Percepção do peso corporal e dificuldades encontradas pelas pessoas com deficiência visual na aquisição, na preparação e no consumo dos alimentos / Perception of body weight and difficulties encounteredby people with visual impairment in acquiring, preparing and consuming food

Objetivo: investigar a percepção do peso corporal e as dificuldades encontradas pelas pessoas com deficiência visual na aquisição, na preparação e no consumo dos alimentos. Metodologia: estudo observacional transversal, com adultos e idosos com deficiência visual em Pelotas/RS, realizado no período de abril a maio de 2023. Foi utilizado um questionário composto de 42 itens. Os dados coletados foram analisados por análise descritiva e analítica, e apresentados como média ± desvio padrão ou percentual. Resultados: a amostra contou com 20 pessoas, predominantemente do sexo feminino e idosas. Em relação ao consumo alimentar, 50% dos participantes consomem feijão, 75% frutas e hortaliças, 50% bebidas adoçadas, biscoitos recheados e doces. Referente à percepção do peso corporal, percebeu-se que a maior parte do grupo sente que está acima do peso adequado e se sentem "insatisfeitos(as)". Sobre as dificuldades encontradas, 85% dos participantes relataram dificuldade extrema para identificar a validade dos alimentos, 70% para comprar alimentos frescos e perecíveis e 40% para usar a faca para cortar e descascar os alimentos. Conclusão: verificou-se que a maior parte do grupo sente que está acima do peso adequado e estão "insatisfeitos(as)" em relação ao peso corporal. Além disso, dependem de outra pessoa para escolher os alimentos a serem comprados, saber o prazo de validade, preparar alimentos que precisam ser porcionados, servir refeições no prato, cortar carnes, descascar vegetais e frutas, utilizar faca, entre outros. Esta dependência pode influenciar diretamente no seu consumo alimentar quando essas pessoas se encontram sozinhas, optando por consumir alimentos industrializados de fácil preparo ou prontos.

Objective: to investigate the perception of body weight and the difficulties encountered by people with visual impairments in acquiring, preparing and consuming food. Methodology: cross-sectional observational study, with adults and elderly people with visual impairment in Pelotas/RS, carried out from April to May 2023. A questionnaire composed of 42 items was used. The collected data were analyzed using descriptive and analytical analysis, and presented as mean ± standard deviation or percentage. Results: the sample included 20 people, predominantly female and elderly. Regarding food consumption, 50% of participants consume beans, 75% fruits and vegetables, 50% sweetened drinks, stuffed cookies and sweets. Regarding the perception of body weight, it was noticed that the majority of the group feels that they are overweight and feel "dissatisfied". Regarding the difficulties encountered, 85% of participants reported extreme difficulty in identifying the expiration date of food, 70% in purchasing fresh and perishable foods and 40% in using a knife to cut and peel food. Conclusion: it was found that the majority of the group feels that they are overweight and are "dissatisfied" with their body weight. Furthermore, they depend on someone else to choose the food to be purchased, know the expiration date, prepare food that needs to be portioned, serve meals on the plate, cut meat, peel vegetables and fruits, use a knife, among others. This dependence can directly influence their food consumption when these people are alone, choosing to consume easily prepared or ready-made processed foods.

Bilateral visual loss as the initial presentation of chronic myeloid leukemia: a case report.

Introduction: Chronic myeloid leukemia (CML) is the most common leukemia in adults. It can present with a wide variable range of symptoms and signs related to the phase of the disease. Ophthalmic manifestations as the first presentation of CML are unique, although they can occur during any stage of the disease. Ocular lesions in CML patients may be asymptomatic, so all patients should undergo an eye evaluation at the initial diagnosis. Case presentation: The authors report a case of a 17-year-old Syrian male who initially presented with progressive loss of vision, fatigue, and abdominal pain. Clinical examination showed bilateral retinal aneurysm hemorrhage, jaundice, and splenomegaly. Bone marrow biopsy results were consistent with the diagnosis of CML returning to AML. The patient was treated with intensive chemotherapy and then prepared for hematopoietic transplantation. Discussion: CML can present with variable symptoms and signs, but the ophthalmic manifestations are uncommon. Ophthalmic problems occur either from infiltration of neoplastic cells or from secondary causes, like thrombocytopenia, leukocytosis, hyperviscosity syndrome, or leukoembolization. In the literature, only some case reports presented eye involvement in CML as the first manifestation. Conclusion: Although this is a rare presentation of CML, we believe that it should be taken into consideration when managing these situations to obtain the right diagnosis and better treatment results. Collaboration between hematologists and ophthalmologists is necessary in deciding the treatment. Acute myeloid leukemia needs immediate medical attention and different treatment from CML.

Managing neurofibromatosis type I and vision impairment in a resource-limited setting: a case study and multidisciplinary approach.

Background: Neurofibromatosis type I (NF1) is a genetic disorder characterized by the development of multiple benign tumors along nerves in the skin, brain, and other parts of the body. It is associated with a range of clinical manifestations, including skin lesions, neurofibromas, and ocular abnormalities, which can significantly impact a patient's quality of life. Management of NF1 is particularly challenging in resource-limited settings due to limited access to diagnostic and therapeutic resources. Clinical presentation: A 62-year-old woman with a known history of NF1 presented with progressive visual impairment. Her condition began in childhood with multiple hyperpigmented skin macules, which developed into numerous cutaneous tumors over time. Examination revealed numerous neurofibromas, café-au-lait spots, and axillary freckling. Significant visual impairment was caused by large fibromas on her eyelids. Histological analysis confirmed benign nerve tissue tumors. Clinical discussion: The management strategy in this resource-limited setting focused on regular monitoring, patient education, symptomatic treatment, and multidisciplinary care. Despite the limitations, the patient's condition was managed effectively through these adapted strategies. The importance of genetic testing for confirmation and further management was noted but not performed due to resource constraints. Conclusion: This case highlights the complexities of managing NF1 in resource-limited settings, emphasizing the need for adaptable management approaches. Multidisciplinary care and patient education were crucial in improving the patient's quality of life. This case underscores the importance of early diagnosis and intervention to prevent complications like visual impairment.

Post-operative Unilateral Visual Loss and Ophthalmoplegia following Cervical Spine Surgery in Prone Position: A Case Report.

ABSTRACT: Visual loss following a spine surgery in a prone position is a disastrous and irreversible complication. Moreover, the recommended treatment for such visual loss is lacking and the outcome is not so satisfactory. A 38-year-old gentleman developed profound right sided visual loss after an uneventful cervical spine surgery in a prone position that lasted approximately two and half hours. Immediate ophthalmic consultation was done and the case was diagnosed as right-sided central retinal artery occlusion. Despite the initiation of vasodilatation, anticoagulation, and adequate fluid infusion, satisfactory improvement was not achieved. Extensive review of pertinent literature highlighted limited efficacy of treatments for postoperative visual loss after prone spinal surgery, further emphasizing the importance of preventive measures as the cornerstone in such procedures.

Histopathology-driven prostate cancer identification: A VBIR approach with CLAHE and GLCM insights.

Efficient extraction and analysis of histopathological images are crucial for accurate medical diagnoses, particularly for prostate cancer. This research enhances histopathological image reclamation by integrating Visual-Based Image Reclamation (VBIR) techniques with contrast-limited adaptive Histogram Equalization (CLAHE) and the Gray-Level Co-occurrence Matrix (GLCM) algorithm. The proposed method leverages CLAHE to improve image contrast and visibility, crucial for regions with varying illumination, and employs a non-linear Support Vector Machine (SVM) to incorporate GLCM features. Our approach achieved a notable success rate of 89.6%, demonstrating significant improvement in image analysis. The average execution time for matched tissues was 41.23 s (standard deviation 36.87 s), and for unmatched tissues, 21.22 s (standard deviation 29.18 s). These results underscore the method's efficiency and reliability in processing histopathological images. The findings from this study highlight the potential of our method to enhance image reclamation processes, paving the way for further research and advancements in medical image analysis. The superior performance of our approach signifies its capability to significantly improve histopathological image analysis, contributing to more accurate and efficient diagnostic practices.

Role of Pregabalin in Pre-Operative and Post-Operative Pain Management of Lower Limb Orthopedic Surgeries.

Introduction: Post-operative pain after orthopedic surgery has remained a challenging problem, which prolongs hospital stay and early rehabilitation. Pregabalin comes under the class of gabapentinoids that have been used in postoperative pain in arthroplasty and spine surgeries but studies regarding its role as pre-emptive analgesia in orthopedic limb surgeries are very few. Aims: To compare the efficacy of pre-operative pregabalin with a placebo drug in early post-operative pain management for lower limb orthopedics surgeries. Materials and Methods: A randomized double blinded prospective study was undertaken. Sixty patients were enrolled with age between 18 and 70 years and were divided into 2 groups. Group A - received 150 mg of oral pregabalin capsule, and Group B - received matched color empty capsules. Standard spinal anesthesia was given. Breakthrough analgesia was given with an injection of tramadol 50 mg intravenous. Assessment of pain was done with a Visual Analog Scale (VAS) at 6, 12, 24, and 48 h. Results: In comparison to Group B, Group A had a significantly lower postoperative VAS score and required much less breakthrough analgesia within the 1st 24 h after surgery. Conclusion: In orthopedic lower limb fracture surgeries, pre-emptive pregabalin of 150 mg provides adequate postoperative analgesia with relatively few unfavorable side effects.

The current state of inflammation-related research in prostate cancer: a bibliometric analysis and systematic review.

Background: Prostate cancer (PCa) is the second most prevalent malignancy among men globally. The diagnosis, treatment, and prognosis of prostate cancer frequently fall short of expectations. In recent years, the connection between inflammation and prostate cancer has attracted considerable attention. However, there is a lack of bibliometric studies analyzing the research on inflammation within the domain of prostate cancer. Research methods: We utilized the Web of Science Core Collection (WOSCC) as our data source to extract articles and reviews related to inflammation in prostate cancer, published up until April 12, 2024. The collected data underwent meticulous manual screening, followed by bibliometric analysis and visualization using the Biblioshiny package in R. Results: This study encompasses an analysis of 2,786 papers focusing on inflammation-related research within the realm of prostate cancer. Recent years have seen a significant proliferation of publications in this area, with the United States and China being the foremost contributors. The most prolific author in this domain is Demarzoam, with Johns Hopkins University standing out as the most influential institution. The leading journal in disseminating these studies is PROSTATE. Keyword co-occurrence analysis reveals that 'inflammation-related biomarkers', 'inflammation index', and 'tumor immune microenvironment' represent the current research hotspots and frontiers. Conclusion: The findings of this bibliometric study serve to illuminate the current landscape of inflammation-related research in the field of prostate cancer, while further augmenting the discourse on inflammation-mediated cancer therapeutics. Of particular note is the potential of these discoveries to facilitate a more nuanced understanding among researchers regarding the interplay between inflammation and prostate cancer.

Evaluation of a new classification system for measuring the progression of ocular cystinosis: an analysis of 64 patients.

AIMS: To analyse the correlation between the physician categories defined by the 3C classification (crystal-complication-compliance) and the ocular manifestations of nephropathic cystinosis. METHODS: The last visit data of 64 patients aged between 2 and 64 attending the centre for management of cystinosis were reviewed. Each patient had been placed into one of four categories by the clinician based on disease severity. The correlation between these categories and markers of the disease was assessed using Pearson's correlation. RESULTS: Photophobia (0.647, p<0.001), visual acuity (-0.695, p<0.001), Gahl's score (0.603, p<0.001), optical coherence tomography (OCT)% (0.713, p<0.001) and in vivo confocal microscopy (IVCM)% (0.845, p<0.001), showed a strong, highly significant correlation between key signs and symptoms and the 3C classification. Corneal complications were strongly correlated with the 3C classification with scores of 0.802 (p<0.001), 0.634 (p<0.001), 0.726 (p<0.001) and 0.677 (p<0.001) for band keratopathy, keratitis, neovascularisation and corneal ulceration, respectively. 75% of those classified as most severe had all four complications. The use of artificial tears and ciclosporin strongly correlated with the categorisation, 0.574 (p<0.001) and 0.631 (p<0.001), respectively. With all cystinosis markers, the 3C classification showed a stronger correlation than age and crystal scores by Gahl's and OCT. Category and age were strongly correlated (0.656, p<0.001). There was a moderate negative correlation with therapeutic compliance with cysteamine eye-drops and categorisation (-0.422, p<0.001). The compliance pattern observed may help to explain why the disease progresses in some patients. CONCLUSION: 3C classification is a reliable tool to categorise ocular cystinosis and can support clinical management decisions allowing more reliable comparison of datasets.

The Role of Mucociliary Clearance Function of Eustachian Tube as an Outcome Predictor for Type 1 Tympanoplasty.

OBJECTIVES: To evaluate the association between mucociliary function of the Eustachian tube using the Saccharin test preoperatively and its correlation with dynamic slow-motion video endoscopy on the outcome of Type-I Tympanoplasty in patients with inactive mucosal chronic otitis media. METHODOLOGY: Eighty patients diagnosed with inactive mucosal chronic otitis media who underwent Type-I Tympanoplasty were included in the study. Preoperative assessment of Eustachian tube function was conducted using the Saccharin test. Results of this test were categorized as normal, partial, or gross dysfunction. Dynamic slow-motion video endoscopy was performed to assess motion and pathological factors of the Eustachian tube. Results were evaluated based on a previously validated Visual Analogue Score (VAS). Patients were followed up postoperatively for 3 months. RESULTS: The proportion of patients with surgical failure at the end of the 1st and 3rd month postoperatively was significantly higher in cases of gross Eustachian tube dysfunction compared to those with normal and partial dysfunction (p-value < 0.0001 and p-value = 0.0001, respectively). Preoperative VAS scores in normal Eustachian tubes were significantly higher compared to those with partial dysfunction and gross dysfunction. CONCLUSION: The Saccharin test is a valuable tool for preoperative evaluation of mucociliary clearance of the Eustachian tube, and dynamic slow-motion video endoscopy serves as a useful adjunct in predicting the outcome of Type-I Tympanoplasty. Routine evaluation of mucociliary clearance function of the Eustachian tube should be included in the preoperative workup for patients undergoing Tympanoplasty to achieve optimal surgical outcomes.

Topical Anesthesia Versus Submucosal Injection for Radiofrequency Turbinoplasty: Same Benefit but without Patient's Pain. A Comparative Study.

This study aimed at comparing the anesthetic efficacy of lidocaine injection versus pledgets soaked in lidocaine and epinephrine during radiosurgery of inferior turbinates. The study prospectively enrolled 120 outbound patients, who were randomly assigned to group 1 -anaesthesia with tampon soaked in lidocaine and adrenaline- or group 2 -anesthesia with tampon followed by lidocaine and adrenaline injection. The following parameters were evaluated by a visual analogue scale 1 h after surgery: pain, anxiety, chocking sensation and difficulty swallowing. Nasal obstruction, rhinorrhea, sneezing, headache and inferior turbinate size were evaluated preoperatively (T0), after 1 (T1), 2 (T2) and 3 months (T3) to surgery. The data collected were analyzed by statistic tests. Group 1 showed lesser pain than group 2 during the procedure (p < 0.01); no statistically significant differences were observed for anxiety, chocking sensation and difficulty swallowing. All patients, independently from the belonging group, significantly improved the nasal symptoms comparing T0 and T1 (p < 0.01), T2 (p < 0.01) and T3 (p < 0.01), without statistically significant differences among the groups. Radiofrequency turbinoplasty allowed to all patients to reduce the turbinates hypertrophy. Local anaesthesia with tampon allowed to obtain the same results the injective anaesthesia in term of surgical outcomes; the use of tampon allowed patients did not experience pain.

Treatment of isolated pediatric optic nerve glioma: A nationwide retrospective cohort study and systematic literature review on visual and radiological outcome.

BACKGROUND: Progressive isolated optic nerve glioma (ONG) in children is a rare disease, treated with various modalities. A global treatment consensus is not available. METHODS: We conducted a national retrospective multicenter cohort study (1995-2020) to investigate how different treatment strategies impact outcome for ONG in children, by assessing treatment responses to systemic anticancer therapy (SAT), surgery, and radiotherapy for ONG. The primary endpoints included changes in best-corrected visual acuity (BCVA) and tumor volume (TV) on MRI, both evaluated at the start and end of therapy and at long-term follow up. RESULTS: A total of 21 ONGs (20 patients) received SAT (n = 14 (66.7%)), surgery (n = 4 (19.0%)), and radiotherapy (n = 3 (14.3%)). After SAT BCVA stabilized or improved in 66.6% (n = 4) and the TV decreased by a median of 45.1% (range: -88.6% to +31.5%) (n = 13). Before resection two eyes were already blind. After resection BCVA decreased to blindness in one eye. In total all four eyes were blind after resection. After first-line RT BCVA decreased in 66.7% of ONG to counting fingers or less, TV increased <3 months after RT by a median of 47.3% (range: -42.8% to +245.1%) (n = 3), followed by a long-term decrease of 94.4 and 13.8% (n = 2), respectively. CONCLUSION: SAT appears to be the preferred modality for progressive ONG in case of potential rescue of visual functions. Complete resection of ONG appears effective to reduce proptosis in case of preexisting blindness. The use of radiotherapy requires careful consideration due to the risk of severe visual impairment and secondary disease.

Modifiable dementia risk factors associated with objective and subjective cognition.

INTRODUCTION: Early detection of both objective and subjective cognitive impairment is important. Subjective complaints in healthy individuals can precede objective deficits. However, the differential associations of objective and subjective cognition with modifiable dementia risk factors are unclear. METHODS: We gathered a large cross-sectional sample (N = 3327, age 18 to 84) via a smartphone app and quantified the associations of 13 risk factors with subjective memory problems and three objective measures of executive function (visual working memory, cognitive flexibility, model-based planning). RESULTS: Depression, socioeconomic status, hearing handicap, loneliness, education, smoking, tinnitus, little exercise, small social network, stroke, diabetes, and hypertension were all associated with impairments in at least one cognitive measure. Subjective memory had the strongest link to most factors; these associations persisted after controlling for depression. Age mostly did not moderate these associations. DISCUSSION: Subjective cognition was more sensitive to self-report risk factors than objective cognition. Smartphones could facilitate detecting the earliest cognitive impairments. HIGHLIGHTS: Smartphone assessments of cognition were sensitive to dementia risk factors. Subjective cognition had stronger links to most factors than did objective cognition. These associations were not fully explained by depression. These associations were largely consistent across the lifespan.

Global Knowledge Map and Emerging Research Trends in Induced Pluripotent Stem Cells and Hereditary Diseases: A CiteSpace-based Visualization and Analysis.

The rise of induced pluripotent stem cells (iPSCs) technology has ushered in a landmark shift in the study of hereditary diseases. However, there is a scarcity of reports that offer a comprehensive and objective overview of the current state of research at the intersection of iPSCs and hereditary diseases. Therefore, this study endeavors to categorize and synthesize the publications in this field over the past decade through bibliometric methods and visual knowledge mapping, aiming to visually analyze their research focus and clinical trends. The English language literature on iPSCs and hereditary diseases, published from 2014 to 2023 in the Web of Science Core Collection (WoSCC), was examined. The CiteSpace (version 6.3.R1) software was utilized to visualize and analyze country/region, institution, scholar, co-cited authors, and co-cited journals. Additionally, the co-occurrence, clustering, and bursting of co-cited references were displayed. Analysis of 347 articles that met the inclusion criteria revealed a steady increase in the number of published articles and citation frequency in the field over the past decade. With regard to the countries/regions, institutions, scholars, and journals where the articles were published, the highest numbers were found in the USA, the University of California System, Suren M. Zakian, and Stem Cell Research, respectively. The current research is focused on the construction of disease models, both before and after correction, as well as drug target testing for single-gene hereditary diseases. Chromosome transplantation genomic therapy for hereditary diseases with abnormal chromosome structures may emerge as a future research hotspot in this field.

Exploring cross-modal plasticity in the auditory-visual cortex post cochlear implantation: implications for auditory and speech function recovery and mechanisms.

Objective: The aim of this is to explore changes in cross-modal reorganization within the auditory-visual cortex after cochlear implantation, examining their influence on auditory and speech functions along with their underlying mechanisms. Methods: Twenty prelingually deaf children who received cochlear implantation and rehabilitation training at our hospital between February 2022 and February 2023 comprised the prelingual deaf group. Simultaneously, 20 healthy children served as the control group. The prelingual deaf group underwent brain cortical activity assessment and evaluation of auditory-speech recovery pre-surgery, at postoperative weeks 1 and 2, and at months 1, 3, 6, 9, and 12. The control group underwent parallel assessments and evaluations. We analyzed the correlation between cortical activity in the auditory-visual cortex of patients and their auditory-speech functional recovery. Results: The group with prelingual deafness displayed elevated levels of auditory and visual cortical electromagnetic intensity compared to the control group, both prior to and 9 months after surgery. However, by the 12-month mark post-surgery, there was no discernible distinction between the two groups. Following surgery, the prelingually deaf group exhibited a progressive improvement in both Categories of Auditory Performance (CAP) and Speech Intelligibility Rate (SIR), initially lagging behind the control group. Notably, a negative correlation emerged between auditory and visual cortical electromagnetic intensity values and CAP/SIR scores at the 12-month post-surgery assessment. Conclusion: Cochlear implantation in prelingually deaf children results in elevated activity within the auditory and visual cortices, demonstrated by heightened electromagnetic intensity readings. Cross-modal reorganization is observed temporarily at 3 months post-surgery, which resolves to baseline levels by 12 months post-surgery. This phenomenon of reversal correlates with the restoration of auditory and speech functions in these children.

Predictors of Chronic Dizziness in Acute Unilateral Vestibulopathy: A Longitudinal Prospective Cohort Study.

OBJECTIVE: Chronic dizziness after acute unilateral vestibulopathy (AUVP) causes significant social and economic burdens. This study aims to identify predictors of chronic dizziness. STUDY DESIGN: Prospective, longitudinal cohort study. SETTING: ENT departments from secondary and tertiary hospitals. METHODS: Participants meeting the Barany Society's diagnostic criteria for AUVP were included. Evaluations occurred within 0 to 21 days (T1), and at 4 (T2) and 10 weeks (T3) postonset. The primary outcome measure was the Dizziness Handicap Inventory (DHI) at 6 months, with a score >30 indicating chronic dizziness. Five clusters of predictors were assessed at T1-3: central vestibular compensation, visual dependence, movement exposure, psychological factors, and balance performance. Separate linear regression models for T1, T2, and T3 were constructed to explain the variability in the 6-month DHI score. Receiver operating characteristics analyses were conducted to predict chronic dizziness. RESULTS: From June 2021 to January 2024, 103 participants (55.2 ± 16.6 years old, 49 women) were included. The regression models explained the variability in the 6-month DHI score by 33.0% at T1, 47.6% at T2, and 64.0% at T3 (P < .001), including psychological factors (T1, T2, T3), visual dependence (T2, T3), and static balance performance (T3). Cutoff values for the Vestibular Activities Avoidance Instrument (23/54), Visual Vertigo Analog Scale (33.5/100), and Hospital Anxiety and Depression Scale-Anxiety (7.5/21) at 10 weeks postonset predicted chronic dizziness. CONCLUSION: Higher psychological burden, increased visual dependence, and poorer static balance performance were associated with chronic dizziness. Cutoff values were determined to identify individuals with AUVP at risk for chronic dizziness.

A visualized and bibliometric analysis of cancer vocational rehabilitation research using CiteSpace.

BACKGROUND: There are numerous publications on cancer vocational rehabilitation, visual techniques can help medical researchers and social workers be more familiar with the state of this field. OBJECTIVE: To summarize cancer vocational rehabilitation research, we applied visualized and bibliometric analysis to enable medical workers and social workers to identify evolving patterns of knowledge among articles and research trends, understand the current research status of vocational rehabilitation of cancer, and carry out further research on hot topics. METHODS: Based on a review of 933 papers on cancer vocational rehabilitation published in the Web of Science Core Collection, this study used Citespace software to systematically and objectively describe cancer vocational rehabilitation. RESULTS: Since 2003, the field of cancer vocational rehabilitation began to sprout. The most published and most cited country, institution, author and cited journal were the United States, University of Amsterdam, Angela G. E. M. de Boer, and Psycho-Oncology, respectively. The three most frequently cited keywords were breast cancer, quality of life and cancer survivor. The three keywords with the largest spike in citations were cohort, absence and symptom. Conducting randomized controlled trials or prospective cohort studies to help cancer survivors return to work, and using qualitative methods to understand the vocational rehabilitation experiences or perceptions of cancer survivors or medical staff are hotspots in this field. CONCLUSIONS: Cancer vocational rehabilitation has attracted the attention of researchers all over the world. Future studies may focus on other cancer types and explore more high quality interventions.

Comparison of long-term changes in the effective optical zone following SMILE and FS-LASIK for moderate and high myopia.

BACKGROUND: Visual quality after corneal refractive surgery is linked to the postoperative effective optical zone (EOZ). This study aims to compare long-term changes in the EOZ following small incision lenticule extraction (SMILE) and femtosecond laser-assisted in-situ keratomileusis (FS-LASIK) for moderate and high myopia. METHODS: This study included 42 patients (72 eyes) who underwent either SMILE (36 eyes) or FS-LASIK (36 eyes). A custom software program based on the tangential curvature difference map of the Pentacam HR (Oculus Optikgeräte GmbH) was used to define the EOZ at 3 and 7 years postoperatively. The EOZ, its chronological changes compared to the programmed optical zone (POZ), and the corneal wavefront aberrations following SMILE and FS-LASIK were analyzed. Correlations between the EOZ changes and relevant parameters were evaluated. RESULTS: Three years postoperatively, EOZ following SMILE and FS-LASIK were 5.13 ± 0.27 mm and 4.70 ± 0.24 mm (P < 0.001), respectively. Seven years postoperatively, EOZ following SMILE and FS-LASIK decreased to 5.03 ± 0.28 mm and 4.63 ± 0.23 mm (P < 0.001), respectively. At postoperative 7 years, the percentages of EOZ/POZ were negatively correlated with Q-value changes (ß = -5.120, P = 0.009) following SMILE and positively correlated with the cylinder correction (ß = 1.184, P = 0.004) following FS-LASIK. The induced spherical aberrations in the SMILE group were less than those in the FS-LASIK group (P < 0.05) and were negatively correlated with the EOZ/POZ (ß = -16.653, P < 0.001). CONCLUSIONS: The EOZ following SMILE was larger than that following FS-LASIK in the long postoperative term for moderate and high myopia. Furthermore, a continual reduction in the EOZ was noted after both surgical modalities.

Visual field loss and falls requiring hospitalisation: results from the eFOVID study.

BACKGROUND: Visual fields are important for postural stability and ability to manoeuvre around objects. OBJECTIVE: Examine the association between visual field loss and falls requiring hospitalisation in adults aged 50 +. METHODS: Older adults aged 50+ with and without visual field loss were identified using a fields database obtained from a cross-section of ophthalmologists' practices in Western Australia (WA). Data were linked to the Hospital Morbidity Data Collection and WA Hospital Mortality System to identify participants who experienced falls-related hospitalisations between 1990 and 2019. A generalised linear negative binomial regression model examined the association between falls requiring hospitalisation for those with and without field loss, based on the better eye mean deviation (mild: -2 to -6 dB, moderate: -6.01 dB to -12 dB, severe < -12.01 dB) in the most contemporaneous visual field test (3 years prior or if not available, 2 years after the fall), after adjusting for potential confounders. RESULTS: A total of 31 021 unique individuals of whom 6054 (19.5%) experienced 11 818 falls requiring hospitalisation during a median observation time of 14.1 years. Only mean deviation index of <-12.01 dB (severe) was significantly associated with an increased rate of falls requiring hospitalisations by 14% (adjusted IRR 1.14, 95% CI 1.0-1.25) compared with no field loss, after adjusting for potential confounders. Other factors included age, with those aged 80+ having an increased rate (IRR 29.16, 95% CI 21.39-39.84), other comorbid conditions (IRR 1.49, 95% CI 1.38-1.60) and diabetes (IRR 1.25, 95% CI 1.14-1.37). Previous cataract surgery was associated with a decreased rate of falls that required hospitalisations by 13% (IRR 0.87, 95% CI 0.81-0.95) compared with those who did not have cataract surgery. CONCLUSION: The findings highlight the importance of continuous clinical monitoring of visual field loss and injury prevention strategies for older adults with visual field loss.

Terson syndrome in association with sub-arachnoid hemorrhage: a case report.

Introduction: Terson syndrome is characterized by intraocular hemorrhage, which includes retinal, subretinal, subhyaloid, and vitreous hemorrhages, typically associated with sub-arachnoid, intracerebral, and traumatic brain injuries. The incidence of Terson syndrome varies significantly, ranging from 10 to 40% following sub-arachnoid hemorrhage. Case presentation: A 48-year-old woman presented to the emergency department with a loss of consciousness for 1 h, 8 h prior to presentation, accompanied by teeth clenching, upward rolling of eyes, and frothing from the mouth. A non-contrast-enhanced computed tomography scan of the head revealed sub-arachnoid hemorrhage. Two days post-admission, the patient experienced decreased vision. Visual acuity tests showed significant impairment, and fundus examination revealed vitreous hemorrhage in both eyes. Digital subtraction angiography identified an aneurysm in the V4 segment of the left vertebral artery. Following flow diverter placement, the patient's visual acuity improved and normalized after 21 days. Discussion: Terson syndrome is often linked with sub-arachnoid hemorrhage due to elevated intracranial pressure. It frequently occurs with aneurysms of the anterior communicating or internal carotid arteries. Diagnosis is often delayed until after patient stabilization. Ophthalmic evaluations, such as fundoscopic examinations and ocular ultrasonography, are crucial for early detection. The presence of Terson Syndrome correlates with higher mortality rates in SAH patients. While spontaneous resolution of intraocular hemorrhage is common, some cases necessitate surgical intervention for quicker recovery. Conclusion: Comprehensive ophthalmic assessments in sub-arachnoid hemorrhage patients are essential for early detection and intervention, potentially preventing long-term visual impairment.

Efficacy of endoscopic decompression surgery for treatment of lumbar spinal stenosis.

Background: The overall aim of this study was to assess the effectiveness of endoscopic decompression for outcomes in patients with lumbar spinal stenosis (LSS). Methods: We conducted a retrospective cohort, single-institution study of n = 139 patients from 2019 to 2022 who underwent endoscopic decompression for LSS. The primary outcome was improvement of Oswestry Disability Index (ODI) between baseline and 12-month follow-up. Results: In the present sample (n = 139) the average age was 57.6 years (SD = 17.4, with even distribution of men (49%) vs. women (51%). In patients with LSS, lumbar disc herniation was the most common diagnosis in 49 patients followed by lumbar radiculopathy in 25 patients. Lumbar radicular pain was the 3rd most common diagnosis in 21 patients with all other diagnosis listed in Table S1. There was a significant improvement (i.e., decrease) in ODI following endoscopic decompression (mean change: -8.3, 95% CI: -9.4, -7.2, P < 0.001, Fig. 1). Prior lumbar spine surgery (P = 0.048), BMI (P = 0.053), and age (P = 0.022) were associated with changes in ODI. Nearly half (47%) of the sample had prior lumbar spine surgery. Those with prior lumbar spine surgery (-7.5, 95% CI: -8.3, -6.6) showed less improvement than those without prior lumbar spine surgery (-9.1, 95% CI: -10.9, -7.2, Fig. 2). For BMI, 23% had normal BMI while 24% were overweight and 53% were obese. Patients with normal BMI (-10.3, 95% CI: -13.4, -7.2) showed greater improvements compared to overweight (-7.9, 95% CI: -9.4, -6.4) and obese (-7.6, 95% CI: -9.0, -6.3, Fig. 3) patients. Patients under 40 years old (-10.2, 95% CI: -13.6, -6.8) showed greater improvements in ODI compared to those 40 years and older (-7.8, 95% CI: -8.6, -6.8, Fig. 4). Conclusions: In patients with lumbar spinal stenosis, endoscopic decompression was associated with reduced disability. Patients with no prior lumbar spine surgery, normal BMI, and who were under 40 years old showed greater improvements.