Impaired vestibular function associated with orthostatic hypotension in patients with multiple system atrophy.

BACKGROUND: Orthostatic hypotension (OH) is one of the most common symptoms in patients with multiple system atrophy (MSA). Vestibular system plays an important role in blood pressure regulation during orthostatic challenges through vestibular-sympathetic reflex. The current study aimed to investigate the relationship between vestibular function and OH in patients with MSA. METHODS: Participants with MSA, including 20 with OH (mean age, 57.55 ± 8.44 years; 7 females) and 15 without OH (mean age, 59.00 ± 8.12 years; 2 females) and 18 healthy controls (mean age, 59.03 ± 6.44 years; 8 females) were enrolled. Cervical and ocular vestibular evoked myogenic potentials (cVEMPs and oVEMPs) tests were conducted to evaluate vestibular function. RESULTS: Patients with MSA presented with significantly higher rate of absent cVEMPs (57.1% vs 11.1%, p = 0.001) and oVEMPs (25.7% vs 0, p = 0.021) than controls. MSA patients with OH showed more absent cVEMPs (75.0% vs 11.1%, Bonferroni corrected p < 0.001) and oVEMPs (40.0% vs 0, Bonferroni corrected p = 0.003) than controls. Patients with OH also showed higher rate of absent cVEMPs than those without OH (33.3%, Bonferroni corrected p = 0.014). CONCLUSIONS: Our results demonstrated that impairment of vestibular function was associated with MSA, particularly in those with OH. Absent VEMPs may be a potential marker for MSA severity. Our findings suggest that impaired vestibular function is involved in OH development and may serve as an intervention target.

Changes in corneal nerve morphology and function in patients with dry eyes having type 2 diabetes.

BACKGROUND: Dry eye syndrome (DES) is a common disease with various clinical manifestations. DES had a significant association with diabetes. Blink reflex (BR) is also known as trigeminal nerve facial reflex. The stimulation of corneal nerves is one of the origins of BR stimulation. The parasympathetic fibers sent out through the facial nerve are the outlet of tear reflexes. BR can be used to assess the function of the corneal nerve closed-loop; however, whether the BR changes in these patients is unclear. AIM: To understand the morphology and function of the corneal nerve in patients with dry eyes having diabetes or not. METHODS: This study enrolled 131 patients who visited the inpatient and outpatient services of ophthalmology and endocrinology departments between January 2019 to August 2020 with subjective symptoms of dry eyes and non-dry eye reasons, as well as volunteers such as colleagues. The patients were divided into four groups: DEwDM, with dry eyes having type 2 diabetes mellitus (T2DM); DMnDE, with T2DM not having dry eyes; DEnDM, with dry eyes not having diabetes; and nDMnDE, with neither dry eyes nor diabetes. The tear film break-up time, Schirmer I test, in vivo confocal microscopy, and BR were performed. RESULTS: The DEwDM, DMnDE, DEnDM, and nDMnDE groups included 56, 22, 33, and 20 patients, respectively. Sex and age were not statistically different among the four groups. The nerve fiber length (NFL) of patients in the DEwDM, DEnDM, and DMnDE groups reduced (P < 0.001, P = 0.014, and P = 0.001, respectively). No significant difference in corneal nerve fiber density (NFD) (P = 0.083) and corneal nerve branch density (NBD) (P = 0.195) was found among the four groups. The R1 Latency of blink reflexes increased only in the DEwDM group (P = 0.008, P = 0.001, P < 0.001, compared with the DMnDE, DEnDM, and nDMnDE groups, respectively). The NBD and R1 Latency were different between DEwDM and DEnDM groups in patients with moderate and severe dry eyes. CONCLUSION: The corneal nerve morphology changed in patients with dry eyes or diabetes, or with both, while the function of corneal nerve closed-loop reduced only in those with dry eyes and diabetes.

Transverse mode switchable fiber laser through wavelength tuning.

We report a fiber laser design that is capable of producing switchable transverse modes through wavelength tuning. The transverse mode switching is realized by exploiting the particular transverse mode-wavelength association characteristics of the few-mode fiber Bragg grating. Different transverse mode outputs with high spatial mode quality can be obtained by adjusting the oscillating wavelength with a tunable filter within the fiber laser cavity. For each of the spatial mode outputs, the laser operates at the corresponding single wavelength with narrow linewidth. Through adding polarization controllers in the laser cavity, output modes with cylindrical vector polarization are also realized.

Low-threshold single-wavelength all-fiber laser generating cylindrical vector beams using a few-mode fiber Bragg grating.

We propose and demonstrate a low-threshold single-wavelength all-fiber laser generating cylindrical vector beams using a few-mode fiber Bragg grating. Both radially and azimuthally polarized beams have been generated with very good modal symmetry and polarization purity higher than 94%. The radially and azimuthally polarized modes can be switched by simply adjusting the polarization controllers built in the fiber laser cavity. This fiber laser operates at a single wavelength of 1053 nm with a 3 dB linewidth of less than 0.02 nm, signal-to-background ratio of more than 55 dB, and a threshold as low as 16 mW. A new method for the polarization purity measurement is also proposed.