Red and green defocus curves and duochrome test in different age groups / Curvas de desenfoque rojo y verde y prueba de duocromo en diferentes grupos de edad

Purpose: To compare the eye defocus curves (DCs) obtained with stimuli on red, green, and white backgrounds and to investigate the applicability of the duochrome test (DT) in different age groups. Methods: 12 elderly (ELD: 59.3 ± 3.9 years) and 8 young (YG: 22.1 ± 1.1 years) subjects were recruited. An optometric assessment with the DT was carried out to obtain the subjective refraction at distance. DCs at distance on green, white, and red backgrounds were measured and the following parameters were deduced: dioptric difference between red-green, green-white, red-white focal positions (minima of the DCs), best corrected visual acuity (BCVA), and widths of the DCs for red, green, and white. Results: The DC difference between the green-white focal positions (mean ± standard deviation) was -0.12±0.17 diopters (D) (ELD, p = 0.012) and -0.11±0.12 D (YG, p = 0.039), while the red-white difference was not statistically significant. The DC red-green difference was 0.20±0.16 D (ELD, p = 0.002) and 0.18±0.18 D (YG, p = 0.008). The ELD BCVA with green background was significantly worse than BCVA with red (p = 0.007) and white (p = 0.007). The mean value of the DC's width in ELD for green (1.01±0.36 D) was higher than for red (0.77±0.21 D) and for white (0.84±0.35 D), but with no statistical significance. Conclusion: Both age groups showed a slight focusing preference for red when using white light. Moreover, ELD showed a worse BCVA with a green compared to a red background. Despite these results deduced by DC analyses, these aspects do not compromise the possibility of using the DT in clinical practice both in the young and in the elderly. Furthermore, the difference of about 0.20 D between red-green DC in both groups confirms the clinical appropriateness of the widespread use of 0.25 D step as the standard minimum difference in power between correcting lenses.(AU)

The correlation between rapid eye movement sleep behavior disorder and the progress of Parkinson's disease: a systematic review and meta-analysis.

Background: This meta-analysis was conducted to evaluate potential differences in symptoms between PD patients with or without RBD. Methods: A systematic search was conducted in PubMed, Cochrane, Embase, and Web of Science databases (as of August 16, 2023), to identify relevant studies on PD and RBD. Statistical analysis was performed using Stata 15.0. Continuous variables were analyzed using the standardized mean difference (SMD) and 95% confidence interval (95% CI), while count data were assessed using the odds ratio (OR) and 95% CI as statistical effect sizes. Heterogeneity among all included studies was tested; for studies with low heterogeneity (I2 < 50%), a fixed-effects model was used to calculate statistical results. For studies with relatively high heterogeneity (I2 > 50%), a random-effects model was applied, followed by sensitivity and subgroup analyses to identify sources of heterogeneity. Results: A total of 5,672 subjects were involved in this study. Compared to the NRBD group, the UPDRS-III score in the RBD group was significantly higher (SMD = 0.20, 95% CI: [0.11, 0.29], P < 0.001), and the Hoehn-Yahr score in the RBD group was also significantly higher (SMD = 0.29, 95% CI: [0.03, 0.55], P < 0.001). Patients with PD in the RBD group had more severe cognitive impairments than those in the NRBD group (SMD = -0.30, 95% CI: [-0.48, -0.11], P < 0.001). The incidence of hallucination in PD patients in the RBD group was 3.0 times that of the NRBD group (OR = 3.0, 95% CI: [2.15, 4.20], P = 0.110). PD patients in the RBD group also experienced more severe anxiety symptoms (SMD = 0.13, 95% CI: [-0.26, 0.51], P < 0.001), had higher scores in depression scales (SMD = 0.22, 95% CI: [0.02, 0.43], P < 0.001), and higher scores in sleep disorder scales than those in NRBD group (SMD = 0.10, 95% CI: [-0.11, 0.31], P < 0.001). Conclusion: Results show PD patients with co-occurring RBD have more severe motor and non-motor symptoms likely due to overlapping affected regions in RBD and PD-related pathology, plus broader neurodegeneration seen in PD patients with RBD. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/#searchadvanced, identifier CRD42023476331.

Do autistic adults spontaneously reason about belief? A detailed exploration of alternative explanations.

Southgate et al.'s (Southgate 2007 Psychol. Sci. 18, 587-92 (doi:10.1111/j.1467-9280.2007.01944.x)) anticipatory-looking paradigm has presented exciting yet inconclusive evidence surrounding spontaneous mentalizing in autism. The present study aimed to develop this paradigm to address alternative explanations for the lack of predictive eye movements on false-belief tasks by autistic adults. This was achieved through implementing a multi-trial design with matched true-belief conditions, and both high and low inhibitory demand false-belief conditions. We also sought to inspect if any group differences were related to group-specific patterns of attention on key events. Autistic adults were compared with non-autistic adults on this adapted implicit mentalizing task and an established explicit task. The two groups performed equally well in the explicit task; however, autistic adults did not show anticipatory-looking behaviour in the false-belief trials of the implicit task. Critically, both groups showed the same attentional distribution in the implicit task prior to action prediction, indicating that autistic adults process information from social cues in the same way as non-autistic adults, but this information is not then used to update mental representations. Our findings further document that many autistic people struggle to spontaneously mentalize others' beliefs, and this non-verbal paradigm holds promise for use with a wide range of ages and abilities.

Attentional bias to social media stimuli is moderated by fear of missing out among problematic social media users.

Background and aims: Previous evidence has indicated that problematic social media use (PSMU) is characterized by an attentional bias to social media icons (such as Facebook icons), but not to social webpages (such as Facebook webpages). They suggest that there may be other factors influencing attentional bias like fear of missing out (FoMO). But it remains unclear how FoMO moderates attentional bias in PSMU. This study aims to investigate whether PSMU show attentional bias for stimuli associated with social media, and how FoMO moderates on attentional bias among PSMU through experimental methods. Methods: Based on the Interaction of Person-Affect-Cognition-Execution (I-PACE) model, this study explored mechanisms of attentional bias to social media icons (such as WeChat) related to PSMU and further examined the role of FoMO in this relationship. Specifically, attentional bias patterns to social media icons of 62 participants (31 PSMU and 31 control group) were explored during a dot-probe paradigm combined with eye-tracking in Experiment 1, and attentional bias patterns to social media icons of another 61 individuals with PSMU with different FoMO levels was explored during a dot-probe paradigm combined with eye-tracking in Experiment 2. Results: Results revealed that individuals with PSMU had an attentional bias toward social media icons, demonstrated by attentional maintenance, and such bias such bias was moderated by FoMO negatively, demonstrated by attentional vigilance and maintenance in PSMU/high FoMO. Conclusion: These results suggest that attentional bias is a common mechanism associated with PSMU, and FoMO is a key factor on the development of PSMU.

Safety and tolerability of pooled human immune globulins after topical ophthalmic administration in New Zealand White rabbits.

PURPOSE: To evaluate the safety and tolerability of pooled human immune globulins, Flebogamma® 5% DIF and Flebogamma® 10% DIF, administered by topical ophthalmic instillation to New Zealand White (NZW) rabbits. METHODS: Male NZW rabbits were used in this study. In the acute single dose tolerability study, rabbits (n = 12) received a single topical dose of Flebogamma® 5% DIF. In the two-week repeated-dose tolerability study, rabbits (n = 5 for each group) were administered either Flebogamma® 5% DIF or Flebogamma® 10% DIF by topical bilateral administration four times daily (q.i.d.) between 8 am and 6 pm for a period of two weeks. Full ophthalmic examinations were conducted to evaluate ocular tolerability at baseline, Day 7, and Day 14. RESULTS: In the acute single dose study, mild hyperaemia was observed in 1 out of 4 eyes at each 4 h and 24 h post-instillation of Flebogamma® 5% DIF. In the repeated dose study, no ocular signs were detected after q.i.d. topical instillation of Flebogamma® 5% DIF, while Flebogamma® 10% DIF resulted in mild hyperaemia in 8 out of 10 eyes on Day 7, and 5 out of 10 eyes on Day 14. No positive corneal fluorescein staining was detected. Schirmer tear test results were unremarkable. No other ocular signs were observed. Administration of immune globulins had no effect on intraocular pressure. CONCLUSIONS: Flebogamma® 5% DIF and Flebogamma® 10% DIF were well-tolerated by NZW rabbits following single and repeat dose topical ophthalmic administration, supporting the future development of topical pooled human immune globulins for the treatment of ocular surface disease.

Ocular trauma in badminton: A 5-year review of badminton-related eye injury emergency department presentations.

OBJECTIVE: To examine the nature and severity of badminton-related ocular injuries in Melbourne, Australia. METHODS: This is a retrospective chart review. A search of the medical records was conducted for patients presenting to the ED at The Royal Victorian Eye and Ear Hospital, with badminton-related eye injuries from June 2018 to May 2023. Data were extracted, focusing on injury mechanism, patient demographics and treatment outcomes. RESULTS: In total, 88 patients were included in the study, comprising 64 (73%) men and 24 (27%) women. The mean patient age was 36.13 years. The most common injury was hyphaema (73%), followed by commotio retinae (45%). One patient sustained a penetrating eye injury when a shuttlecock shattered the spectacles he was wearing during play. Medical intervention was required for 90% of patients. The most common interventions were steroid eye drops (80%) and cycloplegic eyedrops (76%). A total of six (7%) patients required surgical management. For those 69 patients followed up at The Royal Victorian Eye and Ear Hospital, 77% of patients had a final best-corrected visual acuity of 6/6 or greater. CONCLUSIONS: Hyphaema, commotio retinae and traumatic uveitis were the most commonly diagnosed injuries. The majority of patients with badminton-related eye injuries required medical treatment, and some necessitated surgical intervention. To mitigate these risks, there is a pressing need to develop an eye safety policy for Australian badminton players, and players should exercise caution when wearing spectacles during play to prevent potential penetrating eye injuries.

Development of a dry eye index as a new biomarker of dry eye disease.

PURPOSE: To evaluate signs and symptoms in patients diagnosed with dry eye disease (DED), divided into dry eye (DE) groups, in order to find a new biomarker that allows an accurate diagnosis, management and classification of DED. METHODS: This cross-sectional, observational study included 71 DED subjects. Subjective symptoms, visual quality and DE signs were assessed using the Ocular Surface Disease Index (OSDI), the Quality of Vision (QoV) questionnaire, best corrected distance visual acuity (VA), functional visual acuity (FVA), contrast sensitivity (CS), high- and low-order corneal aberrations (HOA and LOA, respectively), tear break-up time (TBUT), Meibomian Gland Dysfunction (MGD), Schirmer test, corneal staining, lid wiper epitheliopathy (LWE) and meibography. Participants were classified into three groups based on dryness severity using a cluster analysis, i.e., mild (N = 17, 55.8 ± 15.4 years), moderate (N = 41, 63.5 ± 10.6 years) and severe (N = 13, 65.0 ± 12.0). A new Dry Eye Severity Index (DESI) based on ocular surface signs has been developed and its association with symptoms, visual quality and signs was assessed. Comparisons between groups were made using Kruskal-Wallis and Chi-squared tests. Spearman correlation analysis was also performed. RESULTS: The DESI was based on three tests for DE signs: TBUT, Schirmer test and MGD. The DESI showed significant differences between different pairs of groups: Mild Dryness versus Moderate Dryness (p < 0.001), Mild Dryness versus Severe Dryness (p < 0.001) and Moderate Dryness versus Severe Dryness (p < 0.001). The DESI was significantly correlated with age (rho = -0.30; p = 0.01), OSDI score (rho = -0.32; p = 0.007), QoV score (rho = -0.35; p = 0.003), VA (rho = -0.34; p = 0.003), FVA (rho = -0.38; p = 0.001) and CS (rho = 0.42; p < 0.001) Also, significant differences between the severity groups were found for OSDI and QoV scores, VA, FVA, CS and MGD (p < 0.05). CONCLUSIONS: The DESI has good performance as a biomarker for the diagnosis, classification and management of DED.

Reciprocal Coupling of Circadian Clocks in the Compound Eye and Optic Lobe in the Cricket Gryllus bimaculatus.

The circadian system comprises multiple clocks, including central and peripheral clocks. The central clock generally governs peripheral clocks to synchronize circadian rhythms throughout the animal body. However, whether the peripheral clock influences the central clock is unclear. This issue can be addressed through a system comprising a peripheral clock (compound eye clock [CE clock]) and central clock (the optic lobe [OL] clock) in the cricket Gryllus bimaculatus. We previously found that the compound eye regulates the free-running period (τ) and the stability of locomotor rhythms driven by the OL clock, as measured by the daily deviation of τ at 30°C. However, the role of the CE clock in this regulation remains unexplored. In this study, we investigated the importance of the CE clock in this regulation using RNA interference (RNAi) of the period (per) gene localized to the compound eye (perCE-RNAi). The perCE-RNAi abolished the compound eye rhythms of the electroretinogram (ERG) amplitude and clock gene expression but the locomotor rhythm driven by the OL clock was maintained. The locomotor rhythm of the tested crickets showed a significantly longer τ and greater daily variation of τ than those of control crickets treated with dsDsRed2. The variation of τ was comparable with that of crickets with the optic nerve severed. The τ was considerably longer but was comparable with that of crickets with the optic nerve severed. These results suggest that the CE clock regulates the OL clock to maintain and stabilize τ.

Carbon quantum dots for the diagnosis and treatment of ophthalmic diseases.

Carbon quantum dots (CQDs), an emerging nanomaterial, are gaining attention in ophthalmological applications due to their distinctive physical, chemical, and biological characteristics. For example, their inherent fluorescent capabilities offer a novel and promising alternative to conventional fluorescent dyes for ocular disease diagnostics. Furthermore, because of the excellent biocompatibility and minimal cytotoxicity, CQDs are well-suited for therapeutic applications. In addition, functionalized CQDs can effectively deliver drugs to the posterior part of the eyeball to inhibit neovascularization. This review details the use of CQDs in the management of ophthalmic diseases, including various retinal diseases, and ocular infections. While still in its initial phases within ophthalmology, the significant potential of CQDs for diagnosing and treating eye conditions is evident.

The relationship between sex hormone levels and ocular surface parameters in girls with idiopathic central precocious puberty.

Purpose: The study aimed to investigate the correlation between the change of sex hormone levels and ocular surface parameters in girls with idiopathic central precocious puberty(ICPP). Methods: Eighteen girls with ICPP and 18 age-matched normal girls participated in this study, all of the participants had undergone physical measurements, laboratory tests, imaging examination and ocular surface assessments. Results: The Objective Scatter Index (OSI) in the ICPP group was significantly higher than in the control group (P = 0.031), girls with ICPP showed slightly lower MNITBUT compared to the normal control group, although this difference was not statistically significant. Bivariate analysis revealed a positive association between estradiol and OSI (r=0.383, P=0.021), Additionally, in the study population, both Luteinizing hormone (LH) and Follicle-stimulating hormone (FSH) were negatively correlated with Mean noninvasive tear breakup time (MNITBUT) (r=-0.359, P=0.031)(r=-0.357, P=0.032). Conclusion: In comparison with the normal control group, alterations in the OSI were observed in girls with ICPP. This alteration may be associated with an elevation in estrogen levels. Although there was a slight non-significant decrease in NITBUT in ICPP girls, the negative correlation between LH and FSH with MNITBUT suggests new perspective for further investigation.

Reversible cerebral vasoconstriction syndrome due to teprotumumab: two case reports.

BACKGROUND: Reversible Cerebral Vasoconstriction Syndrome (RCVS) involves cerebral vasculature constriction and dilation. While the exact pathophysiology of RCVS is still not fully understood, there are multiple etiological factors suggested to be implicated in triggering RCVS. We report two RCVS cases potentially linked to teprotumumab. Case 1: A 59-year-old female with Graves' eye disease (GED) developed leg weakness and headache after initiating teprotumumab, and neuroimaging studies revealed multifocal cerebral vasospasm (CVS). Verapamil mitigated vasospasm and the patient overall improved. Case 2: A 71-year-old female with GED developed thunderclap headache two months after starting teprotumumab, with subarachnoid hemorrhage (SAH) and CVS revealed on neuroimaging studies. The patient improved on verapamil and was discharged without deficits. CONCLUSIONS: The temporal correlation between teprotumumab initiation and RCVS's symptom onset raises concern for the potential involvement of teprotumumab in triggering RCVS via disrupting cerebrovascular modulation. Further research is needed to investigate this proposed association.

Ancestral role of Pax6 in chordate brain regionalization.

The Pax6 gene is essential for eye and brain development across various animal species. Here, we investigate the function of Pax6 in the development of the anterior central nervous system (CNS) of the invertebrate chordate amphioxus using CRISPR/Cas9-induced genome editing. Specifically, we examined Pax6 mutants featuring a 6 bp deletion encompassing two invariant amino acids in the conserved paired domain, hypothesized to impair Pax6 DNA-binding capacity and gene regulatory functions. Although this mutation did not result in gross morphological changes in amphioxus larvae, it demonstrated a reduced ability to activate Pax6-responsive reporter gene, suggesting a hypomorphic effect. Expression analysis in mutant larvae revealed changes in gene expression within the anterior CNS, supporting the conserved role of Pax6 gene in brain regionalization across chordates. Additionally, our findings lend support to the hypothesis of a zona limitans intrathalamica (ZLI)-like region in amphioxus, suggesting evolutionary continuity in brain patterning mechanisms. ZLI region, found in both hemichordates and vertebrates, functions as a key signaling center and serves as a restrictive boundary between major thalamic regions.

Investigating the influence of eye-catching effect on mental workload in highway tunnel entrances: a comprehensive analysis of eye blink behavior.

OBJECTIVE: The objective of this study was to investigate the relationship between eye-catching effects and mental workload at highway tunnel entrances. Specifically, the study aimed to analyze drivers' eye blink behavior to gain a comprehensive understanding of how visual attraction at tunnel entrances affects cognitive workload. METHODS: 50 participants were recruited for the naturalistic driving experiment. Four different visually attractive driving scenarios (baseline, landscape-style architecture, tip slogan, and billboard) were selected. Eye-tracking technology was utilized to record and analyze the eye blink behavior of participating drivers. Various metrics, including blink frequency, blink duration, inter-blink interval, and pupil diameter after a blink, were measured and compared across different scenarios. RESULTS: The results of the study demonstrated significant differences in drivers' eye blink behavior across the different experimental scenarios, indicating the influence of visual attraction conditions on mental workload. The presence of eye-catching stimuli (landscape-style architecture, tip slogan, and billboard scenarios) at tunnel entrances resulted in decreased blink frequency, shorter blink duration, longer inter-blink intervals, and larger pupil diameter after a blink compared to when no specific eye-catching stimuli were present (baseline condition). These findings suggest that visual attractions capture drivers' attention, leading to increased cognitive workload and attentional demands. CONCLUSIONS: The findings of this study contribute to the existing literature on driver attention and mental workload, particularly in relation to eye-catching effect in tunnel environments. The presence of eye-catching stimuli at tunnel entrances can distract drivers and increase their mental workload, potentially compromising driving performance and safety. It is crucial for transportation authorities and designers to carefully consider the design and placement of visual attractions in tunnel entrances to minimize distraction and cognitive workload. By doing so, driving safety and performance can be enhanced in tunnel entrances.

The profile of patients attending to the general emergency department with ocular complaints within the last year: is it a true ocular emergency?

PURPOSE: Ocular emergencies require immediate intervention to prevent rapid vision loss or functional impairment. The aim of this study was to determine the proportion of true ocular emergencies among patients who presented to the general emergency department with ocular complaints and were referred to the Eye Clinic. METHODS: In a retrospective cross-sectional study in a tertiary hospital in Istanbul, patients aged 0-100 years who presented to the general emergency department with ocular complaints between January and December 2022 were included. Inconclusive diagnoses and incomplete records were excluded. Patients were divided into three groups: top eye emergencies (TE), relative eye emergencies (REE), and non-emergency eyes (NEE). RESULTS: Among the 652,224 individuals seeking care, 9,982 (1.5%) were referred to the Eye Emergency Clinic. Of these, 2,788 (27.9%) were female, and 7,194 (72.1%) were male, with ages ranging from 0 to 98 years. TopEye Emergencies (TEE), Relative Eye Emergencies (REE), and Non-Eye Emergencies (NEE) accounted for 13%, 60%, and 27% of the cases, respectively. Common top-eye emergencies (TEE) include chemical injuries, orbital-preseptal cellulitis, and orbital fractures. Relative eye emergencies (REEs) commonly feature corneal foreign bodies, corneal erosion, and conjunctivitis. Nonemulsion eye (NEE) methods involve simple eye redness, trauma without eye involvement, and subconjunctival haemorrhage. CONCLUSIONS: Consistent with the literature, 1.5% of patients presenting to the general emergency department had eye complaints.However, 27% of those referred to the ophthalmological clinic did not have an urgent eye condition. This is partly due to the high proportion of patients presenting to the emergency department with ocular complaints and the lack of knowledge of ophthalmological diseases by emergency physicians, leading to unnecessary referrals to the ophthalmology clinic, resulting in a loss of the workforce and reduced time allocated to patients with true ocular emergencies.

Adverse effects of meteorological factors and air pollutants on dry eye disease: a hospital-based retrospective cohort study.

Although previous studies have suggested that meteorological factors and air pollutants can cause dry eye disease (DED), few clinical cohort studies have determined the individual and combined effects of these factors on DED. We investigated the effects of meteorological factors (humidity and temperature) and air pollutants [particles with a diameter ≤ 2.5 µ m (PM2.5), ozone (O3), nitrogen dioxide (NO2), and carbon monoxide (CO)] on DED. A retrospective cohort study was conducted on 53 DED patients. DED was evaluated by Symptom Assessment in Dry Eye (SANDE), tear secretion, tear film break-up time (TBUT), ocular staining score (OSS), and tear osmolarity. To explore the individual, non-linear, and joint associations between meteorological factors, air pollutants, and DED parameters, we used generalized linear mixed model (GLMM) and Bayesian kernel machine regression (BKMR). After adjusting for all covariates, lower relative humidity or temperature was associated with a higher SANDE (p < 0.05). Higher PM2.5, O3, and NO2 levels were associated with higher SANDE and tear osmolarity (p < 0.05). Higher O3 levels were associated with lower tear secretion and TBUT, whereas higher NO2 levels were associated with higher OSS (p < 0.05). BKMR analyses indicated that a mixture of meteorological factors and air pollutants was significantly associated with increased SANDE, OSS, tear osmolarity, and decreased tear secretion.

Topical anti-glaucoma medications effects on meibomian glands: Systematic review and meta-analysis.

Meibomian gland (MG) dysfunction and glaucoma are very prevalent ocular conditions that significantly impact patients' quality of life. A growing number of clinical and experimental studies have reported an association between the use of topical eye drops to reduce intraocular pressure and the development or exacerbation of MG dysfunction. Studies investigating the impact of glaucoma eyedrops on MG diagnostic parameters have shown variable results, particularly regarding the morphology and function of MG and tear film instability. Herein, we corroborated the findings of greater changes in morphological and functional variables related to MG in patients treated with antiglaucoma eye drops through a systematic review and meta-analysis.

Selective and prolonged attention to emotional scenes in humans and bonobos.

Perceiving emotions in others is at the foundation of higher-order social cognition. The importance of emotions is evidenced by the fact that they receive prioritized attention at early stages of processing the environment in humans and some other primates. Nevertheless, we do not fully understand how emotion modulates attention over longer durations in primates, particularly in great apes. Bonobos, one of our closest relatives, stand out in emotion processing and regulation among great apes. This makes them an interesting comparison species and a valuable model for studying the evolution of emotion perception in hominids. We investigated how bonobos and humans spontaneously attend to emotionally valent scenes in a preferential looking task using eye-tracking. With Bayesian mixed modelling, we found that bonobos and humans generally looked longer at emotional scenes, mainly of conspecifics. Moreover, while bonobos did not have a bias toward emotional human scenes, humans sustained their attention toward bonobos playing, grooming and having sex. Furthermore, when exploring an immediate bias for emotions, humans showed a bias toward affiliative human scenes, and bonobos showed a bias away from bonobos-in-distress scenes. These findings suggest that emotions modulate attention at early and later attentional stages in bonobos, similar to humans.

Analyzing histopathological aspects and cell populations in orbital inflammatory involvement in systemic diseases: A case series from the Rheumatologist's perspective.

Orbital inflammatory disease (OID) comprises approximately 6% of orbital conditions, affecting individuals across all ages. The range of the primary orbital inflammation's differential diagnosis is extensive, encompassing autoimmune disorders such as thyroid diseases, vasculitis, sarcoidosis, connective tissue diseases, immunoglobulin G4-related disease (IgG4-RD), and giant cell myositis, whereas secondary causes span from infections to drug-induced causes. Analyzing histopathological aspects and cell populations could enhance our comprehension of the etiology of orbital inflammatory involvement in systemic diseases such as IgG4-RD. We present a series of four patients from our Rheumatology clinic, each with distinct systemic diseases, illustrating diverse manifestations of OID. This series was conducted to facilitate discussions and diagnoses of challenging cases of OID in a rheumatologic setting. The difficulty in the differential diagnosis arises from the extensive range of structures involved, resulting in a significant variation of clinical manifestations. Furthermore, the lack of definitive diagnostic laboratory tests and, often, histological findings add to the complexity. OID poses diagnostic challenges with variable clinical manifestations and overlapping imaging findings. As a diagnosis of exclusion, a comprehensive evaluation is crucial, often necessitating an orbital biopsy for confirmation. Collaborative efforts among specialists are essential for managing these intricate cases.

Oculomotor differences in adults with and without probable developmental coordination disorder.

Adults with Developmental Coordination Disorder (DCD), sometimes referred to as dyspraxia, experience difficulties in motor development and coordination, which impacts on all aspects of their daily lives. Surprisingly little is known about the mechanisms underlying the difficulties they experience in the motor domain. In childhood DCD, aspects of oculomotor control have been shown to be altered. The purpose of this study was to determine whether oculomotor differences are present in adults with and without probable DCD. Visual fixation stability, smooth pursuit, and pro-and anti-saccade performance were assessed in 21 adults (mean age 29 years) with probable DCD/dyspraxia (pDCD) and 21 typically-developing (TD) adults (mean age 21 years). Eye tracking technology revealed that oculomotor response preparation in the pro- and anti-saccade tasks was comparable across groups, as was pursuit gain in the slower of the two smooth pursuit tasks. However, adults with pDCD made significantly more saccades away from the fixation target than those without DCD and significantly more anti-saccade errors. Further, compared to TD adults, adults with pDCD demonstrated difficulties in maintaining engagement and had lower pursuit gain in the faster pursuit task. This suggests that adults with pDCD have problems with saccadic inhibition and maintaining attention on a visual target. Since this pattern of results has also been reported in children with DCD, oculomotor difficulties may be persistent for those with DCD across the lifespan. An awareness of the impact of atypical oculomotor control in activities of daily living across the lifespan would support clearer understanding of the causes and impacts of these difficulties for those with DCD.

Adherence to Periodic Dilated Eye Examinations and Its Determinants Among Nepalese Patients With Diagnosed Diabetes: A Single-Center Hospital-Based Analysis Using Health Belief Model.

Introduction: To find the adherence rate to periodic dilated eye examinations (DEEs) and its determinants among patients with diagnosed diabetes. Research Design and Methods: In this cross-sectional study of 165 participants with diagnosed diabetes (Type 1/2) attending a general hospital with a diabetes clinic, we explored perceptions of barriers and facilitators of DEE at the individual level using a framework adapted from the health belief model (HBM). Patients were compared using t tests for continuous data and chi-square tests for categorical data. Results: The rate of adherence to DEE (as defined by DEE within a year) was 62.4% (95% confidence interval [CI] = 55.0%-69.8%). The mean age of the patients was 56.81 (±13.29) years. We found that the mean benefit score was significantly higher, and the mean barrier score was significantly lower in those adhering to DEE (p < 0.001); but the susceptibility, severity, and self-efficacy scores were not significantly different. Furthermore, those under treatment for diabetes mellitus (DM), those with diabetic retinopathy (DR) in them or their family member, and those with DM duration of 1 year or less were significantly likely to adhere to DEE (p < 0.005). Additionally, those who had received advice for eye screening from their physicians were about 25 times more likely to adhere to DEE (95% CI =6.80-92.05) than those who were not advised. Conclusion: A larger proportion of people with diabetes did not adhere to periodic DEE. Benefits and barriers were found to be determinants in this population. Further exploration in a larger population and the use of HBM to increase adherence to periodic DEE can be tested by targeting behavioral counseling along with other traditional approaches.