RESUMO
PurposeThe purpose of the study was to study the effect of an organic light-emitting diode sleep mask on daytime alertness, wellbeing, and retinal structure/function in healthy volunteers and in diabetic macular oedema (DMO).Patients and methodsHealthy volunteers in two groups, 18-30 yrs (A), 50-70 yrs (B) and people with DMO (C) wore masks (504 nm wavelength; 80 cd/m2 luminance; ≤8 h) nightly for 3 months followed by a 1-month recovery period. Changes from baseline were measured for (means): psychomotor vigilance task (PVT) (number of lapses (NL), response time (RT)), sleep, depression, psychological wellbeing (PW), visual acuity, contrast sensitivity, colour, electrophysiology, microperimetry, and retinal thickness on OCT.ResultsOf 60 participants, 16 (27%) withdrew, 8 (13%) before month 1, due to sleep disturbances and mask intolerance. About 36/55 (65%) who continued beyond month 1 reported ≥1 adverse event. At month 3 mean PVT worsened in Group A (RT (7.65%, P<0.001), NL (43.3%, P=0.005)) and mean PW worsened in all groups (A 28.0%, P=0.01, B 21.2%, P=0.03, C 12.8%, P<0.05). No other clinically significant safety signal was detected. Cysts reduced/resolved in the OCT subfield of maximal pathology in 67% Group C eyes. Thinning was greater at 3 and 4 months for greater baseline thickness (central subfield P<0.001, maximal P<0.05).ConclusionSleep masks showed no major safety signal apart from a small impairment of daytime alertness and a moderate effect on wellbeing. Masks were acceptable apart from in some healthy participants. Preliminary data suggest a beneficial effect on retinal thickness in DMO. This novel therapeutic approach is ready for large clinical trials.
Assuntos
Retinopatia Diabética/terapia , Edema Macular/terapia , Fototerapia/métodos , Adolescente , Adulto , Idoso , Percepção de Cores/efeitos da radiação , Sensibilidades de Contraste/efeitos da radiação , Retinopatia Diabética/fisiopatologia , Feminino , Humanos , Edema Macular/fisiopatologia , Masculino , Máscaras , Pessoa de Meia-Idade , Satisfação do Paciente , Fototerapia/efeitos adversos , Estudos Prospectivos , Desempenho Psicomotor/efeitos da radiação , Tempo de Reação/efeitos da radiação , Retina/fisiopatologia , Retina/efeitos da radiação , Sono/efeitos da radiação , Transtornos do Sono-Vigília/etiologia , Tomografia de Coerência Óptica , Acuidade Visual/fisiologia , Campos Visuais/fisiologia , Adulto JovemRESUMO
Sub-Saharan Africa contributes at least 70% of the global cryptococcal meningoencephalitis cases each year and the majority of cases are caused by the Cryptococcus neoformans species. We present a case of meningoencephalitis due to Cryptococcus gattii in an 18 year old apparently immunocompetent male patient from Zimbabwe.