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1.
J Am Coll Radiol ; 21(6S): S219-S236, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38823946

RESUMO

Orbital disorders in children consist of varied pathologies affecting the orbits, orbital contents, visual pathway, and innervation of the extraocular or intraocular muscles. The underlying etiology of these disorders may be traumatic or nontraumatic. Presumed location of the lesion along with the additional findings, such as eye pain, swelling, exophthalmos/enophthalmos, erythema, conjunctival vascular dilatation, intraocular pressure, etc, help in determining if imaging is needed, modality of choice, and extent of coverage (orbits and/or head). Occasionally, clinical signs and symptoms may be nonspecific, and, in these cases, diagnostic imaging studies play a key role in depicting the nature and extent of the injury or disease. In this document, various clinical scenarios are discussed by which a child may present with an orbital or vision abnormality. Imaging studies that might be most appropriate (based on the best available evidence or expert consensus) in these clinical scenarios are also discussed. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.


Assuntos
Doenças Orbitárias , Humanos , Criança , Estados Unidos , Doenças Orbitárias/diagnóstico por imagem , Medicina Baseada em Evidências , Sociedades Médicas , Diagnóstico por Imagem/métodos , Cegueira/diagnóstico por imagem
2.
J. optom. (Internet) ; 17(2): [100495], Abr-Jun, 2024. graf, tab
Artigo em Inglês | IBECS | ID: ibc-231628

RESUMO

Purpose: This systematic review evaluates current literature on the impact vision impairment has on reading and literacy levels within education. Methods: Six databases were searched with inclusion criteria of trials or studies involving children who are blind or vision impaired, and impact on academic or school performance – including reading and literacy. 1262 articles were identified, with 61 papers undergoing full screening. Quality appraisal was performed using Critical Appraisal Skills Program (CASP) and seven articles deemed eligible for inclusion. Results: Included articles achieved a quality score of over 70 % using the CASP checklists. Direct comparison of articles was not possible due to methodological differences in assessing reading and literacy levels. All seven studies investigated aspects of reading speed, with additional measures of reading performance, such as reading reserve, comprehension, and reading accuracy. Discussion: Underlying trends highlighted students with a vision impairment do not perform at same level as their normally sighted peers with respect to reading performance - in terms of speed, but not ability. Additionally, early intervention to enhance literacy skills may help improve educational outcomes. Future direction should be aimed at identifying specific obstacles to learning these students face and providing interventions to improve academic outcomes. (AU)


Assuntos
Humanos , Criança , Cegueira , Educação , Literatura , Leitura
3.
J Glob Health ; 14: 04100, 2024 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-38867671

RESUMO

Background: Asia accounts for more than half of the world's population and carries a substantial proportion of the global burden of blindness and vision impairment. Characterising this burden, as well as its causes and determinants, could help with devising targeted interventions for reducing the occurrence of blindness and visual impairment. Methods: Using the Global Burden of Disease Study 2019 database, we retrieved data on the number of disability-adjusted life years (DALYs); crude and age-standardised rates; and the prevalence (with 95% uncertainty intervals (95%UIs)) of blindness and vision loss due to six causes (age-related macular degeneration, cataracts, glaucoma, near-vision impairment, refractive error, and other vision loss) for Asian countries for the period between 1990 and 2019. We defined DALYs as the sum of the years lost due to disability and years of life lost, and calculated age-standardised figures for the number of DALYs and prevalence by adjusting for population size and age structure. We then evaluated the time trend of the disease burden and conducted subgroup analyses by gender, age, geographic locations, and socio-demographic index (SDI). Results: In 2019, the DALYs and prevalence of blindness and vision loss had risen by 90.1% and 116% compared with 1990, reaching 15.84 million DALYs (95% UI = 15.83, 15.85) and 506.71 million cases (95% UI = 506.68, 506.74). Meanwhile, the age-standardised rate of DALYs decreased from 1990 to 2019. Cataracts, refractive error, and near vision impairment were the three most common causes. South Asia had the heaviest regional disease burden (age-standardised rate of DALYs = 517 per 100 000 population; 95% UI = 512, 521). Moreover, the burden due to cataracts ranked high in most Asian populations. Being a woman; being older; and having a lower national SDI were factors associated with a greater vision loss burden. Conclusions: The burden due to vision loss remains high in Asian populations. Cataracts, refractive error, and near vision loss were the primary causes of blindness and vision loss. Greater investment in ocular disease prevention and care by countries with lower socioeconomic status is needed, as well as specific strategies targeting cataract management, women and the elderly.


Assuntos
Cegueira , Anos de Vida Ajustados por Deficiência , Carga Global da Doença , Humanos , Cegueira/epidemiologia , Cegueira/etiologia , Feminino , Masculino , Idoso , Pessoa de Meia-Idade , Ásia/epidemiologia , Adulto , Idoso de 80 Anos ou mais , Prevalência , Adulto Jovem , Adolescente , Criança , Pré-Escolar , Lactente , Catarata/epidemiologia , Catarata/complicações , Baixa Visão/epidemiologia , Erros de Refração/epidemiologia , Erros de Refração/complicações
4.
PLoS One ; 19(5): e0294371, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38776330

RESUMO

PURPOSE: To determine the prevalence and causes of blindness and visual impairment among adults in Kogi, Nigeria. METHODS: A Rapid assessment of avoidable blindness (RAAB) protocol was used with additional tools measuring disability and household wealth to measure the prevalence of blindness and visual impairment (VI) and associations with sex, disability, wealth, cataract surgical coverage and its effectiveness. RESULTS: Age- and sex-adjusted all-cause prevalence of bilateral blindness was 3.6% (95%CI 3.0-4.2%), prevalence of blindness among people living with additional, non-visual disabilities was 38.3% (95% CI 29.0-48.6%) compared to 1.6% (95%CI 1.2-2.1%; [Formula: see text] = 771.9, p<0.001) among people without additional disabilities. Cataract was the principal cause of bilateral blindness (55.3%). Cataract surgical coverage (CSC) at visual acuity (VA) 3/60 was 48.0%, higher among men than women (53.7% vs 40.3%); 12.0% among people with non-visual disabilities; 66.9% among people without non-visual disabilities, being higher among people in the wealthiest two quintiles (41.1%) compared to the lowest three (24.3%). Effective Cataract Surgical Coverage at Visual Acuity 6/60 was 31.0%, higher among males (34.9%) than females (25.5%), low among people with additional, non-visual disabilities (1.9%) compared to people with no additional disabilities (46.2%). Effective CDC was higher among people in the wealthiest two quintiles (411%) compared to the poorest three (24.3%). Good surgical outcome (VA>6/18) was seen in 61 eyes (52.6%) increasing to 71 (61.2%) eyes with best correction. Cost was identified as the main barrier to surgery. CONCLUSION: Findings suggest there exists inequalities in eye care with women, poorer people and people with disabilities having a lower Cataract Surgical Coverage, thereby, underscoring the importance of eye care programs to address these inequalities.


Assuntos
Cegueira , Humanos , Nigéria/epidemiologia , Masculino , Feminino , Cegueira/epidemiologia , Cegueira/etiologia , Pessoa de Meia-Idade , Prevalência , Idoso , Adulto , Catarata/epidemiologia , Catarata/complicações , Extração de Catarata/estatística & dados numéricos , Acuidade Visual , Adolescente , Adulto Jovem , Idoso de 80 Anos ou mais , Pessoas com Deficiência/estatística & dados numéricos
5.
Immunol Cell Biol ; 102(5): 308-314, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38724046

RESUMO

The May-June 2024 issue of Immunology & Cell Biology contains an Immunology Futures Special Feature on Disability Inclusion in Science. Diverse groups do better in science, yet individuals with disabilities face barriers to accessing education and opportunities within scientific disciplines. The Monash Sensory Science program, led by Professor Jamie Rossjohn and legally blind artist in residence Dr Erica Tandori, has transformed the accessibility for those with blindness, low vision and diverse needs (BLVDN) to experience biomedical data visualization through the form of multisensory scientific communication. The Monash Sensory Science Exhibition, first hosted in 2018 with the support of Monash University and the Australian Research Council, utilizes tactile multisensory and multimodal artworks, interactive displays and multisensory science books for BLVDN participants. In this Special Feature, scientists and researchers involved in the 2023 Autoimmunity Monash Sensory Science Exhibition discuss the novel models and displays designed to improve the scientific understanding of complex autoimmune diseases including rheumatoid arthritis, lupus, celiac disease, psoriasis and type 1 diabetes. This Special Feature aims to inform the inclusive teaching of immunology and raise discussions of how to improve access to all within our scientific institutions.


Assuntos
Cegueira , Humanos , Cegueira/terapia , Cegueira/imunologia , Baixa Visão/terapia , Pessoas com Deficiência Visual , Ciência , Pessoas com Deficiência
6.
PLoS One ; 19(5): e0300793, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38748713

RESUMO

In nature, animals must navigate to forage according to their sensory inputs. Different species use different sensory modalities to locate food efficiently. For teleosts, food emits visual, mechanical, chemical, and/or possibly weak-electrical signals, which can be detected by optic, auditory/lateral line, and olfactory/taste buds sensory systems. However, how fish respond to and use different sensory inputs when locating food, as well as the evolution of these sensory modalities, remain unclear. We examined the Mexican tetra, Astyanax mexicanus, which is composed of two different morphs: a sighted riverine (surface fish) and a blind cave morph (cavefish). Compared with surface fish, cavefish have enhanced non-visual sensory systems, including the mechanosensory lateral line system, chemical sensors comprising the olfactory system and taste buds, and the auditory system to help navigate toward food sources. We tested how visual, chemical, and mechanical stimuli evoke food-seeking behavior. In contrast to our expectations, both surface fish and cavefish did not follow a gradient of chemical stimulus (food extract) but used it as a cue for the ambient existence of food. Surface fish followed visual cues (red plastic beads and food pellets), but, in the dark, were likely to rely on mechanosensors-the lateral line and/or tactile sensor-as cavefish did. Our results indicate cavefish used a similar sensory modality to surface fish in the dark, while affinity levels to stimuli were higher in cavefish. In addition, cavefish evolved an extended circling strategy to forage, which may yield a higher chance to capture food by swimming-by the food multiple times instead of once through zigzag motion. In summary, we propose that ancestors of cavefish, similar to the modern surface fish, evolved extended food-seeking behaviors, including circling motion, to adapt to the dark.


Assuntos
Characidae , Comportamento Alimentar , Animais , Comportamento Alimentar/fisiologia , Characidae/fisiologia , Evolução Biológica , Cavernas , Sinais (Psicologia) , Cegueira/fisiopatologia
7.
Sensors (Basel) ; 24(9)2024 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-38733054

RESUMO

The problem of supporting visually impaired and blind people in meaningful interactions with objects is often neglected. To address this issue, we adapted a tactile belt for enhanced spatial navigation into a bracelet worn on the wrist that allows visually impaired people to grasp target objects. Participants' performance in locating and grasping target items when guided using the bracelet, which provides direction commands via vibrotactile signals, was compared to their performance when receiving auditory instructions. While participants were faster with the auditory commands, they also performed well with the bracelet, encouraging future development of this system and similar systems.


Assuntos
Força da Mão , Tato , Pessoas com Deficiência Visual , Humanos , Masculino , Tato/fisiologia , Feminino , Força da Mão/fisiologia , Adulto , Cegueira/fisiopatologia , Cegueira/reabilitação , Movimento/fisiologia , Pessoa de Meia-Idade
8.
Immunol Cell Biol ; 102(5): 315-320, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38693615

RESUMO

Art is a powerful tool for conveying scientific discovery. Despite the perceived gap between art and science, as highlighted by CP Snow and others, examples of art communicating science can be found in the ancient world, the Renaissance and contemporary data visualization, demonstrating an enduring and historic connection. However, much of science relies on visual elements, excluding those with blindness, low vision and diverse needs, resulting in their low representation in STEM discourse. This paper introduces a novel science and art collaboration in the form of an exhibition program exploring the concepts of Immunology and Biomedicine to blind and vision-impaired audiences, capitalizing on the lived experience of a legally blind artist. Employing multisensory design, art and co-creation methodologies, it transcends traditional vision-based science communication, showcasing the potential for multisensory art to bridge the gap at the intersection of science and inclusion.


Assuntos
Alergia e Imunologia , Arte , Humanos , Alergia e Imunologia/história , Cegueira/imunologia , Cegueira/terapia , Baixa Visão/imunologia , Ciência
9.
Immunol Cell Biol ; 102(5): 358-364, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38700076

RESUMO

This paper presents interdisciplinary research exploring the development of inclusive multisensory science books, communicating immunology data for blind, low-vision and diverse-needs audiences. The research adopted an inductive theory-building approach, practice-based art methods and music and design methods, leveraging the lived experience of a legally blind artist. The research also involved designers and scientists in a cocreation process, producing books that incorporate tactile artworks, Braille-inspired protein models, image sonification and interaction. Two multisensory book titles, "The Heroes Within You: A Multisensory Exploration of Infection and Immunity" and "My Goodness: A Multisensory Exploration of Nutrition and Immunity", were developed for the Monash Sensory Science 2023 Exhibition Day. The books offer an innovative way to make science and art more accessible and engaging, addressing the limitations of traditional museum methods. Feedback from audiences has been positive, emphasizing the fascination, sensory engagement and ease of understanding. This paper highlights the potential for an interdisciplinary and inclusive approach to science and art, demonstrating the value of multisensory books as tools for science communication. The findings highlight the positive reception of this novel approach and suggest its potential for broader applications, promoting inclusivity and accessibility.


Assuntos
Alergia e Imunologia , Livros , Humanos , Cegueira/imunologia , Cegueira/terapia , Arte , Pessoas com Deficiência Visual
11.
eNeuro ; 11(5)2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38811162

RESUMO

This study compared the impact of spectral and temporal degradation on vocoded speech recognition between early-blind and sighted subjects. The participants included 25 early-blind subjects (30.32 ± 4.88 years; male:female, 14:11) and 25 age- and sex-matched sighted subjects. Tests included monosyllable recognition in noise at various signal-to-noise ratios (-18 to -4 dB), matrix sentence-in-noise recognition, and vocoded speech recognition with different numbers of channels (4, 8, 16, and 32) and temporal envelope cutoff frequencies (50 vs 500 Hz). Cortical-evoked potentials (N2 and P3b) were measured in response to spectrally and temporally degraded stimuli. The early-blind subjects displayed superior monosyllable and sentence recognition than sighted subjects (all p < 0.01). In the vocoded speech recognition test, a three-way repeated-measure analysis of variance (two groups × four channels × two cutoff frequencies) revealed significant main effects of group, channel, and cutoff frequency (all p < 0.001). Early-blind subjects showed increased sensitivity to spectral degradation for speech recognition, evident in the significant interaction between group and channel (p = 0.007). N2 responses in early-blind subjects exhibited shorter latency and greater amplitude in the 8-channel (p = 0.022 and 0.034, respectively) and shorter latency in the 16-channel (p = 0.049) compared with sighted subjects. In conclusion, early-blind subjects demonstrated speech recognition advantages over sighted subjects, even in the presence of spectral and temporal degradation. Spectral degradation had a greater impact on speech recognition in early-blind subjects, while the effect of temporal degradation was similar in both groups.


Assuntos
Cegueira , Percepção da Fala , Humanos , Masculino , Feminino , Percepção da Fala/fisiologia , Adulto , Cegueira/fisiopatologia , Adulto Jovem , Eletroencefalografia/métodos , Estimulação Acústica , Reconhecimento Psicológico/fisiologia , Potenciais Evocados Auditivos/fisiologia
12.
West J Emerg Med ; 25(3): 350-357, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38801041

RESUMO

Introduction: Blind and visually impaired individuals, an under-represented population of the emergency department (ED), possess comorbidities and have a higher chance of in-hospital sequelae, including falls. This potentially vulnerable population, if not treated mindfully, can be subject to decreased quality of care, recurrent and/or longer hospitalizations, persistence of health issues, increased incidence of falls, and higher healthcare costs. For these reasons, it is crucial to implement holistic practices and train clinicians to treat blind and visually impaired patients in the ED setting. Methods: We identified and used a comprehensive article describing best practices for the care of blind and visually impaired patients to establish the ED-specific recommendations presented in this paper. A scoping review of the literature was then performed using PubMed to identify additional articles to support each recommendation. To ensure that recommendations could be implemented in a representative, scalable, and sustainable manner, we consulted an advocate for the blind to help refine and provide additional suggestions. Results: We identified 14 recommendations that focus on communication strategies, ED resource access, and continuity of care. The main recommendation is for the clinician to support the unique healthcare needs of the visually impaired individual and maintain the patient's autonomy. Another recommendation is the consistent use of assistive devices (eg, canes, guide dogs) to aid patients to safely ambulate in the ED. Also identified as best practices were discharge education with the use of a screen reader and timely follow-up with a primary care physician. Conclusion: While we summarize a variety of recommendations in this article, it is important to implement only the strategies that work best for the patients, personnel, and environment specific to your ED. After implementation, it is vital to refine (as frequently as needed) the interventions to optimize the strategies. This will enable the provision of exceptional and equal care to blind and visually impaired patients in the ED.


Assuntos
Serviço Hospitalar de Emergência , Pessoas com Deficiência Visual , Humanos , Cegueira , Acessibilidade aos Serviços de Saúde , Guias de Prática Clínica como Assunto , Tecnologia Assistiva , Continuidade da Assistência ao Paciente
13.
Nat Commun ; 15(1): 4481, 2024 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-38802397

RESUMO

Retinal degeneration, a leading cause of irreversible low vision and blindness globally, can be partially addressed by retina prostheses which stimulate remaining neurons in the retina. However, existing electrode-based treatments are invasive, posing substantial risks to patients and healthcare providers. Here, we introduce a completely noninvasive ultrasonic retina prosthesis, featuring a customized ultrasound two-dimensional array which allows for simultaneous imaging and stimulation. With synchronous three-dimensional imaging guidance and auto-alignment technology, ultrasonic retina prosthesis can generate programmed ultrasound waves to dynamically and precisely form arbitrary wave patterns on the retina. Neuron responses in the brain's visual center mirrored these patterns, evidencing successful artificial vision creation, which was further corroborated in behavior experiments. Quantitative analysis of the spatial-temporal resolution and field of view demonstrated advanced performance of ultrasonic retina prosthesis and elucidated the biophysical mechanism of retinal stimulation. As a noninvasive blindness prosthesis, ultrasonic retina prosthesis could lead to a more effective, widely acceptable treatment for blind patients. Its real-time imaging-guided stimulation strategy with a single ultrasound array, could also benefit ultrasound neurostimulation in other diseases.


Assuntos
Cegueira , Retina , Próteses Visuais , Retina/diagnóstico por imagem , Retina/fisiologia , Animais , Cegueira/terapia , Cegueira/fisiopatologia , Degeneração Retiniana/terapia , Degeneração Retiniana/diagnóstico por imagem , Ondas Ultrassônicas , Humanos , Neurônios/fisiologia , Ultrassonografia/métodos , Visão Ocular/fisiologia
14.
Int Ophthalmol ; 44(1): 227, 2024 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-38776029

RESUMO

PURPOSE: Artificial eye users (AEUs) can experience a negative impact on psychological and emotional wellbeing, including reduced social functioning, which may be a consequence of living with one eye removed, and/or of having a prosthetic eye. This may have wider consequences for their families. We aimed to explore what it means to live with a prosthetic eye, for both AEUs and their families-and how any quality of life (QoL) issues impact on their day-to-day functioning. METHODS: A subset of AEUs and their family members taking part in a feasibility randomised controlled trial comparing hand-painted to digitally printed artificial eyes were invited for semi-structured interviews. Transcripts were analysed using reflexive thematic analysis. Qualitative results related to trial participation are covered elsewhere. Here, we focus on QoL and day-to-day functioning. RESULTS: Twelve AEUs (eight males) and five spouses (one male) who had worn artificial eyes for 2-65 years took part, and four themes were identified. (1) Impact on day-to-day life: AEUs and their spouses have to adapt to (partial) sight loss, reduced levels of confidence, and social withdrawal. (2) Impact on psychological and emotional wellbeing: distress among AEUs and their spouses can be severe and prolonged, highlight unmet support needs. (3) Challenges with treatment experiences: AEUs experienced negative impact of fragmentation of care and long waiting times. (4) Worries about the future: AEUs mentioned fragility of remaining sight, and concerns around potential need for further treatment. CONCLUSION: Patients and their family members experience negative impact of being an AEU on their everyday lives and quality of life. There is a potential role for psychosocial support services in supporting AEUs and their families even long after eye loss.


Assuntos
Olho Artificial , Qualidade de Vida , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Adulto , Família/psicologia , Pesquisa Qualitativa , Cegueira/psicologia
16.
Science ; 384(6698): 907-912, 2024 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-38781366

RESUMO

Human visual recognition is remarkably robust to chromatic changes. In this work, we provide a potential account of the roots of this resilience based on observations with 10 congenitally blind children who gained sight late in life. Several months or years following their sight-restoring surgeries, the removal of color cues markedly reduced their recognition performance, whereas age-matched normally sighted children showed no such decrement. This finding may be explained by the greater-than-neonatal maturity of the late-sighted children's color system at sight onset, inducing overly strong reliance on chromatic cues. Simulations with deep neural networks corroborate this hypothesis. These findings highlight the adaptive significance of typical developmental trajectories and provide guidelines for enhancing machine vision systems.


Assuntos
Cegueira , Percepção de Cores , Visão de Cores , Reconhecimento Visual de Modelos , Criança , Feminino , Humanos , Masculino , Cegueira/reabilitação , Cegueira/cirurgia , Sinais (Psicologia) , Redes Neurais de Computação , Adolescente , Adulto Jovem
17.
Harefuah ; 163(5): 305-309, 2024 May.
Artigo em Hebraico | MEDLINE | ID: mdl-38734944

RESUMO

INTRODUCTION: Ocular inflammation, uveitis, represents over 40 distinct diseases, caused by infectious or non-infectious etiologies. Non-infectious uveitis may be related to systemic autoimmune diseases. Most uveitis patients are of working age, and prolonged disease may affect their independence and ability to work. Uveitis has various clinical manifestations and may result in the development of ocular complications and vision loss. Uveitis accounts for 10-15% of blindness in the developed world. Autoimmune diseases are increasing globally and often involve the eyes. Most cases occur in young active people and therefore any ocular changes have a longer effect. Symptoms may be mild but they might be severe, even blindness. It accounts for 10% to 15% of all causes of blindness among people of working age in the developed world. OBJECTIVES: To describe the ocular manifestation of uveitis related to systemic autoimmune diseases. We will describe ocular signs related to the disease and discuss the treatment approach to prevent the development of ocular complications and vision loss. METHODS: Review of clinical findings and treatment approach to non-infectious uveitis. CONCLUSIONS: Ocular involvement is commonly found in many autoimmune diseases. The severity of ocular disease varies between cases and complications may result in vision loss. Early diagnosis and treatment may prevent the development of ocular complications, maintaining visual acuity and patient independence.


Assuntos
Doenças Autoimunes , Uveíte , Acuidade Visual , Humanos , Doenças Autoimunes/diagnóstico , Uveíte/etiologia , Uveíte/diagnóstico , Cegueira/etiologia , Índice de Gravidade de Doença , Diagnóstico Precoce
18.
Harefuah ; 163(5): 310-314, 2024 May.
Artigo em Hebraico | MEDLINE | ID: mdl-38734945

RESUMO

INTRODUCTION: Corneal disease is among the leading reversible causes of blindness worldwide. Corneal transplantation is a successful and curative treatment for most of these cases. However, in certain indications it is not amendable for standard corneal transplantation, the only available option to restore functional vision is keratoprosthesis (KPro) implantation. KPros may also offer an alternative to the global shortage of donor corneas, limiting the access to transplantations. However, current KPros face many challenges, including surgical complexity that requires skilled surgeons and vast resources as well as unique surgical and post-operative complications. Although several artificial corneas have been proposed over the years, two implants are mostly used in the clinical setting today. The first, the Boston KPro, consists of a front plate with an optical stem and a back plate snapped together with donor corneal tissue in-between, which is then sutured to the patient's cornea. The second, the Osteo-odonto-keratoprosthesis (OOKP), uses biological tissue of the alveolar bone to support an optical cylinder within the eye. The indications, surgical techniques, and complication profile of the two procedures are different and will be discussed in this review. Extensive research continues to improve the accessibility and technological developments of KPros in the search for a potential breakthrough in the treatment of these difficult cases.


Assuntos
Córnea , Doenças da Córnea , Transplante de Córnea , Próteses e Implantes , Humanos , Doenças da Córnea/cirurgia , Transplante de Córnea/métodos , Córnea/cirurgia , Órgãos Artificiais , Cegueira/etiologia , Complicações Pós-Operatórias
19.
Harefuah ; 163(5): 298-304, 2024 May.
Artigo em Hebraico | MEDLINE | ID: mdl-38734943

RESUMO

INTRODUCTION: Glaucoma is a progressive optic neuropathy and is the leading cause of preventable irreversible blindness worldwide. Glaucoma causes progressive visual field loss and can have significant implications on the patient's quality of life. Lowering intraocular pressure (IOP) is the only treatment proven to prevent vision loss from glaucoma. It is achieved using medication, laser treatment and surgery. The treatment paradigm of glaucoma has been one whereby surgical intervention has been left for advanced cases due to a variety of reasons, mainly concerning safety and long term success. The past two decades have seen a paradigm shift towards earlier IOP lowering interventions using a wide array of different technologies in the laser and surgical spaces. This review aims to understand the background to this paradigm shift, its necessity, and its potential impact on the vision and life of glaucoma patients.


Assuntos
Glaucoma , Pressão Intraocular , Terapia a Laser , Qualidade de Vida , Humanos , Glaucoma/terapia , Glaucoma/cirurgia , Pressão Intraocular/fisiologia , Terapia a Laser/métodos , Cegueira/etiologia , Cegueira/prevenção & controle , Campos Visuais/fisiologia , Progressão da Doença , Doenças do Nervo Óptico/etiologia , Doenças do Nervo Óptico/terapia
20.
J Med Primatol ; 53(3): e12700, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38706108

RESUMO

A 40-year old female chimpanzee (Pan troglodytes) developed hyporexia, weight loss, followed by progressive and complete blindness. Tomography demonstrated an intracranial mass in the rostroventral brain involving the optic chiasm, with a presumptive diagnosis of neoplasm. However, histopathology revealed a granulomatous meningoencephalitis, and tissue samples tested positive for Mycobacterium tuberculosis.


Assuntos
Doenças dos Símios Antropoides , Cegueira , Meningoencefalite , Mycobacterium tuberculosis , Pan troglodytes , Animais , Feminino , Doenças dos Símios Antropoides/diagnóstico , Doenças dos Símios Antropoides/microbiologia , Doenças dos Símios Antropoides/patologia , Mycobacterium tuberculosis/isolamento & purificação , Cegueira/veterinária , Cegueira/etiologia , Cegueira/microbiologia , Cegueira/diagnóstico , Meningoencefalite/veterinária , Meningoencefalite/microbiologia , Meningoencefalite/diagnóstico , Granuloma/veterinária , Granuloma/microbiologia , Granuloma/patologia , Granuloma/diagnóstico , Tuberculose/veterinária , Tuberculose/diagnóstico , Tuberculose/complicações
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