Compartmental Differences in Macular Retinal Ganglion Cell Function.

Purpose: The purpose of this study was to investigate local differences of macular retinal ganglion cell (RGC) function by means of the steady-state pattern electroretinogram (SS-PERG). Methods: SS-PERGs were recorded in healthy subjects (n = 43) in response to gratings (1.6 c/deg, 15.63 reversals/s, and 98% contrast) presented on an LED display (800 cd/m2, 12.5 degrees eccentricity at 30 cm viewing distance) partitioned in triangular sectors (inferior [I]; nasal [N]; superior [S]; and temporal [T]) or concentric regions (central [C] and annulus [A]). For each partition, response amplitude (nV), amplitude adaptation (% change over recording time), phase/latency (deg/ms), and oscillatory potentials (OPs) amplitude (root mean square [RMS] nV) were measured. Data were analyzed with Generalized Estimating Equation (GEE) statistics. Results: Amplitude differed (P < 0.001) between sectors (I: 254 nV; N: 328 nV; S: 275 nV; T: 264 nV; and N>T, I) as well as concentrically (C: 684 nV; A: 323 nV; and C>A). Latency did not differ between sectors (range = 53-54 ms, P = 0.45) or concentrically (range = 51-51 ms, P = 0.7). Adaptation did not differ (P = 0.66) concentrically (C: -19% and A: -22%) but differed (P = 0.004) between sectors (I: +25% and S: -29%). The OP amplitude did not differ (P = 0.5) between sectors (range = 63-73 nV) as well as concentrically (range = 82-90 nV, P = 0.3). Conclusions: Amplitude profiles paralleled RGC densities from histological studies. Adaptation profile suggested greater autoregulatory challenge in the inferior retina. Latency profile may reflect axonal conduction time to the optic nerve head assuming a direct relationship between axon length and its size/velocity. Location-independent OPs may reflect preganglionic activity. Translational Relevance: Normal macular RGC function displays local differences that may be related to local vulnerability in optic nerve disorders.

White donor, younger donor and double lung transplant are associated with better survival in sarcoidosis patients.

Sarcoidosis commonly affects the lung. Lung transplantation (LT) is required when there is a severe and refractory involvement. We compared post-transplant survival rates of sarcoidosis patients with chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis (IPF). We also explored whether the race and age of the donor, and double lung transplant have any effect on the survival in the post transplant setting. We analyzed 9,727 adult patients with sarcoidosis, COPD, and IPF who underwent LT worldwide between 2005-2015 based on United Network for Organ Sharing (UNOS) database. Survival rates were compared with Kaplan-Meier, and risk factors were investigated by Cox-regression analysis. 469 (5%) were transplanted because of sarcoidosis, 3,688 (38%) for COPD and 5,570 (57%) for IPF. Unadjusted survival analysis showed a better post-transplant survival rate for patients with sarcoidosis (p < 0.001, Log-rank test). In Cox-regression analysis, double lung transplant and white race of the lung donor showed to have a significant survival advantage. Since double lung transplant, those who are younger and have lower Lung Allocation Score (LAS) at the time of transplant have a survival advantage, we suggest double lung transplant as the procedure of choice, especially in younger sarcoidosis subjects and with lower LAS scores.

Orbital cellulitis as a complication of mandibular odontogenic infection.

A 30-year-old man presented with an acute left eye proptosis, pain, and decreased vision. He had been having a dental infection since 3 days. Orbital CT scan showed abscess in the left orbit. On dental X-ray a periapical radiolucency of the mandibular left-second molar was observed, and no obvious sinus involvement was noted. Intravenous antibiotic therapy did not lead to any significant improvement. Therefore, the patient underwent combined dental and orbital surgery to drain the abscess. Following the surgery, the patient's clinical signs and symptoms resolved completely.

Antiphospholipid syndrome following toxoplasma retinochoroiditis.

PURPOSE: To report a case of antiphospholipid syndrome (APS) following toxoplasma retinochoroiditis. DESIGN: Interventional case report. METHOD: The patient was a 24-year-old female with an attack of visual loss due to toxoplasma retinochoroiditis concomitant with branch retinal vein occlusion. Retinitis resolved with anti-toxoplasma treatment. However, a recurrent episode of BRVO and vitreous hemorrhage occurred later. RESULT: In systemic evaluation, evidence of APS was detected, including high titers of anti-cardiolipin antibody, increased beta-2 microglobulin and anti-toxoplasma IgG antibody, and also low titers of C3, C4, and CH50. CONCLUSION: Ocular toxoplasmosis should be included in the list of etiologies of secondary APS. Systemic evaluation for detection of APS is a necessary approach to patients with toxoplasma retinochoroiditis and concomitant vascular accident.