脑源性视觉障碍是一组由中枢视觉通路受损导致的视觉功能障碍症候群。脑源性视觉障碍对儿童的运动、认知等方面影响深远，早发现、早干预至关重要。基于临床实践的迫切需要，中华医学会儿科学分会康复学组和眼科学组组织国内相关专家联合制订“儿童脑源性视觉诊断与治疗专家共识（2023）”，对儿童脑源性视觉障碍的定义、评估、诊断及治疗提出了15条推荐意见。.

This article aims to describe the design and validation process of food guideline messages written in the braille reading and writing system for people with visual impairment. The process involved the following stages: i) design and elaboration of the material containing the food guideline messages, as well as its adaptation to the format; ii) technical validation with representatives of the National Council for the Integration of Persons with Disabilities (CONADIS); and iii) operational validation through focus groups with children, adolescents and adults with visual disabilities who can read braille. The participants agreed on the legibility, clarity and comprehension of the messages and approved the format of the material. Finally, it should be noted that the participation of key informants and people with visual impairment in all stages was important for the development of an informative material with healthy eating messages in braille.

UNASSIGNED: This study aimed to evaluate the impact of a standardized vision screen guideline on occupational therapy vision screens in a pediatric inpatient rehabilitation unit.
UNASSIGNED: Charts of patients admitted to a pediatric inpatient rehabilitation before guideline implementation (n = 47) versus charts after implementation (n = 47) were randomly, retrospectively reviewed to explore differences in visual skills screened and use of standardized assessments.
UNASSIGNED: Significant improvements (p < = 0.05) were found in the number of visual skills screened (p = 0.034), use of standardized assessments (p = 0.005), and screening of the specific visual skills of accommodative amplitude (p = 0.05), suppression (p = 0.015), and double vision (p < 0.001).
UNASSIGNED: Implementation of a standardized vision screen guideline improved the frequency of vision screens during occupational therapy evaluations in a pediatric inpatient rehabilitation unit. The use of standardized assessments may also improve the quality of vision screens by encouraging staff to complete more comprehensive vision screens, including screening more visual skills, and by prompting use of standardized assessments, which can improve accuracy of screening procedures.

Glaucoma is a leading cause of irreversible blindness, and its worsening is most often monitored with visual field (VF) testing. Deep learning models (DLM) may help identify VF worsening consistently and reproducibly. In this study, we developed and investigated the performance of a DLM on a large population of glaucoma patients. We included 5099 patients (8705 eyes) seen at one institute from June 1990 to June 2020 that had VF testing as well as clinician assessment of VF worsening. Since there is no gold standard to identify VF worsening, we used a consensus of six commonly used algorithmic methods which include global regressions as well as point-wise change in the VFs. We used the consensus decision as a reference standard to train/test the DLM and evaluate clinician performance. 80%, 10%, and 10% of patients were included in training, validation, and test sets, respectively. Of the 873 eyes in the test set, 309 [60.6%] were from females and the median age was 62.4; (IQR 54.8-68.9). The DLM achieved an AUC of 0.94 (95% CI 0.93-0.99). Even after removing the 6 most recent VFs, providing fewer data points to the model, the DLM successfully identified worsening with an AUC of 0.78 (95% CI 0.72-0.84). Clinician assessment of worsening (based on documentation from the health record at the time of the final VF in each eye) had an AUC of 0.64 (95% CI 0.63-0.66). Both the DLM and clinician performed worse when the initial disease was more severe. This data shows that a DLM trained on a consensus of methods to define worsening successfully identified VF worsening and could help guide clinicians during routine clinical care.

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Cerebral Visual Impairment (CVI) is a common condition in the UK. Patients with conditions associated with CVI are frequently seen in paediatric ophthalmology clinics offering eye care professionals an opportunity to identify children proactively. In most cases CVI occurs as part of a neurodevelopmental condition or as a feature of multiple and complex disabilities. However, CVI can also be seen in children with apparently typical development. In some cases, high contrast visual acuity is normal and in other cases severely impaired. As such, identification of CVI requires evaluation of aspects of visual performance beyond high contrast acuity and consideration that visual function of those with CVI may fluctuate. Few paediatric ophthalmologists have received formal training in CVI. The detection and diagnosis of CVI varies across the UK and patients report hugely different experiences. A diagnosis of CVI is made based on professional clinical judgement and it is recognised that individual perspectives and local practice in the specific methodologies of assessment will vary. A systematic review and survey of professionals is underway to attempt to reach agreement on diagnostic criteria. Nonetheless, established pathways and published protocols can offer guidance on how a paediatric ophthalmology service can approach assessment of the child with suspected CVI. The purpose of this paper is to present a summary of research and clinical practice methods for detecting and diagnosing CVI in a paediatric ophthalmology outpatient setting. It represents current understanding of the topic and acknowledges the evolving nature of both practice and the evidence-base. A rapid literature review was undertaken to identify articles relating to clinical investigation of children with CVI. A focus group of QTVI and subject matter experts from sight loss charities was undertaken to address areas which were not covered by the literature review.
摘要: 脑源性视力障碍(CVI)是英国的常见疾病。患有CVI相关疾病的患者经常在儿科眼科诊所就诊, 为眼科护理专业人员提供了主动识别儿童CVI的机会。多数情况下, CVI为神经发育疾病的一部分, 或作为多种复杂残疾的一种临床体征。然而, CVI也可见于发育正常的儿童。在某些情况下, 高对比度视力可以正常, 而在其他情况下则严重受损。因此, CVI的识别需要评价高对比度视力以外的视觉表现方面, 并考虑CVI患者的视觉功能波动的可能性。很少有儿科眼科医生接受过CVI的正式培训。CVI 的检测和诊断在英国各不相同, 患者报告的体验差异很大。CVI的诊断是基于专业的临床判断, 并且需认识到特定评估方法中的个体观点和当地实践有所不同。目前正在对专业人员进行系统审核和调查, 以试图就诊断标准达成一致。尽管如此, 已确立的途径和已发表的方案可为针对如何处理疑似CVI儿童的儿科眼科治疗评估提供指导。本文旨在对在儿科眼科门诊检测和诊断CVI的研究和临床实践方法进行总结。它代表了目前对这一专题的理解, 并承认了实践和证据基础的演变特性。本文进行了快速文献回顾, 以识别与CVI儿童临床研究相关的文章。我们成立了聚焦于QTVI 的专家小组并组织关心视力丧失的慈善机构专家以解决文献综述未涵盖的领域。.

Brolucizumab has high efficacy in retinal fluid resolution and provides the possibility for longer dosing intervals in the treatment of neovascular age-related macular degeneration. However, brolucizumab has been associated with events of retinal vasculitis and retinal vascular occlusion typically in the presence of other signs of intraocular inflammation (IOI). The purpose of this report is to provide guidance on the use of brolucizumab for neovascular age-related macular degeneration to a global audience.
A literature review was conducted on adverse events related to IOI after administration of brolucizumab in eyes with neovascular age-related macular degeneration.
Possible risk factors for IOI and retinal vascular occlusion after brolucizumab should be considered before administering brolucizumab. Patients who receive brolucizumab should be educated on the symptoms, signs, and time course of IOI after brolucizumab. Before each injection of brolucizumab, physicians should assess the eye for any signs of inflammation and not treat with brolucizumab if inflammation is detected. Treatment of IOI should be prompt and provided with particular attention to the posterior segment.
Careful patient selection, patient education, assessment for inflammation, and intensive treatment of possible inflammation are important when using brolucizumab in patients with neovascular age-related macular degeneration.

Despite known benefits of engaging in recommended amounts of physical activity (PA), sleep, and sedentary behavior (SB), little is known about how adults with visual impairments (VIs) meet these guidelines in isolation or simultaneously.
This study estimated (a) the prevalence of US adults with VIs who are partially or fully meeting the 24-h movement guidelines, and (b) the differential contribution of work-related, leisure, and transportation to total time accrued for PA.
A cross-sectional sample of adults with VIs (n = 466) was drawn from the National Health and Nutritional Examination Survey (NHANES) 2015-2018 combined datasets. Guideline adherence was measured using self-report items for average time spent physically active, sitting and sleeping. Weighted prevalence estimates were produced for meeting guidelines separately and in combination. The average percent of PA minutes accrued across work-related, leisure and transportation were compared among those meeting PA guidelines.
An estimated 29.6% (SE = 3.6) of US adults with VIs met all three guidelines. An estimated 59.3% (SE = 3.5) adults with VIs met PA guidelines alone or in combination with SB and sleep. Within this group, the majority of weekly PA minutes (average 63.9%) was accrued at work.
An estimated two thirds of adults with VIs are not engaged in healthful 24-h movement behaviors. Targeted interventions for adults with VIs are warranted that may require a comprehensive approach to PA, SB, and sleep. Work emerged as an important location for adults with VIs to accrue PA, inviting future research to explore associations between employment and 24-h movements within this population.

Reporting of research for stroke-related visual impairment is inconsistent. The aim of this study was to define three core outcome sets (COS) and related core outcome measurements (COM) for central visual impairment, visual field loss and ocular motility disorders in stroke research.
The consensus process consisted of an online three-round Delphi survey followed by a consensus meeting of key stakeholders.
UK-wide survey.
Stakeholders included orthoptists, occupational therapists, ophthalmologists, stroke survivors and COS users such as researchers, journal editors and guideline developers.
For COS development, a list of potentially relevant visual outcomes was created after review of the literature and further grouped into outcome domains. For COM development, a list of potential instruments was created after review of the literature and quality appraised for reliability and validity.
COS-119 potential outcomes extracted from published literature. Similar assessment outcomes were grouped into 24 outcome domains. Delphi process included 123 participants in round 1, 65 round 2, 51 round 3. Twelve participants attended the consensus meeting with recommended outcome domains for central visual impairment (visual acuity, functional vision, quality of life), visual field loss (visual fields, functional vision, quality of life) and ocular motility disorders (eye alignment, eye movements, functional vision, quality of life). COM-52 test options extracted from the COS outcomes and grouped into 16 domains. Thirteen participants attended the COM consensus meeting. Recommended instruments for measurement of these outcomes include; Logarithm of the Minimal Angle of Resolution visual acuity, cover test, cardinal position eye movement assessments, peripheral visual field perimetry, Visual Function Questionnaire-25.
COS and COM are defined for vision research for stroke survivors. Their use has potential to reduce heterogeneity in routine clinical practice and improve standardisation and accuracy of vision assessment. Future research is required to evaluate the use of these COS and COM.