RESUMO
The authors report two cases of retinal artery macroaneurysm (RAM) complicated with subhyaloid hemorrhage. There are multiple cases about RAM that have been published; however, none of them present all the different treatments with its benefits and its limitations. Our study highlights all aspects of treatment. RAM is an uncommon pathology that affects generally elderly women with systemic vascular pathologies. It is often unilateral, and the patients stay mostly asymptomatic. Most cases of RAM regress without any treatment. A case of a 54-year-old male, with a medical history of hypertension who presented with an acute and unilateral decreased visual acuity (VA). Initial VA was limited to counting fingers at 1 m in the right eye (RE). The anterior segment was normal in both eyes. A fundus examination in the RE showed a large subhyaloid hemorrhage associated to retinal hemorrhage. Fluorescein angiography in the RE did not reveal any sign of macroaneurysm due to blockage of fluorescein by the hemorrhage. In the left eye, there was a hyperfluorescent paramacular lesion. Optical coherence tomography showed the hyperreflectivity of the subhyaloid hemorrhage and the underlying retinal layers could not be seen. Neodymium-doped yttrium aluminum garnet laser hyaloidotomy was performed for this patient to release the trapped hemorrhage into the vitreous, 3 weeks after initial loss of vision with a good visual outcome after the treatment. An 80-year-old woman, with medical history of rheumatoid arthritis who presented with an acute loss of vision in the RE. VA in the RE was 20/200. She had a nuclear cataract in both eyes. A fundus examination showed a subyaloid hemorrhage. Fluorescein angiography in the RE revealed a hyperfluorescent structure emanating from the superotemporal arcade of the artery compatible with a macroaneurysm. The patient was treated with three intravitreal antivascular endothelial growth factor injections with poor visual outcomes. Vision loss occurs with RAM complications. They mainly involve hemorrhages and macular exudations and are usually associated with poor visual recovery. There is no established treatment for RAM and its complications. There are many options, but the optimal therapy is still unknown.
RESUMO
The effect of exercise on sleep remains controversial in athletes especially in junior athletes. This study tested the acute effect of additional intense rugby training on sleep, next-day dietary intake, and physical performances in adolescent rugby players compared to a day with regular exercise. 17 male rugby players in the national under-17 category (age: 15.7 ± 1.1 years, height: 1.78 ± 0.1 m, weight: 84.4 ± 13.6 kg, BMI: 26.6 ± 3.8 kg/m2, fat mass: 14.5 ± 3.4%, VO2max Yo-Yo test: 52.1 ± 4.4 mL/min/kg, evening chronotype) took part in this study. The athletes completed two 36-h experimental sessions in random order: a regular exercise program (REP) vs. an intensified exercise program (IEP) at a 1-week interval. Physical activity and sleep data were collected using accelerometers. Performance tests were conducted the next morning after an ad libitum breakfast. Sleep improved during intensive training (TST: + 26 min, SL: - 4%, WASO: - 39%, SE: + 8.5%) with moderate effect size. There was no next-day difference in calorie intake from breakfast, but macronutrient composition shifted toward proteins (regular: 15.4 ± 6.1% vs. intensive: 18.9 ± 7.4%, ES = - 0.650 [- 1.13; - 0.18]). There were no significant differences in Wingate test performance or spatial awareness task time. However, performance in submaximal tests improved. Acute intensified training results in increased sleep duration and quality without disturbing next-day performance or dietary intake in young rugby players.