Background: Vision impairments (VIs) and blindness are major global public health issues. A visual acuity (VA) test is one of the most crucial standard psychophysical tests of visual function and has been widely used in a broad range of health care domains, especially in many clinical settings. In recent years, there has been increasing research on mobile app–based VA assessment designed to allow people to test their VA at any time and any location. Objective: The goal of the review was to assess the accuracy and reliability of using mobile VA measurement apps. Methods: We searched PubMed, Embase, Cochrane Library, and Google Scholar for relevant articles on mobile apps for VA assessment published between January 1, 2008, and July 1, 2020. Two researchers independently inspected and selected relevant studies. Eventually, we included 22 studies that assessed tablet or smartphone apps for VA measurement. We then analyzed sensitivity, specificity, and accuracy in the 6 papers we found through a meta-analysis. Results: Most of the 22 selected studies can be considered of high quality based on the Quality Assessment of Diagnostic Accuracy Studies–2. In a meta-analysis of 6 studies involving 24,284 participants, we categorized the studies based on the age groups of the study participants (ie, aged 3-5 years, aged 6-22 years, and aged 55 years and older), examiner (ie, professional and nonprofessional examiners), and the type of mobile devices (ie, smartphone, iPad). In the group aged 3 to 5 years, the pooled sensitivity for VA app tests versus clinical VA tests was 0.87 (95% CI 0.79-0.93; P=.39), and the pooled specificity was 0.78 (95% CI 0.70-0.85; P=.37). In the group aged 6 to 22 years, the pooled sensitivity for VA app tests versus clinical VA tests was 0.86 (95% CI 0.84-0.87; P<.001), and the pooled specificity for VA app tests versus clinical VA tests was 0.91 (95% CI 0.90-0.91; P=.27). In the group aged 55 years and older, the pooled sensitivity for VA app tests versus clinical VA tests was 0.85 (95% CI 0.55-0.98), and the pooled specificity for VA app tests versus clinical VA tests was 0.98 (95% CI 0.95-0.99). We found that the nonprofessional examiner group (AUC 0.93) had higher accuracy than the professional examiner group (AUC 0.87). In the iPad-based group, the pooled sensitivity for VA app tests versus clinical VA tests was 0.86, and the pooled specificity was 0.79. In the smartphone-based group, the pooled sensitivity for VA app tests versus clinical VA tests was 0.86 (P<.001), and the pooled specificity for VA app tests versus clinical VA tests was 0.91 (P<.001). Conclusions: In this study, we conducted a comprehensive review of the research on existing mobile apps for VA tests to investigate their diagnostic value and limitations. Evidence gained from this study suggests that mobile app–based VA tests can be useful for on-demand VI detection.

Purpose This study evaluates the value of [¹⁸F]AlF-NOTA-FAPI-04PET/CT in assessing the disease activity of thyroid eye disease (TED). Methods Twenty-three TED patients and ten healthy controls were prospectively recruited and underwent [¹⁸F]AlF-NOTA-FAPI-04 PET/CT scans. TED eyes were classified by Clinical Activity Score (CAS) as active (CAS +) or inactive (CAS-). PET analysis included qualitative and quantitative evaluations. Qualitative analysis categorized TED eyes as positive (FAPI +) or negative (FAPI-), while quantitative analysis including SUVmax and target-to-backgroud ratio (TBR) of each extraocular muscle (EOM). Pathological assessment of 16 EOM samples from 15 TED eyes was used as a gold standard to evaluate the diagnostic accuracy of CAS-driven and FAPI-driven assessments. Results Eye-based analysis included 42 TED eyes and 20 control eyes. SUVmax did not differ significantly between CAS-/FAPI + (n = 8) and CAS + /FAPI + (n = 17) eyes; though both groups had significantly higher SUVmax than CAS-/FAPI- (n = 16), CAS + /FAPI- (n = 1), and control eyes (n = 20) (all P < .05). Diffuse high FAPI uptake with excellent TBR was observed in pathologically active EOMs and had higher SUVmax and TBR than inactive EOMs (SUVmax: 9.57 ± 2.79 vs. 4.04 ± 1.02, TBR: 2.99 ± 1.00 vs. 1.00 ± 0.35, both P < .001). An SUVmax cutoff value of 5.95 yielded an area under the receiver operating characteristic curve of 0.98 for predicting active disease. Sensitivity and specificity of CAS-driven and FAPI-driven assessments for TED activity were 72.7% and 100%, 100% and 100%, respectively. SUVmax positively correlated with pathological fibroinflammatory score (r = 0.68, P = .004). Conclusion The diffuse high FAPI uptake with excellent TBR in the EOMs could illustrate the activity of TED, positively correlated with pathological fibroinflammatory scores. These findings suggest that [¹⁸F]AlF-NOTA-FAPI-04 PET/CT may serve as a promising reliable non-invasive approach for assessing disease activity in TED, potentially superior to the CAS.

The retina is a high-metabolism tissue composed of various cell types with complex functions that relies heavily on the blood supply to maintain homeostasis. Retinal ischemia-reperfusion injury is a critical pathogenic mechanism in glaucoma, and changes in lipid molecules may lead to retinal tissue damage. However, retinal lipid profile alterations caused by this mechanism remain unclear. Thus, this study employed a retinal ischemia-reperfusion model to analyze changes in the lipid profile between sham-operated and ischemia-reperfusion groups. We discovered that ischemia-reperfusion injury-induced alterations in 338 lipid molecules, which potentially caused lipid droplet formation and mitochondrial damage. Notably, we identified characteristic changes in various lipids, including cholesterol esters, cardiolipin, and ceramide, which may serve as potential biomarkers for assessing the severity of retinal injury and therapeutic interventions. The ischemia-reperfusion-specific features identified in this study provide a more comprehensive understanding of the pathophysiological mechanisms underlying this condition.

To evaluate choroidal and optic disc alterations in eyes with thyroid eye disease (TED) compared with healthy eyes by using TowardPi widefield optical coherence tomography angiography (OCTA). This was a retrospective cross-sectional cohort study. A total of 112 participants (60 TED patients and 52 healthy controls) underwent TowardPi widefield OCTA, which provided detailed demographic and clinical data. Three-dimensional choroidal data, including thickness, vascular metrics, and optic disc measurements, were obtained from the built-in software. The study included 24 eyes with dysthyroid optic neuropathy (DON), 24 eyes with active non-DON TED, 71 eyes with inactive TED, and 104 healthy eyes. Choroidal thickness significantly decreased in the optic disc region during the DON phase (148.71 ± 78.98 µm) compared to normal eyes (182.35 ± 51.98 µm) and inactive TED eyes (191.34 ± 58.86 µm) (P = 0.030). In DON, choroidal stromal volume was reduced (34,183.81 ± 10,649.01 × 106 µm3) compared to normal (46,339.53 ± 16,711.99 × 106 µm3) (P = 0.002), whereas the choroidal vascular index increased (42.67% ± 3.41%) compared to normal (38.53% ± 6.35%) (P = 0.002). Optic disc area increased in DON (1.99 ± 1.24 mm2) compared to inactive TED (1.39 ± 0.38 mm2) (P < 0.001), along with reduced retinal nerve fiber layer blood-flow density in DON (45.09% ± 3.07%,) compared to normal (47.84% ± 1.41%) (P < 0.001). This study highlights the critical role of choroidal and optic disc alterations in TED pathophysiology and underscore the utility of widefield OCTA in identifying these changes, particularly in DON-risk patients.

We evaluated the reading characteristics of normal-sighted young adults using C-Read to provide baseline healthy population values. We also investigated the relationship between the National Eye Institute’s Visual Functioning Questionnaire (VFQ-25) score and reading ability, myopia, and hours of screen use, focusing on the extent to which these factors affect participants’ visual function and, ultimately, their vision-related quality of life (QoL). Overall, 207 young, healthy participants (414 eyes) aged 18–35 years were tested for reading speed using C-Read connected to a smartphone-based application between December 2022 and January 2023. Each participant received a VFQ-25 questionnaire to evaluate vision-related QoL. Data on daily e-screen usage hours were collected. Among the participants, 91 (44.0%) were women; their mean (SD) age was 22.45 (4.01) years. The mean (SD) reading acuity (RA) was 0.242 (0.124), 0.249 (0.120), and 0.193 (0.104) logarithmic minimum angle of resolution (logMAR) for the right, left, and both eyes, respectively. The mean (SD) maximum reading speed (MRS) was 171.65 (46.27), 168.59 (45.68), and 185.16 (44.93) words per minute (wpm) with the right, left, and both eyes, respectively. The mean (SD) critical print size (CPS) was 0.412 (0.647), 0.371 (0.229), and 0.419 (1.05) logMAR per the right, left, and both eyes, respectively. The RA and CPS were significantly different between sexes (p = 0.002 and p = 0.001). MRS was significantly different between the education level (p = 0.005) and myopia level groups (p = 0.010); however, it was not clear whether this difference was confounded by age. The myopic power in diopters significantly affected RA (coefficient, −0.012; 95% CI, −0.018 to −0.006; p = 0.001); screen time significantly affected MRS (coefficient, 0.019; 95% CI, 0.57 to 6.33; p = 0.019). RA (coefficient, −21.41; 95% CI, −33.74 to −9.08; p = 0.001) and duration of screen use (coefficient, -0.86; 95% CI, −1.29 to −0.43; p < 0.001) independently had a significantly negative correlation with VFQ-25 scores. Our findings provide a baseline value for C-Read in normal-sighted young adults. Refractive status significantly affected RA, while screen time significantly affected MRS. Interventions aimed at enhancing RA may have the potential to maximize vision-related QoL and enable older adults with impaired vision to achieve greater outcomes. Future, larger-scale, C-Read experiments will help provide newer, more optimal methods for the early diagnosis of visual impairment.