Oculometric biomarkers of visuomotor deficits in clinically asymptomatic patients with systemic lupus erythematosus undergoing long-term hydroxychloroquine treatment.

Introduction: This study examines a set of oculomotor measurements, or "oculometric" biomarkers, as potential early indicators of visual and visuomotor deficits due to retinal toxicity in asymptomatic Systemic Lupus Erythematosus (SLE) patients on long-term hydroxychloroquine (HCQ) treatment. The aim is to identify subclinical functional impairments that are otherwise undetectable by standard clinical tests and to link them to structural retinal changes. Methods: We measured oculomotor responses in a cohort of SLE patients on chronic HCQ therapy using a previously established behavioral task and analysis technique. We also examined the relationship between oculometrics, OCT measures of retinal thickness, and standard clinical perimetry measures of visual function in our patient group using Bivariate Pearson Correlation and a Linear Mixed-Effects Model (LMM). Results: Significant visual and visuomotor deficits were found in 12 asymptomatic SLE patients on long-term HCQ therapy compared to a cohort of 17 age-matched healthy controls. Notably, six oculometrics were significantly different. The median initial pursuit acceleration was 22%, steady-state pursuit gain 16%, proportion smooth 7%, and target speed responsiveness 31% lower, while catch-up saccade amplitude was 46% and fixation error 46% larger. Excluding the two patients with diagnosed mild toxicity, four oculometrics, all but fixation error and proportion smooth, remained significantly impaired compared to controls. Across our population of 12 patients (24 retinae), we found that pursuit latency, initial acceleration, steady-state gain, and fixation error were linearly related to retinal thickness even when age was accounted for, while standard measures of clinical function (Mean Deviation and Pattern Standard Deviation) were not. Discussion: Our data show that specific oculometrics are sensitive early biomarkers of functional deficits in SLE patients on HCQ that could be harnessed to assist in the early detection of HCQ-induced retinal toxicity and other visual pathologies, potentially providing early diagnostic value beyond standard visual field and OCT evaluations.

Processes for Designing Innovative Biomedical Hardware to Use in Space and on Earth.

The new era of space exploration is increasing the astronaut's number and diversity in low orbit and beyond. The influx of such a diverse crew population will also increase the need for medical technologies to ensure safe and productive missions. Such a need represents a unique opportunity to innovate and develop diagnostics and treatment tools to meet future needs. Historically, terrestrial regulatory oversight of biomedical design processes was considered separate from spaceflight regulatory processes because it did not address spaceflight constraints. These constraints challenge the creative development of unique solutions for use in space. Translation between healthcare innovation in spaceflight to healthcare on Earth and vice versa requires understanding the commonalities, unique needs and constraints. This manuscript provides a framework for comparing Earth-space design processes and a perspective on the best practices to improve healthcare equity and health outcomes.

Vestibular stimulation interferes with the dynamics of an internal representation of gravity.

The remembered vanishing location of a moving target has been found to be displaced downward in the direction of gravity (representational gravity) and more so with increasing retention intervals, suggesting that the visual spatial updating recruits an internal model of gravity. Despite being consistently linked with gravity, few inquiries have been made about the role of vestibular information in these trends. Previous experiments with static tilting of observers' bodies suggest that under conflicting cues between the idiotropic vector and vestibular signals, the dynamic drift in memory is reduced to a constant displacement along the body's main axis. The present experiment aims to replicate and extend these outcomes while keeping the observers' bodies unchanged in relation to physical gravity by varying the gravito-inertial acceleration using a short-radius centrifuge. Observers were shown, while accelerated to varying degrees, targets moving along several directions and were required to indicate the perceived vanishing location after a variable interval. Increases of the gravito-inertial force (up to 1.4G), orthogonal to the idiotropic vector, did not affect the direction of representational gravity, but significantly disrupted its time course. The role and functioning of an internal model of gravity for spatial perception and orientation are discussed in light of the results.