Die Thematik hat nicht nur die Medizin und insbesondere natürlich unser Kernfach, die Ophthalmologie, voll erfasst, sondern auch die Patienten, die das Internet als Informationsmedium nutzen; und es ist kein Geheimnis, dass „DoktorGoogle“ inmehrerenhunderttausend Fällen täglich um Aufklärung bemüht wird. Das Thema „Digitalisierung in der Augenheilkunde“wie auchdasderkünstlichen Intelligenz in derselben ist für uns alle und auch für mich teils angstbesetzt. Wir verstehen im Prinzip zu wenig davonundkönnenunsnicht vorstellen,was ein Algorithmus mit den Unmengen an Daten anstellt, die durch unsere diagnostischen Geräte und Untersuchungen erhoben werden. Vor diesemHintergrund habe ich das Leitthema „Digitale Augenheilkunde“ gewählt, denn die beste Chance, Ängste abzubauen, ist die der Informationsvermittlung und Aufklärung. Künstliche Intelligenz darf und wird niemals den Augenarzt/dieAugenärztin ersetzen.Wir sollten die neuen Medien und die digitalen Möglichkeiten als Hilfswerkzeuge für unsere Arbeit nutzen, sowie Albrecht von Graefe vor über 170 Jahren nach der Erfindung des Augenspiegels durch Helmholtz diesen als solchen verstanden und gebraucht hat. In der Benutzung neuer Geräte sind wir sehr geschult, und ich bin davon überzeugt, dass wir den Übergang indie digitaleAugenheilkunde mit Bravour bestehen werden. UnterBerücksichtigungdiesesAspekts habe ich 3 facettenreiche Einzelthemen unter dem Leitthema „Digitale Augenheilkunde“ ausgewählt, die einen guten Überblick verschaffen sollen, was an digitalen Ansätzen und telemedizinischen Versuchen im Moment interessant, aber auch kritisch zu hinterfragen ist. So gibt die Arbeit von Choritz et al. einen Einblick in die Möglichkeiten von Tablets und Mobiltelefonen für die Anwendung durch Ärzte und Patienten. Es ist eine interessante Frage, der wir uns stellen müssen: nämlich, inwieweit eine App, die suggeriert, eine Visusprüfung durchführen zu können, wirklich dazu imstande ist. Gleichzeitig sehen wir aber auchindieserArbeit sowohlguteAnsätze für telemedizinische Screeningverfahren als auch die Möglichkeit von Monitoring bei chronischen Augenerkrankungen.

Current initiatives to restore vision emphasize the need for objective assessments of visual field (VF) defects as pursued with functional magnetic resonance imaging (fMRI) approaches. Here, we compared population receptive field (pRF) mapping-based VF reconstructions to an fMRI method that uses more robust visual stimulation (on-off block design) in combination with individualized anatomy-driven retinotopic atlas-information (atlas-based VF). We investigated participants with sizable peripheral VF-deficits due to advanced glaucoma (n = 4) or retinitis pigmentosa (RP; n = 2) and controls (n = 6) with simulated scotoma. We obtained (1) standard automated perimetry (SAP) data as reference VFs and 3T fMRI data for (2) pRF-mapping [8-direction bar stimulus, fixation color change task] and (3) block-design full-field stimulation [8-direction drifting contrast patterns during (a) passive viewing (PV) and (b) one-back-task (OBT; reporting successions of identical motion directions) to probe the impact of previously reported task-related unspecific visual cortex activations]. Correspondence measures between the SAP and fMRI-based VFs were accuracy, assisted by sensitivity and specificity. We found an accuracy of pRF-based VF from V1 in patients [median: 0.62] that was similar to previous reports and increased by adding V2 and V3 to the analysis [0.74]. In comparison to the pRF-based VF, equivalent accuracies were obtained for the atlas-based VF for both PV [0.67] and, unexpectedly, the OBT [0.59], where, however, unspecific cortical activations were reflected by a reduction in sensitivity [0.71 (PV) and 0.35 (OBT)]. In conclusion, in patients with peripheral VF-defects, we demonstrate that previous fMRI procedures to obtain VF-estimates might be enhanced by: (1) pooling V1-V3 to enhance accuracy; (2) reporting sensitivity and specificity measures to increase transparency of the VF-reconstruction metric; (3) applying atlas-based procedures, if pRF-based VFs are not available or difficult to obtain; and (4) giving, counter-intuitively, preference to PV. These findings are expected to provide guidance to overcome current limitations of translating fMRI-based methods to a clinical work-up.

Purpose To test the feasibility of simultaneous steady-state pattern electroretinogram (PERG) and intraocular pressure (IOP) measurements with an IOP sensor and to test a model for IOP manipulation during lateral decubitus positioning (LDP) and its impact on the PERG. Design A prospective, observational study. Methods 15 healthy controls and 15 treated glaucoma patients participated in the study. 8 patients had an intraocular IOP sensor (eyemate-IO ® , Implandata Ophthalmic Products GmbH) in the right eye (GLA IMP ) and 7 had no sensor and with glaucoma in the left eye. (1) We tested the feasibility of simultaneous IOP and PERG recordings by comparing PERGs with and without simultaneous IOP-read out in GLA IMP . (2) All participants were positioned in the following order: sitting1 (S1), right LDP (LD R ), sitting2 (S2), left LDP (LD L ) and sitting3 (S3). For each position, PERG amplitudes and IOP were determined with rebound tonometry (Icare® TA01i) in all participants without the IOP sensor. Results Electromagnetic intrusions of IOP sensor readout onto steady-state PERG-recordings had, due to different frequency ranges, no relevant effect on PERG amplitudes. IOP and PERG measures were affected by LDP, e.g., IOP was increased during LD R vs S1 in the lower eyes of GLA IMP and controls (P < 0.001 and P < 0.05, respectively) and PERG amplitude was decreased (P < 0.05 and P < 0.01, respectively). Conclusions During LDP, IOP and PERG measurements changed more in the lower eye. IOP changes induced by LDP may be a model for studying the interaction of IOP and ganglion cell function.

fMRI studies in macular degeneration (MD) and retinitis pigmentosa (RP) demonstrated that responses in the lesion projection zones (LPZ) of V1 are task related, indicating significant limits of bottom-up visual system plasticity in MD and RP. In advanced glaucoma (GL), a prevalent eye disease and leading cause of blindness, the scope of visual system plasticity is currently unknown. We performed 3T fMRI in patients with extensive visual field defects due to GL (n=5), RP (n=2) and healthy controls (n=7; with simulated defects). Participants viewed contrast patterns drifting in 8 directions alternating with uniform gray and performed 3 tasks: (1) passive viewing (PV), (2) one-back task (OBT) and (3) fixation-dot task (FDT). During PV, they passively viewed the stimulus with central fixation, during OBT they reported the succession of the same two motion directions, and during FDT a change in the fixation color. In GL, LPZ responses of the early visual cortex (V1, V2 and V3) shifted from negative during PV to positive for OBT [p (corrected): V1(0.006); V2(0.04); V3(0.008)], while they were negative in the controls’ simulated LPZ for all stimulation conditions. For RP a similar pattern as for GL was observed. Consequently, activity in the de-afferented visual cortex in glaucoma is, similar to MD and RP, task-related. In conclusion, the lack of bottom-up plasticity appears to be a general feature of the human visual system. These insights are of importance for the development of treatment and rehabilitation schemes in glaucoma.Highlights 1. Functional dynamics of early visual cortex LPZ depend on task demands in glaucoma2. Brain activity in deprived visual cortex suggests absence of large-scale remapping3. Limited scope of bottom-up plasticity is a general feature of human visual system4. Visual system stability and plasticity is of relevance for therapeutic advances### Competing Interest StatementThe authors have declared no competing interest.

Visual acuity (VA) is an important determinant of visual function. Here we establish procedures and recommendations for VA testing extending beyond the classical VA and thus make them available for future studies of visual function in health and disease. Specifically, we provide reference values for photopic and scotopic conventional uncrowded visual acuity (cVA) and Vernier-hyperacuity (hVA) and assess their reproducibility and dependence on contrast polarity.

A fundamental scheme in the organization of the early visual cortex is the retinotopic representation of the contralateral visual hemifield on each hemisphere. We determined the cortical organization in a novel congenital visual pathway disorder, FHONDA-syndrome, where the axons from the temporal retina abnormally cross to the contralateral hemisphere. Using ultra-high field fMRI at 7 T, the population receptive field (pRF) properties of the primary visual cortex were modeled for two affected individuals and two controls. The cortical activation in FHONDA was confined to the hemisphere contralateral to the stimulated eye. Each cortical location was found to contain a pRF in each visual hemifeld and opposing hemifields were represented as retinotopic cortical overlays of mirror-symmetrical locations across the vertical meridian. Since, the enhanced crossing of the retinal fibers at the optic chiasm observed in FHONDA has been previously assumed to be exclusive to the pigment-deficiency in albinism, our direct evidence of abnormal mapping in FHONDA highlights the independence of pigmentation and development of the visual cortex. These findings thus provide fundamental insights into the developmental mechanisms of the human visual system and underline the general relevance of the interplay of subcortical stability and cortical plasticity.

The data presented in this article are related to the research article entitled "Retinal conduction speed analysis reveals different origins of the P50 and N95 components of the (multifocal) pattern electroretinogram" (Bach et al., 2018) [1]. That analysis required the individual length data of the retinal nerve fibers (from ganglion cell body to optic nerve head, depending on the position of the ganglion cell body). Jansonius et al. (2009, 2012) [2,3] mathematically modeled the path morphology of the human retinal nerve fibers. We here present a working implementation with source code (for the free and open-source programming environment "R") of the Jansonius' formulas, including all errata. One file defines Jansonius et al.'s "phi" function. This function allows quantitative modelling of paths (and any measures derived from them) of the retinal nerve fibers. As a working demonstration, a second file contains a graph which plots samples of nerve fibers. The included R code runs in base R without the need of any additional packages.

Current developments in functional magnetic resonance imaging (fMRI) of the human visual system have generated a set of powerful approaches that are of great promise for modern ophthalmology. These make it possible to perform an objective spatially resolved test of visual function in patients with strong visual impairment and even to investigate the functional organisation of the visual cortex in the blind. As a consequence, they open a broad field of applications for functional assessment in ophthalmology and provide fundamental insights into the interplay of pathology and plasticity in the human visual system. This is highlighted by current studies investigating patients with acquired or congenital defects of the macula, or with visual pathway abnormalities, extended retinal damage, and complete blindness. Therapeutic approaches targeting the restoration of visual input are expected to benefit from these fMRI applications, either for the estimation of the success rate of a planned retinal therapy or as an objective high-level biomarker for the readout of therapy success.

Aufgrund der partiellen Kreuzung der Sehnerven am Chiasma opticum erhält der menschliche visuelle Kortex jeder Hirnhälfte einen binokularen Eingang aus der jeweils gegenüberliegenden Gesichtsfeldhälfte. Bei Patienten mit Albinismus hingegen projiziert die temporale Netzhaut abnormal nach kontralateral [1]. Der visuelle Kortex erhält also einen zusätzlichen Eingang aus der gleichseitigen Gesichtsfeldhälfte. fMRT-Studien zeigten, dass diese kortikale Repräsentation der der gegenüberliegenden Gesichtsfeldhälfte überlagert ist [2].

Das menschliche Kontrastsehen und seine Prüfung haben aktuell an Bedeutung gewonnen. Die Literatur dazu ist teils sehr unübersichtlich, was auch an der Vielfalt verschiedener Kontrastdefinitionen liegt. Zum Beispiel sind der von der DOG-Verkehrskommission verwendete „Aulhorn-Harms-Kontrast“ und das DIN-Kontrastverhältnis reziprok zueinander. In der vorliegenden Arbeit werden die 5 wichtigsten Helligkeitskontrastdefinitionen erläutert sowie ihre Anwendungsbereiche und Umrechnungsformeln in einer Äquivalenztabelle angegeben. Zur Vereinheitlichung empfehlen wir, wann immer möglich, statt der Kontrastverhältnisse die Einheit „logCS“ zu verwenden, auch wenn anfangs ungewohnt. Für wissenschaftliche Untersuchungen zum Kontrastsehen erscheint uns die Verwendung von logCS zwingend geboten.

Motion correction of echo-planar imaging (EPI) data used in functional MRI (fMRI) is an essential preprocessing step performed prior to statistical analysis. At ultra-high resolution fMRI, current requirements regarding translational and rotational motion may no longer be acceptable. This prompts the need for a systematic investigation of the effects of motion correction procedures with in vivo fMRI data. Here we systematically evaluated the effect of retrospective motion correction with freely available fMRI analysis software packages (FSL, AFNI, and SPM) on activation maps using fMRI data acquired with prospective motion detection, to identify and quantify confounding effects of retrospective motion correction, and to evaluate its dependence on spatial resolution and motion correction algorithms. Brain activation maps were obtained for two different resolutions, an ultrahigh, that is, 0.653 mm3 , and a more widely used 2.03 mm3 isotropic resolutions at 7 T. The EPI data were acquired using simultaneous non-image-based optical moiré phase tracking (MPT) of physical motion. The results showed that image-based motion detection, performed by SPM8 software package, may be erroneous in high-field fMRI data with partial brain coverage and can introduce spurious motion leading to false-positive and false-negative activation. Further analyses demonstrated that limited acquisition field of view has the dominant influence on the effect. Hum Brain Mapp 38:4497-4510, 2017. © 2017 Wiley Periodicals, Inc.

Adaptation to visual or auditory motion affects within‐modality motion processing as reflected by visual or auditory free‐field motion‐onset evoked potentials (VEPs, AEPs). Here, a visual–auditory motion adaptation paradigm was used to investigate the effect of visual motion adaptation on VEPs and AEPs to leftward motion‐onset test stimuli. Effects of visual adaptation to (i) scattered light flashes, and motion in the (ii) same or in the (iii) opposite direction of the test stimulus were compared. For the motion‐onset VEPs, i.e. the intra‐modal adaptation conditions, direction‐specific adaptation was observed – the change‐N2 (cN2) and change‐P2 (cP2) amplitudes were significantly smaller after motion adaptation in the same than in the opposite direction. For the motion‐onset AEPs, i.e. the cross‐modal adaptation condition, there was an effect of motion history only in the change‐P1 (cP1), and this effect was not direction‐specific – cP1 was smaller after scatter than after motion adaptation to either direction. No effects were found for later components of motion‐onset AEPs. While the VEP results provided clear evidence for the existence of a direction‐specific effect of motion adaptation within the visual modality, the AEP findings suggested merely a motion‐related, but not a direction‐specific effect. In conclusion, the adaptation of veridical auditory motion detectors by visual motion is not reflected by the AEPs of the present study.