Topical tacrolimus in high-risk corneal transplants.

PURPOSE: The purpose of this study was to assess the use of topical tacrolimus ointment in preventing rejection in high-risk corneal grafts, when added to the standard immunosuppressive regimen. METHODS: We conducted an observational, retrospective study using clinical data of high-risk patients subjected to penetrating keratoplasty, who were treated with topical tacrolimus ointment 0.2 mg/g twice a day plus topical dexamethasone 0.1 mg/ml 6 id and compared it with a similar control group treated with topical dexamethasone 0.1 mg/ml 6 id alone. High-risk status was attributed to patients with previous ipsilateral corneal graft failure, two or more quadrants with corneal neovascularization or an infectious or inflammatory corneal disease. RESULTS: We analysed 53 patients in the trial group versus 53 patients in the control group, with similar age, baseline diagnosis and risk factors, and median follow-up times of 30 and and 24 months, respectively. Survival analysis showed a higher graft survival rate at all follow-up periods for patients treated with topical tacrolimus (p < 0.01). No adverse reactions were reported. DISCUSSION: This study shows that topical tacrolimus ointment increases the survival rate of the graft if added to the previous topical steroid regimen in high-risk patients. CONCLUSION: Topical tacrolimus is safe and effective in prolonging graft survival in high-risk patients.

The influence of personality on the quality of vision after multifocal intraocular lens implantation.

OBJECTIVE: To assess the possible correlation between patients' personality traits and subjective perception of quality of vision (QoV), after multifocal intraocular lens (mIOL) implantation. METHODS: patients who had bilateral implantation of a non-diffractive X-WAVE or a trifocal lens were assessed 6 months postoperatively. Patients answered the NEO-Five Factor Inventory (NEO-FFI-20) questionnaire ("Big Five five-factor personality model") to examine their personality. Six months following surgery, patients were asked to fill a QoV questionnaire where they graded the frequency of 10 common visual symptoms. Primary outcomes were to evaluate the correlation between personality scores and the reported frequency of visual disturbances. RESULTS: The study comprised 20 patients submitted to bilateral cataract surgery, 10 with a non-diffractive X-WAVE lens (AcrySof® IQ Vivity) and 10 with a trifocal lens (AcrySof® IQ PanOptix). Mean age was 60.23 (7.06) years. Six months following surgery, patients with lower scores of conscientiousness and extroversion reported a higher frequency of visual disturbances (blurred vision, P = .015 and P = .009, seeing double images P = .018 and P = .006, and having difficulties focusing, P = .027 and P = .022, respectively). In addition, patients with high neuroticism scores had more difficulty focusing (P = .033). CONCLUSIONS: In this study, personality traits such as low conscientiousness and extroversion and high neuroticism significantly influenced QoV perception 6 months after bilateral multifocal lens implantation. Patients' personality questionnaires could be a useful preoperative assessment test to a mIOL.

Comparison of outcomes between cross-linking plus topoguided excimer laser ablation and intrastromal corneal ring segments for keratoconus.

OBJECTIVE: To compare cross-linking (CXL) plus topography-guided photorefractive keratectomy (t-PRK) and intrastromal corneal ring segments (ICRS) in keratoconus patients, at 12 months of follow-up. METHODS: This was a longitudinal, retrospective multi-center study. We included a referred sample of 154 eyes from 149 patients with grade I-III Amsler-Krümeich keratoconus with insufficient corrected-distance visual acuity (CDVA). In group 1 (CXL plus t-PRK, 87 eyes), another possible indication for surgery was evidence of progression. Group 2 (ICRS, 67 eyes) included only eyes with paracentral keratoconus (thinnest point at the inferotemporal quadrant) with coincident axes, and evidence of stabilization was required. A subgroup analysis was performed regarding the disease topographic phenotype. At 12 months postoperatively, visual, refractive, and topographic outcomes were evaluated. RESULTS: Comparison of the outcomes between CXL plus t-PRK (group 1) and ICRS (group 2) showed similar improvements in CDVA (in group 1, CDVA improved 0.18 logMAR, and in group 2 0.12 logMAR, P = .18) and K2 (-2,45 [6.46] D in group 1 and -2.13 [1.67] D in group 2, P = .34) The improvement in cylinder power was greater in group 2 (-2.37 [2.07] D in group 2 versus -1.18 [2.63] D in group 1, P = .003); group 1 had a higher decrease in Kmax (- 3.26 [3.64] versus-1.74 [2.67], P = .001). CONCLUSIONS: Both CXL plus t-PRK and ICRS were equally effective in improving CDVA and topographic parameters in a similar group of keratoconus patients at 12 months.

Customized corneal crosslinking with excimer laser-assisted epithelium removal for progressive keratoconus: 1-year results.

PURPOSE: To evaluate the 1-year visual and tomographic results of customized crosslinking using excimer laser-assisted epithelium removal and topography-guided irradiation in the treatment of progressive keratoconus. SETTING: Coimbra Ophthalmology Unit, Private Practice, Coimbra, Portugal. DESIGN: Prospective nonrandomized clinical trial. METHODS: Eyes with documented progressive keratoconus were enrolled. After de-epithelialization with phototherapeutic keratectomy, customized UV irradiation was performed, designed as 3 concentric circular areas centered on the thinnest point (Mosaic System). Energy exposure was 5.4 J/cm 2 in the outer circle and then increased centripetally to 7.2 J/cm 2 and 10 J/cm 2 . Corrected distance visual acuity (CDVA), refractive outcomes, and Scheimpflug tomographies (Allegro Oculyzer) were assessed at baseline, and 6 months, and 12 months postoperatively. RESULTS: 37 eyes of 32 patients were enrolled in this prospective study. The mean diameter for treated areas was 6.17 ± 0.80 mm, 4.45 ± 0.47 mm, and 2.58 ± 0.14 mm for the outer, medium, and inner circle, respectively. At the 1-year follow-up, the mean CDVA improved significantly from 0.38 ± 0.19 to 0.20 ± 0.16 logMAR ( P < .01), with 34 (91.89%) of the 37 eyes retaining or improving CDVA. The mean preoperative minimum pachymetry decreased from 449.26 ± 41.62 to 443.26 ± 41.06 µm ( P = .02). The maximum keratometry decreased significantly from 58.50 ± 7.84 to 57.05 ± 7.27 diopters ( P < .01). After 1 year, 34 eyes (91.89%) showed no signs of progression. CONCLUSIONS: 1 year postoperatively, patients showed a significant improvement in visual acuity while achieving stabilization of disease progression.

Stability of Subnanometer MoS Wires under a Realistic Environment.

The interaction of small molecules with low-dimensional structures plays a major role in many important practical processes such as metal hydride formation, energy storage systems, and catalysis. In this work, we carried out first-principles density functional theory calculations of hydrogen and oxygen adsorption as well as their diffusion on subnanometer MoS nanowires. The nanowires are robust against adsorption of hydrogen. On the other hand, interaction with oxygen shows that the nanowires can oxidize with a small barrier (0.20 eV). In addition, our findings indicate that the interaction with hydrogen or oxygen does not modify the metallic character of the nanowire. The calculations also show that the singlet state is the most stable for 2O adsorbed on the MoS nanowire. Such results open the path for understanding the behavior of MoS nanowires under a realistic environment.

Electronic structure of molecular hydrogen in MoS2nanopores.

Atom controlled sub-nanometer MoS2pores have been recently fabricated with promising applications, such gas sensing, hydrogen storage and DNA translocation. In this work we carried out first-principles calculations of hydrogen adsorption in tiny MoS2nanopores. Some of the pores show metallic behaviour whereas others have a sizeable band gap. Whereas adsorption of molecular hydrogen on bare pores are dominated by physisorption, adsorption in the nanopores show chemisorption behaviour with high selectivity depending on the pore inner termination. Finally, we show that functionalization with copper atoms leads to does not improve dignificantly the adsorption energies of selected pores.

Exploring charge density distribution and electronic properties of hybrid organic-germanium layers.

Band gap tuning and dielectric properties of small organic ligands adsorbed on bidimensional germanium monolayers (germanene) have been investigated using first-principles calculations. We show that the adsorption of these small groups retains the initially stable free-standing pristine buckled structure form. Charge density and chemical bonding analyses show that the ligands are chemisorbed on the germanium layers. Finally, we demonstrate that the dielectric properties of the bare and ligand adsorbed germanene have a large anisotropy. Our findings of a finite gap open a path for the rational design of nanostructures with possible applications in biosensors and solar cells.

An adaptive design approach for defects distribution modeling in materials from first-principle calculations.

Designing and understanding the mechanism of non-stoichiometric materials with enhanced properties is challenging, both experimentally and even computationally, due to the large number of chemical spaces and their distributions through the material. In the current work, it is proposed a Machine Learning approach coupled with the Efficient Global Optimization (EGO) method-an Adaptive Design (AD)-to model local defects in materials from first-principle calculations. Our method takes into account the smallest sample set as possible, envisioning the material defect structure relationship with target properties for new insights. As an example, the AD framework allows us to study the stability and the structure of the modified goethite (Fe0.875Al0.125OOH) by considering a proper defect distribution, from first-principle calculations. The chemical space search for the modified goethite was evaluated by starting from different sizes and configurations of the samples as well as different surrogate models (ANN and Gaussian Process; GP), acquisition functions, and descriptors. Our results show that the same local solution of several defect arrangements in Fe0.875Al0.125OOH is found regardless of the initial sample and regression model. This indicates the efficiency of our search method. We also discuss the role of the descriptors in the accelerated global search for defects in material modeling. We conclude that the AD method applied in material defects is a successful approach in automating the search within huge chemical spaces from first-principle calculations by considering small samples. This method can be applied to mechanistic elucidation of non-stoichiometric materials, solid solutions, alloys, and Schottky and Frenkel defects, essential for material design and discovery. Graphical abstract.

Anterior Segment Optical Coherence Tomography in the Early Management of Microbial Keratitis: A Cross-Sectional Study.

INTRODUCTION: Infectious keratitis is an important cause of visual loss. The purpose of this study was to investigate anterior segment optical coherence tomography patterns in infectious keratitis and evaluate the role of this tool in the early management of this disorder. MATERIAL AND METHODS: In this cross-sectional study, we included patients with proven infectious keratitis, either by culture or therapeutic trial. Subjects underwent baseline anterior segment optical coherence tomography (Spectralis® anterior segment module, Heidelberg Engineering, Germany) performed by the same operator. We used anterior segment optical coherence tomography vertical and horizontal raster default scans with 6.0 mm scan lines. RESULTS: Twenty-five patients (14 men and 11 women) were included. The most common risk factors identified were ocular trauma (11 cases) and contact lens wear (7 cases). Fifteen patients presented bacterial infection; three, fungal infection; two parasitic infection; and five cases presented a negative microbiological culture. Anterior segment optical coherence tomography depicted nine distinct morphological patterns. DISCUSSION: Anterior segment optical coherence tomography allows the depth of corneal involvement to be assessed. When the only patterns identified were hyperreflective stromal lesion and stromal edema, the visual outcome was better. Cystic spaces were present in severe bacterial keratitis. CONCLUSION: Anterior segment optical coherence tomography can complement biomicroscopy, allowing for a better characterization of corneal involvement at presentation that can help in staging and providing useful prognostic information.

Introdução: As queratites infeciosas são uma causa importante de perda da acuidade visual. O objetivo deste estudo foi investigar padrões das queratites infeciosas na tomografia de coerência ótica do segmento anterior e avaliar o seu papel na orientação precoce desta patologia. Material e Métodos: Neste estudo transversal, incluímos doentes com queratite infeciosa comprovada, por cultura microbiológica ou prova terapêutica. Os doentes foram submetidos a tomografia de coerência ótica do segmento anterior na baseline (Spectralis® anterior segment module, Heidelberg Engineering, Germany) executados pelo mesmo operador. Adquiriram-se cortes verticais e horizontais de 6,0 mm com tomografia de coerência ótica spectral domain. Resultados: Foram incluídos 25 doentes (14 homens e 11 mulheres). Os fatores de risco mais comummente identificados foram o trauma ocular (11 casos) e o uso de lentes de contato (sete casos). Quinze doentes apresentaram infeção bacteriana, três infeção fúngica, dois infeção parasitária e cinco casos apresentaram culturas microbiológicas negativas. Distinguiram-se nove padrões morfológicos na tomografia de coerência ótica do segmento anterior. Discussão: A tomografia de coerência ótica do segmento anterior permite avaliar a profundidade do envolvimento corneano na queratite infeciosa. Quando os únicos padrões identificados eram a lesão estromal hiper-refletiva e edema estromal o outcome visual foi melhor. Os espaços quísticos observaram-se nas queratites bacterianas graves. Conclusão: A tomografia de coerência ótica do segmento anterior permite complementar a biomicroscopia, melhorar o estadiamento e fornecer informação prognóstica útil nas queratites infeciosas.

High pressure extraction of olive leaves (Olea europaea): bioactive compounds, bioactivity and kinetic modelling.

In this study, the extraction yield, the mathematical modeling of pressurized liquid extraction (PLE) kinetics with sub- and supercritical carbon dioxide (SC-CO2) of olive leaves (Olea europaea) and the biological activity of the extracts were evaluated. The extraction with PLE was conducted isobarically (10.3 MPa), varying the temperature (20, 40 and 60 °C) and the solvent (ethyl acetate, acetone, ethanol, ethanol:water-80:20, v:v), solvent flow (2 mL min-1) and time (110 min) and the extractions with SC-CO2, varying the temperature between 20 and 60 °C and the pressure between 8 and 25 MPa, keeping the time constant (210 min) and the CO2 flow of 2 mL min-1. In the extracts, antioxidant activity, total phenolic and flavonoid contents and oleuropein were evaluated. The highest total extract yield in the PLE was 30.91% at 60 °C, 10.3 MPa using ethanol:water (80:20, v:v). The yield obtained using the supercritical fluid was 0.68% at 60 °C and 25 MPa. The PLE extract obtained with ethanol at 60 °C presented the highest concentration of total phenolic content (386.42 mg GAE g-1 extract), total flavonoids content (33.43 mg CAT g-1 extract), oleuropein (73.65 mg g-1 extract) and antioxidant activity (82.87%). The overall extraction curves were modeled using the well-established Sovová model and kinetic extraction model based on the Brunauer-Emmett-Teller theory of adsorption. Both kinetic models used were able to correlate well with the experimental data with slightly better results obtained by the former. The alternative PLE extraction technique investigated in this work was found to be suitable for the extraction of olive leaves after short times of extraction obtaining an extract with high biological activities.

Salzmann nodular degeneration features in a case of Kabuki make-up syndrome.

Kabuki syndrome (KS) is a multiple congenital anomaly syndrome with diversified ophthalmological manifestations. We report a case of a boy with bilateral features of Salzmann nodular degeneration (SND) associated with KS. An 18-year-old Caucasian man with KS presented for a second opinion regarding incapacitating photophobia in his right eye, refractory to medical therapy. Biomicroscopy revealed bilateral subepithelial nodules in the midperiphery of the cornea, less extensive in the left eye, consistent with SND. Symptomatic improvement was achieved after superficial keratectomy, manually performed with a blade and adjuvant application of mitomycin C. We report a rare case of a KS patient with SND. Since KS manifestations may vary widely, it is important to perform an early ophthalmological examination for prompt detection and treatment of ocular abnormalities and thus improve life quality in these patients.

Posaconazole in the treatment of refractory Purpureocillium lilacinum (former Paecilomyces lilacinus) keratitis: the salvation when nothing works.

We report a case of a 41-year-old woman, wearer of contact lenses who was presented to the emergency room with a 2-month history of pain and red eye. She presented with a severe keratitis refractory to quinolones, fortified antibiotics and clotrimazole. Due to the risk of perforation, a tectonic penetrating keratoplasty (PK) was performed. Clinical signs of keratitis recurrence were observed and cultures were positive for Purpureocillium lilacinum (former Paecilomyces lilacinus) The patient did not improve on topical amphotericin B and intracameral voriconazole. Worsening of clinical condition required a new PK. Oral posaconazole was initiated postoperatively and suspended at the fourth postoperative month. The cornea remains clear until the last follow-up visit, 12 months after the second graft. To our knowledge, this is the second case report that documents the effectiveness of oral posaconazole in a refractory P. lilacinus keratitis, resistant to other second-generation triazoles and conventional antifungals.

Optical Properties Influence Visual Cortical Functional Resolution After Cataract Surgery and Both Dissociate From Subjectively Perceived Quality of Vision.

Purpose: To investigate the relation between optical properties, population receptive fields (pRFs), visual function, and subjectively perceived quality of vision after cataract surgery. Methods: The study includes 30 patients who had recently undergone bilateral sequential cataract surgery. We used functional magnetic resonance imaging and pRF modelling methods to assess pRF sizes across visual cortical regions (V1-V3). Subjects also performed a complete ophthalmologic and psychophysical examination and answered a quality of vision questionnaire. Results: Subjects with worse optical properties had, as predicted, larger pRF sizes. In addition, analysis in the primary visual cortex revealed significantly larger mean pRF sizes for operated subjects with worse contrast sensitivity (P = 0.038). In contrast, patients who scored high in the subjective "bothersome" dimension induced by dysphotic symptoms had surprisingly lower pRF size fitting interception (P = 0.012) and pRF size fitting slopes (P = 0.020), suggesting a dissociation between objective quality of vision and subjective appraisal. Conclusions: Optical properties of the eye influence pRF size. In particular, visual aberrations have a negative impact on visual cortical processing. A novel dissociation between subjective reports of quality of vision and pRF sizes was further identified. This suggests that patients with better cortical resolution may have a negative subjective response possibly because of improved perception of dysphotic phenomena. pRF properties represent a valuable quantitative measure to objectively evaluate quality of vision but do not necessarily predict subjective complaints.

Incidence of aflatoxin M1 in fresh milk from small farms

Abstract The objective of this work was to determine aflatoxin M1 in fresh milk from fifty-two small farms in the city of Concórdia - SC, Brazil. Samples from the cooling tanks of each property were collected from November 2014 to January 2015. The QuEChERS method was used for the extraction of aflatoxin M1, and quantification was performed in UHPLC-FL. 40.4% of the analyzed samples (eg, 21 samples) showed contamination levels by aflatoxin M1 above the maximum limit allowed by the Brazilian regulation, which is 0.5 μg L-1. These results suggest the importance of implementing Good Practices in obtaining feed for dairy cows, since the contamination of milk by aflatoxin M1 occurs through the biotransformation of aflatoxin B1, after the ingestion of feed or silage contaminated by the animals, posing risk to the animals themselves, as well as to consumers of milk and dairy products.

Functional magnetic resonance imaging to assess neuroadaptation to multifocal intraocular lenses.

PURPOSE: To evaluate the use of functional magnetic resonance imaging (MRI) to assess neuroadaptation to multifocal intraocular lenses (IOLs). SETTING: Faculty of Medicine, University of Coimbra, Coimbra, Portugal. DESIGN: Prospective case study. METHODS: Patients with bilateral diffractive IOL implantation after cataract surgery had functional MRI at postoperative intervals of 3 weeks and 6 months. A nonintervention control group was included as proof of concept. Functional stimuli consisted of sinusoidal gratings with threshold contrast and a light source to induce disability glare. Subjective quality of vision and reading performance were assessed and wavefront analyses were performed. RESULTS: The study comprised 30 patients in the study group and 15 in the control group. Glare decreased the functional MRI signal measured for sinusoidal gratings initially (3 weeks) but not at 6 months (P = .04), which was confirmed by contrast detection under glare improvement (P = .002). Patients showed increased activity of cortical areas involved in visual attention, procedural learning, effortful cognitive control, and goal-oriented behavior in the early postoperative period, which normalized at 6 months. There were no differences in aberrations, Strehl ratio, or modulation transfer function despite significant decreases in questionnaire symptom scores and visual acuity and reading performance improvements. The control group remained unchanged. CONCLUSIONS: Neuroadaptation to multifocal IOLs took place initially through recruitment of visual attentional and procedural learning networks. Thereafter, a form of long-term adaptation/functional plasticity occurred, leading to brain activity regularization toward a non-effort pattern. These findings, which reinforce the crucial role of higher-level brain regions in the perceptual construction of vision, were consistent with functional and questionnaire outcomes and were unrelated to optical properties.

Neurotrophic Keratopathy: Therapeutic Approach Using a Novel Matrix Regenerating Agent.

PURPOSE: To evaluate the efficacy and tolerance of a new matrix-regenerating agent (RGTA), Cacicol®, a polymer that mimics heparan sulfates bound to extracellular matrix proteins, avoiding its proteolysis, to treat neurotrophic keratopathy (NK). METHODS: Uncontrolled prospective clinical study performed between January 2014 and May 2016. Twenty-five patients (25 eyes) with corneal neurotrophic ulcers, nonresponsive to at least 2 weeks of conservative therapy, were treated with Cacicol, instilled once/twice a week. During follow-up, slit-lamp examination, anterior segment photography, fluorescein-dye testing, and best-corrected visual acuity were analyzed. Ulcer evolution was evaluated using image analysis software (ImageJ®) and healing defined as decrease of the corneal ulcer area. An independent observer measured ulcer area. RESULTS: All patients had complete corneal healing within an average of 4.13 ± 2.32 weeks. Mean ulcer area decreased significantly (P = 0.001) from 16.51% ± 18.56% (1st day) to 8.68% ± 11.25% at the 7th day and to 4.73% ± 10.75% at the 14th day. Compared with day 1, mean ulcer area decreased 60.24% after 7 days (P = 0.001), 54.92% after 14 days (P = 0.059), and 83.00% after 21 days (P = 0.003). Two cases of recurrence (8.0%) were registered. No systemic or local side effects were noticed. CONCLUSIONS: The new regenerating agent, Cacicol, represents an effective and safe therapy to treat NK.

Functional Magnetic Resonance Imaging to Assess the Neurobehavioral Impact of Dysphotopsia with Multifocal Intraocular Lenses.

PURPOSE: To investigate the association between dysphotopsia and neural responses in visual and higher-level cortical regions in patients who recently received multifocal intraocular lens (IOL) implants. DESIGN: Cross-sectional study. PARTICIPANTS: Thirty patients 3 to 4 weeks after bilateral cataract surgery with diffractive IOL implantation and 15 age- and gender-matched control subjects. METHODS: Functional magnetic resonance imaging (fMRI) was performed when participants viewed low-contrast grating stimuli. A light source surrounded the stimuli in half of the runs to induce disability glare. Visual acuity, wavefront analysis, Quality of Vision (QoV) questionnaire, and psychophysical assessment were performed. MAIN OUTCOME MEASURES: Cortical activity (blood oxygen level dependent [BOLD] signal) in the primary visual cortex and in higher-level brain areas, including the attention network. RESULTS: When viewing low-contrast stimuli under glare, patients showed significant activation of the effort-related attention network in the early postoperative period, involving the frontal, middle frontal, parietal frontal, and postcentral gyrus (multisubject random-effects general linear model (GLM), P < 0.03). In contrast, controls showed only relative deactivation (due to lower visibility) of visual areas (occipital lobe and middle occipital gyrus, P < 0.03). Patients also had relatively stronger recruitment of cortical areas involved in learning (anterior cingulate gyrus), task planning, and solving (caudate body). Patients reporting greater symptoms induced by dysphotic symptoms showed significantly increased activity in several regions in frontoparietal circuits, as well as cingulate gyrus and caudate nucleus (q < 0.05). We found no correlation between QoV questionnaire scores and optical properties (total and higher order aberration, modulation transfer function, and Strehl ratio). CONCLUSIONS: This study shows the association between patient-reported subjective difficulties and fMRI outcomes, independent of optical parameters and psychophysical performance. The increased activity of cortical areas dedicated to attention (frontoparietal circuits), to learning and cognitive control (cingulate), and to task goals (caudate) likely represents the beginning of the neuroadaptation process to multifocal IOLs.

Development of the Portuguese version of a standardized reading test: the Radner-Coimbra Charts.

PURPOSE: To develop 27 short sentence optotypes for the Portuguese version of the Radner Reading Charts. METHODS: Thirty-four Portuguese sentences were constructed following the concept of the Radner Reading Charts to obtain highly comparable sentences in terms of lexical difficulty, syntactical complexity, word length, number of syllables, and position of words. A long text (106 words) at the 5th grade reading level was also tested to assess the validity of the reading speeds obtained with the short sentences. The short sentences and long text were tested in 50 volunteers with similar educational backgrounds (mean age 30.98 years ± 6.99 years, range 19-47 years). Reading speeds were measured with a stop-watch and reported as words per minute (wpm). The reading time for each of the short sentences to be selected for the chart was defined as falling within the range of the mean ± 0.40 × standard deviation (SD). RESULTS: The overall mean reading speed for each of the short sentences was 235.43 ± 36.39 wpm. The 27 sentences with a mean between 220.8 and 250.0 wpm (overall mean ± 0.40 × SD) were selected for construction of the reading charts. The mean reading speed for the long text was 212.42 ± 26.20 wpm. Correlation between the selected short sentences and long text was high (r =0.86). Reliability analysis yielded an overall Cronbach's alpha coefficient of 0.97. CONCLUSIONS: The 27 short Portuguese sentences were highly comparable in terms of syntactical structure, number, position and length of words, lexical difficulty, and reading length. This reading test can overcome the limitations of the current tests for homogeneity and comparability, reducing subjectivity in the evaluation of the functional outcomes of medical and surgical ophthalmologic treatments.

Development of the Portuguese version of a standardized reading test: the Radner-Coimbra Charts / Desenvolvimento da versão portuguesa do teste padronizado de leitura: tabelas Radner-Coimbra

ABSTRACT Purpose: To develop 27 short sentence optotypes for the Portuguese version of the Radner Reading Charts. Methods: Thirty-four Portuguese sentences were constructed following the concept of the Radner Reading Charts to obtain highly comparable sentences in terms of lexical difficulty, syntactical complexity, word length, number of syllables, and position of words. A long text (106 words) at the 5th grade reading level was also tested to assess the validity of the reading speeds obtained with the short sentences. The short sentences and long text were tested in 50 volunteers with similar educational backgrounds (mean age 30.98 years ± 6.99 years, range 19-47 years). Reading speeds were measured with a stop-watch and reported as words per minute (wpm). The reading time for each of the short sentences to be selected for the chart was defined as falling within the range of the mean ± 0.40 × standard deviation (SD). Results: The overall mean reading speed for each of the short sentences was 235.43 ± 36.39 wpm. The 27 sentences with a mean between 220.8 and 250.0 wpm (overall mean ± 0.40 × SD) were selected for construction of the reading charts. The mean reading speed for the long text was 212.42 ± 26.20 wpm. Correlation between the selected short sentences and long text was high (r =0.86). Reliability analysis yielded an overall Cronbach's alpha coefficient of 0.97. Conclusions: The 27 short Portuguese sentences were highly comparable in terms of syntactical structure, number, position and length of words, lexical difficulty, and reading length. This reading test can overcome the limitations of the current tests for homogeneity and comparability, reducing subjectivity in the evaluation of the functional outcomes of medical and surgical ophthalmologic treatments.

RESUMO Objetivo: Desenvolver 27 frases-optotipo para a versão em português das tabelas de leitura de Radner. Métodos: Trinta e quatro frases em português foram elaboradas de acordo com o conceito das tabelas de leitura de Radner, de forma a obter frases-optotipo, altamente comparáveis em termos dificuldade lexical, complexidade sintática, tamanho das palavras, número de sílabas e posição das palavras. Foi também avaliado um texto longo (106 palavras) ao nível do 5o ano de escolaridade para determinar a validade dos resultados obtidos com as frases curtas. As frases curtas e o texto longo foram testados em 50 voluntários de nível acadêmico semelhante e média de idades de 30,98 anos ± 6,99 (intervalo de 19-47 anos). A velociade de leitura foi medida com cronômetro, de forma a obter o número de palavras por minuto (wpm). O intervalo válido para tempo de leitura das frases curtas foi definido como a média ± 0,40 x desvio padrão (SD). As frases mais semellhantes foram estatisticamente selecionadas para a construção das tabelas de leitura Radner-Coimbra. Resultados: A velocidade média de leitura obtida com as frases curtas foi 235,43 ± 36,39 wpm. As frases com velocidade média entre 220,8 e 250,0 palavras por minuto (média ± 0,40 x SD) foram selecionadas. Vinte e sete frases cumpriram este critério. A velocidade média de leitura do texto longo foi 212,42 ± 26,20 wpm. A correlação entre as frases curtas selecionadas e o texto longo foi alta (r=0,86). A análise de fiabilidade originou um coeficiente alfa de Cronbach de 0,97. Conclusões: As 27 frases em português são altamente semelhantes em termos de estrutura sintática, número, posição e comprimento das palavras, dificuldade lexical e duração da leitura. Este teste permite ultrapassar as limitações dos testes existentes em termos de homogeneidade e comparabilidade, reduzindo a subjetividade na avaliação dos resultados de terapêuticas médicas e cirúrgicas.