Association of optical cataract indices with cataract severity and visual function

Souza, Rodrigo G. de; Golla, Abhinav; Khan, Mahmood; de, Ildamaris Montes; Khandelwal, Sumitra; Al-Mohtaseb, Zaina

doi:10.1007/s10792-021-01995-8

Cited by 8 publications

(13 citation statements)

References 19 publications

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Section: Discussionmentioning

confidence: 99%

“…The concept of the DLS has gained acceptance for describing the aging spectrum of the crystalline lens [2][3][4][5][6]. However, only analyses of lens density, objective scatter index, and HOAs have been published [1][2][3][4][5][6][7]. No information has been published about the disrupted visual function that intermediate DLS patients experience, and only standard photopic VA and CS results have been published [1,3,4,6,7].…”

Section: Discussionmentioning

confidence: 99%

“…However, only analyses of lens density, objective scatter index, and HOAs have been published [1][2][3][4][5][6][7]. No information has been published about the disrupted visual function that intermediate DLS patients experience, and only standard photopic VA and CS results have been published [1,3,4,6,7]. Consequently, we investigated for the first time the relationship between the initial sclerosis of the different lens parts and mesopic visual performance, including under diverse progressive oncoming glare sources, in subjects with intermediate stage-2 DLS.…”

Section: Discussionmentioning

confidence: 99%

“…The inclusion criteria were age 50 years and older with bilateral crystalline lens characteristics within the definition of stage-2 DLS [2,3], which encompassed Lens Opacities Classification System III [LOCS-III] [21] scores up to 3, and corrected distance visual acuity (CDVA) of 20/25 or better. The exclusion criteria were amblyopia; abnormal binocular vision; previous ocular trauma or surgery; ocular diseases; and cortical, nuclear opalescence, or posterior subcapsular scores exceeding 3 with the LOCS-III in either eye based on previous criteria for classification of early versus late cataract [6].…”

Section: Samplementioning

confidence: 99%

“…Subsequently, the term dysfunctional lens syndrome (DLS) was coined [2] and staged as (1) near visual loss and development of higherorder aberrations (HOAs) between 40 and 50 years of age; (2) accommodative loss, further HOA increases and forward light scatter, decreased contrast sensitivity (CS) and night vision, and early lens opacities, typically at 50 years and older; and (3) full cataract, poor visual quality, lens nucleus opacification affecting color perception, typically at 65 years and older [2,3]. DLS is thought to be linked closely with modern technological developments for assessing potential candidates who may benefit from lens surgery [2][3][4][5][6][7][8][9][10][11], and the need for further evidence-based information about measures of visual performance has been emphasized [7].…”

Section: Introductionmentioning

confidence: 99%

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Mesopic Disability Glare in Stage-Two Dysfunctional Lens Syndrome

et al. 2022

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Introduction: There is a lack of evidence about the exact deterioration of visual function associated with the age-related natural changes in the lens, particularly in intermediate (stage-2) dysfunctional lens syndrome (DLS). Standard photopic visual acuity and contrast sensitivity tests may not show the visual worsening in daily life activities, such as oncoming vehicle headlights at night. The purpose of this study was to analyze visual function under different conditions and glare sources in stage-2 DLS. Methods: Forty patients over 49 years of age with initial bilateral lens opacification (Lens Opacities Classification System III [LOCS-III] scores up to 3), best-corrected visual acuity of 20/25 or better, and no ocular disease were evaluated. Binocular photopic and mesopic contrast sensitivity (CS) with/without halogen and xenon increasing glare sources were analyzed. Mesopic disability glare (MDG) was calculated as the difference between mesopic CS with/without the glare source. Results: The median logarithmic CS (logCS) values were lower under mesopic conditions (1.05) than under photopic illumination (1.65; P \ 0.001). Halogen and xenon glare further decreased mesopic CS (both, median logCS 0.75, P \ 0.001). The mean MDG was 0.31 ± 0.10 log units for halogen glare and 0.33 ± 0.09 log units for xenon glare. The mesopic CS and MDG were not associated with any photopic test. The mesopic CS with glare but not photopic CS or mesopic CS was correlated with the LOCS-III scores. The best association was provided by MDG, which showed a pooled correlation with LOCS-III nuclear opalescence (r = 0.411, P \ 0.001) and cortical scores (r = 0.226, P = 0.04). Conclusion:The mesopic CS under a glare source is an independent early indicator of visual impairment in stage-2 DLS patients, and appears to be substantial. Furthermore, the MDG is more sensitive than photopic and mesopic CS for evaluating patients with initial phacosclerosis. Surgeons should consider this in the decision-making process of the correct timing for lens surgery.

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