Sympathetic ophthalmia presenting 5 days after penetrating injury.

PURPOSE: To describe a rare case of early sympathetic ophthalmia that presented 5 days after penetrating injury. OBSERVATIONS: A 13-year-old boy presented with a penetrating left globe injury from a BB metallic projectile that was emergently repaired. Five days later, routine dilated exam of the right eye revealed interval development of vitritis over the posterior pole. Optical coherence tomography revealed fine, vitreous hyper-reflective material. Intravenous and topical steroid therapy was started, and the patient underwent prompt enucleation of the traumatized eye. Histopathologic examination of the globe demonstrated lymphocytic choroiditis and macrophage infiltration, consistent with prior reports of early sympathetic ophthalmia. The sympathizing eye maintained 20/20 acuity and never caused visual complaints. CONCLUSIONS AND IMPORTANCE: This is the earliest reported case of sympathetic ophthalmia, to our knowledge, and it presented without visual symptoms only five days after penetrating trauma. This case suggests that routine examination should start before the typical 14 days associated with development of sympathetic ophthalmia.

Age-related preservation of top-down control over distraction in visual search.

Visual search studies have demonstrated that older adults can have preserved or even increased top-down control over distraction. However, the results are mixed as to the extent of this age-related preservation. The present experiment assesses group differences in younger and older adults during visual search, with a task featuring two conditions offering varying degrees of top-down control over distraction. After controlling for generalized slowing, the analyses revealed that the age groups were equally capable of utilizing top-down control to minimize distraction. Furthermore, for both age groups, the distraction effect was manifested in a sustained manner across the reaction time distribution.

Adult age differences in functional connectivity during executive control.

Task switching requires executive control processes that undergo age-related decline. Previous neuroimaging studies have identified age-related differences in brain activation associated with global switching effects (dual-task blocks versus single-task blocks), but age-related differences in activation during local switching effects (switch trials versus repeat trials, within blocks) have not been investigated. This experiment used functional magnetic resonance imaging (fMRI), and diffusion tensor imaging (DTI), to examine adult age differences in task switching across adjacent trials (i.e., local task switching). During fMRI scanning, participants performed a cued, word categorization task. From interspersed cue-only trials, switch-related processing associated with the cue was estimated separately from the target. Activation associated with task switching, within a distributed frontoparietal network, differed for cue- and target-related processing. The magnitude of event-related activation for task switching was similar for younger adults (n=20; 18-27years) and older adults (n=20; 60-85years), although activation sustained throughout the on-tasks periods exhibited some age-related decline. Critically, the functional connectivity of switch-related regions, during cue processing, was higher for younger adults than for older adults, whereas functional connectivity during target processing was comparable across the age groups. Further, individual differences in cue-related functional connectivity shared a substantial portion of the age-related variability in the efficiency of target categorization response (drift rate). This age-related difference in functional connectivity, however, was independent of white matter integrity within task-relevant regions. These findings highlight the functional connectivity of frontoparietal activation as a potential source of age-related decline in executive control.