps, respectively. After the fiber, the test set-up was arranged to create a linear scan on the fundus, perceived by the volunteer as a horizontal line (Fig. 1). To measure minimal power of the laser beam causing a visual sensation (sensitivity threshold), a neutral density filter (NDF) filter was adjusted by the subject during the test. Values measured by the power meter were saved in PC memory after the subject pressed a mouse button and measurements were repeated 10 times. The setup was isolated from residual ambient light by its dedicated housing, a subject’s head was covered by a black curtain attached to the housing. All individuals were dark adapted. The study was performed in 16 healthy volunteers of ages ranging from 24-84 years. All tests were conducted in compliance with ANSI Z136.1 and EN 60825−1. The study was approved by the Ethics Committee of the Collegium Medicum NCU. Examinations were carried out after written informed consent was obtained. Results: The results are presented in Fig. 2. Volunteers were divided into two groups differing in age. Mean threshold power values for short pulses of the two groups were: 52±8 uW for subjects of age <50 and 169±33 uW for the more elderly. For long pulses, means for both groups were: 184±44 uW and 300±280 uW, respectively. The one-way ANOVA test performed in the two groups with significance level ≤0.05 showed that the mean values were significantly different for short pulses but not for long ones. Conclusions: This study indicated that the sensitivity threshold for human IR vision is age-dependent for short pulses. The two-photon absorption process is stronger for short pulses causing a statistically significant correlation with age. 1. Optical set-up for sensitivity measurements. 2. Sensitivity thresholds for a 1040 nm beam with different pulse lengths. Grey bars show mean values calculated for two subgroups of volunteers: <50 years old (black symbols) and >50 years old (red symbols). Commercial Relationships: Katarzyna Komar, None; Patrycjusz Stremplewski, None; Agnieszka Zielinska, None; Grazyna Palczewska, Polgenix Inc (E); Krzysztof Palczewski, Polgenix Inc (E), US patent 7,706,863 (P), US patent 8,346,345 (P); Maciej Wojtkowski, None Support: This work was supported by TEAM project of Foundation of Polish Science and by NIH R44 AG043645. Program Number: 4309 Poster Board Number: D0243 Presentation Time: 8:30 AM–10:15 AM Evaluation of three distinct parameters for visual fatigue assessment Nisha Singh. R&D, Essilor, Singapore, Singapore. Purpose: Various studies have measured accommodative microfluctuations (AM) and Critical Flicker Fusion Frequency (CFFF) for visual fatigue assessment. Also, several products are available these days claiming relief from eyestrain mostly either by relaxing accommodation or enhancing contrast. Apart from AM, either CFFF or contrast measurements are not well established for visual fatigue assessment. Therefore, this study aims to measure three distinct parameters: AM, Contrast Sensitivity (CS) and CFFF in one study; to compare their efficacy for the assessment of visual fatigue. Methods: 30 non-symptomatic & non-presbyopic emmetropes (age 19-42 years) performed 30 min of visual search task displayed on a LCD monitor placed 40 cm away from the eye. During the task, fixation target was displayed for 1 min at the beginning and end of the task. AM were analyzed from refraction recorded using PowerRef II during fixations that is, before and after task. CS using Functional Acuity Contrast Test (FACT) and CFFF with a Visual fatigue detector (developed by a local company in China) was also measured before and after the task. To obtain AM, Low frequency component (LFC) <1Hz and High frequency component (HFC) 1.0Hz–2.5Hz were acquired using FFT. In addition, subjective measurement of visual fatigue was done using a questionnaire before and after the task. Results: Subjective measurement of visual fatigue showed significant increase after task (Wilcoxon signed rank test; p<0.05). Before and after measurements were compared using paired t-test. Only LFC of AM increased significantly (p<0.05) while CS (p >0.05 for all measured spatial frequencies), CFFF (p =0.53) did not change after the task. Conclusions: Out of 3 parameters measured, only AM changed significantly after performing 30 minutes of visually taxing task which is in coherence with subjective measurement. Thus, reinforces that AM is an effective indicator for visual fatigue assessment. As induced visual fatigue could cause changes in the microfluctuations of accommodation of non-symptomatic people implies that symptomatic visual fatigue people would probably have exhausted & fragile accommodative system and needs to be taken care of in the management of visual fatigue. Commercial Relationships: Nisha Singh, ESSILOR (E), ESSILOR (F), ESSILOR (P) Program Number: 4310 Poster Board Number: D0244 Presentation Time: 8:30 AM–10:15 AM Comparison of Psychophysical and Electrophysiological Acuity Measurements in Non-Human Primates (NHPs). William H. Ridder1, Kai-Ming Zhang2, James A. Burke2. 1Marshall B. Ketchum University, Fullerton, CA; 2Allergan, Inc, Irvine, CA. Purpose: Non-human primates are frequently investigated to understand human diseases of the visual system. A common clinical measurement for many visual diseases is visual acuity. Visual acuity can be measured by employing psychophysical (e.g., the contrast sensitivity function) or electrophysiological (e.g. the sweep visual evoked potential (sVEP)) techniques in NHPs. The purpose of this investigation was to determine the relationship between acuities determined with psychophysical and electrophysiological techniques in the same NHPs. ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Methods: Four normal, adult NHPs took part in this project. The PowerDiva was used to measure the sVEP on three separate occasions. The NHPs were anesthetized and paralyzed for the measurements (10 mg/kg ketamine and 0.45 mg/kg zemuron). The active electrode (i.e., a stainless steel needle) was placed over the lunate sulcus of each hemisphere. Ten spatial frequencies from 3 to 30 cpd were presented at 80% contrast. The stimulus was focused on the retina with a fundus camera stimulator. A minimum of 10 sweeps (minimum S/N 3.0) were averaged for an acuity estimate. The psychophysical estimate of acuity was determined from the contrast sensitivity function (measured three times on different days). The monkeys were trained to release a lever when they detected a sine wave grating on a monitor. Threshold was determined with a descending method of limits. The contrast sensitivity functions were fit with a double exponential function and the acuity was taken at the 80% contrast level. Results: The average sVEP acuity was 18.6 ± 0.045 cpd and the average acuity estimated from the contrast sensitivity function was 27.5 ± 7.86 cpd for the four NHPs. A paired t-test indicated that the two test results were not significantly different (p = 0.109). Conclusions: Even though the visual acuity is higher with the psychophysical technique, there is no statistically significant difference between the two measurements. Both results produced repeatable data for a given NHP. Similar results are seen in human subjects. Commercial Relationships: William H. Ridder, None; Kai-Ming Zhang, None; James A. Burke, None Program Number: 4311 Poster Board Number: D0245 Presentation Time: 8:30 AM–10:15 AM Spatial vision in the mesopic range: the effect of illumination spectra Hanna Gillespie-Gallery, Gary Bargary, Wei Bi, John L. Barbur. City University London, London, United Kingdom. Purpose: The variation in the spatial resolving power of the cone and rod systems with the level of illumination is well established. In the mesopic range, when both cones and rods are active and operating at the limit of their range, the situation is more complex. Recently, the ability to fine-tune the spectral power distribution of LED lighting installations has led to the potential for optimisations of illumination spectra. These optimisations are limited by our current understanding of how cones and rods contribute to functional vision in the mesopic range. This study assessed visual acuity (VA) over some 4.7 log units change in illumination with emphasis on the mesopic range. A fourprimary LED system was used to provide controlled rod and cone stimulation. Methods: VA thresholds were estimated on an eink reflective display by a staircase procedure. The participants’ task was to indicate the orientation of a Landolt C by button press. The illumination was set to five different photopic luminances (0.001, 0.01, 0.1, 1 & 50 cd/m2). At each light level six different scotopic luminances were investigated; scotopic/photopic (S/P) luminance ratios varied from 0.5-5.5. Measurements were carried out at the fovea and 12 degrees in the periphery. Pupil diameter was recorded throughout and used to calculate retinal illuminance. To ensure adequate fixation eye position was measured and trials were repeated if fixation deviated more than ±1.5 degrees. Results: The fovea was only affected significantly by variation in S/P luminance ratios at the lowest light level when VA thresholds were high and led to part of the stimuli lying outside the rod free zone of the retina. In the periphery S/P ratios significantly improved vision at light levels below 1 cd/m2. In the mid-mesopic range (0.1 and 0.01 cd/m2) VA was improved with increasing S/P ratio, whereas at the lowest light level VA thresholds only improved only up to an S/P ratio of 2.5. The change in pupil diameter with variations in illuminants S/P ratio was small. Based on these findings we explore the possibility that rod-cone interactions play a role in the improvement of VA in the mid- to high-mesopic range. Conclusions: In the mesopic range, VA in the periphery can be improved by increasing the S/P ratio of the illuminant. When vision is dominated by rod signals, VA improves significantly with increasing S/P ratio. Commercial Relationships: Hanna Gillespie-Gallery, None; Gary Bargary, None; Wei Bi, None; John L. Barbur, None Support: Engineering and Physical Sciences Research Council Program Number: 4312 Poster Board Number: D0246 Presentation Time: 8:30 AM–10:15 AM The benefits of a Red Background when measuring Dark Adaptation Elena Rodrigo Diaz de Cerio, Jeremiah M. Kelly, David Carden, Ian J. Murray. Faculty of Life Sciences, University of Manchester, Manchester, United Kingdom. Purpose: Dark Adaptation (DA) is now accepted as important for the study of retinal health. The slope of the rod-mediated sensitivity recovery function, called S2, is particularly affected in aging and several diseases such as early age-related macular degeneration (AMD). DA has not been extensively studied in clinics because of the prolonged testing time and patient discomfort. Introducing a red background, which is blind to the rods, should theoretically reduce testing time and also be more acceptable compared with a black background. Here we test this idea in a novel digital set up, designed for application in a clinical setting. Methods: A custom setup was used to measure DA curves in 11 subjects (mean age 32.5, sd 10.13 years). The test was performed four times under four experimental conditions using zero and three different red backgrounds (0.05, 0.10 and 0.20 cd.m-2 photopic) (λ max=655 nm). Following a localized bleach, (min 30%), a method of adjustment technique was used to respond to a flickering (4Hz) green stimulus (λ max= 530 nm) at 80 on the temporal retina. Results: Results: The time to rod cone break, sometimes called the alpha point, was significantly shortened when the red background was used. The mean alpha time decreased from 4.9 min, for the black background to 4.0 min for the highest intensity red background (p <0.001). Crucially the mean slope of the rod recovery, S2, (-0.29 (0.08) log10 (cd.m-2). min-1) was independent of background intensity (p= 0.39) and matched values in the literature. Cone threshold rose systematically as the red background increased (p<0.0001). Conclusions: Conclusions: The addition of a cone-suppressing background allows significantly quicker measurement of S2 compared with no background and is also more acceptable to patients. Our technique has the potential to be useful for clinical measurements of rod function in older and diseased eyes, particularly in AMD where early diagnosis is important. Commercial Relationships: Elena Rodrigo Diaz de Cerio, None; Jeremiah M. Kelly, None; David Carden, None; Ian J. Murray, None Support: NERC Charity / scholarship Ref: 13194 ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Program Number: 4313 Poster Board Number: D0247 Presentation Time: 8:30 AM–10:15 AM Automated Photosensitivity Assessment in Achromatopsic and Healthy Subjects Mariela C. Aguilar1, Alex Gonzalez1, Cornelis J. Rowaan1, Potyra R. Rosa2, Karam Alawa1, Byron L. Lam2, Jean-Marie A. Parel1, 3 1 . Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL; 2 Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL; 3Brien Holden Vision Institute, UNSW, Sydney, NSW, Australia. Purpose: To assess and compare the photosensitivity discomfort threshold in Achromatopsic and healthy subjects using the 2nd Generation BPEI Photosensitivity Tester. Methods: The 1st Generation instrument (Aguilar MC et al, IOVS. 2014; 55: E-Abstract 4108 and Alawa K, IOVS. 2014; 55: E-Abstract 4109) was modified to comprise a bi-cupola concave light array panel with 210 white LED’s that are either manually controlled with a knob or computer controlled. The light intensity ranges from 1-32,000 lux at 50 cm. The instrument has two testing modes; one for subjects with normal light tolerance, the other has an enhanced mode for subjects having low light tolerance. The audio prerecorded testing instructions can be provided in four languages (English, Spanish, French, and Portuguese). The automated instrument varies the intensity of the light stimuli and the subject is instructed in their preferred language to indicate if it is uncomfortable by pressing a hand-held button. The testing is complete after 10 response reversals, from which a predicted photosensitivity threshold is calculated. Thus far, seven Achromatopsic subjects (5 females and 2 males, age = 14.3±6.0) and eleven healthy subjects (5 females and 6 males, age = 31.9±8.5) were tested under an IRB approved protocol. Prior to testing, the subjects rested during a 5 min. adaptation period in the examination room illuminated with 4 lux. Ambient conditions are monitored utilizing: humidity, temperature, and lux meters. Results: Seven Achromatopsic subjects were found to have a mean predicted photosensitivity threshold of 0.75±0.66 log(lux). Eleven healthy subjects were found to have a mean predicted photosensitivity threshold of 3.32±0.66 log(lux). A one-way analysis of variance was performed and there is a statistically significant difference (p<0.0001) in the threshold of photosensitivity experienced between the Achromatopsic and healthy subject groups. Conclusions: The autonomous 2nd Generation BPEI Photosensitivity Tester can assess a wide range of photosensitivity thresholds by detecting, quantifying, and recording the individual differences in sensory capabilities. Ongoing studies are being conducted in order to better understand the wide range of photosensitivity thresholds. None; Karam Alawa, None; Byron L. Lam, None; Jean-Marie A. Parel, None Support: NEI Grant R24 EY022023, DOD Grant DAMDW81XWH-09-1-0675, Florida Lions Eye Bank, Drs. KR Olsen and ME Hildebrandt, NIH Center Grant P30EY14801, Research to Prevent Blindness, Henri and Flore Lesieur Foundation (JMP). Program Number: 4314 Poster Board Number: D0248 Presentation Time: 8:30 AM–10:15 AM Halo size and subjective complaints of dysphotopsia in a normal population Maana Aujla, James S. Wolffsohn, Amy L. Sheppard. School of Life and Health Sciences, Aston University, Birmingham, United Kingdom. Purpose: Dysphotopsia is common with multifocal intraocular lenses (MIOLs), with complaints from as many as 45% of those implanted. Some find it severely problematic in day-to-day tasks, such as night driving. Several objective and subjective techniques are available to investigate dysphotopsia, but the relationship between objective and subjective measures is unclear and it is difficult to predict preoperatively those who might be worst affected subjectively. The aim of this prospective study was to investigate the relationship between objective measures and subjective complaints of dysphotopsia. The normal range of subjective/objective grade (the glare effect ratio) will be determined. Methods: Measurements were taken both binocularly and monocularly from 100 healthy participants (mean age: 22 ± 3.21 years; range 18 to 33 years). A bespoke halometer device with glare source was used to quantify the extent of the glare area in 8 meridians. The commercially available C-Quant objectively assessed the amount of straylight falling on the retina using the compensation comparison method. Subjective grading of glare was performed using simulated images from the Photographic Images of Photic Phenomena plates. Results: Monocular glare areas (median: 4.25 cm2; range 1.97 to 19.61 cm2) were significantly larger than the binocular glare areas (median: 3.24 cm2; range 1.64 to 8.26 cm2) with the halometer (P < 0.001). There was no relationship between halometer glare area and subjective complaints (rs = -0.048, rs2 = 0.002, P = 0.635); C-Quant and subjective complaints (rs = 0.109, rs2 = 0.012, P = 0.279); halometer and C-Quant (rs = 0.121, rs2 = 0.015, P = 0.231). The normal ranges for the glare effect ratio were 0 - 2.47 (median: 0.87) for halometry, and 0 - 9.41 (median: 3.23) for C-Quant. Conclusions: Binocular summation was evident with binocular halos being smaller than monocular halos, suggesting halometry should be performed binocularly. The lack of relationship between subjective and objective measures highlights the difficulty of predicting the potential subjective complaints a patient may experience from an objective measure alone. The normal range of the glare effect ratio could be used for comparison purposes pre- and post- refractive surgery; individuals with the highest ratios may be less suitable for refractive surgery procedures that may induce glare. Commercial Relationships: Maana Aujla, None; James S. Wolffsohn, None; Amy L. Sheppard, None Figure. 2nd Generation BPEI Photosensitivity Tester Commercial Relationships: Mariela C. Aguilar, None; Alex Gonzalez, None; Cornelis J. Rowaan, None; Potyra R. Rosa, ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Program Number: 4315 Poster Board Number: D0249 Presentation Time: 8:30 AM–10:15 AM Development of Mapping Methods with Simulated Phosphenes for Implementation in Intracortical Visual Prosthesis Recipients Gayatri P. Kaskhedikar1, Lindsey Yang2, Thomas Boucher3, Philip Troyk1, Gislin Dagnelie2. 1Biomedical Engineering, Illinois Institute of Technology, Chicago, IL; 2Ophthalmology, Johns Hopkins University, Baltimore, MD; 3Johns Hopkins University, Baltimore, MD. Purpose: Cortical visual prostheses evoke phosphenes spatially scattered throughout the visual field in a complex pattern unlike the geometric distribution of the implanted electrode array. Determining consistent and reliable phosphene maps in the prosthesis recipients to effectively convey visual information is crucial. We have devised phosphene mapping methods with simulated phosphenes in sighted individuals based on both absolute estimation of single phosphene locations and relative positions of phosphene pairs. Methods: Three mapping methods were tested in 3 normally sighted individuals. Thirty-two simulated phosphenes or dots were presented in the right hemifield one by one on a display screen while central fixation was monitored by an infrared pupil tracker. The subject’s perceived location was recorded on a touchscreen. The subjects’ head position was stabilized and calibration of the pupil tracking and touchscreen systems was conducted. In the first absolute mapping method, dots were sequentially presented and the subject indicated the perceived position on the touchscreen while maintaining central fixation. In the second absolute method, an eye movement made to the remembered eccentric dot location was recorded. Maps from these two tests were super-positioned by two-dimensional translation and scaling. As a relative method to locate and reduce angular distortions, 20 pairs of dots were selected. Each pair was sequentially presented, and the subject traced the relative direction of the two dots on the touchscreen. Three trials were conducted for each test. Results: The radial distortion from the touchscreen tests in S1 (1.37±0.54) and S2 (1.74±1.12) was higher than those from the eye movement tests (1.17±0.45 and 1.62±0. 70, resp.). In both tests, distortions were lower with higher eccentricity. Angular distortions were substantial, with SD up to 25°. Combining the results from the dot-pair test reduced both radial (1.15±0.27) and angular (0.016°±7.0°) distortions in S1. In S2 and S3 only the angular distortion was relatively reduced while reduction of radial distortions was inconsistent. Conclusions: The results from these preliminary tests indicate that the combination of the mapping methods can provide phosphene maps with greater accuracy. The optimal integration of information from all 3 tests to obtain reliable phosphene maps is being examined. Program Number: 4316 Poster Board Number: D0250 Presentation Time: 8:30 AM–10:15 AM Enhancing the efficiency of non-image-forming visual stimulation in humans Garen Vartanian1, Kwoon Y. Wong2. 1Macromolecular Science & Engineering, University of Michigan, Ann Arbor, MI; 2 Ophthalmology & Visual Sciences, University of MIchigan, Ann Arbor, MI. Purpose: Melanopsin-expressing retinal ganglion cells mediate various non-image-forming (NIF) visual functions such as the pupillary light reflex (PLR), circadian entrainment, and suppression of pineal melatonin release. Inadequate daytime NIF photostimulation can cause depression, sleep disorders and cognitive impairment, which can be treated with phototherapy. In an attempt to increase the efficacy of phototherapy, significant work has been done to identify wavelengths optimal for NIF vision. Here, we seek to enhance NIF visual stimulation using flickering light instead of steady light. Methods: Five subjects were studied. An infrared pupillometer was used to present 463 nm light to the right eye and image the consensual PLR from the left eye. Each subject was tested with a three-dimensional matrix of 63 flickering stimuli: 3 total photon counts (13.8, 14.8 and 15.8 log photons cm-2), 3 duty cycles (12%, 47% and 93%) and 7 flicker frequencies (0.1, 0.25, 0.5, 1, 2, 4 and 7 Hz). Each stimulus was presented for 4 min and steady-state pupil constriction measured during the final min. For comparison, steady lights with equivalent intensities or total photons were also tested. Results: Among stimuli delivering a total of 13.8 log photons cm-2, the one flickering at 2 Hz with a 12% duty cycle evoked the greatest PLR, constricting the pupil by 48%. This constriction was ~70% greater than that evoked by an equal-intensity (12.4 log photons cm-2 s-1) light presented continuously for 4 min. For stimuli containing 14.8 log photons cm-2, the most potent was again the 2 Hz light with a 12% duty cycle, inducing a 58% constriction. This was ~40% more than that caused by a 4-min continuous light of an equal intensity (13.4 log photons cm-2 s-1). For 15.8 log photons cm-2 stimuli, the 1Hz light with a 47% duty cycle was the best although the constriction was the same as that evoked by the best 14.8 log photons cm-2 light. While this constriction was ~20% greater than that caused by a 4-min continuous light totaling 15.8 log photons cm-2, it was statistically indistinguishable from that evoked by a continuous light of an equal intensity (13.8 log photons cm-2 s-1). Conclusions: This is the first demonstration that the magnitude of the PLR is affected by the duty cycle of the light. Under our recording conditions, a 13.4 log photons cm-2 s-1 stimulus flickering at 2 Hz with a 12% duty cycle stimulates the NIF visual system most efficiently. Commercial Relationships: Garen Vartanian, None; Kwoon Y. Wong, None Support: NIH Grants EY013934 and EY007003 Phosphene Map of S1 Commercial Relationships: Gayatri P. Kaskhedikar, I (); Lindsey Yang, None; Thomas Boucher, None; Philip Troyk, None; Gislin Dagnelie, None Support: TATRC W81XWH-12-1-0394, R01 EY021220 ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics 436 Vision during childhood development Wednesday, May 06, 2015 11:00 AM–12:45 PM 702/704/706 Paper Session Program #/Board # Range: 4392–4397 Organizing Section: Visual Psychophysics / Physiological Optics Program Number: 4392 Presentation Time: 11:00 AM–11:15 AM Contrast threshold of the preterm infant Angela M. Brown1, Delwin T. Lindsey2, 1, Edward Kopidlansky3, Michael R. Stenger4. 1College of Optometry, Ohio State University, Columbus, OH; 2Department of Psychology, Ohio State University, Mansfield, OH; 3Precision Vision, Inc., La Salle, IL; 4Department of Pediatrics, Ohio State University College of Medicine, Columbus, OH. Purpose: Preterm infants are at risk for many blinding disorders, but there is no body of normative data available to support the development of methods of testing their visual function. Particularly, it is not known whether the contrast sensitivity of preterm infants is good enough to allow visual acuity to be measured using printed gratings of ~0.9 contrast. For example, if median preterm infant contrast sensitivity were 0.9, acuity measurement would be impossible for half the infants, and it would probably be difficult for the remainder. Here, we measured the contrast sensitivity of preterm infants in the Neonatal Intensive Care Unit (NICU) to determine whether their contrast sensitivity is high enough in the neonatal period to support visual acuity measurement. Methods: Healthy, awake, preterm infants (born 33.5 SD=1.4 wks gestational age, tested at 34–38 wks corrected gestational age, avg=36 wks SD=1 wk; N=11) were tested in the NICU just before or after feeding. Stimuli were 31x61 cm gray cards with 3-cycle, 0.05 cy/deg vertical square-wave gratings in the center. The tester placed each card along the infant’s line of sight, then moved it laterally, observing the presence or absence of fixation-and-following behavior. The stimulus was “seen” if the infant attempted to refixate the grating. After presentation of a 0.96-contrast “easy” stimulus, testing at contrasts 0.50, 0.71, and 0.96 was under the method of constant stimuli (MCS), with the tester unaware of the contrast values or their order during presentation. The tester made a yes-no decision on each card, and infant contrast threshold was the lowest contrast judged to be “seen”. Results: The main challenge in testing preterm infants is finding them awake for long enough to test them, and all the infants in this study were alert and awake. All of them saw at least the first “easy” stimulus, and all but one saw at least the 0.96 contrast stimulus during MCS testing. The average contrast threshold was 0.705 (SEM = 0.055), and 8/11 (72%) of the infants had contrast thresholds at or better than 0.71. When we combined the present results with previous data on full-term infants, neonatal contrast threshold improved with age (r=-0.414, p<0.005) at an overall rate of 0.042 contrast improvement per week. Conclusions: The contrast sensitivity of most preterm infants can be measured starting by age 34 weeks. The contrast thresholds of many infants were good enough to allow visual acuity measurement. Commercial Relationships: Angela M. Brown, Precision Vision (F); Delwin T. Lindsey, None; Edward Kopidlansky, Precision Vision (E); Michael R. Stenger, None Support: R41EY022545, UL1TR001070 Program Number: 4393 Presentation Time: 11:15 AM–11:30 AM Global Motion Perception is Independent of Contrast Sensitivity and Visual Acuity in 4.5-year-old Children Arijit Chakraborty1, Nicola Anstice1, Robert J. Jacobs1, Jane E. Harding2, Trecia A. Wouldes3, Benjamin Thompson1, 4. 1Optometry & Vision Science, University of Auckland, Auckland, New Zealand; 2 Liggins Institute, University of Auckland, Auckland, New Zealand; 3 Psychological Medicine, University of Auckland, Auckland, New Zealand; 4Optometry & Vision Science, University of Waterloo, Waterloo, ON, Canada. Purpose: Global motion perception is a function of area V5 within the dorsal visual stream and may be a biomarker for abnormal visual cortex development. The use of global motion perception to assess dorsal stream function assumes this ability is relatively independent of functions related to V1 such as contrast sensitivity and visual acuity. In this prospective, observational study we tested this assumption by assessing the relationships among global motion perception, contrast detection thresholds for the global motion stimulus and visual acuity in a cohort of children with perinatal risk factors. Methods: One hundred and seventeen 4.5-year-old children who were enrolled in the CHYLD (Children with Hypoglycemia and Later Development) or IDEAL (Infant, Development, Environment and Lifestyle) studies participated. All children were born with at least one of the following risk factors: small for gestational age, large for gestational age, babies of diabetic mothers, or prenatal drug exposure. Motion coherence thresholds (MCT), a measure of global motion perception, were measured using random-dot-kinematograms (100 dots, speed 6 deg/sec). The contrast of the stimuli was fixed at 100% and coherence was varied using a 2-down-1-up staircase. Contrast detection thresholds (CDT) were measured for the same stimuli, whereby motion coherence was fixed at 100% and dot contrast was varied. Visual acuity (crowded Lea symbols / Keeler LogMAR test) and stereopsis (stereo fly test) were also measured. Results: MCT and CDT were not significantly correlated (rho=0.04, p=0.5). Children with both the best and poorest MCTs (threshold values in the first and fourth quartiles, respectively) had similar CDTs (p = 0.8). MCT was also not correlated with visual acuity (rho=0.005, p=0.9). However, MCT was moderately but significantly correlated with stereoacuity (rho=0.36, p<0.001). A weak but statistically significant correlation between CDT and visual acuity (rho=0.26, p=0.004) was observed, suggesting a partial relationship between these two measures of spatial vision. Conclusions: Global motion perception for high contrast stimuli appears to be independent of contrast detection thresholds and visual acuity in children born with developmental risk factors. This suggests that global motion perception can be used to assess the function of dorsal extra striate visual areas. Commercial Relationships: Arijit Chakraborty, None; Nicola Anstice, None; Robert J. Jacobs, None; Jane E. Harding, None; Trecia A. Wouldes, None; Benjamin Thompson, None Support: CHYLD - NIH Grant 1R01HD06922-01; IDEAL National Institute on Drug Abuse Grant R01DA021757 and Auckland Medical Research Foundation ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Program Number: 4394 Presentation Time: 11:30 AM–11:45 AM Relationship between monocular grating acuity at 12-months and recognition acuity at 4.5-years in the Infant Aphakia Treatment Study E Eugenie Hartmann1, Lindreth DuBois2, Michael Lynn2, Scott R. Lambert2. 1Department of Vision Sciences, Univ of Alabama at Birmingham, Birmingham, AL; 2Emory University, Atlanta, GA. Purpose: To determine the relationship between grating acuity measured at 12-months and recognition acuity at 4.5-years of age in the treated eyes of infants enrolled in the Infant Aphakia Treatment Study (IATS). Methods: IATS is a multi-center, randomized clinical trial sponsored by NEI to compare contact lenses (CL) and intraocular lenses (IOL) for initial correction of unilateral aphakia in patients with an infantile cataract whose surgery was performed from 1 to <7 months of age. Patients were enrolled in IATS at 12 sites (2004-2009;n=57 per treatment). Grating acuity was tested at 12 months of age (Teller Acuity Cards) and recognition acuity at 4.5 years of age (ATS-HOTV protocol) by a traveling tester masked to the treatment groups. Visual acuity (VA) was obtained on all 114 patients at 12-months and 112 patients at 4.5-years. The relationship between VA at the two ages in the treated eye was evaluated using the Spearman rank correlation coefficient. Results: There was no significant difference in logMAR VA at either age between the two treatment groups. A comparison of logMAR VA at the two ages for all patients is shown in the scatter plot. Correlation was 0.47 (p<0.001). This plot shows that almost equal numbers of patients demonstrated improved versus worsened VA. When the data are categorized relative to norms for grating VA and specific ranges of recognition VA, it is apparent that infants whose grating VA was >20/150 (lower 95th% predictive limit of normal) were more likely to have >20/200 recognition VA. More infants whose grating acuity was <20/150 at age 12 months were able to maintain a reasonable level of acuity, with only 32% of these patients having VA of >20/200 at age 4.5 years. Conclusions: Our results suggest that grating VA at 12 months can provide some indication of long-term recognition VA. While there is not a strict predictive relationship between the two measures, as expected, infants whose VA was within the 95% predictive limits for normal at 12 months were more likely to demonstrate recognition VA up to 20/80 in the treated eye compared with infants whose grating acuity was below this level (48% vs 26%). Thus, a grating VA within normal limits at 12 months is reason for cautious optimism. On the contrary, a grating VA below normal limits cannot be conclusively interpreted as an eye that will ultimately be considered legally blind. Commercial Relationships: E Eugenie Hartmann, None; Lindreth DuBois, None; Michael Lynn, None; Scott R. Lambert, None Support: National Institutes of Health Grants U10 EY13272 and U10 EY013287 and in part by NIH Departmental Core Grant EY06360 and Research to Prevent Blindness, Inc New York, New York Clinical Trial: NCT00212134 Program Number: 4395 Presentation Time: 11:45 AM–12:00 PM Developmental changes in chromatic discrimination at 5-14 years Caterina Ripamonti2, 1, Sarah Kalwarowsky1, Marko Nardini3, 1. 1 Institute of Ophthalmology, University College London, London, United Kingdom; 2Cambridge Research Systems Ltd, Rochester, United Kingdom; 3Department of Psychology, Durham University, Durham, United Kingdom. Purpose: Previous studies have shown that chromatic discrimination thresholds across the life span are characterised by a dipper function that has its minimum at 20-30 years; after this age thresholds tend to rise due to age-related ocular and neuronal changes. However, it is unclear why thresholds should be elevated in the paediatric age range. In this study we tested psychophysically if the elevated discrimination thresholds of a paediatric population reflect a real anatomical and/or functional visual development; or if they are biased by the difficulty in performing the discrimination task, and the attentional resources required to execute the test. Methods: We compared paediatric performance at two chromatic discrimination tests: the Universal Colour Discrimination Test (UCDT), and the Fansworth-Munsell 100 Hue Test (FM100HT). The UCDT used a simple 2-alternative-forced-choice task to measure the minimum saturation required to discriminate the chromatic target from its achromatic background. Saturation thresholds were measured along the protan, deutan, and tritan confusion lines. Each threshold took about 2 minutes and was repeated twice for a measure of reliability. The FM100HT required the observer to sort a large number of caps according to their hue, and on average it took about 20 minutes to complete the test. The two tests were run on the same day and in random order. We tested a population of 56 paediatric observers: 18 aged 5-6 years, 20 aged 9-10 years and 18 aged 13-14 years; all had normal colour vision, as assessed by either the Ishihara or the HRR plates. Our control group consisted of 25 adult observers aged 20-40 years; all had normal colour vision. Results: Expectedly, we found that the mean total error scores measured with the FM100HT dramatically varied with age (Figure 1). Surprisingly, chromatic discrimination thresholds measured with the UCDT were approximately constant across age for all confusion axes. In fact, apart from a few outliers, all paediatric observers showed chromatic discrimination thresholds that fell within the normal trichromatic range (see, for example, tritan thresholds in Figure 2). Conclusions: We found that chromatic discrimination in our paediatric population can be as good as chromatic discrimination in young adults, when assessed with a sensitive and fast colour discrimination test based on a simple task, like the UCDT. ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Total error scores from the FM100HT. Tritan thresholds from the UCDT. Commercial Relationships: Caterina Ripamonti, None; Sarah Kalwarowsky, None; Marko Nardini, None Support: Fight for Sight, NIHR Biomedical Research Centre for Ophthalmology at Moorfields and the UCL Institute of Ophthalmology. Program Number: 4396 Presentation Time: 12:00 PM–12:15 PM Effect of blur adaptation on peripheral visual performance in myopes and emmetropes Atanu Ghosh, Len Zheleznyak, Antoine Barbot, Geunyoung Yoon. Flaum Eye Institute, University Of Rochester, Rochester, NY. Purpose: To investigate the effect of blur adaptation (2D myopic defocus) at fovea (0°) and parafovea (10°) over time in emmetropes and myopes with and without higher order aberrations (HOAs). Methods: An adaptive optics (AO) vision simulator was used to measure high contrast tumbling E visual acuity (HCVA) at fovea and at 10° nasal visual field before, during and after a 60 min blur adaptation. 6 young adults (3 emmetropes and 3 myopes) participated in this study, and were dilated with phenylepherine eye drops. Visual performance was measured over 6-mm pupil under two conditions: (i) HCVA measured with corrected HOAs before and after a 60 min adaptation in which aberrations were dynamically corrected with closed-loop AO, and (ii) HCVA measured with subject’s native HOAs every 10 min over a 60 min adaptation period; i.e., the time course of blur adaptation observed. During blur adaptation subjects watched video at 2m distance using their foveal (0°) and parafoveal (10°) vision, while wearing a +2D trial lens and 6-mm artificial pupil, in two separate, counter balanced sessions. Results: Defocused HCVA with corrected HOAs improved significantly after 60 min of blur adaptation for both foveal (group mean logMAR: 0.65±0.06 and 0.58±0.07 before and after adaptation, respectively, p=0.03) and parafoveal vision (group mean logMAR 0.85±0.03 and 0.78±0.06 before and after adaptation, respectively, p=0.01). When the subjects’ native HOAs remained uncorrected we also observed significant improvements in HCVA over time for both foveal (R2= 0.859; mean HCVA improved by 36%) and parafoveal (R2= 0.788; mean HCVA improved by 11%) vision (ANOVA, time, p<0.01). Myopic subjects had significantly greater improvement in parafoveal HCVA after 60 min of adaptation with the corrected HOAs condition (mean HCVA improvement: logMAR 0.10±0.02), than that of emmetropic subjects (mean HCVA improvement: logMAR 0.04±0.03). However there was no significant difference observed in parafoveal HCVA after 60 min of adaptation between refractive error groups (mean difference: logMAR 0.02±0.02), when subject’s HOAs remained uncorrected. Conclusions: Myopes exhibited a greater level of adaptation to peripheral defocus than emmetropes, while optics of the eye in both groups was fully corrected. This finding suggests that neural compensatory response to myopic defocus might have different impact on peripheral visual performance in myopes and emmetropes. Commercial Relationships: Atanu Ghosh, None; Len Zheleznyak, None; Antoine Barbot, None; Geunyoung Yoon, None Support: NIH EY014999 Program Number: 4397 Presentation Time: 12:15 PM–12:30 PM Long-term visual follow-up in children with malarial retinopathy Paul C. Knox1, Ian J. MacCormack1, 2, Macpherson Mallewa2, Simon P. Harding1. 1Eye and Vision Science, University of Liverpool, Liverpool, United Kingdom; 2University of Malawi College of Medicine, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi. Purpose: Paediatric cerebral malaria (CM), which results in coma, is associated with a distinct group of changes in the retina (eg retinal whitening, retinal haemorrhages) which together are called malarial retinopathy. These retinal changes have considerable diagnostic and prognostic value (Beare et al, 2004, Arch Ophthalmol 122:1141). What is less clear is whether CM has long term visual consequences either due to retinal or central nervous system damage. Methods: We recruited 54 participants who had retinopathyconfirmed paediatric cerebral malaria (CM group; mean age at time of admission: 57 months; mean time since admission: 76 months; mean age at time of testing: 124±26 months) and compared their performance with 49 hospital admission controls (CON group; mean age 116 ± 23 months; t-test for group ages: t=1.6, p>0.05). Monocular visual acuity (VA), contrast sensitivity (both tested using Lea symbols) and vernier offset hyperacuity were tested in both eyes using Test Chart Pro 2000 software run on a laptop computer. In order to examine higher order vision, and an aspect of visual function which has a temporally extended developmental profile, we used a handheld test of global radial shape discrimination (hRSD; Wang et al, 2009, OVS 86:695). This measured the threshold for detecting distortions in circular radial frequency patterns, recording them as a LogMAR value. . Results: We found no statistically significant differences between groups for any of the aspects of vision tested. For VA, values were as expected for the ages tested (CM RE:-0.07±0.14; LE: -0.08±0.15 LogMAR; CON RE:-012±0.14; LE:-0.09±0.12 LogMAR; ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics mean±SD). However, for the hRSD test, thresholds for detecting distortion were higher than anticipated based on published reports. For participants aged 9-11y average thresholds were CM: -0.41±0.17, CON: -0.44±0.24 LogMAR. In both groups this was well above the previously published value for this age range of approximately -0.80 LogMAR. Conclusions: We have confirmed that the retinal damage observed in CM does not appear to have long-term consequences for visual function. However, higher level visual function may be generally compromised in the population we have studied. Commercial Relationships: Paul C. Knox, None; Ian J. MacCormack, None; Macpherson Mallewa, None; Simon P. Harding, None Support: Wellcome Trust 471 High Resolution Photoreceptor Imaging Wednesday, May 06, 2015 3:45 PM–5:30 PM Exhibit Hall Poster Session Program #/Board # Range: 4920–4944/B0048–B0072 Organizing Section: Visual Psychophysics / Physiological Optics Contributing Section(s): Multidisciplinary Ophthalmic Imaging, Physiology/Pharmacology, Retinal Cell Biology, Retina Program Number: 4920 Poster Board Number: B0048 Presentation Time: 3:45 PM–5:30 PM The relationship between visual acuity, perifoveal achromatic-, Land M-cone acuity and retinal structure as imaged with OCT Elisabeth Bratlie Finstad, Siri Bjørnetun Jacobsen, Jon B. Gjelle, Stuart J. Gilson, Rigmor C. Baraas. Department of Optometry and Visual Science, Faculty of Health Sciences, Buskerud and Vestfold University College, Gjøvik, Norway. Purpose: A negative correlation between best-corrected visual acuity (BCVA) and photoreceptor and retinal pigment epithelium aggregate (PR+RPE) thickness has been reported in high myopes. We investigated BCVA, perifoveal achromatic-, L- and M-cone acuity and retinal structure in healthy young male Norwegians. Methods: Twenty-eight healthy males aged 20-38 yrs, with normal logMAR letter acuity and no observed ocular abnormalities, were included in the study. Color vision was examined with a battery of standard tests. Perifoveal achromatic and isolated L- and M-cone spatial acuity was measured in the dominant eye with a Sloan E letter of 90% achromatic or 23% cone contrast, respectively. The Sloan E was presented at 5 deg eccentricity and fixation was verified by an eye-tracker. Observers were corrected to best logMAR letter acuity and viewed the stimuli monocularly from a distance of 2.3 m. The central 30 deg of the dominant eye was imaged with the Heidelberg Spectralis OCT. Retinal layers were analyzed by calculating longitudinal reflectivity profiles. Results: Axial lengths ranged from 22.60–25.18 mm and spherical equivalent refraction from -4.50–2.43D. Foveal thickness and PR+RPE thickness ranged from 187–241 mm and 86–110 mm, respectively. Perifoveal retinal thickness ranged from 287–335 mm and perifoveal PR+RPE thickness from 63–80 mm. No correlation was found between BCVA (logMAR -0.16–0.04) and PR+RPE (r=0.305, p=0,11) or foveal thickness (r=-0.237, p=0.226). Perifoveal achromatic, L- and M-cone logMAR acuity ranged from 0.28–0.53, 0.46–0.80 and 0.54-1.25, respectively. Observers with red-green color-vision deficiencies (n=4, 13.3 %) had achromatic acuity within the normal range and performed as expected according to type and degree of deficiency. No correlation was found between either perifoveal achromatic, L- or M-cone acuity and retinal thickness (r=0.20, p=0.31; r=-0.141, p=0.48; r=-0.07, p=0.74) or thickness of the PR+RPE (r=-0.28, p=0.15; r=-0.11, p=0.60; r=0.28, p=0.14) at 5 deg temporal eccentricity. Conclusions: The correlation between BCVA and foveal PR+RPE thickness in high myopes could not be replicated in low hyperopes to moderate myopes. The lack of correlation between different retinal thicknesses and perifoveal measures of achromatic and isolated cone acuity support this finding. Commercial Relationships: Elisabeth Bratlie Finstad, None; Siri Bjørnetun Jacobsen, None; Jon B. Gjelle, None; Stuart J. Gilson, None; Rigmor C. Baraas, None Program Number: 4921 Poster Board Number: B0049 Presentation Time: 3:45 PM–5:30 PM Repeatability and inter-observer variability of in vivo retinal cone imaging using a modified Heidelberg Retinal Angiography (HRA2) in normal subjects Marketa Cilkova1, 2, Juliane Matlach2, Reena Chopra2, Andy Rider1, Nilpa Shah1, 2, Padraig Mulholland2, Steven C. Dakin3, Adnan Tufail2, 1, Roger S. Anderson1, 4. 1Institute of Ophthalmology, University College London, London, United Kingdom; 2Moorfields Eye Hospital, NIHR Biomedical Research Centre, London, United Kingdom; 3Optometry and Vision Science, University of Auckland, Auckland, New Zealand; 4Vision Science, University of Ulster, Coleraine, United Kingdom. Purpose: To determine whether the modified narrow-angle Heidelberg Retina Angiograph (HRA2) is repeatable and reliable for acquiring good quality in vivo cone images, and the future potential to develop such an instrument for routine high resolution imaging in primary and secondary care. Methods: 3 x 3 degrees retinal images were acquired at an eccentricity of six degrees from the fovea, in a group of thirty healthy subjects (21 – 65 years of age), using the 680nm laser arm of the modified Heidelberg Retinal Angiograph (HRA2). Two different operators performed the cone imaging and one operator repeated the measurements over two separate sessions. The images were analysed and cone counts generated by using customized software. Results: The mean cone count was 4797 cones per scan area (7054 cones/mm2) ranging from 4258 to 5125 cones per scanned area. The cone counts acquired by the two operators were on average different by 12 cones (<1%) within the scan window with a coefficient of repeatability of 212 cones (1.96 x SD). Cone counts from images acquired by the same observer on two different occasions ranged from 4258 to 5120 with mean bias of 46 cones and coefficient of repeatability of 284 cones per scan area. Conclusions: The narrow-scan HRA2 showed very good inter- and intra-examiner repeatability in comparison with alternative adaptive optics cone imaging devices.1 However, our data were acquired in a younger population (<66 years) and therefore more data are needed to determine the level of repeatability in an older population. The modified HRA2 could be used in patients with diseases affecting retinal cone density to determine how density relates to visual function at the early stages of the disease. The method has a potential for diagnosis and monitoring of retinal disease in a clinical setting. ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics in cone density was found between healthy controls and moderate/ severe NPDR group (figure); however, no statistical significance was found between controls and no retinopathy or mild NPDR groups. An inverse relationship between cone density and Hb1Ac was observed in all parafoveal regions; however, no relationship could be correlated for the duration of diabetes. Conclusions: Patients with diabetes may have loss of photoreceptors with increasing severity of DR. AO provides assessment of photoreceptors, which may allow better understanding of the disease pathology. Commercial Relationships: Marketa Cilkova, None; Juliane Matlach, None; Reena Chopra, None; Andy Rider, None; Nilpa Shah, None; Padraig Mulholland, None; Steven C. Dakin, None; Adnan Tufail, None; Roger S. Anderson, None Support: Fight For Sight Clinical Fellowship grant Program Number: 4922 Poster Board Number: B0050 Presentation Time: 3:45 PM–5:30 PM High Resolution Imaging of Parafoveal Cones in Different Stages of Diabetic Retinopathy using Adaptive Optics Fundus Camera Mohamed K. Soliman1, 2, Mohammad A. Sadiq1, Aniruddha Agarwal1, Salman Sarwar1, Mostafa S. Hanout1, Frank E. Graf1, Robin High3, Diana V. Do1, Quan Dong Nguyen1, Yasir J. Sepah1. 1Ophthalmology and Visual Sciences, University of Nebraska Medical Center, Omaha, NE; 2Ophthalmology, Assiut University, Assiut, Egypt; 3College of Public Health, University of Nebraska Medical Center, Omaha, NE. Purpose: Neurodegeneration has been proposed as one of the possible pathophysiological mechanisms underlying diabetic retinopathy (DR). In this prospective cohort study, we investigated parafoveal cone density in different stages of DR using adaptive optics (AO) retinal imaging. Methods: An AO retinal camera (rtx1; Imagine Eyes, Orsay, France) was used to acquire images of parafoveal cones from patients with diagnosis of diabetes mellitus with or without retinopathy and from healthy controls with no known systemic or ocular disease. Eyes with myopia (> 10 diopters), media opacity, current macular edema, or any coexistent retinal diseases other than DR were excluded. The final image produced by the AO camera is equivalent to ≈ 1.2 × 1.2 mm (4° × 4°) based on axial length (AL) of the eye. The density of the parafoveal cones was calculated in 100 × 100 mm square located at 300 and 500 mm from the foveal center (a minimum of 250 mm from the foveal center is recommended for feasible cone assessment) along nasal, temporal, superior and inferior quadrants. The measurements (cones/mm2) were done using automated AOdetect Ver. 0.1. Software provided by the manufacturer. AL were measured using non-contact biometry (IOL Master®; Carl Zeiss Meditech, Germany). Correlation between diabetes control (Hb1Ac) and severity of DR with cone density was analyzed using Spearman correlation test. Results: Ten subjects (10 eyes) with no known ocular or systemic diseases and 14 (17 eyes) with diabetes were included (Table). Among those with diabetes, 4 patients (5 eyes) did not have retinopathy, 3 (4 eyes) had mild NPDR, 5 (6 eyes) had moderate NPDR and 2 (2 eyes) had severe NPDR. The mean Hb1Ac among patients with diabetes was 8.5 ±2. A significant difference (P< 0.001) Figure - Cone density in different stages of diabetic retinopathy Commercial Relationships: Mohamed K. Soliman, None; Mohammad A. Sadiq, None; Aniruddha Agarwal, None; Salman Sarwar, None; Mostafa S. Hanout, None; Frank E. Graf, None; Robin High, None; Diana V. Do, None; Quan Dong Nguyen, None; Yasir J. Sepah, None Program Number: 4923 Poster Board Number: B0051 Presentation Time: 3:45 PM–5:30 PM Novel adaptive optics imaging biomarkers to investigate the early pathologic changes of the cone mosaic in patients with type 1 diabetes mellitus Marco Lombardo1, Maria Cristina Parravano1, Daniela Giannini1, Sebastiano Serrao1, Lucia Ziccardi1, Giuseppe Lombardo2. 1IRCCS Fondazione GB Bietti, Rome, Italy; 2IPCF, CNR, Messina, Italy. Purpose: To evaluate the accuracy of adaptive optics (AO)-based imaging biomarkers to assess the spatial arrangement of cones in patients suffering from type 1 diabetes mellitus (DM1). Methods: An AO flood-illumination retinal camera was used to obtain images of the cone mosaic in 16 DM1 patients, aged 22-57 years old. Eight DM1 patients had mild non proliferative diabetic retinopathy (NPDR) and eight patients had no sign of diabetic retinopathy (noDR); 16 healthy volunteers were recruited as controls. Cone density, spacing between cones, and the preferred packing ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics arrangements of cones were assessed in 160x160 mm sampling areas at 1.5 degree eccentricity from the fovea along all retinal meridians. The cone spacing and preferred arrangements of cones were calculated using the Nearest Neighbours Distance (NND) and the Voronoi diagrams respectively. The novel metrics included the linear dispersion index (LDi) and the heterogeneity packing index (HPi). The LDi is the ratio between the standard deviation and the mean of the NND; the HPi represents the fraction of hexagonal Voronoi tiles over the non-hexagonal tiles and is expressed in percentage. Logistic regression analysis was performed to identify patients with DM1 using cone density, LDi and HPi parameters as descriptors. Results: The cone density was lower in DM1 patients than controls, though the differences reached statistically significance only between NPDR cases and controls (P<0.001). The LDi was higher in DM1 patients than controls, though the difference was statistically significance only between NPDR cases and controls (P=0.01). The HPi was statistically significantly lower in patients with DM1, both NPDR and noDR cases, than controls (P≤0.01). Logistic regression analysis achieved 94% classification accuracy for DM1 patients based on the complementary use of the AO-based imaging biomarkers. Conclusions: The complementary use of cone metrics shows great potential to detect early pathologic changes of the cone mosaic in patients affected by diabetes mellitus. Commercial Relationships: Marco Lombardo, None; Maria Cristina Parravano, None; Daniela Giannini, None; Sebastiano Serrao, None; Lucia Ziccardi, None; Giuseppe Lombardo, None Support: PON01_00110; Italian Ministry of Health 5x1000 funding Program Number: 4924 Poster Board Number: B0052 Presentation Time: 3:45 PM–5:30 PM Multimodal investigation of the pathologic changes of the retinal microstructure in patients with type 1 diabetes mellitus using adaptive optics Maria Cristina Parravano1, Lucia Ziccardi1, Giuseppe Lombardo2, Daniela Giannini3, Monica Varano1, Paola Giorno1, Marco Lombardo1. 1Ophthalmology, Fondazione GB Bietti-IRCCS, Rome, Italy; 2IPCF - Unit Support of Cosenza, CNR, Cosenza, Italy; 3 Statistics, University of Rome La Sapienza, Rome, Italy. Purpose: to explore the correlation between metrics of the cone mosaic imaged by an adaptive optics (AO) flood illumination retinal camera and retinal thickness in cross-section SD-OCT images in type 1 diabetes mellitus (DM1). Methods: AO retinal images of the photoreceptor mosaic were acquired in 16 DM1 patients; 16 healthy subjects were recruited as controls. Cone density, spacing of cones and packing arrangements of cones, estimated using Voronoi diagrams, were calculated within 1.5 degree eccentricity from the fovea along the vertical and horizontal meridians. From spacing of cones and Voronoi diagrams, two novel descriptors of the cone mosaic, the Linear Dispersion index (LDi) and the Heterogeneity Packing index (Pi), were calculated respectively. The subfoveal retinal thickness (SRT) was estimated in retinal cross-sections in SD-OCT images. Linear correlation analysis was performed to determine the relationships between cone metrics and SRT. Results: Patients had diagnosis of DM1 from 9 to 21 years earlier. Eight patients were diagnosed with no signs of diabetic retinopathy (noDR) and 8 with mild signs of DR (NPDR). The SRT was statistically significant thicker in DM1 eyes than controls (194±18 mm in NPDR, 199±31 mm in noDR and 153±36 in controls, p<0.05). Cone density showed no significant correlation with SRT (r=-0.30, p=0.09); the LDi approached statistical significance (r=0.35; p=0.05) and the HPi showed a high statistically significant correlation with SRT (r=-0.45, p=0.009). Conclusions: Cone density alone is not descriptive of the pathologic changes of the cones. The novel metrics based on spacing and packing arrangements of cones showed to correlate with the pathologic changes of foveal retinal thickness in patients with type 1 diabetes mellitus. Commercial Relationships: Maria Cristina Parravano, None; Lucia Ziccardi, None; Giuseppe Lombardo, None; Daniela Giannini, None; Monica Varano, None; Paola Giorno, None; Marco Lombardo, None Program Number: 4925 Poster Board Number: B0053 Presentation Time: 3:45 PM–5:30 PM Analysis of the Photoreceptor Mosaic Within, On and Outside the Borders of Hyperautofluorescent Rings in Retinitis Pigmentosa Using Adaptive Optics Scanning Light Ophthalmoscopy Emily S. Smith1, Toco Y. Chui2, Ching-Lung Chen3, 4, Joseph Carroll5, Alfredo Dubra5, Robert F. Cooper6, Richard B. Rosen2, Donald Hood1, 3 , Vivienne C. Greenstein3. 1Department of Psychology, Columbia University, New York, NY; 2Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY; 3Ophthalmology, Columbia University, New York, NY; 4Ophthalmology, Chang Gung Memorial Hospital, Chiayi, Taiwan; 5Ophthalmology, Medical College of Wisconsin, Milwaukee, WI; 6Biomedical Engineering, Marquette University, Milwaukee, WI. Purpose: To compare the appearance, density, and spatial organization of photoreceptor cells (PRCs) in patients with retinitis pigmentosa (RP) to measures of visual function and retinal structure within, on and outside the borders of the hyperautofluorescent (hyperAF) ring. Methods: A custom research adaptive optics scanning light ophthalmoscope (AO-SLO) [1] was used to image the PRC mosaic in 8 eyes of 8 RP patients with visual acuities 20/20-20/30, and hyperAF rings and in 5 healthy eyes. Cone photoreceptor densities and mean nearest neighbor distances were estimated along the horizontal meridian (fovea ± 10°) using custom semi-automated cone counting software.[2] In addition, 10-2 visual fields (Carl Zeiss Meditec Inc.) and dark-adapted cone and rod mediated visual sensitivities were measured (Haag-Streit AG). Fundus autofluorescence and spectral domain-optical coherence tomography (OCT) line scans through the fovea were also obtained (Spectralis HRA+OCT Heidelberg Engineering GmbH). Total receptor layer thickness (R+: Bruch’s membrane to the border between the inner nuclear layer and outer plexiform layer) was measured and compared to values for 30 agesimilar normals. Results: Within the hyperAF ring, the ellipsoid zone band was preserved in all eyes. However, R+ thickness was significantly decreased and cone mediated visual sensitivities ranged from 0 to -8dB of normal. The AO-SLO images showed dark regions, and cone densities were decreased for 3 eyes that had significantly decreased cone sensitivities and R+ thickness values from the fovea to the inner ring border. On the ring border, for all 8 eyes, the clarity of the mosaic decreased, the number and extent of dark regions increased and PRCs appeared misshapen/fragmented. Outside the border, where sensitivities and R+ thickness values were markedly decreased, cones could not be reliably identified, although the size and shape of the cells were consistent with retinal pigment epithelium cells. Conclusions: In patients with RP, both decreased cone density and cone structure abnormalities were observed, even within the hyperAF ring (i.e. in “relatively healthy” parafoveal regions). 1. Sulai, Dubra. Biomed Opt Express. 2012, 3:1647-61. 2. Garrioch et al. Optom Vis Sci. 2012, 89: 632-43. ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Commercial Relationships: Emily S. Smith, None; Toco Y. Chui, None; Ching-Lung Chen, None; Joseph Carroll, None; Alfredo Dubra, US Patent No: 8,226,236 (P); Robert F. Cooper, None; Richard B. Rosen, Advanced Cellular Technologies (C), Allergan (C), Carl Zeiss Meditech (C), Clarity (C), OD-OS (C), Opticology (I), Optovue (C); Donald Hood, TOPCON (F); Vivienne C. Greenstein, None Support: NIH Grant R01 EY09076, R01 EY017607, P30EY001931, Research to Prevent Blindness, The Starr Foundation, Chairman’s Research Fund of NYEEI, Marrus Family Foundation, BendheimLowenstein Family Foundation, Wise Family Foundation, RPB Career Development Award, & Glaucoma Research Foundation Catalyst for a Cure Commercial Relationships: Angela N. Baldwin, NIH K-12 Career Development Grant (F); Shane Griffin, None; Nicolas Sippl-Swezey, None; Panagiota Loumou, None; Jaskiran Mann, None; Ravi Keshavamurthy, None; Travis Porco, None; Austin Roorda, Foundation Fighting Blindness (F), NIH EY014375 (F), US 6,890,076 (P), US 7,118,216 (P); Jacque L. Duncan, FDA R01-41001 (F), Foundation Fighting Blindness (F), Hope for Vision (F), NIH Grant EY002162 (F), Research to Prevent Blindness (F), That Man May See Inc. (F), The Benard A. Newcomb Macular Degeneration Fund (F) Support: NIH Grant EY002162, NIH K-12 Career Development Grant, NIH EY014375 Clinical Trial: NCT00254605 Program Number: 4926 Poster Board Number: B0054 Presentation Time: 3:45 PM–5:30 PM Cone spacing measures over 12 months in eyes with retinitis pigmentosa Angela N. Baldwin1, Shane Griffin1, Nicolas Sippl-Swezey1, Panagiota Loumou1, Jaskiran Mann1, Ravi Keshavamurthy1, Travis Porco1, 2, Austin Roorda3, Jacque L. Duncan1. 1Ophthalmology, University of California San Francisco, San Francisco, CA; 2 Ophthalmology, University of California San Francisco, Francis I. Proctor Foundation, San Francisco, CA; 3School of Optometry and Vision Science Graduate Group, University of California Berkeley, Berkeley, CA. Purpose: To determine the inter-visit, inter-grader and inter-ocular variability of Adaptive Optics Scanning Laser Ophthalmoscopy (AOSLO)-derived cone spacing measures in eyes with retinal degenerations (RD) followed for 12 months. Methods: Six patients with inherited RD including retinitis pigmentosa and choroideremia underwent AOSLO imaging at 3 visits (2 baseline visits separated by no more than 1 month and one visit 12 months after the first visit). Cone spacing was measured in multiple regions in each image by 2 independent graders. Variability of cone spacing measures between visits and between graders was determined. Standard macular measures, including visual acuity, foveal sensitivity, Goldmann perimetry, static perimetry in the central 20 degrees, and spectral-domain optical coherence tomography (SDOCT)-derived outer segment length and inner/outer segment junction or Ellipsoid Zone (EZ) band width were obtained. Results: Overall, cone spacing was measured in 309 regions. Agreement between graders for cone spacing measures at each location and each visit was acceptable (intraclass correlation (ICC=0.75, 95% CI 0.61-0.87); mean difference between graders was 0.08 arcminutes (95% CI 0.07-0.1). Cone spacing measures were similar at the two baseline visits; median absolute difference was 0.044 arcmin (95% CI= 0.041-0.057). Cone spacing measures at 12 months compared to spacing measures at baseline increased by 0.027 arcminutes (95% CI 0.02-0.04). There were no significant changes in standard clinical measures of disease progression including visual acuity, foveal threshold, area of I4e and V4e kinetic isopters, sensitivity in the central 20 degrees, EZ band width or outer segment thickness in the central 3 degrees. Conclusions: Cone spacing measures using AOSLO showed substantial inter-grader agreement. Measures were similar between baseline visits separated by less than 1 month. Cone spacing increased over 12 months in eyes with inherited RD, although standard clinical measures showed no significant change during this period. This information establishes the repeatability for current and future clinical trials involving AOSLO imaging of eyes with inherited RD. Program Number: 4927 Poster Board Number: B0055 Presentation Time: 3:45 PM–5:30 PM Adaptive optics and high-resolution imaging of structure and function in retinitis pigmentosa patients with verses without a hyper-autofluorescent ring Grace K. Han, Tomas S. Aleman, Jessica I. Morgan. Scheie Eye Institute, Ophthalmology, University of Pennsylvania, Philadelphia, PA. Purpose: Hyper-autofluorescent (AF) rings are prevalent in patients with retinitis pigmentosa (RP). This study uses multimodal highresolution imaging, including confocal adaptive optics scanning light ophthalmoscopy (AOSLO), to compare the structural and functional phenotypes in RP patients with verses without hyper-AF rings. Methods: 10 RP patients aged 11-63 years were imaged using AOSLO (Canon, Inc. and/or a custom system), spectral domain optical coherence tomography (SD-OCT) and AF (Heidelberg Engineering, HRA), fundus photography (8 patients), and microperimetry (Nidek MP1, 8 patients). One patient participated in retinal densitometry (10 deg, temporal retina) using the Optos P200C-AF SLO. Images from all modalities were registered in Photoshop. Cell density was measured using a semi-automated Matlab script. Results: AF imaging revealed a hyper-AF ring in parafoveal retina in 6 of 10 patients. 2/4 who did not show the hyper-AF ring were diagnosed as X-linked RP. Foveal sensitivity was reduced 7.3 ± 5.5dB and was not significantly different in patients with vs. without a hyper-AF ring. Outside of the hyper-AF ring, OCTs showed loss of the IS/OS layer and thinning of the outer nuclear layer (ONL). The retinal area corresponding to the ring appeared as a transition zone to photoreceptor layer loss. OCTs of patients without the hyperAF ring showed severe ONL thinning with a smoother transition in thickness. AOSLO revealed a regular cone mosaic central to the parafoveal hyper-AF rings. Images of retinal areas corresponding to the hyper-AF ring showed sparsely remaining cones. Outside of the hyper-AF ring, the cone mosaic was not visible. In images showing a contiguous cone mosaic, parafoveal cone density was normal between 1 and 1.5 mm eccentricities. At 0.5mm eccentricity one third of locations showed reduced cone density while two thirds were normal. The increase in reflectance from retinal densitometry was ~1/6 of the normal response. Conclusions: AOSLO imaging demonstrates a dramatic transition in the organization of the cone photoreceptor mosaic co-localizing with the hyper-AF rings commonly described in retinal degenerations. The outer boundary of the hyper-AF ring demarcates the transition zone to loss of the cone photoreceptor mosaic, a region that may be used to monitor disease severity and progression. Commercial Relationships: Grace K. Han, None; Tomas S. Aleman, None; Jessica I. Morgan, 8226236 (P), Canon Incorporated (C), Canon Incorporated (F), Optos PLC (F), Optos PLC (R) ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Support: National Institutes of Health (Grants: EY019861, R24EY019861, 8DP1EY02317), Foundation Fighting Blindness, Choroideremia Research Foundation, Research to Prevent Blindness, the F. M. Kirby Foundation, the Paul and Evanina Mackall Foundation Trust, Lois Pope Life Foundation, Canon Inc, Optos PLC Clinical Trial: NCT01866371 Program Number: 4928 Poster Board Number: B0056 Presentation Time: 3:45 PM–5:30 PM Reliability of cone density measurements on adaptive optics images in Stargardt disease Melissa Kasilian1, Michael G. Ring1, Rupert W. Strauss2, Moataz M. Razeen3, Alfredo Dubra3, 4, Tunde Peto1, Catey Bunce2, Joseph Carroll3, 5, Adam M. Dubis2, 6, Michel Michaelides2, 6 1 . Reading Centre, Moorfields Eye Hospital, London, United Kingdom; 2Moorfields Eye Hospital, London, United Kingdom; 3 Ophthalmology, Medical College of Wisconsin, Milwaukee, WI; 4 Biophysics, Medical College of Wisconsin, Milwaukee, WI; 5Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI; 6Genetics, University College London, London, United Kingdom. Purpose: Quantification of the photoreceptor mosaic in normal subjects has been done using manual and automated methods, however in patients with retinal degeneration, cone cell identification becomes increasingly challenging. It is critically important to determine how reliable cone counting measurements are and what factors affect reliability. This knowledge can then be applied to natural history studies and clinical trials that intend to use it to monitor progression and efficacy respectively. Methods: Twelve patients (8-37 years) with molecularly confirmed Stargardt Disease (STGD) were imaged using a custom built adaptive optics scanning light ophthalmoscope (AOSLO) designed to simultaneously acquire images in confocal and split detection imaging modes. Cone photoreceptors were identified by two graders (G1 and G2) in the confocal and split detector images acquired at 100 parafoveal regions of interest (ROI). All 200 images were graded twice by each observer. Reliability of cone cell identification was compared between trials, between observers and between imaging modes. Statistical significance for all tests was assessed at the 5% level. Results: The between trial average variance was 11% for G1 and 19% for G2 (p 0.04, paired t-test). The average variance in cones identified between observers was 15%, which did not result in a statistically significant difference in number of cones identified (p=0.06, t-test). There was a significant difference in mean cones identified (p <0.0001, paired t-test) between imaging modes. For both graders, the between trial average variance was 18% for confocal images compared to 3% for split detection images. Conclusions: Split detection greatly facilitated more reliable cone photoreceptor identification and will be the mode of choice for natural history studies and clinical trials using AOSLO. There was significant variance between the graders, which may in part relate to the fact that this group is the first one to use non-medically trained graders in a reading-center setting to analyse images. Understanding the factors behind these differences, establishing detailed training and standardised protocols, will lead to increased measurement reliability in order to take the first step towards a reading center-based format of AOSLO analysis for large multi-centre trials. Commercial Relationships: Melissa Kasilian, None; Michael G. Ring, None; Rupert W. Strauss, None; Moataz M. Razeen, None; Alfredo Dubra, US Patent 8,226,236. (P); Tunde Peto, None; Catey Bunce, None; Joseph Carroll, None; Adam M. Dubis, None; Michel Michaelides, None Support: National Institute for Health Research Biomedical Research Centre at Moorfields Eye Hospital National Health Service Foundation Trust and UCL Institute of Ophthalmology; National Institutes of Health Grants R01EY017607, P30EY001931, and C06RR016511; Fight For Sight; Moorfields Eye Hospital Special Trustees; the Foundation Fighting Blindness; Retinitis Pigmentosa Fighting Blindness; and an unrestricted departmental grant (Medical College of Wisconsin) from Research to Prevent Blindness. Also supported by a multiuser equipment grant from The Wellcome Trust (099173/Z/12/Z); a Burroughs Wellcome Fund Career Award at the Scientific Interface and a Career Development Award from Research to Prevent Blindness (AD); and a Foundation Fighting Blindness Career Development Award (MM). Supported in part by the National Center for Advancing Translational Sciences, National Institutes of Health (Grant UL1TR000055). Program Number: 4929 Poster Board Number: B0057 Presentation Time: 3:45 PM–5:30 PM Longitudinal adaptive optics imaging reveals regional variation in cone and rod loss in Stargardt disease Maxwell A. Reback1, Hongxin Song2, Lisa R. Latchney3, Mina M. Chung3, 2. 1School of Medicine and Dentistry, University of Rochester, Rochester, NY; 2Center for Visual Science, University of Rochester, Rochester, NY; 3Flaum Eye Institute, University of Rochester, Rochester, NY. Purpose: Stargardt disease (SD) is defined clinically by lipofuscin deposition and atrophy of the retinal pigment epithelium (RPE), but the causative ABCA4 gene encodes a protein uniquely expressed in cone and rod outer segments. How mutations in ABCA4 lead to clinically detectable RPE changes, or whether photoreceptors are affected prior to the RPE remains unclear. Using adaptive optics scanning laser ophthalmoscopy (AOSLO), we investigated the sequence of changes in the photoreceptor mosaic in the macular atrophy phenotype of SD. Methods: Two brothers with genetically confirmed SD underwent comprehensive eye exams and AOSLO imaging 3 times in a 28-month period. Reflectance images of the cone and rod photoreceptors were obtained from the central fovea to 10 degrees inferior. Photoreceptors were counted in sampling windows at 100μm intervals of 200x200mm for cones and 50x50mm for rods, using custom semi-automated software. Photoreceptor density and spacing were measured and compared across imaging sessions using one-way ANOVA. Results: Over 28 months, visual acuity declined from 20/30 to 20/150 with an expanding bull’s eye lesion in the younger, more mildly affected brother; the older brother maintained 20/150 visual acuity with a central scotoma and expanding macular RPE atrophy. In the younger brother, AOSLO showed a 30% decline in peak foveal cone density after 8 months, and complete loss of foveal cones at 28 months; the older brother had no detectable foveal cones at baseline. In the peripheral macula, cone and rod spacing was greater than normal in both patients. Rod spacing increased significantly in the younger brother after 28 months (p<0.01) and remained unchanged in the older brother. There was no change in peripheral cone spacing in either patient over 28 months. The ratio of cone to rod spacing was greater than normal over all eccentricities tested, with greater divergence closer to the foveal center. Conclusions: AOSLO demonstrates early foveal cone loss and increasing rod spacing in the peripheral macula in SD. Cones and rods are reduced in the peripheral macula in areas that appear normal by conventional imaging methods. The ratio of cone to rod spacing is increased, particularly near the foveal center. These findings suggest that central cone loss may be an early pathogenetic step in ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics SD. AOSLO provides the capability to track individual cone and rod changes in SD longitudinally. Commercial Relationships: Maxwell A. Reback, None; Hongxin Song, None; Lisa R. Latchney, None; Mina M. Chung, None Support: NEI EY021786, EY014375, EY001319, Research to Prevent Blindness Unrestricted Grant, Edward N. & Della L. Thome Memorial Foundation to Mina Chung Program Number: 4930 Poster Board Number: B0058 Presentation Time: 3:45 PM–5:30 PM Factors Affecting Cone Photoreceptor Identification in RPGRAssociated Retinopathy Michael G. Ring1, 2, Melissa Kasilian1, 2, James Tee2, 1, Alfredo Dubra3, 4 , Tunde Peto1, Catey Bunce1, Ana Quartilho1, Joseph Carroll3, 5, Michel Michaelides6, 7, Adam M. Dubis6, 7. 1Moorfields, London, United Kingdom; 2Inst Opthalmology - Genetics, UCL, London, United Kingdom; 3Ophthalmology, Medical College of Wisconsin, Milwaukee, WI; 4Biophysics, Medical College of Wisconsin, Milwaukee, WI; 5Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI; 6Moorfields Eye Hospital, London, United Kingdom; 7Institute of Ophthalmology, University College London, London, United Kingdom. Purpose: Cone photoreceptor quantification has been carried out in normal subjects using either manual or semi automated methods. Natural history studies and clinical trials of subjects with degenerative retinal diseases need to have a reliable and objective method of assessing the cone mosaic if this technique is to be incorporated into trial protocols. We present data on cone counting reliability in subjects with RPGR-associated retinopathy. Methods: Fourteen subjects (8-51 years) with molecularly confirmed RPGR-associated retinopathy were imaged using a custom built adaptive optics scanning light ophthalmoscope (AOSLO) designed to simultaneously acquire images in confocal and split detection imaging modes. Cone photoreceptors were manually identified by two graders (G1 and G2) in the confocal and split detection images acquired at 42 parafoveal regions of interest. All 84 images were graded twice by each observer. Reliability of cone cell identification was compared between trials, between observers and between imaging modes. Statistical significance for all tests was assessed at the 5% level. Results: Mean variance between trials was 9% for G1 and 16% for G2 across all images, however the mean number of photoreceptors identified was not statistically significantly different for either grader (p=0.1 for G1, p = 0.06 for G2, paired t-test). There was not a significant difference in mean variance between imaging modes (p=0.28, paired t-test). There was no statistically significant difference in mean variance between trials for confocal (5 ± 34%) or split detection (2 ± 6%). Conclusions: While there was no statistical difference in mean variance between split detection and confocal images, the standard deviation of the variance was significantly different. Therefore split detection greatly facilitated the reliability of photoreceptor identification. The significant difference between graders will require further investigation to identify the underlying contributing factors, with refinement of training and certification methods likely to also help address this difference and thereby allow this image analysis modality to enter the reading center-based format for future large multi-center trials. Commercial Relationships: Michael G. Ring, None; Melissa Kasilian, None; James Tee, None; Alfredo Dubra, US 8,226,236 (P); Tunde Peto, None; Catey Bunce, None; Ana Quartilho, None; Joseph Carroll, None; Michel Michaelides, None; Adam M. Dubis, None Support: National Institute for Health Research Biomedical Research Centre at Moorfields Eye Hospital National Health Service Foundation Trust and UCL Institute of Ophthalmology; National Institutes of Health Grants R01EY017607, P30EY001931, and C06RR016511; Fight For Sight; Moorfields Eye Hospital Special Trustees; the Foundation Fighting Blindness; Retinitis Pigmentosa Fighting Blindness; and an unrestricted departmental grant (Medical College of Wisconsin) from Research to Prevent Blindness. Also supported by a multiuser equipment grant from The Wellcome Trust (099173/Z/12/Z); a Burroughs Wellcome Fund Career Award at the Scientific Interface and a Career Development Award from Research to Prevent Blindness (AD); and a Foundation Fighting Blindness Career Development Award (MM). Supported in part by the National Center for Advancing Translational Sciences, National Institutes of Health (Grant UL1TR000055). Program Number: 4931 Poster Board Number: B0059 Presentation Time: 3:45 PM–5:30 PM Adaptive optics imaging of putative cone inner segments within geographic atrophy lesions Ethan A. Rossi1, Kenichi Saito2, Charles E. Granger3, Koji Nozato2, Qiang Yang1, Tomoaki Kawakami4, Jie Zhang1, William Fischer5, David R. Williams1, 3, Mina M. Chung5. 1Center for Visual Science, University of Rochester, Rochester, NY; 2Canon U.S.A., Inc., Melville, NY; 3The Institute of Optics, University of Rochester, Rochester, NY; 4Canon, Inc., Tokyo, Japan; 5Flaum Eye Institute, University of Rochester Medical Center, Rochester, NY. Purpose: The time course of cone loss relative to the formation of geographic atrophy (GA) lesions in age-related macular degeneration is not well characterized. Confocal adaptive optics scanning light ophthalmoscopy (AOSLO) images of GA lesions contain hyperreflective cone-like features, but such images are difficult to interpret in advanced disease states such as GA. Non-confocal split-detector imaging in AOSLO has been shown to reveal structures consistent with cone inner segments (Scoles et al. 2014). Here we use two nonconfocal AOSLO methods to determine whether putative cone inner segments exist within GA lesions and if they correlate with the conelike structures seen in confocal AOSLO images. Methods: Six patients were imaged, five with near-infrared (NIR) light in a compact commercial AOSLO prototype modified for split-detector imaging. The central portion of the PSF was directed to one detector for confocal imaging and a knife edge prism split the remaining light into two additional detectors. Five patients were imaged with visible light in a research AOSLO with a novel nonconfocal method based on offset aperture (Chui et al. 2012) and split-detector methods. At each location, images were sequentially obtained with a ~10 Airy disk aperture offset by ~6 Airy disks to 8 equally spaced radial positions. Images were co-registered with simultaneously acquired NIR images. Registered images from each position were averaged and combined to enhance contrast. Identical locations were imaged in both instruments in some eyes permitting method comparison. Results: Structures consistent in appearance to putative cone inner segments were observed within some small GA lesions. Cone-like features in confocal AOSLO images did not always co-localize with putative cone inner segments, suggesting that some hyper-reflective features in confocal AOSLO arise from light scattered by other structures. Conversely, some areas where cones were not visible in confocal AOSLO contained putative cone inner segment structures in non-confocal images. Conclusions: Some cones survive in small GA lesions. Images similar to those obtained with the split-detector method can be obtained using a single detector. Cone survival in small GA lesions ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics offers hope that future treatments aimed at restoring RPE health may rescue remaining cones. Further study is needed to understand the rate of cone survival after RPE cell loss is initiated in AMD. Commercial Relationships: Ethan A. Rossi, University of Rochester (P); Kenichi Saito, Canon U.S.A., Inc. (E), Canon, Inc. (F), Canon, Inc. (P), University of Rochester (P); Charles E. Granger, Canon, Inc. (F); Koji Nozato, Canon U.S.A., Inc. (E), Canon, Inc. (F), Canon, Inc. (P), University of Rochester (P); Qiang Yang, Canon, Inc. (F), Canon, Inc. (P), Montana State University (P), University of Rochester (P); Tomoaki Kawakami, Canon, Inc. (E), Canon, Inc. (P); Jie Zhang, Canon, Inc. (F), Canon, Inc. (P), University of Rochester (P); William Fischer, Canon, Inc. (F); David R. Williams, Canon, Inc. (F), Canon, Inc. (R), University of Rochester (P), University of Rochester (P); Mina M. Chung, Canon, Inc. (F), GlaxoSmithKline (C) Support: This research was supported by the National Eye Institute of the National Institutes of Health under Awards R01 EY021786, F32 EY021669, P30 EY001319, BRP EY014375, R01 EY004367, and EY007125. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Inst. of Health. This work was also supported by a research grant from Canon, Inc., a grant from the Edward N. & Della L. Thome Memorial Foundation to Mina M. Chung, and an unrestricted grant to the University of Rochester Department of Ophthalmology from Research to Prevent Blindness, New York, New York. Program Number: 4932 Poster Board Number: B0060 Presentation Time: 3:45 PM–5:30 PM Quantitative analysis of photoreceptor recovery in acute zonal occult outer retinopathy (AZOOR) using adaptive optics scanning laser ophthalmoscope Hisashi Fukuyama1, Takashi Fujikado2, Suguru Miyagawa3, Kazuo Kitamura3, Hiroyuki Kanda2, Takeshi Morimoto2, Kohji Nishida1. 1 Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan; 2Applied Visual Science, Osaka University Graduate School of Medicine, Osaka, Japan; 3Optical Engineering Laboratory, Topcon Corporation, Tokyo, Japan. Purpose: To assess the photoreceptor abnormalities quantitatively in eyes with acute zonal occult outer retinopathy (AZOOR) in the recovery phase by adaptive optics scanning laser ophthalmoscope (AO-SLO). Methods: Four consecutive patients with unilateral AZOOR were examined at the Osaka University Hospital (4 women; ages ranged from 23 to 32 years). A custom built wide-field AO-SLO (Topcon) was used to evaluate the cone density of the affected retinal area before and after treatment by oral corticosteroids. Four hundred retinal images were photographed sequentially at 30 frames/sec. The wavefront aberrations were continuously corrected. The field of view of the retinal images was 0.920 ×1.250 for counting the cone density and 6.90 ×8.30 for evaluating the affected area. The cone density was measured at 30 and 50 nasal and temporal to the fovea. The size of lesion area was determined by a prototype software. Results: The lesion was located on the nasal side in 3 patients and on the temporal side in one patient. The visual fields improved in all four patients after the treatment. The cone density in lesion area was 11069 ± 2287 cones/mm2 at 30 and 7286 ± 937 cones/mm2 at 50. After the treatment, the cone density in lesion area increased to 15931 ± 3611 cones/mm2 at 30 (P=0.097), and to 14021 ± 2055 cones/mm2 at 50 (P=0.010). The size of the lesion was reduced from 20069 ± 4871 to 7933 ± 3370 pixels (60%) after the treatment (P=0.013). Conclusions: Our results demonstrated that AO-SLO can detect the decrease in the lesion area and the increase in cone density quantitatively after corticosteroid therapy in eyes with AZOOR. We recommend the use of AO-SO to evaluate the retinal structure of eyes with AZOOR during the recovery phase. Commercial Relationships: Hisashi Fukuyama, None; Takashi Fujikado, Topcon Corporation (F); Suguru Miyagawa, Topcon Corporation (E); Kazuo Kitamura, Topcon Corporation (E); Hiroyuki Kanda, None; Takeshi Morimoto, None; Kohji Nishida, None Program Number: 4933 Poster Board Number: B0061 Presentation Time: 3:45 PM–5:30 PM Extrafoveal Cone Packing Density and Geometry in Retinopathy of Prematurity (ROP) Ramkumar Ramamirtham1, Garima Soni1, 2, James D. Akula1, 3, Emily A. Swanson1, Tara L. Favazza1, Mircea Mujat4, R D. Ferguson4, Toco Y. Chui5, Anne Moskowitz1, 3, Anne B. Fulton1, 3. 1Ophthalmology, Boston Children’s Hospital, Boston, MA; 2Psychology, Northeastern University, Boston, MA; 3Ophthalmology, Harvard Medical School, Boston, MA; 4PSI Corp, North Andover, MA; 5Department of Ophthalmology, New York Eye & Ear Infirmary, New York, NY. Purpose: To study cone packing density and geometry using an adaptive optics scanning laser ophthalmoscope (AOSLO) in eyes with history of ROP and age matched control subjects. Methods: Subjects with a history of severe, treated ROP (n=3, SROP), with a history of mild ROP that resolved without treatment (n=3, MROP), and term born controls (n=6, CT) were studied. The subjects were aged 15–23 (median: 19.8) years at test. Two to four confocal and offset-pinhole AOSLO videos (64 frames) subtending 1°×1° visual angle were obtained from each subject at retinal eccentricities 4.5°, 9°, 13.5° and 18° (Chui et al, Biomed Opt Exp, 2012) by directing the subjects’ gaze using a fixation target. Offline, non-rigid registration was used to obtain a final image for analysis. Cones were counted using a custom MATLAB program and cone geometry was assessed by fit of Voronoi polynomials. Cone density (cones/mm2) was estimated after correction of the image magnification based on axial lengths (ROP = 22.5 ± 1.11 mm vs. CT = 23.6 ± 1.10 mm). Effects of group and eccentricity were detected by repeated-measures ANOVA. Results: Cone density decreased with increasing retinal eccentricity (4.5° to 13.5°) in all groups. Cone density was markedly lower in SROP than in CT and MROP eyes (p<0.01); however, image quality was also lower in SROP subjects. The Voronoi polygons were significantly more irregular in SROP than in MROP and CT eyes (p< 0.05). Conclusions: SROP (but not MROP) subjects displayed reduced number and organization of cone photoreceptors. This may indicate loss of cone photoreceptors, consistent with recognized visual deficits in SROP subjects. Alternatively, low cone counts maybe due to the relatively poor quality of images obtained from SROP eyes. Commercial Relationships: Ramkumar Ramamirtham, None; Garima Soni, None; James D. Akula, None; Emily A. Swanson, None; Tara L. Favazza, None; Mircea Mujat, PSI Corp (E), PSI Corp (E); R D. Ferguson, PSI Corp (E); Toco Y. Chui, None; Anne Moskowitz, None; Anne B. Fulton, None Support: EY10597 ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Program Number: 4934 Poster Board Number: B0062 Presentation Time: 3:45 PM–5:30 PM The optical Stiles-Crawford effect strongly affects photoreceptor imaging in diseased retina Michel Paques1, Chahira Miloudi1, Laurent Mugnier2, José Sahel1, Isabelle Bloch3, Florence Rossant4, Sarah Mrejen1. 1Clinical Investigation Center 1423, Quinze-Vingts Hospital, Paris, France; 2 DOTA, ONERA, Chatillon, France; 3Telecom ParisTech, Institut Mines-Telecom, Paris, France; 4LISITE, ISEP, Issy-les-Moulineaux, France. Purpose: The optical Stiles-Crawford effect (oSCE) describes the directional reflectance of cone photoreceptors. To which extent does it affect cone photoreceptor imaging in diseased eyes is poorly documented. Here we investigated by adaptive optics (AO) en face imaging and optical coherence tomography (OCT) the directional reflectance of photoreceptors in patients recovering from macular edema. Methods: AO fundus images were obtained through dilated pupils with a commercially available flood imaging AO camera (rtx1™ camera; Imagine Eyes, Orsay, France) in normal eyes (n=6) and eyes recovering from macular edema (n=6). Cone density counts were compared in sets of three images with three different entrance pupils: one through the central cornea (termed here coaxial image) and two after laterally shifting the entry pupil by 2.3° in both directions. Fusion maps were constructed after realignment of the three maps. The optical characteristics of control and diseased retina were analyzed in homologous areas. In parallel, OCT scans taken through these different entry pupils were aligned and fused. Results: In patients, coaxial AO images and OCT scans both showed patchy defects of photoreceptor structures. Comparison of AO images at different entrance pupils showed that, in diseased areas, 65% (range, 47-79%) of cones were detected only through one of the 3 entry pupil versus 34% (range, 23-41%) in controls. Fusion maps increased the amount of detected cones by a mean of 69% (range, 26-113%) versus 24% (range, 5-56%) in controls. Final cone counts on fusion maps ranged from 31% to 56% of controls. On OCT scans of the same areas, the interdigitation line showed the most important directional reflectance; fusion of multiangle OCT scans markedly reduced the extent of outer layer destructuration. Conclusions: Following retinal edema, photoreceptors show striking modifications of their optical properties which may lead to an overestimate of destructuration of the outer retina. Integration of AO images as well as OCT scans taken at different entry pupils improves the characterization of photoreceptor density and structure. These changes may participate to visual impairment. Further investigations are needed to determine if this is due to increased oSCE and/or to cone misalignment, the evolution of these changes over time and their presence in other retinal diseases. Commercial Relationships: Michel Paques, ImagineEye (C), ImagineEye (C), UPMC (P), UPMC (P); Chahira Miloudi, None; Laurent Mugnier, None; José Sahel, ImagineEye (S); Isabelle Bloch, None; Florence Rossant, None; Sarah Mrejen, UPMC (P) Support: ANR-09-TECS-009 and ANR-12-TECS-0015-03 Clinical Trial: NCT01546181 Program Number: 4935 Poster Board Number: B0063 Presentation Time: 3:45 PM–5:30 PM Perifoveal correlations between cone mosaic, achromatic acuity and L-cone acuity Siri Bjørnetun Jacobsen, Jon B. Gjelle, Elisabeth Bratlie Finstad, Stuart J. Gilson, Rigmor C. Baraas. Optometry and Visual Science, Buskerud and Vestfold University College, Kongsberg, Norway. Purpose: To investigate perifoveal measures of achromatic acuity and L-cone acuity and its association with cone density in healthy young men using experimental psychophysics and high-resolution retinal imaging. Methods: Twenty-one healthy males aged 21–31 years, with normal logMAR letter acuity and no observed ocular abnormalities, were included in the study. Color vision was examined with a battery of standard tests. Achromatic and isolated L-cone spatial acuity was measured in the dominant eye with a Sloan E letter of 90% achromatic decrement contrast or 23% L-cone increment contrast, respectively. The Sloan E was presented at 5 deg temporal eccentricity and fixation was verified by an eye-tracker. Observers were corrected to best logMAR letter acuity and viewed the stimuli monocularly from a distance of 2.3 m. Average luminance of the stimuli was 10 cd/m2. Para- and perifoveal areas within the central 12 deg of the dominant eye were imaged with the Kongsberg Adaptive Optics Ophthalmoscope II. The subject’s eye was dilated and accommodation suspended with Cyclopentolate 1% prior to imaging. Cone density and nearest-neighbor distance (NND) analysis was performed using custom software. Results: LogMAR acuity for achromatic and L- cone experiments ranged from 0.330.53 and 0.460.80, respectively. All observers had cone densities within the normal range. There was no correlation between achromatic logMAR and cone density or achromatic logMAR and mean NND at 5 deg. There was, however, a significant correlation between higher cone density and better L-cone logMAR (r =0.58, p<0.01) and lower mean NND and better L-cone logMAR (r=0.51, p<0.05). Conclusions: The results indicate that L-cone acuity, but not achromatic acuity, may be a useful clinical measure to determine changes in the perifoveal cone mosaic. Commercial Relationships: Siri Bjørnetun Jacobsen, None; Jon B. Gjelle, None; Elisabeth Bratlie Finstad, None; Stuart J. Gilson, None; Rigmor C. Baraas, None Program Number: 4936 Poster Board Number: B0064 Presentation Time: 3:45 PM–5:30 PM Automatic cones counting in adaptive optics images in healthy subjects Konstantin E. Kotliar1, Peter Linder1, Lislotte A. Sigha Yongua1, Ines Lanzl3, Jose A. Sahel2, Ieva Sliesoraityte2. 1Biomedical Engineering, FH Aachen University of Applied Sciences, Juelich, Germany; 2 Institut de la Vision, INSERM, CIC 1243, Paris, France; 3Eye Clinic, Munich University of Technology, Munich, Germany. Purpose: Reliable automatic cone detection and cone mosaic assessment using adaptive optics (AO) is of the key importance in tracking of macular pathologies, especially ones related to the inherited retinal degenerations (e.g. Usher syndrome). The automatic cone detection (especially fovea centered) in AO is an unsolved issue mainly due to the dense cones concentration both in healthy retina and in retinal pathologies. An automatic cone quantification tool was developed with the aim to provide quick and reliable cone counting in fovea centered AO images. The tool was first tested in healthy subjects. In addition cone mosaic profile was compared between healthy subjects and patients with Usher syndrome. Methods: A flood-illumination AO retinal camera (rtx1, Imagine Eyes, France) was used to acquire fovea centered images of the cone mosaic. The cone mosaic in 10 images of 8°x8° (1500x1500 pixel) corresponding to the macular area of 1181x1181 mm were analyzed in healthy subjects. The automatic tool in LabVIEW visual programming language (National Instruments, USA) with sequenced image filtration was employed to obtain clearly discerned cell mosaic. The reliability of the automatic tool was compared to an expert ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics based manual counting using a set of 30 images with 120x120 pixel (95x95mm), which were randomly selected from the initial large images. The repeatability of manual and automatic counting was tested in 3 randomly selected images. In addition, healthy subjects’ cone mosaic profile was compared with ones having genetically confirmed Usher syndrome. Results: The mean amount of cones per 1 mm2 was 23120(21760 – 23530) [median(1st quartile – 3rd quartile)]. There was no significant difference in cones count comparing automatic counting: 248(213 – 282) cells/picture, and manual counting: 248(214–273) cells/ picture (p = 0.8, Wilcoxon test). The repeatability amounted to 100% (automatic counting) and to 98% (manual counting). Comparing healthy subjects’ cone mosaic profile with ones having Usher syndrome significant decrease of 30% in cones quantity per area was shown. Conclusions: Our developed automatic cone detection tool seems to be reliable for automatic cone quantification and mosaic assessment in the normal fovea using AO images. In addition, the automatic tool could be potentially used for tracking macular pathologies, especially ones related to inherited retinal degenerations. Commercial Relationships: Konstantin E. Kotliar, None; Peter Linder, None; Lislotte A. Sigha Yongua, None; Ines Lanzl, None; Jose A. Sahel, None; Ieva Sliesoraityte, None Support: ERAREl N°58: Eur-USH Clinical Trial: NCT01954953 Program Number: 4937 Poster Board Number: B0065 Presentation Time: 3:45 PM–5:30 PM Reliability and Repeatability of a Quality Grading System for Para-foveal Cone Photoreceptor Adaptive Optics Images Nick M. Muthiah1, Fred K. Chen4, Joe Zhong3, Zoe McClelland3, Ferenc Sallo1, Tunde Peto1, Pete Coffey2, Lyndon da Cruz1. 1 NIHR Biomedical Rsrch Ctr for Ophthalmology, Moorfields Eye Hospital & UCL IOO, London, United Kingdom; 2UCL Institute of Ophthalmology, London, United Kingdom; 3Moorfields Eye Hospital, London, United Kingdom; 4Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, WA, Australia. Purpose: To investigate the reliability and repeatability of an image quality – grading system for cone photoreceptors imaged on an adaptive optics (AO) camera. Methods: 50 healthy subjects, aged 20-35 years old, with no eye diseases were recruited prospectively. The left eyes of the participants were imaged using an AO camera (rtx1, Imagine Eyes, Orsay, France) at 5 degrees of retinal eccentricity, twice. The 2 images acquired on each subject were anonymized and randomized and the resulting 100 independent unpaired images were graded. A set of AO images validated by two independent experts in AO images and confirmed by a master grader was used as the basis of the 3-level grading system. Two masked independent observers (A and B) graded all the 100 images twice. Grading concordance was assessed by percentage of perfect agreement and kappa statistics. Results: Exact intra-grader agreement on the quality of images for A and B were 90% and 79% respectively, (unweighted k statistics 0.85 and 0.68 respectively, P’s<0.001). Exact inter-grader agreement between A and B’s, 1st grade was 73% and 2nd grade in 76% (unweighted κ statistics 0.59 and 0.63 respectively, P’s < 0.001). Conclusions: The high intra and inter – grader agreement of observer A and B’s 1st and 2nd grades from this study demonstrates a high degree of reproducibility of the grading scores. This AO image grading system can be used as a reliable indicator for assessing the quality of images acquired on this AO camera prior to assessing changes in cone counts. Commercial Relationships: Nick M. Muthiah, None; Fred K. Chen, None; Joe Zhong, None; Zoe McClelland, None; Ferenc Sallo, None; Tunde Peto, None; Pete Coffey, None; Lyndon da Cruz, None Program Number: 4938 Poster Board Number: B0066 Presentation Time: 3:45 PM–5:30 PM Evaluating Descriptive Metrics of the Human Photoreceptor Mosaic Robert F. Cooper1, Melissa A. Wilk2, Alfredo Dubra4, 3, Joseph Carroll2, 3. 1Biomedical Engineering, Marquette University, Wauwatosa, WI; 2Cell Biology, Neurology and Anatomy, Medical College of Wisconsin, Milwaukee, WI; 3Ophthalmology, Medical College of Wisconsin, Milwaukee, WI; 4Biophysics, Medical College of Wisconsin, Milwaukee, WI. Purpose: Vital to expanding the clinical utility of adaptive optics (AO) ophthalmic imaging is the development of robust geometrical metrics for describing the photoreceptor mosaic. This requires a firm theoretical understanding of the strengths and limitations of various metrics as well as empirical data on the sensitivity of individual metrics and the relationships between metrics. Here we explore the relationship between individual metrics as a potential space to identify abnormalities across subjects. In particular, we focus on the effects of diffuse and focal photoreceptor loss. Methods: Between 10 and 90 regions of interest were extracted from 14 normal confocal and split-detector AO scanning light ophthalmoscope photoreceptor montages, and cone locations were identified using a previously described algorithm. Density, nearest neighbor distance (NND), inter-cell distance (ICD), furthest distance (FD), percent six-neighbor cells, nearest neighbor regularity (NNR), number of neighbors regularity (NoNR), and Voronoi cell area regularity (VCAR) were extracted from coordinates with bound Voronoi regions. Confidence intervals (CIs) with 95% significance were calculated for each of the metric relationships. Between 5-80% of cones were removed to simulate diffuse and focal cell loss. Results: NND, ICD, and FD fell outside their CIs at 50, 80 and 30% diffuse cell loss, respectively. Percent six-neighbor cells, NNR, NoNR, and VCAR fell outside their CIs at 10, 30, 60 and 10% cone loss, respectively. All regularity metrics were more sensitive to cell loss at lower densities. VCAR was most sensitive to focal cell loss, with its values falling outside the CI at 5% loss. ICD was sensitive to focal changes in high-density mosaics above 15% focal loss, whereas FD fell outside its CI at 31% focal loss in only low-density mosaics. NND, NoNR, NNRI, and percent six-neighbor cells were insensitive to any focal cell loss. Conclusions: Spacing metrics are insensitive to cell undersampling, which enables estimating mosaic spacing in cases where every cell cannot be reliably identified. However, these same metrics are unable to detect early pathology. Conversely, regularity metrics are highly sensitive to both focal and diffuse cell loss, but require accurate cell identification. Thus, both types of metrics may be needed in combination to provide complete and accurate assessments of mosaic integrity. Commercial Relationships: Robert F. Cooper, None; Melissa A. Wilk, None; Alfredo Dubra, US Patent 8,226,236 (P); Joseph Carroll, None Support: T32EY014537, R01EY017607, P30EY001931, Research to Prevent Blindness, Departmental and Career Award (Dubra) ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Program Number: 4939 Poster Board Number: B0067 Presentation Time: 3:45 PM–5:30 PM Cone density estimates derived from the reflectivity of the inner segment ellipsoid band on en-face spectral domain OCT Maher Saleh1, Alois Bully2, 1, Mathieu Flores1. 1Department of Ophthalmology, University Hospital of Besançon, Besançon, France; 2The Superior Institute for Biomedical Engineering (ISIFC), Besancon, France. Purpose: The objective of this project is to develop, test and validate a software allowing to estimate photoreceptor density derived from the inner segment ellipsoid (ISe) band reflectivity on en-face OCT. Methods: Eight eyes displaying various degrees of outer retinal impairment (five eyes with resolved central serous chorioretinopathy, one with hydroxychloroquine toxicity, and two healthy eyes) were imaged using a spectral-domain OCT (Spectralis, Heidelberg, Heidelberg Engineering, Germany). En-face OCT was generated from horizontal transverse scans, 11m apart, with a resolution of 384A scan/Bscan. Segmentation of the Ise band was automatically performed with the Heidelberg Explorer plug-in provided by the manufacturer. The relevance of the “PR1” segmentation line was checked by two readers. At the same time, a software running on Matlab, (Matlab, Mathworks Inc., Natick, USA) that transforms the grey level into cone density was developed. Its algorithm is based on a previous work comparing OCT reflectivity and adaptive optics. The program determines the cone density in a ring ranging from 1.5 to 2 degrees of eccentricity from the fovea. In order to validate the estimates, cone densities were measured in the same eyes, in a blind manner, by an independent observer, using adaptive optics (AOdetect v0.2, Imagine Eyes, Orsay, France). Results: Thirty five points of comparison were obtained. The program estimates were closely correlated with the results of the reference counting method, i.e. adaptive optics (r2=0.81, p<0.05). Bland-Altman plot displayed a moderate estimated bias of 204±2660 cellules/mm2(CI95%: 5008-5418). The estimatation was considered relevant (defined as a difference of more and less 10%) in 80% of the cases. Conclusions: It has become possible to estimate cone density with an OCT device currently used in routine practice, at least in a defined retinal area. Improvement in the acquisition procedure (resolution, artefact management...) will eventually improve the accuracy of the results. Commercial Relationships: Maher Saleh, None; Alois Bully, None; Mathieu Flores, None Support: This work was supported by AFCRO grant number [130712]. Program Number: 4940 Poster Board Number: B0068 Presentation Time: 3:45 PM–5:30 PM Adaptive optics photoreceptor mapping : Compensation of photoreceptor scintillation by image fusion Chahira Miloudi1, Laurent Mugnier2, Jose A. Sahel1, Florence Rossant3, Isabelle Bloch4, Michel Paques1. 1CIC 1423, Quinze-Vingts Hospital, Paris, France; 2ONERA, Chatillon, France; 3ISEP, Issy les Moulineaux, France; 4Telecom ParisTech, Paris, France. Purpose: Adaptive optics (AO) images of photoreceptors are affected by spatial and temporal variability. In particular, high frequency (>10Hz) variation of reflectance of individual cones, termed here scintillation, may be observed. We hypothesized that scintillation is a major source of photoreceptor reflectance variability and hence of cone counting. In order to improve the reliability of cone countings, we developed a procedure for compensating scintillation based on fusion of deconvolved AO images. Methods: AO fundus images were obtained through dilated pupils with a commercially available flood imaging AO camera (rtx1™ camera; Imagine Eyes, Orsay, France; illumination wavelength 840nm) within an IRB-approved clinical study in 5 normal eyes. The routine acquisition procedure comprised a stack of 40 raw images acquired over 4.2 seconds, 2° from the fovea. For each subject, raw images were deconvolved with a myopic deconvolution method [Blanco and Mugnier, 2011] and underwent automatic cone detection [Loquin et al. 2011] over a 94x94mm area. Cone maps obtained from raw images were fused; the increment in cone density at every step was measured. The results were compared to cone maps obtained by image averaging (AO image 2.0) Results: In three subjects, the increment in cone density reached an asymptotic plateau between the 10th and 20th map integration. In one subject the plateau was not obtained (i.e. the addition of new raw images increased the total amount of cone detected). The last subject had limited scintillation, hence there was limited increment. The relative improvement in total number of detected cone by fusing 20 raw deconvolved images compared to the number of cones detected on averaged image ranged from 5% to 71%. Conclusions: Fusion of deconvoluted raw images improves the quality of cone detection from flood-illuminated AO images. Commercial Relationships: Chahira Miloudi, None; Laurent Mugnier, None; Jose A. Sahel, ImagineEye (S); Florence Rossant, None; Isabelle Bloch, None; Michel Paques, ImagineEye (C) Support: the Institut National de la Santé et de la Recherche Médicale (Contrat d’Interface 2011), the Agence Nationale de la Recherche (ANR-09-TECS-009 and ANR-12-TECS-0015-03), the Foundation Fighting Blindness (C-GE-0912-0601-INSERM02) and the French Ministry of Research (CIFRE131145A10). Clinical Trial: NCT01546181 Program Number: 4941 Poster Board Number: B0069 Presentation Time: 3:45 PM–5:30 PM Evaluate Reproducibility and Repeatability of Automatic Cone Cell Count Comparing to Manual Count Using Adaptive Optics Scanning Laser Ophthalmoscopes Jackie Ching-Lung Chen1, 2, Huei-Chung Huang3, Alice Jih3, Won Seok Choi1, Stanley Chang1. 1Ophthalmology, Columbia University medical center, Newyork, NY; 2Ophthalmology department, Chang Gang Memorial Hospital, Chiayi, Taiwan; 3Programs in Occupational Therapy, Columbia University, New York, NY. Purpose: To present the reproducibility and repeatability of cone distribution and density measurement, comparing the automatic count to the manual count. The imaging quality and individual differences of operators are also considered using by adaptive optics scanning laser ophthalmoscopes (AOSLO) images and preprocessing with software of ARIA system, Canon Inc. Methods: Total 22 eyes of 11 healthy subjects were included for repeatability test of AOSLO imaging system, prototype II Canon. The S1(340X340um) image was taken at each different meridian of macula of the same 1.0mm distance from fovea by the same operator in 3 different days. Another 18 eyes of 9 healthy volunteers were recruited for reproducibility test and P0 (680X680um) images were also obtained by the same method above, but performed by 3 different skilled operators following totally randomized order within 30 minutes. The 100X100um area was selected by choosing the entirely same cone mosaic location of 3 different images from different times (repeatability) and different operators (reproducibility). All the selected 100X100um images were measured automatically by ARIA and point-by-point by manual counting. Each selected image was also evaluated using the subjective score grading level from 0 to 10. Using blocking analysis of variance (ANOVA) ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics and regression methods, image quality, counting method, and meridian of macula were evaluated on the measurements at statistical significant level of 0.05. Results: Results of repeatability analysis: within each meridian, there is no significant difference between automatic and manual counting (p = 0.294). We also observed no statistically significance for the interaction effect between meridian and image quality (p = 0.408). However, when the quality of image increased the average difference in auto counting and manual counting measurements shrunk (p < 0.01). Results of reproducibility analysis: we found no significant difference between two counting methods and each meridian of macula (p = 0.27). There is also no statistical significance between both methods and different operator (p = 0.94). Conclusions: The repeatability and reproducibility analyses of AOSLO showed that both automatic and manual counting methods were reliable, but as image quality decreased manual counting remained accountable. Bad image quality induced counting error. Commercial Relationships: Jackie Ching-Lung Chen, None; Huei-Chung Huang, None; Alice Jih, None; Won Seok Choi, None; Stanley Chang, Alcon (C) Program Number: 4942 Poster Board Number: B0070 Presentation Time: 3:45 PM–5:30 PM In situ Densitometry of Cone Photoreceptors in Human Eyes by Adaptive Optics Scanning Laser Ophthalmoscopy Masakazu Hirota1, Suguru Miyagawa1, 2, Hiroyuki Kanda1, Takao Endo3, Tibor K. Lohmann1, 4, Takeshi Morimoto1, Takashi Fujikado1. 1Applied Visual Science, Osaka University, Suita-shi, Japan; 2Fundamental Technology Sec, R&D Department, Topcon, Itabashi, Japan; 3Ophthalmology, Osaka University, Suita-shi, Japan; 4 Ophthalmology, RWTH Aachen University, Aachen, Germany. Purpose: To measure the changes in the reflectance of human cone photoreceptors in situ with an adaptive optics scanning laser ophthalmoscope (AO-SLO) before and after bleaching. Methods: Eight eyes of 8 healthy young adult subjects (age: 21-33 years) were studied. The changes in the cone reflectance were measured with a custom-built AO-SLO (developed by Osaka University and Topcon) with a sampling rate of 5-Hz. The AO-SLO had a resolution of 512 × 512 pixels and had a 12-bit gray scale resolution. The field of view was set at 7×7 degrees with the center at 1 or 3 degrees temporal to the fovea. We calculated the cone density in this area. For bleaching, we used 630-nm red light emitting diodes (LEDs, brightness of 3600 cd/m2). Twenty-one red LEDs were set in a circular pattern and placed 7 cm in front of the cornea of the right eye. After mydriasis and 10 min of dark-adaptation, images of the cone mosaics were recorded continuously for 300 seconds without light stimulation, then after bleaching by the LEDs for 300 seconds, and then for 300 seconds after the cessation of light stimulation. The measurements were made in a dark room of 0.01 lx. The average cone reflectance was computed by the ImageJ software (Rasband W, NIH, USA), and the average cone reflectance before light stimulation was set as the baseline. The reflectance at the baseline was compared to that during and after light stimulation at 1 and 3 degrees. Results: The average cone density was significantly higher at 51283.87±2736.97 cells/mm2 at 1 degree than the 30388.38±2176.05 cells/mm2 at 3 degrees (P<0.001 Wilcoxon). After light-adaptation, the reflectance increased relative to that at the baseline by 134.3±13.8% at 1 degree and by 126.0±10.2% at 3 degrees (P<0.001, Wilcoxon). The increase in the cone reflectance after bleaching at 1 degree was significantly greater than that at 3 degrees (P<0.05, Wilcoxon). Conclusions: The significantly greater reflectance change where the cone density was higher (1 degree) indicates that the amount of reflectance change is related to the cone density. Commercial Relationships: Masakazu Hirota, None; Suguru Miyagawa, Topcon (E); Hiroyuki Kanda, None; Takao Endo, None; Tibor K. Lohmann, None; Takeshi Morimoto, None; Takashi Fujikado, None Program Number: 4943 Poster Board Number: B0071 Presentation Time: 3:45 PM–5:30 PM Cone spacing measures in visually normal eyes imaged at baseline and 12 months Shane Griffin1, Angela N. Baldwin1, Nicolas Sippl-Swezey1, Jaskiran Mann1, Panagiota Loumou1, Ravi Keshavamurthy1, Travis Porco1, Austin Roorda2, Jacque L. Duncan1. 1Ophthalmology, University of California San Francisco, San Francisco, CA; 2School of Optometry and Vision Science Graduate Group, University of California Berkeley, Berkeley, CA. Purpose: To determine the inter-visit and inter-grader variability of Adaptive Optics Scanning Laser Ophthalmoscopy (AOSLO) derived cone spacing measures in normal eyes monitored longitudinally over 12 months. Analysis of cone spacing measures in normal eyes will establish the variability of cone spacing as an outcome measure for use in clinical studies of photoreceptor change utilizing AOSLO. Methods: Eight visually normal patients underwent AOSLO imaging at 3 visits; 2 baseline visits were separated by no more than 1 month, and one visit occurred 12 months after the baseline visits. Cone spacing was measured in each image by two independent graders. Cone spacing measures were compared between visits and graders, and then correlated with standard macular measures including visual acuity, foveal sensitivity, Goldmann perimetry, and spectral-domain optical coherence tomography (SD-OCT)-derived outer segment layer thickness. Results: Cone spacing was measured in 424 regions within 3.5 degrees of the fovea. Agreement between graders was strong (ICC = 0.87, 95% confidence interval (CI) 0.81-0.90); mean difference between graders was 0.07 arcminutes (95% CI 0.05-0.08). Median absolute difference between cone spacing measures at each ROI between the 2 baseline visits was 0.047 arcminutes (95% CI=0.040.059). Cone spacing at 12 months decreased by -0.0039 arcminutes (95% CI: -0.01 to 0.0023), consistent with no change over time in this normal population. Similarly, there were no significant changes in any clinical measures of retinal degeneration. Conclusions: A high degree of inter-visit and inter-grader agreement of AOSLO-derived cone spacing measures was observed in visually normal eyes examined twice at baseline and at 12 months. The reproducibility of cone spacing measures in normal eyes lends support to the future use of AOSLO in clinical trials studying photoreceptor change over time. Commercial Relationships: Shane Griffin, None; Angela N. Baldwin, None; Nicolas Sippl-Swezey, None; Jaskiran Mann, None; Panagiota Loumou, None; Ravi Keshavamurthy, None; Travis Porco, None; Austin Roorda, University of Houston, US 7,118,216 (P), University of Rochester, US 6,890,076 (P) (P); Jacque L. Duncan, None Support: NIH Grant EY002162, FDA R01-41001, Research to Prevent Blindness, The Bernard A. Newcomb Macular Degeneration Fund, That Man May See, Inc., Hope for Vision, NIH EY014375, Foundation Fighting Blindness Clinical Trial: NCT00254605 ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Program Number: 4944 Poster Board Number: B0072 Presentation Time: 3:45 PM–5:30 PM Stimulus-evoked optical response of individual cone photoreceptors observed with adaptive optics scanning light ophthalmoscopy Kenneth M. McKay1, Zachary Harvey2, Grace K. Han3, Alfredo Dubra2, 4, Jessica I. Morgan3. 1Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; 2Ophthalmology, Medical College of Wisconsin, Milwaukee, WI; 3Scheie Eye Institute, Ophthalmology, University of Pennsylvania, Philadelphia, PA; 4 Biophysics, Medical College of Wisconsin, Milwaukee, WI. Purpose: In vivo functional assessment of the retina at the cellular level remains elusive and is increasingly important as therapies for blinding conditions are developed. Though the physiology is largely unknown, stimulus-evoked intrinsic signals have potential to assess photoreceptor function. Here, we describe a stimulus-evoked optical response, visible at the cellular level. Methods: Neither dark adapted nor bleached parafoveal cones in 3 normal controls (2 females, ages 34 and 24 and 1 male, age 27) were imaged using a custom adaptive optics scanning light ophthalmoscope. A one-degree square field was illuminated with 8.3μW of 848nm for wavefront sensing, 75μW of 795nm Δ15nm for reflectance imaging, and a background of 344.7nW at 675nm. Half of the field was stimulated with 17.4μW of 675nm for 2s. Images were acquired at 16Hz for 5s before, during, and 20s after stimulation. Intensities of stimulated cones in the 795nm image were normalized by the average intensity of non-stimulated cones in the same image. The change in intensity ratio over time was calculated by subtracting the average pre-stimulus intensity ratio from the intensity ratio for each stimulated cone in each frame. Then, for each image, the standard deviation of the change in intensity ratios over all stimulated cones was calculated to describe the global reflectance variability across the stimulated cones. Results: We observed a stimulus-evoked response in approximately just under half of cones in the stimulated field of all 3 subjects. Following the stimulus onset, the cone intensity ratio either oscillated between bright and dim, increased, decreased, or remained unchanged. While an individual cone’s change in intensity ratio pattern was not repeatable, each trial did produce a response. On average, the reflectance variability metric reliably increased 229ms (188, 250, 250ms) post-stimulus onset. Non-stimulated cones did not show a response. Conclusions: We describe a cellular-level near infrared optical response to visible red light stimulation, possibly showing L cone function. Future studies will correlate this optical response to physiological function and examine the response in conditions where photoreceptor function is compromised. Commercial Relationships: Kenneth M. McKay, None; Zachary Harvey, None; Grace K. Han, None; Alfredo Dubra, 8226236 (P), Canon, Inc. (C); Jessica I. Morgan, 8226236 (P), Canon Inc. (C), Canon Inc. (F), Optos, PLC (F), Optos, PLC (R) Support: Foundation Fighting Blindness, Glaucoma Research Foundation Catalyst for a Cure, Research to Prevent Blindness Career Development Award, National Institutes of Health (Grant EY019861), Research to Prevent Blindness, the F. M. Kirby Foundation, the Paul and Evanina Mackall Foundation Trust, Lois Pope Life Foundation, and the Jeffrey W. Berger Medical Student Research in Ophthalmology Award. Clinical Trial: NCT01866371 504 High-resolution Blood Flow Imaging Thursday, May 07, 2015 8:30 AM–10:15 AM Exhibit Hall Poster Session Program #/Board # Range: 5296–5306/A0050–A0060 Organizing Section: Visual Psychophysics / Physiological Optics Contributing Section(s): Eye Movements/Strabismus/Amblyopia/ Neuro-Ophthalmology, Multidisciplinary Ophthalmic Imaging Program Number: 5296 Poster Board Number: A0050 Presentation Time: 8:30 AM–10:15 AM High resolution imaging of retinal vascular network geometry Jonathan Benesty1, 2, Edouard Koch2, David Rosenbaum3, Xavier Girerd3, José Sahel1, 2, Florence Rossant4, Isabelle Bloch5, Michel Paques1, 2. 1CHNO des Quinze Vingts, Paris, France; 2CIC 503 INSERM, Paris, France; 3Pitié-Sapetrière Hospital, Paris, France; 4 Institut Supérieur d’Electronique de Paris, Paris, France; 5Telecom ParisTech, Paris, France. Purpose: An energetically optimal vascular network should theoretically respect some physical principles among which the cubic mathematical relationship between parent and daughter vessels at bifurcations (Murray’s law). Deviations from this optimal geometry have been reported in several vascular diseases. The availability of high resolution imaging of vessels offers the opportunity to reevaluate these results. Here, following our initial evaluation of adaptive optics (AO) retinal vascular imaging (Koch et coll. 2014), we mathematically analyzed arterial and venous bifurcations to calculate more precisely the junction exponent and to evaluate the effect of cardiovascular risk factors. Methods: Flood-illumination AO imaging was done in 93 arterial and 25 venous bifurcations of 21 controls and 65 patients (mean age 45.7 years ±15.2; M/F 44/49) with various cardiovascular risk factors (hypercholesterolemia, hypertension, diabetes, smoking). A semiautomated procedure was used to measure vascular diameters and angles. Results: In control arteries, the mean value of the arterial junction exponent (theoretically equal to 3) was 2.80 (±0.44). The linear regression for measured vs predicted parent arterial diameter was 0.993 with a coefficient of determination R2=0.942. Mean arterial bifurcation angle measured was 85.05° (±11.7°), which was significantly different from the mean optimal angle 71.7°(±13.9°) (p<0.01). In the cardiovascular risk group, the arterial junction exponent was significantly higher than controls (3.24±1.4 versus 2.8±0.44; p=0.02) but not the venous junction exponent (2.47 ±0.45 versus 2.42 ±0.46; p=0.8). The junction exponent in the diabetic group (n=9) was 3.9 (±2.5), no difference was found with the control group (p=0.25) but it might be a consequence of the small number of diabetic patients. Conclusions: In arterial bifurcations of normal eyes, the junction exponent is not significantly different from 3, further confirming Murray’s law as a general principle for small arteries but not veins. Patients with cardiovascular risk factors have a higher arterial junction exponent, suggesting an alteration of flow distribution. AO imaging of arterial bifurcations may therefore provide a novel biomarker of the general vascular state. Further studies are needed to understand the anatomical, functional and clinical significance of this finding. Commercial Relationships: Jonathan Benesty, None; Edouard Koch, None; David Rosenbaum, None; Xavier Girerd, None; José Sahel, Imagine Eyes (S); Florence Rossant, None; Isabelle Bloch, None; Michel Paques, C (C) ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Program Number: 5297 Poster Board Number: A0051 Presentation Time: 8:30 AM–10:15 AM Follow-up of morphometric parameters of retinal arterioles in hypertensive subjects: an adaptive optics imaging study Edouard Koch4, 1, Florence Rossant2, Nicolas Lerme2, Marthe Lagarrigue2, Isabelle Bloch3, José Sahel4, Xavier Girerd5, Jonathan Benesty4, David Rosenbaum5, Michel Paques4. 1Ophthalmology, Hospital, Versailles, France; 2ISEP, Paris, France; 3Telecom Paristech, Paris, France; 4Clinical Investigation Center, Quinze-Vingts Hospital - INSERM, Paris, France; 5Cardiology, Pitié Salpétrière Hospital, Paris, France. Purpose: Morphological changes affecting the wall of small retinal arteries are observable using adaptive optics (AO) imaging (Koch et al, J Hypertens. 2014). Here, we prospectively and quantitatively investigated the changes of the inner diameter (ID) and wall-to-lumen ratio (WLR) of retinal arterioles in hypertensive humans during treatment. Methods: In a group of hypertensive subjects (n = 21; mean age 50 years [32;71]) the ID and the WLR of the superotemporal artery from AO images (rtx1; ImagineEyes, France) was measured using a dedicated software. Two groups of hypertensive subjects were followed and analysed : the first group of naïve patients (n=9) before and after initiation of hypotensive treatment, the second group of treated patients (n=12). Results: The mean follow-up was 234 days [range, 42-552]. The ID increased within three months of initiation of hypotensive treatment (69μm [60-83] before versus 73μm [range, 57-87] after), and remained stable thereafter. Accordingly, the WLR was smaller after initiation of hypotensive treatment patients (0.35 [0.17-0.51] before versus 0.32 [0.17-0.47] after initiation of hypotensive treatment). In the group of treated patients the WLR and ID did not change over time (0.35 [0.23-0.5] versus 0.34 [0.27-0.45], 69.5 [59-90] versus 70.24 [61.4-83.8]. These modifications were not significantly correlated to changes in arterial pressure. Conclusions: Initiation of hypotensive treatment induces vasodilation of arteries, independantly of the changes of arterial pressure. This suggests that microvascular changes may provide additional medical information, in particular regarding cerebral perfusion given the functional similarities between the retina and the brain microcirculations. For instance, arterial pressure drop without change in microvascular resistances may decrease downstream perfusion. Additional studies are needed to identify drug-specific effects. Commercial Relationships: Edouard Koch, None; Florence Rossant, None; Nicolas Lerme, None; Marthe Lagarrigue, None; Isabelle Bloch, None; José Sahel, None; Xavier Girerd, None; Jonathan Benesty, None; David Rosenbaum, None; Michel Paques, None Support: ANR_09_TECS_009_01_iPhot Clinical Trial: C10-03 Program Number: 5298 Poster Board Number: A0052 Presentation Time: 8:30 AM–10:15 AM Imaging of Periarteriolar Capillary Free Zone using Offset Pinhole Adaptive Optics Scanning Light Ophthalmoscopy Toco Y. Chui1, 2, Nikhil Menon1, 2, Nadim Choudhury1, 2, Alexander Pinhas1, 2, Michael Dubow1, 2, Nishit Shah1, Alfredo Dubra3, 4, Richard B. Rosen1, 2. 1Ophthalmology, New York Eye & Ear Infirmary of Mount Sinai, New York, NY; 2Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY; 3Ophthalmology, Medical College of Wisconsin, Milwaukee, WI; 4Biophysics, Medical College of Wisconsin, Milwaukee, WI. Purpose: Previous studies have shown that the dimension of the periarteriolar capillary free zone (CFZ) is associated with the retinal oxygen level. In this study, we imaged and quantified the CFZ in healthy controls using an offset pinhole adaptive optics scanning light ophthalmoscope (AOSLO). Methods: Periarteriolar CFZ imaging was performed on 7 healthy controls (7 eyes, 6 males) using an offset pinhole AOSLO with an imaging wavelength centered at 790nm. Images were obtained along the retinal vascular arcades starting at the superior or inferior optic disc margin. Image sequences were acquired using a 1.5-degree field of view at a frame rate of 15Hz. After sinusoidal distortion and eye motion artifacts were removed, averaged vascular structural images and motion contrast vascular perfusion maps were obtained for quantitative measurements of lumen diameter, vessel wall thickness, and periarteriolar CFZ width using a semi-automatic MATLAB software. Results: Arteriolar lumen diameter, vessel wall thickness, and CFZ width were visualized in all subjects. CFZ was found at the same retinal depth as the arterioles. Vessels with a lumen diameters ranging in size from 16 to 76 mm were imaged and measured. The mean±SD mm of lumen diameter, vessel wall thickness, and CFZ was 42±15 mm, 10±2 mm, and 46±7 mm, respectively. The wall-to-lumen ratio was 0.24±0.08 mm (range: 0.13-0.44). The CFZ width measurements ranged from 36 to 71 mm. Although there was a weak positive correlation, no statistical significance was found between the CFZ width and lumen diameter (Linear Regression; p>0.05). Conclusions: Offset pinhole AOSLO provides the ability to noninvasively and quantitatively assess periarteriolar CFZ. This has the potential for better understanding of the retinal vascular development in the healthy retina and in disease states such as diabetic retinopathy and retinopathy of prematurity. Commercial Relationships: Toco Y. Chui, None; Nikhil Menon, None; Nadim Choudhury, None; Alexander Pinhas, None; Michael Dubow, None; Nishit Shah, None; Alfredo Dubra, Canon USA Inc (C), US patent 8,226,236 (P); Richard B. Rosen, Advanced Cellular Technologies (C), Advanced Cellulat Technologies (C), Allergan (C), Clarity (C), OD-OS (C), Opticology (I), Optovue (C) Support: Marrus Family Foundation, Wise Family Foundation, Glaucoma Research Foundation Catalyst for a Cure and RPB Career Development Award. Program Number: 5299 Poster Board Number: A0053 Presentation Time: 8:30 AM–10:15 AM Comparison of retinal vascular caliber measured by adaptive optics and from fundus photographs softwar. granados loic1, Edouard Koch2, Jonathan Benesty2, Florence Rossant3, Nicolas Lerme3, Max Villain1, Vincent Daien1, 4, Michel Paques2. 11Department of Ophthalmology, Gui De Chauliac Hospital, Montpellier, France; 2Clinical Investigation Center 503, Centre Hospitalier National des Quinze-Vingts, INSERM and Université Pierre et Marie Curie-Paris6, Paris, France; 33Institut Supérieur d’Electronique de Paris, Paris, France; 4Inserm, U1061, Montpellier, France. Purpose: Retinal vascular caliber analysis has been linked with increased cardiovascular risk and is predictive of cardiovascular pathology. The main purpose of this study was to compare 2 methods to evaluate retinal vascular caliber: IVAN® software from fundus photography and retinal vascular diameters from adaptive optics optics (AO) imaging. Secondary objective was to assess the relationships of each retinal vascular variables with systolic blood pressure (BP). Methods: 25 treatment-naive individuals underwent both AO imaging and fundus photography. Central Retinal artery equivalent (CRAE) was measured from fundus photographs using semiautomated standardized IVAN® software. Adaptive optics imaging of ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics the superotemporal retinal artery was performed and semi-automated segmentation allowed extracting parietal thickness and lumen diameter. Pearson’s correlation coefficient and Bland-Altman method were used to assess relationship between both technics of retinal vascular caliber assessment. Results: Mean (+/- standard deviation [SD]) CRAE from IVAN® software was 135.37 +/- 14.0 mm and mean arterial diameter from adaptive optics was 76.41+/- 11.7 mm. Mean systolic BP was 130.2 +/- 20 mmHg. Correlation coefficient between arterial diameter using AO and CRAE was 0.66 (p=0.0003). The biais between both technic (95% confidence interval) according to the Bland–Altman definition was 58.8 (54.7-63.2) mm. Inverse correlation was found between CRAE and wall to lumen ratio (r=-0.52, p=0.008). Systolic BP was significantly correlated with arterial parameters (r=-0.41, p=0.04; r=0.50, p=0.01 and r=0.71, p<0.001; for CRAE, arterial diameter from AO and wall to lumen ratio from AO respectively). Conclusions: Our study shows correlation between adaptive optics measures (both diameters and wall to lumen ratio) and central retinal artery equivalent from fundus photography. All parameters were correlated with systolic BP. Larger studies are necessary to confirm these results and to compare variables derived from retinal arterial caliber with cardiovascular outcome. Commercial Relationships: granados loic, None; Edouard Koch, None; Jonathan Benesty, None; Florence Rossant, None; Nicolas Lerme, None; Max Villain, None; Vincent Daien, None; Michel Paques, None Program Number: 5300 Poster Board Number: A0054 Presentation Time: 8:30 AM–10:15 AM In vivo retinal vascular wall imaging in patients with diabetic retinopathy using non-confocal Split Detection Adaptive Optics Scanning Light Ophthalmoscopy Nikhil Menon1, 2, Nadim Choudhury1, 2, Toco Y. Chui1, 2, Alexander Pinhas1, 2, Yusufu N. Sulai3, Alfredo Dubra3, 4, Richard B. Rosen1, 2. 1 Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY; 2Icahn School of Medicine at Mount Sinai, New York, NY; 3Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, WI; 4Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI. Purpose: To measure lumen diameter and wall thickness of perfused retinal vasculature, and to quantify changes in diabetic retinopathy (DR) relative to healthy control eyes. Methods: The retinal vasculature of 5 subjects with DR [2 background DR (BDR), 1 nonproliferative DR (NPDR), 2 proliferative DR (PDR)] secondary to type II diabetes mellitus (mean age 54, range 41-62; mean HbA1c 8.2) and 5 healthy control subjects (mean age 31, range 25-55, mean HbA1c 5.2) was imaged with non-confocal split detection adaptive optics scanning light ophthalmoscopy (SD AOSLO; Scoles et al., 2014) using 790 nm light. Images of arterioles and venules along the retinal vascular arcades starting at the optic disc margin, as well as of the capillaries adjacent to the foveal avascular zone were acquired. After sinusoidal distortion and eye motion were removed, lumen diameter, vessel wall thickness, and wall to lumen ratio (WLR) were estimated in averaged images semiautomatically using custom Matlab software (MathWorks, Natick, MA) (Hillard et al, IOVS 2013. E-Abstract 6061). Results: Lumen (diameter) of arterioles and venules ranged between 8 and 135 μm. Mean ±SD of arteriolar wall thickness in DR subjects was 14±2 μm (range 5-27) as compared to 12±2μm (range 5-23) in controls (p<0.07). Mean±SD venular wall thickness was 9±1 μm (range 5-18) in DR as compared to 8±1 μm (range 4-17) in controls (p=0.50). DR subject eyes had significantly higher arteriolar WLR than control eyes (mean±SD: 0.35±0.06 vs. 0.26±0.03, unpaired t test, p<0.03). The same was also true of venular WLR in DR subject eyes as compared to controls (mean±SD: 0.19±0.03 vs. 0.15±0.02, unpaired t test, p<0.02). Conclusions: Microscopic non-invasive imaging of the fine retinal vasculature using SD AOSLO allows quantification of lumen and wall thickness. This technique has potential both for early detection of DR, as well as accurate monitoring of progression and personalizing treatment. Commercial Relationships: Nikhil Menon, None; Nadim Choudhury, None; Toco Y. Chui, None; Alexander Pinhas, None; Yusufu N. Sulai, None; Alfredo Dubra, Canon USA Inc. (C), RPB Career Development Award (F), US Patent No: 8,226,236 (P); Richard B. Rosen, Advanced Cellular Technologies (C), Allergan (C), Carl Zeiss Meditech (C), Clarity (C), OD-OS (C), Opticology (I), Optovue (C) Support: Marrus Family Foundation, Wise Family Foundation, Glaucoma Research Foundation Catalyst for a Cure, RPB Career Development Award Program Number: 5301 Poster Board Number: A0055 Presentation Time: 8:30 AM–10:15 AM Murray’s law and vascular branching in normal and diabetic subjects Ting Luo, Thomas Gast, Tyler Vermeer, Stephen A. Burns. Indiana University Bloomington, Bloomington, IN. Purpose: To examine the branching pattern of the retinal vasculature using high resolution imaging with regard to vessel diameters and angle. The branching of the retinal vasculature is constrained by physical principles, which are expressed in Murray’s law, which states that the cube of a parent vessel’s diameter is equal to the sum of the cubes of the branches. Studies have suggested that this is followed relatively well in normal for the large vessels of the eye and deviates for smaller vessels. Methods: We used an adaptive optics scanning laser ophthalmoscope to measure the outer diameters for retinal vessels. We tested 10 normal and 11 diabetic subjects. Following imaging the resulting videos were averaged. Photoshop was used to measure the diameters of both parent and daughter branches of the images. For each vessel location, measurements were repeated five times and averaged. Averaged data were fit to a Murray’s law type power law, but determining the best fit exponent. Results: Vessels could be reliably measured for sizes from 10 to over 100 microns. While Murray’s law predicts a cubic relation between the parent vessel radius and the sum of the cubed daughter vessels we found that the best fit exponent was not 3. For both the arterioles and venules of normals, the best fit exponet for vessels greater than 10 microns was 2.4 (95% CI 2.3-2.5). For the diabetics we found a value of 2.5 (95% CI 2.3-2.8), also a deviation from the expected value of 3 . Angles for capillaries could be measured in the normals, and they had a high exponent of 3.4 (95% CI 3.0-3.8). In the diabetics, due to the variability in caillary diameter observed, we were unable to make a comparison to. Conclusions: While diabetes changes capillary diameters, it does not seem to be changing the bifurcation relations of vessels slightly larger than capillaries. In our analysis we measured sizes very close to the vessel bifurcation and it could be that the size relations vary more at larger distances from the bifurcation. Commercial Relationships: Ting Luo, None; Thomas Gast, None; Tyler Vermeer, None; Stephen A. Burns, None Support: EY04395 ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Program Number: 5302 Poster Board Number: A0056 Presentation Time: 8:30 AM–10:15 AM Retinal arterial and venous wall visualization using nonconfocal split-detector adaptive optics laser scanning ophthalmoscopy Shigeta Arichika, Akihito Uji, Nagahisa Yoshimura. Kyoto University Graduate School of Medicine, Kyoto, Japan. Purpose: As it is well known that Adaptive Optics Scanning Laser Ophthalmoscopy (AOSLO) is a noninvasive technique enabling direct visualization of photoreceptors and vasculature, we decided to study the vascular wall structure of 3 normal subjects using our novel prototype of nonconfocal split-detector AOSLO system developed by Canon Inc. Methods: In our split-detector nonconfocal AOSLO, confocal and 2 split nonconfocal signals were simultaneously recorded. The splitdetector signal results from the difference between the intensities of the 2 nonconfocal signals divided by their sum at every pixel. The imaging light wavelength of our AOSLO was 840 nm and its optical resolution was 3 μm. The nonconfocal AOSLO images including split-detector images were acquired for 3 normal subjects (5 eyes; mean age, 35 years). The retinal area scanned was 1.4 × 1.4° and 2.8 × 2.8°, and AOSLO images of the upper largest temporal artery and vein were obtained. The scans were recorded for 3 s per area (frame rate, 32 Hz). Results: For all 3 subjects, artery and vein were clearly described. The average literal arterial and venous wall thickness was 10.8 mm and 4.91 mm for subject A, 8.96 mm and 5.13 mm for subject B, and 11.0 mm and 5.99 mm for subject C, respectively. Conclusions: Nonconfocal split-detector AOSLO is a noninvasive technique which enables clear vascular visualization for both arteries and veins. This technique has the potential to identify preclinical or histological microvascular changes. However, further clinical studies are needed to validate our results. Commercial Relationships: Shigeta Arichika, None; Akihito Uji, None; Nagahisa Yoshimura, Canon (C), Canon (F) Program Number: 5303 Poster Board Number: A0057 Presentation Time: 8:30 AM–10:15 AM Adaptive Optics imaging patterns of retinal vasculitis. Marie-Helene Errera1, 2, Jonathan Benesty1, 2, Edouard Koch1, 2, Céline Chaumette1, 2, Jose A. Sahel1, 2, Bahram Bodaghi3, Michel Paques1, 2. 1Hopital des Quinze-Vingts, Paris, France; 2DHU ViewMaintain, INSERM-DHOS CIC 1423, Paris, F-75012, France, INSERM & Université Pierre et Marie Curie-Paris 6, Paris, France; 3 Ophthalmologydepartment, DHU ViewMaintain, Pitié-Salpêtrière Hospital, Université Pierre et Marie Curie-Paris 6,, Paris, France. Purpose: To describe the morphologic features of eyes with retinal vasculitis using adaptive optics (AO) imaging Methods: We analyzed the AO images (rtx1 camera, ImagineEye, Orsay, France) of a series of 12 eyes from 12 patients with various etiologies of retinal vasculitis (toxoplasmosis (n=3), multiple sclerosis (n=3), birdshot chorioretinopathy (n=2), and syphilis, dengue, sarcoidosis, and tuberculosis (n=1 each). We paid particular attention to perivascular opacification and changes in lumen diameter. Results: Besides areas of paravascular opacification which was observed in all eyes, we identified by AO several novel features: glistening whitish dots similar to Gunn’s dots on the surface of retinal vessels (3 eyes); focal irregularities in the lumen diameter of arteries with (6 eyes) or without perivascular opacification (n=5); focal reduction of vein lumen with perivenous opacification (3 eyes). Conclusions: AO imaging reveals novel patterns of fundus changes related to retinal vasculitis. An interesting finding was the frequent presence of focal narrowing of arterioles. Additional studies are needed to understand the significance of these features. Commercial Relationships: Marie-Helene Errera, None; Jonathan Benesty, None; Edouard Koch, None; Céline Chaumette, None; Jose A. Sahel, None; Bahram Bodaghi, None; Michel Paques, ImagineEye, Orsay, France (C) Clinical Trial: ClinicalTrials.gov number, NCT0154618 Program Number: 5304 Poster Board Number: A0058 Presentation Time: 8:30 AM–10:15 AM Detecting Early AMD with Retinoscopy Clinton N. Sims. C. Norton Sims, MD PA, Ft Myers, FL. Purpose: To evaluate the detection of AMD by a retinoscopic technique. Pupillary streaks produced using a calibrated streak retinoscope (Fig. 1) and parallel light vary in reflectance with the pigment and health of the retinal pigment epithelium (RPE). The brightness of the reflected pupillary streak was evaluated using a reflectance scale of #5 to #1, with #5 describing a bright streak decreasing to #2, a faint streak, and #1, no visible streak reflex. Methods: This was a retrospective study of patients seen in a general ophthalmology practice. Patients with healthy streaks and those with conditions which interfere with retinoscopic streaks were excluded. Patients with depressed streaks, 1-3, and/ or abnormal fundus exams were referred to retinal specialists. Patient’s ages ranged 27-93; 25% of the patients had previous diagnoses of AMD, 83% had negative personal or family history of AMD and 98% were Caucasian with 64% female. The parallel retinoscopic technique (Fig. 2) was performed after the preliminary ophthalmic examination and a subjective refraction. Slide locks maintained the calibration alignment of the thumb slide of the retinoscope. Pupils were dilated for fundus exams. Results: Of the 124 eyes with depressed 1-3 streaks, 96% were subsequently diagnosed with AMD by a retinal specialist, i.e. there was a high correlation between abnormal retinoscopic streaks and AMD. Of the 44 eyes previously diagnosed with AMD, 100% had depressed streaks. Of eyes not previously diagnosed with AMD but with depressed streaks, 86% were confirmed to have AMD by the retinal specialist. Conclusions: This study demonstrates that retinoscopy can detect early and late AMD. Macular pigment is the common element in retinoscopy and AMD. Current evidence suggests that a decrease in the RPE function may contribute to the onset and progression of AMD. This retinoscopic technique may be a useful tool for monitoring the progression and response of AMD to various therapeutic interventions, evaluating patients with AMD scheduled for cataract surgery and improving one’s skills ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics in recognizing early AMD pigment changes. Eye physicians are trained in retinoscopy making inexpensive mass screenings for AMD possible. Early detection could greatly benefit research, patients and society. Fig. 2 Fig. 2 Retinoscopic requirements to evaluate the melanin pigment reflectance. Commercial Relationships: Clinton N. Sims, C. Norton Sims, MD (P), C. Norton Sims, MD (P) Fig. 1 Retinoscope calibrated for parallel and +0.50D converging retinoscopy. Program Number: 5305 Poster Board Number: A0059 Presentation Time: 8:30 AM–10:15 AM Wavefront sensorless adaptive optics fluorescence imaging in mouse retina Daniel Wahl1, Yifan Jian1, Robert J. Zawadzki2, Marinko V. Sarunic1. 1Engineering Science, Simon Fraser University, Burnaby, BC, Canada; 2Department of Cell Biology and Human Anatomy, University of California Davis, Davis, CA. Purpose: Transgenic mice expressing Green Fluorescent Protein (GFP) as a reporter molecular are particularly important for vision research. The ability to image molecular markers has the potential to accelerate vision research by allowing retina function to be observed in vivo. To achieve cellular resolution imaging in the mouse eye, a wavefront sensorless adaptive optics (WSAO) bio-microscope with fluorescence detection was developed and evaluated by imaging various types of transgenic mice expressing GFP. Methods: We developed a lens-based WSAO mouse retinal imaging system that allowed a more compact optical design. An objective lens focused the light through a glass slide placed on the mouse eye to cancel refraction at the cornea and retain the mouse eye moisture to prevent corneal clouding. The numerical aperture of the imaging system was 0.17, providing an estimated focal waist of 0.9 μm. We utilized a segmented deformable mirror from IrisAO Inc. to perform modal control wavefront sensorless correction, using the intensity of the fluorescence signal as the merit function. Wildtype (c57BL/6) mice, and GFP labeled microglia (Cx3cr1-GFP) and ganglion cell (Thy1-GFP) mice were used in this research. The mice were ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics anesthetized and dilated prior to the imaging session. A generous amount of artificial tear gel was applied in order to maintain corneal hydration. The optical power at the mouse eye was ~100μw which is below the ANSI standard. Results: Representative WSAO bio-microscope images acquired from a mouse with GFP labeled microglia before and after correction are presented in Fig. 1. Optimization was performed on the small field of view (Top), which was then expanded (Bottom). After WSAO optimization the features in the focal plane were sharper and the overall image brightness was increased. Conclusions: We have demonstrated a lens based WSAO biomicroscope for high resolution fluorescence imaging in the mouse eye. The WSAO technique is an accessible method of improving image quality with increasing numerical aperture. Fig.1 : Images acquired from a mouse retina with GFP labeled microglia before and after WSAO correction. Scale bar: 10μm (Top), 20μm (Bottom) Commercial Relationships: Daniel Wahl, None; Yifan Jian, None; Robert J. Zawadzki, None; Marinko V. Sarunic, None Support: CIHR, NSERC, Michael Smith Foundation for Health Research, and Simon Fraser University Vice President of Research. NEI (R01 EY024239), UC Davis RISE Grant, NSF I/UCRC CBSS Grant. can be detected robustly by measuring the amount of polarization change that the surrounding birefringent nerve fibers cause during double passage of a beam of polarized light through them upon fundus reflection in double-pass systems. Polarized near-infrared light is reflected from the foveal and optic disc areas in bow-tie or propeller patterns of polarization states. These patterns are of constant shape, size, and location, for a given type of polarized light entering the eye, and are therefore detectable, offering the opportunity for eye tracking. The major advantage of this eye-fixation detection and tracking method is that it uses true information coming directly from retinal landmarks, as opposed to existing eye-tracking systems which use reflections from other structures, to identify the direction of foveal gaze. Methods: A coaxial emitter/detector sensor was developed, consisting of a solid state laser diode, a polarizer, a filter and a photodetector. Several such sensors could be used to interrogate different spots on the retina, thus eliminating the need for scanning systems with moving parts. To test the signal quality obtainable, using just one sensor, the test subject was asked to fixate successively on twelve “glow-in-the-dark” targets located on a circle around the emitter/detector to simulate the retina’s being interrogated by twelve sensors placed on a 3-deg diameter circle surrounding the projection of the fovea (Fig 1). Results: The resulting signals were plotted (Fig. 2). They are close to the ideal sine wave that would have been recorded from an ideal propeller-type birefringence pattern from a human fovea. We deem these results satisfactory, considering factors such as imperfect bowtie, imperfect fixation by the test subject, and signal noise. Conclusions: The method can be used in the detection of central fixation for medical and other purposes. It does not require calibration, strict restrictions on head position, or head-mounted appliances. Fig. 1 Program Number: 5306 Poster Board Number: A0060 Presentation Time: 8:30 AM–10:15 AM A no-moving-parts sensor for detection of eye fixation using polarized light and retinal birefringence information Boris I. Gramatikov, David L. Guyton. Ophthalmology, Johns Hopkins Wilmer Eye Inst, Baltimore, MD. Purpose: When an individual looks at a target, that target is imaged on the fovea. It is thus foveal fixation that correlates precisely with gaze direction. Recent research has shown that techniques which effectively track the optical projection of fundus landmarks out from the eye afford a more direct measurement of fixation direction. It has also been shown that landmarks such as the fovea and the optic disc ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Processing of 10° data for subject 2 is ongoing. NND measurements are consistent with the 2D power spectra estimations of 11.9 μm and 12.9 μm of subject 1 (3° and 10°), and 12.7 μm of subject 2 (3°). Conclusions: AO-OCT imaging permits visualization and quantification of the RPE packing geometry in the living human retina. Commercial Relationships: Zhuolin Liu, None; Omer P. Kocaoglu, None; Tim L. Turner, None; Donald T. Miller, U.S. Patent 7,364,296 (P) Support: NEI grants 1R01 EY018339 and P30 EY019008. Fig. 2 Commercial Relationships: Boris I. Gramatikov, Johns Hopkins University (P); David L. Guyton, Johns Hopkins University (P) Support: Individual Research Award from The Hartwell Foundation 533 Adaptive optics and retinal imaging Thursday, May 07, 2015 12:00 PM–1:45 PM 702/704/706 Paper Session Program #/Board # Range: 5883–5889 Organizing Section: Visual Psychophysics / Physiological Optics Program Number: 5883 Presentation Time: 12:00 PM–12:15 PM Imaging the retinal pigment epithelium mosaic with AO-OCT Zhuolin Liu, Omer P. Kocaoglu, Tim L. Turner, Donald T. Miller. School of Optometry, Indiana university, Bloomington, IN. Purpose: The retinal pigment epithelium (RPE) is critical for support and maintenance of photoreceptors. While dysfunction of the RPE underlies numerous retinal pathologies, biomarkers sensitive to early changes in RPE have been elusive. Because such changes start at cellular level, there has been increased interest in targeting the spatial arrangement and distribution of individual RPE cells. To do so in the living human retina is extremely challenging, owing to the lack of intrinsic contrast of RPE, optical waveguiding by the overlying photoreceptors, and blurring by ocular aberrations. In this study, we take advantage of the micron-level 3D resolution afforded by adaptive optics and optical coherence tomography (AO-OCT) to overcome these obstacles in order to visualize RPE cells and investigate their packing geometry. Methods: Using the Indiana AO-OCT imaging system (λc=790 nm, Δλ=42 nm), volumes of 1°×1° field of view were acquired at 3° and 10° temporal retina in two normal subjects. Volumes were registered, segmented, and RPE en face images extracted. Voronoi analysis was applied to the en face images to determine number of neighbors (NN) and center-to-center nearest neighbor distance (NND) of the RPE cells. 2D power spectra were used to provide additional information about cell spacing. Results: RPE cell mosaics were resolved in both subjects and retinal eccentricities. Voronoi analysis indicates hexagonal cells (with six NN) are most frequent (>50%) at 3° retinal eccentricity and are of lower frequency (<50%) at 10° retinal eccentricity. NND was 11.4±2.2 μm and 12.8±3.0 μm for subject 1 at 3° and 10° retinal eccentricities respectively, and 12.0±2.0 μm for subject 2 at 3°. Program Number: 5884 Presentation Time: 12:15 PM–12:30 PM Photoreceptor topography and marked discontinuity at the optic nerve head in young healthy subjects Ann E. Elsner, Joel A. Papay, Christopher A. Clark, Lucie Sawides, Alberto De Castro, Stephen A. Burns. Optometry, Indiana University, Bloomington, IN. Purpose: Individual differences in photoreceptor topography include a higher density of cones in the fovea and different rates of decrease of cone density with increasing eccentricity. We investigated the lack of a smooth change in cone density at the border of and extending into the scleral crescent, where there are no apparent retinal pigment epithelial (RPE) cells. Methods: To measure cone density at the optic nerve head without the presence of confounding factors such as high myopia or glaucoma, we recruited two subjects < 35 yr with wide scleral crescents despite healthy eyes and low refractive errors. The topography of the scleral crescent was documented with SD-OCT (Spectralis). The hyperreflectivity indicating the lack of melanincontaining RPE cells and the scleral pattern of birefringence were localized with scanning laser polarimetry (GDx). For high resolution imaging at the scleral crescent, a focus series with the Indiana Adaptive Optics Scanning Laser Ophthalmoscope (AOSLO) was used to document the thinned aspect of the scleral crescent and topography change, along with depigmentation. We used the AOSLO to image photoreceptors, the scleral crescent, and the overlying retinal blood vessels. The AOSLO had two channels for imaging photoreceptors via direct backscatter and multiple scattering, using center wavelengths of 785 and 810 nm. We documented cones in the scleral crescent with two operators. Two masked graders counted cones in 6 sampled regions per image, computing cone density with visual angle. Results: Cones density changed markedly near the scleral crescent over RPE cells and within the scleral crescent, where there was no evidence of RPE cells. Patches of higher cone density were found near the scleral crescent, but also regions of low density and even cones that appeared sideways in or near the scleral crescent. The ratio of cone density on and near the edge of scleral crescent to farther away and having RPE cells varied from 0.50 to 1.4 within a single image. In contrast, cones sampled within a single image but nearer to the fovea had more uniform coverage, ranging in density by only .83 to .99. Conclusions: Cone density, known to decrease systematically with increasing distance from the fovea, increases in some patches near the optic nerve head. Cones that are not over RPE cells have irregular densities and sometimes orientations. Commercial Relationships: Ann E. Elsner, None; Joel A. Papay, None; Christopher A. Clark, None; Lucie Sawides, None; Alberto De Castro, None; Stephen A. Burns, None Support: NIH Grants EY007624, EY004395, and P30EY019008 ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Program Number: 5885 Presentation Time: 12:30 PM–12:45 PM Variability in human cone topography enabled by adaptive optics scanning laser ophthalmoscopy (AOSLO) imaging of foveal centers Tianjiao Zhang2, 1, Christine A. Curcio1, Yuhua Zhang1, 2. 1 Ophthalmology, The University of Alabama at Birmingham, Birmingham, AL; 2Biomedical Engineering, The University of Alabama at Birmingham, Birmingham, AL. Purpose: Accurate assessment of variability of the human cone topography is important for interpreting the effects of aging and disease on the photoreceptor mosaic. We measure foveal cone densities to acquire a better estimation of variability between eyes of single individuals and between individuals, using a new generation research AOSLO. Methods: Forty eyes of 20 subjects with normal retinal health aged 19-29 years were studied. The refractive errors of the participants range from -3.0 D to 0.63 D and the fellow eye refractive error difference of individual subject is less than 0.50 D. AOSLO was performed to image the cone photoreceptors. Cone density was assessed on a two-dimensional mesh grid over the central 2.4 mm x 2.4 mm macula at up to 139 points. Mean cone densities, standard deviation, the coefficient of variation (CV), and cumulative cone numbers as a function of eccentricity were calculated to estimate the inter-subject variability. Cone density difference between fellow eyes was statistically assessed with a mixed model approach and quantified by the root-mean-square (RMS) and the maximum difference. Results: The peak densities of all eyes are 168,162 ± 23,529 cones/ mm2 (mean ± SD) (CV = 0.14). The mean cone density agrees well with the histological data (p = 0.9983 for both eyes). The total number of cones within the cone-dominated foveola is 38,311 ± 2,319 (mean ± SD) (CV = 0.06). The RMS cone density difference between fellow eyes is 6.78%, and the maximum intra-subject difference is 23.6%. There is no difference in the association between eccentricity and cone density in fellow eyes for the superior/nasal (p=0.8503), superior/temporal (p=0.1551), inferior/nasal (p=0.8609), and inferior/temporal (p=0.6662) quadrants of the retina. Conclusions: By measuring the foveal center cone density in a large number of eyes, we were able to determine the center of many retinae, thereby accurately assessing the cone density variability. Our results agree well with data provided by classical histology. We have confirmed that in living human eyes, though cone densities vary significantly in the fovea, the total number of cones within the conedominated foveola is less variant both within and between subjects. Thus, the total number of foveola cones may serve as an important measure for assessing cone loss due to aging or disease. Cone density and total cone counts. Commercial Relationships: Tianjiao Zhang, None; Christine A. Curcio, None; Yuhua Zhang, None Support: This project is funded by EyeSight Foundation of Alabama (YZ), International Retina Research Foundation (YZ), 5R21EY021903 (YZ), and R01EY06109 (CC) and institutional support from Research to Prevent Blindness, EyeSight Foundation of Alabama, Buck Trust of Alabama, and NIH P30 EY003039. Program Number: 5886 Presentation Time: 12:45 PM–1:00 PM Structural properties of the cone photoreceptor packing: Cone spacing and local anisotropy assessed with a cone-averaging method Lucie Sawides, Alberto De Castro, Stephen A. Burns. School of Optometry, Indiana University, Bloomington, IN. Purpose: To rapidly estimate cone spacing properties of the normal cone photoreceptor mosaic and to measure local anisotropies in the hexagonal pattern using a cone-averaging method. Methods: The Indiana high-resolution Adaptive Optics Scanning Laser Ophthalmoscope was used to image the cone photoreceptors of 5 normal healthy subjects (refractive error: -2.25±1.35 D, 28.8 ± 3.4 years old, 0.5% tropicamide dilated pupil). Measurement of cones were recorded while the subjects looked at each corner and the center of a 1 degree imaging field (0.5 Airy disk confocal aperture). In addition four strips of 2x5 degrees of cones corresponding to the four primary meridians (Temporal (T), ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Nasal (N), Superior (S), Inferior (I)) were recorded using a 2degrees imaging field (and 1.5 Airy disk confocal aperture). Montages of average images were generated using an automated algorithm (combining Matlab, i2k Retina and Adobe Photoshop). Cone spacing properties were analyzed using a custom program that automatically identified individual cones, within a window (50 or 100 microns) that varied with retinal location. Within each window, interior subregions around each cone were extracted and averaged, providing a “kernel” image of an average cone and its surrounding retina. From each kernel image, we measured the averaged cone spacing –computed as the first maximum of the radial profile, then estimated the orientation and spacing anisotropy of the hexagonal patterns based in determining the principle axes of the packing (fig.1). Results: There was a lower averaged cone spacing (higher cone density) along the horizontal (T, N) meridians than along the vertical (S, I) meridians. Locally the cone spacing was lower in vertical than in horizontal axes for all meridians near the fovea (<1°) with horizontal/vertical ratio of: 1.08±0.04 (T), 1.04±0.05 (N), 1.03±0.03 (S) and 1.05±0.01 (I). This tendency was maintained for Temporal and Nasal meridians in the parafovea (up to 5°) while it reversed for Superior meridian (1.11±0.07 (T), 1.10±0.06 (N), 0.97±0.05 (S), 1.00±0.03 (I)). Conclusions: The method allows rapid automated estimates of cone packing properties and provides an analysis of individual difference in cone spacing and local anisotropies of the hexagonal cone array. fig1: Kernel images with axes of the hexagonal packing (one subject, Temporal and Superior meridians from 0.1° to 4° eccentricity) Commercial Relationships: Lucie Sawides, None; Alberto De Castro, None; Stephen A. Burns, None Support: NIH EY04395; P30EY019008 Program Number: 5887 Presentation Time: 1:00 PM–1:15 PM Magnification Characteristics on Optical Coherence Tomography Systems Dirk-Uwe G. Bartsch. Ophthalmology-Shiley Eye Ctr, Univ of California-San Diego, La Jolla, CA. Purpose: Recent advances in optical coherence tomography (OCT) technology have led to the expansion of this technology into all areas of medicine. A large number of clinical studies have been conducted in areas such as glaucoma, macular degeneration, Alzheimer’s disease, and others. In these studies patients with different refractive errors are studied with different OCT devices using a variety of imaging protocols that measure retinal thickness. Our purpose was to study the lateral and axial magnification characteristics in six different optical coherence tomography devices in a model eye and draw conclusions for clinical studies. Methods: We build an eye model with a simulated retina and an achromatic doublet lens. The axial length of the eye model was adjustable to yield a corresponding defocus of +4D to -10D from emmetropia. We imaged the model eye with six different optical coherence tomographs (CirrusOCT, Optos OCT, Optovue, SpectralisOCT, StratusOCT, and Topcon DRI). We measured the lateral dimension of features on the simulated retina with each instrument. Additionally, we measured the axial dimension of a microscope cover glass. Results: In the first study we analyzed lateral magnification. The SpectralisOCT was the only telecentric imaging system and showed no magnification error with axial length. The Topcon DRI and Optovue showed 12% and 13% variability over the defocus range, respectively. The CirrusOCT and StratusOCT showed 30% variability and the Optos OCT showed 45% variability over the defocus range. In the second study we analyzed axial magnification error. None of the instruments showed any axial magnification error. Conclusions: Optical coherence tomography has dramatically altered retinal imaging and anatomical understanding. Recently, the instruments have been used to collect cross-sectional normative databases in large number of patients. These studies rely on the accuracy of the instrument for different refractive powers and different axial lengths. It appears that several instruments exhibit lateral magnification errors that need to be considered in crosssectional studies. Our studies indicate that none of the instruments exhibit axial magnification error. Commercial Relationships: Dirk-Uwe G. Bartsch, Heidelberg Engineering (R), Heidelberg Engineering (R) Support: NIH grant R01EY016323, NIH grant R01EY016323, NIH grant 1P30EY022589, Research to Prevent Blindness Program Number: 5888 Presentation Time: 1:15 PM–1:30 PM Adaptive optics SLO/OCT for visualizing retinal vasculature Michael Pircher, Franz Felberer, Matthias Rechenmacher, Richard Haindl, Bernhard Baumann, Christoph K. Hitzenberger. Center for Med Pyhs & Biomed Eng, Medical University of Vienna, Vienna, Austria. Purpose: To investigate the capability of our previously developed adaptive optics scanning laser ophthalmoscope / optical coherence tomography (AO-SLO/OCT) instrument for visualizing retinal vasculature on a cellular level. Methods: The SLO/OCT instrument records both imaging modalities simultaneously and is operated at frame rates between 10 and 40 fps. The field of view of the system can be varied between 1° x 1° and 4°x4°. The small field of view allows for an optimum adaptive optics correction and high resolution imaging. The larger field of view is used to generate overview images of the retina that enable an easy determination of the imaged location. A typical measurement takes several seconds. The en-face OCT technique provides two different operating modes. In the first mode, a 3D volume scan of the retina is recorded. Since the system is equipped with a dynamic focus scheme, an entirely sharp 3D volume can be recorded. In the second mode, the coherence plane and the focus plane can be set into a layer of interest (such as a layer containing a vessel) and several en-face OCT images of this layer are recorded with high speed. This enables the visualization of dynamic processes such as blood flow and frame averaging (similar to AO-SLO instruments) in order to increase the signal to noise ratio. Axial eye motion is compensated using active axial eye tracking and transverse motion is corrected in a post processing step. Results: Retinal blood flow on a cellular level was visualized using this technology. For larger vessels the coherence gate was set at different locations (anterior vessel wall, center part of vessel, posterior vessel wall) within the tissue enabling the visualization of different structures. The en-face OCT images show subtle details such as individual erythrocytes or vessel walls. Frame averaging enabled the visualization of different blood streams within a vessel. In addition new structures within the surrounding tissue of the vessels were found. ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Conclusions: The AO-SLO/OCT instrument is well suited to study dynamic processes such as blood flow on a cellular level. The high depth resolution provided by OCT enables a clear separation between different structures of the retina. The overview images and the 3D information that can be recorded by the same instrument allow an exact localization of the imaged region. Commercial Relationships: Michael Pircher, None; Franz Felberer, None; Matthias Rechenmacher, None; Richard Haindl, None; Bernhard Baumann, None; Christoph K. Hitzenberger, None Support: Austrian Science Fund P22329-N02 Program Number: 5889 Presentation Time: 1:30 PM–1:45 PM Structural and Functional Correlation of Retinal Photoreceptors Overlying Lesions in White Dot Syndrome Aniruddha Agarwal1, Mohamed K. Soliman1, 2, Nithya Rajagopalan1, Mostafa S. Hanout1, Mohammad A. Sadiq1, Loren S. Jack1, Salman Sarwar1, Diana V. Do1, Quan Nguyen1, Yasir J. Sepah1. 1 Ophthalmology, University of Nebraska Medical Center, Omaha, NE; 2Ophthalmology, Assiut University, Assiut, Egypt. Purpose: Lesions in white dot syndromes (WDS) may be associated with photoreceptor (PR) loss. A prospective cohort study was performed to evaluate PR density and correlate it with retinal sensitivity overlying lesions in WDS. Methods: Lesions of WDS (≤ 3 chosen/eye), within 5° foveal eccentricity, were imaged using adaptive optics (AO) (rxt1, Imagine Eyes, France), spectral-domain optical coherence tomography (SDOCT) and fundus autofluorescence (FAF) (Heidelberg Spectralis®, Germany). In this study, lesions were defined as active if there were presence of hyper-autofluorescence within the lesions. Eyes with choroidal neovascularization, high myopia (> 6 diopters), media opacity and other concomitant diseases were excluded. PR density was calculated using manufacturer-provided AO Detect 1.0 software after adjustment for axial length using IOLMaster® (Zeiss Meditech, CA). Retinal sensitivity was assessed using microperimetry (MP) (Optos SLO, UK) and correlated with PR density using Spearman Rank Correlation test. Results: Twenty-six lesions (9 patients: 7 females, mean age of 54.9 ± 16.6 years; 16 eyes) were analyzed. Diagnoses included serpiginous choroiditis (2 eyes), birdshot choroidopathy (3 eyes), presumed ocular histoplasmosis syndrome (2 eyes), punctate inner choroidopathy (6 eyes) and multifocal choroiditis (4 eyes). Mean PR density overlying 8 active lesions was 3076 ± 4654.89 cones/ mm2 and 6943.5 ± 5739.51 cones/mm2 overlying 18 inactive lesions (p = 0.117). Mean PR density over 20 lesions with disrupted inner segment-outer segment (IS-OS) junction on SD-OCT was 5005.64 ± 5024.89 cones/mm2 and 6943.5 ± 5739.51 cones/mm2 over 6 lesions with intact IS-OS junction (p = 0.28). Mean retinal sensitivity (7.42 ± 4.70 dB) showed fair correlation with PR density (ρ = 0.43, p = 0.04). Mean retinal sensitivity over lesions with intact IS-OS junction was 13 ± 2.45 dB and 5.71 ± 4.16 dB over lesions with disrupted IS-OS junction (p = 0.007). Appearance of lesions on AO imaging is shown in figure. Conclusions: AO imaging may allow high-resolution analysis of PR loss among lesions in WDS. Such microstructural changes may correlate with functional loss. Image shows an active lesion on FAF (A) associated with focal hypo-intensities on AO imaging (yellow asterisks) suggestive of PR loss (B). Healed lesions (C) show circumferential hypo-intense halo (white arrowheads) surrounding area of scarring (D). Commercial Relationships: Aniruddha Agarwal, None; Mohamed K. Soliman, None; Nithya Rajagopalan, None; Mostafa S. Hanout, None; Mohammad A. Sadiq, None; Loren S. Jack, None; Salman Sarwar, None; Diana V. Do, None; Quan Nguyen, None; Yasir J. Sepah, None 538 Accommodation and optical quality Thursday, May 07, 2015 12:00 PM–1:45 PM Exhibit Hall Poster Session Program #/Board # Range: 5997–6021/B0146–B0170 Organizing Section: Visual Psychophysics / Physiological Optics Contributing Section(s): Lens, Multidisciplinary Ophthalmic Imaging Program Number: 5997 Poster Board Number: B0146 Presentation Time: 12:00 PM–1:45 PM Ciliary muscle morphology in emmetropia and ocular biometric correlates Richa Saigal, Leon N. Davies, Amy L. Sheppard. School of Life and Health Sciences, Aston University, Birmingham, United Kingdom. Purpose: Recent studies have documented a link between axial myopia and ciliary muscle morphology; yet, the variation in biometric characteristics of the emmetropic ciliary muscle are not fully known. Ciliary muscle morphology, including symmetry, was investigated between both eyes of emmetropic participants and correlated to ocular biometric parameters. Methods: Anterior segment optical coherence tomography (Zeiss, Visante) was utilised to image both eyes of 49 emmetropic participants (mean spherical equivalent refractive error (MSE) ≥ -0.55; < +0.75 D), aged 19 to 26 years. High resolution images were obtained of nasal and temporal aspects of the ciliary muscle in the relaxed state. MSE of both eyes was recorded using the Grand Seiko WAM 5500; axial length (AXL), anterior chamber depth (ACD) and lens thickness (LT) of the right eye were obtained using the Haag-streit Lenstar LS 900 biometer. A bespoke semi-objective ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics analysis programme was used to measure a range of ciliary muscle parameters. Results: Temporal ciliary muscle overall length (CML) was greater than nasal CML, in both eyes (right: 3.58 ± 0.40 mm and 3.85 ± 0.39 mm for nasal and temporal aspects, respectively, P < 0.001; left: 3.65 ± 0.35 mm and 3.88 ± 0.41 mm for nasal and temporal aspects, respectively, P < 0.001). Temporal ciliary muscle thickness (CMT) was greater than nasal CMT at 2 mm and 3 mm from the scleral spur (CM2 and CM3, respectively) in each eye (right CM2: 0.29 ± 0.05 mm and 0.32 ± 0.05 mm for nasal and temporal aspects, respectively, P < 0.001; left CM2: 0.30 ± 0.05 mm and 0.32 ± 0.05 mm for nasal and temporal aspects, respectively, P < 0.001; right CM3: 0.13 ± 0.05 mm and 0.16 ± 0.04 mm for nasal and temporal aspects, respectively, P < 0.001; left CM3: 0.14 ± 0.04 mm and 0.17 ± 0.05 mm for nasal and temporal aspects, respectively, P < 0.001). AXL was positively correlated with ciliary muscle anterior length (AL) (e.g. P < 0.001, r2 = 0.262 for left temporal aspect), CML (P = 0.003, r2 = 0.175 for right nasal aspect) and ACD (P = 0.01, r2 = 0.181). Conclusions: Morphological characteristics of the ciliary muscle in emmetropic eyes display high levels of symmetry between the eyes. Greater CML and AL are linked to greater AXL and ACD, indicating ciliary muscle growth with normal ocular development. Commercial Relationships: Richa Saigal, None; Leon N. Davies, None; Amy L. Sheppard, None Support: UK College of Optometrists Research Studentship (20132016) Program Number: 5998 Poster Board Number: B0147 Presentation Time: 12:00 PM–1:45 PM Anatomically-accurate paraxial optical model of cynomolgus lens accommodation with continuous gradient Fabrice Manns1, 2, Bianca Maceo Heilman1, 2, Arthur Ho3, 1, JeanMarie A. Parel1, 4. 1Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami, Miami, FL; 2Biomedical Optics and Laser Laboratory, Department of Biomedical Engineering, University of Miami, Coral Gables, FL; 3Brien Holden Vision Institute, Sydney, NSW, Australia; 4Vision Cooperative Research Center, Sydney, NSW, Australia. Purpose: To develop an anatomically-accurate model of the primate crystalline lens with continuous refractive index gradient that predicts the accommodative response. Methods: We used data acquired on 6-year old cynomolgus monkey lenses (n=7, age=6.0 to 6.8 years) during simulation of accommodation in a lens stretcher (Ehrmann et al, Clin Exp Opt, 2008). During stretching, lens power was measured with a system based on the Scheiner principle. Anterior and posterior curvature and thickness were obtained from cross-sectional optical coherence tomography images (Uhlhorn et al, Vis Res 2008). An anatomical model of the accommodating lens was created by averaging the unstretched radii of curvature, unstretched thickness, unstretched power, accommodation, curvature-power slope, and thicknesspower slope of the 7 lenses. The values were entered in a paraxial lens model with continuous index gradient (Manns et al, ARVO 2008). The gradient is modeled as a set of spherical iso-indicials with radius that varies linearly from the equator to the surface. The refractive index at the lens center and surface are set to be equal to 1.429 and 1.375 independent of accommodation (De Castro et al, IOVS, 2013). A power-dependence is assumed for the axial index variation: n(z)=1.429-0.054 zb/tb, where t is the anterior or posterior half-thickness. The power coefficient b was calculated so that the accommodative response predicted by the optical model matches that of the anatomical model. Results: Unstretched radius: Anterior = 4.28+/-0.43 mm and posterior = 3.23+/-0.11 mm; unstretched thickness = 3.91+/-0.12 mm; unstretched power = 49.2+/-3.6D; accommodation = 20.1+/6.1D; curvature-power slope: Anterior = 0.00646+/-0.00102 mm-1/D and posterior = 0.00525+/-0.00097mm-1/D; thickness-power slope = 0.042+/-0.002 mm/D. The power coefficient increased non-linearly from b=5.0 in the relaxed state to b=5.8 in the accommodated state. The corresponding average/equivalent indices are approximately independent of accommodation: 1.420/1.440 for the relaxed and 1.421/1.438 for the accommodated lens. The power coefficient, average and equivalent index and their changes with accommodation are consistent with results obtained using a gradient reconstruction algorithm (De Castro et al, IOVS 2013). Conclusions: The model with continuous gradient accurately predicts the anatomical and optical accommodative response of cynomolgus lenses. Commercial Relationships: Fabrice Manns, None; Bianca Maceo Heilman, None; Arthur Ho, None; Jean-Marie A. Parel, None Support: NEI Grants: R01EY14225, R01EY021834, F31EY021444 (Maceo), P30EY14801 (Center Grant); Australian Federal Government CRC Program (Vision CRC); Research to Prevent Blindness; the Florida Lions Eye Bank; Drs. KR Olsen and ME Hildebrandt; the Henri and Flore Lesieur Foundation (JMP) Program Number: 5999 Poster Board Number: B0148 Presentation Time: 12:00 PM–1:45 PM Experimental Protocols for Ex-Vivo Lens Stretching Tests to Investigate the Biomechanics of the Human Accommodation Apparatus Ralph Michael1, Laura Pinilla Cortés1, Gustavo A. Montenegro1, Justin C. D’Antin1, Marek Mikielewicz1, Rafael I. Barraquer1, Harvey J. Burd2. 1Institut Universitari Barraquer, Barcelona, Spain; 2 Department of Engineering Science, University of Oxford, Oxford, United Kingdom. Purpose: To explore alternative experimental protocols to investigate the biomechanical behavior of the crystalline lens and zonules using ex-vivo stretching. Methods: Radial stretching tests were conducted on the anterior segment (consisting of lens, zonules, ciliary body and sclera) of four pairs of presbyopic human donor eyes. A simple mechanical model is used to describe the behavior of the anterior segment when tested in this way. Each pair of samples was initially stretched with the ciliary body intact. One sample was re-tested after cutting the ciliary body radially and the other sample was re-tested after removing the lens. Results: The external forces needed to stretch the sample with the ciliary body intact were significantly greater than for the tests in which the ciliary body had been cut. The forces measured with the ciliary body intact and lens in-situ, were comparable to the sum of the forces measured in the tests where the ciliary body had been cut (lens in-situ) and the forces measured in the tests on the intact ciliary body, with the lens removed. Conclusions: When stretching tests are conducted on the anterior segment, significant circumferential tensions develop in the ciliary body. This means that the forces applied to the lens and zonules cannot be related directly to the forces applied by the external loading system. If radial cuts are introduced in the ciliary body prior to testing, however, then this difficulty does not arise. Commercial Relationships: Ralph Michael, None; Laura Pinilla Cortés, None; Gustavo A. Montenegro, None; Justin C. D’Antin, None; Marek Mikielewicz, None; Rafael I. Barraquer, None; Harvey J. Burd, None ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Program Number: 6000 Poster Board Number: B0149 Presentation Time: 12:00 PM–1:45 PM Isolated human lens shape determined by tridimensional digital shadowphotogrammetry: A pilot study Ashik Mohamed1, 2, Heather A. Durkee3, Fabrice Manns3, 4, Arthur Ho2, 5, Virender S. Sangwan1, 5, Jean-Marie A. Parel3, 5, Robert C. Augusteyn2, 5. 1Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India; 2School of Optometry and Vision Science, The University of New South Wales, Sydney, NSW, Australia; 3Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL; 4 Biomedical Optics and Laser Laboratory, Department of Biomedical Engineering, University of Miami College of Engineering, Miami, FL; 5Vision Cooperative Research Centre, Brien Holden Vision Institute, Sydney, NSW, Australia. Purpose: To examine the curvature of the anterior and posterior surfaces of isolated human crystalline lenses using a digital minishadowphotogrammetric system. Methods: Crystalline lenses (n = 103, aged 1 month to 88 years, median post-mortem time 26 hours) were isolated from eyes received from the Ramayamma International Eye Bank, Hyderabad, India. Axial thickness, equatorial diameter and surface curvatures (central 3 mm) were calculated from coronal and sagittal profiles of the lenses imaged using a custom-built shadowphotogrammetric system (Mohamed et al, IOVS 2014;55: E-Abstract 747) (Fig. 1). The data were analyzed as a function of age using regression analysis. Results: For the younger lenses (aged 1 month to 5 years), the anterior (3.99 ± 0.61 mm) and posterior (4.16 ± 0.74 mm) radii of curvature (R) were independent of age (p>0.05). There was no significant difference between the anterior and posterior radii of curvature in young lenses (p = 0.71, Paired t-test). For older lenses (aged 14 to 88 years), the anterior radius (8.74 ± 2.22 mm) was independent of age (p>0.05), whereas the posterior radius showed a significant increase with age (R = 4.94 + 0.02*Age, p = 0.0003). In these lenses, the anterior radius was significantly larger than the posterior radius (p<0.0001, Wilcoxon signed-rank test). The ratio of anterior radius to posterior radius showed no age dependency (p>0.05) in both young (0.99 ± 0.24) and adult (1.51 ± 0.37) lenses, the difference between the two groups being significant (p = 0.001, Mann-Whitney test) (Fig. 2). Thickness (T) decreases from ~5.4 mm during infancy to ~4.2 mm by 5 years, and increases significantly with age from 14 to 88 years (T = 3.79 + 0.01*x, p<0.0001). The diameter shows an exponential relationship with age (y = 7.21x0.07). Conclusions: The human crystalline lens anterior and posterior surface curvatures are quasi equal in very young isolated lenses. Lens curvatures stabilize around age 14. Representative Coronal and Sagittal Images The ratio of anterior radius to posterior radius as a function of age Commercial Relationships: Ashik Mohamed, None; Heather A. Durkee, None; Fabrice Manns, None; Arthur Ho, None; Virender S. Sangwan, None; Jean-Marie A. Parel, None; Robert C. Augusteyn, None Support: NIH R01EY021834, R01EY014225 and P30EY14801, the Australian Federal Government CRC Scheme through the Vision Cooperative Research Centre, Florida Lions Eye Bank, and Henri and Flore Lesieur Foundation (JMP). Raksha Urs, Victor Hernandez and Andres Bernal provided technical support. Program Number: 6001 Poster Board Number: B0150 Presentation Time: 12:00 PM–1:45 PM Performance of the crystalline lens in the accommodated eye of myopia Jennifer Bruhns, Ji C. He. New England College of Optometry, Boston, MA. Purpose: Accommodation of the eye is performed by deformation of the crystalline lens, and deficiency of the accommodation is believed to be a factor associated with myopia development. However, the lens performance during accommodation in the myopic eyes has not been well investigated. The purpose of this study was to measure optical and structural changes in the accommodated lens of myopic eyes. Methods: A custom developed Hartmann-Shack wavefront sensor, integrated with a custom developed spectral domain optical coherent tomography (SD-OCT) system, was used to measure accommodative responses (AR) for 17 young adults (aged 21 to 39 yrs old, Rx from -0.75 D to -8.50D with a mean of -4.50±2.44D). The wavefront sensor measured Zernike aberrations up to 7th order for the right eye when accommodative stimulation (AS) was presented for the same eye at 0.0, 2.0, 4.0 and 6.0D with a Badal system. The 840nm SDOCT system, co-axially aligned with the wavefront sensor, was used to image the cornea and the lens. Results: When accommodating 6D, the mean accommodative changes were 5.40±0.48D in refractive power and -0.03±0.04micron in spherical aberration. With 6D accommodation, the mean anterior chamber depth (ACD) was shortened by 0.28±0.06mm while the lens thickness (LT) was thicken by 0.313±0.07mm, and thus resulting in a backward movement of the posterior lens surface of 0.04±0.04mm. The mean anterior lens radius changed from 12.68±1.91mm at 0D to 8.99±1.69mm at 6D of accommodation. Whereas, the mean posterior lens surface was more curved. It ranged from 6.90±1.09 mm in radius at 0D to 6.30±1.02mm at 6D accommodation. There was a significant correlation between the LT change and the ACD change (R2 = 0.76, p<0.001). ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Conclusions: Compared to a forward movement of the lens in the accommodated eye of emmetropia, as we reported in last ARVO, the lens moves backward more in the accommodated eye of myopia. The relatively more backward movement of the lens might contribute to the deficiency of accommodation in myopic eye and thus be associated with myopia development. Commercial Relationships: Jennifer Bruhns, None; Ji C. He, None Support: 1R21EY021336 Program Number: 6002 Poster Board Number: B0151 Presentation Time: 12:00 PM–1:45 PM Impact of scattering on accommodation responses Alexandros Pennos1, Emmanuel Chirre1, Pedro M. Prieto1, Ulrich Wildenmann2, Frank Schaeffel2, Pablo Artal1. 1Laboratorio de Óptica, Universidad de Murcia, Murcia, Spain; 2Ophthalmic Research Institute, Universitat Tübingen, Tübingen, Germany. Purpose: Increased intraocular scattering degrades vision due to a reduction of contrast in the retinal images. This may also have an impact on accommodation. The aim of this study is to investigate the relationship between increased scatter and accommodation performance. Methods: An open-view binocular sensor [Chirre et al., Opt. Lett., 39, 4773, (2014)] operating in real time (25Hz) with an invisible infrared beam (1050 nm) was used to measure accommodation, pupil size and aberrations in both eyes simultaneously. Six young subjects (29.5 ±2.6 years old) without any known ocular anomaly were measured while accommodating monocularly with their dominant eye from far (3 m) to a near (0.3 m) target through scattering diffusers. Accommodation was measured in the contralateral eye, not covered with the diffuser nor exposed to the stimuli. Six diffuser conditions were tested: no filter (baseline), 0.1 and 0.6 Bangerter foils (Ryser Optik, St. Gallen, Switzerland), BlackProMist 2, ProMist 1, and the combination of ProMist1 and ProMist2 (Tiffen Company, Hauppauge, NY, USA). All of them were characterized by means of a single-pass optical integration method [Ginis et al., J. Vis. 12(3), 20, (2012)]. Results: A very good correlation (R2 = 0.94) was found between the scatter coefficient induced by each filter and the average lag of accommodation. For the densest filter (0.1 Bangerter foil), the average loss of accommodative response was 0.64±0.62 D, with values close to 1.5 D for one subject. The increase in the lag of accommodation is mainly produced by under-accommodation to the near stimulus although for the 0.1 Bangerter foil most subjects also found difficulties to relax their accommodation when the stimulus is placed at far. Conclusions: Intraocular scattering, which is known to reduce the contrast of the retinal images, impairs the performance of the accommodation response. We have found a high correlation between the amount of induced scattering and the increase in the lag of accommodation. In early presbyopic subjects with elevated scatter, this effect could be a factor in age-related loss of accommodation. Commercial Relationships: Alexandros Pennos, None; Emmanuel Chirre, None; Pedro M. Prieto, None; Ulrich Wildenmann, None; Frank Schaeffel, None; Pablo Artal, None Support: Supported by the SEIDI, Spain (grant FIS2013-41237-R), ITN-OPAL (supported by European Commission’s Seventh Framework Programme under the Marie Curie Actions) and Seecat (Advanced Research Grant of the European Research Council). Program Number: 6003 Poster Board Number: B0152 Presentation Time: 12:00 PM–1:45 PM Effect of Orthokeratology on the dynamics of ocular accommodation Yimin Yuan, Yilei Shao, Weigen Zhu, Meixiao Shen, Fan Lu. School of Ophthalmology & Optometry, Wenzhou Medical University, Wenzhou, China. Purpose: To investigate the pattern of dynamic accommodative response of myopic eyes after orthokeratology. Methods: Ten myopic children (mean ± SD age: 10.1 ± 2.4 years) who fitted orthokeratology lenses in both eyes were recruited. The right eye of each subject was investigated before dispensing, and 1 month, 3 month and 6 month after Orthokeratology. For each visit, accommodative stimuli was given by a Badal system. Meanwhile, dynamic accommodation was continuously recorded using Grandseiko WAM-5500 auto-refractor. Real-time imaging of the anterior segment was simultaneously performed using a custombuilt ultra-long scan depth OCT based on CMOS camera. The values of accommodative response (AR), as well as anterior chamber depth (ACD), pupil diameter (PD), lens thickness (LT), anterior (LAC) and posterior (LPC) surfaces curvatures of the lens were obtained. Then custom algorithms were developed to fit curves and to yield dynamic aspects (latency, peak velocity, and amplitude) for the changes of the above parameters. Results: The latency of AR decreased and the peak velocity of AR increased at 3 months and 6 month after orthokerotology compared to baseline (Re-ANOVA and post hoc test, P < 0.01). The amplitude of AR increased at 6 month after orthokerotology (P < 0.01). For non-accommodative condition, ACD, and the radii of ASC were found significantly decreased at 1 month, 3 month and 6 month after Orthokeratology compared to baseline (P < 0.01). Meanwhile, the LT was found significantly increased (P < 0.01). Conclusions: Dynamic accommodation was improved in myopic children after Orthokeratology. The morphology of anterior eye seemed to be more “accommodative” at relax status. This may suggest that the improvement of accommodation is a key factor for myopia control using Orthokeratology. Commercial Relationships: Yimin Yuan, None; Yilei Shao, None; Weigen Zhu, None; Meixiao Shen, None; Fan Lu, None Support: National Natural Science Foundation of China (Grant No. 81170869) Program Number: 6004 Poster Board Number: B0153 Presentation Time: 12:00 PM–1:45 PM Accommodative changes of the wavefront aberration, lens shape and ciliary muscle in the emmetropic eyes of young adults Ji C. He1, Jianhua Wang2, Mian C. Wei1, Jing C. Mao1. 1New England College of Optometry, Boston, MA; 2Bascom Palmer Eye Institute, Miami, FL. Purpose: Accommodation of the human eye involves a loop of biological and optical processes, including the ciliary muscle contraction, the lens shape deformation, and the change of ocular wavefront aberrations. But, inter-relationship of the accommodative changes between different accommodative components within the loop has not been well explored. The purpose of this study was to study the inter-relationship between the different components by in vivo measuring accommodative changes of the wavefront aberration, lens shape and ciliary muscle for emmetropic young adults. Methods: A Hartmann-Shack wavefront sensor, integrated with two OCT systems, was developed to measure wavefront aberrations for 15 subjects (aged 22 to 27 yrs old; Rx from -0.50 to +1.00D) during accommodation. One OCT system was used to image the lens ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics deformation while the other was aligned for imaging ciliary muscle contraction. Results: Over a 6D accommodation, mean accommodative changes were: 5.43±0.26D in refractive power; -0.083±0.027 micron in spherical aberration, 44.4±7.5 and 24.0.1±21.3 (m-1) in curvature of the anterior and posterior lens surfaces respectively, 0.38±0.03mm in lens thickness (LT), and 0.065±0.048mm in the difference of ciliary thickness between 1.0mm and 3.0mm from the scleral spur. For individual eye, the change in anterior lens curvature was significantly correlated to the refractive power change (mean correlation coefficient r=0.97) and also to the change in the difference of ciliary thickness (mean r=0.81). The LT was negatively correlated to spherical aberration for every eye (mean r=-0.95). Conclusions: For emmetropic eye, accommodative change in refractive power is in proportion to the changes in lens curvatures, which are in turn proportionally related to the change of ciliary muscle thickness. The results provide basic information for characterizing accommodation performance and also for designing accommodative intraocular lens. Commercial Relationships: Ji C. He, None; Jianhua Wang, None; Mian C. Wei, None; Jing C. Mao, None Support: NEI 1R21EY021336 Program Number: 6005 Poster Board Number: B0154 Presentation Time: 12:00 PM–1:45 PM Accommodative response to electrical stimulation of the sclera of peripheral cornea in cats and porcines Toshifumi Mihashi1, Yoko Hirohara2, 4, Tomomitsu Miyoshi3, Suguru Miyagawa4, 5, Hiroyuki Kanda4, Hajime Sawai3, Takashi Fujikado4, Thomas Drew6, James S. Wolffsohn6. 1Innovative Research Initiatives, Tokyo Institute of Technology, Yokohama, Japan; 2Product Technology Sec., Topcon Corp., Itabashi, Japan; 3 Department of Integrative Physiology, Osaka University Graduate School of Medicine, Suita, Japan; 4Department of Applied Visual Science, Osaka University Graduate School of Medicine, Suita, Japan; 5Fundamental Technology Sec., Topcon Corp., Itabashi, Japan; 6 School of Life and Health Sciences, Aston University, Birmingham, United Kingdom. Purpose: We have reported that the changes in the accommodative response to electrical stimulation of the branches of the ciliary nerves in cats. (Miyagawa et al, PLoS One, 2014). We have also reported that no robust accommodative responses to the electrical stimulations of the sclera of peripheral cornea (SSPC) were observed in enucleated porcine eyes (Mihashi et al, VPOptics, 2014). In this study, accommodative responses to SSPC stimulation in cats and porcines were investigated. Methods: Two eyes of two cats under anesthesia and after they were sacrificed were studied. Three enucleated porcine eyes obtained from a local slaughterhouse were also studied. Trains of biphasic pulses (current, 3 mA; duration, 2 ms/phase; frequency, 40 Hz) were applied using a tungsten electrode (0.3mm diameter) from several orientations. Wavefront sensing with a compact wavefront aberrometer (Uday et al J Cataract Refract Surg, 2013) were performed before and 4 s (cat) and 10 s (pig) after the stimulations and wavefront aberrations including spherical errors were analyzed over a 4-mm pupil area. Results: In the first cat under anesthesia, at three out of seven stimulus positions, 0.2 D hyperopic accommodative responses were observed and in two orientations, myopic responses were observed. For the other cat, weak accommodative responses including astigmatic changes were observed. In the sacrificed condition of the second cat, 0.1 D myopic response was observed for one stimulus orientation and the smaller responses were observed at six out of eight stimulus positions. No accommodative responses were elicited for the enucleated porcine eyes. Conclusions: In the anesthetized cats, electrical stimulation of the SSPC induced accommodative responses; the responses were unstable and weaker than the responses by the ciliary nerve stimulations we observed in our previous study. Small accommodative responses were observed after one of two cats had been sacrificed, but no accommodative responses were detected in the enucleated porcine eyes. Further studies are needed to confirm difference in the accommodation functions in the two species. Commercial Relationships: Toshifumi Mihashi, Topcon CorpÔºé (F); Yoko Hirohara, Topcon Corp. (E); Tomomitsu Miyoshi, None; Suguru Miyagawa, Topcon Corp. (E); Hiroyuki Kanda, None; Hajime Sawai, None; Takashi Fujikado, None; Thomas Drew, Johnson and Johnson (F); James S. Wolffsohn, Johnson and Johnson (F) Program Number: 6006 Poster Board Number: B0155 Presentation Time: 12:00 PM–1:45 PM Comparison of three methods to measure objective amplitude of accommodation Yunyun Chen1, 2, Wanqing Jin1, 2, Zhili Zheng1, Bjorn Drobe3, 2, Hao Chen1, 2. 1School of Ophthalmology and Optometry, Wenzhou Medical University, WenZhou, China; 2WEIRC, WMU-Essilor International Research Centre, WenZhou, China; 3R&D Optics Asia, Essilor International, WenZhou, China. Purpose: To compare objective amplitudes of accommodation measured by autorefraction associated with a motorized Badal system in static and dynamic conditions and objective minus lens technique. Methods: Thirty-one young adults (age 23.35 ± 2.04 years) were enrolled in the study. Subjects’ refraction ranged from +0.25 to -6.00DS with astigmatism less than 0.50DC. Refractive errors were corrected by contact lenses. Accommodative response was measured using Grand Seiko WAM-5500 open field autorefractor. Accommodation was stimulated using a static (SB) or dynamic (DB) (speed 0.25D/s) Badal system with a high contrast distance fixation target or using minus lens technique (ML), the fixation target placed at 33 cm. Objective amplitude of accommodation was defined as difference between maximum and minimum responses for SB and DB, and as difference between maximum response and distance autorefraction for ML. Results: Objective amplitudes of accommodation measured using SB and DB were similar (respectively 5.58 ±0.85D and 5.62 ±1.34D; p=0.80 Fisher LSD). Mean interdevice difference was SB-DB= -0.05D with 95% limits of agreement of [-1.12; 1.02] D. ML gave significantly higher accommodative responses compared to SB and DB (6.17±0.90D, p<0.05 Fisher LSD). Mean interdevice difference were ML-SB=+0.60D and ML-DB=+0.55D with 95% limits of agreement of respectively [-0.06; 1.47D] D and [-0.34; 1.44] D. Conclusions: Static and dynamic Badal techniques underestimated objective amplitude of accommodation by approximately 10%, compared to minus lens technique. Minification of minus lenses and proximal cues of fixation target may be responsible for this difference. Commercial Relationships: Yunyun Chen, Essilor Int. (F); Wanqing Jin, Essilor Int. (F); Zhili Zheng, Essilor Int. (F); Bjorn Drobe, Essilor Int. (E); Hao Chen, Essilor Int. (F) Support: International S&T Cooperation Program of China (Grant No. 2014DFA30940) ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Program Number: 6007 Poster Board Number: B0156 Presentation Time: 12:00 PM–1:45 PM The effect of longitudinal chromatic aberration on the lag of accommodation and depth of field Mateusz T. Jaskulski2, 1, Ivan Marin-Franch1, Paula BernalMolina1, Norberto Lopez-Gil2, 1. 1Universidades de Murcia y Valencia, Laboratorio Interuniversitario de Investigación en Visión y Optometría, Murcia, Spain; 2Universidad de Murcia, Instituto Universitario de Investigación en Envejecimiento, Murcia, Spain. Purpose: Recently it has been proven that spherical aberration has influence over the depth of field (DOFi) and the accommodation lag (Bernal-Molina et al., OVS, 2014). We study if the longitudinal chromatic aberration (LCA) also plays a role in increasing the DOFi during accommodation, thus providing an effectively larger range of accommodation. Methods: Wavefront aberration maps for three accommodative demands (AD) 0D, 2D, 4D were measured in 4 subjects using a custom-made adaptive optics system equipped with a ShackHartmann sensor, a deformable mirror (Mirao 52-e, Imagine Eyes), and a Badal system controlled by the subject. The accommodation was paralyzed with 2 drops of cyclopentolate (1%). The deformable mirror was then set to cancel out the paralyzed aberrations and add the ones obtained for each AD, to the end that the system simulated the optics of the accommodated eye. Subjects looked through the system including the mirror and a 5.7 mm artificial pupil at a target on an OLED microdisplay. The target consisted of 5 Sloan letters (0.1 logMAR) shown in sequence in B&W, red (R, 650nm), green (G, 550nm) and blue (B, 468nm). The luminance was in all cases constant at 12 cd/m2. By means of the Badal system, subjects indicated near and far borders of the perceived DOFi based upon the objectionable blur criterion. The DOFi of the cycloplegic eyes with all the aberrations corrected (VA < -0.3 logMAR) was also obtained in all color conditions. Results: Intersubject mean values of DOFi were similar between different color conditions: for the AD of 0D we obtained 0.90±0.15D for B&W, 1.10±0.14D for R, 0.95±0.25D for G, and 0.91±0.12D for B. The mean DOFi was also stable between different simulated accommodation conditions, for example the B&W DOFi was 0.9±15D for 0D, 1.0±15D for 2D and 0.8±0.28D for 4D, and 1.0±0.10D for the fully corrected eye. The DOFi due to the chromatic aberration (the dioptric span between the outer limits of the R and B DOFi) was on average 1.9 times larger than the DOFi found for the B&W condition, for each of the AD’s. Conclusions: The values of the B&W and monochromatic DOFi are similar and practically do not change for any of the simulated AD’s. However the DOFi due to the full range of LCA is nearly twice as large as the one obtained for the B&W. These results indicate that the presence of an accommodative lag should not be influenced by the presence of chromatic aberration. Commercial Relationships: Mateusz T. Jaskulski, None; Ivan Marin-Franch, None; Paula Bernal-Molina, None; Norberto Lopez-Gil, None Support: This work was supported by the Marie Curie ITN grant “AGEYE” 608049. Founded by an European grant ERC-2012-StG 309416-SACCO. Program Number: 6008 Poster Board Number: B0157 Presentation Time: 12:00 PM–1:45 PM Relationship between the subjective measurement of accommodative facility and the objective assessment of the dynamic accommodative response Nicola Szostek1, Hetal Buckhurst1, Christine Purslow1, 2, Avril Collinson1, Phillip J Buckhurst1. 1Faculty of Health and Human Sciences, Plymouth University, Plymouth, United Kingdom; 2School of Optometry and Vision Sciences, Cardiff University, Cardiff, United Kingdom. Purpose: The dynamic accommodative response can be assessed objectively using a modified open field autorefractor. Previous studies have utilised the results of autorefraction to describe accommodative latency and lag. Accommodative facility is a subjective method, used in clinical practice for the assessment of the speed of accommodative change. This study proposes new metrics for assessing accommodative dynamics and relates these metrics to the measurement of accommodative facility. Methods: Accommodative dynamics were measured using the Grand Seiko WAM 5500 autorefractor (RyuSyo, Japan) on 42 healthy adults (mean 30±8yrs, range 19-47yrs). A 4.00D accommodative stimulus was presented in 5-second cycles using the DynaWAM Badal adaption. A 4-parameter sigmoidal regression curve function was fitted to each data set and used to determine: time taken to full accommodation (SoA) and disaccomodation (SoD), latency of accommodation (LoA) and disaccommodation (LoD). The total objective speed of accommodative change (oSoAC) was defined as the sum of SoA and SoD. In addition LoA was calculated again using a data smoothing method used in previous studies (sLoA). Accommodative facility (AF) with a 4.00D stimulus change was assessed via the number of cycles achieved per minute (CPM). Spearman’s Rho test was conducted to examine the correlation between accommodative dynamics metrics, AF and age. Results: The mean SoA: 2.45s±1.32; SoD: 1.88s±0.56; AF: 11.5±6.5; oSoAC: 4.36s±1.42; LoD: 1.04s±0.50; LoA: 1.17s±0.4; and sLoA: 0.93s±0.41. The age of the subject was found to correlate with the measures of SoA (r=0.339, p<0.028), SoD (r=0.415, p<0.06), AF (r=-0.611, p<0.001), and total oSoAC (r=0.661, p<0.001). However, neither metric for determining accommodative latency correlated with age (p>0.05). AF showed a significant, inverse correlation with SoD (r =-0.454, p<0.03), LoD (r =-0.325, p <0.36) and oSoAC (r =-0.390, p <0.11) but failed to show any significant association with SoA and both measures of accommodative latency (p>0.05). Conclusions: The traditional assessment of accommodative latency via accommodative dynamics did not correlate with age or AF. The novel metrics of SoD, LoD and SoAC proposed in this study correlated with both AF and age and may provide additional insight into accommodative dynamics that relate to clinical measurements and patient symptoms. Commercial Relationships: Nicola Szostek, Bausch and Lomb (F); Hetal Buckhurst, None; Christine Purslow, None; Avril Collinson, None; Phillip J Buckhurst, Bausch and Lomb (C) Support: Baulsh and Lomb: Unrestricted PhD grant Program Number: 6009 Poster Board Number: B0158 Presentation Time: 12:00 PM–1:45 PM Calculating Accommodative Optical Response in Young and Prepresbyopic Eyes using Paraxial Schematic Eye Models Viswanathan G. Ramasubramanian, Adrian Glasser. College of Optometry, University of Houston, Houston, TX. Purpose: Ultrasound biomicroscopy (UBM) studies on young and pre-presbyopic subjects show that the accommodative optical response (AOR) can be predicted in a population from each UBM ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics measured biometry parameter using linear relationships between AOR and accommodative biometric changes, with standard deviations of less than 0.55 D. Here, ocular biometry parameters measured for different accommodative states were used to construct accommodating paraxial schematic eyes (SE) to predict the AOR. Methods: The ocular parameters measured were corneal thickness, anterior and posterior corneal radii of curvature (from OCT), anterior chamber depth, lens thickness, anterior and posterior lens radii of curvature (from UBM) and axial length (from A-scan ultrasound). UBM parameters were measured while subjects accommodated to different stimulus demands. The AOR to the same stimulus demands was measured objectively with a Grand-Seiko (GS) autorefractor. Subjects included 24 young and 24 pre-presbyopes. Paraxial SE models were constructed for all subjects for all accommodative states. Standard and iteratively calculated lens equivalent refractive index values were used. Individual SE models were also constructed for all subjects using the average change in each UBM parameter for each stimulus demand from the baseline unaccommodated state in each subject population. The AOR calculated from the SE models were compared with the GS measured AOR from each subject. Results: The slopes and r2 values of the linear regressions between individual schematic eye calculated and GS measured AOR for the young subjects were 0.77 and 0.86 and for the pre-presbyopic subjects were 0.64 and 0.55. The mean difference in AOR (GS individual SEs) was -0.27 D for the young subjects and 0.33 D for the pre-presbyopic subjects. In the individual eyes, the mean ± SD of the absolute differences in AOR between the GS and SEs for the young and pre-presbyopic subjects was 0.50 ± 0.39 D and 0.50 ± 0.37 D, respectively. For average SEs, the mean ± SD of the absolute differences in AOR between the GS and the SEs for the young and pre-presbyopic subjects was 0.77 ± 0.88 D and 0.51 ± 0.49 D, respectively. Conclusions: Individual paraxial SE models calculated from measured ocular biometry parameters offer better prediction of AOR than from individual biometry parameters in young and prepresbyopic subject populations. Commercial Relationships: Viswanathan G. Ramasubramanian, None; Adrian Glasser, None Support: NIH R01 EY017076, NIH P30 EY07551 Program Number: 6010 Poster Board Number: B0159 Presentation Time: 12:00 PM–1:45 PM Measurement of Accommodation with High Dynamic Range Using a Shack-Hartmann Wavefront Sensor and Dual Channel Accommodation Stimulus Victor M. Hernandez1, 2, Marco Ruggeri1, Fabrice Manns1, 2, JeanMarie A. Parel1, 3. 1Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, Miami, FL; 2Department of Biomedical Engineering, University of Miami, Biomedical Optics and Lasers Laboratory, Coral Gables, FL; 3Vision Cooperative Research Centre, Sydney, NSW, Australia. Purpose: To develop a combined Shack-Hartmann wavefront sensor and modified extended range dual-channel Badal optometer stimulus for the dynamic refractive measurement of accommodation with high dynamic range without refractive correction, and with a long working distance to allow coupling with an Optical Coherence Tomography system for simultaneous lens biometry. Methods: We designed a system that combines a superluminescent diode emitting at 750 nm and a Shack-Hartmann wavefront sensor (WFS150-5C, Thorlabs; Newton, NJ) equipped with a 4-f relay system via a hot mirror to a two channel (far/near) accommodation stimulus (Figure 1). The 4f relay system uses f=100 mm lenses to provide a working distance sufficient to allow future combination with an anterior segment OCT system. The accommodation stimulus was designed to present a 10 D stimulus in subjects with refractive error ranging from –10 D to +6 D. The far target channel is used as a baseline and adjusted to provide a stimulus at the far point of the subject. The near target channel is adjusted manually to provide the desired amount of accommodation stimulus. The stimulus is presented via a microprocessor-controlled 1.8” liquid crystal display. Switching the displays on/off provides a step-stimulus that allows measurement of the dynamic accommodative response. The system was mounted on an adjustable motorized slit-lamp table. Preliminary experiments were performed on 4 subjects (age range: 24-49, refractive error range: -8 D-+1.75 D) following an IRB-approved protocol. The accommodative response to a stimulus ranging from 0 D to -6 D in 2 D was measured for the right eye of each subject. Results: The system was able to measure the accommodative response in all subjects when the stimulus was switched from far to near. Conclusions: The preliminary experiments demonstrate the feasibility of the design. Figure 1: Profile image of the device mounted to a motorrized examination table with a chin rest. Commercial Relationships: Victor M. Hernandez, None; Marco Ruggeri, None; Fabrice Manns, None; Jean-Marie A. Parel, None Support: NEI Grants: R01EY14225, P30EY14801 (Center Grant); Australian Federal Government CRC Program (Vision CRC); Research to Prevent Blindness; the Florida Lions Eye Bank; Drs. KR Olsen and ME Hildebrandt; the Henri and Flore Lesieur Foundation (JMP) Program Number: 6011 Poster Board Number: B0160 Presentation Time: 12:00 PM–1:45 PM Uniformity of Accommodation across the Visual Field Tao Liu, Vidhyapriya Sreenivasan, Larry N. Thibos. School of Optometry, Indiana University, Bloomington, IN. Purpose: Optical blur due to accommodative error in peripheral vision has been implicated in myopia development and progression. We investigated the uniformity of focusing errors over central retina as a function of accommodation demand in young adult and juvenile subjects. ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Methods: A laboratory scanning wavefront aberrometer (Wei & Thibos, Opt Express. 2010;18/2:1134-43) uses rotating mirrors to pivot a laser probe beam (850 nm) about the pupil center to place a “retinal beacon” at a random sequence of 37 retinal locations over the central 27° of visual field. For each retinal location, beacon light reflected out of the eye is de-scanned by the same mirrors and then directed to a conventional Shack-Hartmann wavefront sensor for analysis. The visual stimulus was displayed on an achromatic micro-display in a Badal configuration. Aberrations were measured at 8 levels of accommodative demand (1D steps of target vergence starting 1D beyond the estimated far point). Accommodative error is the difference between target vergence and the eye’s refractive state as measured by defocus Zernike coefficient C20 (in diopters). Results: For most adult subjects, ocular refractive state changed uniformly over the central visual field as the eye accommodated. Visual field maps of accommodative error reveal subtle patterns of deviation on the order of ±0.5 D that are unique to the individual and relatively invariant to changes in accommodative state. Population mean maps for accommodative error are remarkably uniform across the central visual field, indicating the retina of the hypothetical “average eye” is conjugate to a sphere of constant target vergence for all states of accommodation, even though individual eyes might deviate from the mean due to random variations. This result confirms and extends previous work on adults (Mathur, Atchison, & Charman, 2009. J Vis 9, 20 1-11). Similar results were observed also for children. No systematic difference between emmetropic and myopic eyes was evident. Conclusions: Ocular refractive state changes uniformly over the central visual field as the eye accommodates. Accuracy of accommodation across the visual field is similar to that measured in the fovea. Thus loss of image quality due to accommodative errors, which potentially drives myopia, will be similar across the central retina. Commercial Relationships: Tao Liu, None; Vidhyapriya Sreenivasan, None; Larry N. Thibos, None Support: P30EY019008 Program Number: 6012 Poster Board Number: B0161 Presentation Time: 12:00 PM–1:45 PM Effect of Age on Amplitude of Accommodation in a Swedish Population Baskar Theagarayan, Yelene Sorman. Department of Medicine and Optometry, Linnaeus University, Kalmar, Sweden. Purpose: The purpose of this study was to determine the relationship between age and amplitude of accommodation in a Swedish population and also to investigate the age of onset of Presbyopia in this population. Methods: All the measurements were performed in a Eye Clinic in Sweden. Subjects living in and around southern part of Sweden were recruited for this study. All the subjects had at least 20/20 best corrected visual acuity and normal binocular vision. The sample size was 103 subjects aged between 9 and 68 years. The amplitude of accommodation was measured using the push-up and the push-down method with a Royal Air Force (RAF) ruler. The ruler has both a metric scale in centimeters and a dioptric scale. The subjects were asked to read letters of N5 print size and report first sustained blur in push-up method and first sustained clear in push-down method. The subjects had their best correction in place during the measurements. All the measurements were done both monocularly (Right eye-OD and Left eye-OS) and binocularly (OU). Results: Regression analysis showed a significant decrease in the amplitude of accommodation with age (p < 0.05). Age of onset of presbyopia (less than 5 D amplitude) was 39 and 41 years based on monocular and binocular values respectively in this sample. There was no significant difference in the amplitude values between OD and OS (p > 0.05). Binocular amplitude values were higher than monocular values. There was a significant difference between push-up and push-down values (p < 0.05). Compared to Hofstetter’s results, this study showed lower values than expected. Conclusions: Amplitude of accommodation decreased with age as suggested by previous studies. At the age of 54 years, the amplitude reached around 0.85 D and remained constant after that. Age of onset of presbyopia in this Swedish population was similar to other European population. Commercial Relationships: Baskar Theagarayan, None; Yelene Sorman, None Program Number: 6013 Poster Board Number: B0162 Presentation Time: 12:00 PM–1:45 PM A pilot study on effects of sustained accommodation on the optics of the human eye Jason Shen, Frank Spors, Don Egan, Chunming Liu, Xiangyun Liu. College of Optometry, Western Univ of Hlth Sciences, Pomona, CA. Purpose: Myopia often presents and progresses throughout the school years and it has been hypothesized that high levels of near work may contribute to its development. The optics change during near work; for example, lag of accommodation might be related to myopia progression. This study is to investigate the possible changes of the optics of the eye during the sustained near work. Methods: A commercial Shack-Hartmann aberrometer was modified to be an open field instrument in order to achieve unrestricted visual field. Twenty-one low myopes were recruited into the study with only their left eyes being measured. Subjects were instructed to watch a 15 minutes long video displayed on a computer screen placed 50 cm in front of the eyes. Measurements were taken at one minute intervals while the subjects were directed to fixate on a central Maltese Cross target. Up to six-order Zernike coefficients were recorded and analyzed. Both a small sample non-parametric signed rank test and paired t-test were used for statistical data analysis. Results: The averaged mean spherical equivalent (MSE) refractive error decreased in the first 9 minutes at the rate of 0.06 D per minute. After 9 minutes, MSE showed more fluctuation with time. Changes of 3rd-order coma were more pronounced than changes in other higher order aberration terms. 4th order spherical aberration consistently decreased during the first 7 minutes. Compared to 2nd order defocus change, higher order aberrations had no significant impact to the changes of the optics of the measured eyes within 15 minutes of accommodation (p > 0.05). Conclusions: The accommodation of the eye decreases first, but later shows more fluctuation with sustained near work. Optical changes in the eye with prolonged near work appear to be mainly caused by the changes in the 2nd order defocus term rather than by higher order wavefront errors in the eye. Commercial Relationships: Jason Shen, None; Frank Spors, None; Don Egan, None; Chunming Liu, None; Xiangyun Liu, None Program Number: 6014 Poster Board Number: B0163 Presentation Time: 12:00 PM–1:45 PM Pseudoaccommodation in children after congenital cataract surgery and implanted with monofocal intraocular lens : incidence and mechanisms Charlotte Marie Dénier1, Pascal Dureau2, Catherine Edelson2, Georges Caputo2. 1Hôpital Necker, Paris, France; 2Fondation Rothschild, Paris, France. ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Purpose: Some pseudophakic patients implanted with monofocal intraocular lens (IOL) have good near visual acuity with their distance correction. This apparent accommodation has been called “pseudo-accommodation”. The objective of this study was to evaluate the prevalence of pseudo-accommodation in children after bilateral congenital cataract surgery, without amblyopia, and to define its mechanisms. Methods: We included 40 eyes of 23 children aged 6 to 18, with a corrected distance visual acuity above 8/10 and a normal near visual acuity (P2) with +3 addition. We also included a group of 14 pseudophakic adults, with a corrected distance visual acuity superior to 8/10 and a normal near visual acuity (P2) with +3 addition. Pseudo-accomodation was defined as a near visual acuity better than P4 with the distance correction and without addition. Prevalence of pseudo-accommodation was calculated in each group. In order to determine the factors accounting for pseudoaccommodation in children, we compared the group of children with pseudo-accommodation with to that of adults without pseudoaccommodation under several parameters : refraction, axial length, corneal topography, aberrometry, pupillary diameter, implant’s shift after cyclopentolate mesured with OCT-SD. Results: In the children group, 36 (90%) had a near visual acuity at equal to P4 without addition. Among the 28 included adults eyes, 2 (7%) had pseudo-accommodation. When we compared the 36 children eyes with pseudo-accommodation and the 26 adults eyes without pseudo-accommodation, we found that spherical equivalent, implant’s power, corneal multifocality and corneal higher-order aberrations (mainly coma and trefoil) were significantly higher in the group with pseudo- accommodation, while pupil diameter and implant’s shift were statistically the same in both groups. Axial length was smaller in the pseudo-accommodation group. Conclusions: Pseudo-accommodation in pseudophakic children is a poor known phenomenon. With this study, we have highlighting its high prevalence among non-amblyopic children. In children no mechanism has ever really been identified. This study found several possible mechanisms to explain pseudo-accommodation in children : a high power of the IOL and a small axial length, maximizing the effect of the IOL’s shift, corneal multifocality and corneal higherorder aberrations. Commercial Relationships: Charlotte Marie Dénier, None; Pascal Dureau, None; Catherine Edelson, None; Georges Caputo, None Program Number: 6015 Poster Board Number: B0164 Presentation Time: 12:00 PM–1:45 PM Accommodation in young adults wearing multifocal soft contact lenses under long- and short- wavelength lighting Manbir Nagra1, Christine F. Wildsoet2. 1Aston University, Birmingham, United Kingdom; 2UC Berkeley, Berkeley, CA. Purpose: Several studies have suggested accommodative lags may serve as a stimulus for myopic growth, and while a blurred foveal image is believed to the main stimulus for accommodation, spectral composition of the retinal image is also believed to influence accommodative accuracy. Of particular interest is how altering spectral lighting conditions influences accommodation in the presence of soft multifocal contact lenses, which are currently being used off-label for myopia control. Methods: Accommodative responses were assessed using a Grand Seiko WAM-5500 autorefractor for four target distances: 25, 33, 50, and 100cm for 30 young adult subjects (14 myopic, 16 emmetropic; mean refractive errors (±SD, D) -4.22±2.04 and -0.15±0.67 respectively). Measurements were obtained with four different soft contact lenses, Single vision distance (SVD), Single vision near (SVN), Centre-Near (CN) and Centre-Distance (CD) (+1.50 add), and three different lighting conditions: red (peak λ 632nm), blue (peak λ 460nm), and white (peak λ 560nm). Corrections for chromatic differences in refraction were made prior to calculating accommodative errors. Results: The size of accommodative errors was significantly affected by lens design (p<0.001), lighting (p=0.027), and target distance (p=0.009). Mean accommodative errors were significantly larger with the SV lenses compared to the CD and CN designs (p<0.001). Errors were also significantly larger under blue light compared to white (p=0.004) and a significant interaction noted between lens design and lighting (p<0.001). Blue light generally decreased accommodative lags and increased accommodative leads relative to white and red light, the opposite was true of red light (p≤0.001). Lens design also significantly influenced direction of accommodative error (i.e. lag or lead) (p<0.001). Interactions with or between refractive groups were not found to be statistically significant for either the magnitude or direction of accommodative error (p>0.05 for all). Conclusions: Accuracy of accommodation is affected by both lens design and by wavelength of lighting. These accommodative lag data lend some support to recent speculation about the potential therapeutic value of lighting with a spectral bias towards blue during near work for myopia, although such treatment effects are likely to be more subtle under broad compared to the narrow spectrum lighting conditions used here. Commercial Relationships: Manbir Nagra, Coopervision (R); Christine F. Wildsoet, None Support: Part-funded by an internal Aston University grant Program Number: 6016 Poster Board Number: B0165 Presentation Time: 12:00 PM–1:45 PM Relationship between the subjectively and objectively determined depth of focus of the human eye using defocus curves Alexander Leube1, Arne Ohlendorf1, Juan Tabernero2, Siegfried Wahl1. 1Ophthalmic Research Institut, University Tuebingen, Tuebingen, Germany; 2Laboratorio de Óptica, Universidad Murcia, Murcia, Spain. Purpose: The study compared the depth of focus (DoF) of the human eye, calculated from objective image quality metrics (IQM) and subjectively measured defocus curves. Methods: 15 subjects with a mean age of 25.5±3.3 years and a mean spherical equivalent refractive error of M=-0.45D±2.46D participated and mydrias was assessed using three drops of 1% cyclopentolat (assessed three times with 10 min between applications). Monocular subjective defocus curves (range: ±1.5D in 0.5D steps) were measured in a distance of 5m in the fully corrected dominate eye using a 4mm artificial pupil. The DoF was calculated as the dioptric range under the defocus curve at the threshold “maximum visual acuity [logMAR] + 0.1”. A commercial aberrometer (i.Profilerplus, ZEISS, Germany) was used to assess the ocular wavefront. The point spread function (PSF) and the optical transfer function (OTF) were analyzed of the single wavefront aberrations for a 4mm pupil, using Matlab (MathWorks, Natick, USA). The DoF was calculated using the augmented visual Strehl-Ratio of the OTF (VSOTFa) at the thresholds 80% and 50% of the maximum value as well as the visual Strehl-Ratio of the PSF (VSPSF) at a threshold of 50% of the maximum value. A two-tailed Student’s t-test was used for statistical analysis. Results: Using the VSOTFa, the DoF was 0.41±0.08D for the 80% and 0.76±0.11D for the 50% threshold, while the DoF was 0.71±0.12D for the VSPSF at the 50% threshold. Subjective assessment of the DoF gave a mean value of 0.70±0.23D and showed a correlation to the individual RMS of the higher order aberrations ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics (RMS HOA) (r=0.677, p=0.006). DoF was significantly different for 80% VSOTFa (p<0.001) and 80% VSPSF (p<0.001) compared to the subjective DoF, while the DoF at 50% VSOTFa (p=0.349) and 50% VSPSF (p=0.730) was not. Nevertheless, there was no significant relationship between the metrics and subjective measurements of DoF (50% VSOTFa r=0.20; 50% VSPSF r= 0.24). Individual thresholds for VSOTFa showed a significant correlation with the RMS-value of the HOA (r=-0.621, p=0.013). Conclusions: The estimation of the DoF using the VSOTFa and the VSPSF at a 50% threshold showed no significant difference to the subjectively measured DoF, but lacked a significant correlation. To predict the DoF from objective wavefront measurements, we propose the use of the VSOTFa at an individual threshold that is estimated from the RMS HOA. Commercial Relationships: Alexander Leube, None; Arne Ohlendorf, ZEISS Vision international GmbH (E); Juan Tabernero, None; Siegfried Wahl, ZEISS Vision international GmbH (E) Program Number: 6017 Poster Board Number: B0166 Presentation Time: 12:00 PM–1:45 PM WAVEFRONT ANALYSIS OF HIGHER-ORDER ABERRATIONS IN PATIENTS WITH HIGH MYOPIA Santiago Delgado-Tirado, Yazmin Báez-Peralta, Lucia GonzalezBuendia, Iztiar Fernandez, Miguel José Maldonado, Rosa Coco. Ophthalmology, IOBA, Valladolid, Spain. Purpose: We performed a prospective, observational and analytical study to elucidate the correlation between axial length (AXL) and higher-order aberrations (HOAs) in patients with high myopia (<-6D). It is believed that an increase in HOAs is correlated with a significant decrease in quality of vision, especially under scotopic conditions. Methods: We analysed 95 eyes from 51 high myopic patients, with a median age of 43 years. Patients presenting any corneal or lens disease that could interfere in their aberrometry values, and those suffering any macular disease evidenced by OCT (3D OCT-2000 FA plus, Topcon) were excluded. Wavefront analysis of corneal, internal and ocular aberrations was performed with a HartmannShack aberrometer (Wavefront® Analyzer KR-1W, Topcon). In order to assess the relationship between both variables the Spearman correlation coefficient was used. Results: A statistically significant positive correlation between AXL and internal spherical aberration was detected for the whole sample. Besides, a statistically significant positive correlation between AXL and internal tetrafoil aberration, was observed. Conclusions: According to our results, patients with high myopia show greater values of HOAs. Thus, it appears to be a positive correlation between AXL and internal aberrometry. This findings may help to understand why patients with high myopia reiteratedly complain about its poor quality of vision, despite of having an optimum correction of their refractive error and a good visual acuity. Commercial Relationships: Santiago Delgado-Tirado, None; Yazmin Báez-Peralta, None; Lucia Gonzalez-Buendia, None; Iztiar Fernandez, None; Miguel José Maldonado, None; Rosa Coco, None Program Number: 6018 Poster Board Number: B0167 Presentation Time: 12:00 PM–1:45 PM Numerical simplification of ray tracing for non-circularly symmetric models of the human eye Danilo Andrade de Jesus, D Robert Iskander. Wroclaw University of Technology, Wroclaw, Poland. Purpose: To simplify numerical analysis of ray tracing techniques in application to models of the human eye. Methods: Recently a method that simplifies calculation of geometrical points spread function has been proposed for circularly symmetric systems (Gagnon et al., App. Opt. 2014). The method is based on Chebyshev polynomials and it is realized with the help of Matlab Chebfun toolbox – a new tool for computing with functions developed at Oxford University (www.chebfun.org). An extension of this method to 2D non-circularly symmetric systems is proposed. In this method, surfaces, rays, and refractive indices are all represented in functional forms being approximated by Chebyshev polynomials. Although generalization from one dimensional to two dimensional Chebyshev polynomials is not trivial (i.e., not all properties of 1D Chebyshev polynomials are present in their 2D representations), there are many benefits of using them including the ease of surface representation, manipulation of multiple surface designs, and the ability to represent gradient index (GRIN) type lenses. Such a representation appears to be an ideal tool for performing ray tracing in anatomically correct eye models such as the one proposed by Liou and Brenner (JOSA A, 1997). Results: A two-dimensional Chebyshev function based ray tracing procedure for an arbitrary number of surfaces and arbitrary surface shapes has been developed. The Liou and Brenner anatomically accurate model of the human eye has been used for evaluating the method (Figure 1). Computational complexity (assessed as the CPU time) increases with the addition of each surface in a linear form indicating that the method has a great computational potential to be used for more intricate eye models in which, for example, the crystalline lens is described with multiple surfaces. Conclusions: Performing ray tracing with Chebfun toolbox substantially simplifies calculations as it is based on object oriented programming with handle functions. Realization of the ray tracing technique in Matlab is particularly attractive among researchers for whom other ray tracing optical engineering packages such as those employed in Zemax are more cumbersome and sometimes difficult to acquire. An example of chebfun-based ray tracing using the anatomically correct eye model of Liou and Brenner (JOSA A, 1997) where all the distances corresponds to millimeters. Commercial Relationships: Danilo Andrade de Jesus, None; D Robert Iskander, None Support: FP7-PEOPLE-2013-ITN, AGEYE 608049 ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Program Number: 6019 Poster Board Number: B0168 Presentation Time: 12:00 PM–1:45 PM Wide-field schematic model of the Human Eye with Asymmetrically Tilted and Decentered Lens James Polans1, Bart Jaeken2, Ryan P. McNabb3, 1, Lucia Hervella2, Pablo Artal4, Joseph A. Izatt1, 3. 1Biomedical Engineering, Duke University, Durham, NC; 2R&D, VOPTICA SL, Murcia, Spain; 3 Ophthalmology, Duke University, Durham, NC; 4Laboratorio de Optica, Universidad de Murcia, Murcia, Spain. Purpose: More accurate schematic eye models would aid in the design of advanced ophthalmic instrumentation, including OCT, SLO, fundus cameras and fluorescence imagers. Since the aberrations of the human eye vary strongly with retinal eccentricity, it becomes increasingly important to have an optically accurate eye model for the design of instruments requiring a wide field-of-view. We propose a schematic eye that reproduces the aberrations of the human eye across a wide visual field. Methods: The model eye was built to reproduce the experimentally measured wavefront aberrations for 4-mm pupil recorded for the central 80° of the horizontal meridian (101 eyes) and 50° of the vertical meridian (10 eyes). These data were acquired using a custom scanning Shack-Hartmann wavefront sensor [1]. Optical modeling software (Zemax) and a reverse building eye modeling technique were used to optimize a merit function. We developed a custom surface in order to allow the model to be more easily incorporated into the design of imaging instruments. Results: Across the entire field-of-view, the eye model shows excellent agreement with the measured data both comprehensively and for low-order and high-order aberrations (Fig. 1). In comparison to previous eye models (Fig. 2), our schematic eye excels at reproducing the aberrations at the peripheral retinal. Tilt and decentration of the crystalline lens permits our model to mimic the asymmetries of the aberrations found in real eyes. Conclusions: Our proposed model shows great promise towards the design of wide-field imaging instruments, and it has the potential to provide further insights in the study of the peripheral optics of the human eye. Also, we outline a robust eye modeling technique that is capable of predicting trends beyond those defined explicitly in the optimization routine. 1. B. Jaeken, L. Lundstrom, and P. Artal, Opt Express 19, 7903 (2011). 2D grid of measured wavefront data (left) compared with the aberrations calculated for the newly proposed eye model (right) in the pupil plane. Plots showing Zernike aberrations versus retinal eccentricity across the horizontal meridian: oblique astigmatism (a), defocus (b), vertical astigmatism (c), horizontal coma (d), oblique trefoil (e), spherical aberration (f), mean sphere (g), and cylinder (h). Error bars correspond to the standard deviation in the measured data (101 eyes). Commercial Relationships: James Polans, None; Bart Jaeken, Voptica (E); Ryan P. McNabb, None; Lucia Hervella, Voptica (E); ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected]. ARVO 2015 Annual Meeting Abstracts by Scientific Section/Group - Visual Psychophysics / Physiological Optics Pablo Artal, Voptica (I), Voptica (P), Voptica (S); Joseph A. Izatt, Bioptigen Inc (I), Bioptigen Inc (P), Bioptigen Inc (S) Support: National Science Foundation (CBET-1-03905); European Research Council Advanced Grant (SEECAT, ERC-2013AdG-339228); SEIDI, Spain (FIS2013-41237-R) Program Number: 6020 Poster Board Number: B0169 Presentation Time: 12:00 PM–1:45 PM Higher order statistical eye model for normal eyes Jos J. Rozema1, 2, Pablo Rodriguez Perez3, Rafael Navarro3, MarieJose B. Tassignon1, 2. 1Ophthalmology, Antwerp University Hospital, Edegem, Belgium; 2Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; 3Facultad de Ciencias, ICMA Consejo Superior de Investigaciones Científicas-Universidad de Zaragoza, Zaragoza, Spain. Purpose: This work presents a stochastic model capable of generating an unlimited number of random, but realistic biometry sets, including the corneal elevation, intraocular distances and wavefronts, with the same statistical and epidemiological properties as the original data it is based on. Methods: One cohort of 312 eyes of 312 healthy Caucasian subjects (aged 20 – 60 years) was measured with an autorefractometer, Scheimpflug imaging (Oculus Pentacam), optical biometer (Haag– Streit Lenstar) and an aberrometer (Tracey iTrace). The corneal elevation maps, represented by Zernike coefficients, were compressed using Principal Component Analysis, leaving a total of 17 parameters to describe the variability of the ocular biometry. These data were then fitted with a linear combination of three multivariate Gaussians through an Expectation Maximization algorithm, which has been shown to give a good representation of the ocular biometry in a population. Based on this fit a stochastic model was built that generates an unlimited number of random biometry sets, from which total wavefronts and other ocular parameters can be calculated. Equality between the original and the synthetic data was assessed using non-parametric “two one-sided” tests. Results: The wavefronts calculated using the measured biometry were significantly equal to the originally measured wavefronts (two one-sided Wilcoxon test, p < 0.05), confirming the accuracy of the ray tracing algorithm. Subsequently, the stochastic model was used to randomly generate the biometry of 1000 eyes and calculate the associated wavefronts by ray tracing. For both the biometry and the wavefront this synthetic data were significantly equal to the originally measured data (two one-sided Mann-Witney test, p < 0.05), thus making them statistically indistinguishable. Conclusions: The statistical eye model is able to produce synthetic biometry data that is indistinguishable from actual biometry. As such this model may be an interesting alternative to static eye models for researchers in visual optics that do not have access to biometry data. Commercial Relationships: Jos J. Rozema, None; Pablo Rodriguez Perez, None; Rafael Navarro, None; Marie-Jose B. Tassignon, None Support: Flemish Agency for Innovation by Science and Technology, grant IWT/110684 (Sarkar et al., IERG, 2014). This study modeled the effects of inter-ocular differences in phase noise and contrast induced by these wavefront errors on stereo-acuity in keratoconus. Methods: Lower-order aberrations (LOAs) and HOAs were measured in 9 keratoconus cases and 5 control subjects, postcycloplegia with 6 mm diameter pupils, either unaided or through RGP contact lenses (CLs), using a Shack-Hartmann irx3™ wavefront aberrometer. Refractive data and stereo-depth thresholds were measured through spectacles and CLs under the same conditions to compare low and high magnitudes of HOAs. Phase effects were modeled from the horizontal cross-correlation functions of random dot patterns convolved with point-spread functions of right and left eyes. Contrast effects were modeled with retinal image quality (IQ) metrics computed for each eye using aberrations scaled to 4 mm diameter pupils. Analyses of variance were performed to investigate the contribution of inter-ocular differences in phase noise and contrast to the empirical stereo-depth thresholds. Results: Stereo-thresholds ranged from 56 – 872 arc sec in cases and from 29 – 134 arc sec in controls. Some of the variance seen in the empirical stereo-thresholds in keratoconus obtained with spectacles (i.e. with HOAs uncorrected) was explained by the signal to noise ratio derived from the cross-correlation functions (r = -0.59; R2 = 0.36; p < 0.05). The width of the cross-correlation function, estimated from the standard deviation, was moderately correlated with stereothresholds obtained with spectacles (r = 0.43; R2 = 0.18; p = 0.13). Inter-ocular differences in IQ metrics chosen to highlight contrast differences due to HOAs (VSOTF, VSMTF), showed little or no relationship to the stereo-thresholds. Conclusions: Inter-ocular HOA differences in keratoconus subjects introduce phase noise in the disparity domain that affect the fidelity of disparity signals for stereo-depth perception. The contribution of contrast differences from HOAs is small in comparison. However, small residual LOAs could have a larger contrast-difference effect on stereopsis. Commercial Relationships: Sangeetha Metlapally, None; Vinay K. Nilagiri, None; Tiffanie T. Yu, None; Shrikant R. Bharadwaj, None; Clifton M. Schor, None Program Number: 6021 Poster Board Number: B0170 Presentation Time: 12:00 PM–1:45 PM A Cross-correlation Model of the Effect of Higher and Lowerorder Aberrations on Stereopsis in Keratoconus Sangeetha Metlapally1, Vinay K. Nilagiri2, Tiffanie T. Yu1, Shrikant R. Bharadwaj2, Clifton M. Schor1. 1Optometry, University of California, Berkeley, Berkeley, CA; 2L V Prasad Eye Institute, Hyderabad, India. Purpose: Inter-ocular differences and averages of higher-order aberrations (HOAs) both co-vary with stereo-acuity in keratoconus ©2015, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected].
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