Clinical Ophthalmology

Xiaoyuan Shen,1,&ast; Zidong Chen,1,&ast; Kaixin Tan,1 Yanmei Fan,1 Pingping Liu,1 Haorui Wang,2 Jing Samantha Pan,2 Yangfan Yang,1 Minbin Yu11State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, People’s Republic of China; 2Department of Psychology, Sun Yat-Sen University, Guangzhou, Guangdong, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Minbin Yu, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, People’s Republic of China, Tel +86 20 6661 5460, Email yuminbin@mail.sysu.edu.cnPurpose: To evaluate the diagnostic performance and spatial agreement of an online suprathreshold perimeter (Perimouse) compared with the Humphrey Field Analyzer (HFA) for detecting glaucomatous visual field defects.Patients and Methods: In this prospective comparative study, 174 participants (283 eyes with open-angle glaucoma or healthy controls) underwent Perimouse suprathreshold program and HFA. Abnormal points (missed stimuli in Perimouse; points with P< 0.5% on HFA total deviation map) were compared. Diagnostic performance was assessed using receiver operating characteristic (ROC) curve analysis. Point-wise performance used neural network–derived area under the curve (AUC) and Cohen’s κ.Results: Perimouse abnormal-point counts were correlated with HFA abnormal-point counts (r = 0.88, P < 0.001) and negatively correlated with HFA mean deviation (r = − 0.80, P < 0.001). The intraclass correlation coefficient for abnormal-point counts between Perimouse and HFA was 0.93, and Bland–Altman analysis showed a mean bias of 0.73 abnormal points, with 95% limits of agreement ranging from − 10.70 to 12.17. A cutoff of five abnormal points achieved 85.9% sensitivity and 97.9% specificity (AUC = 0.97), with performance improving with disease severity. Point-wise κ values ranged from 0.32 to 0.78 (AUC, 0.67– 0.96). The test duration for Perimouse was 2.64 ± 1.83 minutes.Conclusion: Perimouse demonstrated reasonable overall diagnostic accuracy for detecting HFA-defined visual field defects. Diagnostic performance was higher for moderate and advanced glaucomatous defects than for early defects, with variable point-wise agreement with HFA. Perimouse may serve as a rapid, adjunctive tool for preliminary functional screening of glaucomatous visual field loss.Keywords: glaucoma, visual field tests, screening, telemedicine

Claudio Iovino,1 Livio Vitiello,2 Aldo Vagge,3 Alfonso Pellegrino,2 Dominique Bremond-Gignac,4 Andrzej Grzybowski,5 Yousif Subhi,6,7 Giuseppe Giannaccare81Ophthalmology Unit, Acerra, Naples, Italy; 2Eye Unit, &quot;Luigi Curto&rdquo; Hospital, Azienda Sanitaria Locale Salerno, Polla, Salerno, Italy; 3Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University Eye Clinic of Genoa, University of Genoa, Genoa, Italy; 4Ophthalmology Department, Necker-Enfants Malades University Hospital, AP-HP, OPHTARA Rare Eye Disease Center, Paris Cit&eacute; University, Paris, France; 5Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland; 6Department of Regional Health Research, University of Southern Denmark, Odense, Denmark; 7Department of Ophthalmology, University Hospital of Southern Denmark, S&oslash;nderborg, Denmark; 8Eye Clinic, Department of Surgical Sciences, University of Cagliari, Cagliari, ItalyCorrespondence: Livio Vitiello, Email livio.vitiello@gmail.com

Marin Pattanapattana, Pichaya Kulniwatcharoen, Linda HansapinyoDepartment of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand&ast;These authors contributed equally to this workCorrespondence: Linda Hansapinyo, Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Sriphoom, Mueang Chiang Mai, Chiang Mai, 50200, Thailand, Tel +66-53-935512-3, Fax +66-53-936121, Email linda.h@cmu.ac.thPurpose: To compare the magnitude of visual recovery at 12 months after optic neuritis (ON), with long-term change as a secondary outcome, and distinguish numerical improvement from attained visual acuity (VA).Patients and Methods: This retrospective cohort included 184 adults with idiopathic ON, AQP4-IgG-positive NMOSD-ON, MOGAD-ON, or MS-ON. One affected eye per patient was selected by worse baseline VA, with right-eye ties. Primary recovery was baseline minus 12 ± 3-month logMAR VA; secondary recovery used last-follow-up VA. Baseline-adjusted VA contextualized change scores. MOGAD was descriptive only.Results: Twelve-month VA was available in 153 patients. Mean improvement was 0.76, 0.80, and 1.10 logMAR in idiopathic ON, NMOSD-ON, and MS-ON, respectively (ANOVA P=0.406). Corresponding last-follow-up changes were 0.78, 0.71, and 0.89 logMAR, over median follow-up of 38, 52, and 82 months. The baseline-adjusted 12-month analysis included 150 patients. Early steroid initiation was associated with better attained VA (β=− 0.45; 95% CI − 0.77 to − 0.14; P=0.005).Conclusion: Recovery magnitude and attained vision provide complementary descriptions. No statistically significant difference in 12-month numerical recovery was detected across the three main etiologies; equivalence was not established. Long-term change reflects unequal observation time and possible recurrent attacks. Treatment-timing associations are observational.Keywords: optic neuritis, visual recovery, logMAR, visual acuity, NMOSD, corticosteroids

Stephanie Kearney,1 Natalia Vlasak2,31Vision Sciences, Glasgow Caledonian University, Glasgow, UK; 2HOYA Vision Care, Amsterdam, Netherlands; 3Institute of Experimental Ophthalmology, Saarland University, Homburg, Saar GermanyCorrespondence: Stephanie Kearney, Email stephanie.kearney@gcu.ac.ukAbstract: Myopia control may involve targeting the peripheral retina to slow eye growth; however, there is no consensus on the optimal lens design, and treatment effects remain variable. This scoping review explored whether a specific retinal region is sensitive to visual manipulation, which could inform more effective treatments. A literature search was conducted in December 2025, with updates in March and June 2026 using PubMed, MEDLINE, and the Cochrane Library. Full manuscripts in English in animals and humans were included and screened by title, abstract, and full text for relevance. A total of 134 studies were identified, with 22 meeting inclusion criteria (13 human, 9 animal studies). Evidence across studies suggests that both the extent and location of defocus influence axial elongation. Increasing the treatment area may enhance myopia control efficacy, although findings are inconsistent regarding whether this relationship is dose-dependent. Several studies indicate that retinal sensitivity to defocus is not uniform, with the horizontal retina, particularly the temporal region, potentially more responsive to defocus than the vertical retina. Notably, converging evidence from human electrophysiological and intervention studies suggests that the near peripheral retina, approximately 6°– 12° eccentricity, may be particularly sensitive to defocus with possible greater sensitivity in the horizontal meridian. While expanding treatment zones may enhance therapeutic effects, the relationship is likely more complex than a simple linear dose-response. Interpretation is limited by variability across studies and heavy reliance on adult and animal studies. Further research in children with progressive myopia is needed to further validate this potential "sweet spot”, investigate inter-individual variability in retinal sensitivity, and determine whether targeting the near peripheral, horizontal retina leads to improved clinical outcomes in myopia control.Keywords: myopia control, defocus, retina, sweet spot