"Blindsight" and subjective awareness of fearful faces: Inversion reverses the deficits in fear perception associated with core psychopathic traits.

Though emotional faces preferentially reach awareness, the present study utilised both objective and subjective indices of awareness to determine whether they enhance subjective awareness and "blindsight". Under continuous flash suppression, participants localised a disgusted, fearful or neutral face (objective index), and rated their confidence (subjective index). Psychopathic traits were also measured to investigate their influence on emotion perception. As predicted, fear increased localisation accuracy, subjective awareness and "blindsight" of upright faces. Coldhearted traits were inversely related to subjective awareness, but not "blindsight", of upright fearful faces. In a follow-up experiment using inverted faces, increased localisation accuracy and awareness, but not "blindsight", were observed for fear. Surprisingly, awareness of inverted fearful faces was positively correlated with coldheartedness. These results suggest that emotion enhances both pre-conscious processing and the qualitative experience of awareness, but that pre-conscious and conscious processing of emotional faces rely on at least partially dissociable cognitive mechanisms.

Survey of occupational musculoskeletal pain and injury in Canadian ophthalmology.

OBJECTIVE: Surgeons and other physicians have reported occupational musculoskeletal (MSK) pain, and it has been recently raised as a growing issue by ophthalmologists and optometrists. What is most concerning is that it could be a serious threat to career longevity and performance. MSK pain and injury in Canadian ophthalmologists has not been quantified. Our goal was to estimate the prevalence of MSK issues, to determine the impact of MSK injuries to working hours and health, and to ascertain physician characteristics and practice patterns associated with MSK problems. DESIGN: Survey. PARTICIPANTS: One hundred sixty-nine ophthalmologists and 121 optometrists. METHODS: A voluntary internet-based (Survey Monkey) survey was conducted. All Canadian ophthalmologists and ophthalmology residents were contacted via the Canadian Ophthalmological Society, and all optometrists registered through the Canadian Association of Optometrists were contacted through their respective listserve email. RESULTS: One hundred sixty-nine ophthalmologists (response rate 17%) and 121 optometrists (2.4%) responded to a voluntary internet-based survey. Fifty percent of the ophthalmology respondents reported clinic-associated MSK pain in the preceding 12 months, compared to 61% of optometry respondents (p = 0.06). Of the ophthalmologists, 48.3% said they had experienced occupational MSK pain in the preceding 12 months, which they directly attributed to their operating room activities. Neck pain was reported in 46%, lower back in 36% and shoulder pain in 28% of ophthalmology respondents. This was compared to 34% (p = 0.04), 37% (p = 0.90) and 41% of optometrists (p= 0.02). Respondents in our survey listed "performing the same task over and over", "working in cramped or awkward positions" and "bending or twisting your neck" as the most common causes of MSK pain. CONCLUSION: Our survey identified that a large proportion of respondents reported MSK pain associated with clinical and surgical duties. Physician-led research is needed before industry and administrative partners can develop equipment and work-spaces that are better suited to the needs of physicians.

Corneal infection in Shandong peninsula of China: a 10-year retrospective study on 578 cases.

AIM: To determine the epidemiological characteristics, clinical signs, laboratory findings, and outcomes in patients with corneal infection in Shandong peninsula of China. METHODS: The medical records of 578 inpatients (578 eyes) with corneal infection were reviewed retrospectively for demographic characteristics, risk factors, seasonal variation, clinical signs, laboratory findings, and treatment strategy. Patient history, ocular examination findings using slit-lamp biomicroscopy, laboratory findings resulted from microbiological cultures, and treatment. RESULTS: Fungal keratitis constituted 58.48% of cases of infectious keratitis among the inpatients, followed by herpes simplex keratitis (20.76%), bacterial keratitis (19.03%) and acanthamoeba keratitis (1.73%). The most common risk factor was corneal trauma (71.80%). The direct microscopic examination (338 cases) using potassium hydroxide (KOH) wet mounts was positive in 296 cases (87.57%). Among the 298 fungal culture-positive cases, Fusarium species were the most common isolates (70.47%). A total of 517 cases (89.45%) received surgical intervention, including 255 (44.12%) cases of penetrating keratoplasty, 74 (12.80%) cases of lamellar keratoplasty which has become increasingly popular, and 77 cases (13.32%) of evisceration or enucleation. CONCLUSION: At present, infectious keratitis is a primary corneal disease causing blindness in China. With Fusarium species being the most commonly identified pathogens, fungal keratitis is the leading cause of severe infectious corneal ulcers in Shandong peninsula of China.

Comparison of the in vitro toxicity of indocyanine green to that of trypan blue in human retinal pigment epithelium cell cultures.

PURPOSE: To compare the in vitro toxicity of indocyanine green (ICG) to that of trypan blue (TB) in human retinal pigment epithelium cell cultures. The use of ICG and TB in macular hole surgery is discussed. DESIGN: In vitro cell biology experimental study. METHODS: The ICG dye and TB were applied to ARPE-19, a commercially available human retinal pigment epithelium cell line. Cultures were established and maintained according to supplier protocols. The ICG dye, TB or Hank's balanced salt solution (controls) were then applied to the cells at varying concentrations and over various exposure periods. Fiberoptic light was also applied to cells to assess for the possibility of a potentiating phototoxic effect. Cell viability fractions were determined using a well-studied mitochondrial dehydrogenase assay. RESULTS: The TB was not toxic to the retinal pigment epithelium cell cultures at any concentration or over any period of exposure, whereas ICG dye demonstrated dose-dependent and exposure-dependent toxicity. The ICG dye was found to be toxic to the cells at all tested concentrations between 5.0 mg/ml (stock concentration, 26.1% cell survival) and 0.5 mg/ml (92.8% cell survival) over a 3-minute exposure. No toxicity to TB was seen at the stock concentration of 1.5 mg/mL. Addition of light to the cultures did not significantly alter cell viability with either dye. Long periods of exposure, 2 hours, 24 hours, and 72 hours, to minute concentrations of either dye did not produce significant cell death. CONCLUSIONS: Indocyanine green demonstrates more toxicity than TB to human retinal pigment epithelium cell cultures. This is independent of any phototoxic potentiating effect of fiberoptic light or solvent toxicity. A clinically useful concentration of 0.5-mg/ml ICG causes low cytotoxicity at 3 minutes' exposure (cell survival 92.8%) and shows no detectable toxicity at 1-minute exposure (cell survival 102%).

SLT and adjunctive medical therapy: a prediction rule analysis.

PURPOSE: To investigate if specific classes of antiglaucoma medications have an influence on selective laser trabeculoplasty (SLT) success. METHODS: This retrospective prediction rule analysis investigated 120 eyes from 120 patients diagnosed with either open angle glaucoma or ocular hypertension, who underwent SLT treatment. Treatment success was defined as ≥20% intraocular pressure (IOP) reduction at 3 and 6 months after the treatment date. Multivariate logistic regression analyses were performed to determine success predictors. RESULTS: Pre-SLT IOP (up to 4 wk before SLT therapy) was the only independent predictor for ≥20% IOP reduction with an odds ratio of 1.30 when controlling for pre-SLT antiglaucoma drops. The area under receiver operator characteristic curve was 0.777. CONCLUSIONS: Topical medications do not adversely, nor favorably, affect SLT success. SLT efficacy is positively associated with the degree of IOP elevation before SLT treatment. Pigmentation of the anterior chamber angle, class of antiglaucoma medications, diabetes, sex, corneal thickness, pseudophakia, diagnosis, washout of eye drops, and previous argon laser trabeculoplasty treatment are not associated with SLT treatment efficacy.

Can preoperative anterior chamber angle width predict magnitude of intraocular pressure change after cataract surgery?

OBJECTIVE: To determine whether preoperative anterior chamber angle width, captured by anterior segment optical coherence tomography (AS-OCT), can be a predictor of intraocular pressure (IOP) change following cataract surgery. DESIGN: Prospective comparative observational study. PARTICIPANTS: Fifty-three eyes of 53 patients awaiting cataract surgery were included. METHODS: Measurement of anterior chamber angle width and IOP using AS-OCT and Goldmann's applanation tonometry, respectively, were performed before and 6 months after phacoemulsification and intraocular lens implantation. Preoperative and postoperative measurements were compared using paired t test. The prediction rule defined success as > or =20% IOP reduction from the baseline preoperative IOP measurement. Multivariate regression analysis was performed to assess the association of postoperative IOP with independent variables, including age, sex, systemic hypertension, diabetes mellitus, glaucoma, and preoperative anterior chamber angle width. RESULTS: Data were collected from 32 females and 21 males with visually significant cataract. Mean age was 73.3 (SD 8.2) years. Mean IOP dropped from 15.1 (SD 3.1) mm Hg to 12.8 (SD 2.5) mm Hg (p < 0.0001) after cataract extraction. Mean anterior chamber angle width increased from 24.7 degrees (SD 7.1 degrees ) to 38.1 degrees (SD 6.0 degrees ) after surgery (p < 0.001). Multivariate regression analysis did not identify preoperative variables to be significantly associated with > or =20% postoperative IOP reduction. CONCLUSIONS: Cataract surgery results in significant and sustained mean reductions in IOP and concurrent increases in anterior chamber angle width for a period of at least 6 months after surgery. However, measurements of the preoperative anterior chamber angle width did not predict the IOP-lowering effect of cataract surgery.

Development of a prediction rule to estimate the probability of acceptable intraocular pressure reduction after selective laser trabeculoplasty in open-angle glaucoma and ocular hypertension.

PURPOSE: To develop and validate a prediction rule to estimate the probability of acceptable intraocular pressure (IOP) reduction after selective laser trabeculoplasty (SLT) in ocular hypertension and open-angle glaucoma. PATIENTS AND METHODS: The study population was derived from a cohort of 220 patients with ocular hypertension, open-angle glaucoma, or normal tension glaucoma. A > or =20% reduction in IOP (mm Hg) from the baseline IOP at 6 months after SLT was considered treatment success. Logistic multivariate regression modeling was performed to develop a prediction rule. RESULTS: In multivariate logistic regression analyses, pre-SLT IOP and maximum IOP were identified as independent predictors for > or =20% IOP reduction at 6 months with adjusted odds ratios of 1.3 and 0.9, respectively, controlling for sex, diagnosis, pigment of anterior chamber, and washout of eye drops. The area under receiver operator characteristic curve was 0.716. Calibration of this prediction rule showed good agreement between predicted and observed probabilities of acceptable IOP reduction. If a probability of acceptable IOP reduction of 50% or greater is used as the minimal clinical threshold for treatment, the prediction rule had a sensitivity and specificity of 91.3% and 30.4%, respectively. CONCLUSIONS: SLT efficacy is positively associated with IOP elevation before SLT treatment and adversely associated with the maximum IOP ever recorded in history. Pigmentation of the anterior chamber angle, diagnosis, washout of eye drops, and sex are not associated with SLT treatment efficacy. This prediction rule should be further validated with a comparable prospective clinical study cohort.