The Association Between Acquired Color Deficiency and PET Imaging of Neurodegeneration in Mild Cognitive Impairment and Alzheimer Disease.

Purpose: To evaluate color vision changes and retinal processing of chromatic and luminance pathways in subjects with Alzheimer disease (AD) and mild cognitive impairment (MCI) compared with a matched control group and whether such changes are associated with impaired brain glucose metabolism and ß-amyloid deposition in the brain. Methods: We evaluated 13 patients with AD (72.4 ± 7.7 years), 23 patients with MCI (72.5 ± 5.5 years), and 18 controls of comparable age (P = 0.44) using Cambridge color test and the heterochromatic flicker ERG (HF-ERG). The Cambridge color test was performed using the trivector protocol to estimate the protan, deutan and tritan color confusion axes. HF-ERG responses were measured at a frequency of 12 Hz, which ERGs reflect chromatic activity, and at 36 Hz, reflecting luminance pathway. A study subsample was performed using neuropsychological assessments and positron emission tomography. Results: Patients with AD presented higher mean values indicating poorer color discrimination for protan (P = 0.04) and deutan (P = 0.001) axes compared with the controls. Along the tritan axis, both patients with AD and patients with MCI showed decreased color vision (P = 0.001 and P = 0.001) compared with controls. The analyses from the HF-ERG protocol revealed no differences between the groups (P = 0.31 and P = 0.41). Diffuse color vision loss was found in individuals with signs of neurodegeneration (protan P = 0.002, deutan P = 0.003 and tritan P = 0.01), but not in individuals with signs of ß-amyloid deposition only (protan P = 0.39, deutan P = 0.48, tritan P = 0.63), regardless of their clinical classification. Conclusions: Here, patients with AD and patients with MCI present acquired color vision deficiency that may be linked with impaired brain metabolism.

Alterations of color vision and pupillary light responses in age-related macular degeneration.

Introduction: Age-related macular degeneration (AMD) is the leading cause of irreversible central vision loss in developed countries and one of the leading causes of blindness. In this work, we evaluated color vision and the pupil light reflex (PLR) to assess visual function in patients with early and neovascular AMD (NVAMD) compared with the control group. Methods: We recruited 34 early patients with dry AMD and classified them into two groups following AREDS: 13 patients with NVAMD and 24 healthy controls. Controls and patients with early dry AMD had visual acuity (VA) best or equal to 20/25 (0.098 logMAR). Color vision was assessed in controls and patients with early dry AMD using the Cambridge Color Test (CCT) 2.0 through the Trivector protocol. The PLR was evaluated using a Ganzfeld, controlled by the RETI-port system. The stimuli consisted of 1s blue (470 nm) and red (631 nm) light flashes presented alternately at 2-min intervals. To assess the cone contribution, we used a red flash at 2.4 log cd.m-2, with a blue background at 0.78 log cd.m-2. For rods, we used 470-nm flashes at -3 log cd.m-2, and for the melanopsin function of ipRGCs, we used 470 nm at 2.4 log cd.m-2. Results: Patients with early dry AMD had reduced color discrimination in all three axes: protan (p = 0.0087), deutan (p = 0.0180), and tritan (p = 0.0095) when compared with the control group. The PLR has also been affected in patients with early dry AMD and patients with NVAMD. The amplitude for the melanopsin-driven response was smaller in patients with early dry AMD (p = 0.0485) and NVAMD (p = 0.0035) than in the control group. The melanopsin function was lower in patients with NVAMD (p = 0.0290) than the control group. For the rod-driven response, the latency was lower in the NVAMD group (p = 0.0041) than in the control group. No changes were found in cone-driven responses between the control and AMD groups. Conclusion: Patients with early dry AMD present diffusely acquired color vision alteration detected by CCT. Rods and melanopsin contributions for PLR are affected in NVAMD. The CCT and the PLR may be considered sensitive tests to evaluate and monitor functional changes in patients with AMD.

Longitudinal visual acuity development in ZIKV-exposed children.

PURPOSE: To follow the visual acuity development of children exposed to or infected with the Zika virus (ZIKV) during gestation and to relate potential visual acuity deficits to their clinical condition. METHODS: In this prospective study, visual acuity was measured via Teller Acuity Cards in three groups of children: (1) those with confirmed ZIKV exposure (ZE) through the mother only, (2) those with confirmed infection (ZI), and (3) unaffected controls. Visual acuity was measured 2-4 times in each child during the first 30 months of age. RESULTS: The study included 22 children in the ZE group, 11 in the ZI group, and 27 controls. Visual acuity developed normally in both patient groups, including infected patients (ZI) that did not manifest clinical symptoms. In a small subgroup of patients with characteristics consistent with congenital Zika syndrome (CZS), visual acuity was within normative values, with the exception of single child with chorioretinal atrophy. CONCLUSIONS: In this southeastern Brazil study cohort, visual acuity development seemed to progress normally in infected children without CZS symptoms.

Alterations in visual acuity and visual development in infants 1-24 months old either exposed to or infected by Zika virus during gestation, with and without microcephaly.

PURPOSE: To evaluate visual acuity and visual acuity development in children from the state of São Paulo, Brazil, who were exposed to the Zika virus (ZIKV) gestationally. METHODS: Children who had been exposed to ZIKV during gestation and age-matched control subjects received visual acuity and funduscopic examination. ZIKV exposure was confirmed by maternal quantitative polymerase chain reaction testing or serology assay. The ZIKV group was divided into two subgroups: exposed (ZE), with only the mother having confirmed ZIKV infection, and infected (ZI), with confirmed infection. Visual acuity development was compared with prior norms and quantified by measuring visual acuity correlation with age. RESULTS: A total of 110 children were included: 47 who had been exposed to ZIKV (ZE, 23; ZI, 24) and 63 controls. Abnormal visual acuity was found in 5 of 24 ZI children. Of the 4 children with microcephaly, only 2 had visual acuity loss (only 1 also had abnormal funduscopic findings). There was significant correlation between age and visual acuity in both the control group (R2 = 0.8; P < 0.0000) and the ZE subgroup (R2 = 0.6; P < 0.0000). However, visual acuity did not correlate with age in the ZI subgroup (R2 = 0.04; P = 0.38). Furthermore, the increment in octaves/month was much lower in the ZI subgroup. CONCLUSIONS: Our data indicate that visual acuity losses only occur in infants who suffered gestational-infection, not simply exposure. Lack of correlation between age and visual acuity in the ZI subgroup suggests a slowing of visual development even in the absence of microcephaly. This result may have broad implications for the deleterious effects of ZIKV on the central nervous system.

Ocorrência de enteroparasitoses na população de um bairro da cidade de Cândido Mota-SP / Occurrence of enteroparasitoses in the population of a neighbourhood in the city of Cândido Mota-SP

Objetivo - Verificar a incidência de parasitoses intestinais na população de um bairro da cidade de Cândido Mota-SP, e verificar a possibilidade de associação entre a ocorrência de parasitoses e as condições socioeconômicas e sanitárias. As parasitoses intestinais são consideradas um problema de saúde pública, principalmente onde as condições de saneamento básico, higiene pessoal e o nível intelectual do indivíduo são precários, o que pode facilitar a transmissão. Métodos - As coletas foram feitas nas residências e as fezes analisadas pelos métodos de Hoffmann et al. e Faust et al., enquanto que o nível socioeconômico foi investigado através de questionário, respondido pelo responsável pela residência. Resultados - Foram analisadas 177 amostras e 35% encontrados: Ascaris lumbricoides, Giardia lamblia, Entamoeba histolytica, Enterobius vermicularis, Strongyloides stercoralis, Trichuris trichiura, com um caso de biparasitismos (Entamoeba coli com Ancylostomidae) e a faixa etária mais jovem foi a mais acometida. Da população estudada, 69% afirmaram não ter nenhum ou muito pouco conhecimento sobre as enteroparasitoses. Conclusão - A grande maioria da população residente no bairro era de baixa renda, com famílias numerosas vivendo em casas pequenas, demonstrando precariedade de higiene pessoal, ambiental e habitacional e o baixo conhecimento sobre as enteroparasitoses. Assim, é de suma importância a conscientização das populações quanto às principais formas de transmissão e profilaxia das enteroparasitoses, visando diminuir os índices apresentados, dando ênfase a trabalhos nas escolas que estimulem os hábitos de higiene pessoal e do ambiente.

Objective - To verify the incidence of intestinal parasitoses in the population of a neighbourhood in the city of Cândido Mota-SP, and the possibility of association between parasitosis conditions and sanitation and socioeconomic conditions. Intestinal parasitoses are considered a public health problem, especially in areas where basic sanitation conditions, personal hygiene and educational level of the individual are precarious, which may favour transmission. Methods - The collections were made in residences and the faeces were analysed through Hoffmann et al. and Faust et al. methods, and the socioeconomic level was investigated through questionnaires, answered by the person responsible for the household. Results - A total of 177 samples were analysed and 35% of them were positive for one or more types of parasites,and the most commonly found were: Ascaris lumbricoides, Giardia lamblia, Entamoeba histolytica, Enterobius vermicularis, Strongyloides stercoralis, Trichuris trichiura, with one case of biparasitism (Entamoeba coli with Ancylostomidae) and the youngest age range was the most affected. Of the studied population 69% claimed not to have or have very little knowledge of enteroparasitoses. Conclusion - Most of the population living in that neighbourhood consisted of low-income, large families living in small houses, showing precarious personal, environmental and residential hygiene, and little knowledge of enteroparasitoses. Therefore, it is essential to create awareness regarding the mainforms of transmission and prophylaxis of enteroparasitoses, aiming to reduce the present rates, emphasizing school work whicher stimulates environmental and personal hygiene habits.