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1.
Science ; 367(6482): 1112-1119, 2020 03 06.
Artigo em Inglês | MEDLINE | ID: mdl-32139539

RESUMO

The genome versus experience dichotomy has dominated understanding of behavioral individuality. By contrast, the role of nonheritable noise during brain development in behavioral variation is understudied. Using Drosophila melanogaster, we demonstrate a link between stochastic variation in brain wiring and behavioral individuality. A visual system circuit called the dorsal cluster neurons (DCN) shows nonheritable, interindividual variation in right/left wiring asymmetry and controls object orientation in freely walking flies. We show that DCN wiring asymmetry instructs an individual's object responses: The greater the asymmetry, the better the individual orients toward a visual object. Silencing DCNs abolishes correlations between anatomy and behavior, whereas inducing DCN asymmetry suffices to improve object responses.


Assuntos
Encéfalo/crescimento & desenvolvimento , Drosophila melanogaster/crescimento & desenvolvimento , Individualidade , Neurogênese , Campos Visuais/fisiologia , Vias Visuais/crescimento & desenvolvimento , Animais , Encéfalo/anatomia & histologia , Drosophila melanogaster/genética , Variação Genética , Orientação/fisiologia , Vias Visuais/anatomia & histologia
3.
Curr Opin Ophthalmol ; 31(2): 107-113, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31895152

RESUMO

PURPOSE OF REVIEW: Patients with glaucoma with disease progression despite low or normal intraocular pressure (IOP) present special challenges to the treating clinician. Treatment goals may depend on whether patients have apparent low IOP with concurrent treatment or have low IOP at baseline without treatment. We review the diagnostic and therapeutic approaches to these patients. RECENT FINDINGS: Apparent progression at low IOP should start with confirmation of IOP, made easier by devices enabling patient home self-tonometry. Suspected visual field progression should be confirmed by repeat testing prior to advancement of therapy. Trabeculectomy remains the most effective surgical method of achieving long-term success, particularly when there is a low starting IOP. Drainage tube implantation or the use of novel micro-incisional non-bleb-forming procedures are less likely to be successful in achieving low IOP goals. SUMMARY: Diagnostic testing is important in confirming progressive glaucomatous disease at low IOP levels. The most effective way of slowing the progression of glaucoma in a patient with low IOP is to lower the IOP further, sometimes to single digit levels, which is most often achievable with trabeculectomy.


Assuntos
Glaucoma de Ângulo Aberto/fisiopatologia , Glaucoma de Ângulo Aberto/cirurgia , Pressão Intraocular/fisiologia , Trabeculectomia , Progressão da Doença , Implantes para Drenagem de Glaucoma , Glaucoma de Ângulo Aberto/diagnóstico , Humanos , Tonometria Ocular , Campos Visuais/fisiologia
5.
Eur J Ophthalmol ; 30(1): 175-180, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30644317

RESUMO

AIM: To find out and compare various predictors of glaucoma-related visual impairments in primary and secondary glaucoma. METHODS: A prospective observational study of patients, who were above 30 years of age. They were diagnosed as primary/secondary glaucoma with visual acuity <20/200 Snellen's/visual field showing less than 20° isopter in at least one eye, with a minimum follow-up of one year at a tertiary center. Patients were classified into advanced and end-stage glaucoma and outcome was assessed according to visual acuity and visual fields to see predictors of visual impairments. RESULTS: There were 169 (99 primary/70 secondary) glaucoma patients with mean age of 62.67 ± 11.9 and 54.65 ± 15.26 years, respectively. Trauma (21.4%), complicated cataract surgery (15.7%), and silicon oil tamponade (14.3%) were common causes of secondary glaucoma. There was significant delay in diagnosis in primary compared to secondary glaucoma (57.57% vs 32.85%) and non-compliance was significantly higher in primary glaucoma (34.3% vs 17.1%, p = 0.01). In univariate analysis, literacy, income status, locality, and delayed or missed diagnosis were found to be significant (p < 0.05) according to visual acuity criteria. Out of the 33 patients who had undergone glaucoma filtration surgery, 18 (54.5%) were in the end-stage group. While 105 (77.2%) of 136 patients who were not subjected to any glaucoma filtration surgery reached end-stage glaucoma as per visual fields criteria (p = 0.011). CONCLUSION: Lack of awareness, delayed diagnosis, low literacy, and income were associated with poor visual outcome. Patients who underwent glaucoma filtration surgery had significantly better visual outcome in comparison to patients managed medically.


Assuntos
Glaucoma de Ângulo Fechado/diagnóstico , Glaucoma de Ângulo Aberto/diagnóstico , Transtornos da Visão/diagnóstico , Adulto , Idoso , Feminino , Cirurgia Filtrante , Glaucoma de Ângulo Fechado/fisiopatologia , Glaucoma de Ângulo Fechado/cirurgia , Glaucoma de Ângulo Aberto/fisiopatologia , Glaucoma de Ângulo Aberto/cirurgia , Humanos , Índia , Pressão Intraocular/fisiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Centros de Atenção Terciária , Transtornos da Visão/fisiopatologia , Transtornos da Visão/cirurgia , Acuidade Visual/fisiologia , Campos Visuais/fisiologia , Pessoas com Deficiência Visual
6.
Artigo em Russo | MEDLINE | ID: mdl-31825371

RESUMO

OBJECTIVE: Assessment of frequency and severity of visual field disorders after neurosurgical operations at patients with pharmacoresistant form of epilepsy in hippocampus sclerosis. MATERIAL AND METHODS: The study included 48 patients having surgical operations for a pharmacoresistant form of temporal lobe epilepsy due to hippocampus sclerosis. Anterior lobectomy with amygdalohippocampectomy (LE + AHE) was performed in 25 patients; Selective amygdalohippocampectomy (SAHE) was performed in 23 patients. We evaluated both the frequency of cases of homonymous visual field disorders and their severity. RESULTS: After surgery the normal visual field was preserved at 7 (14.6%) patients. The appearance of visual field disorder by the type of homonymous hemianopsia was observed at 41 (85.4%) patients. When assessing the severity of visual field disorder, the smallest disorder was at patients who underwent sub-temporal access of SAHE: a statistically significant difference in the frequency of severe visual field disorder was revealed when comparing this group with patients having LE + AHE (p<0.02), as well as with patients having SAHE with access through sylvian gap (p<0.02). CONCLUSION: SAHE with sub-temporal access allows maintaining or minimally injuring the central optic neuron fibers, including the Meyer loop at patients operated for symptomatic temporal lobe epilepsy.


Assuntos
Epilepsia do Lobo Temporal , Esclerose , Tonsila do Cerebelo , Hipocampo , Humanos , Procedimentos Neurocirúrgicos , Resultado do Tratamento , Campos Visuais
7.
BMC Ophthalmol ; 19(1): 212, 2019 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-31684897

RESUMO

BACKGROUND: To report and describe an unusual case of a patient with optic disc pit in one eye and optic disc coloboma with a focal pit associated with macular retinoschisis in the other eye. CASE PRESENTATION: A 21-year-old woman presented with optic disc pit in the right eye and optic disc coloboma with a focal pit like excavation in the left eye. Macular spectral domain optical coherence tomography (SD-OCT) of the left eye revealed macular retinoschisis, without serous detachment. CONCLUSIONS: Proper monitoring of patients with disc anomalies associated with maculopathy is mandatory. The use of OCT imaging during follow-up can help to identify involvement of the fovea or enlargement of the retinoschisis area.


Assuntos
Coloboma/complicações , Angiofluoresceinografia/métodos , Macula Lutea/patologia , Disco Óptico/patologia , Nervo Óptico/anormalidades , Retinosquise/complicações , Tomografia de Coerência Óptica/métodos , Campos Visuais , Coloboma/diagnóstico , Feminino , Fundo de Olho , Humanos , Retinosquise/diagnóstico , Adulto Jovem
8.
Medicine (Baltimore) ; 98(45): e17924, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31702674

RESUMO

Bilateral asymmetry has been used in optical coherence tomography tests to find early damage to the optic nerve. However, limited studies have quantitatively evaluated bilateral asymmetry in electrophysiological disorders in patients with glaucoma. The aim of the study was to evaluate bilateral asymmetry in pattern visual evoked potentials (PVEPs) and conventional clinical markers as well as its potential use in detecting glaucomatous impairment. After investigating 60 glaucomatous patients (120 eyes) and 65 age and sex-matched normal control subjects (130 eyes) using uni- and multivariable analysis, we found that vision-related quality of life (VRQOL) impairment was significantly associated with larger bilateral asymmetry index (BAI) of clinical markers. Rasch-calibrated National Eye Institute Visual Function Questionnaire-25 scores were significantly associated with the BAI in PVEPs latency in 15 minutes check size (ß = -0.478, 95% confidence interval [CI], -0.708 to -0.248, P < .001) and the BAI in visual field mean deviation (ß = -0.249, 95% CI, -0.454 to -0.044, P = .018) according to multivariable analysis. Bilateral asymmetry in objective and subjective functional measurements was quantitatively associated with glaucomatous VRQOL impairment. This finding may help bridge the gap in understanding between patients and clinicians, and increase awareness of how glaucomatous neuropathic progression may interfere with patients' daily life.


Assuntos
Glaucoma de Ângulo Fechado/fisiopatologia , Glaucoma de Ângulo Aberto/fisiopatologia , Qualidade de Vida , Campos Visuais/fisiologia , Idoso , Estudos de Casos e Controles , Estudos Transversais , Feminino , Glaucoma de Ângulo Fechado/psicologia , Glaucoma de Ângulo Aberto/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Inquéritos e Questionários , Testes de Campo Visual/métodos
9.
Invest Ophthalmol Vis Sci ; 60(14): 4548-4555, 2019 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-31675072

RESUMO

Purpose: To determine the association of statins, five classes of antihypertensive medications, and proton pump inhibitors with (1) primary open-angle glaucoma (POAG) progression and (2) conversion of POAG suspects to POAG. Methods: We retrospectively investigated the records of a cohort with POAG cases and suspects from the Groningen Longitudinal Glaucoma Study. To quantify visual field (VF) deterioration in cases, we used the rate of progression of the mean deviation (MD). Suspects were considered to have converted at the time point after which two consecutive VF tests for at least one eye were abnormal (glaucoma hemifield test outside normal limits). Progression and conversion were analyzed with quantile and logistic regression, respectively, with the systemic medications as predictors, controlling for age, sex, body mass index, pretreatment IOP, corneal thickness, and baseline MD. The multivariable models were built with and without IOP intervention. Results: No systemic medications were associated with POAG progression in the final IOP/treatment-adjusted or unadjusted model. However, angiotensin II receptor blockers (ARBs) appeared to slow progression in older patients (b = 0.014, P = 0.0001). Angiotensin-converting enzyme inhibitors (ACEIs) were significantly associated with a decrease in POAG suspect conversion in both the IOP/treatment-adjusted and -unadjusted model (odds ratio [OR] 0.23, 95% confidence interval [CI] 0.07-0.79, P = 0.012; OR=0.24, 95% CI 0.07-0.78, P = 0.021, respectively), as were ARBs (OR 0.12, 95% CI 0.01-0.98, P = 0.014; OR 0.11, 95% CI 0.01-0.87, P = 0.005, respectively). Conclusions: No overall association of VF progression with systemic medication was found; ARBs delayed progression in older patients. ACEIs and ARBs were associated with lower risk of suspect conversion. The pathophysiology of this relationship is to be disentangled.


Assuntos
Anti-Hipertensivos/uso terapêutico , Glaucoma de Ângulo Aberto/diagnóstico , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Idoso , Anti-Hipertensivos/efeitos adversos , Progressão da Doença , Feminino , Alemanha , Glaucoma de Ângulo Aberto/induzido quimicamente , Glaucoma de Ângulo Aberto/fisiopatologia , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Pressão Intraocular/efeitos dos fármacos , Pressão Intraocular/fisiologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Nível de Efeito Adverso não Observado , Hipertensão Ocular/induzido quimicamente , Hipertensão Ocular/diagnóstico , Hipertensão Ocular/fisiopatologia , Estudos Retrospectivos , Fatores de Risco , Tonometria Ocular , Transtornos da Visão/induzido quimicamente , Transtornos da Visão/diagnóstico , Testes de Campo Visual , Campos Visuais/efeitos dos fármacos , Campos Visuais/fisiologia
10.
Invest Ophthalmol Vis Sci ; 60(14): 4556-4563, 2019 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-31675073

RESUMO

Purpose: To determine the importance of various vision parameters to functionality in glaucoma. Methods: Vision was measured using seven parameters: visual acuity (VA), contrast sensitivity (CS), integrated visual field (IVF), area under the log CS function (AULCSF), color vision, stereoacuity, and VA with noise (ViN). Likelihood ratio testing (LRT) determined if the full set of visual parameters significantly explained variability in 10 functional outcomes. For outcomes where the visual contribution was significant, dominance analysis determined the relative importance of the various visual parameters. Results: The analysis included 151 glaucoma patients. Mean age was 70 ± 6.8 years, and 47% were men. Significant visual contributions (LRT P < 0.05) were noted for glaucoma quality of life (GQL-15), reading speed, driving cessation, daily steps, and base of support while walking, but not for fear of falling, balance, gait velocity, stride velocity, and stride length while walking (LRT P > 0.05). The most important parameter (and percent contribution) to vision-explained variability were AULCSF for daily steps (45%), IVF for base of support (35%), VA for reading speed (34%), CS for GQL-15 (30%), and VA for driving cessation (26%). Conclusions: Measures of visual ability are important for several aspects of quality of life and functionality. The most important vision parameter for functionality differs depending on the domain studied. Reading and driving were explained by VA and IVF sensitivity. On the other hand, GQL-15 and daily steps were more heavily influenced by CS and AULCSF, which are rarely performed clinically.


Assuntos
Visão de Cores/fisiologia , Sensibilidades de Contraste/fisiologia , Glaucoma/fisiopatologia , Visão Ocular/fisiologia , Acuidade Visual/fisiologia , Campos Visuais/fisiologia , Idoso , Condução de Veículo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Leitura , Perfil de Impacto da Doença , Inquéritos e Questionários
11.
Invest Ophthalmol Vis Sci ; 60(14): 4711-4716, 2019 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-31725170

RESUMO

Purpose: Neuroretinopathy is increasingly being recognized as an independent cause of vision loss in diabetes. Visual field loss, as detected by frequency doubling technology (FDT)-based visual perimetry, is a sign of neuroretinopathy and occurs in early stages of diabetic retinopathy (DR). Here, we hypothesized that FDT visual field testing could identify patients with diabetic neuroretinopathy in the absence of clinically detectable microvascular DR. Methods: All National Health and Nutrition Examination Survey (NHANES) 2005-2008 participants receiving fundus photography and visual field screening by FDT were included in this study. Participants with self-reported glaucoma, use of glaucoma medications, or determination of glaucoma based on disk features were excluded. Visual fields were screened using FDT protocol in which participants underwent a 19-subfield suprathreshold test. Results: Patients with diabetes but no DR were more likely to have ≥1 subfield defects at 5%, 2%, and 1% probability levels than patients without diabetes (41.3% vs. 28.6%; 27.4% vs. 17.5%; 15.9% vs. 9.4%; all P < 0.0008). Multivariable regression showed that each additional glycated hemoglobin % (HbA1c) was associated with 19% greater odds of having ≥1 visual subfield defects in those with diabetes without DR (odds ratio: 1.19, 95% confidence interval: 1.07-1.33; P = 0.0020). Conclusions: Patients with diabetes have visual field defects in the absence of clinically detectable DR, suggesting neuroretinopathy precedes classical microvascular disease. These defects become more frequent with the onset of visible retinopathy and worsen as the retinopathy becomes more severe. Longitudinal studies are required to understand the pathogenesis of diabetic neuroretinopathy in relation to classic DR.


Assuntos
Diabetes Mellitus Tipo 2/diagnóstico , Retinopatia Diabética/diagnóstico , Transtornos da Visão/diagnóstico , Campos Visuais/fisiologia , Glicemia/metabolismo , Diabetes Mellitus Tipo 2/fisiopatologia , Retinopatia Diabética/fisiopatologia , Feminino , Hemoglobina A Glicada/metabolismo , Inquéritos Epidemiológicos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Fotografação , Transtornos da Visão/fisiopatologia , Testes de Campo Visual
12.
Acta Psychol (Amst) ; 201: 102938, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31726419

RESUMO

Visual stimuli presented in peripheries can be barely recognized when they are surrounded by flankers (crowding). The target-flanker interference can be asymmetrical, and this asymmetry depends on a stimulus type. In particular, recognition of a letter or a number is more disturbed by the presence of a leftward flanker, reflecting the direction of reading. So far, such reading-related asymmetry has been observed with visual recognition tasks. In the following studies, we used numbers as stimuli to examine whether the leftward asymmetry in crowding extends to other levels of information processing, i.e. whether it is present when more abstract, semantic features are extracted. We presented participants with numerical triplets in the left or right visual field, and asked them to classify the middle number according to its magnitude (Experiment 1), physical characteristics (Experiment 2) or parity (Experiment 3). We observed that the leftward flanker interfered stronger with the target than the rightward flanker, but only when magnitude and physical characteristics were classified. Our findings suggest that the leftward asymmetry in crowding extends up to the semantic level of number processing, but only selectively, i.e. when a certain sort of information (magnitude) is extracted.


Assuntos
Conceitos Matemáticos , Reconhecimento Visual de Modelos/fisiologia , Estimulação Luminosa/métodos , Leitura , Campos Visuais/fisiologia , Adolescente , Adulto , Cognição/fisiologia , Aglomeração , Feminino , Humanos , Masculino , Semântica , Adulto Jovem
13.
Invest Ophthalmol Vis Sci ; 60(14): 4915-4923, 2019 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-31764948

RESUMO

Purpose: Glaucoma is more common in urban populations than in others. Ninety percent of the world's population are exposed to air pollution above World Health Organization (WHO) recommended limits. Few studies have examined the association between air pollution and glaucoma. Methods: Questionnaire data, ophthalmic measures, and ambient residential area air quality data for 111,370 UK Biobank participants were analyzed. Particulate matter with an aerodynamic diameter < 2.5 µm (PM2.5) was selected as the air quality exposure of interest. Eye measures included self-reported glaucoma, intraocular pressure (IOP), and average thickness of macular ganglion cell-inner plexiform layer (GCIPL) across nine Early Treatment Diabetic Retinopathy Study (ETDRS) retinal subfields as obtained from spectral-domain optical coherence tomography. We examined the associations of PM2.5 concentration with self-reported glaucoma, IOP, and GCIPL. Results: Participants resident in areas with higher PM2.5 concentration were more likely to report a diagnosis of glaucoma (odds ratio = 1.06, 95% confidence interval [CI] = 1.01-1.12, per interquartile range [IQR] increase P = 0.02). Higher PM2.5 concentration was also associated with thinner GCIPL (ß = -0.56 µm, 95% CI = -0.63 to -0.49, per IQR increase, P = 1.2 × 10-53). A dose-response relationship was observed between higher levels of PM2.5 and thinner GCIPL (P < 0.001). There was no clinically relevant relationship between PM2.5 concentration and IOP. Conclusions: Greater exposure to PM2.5 is associated with both self-reported glaucoma and adverse structural characteristics of the disease. The absence of an association between PM2.5 and IOP suggests the relationship may occur through a non-pressure-dependent mechanism, possibly neurotoxic and/or vascular effects.


Assuntos
Poluentes Atmosféricos/efeitos adversos , Glaucoma/etiologia , Material Particulado/efeitos adversos , Adulto , Idoso , Poluição do Ar , Feminino , Glaucoma/diagnóstico por imagem , Humanos , Pressão Intraocular/fisiologia , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Células Ganglionares da Retina/patologia , Autorrelato , Inquéritos e Questionários , Tomografia de Coerência Óptica/métodos , Tonometria Ocular , Campos Visuais
14.
Invest Ophthalmol Vis Sci ; 60(14): 4931-4942, 2019 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-31770433

RESUMO

Purpose: We studied the relationship between structure and function of the choriocapillaris (CC), retinal pigment epithelium (RPE), and photoreceptors in patients with choroideremia (CHM). Methods: Six CHM patients (12 eyes) and four normal subjects (six eyes) were studied with fundus-guided microperimetry, confocal and nonconfocal adaptive optics scanning laser ophthalmoscopy (AOSLO), near-infrared and color fundus photos, short wavelength fundus autofluorescence (SW-AF), and swept-source optical coherence tomography (SS-OCT) and angiography (SS-OCTA) images. Cone spacing was represented using Z-scores (standard deviations from the mean at that eccentricity). CC flow voids were defined using a threshold of 1 SD below the normal mean. Results: Cone spacing Z-scores were not significantly correlated with distance from the borders of preserved RPE, determined using either the SS-OCT or SW-AF scans. Cone spacing Z-scores were significantly correlated with CC flow voids and retinal sensitivity. Flow voids were abnormal in regions of preserved RPE and increased progressively from within -2° of the preserved area to +2° beyond the border. Visual sensitivity decreased as CC flow voids increased approaching and beyond the border of preserved structure. Conclusions: In CHM, cone spacing Z-scores correlated with CC flow voids, and were negatively correlated with retinal sensitivity, suggesting cone degeneration accompanied reduced CC perfusion. Functional cones were found outside the presumed borders of preserved outer-retina/RPE as defined by SW-AF, but not outside the borders determined by SS-OCT. The use of SW-AF to identify the border of preserved structures may underestimate regions with cells that may be amenable to treatment.


Assuntos
Corioide/patologia , Coroideremia/patologia , Células Fotorreceptoras Retinianas Cones/patologia , Epitélio Pigmentado da Retina/patologia , Adolescente , Adulto , Idoso , Corioide/diagnóstico por imagem , Coroideremia/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Imagem Multimodal , Oftalmoscopia , Imagem Óptica , Ondas de Rádio , Tomografia de Coerência Óptica , Testes de Campo Visual , Campos Visuais/fisiologia , Adulto Jovem
15.
Invest Ophthalmol Vis Sci ; 60(14): 4896-4903, 2019 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-31752019

RESUMO

Purpose: The geometry of retinal nerve fibers may be altered with myopia, a known risk factor for glaucoma. Recent developments in high resolution imaging have enabled direct visualization of nerve fiber bundles at the temporal raphe with clinical hardware, providing evidence that this area is sensitive to glaucomatous damage. Here, we test the hypothesis that nerve fiber geometry is altered by myopia, both at the temporal raphe and surrounding the optic nerve head. Methods: Seventy-eight healthy individuals participated, with refractive errors distributed between emmetropia and high myopia (+0 to -13 DS). Custom high-density OCT scans were used to visualize RFNL bundle trajectory at the temporal raphe. A standard clinical OCT protocol was used to assess papillary minimum rim width (MRW) and peripapillary retinal nerve fiber layer (RNFL) thickness. Results: Measures of raphe shape-including position, orientation, and width-did not depend significantly on axial length. In 7.5% of subjects, the raphe was rotated sufficiently that inversion of structure-function mapping to visual field space is predicted in the nasal step region. Low concordance to ISNT and related rules was observed in myopia (e.g., for RNFL, 8% of high axial myopes compared with 67% of emmetropes). Greater robustness to refractive error was observed for the IT rule. Conclusions: High density OCT scans enabled visualization of marked interindividual variation in temporal raphe geometry; however, these variations were not well predicted by degree of myopia as represented by axial length. That said, degree of myopia was associated with abnormal thickness profiles for the papillary and peripapillary nerve fiber layer.


Assuntos
Comprimento Axial do Olho/patologia , Emetropia/fisiologia , Miopia/patologia , Fibras Nervosas/patologia , Nervo Óptico/patologia , Retina/patologia , Células Ganglionares da Retina/patologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Nervo Óptico/diagnóstico por imagem , Retina/diagnóstico por imagem , Tomografia de Coerência Óptica , Campos Visuais , Adulto Jovem
16.
BMC Neurol ; 19(1): 302, 2019 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-31779601

RESUMO

BACKGROUND: Visual field defects caused by injury to Meyer's loop (ML) are common in patients undergoing anterior temporal lobectomy during epilepsy surgery. Evaluation of the anatomical shapes of the curving, fanning and sharp angles of ML to guide surgeries is important but still challenging for diffusion tensor imaging. We present an advanced diffusion data-based ML atlas and labeling protocol to reproduce anatomical features in individuals within a short time. METHODS: Thirty Massachusetts General Hospital-Human Connectome Project (MGH-HCP) diffusion datasets (ultra-high magnetic gradient & 512 directions) were warped to standard space. The resulting fibers were projected together to create an atlas. The anatomical features and the tractography correspondence rates were evaluated in 30 MGH-HCP individuals and local diffusion spectrum imaging data (eight healthy subjects and six hippocampal sclerosis patients). RESULTS: In the atlas, features of curves, sharp angles and fanning shapes were adequately reproduced. The distances from the anterior tip of the temporal lobe to the anterior ridge of Meyer's loop were 23.1 mm and 26.41 mm on the left and right sides, respectively. The upper and lower divisions of the ML were revealed to be twisting. Eighty-eight labeled sides were achieved, and the correspondence rates were 87.44% ± 6.92, 80.81 ± 10.62 and 72.83% ± 14.03% for MGH-HCP individuals, DSI-healthy individuals and DSI-patients, respectively. CONCLUSION: Atlas-labeled ML is comparable to high angular resolution tractography in healthy or hippocampal sclerosis patients. Therefore, rapid identification of the ML location with a single modality of T1 is practical. This protocol would facilitate functional studies and visual field protection during neurosurgery.


Assuntos
Lobectomia Temporal Anterior/métodos , Epilepsia do Lobo Temporal/cirurgia , Transtornos da Visão/etiologia , Campos Visuais , Adolescente , Adulto , Estudos de Casos e Controles , Imagem de Difusão por Ressonância Magnética/métodos , Imagem de Tensor de Difusão/métodos , Epilepsia do Lobo Temporal/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Neurocirúrgicos/métodos , Testes de Campo Visual , Adulto Jovem
17.
Exp Eye Res ; 189: 107835, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31634478

RESUMO

Glaucoma, the leading cause of irreversible blindness worldwide, can be divided into two major types: primary open angle glaucoma (POAG) and primary angle closure glaucoma (PACG). PACG could lead to severe vision loss and has a high prevalence among Asian populations. The worldwide population affected by PACG is estimated to exceed 20 million by 2020. Recent studies have shown that there are at least eight genetic loci significantly associated with risk of PACG, possibly contributing to the phenotype by interacting with environmental factors. This review presents the progress that has been achieved in the genetics of PACG and its future perspectives. This article should be considered as a memorial article to honor Dr. R. Rand Allingham's remarkable contribution to genetic association studies in glaucoma. We are deeply saddened by the loss of Dr. Allingham, not only a huge loss for ophthalmology, but also loss of a dear friend. Looking back to his extraordinary career, Dr. Allingham devoted his whole life and passion into establishing the genetic basis of different forms of glaucoma such as open angle, angle closure, and exfoliation glaucoma. He had a special interest in analyses of populations from African ancestry, which greatly boosted the understanding of glaucoma genetics.


Assuntos
Predisposição Genética para Doença , Glaucoma de Ângulo Fechado/genética , Pressão Intraocular/fisiologia , Campos Visuais/fisiologia , Glaucoma de Ângulo Fechado/fisiopatologia , Saúde Global , Humanos , Prevalência
18.
Invest Ophthalmol Vis Sci ; 60(13): 4462-4468, 2019 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-31658354

RESUMO

Purpose: To investigate the serum changes of antioxidant/oxidant markers and the relationship between these factors and visual function in patients with retinitis pigmentosa (RP). Methods: Fifty-two RP patients <40 years old and 25 controls were included. Serum samples were analyzed for superoxide dismutase 3 (SOD3) activity, glutathione peroxidase (GPx), potential antioxidant (PAO), and hexanoyl-lysine (HEL). The relationships between these markers and visual parameters, including best-corrected visual acuity (BCVA), mean deviation (MD), and average retinal sensitivity of 4 or 12 central points on static perimetry tests (Humphrey Field Analyzer, the central 10-2 program) were examined in the RP patients. Results: Although there was no significant difference in the serum SOD3 activity between RP patients and controls, serum SOD3 activity in the severe degeneration group with macular involvement (16.3 ± 11.3 U/mL) was significantly lower compared with those in the mild degeneration group (those with midperipheral scotomas; 28.5 ± 16.6 U/mL, P = 0.0459). SOD3 was significantly related to visual acuity (r = -0.3701, P = 0.0069) and the average retinal sensitivity of four central points (r = 0.3463, P = 0.0137) in RP patients. The linear trends of these two parameters across SOD3 levels were also significant (P = 0.0264 and 0.0172, respectively). There was no consistent correlation between other serum antioxidant/oxidant markers and visual parameters. Conclusions: Lower serum SOD3 activity was associated with the severe retinal degeneration in RP patients. Our results suggest that serum SOD3 activity may be related to disease severity in RP.


Assuntos
Antioxidantes/metabolismo , Biomarcadores/sangue , Oxidantes/sangue , Retinite Pigmentosa/sangue , Acuidade Visual/fisiologia , Adulto , Feminino , Glutationa Peroxidase/sangue , Humanos , Lisina/sangue , Masculino , Oxirredutases atuantes sobre Doadores de Grupo CH-NH/sangue , Retinite Pigmentosa/fisiopatologia , Superóxido Dismutase/sangue , Testes de Campo Visual , Campos Visuais/fisiologia , Adulto Jovem
19.
Korean J Ophthalmol ; 33(5): 422-429, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31612652

RESUMO

PURPOSE: We investigated changes in the thickness of the peripapillary retinal nerve fiber layer (RNFL) following the onset of an epiretinal membrane (ERM) in glaucoma patients. METHODS: Among regularly monitored glaucoma patients, patients with a newly diagnosed ERM were consecutively enrolled. Before and after the onset of ERM, the RNFL thickness was measured using spectral domain optical coherence tomography, and a visual field examination was performed using a Humphrey field analyzer. Changes in RNFL thickness parameters and global indices of the visual field analyzer were assessed. RESULTS: In a total of 28 eyes from 28 patients, the average RNFL thickness increased by a mean of 4.0 ± 7.4 µm (p = 0.009) after ERM onset. There was an increase in the superior, nasal, and temporal quadrant RNFL thicknesses, and the change in the temporal RNFL thickness was significant (14.4 ± 21.2 µm, p < 0.001). However, the inferior RNFL thickness decreased by -0.6 ± 7.5 µm (p = 0.116). In the visual field examination, the mean deviation decreased significantly by -0.8 ± 1.7 dB (p = 0.038), from -14.6 to -15.4 dB. CONCLUSIONS: A significant increase in average RNFL thickness was detected following ERM onset in glaucoma patients, although there was deterioration of the mean deviation in the visual field. When ERM occurs in glaucoma patients, clinicians should be aware that RNFL thickness measurements obtained with a spectral domain optical coherence tomography may underestimate the status of glaucomatous optic neuropathy.


Assuntos
Membrana Epirretiniana/diagnóstico , Glaucoma/diagnóstico , Células Ganglionares da Retina/patologia , Tomografia de Coerência Óptica/métodos , Adulto , Idoso , Progressão da Doença , Membrana Epirretiniana/etiologia , Membrana Epirretiniana/fisiopatologia , Feminino , Seguimentos , Glaucoma/complicações , Glaucoma/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Disco Óptico/patologia , Estudos Retrospectivos , Campos Visuais/fisiologia
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