EEG alpha reactivity on eyes opening discriminates patients with schizophrenia and schizoaffective disorder.

OBJECTIVE: Alpha activity in the electroencephalogram (EEG) is typically dominant during rest with closed eyes but suppressed by visual stimulation. Previous research has shown that alpha-blockade is less pronounced in schizophrenia patients compared to healthy individuals, but no studies have examined it in schizoaffective disorder. METHODS: A resting state EEG was used for the analysis of the alpha-reactivity between the eyes closed and the eyes opened conditions in overall (8 - 13 Hz), low (8 - 10 Hz) and high (10 - 13 Hz) alpha bands in three groups: schizophrenia patients (SC, n = 30), schizoaffective disorder (SA, n = 30), and healthy controls (HC, n = 36). All patients had their first psychotic episode and were receiving antipsychotic therapy. RESULTS: A significant decrease in alpha power was noted across all subjects from the eyes-closed to eyes-open condition, spanning all regions. Alpha reactivity over the posterior regions was lower in SC compared to HC within overall and high alpha. SA showed a trend towards reduced alpha reactivity compared to HC, especially evident over the left posterior region within the overall alpha. Alpha reactivity was more pronounced over the middle and right posterior regions of SA as compared to SC, particularly in the high alpha. Alpha reactivity in SC and SA patients was associated with various negative symptoms. CONCLUSIONS: Our findings imply distinct alterations in arousal mechanisms in SC and SA and their relation to negative symptomatology. Arousal is more preserved in SA. SIGNIFICANCE: This study is the first to compare the EEG features of arousal in SC and SA.

Automated Machine Learning for Predicting Diabetic Retinopathy Progression From Ultra-Widefield Retinal Images.

Importance: Machine learning (ML) algorithms have the potential to identify eyes with early diabetic retinopathy (DR) at increased risk for disease progression. Objective: To create and validate automated ML models (autoML) for DR progression from ultra-widefield (UWF) retinal images. Design, Setting and Participants: Deidentified UWF images with mild or moderate nonproliferative DR (NPDR) with 3 years of longitudinal follow-up retinal imaging or evidence of progression within 3 years were used to develop automated ML models for predicting DR progression in UWF images. All images were collected from a tertiary diabetes-specific medical center retinal image dataset. Data were collected from July to September 2022. Exposure: Automated ML models were generated from baseline on-axis 200° UWF retinal images. Baseline retinal images were labeled for progression based on centralized reading center evaluation of baseline and follow-up images according to the clinical Early Treatment Diabetic Retinopathy Study severity scale. Images for model development were split 8-1-1 for training, optimization, and testing to detect 1 or more steps of DR progression. Validation was performed using a 328-image set from the same patient population not used in model development. Main Outcomes and Measures: Area under the precision-recall curve (AUPRC), sensitivity, specificity, and accuracy. Results: A total of 1179 deidentified UWF images with mild (380 [32.2%]) or moderate (799 [67.8%]) NPDR were included. DR progression was present in half of the training set (590 of 1179 [50.0%]). The model's AUPRC was 0.717 for baseline mild NPDR and 0.863 for moderate NPDR. On the validation set for eyes with mild NPDR, sensitivity was 0.72 (95% CI, 0.57-0.83), specificity was 0.63 (95% CI, 0.57-0.69), prevalence was 0.15 (95% CI, 0.12-0.20), and accuracy was 64.3%; for eyes with moderate NPDR, sensitivity was 0.80 (95% CI, 0.70-0.87), specificity was 0.72 (95% CI, 0.66-0.76), prevalence was 0.22 (95% CI, 0.19-0.27), and accuracy was 73.8%. In the validation set, 6 of 9 eyes (75%) with mild NPDR and 35 of 41 eyes (85%) with moderate NPDR progressed 2 steps or more were identified. All 4 eyes with mild NPDR that progressed within 6 months and 1 year were identified, and 8 of 9 (89%) and 17 of 20 (85%) with moderate NPDR that progressed within 6 months and 1 year, respectively, were identified. Conclusions and Relevance: This study demonstrates the accuracy and feasibility of automated ML models for identifying DR progression developed using UWF images, especially for prediction of 2-step or greater DR progression within 1 year. Potentially, the use of ML algorithms may refine the risk of disease progression and identify those at highest short-term risk, thus reducing costs and improving vision-related outcomes.

Dysfunction in the fellow eyes of strabismic and anisometropic amblyopic children assessed by visually evoked potentials / Alterações dos potenciais visuais evocados nos olhos contralaterais de crianças com ambliopia estrabísmica e anisometrópica

ABSTRACT Purpose: To evaluate visual acuity and transient pattern reversal (PR) visual evoked potentials (VEPs) in the fellow eyes of children with strabismic and/or anisometropic amblyopia. Methods: Children diagnosed with strabismic and/or anisometropic amblyopia were recruited for electrophysiological assessment by VEPs. Monocular grating and optotype acuity were measured using sweep-VEPs and an Early Treatment Diabetic Retinopathy Study chart, respectively. During the same visit, transient PR-VEPs of each eye were recorded using stimuli subtending with a visual angle of 60', 15', and 7.5'. Parameters of amplitude (in μV) and latency (in ms) were determined from VEP recordings. Results: A group of 40 strabismic and/or anisometropic amblyopic children (22 females: 55%, mean age= 8.7 ± 2.2 years, median= 8 years) was examined. A control group of 19 healthy children (13 females: 68.4%, mean age= 8.2 ± 2.6 years, median= 8 years) was also included. The fellow eyes of all amblyopes had significantly worse optotype acuity (p=0.021) than the control group, regardless of whether they were strabismic (p=0.040) or anisometropic (p=0.048). Overall, grating acuity was significantly worse in the fellow eyes of amblyopes (p=0.016) than in healthy controls. Statistically prolonged latency for visual angles of 15' and 7.5' (p=0.018 and 0.002, respectively) was found in the strabismic group when compared with the control group. For the smaller visual stimulus (7.5'), statistically prolonged latency was found among all fellow eyes of amblyopic children (p<0.001). Conclusions: The fellow eyes of amblyopic children showed worse optotype and grating acuity, with subtle abnormalities in the PR-VEP detected as prolonged latencies for smaller size stimuli when compared with eyes of healthy children. These findings show the deleterious effects of amblyopia in several distinct visual functions, mainly those related to spatial vision.

RESUMO Objetivo: Avaliar a acuidade visual e os potenciais visuais evocados transientes por reversão de padrões no olho contralateral de crianças com ambliopia estrabísmica e/ou anisometrópica. Métodos: Foram avaliados os potenciais visuais evocados de crianças com ambliopia estrabísmica e/ou anisometrópica. As acuidades visuais monoculares de grades e de optotipos foram mensuradas utilizando o PVE de varredura e a tabela EDTRS, respectivamente. Na mesma visita, foram registrados os PVERP transients de cada olho usando estímulos de ângulo visual de 60'; 15' e 7,5'. Parâmetros de amplitude (em microvolts) e latência (em milissegundos) foram determinados para os registros dos potenciais visuais evocados. Resultados: Um grupo de 40 crianças amblíopes estrábicas e/ou anisometrópicas (22 meninas - 55%, media idade= 8,7 ± 2,2, mediana= 8) foi examinado. Um grupo de 19 crianças saudáveis (13 meninas 68,4%, media idade= 8,2 ± 2,6, mediana= 8) de controle também foi incluído. A acuidade visual por optotipos foi significativamente pior (p=0,021) nos olhos contralaterais de todos os amblíopes, quando comparado com o grupo controle, independentemente se estrábico (p=0,040) ou anisometrópico (p=0,048). No geral, a acuidade visual por grades foi significativamente pior nos olhos contralaterais dos amblíopes (p=0,016), quando comparados com o grupo controle. Foi encontrada latência estatisticamente prolongada para ângulos visuais de 15' (p=0,018) e 7,5' (p=0,002) no grupo estrábico, quando comparado com o grupo controle. Para o menor estímulo visual (7,5') foi encontrada latência estatisticamente prolongada nos olhos contralaterais de todas crianças amblíopes (p<0,001). Conclusões: Os olhos contralaterais de crianças amblíopes mostraram pior acuidade visual de optotipo e de resolução de grades, com alterações sutis nos PVERP, detectadas pelas latências prolongadas para estímulos de menor tamanho, quando comparados com os olhos de crianças saudáveis. Estes resultados mostram os efeitos deletérios da ambliopia em várias funções visuais distintas, principalmente relacionadas à visão espacial.

The eye-tracking of social stimuli in patients with Rett syndrome and autism spectrum disorders: a pilot study / Rastreamento do olhar para estímulos sociais em pacientes com síndrome de Rett e transtornos do espectro do autismo: estudo piloto

Objective To compare visual fixation at social stimuli in Rett syndrome (RT) and autism spectrum disorders (ASD) patients. Method Visual fixation at social stimuli was analyzed in 14 RS female patients (age range 4-30 years), 11 ASD male patients (age range 4-20 years), and 17 children with typical development (TD). Patients were exposed to three different pictures (two of human faces and one with social and non-social stimuli) presented for 8 seconds each on the screen of a computer attached to an eye-tracker equipment. Results Percentage of visual fixation at social stimuli was significantly higher in the RS group compared to ASD and even to TD groups. Conclusion Visual fixation at social stimuli seems to be one more endophenotype making RS to be very different from ASD. .

Objetivo Comparar a fixação visual em estímulos sociais em pacientes com síndrome de Rett (SR) e com transtornos do espectro do autismo (TEA). Método Fixação visual em estímulos sociais foi analisada em 14 pacientes do sexo feminino com SR (idades entre 4 e 30 anos), 11 pacientes do sexo masculino com TEA (idades entre 4 e 20 anos), e 17 crianças do sexo feminino com desenvolvimento típico (DT). Os participantes foram expostos a três figuras diferentes (duas figuras de faces humanas e uma figura contendo estímulo social e não social) apresentadas por 8 segundos cada uma no monitor de um computador acoplado a um equipamento de rastreamento de olhar. Resultados A porcentagem de fixação visual em estímulos sociais foi significativamente maior no grupo SR do que no grupo TEA e mesmo no grupo DT. Conclusão A fixação visual em estímulos sociais parece ser mais um dos endofenótipos que esclarecem as diferenças entre SR e TEA. .

Modificaciones del segmento anterior ocular posterior a iridotomía láser periférica mediante tomografía de coherencia óptica / Modifications of posterior ocular anterior segment with peripheral laser iridotomy

OBJETIVO: Evaluar los cambios a corto plazo en el segmento anterior ocular pos-iridotomía láser periférica, mediante tomografía de coherencia óptica de segmento anterior. MÉTODOS: Estudio longitudinal prospectivo de serie de casos en 30 pacientes (46 ojos) con sospecha de cierre angular primario. Las imágenes fueron tomadas con el equipo SL-OCT Heidelberg Engineering en el preoperatorio y a los 7 días posoperatorios. Se evaluaron variables relacionadas con mensuraciones de las estructuras del segmento anterior. RESULTADOS: Las mensuraciones de cada cuadrante fueron similares en el preoperatorio mientras en el posoperatorio hubo diferencias significativas en todas las variables a expensas de los cuadrantes nasal e inferior, excepto para la distancia iris-espolón (p = 0,926) y distancia de apertura angular a 750 Ám (p = 0,069). Los cambios posláser fueron significativos en todas las variables relacionadas con mensuraciones angulares (p = 0,000), volumen de cámara anterior (p = 0 000) y profundidad central de cámara anterior (p =0,011). La amplitud angular se incrementó como promedio en 8,7 ±,5,9 grados pos-láser y se correlacionó negativamente con las variables preoperatorias distancia iris-espolón (p =0,007), distancia de apertura angular a 500 Ám (p = 0,031), área del espacio irido-trabecular a 500 Ám (p = 0,003) y 750 Ám (p =0,026). Al comparar los cambios pos-operatorios entre ojos adelfos las diferencias no fueron significativas. CONCLUSIÓN: La iridotomía láser es efectiva en incrementar la amplitud angular, asociándose a incremento en el volumen y profundidad central de la cámara anterior en la sospecha de cierre angular primario

OBJECTIVE: To evaluate post-laser peripheral iridotomy variations of anterior ocular segment by anterior segment optical coherence tomography. METHOD: Prospective observational case series in 30 patients (46 eyes) diagnosed with primary angle- closure suspect. The tomography was obtained pre-operative and at seven days post-operative by SL-OCT Heidelberg Engineering. Quantitative variables related to anterior segment structures were analyzed before and after the laser peripheral iridotomy treatment. RESULTS: There were no pre-operative statistical differences between quadrants. In the pos-op period all variables showed significant differences particularly at inferior and nasal quadrant, except for iris-scleral spur distance (p=0.926) and angle opening distance at 750Ám (p=0.069). Pos-laser changes were significant for variables related to the angle (p=0.000), anterior chamber volume (p=0.000), and anterior chamber depth (p=0.011). The average increase in post-laser anterior chamber angle was 8.7±5.9 degrees and it was correlated negatively to pre-operative iris-scleral spur distance (p=0.007), angle opening distance at 500Ám (p=0.031), trabecular-iris space area at 500 Ám (p=0.003), and 750Ám (p= 0.026). Inter-eye differences were non significant for post-operative changes. CONCLUSION: Laser iridotomy is effective to increase the anterior chamber angle, and it is associated with the increase in anterior chamber volume and central depth in primary angle- closure suspect

Twenty-four-hour repeatability of diurnal intraocular pressure patterns in glaucomatous and ocular hypertensive individuals

OBJECTIVE: To verify the 24-hour repeatability of diurnal intraocular pressure patterns in glaucomatous and ocular hypertensive individuals. METHODS: A prospective analysis of 88 eyes from 88 ocular hypertensive or open-angle glaucoma patients was conducted on diurnal tension curves obtained by the same examiner on two consecutive days. The intraclass correlation coefficient test was used for statistical analysis. RESULTS: Eighty-eight eyes from 88 patients were analyzed. Fifty-seven patients (64.8 percent) were female. The mean age of all participants was 68.7 (SD 10.8, range 51-79) years. The intraclass correlation coefficient values for measurements at 8 AM, 11 AM, 2 PM, and 4 PM were 0.80, 0.82, 0.83, and 0.86, respectively (all intraclass correlation coefficient values, p<0.001). CONCLUSION: Diurnal intraocular pressure data collected on a single day characterize the diurnal intraocular pressure variability over 24 hours in primary open-angle glaucoma and ocular hypertensive patients.

Metástasis coroidea como primera manifestación de recaída sistémica en el cáncer de mama / Choroid metastases are a first manifestation of system relapse in breast cancer

La metástasis coroidea es una entidad poco frecuente y está asociada usualmente a un mal pronóstico, siendo el cáncer de mama su principal causa. Se presenta el caso de un paciente femenino de 47 años de edad con antecedente de cáncer de mama estadio IIIA diagnosticado y tratado en 1998, permaneciendo libre de enfermedad locorregional y a distancia hasta julio de 2005 cuando presenta disminución de la agudeza visual basados en los test clínicos se le diagnosticó metástasis coroidea en ojo derecho. Inicia tratamiento local y sistémico con evolución satisfactoria y remisión completa de la lesión corroborada por estudios complementarios.

The choroid metastasis, are not frequent in intraocular malignant tumors, the breast cancer, is the primary tumor more frequently responsible for ocular metastases. These reports describe a feminine 47 years old diagnosed with infiltrating ductal carcinoma of her right breast classified how state III. A treated in 1998, she was free of disease until July of 2005, she complained of diminished visual acuity of her right eye. Based on the clinical and test outcomes the following diagnosis was reached: Choroid metastasis in the right eye, from a known primary tumor. The patient started treatment local and systemically chemotherapy with excellent response.

Mudanças oculares durante a gestação / Ocular changes during pregnancy

A gestação pode causar várias alterações no funcionamento do olho humano, tanto nas condições sistêmicas quanto em doenças oculares, sendo seus efeitos divididos em três categorias: alterações fisiológicas, mudanças em doenças oculares pré-existentes e alterações patológicas. O presente texto propõe uma revisão bibliográfica sobre o tema. Os autores pesquisaram os bancos de dados do PubMed (MEDLINE) e LILACS.

Pregnancy can cause several alterations in human eye function in healthy condition as well in ocular disease; these effects on the eyes are divided into three categories: physiologic alterations, ocular diseases changes already existing before the pregnancy, and pathological alterations. The present text proposes a bibliographical revision on the theme. The authors researched PubMed (MEDLINE) and LILACS databases.

Mucocele frontal lateral, tratamiento combinado endoscópico y externo: caso clínico / Frontal lateral mucocele, combined endoscopic and external treatment: clinical case

El mucocele frontal es la ubicación más frecuente de los mucoceles de senos paranasales, sin embargo aún no hay consenso respecto a la técnica quirúrgica adecuada para su tratamiento. El presente trabajo muestra un caso clínico de un mucocele frontal lateralizado, que desplaza el globo ocular y lóbulo cerebral frontal. Se muestra la técnica quirúrgica empleada (vía externa combinada con vía endoscópica). Se exponen las distintas técnicas de imagenología diagnóstica y técnicas computacionales que ayudan en el procedimiento quirúrgico.

Orbital fat prolapse in a Persian cat. Case report

Relata-se o caso de um gato da raça Persa, com dois anos e oito meses de idade, apresentando histórico de secreção ocular crônica bilateral. Ao exame oftálmico rotineiro, observou-se epifora, secreção ocular mucosidade bilateral e aumento de volume na conjuntiva bulbar, no quadrante dorsolateral, do olho direito. A punção por biopsia aspirativa da lesão do quadrante dorsolateral do olho direito demonstrou tratar-se de acúmulo de tecido adiposo, factível com prolapso de gordura orbitária.

Las lecciones derivadas del ASA Closed Claims Project (ASACCP). Proyecto de la ASA acerca de las razones que promovieron demandas contra anestesiólogos cuyos casos estuviesen ya archivados. 5a. parte: Pérdida de la visión y otras complicaciones oculares del postoperatorio / Lessons learned from the ASA Closed Claims Project (ASACCP). ASA project about the reasons for wich claims against anesthesiologists were renewed in cases that had already been closed. Part 5: Loss of vision and other postoperative ocular complications

A pesar de ser la ceguera postoperatoria una complicación rara en la cual la neuropatía isquémica del nervio óptico parecer ser la causa predominante, ella se habría incrementado en los últimos tiempos, por lo menos en lo que respecta a la frecuencia con que aparece descripta en la literatura médica. El ASACCP, luego de analizar más de 5.800 expedientes cuyos juicios por presunta mala praxis estaban concluídos, descubrió que solamente el 3 por ciento de las demandas estaban relacionadas con amaurosis postoperatoria en cirugías no oftalmológicas. A partir de este estudio, y con el objeto de ahondar más en las causas de una complicación tan grave, en junio de 1999 la ASA formó una comisión especial dentro del ASACCP (ASA Closed Claims Proyect), el Postoperative Visual Loss Registry (PVLR) que elaboró un formulario para ser llenado, en forma anónima, por los miembros de la entidad cuando se enfrentan con un caso de lesión ocular postoperatoria. En este trabajo se analizan las causas dela ceguera postoperatoria y se describe su aparición durante distintos procedimientos quirúrgicos y anestésicos.

Alteraciones oftalmológicas en pacientes con artritis reumatoide juvenil / Ophthalmological features in subjects with juvenile rheumatoid arthritis

Se realizó un estudio retrospectivo en el Instituto Nacional de Pediatría del año 1993 a 1998 donde se estudiaron 104 expedientes de pacientes con diagnóstico de artritis reumatoide juvenil (ARJ) y se buscaron datos de uveítis, encontrándose 13 pacientes con esta complicación, siendo el sexo femenino con ARJ de tipo pauciarticular y anticuerpos antinucleares positivos el de mayor riesgo; los hombres que presentaron datos de uveítis fueron el grupo que presentó un peor pronóstico visual y mayores complicaciones. La detección temprana y el tratamiento oportuno de todos los pacientes con ARJ sin importar el sexo nos da un mejor pronóstico visual.

Incidência de problemas oculares em portadores do HIV/AIDS: uma manifestaçäo na consulta de enfermagem / Incidence of ocular disorders in HIV positive patients: findings during nursing consultation / Incidencia de enfermedades oftalmológicas en personas con SIDA: hallazgos en la consulta de enfermería

O objetivo deste estudo, do tipo exploratório-descritivo, foi conhecer os problemas oculares em indivíduos portadores do HIV/AIDS e correlacionar estas disfunções com a fase da doença e as queixas referidas. Seu desenvolvimento ocorreu em hospital de referência em AIDS. com amostra de 100 indivíduos portadores de HIV/AIDS. Da amostra, 16 indivíduos foram categorizados em achado ocular ausente, 68 indivíduos com achado ocular sem relação à AIDS e 16 indivíduos com achado relacionados à AIDS; as alterações oculares estão presentes predominantemente no estágio IV da doença. Os que apresentaram achados oculares relacionados à AIDS, têm severo comprometimento da acuidade visual, fundo de olho e campo visual. Quanto a queixas e sintomas, os pacientes referiram 233..

Pênfigo ocular cicatricial / Ocular cicatricial pemphigoid

As lesöes oculares induzidas pelo pênfigo ocular cicatricial (POC) säo progressivas, irreversíveis e, em alguns casos, resistentes à terapêutica médica. A propósito de um caso, apresentamos as dificuldades terapêuticas encontradas e a aparente remissäo conseguida com um protocolo de pulsoterapia

Estudo da variação da pressão intra-ocular postural e do tempo do ciclo pupilar na hanseníase / ?

Com o objetivo de estudar a variação da pressão intra-ocular postural e o tempo do ciclo pupilar em hansenianos de controle ambulatorial de um hospital universitário, foram selecionados voluntários sadios e pacientes paucibacilares e multibacilares. As medidas da pressão intra-ocular, realizadas com a tonometria de aplanação, demonstraram que as pressões intra-oculares médias na posição sentada, não apresentaram diferenças estatisticamente significativas entre os grupos estudados. As medidas realizadas na posição sentada e em decúbito dorsal imediato demonstraram que houve tendência à maior variação da pressão intra-ocular postural no grupo multibacilar, não havendo, entretando, significância estatística no achado; as medidas realizadas cinco minutos após a permanência na posição de decúbito dorsal demonstraram aumento siginificativo da pressão intra-ocular no grupo multibacilar. As medidas do tempo do ciclo pupilar, realizadas clinicamante na lâmpada de fenda, apresentaram-se mais prolongadas no grupo multibacilar, seguidas pelo paucibacilar e pelo controle, havendo diferenças estatíticamente significativas entre este e o multibacilar. Os achados podem sugerir comprometimento do sistema nervoso autônomo ocular, mas não foi observada correlação entre a variação da pressão intra-ocular postural e o tempo do ciclo pupilar na hanseníase.