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1.
Vestn Oftalmol ; 137(2): 26-33, 2021.
Artigo em Russo | MEDLINE | ID: mdl-33881260

RESUMO

The active exploration of space requires minimizing negative effects induced by weightlessness (microgravity). Risk reduction can be achieved with the use of artificial gravity created by short-radius centrifuge (SRC). Short-radius centrifuge causes redistribution of body liquids towards the caudal portion of the body imitating a vertical human pose. Presently, studying the safety of this prevention method for the human body in general, and for the visual system in particular, is one of the priority tasks of space medicine. PURPOSE: To study the effects of artificial gravity on the perimetry measurements of the eye. MATERIAL AND METHODS: The study included 9 volunteers (men) aged 31.2±6 years (from 25 to 40 years). Each man was subjected to three rotations on SRC. The operative factor in the tests was overloads in the «head-pelvis¼ direction. Rotations were carried out in three different modes with varying maximum overload value at the feet level of up to 2.0; 2.4; 2.9 G. Pulsar-perimetry was carried out before and 1-2 hours after the rotations estimating the mean threshold of retinal photosensitivity Mean Sensitivity (MS), mean loss of sensitivity Mean Defect (MD), square root of Loss Variance (sLV); the Bebie curve; additionally, cluster analysis was performed. RESULTS: Mean threshold of retinal photosensitivity, mean loss of photosensitivity, square root of Loss Variance by Pulsar-perimetry before (MS=22.75 dB; MD= -0.6 dB; sLV=1.5) and after rotations on SRC (in Mode 1: 23.4; -0.2; 1.5, Mode 2: 23.2; -0.4; 1.4 and Mode 3: 23.5; -0.8; 1.4 respectively) did not change significantly. No adverse phenomena were detected in the eyes. CONCLUSIONS: There were no significant changes in the visual fields of the test subjects after rotations in three different modes according to Pulsar-perimetry data, which gives reason to tentatively conclude that using SCR in these modes is safe for the visual sensory system. According to preliminary data, this method can be successfully used to reduce the risk of long-term space flights and prevent unwanted phenomena caused by weightlessness.


Assuntos
Gravidade Alterada , Testes de Campo Visual , Adulto , Olho , Humanos , Masculino , Sensibilidade e Especificidade , Campos Visuais
2.
Cesk Slov Oftalmol ; 77(1): 22-26, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33740864

RESUMO

AIMS: The aim of the work is to verify the necessity of full-field perimetry test in incipient glaucoma. MATERIAL AND METHODS: The study included group of 16 incipient hypertension glaucoma (HTG group) patients without obvious changes in visual field and control group of 10 patients with normal ocular findings and value 1.0 of visual acuity. In both groups, full-field perimetry test was performed followed by a glaucoma perimetry test (rapid threshold strategy in both cases). Evaluated parameters were pattern defect (PD) and overall defect (OD) using Pearsons correlation coefficient. RESULTS: Strong correlation coefficient between PD (r = 0.74) and OD (r = 0.63) of both perimetry test were found in HTG group. Moderate correlation of PD (r = 0.54) and strong correlation of OD (r = 0.64) in control group. CONCLUSION: Results of the study shows, that expected changes of peripheral visual field will be recorded first in HTG group, but opposite is true. Perimetry glaucoma test is for incipient glaucoma sufficient to document the course and the examination of glaucoma disease.


Assuntos
Glaucoma , Hipertensão , Hipertensão Ocular , Glaucoma/complicações , Glaucoma/diagnóstico , Humanos , Pressão Intraocular , Testes de Campo Visual , Campos Visuais
3.
Zhonghua Yan Ke Za Zhi ; 57(3): 194-200, 2021 Mar 11.
Artigo em Chinês | MEDLINE | ID: mdl-33721958

RESUMO

Objective: To investigate and compare the sub-foveal choroidal thickness (SFCT) in both eyes of patients with unilateral primary open-angle glaucoma (POAG) and healthy controls. Methods: Cross-sectional study. Patients with unilateral POAG and healthy controls were recruited from September 2018 to September 2019 in the Beijing Tongren Hospital. All subjects underwent enhanced depth imaging optical coherence tomography. The SFCT was measured at the fovea, and at 500 µm, 1 000 µm and 2 000 µm nasal and temporal to the fovea. Paired t test was conducted to compare the choroidal thickness between affected POAG eyes and unaffected fellow eyes. Analysis of covariance was conducted to compare the choroidal thicknesses between POAG eyes and controls. Multiple regression analysis determined the association between choroidal thickness and age, gender, spherical equivalent and mean deviation. Results: Seventy-five patients with unilateral POAG (mean age, 46 years; 48 males, 27 females) and 61 healthy controls (mean age, 44 years; 34 males, 27 females) were included in this study. The SFCT of POAG eyes was (244.41±83.18) µm, which was not significantly different from their unaffected fellow eyes [(254.28±88.92) µm, P>0.05] and controls (right eyes) [(272.98±55.87) µm, P>0.05]. Choroidal thickness at 2 000 µm nasal to the fovea was significantly decreased in the glaucomatous eyes compared with the unaffected fellow eyes [(167.84±70.44) vs. (188.84±89.06) µm, t=-3.55; P<0.01]. There were no significant differences among the glaucomatous eyes, unaffected fellow eyes and healthy controls in choroidal thickness at 500 µm and 1 000 µm nasal and temporal to the fovea, as well as at 2 000 µm temporal to the fovea (all P>0.05). The SFCT of POAG eyes was associated with mean deviation (ß=14.66, P<0.05) and spherical equivalent (ß=14.95, P<0.01) but not with age and gender (both P>0.05). Conclusions: The SFCT of affected eyes in patients with unilateral POAG has no significant difference from unaffected fellow eyes and healthy controls. However, the choroidal thickness at 2 000 µm nasal to the fovea is thinner in the POAG eyes as compared with the fellow eyes. A thinner SFCT is correlated with the loss of visual field and a higher spherical equivalent in myopia. This may suggest a contributing role of the perfusion of the choroid in the pathogenesis of glaucoma. (Chin J Ophthalmol, 2021, 57: 194-200).


Assuntos
Corioide , Glaucoma de Ângulo Aberto , Adulto , Corioide/diagnóstico por imagem , Estudos Transversais , Feminino , Glaucoma de Ângulo Aberto/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia de Coerência Óptica , Campos Visuais
4.
Zhonghua Yan Ke Za Zhi ; 57(3): 201-206, 2021 Mar 11.
Artigo em Chinês | MEDLINE | ID: mdl-33721959

RESUMO

Objective: To evaluate the retinal vessel density in eyes with primary open-angle glaucoma (POAG) with single-hemifield visual field (VF) defects and its relationship to retinal nerve fiber layer (RNFL) thickness and visual field indices. Methods: Cross-sectional study. Twenty-eight POAG patients with single-hemifield VF defects and 31 normal controls were recruited from October 2015 to October 2018 in the Eye, Ear, Nose and Throat Hospital of Fudan University. All subjects underwent complete ophthalmological examinations, including RNFL, retinal ganglion cell complex (GCC) thickness and visual field tests, and the general information was collected. The peripapillary radial peripapillary capillaries (RPC) and macular superifical retinal capillary plexus (SCP) were derived from optical coherence tomography angiography. The retinal vessel density, structural values, and VF values were compared among the corresponding hemifields of POAG and healthy eyes using the Rank Sum test. Results: There were 16 males and 12 females in POAG patients, with the age of (47±12) years; there were no significant differences in gender distribution, age, intraocular pressure, central corneal thickness, axial length and intraocular perfusion pressure between POAG patients and the normal controls (all P>0.05). Among POAG patients, there were 19 cases with upper and 9 cases with lower visual field defect. In the POAG eyes, the vascular density of peripapillary RPC and macular SCP were 45.86% (34.92%-52.78%) and 39.31% (32.55%-46.79%), respectively. In the normal eyes, the vascular density of peripapillary RPC and macular SCP were 56.90% (51.69%-60.84%) and 47.48% (37.95%-52.25%), respectively. The difference was statistically significant (Z=-6.56, -5.86; both P<0.01). The RNFL and GCC thicknesses in the POAG group were 84.4 (62.1-97.1), 76.4 (60.3-92.5) µ m, respectively, which were smaller than those in normal controls [110.6 (95.7-131.6), 98.1 (84.0-109.2) µm; Z=-6.57, -6.36; both P<0.01]. In the POAG eyes, the peripapillary RPC [44.12% (34.73%-53.20%) vs. 51.85% (38.64%-61.02%); Z=-4.62; P<0.01] and macular SCP [36.81% (29.73%-47.82%) vs. 41.78% (33.93%-49.22%); Z=-4.12; P<0.01] vessel densities were reduced in the abnormal hemisphere compared with the opposite hemisphere. Compared with the normal eyes, the normal hemisphere of the POAG eyes had lower peripapillary RPC and macular SCP vessel densities (Z=-5.08, -4.95; both P<0.01), a thinner RNFL and a thinner retinal GCC [93.0 (61.9-116.5) µm vs. 110.6 (95.7-131.6) µm, Z=-5.15; 86.3 (67.2-98.2) µm vs. 98.1 (84.0-109.2) µm, Z=-5.35; both P<0.01]. But the mean deviation and pattern standard deviation values of the VF were not significantly different between them (both P>0.05). Conclusions: The retinal vessel density reduce in eyes with POAG with single-hemifield VF defects. The normal hemisphere of POAG eyes have a reduced retinal microcirculation along with the thinning of the RNFL and GCC, suggesting that vascular dysfunction and structural changes preceded VF loss in POAG. (Chin J Ophthalmol, 2021, 57: 201-206).


Assuntos
Glaucoma de Ângulo Aberto , Disco Óptico , Adulto , Estudos Transversais , Feminino , Humanos , Pressão Intraocular , Masculino , Pessoa de Meia-Idade , Fibras Nervosas , Vasos Retinianos/diagnóstico por imagem , Tomografia de Coerência Óptica , Campos Visuais
5.
Zhonghua Yan Ke Za Zhi ; 57(3): 207-214, 2021 Mar 11.
Artigo em Chinês | MEDLINE | ID: mdl-33721960

RESUMO

Objective: To evaluate the quality of life of patients with primary open-angle glaucoma (POAG) and its related factors in Wenzhou. Methods: Cross-sectional analysis. A total of 339 POAG patients diagnosed in the Wenzhou glaucoma progression study conducted in the Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University from March 2014 to October 2019 were included. Quality of life of POAG patients was assessed by EQ-5D including the visual analogue scale (VAS). The effects of gender, age, visual field loss (VFL), family history of glaucoma, hypertension, diabetes, migraine, sleep quality, and amateur exercise on the quality of life were analyzed. The utility value (UV) and VAS score were expressed as the median (P25, P75), and Mann-Whitney U was used for the comparison between two groups. Kruskal-Wallis H was performed to compare the differences among multiple groups. Results: A total of 339 POAG patients were included in the study; 164 were males (48.4%), and 175 were females (51.6%). The mean age was (63±10) years. Thirty-four patients (10.0%) had received medication (including one with combined surgical treatment), while the remaining 305 patients (90.0%) had received no anti-glaucoma treatment. Among the patients, 10.5% (32/305) had no VFL, 68.9% (210/305) had mild VFL, 17.0% (52/305) had moderate VFL, and 3.6% (11/305) had severe VFL. In all patients, the median of UV was 1.000 (1.000, 1.000), the mean of UV was 0.964, and the median of VAS score was 80 (75, 90), the mean of VAS score was 81.58. Anxiety or depression and pain or discomfort occurred in 45.7% (43/94) and 34.1% (32/94), respectively, of POAG patients with decreased UVs, as well as mobility constraints in 13.8 % (13/94) and usual activity constraints in 6.4% (6/94). The median of UV of the eye with a better visual field in the group without VFL or with mild or moderate VFL was 1.000 (1.000, 1.000), and in the group with severe VFL was 1.000 (0.862, 1.000), but there was no significant difference in the UV and the VAS score of the eye with a better visual field among groups with different degrees of VFL (both P>0.05). There was statistically significant difference in the UV among groups with different sleep qualities (H=17.465; P<0.01). Using pairwise comparison, the median of UV of the very good sleep group was 1.000 (1.000, 1.000), significantly different to the slightly poor sleep group 1.000 (0.866, 1.000) (z=3.613; P<0.05). The median of UV in patients with migraine was 1.000 (0.875, 1.000), without migraine 1.000 (1.000, 1.000), and in patients with hypertension was 1.000 (0.875, 1.000), without hypertension 1.000 (1.000, 1.000), and in patients with diabetes was 1.000 (0.875, 1.000), without diabetes was 1.000 (1.000, 1.000), the difference was statistically significant (Z=-2.189, -3.864, -2.417; all P<0.05). The UV was not related to age, gender, family history of glaucoma, amateur exercise, alcohol and tobacco, and history of anti-glaucoma medication (all P>0.05). Conclusions: VFL is related to the UV of POAG patients in Wenzhou. Quality of life in mild POAG patients is good but decrease in advanced POAG patients. Sleep quality, systemic complications and physical or psychological discomfort impact on quality of life in POAG patients. (Chin J Ophthalmol, 2021, 57: 207-214).


Assuntos
Glaucoma de Ângulo Aberto , Qualidade de Vida , Idoso , Estudos Transversais , Feminino , Humanos , Pressão Intraocular , Masculino , Pessoa de Meia-Idade , Campos Visuais
6.
Nat Commun ; 12(1): 1900, 2021 03 26.
Artigo em Inglês | MEDLINE | ID: mdl-33772000

RESUMO

The computations performed by a neural circuit depend on how it integrates its input signals into an output of its own. In the retina, ganglion cells integrate visual information over time, space, and chromatic channels. Unlike the former two, chromatic integration is largely unexplored. Analogous to classical studies of spatial integration, we here study chromatic integration in mouse retina by identifying chromatic stimuli for which activation from the green or UV color channel is maximally balanced by deactivation through the other color channel. This reveals nonlinear chromatic integration in subsets of On, Off, and On-Off ganglion cells. Unlike the latter two, nonlinear On cells display response suppression rather than activation under balanced chromatic stimulation. Furthermore, nonlinear chromatic integration occurs independently of nonlinear spatial integration, depends on contributions from the rod pathway and on surround inhibition, and may provide information about chromatic boundaries, such as the skyline in natural scenes.


Assuntos
Potenciais de Ação/fisiologia , Retina/fisiologia , Células Ganglionares da Retina/fisiologia , Campos Visuais/fisiologia , Vias Visuais/fisiologia , Potenciais de Ação/efeitos dos fármacos , Algoritmos , Animais , Cor , Feminino , HEPES/farmacologia , Masculino , Camundongos Endogâmicos C57BL , Dinâmica não Linear , Estimulação Luminosa/métodos , Piridazinas/farmacologia , Retina/citologia , Estricnina/farmacologia
7.
Nat Commun ; 12(1): 1757, 2021 03 19.
Artigo em Inglês | MEDLINE | ID: mdl-33741947

RESUMO

Voluntary allocation of visual attention is controlled by top-down signals generated within the Frontal Eye Fields (FEFs) that can change the excitability of lower-level visual areas. However, the mechanism through which this control is achieved remains elusive. Here, we emulated the generation of an attentional signal using single-pulse transcranial magnetic stimulation to activate the FEFs and tracked its consequences over the visual cortex. First, we documented changes to brain oscillations using electroencephalography and found evidence for a phase reset over occipital sites at beta frequency. We then probed for perceptual consequences of this top-down triggered phase reset and assessed its anatomical specificity. We show that FEF activation leads to cyclic modulation of visual perception and extrastriate but not primary visual cortex excitability, again at beta frequency. We conclude that top-down signals originating in FEF causally shape visual cortex activity and perception through mechanisms of oscillatory realignment.


Assuntos
Lobo Frontal/fisiologia , Estimulação Magnética Transcraniana/métodos , Córtex Visual/fisiologia , Campos Visuais/fisiologia , Percepção Visual/fisiologia , Adulto , Algoritmos , Eletroencefalografia/métodos , Feminino , Humanos , Masculino , Modelos Neurológicos , Lobo Occipital/fisiologia , Estimulação Luminosa
8.
Int J Mol Sci ; 22(4)2021 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-33669876

RESUMO

We present a long-term follow-up in autosomal dominant gyrate atrophy-like choroidal dystrophy (adGALCD) and propose a possible genotype/phenotype correlation. Ophthalmic examination of six patients from two families revealed confluent areas of choroidal atrophy resembling gyrate atrophy, starting in the second decade of life. Progression continued centrally, reaching the fovea at about 60 years of age. Subretinal deposits, retinal pigmentation or choroidal neovascularization as seen in late-onset retinal degeneration (LORD) were not observed. Whole genome sequencing revealed a novel missense variant in the C1QTNF5 gene (p.(Q180E)) which was found in heterozygous state in all affected subjects. Haplotype analysis showed that this variant found in both families is identical by descent. Three-dimensional modeling of the possible supramolecular assemblies of C1QTNF5 revealed that the p.(Q180E) variant led to the destabilization of protein tertiary and quaternary structures, affecting both the stability of the single protomer and the entire globular head, thus exerting detrimental effects on the formation of C1QTNF5 trimeric globular domains and their interaction. In conclusion, we propose that the p.(Q180E) variant causes a specific phenotype, adGALCD, that differs in multiple clinical aspects from LORD. Disruption of optimal cell-adhesion mechanisms is expected when analyzing the effects of the point mutation at the protein level.


Assuntos
Corioide/patologia , Colágeno/genética , Genes Dominantes , Atrofia Girata/genética , Adolescente , Adulto , Idade de Início , Colágeno/química , Progressão da Doença , Feminino , Seguimentos , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Moleculares , Mutação de Sentido Incorreto , Linhagem , Fenótipo , Domínios Proteicos , Eletricidade Estática , Tomografia de Coerência Óptica , Campos Visuais
9.
Ophthalmologe ; 118(5): 512-516, 2021 May.
Artigo em Alemão | MEDLINE | ID: mdl-33740090

RESUMO

The focus of this large multicenter trial commissioned by the Joint Federal Committee (Gemeinsamer Bundesausschuss, G­BA) is to determine a benefit of transcorneal electrical stimulation for retinitis pigmentosa (RP) patients. The main criterion for benefit is the kinetic visual field and whether the deterioration progresses more slowly in the study eyes compared to the sham-stimulated fellow eyes over a treatment period of 3 years.


Assuntos
Terapia por Estimulação Elétrica , Retinite Pigmentosa , Humanos , Estudos Multicêntricos como Assunto , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto , Retinite Pigmentosa/diagnóstico , Retinite Pigmentosa/terapia , Resultado do Tratamento , Campos Visuais
10.
Int J Mol Sci ; 22(5)2021 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-33673512

RESUMO

In this retrospective, longitudinal, observational cohort study, we investigated the phenotypic and genotypic features of retinitis pigmentosa associated with variants in the PDE6B gene. Patients underwent clinical examination and genetic testing at a single tertiary referral center, including best-corrected visual acuity (BCVA), kinetic visual field (VF), full-field electroretinography, full-field stimulus threshold, spectral domain optical coherence tomography, and fundus autofluorescence imaging. The genetic testing comprised candidate gene sequencing, inherited retinal disease gene panel sequencing, whole-genome sequencing, and testing for familial variants by Sanger sequencing. Twenty-four patients with mutations in PDE6B from 21 families were included in the study (mean age at the first visit: 32.1 ± 13.5 years). The majority of variants were putative splicing defects (8/23) and missense (7/23) mutations. Seventy-nine percent (38/48) of eyes had no visual acuity impairment at the first visit. Visual acuity impairment was mild in 4% (2/48), moderate in 13% (6/48), and severe in 4% (2/48). BCVA was symmetrical in the right and left eyes. The kinetic VF measurements were highly symmetrical in the right and left eyes, as was the horizontal ellipsoid zone (EZ) width. Regarding the genetic findings, 43% of the PDE6B variants found in our patients were novel. Thus, this study contributed substantially to the PDE6B mutation spectrum. The visual acuity impairment was mild in 83% of eyes, providing a window of opportunity for investigational new drugs. The EZ width was reduced in all patients and was highly symmetric between the eyes, making it a promising outcome measure. We expect these findings to have implications on the design of future PDE6B-related retinitis pigmentosa (RP) clinical trials.


Assuntos
Nucleotídeo Cíclico Fosfodiesterase do Tipo 6/genética , Mutação , Fenótipo , Retinite Pigmentosa/genética , Adolescente , Adulto , Criança , Eletrorretinografia , Proteínas do Olho/genética , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Retinite Pigmentosa/metabolismo , Retinite Pigmentosa/fisiopatologia , Estudos Retrospectivos , Análise de Sequência de DNA , Tomografia de Coerência Óptica , Acuidade Visual , Campos Visuais , Adulto Jovem
11.
Medicine (Baltimore) ; 100(8): e24513, 2021 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-33663058

RESUMO

ABSTRACT: To compare visual function of 2-wall (medial and lateral) versus 3-wall (medial, lateral, and inferior) orbital decompression in patients with dysthyroid optic neuropathy (DON).A total of 52 eyes of 37 patients underwent orbital decompression for DON between 2013 and 2019 were retrospectively reviewed. Two- or 3-wall decompression was performed in 31 eyes of 23 patients and 21 eyes of 14 patients, respectively. We examined best-corrected visual acuity (BCVA), visual field mean deviation (MD) and pattern standard deviation (PSD), pattern-reversed visual evoked potential (PVEP) for P100 latency and amplitude at 60 and 15 arcmin stimulation checkerboard size, as well as proptosis using Hertel exophthalmometry.Whether 2-wall or 3-wall decompression, all parameters of visual function were improved after surgery (all P < .05). The improvement in BCVA, MD, and PSD was not statistically significant between groups (all P > .05). Proptosis reduction was higher after 3-wall decompression (P = .011). Mean increase in P100 amplitude after 3-wall decompression was statistically higher than that of after 2-wall decompression at 60 and 15 arcmin (P = .045 and .020, respectively), while the mean decrease in P100 latency was similar between the groups (P = .821 and .655, respectively). Six patients (66.67%) had persistent postoperative diplopia and 1 patient (20%) had new-onset diplopia in 3-wall decompression group, which were higher than in 2-wall decompression group (46.15% persistent postoperative diplopia and no new-onset diplopia).Both 2-wall and 3-wall decompression can effectively improve visual function of patients with DON. Three-wall decompression provides better improvement in P100 amplitude and proptosis, however new-onset diplopia is more common with this surgical technique.


Assuntos
Descompressão Cirúrgica/métodos , Oftalmopatia de Graves/cirurgia , Órbita/cirurgia , Percepção Visual , Adulto , Fatores Etários , Idoso , Potenciais Evocados Visuais , Feminino , Oftalmopatia de Graves/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Sexuais , Testes de Função Tireóidea , Fumar Tabaco/epidemiologia , Acuidade Visual , Campos Visuais
12.
Indian J Ophthalmol ; 69(4): 989-991, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33727475

RESUMO

Ocular manifestations of COVID-19 are still being studied. Posterior segment involvement in viral entities is either direct viral involvement or a delayed immune response to the antigen. A 22-year-old woman presented with history of perceiving absolute inferior scotoma in the right eye for 4 days and history of fever and sore throat 10 days ago. Fundus examination revealed disc edema and vessel tortuosity. Humphreys Field Analyzer confirmed inferior field defect and Optical Coherence Tomography showed superior, nasal and inferior retinal nerve fiber layer thickening in the right eye. Patient was positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcription polymerase chain reaction (RT-PCR) testing. Patient received three doses of injection methylprednisolone over 3 days. There was subjective resolution of scotoma reported 3 weeks posttreatment. We bring forward the first reported case of parainfectious optic neuritis associated with COVID-19.


Assuntos
/diagnóstico , Infecções Oculares Virais/diagnóstico , Papiledema/diagnóstico , Escotoma/diagnóstico , Campos Visuais/fisiologia , /tratamento farmacológico , Infecções Oculares Virais/tratamento farmacológico , Infecções Oculares Virais/virologia , Feminino , Glucocorticoides/uso terapêutico , Humanos , Metilprednisolona/uso terapêutico , Papiledema/tratamento farmacológico , Papiledema/virologia , Escotoma/tratamento farmacológico , Escotoma/virologia , Tomografia de Coerência Óptica , Acuidade Visual , Testes de Campo Visual , Adulto Jovem
13.
Arq Bras Oftalmol ; 84(2): 113-120, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33567005

RESUMO

PURPOSE: To compare the use of visual field and/or optical coherence tomography (OCT) combined with color retinography by non-glaucoma specialists for differentiating glaucoma from physiological cupping. METHODS: Eighty patients with glaucoma or physiological cupping (40 of each) were randomized according to the examination used (GI: color retinography, GII: color retinography + visual field, GIII: color retinography + optical coherence tomography, GIV: color retinography + visual field + optical coherence tomography). Twenty non-specialist ophthalmologists diagnosed glaucoma from PowerPoint slide images, without direct patient examination. RESULTS: Inter-examiner agreement was good for GII (ĸ: 0.63; 95%CI, 0.53-0.72), moderate for GIII (ĸ: 0.58; 95%CI, 0.48-0.68) and GIV (ĸ: 0.41; 95%CI, 0.31-0.51), and low for GI (ĸ: 0.30; 95%CI, 0.20-0.39) (p<0.001). Diagnostic accuracy was higher in GIII (15.8 ± 1.82) than GI (12.95 ± 1.46, p<0.001) and higher in GII (16.25 ± 2.02) than GI and GIV (14.10 ± 2.24) (both p<0.001). For glaucoma patients only, diagnostic accuracy in GII and GIII was superior to that in GI and GIV (both p<0.001). Sensitivity and specificity were 59% and 70.5% in GI; 86.5% and 76% in GII, 86.5% and 71.5% in GIII; and 68.5% and 72.5% in GIV, respectively. Accuracy was highest in GII (81.3% [95%CI, 77.1-84.8]), followed by GIII (79% [95%CI, 74.7-82.7]), GIV (70,5% [95%CI, 65.9-74.8]), and GI (64.8% [95%CI, 60.0-69.3]). CONCLUSIONS: Non-glaucoma specialists could not differentiate glaucoma from increased physiological cupping when using color retinography assessment alone. Diagnostic accuracy and inter-rater agreement improved significantly with the addition of visual field or optical coherence tomography. However, the use of both modalities did not improve sensitivity/specificity.


Assuntos
Glaucoma , Tomografia de Coerência Óptica , Glaucoma/diagnóstico por imagem , Humanos , Especialização , Testes de Campo Visual , Campos Visuais
14.
Neuron ; 109(7): 1227-1241.e5, 2021 04 07.
Artigo em Inglês | MEDLINE | ID: mdl-33592180

RESUMO

Normative theories and statistical inference provide complementary approaches for the study of biological systems. A normative theory postulates that organisms have adapted to efficiently solve essential tasks and proceeds to mathematically work out testable consequences of such optimality; parameters that maximize the hypothesized organismal function can be derived ab initio, without reference to experimental data. In contrast, statistical inference focuses on the efficient utilization of data to learn model parameters, without reference to any a priori notion of biological function. Traditionally, these two approaches were developed independently and applied separately. Here, we unify them in a coherent Bayesian framework that embeds a normative theory into a family of maximum-entropy "optimization priors." This family defines a smooth interpolation between a data-rich inference regime and a data-limited prediction regime. Using three neuroscience datasets, we demonstrate that our framework allows one to address fundamental challenges relating to inference in high-dimensional, biological problems.


Assuntos
Interpretação Estatística de Dados , Neurologia/estatística & dados numéricos , Algoritmos , Animais , Teorema de Bayes , Caenorhabditis elegans/fisiologia , Simulação por Computador , Bases de Dados Factuais , Entropia , Humanos , Modelos Neurológicos , Neurônios/fisiologia , Retina/fisiologia , Córtex Visual/fisiologia , Campos Visuais/fisiologia
15.
Laterality ; 26(1-2): 106-129, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33593226

RESUMO

The visual system and lifestyle characteristics make the even-toed ungulates an excellent model for the studies of behavioural lateralization. Recent research has focused on these mammals providing evidence of lateralization in a wide range of behaviours. This provides an opportunity for the collation of the current theoretical assumptions and the existing empirical evidence for visual lateralization in artiodactyls. In the present study, we aim first to gain a fuller picture of hemispheric specializations in saiga antelopes by investigating the lateralization of vigilance and novel object inspection in the wild. Second, we summarized the results of the research into visual lateralization in even-toed ungulates and attempted to assess the applicability of two popular hypotheses about the division of hemispheric roles. The results on saigas show a significant preference for head turns to the right visual field during vigilance which was more robust in individuals in larger groups. When an unfamiliar artificial object was placed in their natural setting, saigas preferentially viewed it predominantly with the right eye. These results, together with the cumulative evidence in artiodactyls, do not follow either the approach-withdrawal or positivity-negativity dichotomous patterns widely used to explain the division of functions between the hemispheres.


Assuntos
Antílopes , Animais , Lateralidade Funcional , Humanos , Campos Visuais
16.
BioDrugs ; 35(2): 201-214, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33566264

RESUMO

BACKGROUND: Leber hereditary optic neuropathy (LHON) is a maternally inherited mitochondrial disease whose primary clinical manifestation is bilateral visual loss. Only a single therapy, idebenone, is approved in Europe for use in exceptional circumstances and no therapy is currently approved in the USA. LHON remains a disease with a high unmet medical need. OBJECTIVE: This is a report of an open-label, single-center, dose-escalation study that evaluated the safety and tolerability of lenadogene nolparvovec in 15 subjects with LHON for up to 5 years following a single intravitreal injection at four dose levels. METHODS: Subjects were enrolled sequentially in four cohorts followed by an additional cohort at the dose selected, and safety was assessed by an independent data safety monitoring board (DSMB) prior to any dose escalation. RESULTS: Overall, the treatment was well tolerated during the 5-year follow-up. No serious adverse events were considered related to treatment, no unexpected adverse events occurred, and no grade 3 or 4 Common Terminology Criteria for Adverse Events were reported. Anterior chamber inflammation and vitritis were mostly managed with topical steroids, and ocular inflammation was considered to be dose limiting by the DSMB based on the benefits/risks for the subjects. Analysis of the logarithm of the minimal angle of resolution (LogMAR) visual acuity in both treated and untreated eyes showed clinically relevant and durable improvements compared with baseline. Mean improvements of - 0.44 and - 0.49 LogMAR for treated and untreated eyes, respectively, were noted, with a mean (± standard deviation) final value of LogMAR + 1.96 ± 0.60 and + 1.65 ± 0.34, respectively, at 5 years post-treatment administration. For the six subjects treated with the optimal dose level (9 × 1010 viral genomes [vg]/eye), the mean visual acuity improvement from baseline reached - 0.68 LogMAR for treated eyes and - 0.64 LogMAR for untreated eyes, with a mean final value of LogMAR + 1.77 ± 0.52 and + 1.78 ± 0.34, respectively. While there was a meaningful improvement in visual acuity for REVEAL subjects, the final visual acuity was less favorable than that seen in the two subsequent pivotal phase III studies in which subjects were treated earlier during the course of their disease. CONCLUSION: Lenadogene nolparvovec was well tolerated with a good safety profile during 5 years of follow-up and may offer meaningful lasting improvements in vision for this LHON population. CLINICAL TRIAL NUMBER: EUDRACT N° 2013-001405-90.


Assuntos
Atrofia Óptica Hereditária de Leber , Europa (Continente) , Terapia Genética , Humanos , Mutação , Atrofia Óptica Hereditária de Leber/tratamento farmacológico , Atrofia Óptica Hereditária de Leber/genética , Tomografia de Coerência Óptica , Campos Visuais
18.
Artigo em Inglês | MEDLINE | ID: mdl-33435305

RESUMO

Purpose: The aim of this study was to identify and analyse the quality of life of patients with primary open-angle glaucoma (POAG) based on their visus and peripheral vision. Methods: Our study was observational in nature; it was a cross-sectional study. In total, 119 patients with POAG were included in a causal-comparative character, ex post facto research design. The authors collected data using the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25) and World Health Organization Quality of Life abbreviated version questionnaire (WHOQOL-BREF) tools. Results: Only patients with POAG that were over 18 years of age and had no other ocular or chronic illnesses were included. The mean duration of glaucoma was 8.77 (SD ± 5.63) years. Binocular disability was observed in 68.0% of patients. Using WHOQOL-BREF, there were significant differences found in the better-eye-vision group in psychological (p < 0.001) and environment (p < 0.001) domains. In the worse-eye-vision group, significant differences were found in physical health (p < 0.001), environment (p < 0.001), and quality related to health (p < 0.001) domains. Using NEI VFQ-25, there were significant differences found (p = 0.000) in all domains except subscale driving. Conclusion: Quality of life of patients with visual impairment is significantly lower in comparison to that of patients without a visual impairment.


Assuntos
Glaucoma , Qualidade de Vida , Adolescente , Adulto , Estudos Transversais , Glaucoma/epidemiologia , Humanos , Eslováquia/epidemiologia , Inquéritos e Questionários , Acuidade Visual , Campos Visuais
19.
J Glaucoma ; 30(3): 219-222, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33394847

RESUMO

PRECIS: Designing and demonstrating an experiment that shows the risk of airborne transmission of COVID-19 between patients having visual fields analyzed is low. PURPOSE: The aim was to investigate the possibility of airborne transmission of COVID-19 during Humphrey visual field testing in a real-world scenario. METHODS: A particle counter was placed within the bowl of Humphrey visual field analyzer (HFA) before and after turning on the machine to ascertain the effect of the air current produced by the ventilation system on aerosols. A second experiment was run where the particle counter was placed in the bowl and recorded particulates, in the air, as a 24-2 SITA standard was performed by a mock patient and then again immediately after the patient had moved away. We measured aerosol particle counts sized ≤0.3 µm, >0.3≤0.5 µm, >0.5≤1 µm, >1≤2.5 µm, >2.5≤5 µm, and >5≤10 µm. RESULTS: Particulates of all sizes were shown to be significantly reduced within the bowl after turning the machine on, demonstrating that the air current produced by the HFA pushes air out of the bowl and it cannot stagnate. There was no significant difference in measurement of aerosol while there was a patient performing the test and immediately after they had moved away, suggesting that aerosols breathed out by the patient are not able to remain in suspension in the bowl because of the ventilation current. CONCLUSION: There is no significant difference between aerosol count in the bowl of a HFA before, during and after testing. This suggests the risk of airborne transmission of COVID-19 is low between subsequent patients. This is in keeping with manufacturer's guidance on Humphrey visual field testing.


Assuntos
Aerossóis/efeitos adversos , Transmissão de Doença Infecciosa/prevenção & controle , Hipertensão Ocular/diagnóstico , Testes de Campo Visual/métodos , Campos Visuais/fisiologia , /epidemiologia , Comorbidade , Humanos , Pressão Intraocular/fisiologia , Hipertensão Ocular/epidemiologia , Hipertensão Ocular/fisiopatologia
20.
Curr Opin Ophthalmol ; 32(2): 92-97, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33443958

RESUMO

PURPOSE OF REVIEW: Perimetry remains important for the diagnosis and management of glaucoma despite advances in imaging technology. The purpose of this review is to describe advances in the acquisition and analysis of visual field data and highlight novel techniques for performing perimetry. RECENT FINDINGS: Studies have focused on improving the detection of patients at highest risk of severe vision loss and the development of innovative testing strategies that allow for more frequent testing. Artificial intelligence has been utilized in research settings to improve detection and characterization of glaucomatous field damage. Furthermore, tablet-based strategies and virtual reality headsets show promise for glaucoma screening and remote monitoring of patients with glaucoma. SUMMARY: New testing strategies and research findings have improved our ability to identify patients with both paracentral and mid-peripheral visual field progression. New strategies have the potential to make visual field testing more efficient, reliable and accessible for patients with glaucoma.


Assuntos
Glaucoma/diagnóstico , Transtornos da Visão/diagnóstico , Testes de Campo Visual/métodos , Campos Visuais/fisiologia , Inteligência Artificial , Progressão da Doença , Humanos , Transtornos da Visão/fisiopatologia
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