This review focuses on the plasticity in the vestibulo-ocular reflex (VOR), especially in the otolith-ocular reflex (OOR). The VOR is a mechanism for the production of rapid compensatory eye movements during head movements. The VOR is under adaptive control which corrects VOR performance when visual-vestibular mismatch arises during head movements. It has been demonstrated that chronic exposure to certain visual environments, those generated by magnifying lenses and reversing prisms, alter the gain and phase of VOR in the dark in numerous species. Most experiments concerning such modification of the VOR have used semicircular canal stimulation. The VOR consists of the semicircular-ocular reflex (ScOR) and the OOR. There are few results regarding the relationship between the gain of the ScOR and the OOR. This review summarizes the studies on plasticity in the OOR. In addition, the difficulty in evaluating the OOR using current conventional methods including earth horizontal axis (EHA) rotation, off-vertical axis rotation (OVAR) and linear sled, is discussed. We believe that the ScOR and the OOR share common neural pathways in such a way that a change in the synaptic efficacy of one pathway is accompanied by a change in the other.
Lewis, Richard F.; Clendaniel, Richard A.; Zee, David S.; Shelhamer, M. J. (Principal Investigator)
The gain of the vestibulo-ocular reflex (VOR) normally depends on the distance between the subject and the visual target, but it remains uncertain whether vergence angle can be linked to changes in VOR gain through a process of context-dependent adaptation. In this study, we examined this question with an adaptation paradigm that modified the normal relationship between vergence angle and retinal image motion. Subjects were rotated sinusoidally while they viewed an optokinetic (OKN) stimulus through either diverging or converging prisms. In three subjects the diverging prisms were worn while the OKN stimulus moved out of phase with the head, and the converging prisms were worn when the OKN stimulus moved in-phase with the head. The relationship between the vergence angle and OKN stimulus was reversed in the fourth subject. After 2 h of training, the VOR gain at the two vergence angles changed significantly in all of the subjects, evidenced by the two different VOR gains that could be immediately accessed by switching between the diverged and converged conditions. The results demonstrate that subjects can learn to use vergence angle as the contextual cue that retrieves adaptive changes in the angular VOR.
Migliaccio, Americo A; Schubert, Michael C
A recent study showed that the angular vestibulo-ocular reflex (VOR) can be better adaptively increased using an incremental retinal image velocity error signal compared with a conventional constant large velocity-gain demand (×2). This finding has important implications for vestibular rehabilitation that seeks to improve the VOR response after injury. However, a large portion of vestibular patients have unilateral vestibular hypofunction, and training that raises their VOR response during rotations to both the ipsilesional and contralesional side is not usually ideal. We sought to determine if the vestibular response to one side could selectively be increased without affecting the contralateral response. We tested nine subjects with normal vestibular function. Using the scleral search coil and head impulse techniques, we measured the active and passive VOR gain (eye velocity / head velocity) before and after unilateral incremental VOR adaptation training, consisting of self-generated (active) head impulses, which lasted ≈ 15 min. The head impulses consisted of rapid, horizontal head rotations with peak-amplitude 15°, peak-velocity 150°/s and peak-acceleration 3,000°/s(2). The VOR gain towards the adapting side increased after training from 0.92 ± 0.18 to 1.11 ± 0.22 (+22.7 ± 20.2 %) during active head impulses and from 0.91 ± 0.15 to 1.01 ± 0.17 (+11.3 ± 7.5 %) during passive head impulses. During active impulses, the VOR gain towards the non-adapting side also increased by ≈ 8 %, though this increase was ≈ 70 % less than to the adapting side. A similar increase did not occur during passive impulses. This study shows that unilateral vestibular adaptation is possible in humans with a normal VOR; unilateral incremental VOR adaptation may have a role in vestibular rehabilitation. The increase in passive VOR gain after active head impulse adaptation suggests that the training effect is robust.
Jan, J. E.; Groenveld, M.
This article shows the usefulness of understanding visual behaviors in the diagnosis of various types of visual impairments that are due to ocular and cortical disorders. Behaviors discussed include nystagmus, ocular motor dyspraxia, head position, close viewing, field loss adaptations, mannerisms, photophobia, and abnormal color perception. (JDD)
Welch, R. B.; Bridgeman, B.; Williams, J. A.; Semmler, R.
In two experiments, we examined the possibility that the human vestibulo-ocular reflex (VOR) is subject to dual adaptation (the ability to adapt to a sensory rearrangement more rapidly and/or more completely after repeated experience with it) and adaptive generalization (the ability to adapt more readily to a novel sensory rearrangement as a result of prior dual adaptation training). In Experiment 1, the subjects actively turned the head during alternating exposure to a visual-vestibular rearrangement (target/head gain = 0.5) and the normal situation (target/head gain = 0.0). These conditions produced both adaptation and dual adaptation of the VOR but no evidence of adaptive generalization when tested with a target/head gain of 1.0. Experiment 2, in which exposure to the 0.5 gain entailed externally controlled (i.e., passive) whole body rotation, resulted in VOR adaptation but no dual adaptation. As in Experiment 1, no evidence of adaptive generalization was found.
L.J.J.M. Boumans (Leon)
textabstractThis thesis systematically investigates the influence of adaptation on the human VOR-response. Various types of angular acceleration around the vertical axis are used to determine the time constants of the VOR-system. Care is taken as far as possible to avoid fatigue, habituation and the
Bloomberg, J. J.; Merkle, L. A.; Barry, S. R.; Huebner, W. P.; Cohen, H. S.; Mueller, S. A.; Fordice, J.
The goal of the present study was to determine if adaptive modulation of vestibulo-ocular reflex (VOR) function is associated with commensurate alterations in manual target localization. To measure the effects of adapted VOR on manual responses we developed the Vestibular-Contingent Pointing Test (VCP). In the VCP test, subjects pointed to a remembered target following passive whole body rotation in the dark. In the first experiment, subjects performed VCP before and after wearing 0.5X minifying lenses that adaptively attenuate horizontal VOR gain. Results showed that adaptive reduction in horizontal VOR gain was accompanied by a commensurate change in VCP performance. In the second experiment, bilaterally labyrinthine deficient (LD) subjects were tested to confirm that vestibular cues were central to the spatial coding of both eye and hand movements during VCP. LD subjects performed significantly worse than normal subjects. These results demonstrate that adaptive change in VOR can lead to alterations in manual target localization.
Ozolinsh, Maris; Muizniece, Kristine; Berzinsh, Janis
Chromostereopsis can be sight and feel in "Virtual Reality" adapters, that induces the appearance of color dependant depth sense and, finally, combines this sense with the source conceived depth scenario. Present studies are devoted to investigation the induced chromastereopsis when using adapted "Virtual Reality" frame together with mobile devices as smartphones. We did observation of composite visual stimuli presented on the high spatial resolution screen of the mobile phone placed inside a portable "Virtual Reality" adapter. Separated for the left and right eyes stimuli consisted of two areas: a) identical for both eyes color chromostereopsis part, and b) additional conventional color neutral random-dot stereopsis part with a stereodisparity based on the horizontal shift of a random-dot segment in images for the left and right eyes, correspondingly. The observer task was to equalize the depth sense for neutral and colored stimuli areas. Such scheme allows to determine actual observed chromostereopsis disparity value versus eye stimuli color difference. At standard observation conditions for adapter with +2D ocular lenses for mobile red-blue stimuli, the perceptual chromostereopsis depth sensitivity on color difference was linearly approximated with a slope SChS ≈ 2.1[arcmin/(Labcolor difference)] for red-blue pairs. Additional to standard application in adapter the tuneable "Varioptic" liquid lens oculars were incorporated, that allowed stimuli eye magnification, vergence and disparity values control electrically.
Lenz, A; Balakrishnan, T; Pipe, A G; Melhuish, C
The vestibulo-ocular reflex stabilizes vision in many vertebrates. It integrates inertial and visual information to drive the eyes in the opposite direction to head movement and thereby stabilizes the image on the retina. Its adaptive nature guarantees stable vision even when the biological system undergoes dynamic changes (due to disease, growth or fatigue etc), a characteristic especially desirable in autonomous robotic systems. Based on novel, biologically plausible neurological models, we have developed a robotic testbed to qualitatively evaluate the performance of these algorithms. We show how the adaptive controller can adapt to a time varying plant and elaborate how this biologically inspired control architecture can be employed in general engineering applications where sensory feedback is very noisy and/or delayed.
Fadaee, Shannon B; Migliaccio, Americo A
The primary function of the angular vestibulo-ocular reflex (VOR) is to stabilise images on the retina during head movements. Retinal image movement is the likely feedback signal that drives VOR modification/adaptation for different viewing contexts. However, it is not clear whether a retinal image position or velocity error is used primarily as the feedback signal. Recent studies examining this signal are limited because they used near viewing to modify the VOR. However, it is not known whether near viewing drives VOR adaptation or is a pre-programmed contextual cue that modifies the VOR. Our study is based on analysis of the VOR evoked by horizontal head impulses during an established adaptation task. Fourteen human subjects underwent incremental unilateral VOR adaptation training and were tested using the scleral search coil technique over three separate sessions. The update rate of the laser target position (source of the retinal image error signal) used to drive VOR adaptation was different for each session [50 (once every 20 ms), 20 and 15/35 Hz]. Our results show unilateral VOR adaptation occurred at 50 and 20 Hz for both the active (23.0 ± 9.6 and 11.9 ± 9.1% increase on adapting side, respectively) and passive VOR (13.5 ± 14.9, 10.4 ± 12.2%). At 15 Hz, unilateral adaptation no longer occurred in the subject group for both the active and passive VOR, whereas individually, 4/9 subjects tested at 15 Hz had significant adaptation. Our findings suggest that 1-2 retinal image position error signals every 100 ms (i.e. target position update rate 15-20 Hz) are sufficient to drive VOR adaptation.
Full Text Available Introduction : We assessed the ocular status and visual adaptation among children studying at a school for visually disabled children in Muscat, Oman. Materials and Methods : This descriptive study was conducted in 2009-2010. We assessed the visual and ocular status of the participants. They were interviewed to elicit the past history of eye problems and management. They also expressed their visual adaptation in their ′day-to-day′ life, and their ambitions. Result : We examined and interviewed 47 participants (29 male and 18 female. The mean age of the participants was 19.7 years (Standard deviation 5.9 years. Twenty-six of them were blind since birth. Phthisical eyes, disfigured eyes and anophthalmic sockets were noted in 19, 58, and six eyes of participants. Twenty-six (55.5% participants had visual disabilities due to genetic causes, since birth. In 13 participants, further investigations were needed to confirm diagnosis and determine further management After low vision training, 13 participants with residual vision could be integrated in the school with normal children. One participant was recommended stem cell treatment for visual restoration. Five children were advised reconstructive orbital surgery. The participants were not keen to use a white cane for mobility. Some participants, 16 / 28 (57%, with absolute blindness, were not able to read the Braille language. Singing and playing music were not very well-accepted hobbies among the participants. Nineteen participants were keen to become teachers. Conclusions : Children with visual disabilities need to be periodically assessed. The underlying causes of visual disabilities should be further explored to facilitate prevention and genetic counseling. Participants had visual adaptation for daily living and had ambitions for the future.
According to the experimental studies, the duration of the transient phenomenon of the synaptic modification involved in vestibulo-ocular reflex (VOR) adaptation lasts considerably long after the synaptic inputs. In the present article, effect of the transient phenomenon on VOR adaptation is studied by incorporating the transient phenomenon into the cerebellar model proposed by Fujita. In the present extended model, it is assumed that the synaptic modification is a modification of the concentrations of reactants and products for a certain reaction. The synaptic efficacy is given by the concentration of products. The model of reaction includes the supply of reactants and flux of reactants and products out of the reaction system. The supply of reactants is induced by correlation between two different types of input signals, which has been considered to be proportional to the amount of the synaptic modification at the moment. The flux produces natural recovery of the synaptic modification, which was observed in experiments. The simulation results suggest that VOR adaptation takes two types of courses according to the efficiency of the reactant supply to the synaptic inputs under the slow transient phenomenon of the synaptic modification. The present extended model gives approaches to control mechanisms of VOR adaptation.
Trillenberg, P.; Shelhamer, M.; Roberts, D. C.; Zee, D. S.
The three pairs of semicircular canals within the labyrinth are not perfectly aligned with the pulling directions of the six extraocular muscles. Therefore, for a given head movement, the vestibulo-ocular reflex (VOR) depends upon central neural mechanisms that couple the canals to the muscles with the appropriate functional gains in order to generate a response that rotates the eye the correct amount and around the correct axis. A consequence of these neural connections is a cross-axis adaptive capability, which can be stimulated experimentally when head rotation is around one axis and visual motion about another. From this visual-vestibular conflict the brain infers that the slow-phase eye movement is rotating around the wrong axis. We explored the capability of human cross-axis adaptation, using a short-term training paradigm, to determine if torsional eye movements could be elicited by yaw (horizontal) head rotation (where torsion is normally inappropriate). We applied yaw sinusoidal head rotation (+/-10 degrees, 0.33 Hz) and measured eye movement responses in the dark, and before and after adaptation. The adaptation paradigm lasted 45-60 min, and consisted of the identical head motion, coupled with a moving visual scene that required one of several types of eye movements: (1) torsion alone (-Roll); (2) horizontal/torsional, head right/CW torsion (Yaw-Roll); (3) horizontal/torsional, head right/CCW torsion (Yaw+Roll); (4) horizontal, vertical, torsional combined (Yaw+Pitch-Roll); and (5) horizontal and vertical together (Yaw+Pitch). The largest and most significant changes in torsional amplitude occurred in the Yaw-Roll and Yaw+Roll conditions. We conclude that short-term, cross-axis adaptation of torsion is possible but constrained by the complexity of the adaptation task: smaller torsional components are produced if more than one cross-coupling component is required. In contrast, vertical cross-axis components can be easily trained to occur with yaw head
Migliaccio, Americo A; Minor, Lloyd B; Della Santina, Charles C
To maintain visual fixation on a distant target during head rotation, the angular vestibulo-ocular reflex (aVOR) should rotate the eyes at the same speed as the head and in exactly the opposite direction. However, in primates for which the 3-dimensional (3D) aVOR has been extensively characterised (humans and squirrel monkeys (Saimiri sciureus)), the aVOR response to roll head rotation about the naso-occipital axis is lower than that elicited by yaw and pitch, causing errors in aVOR magnitude and direction that vary with the axis of head rotation. In other words, primates keep the central part of the retinal image on the fovea (where photoreceptor density and visual acuity are greatest) but fail to keep that image from twisting about the eyes' resting optic axes. We tested the hypothesis that aVOR direction dependence is an adaptation related to primates' frontal-eyed, foveate status through comparison with the aVOR of a lateral-eyed, afoveate mammal (Chinchilla lanigera). As chinchillas' eyes are afoveate and never align with each other, we predicted that the chinchilla aVOR would be relatively low in gain and isotropic (equal in gain for every head rotation axis). In 11 normal chinchillas, we recorded binocular 3D eye movements in darkness during static tilts, 20-100 deg s(1) whole-body sinusoidal rotations (0.5-15 Hz), and 3000 deg s(2) acceleration steps. Although the chinchilla 3D aVOR gain changed with both frequency and peak velocity over the range we examined, we consistently found that it was more nearly isotropic than the primate aVOR. Our results suggest that primates' anisotropic aVOR represents an adaptation to their forward-eyed, foveate status. In primates, yaw and pitch aVOR must be compensatory to stabilise images on both foveae, whereas roll aVOR can be under-compensatory because the brain tolerates torsion of binocular images that remain on the foveae. In contrast, the lateral-eyed chinchilla faces different adaptive demands and thus enlists a
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Hübner, Patrick P; Khan, Serajul I; Migliaccio, Americo A
One commonly observed phenomenon of vestibulo-ocular reflex (VOR) adaptation is a frequency-selective change in gain (eye velocity/head velocity) and phase (relative timing between the vestibular stimulus and response) based on the frequency content of the adaptation training stimulus. The neural mechanism behind this type of adaptation is not clear. Our aim was to determine whether there were other parameter-selective effects on VOR adaptation, specifically velocity-selective and acceleration-selective changes in the horizontal VOR gain and phase. We also wanted to determine whether parameter selectivity was also in place for cross-axis adaptation training (a visual-vestibular training stimulus that elicits a vestibular-evoked torsional eye movement during horizontal head rotations). We measured VOR gain and phase in 17 C57BL/6 mice during baseline (no adaptation training) and after gain-increase, gain-decrease and cross-axis adaptation training using a sinusoidal visual-vestibular (mismatch) stimulus with whole-body rotations (vestibular stimulus) with peak velocity 20 and 50°/s both with a fixed frequency of 0.5 Hz. Our results show pronounced velocity selectivity of VOR adaptation. The difference in horizontal VOR gain after gain-increase versus gain-decrease adaptation was maximal when the sinusoidal testing stimulus matched the adaptation training stimulus peak velocity. We also observed similar velocity selectivity after cross-axis adaptation training. Our data suggest that frequency selectivity could be a manifestation of both velocity and acceleration selectivity because when one of these is absent, e.g. acceleration selectivity in the mouse, frequency selectivity is also reduced.
Al Abdlseaed, Abdlsaed; McTaggart, Yvonne; Ramage, Thomas; Hamilton, Ruth; McCulloch, Daphne L
This study characterizes differences in human ERGs based on ocular pigmentation. Light- and dark-adapted luminance-response (LR) series for a-, b- and i-waves and light-adapted oscillatory potentials (OPs) were recorded in 14 healthy volunteers (7 blue-eyed Caucasians; 7 brown-eyed Asians, aged 20-22 years). Amplitude interpolations were by logistic growth (Naka-Rushton), Gaussian or the combined 'photopic hill' functions. Implicit times (IT) for dark-adapted a- and b-waves, and for light-adapted a-, b- and i-waves were earlier in the blue-eyed group than in the brown-eyed group across all flash strengths (P dark-adapted ERGs, saturated a-wave amplitude was larger for blue eyes (397 vs. 318 μV, P blue-eyed group (photopic hill, Gaussian peak: 155 vs. 82 μV, P blue-eyed group (52 vs. 39 μV; 209 vs. 133 μV, P blue irides than in those with dark pigmentation. Amplitude differences are highly non-linear and substantially larger from eyes with light pigmentation for components thought to be associated with the OFF retinal pathways.
Fernández, Enrique; Drexler, Wolfgang
Optical coherence tomography (OCT) enables visualization of the living human retina with unprecedented high axial resolution. The transverse resolution of existing OCT approaches is relatively modest as compared to other retinal imaging techniques. In this context, the use of adaptive optics (AO) to correct for ocular aberrations in combination with OCT has recently been demonstrated to notably increase the transverse resolution of the retinal OCT tomograms. AO is required when imaging is performed through moderate and large pupil sizes. A fundamental difference of OCT as compared to other imaging techniques is the demand of polychromatic light to accomplish high axial resolution. In ophthalmic OCT applications, the performance is therefore also limited by ocular chromatic aberrations. In the current work, the effects of chromatic and monochromatic ocular aberrations on the quality of retinal OCT tomograms, especially concerning transverse resolution, sensitivity and contrast, are theoretically studied and characterized. The repercussion of the chosen spectral bandwidth and pupil size on the final transverse resolution of OCT tomograms is quantitatively examined. It is found that losses in the intensity of OCT images obtained with monochromatic aberration correction can be up to 80 %, using a pupil size of 8 mm diameter in combination with a spectral bandwidth of 120 nm full width at half maximum for AO ultrahigh resolution OCT. The limits to the performance of AO for correction of monochromatic aberrations in OCT are established. The reduction of the detected signal and the resulting transverse resolution caused by chromatic aberration of the human eye is found to be strongly dependent on the employed bandwidth and pupil size. Comparison of theoretical results with experimental findings obtained in living human eyes is also provided.
Tanaka, Shinsuke; Kawaguchi, Shin-Ya; Shioi, Go; Hirano, Tomoo
Synaptic plasticity in the cerebellum is thought to contribute to motor learning. In particular, long-term depression (LTD) at parallel fiber (PF) to Purkinje neuron (PN) excitatory synapses has attracted much attention of neuroscientists as a primary cellular mechanism for motor learning. In contrast, roles of plasticity at cerebellar inhibitory synapses in vivo remain unknown. Here, we have investigated the roles of long-lasting enhancement of transmission at GABAergic synapses on a PN that is known as rebound potentiation (RP). Previous studies demonstrated that binding of GABAA receptor with GABAA receptor-associated protein (GABARAP) is required for RP, and that a peptide that blocks this binding suppresses RP induction. To address the functional roles of RP, we generated transgenic mice that express this peptide fused to a fluorescent protein selectively in PNs using the PN-specific L7 promoter. These mice failed to show RP, although they showed no changes in the basal amplitude or frequency of miniature IPSCs. The transgenic mice also showed no abnormality in gross cerebellar morphology, LTD, or other excitatory synaptic properties, or intrinsic excitability of PNs. Next, we attempted to evaluate their motor control and learning ability by examining reflex eye movements. The basal dynamic properties of the vestibulo-ocular reflex and optokinetic response, and adaptation of the latter, were normal in the transgenic mice. In contrast, the transgenic mice showed defects in the adaptation of vestibulo-ocular reflex, a model paradigm of cerebellum-dependent motor learning. These results together suggest that RP contributes to a certain type of motor learning.
Marcos, Susana; Sawides, Lucie; Gambra, Enrique; Dorronsoro, Carlos
We evaluated the visual benefit of correcting astigmatism and high-order aberrations with adaptive optics (AO) on visual acuity (VA) measured at 7 different luminances (ranging from 0.8 to 50 cd/m(2)) and two contrast polarities (black letters on white background, BoW, and white letters on black background, WoB) on 7 subjects. For the BoW condition, VA increased with background luminance in both natural and AO-corrected conditions, and there was a benefit of AO correction at all luminances (by a factor of 1.29 on average across luminances). For WoB VA increased with foreground luminance but decreased for the highest luminances. In this reversed polarity condition AO correction increased VA by a factor of 1.13 on average and did not produce a visual benefit at high luminances. The improvement of VA (averaged across conditions) was significantly correlated (p = 0.04) with the amount of corrected aberrations (in terms of Strehl ratio). The improved performance with WoB targets with respect to BoW targets is decreased when correcting aberrations, suggesting a role of ocular aberrations in the differences in visual performance between contrast polarities.
Clopath, Claudia; Badura, Aleksandra; De Zeeuw, Chris I; Brunel, Nicolas
Mechanisms of cerebellar motor learning are still poorly understood. The standard Marr-Albus-Ito theory posits that learning involves plasticity at the parallel fiber to Purkinje cell synapses under control of the climbing fiber input, which provides an error signal as in classical supervised learning paradigms. However, a growing body of evidence challenges this theory, in that additional sites of plasticity appear to contribute to motor adaptation. Here, we consider phase-reversal training of the vestibulo-ocular reflex (VOR), a simple form of motor learning for which a large body of experimental data is available in wild-type and mutant mice, in which the excitability of granule cells or inhibition of Purkinje cells was affected in a cell-specific fashion. We present novel electrophysiological recordings of Purkinje cell activity measured in naive wild-type mice subjected to this VOR adaptation task. We then introduce a minimal model that consists of learning at the parallel fibers to Purkinje cells with the help of the climbing fibers. Although the minimal model reproduces the behavior of the wild-type animals and is analytically tractable, it fails at reproducing the behavior of mutant mice and the electrophysiology data. Therefore, we build a detailed model involving plasticity at the parallel fibers to Purkinje cells' synapse guided by climbing fibers, feedforward inhibition of Purkinje cells, and plasticity at the mossy fiber to vestibular nuclei neuron synapse. The detailed model reproduces both the behavioral and electrophysiological data of both the wild-type and mutant mice and allows for experimentally testable predictions.
Miller, Chris; Mulavara, Ajitkumar; Richards, Jason; Peters, Brian; Houser, Jeremy; Marshburn, Ann; Bloomberg, Jacob
Controlling locomotion while maintaining a stable gaze requires precise coordination between several, interdependent full-body sensorimotor subsystems (Bloomberg and Mulavara, 2003; McDonald, et al., 1997). The overall goal of this study is to determine how this full-body gaze stabilization system responds to adaptive changes in vestibuloocular reflex (VOR) function. Locomotion involves cyclical physical interactions (impacts) with the environment. Hence, focusing on a target and maintaining visual acuity during this activity may require mechanisms to manage the energy flow, so it does not disrupt the visual and vestibular sensory information processing that stabilizes gaze. It has been shown that increasing the difficulty of a gaze task (reading numbers on a screen as opposed to simply focusing on a central dot pattern) resulted in an increase in the amount of knee flexion movement during the critical phase immediately following the heel strike event (Mulavara and Bloomberg, 2003). The increase in knee flexion during the stance phase of the gait cycle has been suggested to function as a shock absorbing mechanism associated with the rapid weight transfer from the trailing to the leading leg during walking. To understand this full-body coordination, the relative contributions of each component and the resulting effects should be assessed. In this study, we hypothesized that VOR adaptation would result in a reorganization of the lower limb joint coordination during treadmill walking in a manner to facilitate the gaze stabilization task and preserve locomotor function.
Anzai, Mari; Nagao, Soich
Adaptation of the horizontal vestibulo-ocular reflex (HVOR) provides an experimental model for cerebellum-dependent motor learning. We developed an eye movement measuring system and a paradigm for induction of HVOR adaptation for the common marmoset. The HVOR gain in dark measured by 10° (peak-to-peak amplitude) and 0.11-0.5Hz turntable oscillation was around unity. The gain-up and gain-down HVOR adaptation was induced by 1h of sustained out-of-phase and in-phase 10°-0.33Hz combined turntable-screen oscillation in the light, respectively. To examine the role of long-term depression (LTD) of parallel fiber-Purkinje cell synapses, we intraperitonially applied T-588 or nimesulide, which block the induction of LTD in vitro or in vivo preparations, 1h before the test of HVOR adaptation. T-588 (3 and 5mg/kg body weight) did not affect nonadapted HVOR gains, and impaired both gain-up and gain-down HVOR adaptation. Nimesulide (3 and 6mg/kg) did not affect nonadapted HVOR gains, and impaired gain-up HVOR adaptation dose-dependently; however, it very little affected gain-down HVOR adaptation. These findings are consistent with the results of our study of nimesulide on the adaptation of horizontal optokinetic response in mice (Le et al., 2010), and support the view that LTD underlies HVOR adaptation.
Koh, Doo-Yeol; Kim, Young-Kook; Kim, Kyung-Soo; Kim, Soohyun
In mobile robotics, obtaining stable image of a mounted camera is crucial for operating a mobile system to complete given tasks. This note presents the development of a high-speed image stabilizing device using linear shaft actuator, and a new image stabilization method inspired by human gaze stabilization process known as vestibulo-ocular reflex (VOR). In the proposed control, the reference is adaptively adjusted by the VOR adaptation control to reject residual vibration of a camera as the VOR gain converges to optimal state. Through experiments on a pneumatic vibrator, it will be shown that the proposed system is capable of stabilizing 10 Hz platform vibration, which shows potential applicability of the device to a high-speed mobile robot.
Anzai, Mari; Kitazawa, Hiromasa; Nagao, Soichi
The adaptation of the horizontal vestibulo-ocular reflex (HVOR) provides an experimental model for motor learning. Two studies, using cats and mice, respectively, have recently suggested pharmacologically that the memory of adaptation is located multiply in the cerebellum and brainstem. Here, we examined the effects of acute cerebellar flocculus shutdown on the adaptation in four monkeys. Two hours of 0.11Hz-10° turntable oscillation while viewing a stationary checked-patterned screen through the left-right reversing prism decreased the HVOR gains by 0.16, and 3 days of prism wearing combined with 2h of daily turntable oscillation decreased the HVOR gains by 0.27. Injections of lidocaine into bilateral flocculi did not affect the nonadapted HVOR gains, but depressed the visual suppression of the HVOR. They recovered the HVOR gains decreased by 2h of training, but very little affected the HVOR gains decreased by previous 2 days of training. Injections of control Ringer's solution did not affect the gains adapted by 2h or 3 days of training. These results are consistent with the previous studies, and suggest that the memory trace of adaptation of the HVOR initially resides in the flocculus but later resides, presumably, in the vestibular nuclei in the monkey.
Full Text Available Five cases of ocular rosacea (one male and four females are reported in this paper. Two of the patients were with keratoconjunctivitis sicca, one with conjunctivitis chronica and blepharitis, one with conjunctivitis chronica and meibomitis, and one with reccurent corneal erosions with meibomitis and chordeloum. In four patients ocular symptoms preceded the occurence of skin lesions. The treatment with oral tetracyclines significantly improved the state of ocular rosacea in four patients, while in one case the changes of the anterior eye segment progressed in more severe state of ulcerative keratitis. It is considered that in almost 20% of the patients with rosacea ocular lesions may precede the skin changes, representing a diagnostic problem. Thus, in those cases multidisciplinary approach is suggested. Such approach is particularly important because of the decrease of morbidity and the prevention of the onset of the eye complications such as drastic worsening of visual acuity, i.e., the blindness.
Arevalo, J Fernando; Espinoza, Juan V; Arevalo, Fernando A
Ocular toxocariasis is an uncommon worldwide parasitic infection that affects mostly children and is found in both rural and metropolitan areas. In many parts of the world, parasitic infections of the eye are a major cause of blindness. The diagnosis of toxocariasis is essentially clinical, based on the lesion morphology and supportive laboratory data such as serum enzyme-linked immunosorbent assay (ELISA) titers and ELISA Toxocara titers on aqueous humor; other diagnostic methods are imaging studies including optical coherence tomography, fluorescein angiography, computed tomography, and ocular ultrasound. Treatment is directed at complications arising from intraocular inflammation and vitreous membrane traction. Early vitrectomy may be of value both diagnostically and therapeutically.
Hegemann, S.; Shelhamer, M.; Kramer, P. D.; Zee, D. S.
The phase of the translational linear VOR (LVOR) can be adaptively modified by exposure to a visual-vestibular mismatch. We extend here our earlier work on LVOR phase adaptation, and discuss the role of the oculomotor neural integrator. Ten subjects were oscillated laterally at 0.5 Hz, 0.3 g peak acceleration, while sitting upright on a linear sled. LVOR was assessed before and after adaptation with subjects tracking the remembered location of a target at 1 m in the dark. Phase and gain were measured by fitting sine waves to the desaccaded eye movements, and comparing sled and eye position. To adapt LVOR phase, the subject viewed a computer-generated stereoscopic visual display, at a virtual distance of 1 m, that moved so as to require either a phase lead or a phase lag of 53 deg. Adaptation lasted 20 min, during which subjects were oscillated at 0.5 Hz/0.3 g. Four of five subjects produced an adaptive change in the lag condition (range 4-45 deg), and each of five produced a change in the lead condition (range 19-56 deg), as requested. Changes in drift on eccentric gaze suggest that the oculomotor velocity-to-position integrator may be involved in the phase changes.
Dai, Chenkai; Fridman, Gene Y; Chiang, Bryce; Davidovics, Natan S; Melvin, Thuy-Anh; Cullen, Kathleen E; Della Santina, Charles C
By sensing three-dimensional (3D) head rotation and electrically stimulating the three ampullary branches of a vestibular nerve to encode head angular velocity, a multichannel vestibular prosthesis (MVP) can restore vestibular sensation to individuals disabled by loss of vestibular hair cell function. However, current spread to afferent fibers innervating non-targeted canals and otolith end organs can distort the vestibular nerve activation pattern, causing misalignment between the perceived and actual axis of head rotation. We hypothesized that over time, central neural mechanisms can adapt to correct this misalignment. To test this, we rendered five chinchillas vestibular deficient via bilateral gentamicin treatment and unilaterally implanted them with a head-mounted MVP. Comparison of 3D angular vestibulo-ocular reflex (aVOR) responses during 2 Hz, 50°/s peak horizontal sinusoidal head rotations in darkness on the first, third, and seventh days of continual MVP use revealed that eye responses about the intended axis remained stable (at about 70% of the normal gain) while misalignment improved significantly by the end of 1 week of prosthetic stimulation. A comparable time course of improvement was also observed for head rotations about the other two semicircular canal axes and at every stimulus frequency examined (0.2-5 Hz). In addition, the extent of disconjugacy between the two eyes progressively improved during the same time window. These results indicate that the central nervous system rapidly adapts to multichannel prosthetic vestibular stimulation to markedly improve 3D aVOR alignment within the first week after activation. Similar adaptive improvements are likely to occur in other species, including humans.
Full Text Available Dirofilaria is a parasite of domestic and wild animals that can infect humans accidentally. It is being reported in increasing numbers from Mediterranean countries like Italy. In India this infection is occasionally being reported. We report three cases of ocular dirofilariasis from the state of Assam presenting as periorbital and subconjunctival cysts. The parasites were identified as Dirofilaria repens. The purpose of this article is to take note of this emerging zoonosis in Assam; also to review literature in the cases reported.
Machado, Anderson Silva; Carneiro, Ana Carolina Aguiar Vasconcelos; Béla, Samantha Ribeiro; Andrade, Gláucia Manzan Queiroz; Vasconcelos-Santos, Daniel Vitor; Januário, José Nélio; Coelho-dos-Reis, Jordana G.; Ferro, Eloisa Amália Vieira; Teixeira-Carvalho, Andréa; Vitor, Ricardo Wagner Almeida; Martins-Filho, Olindo Assis; —UFMG-CTBG, UFMG Congenital Toxoplasmosis Brazilian Group
Toxoplasma gondii is the main infectious cause of human posterior retinochoroiditis, the most frequent clinical manifestation of congenital toxoplasmosis. This investigation was performed after neonatal screening to identify biomarkers of immunity associated with immunopathological features of the disease by flow cytometry. The study included infected infants without NRL and with retinochoroidal lesions (ARL, ACRL, and CRL) as well as noninfected individuals (NI). Our data demonstrated that leukocytosis, with increased monocytes and lymphocytes, was a relevant hematological biomarker of ARL. Immunophenotypic analysis also revealed expansion of CD14+CD16+HLA-DRhigh monocytes and CD56dim cytotoxic NK-cells in ARL. Moreover, augmented TCRγδ+ and CD8+ T-cell counts were apparently good biomarkers of morbidity. Biomarker network analysis revealed that complex and intricated networks underscored the negative correlation of monocytes with NK- and B-cells in NRL. The remarkable lack of connections involving B-cells and a relevant shift of NK-cell connections from B-cells toward T-cells observed in ARL were outstanding. A tightly connected biomarker network was observed in CRL, with relevant connections of NK- and CD8+ T-cells with a broad range of cell subsets. Our findings add novel elements to the current knowledge on the innate and adaptive immune responses in congenital toxoplasmosis. PMID:25328286
Wall, C. 3rd; Smith, T. R.; Furman, J. M.
The eye movement response to earth vertical axis rotation in the dark, a semicircular canal stimulus, can be altered by prior exposure to combined visual-vestibular stimuli. Such plasticity of the vestibulo-ocular reflex has not been described for earth horizontal axis rotation, a dynamic otolith stimulus. Twenty normal human subjects underwent one of two types of adaptation paradigms designed either to attenuate or enhance the gain of the semicircular canal-ocular reflex prior to undergoing otolith-ocular reflex testing with horizontal axis rotation. The adaptation paradigm paired a 0.2 Hz sinusoidal rotation about a vertical axis with a 0.2 Hz optokinetic stripe pattern that was deliberately mismatched in peak velocity. Pre- and post-adaptation horizontal axis rotations were at 60 degrees/s in the dark and produced a modulation in the slow component velocity of nystagmus having a frequency of 0.17 Hz due to putative stimulation of the otolith organs. Results showed that the magnitude of this modulation component response was altered in a manner similar to the alteration in semicircular canal-ocular responses. These results suggest that physiologic alteration of the vestibulo-ocular reflex using deliberately mismatched visual and semicircular canal stimuli induces changes in both canal-ocular and otolith-ocular responses. We postulate, therefore, that central nervous system pathways responsible for controlling the gains of canal-ocular and otolith-ocular reflexes are shared.
Kawali, Ankush A
Background and Objectives: The purpose of this study was to evaluate ocular inflammatory and non-inflammatory conditions using commercially available thermal camera. Materials and Methods: A non-contact thermographic camera (FLIR P 620) was used to take thermal pictures of seven cases of ocular inflammation, two cases of non-inflammatory ocular pathology, and one healthy subject with mild refractive error only. Ocular inflammatory cases included five cases of scleritis, one case of postoperative anterior uveitis, and a case of meibomian gland dysfunction with keratitis (MGD-keratitis). Non-inflammatory conditions included a case of conjunctival benign reactive lymphoid hyperplasia (BRLH) and a case of central serous chorio-retinopathy. Thermal and non-thermal photographs were taken, and using analyzing software, the ocular surface temperature was calculated. Results: Patient with fresh episode of scleritis revealed high temperature. Eyes with MGD-keratitis depicted lower temperature in clinically more affected eye. Conjunctival BRLH showed a cold lesion on thermography at the site of involvement, in contrast to cases of scleritis with similar clinical presentation. Conclusion: Ocular thermal imaging is an underutilized diagnostic tool which can be used to distinguish inflammatory ocular conditions from non-inflammatory conditions. It can also be utilized in the evaluation of tear film in dry eye syndrome. Its applications should be further explored in uveitis and other ocular disorders. Dedicated “ocular thermographic” camera is today's need of the hour. PMID:24347863
Ahmad M Mansour
Full Text Available Purpose: To present the visual outcomes and ocular sequelae of victims of cluster bombs. Materials and Methods: This retrospective, multicenter case series of ocular injury due to cluster bombs was conducted for 3 years after the war in South Lebanon (July 2006. Data were gathered from the reports to the Information Management System for Mine Action. Results: There were 308 victims of clusters bombs; 36 individuals were killed, of which 2 received ocular lacerations and; 272 individuals were injured with 18 receiving ocular injury. These 18 surviving individuals were assessed by the authors. Ocular injury occurred in 6.5% (20/308 of cluster bomb victims. Trauma to multiple organs occurred in 12 of 18 cases (67% with ocular injury. Ocular findings included corneal or scleral lacerations (16 eyes, corneal foreign bodies (9 eyes, corneal decompensation (2 eyes, ruptured cataract (6 eyes, and intravitreal foreign bodies (10 eyes. The corneas of one patient had extreme attenuation of the endothelium. Conclusions: Ocular injury occurred in 6.5% of cluster bomb victims and 67% of the patients with ocular injury sustained trauma to multiple organs. Visual morbidity in civilians is an additional reason for a global ban on the use of cluster bombs.
Petersen, E.; Kijlstra, A.; Stanford, M.
Retinal infection with Toxoplasma gondii is the most important cause of posterior uveitis, whereby prevalence and incidence of ocular symptoms after infection depend on socio-economic factors and the circulating parasite genotypes. Ocular toxoplasmosis is more common in South America, Central Americ
Full Text Available São relatados 4 casos de miopatia ocular descendente (MOD com história familial levantada em três gerações. Biópsia musculares e eletromiografia em um caso confirmaram o caráter miogênico da doença. A MOD nada mais seria do que uma forma clínica especial de distrofia muscular, de início tardio.Four cases of the so-called descending ocular myopathy with a family history in three generations are reported. In the first case muscular biopsy and electromyographic studies proved the myogenic nature of the process. Descending ocular myopathy seems to be just a clinical form of muscular distrophy of late onset.
J Gordon Millichap
Full Text Available The clinical and neuroradiological findings, and long-term intellectual prognosis in 10 patients (4 boys and 6 girls with congenital ocular motor apraxia (COMA are reviewed by researchers at Tottori University, Yonago, Japan.
Ana Carolina Cabreira Vieira
Full Text Available Rosacea is a prevalent chronic cutaneous disorder with variable presentation and severity. Although considered a skin disease, rosacea may evolve the eyes in 58-72% of the patients, causing eyelid and ocular surface inflammation. About one third of the patients develop potentially sight-threatening corneal involvement. Untreated rosacea may cause varying degrees of ocular morbidity. The importance of early diagnosis and adequate treatment cannot be overemphasized. There is not yet a diagnostic test for rosacea. The diagnosis of ocular rosacea relies on observation of clinical features, which can be challenging in up to 90% of patients in whom accompanying roseatic skin changes may be subtle or inexistent. In this review, we describe the pathophysiologic mechanisms proposed in the literature, clinical features, diagnosis and management of ocular rosacea, as well as discuss the need for a diagnostic test for the disease.
The ocular surface is exceptionally rich in complexity and functionality. Severe ocular surface disorders/conditions, such as chemical or thermal injuries, Stevens-Johnson syndrome (SJS), ocular cicatricial pemphigoid, neurotrophic keratopathy, chronic limbitis, and severe microbial keratitis cause significant morbidities and even corneal blindness. Hypofunction may be caused by Aniridia, Neurotrophy, Endocrine, Pterygium and Chronic limbitis Approximately 6000 patients are seen in Ocular Sur...
Janecka, I P
The purpose of this study was to examine results with elective surgical correction of enophthalmos. The study was a retrospective assessment in a university-based referral practice. A consecutive sample of 10 patients who developed ocular dystopia following orbital trauma was examined. The main outcome measures were a subjective evaluation by patients and objective measurements of patients' eye position. The intervention was three-dimensional orbital reconstruction with titanium plates. It is concluded that satisfactory correction of enophthalmos and ocular dystopia can be achieved with elective surgery using titanium plates. In addition, intraoperative measurements of eye position in three planes increases the precision of surgery.
Bazzazi, Nooshin; Yavarikia, Alireza; Keramat, Fariba
A 29-year-old male diagnosed with brucellosis a week earlier was referred to the ophthalmology clinic with visual complaints. On examination, visual acuity was 20/25, he had conjunctival injection on slit lamp examination. There was also bilateral optic disk swelling plus retinal hyperemia (optic disc hyperemia and vascular tortuosity) and intraretinal hemorrhage on funduscopy. The patient was admitted and treated with cotrimoxazole, rifampin, doxycycline and prednisolone for 2 months. Ocular manifestations subsided gradually within 6 months after treatment. Brucellosis can affect the eye and lead to serious ocular complications. Early diagnosis and prompt treatment should be considered in endemic areas.
Roque, Pedro J; Hatch, Nicholas; Barr, Laurel; Wu, Teresa S
Many ocular emergencies are difficult to diagnose in the emergency setting with conventional physical examination tools. Additionally, persistent efforts to re-examine the eye may be deleterious to a patient's overall condition. Ultrasound is an important tool because it affords physicians a rapid, portable, accurate, and dynamic tool for evaluation of a variety of ocular and orbital diseases. The importance of understanding orbital anatomy, with attention to the firm attachment points of the various layers of the eye, cannot be understated. This article describes the relevant eye anatomy, delves into the ultrasound technique, and illustrates a variety of orbital pathologies detectable by bedside ultrasound.
Webster, Guy; Schaller, Martin
As many as 50% of patients given the diagnosis of cutaneous rosacea also have ocular rosacea. Conservative figures indicate that approximately 10 million patients are affected by ocular rosacea in the United States alone. Despite this prevalence, ocular symptoms of rosacea are often improperly diagnosed, particularly when they occur in the absence of skin involvement.
Full Text Available Leptospiral uveitis is a common entity in tropical countries. Ocular manifestations are noted in the second phase of illness, but these remain under-diagnosed mainly because of the prolonged symptom-free period that separates the systemic manifestations from detection of ocular manifestations.Varying ophthalmic presentations and the intrinsic nature of different types of uveitis to mimic one another also challenge the accuracy of the diagnosis. Of the individual ocular signs, the combination of acute, non-granulomatous, panuveitis, hypopyon, vasculitis, optic disc edema, membranous vitreous opacities and absence of choroiditis or retinitis have high predictive value for the clinical diagnosis of leptospiral uveitis. Geographic location of the patient, occupation, socio-economic status, risk factors related to exposure, past history of fever or jaundice also aid in diagnosis.Steroids are the mainstay of treatment for leptospiral uveitis. Depending upon the severity and anatomical location of inflammatory lesion, topical, peri-ocular and/or systemic steroids are given. The prognosis is generally good, even when the inflammation is severe.
Rasmussen, Peter K; Coupland, Sarah E; Finger, Paul T
IMPORTANCE The clinical features of the follicular subtype of ocular adnexal lymphoma (OAL) have not been previously evaluated in a large cohort. OBJECTIVE To characterize the clinical features of follicular OAL. DESIGN, SETTING, AND PARTICIPANTS We performed a retrospective multicenter study tha...
Full Text Available Keratoconus is the most common corneal ectatic disorder, the cause of which is largely unknown. Many factors have been implicated, and the ocular allergy is being one of them. The commonly proposed pathogenesis includes the release of inflammatory mediators due to eye rubbing which may alter the corneal collagen and lead to corneal ectasias. The onset of keratoconus is often early in cases associated with allergy and routine corneal topography may detect subtle forms of keratoconus. These cases may require early keratoplasty and are at an increased risk of having acute corneal hydrops. Surgical outcomes are similar to primary keratoconus cases. However, post-operative epithelial breakdown may be a problem in these cases. Control of allergy and eye rubbing is the best measure to prevent corneal ectasias in cases of ocular allergy.
Full Text Available São relatados 4 casos de miopatia ocular descendente (MOD com história familial levantada em três gerações. Biópsia musculares e eletromiografia em um caso confirmaram o caráter miogênico da doença. A MOD nada mais seria do que uma forma clínica especial de distrofia muscular, de início tardio.
Nath, Reema; Gogoi, Rajendra Nath
Sparganosis is caused by plerocercoid larvae of the Pseudophyllidea tapeworms of the genus Spirometra. Though prevalent in East Asian and south east Asian countries like China, Japan, Korea, Taiwan, Vietnam, Thailand; yet very few cases are reported from India. We report a case of migrating sub-conjunctival ocular sparganosis mimicking scleritis which later on developed into orbital cellulitis from Dibrugarh, Assam, North-eastern part of India. This case is reported for its rarity. PMID:25709957
Flynn, T H
OBJECTIVES: To describe the clinical characteristics of ocular injuries sustained in hurling in the south of Ireland and to investigate reasons for non-use of protective headgear and eye wear. METHODS: Retrospective review of the case notes of 310 patients who attended Cork University Hospital or Waterford Regional Hospital between 1 January 1994 and 31 December 2002 with ocular injuries sustained during a hurling match. A confidential questionnaire on reasons for non-use of protective headgear and eye wear was completed by 130 players. RESULTS: Hurling related eye injuries occurred most commonly in young men. Fifty two patients (17%) required hospital admission, with hyphaema accounting for 71% of admissions. Ten injuries required intraocular surgical INTERVENTION: retinal detachment repair (5); macular hole surgery (1); repair of partial thickness corneal laceration (1); repair of globe perforation (1); enucleation (1); trabeculectomy for post-traumatic glaucoma (1). Fourteen eyes (4.5%) had a final best corrected visual acuity (BCVA) of <6\\/12 and six (2%) had BCVA <3\\/60. In the survey, 63 players (48.5%) reported wearing no protective facemask while playing hurling. Impairment of vision was the most common reason cited for non-use. CONCLUSIONS: Hurling related injury is a significant, and preventable, cause of ocular morbidity in young men in Ireland. The routine use of appropriate protective headgear and faceguards would result in a dramatic reduction in the incidence and severity of these injuries, and should be mandatory.
Díaz-Doutón, Fernando; Pujol, Jaume; Arjona, Montserrat; Luque, Sergio O
We describe a new wavefront sensor for ocular aberration determination, based on the curvature sensing principle, which adapts the classical system used in astronomy for the living eye's measurements. The actual experimental setup is presented and designed following a process guided by computer simulations to adjust the design parameters for optimal performance. We present results for artificial and real young eyes, compared with the Hartmann-Shack estimations. Both methods show a similar performance for these cases. This system will allow for the measurement of higher order aberrations than the currently used wavefront sensors in situations in which they are supposed to be significant, such as postsurgery eyes.
Full Text Available There is a high prevalence of ocular defects in children with developmental disabilities. This study evaluated visual disability in a group of 200 cerebral palsy (CP patients and found that 68% of the children had significant visual morbidity. These findings emphasize the need for an early ocular examination in patients with CP.
Akhyani, Maryam; Keshtkar-Jafari, Alireza; Chams-Davatchi, Cheyda; Lajevardi, Vahide; Beigi, Sara; Aghazadeh, Nessa; Rayati Damavandi, Maede; Arami, Shabnam
Pemphigus vulgaris (PV) is an autoimmune disorder affecting the skin and mucous membranes. Ocular involvement in PV has been reported but its prevalence and clinical characteristics are not well defined. This prospective cross-sectional study of 103 PV patients was designed to determine the prevalence, clinical types and epidemiological trends of ocular involvement in a population of Iranian patients with PV. Ocular involvement was present in 17 (16.5%) patients. Conjunctivitis was the most prevalent type of ocular involvement (9/17, 52.9%), followed by erosion of the palpebral conjunctiva (7/17, 41.2%). Erosion of the bulbar conjunctiva was noted in only one patient (5.9%). The most commonly reported symptoms were eye irritation (76.5%) and redness (76.5%). No significant relation was found between ocular involvement and disease activity (partial remission or relapse). Mucoid discharge was significantly more common in patients with conjunctival erosions as compared to patients with conjunctivitis (P = 0.038). We conclude that ocular involvement is not rare in PV; 16.5% of PV patients develop ocular disease independent of the disease activity and extension. Conjunctivitis is the most common type of involvement, however, palpebral conjunctival erosion is more frequent than previously realized.
Diaz, Rocio I; Sigler, Eric J; Rafieetary, Mohammad R; Calzada, Jorge I
Ocular histoplasmosis syndrome (OHS) is a chorioretinal disorder with a distinct fundus appearance that is commonly found in regions endemic for Histoplasma capsulatum. Choroidal neovascularization (CNV) secondary to OHS is considered one of the principal causes of central vision loss among young adults in endemic areas. Although there is no consensus regarding its pathogenesis, evidence points to Histoplasma capsulatum as the most probable etiology. Once considered an intractable hemorrhagic maculopathy, CNVs are now treatable. Extrafoveal CNVs are successfully treated with laser photocoagulation. Subfoveal and juxtafoveal CNVs are managed with anti-vascular endothelial growth factor therapy, photodynamic therapy, or a combination of both. Modern imaging technologies such as spectral-domain optical coherence tomography have improved our diagnostic abilities, making it easier to monitor disease activity and CNV regression. We review the epidemiology, pathogenesis, clinical manifestations, differential diagnosis, and current treatment of this disease.
Mishra, Avinash; Verma, Ashok K
Every year > 600,000 sports and recreation related eye injuries occur, out of which roughly 13,500 of these result in permanent loss of sight. Up to 90% of these sports related eye injuries are preventable by using adequate eye protection equipment. Protective eyewear is made of polycarbonate, a highly impact-resistant plastic which is now easily available as prescription and non-prescription eyewear and all players should be encouraged to use them. The medical officers by educating their patients regarding the risks of eye injuries in various sports and the confirmed benefits of using protective equipment have the potential to prevent injury to over thousands of eyes every year. The medical fraternity can also play a very important role in educating the coaches, parents, and children and thus put an end to unnecessary blindness and vision loss from sports related ocular injuries, therefore ensuring a lifetime of healthy vision.
Full Text Available Faiz I Shakarchi1,21Ibn Al-Haetham Teaching Eye Hospital, 2Department of Opthalmology, Medical College, Al-Mustansiriya University, Baghdad, IraqAbstract: The World Health Organization currently estimates that nearly two billion people, or one-third of the world’s population, are infected by tuberculosis, and that roughly 10% of the infected people are symptomatic. Tuberculosis affects the lungs in 80% of patients, while in the remaining 20% the disease may affect other organs, including the eye. Uveitis can be seen concurrently with tuberculosis, but a direct association is difficult to prove. Ocular tuberculosis is usually not associated with clinical evidence of pulmonary tuberculosis, as up to 60% of extrapulmonary tuberculosis patients may not have pulmonary disease. The diagnosis of tuberculous uveitis is often problematic and in nearly all reported cases, the diagnosis was only presumptive. Tuberculous uveitis is a great mimicker of various uveitis entities and it can be considered in the differential diagnosis of any type of intraocular inflammation. It is still unknown if ocular manifestations result from a direct mycobacterium infection or hypersensitivity reaction and this is reflected on the management of tuberculous uveitis. Prevalence of tuberculosis as an etiology of uveitis may reach up to 10% in endemic areas. Tuberculous uveitis is a vision-threatening disease that inevitably leads to blindness if not properly diagnosed and treated. The aim of this review is to illustrate the various clinical features and management of presumed tuberculous uveitis. The current review focuses on the diagnostic criteria, significance of tuberculin skin test, and use of systemic corticosteroids in the management of tuberculous uveitis as recommended in recent publications.Keywords: tuberculosis, uveitis, choroiditis, tuberculin skin test
Andrew, S E
Feline herpesvirus-1 (FHV-1) infection is ubiquitous in the domestic cat population worldwide. The most common clinical ocular manifestations of infection with FHV-1 are conjunctivitis and keratitis. This paper reviews the pathogenesis of feline herpesvirus-1 and discusses the various clinical ocular manifestations, diagnostic techniques and treatment of FHV-1-induced diseases. Ocular manifestations include: conjunctivitis, keratitis, stromal keratitis, keratoconjunctivitis sicca, ophthalmia neonatorium, symblepharon, corneal sequestrum, eosinophilic keratitis and anterior uveitis. Diagnostic techniques discussed include: virus isolation, fluorescent antibody testing, serum neutralising titers, ELISA and polymerase chain reaction. Various therapies are also discussed.
Lessell, S.; Lessell, I.M.; Rizzo, J.F. III
Ocular neuromyotonia is a paroxysmal monocular deviation that results from spasm of eye muscles secondary to spontaneous discharges from third, fourth, or sixth nerve axons. We observed this rare disorder in four patients who had been treated with radiation for tumors in the region of the sella turcica and cavernous sinus. Based on these cases and four others identified in the literature it would appear that radiation predisposes to a cranial neuropathy in which ocular neuromyotonia may be the major manifestation. Radiation appears to be the most common cause of ocular neuromyotonia.
Akshay Gopinathan Nair
Full Text Available Myasthenia gravis (MG is a disease that affects the neuro-muscular junction resulting in classical symptoms of variable muscle weakness and fatigability. It is called the great masquerader owing to its varied clinical presentations. Very often, a patient of MG may present to the ophthalmologist given that a large proportion of patients with systemic myasthenia have ocular involvement either at presentation or during the later course of the disease. The treatment of ocular MG involves both the neurologist and ophthalmologist. Thus, the aim of this review was to highlight the current diagnosis, investigations, and treatment of ocular MG.
Full Text Available The main function of ocular blood flow is to supply sufficient oxygen and nutrients to the eye. Local blood vessels resistance regulates overall blood distribution to the eye and can vary rapidly over time depending on ocular need. Under normal conditions, the relation between blood flow and perfusion pressure in the eye is autoregulated. Basically, autoregulation is a capacity to maintain a relatively constant level of blood flow in the presence of changes in ocular perfusion pressure and varied metabolic demand. In addition, ocular blood flow dysregulation has been demonstrated as an independent risk factor to many ocular diseases. For instance, ocular perfusion pressure plays key role in the progression of retinopathy such as glaucoma and diabetic retinopathy. In this review, different direct and indirect techniques to measure ocular blood flow and the effect of myogenic and neurogenic mechanisms on ocular blood flow are discussed. Moreover, ocular blood flow regulation in ocular disease will be described.
Laxman Singh Kaira
Full Text Available An ocular prosthesis is a simulation of of a perfectly normal healthy eye and surrounding tissues. The primary purpose of an ocular prosthesis is to maintain the volume of eye socket and create the illusion of a healthy eye and surrounding tissue. A custom ocular prosthesis is a good option when reconstruction by plastic surgery or the use of Osseo-integrated implants is not possible or not desired. Prosthetic rehabilitation of a patient with missing eye with custom made ocular prosthesis was described. Advantages include improved adaptation, increased mobility of prosthesis, improved facial contours and enhanced esthetics gained from the control of the iris and sclera. An accurate alignment of the artificial eye is one of the major prerequisites for esthetic success of the ocular prosthesis.
Costa, Vital P; Harris, Alon; Anderson, Douglas; Stodtmeister, Richard; Cremasco, Fernanda; Kergoat, Helene; Lovasik, John; Stalmans, Ingborg; Zeitz, Oliver; Lanzl, Ines; Gugleta, Konstantin; Schmetterer, Leopold
This review article discusses the relationship between ocular perfusion pressure and glaucoma, including its definition, factors that influence its calculation and epidemiological studies investigating the influence of ocular perfusion pressure on the prevalence, incidence and progression of glaucoma. We also list the possible mechanisms behind this association, and discuss whether it is secondary to changes in intraocular pressure, blood pressure or both. Finally, we describe the circadian variation of ocular perfusion pressure and the effects of systemic and topical medications on it. We believe that the balance between IOP and BP, influenced by the autoregulatory capacity of the eye, is part of what determines whether an individual will develop optic nerve damage. However, prospective, longitudinal studies are needed to better define the role of ocular perfusion pressure in the development and progression of glaucoma.
SHEN Xi; XU Ge-zhi; JIAO Qin; LI Xia; SHI Ruo-fei
Objective To describe the ocular complications of 62 patients with active atopic dermatitis( AD) during the period of 2003 2006. Methods Routine ophthalmic examinations, including slit-lamp microscope, indirect ophthalmoscope or Goldmann three-mirror lens, A-scan and B-scan ultrasound, ultrasound biomicroscope (UBM) and corneal topography, as well as tear film break-up time (BUT) and Schirmer tests were carried out. Results Cataract (28 eyes), keratoconjunctivitis (42 eyes), superficial punctate keratopathy (45 eyes) and tear function abnormality ( 76 eyes) were major ocular complications in AD patients. Retinal detachment (6 eyes) was the most severe ocular complication in the AD patients. Conclusion Ocular complications are common in AD patients and a very careful examination of eyes is essential in treating AD patients. If the eyes can be examed carefully and in time, some operations and severe complications can be avoidable, especially for the patients with retinal breaks or retinal detachment.
Chekrine, T; Tawfiq, N; Bouchbika, Z; Benchakroun, N; Jouhadi, H; Sahraoui, S; Benider, A
Ocular metastasis is a rare presenting feature of gastric adenocarcinoma. We report a 48-year-old woman who presented with a decrease in visual acuity of the right eye leading to the discovery of an ocular metastasis. Diagnostic work-up identified a gastric adenocarcinoma with pulmonary metastases. She received four cycles of chemotherapy combining epirubicin, cisplatin and fluorouracil. The patient died 6 months after the diagnosis of respiratory failure.
Chirinos-Saldaña, P; Zuñiga-Gonzalez, I; Hernandez-Camarena, J C; Navas, A; Ramirez-Luquin, T; Robles-Contreras, A; Jimenez-Martinez, M C; Ramirez-Miranda, A; Bautista-de Lucio, V M; Graue-Hernandez, E O
Purpose To describe the clinical characteristics of ocular involvement in patients with pemphigus at an ophthalmological referral center. Methods A retrospective review was conducted on patients with the immunopathological diagnosis of pemphigus examined between 1 January 2000 and 1 April 2010. Uncorrected distance visual acuity (UDVA), best corrected distance visual acuity (BCVA), ocular symptoms, and ocular surface inflammatory and scarring changes were assessed. Results A total of 15 patients were identified, with a mean age of 68.27±14.35 years, and 80% (n=12) were female. Extraocular involvement was reported in one patient. All of the eyes showed cicatricial changes in the conjunctiva. In all, 6 eyes (20%) were classified as stage I; 12 eyes (40%) as stage II; 10 eyes (33%) as stage III; and 2 eyes (7%) as stage IV. A statistically significant association was found between BCVA and the severity of ocular involvement. The mean BCVA logMAR was 1.66 (20/914), with a range from logMAR 0 (20/20) to logMAR 4 (NLP). Other ocular diseases were found in 8 (53.3%), systemic diseases in 10 (66.7%), and the use of pemphigus-inducing drugs in 10 patients (66.7%). Conclusions The present report represents the largest series of ocular involvement in pemphigus confirmed by immunopathology. The clinical manifestations varied from conjunctival hyperemia to corneal scarring and perforation. There was a strong association between scarring changes and low BCVA. Ocular and systemic diseases as well as the use of pemphigus-inducing drugs may predispose to ocular cicatricial changes observed in this series. PMID:24480839
Mariela Julia Curbelo Gómez
Full Text Available A clinical case on ocular toxocariasis is presented. The clinical manifestations were pain and red eye in a four year-old child. A prior acute uveitis in the LE was found in the physical ocular exam. Vitrea band that was out of the superior edge of papila and a marginal granuloma were found in the eyes fundus. The patient was admitted and treated with oral corticoids and oral antihelmintics
Full Text Available Purpose: To review current knowledge about ocular effects of sulfur mustard (SM and the associated histopathologic findings and clinical manifestationsMethods: Literature review of medical articles (human and animal studies was accomplished using PubMed, Scopus and ISI databases. A total of 274 relevant articles in English were retrieved and reviewed thoroughly.Results: Eyes are the most sensitive organs to local toxic effects of mustard gas. Ocular injuries are mediated through different toxic mechanisms including: biochemical damages, biomolecular and gene expression modification, induction of immunologic and inflammatory reactions, disturbing ultrastructural architecture of the cornea, and long-lasting corneal denervation. The resulting ocular injuries can roughly be categorized into acute or chronic complications. Most of the patients recover from acute injuries, but a minority of victims will suffer from chronic ocular complications. Mustard gas keratopathy (MGK is a devastating late complication of SM intoxication that proceeds from limbal stem cell deficiency (LSCD.Conclusion: SM induces several different damaging changes in case of ocular exposure; hence leading to a broad spectrum of ocular manifestations in terms of severity, timing and form. Unfortunately, no effective strategy has been introduced yet to inhibit or restore these damaging changes.
Renouf, Daniel J; Velazquez-Martin, Juan P; Simpson, Rand; Siu, Lillian L; Bedard, Philippe L
Molecularly targeted agents are commonly used in oncology practice, and many new targeted agents are currently being tested in clinical trials. Although these agents are thought to be more specific and less toxic then traditional cytotoxic chemotherapy, they are associated with a variety of toxicities, including ocular toxicity. Many of the molecules targeted by anticancer agents are also expressed in ocular tissues. We reviewed the literature for described ocular toxicities associated with both approved and investigational molecularly targeted agents. Ocular toxicity has been described with numerous approved targeted agents and also seems to be associated with several classes of agents currently being tested in early-phase clinical trials. We discuss the proposed pathogenesis, monitoring guidelines, and management recommendations. It is important for oncologists to be aware of the potential for ocular toxicity, with prompt recognition of symptoms that require referral to an ophthalmologist. Ongoing collaboration between oncologists and ocular disease specialists is critical as the use of molecularly targeted agents continues to expand and novel targeted drug combinations are developed.
Myrna Serapião dos Santos
Full Text Available PURPOSE: To establish current definition, classification and staging, and to develop diagnosis and treatment recommendations for ocular allergy, by using Delphi approach. METHODS: Ten Latin American experts on ocular allergy participated in a 4-round Delphi panel approach. Four surveys were constructed and answered by panelists. A two-thirds majority was defined as consensus. Definition, classification, staging and diagnosis and treatment recommendations were the main outcomes. RESULTS: "Ocular allergy" was proposed as the general term to describe ocular allergic diseases. Consensus regarding classification was not reached. Signs and symptoms were considered extremely important for the diagnosis. It was consensus that a staging system should be proposed based on the disease severity. Environmental control, avoidance of allergens and the use of artificial tears were recommended as first line treatment. The secondary treatment should include topical anti-histamines, mast cell stabilizers and multi actions drugs. Topical non-steroidal anti-inflammatory and vasoconstrictors were not recommended. Topical corticosteroids were recommended as third line of treatment for the most severe keratoconjunctivitis. Consensus was not reached regarding the use of systemic corticosteroids or immunosuppressant. Surgical approach and unconventional treatments were not recommended as routine. CONCLUSION: The task of creating guidelines for ocular allergies showed to be very complex. Many controversial topics remain unsolved. A larger consensus including experts from different groups around the world may be needed to further improve the current recommendations for several aspects of ocular allergy.
Full Text Available Inflammation is a complex process that implies the interaction between cells and molecular mediators, which, when not properly “tuned,” can lead to disease. When inflammation affects the eye, it can produce severe disorders affecting the superficial and internal parts of the visual organ. The nucleoside adenosine and nucleotides including adenine mononucleotides like ADP and ATP and dinucleotides such as P1,P4-diadenosine tetraphosphate (Ap4A, and P1,P5-diadenosine pentaphosphate (Ap5A are present in different ocular locations and therefore they may contribute/modulate inflammatory processes. Adenosine receptors, in particular A2A adenosine receptors, present anti-inflammatory action in acute and chronic retinal inflammation. Regarding the A3 receptor, selective agonists like N6-(3-iodobenzyl-5′-N-methylcarboxamidoadenosine (CF101 have been used for the treatment of inflammatory ophthalmic diseases such as dry eye and uveoretinitis. Sideways, diverse stimuli (sensory stimulation, large intraocular pressure increases can produce a release of ATP from ocular sensory innervation or after injury to ocular tissues. Then, ATP will activate purinergic P2 receptors present in sensory nerve endings, the iris, the ciliary body, or other tissues surrounding the anterior chamber of the eye to produce uveitis/endophthalmitis. In summary, adenosine and nucleotides can activate receptors in ocular structures susceptible to suffer from inflammatory processes. This involvement suggests the possible use of purinergic agonists and antagonists as therapeutic targets for ocular inflammation.
Full Text Available The present review provides general information about the parasitic infection of toxoplasmosis and describes the ways of its transmission. It outlines the importance of the consequences of toxoplasmosis infection and the methods of its prevention. The review traces the harmful effects of the disease on human and animal organisms, the causes and stages of development of the disease. The review specifically focuses on the ocular manifestations of toxoplasmosis which can cause ocular lesions, inflammation and scarring. Herein are described the ways toxoplasmosis can damage the eyes causing chorioretinitis, nystagmus, microphthalmia, etc. Furthermore, the review addresses the problem of how congenital and acquired toxoplasmosis affects eyes. The ocular symptoms of toxoplasmosis include weakened or blurred vision, eyeballs pain, ocular sensitivity to light, etc. The harmful effects of toxoplasmosis to pregnant women and immunocompromised patients have been delineated. Some of the disease manifestations include jaundice, rash, asphyxia, etc. The review traces the diagnostic work-up and comments on common tests for toxoplasmosis, such as taking of blood serum samples. The review ends with the treatment of the disease and of its ocular manifestations in particular, for example application of intravitreous injection. The prevention of the infection is extremely important for pregnant women, immunocompromised patients and patients with AIDS.
Schor, Clifton M
The near response is composed of cross-coupled interactions between convergence and other distance-related oculomotor responses including accommodation, vertical vergence, and cyclovergence. The cross-coupling interactions are analogous to the body postural reflexes that maintain balance. Near-response couplings guide involuntary motor responses during voluntary shifts of distance and direction of gaze without feedback from defocus or retinal-image disparity. They optimize the disparity stimulus for stereoscopic depth perception and can be modified by optically induced sensory demands placed on binocular vision. In natural viewing conditions, the near response is determined by passive orbital mechanics and active-adaptable tonic components. For example, the normal coupling of vertical vergence with convergence in tertiary gaze is partly a byproduct of passive orbital mechanics. Both, adapted changes of vertical vergence in response to anisophoria, produced by unequal ocular magnification (aniseikonia), and adapted changes in the orientation of Listing's plane in response to torsional disparities can be achieved by a combination of passive orbital mechanics and neural adjustments for the control of the vertical vergence and cyclovergence. Adaptive adjustments are coupled with gaze direction, convergence angle, and head tilt. Several adaptation studies suggest that it is possible to achieve non-linear changes in the coupling of both vertical vergence and cyclovergence with gaze direction. This coupling can be achieved with changes in neural control signals of ocular elevator muscles that are cross-coupled with both convergence and direction of tertiary gaze. These linear and non-linear coupling interactions can be adapted to compensate for (1) anisophoria induced by spectacle corrections for anisometropia, (2) accommodative esotropia, (3) convergence excess and insufficiency, and (4) non-concomitant deviations with ocular torticollis associated with trochlear palsy
Zicai Huang; Hongni Li; Yixia Huang; Zhongxia Zhou
Purpose: To investigate the clinical characteristics of ocular trauma in children and put forward the major treatment and prevention of ocular trauma in children.Methods: To analyze the clinical data by 77 eyes in 77 cases of ocular trauma in children from April 1999 to February 2002. Results: The male and female were in the ratio of 2.21: 1. Right eye ocular traumas were more than left ones. Ocular penetrating trauma was 83.12% and blunt trauma 12.99%. 41 cases (53.25%) were injured by themselves while 33 cases by others. 90.91% patients came from the countryside.Conclusion: The rate of blindness of children with ocular trauma could be reduced by prompt treatment. The study indicated that ocular trauma preventive publicity should be faced in the countryside in order to improve the understanding of the severity of ocular trauma and treat it as a social problem.
Full Text Available Gene therapy is a novel form of drug delivery that enlists the synthetic machinery of the patient′s cells to produce a therapeutic agent. Genes may be delivered into cells in vitro or in vivo utilising viral or non-viral vectors. Recent technical advances have led to the demonstration of the molecular basis of various ocular diseases. Ocular disorders with the greatest potential for benefit of gene therapy include hereditary diseases such as retinitis pigmentosa, tumours such as retinoblastoma or melanoma, and acquired proliferative and neovascular retinal disorders. Gene transfer into ocular tissues has been demonstrated with growing functional success and may develop into a new therapeutic tool for clinical ophthalmology in future.
Full Text Available An intact cerebellum is a prerequisite for optimal ocular motor performance. The cerebellum fine-tunes each of the subtypes of eye movements so they work together to bring and maintain images of objects of interest on the fovea. Here we review the major aspects of the contribution of the cerebellum to ocular motor control. The approach will be based on structural-functional correlation, combining the effects of lesions and the results from physiologic studies, with the emphasis on the cerebellar regions known to be most closely related to ocular motor function: 1 the flocculus/paraflocculus for high-frequency (brief vestibular responses, sustained pursuit eye movements and gaze-holding, 2 the nodulus/ventral uvula for low-frequency (sustained vestibular responses, and 3 the dorsal oculomotor vermis and its target in the posterior portion of the fastigial nucleus (the fastigial oculomotor region for saccades and pursuit initiation.
Full Text Available Ocular chemical burns are common and serious ocular emergencies that require immediate and intensive evaluation and care. The victims of such incidents are usually young, and therefore loss of vision and disfigurement could dramatically affect their lives. The clinical course can be divided into immediate, acute, early, and late reparative phases. The degree of limbal, corneal, and conjunctival involvement at the time of injury is critically associated with prognosis. The treatment starts with simple but vision saving steps and is continued with complicated surgical procedures later in the course of the disease. The goal of treatment is to restore the normal ocular surface anatomy and function. Limbal stem cell transplantation, amniotic membrane transplantation, and ultimately keratoprosthesis may be indicated depending on the patients’ needs.
Merwin, W. H., Jr.; Wall, Conrad, III; Tomko, D. L.
The horizontal vestibulo-ocular reflex (VOR) was measured and characterized in seven adult chinchillas using 0.01 to 1.0 Hz angular velocity sinusoids. Gains were less than compensatory, and were variable from day to day, but phases were highly repeatable both within and between animals. The best fitting transfer function to the average data of all animals had a dominant time constant of 7.5 sec, and an adaptation operator with a time constant of 24.0 sec. There were certain nonlinearities in the horizontal VOR of this animal, and it was difficult to elicit a robust optokinetic response. Results are discussed in relation to similar measurements in other species.
Safer, J N; Guibor, P
Three ocular complications directly related to orbital venography are described, one resulting in permanent loss of vision,. The patient had lymphangioma of the orbit which evidently had bled secondary to increased venous pressure and injection of contrast bolus. Both of the 2 patients with transient visual disturbances had diabetic retinopathy. The common factor is felt to be an imparied vascular bed which cannot meet the stress of increased venous pressure and contrast medium injection. Conditions which predispose to ocular-orbital stasis and/or hemorrhage are discussed.
Swann, Peter G
Hyperpigmentation of the ocular tissues and of the skin around the eye is uncommon. In ocular melanosis, the episclera, uveal tract and the angle of the anterior chamber may be involved. Heterochromia iridis may be present, if the iris is affected. In oculodermal melanocytosis or the naevus of Ota, hyperpigmentation of the skin follows the distribution of the first and second divisions of the fifth cranial nerve. This report documents a patient with episcleral pigment, heterochromia iridis and numerous tiny pigmented nodules on the iris (mammillations). The possible significance of these findings is discussed.
Nihat Sayin; Necip Kara; Gokhan Pekel
Diabetes mellitus （DM） is a important health problemthat induces ernestful complications and it causessignificant morbidity owing to specific microvascularcomplications such as, retinopathy, nephropathy andneuropathy, and macrovascular complications such as,ischaemic heart disease, and peripheral vasculopathy.It can affect children, young people and adults and isbecoming more common. Ocular complications associatedwith DM are progressive and rapidly becoming theworld＇s most significant cause of morbidity and arepreventable with early detection and timely treatment.This review provides an overview of five main ocularcomplications associated with DM, diabetic retinopathyand papillopathy, cataract, glaucoma, and ocular surfacediseases.
Ferreira, T.; Verbist, B.M.; Buchem, M. van; Osch, T. van; Webb, A.
The ocular motor nerves (OMNs) comprise the oculomotor, trochlear and the abducens nerves. According to their course, they are divided into four or five anatomic segments: intra-axial, cisternal, cavernous and intra-orbital and, for the abducens nerve, an additional interdural segment. Magnetic reso
• A new attention to post-natally acquired infections. Previously, most attention was focused on infection during pregnancy, and the risk of congenital disease, with the feeling that infection in older individuals was benign, without a substantial risk of disease morbidity, such as ocular involvemen...
Yogish S Kamath
Full Text Available We report an atypical presentation of Toxoplasma retinochoroiditis with associated scleritis in a young and immunocompetent patient. The diagnosis was done on the basis of Polymerase chain reaction of vitreous sample, and the clinical response to specific treatment. This case highlights the unusual presentation of ocular toxoplasmosis as scleritis.
Full Text Available Drug induced bilateral ptosis is a very rare adverse drug reaction. Here we report a case of ten year old male child with chlorpromazine induced bilateral ptosis due to ocular myasthenia. [Int J Basic Clin Pharmacol 2013; 2(5.000: 653-654
Full Text Available Introduction Diagnostic testing of the vestibular system is an essential component of treating patients with balance dysfunction. Until recently, testing methods primarily evaluated the integrity of the horizontal semicircular canal, which is only a portion of the vestibular system. Recent advances in technology have afforded clinicians the ability to assess otolith function through vestibular evoked myogenic potential (VEMP testing. VEMP testing from the inferior extraocular muscles of the eye has been the subject of interest of recent research. Objective To summarize recent developments in ocular VEMP testing. Results Recent studies suggest that the ocular VEMP is produced by otolith afferents in the superior division of the vestibular nerve. The ocular VEMP is a short latency potential, composed of extraocular myogenic responses activated by sound stimulation and registered by surface electromyography via ipsilateral otolithic and contralateral extraocular muscle activation. The inferior oblique muscle is the most superficial of the six extraocular muscles responsible for eye movement. Therefore, measurement of ocular VEMPs can be performed easily by using surface electrodes on the skin below the eyes contralateral to the stimulated side. Conclusion This new variation of the VEMP procedure may supplement conventional testing in difficult to test populations. It may also be possible to use this technique to evaluate previously inaccessible information on the vestibular system.
Full Text Available Purpose: The purpose of this study is to describe a case of ocular rosacea with a very complex evolution. Rosacea is a chronic dermatological disease that may affect the ocular structures up to 6-72% of all cases. This form is often misdiagnosed, which may lead to long inflammatory processes with important visual consequences for affected patients. Therefore, an early diagnosis and an adequate treatment are important. Methods: We report the case of a 43-year-old patient who had several relapses of what seemed an episode of acute bacterial conjunctivitis. Two weeks later, he developed a corneal ulcer with a torpid evolution including abundant intrastromal infiltrators and calcium deposits. He was diagnosed with ocular rosacea and treated with systemic doxycycline and topical protopic. Results: A coating with amniotic membrane was placed in order to heal the ulcer, but a deep anterior lamellar keratoplasty to restore the patient’s vision because of the corneal transparency loss was necessary. Conclusions: Ocular rosacea includes multiple ophthalmic manifestations ranging from inflammation of the eyelid margin and blepharitis to serious corneal affectations. A delayed diagnosis can result in chronic inflammatory conditions including keratinization and loss of corneal transparency, which lead to important visual sequelae for affected patients.
Full Text Available En el presente trabajo se analiza la toxicidad ocular inducida por cuatro grupos de fármacos sistémicos: tamoxifeno, cloroquina y derivados, anticolinérgicos y tamsulosina. El objetivo principal es dar unas normas prácticas que sirvan para el manejo diario de los pacientes sometidos a estos tratamientos, más que profundizar en los mecanismos de acción de cada uno de ellos.This paper analyses ocular toxicity induced by four groups of systemic medicines: tamoxifen, chloroquine and derivatives, anticholinergics and tamsulosin. Our main aim is to provide some practical rules that will be of use in the everyday management of patients receiving these treatments, rather than to examine the mechanisms by which each of these medicines act.
Highstein, S. M.
Structure-function studies at the systems level are an effective method for understanding the relationship of the central nervous system to behavior. Motor learning or adaptation of the vestibulo-ocular reflex is a clear example wherein this approach has been productive. During a vestibulo-ocular reflex the brain converts a head velocity signal, transduced through the vestibular semicircular canals, into an eye movement command delivered to the extraocular muscles. If the viewed target remains on the fovea of the retina, the reflex is compensatory, and its gain, eye velocity/head velocity, is one. When the image of the viewed object slips across the retina, visual acuity decreases, and the gain of the reflex, which is no longer one, is plastically adapted or adjusted until retinal stability is restored. The anatomic substrate for this plasticity thus involves brain structures in which visual-vestibular interaction can potentially occur, as well as vestibular and visual sensory and oculomotor motor structures. Further, it has been known for many years that removal of the flocculus of the cerebellum permanently precludes further vestibulo-ocular reflex adaptation, demonstrating the involvement of the cerebellum in this behavior. Maekawa and Simpson (J Neurophysiol 1973;36: 649-66) discovered that one visual input to the flocculus involved the accessory optic system and the inferior olive. Ensuing work has demonstrated that the visual signals used to adapt the vestibulo-ocular reflex are transmitted by this accessory optic system to the flocculus and subsequently to brain stem structures involved in vestibulo-ocular reflex plasticity. Presently the inclusive list of anatomic sites involved in vestibulo-ocular reflex circuitry and its adaptive plasticity is small. Our laboratory continues to believe that this behavior should be caused by interactions within this small class of neurons. By studying each class of identified neuron and its interactions with others within
Costa Daniella Socci da
Full Text Available Os autores relatam dois casos de tuberculose ocular presumida com comprometimento coroidiano. No primeiro caso, um paciente de 43 anos, HIV positivo, com tuberculose pulmonar miliar e tuberculoma cerebral, apresenta um granuloma coroidiano único na região macular do olho esquerdo. No segundo caso, uma paciente de 12 anos, HIV negativa, com tuberculose pulmonar apresenta coroidite multifocal e comprometimento do segmento anterior do olho esquerdo. Ambos os pacientes evoluíram favoravelmente com o tratamento específico, apresentando completa resolução das lesões. As lesões oculares da tuberculose são diversas e devemos continuar atentos a esta enfermidade.
Full Text Available The ocular surface is exceptionally rich in complexity and functionality. Severe ocular surface disorders/conditions, such as chemical or thermal injuries, Stevens-Johnson syndrome (SJS, ocular cicatricial pemphigoid, neurotrophic keratopathy, chronic limbitis, and severe microbial keratitis cause significant morbidities and even corneal blindness. Hypofunction may be caused by Aniridia, Neurotrophy, Endocrine, Pterygium and Chronic limbitis Approximately 6000 patients are seen in Ocular Surface Clinic every year; almost 80% have some form of dry eyes. About 125 new patients of Stevens Johnson Syndrome are seen in a year of which approximately 25% may benefit from Cultured Epithelial Transplant and 75 new patients of thermal/chemical injury in a year of which almost 80% will benefit from Stem Cell Transplantation. Of the 128 severe vernal keratoconjunctivitis which were seen in the ocular surface clinic, 10% require stem cell transplantation. Nearly 30 new cases of Ocular cicatrical pemphigoid every year are seen and they may need stem cell transplantation. In addition, several patients with persistent epithelial defects may benefit from limbal stem cell transplantation to alleviate, maintain conjunctivalization regression and corneal avascularity limbal deficiency, and restore vision. Even if granted that this statistics is for a single large ophthalmic hospital, for a large country as India with 1.1 billion populations, the number of patients requiring corneal stem cell transplantation is enormous. Stem cells in the palisades of Vogt participate in regeneration and preservation of corneal transparency and avascularity. The diminished regenerative capacity seen in LSCD is characterized by persistent epithelial defects, erosion and ulceration, conjunctivalization and neovascularization, and chronic inflammation. Standard corneal transplantation for restoration of corneal clarity and avascularity is a contraindication in the surgical management
Moraru, Andreea; Panfil, Madălina; Totolici, Geanina; Brănişteanu, Daniel; Costin, Dănut; Schmitzer, Speranţa
Ocular Toxocariasis is a parasitosis caused by Toxocara catis/canis larvae localized in the eye. The most frequent clinical manifestations are the central retinal granuloma, peripheral retinal granuloma and chronic endophthalmitis. Secondary complications due to the presence of parasite in the posterior segment of the eye may have significant consequences on visual function. We present the case of a 23 years old patient, admitted for progressive decrease of the right eye BCVA during the last 6 months. After performing clinical examination and serological tests we established the diagnosis of ocular Toxocariasis. The patient presented a particular form of the disease consisting in the presence of both a central retinal granuloma and a peripheral one. We performed 23G pars plana vitrectomy and membrane peeling. VA improved as soon as the first month after surgery.
Ahuja, Munish; Dhake, Avinash S; Sharma, Surendra K; Majumdar, Dipak K
In ocular tissue, arachidonic acid is metabolized by cyclooxygenase to prostaglandins which are the most important lipid derived mediators of inflammation. Presently nonsteroidal anti-inflammatory drugs (NSAIDs) which are cyclooxygenase (COX) inhibitors are being used for the treatment of inflammatory disorders. NSAIDs used in ophthalmology, topically, are salicylic-, indole acetic-, aryl acetic-, aryl propionic- and enolic acid derivatives. NSAIDs are weak acids with pKa mostly between 3.5 and 4.5, and are poorly soluble in water. Aqueous ophthalmic solutions of NSAIDs have been made using sodium, potassium, tromethamine and lysine salts or complexing with cyclodextrins/solubilizer. Ocular penetration of NSAID demands an acidic ophthalmic solution where cyclodextrin could prevent precipitation of drug and minimize its ocular irritation potential. The incompatibility of NSAID with benzalkonium chloride is avoided by using polysorbate 80, cyclodextrins or tromethamine. Lysine salts and alpha-tocopheryl polyethylene glycol succinate disrupt corneal integrity, and their use requires caution. Thus a nonirritating ophthalmic solution of NSAID could be formulated by dissolving an appropriate water-soluble salt, in the presence of cyclodextrin or tromethamine (if needed) in mildly acidified purified water (if stability permits) with or without benzalkonium chloride and polyvinyl alcohol. Amide prodrugs met with mixed success due to incomplete intraocular hydrolysis. Suspension and ocular inserts appear irritating to the inflamed eye. Oil drop may be a suitable option for insoluble drugs and ointment may be used for sustained effect. Recent studies showed that the use of colloidal nanoparticle formulations and the potent COX 2 inhibitor bromfenac may enhance NSAID efficacy in eye preparations.
Ahuja, Munish; Avinash S Dhake; Sharma, Surendra K; Dipak K Majumdar
In ocular tissue, arachidonic acid is metabolized by cyclooxygenase to prostaglandins which are the most important lipid derived mediators of inflammation. Presently nonsteroidal anti-inflammatory drugs (NSAIDs) which are cyclooxygenase (COX) inhibitors are being used for the treatment of inflammatory disorders. NSAIDs used in ophthalmology, topically, are salicylic-, indole acetic-, aryl acetic-, aryl propionic- and enolic acid derivatives. NSAIDs are weak acids with pKa mostly between 3.5 a...
eligible. Women of child bearing age must be taking birth control pills or have been sterilized for other reasons. Men must be using contraceptives . 2...sterile and who are not using oral contraceptive , or men not using contraceptive . c. Previous corneal or other ocular surface disease d. Systemic...must be taking an oral contraceptive to participate in the study. Males also must use contraception . IRB Protocol No. 29780 Version Date: 2/22/10 5
Mittal, Mamta; Sathish, K R; Bhatia, Prashant G; Chidamber, B S
A rare occurrence of ocular subconjunctival dirofilariasis in a 53-year-old healthy Indian male working in Dubai, UAE presenting with an acute red eye is reported. Surgical excision under topical anesthesia was carried out uneventfully in the outpatient clinic. The live worm removed from the subconjunctival space was identified as Dirofilaria repens on the basis of microscopic examination and histopathology. Surgical excision of subconjunctival dirofilariasis is safe in an outpatient setting and curative precluding the need for further systemic antihelminthics.
Shikha Baisakhiya DOMS; FGO
As the number of HIV infected patients is multiplying exponentially day by day so are the associated ocular complications.The increasing longevity of individuals with HIV disease has resulted in greater numbers of pa-tients with ocular opportunistic infection.By the means of this article we describe various opportunistic ocular infections in AIDS and their clinical manifestations,discussed under four headings;1 )adnexal manifestation;2)anterior segment manifestation;3)posterior segment manifestation;4)neuro ophthalmic manifestation . Herpes zoster ophthalmicus,molluscum contagiosum and Kaposi sarcoma are common adnexal manifestations. Molluscum contagiosum being the commonest.Varicella Zoster Virus (VZV)and herpes simplex virus (HSV) most commonly cause infectious keratitis in HIV-positive patients .As compared to the immunocompetent indi-viduals the frequency of bacterial and fungal keratitis is not more in HIV patients,but it tends to be more se-vere.Posterior segment structures involved in HIV-positive patients include the retina,choroid,and optic nerve head.The herpesvirus family is implicated most commonly in infections of the retina and choroid in HIV positive patients.CMV is the most common cause of retinitis and the commonest intraocular infection in AIDS. Atypical presentations resistance to conventional treatment and higher rate of recurrence make the diagnosis and therapeutic intervention more difficult and challenging.In addition,in one eye,several infections may occur at the same time,rendering the situation more difficult.
Stahl, Erin D; Mahomed, Faheem; Hans, Amneet K; Dalal, Jignesh D
HSCT has been linked to the development of an assortment of ocular surface complications with the potential to lead to permanent visual impairment if left untreated or if not treated early in the course of disease. Strategies for therapy include maintenance of lubrication and tear preservation, prevention of evaporation, decreasing inflammation, and providing epithelial support. The ultimate aim of treatment is to prevent permanent ocular sequelae through prompt ophthalmology consultation and the use of advanced techniques for ocular surface rehabilitation. We describe several rehabilitation options of ocular surface complications occurring secondarily during the post-HSCT course.
Xue Luo; Yu-meng Shen; Meng-nan Jiang; Xiang-feng Lou; Yin Shen
The main function of ocular blood flow is to supply sufficient oxygen and nutrients to the eye. Local blood vessels resistance regulates overall blood distribution to the eye and can vary rapidly over time depending on ocular need. Under normal conditions, the relation between blood flow and perfusion pressure in the eye is autoregulated. Basically, autoregulation is a capacity to maintain a relatively constant level of blood flow in the presence of changes in ocular perfusion pressure and va...
Bacchiega, Ana Beatriz Santos; Balbi, Gustavo Guimarães Moreira; Ochtrop, Manuella Lima Gomes; de Andrade, Francisco Assis; Levy, Roger Abramino; Baraliakos, Xenofon
Ocular inflammatory diseases can present as isolated conditions but also as part of systemic inflammatory diseases. Anterior uveitis is closely related to SpA and shares the common genetic background of HLA-B27. Other ocular manifestations, such as episcleritis and scleritis, may also occur, although less frequently. Therefore, ocular involvement has been included as one of the important clinical features of SpA in the recently published classification criteria for axial and peripheral disease. However, there are a wide variety of aetiologies for ocular diseases and this must be considered in assessment of SpA.
Petropoulos, A. E.; Wall, C. 3rd; Oman, C. M.
Ten male subjects underwent two types of adaptation paradigm designed either to enhance or to attenuate the gain of the canal-ocular reflex (COR), before undergoing otolith-ocular reflex (OOR) testing with constant velocity, earth horizontal axis and pitch rotation. The adaptation paradigm paired a 0.2 Hz sinusoidal rotation about an earth vertical axis with a 0.2 Hz optokinetic stimulus that was deliberately mismatched in peak velocity or phase and was designed to produce short-term changes in the COR. Preadaptation and postadaptation OOR tests occurred at a constant velocity of 60 degrees/sec in the dark and produced a modulation component of the slow phase velocity with a frequency of 0.16 Hz due to otolithic stimulation by the sinusoidally changing gravity vector. Of the seven subjects who showed enhancement of the COR gain, six also showed enhancement of the OOR modulation component. Of the seven subjects who showed attenuation of the COR gain, five also showed attenuation of the OOR modulation component. The probability that these two cross-axis adaptation effects would occur by chance is less than 0.02. This suggests that visual-vestibular conditioning of the yaw axis COR also induced changes in the pitch axis OOR. We thus postulate that the central nervous system pathways that process horizontal canal yaw stimuli have elements in common with those processing otolithic stimuli about the pitch axis.
Koraszewska-Matuszewska, B; Pieczara, E; Samochowiec-Donocik, E; Nawrocka, L
The authors analyzed the kind of ocular changes and methods of therapy in 34 children, aged 5 months to 14 years, treated in the clinic in the years 1982-1992. The most frequent change was congenital cataract. The other signs observed were: Brushfield's spots, alternate esotropia, nystagmus, partial optic atrophy, retinal detachment, congenital glaucoma, ectropion and keratoconus. Occurrence of several anomalies were frequent. The adequate surgical treatment was applied depending on the kind of changes. Cataract extraction was made by aspiration method. Visual acuity improved in 58.8% of eyes.
Full Text Available A rare occurrence of ocular subconjunctival dirofilariasis in a 53-year-old healthy Indian male working in Dubai, UAE presenting with an acute red eye is reported. Surgical excision under topical anesthesia was carried out uneventfully in the outpatient clinic. The live worm removed from the subconjunctival space was identified as Dirofilaria repens on the basis of microscopic examination and histopathology. Surgical excision of subconjunctival dirofilariasis is safe in an outpatient setting and curative precluding the need for further systemic antihelminthics.
María Beltrán F
Full Text Available Se presentan tres casos de miasis ocular (dos adultos y un niñoprocedentes de zonas ganaderas de la provincia de Huaura,departamento de Lima,que acudieron al Hospital Regional de Huacho por presentar el ojo rojo,fotofobia, edema palpebral y sensación de cuerpo extraño;se extrajeron larvas adheridas al canto interno del ojo,las cuales se recibieron en el Instituto Nacional de Salud y fueron identificadas como Oestrus ovis .
Ermakov, Igor V.; Sharifzadeh, Mohsen; Gellermann, Warner
The optically transparent nature of the human eye has motivated numerous Raman studies aimed at the non-invasive optical probing of ocular tissue components critical to healthy vision. Investigations include the qualitative and quantitative detection of tissue-specific molecular constituents, compositional changes occurring with development of ocular pathology, and the detection and tracking of ocular drugs and nutritional supplements. Motivated by a better understanding of the molecular mechanisms leading to cataract formation in the aging human lens, a great deal of work has centered on the Raman detection of proteins and water content in the lens. Several protein groups and the hydroxyl response are readily detectable. Changes of protein compositions can be studied in excised noncataractous tissue versus aged tissue preparations as well as in tissue samples with artificially induced cataracts. Most of these studies are carried out in vitro using suitable animal models and conventional Raman techniques. Tissue water content plays an important role in optimum light transmission of the outermost transparent ocular structure, the cornea. Using confocal Raman spectroscopy techniques, it has been possible to non-invasively measure the water to protein ratio as a measure of hydration status and to track drug-induced changes of the hydration levels in the rabbit cornea at various depths. The aqueous humor, normally supplying nutrients to cornea and lens, has an advantageous anterior location for Raman studies. Increasing efforts are pursued to non-invasively detect the presence of glucose and therapeutic concentrations of antibiotic drugs in this medium. In retinal tissue, Raman spectroscopy proves to be an important tool for research into the causes of macular degeneration, the leading cause of irreversible vision disorders and blindness in the elderly. It has been possible to detect the spectral features of advanced glycation and advanced lipooxydation end products in
Jain, Vandana; Shome, Debraj; Sajnani, Manoj; Natarajan, Sundaram
In order to report fungal keratitis in patients of ocular rosacea, a retrospective review of all cases of fungal keratitis was undertaken. Cases in which ocular rosacea coexisted were identified and included in the study. The clinical course of patients thus identified was studied from the medical records and outcomes were evaluated. A total of three cases of fungal keratitis with coexisting ocular rosacea were identified. All three patients were known cases of acne rosacea with an intermittent, irregular treatment for the same. Previous history of contact lens use, ocular surgery or trauma was not present in any of the cases. Microbiological evaluation revealed Aspergillus flavus as the causative organism in two patients and an unidentified hyaline fungus in the third. Patients received simultaneous therapy for fungal keratitis and ocular rosacea. The ocular surface completely stabilized and the infiltrate resolved in all three cases. The chronic ocular surface changes and induced inflammation in ocular rosacea, along with the instillation of topical steroids for therapy, may create an environmental milieu favorable for fungal keratitis. Microbiological evaluation should be considered, even in cases of suspected sterile keratitis, prior to treatment with topical steroids, so as to prevent the possible worsening of an associated infective corneal condition.
Full Text Available The goal of palliative care is the achievement of the best quality of life for patients and their families. Eyes are generally the first features of the face to be noticed. Loss of an eye is a traumatic event which has a crippling effect on the psychology of the patient. Several ocular and orbital disorders require surgical intervention that may result in ocular defects. An ocular prosthesis is fabricated to restore the structure, function, and cosmetics of the defects created by such conditions. Although an implant eye prosthesis has a superior outcome, due to economic factors it may not be a feasible option for all patients. Therefore, a custom-made ocular prosthesis is a good alternative. This case report presents a palliative treatment for a patient with an enucleated eye by fabricating a custom ocular prosthesis which improved his psychological, physical, social, functional, emotional and spiritual needs.
Kim, Jae Hoon; Chun, Yeoun Sook; Kim, Jae Chan
The purpose of this study was to investigate clinical and immunological responses to Demodex on the ocular surface. Thirteen eyes in 10 patients with Demodex blepharitis and chronic ocular surface disorders were included in this study and treated by lid scrubbing with tea tree oil for the eradication of Demodex. We evaluated ocular surface manifestations and Demodex counts, and analyzed IL-1β, IL-5, IL-7, IL-12, IL-13, IL-17, granulocyte colony-stimulating factor, and macrophage inflammatory protein-1β in tear samples before and after the treatment. All patients exhibited ocular surface manifestations including corneal nodular opacity, peripheral corneal vascularization, refractory corneal erosion and infiltration, or chronic conjunctival inflammatory signs before treatment. After treatment, Demodex was nearly eradicated, tear concentrations of IL-1β and IL-17 were significantly reduced and substantial clinical improvement was observed in all patients. In conclusion, we believe that Demodex plays an aggravating role in inflammatory ocular surface disorders.
Ahmad M. Mansour
Full Text Available Purpose. To discuss an unusual presentation of ocular toxocariasis. Methods. Case report. Results. A 40-year-old woman presented with decreased vision in the left eye with a long history of recurrent red eye from uveitis. Eosinophilia and positive ELISA titers for Toxocara canis favored the diagnosis of ocular toxocariasis. Over 3 months, an anterior scleral mass had a rapid growth raising the possibility of medulloepithelioma, which rarely can mimic uveitic syndromes. Surgical plan changed from local excision to enucleation. Histopathology demonstrated a large homogeneous mass of chronic inflammatory cells with inflammation of the overlying thinned out sclera, medial rectus insertion, and limbal cornea. The triad of peripheral granuloma, eosinophilia, and positive blood serology established the diagnosis of ocular toxocariasis. Conclusions. Ocular toxocariasis can mimic ocular malignancy such as medulloepithelioma in adults and rarely presents as an anterior scleral mass.
Sekhar, G C; Vance, G; Otton, S; Kumar, S V; Stanley, J N; Rao, G N
A detailed ophthalmic evaluation including slitlamp biomicroscopy, measurement of corneal sensitivity using Cochet and Bonnet aesthesiometer, Schirmer's test and Goldmann applanation tonometry was carried out in 89 patients of Hansen's disease attending the leprosy clinic with or without ocular symptoms and willing to undergo eye evaluation. Thirty-one patients had lepromatous leprosy (8 with erythema nodosum leprosum), 56 patients had borderline disease (13 with reversal reactions) and 2 had tuberculoid disease. In addition to the well documented changes of lagophthalmos (6.7%), uveitis (7.3%) and cataracts (19%), we noted prominent corneal nerves in 133 eyes (74.7%), beaded corneal nerves in 19 eyes (10.7%), corneal scarring in 10 eyes (5.6%), corneal hypoaesthesia in 51 eyes (28%) and dry eye in 18 eyes (13%). Beaded corneal nerves and/or stomal infiltrates occurred mainly in the lepromatous group (75%). Ocular hypotony (IOP less than 12 mm Hg) was not seen more frequently in Hansen's as compared to age and sex matched controls with refractive errors or cataracts (33.7%, vs. 37.8%, p = 0.33). Our study highlights the primary corneal involvement with corneal neuropathy as the predominant feature of Hansen's disease.
Ferreira, Teresa [Department of Radiology, Leiden University Medical Center (Netherlands)], E-mail: T.A.Ferreira@lumc.nl; Verbist, Berit [Department of Radiology, Leiden University Medical Center (Netherlands)], E-mail: B.M.Verbist@lumc.nl; Buchem, Mark van [Department of Radiology, Leiden University Medical Center (Netherlands)], E-mail: M.A.van_Buchem@lumc.nl; Osch, Thijs van [C.J. Gorter for High-Field MRI, Department of Radiology, Leiden University Medical Center (Netherlands)], E-mail: M.J.P.van_Osch@lumc.nl; Webb, Andrew [C.J. Gorter for High-Field MRI, Department of Radiology, Leiden University Medical Center (Netherlands)], E-mail: A.Webb@lumc.nl
The ocular motor nerves (OMNs) comprise the oculomotor, trochlear and the abducens nerves. According to their course, they are divided into four or five anatomic segments: intra-axial, cisternal, cavernous and intra-orbital and, for the abducens nerve, an additional interdural segment. Magnetic resonance imaging is the imaging method of choice in the evaluation of the normal and pathologic ocular motor nerves. CT still plays a limited but important role in the evaluation of the intraosseous portions at the skull base and bony foramina. We describe for each segment of these cranial nerves, the normal anatomy, the most appropriate image sequences and planes, their imaging appearance and pathologic conditions. Magnetic resonance imaging with high magnetic fields is a developing and promising technique. We describe our initial experience with a Phillips 7.0 T MRI scanner in the evaluation of the brainstem segments of the OMNs. As imaging becomes more refined, an understanding of the detailed anatomy is increasingly necessary, as the demand on radiology to diagnose smaller lesions also increases.
Ferreira, Teresa; Verbist, Berit; van Buchem, Mark; van Osch, Thijs; Webb, Andrew
The ocular motor nerves (OMNs) comprise the oculomotor, trochlear and the abducens nerves. According to their course, they are divided into four or five anatomic segments: intra-axial, cisternal, cavernous and intra-orbital and, for the abducens nerve, an additional interdural segment. Magnetic resonance imaging is the imaging method of choice in the evaluation of the normal and pathologic ocular motor nerves. CT still plays a limited but important role in the evaluation of the intraosseous portions at the skull base and bony foramina. We describe for each segment of these cranial nerves, the normal anatomy, the most appropriate image sequences and planes, their imaging appearance and pathologic conditions. Magnetic resonance imaging with high magnetic fields is a developing and promising technique. We describe our initial experience with a Phillips 7.0T MRI scanner in the evaluation of the brainstem segments of the OMNs. As imaging becomes more refined, an understanding of the detailed anatomy is increasingly necessary, as the demand on radiology to diagnose smaller lesions also increases.
Full Text Available OBJETIVO: Comparar as correlações dos componentes oculares (comprimento axial, comprimento do segmento anterior, poder médio da córnea, profundidade da câmara vítrea e poder refrativo equivalente com o erro refrativo total do olho portador da menor e da maior ametropia em anisométropes. MÉTODOS: Foi realizado um "survey" analítico conduzido em população de 68 anisométropes de duas ou mais dioptrias atendida no Ambulatório da Clinica Oftalmológica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo Os anisométropes foram submetidos à refração estática objetiva e subjetiva, ceratometria e biometria ultra-sônica. RESULTADOS: Não houve diferença significativa entre os valores dos componentes oculares medidos dos olhos portadores da menor e da maior ametropia. Os olhos portadores da menor ametropia apresentaram as mesmas correlações significantes observadas em olhos emétropes, ou seja, correlação da refração com comprimento do segmento anterior e comprimento axial, e correlação do comprimento axial com poder corneano e profundidade da câmara vítrea. Os olhos portadores da maior ametropia apresentaram correlação significante da refração com o comprimento axial e do comprimento axial com a profundidade da câmara vítrea. Ainda em ambos os olhos observou-se correlação significante do poder do cristalino com a profundidade da câmara anterior. CONCLUSÃO: Os olhos portadores da menor ametropia desenvolveram as correlações mais freqüentemente observadas nos olhos emétropes. Os olhos portadores da maior ametropia não desenvolveram as mesmas correlações dos emétropes.PURPOSE: To asses the correlation between ocular components (axial length, anterior segment length, corneal power, vitreous length and equivalent power of the eye and refractive error in eyes with higher and lower ametropia of subjects with anisometropia. METHODS: An analytical survey was carried out in 68 patients
Muhammad Kamran Khalid
Full Text Available Objective: Silicone oil (SO is an invaluable tool in the management of complex retinal detachments (RDs. Injection of silicone oil is associated with a variety of ocular complications specially when it is kept for a long time and its removal is endangering retinal re-detachment. The objective of this study was to determine the frequencies of different ocular complications associated with silicone oil injection in our setup. Study Design: Case series. Place and Duration of Study: This study was conducted at Vitreo-retina division of Al-Shifa Trust Eye Hospital, Rawalpindi from January 2014 to June 2014. Material and Methods: A total of 30 patients were included in the study who underwent pars-planavitrectomy (PPV with silicone oil injection for complex retinal detachments. The patients who had reached between 3 months & 6 months of their postoperative period and were presenting with some complications related to silicone oil injection were included in the study. Their records were reviewed and pre-operative data were collected regarding state of the eye preoperatively. Then the post-operative complications were noted. The descriptive and analytical statistics of different variables were measured using SPSS-17.0 software. Results: Out of thirty patients included in our study 23 (76.7% were male and 7 (23.3% were female. The mean age was 21.53 ± 16.004 years and range was 66 years. The mean pre-operative intra-ocular pressure ( IOP was 14.0 ± 2.150 mmHg and range 8 mmHg and the mean post-operative IOP was 24.93 ± 13.889 mmHg and range 45 mmHg (p=0.001. The pre-operative PVR grade-C was absent in 12 (40% patients and was present in 18 (60% patients and post-operative PVR grade-C was absent in 24 (80% patients and was present in 6 (20% patients (p=0.004; McNemar test. Band keratopathy was seen in 8 (26.7% and corneal decompensation in 2 (6.7% patients. Emulsification of silicone oil was seen in 14 (46.7% patients. Rubeosisiridis was present in 2
Grajewski, Rafael S.; Hansen, Anna M; Agarwal, Rajeev K.; Kronenberg, Mitchell; Sidobre, Stephane; Su, Shao Bo; Silver, Phyllis B.; Tsuji, Moriya; Franck, Richard W.; Lawton, Anne P.; Chan, Chi-Chao; Caspi, Rachel R.
Invariant Natural Killer T cells (iNKT cells) have been reported to play a role not only in innate immunity but also to regulate several models of autoimmunity. Furthermore, iNKT cells are necessary for the generation of the prototypic eye-related immune regulatory phenomenon, anterior chamber associated immune deviation (ACAID). Here we explore the role of iNKT cells in regulation of autoimmunity to retina, using a model of experimental autoimmune uveitis (EAU) in mice immunized with a uveitogenic regimen of the retinal antigen (Ag), IRBP. Natural strain-specific variation in iNKT number or induced genetic deficiencies in iNKT did not alter baseline susceptibility to EAU. However, iNKT function seemed to correlate with susceptibility and its pharmacological enhancement in vivo by treatment with iNKT TCR ligands at the time of uveitogenic immunization reproducibly ameliorated disease scores. Use of different iNKT TCR ligands revealed dependence on the elicited cytokine profile. Surprisingly, superior protection against EAU was achieved with α-C-GalCer, which induces a strong IFN-γ but only a weak IL-4 production by iNKT cells, in contrast to the ligands α-GalCer (both IFN-γ and IL-4) and OCH (primarily IL-4). The protective effect of α-C-Gal-Cer was associated with a reduction of adaptive Ag specific IFN-γ and IL-17 production and was negated by systemic neutralization of IFN-γ. These data suggest that pharmacological activation of iNKT cells protects from EAU at least in part by a mechanism involving innate production of IFN-γ and a consequent dampening of the Th1 as well as the Th17 effector responses. PMID:18802082
Grajewski, Rafael S; Hansen, Anna M; Agarwal, Rajeev K; Kronenberg, Mitchell; Sidobre, Stephane; Su, Shao Bo; Silver, Phyllis B; Tsuji, Moriya; Franck, Richard W; Lawton, Anne P; Chan, Chi-Chao; Caspi, Rachel R
Invariant NKT cells (iNKT cells) have been reported to play a role not only in innate immunity but also to regulate several models of autoimmunity. Furthermore, iNKT cells are necessary for the generation of the prototypic eye-related immune regulatory phenomenon, anterior chamber associated immune deviation (ACAID). In this study, we explore the role of iNKT cells in regulation of autoimmunity to retina, using a model of experimental autoimmune uveitis (EAU) in mice immunized with a uveitogenic regimen of the retinal Ag, interphotoreceptor retinoid-binding protein. Natural strain-specific variation in iNKT number or induced genetic deficiencies in iNKT did not alter baseline susceptibility to EAU. However, iNKT function seemed to correlate with susceptibility and its pharmacological enhancement in vivo by treatment with iNKT TCR ligands at the time of uveitogenic immunization reproducibly ameliorated disease scores. Use of different iNKT TCR ligands revealed dependence on the elicited cytokine profile. Surprisingly, superior protection against EAU was achieved with alpha-C-GalCer, which induces a strong IFN-gamma but only a weak IL-4 production by iNKT cells, in contrast to the ligands alpha-GalCer (both IFN-gamma and IL-4) and OCH (primarily IL-4). The protective effect of alpha-C-GalCer was associated with a reduction of adaptive Ag-specific IFN-gamma and IL-17 production and was negated by systemic neutralization of IFN-gamma. These data suggest that pharmacological activation of iNKT cells protects from EAU at least in part by a mechanism involving innate production of IFN-gamma and a consequent dampening of the Th1 as well as the Th17 effector responses.
Bingham, W F
Ocular pneumoplethysmography (OPG), a semiautomated form of suction ophthalmodynamometry, was used to evaluate and follow 15 patients who underwent carotid endarterectomy and two patients in whom gradual carotid artery occlusion was performed for inoperable intracranial aneurysm. Postoperative corrected ophthalmic arterial pressures (COAP's) on the operated side in the carotid endarterectomy patients averaged 12.5 mm Hg higher than before surgery, the standard deviation being 4.9 mm Hg for clinically stable patients. There was no significant change in COAP on the contralateral side. Several problems were encountered in closing down carotid clamps, the most potentially serious being a precipitous fall in COAP with the final adjustment. The current uses of OPG and similar techniques are reviewed, and potential neurosurgical applications are discussed.
Vinger, P F; Tolpin, D W
Eighty-two injuries secondary to the racket sports were studied during a 15-month period. Ordinary glasses provided considerable protection in the play of tennis and badminton, but not in the play of squash and racquet ball. Plastic safety lenses (USA Standard Practice for Occupational and Educational Eye ,nd Face Protection, approved Sept 18, 1968 by the USA Standards Institute [ANSI Z87.1-1968]) mounted in a sturdy frame (industrial or athletic) or an eye protector are necessary for squash and racquet ball. Contact lenses provide no ocular protection. Males suffered more serious injuries than females, but injuries were not related to the age or experience of the players. Eye protection is recommended for the racket sports.
Prabhakar S Krishnachary
Full Text Available Thelaziasis is an Arthropod-born disease of the eye and adnexa caused by Thelazia callipaeda, a nematode parasite transmitted by drosophilid flies to carnivores and humans. Because of its distribution mainly confined to South Asian countries and Russia, it is commonly known as Oriental Eye worm. It is often under-reported and not been given its due clinical importance. We report first case of human Thelaziasis from Hassan District, Karnataka. Five creamy-white, translucent worms were removed from the conjunctival sac of a 74-year-old male patient. Based on morphological characters, the worms were identified as nematodes belonging to the genus Thelazia and speciation was confirmed by CDC, Atlanta as callipaeda. Rarity of the disease and its ability to cause both extra and intraocular manifestations leading to ocular morbidity is the reason for presenting this case. From the available data, this is the first case report from Karnataka, India.
Fabricio Lopes da Fonseca
Full Text Available Silent sinus syndrome is an acquired condition in which there is a gradual collapse of the orbital floor and inward retraction of the maxillary sinus (atelectasis of the maxillary sinus. This in turn may cause associated ocular occurrences of enophthalmos and hypotropia. This is a report of an 8 year-old boy with silent sinus syndrome and associated ocular motility disorders. The association between silent sinus syndrome and ocular motility disturbance has been recently described in the literature. However, this is an infrequent association, mainly in childhood.
Musat, O; Ochinciuc, Uliana; Gutu, Tatiana; Cristescu, T R; Coman, Corina
We present the case of a 65 years old pacient which was admitted for the sudden decrease of visual acuity in the left eye, accompanied by ocular pain and conjunctival hiperemia, simptoms appeared after an ocular trauma. After the clinical and paraclinical examination we determined the diagnosis of OS: Penetrating ocular trauma with retention of a foreign body; posttraumatic cataract. Surgical treatement was warrented and we performed OS : Facoemulsification + PFK implant in sulcus + 23 Ga posterior vitrectomy + peeling of the posterior hyaloid membrane + extraction of the foreign body + LASER endofotocoagulation + transscleral cryotherapy + SF6 gas injection. The post-operatory evolution was favorable.
ROMAO, Elen A.; BOLELLA, Valdes R.; NARDIN, Maria Estela P.; HABIB-SIMAO, Maria Lucia; FURTADO, João Marcelo; MOYSES-NETO, Miguel
We present a case of ocular syphilis after a renal transplantation involving progressive vision loss without clinically identifiable ocular disease. Electroretinography showed signs of ischemia, especially in the internal retina. A serological test was positive for syphilis. Lumbar puncture revealed lymphocytic meningitis and a positive serologic test for syphilis in the cerebrospinal fluid. The patient was treated with penicillin, and had a quick vision improvement. In the case of transplant recipients, clinicians should always consider the diagnosis of ocular syphilis in cases with unexplained visual acuity decrement, as this condition may cause serious complications if not treated. PMID:27253748
Full Text Available La toxocariosis es una geohelmintiosis producida por la ingestión de
huevos de Toxocara canis y T. catis, cuyos hospederos definitivos son el perro y el gato. En el humano las larvas producen el Síndrome de Migración Larvaria Visceral y Ocular; en este último produce una enfermedad grave que puede semejar un retinoblastoma (1,2. Los niños son más susceptibles a adquirir esta infección (3. Nuestro objetivo es determinar la frecuencia de toxocariosis ocular en menores de edad con sintomatología ocular.
Sandra Saray Quignon Santana
Full Text Available Rheumatoid arthritis is considered an autoimmune disease in which articular and extra articular manifestations are produced and contribute to alter the functional capacity of the individual. This study consists on performing a bibliographical review showing the main ocular manifestations in patients with rheumatoid arthritis. It is our purpose to give you our experiences to the students as well as the internal medicine, ophthalmology and rheumatologist residents about this topic. The ophthalmological consultation of sick patients contributes to the prevention of ocular illnesses which are characteristic of the base disease and improve the ocular health.
Zheleznyak, Len; Alarcon, Aixa; Dieter, Kevin C; Tadin, Duje; Yoon, Geunyoung
Monovision presbyopia interventions exploit the binocular nature of the visual system by independently manipulating the optical properties of the two eyes. It is unclear, however, how individual variations in ocular dominance affect visual function in monovision corrections. Here, we examined the impact of sensory ocular dominance on visual performance in both traditional and modified monovision presbyopic corrections. We recently developed a binocular adaptive optics vision simulator to correct subjects' native aberrations and induce either modified monovision (1.5 D anisometropia, spherical aberration of +0.1 and -0.4 μm in distance and near eyes, respectively, over 4 mm pupils) or traditional monovision (1.5 D anisometropia). To quantify both the sign and the degree of ocular dominance, we utilized binocular rivalry to estimate stimulus contrast ratios that yield balanced dominance durations for the two eyes. Through-focus visual acuity and contrast sensitivity were measured under two conditions: (a) assigning dominant and nondominant eye to distance and near, respectively, and (b) vice versa. The results revealed that through-focus visual acuity was unaffected by ocular dominance. Contrast sensitivity, however, was significantly improved when the dominant eye coincided with superior optical quality. We hypothesize that a potential mechanism behind this observation is an interaction between ocular dominance and binocular contrast summation, and thus, assignment of the dominant eye to distance or near may be an important factor to optimize contrast threshold performance at different object distances in both modified and traditional monovision.
Silpa-archa, Sukhum; Lee, Joan J; Foster, C Stephen
Systemic lupus erythematosus (SLE) can involve many parts of the eye, including the eyelid, ocular adnexa, sclera, cornea, uvea, retina and optic nerve. Ocular manifestations of SLE are common and may lead to permanent blindness from the underlying disease or therapeutic side effects. Keratoconjunctivitis sicca is the most common manifestation. However, vision loss may result from involvement of the retina, choroid and optic nerve. Ocular symptoms are correlated to systemic disease activity and can present as an initial manifestation of SLE. The established treatment includes prompt systemic corticosteroids, steroid-sparing immunosuppressive drugs and biological agents. Local ocular therapies are options with promising efficacy. The early recognition of disease and treatment provides reduction of visual morbidity and mortality.
Muşat, O; Cristescu, R; Coman, Corina; Asandi, R
This papers presents a case of a patient with retinal detachement, 3 days ago operated (posterior vitrectomy internal tamponament with silicon oil 1000) who develop increased ocular pressure following silicon oil output in the anterior chamber.
the usual intestinal manifestations, leading to an earlier diagnosis. Thus, it is important to understand the clinical presentation of possible ocular manifestations in order to initiate appropriate treatment and to help prevent significant visual morbidity.
Tandon, A; Mulvihill, A
Recent research into animal studies has contributed significantly to understanding the pathophysiology of some well-known teratogens, such as alcohol. Techniques, such as positron emission tomography (PET) and retinal synaptogenesis studies, have helped determine the specific areas in the developing brain and ocular structures, which are targeted by various teratogens. In this article, we also highlight a few newer agents, such as benzodiazepines, with potential for ocular malformation and morbidity in the developing foetus.
O K Radhakrishnan; Debapriya Datta; Jyoti Yadav; Priti Kumari; Vasundhara Phillips; Nimrita Nagdev
Introduction: In pregnancy, women undergo a tremendous number of systemic and ocular changes. Physiological changes occur in the cardiovascular, hormonal, metabolic, hematologic and immunologic systems. Hormonal changes are among the most prominent systemic changes in pregnant women with the placenta, maternal endocrine glands and the fetal adrenal glands combining their productivity to make a high-powered hormone factory. Aims: To evaluate the various ocular changes taking place in pregnancy...
Full Text Available Ocular toxocariasis is prevalent among children. The symptoms and signs may mimic other ocular pathologies such as malignancies and other infectious diseases (such as toxoplasmosis and syphilis. We presented a case of progressive blurring of vision in a single eye of a 9-year-old boy. The presence of anti-toxocara antibody in serum samples helps to confirmation the diagnosis in our patient. Despite of treatment, the boy had lost his vision on the affected eye.
Siddesh Kumar Chintal
Full Text Available The disfigurement associated with the loss of an eye can cause significant physical and emotional problems. Various treatment modalities are available, one of which is implants. Although implant has a superior outcome, it may not be advisable in all patients due to economic factors. The present article describes the prosthetic management of an ocular defect with a custom-made ocular prosthesis.
Azira NMS; Zeehaida M
Ocular toxocariasis is prevalent among children. The symptoms and signs may mimic other ocular pathologies such as malignancies and other infectious diseases (such as toxoplasmosis and syphilis). We presented a case of progressive blurring of vision in a single eye of a9-year-old boy. The presence of anti-toxocara antibody in serum samples helps to confirmation the diagnosis in our patient. Despite of treatment, the boy had lost his vision on the affected eye.
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Se presenta el caso de un paciente con un cisticerco retiniano, tratado sin éxito con praziquantel, quien a los cinco meses del tratamiento presentó fibrosis y desprendimiento de la retina. Se realizó intervención quirúrgica y se encontró el cisticerco vivo. Desde antes de la operación el paciente había perdido la visión por el ojo afectado. Se hace una revisión sobre oftalmocisticercosis y se recomienda tratamiento quirúrgico oportuno y no usar los antihelmínticos con efecto sobre los cisticercos, como son praziquantel y albendazol.
One case of ocular cysticercosis with retinal involvement, in which praziquantel treatment was ineffective, is presented. Five months after the medical treatment the patient presented with retinal detachment and fibrosis, loss of vision through the affected eye and at that time the parasite was observed alive. Surgical intervention was performed and the recovered cysticercus showed viability. A review on ophtalmocysticercosis is presented and recommendations are made to treat these cases by early surgery without prior administration of anticysticercus drugs such as praziquantel or albendazole.
Full Text Available We maintain a stable perception of the visual world despite continuous movements of our eyes, head and body. Perception of upright is a key aspect of such orientation constancy. Here we investigated whether changes in upright perception during sustained head tilt were related to simultaneous changes in torsional position of the eyes. We used a subjective visual vertical (SVV task, modified to track changes in upright perception over time, and a custom video method to measure ocular torsion simultaneously. We tested twelve subjects in upright position, during prolonged (~15min lateral head tilts of 20 degrees, and also after the head returned to upright position. While the head was tilted, SVV drifted in the same direction as the head tilt (left tilt: -5.4±1.4 o and right tilt: +2.2±2.1 o. After the head returned to upright position, there was an SVV aftereffect with respect to the pre-tilt baseline, which was also in the same direction as the head tilt (left tilt: -3.9±0.6 o and right tilt: +2.55±1.0 o. Neither the SVV drift nor the SVV aftereffect were correlated with the changes in ocular torsion. Using the Bayesian spatial-perception model we show that the pattern of SVV drift and aftereffect in our results could be explained by a drift and an adaptation in sensory inputs that encode head orientation. The fact that ocular torsion (mainly driven by the otoliths could not account for the perceptual changes suggests that neck proprioception could be the primary source of drift in upright perception during head tilt, and subsequently the aftereffect in upright position.
Park, S; Albert, D M; Bolognia, J L
Disorders of pigmentation can result from either an abnormal number of melanocytes, as in nevus of Ota and vitiligo, or an abnormal amount of melanin production, as in albinism. Melanin-producing cells are found in the skin, mucous membranes, uveal tract, and retinal pigment epithelium of the eye and the stria vascularis of the inner ear. Thus, many of the hereditary or congenital pigmentary disorders of the skin are associated with similar pigmentary abnormalities in the eye, such as iris heterochromia or changes in pigmentation of the fundus; however, more commonly, the associated eye finding is a defect in ocular motility, i.e., strabismus and nystagmus, suggesting a concomitant defect in neurologic development. In albinos, the observed neurologic abnormality in the visual pathway and foveal hypoplasia are hypothesized to be related directly to the lack of melanin in the pigment epithelium during development. In acquired disorders of pigmentation, in particular, vitiligo, Vogt-Koyanagi-Harada syndrome, and onchocerciasis, there is a frequent association with uveitis, suggesting an inflammatory cause for the cutaneous pigmentary changes.
Full Text Available This review article aimed to evaluate ocular biometric changes after trabeculectomy. The PubMed database was searched using the keywords “axial length” (AL, “anterior chamber depth” (ACD, “corneal astigmatism,” “corneal topography” and “trabeculectomy.” The extracted studies were categorized based on the evaluated parameters and the biometry method (contact and non-contact. Comparable studies with respect to their sample size were combined for statistical analysis. Twenty-five studies including 690 individuals which met the inclusion criteria were selected. After trabeculectomy, a significant and persistent AL reduction, with a range of 0.1-0.19 and 0.1-0.9 mm measured with contact and non-contact methods, respectively, was observed. With respect to topographic changes, 0.38-1.4 diopters (D with-the-rule (WTR astigmatism was induced postoperatively. All studies revealed ACD reduction immediately after surgery, which gradually deepened and approximated its preoperative levels on day 14. ACD reduction was not significant after that period in the majority of cases. In conclusion, changes in ACD is of small amount and of short period, thus it can be ignored; however, reported changes in AL and keratometry are of sufficient magnitude and can affect the refractive prediction of combined cataract surgery and trabeculectomy.
Al-Kalbani, M.; Mihaylova, E.; Collins, N.; Toal, V.; Coakley, D.; Boyle, G.
Ocular Microtremor (OMT) is a continual, high frequency physiological tremor of the eye present in all subjects even when the eye is apparently at rest. OMT causes a peak to peak displacement of around 150nm-2500nm with a broadband frequency spectrum between 30Hz to 120Hz; with a peak at about 83Hz. OMT carries useful clinical information on depth of consciousness and on some neurological disorders. Nearly all quantitative clinical investigations have been based on OMT measurements using an eye contacting piezoelectric probe which has low clinical acceptability. Laser speckle metrology is a candidate for a high resolution, non-contacting, compact, portable OMT measurement technique. However, tear flow and biospeckle might be expected to interfere with the displacement information carried by the speckle. The paper investigates the properties of the scattered speckle of laser light (λ = 632.8nm) from the eye sclera to assess the feasibility of using speckle techniques to measure OMT such as the speckle correlation. The investigation is carried using a high speed CMOS video camera adequate to capture the high frequency of the tremor. The investigation is supported by studies using an eye movement simulator (a bovine sclera driven by piezoelectric bimorphs). The speckle contrast and the frame to frame spatiotemporal variations are analyzed to determine if the OMT characteristics are detectable within speckle changes induced by the biospeckle or other movements.
O K Radhakrishnan
Full Text Available Introduction: In pregnancy, women undergo a tremendous number of systemic and ocular changes. Physiological changes occur in the cardiovascular, hormonal, metabolic, hematologic and immunologic systems. Hormonal changes are among the most prominent systemic changes in pregnant women with the placenta, maternal endocrine glands and the fetal adrenal glands combining their productivity to make a high-powered hormone factory. Aims: To evaluate the various ocular changes taking place in pregnancy in women with no other co-morbid ocular or systemic diseases and to compare ocular changes in three trimesters of pregnancy with controls of non pregnant women. Materials and Methods: The ocular changes occuring in varying stages of pregnancy in 225 pregnant women were studied and compared with 75 healthy non pregnant women. Results: Age was similar in the pregnant and non pregnant women studied. Headache was significantly more common among pregnant women when compared to non pregnant women. Diplopia was not significantly different between pregnant and non pregnant women. Intraocular pressure was significantly less among the pregnant women as compared to non pregnant women. Occurrence of conjunctival pigmentation was significantly more in pregnant women when compared to non pregnant women. There was no difference in corneal thickness when pregnant and non pregnant women were compared. Krukenberg's spindles were seen more commonly among pregnant women when compared to non pregnant women. Conclusion: Various ocular changes occur during a normal pregnancy. Knowledge of these changes can help to differentiate the physiological changes occurring in a normal pregnancy from ocular manifestation of systemic diseases. [Natl J Med Res 2016; 6(1.000: 1-4
Kung, Nathan H; Bucelli, Robert C; McClelland, Collin M; Van Stavern, Gregory P
Ocular neuromyotonia (ONM) is a neuro-ophthalmic disorder characterized by episodic diplopia caused by contraction of one or more ocular muscles due to spontaneous excitation of the respective ocular motor nerve. We report a patient whose ocular neuromyotonia arose in the setting of a subacute demyelinating polyneuropathy consistent with chronic inflammatory demyelinating polyneuropathy (CIDP) and subsequently resolved following the initiation of intravenous immunoglobulin (IVIg) for her neuropathy. Our patient provides additional evidence towards the role of demyelination and ephaptic neurotransmission in ocular neuromyotonia and also represents the first reported case of ocular neuromyotonia associated with a systemic neurological condition.
Kaštelan, Snježana; Tomić, Martina; Metež Soldo, Kata; Salopek-Rabatić, Jasminka
The treatment goals for glaucoma are lowering the intraocular pressure and preservation of vision. Topical hypotensive drops are the standard form of therapy which is often associated with some symptoms of toxicity, ocular inflammation, allergy, or ocular surface disease (OSD). OSD is a common comorbidity in glaucoma patients, and its prevalence with glaucoma increases with age. Use of topical treatment could additionally increase symptoms of OSD mostly due to preservatives added to multidose medication bottles used to reduce the risk of microbial contamination. This toxicity has been particularly associated with BAK, the most commonly used preservative which damages conjunctival and corneal epithelial cells and significantly aggravates OSD symptoms. OSD adversely affects patients' quality of life causing discomfort and problems with vision which in turn may result in noncompliance, lack of adherence, and eventually visual impairment. In the management of glaucoma patients OSD symptoms should not be overlooked. If they are present, topical glaucoma treatment should be adapted by decreasing the amount of drops instilled daily, using BAK-free or preservative-free medication and lubricants if necessary. Awareness of the presence and importance of OSD will in turn improve patients' adherence and compliance and thus ultimately the preservation of long-term vision.
Kaštelan, Snježana; Tomić, Martina; Metež Soldo, Kata; Salopek-Rabatić, Jasminka
The treatment goals for glaucoma are lowering the intraocular pressure and preservation of vision. Topical hypotensive drops are the standard form of therapy which is often associated with some symptoms of toxicity, ocular inflammation, allergy, or ocular surface disease (OSD). OSD is a common comorbidity in glaucoma patients, and its prevalence with glaucoma increases with age. Use of topical treatment could additionally increase symptoms of OSD mostly due to preservatives added to multidose medication bottles used to reduce the risk of microbial contamination. This toxicity has been particularly associated with BAK, the most commonly used preservative which damages conjunctival and corneal epithelial cells and significantly aggravates OSD symptoms. OSD adversely affects patients' quality of life causing discomfort and problems with vision which in turn may result in noncompliance, lack of adherence, and eventually visual impairment. In the management of glaucoma patients OSD symptoms should not be overlooked. If they are present, topical glaucoma treatment should be adapted by decreasing the amount of drops instilled daily, using BAK-free or preservative-free medication and lubricants if necessary. Awareness of the presence and importance of OSD will in turn improve patients' adherence and compliance and thus ultimately the preservation of long-term vision. PMID:24224176
Full Text Available The treatment goals for glaucoma are lowering the intraocular pressure and preservation of vision. Topical hypotensive drops are the standard form of therapy which is often associated with some symptoms of toxicity, ocular inflammation, allergy, or ocular surface disease (OSD. OSD is a common comorbidity in glaucoma patients, and its prevalence with glaucoma increases with age. Use of topical treatment could additionally increase symptoms of OSD mostly due to preservatives added to multidose medication bottles used to reduce the risk of microbial contamination. This toxicity has been particularly associated with BAK, the most commonly used preservative which damages conjunctival and corneal epithelial cells and significantly aggravates OSD symptoms. OSD adversely affects patients’ quality of life causing discomfort and problems with vision which in turn may result in noncompliance, lack of adherence, and eventually visual impairment. In the management of glaucoma patients OSD symptoms should not be overlooked. If they are present, topical glaucoma treatment should be adapted by decreasing the amount of drops instilled daily, using BAK-free or preservative-free medication and lubricants if necessary. Awareness of the presence and importance of OSD will in turn improve patients' adherence and compliance and thus ultimately the preservation of long-term vision.
Georgina P. Ossani
Full Text Available Previous studies have shown ocular haemorrhages in choline-deficient rats. The aim of this paper is to study further the relationship between ocular and renal lesions and biochemical alterations in rats fed a choline-deficient diet. Fifty one weanling male Wistar rats, were divided into two groups. Thirty one of them were fed a choline-deficient diet and the rest was fed a choline-supplemented diet ad libitum. Animals from both groups were killed between the fifth and the eighth day. Urea, creatinine and homocysteine concentrations in blood were determined. Eyes were used for light microscopy study; high resolution light microscopy and the study of the retina as "rétine a plat". Kidneys were studied by light microscopy. Choline-supplemented rats did not show ocular or renal lesion. Choline-deficient rats that showed renal lesions, tubular or cortical necrosis, did not always have ocular changes. There were no ocular changes in the only choline-deficient rat without renal lesion. The ocular changes consisted mainly in haemorrhage in both cameras and ciliary and vitreous bodies. Correlations between ocular and renal lesion (r=0.72, pEstudios previos han demostrado hemorragia ocular en ratas deficientes en colina. El objetivo de este trabajo es profundizar en la relación entre las alteraciones oculares, renales y bioquímicas en ratas deficientes en colina. Cincuenta y una ratas Wistar macho recién destetadas fueron divididas en dos grupos: treinta y una fueron alimentadas con una dieta colino deficiente y el resto con colina suplementada ad-libitum. Los animales de ambos grupos fueron sacrificados entre el quinto y el octavo día. Se midió la concentración de urea, creatinina y homocisteína en sangre. Los ojos fueron estudiados por microscopía de luz, microscopía óptica de alta resolución y para el estudio de la retina como retina plana. Los riñones fueron estudiados por microscopía de luz. Las ratas suplementadas con colina no
Full Text Available Abstract Background To determine the ocular changes related to hypothyrodism in newly diagnosed patients without orbitopathy. Findings Thirty-three patients diagnosed to have primary overt hypothyroidism were enrolled in the study. All subjects were assigned to underwent central corneal thickness (CCT, anterior chamber volume, depth and angle measurements with the Scheimpflug camera (Pentacam, Oculus and cup to disc ratio (C/D, mean retinal thickness and mean retinal nerve fiber layer (RNFL thickness measurements with optical coherence tomography (OCT in addition to ophthalmological examination preceeding the replacement therapy and at the 1st, 3rd and 6th months of treatment. The mean age of the patients included in the study were 40.58 ± 1.32 years. The thyroid hormone levels return to normal levels in all patients during the follow-up period, however the mean intraocular pressure (IOP revealed no significant change. The mean CCT was 538.05 ± 3.85 μ initially and demonstrated no statistically significant change as the anterior chamber volume, depth and angle measurements did. The mean C/D ratio was 0.29 ± 0.03 and the mean retinal thickness was 255.83 ± 19.49 μ initially and the treatment did not give rise to any significant change. The mean RNFL thickness was also stable during the control visits, so no statistically significant change was encountered. Conclusions Neither hypothyroidism, nor its replacement therapy gave rise to any change of IOP, CCT, anterior chamber parameters, RNFL, retinal thickness and C/D ratio.
Full Text Available Introduction: The integrity of the cells/tissues in anterior and/or posterior segments of the eye plays a crucial role in biofunctions of the vision. To maintain ocular homeostasis, selective restrictiveness of the ophthalmic membranes and barriers control must act on shuttling of biomolecules. Thus, not all attempts to apply de novo nanotechnology approaches for ocular pharmacotherapy have met with the same successes as those cited here in this review, and sometimes these novel technologies tools provoke a great deal of challenges and hurdles mainly because of functional presence of these barriers. Methods: Recent published articles related to application of ocular nanomedicines were reviewed and highlighted in this review article. Results: It seems the emergence of nanomedicines have arisen great hopes for ophthalmic pharmacotherapy, in which nanostructured medicines are expected to be able to cross the restrictive barriers of the eye. Although such fast inauguration of ocular nanomedicines will literally convey new challenges in the regulatory and translational processes, it will also grant a prolific platform from which many exciting, and yet unimagined, applications of biomedical nanotechnology will emerge for pharmacotherapy of the eye. Conclusion: This review provide recent advancements on ocular nanomedicines.
Tormey, Peter; Bilic Cace, Iva; Boyle, Michael A
Pai Syndrome is a rare congenital malformation syndrome of unknown cause with hypertelorism, midline cleft lip, nasal and facial polyps, ocular anomalies and the presence of distinctive lipomas adjacent to the corpus callosum. Herein, we present an infant girl with Pai Syndrome diagnosed in the first week of life with typical facial findings and associated pericallosal lipoma identified on cranial ultrasound and brain MRI. These typical features identified included median cleft of the upper lip (in her case as a forme fruste) with a cleft alveolus and a mid-anterior alveolar process congenital polyp. In addition to these findings there was mild hypertelorism and an ocular abnormality on the right eye. An ophthalmology assessment on day 5 identified the ocular lesion as a limbal dermoid. Several ocular anomalies have been reported in association with Pai Syndrome, however, dermoids have not been frequently described in this Syndrome and not before in a limbal location. Increasing identification of previously unreported ocular abnormalities in Pai Syndrome may improve diagnosis and may prove useful in future work attempting to elucidate the aetiology of this rare syndrome.
Zemba, M; Avram, Corina Ioana; Ochinciuc, Uliana; Stamate, Alina Cristina; Camburu, Raluca Lăcrămioara
Ocular ischemic syndrome, also known as hypoperfusion/ hypotensive retinopathy or as ischemic oculopathy is a rare ocular disease determined by chronic arterial hypoperfusion through central retinal artery, posterior and anterior ciliary arteries. It is bilateral in 20% of the cases. Most often it appears due to severe occlusion of the carotid arteries (ICA, MCA>ECA), described in 1963 by Kearns and Hollenhorst. Occasionally it can be determined by the obstruction of ophtalmic artery or some arterities (Takayasu, giant cell arteritis). The risk factors are: age between 50-80 years, males (M:F = 2:1), arterial hypertension, diabetes, coronary diseases (5% of the cases develop ocular ischemic syndrome), vascular stroke, hemodialysis. The case we present is of an 63 years old man known with primary arterial hypertension, hypercholesterolemia, diabetes type 2 non insulin dependent and diagnosticated with ischemic cerebral stroke and bilateral obstruction of internal carotid arteries in march 2010, who is presenting for visual impairment in both eyes. The imaging investigations show important carotid occlusion and at the ophthalmologic evaluation there are ocular hypertension and rubeosis iridis at the right eye, optic atrophy at both eyes (complete in the right eye and partial in the left eye), with superior altitudinal visual field defect in left eye. The following diagnosis was established: Chronic ocular ischemic syndrome in both eyes with Neovascular glaucoma at the right eye, Anterior ischemic optic neuropathy at the left eye and laser panphotocoagulation at the right eye was started.
Full Text Available Syphilis is a multi systemic infection caused by Treponema pallidum. Ocular manifestations of Syphilis have a myriad of presentations and severity. A 31year old male patient was referred from ophthalmology department as a case of chorioretinitis for screening for syphilis. Patient had diminished vision and redness of right eye for 2 months duration. History of premarital exposure and extramarital contact was present. Ocular examination revealed - Rt eye: conjunctival congestion and Argyll Robertson pupil; Lt eye: normal. Fundoscopy of right eye showed yellowish white retinal lesions, macular edema and hyperaemia and left eye was normal .No genital lesion, scars or cutaneous lesion was present.VDRL was reactive in 1 dilution,TPHA was positive ; HIV test was negative ; CSF revealed VDRL - Negative and TPHA -Negative.Patient was treated with Injection procaine penicillin 1.2 Million units intramuscularly daily for 21 days. The patient responded well to treatment and there was improvement in his vision. Ocular Syphilis can occur at any stage of Syphilis and may be the only presenting sign. Syphilis serology was positive confirming the disease.This case highlights the importance of syphilis with ocular manifestation - there by proving that diagnosis of syphilis based on ocular finding is clinically challenging.
Aldana, I; Fos, D; Gonzalez Peñas, E; Gazzaniga, A; Gianesello, V; Ceppi Monti, N; Figini, P G; Zato, M A; Bruseghini, L; Esteras, A
The ocular pharmacokinetics of thiamphenicol (TAP, CAS 15318-45-3) was studied in rabbits by means of the assessment of its ocular and systemic absorption, and urinary excretion after instillation of 0.5% TAP eye drops. TAP concentrations in aqueous humor, plasma and urine were evaluated by a coupled LC/GC method (detection limit = 0.1 ng/ml), because the necessity to have a technique much more sensitive than the traditional chromatographic ones available in order to quantify the very low drug concentrations in biological fluids produced by the ocular treatment, and generally by a topical administration. The intravenous route was chosen as reference and allowed the absolute bioavailability to be estimated. TAP proved to be well absorbed through the cornea with the peak aqueous humor concentration of 110 ng/ml at 45 min following the instillation. The good ocular absorption of TAP was confirmed by the plasma concentrations observed after instillation of 0.5% eye drops. In any case, these concentrations were more than 1000 times lower than those observed after the intravenous treatment at the dose normally used for infectious diseases, allowing to exclude any systemic toxicity of TAP eye drops. The absolute ocular bioavailability was 16.2% when estimated from the AUC values and 34.0% from the cumulative urinary excretion values.
H.S. Tan (H.); J. van Neerven (J.); H. Collewijn (Han); O. Pompeiano (O.)
markdownabstract__Abstract__ The effects of microinjection of α-noradrenergic agonists and antagonists in the flocculus on the basic gain and adaptability of vestibulo-ocular and optokinetic responses were investigated. A complementary, previous investigation46 had shown that the adaptation, but no
Schmidl, D; Werkmeister, R; Garhöfer, G; Schmetterer, L
Ocular perfusion pressure is defined as the difference between arterial and venous pressure in ocular vessels. In practice, mean arterial pressure is used to substitute for arterial pressure in ocular vessels while intraocular pressure gives an estimate for ocular venous pressure. This results in a value that is easy to calculate and which is of importance since several studies have shown that it is correlated to the prevalence, incidence and progression of primary open angle glaucoma. Today, ocular perfusion pressure is used to estimate individual risks. Since no target value for ocular perfusion pressure can be defined, direct therapeutic intervention is difficult. Still, it has to be kept in mind that lowering intraocular pressure automatically leads to an increase in ocular perfusion pressure. The present article also points out problems and limitations in the concept of ocular perfusion pressure and suggests possible solutions for these problems in the future.
Ganley, J.P.; Nemo, G.J.; Comstock, G.W.; Brody, J.A.
Lymphocytes from individuals with inactive macular disciform lesions of presumed ocular histoplasmosis challenged with three histoplasmin antigens incorporated tritiated thymidine at a significantly higher rate than histoplasmin-stimulated lymphocytes of matched control and peripheral scar groups. This finding is consistent with the etiologic association of the disciform ocular syndrome and previous systemic infection with Histoplasma capsulatum. The disciform group had a higher mean response than the other two groups to pokeweed mitogen but not to phytohemagglutinin and had higher mean counts per minute to the specific antigens Toxoplasma gondii, Blastomyces dermatitidis, Cryptococcus neoformans, Mycobacterium tuberculosis, M battery, and M gaus, but not to Candida albicans. These data would suggest that individuals with the disciform lesion of presumed ocular histoplasmosis have a hyperreactive cellular immune response; this response may play an important role in the development of the disciform.
Mackay, Devin D; Garza, Philip S
The proficiency of nonophthalmologists with direct ophthalmoscopy is poor, which has prompted a search for alternative technologies to examine the ocular fundus. Although ocular fundus photography has existed for decades, its use has been traditionally restricted to ophthalmology clinical care settings and textbooks. Recent research has shown a role for nonmydriatic fundus photography in nonophthalmic settings, encouraging more widespread adoption of fundus photography technology. Recent studies have also affirmed the role of fundus photography as an adjunct or alternative to direct ophthalmoscopy in undergraduate medical education. In this review, the authors examine the use of ocular fundus photography as an educational tool and suggest future applications for this important technology. Novel applications of fundus photography as an educational tool have the potential to resurrect the dying art of funduscopy.
Full Text Available A year long study of ocular injuries in children below the age of 15 years was conducted in the Ophthalmology Department of a general hospital. Fortyfour cases were studied. Of these 45.45% were in the age group of 6-10 years. The male to female ratio was 5.28 : 1. Pointed objects viz. sticks, wires etc. were found to be the common causative agents; the recent trend being of bow and arrow injuries. Ocular perforation was observed in 28 cases. On follow up of all the cases with ocular trauma, only 12 patients were found to have a visual acuity better than 6/18; perception of light was absent in 7 patients. A need for increased parental awareness and supervision of children is stressed upon.
Full Text Available Transport of drugs applied by traditional dosage forms is restricted to the eye, and therapeutic drug concentrations in the target tissues are not maintained for a long duration since the eyes are protected by a unique anatomy and physiology. For the treatment of the anterior segment of the eye, various droppable products to prolong the retention time on the ocular surface have been introduced in the market. On the other hand, direct intravitreal implants, using biodegradable or non-biodegradable polymer technology, have been widely investigated for the treatment of chronic vitreoretinal diseases. There is urgent need to develop ocular drug delivery systems which provide controlled release for the treatment of chronic diseases, and increase patient’s and doctor’s convenience to reduce the dosing frequency and invasive treatment. In this article, progress of ocular drug delivery systems under clinical trials and in late experimental stage is reviewed.
Victoria Mary Lendrum Cohen
Full Text Available Victoria Mary Lendrum CohenSt. Bartholomew’s and Moorfields Eye Hospital, London UKAbstract: Most lymphomas that involve the ocular adnexal structure are low grade, B cell, non-Hodgkin’s lymphomas. The treatment depends upon the grade and stage of the disease. High grade lymhoma requires treatment with systemic chemotherapy whereas the localized low grade (extranodal marginal zone lymphoma can be successfully managed with local radiotherapy. Chlamydia psittaci infection is associated with low grade ocular lymphoma; however there is wide geographic variation in the strength of this association. Blanket antibiotic therapy is not advised unless there is proof of an infective agent. The monoclonal antibody, rituximab, may be successful for CD20 positive lymphoma, although it is likely that rituximab will have better long-term results when used in combination with systemic chemotherapy.Keywords: ocular adnexal lymphoma, mucosa associated lymphoid tissue, extranodal marginal zone lymphoma, Chlamydia psittaci, rituximab, radiotherapy, chemotherapy
Mulla Summaiya A
Full Text Available Background: Isolation of common pathogens involved in ocular infection and their in-vitro susceptibility to commonly used ocular antibiotics, as well as the trends in antibiotic resistance developed by these pathogens were investigated. Material/Methods: All patients with suspected bacterial ocular infections presenting between march 2010 and feb 2011 were examined under slit lamp microscope and samples were collected by using aseptic techniques. All samples were processed for direct microscopy, culture and identification by standard methods. Susceptibility testing was done by Kirby-Bauer method as per CLSI guideline. Results: Out of 116 patients with ocular infections 130 samples were collected, from which 38 different organisms were isolated. Gram-positive cocci 21 (55%, gram-negative cocco-bacilli 5(31% and gram-negative bacilli 12 (32% were isolated. Coagulase negative Staphylococci (37% and Pseudomonas species (21% were the most commonly-isolated. Gatifloxacin has highest efficacy (89% against all isolates. Majority of gram positive cocci were susceptible to vancomycin, gatifloxacin, cefazolin, gram negative cocco-bacilli to amikacin, tobramycin, fluoroquinolone and gram negative bacilli to gatifloxacin. Conclusion: Majority of ocular infection is caused by gram positive organisms which were susceptible to vancomycin followed by gram negative organisms susceptible to amikacin, fluoroquinolone, gram negative cocco-bacilli to amikacin and tobramycin, and gatifloxacin effective against both type of organisms. The information provided in this article help the clinician in formulating rationale-based empirical antibiotic treatment of bacterial ocular infections. [National J of Med Res 2012; 2(1.000: 22-24
Mohindroo, Chirayu; Ichhpujani, Parul; Kumar, Suresh
Glaucoma may be caused by an interplay of elevated intraocular pressure (IOP), vascular, genetic, anatomical, brain, and immune factors. The direct assessment of ocular hemodynam-ics offers promise for glaucoma detection, differentiation, and possibly new treatment modalities. All the methods currently in use to measure ocular blood flow have inherent limitations and measure different aspects of ocular blood flow. This review article attempts to provide detailed information on ocular perfu-si...
Ocular toxoplasmosis is a vision-threatening disease and the major cause of posterior uveitis worldwide. In spite of the continuing global burden of ocular toxoplasmosis, many critical aspects of disease including the therapeutic approach to ocular toxoplasmosis are still under debate. To assist in addressing many aspects of the disease, numerous experimental models of ocular toxoplasmosis have been established. In this article, we present an overview on in vitro, ex vivo, and in vivo models ...
Alessandra G Commodaro
Full Text Available Ocular toxoplasmosis is the most common cause of posterior uveitis worldwide. The infection can be acquired congenitally or postnatally and ocular lesions may present during or years after the acute infection occur. Current treatment controls ocular infection and inflammation, but does not prevent recurrences. We present a review and update on ocular toxoplasmosis and address misconceptions still found in the current medical literature.
Simone Ribeiro Araújo de Almeida
Full Text Available OBJETIVO: Analisar os achados clínicos da tuberculose ocular e seus aspectos epidemiológicos. MÉTODOS: Foram revisados prontuários médicos de pacientes que foram atendidos no Departamento de Oftalmologia - setor de Uveíte e AIDS da Unifesp-EPM, São Paulo, Brasil, entre janeiro de 1999 e julho de 2002 e que tiveram diagnóstico de tuberculose ocular. Foram inclusos os pacientes que apresentaram PPD forte reator, epidemiologia positiva para tuberculose e lesão ocular que melhorou com tratamento específico. RESULTADOS: Foram analisados prontuários médicos de 17 pacientes, sendo 12 (70,6% do sexo feminino. A idade média foi de 54 (24-84 anos. O tempo médio entre o início dos sintomas e a primeira consulta foi de 100 dias. Os achados oculares foram inespecíficos nesta ocasião mas prevaleceram as alterações de segmento anterior e 41% dos pacientes apresentavam sinais de tuberculose sistêmica. Alterações como glaucoma, descolamento de retina e hemorragia vítrea foram responsáveis pela redução da acuidade visual. CONCLUSÃO: Embora pouco prevalente, a tuberculose ocular apresenta morbidade elevada. A inespecificidade da apresentação clínica da doença ocular pode atrasar o seu diagnóstico.PURPOSE: To analyze clinical findings of ocular tuberculosis and its epidemiological features. METHODS: Were reviewed clinical files of patients who attended the Ophthalmology - Uveitis and AIDS sector of UNIFESP-EPM, São Paulo, Brazil between January 1999 and July 2002 and had a diagnosis of ocular tuberculosis. Patients who had Mantoux test higher than 10 mm, epidemiological history of tuberculosis and ocular findings that improved after specific treatment were included. RESULTS: Seventeen medical files were analyzed, of those, 12 (70,6% were females. The mean age was 54 (24-84 years. The average time between symptoms and diagnosis was 100 days. Ocular findings at the first interview were multiple but most were at the anterior segment of
Norma Ocampo; Liliam Cañas; Marta Hurtado; Jorge Botero; Mónica Lopera
La toxocariosis es una geohelmintiosis producida por la ingestión de
huevos de Toxocara canis y T. catis, cuyos hospederos definitivos son el perro y el gato. En el humano las larvas producen el Síndrome de Migración Larvaria Visceral y Ocular; en este último produce una enfermedad grave que puede semejar un retinoblastoma (1,2). Los niños son más susceptibles a adquirir esta infección (3). Nuestro objetivo es determinar la frecuencia de toxocariosis ocular en menores de edad con s...
Full Text Available Ocular surface squamous neoplasia originates from conjunctiva epithelium and covers a broad spectrum of disease ranging from dysplasia to squamous cell carcinoma. Clinical features may vary from case to case. Traditional treatment of excision with no-touch technique combined with adjuvant therapies because of high recurrence rate. Main adjuvant treatments are cryotherapy and chemotherapy. In this review, clinical forms, differential diagnosis, American Joint Committee on Cancer classification and recent approaches to the management of ocular surface squamous dysplasia were described. (Turk J Ophthalmol 2014; 44: Supplement 8-14
OBJETIVO: Avaliar os aspectos psicológicos decorrentes da anoftalmia unilateral adquirida, a luta pela recuperação estética com o uso de prótese ocular, assim como os fatores interpessoais envolvidos e a reintegração psicossocial destes pacientes. MÉTODO: Trinta pacientes portadores de anoftalmia unilateral adquirida, sem outras deformidades órbito-palpebrais e usuários de prótese ocular, sendo 16 do sexo masculino e 14 feminino, com idade variando de 12 a 66 anos, idade média 31,6 anos foram...
Tessie Beck Martins
Esta tese envolveu o estudo de doenças oculares e perioculares de animais domésticos, e incluiu um artigo sobre lesões de patologia cirúrgica e um artigo sobre hifema em cães e gatos submetidos à necropsia. Para o primeiro trabalho, foram examinados 33.075 laudos de exames histopatológicos realizados num laboratório de diagnóstico de patologia veterinária na Região Central do Rio Grande do Sul durante 50 anos. Destes, 540 (1,6%) eram de lesões oculares e perioculares. Por vária...
Peterson, M Q; Cohen, M M; Sedano, H O; Frerichs, C T
The mean canthal index values of patients with frontonasal dysplasia are tested for differences in facies A, B, C, and D. A general discussion of ocular hypertelorism and dystopia canthorum is presented. Ocular hypertelorism is considered a sign which may occur in a variety of disorders. Quantitative methods for determining ocular hypertelorism are critically reviewed.
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ocular surgery irrigation device. 886.4360 Section... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4360 Ocular surgery irrigation device. (a) Identification. An ocular surgery irrigation device is a device intended to be suspended over...
Taylor, Andrew W.; Kaplan, Henry J.
The phrase “immune privilege” was coined by Peter Medawar to describe the absence of an immune response to allografts placed into the anterior chamber of the eye or brain. We now understand that immune privilege is more than a passive microenvironment with a distinctive anatomical structure that holds back immunity. The ocular microenvironment actively engages the immune system with immunosuppressive biochemical mechanisms. The unique characteristics of ocular immune privilege appear designed...
Full Text Available BACKGROUND The aim of the study was to evaluate the ocular signs in chronic renal failure (CRF in diabetes and hypertensive patients. MATERIALS AND METHODS Two hundred and thirty eight cases were enrolled in the study from the nephrology unit of College Of Medical Science, Bharatpur, Nepal and examined in the department of Ophthalmology. The study duration was carried out over 2 years from January 2011 to December 2012. RESULT The number of cases in each grade of CRF were mild 80 (26.67%, moderate 84 (28%, severe 75 (25%, end stage renal disease 61 (20.33%. In all the groups the commonest cause of CRF were Hypertension (HTN 123 out of 300(41% and diabetes 98(32.67%. The commonest ocular symptoms in CRF was blurring of vision 68%. CONCLUSION Many important ocular findings like vitreous haemorrage, retinal detachment, neovascular glaucoma and cataract are the presentation in chronic renal failure, which can cause marked vision loss. Hence proper awareness should be provided to the people in time to prevent these ocular complications.DOI: http://dx.doi.org/10.3126/jcmsn.v10i2.12949 Journal of College of Medical Sciences-Nepal, 2014, Vol.10(2; 18-26
M.L. Rietman; J.-P. Sommeijer; C.N. Levelt; J.A. Heimel; A.B. Brussaard; J.G.G. Borst; Y. Elgersma; N. Galjart; G.T. van der Horst; C.M. Pennartz; A.B. Smit; B.M. Spruijt; M. Verhage; C.I. de Zeeuw
Many studies have been devoted to the identification of genes involved in experience-dependent plasticity in the visual cortex. To discover new candidate genes, we have reexamined data from one such study on ocular dominance (OD) plasticity in recombinant inbred BXD mouse strains. We have correlated
Charles Oluwole Omolase
Full Text Available Purpose: To determine the pattern of ocular injuries in patients presenting to the eye clinic and the accident and emergency department of Federal Medical Center, Owo, Ondo State, Nigeria. Methods: This prospective study was conducted between January and December 2009. Federal Medical Center, Owo is the only tertiary hospital in Ondo State, Nigeria. The eye center located at this medical center was the only eye care facility in the community at the time of this study. All patients were interviewed with the aid of an interviewer-administered questionnaire and underwent a detailed ocular examination. Results: Of 132 patients included in the study, most (84.1% sustained blunt eye injury while (12.1% had penetrating eye injury. A considerable proportion of patients (37.9% presented within 24 hours of injury. Vegetative materials were the most common (42.4% offending agent, a minority of patients (22% was admitted and none of the patients had used eye protection at the time of injury. Conclusion: In the current series, blunt eye injury was the most common type of ocular trauma. The community should be educated and informed about the importance of preventive measures including protective eye devices during high risk activities. Patients should be encouraged to present early following ocular injury.
Full Text Available Eleven histologically proved cases of ocular malignant lymphoma diagnosed and managed during the year 1974-81 are reported. The follow-up period ranges from 2-7 years. The difficulties in diagnosis, treatment and prognosis are discussed.
Conclusion: OSSN occurs in younger individuals, and is strongly associated with HIV infection in our environment. Early diagnosis and intervention can prevent severe ocular morbidity. Wide surgical excision with intra-operative cryotherapy and adjuvant treatment with topical MMC post-operatively seem to give good outcome in our patients.
Full Text Available Graves' disease and myasthenia gravis are both auto-immune diseases and the coexistence of these two diseases is well recognized. Myasthenia gravis is more frequent in patients with thyroid disease. Here we present a case of thyroid ophthalmopathy and ocular myasthenia.
de Vries, Jan Willem
The field of DNA nanotechnology has progressed rapidly in recent years and now offers facile fabrication of a large variety of nanostructures of different shapes and geometries. In this thesis, short nucleic acid sequences are functionalized with hydrophobic units to form the basis of an ocular drug
Vieira, Ana Carolina; Mannis, Mark J
Rosacea is a prevalent disorder that may be disfiguring and cause significant ocular morbidity, if not diagnosed and managed appropriately. Ocular rosacea, in particular, is often left undiagnosed as no specific test is available to confirm the diagnosis. Accurate diagnosis is further complicated because symptoms of ocular rosacea are not always specific to the disorder alone. Other ophthalmic disorders may present with similar findings. Further challenges exist because the severity of ocular symptoms is often not related to the severity of cutaneous findings in rosacea. Isolating a disease marker may facilitate earlier diagnosis and treatment, and could also contribute to better understanding of disease pathogenesis. The glycomics of tear fluid and saliva in patients with rosacea shows promise as an initial step in the search for a biomarker specific to the disease. We have previously found potentially important disease biomarkers in roseatic tear and saliva samples. Further investigation should prove important in the early stages of developing a set of markers for accurate disease identification.
Whitney, Rachel E; Baum, Carl R; Aronson, Paul L
Although ocular injury from alkaline household cleaning products is well described, there is less known about the significance and extent of injury with ocular exposure to detergent pods. We report a 12-month-old with diffuse corneal abrasion caused by ocular contact with a laundry detergent pod. In addition to the known risks with aspiration with detergent pods, the potential for severe ocular injury is important for parents and clinicians to recognize. Children with ocular exposure to detergent pods should seek immediate medical care.
Osbel Alfonso Sánchez
Full Text Available Rheumatoid arthritis is considered an autoimmune disease in which articular and extra articular manifestations are produced and contribute to alter the functional capacity of the individual. This study consists on performing a bibliographical review showing the main ocular manifestations in patients with rheumatoid arthritis. It is our purpose to give you our experiences to the students as well as the internal medicine, ophthalmology and rheumatologist residents about this topic. The ophthalmological consultation of sick patients contributes to the prevention of ocular illnesses which are characteristic of the base disease and improve the ocular health.La artritis reumatoide se considera una enfermedad autoinmune, la cual produce manifestaciones articulares y extraarticulares que contribuyen a alterar la capacidad funcional del individuo. En esta revisión se muestran las principales manifestaciones oculares en pacientes con diagnóstico de dicha enfermedad. Se describen experiencias válidas para estudiantes y residentes de medicina interna, oftalmología y reumatología y se realiza la valoración de la interconsulta oftalmológica de los pacientes enfermos en la prevención de afecciones oculares propias de la enfermedad de base y su contribución al mejoramiento de su salud ocular.
Full Text Available Introduction/Aim: The goal of our study was to analyze the epidemiological`s characteristics of ocular hypertension, as well as the influence of chronic risk factors on glaucoma development (conversion in glaucoma. We tried to make some entries for solving this complex ophthalmological problem. Material /Methods: From 2009 to 2015, a retrospective control study was performed on 121 patient with diagnoses of bilateral ocular hypertension and without disease progression/conversion of glaucoma (by standard protocols of diagnosis and basic procedures on tertiary level at Clinic of Ophthalmology, Clinical Centre of Kragujevac, Serbia.. The authors analyzed epidemiological characteristics: sex, age groups, positive/negative family history and personal history with chronic risk factors (one and/or two of ocular hypertension. The data obtained from this study were statistically analyzed in SPSS program, version 20.00. Results: As for the patients, 69 of them (57.02% were male and 52 female (42.98%. Dominant age group was between 40-49 (42.15% and then group between 50-59 (40.50% years of age. Anamnesis data indicated the absence of family anamnesis 71 (58.68%. Risk factors for ocular hypertension were presented in 103 (85.13% patients, 18 of them (14.87% did not respond. One risk factor - cardiovascular disease was noted in 83 (68.59%, with two risk factors - cardiovascular diseases and diabetes mellitus in 20 patients (16.53% and with PEX syndroma at other respondents. Conclusion: Ocular hypertension is not a common disease, but with risk factors, such as older age, positive family history, and chronic risk factors syndicated, represents a serious clinical and social problem, so the question remains for ophthalmologists - pro or against therapy? Those in favor of therapy would state the safety and protection from conversion/progression of glaucoma; but those Â against therapy would only mention adequate monitoring of patients.
Full Text Available Objetivo: Identificar as principais doenças oculares numa população de neonatos assistidos pelo Sistema Único de Saúde em maternidades de referência no Estado de Pernambuco, orientando o seguimento e tratamento necessário. Métodos: Realizou-se estudo de corte transversal numa população de recém-nascidos em três maternidades públicas, no período de abril a outubro de 2000. Procedeu-se ao exame oftalmológico durante visitas semanais, orientando-se o seguimento e tratamento dos casos com alterações oculares ou fatores de risco. Resultados: Examinaram-se 3280 recém-nascidos: 1403 (42,8% na Maternidade da Encruzilhada (CISAM, 1232 (37,5% na Maternidade do Hospital Barão de Lucena (MHBL e 645 (19,7% na Maternidade do Hospital Agamenon Magalhães (MHAM. 387 eram pré-termo (11,8% dos casos. Encaminharam-se ao serviço especializado 701 neonatos (21,4% do total examinado com alterações oculares ou com fatores de risco. Destes, 46,4% eram pré-têrmo e 37,9% receberam oxigenoterapia, observando-se maior número porcentual na MHBL (45,4%. Observou-se conjuntivite em 3,0% dos olhos, leucocoria em 0,4% e hemorragia subconjuntival em 2,0%. À fundoscopia, encontraram-se hemorragias retinianas em 7,8% dos casos, com acometimento macular em 4,3%. Conclusões: As doenças oculares mais freqüentes foram: hemorragias retinianas e conjuntivites. Os principais fatores de risco observados foram: prematuridade e doenças infecciosas neonatais. Os autores enfatizam que o exame ocular deve ser realizado rotineiramente nos neonatos.
Dutot, Mélody; Vincent, Jacques; Martin-Brisac, Nicolas; Fabre, Isabelle; Grasmick, Christine; Rat, Patrice
Contact lens care solutions are known to have toxic effects on the ocular surface. The ISO 10993-5 standard describes test methods to assess the cytotoxicity of medical devices, but it needs some improvements to discriminate contact lens care multipurpose solutions. First we evaluated the biological hazards associated with the use of ophthalmic solutions, running a collaborative study with the French medical agency to propose adapted tools to study contact lens care solutions' ocular cytotoxicity (human cell line, short incubation times, and no dilution of solutions to test). Then we took into account the potential risk of these ophthalmic solutions adsorbed on contact lenses and released on the ocular surface, highlighting the addition of a rinse step with unpreserved marine solution in the contact lens cleaning procedure to avoid side effects of contact lens care solutions.
Ricardo Cardona Villa
Full Text Available El ojo es uno de los órganos más sensibles y está permanentemente expuesto a diversos agentes ambientales. Dado que la conjuntiva es un tejido inmunológicamente activo, no es sorprendente que sea un sitio común de respuestas alérgicas. Las alergias oculares son un grupo de enfermedades que afectan la superficie conjuntival y están asociadas usualmente a reacciones de hipersensibilidad tipo 1. Pueden ser divididas en varias categorías: conjuntivitis alérgica estacional, conjuntivitis alérgica perenne, queratoconjuntivitis vernal y queratoconjuntivitis atópica. La inflamación de la superficie ocular produce prurito, lagrimeo, edema conjuntival y fotofobia. Como en otras enfermedades alérgicas, se puede desarrollar una condición crónica, acompañada de remodelación de los tejidos oculares. Las estrategias para el tratamiento de la alergia ocular han aumentado exponencialmente y los clínicos disponen de un inventario cada vez mayor de agentes dirigidos a la protección del ojo contra la inflamación. En este trabajo presentamos una revisión sobre las principales formas de alergia ocular, haciendo énfasis en el cuadro clínico, el diagnóstico y las nuevas opciones terapéuticas disponibles en la actualidad. The eye, one of the most sensitive organs, is permanently exposed to different environmental agents. Since the conjunctiva is an immunologically active tissue, it is not surprising for it to be a common site for allergic responses. Ocular allergies constitute a group of diseases affecting the conjunctival surface; they are usually associated with type 1 hypersensitivity reactions. This disorder can be divided into several categories: seasonal allergic conjunctivitis, perennial allergic conjunctivitis, vernal keratoconjunctivitis and atopic keratoconjunctivitis. Ocular surface inflammation results in itching, tearing, conjunctival edema, and photophobia. As is the case with other allergic diseases, a chronic situation can also
Full Text Available Existe un gran número de enfermedades sistémicas que pueden presentar en algún momento de su evolución manifestaciones oculares. Estas alteraciones pueden provocar sintomatología por sí mismas, pueden ayudar a diagnosticar la enfermedad sistémica que las originó o pueden servir para monitorizar el curso evolutivo de la misma. Se destacan las principales características de una serie de enfermedades sistémicas asociadas a patología ocular que serán estudiadas en detalle a lo largo de esta monografía.A great number of systemic diseases can exhibit ocular manifestations during their evolution. These ocular alterations may cause symptoms by themselves, but can also be useful in diagnosing or monitoring the evolution of the systemic condition. The main characteristics of several systemic diseases exhibiting some kind of ocular sign are highlighted. These diseases will be described in detail in this issue.
Schaffer, J V; Lazova, R; Bolognia, J L
Partial unilateral lentiginosis (PUL) is an unusual pigmentary disorder characterized by numerous lentigines grouped within an area of normal skin; the pigmented macules are often in a segmental distribution with a sharp demarcation at the midline. We report the first case of ocular involvement in a patient with this diagnosis. The patient, a 30-year-old Peruvian woman, had multiple brown macules on the left upper face in primarily a V1 and V2 distribution with a sharp demarcation at the midline of the forehead. The lesions first appeared near the hairline when she was 5 years of age, and then began to extend onto the face. She also had a discrete area of brown pigmentation on the left lateral bulbar conjunctiva. Because the patient had been previously diagnosed by several dermatologists as having either a speckled lentiginous nevus or a nevus of Ota, we draw attention to the entity PUL and the possibility of ocular involvement.
Burcea, M; Avram, Corina-Ioana; Stamate, Alina-Cristina; Malciolu, R; Oprea, S; Zemba, M
The herpes simplex virus is one of the most common pathogens in humans, who are seropositive for the virus in 90% of the cases at the adult age. It determines reccurent infections in more than a third of the population and these infections depend on the immune response of the host. Ocular infections of newborns are due to the herpes simplex virus type 2, meanwhile type 1 is found predominantly at adults; almost all ocular structures can be affected. HSV-1 in the most frequent etiologic agent in infectious anterior uveitis (with the varicelo-zosterian virus) and it is responsible for 6-10% of all cases of anterior uveitis. More than half of the keratouveitides due to HSV will develop intraocular hypertension and open-angle secondary glaucoma, during reccurences and most of them will resolve after proper control of inflammation.
Bolaños-Jiménez, Rodrigo; Navas, Alejandro; López-Lizárraga, Erika Paulina; de Ribot, Francesc March; Peña, Alexandra; Graue-Hernández, Enrique O; Garfias, Yonathan
Sight is one of the most important senses that human beings possess. The ocular system is a complex structure equipped with mechanisms that prevent or limit damage caused by physical, chemical, infectious and environmental factors. These mechanisms include a series of anatomical, cellular and humoral factors that have been a matter of study. The cornea is not only the most powerful and important lens of the optical system, but also, it has been involved in many other physiological and pathological processes apart from its refractive nature; the morphological and histological properties of the cornea have been thoroughly studied for the last fifty years; drawing attention in its molecular characteristics of immune response. This paper will review the anatomical and physiological aspects of the cornea, conjunctiva and lacrimal apparatus, as well as the innate immunity at the ocular surface. PMID:26161163
Aiache, J M; el Meski, S; Beyssac, E; Serpin, G
The different barriers that slow the penetration of active ingredients administered by the ocular route are described, and some novel dosage forms designed for this route are discussed. Both precorneal and corneal factors considerably restrict ocular penetration. The low bioavailability of classical ophthalmic dosage forms can be improved by several approaches, particularly by increasing the time the active ingredients remain in contact with the eye tissues. The new dosage forms are reviewed according to their type and their drug release mechanisms. The characteristics, advantages, and limitations of each are outlined. The potential of these dosage forms can be expected to enhance development. They offer prolonged effectiveness, reproducibility, fewer unwanted side effects, and improved tolerance.
Igras, Estera; Kennedy, Susan; MacDermott, Emma Jane; Murphy, Conor C
Lichen planus (LP) is an autoimmune inflammatory condition of the skin and mucous membranes, of unknown aetiology, that infrequently involves the eye. Ocular LP has not been described in children. We present the case of an 8-year-old girl with severe, filamentous dry eyes and persistent conjunctival hyperemia with bilateral progressive conjunctival symblepharon. Her conjunctival biopsy showed heavy linear fibrinogen deposits along the basement membrane without IgG, IgA, IgM, or C3 deposition, consistent with LP. No skin or other mucosal lesions were present, suggesting a diagnosis of isolated conjunctival LP. Oral and topical cyclosporine combined with methotrexate and low-dose oral steroids led to sustained disease remission. To our knowledge, this is the first case of isolated ocular LP in a child.
Kaur, Indu Pal; Lal, Shruti; Rana, Cheena; Kakkar, Shilpa; Singh, Harinder
Presence of a preservative in an ocular medication has often been considered a culprit in damaging the epithelium. However, the inclusion of a preservative is equally necessary, especially in multiple-dose containers, in order to protect against dangerous organisms accidentally gaining access during instillation. Benzalkonium chloride (BAK), chlorobutanol, chlorhexidine acetate (CHA), and phenylmercuric nitrate or acetate are some commonly used preservatives in eye preparations. New preservatives with a wide range of activity and good safety profiles have been introduced in the market, such as stabilized oxychloro complex (SOC), sofZia, and sodium perborate. In the present review, we discuss various conventional and newly proposed and patented preservative molecules for ocular use. Reasons for discontinuing traditional preservatives and the need for less-toxic molecules are discussed at length, along with newer options coming up in this area.
Solani D. Mathebula
Full Text Available Accumulated data supports the argument that vitamin D possesses several biological and molecular actions apart from its role in calcium absorption and facilitation of gene expression. Vitamin D deficiency has been an associated risk factor for cardiovascular disease,metabolic syndrome and ocular complications. The aim of this review is to summarise the most relevant data regarding these associations and to try to clarify whether, and to what extent, oral vitamin D supplementation could be used as a beneficial intervention in such diseases.Vitamin D is produced in skin exposed to sunlight UVB radiation and is then metabolised by the kidney into calciferol, which is an active form. The main function of vitamin D is to promote calcium and phosphorus absorption, and studies have shown that a lack of itplays an important role in ocular conditions, such as age-related macular degeneration and diabetic retinopathy. Recent studies have suggested that vitamin D may protect the diabetic retina; however, other vitamin D-associated conditions (diabetes, hypertension and cardiovascular diseases may result in secondary ocular manifestations and the potential forsight-threatening complications. The purpose of this review is to describe the current literature on the role of vitamin D in ocular and systemic wellness. However, more research is needed to determine if increasing levels of this vitamin can assist in preventing age-related macular degeneration or diabetic retinopathy. Since vitamin D is a circulating steroid hormone, its receptors are found in almost every cell in the human body, and this suggests that vitamin D might have a very broad role for overall health. However, there is still demand for further research to clarify the clinical use of vitamin D in the prevention and treatment of various chronic diseases.
Pizzi, D R; Maffrand, R A; De Lisa, I S; Pizzi, H L; Plaza Ontiveros, R G
Thirteen cases of ocular toxocariasis attended in the Oftalmology Service of the Pediatric Hospital "Niño Jesús", from Córdoba; and in the Parasitology and Micology Cathedra of the Medicine Collegue of the University of Córdoba were studied from July 1993 till July 1995. The authors determine the needs of taking into account this parasitosis; above all in children and with the antecedent of contact with pets.
Magdei, Corina; Cuşnir, Valeriu; Bârcâ, Ludmila
Epstein-Barr virus (EBV) and Citomegalovirus (CMV) are Herpesviridae family representative and presents a real danger for human. A very high infect risk of population farther the danger The ocular pathology induced by them can affect all media and tunics of optic analyzer. An etiologic differentiation is necessary for the mentioned viruses induced diseases. The etiologic differentiation has like purpose the enforcement of an effective and optimal antiviral and immunomodulating therapy.
Full Text Available Normal tension glaucoma (NTG is known as a multifactorial optic neuropathy characterized by progressive retinal ganglion cell death and glaucomatous visual field loss, even though the intraocular pressure (IOP does not exceed the normal range. The pathophysiology of NTG remains largely undetermined. It is hypothesized that the abnormal ocular blood flow is involved in the pathogenesis of this disease. A number of evidences suggested that the vascular factors played a significant role in the development of NTG. In recent years, the new imaging techniques, fluorescein angiography, color Doppler imaging (CDI, magnetic resonance imaging (MRI, and laser speckle flowgraphy (LSFG, have been used to evaluate the ocular blood flow and blood vessels, and the impaired vascular autoregulation was found in patients with NTG. Previous studies showed that NTG was associated with a variety of systemic diseases, including migraine, Alzheimer’s disease, primary vascular dysregulation, and Flammer syndrome. The vascular factors were involved in these diseases. The mechanisms underlying the abnormal ocular blood flow in NTG are still not clear, but the risk factors for glaucomatous optic neuropathy likely included oxidative stress, vasospasm, and endothelial dysfunction.
Full Text Available Ocular inflammation is one of the leading causes of blindness and loss of vision. Human uveitis is a complex and heterogeneous group of diseases characterized by inflammation of intraocular tissues. The eye may be the only organ involved, or uveitis may be part of a systemic disease. A significant number of cases are of unknown etiology and are labeled idiopathic. Animal models have been developed to the study of the physiopathogenesis of autoimmune uveitis due to the difﬁculty in obtaining human eye inflamed tissues for experiments. Most of those models are induced by injection of speciﬁc photoreceptors proteins (e.g., S-antigen, interphotoreceptor retinoid-binding protein, rhodopsin, recoverin, phosducin. Non-retinal antigens, including melanin-associated proteins and myelin basic protein, are also good inducers of uveitis in animals. Understanding the basic mechanisms and pathogenesis of autoimmune ocular diseases are essential for the development of new treatment approaches and therapeutic agents. The present review describes the main experimental models of autoimmune ocular inflammatory diseases.
Full Text Available AIM This study is designed to enumerate various causes of ocular trauma, clinical spectrum of presentation and to evaluate the visual outcome after appropriate management. MATERIALS AND METHODS A prospective study was conducted on total of 136 patients from the places in and around Kakinada, East Godavari District of Andhra Pradesh, India. A detailed work up of all patients including slit lamp biomicroscopy, direct, indirect ophthalmoscopy and ultra sonography B scan was done. RESULTS Observations from the study were analyzed, discussed and compared with the existing studies in the literature. Mean age group of patients belong to young adults between 20-30 years (57.9%, males (81% affected more than females. Illiterates, Agricultural labourers, Industrial workers affected more. Road Traffic Accidents (25.73%, industrial injuries (22.05% and agricultural hazards (19.11% being the major cause of unilateral eye injury. Closed globe injuries (80.88% more common than Open globe injuries (19.12. CONCLUTIONS Ophthalmic injuries due to innumerable causes results in various types of ocular trauma, leading to untold misery, visual impairment and economic burden to the family, society and country as a whole. Health education regarding use of preventive measures, seeking early treatment and appropriate rehabilitation are very much recommended to reduce the burden of morbidity due to ocular trauma.
Salem, Raga A. A.
Objectives: This study was conducted to identify the main ocular- and vision-threatening complications of leprosy in Yemen. Methods: This is a cross-sectional observational study which took place from February to July 2010. Leprosy patients attending the Skin and Venereal Diseases Hospital in the City of Light in Taiz, Yemen, who consented to participate in the study, were enrolled. Detailed demographic and medical histories were taken and clinical examination findings were recorded. A detailed eye examination, including visual acuity (VA), slit-lamp, and fundus examinations, was conducted on each patient by a qualified ophthalmologist. Results: A total of 192 patients (180 male, 12 female, with a male to female ratio of 15:1) were included in the study. The majority of the patients (157; 81.8%) were over 40 years. Over two-thirds of the patients (129; 67.2%) had had leprosy for more than 20 years. Ocular complications were found in 97% of cases; 150 (39.1%) of the patients’ eyes had at least one pathology. Eyelid involvement was the most common problem observed in 102 (26.5%) patients. Half of the eyes (192; 50%) had a VA of <6/60. The main cause of blindness among these patients was corneal opacity detected in 69 out of 192 patients (35.9%). Conclusion: Ocular complications are frequent among leprosy patients in Yemen. They are true vision-threatening lesions. It is important to prevent these lesions through early diagnosis and adequate treatment. PMID:23275842
Primeau, Brian C.; Goldstein, Goldie L.; Greivenkamp, John E.
Ocular interferometry has potential value in a variety of ocular measurement applications, including measuring ocular thicknesses, topography of ocular surfaces or the wavefront of the eye. Of particular interest is using interferometry for characterizing corneal shape and irregular corneal features, making this technology attractive due to its inherent accuracy and spatial resolution. A particular challenge of designing an ocular interferometer is determining safe laser exposure levels to the eye, including both the retina and anterior segment. Described here are the laser exposure standards relevant in the interferometer design and the corresponding calculations and results. The results of this work can be used to aid in the design of similar laser-based systems for ocular evaluation.
Dhara K. Gosai
Conclusion: Most of the ocular changes of beta thalassemia are attributed to the course and severity of the disease. Reduction in serum iron and serum Ferritin levels by iron- chelating agents and regular ocular examination to look for side-effects of such agents can aid in preventing or delaying ocular complications. [Int J Res Med Sci 2014; 2(2.000: 695-698
Dhara K. Gosai; K. M. Mehariya; Jigarkumar B. Gosai
Background: Purpose of current study was to study the ocular manifestations in beta-thalassemia major patients and assess the ocular side-effects of iron chelating agents. Methods: Cross sectional study included 45 beta Thalassemia major patients from age group of 6months to 12 years were taken. Full medical history, thorough physical examinations were done to all patients groups, and ophthalmological examination to determine the prevalence of ocular manifestations for all patient groups a...
Ana Carolina Cabreira Vieira
Full Text Available Rosacea is a prevalent chronic cutaneous disorder with variable presentation and severity. Although considered a skin disease, rosacea may evolve the eyes in 58-72% of the patients, causing eyelid and ocular surface inflammation. About one third of the patients develop potentially sight-threatening corneal involvement. Untreated rosacea may cause varying degrees of ocular morbidity. The importance of early diagnosis and adequate treatment cannot be overemphasized. There is not yet a diagnostic test for rosacea. The diagnosis of ocular rosacea relies on observation of clinical features, which can be challenging in up to 90% of patients in whom accompanying roseatic skin changes may be subtle or inexistent. In this review, we describe the pathophysiologic mechanisms proposed in the literature, clinical features, diagnosis and management of ocular rosacea, as well as discuss the need for a diagnostic test for the disease.A rosácea é uma condição cutânea crônica, que possui apresentações clínicas variáveis. Apesar de considerada uma doença dermatológica, os olhos podem ser acometidos em 58-72% dos casos, causando inflamação palpebral e da superfície ocular. Aproximadamente um terço dos pacientes desenvolve acometimento corneano, podendo causar baixa visual significativa. Diagnóstico precoce e tratamento adequado são de extrema importância, devido à significativa morbidade ocular que a doença pode causar. Não há, até o momento, um teste diagnóstico para rosácea. O diagnóstico da rosácea ocular depende da observação das manifestações clínicas, o que pode ser bastante desafiador em até 90% dos pacientes, em que os achados cutâneos são discretos ou inexistentes. Nesta revisão, descrevemos os mecanismos fisiopatológicos propostos na literatura, manifestações clínicas, diagnóstico e tratamento da rosácea ocular, assim como abordamos a necessidade de um teste diagnóstico.
Ginsberg, J; Ballard, E T; Buchino, J J; Kinkler, A K
We studied the eyes of two children with proven trisomy 21 and updated the microscopic ocular findings. The ocular malformations, generally of a minor nature, comprise a variety of nonspecific hyperplasia or hamartomata, hypoplasias, tissue defects and heterotopias, and involve virtually every portion of the globe. Ocular and extraocular abnormalities in Down's syndrome do not correlate well embryologically, cytogenetically or in regard to incidence or severity. The type of ocular anomalies usually encountered in trisomy 21 suggests that the globe was affected by the chromosomal anomaly rather late in its development.
Richard W Hertle
Full Text Available The purpose of this report is to summarize an understanding of the ocular motor system in patients with albinism. Other than the association of vertical eccentric gaze null positions and asymmetric, (a periodic alternating nystagmus in a large percentage of patients, the ocular motor system in human albinism does not contain unique pathology, rather has "typical" types of infantile ocular oscillations and binocular disorders. Both the ocular motor and afferent visual system are affected to varying degrees in patients with albinism, thus, combined treatment of both systems will maximize visual function.
Hertle, Richard W
The purpose of this report is to summarize an understanding of the ocular motor system in patients with albinism. Other than the association of vertical eccentric gaze null positions and asymmetric, (a) periodic alternating nystagmus in a large percentage of patients, the ocular motor system in human albinism does not contain unique pathology, rather has "typical" types of infantile ocular oscillations and binocular disorders. Both the ocular motor and afferent visual system are affected to varying degrees in patients with albinism, thus, combined treatment of both systems will maximize visual function.
Thornton, William E.; Pool, Sam L.; Moore, Thomas P.; Uri, John J.
The vestibulo-ocular reflex (VOR) may be altered by weightlessness. Since this reflex plays a large role in visual stabilization, it was important to document any changes caused by space flight. This is a report on findings on STS-4 through 6 and is part of a larger study of neurosensory adaptation done on STS-4 through 8. Voluntary horizontal head oscillations at 1/3 Hz with amplitude of 30 deg right and left of center were recorded by a potentiometer and compared to eye position recorded by electroculography under the following conditions: eyes open, head fixed, tracking horizontal targets switched 0, 15, and 30 degrees right and left (optokinetic reflex - OKR - and calibration); eyes open and fixed on static external target with oscillation, (vestibulo ocular reflex, eyes closed - VOR EC); eyes open and wearing opaque goggles with target fixed in imagination (vestibulo-ocular reflex, eyes shaded - VOR ES); and eyes open and fixed on a head synchronized target with head oscillation (VOR suppression). No significant changes were found in voluntary head oscillation frequency or amplitude in those with (n=5), and without (n=3), space motion sickness (SMS), with phase of flight or test condition. Variations in head oscillation were too small to have produced detectable changes in test results.
Full Text Available Subramaniam Suresh1, Saidin Nor-Masniwati1, Muhd Nor Nor-Idahriani1, Wan-Hitam Wan-Hazabbah1, Mohamed Zeehaida2, Embong Zunaina11Department of Ophthalmology, 2Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, MalaysiaBackground: The purpose of this study was to evaluate the immunoglobulin (Ig G avidity of serological toxoplasmosis testing in patients with ocular inflammation and to determine the clinical manifestations of ocular toxoplasmosis.Methods: A retrospective review of all patients presenting with ocular inflammation to the Hospital Universiti Sains Malaysia, Kelantan, Malaysia between 2005 and 2009 was undertaken. Visual acuity, clinical manifestations at presentation, toxoplasmosis antibody testing, and treatment records were analyzed.Results: A total of 130 patients with ocular inflammation were reviewed retrospectively. The patients had a mean age of 38.41 (standard deviation 19.24, range 6–83 years. Seventy-one patients (54.6% were found to be seropositive, of whom five (3.8% were both IgG and IgM positive (suggestive of recently acquired ocular toxoplasmosis while one (0.8% showed IgG avidity ≤40% (suggestive of recently acquired ocular toxoplasmosis and 65 patients (50.0% showed IgG avidity >40% (suggestive of reactivation of toxoplasmosis infection. Chorioretinal scarring as an ocular manifestation was significantly more common in patients with seropositive toxoplasmosis (P = 0.036. Eighteen patients (13.8% were diagnosed as having recent and/or active ocular toxoplasmosis based on clinical manifestations and serological testing.Conclusion: Ocular toxoplasmosis is a clinical diagnosis, but specific toxoplasmosis antibody testing helps to support the diagnosis and to differentiate between reactivation of infection and recently acquired ocular toxoplasmosis.Keywords: ocular toxoplasmosis, chorioretinal scar, toxoplasmosis antibody, IgG avidity test
Enéias Bezerra Gouveia
Full Text Available A gestação pode causar várias alterações no funcionamento do olho humano, tanto nas condições sistêmicas quanto em doenças oculares, sendo seus efeitos divididos em três categorias: alterações fisiológicas, mudanças em doenças oculares pré-existentes e alterações patológicas. O presente texto propõe uma revisão bibliográfica sobre o tema. Os autores pesquisaram os bancos de dados do PubMed (MEDLINE e LILACS.Pregnancy can cause several alterations in human eye function in healthy condition as well in ocular disease; these effects on the eyes are divided into three categories: physiologic alterations, ocular diseases changes already existing before the pregnancy, and pathological alterations. The present text proposes a bibliographical revision on the theme. The authors researched PubMed (MEDLINE and LILACS databases.
Vital Paulino Costa
Full Text Available PURPOSE: To examine the prevalence of ocular surface complaints in Brazilian patients with glaucoma or ocular hypertension who used topical intraocular pressure (IOP-lowering regimens. METHODS: In this multicenter, noninterventional, single-visit study, adults with glaucoma or ocular hypertension treated with an IOP-lowering regimen were administered the 12-item ocular surface disease index (OSDI questionnaire. Each response was scored on a 5-point scale, with 0 indicating symptom present none of the time and 4 indicating symptom present all of the time. The average of the 12 item responses for each patient was transformed to a scale from 0 to 100, with higher scores representing worse disabilities. OSDI results then were categorized as absence of OSD (scores of 0-12, mild OSD (scores of 13-22, moderate OSD (scores of 23-32, or severe OSD (scores of 33100. RESULTS: The 173 enrolled patients had a mean age of 61.2 years, were women in 65.3% of cases, and had glaucoma in 89.0% of cases and ocular hypertension in 11.0% of cases. OSDI scores for 158 patients using 1 IOP-lowering therapy indicated no OSD in 37.3% of patients (59/158, mild OSD in 20.9% (33/158, moderate OSD in 17.1% (27/158, and severe OSD in 24.7% (39/158. For the 120 patients using 1 IOP-lowering medication and having a known duration of diagnosis of glaucoma or ocular hypertension, mean OSDI scores were numerically higher (worse for the 39 patients with a diagnosis ≥6 years long (score 25 [± 20], indicating moderate OSD than for the 81 patients with a diagnosis lasting <6 years (score 22 [± 20], indicating mild OSD; however, no significant differences in OSDI scores by duration of diagnosis were evident in means (P=0.49, distributions (P≥0.26, or correlation (P=0.77. CONCLUSIONS: A large proportion of Brazilian patients treated with 1 IOP-lowering therapy had some ocular surface complaints.
ZHANG Mao-nian; JIANG Cai-hui
Objective: To investigate the effect of 360-degree retinectomy for severe ocular rupture and evaluate the related factors associated with prognosis.Methods: A retrospective analysis was performed on 28 consecutive patients, 18 men and 10 women, with severe ocular rupture admitted to the Chinese PLA General Hospital between January 1999 and January 2002. The patients' ages ranged from 16 to 58 years, mean 29.5years. All operations were performed by the first author.All patients underwent standard 3-port pars plana vitrectomy with scleral encircling buckle,endophotocoagulation, and tamponaded with silicone oil.Lensectomy were performed on 15 eyes. 360-degree retinotomy and retinectomy were performed at anterior equator on 16 eyes, and posterior equator on 12 eyes.Results: During operation, all patients were confirmed to have vitreous hemorrhage and retinal detachment, in which hemorrhagic ciliary body detachment was found in 9 eyes, suprachoroidal hemorrhage in 12 eyes,retinal twisting like flower stalk in 11 eyes, and retinal incarceration in 17 eyes. Postoperative follow-up was conducted in 26 cases, ranged from 6 months to 46 months.Retinal reattachment achieved in 20 eyes (76. 9%), in which three patients' retina was reattached after revitrectomy. The silicone oil was removed at the fourth month in 8 eyes postoperatively. Corrected visual acuity of 0.02 or more was in 14 eyes (70. 0%) among the 20patients with reattached retina. Visual acuity of 0.05 or more was in 7 eyes ( 35.0 % ), and 0.1 or more was in 3eyes. The best visual acuity was 0.3 in 1 eye.Conclusions: Retinectomy may improve the prognosis of severe ocular rupture and save the visual function of some patients.
Namdar, Hasan; Emaratkar, Elham; Hadavand, Mohammad Bagher
The Persian Traditional Medicine (PTM) system pays special attention to disease prevention. In PTM, physicians believe that overeating may cause accumulation of unhealthy substances in the body and diseases called “Emtela.” With respect to ocular health, foods can be categorized as beneficial and harmful. Harmful foods such as beef, geese, eggplant, cauliflower, and cheese can cause reduced vision. Dehydrating foods such as walnut and salty fish and hot foods such as garlic, onion, and pepper can cause dry eye. Food items that have beneficial effects on ocular health include thyme and saffron and fruits such as grape, fig, apple, plum, and berries. PTM stipulates that one should not drink water with meals or immediately afterwards, since drinking cold (icy) water causes difficulty in absorption of nutrients. Gulping water may have harmful effects on the eyes; therefore, PTM physicians recommend drinking water at a suitable temperature. It is not safe to drink water first at the morning. Sleeping right after eating is harmful too. Avicenna believes that sleeping on one’s belly after a full meal is very harmful for the eyes. Galen says that old people need deep and continuous sleep more than others. From the view of PTM, moving eyes in different directions, making delicate expressions, trying to look at delicate and find pictures and reading small letters would remove ocular fatigue. There have been mentions of local medicine for improving vision as well; for instance, fennel extracts, pomegranate juice, and honey which are suitable for vision improvement. Local administration of pomegranate blossoms is suitable for treating inflammatory reactions. PMID:27800504
Beatriz de A. F Gomes
Full Text Available OBJECTIVE: To evaluate the frequency and characteristics of ocular manifestations in outpatients with systemic sclerosis. METHODS: In this cross-sectional study, 45 patients with systemic sclerosis were enrolled. Data regarding demographics, disease duration and subtype, age at diagnosis, nailfold capillaroscopic pattern and autoantibody profile were collected, and a full ophthalmic examination was conducted. Parametric (Student's t-test and nonparametric (Mann-Whitney U test tests were used to compare continuous variables. Fisher's exact test was used to compare categorical data. P values < 0.05 were considered significant. RESULTS: Twenty-three subjects (51.1% had eyelid skin changes; 22 (48.9% had keratoconjunctivitis sicca, 19 (42.2% had cataracts, 13 (28.9% had retinal microvascular abnormalities and 6 (13.3% had glaucoma. Eyelid skin changes were more frequent in patients with the diffuse subtype of systemic sclerosis and were associated with a younger age and an earlier age at diagnosis. Cataracts were presumed to be age-related and secondary to corticosteroid treatment. There was no association between demographic, clinical or serological data and keratoconjunctivitis sicca. The retinal microvascular abnormalities were indistinguishable from those related to systemic hypertension and were associated with an older age and a severe capillaroscopic pattern. CONCLUSIONS: Eyelid skin abnormalities and keratoconjunctivitis sicca were the most common ocular findings related to systemic sclerosis. Some demographic and clinical data were associated with some ophthalmic features and not with others, showing that the ocular manifestations of systemic sclerosis are characterized by heterogeneity and reflect the differences in the implicated pathophysiological mechanisms.
Lawrence, Brian David
Current biomaterial approaches for repairing the cornea's ocular surface upon injury are partially effective due to inherent material limitations. As a result there is a need to expand the biomaterial options available for use in the eye, which in turn will help to expand new clinical innovations and technology development. The studies illustrated here are a collection of work to further characterize silk film biomaterials for use on the ocular surface. Silk films were produced from regenerated fibroin protein solution derived from the Bombyx mori silkworm cocoon. Methods of silk film processing and production were developed to produce consistent biomaterials for in vitro and in vivo evaluation. A wide range of experiments was undertaken that spanned from in vitro silk film material characterization to in vivo evaluation. It was found that a variety of silk film properties could be controlled through a water-annealing process. Silk films were then generated that could be use in vitro to produce stratified corneal epithelial cell sheets comparable to tissue grown on the clinical standard substrate of amniotic membrane. This understanding was translated to produce a silk film design that enhanced corneal healing in vivo on a rabbit injury model. Further work produced silk films with varying surface topographies that were used as a simplified analog to the corneal basement membrane surface in vitro. These studies demonstrated that silk film surface topography is capable of directing corneal epithelial cell attachment, growth, and migration response. Most notably epithelial tissue development was controllably directed by the presence of the silk surface topography through increasing cell sheet migration efficiency at the individual cellular level. Taken together, the presented findings represent a comprehensive characterization of silk film biomaterials for use in ocular surface reconstruction, and indicate their utility as a potential material choice in the
Full Text Available Background - Ocular surface disorders due to limbal stem cell deficiency are an important cause of ocular morbidity and visual loss. Although autologous limbal stem cell transplants have helped in the management of unilateral disease, allografts in those with bilateral disease often fail due to immunological reasons. The use of autologous buccal epithelium cultivated on amniotic membrane has been described as a useful approach in the management of this condition. It is the purpose of this study to explore the feasibility of using a novel thermo-gelatin polymer (TGP as a substrate to culture these cells, and to characterize them using RNA extraction and RT-PCR. Methods - Oral cheek mucosal biopsies were obtained from 5 adult patients undergoing Modified Osteo-Odonto Keratoprosthesis surgery. The specimens were transported to the laboratory in transport medium. The cells were released using enzymatic digestion and seeded in both convention culture medium and TGP. The resulting cellular growth was characterized using RNA extraction and RT-PCR. Results - Cells could be cultured from 4 of the 5 specimens. In one specimen, contamination occurred and this was discarded. In the other specimens, the cheek epithelial cells could be cultured in both the conventional culture medium and TGP, with equal ease. RT-PCR revealed the presence of K3, a marker for epithelial cells, and GAPDH indicating the presence of some adipose tissue as well. Conclusions - It is possible to culture autologous cheek mucosal epithelial cells using TGP, a synthetic scaffold, without the need for other biological substrates. Since the specimens are obtained from the oral cavity, stringent asepsis is required. Further studies are required for histopathological characterization of the cultured cells and to create a model for delivery onto the ocular surface of eyes with bilateral surface disease due to limbal stem cell deficiency.
Harley E. A. Bicas
Partindo-se de um circuito esquemático relacionando os sistemas sensorial (visual binocular) e oculomotor, cujos defeitos em vias aferentes ou eferentes, ou de suas interações, explicam o aparecimento dos estrabismos e suas conseqüências, são examinados os fundamentos e referenciais da movimentação ocular. Apresentam-se os conceitos de eixos e planos, centro de massa e de rotação, definem-se os movimentos monoculares de translação e de rotação e os binoculares de versões e vergências. É també...
Kalpana Badami Nagaraj
Full Text Available Dengue, one of the most common mosquito-borne flavivirus diseases affecting humans, is spread by the Aedes aegypti mosquito. Most people infected with dengue virus are asymptomatic or only have mild symptoms such as an uncomplicated fever; few have more severe features, while in a small proportion it is life-threatening. Severe dengue is defined as that associated with severe bleeding, severe organ dysfunction, or severe plasma leakage. Ophthalmic manifestations can involve both the anterior and posterior segment. We report an ocular emergency of proptosis and globe rupture in a patient with severe dengue.
Muşat, O; Coman, Corina; Cristescu, R; Asandi, R
We present the case of a 48 year old man who was admitted for the decreased visual acuity of the left eye for about 20 years, when a left sided facial trauma had occured. Clinical examination and lab exams revealed the cause of this change: ocular contusive posttraumatic status for about 20 years (anamnestic), iridodialysis, corectopie, traumatic cataract, PVR, tractional retinal detachment. Surgical treatment was warranted. We performed cataract extraction, posterior vitrectomy with laser fotocoagulation and injection of silicon oil 1000. We followed the pacient's post-operative evolution and we extracted of the silicone oil six months later. The evolution was favorable.
Full Text Available Defects of the eye may follow removal of a part of or the entire orbit. This results in the patient becoming visually, esthetically and psychologically handicapped. Restoring the defect with a silicone- or acrylic-based prosthesis not only restores esthetics but also gives back the lost confidence to the patient. This is a case report of a patient with a `pthisical eye` and details the steps in fabrication of an ocular prosthesis. Particular attention has been given to the laboratory process in this technique to minimize the residual monomer content in the artificial eye.
Jurja, Sanda; Hîncu, Mihaela; Dobrescu, Mihaela Amelia; Golu, Andreea Elena; Bălăşoiu, Andrei Theodor; Coman, Mălina
Vision is based on the sensitivity of the eye to visible rays of the solar spectrum, which allows the recording and transfer of visual information by photoelectric reaction. Any electromagnetic radiation, if sufficiently intense, may cause damages in living tissues. In a changing environment, the aim of this paper is to point out the impact of light radiation on ocular cells, with its phototoxicity potential on eye tissues. In fact, faced with light and oxygen, the eye behaves like an ephemeral aggregate of unstable molecules, like a temporary crystallization threatened with entropia.
Full Text Available Objective To evaluate the predictive value of ocular trauma score(OTS in mechanical ocular injuries occurring in military forces,and compare the difference of OTS application between ocular injury caused by military training and non-military training.Methods The data of 633 inpatients from armed forces suffering from injury of 665 eyes were retrospectively reviewed.Of the 665 injured eyes,326 were injured during military training and 339 during non-military training.The likelihood of final visual acuity(VA calculated with the OTS score was compared with that by the present OTS study,and the correlation between the score and final VA was then analyzed.Results Compared with the distribution of final VA in standard OTS score,the ratio in category 1 was statistically different in present study(P 0.05.There were significant differences in ratio of category 3 between eyes injured by military and non-military training(P < 0.05,and both ratios in category 1 were significantly different compared with those in standard OTS(P < 0.01,e.g.the ratio of NLP was lower(50% vs 73%,P < 0.01;43% vs 73%,P < 0.01;and the ratio in category 2 was significantly different between the eyes injured by non-military training and standard OTS(P < 0.05.However,the OTS showed positive correlation with final VA in present study(P < 0.0001.Conclusion OTS calculated at initial examination may primarily provide a piece of prognostic information of mechanical ocular injuries,and is of special benefit for deciding a prompt management or for evacuation decision for severe ocular injuries caused by military training.
Kijlstra, A.; Pedersen, E.
Despite large advances in the field of ocular toxoplasmosis, large gaps still exist in our knowledge concerning the epidemiology and pathophysiology of this potentially blinding infectious disease. Although ocular toxoplasmosis is considered to have a high health burden, still little is known about
Okahara, Akihiko; Tanioka, Hidetoshi; Takada, Koichi; Kawazu, Kouichi
This study was performed to assess the in vivo ocular toxicity of benzalkonium chloride (BAK) homologs compared with commercially available BAK (BAK mixture) and to assess the ocular toxicity of BAK homolog after repeated ocular application. Rabbit eyes were examined by ophthalmology and scanning electron microscopy (SEM) after 10 applications of BAK homologs with C12 (C12-BAK) and C14 (C14-BAK) alkyl chain lengths and a BAK mixture at concentrations of 0.001% (w/v), 0.003% (w/v), 0.005% (w/v), 0.01% (w/v) and 0.03% (w/v). The ocular toxicity of C12-BAK to rabbit eyes was examined by ophthalmology and histopathology after repeated ocular application for 39 weeks. In addition, the antimicrobial activities of C12-BAK and C14-BAK against A. niger, S. aureus and P. aeruginosa were assessed. Ocular toxicity of C12-BAK was less than those of the BAK mixture and C14-BAK. No ocular toxicity was noted after ocular application of 0.01% C12-BAK to rabbits for 39 weeks. C12-BAK showed antimicrobial activities at a concentration of 0.003%. These results suggest that the use of C12-BAK to replace BAK mixture as a preservative in ophthalmic solutions should be considered in order to reduce the incidence of the corneal epithelial cell injury induced clinically by BAK.
Dukaczewska, Agata; Tedesco, Roberto; Liesenfeld, Oliver
Ocular toxoplasmosis is a vision-threatening disease and the major cause of posterior uveitis worldwide. In spite of the continuing global burden of ocular toxoplasmosis, many critical aspects of disease including the therapeutic approach to ocular toxoplasmosis are still under debate. To assist in addressing many aspects of the disease, numerous experimental models of ocular toxoplasmosis have been established. In this article, we present an overview on in vitro, ex vivo, and in vivo models of ocular toxoplasmosis available to date. Experimental studies on ocular toxoplasmosis have recently focused on mice. However, the majority of murine models established so far are based on intraperitoneal and intraocular infection with Toxoplasma gondii. We therefore also present results obtained in an in vivo model using peroral infection of C57BL/6 and NMRI mice that reflects the natural route of infection and mimics the disease course in humans. While advances have been made in ex vivo model systems or larger animals to investigate specific aspects of ocular toxoplasmosis, laboratory mice continue to be the experimental model of choice for the investigation of ocular toxoplasmosis. PMID:26716018
Enas Elsayed Mohamed
In conclusion: The increased prevalence of ocular symptoms and signs in patients with OSAHS indicates a need to increase awareness and establish close collaboration with the sleep physicians with clear pathways for review of OSAHS patients by the ophthalmic services. We should study the effect of treatment of OSAHS on the ocular manifestations.
Desirée C Murray
Full Text Available Ocular trauma is a significant cause of unilateral blindness in the Caribbean in both adults and children. In Trinidad and Tobago, blunt ocular injury will typically account for around a third of all referrals from the Accident and Emergency department to the ophthalmology unit.
Lee, Jeffrey S
The relativistic Doppler shifting of visible electromagnetic radiation to beyond the human ocular range reduces the incident radiance of the source. Consequently, luminous astrophysical bodies (LABs) can be rendered invisible with sufficient relativistic motion. This paper determines the proper distance as a function of relativistic velocity at which a luminous object attains ocular invisibility.
Willcox, Mark D P
The ocular surface is continually exposed to the environment and as a consequence to different types of microbes, but whether there is a normal microbiota of the ocular surface remains unresolved. Using traditional microbial culture techniques has shown that Contact lenses have also been cultured, and they yield similar microbial types. Microbes can be isolated from the ocular surface almost immediately after birth. The advent of molecular techniques for microbial identification based on 16S rRNA sequencing has opened up the possibility of determining whether there are non-cultivable microbes that can colonise the ocular surface. Additionally, use of these techniques with cross-sectional and longitudinal studies may help to understand whether the ocular surface harbours its own unique microbiota, or whether the microbiota are only transiently present.
Morahan, P; Meehan, J W; Patterson, J; Hughes, P K
The purpose of this study was to investigate electrooculography (EOG) as a measurement of ocular vergence in both collimated and projected simulator environments. The task required participants to shift their gaze between a central fixation point and a target appearing at one of three eccentricities. EOG was effective in recording ocular vergence. The EOG results were similar between collimated and projected displays, except for differences in vergence changes during lateral movement of the eyes, and ocular excursions downward elicited a greater EOG response than the reverse upward movement. The computer-based technique of recording vergence was found to produce measurable traces from a majority of participants. The technique has potential for further development as a tool for measuring ocular vergence in virtual environments where methods that require the wearing of head-mounted apparatus to track ocular structures (e.g., the pupil), which cannot be worn at the same time as a flight or flight-simulator helmet, are unsuitable.
Generali, Elena; Cantarini, Luca; Selmi, Carlo
Eye involvement represents a common finding in patients with systemic autoimmune diseases, particularly rheumatoid arthritis, Sjogren syndrome, seronegative spondyloarthropathy, and antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. The eye is a privileged immune site but commensal bacteria are found on the ocular surface. The eye injury may be inflammatory, vascular or infectious, as well as iatrogenic, as in the case of hydroxychloroquine, chloroquine, corticosteroids, and bisphosphonates. Manifestations may affect different components of the eye, with episcleritis involving the episclera, a thin layer of tissue covering the sclera; scleritis being an inflammation of the sclera potentially leading to blindness; keratitis, referring to corneal inflammation frequently associated with scleritis; and uveitis as the inflammation of the uvea, including the iris, ciliary body, and choroid, subdivided into anterior, posterior, or panuveitis. As blindness may result from the eye involvement, clinicians should be aware of the possible manifestations and their management also independent of the ophthalmologist opinion as the therapeutic approach generally points to the underlying diseases. In some cases, the eye involvement may have a diagnostic implication, as for episcleritis in rheumatoid arthritis, or acute anterior uveitis in seronegative spondyloarthritis. Nonetheless, some conditions lack specificity, as in the case of dry eye which affects nearly 30 % of the general population. The aim of this review is to elucidate to non-ophthalmologists the major ocular complications of rheumatic diseases and their specific management and treatment options.
Holland, G.N.; O' Connor, G.R.; Diaz, R.F.; Minasi, P.; Wara, W.M.
To investigate the role of cellular immunodeficiency in recurrent toxoplasmic retinochoroiditis, six Cynomolgus monkeys (Macaca fascicularis) with healed toxoplasmic lesions of the retina were immunosuppressed by total lymphoid irradiation. Three months prior to irradiation 30,000 Toxoplasma gondii organisms of the Beverley strain had been inoculated onto the macula of eye in each monkey via a pars plana approach. Toxoplasmic retinochoroiditis developed in each animal, and lesions were allowed to heal without treatment. During total lymphoid irradiation animals received 2000 centigrays (cGy) over a 7-week period. Irradiation resulted in an immediate drop in total lymphocyte counts and decreased ability to stimulate lymphocytes by phytohemagglutinin. Weekly ophthalmoscopic examinations following irradiation failed to show evidence of recurrent ocular disease despite persistent immunodeficiency. Four months after irradiation live organisms were reinoculated onto the nasal retina of the same eye in each animal. Retinochoroidal lesions identical to those seen in primary disease developed in five of six animals. Toxoplasma organisms therefore were able to proliferate in ocular tissue following the administration of immunosuppressive therapy. This study fails to support the hypothesis that cellular immunodeficiency alone will initiate recurrent toxoplasmic retinochoroiditis. Results suggest that reactivation of disease from encysted organisms involves factors other than suppression of Toxoplasma proliferation. If reactivation occurs by other mechanisms, however, cellular immunodeficiency then may allow development of extensive disease.
Rodriguez-Ramos Fernandez, Julia; Dubielzig, Richard R
There is little information regarding ocular anatomy and histology in many of the rodent species. Histological analyses for morphologic features were performed in 31 globes from 18 rodent species submitted to and archived at the Comparative Ocular Pathology Laboratory of Wisconsin. The following measurements were taken: thickness of the cornea, corneal epithelium, corneal stroma, Descemet's membrane, and retina. H&E sections were evaluated for the following anatomical features: presence of pigmented epithelial cells in the peripheral cornea, presence and location of Schlemm's canal, presence of iridal sphincter and dilator and ciliary body muscles, presence of pars plicata and plana, presence of retinal vessels, presence of lamina cribrosa, and presence of tapetum lucidum. The springhaas was the only rodent in our collection that presented a well-developed tapetum lucidum fibrosum. The presence of retinal vessels was variable: vessels were observed in all of the members of the mouse-related clade, except the springhaas and the beaver, in all of the squirrel-related clade members, and in none of the Ctenohystrica. In the flying squirrels, blood vessels extended to the outer limiting membrane in the photoreceptor layer. Beavers, chinchillas, capybara, and guinea pigs lacked vessels within the retina; however, they had vessels within the optic nerve head. Ground squirrels have an optic nerve head, which is linear in the horizontal plane and an asymmetric retina. The tree-dwelling squirrels have a rounded but still elongated optic nerve, and the flying squirrel has a round optic nerve head like all the other rodents.
Candia, Oscar A; Alvarez, Lawrence J
This article discusses three largely unrecognized aspects related to fluid movement in ocular tissues; namely, (a) the dynamic changes in water permeability observed in corneal and conjunctival epithelia under anisotonic conditions, (b) the indications that the fluid transport rate exhibited by the ciliary epithelium is insufficient to explain aqueous humor production, and (c) the evidence for fluid movement into and out of the lens during accommodation. We have studied each of these subjects in recent years and present an evaluation of our data within the context of the results of others who have also worked on electrolyte and fluid transport in ocular tissues. We propose that (1) the corneal and conjunctival epithelia, with apical aspects naturally exposed to variable tonicities, are capable of regulating their water permeabilities as part of the cell-volume regulatory process, (2) fluid may directly enter the anterior chamber of the eye across the anterior surface of the iris, thereby representing an additional entry pathway for aqueous humor production, and (3) changes in lens volume occur during accommodation, and such changes are best explained by a net influx and efflux of fluid.
Full Text Available Lipids contain hydrocarbons and are the building blocks of cells. Lipids can naturally form themselves into nano-films and nano-structures, micelles, reverse micelles, and liposomes. Micelles or reverse micelles are monolayer structures, whereas liposomes are bilayer structures. Liposomes have been recognized as carriers for drug delivery. Solid lipid nanoparticles and lipoplex (liposome-polycation-DNA complex, also called lipid nanoparticles, are currently used to deliver drugs and genes to ocular tissues. A solid lipid nanoparticle (SLN is typically spherical, and possesses a solid lipid core matrix that can solubilize lipophilic molecules. The lipid nanoparticle, called the liposome protamine/DNA lipoplex (LPD, is electrostatically assembled from cationic liposomes and an anionic protamine-DNA complex. The LPD nanoparticles contain a highly condensed DNA core surrounded by lipid bilayers. SLNs are extensively used to deliver drugs to the cornea. LPD nanoparticles are used to target the retina. Age-related macular degeneration, retinitis pigmentosa, and diabetic retinopathy are the most common retinal diseases in humans. There have also been promising results achieved recently with LPD nanoparticles to deliver functional genes and micro RNA to treat retinal diseases. Here, we review recent advances in ocular drug and gene delivery employing lipid nanoparticles.
Zhang, Yi; Liu, Hao; Liu, En-Zhong; Lin, You-Zhi; Zhao, Shi-Guang; Jing, Guo-Hua
This study was designed to provide anatomic data to help surgeons avoid damage to the ocular motor nerves during intraorbital operations. The microsurgical anatomy of the ocular motor nerves was studied in 50 adult cadaveric heads (100 orbits). Dissections were performed with a microscope. The nerves were exposed and the neural and muscular relationships of each portion of the nerve were examined and measured. The superior division of the oculomotor nerve coursed between the optic nerve and the superior rectus muscle after it left the annular tendon, and its branches entered into the superior rectus muscle and levator muscle. A mean of five fibers (range 3-7) innervated the superior rectus muscle, and a mean of one fiber (range 1-2) followed a medial direction (84%) or went straight through the superior rectus muscle (16%). The inferior division of the oculomotor nerve branched into the medial rectus, inferior rectus and inferior oblique muscles. The trochlear nerve ended on the orbital side of the posterior one-third of the superior oblique muscle in 76 specimens. The abducens nerve ended on the posterior one-third of the lateral rectus muscle in 86 specimens. If the belly of the lateral rectus muscle was divided into three superior-inferior parts, the nerve commonly entered into the middle one-third in 74 specimens. Based on the observed data, microanatomical relationships of the orbital contents were revised.
Varsha Madanlal Rathi
Full Text Available Context: Boston ocular surface prosthesis (BOSP is a scleral contact lens used in the management of patients who are rigid gas permeable (RGP failures as with corneal ectasias such as keratoconus and in those patients who have ocular surface disease such as Stevens-Johnson syndrome (SJS. Aim: To report utilization of BOSP in a tertiary eye care center in India. Materials and Methods: We retrospectively reviewed charts of 32 patients who received BOSP from July 2008 to May 2009. Indications for fitting these lenses, improvement in visual acuity (VA before and after lens fitting and relief of symptoms of pain and photophobia were noted. Paired t-test was used for statistical analysis using SPSS version 16.0 for Windows. Results: Thirty-two patients (43 eyes received these lenses. These consisted of 23 eyes of 17 patients who failed RGP trials for irregular astigmatism and corneal ectasia such as keratoconus and post radial keratotomy and scar and 20 eyes of 15 patients with SJS. Mean age of RGP failures was 27.94 years. Pre- and post-BOSP wear mean LogMAR VA was 1.13 and 0.29, respectively, in RGP failures. The P value was statistically significant (P 2 lines in 7/20 eyes (35% with SJS, with improvement in symptoms. Conclusion: BOSP improves VA in patients who have irregular astigmatism as in ectasias and RGP failures and improves vision and symptoms in patients with SJS.
Yzer, Suzanne; den Hollander, Anneke I.; Lopez, Irma; Pott, Jan-Willem R.; de Faber, Jan Tjeerd H. N.; Cremers, Frans P. M.; Koenekoop, Robert K.; van den Born, L. Ingeborgh
Purpose: This study investigated the centrosomal protein, 290-KD (CEP290) associated genotype and ocular and extra-ocular phenotype in 18 patients with Leber congenital amaurosis (LCA). Methods: Eighteen patients with LCA from 14 families with mutations in the CEP290 gene were identified with sequen
Yzer, S.; Hollander, A.I. den; Lopez, I.; Pott, J.W.; Faber, J.T. de; Cremers, F.P.; Koenekoop, R.K.; Born, L.I. van den
PURPOSE: This study investigated the centrosomal protein, 290-KD (CEP290) associated genotype and ocular and extra-ocular phenotype in 18 patients with Leber congenital amaurosis (LCA). METHODS: Eighteen patients with LCA from 14 families with mutations in the CEP290 gene were identified with sequen
Full Text Available The vestibular organs consist of complementary sensors: the semicircular canals detect rotations while the otoliths detect linear accelerations, including the constant pull of gravity. Several fundamental questions remain on how the vestibular system would develop and/or adapt to prolonged changes in gravity such as during long-term space journey. How do vestibular reflexes develop if the appropriate assembly of otoliths and semi-circular canals is perturbed? The aim of present work was to evaluate the role of gravity sensing during ontogeny of the vestibular system. In otoconia-deficient mice (ied, gravity cannot be sensed and therefore maculo-ocular reflexes (MOR were absent. While canals-related reflexes were present, the ied deficit also led to the abnormal spatial tuning of the horizontal angular canal-related VOR. To identify putative otolith-related critical periods, normal C57Bl/6J mice were subjected to 2G hypergravity by chronic centrifugation during different periods of development or adulthood (Adult-HG and compared to non-centrifuged (control C57Bl/6J mice. Mice exposed to hypergravity during development had completely normal vestibulo-ocular reflexes 6 months after end of centrifugation. Adult-HG mice all displayed major abnormalities in maculo-ocular reflexe one month after return to normal gravity. During the next 5 months, adaptation to normal gravity occurred in half of the individuals. In summary, genetic suppression of gravity sensing indicated that otolith-related signals might be necessary to ensure proper functioning of canal-related vestibular reflexes. On the other hand, exposure to hypergravity during development was not sufficient to modify durably motor behaviour. Hence, 2G centrifugation during development revealed no otolith-specific critical period.
Sílvia Ligório Fialho
Full Text Available O método mais comum de administração de drogas no olho é por meio de colírios. Entretanto, por este método, não é possível atingir a concentração terapêutica nos fluidos e tecidos posteriores do olho. A administração sistêmica apresenta reduzido acesso ao segmento posterior do olho devido à presença das barreiras oculares. Injeções subconjuntivais e retrobulbares não são capazes de proporcionar níveis adequados da droga, e a injeção intravítrea é método invasivo, inconveniente e que apre-senta riscos de perfuração do bulbo ocular ou descolamento da retina. A iontoforese, no entanto, apresenta-se como alternativa para o transporte de doses terapêuticas de drogas para o segmento posterior do olho. A iontoforese é uma técnica que consiste na administração de drogas para o organismo através dos tecidos, utilizando um campo elétrico. O eletrodo ativo, que se encontra em contato com a droga, é colocado no local a ser tratado, e um segundo eletrodo, com a finalidade de fechar o circuito elétrico, é colocado em outro local do organismo. O campo elétrico facilita o transporte da droga, que deve se encontrar, preferencialmente, na forma ionizada. A iontoforese pode ser considerada como um método seguro e não invasivo de transporte de drogas para locais específicos do olho. Aplicada experimentalmente para o tratamento de doenças oculares, esta técnica tem evoluído muito nos últimos anos e, atualmente, testes clínicos de fase III encontram-se em andamento.The most traditional method of ocular drug delivery is through the use of eyedrops. However, by this method, the therapeutic concentration in deep ocular fluids and tissues can not be efficiently reached. Systemic administration presents poor access to the posterior segment of the eye due to ocular barriers. Subconjuntival and retrobulbar injections are not able to produce adequate levels of the drug, and intravitreal injection is an invasive and problematic
Marta Lucía Muñoz Cardona
Full Text Available The most frequent primary headaches, including migraine variants, and intrinsic optic nerve disorders that produce headache, are reviewed. The latter are often accompanied by autonomic nervous system alterations which lead to vasomotor changes, frequently present in neuralgic processes known as headaches with disautonomic involvement. Epidemiological, semiological, clinical, and therapeutical aspects of different cranial, facial and ocular diseases that produce headache are included. Some physiopathological elements that may help to analyze painful craniofacial processes are discussed. Secondary headaches and common facial neuralgias, on the other hand, are also considered because they may confuse the differential diagnosis. Se revisan las cefaleas primarias más frecuentes que comprometen las estructuras oculares y vecinas al globo ocular, las variantes de la migraña y las alteraciones propias del nervio óptico que alteran la función visual y que se acompañan no solamente de síntomas dolorosos sino también de trastornos vasomotores debidos a alteraciones del sistema nervioso autónomo que suelen ser comunes en algunos procesos neurálgicos llamados ahora cefaleas con compromiso disautonómico. En este artículo se comentan los elementos epidemiológicos de las diferentes enfermedades craneales, faciales y oculares que cursan con cefalea; las diferencias clínicas entre las mismas y su presentación semiológica, al igual que algunos elementos terapéuticos. Se discuten además algunos elementos fisiopatológicos de gran utilidad en el análisis de los procesos dolorosos craneofaciales y el perfil temporal de los mismos; también se comentan algunas cefaleas secundarias que comparten con las primarias elementos que se prestan a confusión en la clínica. Finalmente, se hace un análisis de las neuralgias faciales comunes.
Full Text Available Ocular trauma is a very common incidence that occurs in up to 67% of patients with maxillofacial trauma. It results in life-long agony of not being like others with two eyes, which can see and admire the nature's beauty. This article reports on a case of a 23-year-old male patient with phthisis bulbi, resulting from ocular trauma. The patient was rehabilitated aesthetically by fabrication of custom-made ocular prosthesis for his traumatically injured right eye. The patient was pleased with the aesthetic outcome, comfort, and mobility offered by the custom ocular prosthesis. There were no complications with regard to health of underlying residual ocular tissues and there was no need of relining of the prosthesis at 6 month recall appointment. Rehabilitation of patients with ocular trauma requires a multidisciplinary approach involving ophthalmologist, psychologist, and skilled maxillofacial prosthodontist. Custom-made ocular prosthesis fitted over the phthisical globe seems to be a highly positive, logical, noninvasive, and beneficial approach to increase mobility to the prosthesis, improve the cosmetic appearance and psychological well-being of the patient.
Full Text Available We investigated the effects of a visual picking system on ocular comfort, the ocular surface and tear function compared to those of a voice guided picking solution.Prospective, observational, cohort study.Institutional.A total of 25 young asymptomatic volunteers performed commissioning over 10 hours on two consecutive days.The operators were guided in the picking process by two different picking solutions, either visually or by voice while their subjective symptoms and ocular surface and tear function parameters were recorded.The visual analogue scale (VAS values, according to subjective dry eye symptoms, in the visual condition were significantly higher at the end of the commissioning than the baseline measurements. In the voice condition, the VAS values remained stable during the commissioning. The tear break-up time (BUT values declined significantly in the visual condition (pre-task: 16.6 sec and post-task: 9.6 sec in the right eyes, that were exposed to the displays, the left eyes in the visual condition showed only a minor decline, whereas the BUT values in the voice condition remained constant (right eyes or even increased (left eyes over the time. No significant differences in the tear meniscus height values before and after the commissioning were observed in either condition.In our study, the use of visually guided picking solutions was correlated with post-task subjective symptoms and tear film instability.
Greer, R T; Ryoo, J P
Ring shaped ocular inserts have been developed to administer a therapeutic level of tylosin tartrate throughout a five day period to treat pinkeye in cattle. The inserts are based on polyvinyl chloride rings which are dip coated with a copolymer containing the antibiotic (tylosin tartrate). Scanning electron microscope (SEM) characterization of surfaces has been of value to evaluate the presence and extent of surface flaws in the hydrogel coating, and to contribute to improvement in fabrication of the rings to insure the establishment of satisfactory seals at joints, uniformity of microporosity and cross sections, and the absence of significant cracking or flaking. In vitro release rates were determined using thin layer chromatography techniques, and rates were seen to be above a few micrograms of antibiotic per hour for experiments as long as nine days at simulated tear rates as high as 2 milliliters per hour.
Chen, Haoyu; Zhang, Mingzhi; Tang, Shibo; London, Nyall R; Li, Dean Y; Zhang, Kang
Slit-Robo signaling was firstly discovered as a major repellent pathway at the midline of the central nervous system. Intense investigation found that this pathway also plays an important role in other biological process including angiogenesis. Robo4 is the vascular endothelial cell specific member of Robo family. It was found that Slit-Robo signaling can inhibit endothelial cell migration, tube formation and vascular permeability. Slit-Robo signaling also plays an important role in embryonic and tumor angiogenesis. In animal model of ocular angiogenesis, addition of Slit inhibited laser induced choroidal neovascularization, oxygen induced retinopathy and VEGF induced retinal permeability in a Robo4 dependent manner. Recent data demonstrates that Robo1 and Robo4 form a heterodimer in endothelial cells, The role of this heterodimer in counteracting VEGF signaling is unknown. Further investigation is required to better understand Slit-Robo signaling and develop novel therapy for angiogenesis.
Doroodgar, Masoud; Doroodgar, Moein
The leishmaniases are parasitic diseases that are transmitted to humans by infected female sandflies. Cutaneous leishmaniasis (CL) is one of 3 main forms of the disease. CL is the most common form of the disease and is endemic in many urban and rural parts of Iran and usually caused by two species of Leishmania: L. major and L. tropica. We report a case of unusual leishmaniasis with 25 lesions on exposed parts of the body and right eyelid involvement (ocular leishmaniasis). The patient was a 75-year-old male farmer referred to health care center in Aran va Bidgol city. The disease was diagnosed by direct smear, culture, and PCR from the lesions. PCR was positive for Leishmania major. PMID:28210511
Full Text Available The leishmaniases are parasitic diseases that are transmitted to humans by infected female sandflies. Cutaneous leishmaniasis (CL is one of 3 main forms of the disease. CL is the most common form of the disease and is endemic in many urban and rural parts of Iran and usually caused by two species of Leishmania: L. major and L. tropica. We report a case of unusual leishmaniasis with 25 lesions on exposed parts of the body and right eyelid involvement (ocular leishmaniasis. The patient was a 75-year-old male farmer referred to health care center in Aran va Bidgol city. The disease was diagnosed by direct smear, culture, and PCR from the lesions. PCR was positive for Leishmania major.
Full Text Available Blindness is a major health concern worldwide that has a powerful impact on afflicted individuals and their families, and is associated with enormous socio-economical consequences. The Middle East is heavily impacted by blindness, and the problem there is augmented by an increasing incidence of diabetes in the population. An appropriate drug/gene delivery system that can sustain and deliver therapeutics to the target tissues and cells is a key need for ocular therapies. The application of nanotechnology in medicine is undergoing rapid progress, and the recent developments in nanomedicine-based therapeutic approaches may bring significant benefits to address the leading causes of blindness associated with cataract, glaucoma, diabetic retinopathy and retinal degeneration. In this brief review, we highlight some promising nanomedicine-based therapeutic approaches for drug and gene delivery to the anterior and posterior segments.
Patrinely, J R; Koch, D D
Ocular adnexal amyloidosis is characterized by amyloid deposition within the deep connective tissue layers of the eyelids, conjunctiva, and anterior orbit. Management of advanced cases has traditionally been unsatisfactory, with either no surgery offered because of fear of hemorrhage or an en bloc resection performed of the entire involved area. We present two cases of advanced periorbital amyloidosis successfully managed by preserving the anatomic planes of the eyelids and meticulously debulking the deposits with a spooned curette. Lax eyelid tendons and aponeuroses were simultaneously repaired, and no sacrifice of eyelid tissues was necessary. One patient remained asymptomatic for 2 years after surgery before developing early reaccumulation in the lower eyelids. The other patient required additional eyelid debulking and ptosis revision 8 months after surgery, but was in stable condition at follow-up 2 years after surgery. This technique offers safe, easily repeatable, nondestructive treatment for advanced periocular amyloidosis.
L. K. Moshetova
Full Text Available Structural changes in eyes are present in all patients with chronic kidney disease. A study to detect ocular patho- logy in patients with end-stage chronic renal failure after kidney transplantation in the early and late postopera- tive period compared with patients receiving replacement therapy with hemodialysis. Revealed that in the early post-transplant period in recipients of kidneyas in patients on hemodialysis, continued angioretinopatiya, 40% of patients had «dry eye syndrome». In the delayed post-transplant period, patients showed significant impro- vement in the retina and retinal vessels, the improvement of spatial-temporal parameters of visual perception. However, a decrease of visual acuity on the background of the development of posterior subcapsular cataract caused by prolonged corticosteroid, and an increased incidence of viral and bacterial conjunctivitis.
He, Chang; Yu, Cheng-Rong; Sun, Lin; Mahdi, Rashid M; Larkin, Joseph; Egwuagu, Charles E
Uveitis is a diverse group of potentially sight-threatening intraocular inflammatory diseases and pathology derives from sustained production of pro-inflammatory cytokines in the optical axis. Although topical or systemic steroids are effective therapies, their adverse effects preclude prolonged usage and are impetus for seeking alternative immunosuppressive agents, particularly for patients with refractory uveitis. In this study, we synthesized a 16 amino acid membrane-penetrating lipophilic suppressor of cytokine signaling 1 peptide (SOCS1-KIR) that inhibits JAK/STAT signaling pathways and show that it suppresses and ameliorates experimental autoimmune uveitis (EAU), the mouse model of human uveitis. Fundus images, histological and optical coherence tomography analysis of eyes showed significant suppression of clinical disease, with average clinical score of 0.5 compared to 2.0 observed in control mice treated with scrambled peptide. We further show that SOCS1-KIR conferred protection from ocular pathology by inhibiting the expansion of pathogenic Th17 cells and inhibiting trafficking of inflammatory cells into the neuroretina during EAU. Dark-adapted scotopic and photopic electroretinograms further reveal that SOCS1-KIR prevented decrement of retinal function, underscoring potential neuroprotective effects of SOCS1-KIR in uveitis. Importantly, SOCS1-KIR is non-toxic, suggesting that topical administration of SOCS1-Mimetics can be exploited as a non-invasive treatment for uveitis and for limiting cytokine-mediated pathology in other ocular inflammatory diseases including scleritis.
Full Text Available Crohn’s disease is an inflammatory bowel disease which causes inflammation of the digestive tract. Crohn’s disease most frequently affects the ileum and the colon. In the active stage of the disease signs and symptoms may include diarrhea, abdominal pain and cramping, blood in the stools, reduced appetite and weight loss. In patients with severe Crohn’s disease the following signs and symptoms may be observed: fever, fatigue, arthritis, eye inflammation, oral ulcers, skin disorders, inflammation of the liver or bile ducts or delayed growth. Heredity and dysfunctions of the immune system are considered to cause the development of Crohn’s disease. About 10% of people with inflammatory bowel disease have also ocular problems. The most common ocular manifestations of Crohn’s disease are uveitis, iritis, episcleritis, keratopathy, keratoconjunctivitis and retinal vasculitis. Untreated uveitis may cause glaucoma and vision loss. Uveitis and iritis are four times more common in women than in men. In patients in the active stage of the disease, episcleritis also flares. Symptoms of episcleritis include inflammation, bright red spots on the sclera and localized pain. Keratoconjunctivitis in Crohn’s disease is caused by decreased tear production or increased tear film evaporation. Dry eyes can cause itching, burning or infection. Keratopathy usually causes no pain or vision loss, therefore in most cases no treatment is needed. In retinal vasculitis tortuosity of retinal veins, retinal edema at the posterior pole and intraretinal blood near blood vessels are observed. Intravenous fluorescein angiography shows intraretinal neovascularisation and haemorrhage in the posterior pole.
Full Text Available June Chen1, Stephen A Runyan1, Michael R Robinson21Department of Biological Sciences, 2Ophthalmology Clinical Research, Allergan, Inc, Irvine, CA, USAIntroduction: Glaucoma is a multifactorial disease characterized by progressive optic nerve injury and visual field defects. Elevated intraocular pressure (IOP is the most widely recognized risk factor for the onset and progression of open-angle glaucoma, and IOP-lowering medications comprise the primary treatment strategy. IOP elevation in glaucoma is associated with diminished or obstructed aqueous humor outflow. Pharmacotherapy reduces IOP by suppressing aqueous inflow and/or increasing aqueous outflow.Purpose: This review focuses on novel non-FDA approved ocular antihypertensive compounds being investigated for IOP reduction in ocular hypertensive and glaucoma patients in active clinical trials within approximately the past 2 years.Methods: The mode of IOP reduction, pharmacology, efficacy, and safety of these new agents were assessed. Relevant drug efficacy and safety trials were identified from searches of various scientific literature databases and clinical trial registries. Compounds with no specified drug class, insufficient background information, reformulations, and fixed-combinations of marketed drugs were not considered.Results: The investigational agents identified comprise those that act on the same targets of established drug classes approved by the FDA (ie, prostaglandin analogs and β-adrenergic blockers as well as agents belonging to novel drug classes with unique mechanisms of action. Novel targets and compounds evaluated in clinical trials include an actin polymerization inhibitor (ie, latrunculin, Rho-associated protein kinase inhibitors, adenosine receptor analogs, an angiotensin II type 1 receptor antagonist, cannabinoid receptor agonists, and a serotonin receptor antagonist.Conclusion: The clinical value of novel compounds for the treatment of glaucoma will depend
Ferreira, A I C; De Mattos, C C Brandão; Frederico, F B; Meira, C S; Almeida, G C; Nakashima, F; Bernardo, C R; Pereira-Chioccola, V L; De Mattos, L C
The aim of this study was to investigate risk factors for ocular toxoplasmosis (OT) in patients who received medical attention at a public health service. Three hundred and forty-nine consecutive patients, treated in the Outpatient Eye Clinic of Hospital de Base, São José do Rio Preto, São Paulo state, Brazil, were enrolled in this study. After an eye examination, enzyme-linked immunosorbent assay (ELISA) was used to determine anti-Toxoplasma gondii antibodies. The results showed that 25.5% of the patients were seronegative and 74.5% were seropositive for IgG anti-T. gondii antibodies; of these 27.3% had OT and 72.7% had other ocular diseases (OOD). The presence of cats or dogs [odds ratio (OR) 2.22, 95% confidence interval (CI) 1.24-3.98, P = 0.009] and consumption of raw or undercooked meat (OR 1.77, 95% CI 1.05-2.98, P = 0.03) were associated with infection but not with the development of OT. Age (OT 48.2 ± 21.2 years vs. OOD: 69.5 ± 14.7 years, P < 0.0001) and the low level of schooling/literacy (OT vs. OOD: OR 0.414, 95% CI 0.2231-0.7692, P = 0.007) were associated with OT. The presence of dogs and cats as well as eating raw/undercooked meat increases the risk of infection, but is not associated with the development of OT.
Flavio Mac Cord Medina
Full Text Available Kabuki syndrome is a rare congenital anomaly, characterized by five fundamental features, the "Pentad of Niikawa": dysmorphic facies, skeletal anomalies, dermatoglyphic abnormalities, mild to moderate mental retardation and postnatal growth deficiency. Patients present characteristic external ocular features, nonetheless they may also present significant ocular abnormalities. We report a case of a brazilian child diagnosed with Kabuki syndrome, addressing the clinical features observed, with emphasis on the ocular manifestations. This case highlights the existence of this syndrome and all of its complexity. The identification of preventable causes of loss of vision underlines the value of detailed ophthalmologic examination of Kabuki syndrome patients.
Coroi, Mihaela Cristina; Bungau, Simona; Tit, Mirela
The use of preservatives in eye drops (eyewashes) has known glory at the beginning, but the side effects that they have on the ocular surface have led to a decrease of their popularity. Lachrymal film dysfunction, ocular hyperemia, dotted keratitis or toxic keratopathy were reported and analyzed in terms of pathophysiological mechanism of the role played by preservatives in ophthalmic drops (eyewashes). This article reviews the most common preservatives and the existing alternatives for the maintenance of the eye sterile drops. Keywords: preservatives, eye drops, ocular surface
Ying Ting Chen
Full Text Available Keratinizing squamous metaplasia (SQM of the ocular surface is a blinding consequence of systemic autoimmune disease and there is no cure. Ocular SQM is traditionally viewed as an adaptive tissue response during chronic keratoconjunctivitis sicca (KCS that provokes pathological keratinization of the corneal epithelium and fibrosis of the corneal stroma. Recently, we established the autoimmune regulator-knockout (Aire KO mouse as a model of autoimmune KCS and identified an essential role for autoreactive CD4+ T cells in SQM pathogenesis. In subsequent studies, we noted the down-regulation of paired box gene 6 (Pax6 in both human patients with chronic KCS associated with Sjögren's syndrome and Aire KO mice. Pax6 encodes a pleiotropic transcription factor guiding eye morphogenesis during development. While the postnatal function of Pax6 is largely unknown, we hypothesized that its role in maintaining ocular surface homeostasis was disrupted in the inflamed eye and that loss of Pax6 played a functional role in the initiation and progression of SQM. Adoptive transfer of autoreactive T cells from Aire KO mice to immunodeficient recipients confirmed CD4+ T cells as the principal downstream effectors promoting Pax6 downregulation in Aire KO mice. CD4+ T cells required local signaling via Interleukin-1 receptor (IL-1R1 to provoke Pax6 loss, which prompted a switch from corneal-specific cytokeratin, CK12, to epidermal-specific CK10. The functional role of Pax6 loss in SQM pathogenesis was indicated by the reversal of SQM and restoration of ocular surface homeostasis following forced expression of Pax6 in corneal epithelial cells using adenovirus. Thus, tissue-restricted restoration of Pax6 prevented aberrant epidermal-lineage commitment suggesting adjuvant Pax6 gene therapy may represent a novel therapeutic approach to prevent SQM in patients with chronic inflammatory diseases of the ocular surface.
Betta, Monica; Gemignani, Angelo; Landi, Alberto; Laurino, Marco; Piaggi, Paolo; Menicucci, Danilo
Rapid eye movements (REMs) are a prominent feature of REM sleep, and their distribution and time density over the night represent important physiological and clinical parameters. At the same time, REMs produce substantial distortions on the electroencephalographic (EEG) signals, which strongly affect the significance of normal REM sleep quantitative study. In this work a new procedure for a complete and automated analysis of REM sleep is proposed, which includes both a REMs detection algorithm and an ocular artifact removal system. The two steps, based respectively on Wavelet Transform and adaptive filtering, are fully integrated and their performance is evaluated using REM simulated signals. Thanks to the integration with the detection algorithm, the proposed artifact removal system shows an enhanced accuracy in the recovering of the true EEG signal, compared to a system based on the adaptive filtering only. Finally the artifact removal system is applied to physiological data and an estimation of the actual distortion induced by REMs on EEG signals is supplied.
Full Text Available Michael S Korenfeld,1,2 David K Dueker3 1Comprehensive Eye Care, Ltd. Washington, MO, USA; 2Washington University Department of Ophthalmology and Visual Sciences, St Louis, MO, USA; 3Ophthalmology, Hamad Medical Corporation, Doha, Qatar Purpose: The authors have previously validated an Ocular Pressure Estimator (OPE that can estimate the intraocular pressure (IOP during external ocular compression (EOC. The authors now apply the OPE in clinical states where EOC is clinically important. The original work is described for two periods of risk: during sleep and during the digital ocular massage (DOM maneuver used by surgeons after trabeculectomy to keep the operation functional. Other periods of risk for external ocular compression are then reviewed.Methods: The first protocol estimated the IOP in the dependent eye during simulated sleep. Subjects had their IOPs initially measured in an upright-seated position, immediately upon assuming a right eye dependent side sleeping position (with nothing contacting the eye, and then 5 minutes later while still in this position. While maintaining this position, the fluid filled bladder of the OPE was then placed between the subject’s closed eye and a pillow during simulated sleep. The IOP was continuously estimated in this position for 5 minutes. The subjects then had the IOP measured in both eyes in an upright-seated position. The second protocol determined if a larger vertical cup-to-disc ratio was more common on the side that patients reported they preferred to sleep on. The hypothesis was that chronic asymmetric, compression induced, elevations of IOP during sleep would be associated with otherwise unexplained asymmetry of the vertical cup-to-disc ratio. The third protocol assessed the IOP during DOM. The OPE was used to characterize the IOP produced during the DOM maneuver of five glaucoma surgeons. After this, 90 mmHg was chosen as a target pressure for DOM. The surgeons were then verbally coached
few 12 posterior ocular injuries, using high-resolution optical coherence topography , gross pathology, and optokinetics . In this study of...exposure to ocular blast or in closed- globe ocular injuries. For most ocular trauma studies, work has focused on corneal burns or trauma. However...exposure to ocular blast agree with work from corneal burns or other closed globe models. A recent 17 report from British soldiers in Iraq and
Full Text Available We describe a case of late ocular changes after lightning injury. One year after the injury, complete ankyloblepharon, severe dry eye, corneal opacity, healed iritis and mature cataracts were noted in both eyes of the patient.
T Ashwini Kini
Full Text Available Progressive hemifacial atrophy (PHA is a disease of unknown etiology affecting one-half of the face. Ocular involvement is uncommon. Atrophy of iris is rare, with only a few cases of partial atrophy being reported in the literature. We report a case of total atrophy of iris and ciliary body with associated ocular hypotony in a 16-year-old girl with PHA. We believe this is the first reported case of complete atrophy of iris and ciliary body in PHA. Ocular hypotony in PHA was thought to be due to intra-ocular inflammation. However in our case it appears to be secondary to severe atrophy of the ciliary body.
Conclusion: Any minimal angle of head tilt may cause erroneous measurement of astigmatic axis and should be avoided during refraction. One cannot rely on the compensatory function of ocular counter-torsion during the refraction.
Aref, Ahmad A; Sivaraman, Kavitha R; Djalilian, Ali R
Glaucoma may develop or worsen after ocular surface transplantation and often requires surgical management for adequate intraocular pressure control. Traditional glaucoma filtering procedures in patients with prior ocular surface transplant may be problematic for several reasons, which include mechanical disruption of the pre-existing graft, epithelial and stem cell toxicity induced by antifibrotic agents, and increased risk of future corneal transplantation failure. We describe the implantation of a glaucoma drainage implant via a limbal-based conjunctival incision with tube placement in the ciliary sulcus in three eyes of two patients with prior ocular surface transplantation. At a follow-up interval of 3-7 months, all three eyes have excellent postoperative control of intraocular pressure, stable vision, and healthy ocular surface grafts.
Full Text Available We report successful outcome of a huge post- trabeculectomy intra-bleb hematoma and hyphema that occurred following digital ocular compression. The patient was a 64-year-old lady suffering from bilateral primary angle closure glaucoma and cataract. She was on anti-platelet therapy. She underwent single-site phacoemulsification, intra-ocular lens implantation and trabeculectomy with mitomycin C in the right eye. The trabeculectomy was under-filtering. She was asked to perform digital ocular compression thrice daily. On 15 th post-operative day, she presented with a huge intra-bleb hematoma and hyphema. The hematoma did not respond to conservative measures and was drained to prevent bleb failure. We recommend caution in the consideration of digital ocular compression in patients on prophylactic anti-coagulation.
Shen, Yan; Ling, Xiang; Jiang, Weiwei; Du, Shuang; Lu, Yang; Tu, Jiasheng
Emulgels have been extensively covered as a promising drug delivery system for the administration of lipophilic drugs. This work was conducted to develop an emulgel formulation for Cyclosporin A (CsA) employing polycarbophil as the gelling agent for ocular delivery. The prepared emulgels were evaluated for their physical appearance, rheological behavior, drug release, stability, precorneal clearance and irritation. Results showed that CsA emulgel formulations prepared with polycarbophil exhibited acceptable physical properties and drug release, which remained consistent after storage for 3 months. A prolonged retention time was also observed on the ocular surface with improved ocular bioavailability and no irritation. Therefore, the polycarbophil-based emulgel could be exploited as a potential hydrophobic drug carrier for topical ocular drug delivery.
Conclusion : AMT in various ocular surface pathologies shows success in achieving the goal of symptomatic relief, improved epithelialization, stromal healing and vision. Reduction in inflammation, corneal haze and recurrence of original disease is achieved with minimum complications.
Ranjbaran, Mina; Galiana, Henrietta L
A hybrid nonlinear bilateral model for the horizontal angular vestibulo-ocular reflex (AVOR) is presented in this paper. The model relies on known interconnections between saccadic burst circuits in the brainstem and ocular premotor areas in the vestibular nuclei during slow and fast phase intervals. A viable switching strategy for the timing of nystagmus events is proposed. Simulations show that this hybrid model replicates AVOR nystagmus patterns that are observed in experimentally recorded data.
vitreoretinopathy (PVR), a form of intraocular fibrosis, is often the primary reason for the loss of vision after ocular trauma, and frequently occurs after blunt...metalloproteinase activity by shedding/releasing tagged- ectodomains in the vicinity of affected cells after traumatic eye injury and induction of PVR. We...primary reason for the loss of vision after ocular trauma, and frequently occurs after blunt trauma and open globe injuries caused by penetration
Barar, Jaleh; AGHANEJAD, Ayuob; Fathi, Marziyeh; Omidi, Yadollah
Introduction: Ocular targeted therapy has enormously been advanced by implementation of new methods of drug delivery and targeting using implantable drug delivery systems (DDSs) or devices (DDDs), stimuli-responsive advanced biomaterials, multimodal nanomedicines, cell therapy modalities and medical bioMEMs. These technologies tackle several ocular diseases such as inflammation-based diseases (e.g., scleritis, keratitis, uveitis, iritis, conjunctivitis, chorioretinitis, choroiditis, retinitis...
Kolomeyer, A M; Nayak, N V; Szirth, B C; Khouri, A S
Purpose. To describe integration of fundus autofluorescence (FAF) imaging into an ocular screening program. Methods. Fifty consecutive screening participants were included in this prospective pilot imaging study. Color and FAF (530/640 nm exciter/barrier filters) images were obtained with a 15.1MP Canon nonmydriatic hybrid camera. A clinician evaluated the images on site to determine need for referral. Visual acuity (VA), intraocular pressure (IOP), and ocular pathology detected by color fundus and FAF imaging modalities were recorded. Results. Mean ± SD age was 47.4 ± 17.3 years. Fifty-two percent were female and 58% African American. Twenty-seven percent had a comprehensive ocular examination within the past year. Mean VA was 20/39 in the right eye and 20/40 in the left eye. Mean IOP was 15 mmHg bilaterally. Positive color and/or FAF findings were identified in nine (18%) individuals with diabetic retinopathy or macular edema (n = 4), focal RPE defects (n = 2), age-related macular degeneration (n = 1), central serous retinopathy (n = 1), and ocular trauma (n = 1). Conclusions. FAF was successfully integrated in our ocular screening program and aided in the identification of ocular pathology. Larger studies examining the utility of this technology in screening programs may be warranted.
A. M. Kolomeyer
Full Text Available Purpose. To describe integration of fundus autofluorescence (FAF imaging into an ocular screening program. Methods. Fifty consecutive screening participants were included in this prospective pilot imaging study. Color and FAF (530/640 nm exciter/barrier filters images were obtained with a 15.1MP Canon nonmydriatic hybrid camera. A clinician evaluated the images on site to determine need for referral. Visual acuity (VA, intraocular pressure (IOP, and ocular pathology detected by color fundus and FAF imaging modalities were recorded. Results. Mean ± SD age was 47.4 ± 17.3 years. Fifty-two percent were female and 58% African American. Twenty-seven percent had a comprehensive ocular examination within the past year. Mean VA was 20/39 in the right eye and 20/40 in the left eye. Mean IOP was 15 mmHg bilaterally. Positive color and/or FAF findings were identified in nine (18% individuals with diabetic retinopathy or macular edema (n=4, focal RPE defects (n=2, age-related macular degeneration (n=1, central serous retinopathy (n=1, and ocular trauma (n=1. Conclusions. FAF was successfully integrated in our ocular screening program and aided in the identification of ocular pathology. Larger studies examining the utility of this technology in screening programs may be warranted.
Full Text Available Abstract Background Multiple congenital ocular anomalies (MCOA syndrome is a hereditary congenital eye defect that was first described in Silver colored Rocky Mountain horses. The mutation causing this disease is located within a defined chromosomal interval, which also contains the gene and mutation that is associated with the Silver coat color (PMEL17, exon 11. Horses that are homozygous for the disease-causing allele have multiple defects (MCOA-phenotype, whilst the heterozygous horses predominantly have cysts of the iris, ciliary body or retina (Cyst-phenotype. It has been argued that these ocular defects are caused by a recent mutation that is restricted to horses that are related to the Rocky Mountain Horse breed. For that reason we have examined another horse breed, the Icelandic horse, which is historically quite divergent from Rocky Mountain horses. Results We examined 24 Icelandic horses and established that the MCOA syndrome is present in this breed. Four of these horses were categorised as having the MCOA-phenotype and were genotyped as being homozygous for the PMEL17 mutation. The most common clinical signs included megaloglobus, iris stromal hypoplasia, abnormal pectinate ligaments, iridociliary cysts occasionally extending into the peripheral retina and cataracts. The cysts and pectinate ligament abnormalities were observed in the temporal quadrant of the eyes. Fourteen horses were heterozygous for the PMEL17 mutation and were characterized as having the Cyst-phenotype with cysts and occasionally curvilinear streaks in the peripheral retina. Three additional horses were genotyped as PMEL17 heterozygotes, but in these horses we were unable to detect cysts or other forms of anomalies. One eye of a severely vision-impaired 18 month-old stallion, homozygous for the PMEL17 mutation was examined by light microscopy. Redundant duplication of non-pigmented ciliary body epithelium, sometimes forming cysts bulging into the posterior chamber
Full Text Available Osmo Kari1, K Matti Saari21Department of Allergology, Skin and Allergy Hospital, Helsinki University Central Hospital, Helsinki, Finland; 2Department of Ophthalmology, University of Turku, Turku, FinlandAbstract: Allergic diseases have greatly increased in industrialized countries. About 30% of people suffer from allergic symptoms and 40%–80% of them have symptoms in the eyes. Atopic conjunctivitis can be divided into seasonal allergic conjunctivitis (SAC and perennial allergic conjunctivitis (PAC. The treatment of SAC is simple; antihistamines, anti-inflammatory agents, or chromoglycate. In severe cases of SAC, subcutaneous or sublingual immunotherapy is helpful. PAC needs longer therapy, often year round, with mast cell stabilizers, antihistamines, and sometimes local steroids. Atopic keratoconjunctivitis is a more severe disease showing chronic blepharitis often connected with severe keratitis. It needs, in many cases, continuous treatment of the lid eczema and keratoconjunctivitis. Blepharitis is treated with tacrolimus or pimecrolimus ointment. Conjunctivitis additionally needs corticosteroids and, if needed, cyclosporine A (CsA drops are administered for longer periods. Basic conjunctival treatment is with mast cell-stabilizing agents and in addition, antihistamines are administered. Vernal keratoconjunctivitis is another chronic and serious allergic disease that mainly affects children and young people. It is a long-lasting disease which commonly subsides in puberty. It demands intensive therapy often for many years to avoid serious complicating corneal ulcers. Treatment is mast cell-stabilizing drops and additionally antihistamines. In relapses, corticosteroids are needed. When the use of corticosteroids is continuous, CsA drops should be used, and in relapses, corticosteroids should be used additionally. Nonallergic eosinophilic conjunctivitis (NAEC is a less known, but rather common, ocular disease. It affects mostly middle-aged and
Kambhampati, Siva Pramodh
PAMAM dendrimers are a class of well-defined, hyperbranched polymeric nanocarriers that are being investigated for ocular drug and gene delivery. Their favorable properties such as small size, multivalency and water solubility can provide significant opportunities for many biologically unstable drugs and allows potentially favorable ocular biodistribution. This work exploits hydroxyl terminated dendrimers (G4-OH) as drug/gene delivery vehicles that can target retinal microglia and pigment epithelium via systemic delivery with improved efficacy at much lower concentrations without any side effects. Two different drugs Triamcinolone acetonide (TA) and N-Acetyl Cysteine (NAC) conjugated to G4-OH dendrimers showed tailorable sustained release in physiological relevant solutions and were evaluated in-vitro and in-vivo. Dendrimer-TA conjugates enhanced the solubility of TA and were 100 fold more effective at lower concentrations than free TA in its anti-inflammatory activity in activated microglia and in suppressing VEGF production in hypoxic RPE cells. Dendrimers targeted activated microglia/macrophages and RPE and retained for a period of 21 days in I/R mice model. The relative retention of intravitreal and intravenous dendrimers was comparable, if a 30-fold intravenous dose is used; suggesting intravenous route targeting retinal diseases are possible with dendrimers. D-NAC when injected intravenously attenuated retinal and choroidal inflammation, significantly reduced (˜73%) CNV growth at early stage of AMD in rat model of CNV. A combination therapy of D-NAC + D-TA significantly suppressed microglial activation and promoted CNV regression in late stages of AMD without causing side-effects. G4-OH was modified with linker having minimal amine groups and incorporation of TA as a nuclear localization enhancer resulted in compact gene vectors with favorable safety profile and achieved high levels of transgene expression in hard to transfect human retinal pigment
Eliane Terumi Inada
Full Text Available Relatar um caso de toxicidade ocular causada pela cloroquina. Aferiu-se a acuidade visual de ambos os olhos em tabela de Snellen. Foram realizados biomicroscopia do segmento anterior, refração, oftalmoscopia, angiofluoresceinografia e retinografia numa paciente de 53 anos, sexo feminino, portadora de artrite reumatóide. Fez uso de cloroquina por 6 anos e havia parado há um ano, quando veio ao nosso serviço. Apresentava acuidade visual corrigida de 20/200 e 20/40. À biomicroscopia do segmento anterior apresentava lente intra-ocular no olho direito e catarata nuclear 1+/4+ no olho esquerdo, com opacidade corneana subepitelial inferior ao eixo visual em ambos os olhos. À oftalmoscopia, apresentava mácula com aspecto de tacho batido (atrofia do epitélio pigmentar da retina. A angiofluoresceinografia mostrou maculopatia com aspecto de olho de boi. Relata-se um caso típico de ceratopatia e maculopatia causados pela cloroquina.To report a case of ocular toxicity due to chloroquine. The best visual acuity was measured in both eyes with the Snellen chart. Slit-lamp examination of anterior segment, refraction, dilated fundus examination, fluorescein angiography and retinography was done in a 53-year-old patient, female, with rheumatoid arthritis. She had used chloroquine during 6 years and had stopped for 1 year when she came to our service. She had best corrected visual acuity of 20/200 and 20/40. Slit-lamp examination showed intraocular lens in right eye and nuclear cataract (1+/4 in the other, and bilateral corneal subepithelial opacity inferior to the visual axis. Fundus examination showed macular area with retinal pigment epithelium atrophy. Fluorescein angiography showed a bull's eye maculopathy. Report of a typical keratopathy and maculopathy caused by chloroquine.
Da Costa, Godwin Clovis; Aras, Meena Ajay; Chalakkal, Paul; Da Costa, Michelle Clovis
The article highlights a new method for the fabrication of an ocular prosthesis by the incorporation of a ceramic scleral veneer. The steps of fabrication include impression making, wax try-in, performing a “cut-back” on a selected stock eye, insertion of the IPS e-max press scleral veneer, finishing and insertion. It also includes a detailed review on non-integrated ocular prostheses. PMID:28149792
Da Costa, Godwin Clovis; Aras, Meena Ajay; Chalakkal, Paul; Da Costa, Michelle Clovis
The article highlights a new method for the fabrication of an ocular prosthesis by the incorporation of a ceramic scleral veneer. The steps of fabrication include impression making, wax try-in, performing a "cut-back" on a selected stock eye, insertion of the IPS e-max press scleral veneer, finishing and insertion. It also includes a detailed review on non-integrated ocular prostheses.
Alexandre Mattoso Libório
Full Text Available OBJETIVO: Avaliar a presença de microbiota aeróbia da conjuntiva de portadores de alergia ocular e comparar a um grupo controle. MÉTODOS: Foram examinados 133 pacientes no período de abril a junho de 2001 divididos em 2 grupos. O grupo A foi composto de 63 portadores de conjuntivite alérgica (sem uso de medicação e o grupo B de 70 pacientes do ambulatório geral (controle. Foram coletadas amostras do fundo de saco conjuntival do olho direito de todos os pacientes e o material foi semeado em meios sólidos de cultura (ágar sangue, chocolate e Sabouraud. RESULTADOS: No grupo A, 30 culturas (47,7% foram positivas e no grupo B, 6 (8,6%. Sete bactérias foram isoladas no grupo A e 4 no B. A análise estatística revelou associação significante entre a positividade dos cultivos e conjuntivite alérgica. CONCLUSÃO: Microbiota bacteriana foi mais freqüentemente encontrada nos pacientes com alergia ocular.PURPOSE: To evaluate de presence of conjunctival aerobic microbiota in patients with ocular allergy as compared to a control group. METHODS: One hundred and thirty-three patients were evaluated from April to June 2001 and divided into 2 groups. Sixty-three patients with allergic conjunctivitis (without medication were in group A and 70 patients from the general outpatient clinic were in group B (control group. Samples from the conjunctival sac of the right eye were collected and cultured in solid media (blood, chocolate and Sabouraud agar. RESULTS: In group A, 30 cultures (47.7% were positive and 6 (8.6% in group B. Seven bacteria were isolated from group A and 4 from group B. Statistical analysis revealed significant association between positive cultures and allergic conjunctivitis. CONCLUSION: Bacterial microbiota was more frequently found in patients with ocular allergy.
Mônica Fialho Cronemberger
Full Text Available Objetivo: Estudar as alterações oculares em pacientes com mielomeningocele. Material e Método: Realizado estudo retrospectivo em 72 pacientes com mielomeningocele, descrevendo as alterações oculares presentes nessa população, além de correlacionar com a presença ou não de hidrocefalia. Resultados: Dos 72 pacientes com mielomeningocele, com idade variando de 5 meses a 18 anos, 64 (88,9% pacientes tinham hidrocefalia. Destes 64 pacientes, 36 (56,3% tinham estrabismo, sendo que 21 (58,3% eram endotrópicos, 13 (36,1% exotrópicos, 1 (2,8% exofórico e 1 (2,8% com estrabismo discinético. Do total dos 72 pacientes estudados 38 (52,8% eram estrábicos. A anisotropia foi encontrada em 16 (22,2% pacientes, sendo que em 14 (87,5% em A e em 2 (12,5% em V. Todos os 16 pacientes com anisotropia apresentavam hidrocefalia. O erro refrativo mais freqüente foi a hipermetropia encontrada em 64 (44,4% olhos. Atrofia óptica foi encontrada em 9 (12,5% pacientes. Conclusão: A mielomeningocele, associada a hidrocefalia, apresenta uma porcentagem de estrabismo maior do que o encontrado na população normal.Purpose: To study ocular findings in patients with meningomyelocele. Methods: A retrospective study of 72 patients with myelomeningocele was performed to evaluate ocular motility disorders, refractive errors and indirect ophthalmoscopy findings. Results: In a group of 72 patients with myelomeningocele, aged 5 month -- 18 years, 64 (88.9% had hydrocephalus. Of this group of 64 patients, 36 (56.3% had strabismus, 21 (58.3% of whom were esotropic, and 13 (36.1% exotropic, 1 (2.8% exophoric and 1 (2.8% presented sometimes esotropia and sometimes exotropia. Of the total of 72 studied patients, 38 (52.8% had strabismus. Anisotropia was found in 16 (22.2% patients, 14 (87.5% with an A pattern and 2 (12.5% with a V pattern. The most frequent refractive error was hyperopia, found in 64 (44.4% eyes. All the 16 patients with anisotropia had hydrocephalus
The low intensity laser therapy (LILT) has been extensively used in medicine and dentistry presenting positive effects. However, the laser radiation can also cause adverse effects. Due to the ocular focalization property, in the wavelength from 400 to 1400 nm, the retina is more susceptible to damage by radiation than any other part of the human body. Then, the ocular protection is frequently emphasized. This protection must attenuate the radiation to a safe level. The International Electrotechnical Commission (IEC) standard IEC 60825-1 suggests safety requirements for medical laser equipment, including the ocular protection, based on maximum permissible exposure levels. The Brazilian legislation adopts a corresponding IEC standard, the NBR IEC 601.2.22, for safety requirements. The aim of this study was to analyze the adequacy of the ocular protectors furnished by four laser equipment manufacturers, commercially available in Brazil, commonly used for LILT. For this purpose, the laser equipment and the respective ocular protectors were characterized. The adequacy was verified according to the IEC standards. It was found, among other results, ocular protectors attenuating to safe levels the radiation emitted by the respective laser equipment, however, presenting inadequate visual transmission. Inefficient protection and protection indicated in cases where they were not necessary were also observed. (author)
The design and testing of an ocular Shack-Hartmann aberrometer is presented. The aberrometer objectively measures optical aberrations in the human eye in vivo. The sensor was successfully tested for measurements of refractive error (sphere and cylinder) and spherical aberration. Vignetting limits the measurement range of the wavefront to a range of -10 D to +15 D. Large refractive errors and decentration of the measurement induce aberrations in the test wavefront. Analytical tools to correct for these systematic errors were developed. A clinical study was conducted assessing visual performance in 158 eyes of 89 subjects before and after LARK refractive surgery. The main results of the study were that refractive surgery corrects refractive errors very accurately. A slight regression in refraction during the 12 months after surgery was noted. Measurements of ocular aberrations using the Shack-Hartmann aberrometer revealed that refractive surgery introduced large amounts of higher order aberrations, mainly spherical aberration and coma. The amount of aberrations changed significantly during the 12 months wound healing period. The dark adapted pupil diameter of the eye increased significantly during the first 6 months after surgery. The changes in ocular aberrations and pupil diameter were correlated to changes in contrast sensitivity in the human eye. The analysis of corneal topography showed that while the anterior corneal curvature changed due to surgery, we also saw a change in the posterior corneal curvature as a biomechanical response to surgery. A Customized Eye Model was designed and tested based on the clinical measurements. The model used conic surfaces and modeled defocus and spherical aberration. This computer eye model was then used in optical lens design software to calculate an optimal Customized Ablation Pattern for individual eyes.
Full Text Available Human immunodeficiency virus infection is the first major pandemic of the 20th century. At present, almost 10 million people are known to be infected with this virus, and it is estimated that by the year 2000, approximately 40 million people will be infected. Transmission of this deadly infection is predominantly by sexual contact. Individuals infected with this virus pass through several predictable stages with progressive decrease in circulating CD4+ T cells. During the advanced stage, these patients develop various opportunistic infections or malignancies, or both. It is this advanced stage that was first recognized as AIDS, which has a 100% mortality rate. The opportunistic organisms that can involve the eye in patients with AIDS include cytomegalovirus, herpes zoster, Toxoplasma gondii, Mycobacterium tuberculosis, Cryptococcus neoformans, Mycobacterium avium-intracellulare, Pneumocystis carinii, Histoplasma capsulatum, Candida, and others. Intraocular lesions from these agents often represent disseminated infections. Visual morbidity occurs secondary to retinitis due to cytomegalovirus, herpes zoster, or Toxoplasma gondii. Anti-viral agents such as ganciclovir or foscarnet are effective against cytomegalovirus infection. The role of the ophthalmologist in the diagnosis and management of AIDS is becoming increasingly important. Not only does the eye reflect systemic disease, but ocular involvement may often precede systemic manifestations. In the AIDS patient, the ophthalmologist thus has an opportunity to make not only a slight-saving, but also life-saving diagnosis of disseminated opportunistic infections.
Das, Dipankar; Ramachandra, Varsha; Islam, Saidul; Bhattacharjee, Harsha; Biswas, Jyotirmay; Koul, Akanksha; Deka, Panna; Deka, Apurba
Parasites are a group of eukaryotic organisms that may be free-living or form a symbiotic or parasitic relationship with the hosts. Consisting of over 800,000 recognized species, parasites may be unicellular (Protozoa) or multicellular (helminths and arthropods). The association of parasites with human population started long before the emergence of civilization. Parasitic zoonotic diseases are prevalent worldwide including India. Appropriate epidemiological data are lacking on existing zoonotic parasitic diseases, and newer diseases are emerging in our scenario. Systemic diseases such as cysticercosis, paragonimiasis, hydatidosis, and toxoplasmosis are fairly common. Acquired Toxoplasma infections are rising in immune-deficient individuals. Amongst the ocular parasitic diseases, various protozoas such as Cystoidea, trematodes, tissue flagellates, sporozoas etc. affect humans in general and eyes in particular, in different parts of the world. These zoonoses seem to be a real health related problem globally. Recent intensification of research throughout the world has led to specialization in biological fields, creating a conducive situation for researchers interested in this subject. The basics of parasitology lie in morphology, pathology, and with recent updates in molecular parasitology, the scope has extended further. The current review is to address the recent update in ophthalmic parasites with special reference to pathology and give a glimpse of further research in this field. PMID:27958200
De Masi, Franco
The delusional experience is the result of a grave disjunction in the psyche whose outcome is not readily predictable. Examination of the specific mode of disjunction may help us understand the nature and radical character of delusion. I will present the therapy of a psychotic patient who after many years of analysis and progresses in his life continues to show delusional episodes although limited and contained. In his case, the two visions, one delusional and the other real, remain distinct and differentiated from each other because they both possess the same perceptual character, that of reality. He has a bi-ocular vision of reality and not a binocular one because his vision lacks integration, as would necessarily be the case if the two visions could be compared with each other. The principle of non-contradiction ceases to apply in delusion. A corollary of the failure of the principle of non-contradiction is that, if a statement and its negation are both true, then any statement is true. Logicians call this consequence the principle of explosion. For this reason, the distinction between truth, reality, improbability, probability, possibility and impossibility is lost in the delusional system, thus triggering an omnipotent, explosive mechanism with a potentially infinite progression. The paper presents some thoughts for a possible analytic transformation of the delusional experience.
Full Text Available Parasites are a group of eukaryotic organisms that may be free-living or form a symbiotic or parasitic relationship with the hosts. Consisting of over 800,000 recognized species, parasites may be unicellular (Protozoa or multicellular (helminths and arthropods. The association of parasites with human population started long before the emergence of civilization. Parasitic zoonotic diseases are prevalent worldwide including India. Appropriate epidemiological data are lacking on existing zoonotic parasitic diseases, and newer diseases are emerging in our scenario. Systemic diseases such as cysticercosis, paragonimiasis, hydatidosis, and toxoplasmosis are fairly common. Acquired Toxoplasma infections are rising in immune-deficient individuals. Amongst the ocular parasitic diseases, various protozoas such as Cystoidea, trematodes, tissue flagellates, sporozoas etc. affect humans in general and eyes in particular, in different parts of the world. These zoonoses seem to be a real health related problem globally. Recent intensification of research throughout the world has led to specialization in biological fields, creating a conducive situation for researchers interested in this subject. The basics of parasitology lie in morphology, pathology, and with recent updates in molecular parasitology, the scope has extended further. The current review is to address the recent update in ophthalmic parasites with special reference to pathology and give a glimpse of further research in this field.
Ryle, James P.; Al-Kalbani, Mohammed; Collins, Niamh; Gopinathan, Unnikrishnan; Boyle, Gerard; Coakley, Davis; Sheridan, John T.
Ocular microtremor (OMT) is a biological high frequency (up to 150Hz) low amplitude (25-2500nm peak to peak) involuntary motion of the human eye. Clinical OMT investigations to date have used eye-contacting mechanical piezoelectric probes or piezoelectric strain gauges. Before contact can be made, the eye must first be anaesthetized. In some cases, this eyelid spasms occur making it impossible to measure OMT. Using the contact probe method, the eye motion is mechanically loaded. Results from clinical studies with this method to date have given electrical signal amplitudes from the probe proportional to the displacement, but not the exact displacement information. Recent studies suggest a number of clinical applications for OMT, these include monitoring the depth of anesthesia of a patient in surgery, prediction of outcome in coma, diagnosis of brain stem death. In addition to this, in patients with neurological disorders such as Multiple Sclerosis and Parkinson's disease, abnormal OMT frequency content is present. In this paper, we design a compact non-contact phase modulating optical fiber speckle interferometer to measure eye motions. We simulate OMT motion using a calibrated piezoelectric vibration simulator and compare results produced using a contact method with those using our optical non-contact method.
Dai, M.; Raphan, T.; Kozlovskaya, I.; Cohen, B.
Otolith-induced eye movements of rhesus monkeys were studied before and after the 1989 COSMOS 2044 and the 1992 to 1993 COSMOS 2229 flights. Two animals flew in each mission for approximately 2 weeks. After flight, spatial orientation of the angular vestibulo-ocular reflex was altered. In one animal the time constant of postrotatory nystagmus, which had been shortened by head tilts with regard to gravity before flight, was unaffected by the same head tilts after flight. In another animal, eye velocity, which tended to align with a gravitational axis before flight, moved toward a body axis after flight. This shift of orientation disappeared by 7 days after landing. After flight, the magnitude of compensatory ocular counter-rolling was reduced by about 70% in both dynamic and static tilts. Modulation in vergence in response to naso-occipital linear acceleration during off-vertical axis rotation was reduced by more than 50%. These changes persisted for 11 days after recovery. An up and down asymmetry of vertical nystagmus was diminished for 7 days. Gains of the semicircular canal-induced horizontal and vertical angular vestibulo-ocular reflexes were unaffected in both flights, but the gain of the roll angular vestibulo-ocular reflex was decreased. These data indicate that there are short- and long-term changes in otolith-induced eye movements after adaptation to microgravity. These experiments also demonstrate the unique value of the monkey as a model for studying effects of vestibular adaptation in space. Eye movements can be measured in three dimensions in response to controlled vestibular and visual stimulation, and the results are directly applicable to human beings. Studies in monkeys to determine how otolith afferent input and central processing is altered by adaptation to microgravity should be an essential component of future space-related research.
Full Text Available Objective: To determine the contribution of corporal punishment to ocular morbidity and visual impairment in Nigerian children. Materials and Methods: A prospective study was conducted of all patients aged 0-15 years seen with ocular injuries over a four year period. Those who sustained ocular injuries during the administration of corporal punishment were further studied. Relevant information was documented using a semistructured questionnaire. Data was analyzed by simple descriptive statistics using SPSS statistical package version 10. Results: A total of 186 children were seen within the study period. Eighty-nine (47.8% had ocular injuries and 27 (30.3% had ocular injuries resulting from corporal punishment. Of the latter group, eighteen were males and nine were females. Their ages ranged from 3-15 years (mean = 8.5 ± 2.4 years. Corporal punishment-associated injuries occurred most commonly as seen in 17 (63% of our study population who were aged 7-12 years. These 27 cases of injuries were sustained in the schools: 13 (48.2%, homes: eight (29.6%, market place: three (11.1%, workshop: two (7.4% and worship houses: one (3.7%. A stick was the object mostly implicated in causing ocular injuries in 13 (48.2% followed by a belt in five (18.5% and a whip in four (14.8%. Severe visual impairment occurred in two (7.4% patients while blindness occurred in three (11.1% patients. Conclusion: Corporal punishment is a major cause of ocular morbidity and blindness in Nigerian children.
Barar, Jaleh; Aghanejad, Ayuob; Fathi, Marziyeh; Omidi, Yadollah
Introduction: Ocular targeted therapy has enormously been advanced by implementation of new methods of drug delivery and targeting using implantable drug delivery systems (DDSs) or devices (DDDs), stimuli-responsive advanced biomaterials, multimodal nanomedicines, cell therapy modalities and medical bioMEMs. These technologies tackle several ocular diseases such as inflammation-based diseases (e.g., scleritis, keratitis, uveitis, iritis, conjunctivitis, chorioretinitis, choroiditis, retinitis, retinochoroiditis), ocular hypertension and neuropathy, age-related macular degeneration and mucopolysaccharidosis (MPS) due to accumulation of glycosaminoglycans (GAGs). Such therapies appear to provide ultimate treatments, even though much more effective, yet biocompatible, noninvasive therapies are needed to control some disabling ocular diseases/disorders. Methods: In the current study, we have reviewed and discussed recent advancements on ocular targeted therapies. Results: On the ground that the pharmacokinetic and pharmacodynamic analyses of ophthalmic drugs need special techniques, most of ocular DDSs/devices developments have been designed to localized therapy within the eye. Application of advanced DDSs such as Subconjunctival insert/implants (e.g., latanoprost implant, Gamunex-C), episcleral implant (e.g., LX201), cationic emulsions (e.g., Cationorm™, Vekacia™, Cyclokat™), intac/punctal plug DDSs (latanoprost punctal plug delivery system, L-PPDS), and intravitreal implants (I-vitaion™, NT-501, NT- 503, MicroPump, Thethadur, IB-20089 Verisome™, Cortiject, DE-102, Retisert™, Iluvein™ and Ozurdex™) have significantly improved the treatment of ocular diseases. However, most of these DDSs/devices are applied invasively and even need surgical procedures. Of these, use of de novo technologies such as advanced stimuli-responsive nanomaterials, multimodal nanosystems (NSs)/nanoconjugates (NCs), biomacromolecualr scaffolds, and bioengineered cell therapies
Full Text Available Background / Aims: The eye may be infected from external sources or through intra-ocular invasion of micro-organisms carried by the blood stream. This study was undertaken to isolate and identify the specific bacterial pathogens causing ocular infections and to determine their in-vitro antibacterial susceptibilities to commonly used antibacterial agents. Materials and Methods: A retrospective analysis of all patients with clinically diagnosed bacterial ocular infections such as blepharitis, conjunctivitis, internal and external hordeolum, suppurative scleritis, canaliculitis, keratitis, dacryocystitis, preseptal cellulitis, endophthalmitis and panophthalmitis presenting between January 2005 and December 2005 was performed. Extra-ocular and intra-ocular specimens were collected and were subjected to direct microscopy and culture. Results: A total of 756 patients with bacterial ocular infections were analyzed, of which 462(61% eyes had adnexal bacterial infection, 217(28.7% had corneal infection, 6 (0.8% had scleral involvement and the remaining 71(9.39% eyes had infection of the intra-ocular tissues. The predominant bacterial species isolated was S. aureus (195 of 776; 25% followed by S. pneumoniae (169 of 776; 21.78% and coagulase negative staphylococci (142 of 776; 18.3%. The largest number of gram-positive isolates were susceptible to cefazolin (545 of 624; 87.34%, chloramphenicol (522 of 624; 83.65% and gatifloxacin (511 of 624; 81.89% and gram-negative isolates were to amikacin (127 of 136; 93.38%, gatifloxacin (125 of 136; 91.91% and ofloxacin (119 of 136; 87.5%, while aerobic actinomycetes were to amikacin (100%, gatifloxacin (14 of 16; 87.5%, chloramphenicol (14 of 16; 87.5% and ofloxacin (13 of 16; 81.25%. Conclusions: S. aureus frequently causes infections of eyelids and conjunctiva, S. pneumoniae of lacrimal apparatus and cornea and coagulase negative staphylococci causes intra-ocular infections. Of all routinely used antibacterials
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A 21-year-old female was referred for severe bilateral visual loss 3 weeks after a diagnosis of brucellosis. On ocular examination she had bilateral optic nerve head swelling, preretinal hemorrhages and retinal vasculitis. The patient was diagnosed with bilateral optic neuritis secondary to brucellosis and developed optic atrophy and severe visual loss despite medical treatment. Brucellosis can lead to various types of ocular involvement including vasculitis, optic neuritis and retinal hemorrhage.
Fukuda, Ken; Nishida, Teruo
Severe ocular allergic diseases such as vernal keratoconjunctivitis are characterized not only by conjunctival allergic inflammation, including infiltration of T helper 2 cells and eosinophils into the conjunctiva, but also by various corneal disorders such as persistent epithelial defects and shield ulcer. Although the cornea and conjunctiva are thought to influence each other during ocular allergic inflammation, direct evidence for interaction between these tissues in vivo has been lacking. Eosinophils and eosinophil-derived factors are implicated in the pathogenesis of corneal lesions associated with ocular allergy, with cytotoxic granule proteins such as major basic protein and matrix metalloproteinase 9 derived from eosinophils having been detected in shield ulcer. Major basic protein exhibits cytotoxic effects in cultured corneal epithelial cells and inhibits corneal epithelial wound healing in organ culture, whereas matrix metalloproteinase 9 can degrade the corneal epithelial basement membrane. In vitro studies have revealed that cytokines and other inflammatory mediators directly impair the barrier function of corneal epithelial cells and increase the expression of chemokines and adhesion molecules by corneal stromal fibroblasts, effects that may enhance allergic inflammation. We have recently shown that removal of the corneal epithelium augmented late-phase clinical signs and conjunctival eosinophilia, whereas conjunctival inflammation delayed corneal epithelial wound healing, in a rat model of ocular allergy. Conjunctival allergic inflammation and corneal epithelial disorders thus interact with each other in vivo to generate a vicious cycle, interruption of which might provide the basis for novel approaches to the treatment of severe ocular allergy.
André Augusto Miranda Torricelli
Full Text Available It is widely recognized today that outdoor air pollution can affect human health. Various chemical components that are present in ambient pollution may have an irritant effect on the mucous membranes of the body, particularly those of the respiratory tract. Much less attention has been focused on the adverse effect on the ocular surface, despite the fact that this structure is even more exposed to air pollution than the respiratory mucosa since only a very thin tear film separates the corneal and conjunctival epithelia from the air pollutants. So far, clinical data are the more widespread tools used by ophthalmologists for assessing possible aggression to the ocular surface; however, clinical findings alone appears not to correlate properly with the complaints presented by the patients pointing out the need for further clinical and laboratory studies on the subject. The purpose of this study is to review signs and symptoms associated with chronic long-term exposure to environmental air pollutants on the ocular structures currently defined as the ocular surface and to review clinical and laboratory tests used to investigate the adverse effects of air pollutants on such structures. We also review previous studies that investigated the adverse effects of air pollution on the ocular surface and discuss the need for further investigation on the subject.
Full Text Available Background. The aim of this study is to investigate the ocular thermographic profiles in age-related macular degeneration (AMD eyes and age-matched controls to detect possible hemodynamic abnormalities, which could be involved in the pathogenesis of the disease. Methods. 32 eyes with early AMD, 37 eyes with atrophic AMD, 30 eyes affected by untreated neovascular AMD, and 43 eyes with fibrotic AMD were included. The control group consisted of 44 healthy eyes. Exclusion criteria were represented by any other ocular diseases other than AMD, tear film abnormalities, systemic cardiovascular abnormalities, diabetes mellitus, and a body temperature higher than 37.5°C. A total of 186 eyes without pupil dilation were investigated by infrared thermography (FLIR A320. The ocular surface temperature (OST of three ocular points was calculated by means of an image processing technique from the infrared images. Two-sample t-test and one-way analysis of variance (ANOVA test were used for statistical analyses. Results. ANOVA analyses showed no significant differences among AMD groups (P value >0.272. OST in AMD patients was significantly lower than in controls (P>0.05. Conclusions. Considering the possible relationship between ocular blood flow and OST, these findings might support the central role of ischemia in the pathogenesis of AMD.
Zhang, Hai-Fang; Hua, Hai-Yong; Wang, Wei
Ocular toxocariasis is caused by migration of a Toxocara larva through the posterior eye. We report the first case of pediatric ocular toxocariasis caused by T. canis in Jiangsu Province, eastern China. A 6-year-old girl presented to Suzhou Municipal Children's Hospital with a complaint of right eye redness, minimal white discharge, no photophobia, eye pain, visual impairment, fever or arthralgia. She was initially diagnosed as having conjunctivitis; however, a 2-month treatment with lomefloxacin 0.3% eye drops gave no improvements. The diagnosis was made based on medical history (contact with dogs), clinical features and detection of T. canis IgG antibodies with an enzyme-linked immunosorbent assay (ELISA). Anthelmintic therapy with albendazole in combination with prednisolone resulted in improvement of the ocular symptoms. Ocular toxocariasis is rarely reported in China. However, the rapid economic development in China, could mean an increase in pet dogs with the potential increased risk of contracting toxocariasis if no control measures are taken. Disposal of pet litter, deworming of infected pets, complete cooking of meats, thorough rinsing of fruits and vegetables, and good hand-washing may help prevent human infections. Ocular toxocariasis should be considered in the differential diagnosis of patients with conjunctivitis that does not resolve with treatment.
Cromwell, R. L.; Zanello, S. B.; Yarbough, P. O.; Taibbi, G.; Vizzeri, G.
/D) ratio. For all measures, there was no significant difference between subject groups for pre-bed rest testing. Post bed rest values also remained similar between groups. Comparison of pre- to post bed rest testing within each group did not demonstrate any statistical differences. These preliminary results from 14-day bed rest studies suggest that the combination of exercise and horizontal bed rest as compared to 6 degrees HDT bed rest did not produce differences in the ocular response with regard to IOP and optic disc parameters. The ocular measures reported here only included pre- and post bed rest time points. Further investigation is needed to examine both the acute response and long term adaptation of structural and functional ocular parameters in the bed rest platform and determine its usefulness for studying spaceflight phenomena. From a clinical perspective, the ability to study ocular responses in the controlled environment of the bed rest platform can provide valuable information for the care of patients restricted to bed rest.
Tenkate, Thomas D
I read with interest a recent paper in your journal by Slagor et al on the risk of cataract in relation to metal arc welding (1). The authors highlight that even though welders are exposed to substantial levels of ultraviolet radiation (UVR), "no studies have reported data on how much UVR welders' eyes are exposed to during a working day. Thus, we do not know whether welders are more or less exposed to UVR than outdoor workers" (1, p451). Undertaking accurate exposure assessment of UVR from welding arcs is difficult, however, two studies have reported ocular/facial UVR levels underneath welding helmets (2, 3). In the first paper, UVR levels were measured using polysulphone film dosimeters applied to the cheeks of a patient who suffered from severe facial dermatitis (2). UVR levels of four times the American Conference of Governmental Industrial Hygienists (ACGIH) maximum permissible exposure (MPE) (4) were measured on the workers left cheek and nine times the MPE on the right cheek. The authors concluded that the workers dermatitis was likely to have been due to the UVR exposure received during welding. In the other paper, a comprehensive exposure assessment of personal UVR exposure of workers in a welding environment was reported (3). The study was conducted at a metal fabrication workshop with participants being welders, boilermakers and non-welders (eg, supervisors, fitters, machinists). Polysulphone film dosimeters were again used to measure UVR exposure of the workers, with badges worn on the clothing of workers (in the chest area), on the exterior of welding helmets, attached to 11 locations on the inside of welding helmets, and on the bridge and side-shields of safety spectacles. Dosimeters were also attached to surfaces throughout the workshop to measure ambient UVR levels. For welding subjects, mean 8-hour UVR doses within the welding helmets ranged from around 9 mJ/cm (2)(3×MPE) on the inside of the helmets to around 15 mJ/cm (2)(5×MPE) on the headband
Bang-hua YANG; Liang-fei HE; Lin LIN; Qian WANG
Ocular artifacts cause the main interfering signals within electroencephalogram (EEG) signal measurements. An adaptive filter based on reference signals from an electrooculogram (EOG) can reduce ocular interference, but collecting EOG signals during a long-term EEG recording is inconvenient and uncomfortable for the subject. To remove ocular artifacts from EEG in brain-computer interfaces (BCIs), a method named spatial constraint independent component analysis based recursive least squares (SCICA-RLS) is proposed. The method consists of two stages. In the first stage, independent component analysis (ICA) is used to decompose multiple EEG channels into an equal number of independent components (ICs). Ocular ICs are identified by an automatic artifact detection method based on kurtosis. Then empirical mode decomposition (EMD) is employed to remove any cerebral activity from the identified ocular ICs to obtain exact artifact ICs. In the second stage, first, SCICA applies exact artifact ICs obtained in the first stage as a constraint to extract artifact ICs from the given EEG signal. These extracted ICs are called spatial constraint ICs (SC-ICs). Then the RLS based adaptive filter uses SC-ICs as reference signals to reduce interference, which avoids the need for parallel EOG recordings. In addition, the proposed method has the ability of fast computation as it is not necessary for SCICA to identify all ICs like ICA. Based on the EEG data recorded from seven subjects, the new approach can lead to average classification accuracies of 3.3% and 12.6% higher than those of the standard ICA and raw EEG, respectively. In addition, the proposed method has 83.5% and 83.8% reduction in time-consumption compared with the standard ICA and ICA-RLS, respectively, which demonstrates a better and faster OA reduction.
Conclusions : Trauma is an important cause of childhood ocular morbidity in southern Iran. Playing with sharp objects is an important cause of ocular trauma in children, and most injuries can be prevented by careful supervision.
J. C. Zambrano
Full Text Available Los traumatismos faciales, en especial cuando se producen fracturas que comprometen la órbita, se relaciona en gran medida con daños de las estructuras blandas oculares y perioculares que pueden ser irreversibles. Por lo tanto, es imperativo sospechar y diagnosticar tempranamente las condiciones que ponen en riesgo el globo ocular y sus estructuras anexas y adyacentes para poder realizar un tratamiento temprano y efectivo y prevenir daños mayores. Presentamos una revisión del tema y el algoritmo de tratamiento utilizado en el Servicio de Cirugía Plástica del Hospital Universitario San Ignacio de Bogotá, Colombia, para detectar y tratar tempranamente lesiones oculares asociadas a los traumatismos faciales, potencialmente catastróficas para la función del ojo.Facial trauma, specially associated to fractures of the orbit, is related to a great extent of damages that can be irreversible to the ocular soft structures. Therefore it is imperative to suspect and to diagnose theese conditions that put in risk the ocular globe and its adjacent structures at an early stage, in order to be able to perform rapid and effective treatment to prevent greater damage. We present a review on the subject and the algorithm of treating used at the Service of Plastic Surgery of the Hospital San Ignacio, Bogotá, Colombia, for early detection and treatment of potentially catastrophic injuries to the eye, associated to the facial trauma.
Shivcharan L Chandravanshi
Full Text Available The Hutchinson-Gilford progeria (HGP syndrome is an extremely rare genetic condition characterized by an appearance of accelerated aging in children. The word progeria is derived from the Greek word progeros meaning ′prematurely old′. It is caused by de novo dominant mutation in the LMNA gene (gene map locus 1q21.2 and characterized by growth retardation and accelerated degenerative changes of the skin, musculoskeletal and cardiovascular systems. The most common ocular manifestations are prominent eyes, loss of eyebrows and eyelashes, and lagophthalmos. In the present case some additional ocular features such as horizontal narrowing of palpebral fissure, superior sulcus deformity, upper lid retraction, upper lid lag in down gaze, poor pupillary dilatation, were noted. In this case report, a 15-year-old Indian boy with some additional ocular manifestations of the HGP syndrome is described.
Theodoros Athanassios Papadopoulos
Full Text Available Purpose: To report an unusual case of multifocal bacterial keratitis that despite success-ful treatment caused chronic ocular hypertension. Methods: A 67-year-old woman with unilateral multifocal keratitis and no previous ocular pathology was admitted to our hospital. Corneal scrapings and conjunctival samples were obtained for culture and the patient received intensive therapy with fortified vancomycin and tobramycin eye drops. Results: The cultures demonstrated two strains of Staphylococcus epidermidis, one resistant to ciprofloxacin and both sensitive to vancomycin. Treatment was effective and gradually discontinued after total cessation of the inflammatory activity. During the follow-up period, the patient developed late and persistent ocular hypertension of unknown etiology, in absence of any detectable inflammation or complication, and received permanent antiglaucoma therapy. Conclusion: Differential diagnosis between fungal and bacterial infection is critical in cases of multifocal keratitis. Patients with multifocal bacterial keratitis may need intraocular pressure monitoring, even after complete infection healing.
Chandravanshi, Shivcharan L; Rawat, Ashok Kumar; Dwivedi, Prem Chand; Choudhary, Pankaj
The Hutchinson-Gilford progeria (HGP) syndrome is an extremely rare genetic condition characterized by an appearance of accelerated aging in children. The word progeria is derived from the Greek word progeros meaning ‘prematurely old’. It is caused by de novo dominant mutation in the LMNA gene (gene map locus 1q21.2) and characterized by growth retardation and accelerated degenerative changes of the skin, musculoskeletal and cardiovascular systems. The most common ocular manifestations are prominent eyes, loss of eyebrows and eyelashes, and lagophthalmos. In the present case some additional ocular features such as horizontal narrowing of palpebral fissure, superior sulcus deformity, upper lid retraction, upper lid lag in down gaze, poor pupillary dilatation, were noted. In this case report, a 15-year-old Indian boy with some additional ocular manifestations of the HGP syndrome is described. PMID:22011502
James B. Rose
Full Text Available Gelatin has been used for many years in pharmaceutical formulation, cell culture and tissue engineering on account of its excellent biocompatibility, ease of processing and availability at low cost. Over the last decade gelatin has been extensively evaluated for numerous ocular applications serving as cell-sheet carriers, bio-adhesives and bio-artificial grafts. These different applications naturally have diverse physical, chemical and biological requirements and this has prompted research into the modification of gelatin and its derivatives. The crosslinking of gelatin alone or in combination with natural or synthetic biopolymers has produced a variety of scaffolds that could be suitable for ocular applications. This review focuses on methods to crosslink gelatin-based materials and how the resulting materials have been applied in ocular tissue engineering. Critical discussion of recent innovations in tissue engineering and regenerative medicine will highlight future opportunities for gelatin-based materials in ophthalmology.
Huang, Caihong; Chen, Wensheng; Chen, Yongxiong; Liu, Zuguo
Benzalkonium chloride (BAC) is the most commonly used preservative in ophthalmic preparations.So far large bodies of clinical and experimental studies have shown that use of topical drugs containing BAC can induce a series of ocular surface diseases, such as apoptosis.However, recently, some clinical studies have shown that ocular toxicity in patients treated with eye drops containing BAC has not apparent correlated with BAC.Some scholars consider that the limitations of the research lead people to recognize the BAC toxicity exaggeratedly.Here we summarize numerous clinical and experimental studies of BAC in the past few years, and focus on reviewing recent researches of the toxic effect of BAC on ocular surface.
Full Text Available The ocular insert represents a significant advancement in the therapy of eye disease. Ocular inserts are defined as sterile, thin, multilayered, drug-impregnated, solid or semisolid consistency devices placed into the cul-de-sac or conjuctival sac, whose size and shape are especially designed for ophthalmic application. They are composed of a polymeric support that may or may not contain a drug. The drug can later be incorporated as dispersion or a solution in the polymeric support. They offer several advantages as increased ocular residence and sustained release of medication into the eye. The insert includes a body portion sized to position within a lachrymal canaliculus of the eyelid. The inserts are classified according to their solubility as insoluble, soluble, or bioerodible inserts. The release of drug from the insert depends upon the diffusion, osmosis, and bioerosion of the drug, and this article is an attempt to present a brief about this newer drug delivery system.
Nidhi Dinesh Sinha
Full Text Available Patients requiring treatment with custom ocular prosthesis are those who have lost ocular structures through orbital evisceration or orbital enucleation which was necessary as a surgical intervention for a congenital defect, pathology or an accident. The disfigurement associated with eye loss can cause significant physical and emotional disturbance. As iris placement is a technique sensitive procedure,visual assessment alone may not be accurate.The present article is an illustration of a case report of a lady chosen for a custom ocular prosthesis. The method described here uses a transparent grid template from which the iris is traced. An attempt is also made to mimick the shade and colour of the sclera in the wax pattern itself; using white paraffin wax. This gives an accurate registration of the position and alignment of iris disc assembly, giving a natural look.
Shima, Hiroshi; Hasegawa, Mitsuhiro; Tachibana, Osamu; Nomura, Motohiro; Yamashita, Junkoh; Ozaki, Yuzo; Kawai, Jun; Higuchi, Masanori; Kado, Hisashi
To investigate whether the ocular dominance affects laterality in the activity of the primary visual cortex, we examined the relationship between the ocular dominance and latency or dipole moment measured by checkerboard-pattern and magnetoencephalography in 11 right-handed healthy male participants. Participants with left-eye dominance showed a dipole moment of 21.5+/-6.1 nAm with left-eye stimulation and 16.1+/-3.6 nAm with right, whereas those with right-eye dominance showed a dipole moment of 18.0+/-5.2 and 21.5+/-2.7 nAm with left-eye and right-eye stimulation of the infero-medial quadrant visual field, respectively. Thus, the dipole moment was higher when the dominant eye was stimulated, which implies that ocular dominance is regulated by the ipsilateral occipital lobe.
Carlow, T J; Bicknell, J M
The disorders of ocular motility seen in association with brainstem or cerebellar disorders may point to rather specific anatomical or pathological correlations. Pontine gaze palsy reflects involvement of the pontine paramedian reticular formation. Internuclear ophthalmoplegia signifies a lesion in the medial longitudinal fasciculus. Skew deviation may result from a lesion anywhere in the posterior fossa. Ocular bobbing typically results from a pontine lesion. The Sylvian aqueduct syndrome is characteristic of involvement in the upper midbrain-pretectal region, usually a pinealoma. Cerebellar lesions may be manifested by gaze paresis, skew deviation, disturbances of saccadic or smooth pursuit movements, ocular myoclonus, or several characteristic forms of nystagmus. Familiarity with these disorders may be of great help to the physician dealing with a patient with a possible posterior fossa lesion.
Chandravanshi, Shivcharan L; Rawat, Ashok Kumar; Dwivedi, Prem Chand; Choudhary, Pankaj
The Hutchinson-Gilford progeria (HGP) syndrome is an extremely rare genetic condition characterized by an appearance of accelerated aging in children. The word progeria is derived from the Greek word progeros meaning 'prematurely old'. It is caused by de novo dominant mutation in the LMNA gene (gene map locus 1q21.2) and characterized by growth retardation and accelerated degenerative changes of the skin, musculoskeletal and cardiovascular systems. The most common ocular manifestations are prominent eyes, loss of eyebrows and eyelashes, and lagophthalmos. In the present case some additional ocular features such as horizontal narrowing of palpebral fissure, superior sulcus deformity, upper lid retraction, upper lid lag in down gaze, poor pupillary dilatation, were noted. In this case report, a 15-year-old Indian boy with some additional ocular manifestations of the HGP syndrome is described.
WANG Yan-qing; LI Qiu-ming
@@ The proliferation, differentiation and fibrosis of lens epithelia cells (LECs) is mainly responsible for posterior capsular opacification (PCO). From the primary culture of LECs to the culture of lens capsular bag, the models of posterior capsular opacification have been developed. At present, the most commonly used model is cell culture in medium with serum. But the culture in pure ocular tissue has not been reported. Therefore, we established a new model of posterior capsular opacification-culturing bovine lens capsular bag in pure ocular tissue to exclude the role of serum. Our study established a new culture method to investigate the proliferation,differentiation and apoptosis of lens epithelia cells in the aqueous humor with or without lens cortex and vitreous humor. The purpose of the study is to model posterior capsular opacification in vivo as closely as possible and to discuss the influence of ocular tissue on posterior capsular opacification.
Wei, Shihui; Li, Hongyang
Purpose IgG4-related ocular disease is a chronic systemic disease with lymphocyte abnormal. The lacrimal glands, extraocular muscles and infraorbital nerve were often involved which was often the first symptom of systemic disease. While ophthalmologists did not know this disease well. They usually misdiagnosed it as idiopathic inflammatory pseudotumor, thyroid-associated ophthalmopathy etc, which resulted in delayed treatments. Here pathogenesis, clinical features and treatment methods of IgG4-relative ocular disease were described in order to improve awareness of this ocular disease, reduce clinical misdiagnosis, improve disease prognosis and standardized treatment. As the incidence of this disease increased in recent years, it is very necessary to improve awareness of the disease for ophthalmologists.
Jafari, Alireza Keshtkar; Anvari, Faramarz; Ameri, Ahmad; Bozorgui, Shima; Shahverdi, Nooshin
Although the incidence of ocular trauma has been clearly described in developed countries, few published data are available on the epidemiology and the effects of parameters that can influence the incidence and severity of ocular injuries in Iran. The present study tried to determine epidemiological aspects of ocular traumatic injuries and evaluate their effects on different types of ocular injury. The case series included 1950 consecutive patients with acute ophthalmic trauma presented to the emergency ward of Farabi Hospital in Tehran. Information was collected by interviewing patients and having them fill in a questionnaire. The final diagnosis was made by a medical resident. If there was a difficulty or doubt in diagnosis or classification, confirmation of diagnosis was made by senior faculty. Ocular injuries were classified into globe and non-globe injuries according to the site of injury. Mechanical globe injuries were classified according to Birmingham Eye Trauma Terminology (BETT) into closed and open injuries. The mean age of patients was 28.8 ± 12.8 years; 87.6% were male. The most common causes of injury were work-related (49.0%) and chance events (42.0%). The most frequent ocular injury was globe injury (95.6%), including mechanical (77.6% closed and 5.9% open), chemical (7.6%), photic (2.3%) and thermal (2.2%) injuries. Non-globe injury also occurred in 10.8% of patients; both globe and non-globe injuries occurred in 6.5% of patients. The hospitalization rate in all patients was 8.8%. Previous history of eye trauma was significantly more common in the group with isolated globe injuries (P < 0.001). History of eye trauma is a risk factor for globe injuries and female gender is a risk factor only for non-globe injuries. These two factors may predict future eye injury and increase its risk by 5.2 and 1.6 times, respectively.
Full Text Available Context: Leukemias may present with, or be associated with ocular disorders. Aims: To determine the rates of ophthalmic disorders in adult patients with leukemia. Settings and Design: A prospective study of ocular disorders in adult patients with leukemia at the University of Benin Teaching Hospital, Benin City, Nigeria, between July 2004 and June 2008 was conducted. Methods and Materials: The patients were interviewed and examined by the authors and the ocular findings were recorded. Statistical analysis was performed using Instat GraphPad™ v2.05a statistical package software. The means, standard deviation, and the Kruskal-Wallis non parametric test were performed. Results: Forty-seven patients with leukemias were seen. Nineteen patients (40.4% had CLL, 14(29.8% had CML, 9(19.1% had AML and 5(10.6% had ALL. Seven patients (14.9% had ocular disorders due to leukemia. The ocular disorders due to the leukemia were proptosis in two patients (4.3%, retinopathy in one patient (2.1%, conjunctival infiltration in one patient (2.1%, periorbital edema in one patient (2.1%, retinal detachment in one patient (2.1%, and subconjunctival hemorrhage in one patient (2.1%. There was no significant difference in rate of the ocular disorders in the various types of leukemia (Kruskal-Wallis KW= 4.019; corrected for ties. P=0.2595. One patient (2.1% was blind from bilateral exudative retinal detachment while 1 patient (2.1% had monocular blindness from mature cataract. Conclusions: Ophthalmic disorders that are potentially blinding occur in leukemias. Ophthalmic evaluation is needed in these patients for early identification and treatment of blinding conditions.
Full Text Available The World Health Organization has declared tuberculosis (TB to be a global emergency, as it remains the most common single cause of morbidity and mortality worldwide. TB is caused by the acid-fast bacillus Mycobacterium tuberculosis and primarily affects the lungs [pulmonary TB (PTB]. It can also affect any other part of the body [extrapulmonary TB (EPTB]. It is estimated that 1.4% of patients with PTB will eventually develop ocular disease; however, in the majority of cases of ocular TB, PTB may not be documented. Ocular TB infection is usually a result of hematogenous spread during PTB or EPTB. Symptomatic disease most commonly develops after reactivation of dormant foci in the ocular tissue rather than being the manifestation of the initial infection. Immune-mediated ocular TB can occur due to hypersensitivity to M. tuberculosis antigens from a distant focus (such as lungs, despite the absence of the bacterium in the eye. The most common clinical presentation of intraocular inflammation (uveitis due to TB appears to be posterior uveitis, followed by anterior uveitis, panuveitis and intermediate uveitis. The absence of uniform diagnostic criteria for intraocular TB has led to confusion regarding its diagnosis and management. Recent studies on the clinical importance of purified protein derivative (PPD skin test, interferon-gamma release assays, chest computed tomography and polymerase chain reaction have provided a new approach to diagnosing ocular TB. This review series focuses on the clinical features, diagnostic techniques, diagnostic criteria, and treatment modalities in the light of recent literature. (Turk J Ophthalmol 2011; 41: 171-81
Full Text Available 【Abstract】Objective: Ocular trauma is a common cause of visual impairment and accounts for 38% to 52% of all patients presenting as ophthalmic accident and emer- gency cases to the hospital. The purpose of this study is to describe the pattern of ocular injuries that leads to hospital- ization in the elderly in Kashan, Iran. Methods: In the retrospective consecutive case series, a total of 94 geriatric patients (≥65 years who admitted and underwent management for ocular trauma from April 2001 to March 2011 at Matini Hospital of Kashan, the only center of eye surgery in the region of Kashan, were reviewed. The items include age, sex, injury mechanism, site and ex- tent of damage, presenting and final best corrected visual acuity at least 3 months after trauma, which were reviewed and analyzed with SPSS software. Results: During the 10 years, 94 eyes of 94 patients Chin J Traumatol 2013;16(6:347-350 with ocular trauma were included. Mean age of patients was (77.5±5.1 years (range 65 to 102 years. Male to female ratio was 2.76. The mechanism of ocular injury included sharp trauma in 56 patients (59.6% and blunt in 38 patients (40.4%. Trauma occurred mostly in males (69 patients, 73.4% and at the work place (38 patients, 40.4%. On admission the visual acuity in 50 patients (53.2% with damaged eyes was light perception to hand motion. While the final best corrected visual acuity in 36 patients (38.3% was better than hand motion. Conclusion: Ocular trauma is a serious cause of visual impairment in the elderly. Appropriate and timely manage- ment may improve their visual prognosis. Key words: Eye injuries; Aged; Visual acuity
Full Text Available PURPOSE: To determine the timing of spontaneous venous pulsation (SVP relative to the ocular circulatory cycle by using the movie tool of confocal scanning laser ophthalmoloscope. METHODS: A video recording of the fundus was obtained using a confocal scanning laser ophthalmoscope (Spectralis HRA, Heidelberg Engineering, Heidelberg, Germany at 8 frames/s in 47 eyes (15 glaucoma patients and 32 glaucoma suspects with visible pulsation of both the central retinal artery (CRA and vein (CRV. The timing of the maximum and minimum diameters of the CRA (CRA(max and CRAmin, respectively and CRV (CRV(max and CRV(min, respectively was identified during four pulse cycles. The interval between CRV(min and CRA(min, and between CRV(max and CRA(max was expressed as the number of frames and as a percentage of the ocular circulatory cycle. RESULTS: The ocular circulatory cycle (from one CRA(max to the next lasted 7.7 ± 1.0 frames (958.8 ± 127.2 ms, mean ± SD, with a mean pulse rate of 62.6 beats/min. The diameter of the CRA was increased for 2.4 ± 0.5 frames (301.9 ± 58.8 ms and decreased for 5.3 ± 0.9 frames (656.9 ± 113.5 ms. CRV(max occurred 1.0 ± 0.2 frames after CRA(max (equivalent to 13.0% of the ocular circulatory cycle, while CRV(min occurred 1.1 ± 0.4 frames after CRA(min (equivalent to 14.6% of the ocular circulatory cycle. CONCLUSIONS: During SVP, the diameter of the CRV began to decrease at early diastole, and the reduction persisted until early systole. This finding supports that CRV collapse occurs during ocular diastole.
Dawood Aghadoost; Mohammad Reza Fazel; Hamidreza Aghadoost; Nazilla Aghadoost
Objective:Ocular trauma is a common cause of visual impairment and accounts for 38％ to 52％ of all patients presenting as ophthalmic accident and emergency cases to the hospital.The purpose of this study is to describe the pattern of ocular injuries that leads to hospitalization in the elderly in Kashan,Iran.Methods:In the retrospective consecutive case series,a total of 94 geriatric patients (≥ 65 years) who admitted and underwent management for ocular trauma from April 2001 to March 2011 at Matini Hospital of Kashan,the only center of eye surgery in the region of Kashan,were reviewed.The items include age,sex,injury mechanism,site and extent of damage,presenting and final best corrected visual acuity at least 3 months after trauma,which were reviewed and analyzed with SPSS software.Results:During the 10 years,94 eyes of 94 patients with ocular trauma were included.Mean age of patients was (77.5±5.1) years (range 65 to 102 years).Male to female ratio was 2.76.The mechanism of ocular injury included sharp trauma in 56 patients (59.6％) and blunt in 38 patients (40.4％).Trauma occurred mostly in males (69 patients,73.4％) and at the work place (38 patients,40.4％).On admission the visual acuity in 50 patients (53.2％) with damaged eyes was light perception to hand motion.While the final best corrected visual acuity in 36 patients (38.3％) was better than hand motion.Conclusion:Ocular trauma is a serious cause of visual impairment in the elderly.Appropriate and timely management may improve their visual prognosis.
Kofoed, Peter Kristian; Munch, Inger Christine; Larsen, Michael
Abstract. Purpose: To report the result of ranibizumab administration in an eye with ocular ischaemic syndrome. Methods: Fluorescein angiography, ocular pneumoplethysmography and retinal vessel calibre measurement. Results: An 85-year-old man with ocular ischaemic syndrome demonstrated vision loss......, retinal vessel calibre constriction and profound retinal ischaemia after intravitreal ranibizumab. Conclusion: We advise against the use of intravitreal vascular endothelial growth factor inhibitors in eyes with ocular ischaemic syndrome....
Ozaki, Yukihiro; Mizuno, Aritake
Two examples of Raman and FT-IR studies of the ocular tissues are reviewed in this paper. The first example treats Raman studies on cataract development cataract-related lens hydration and structural changes in the lens proteins monitored in situ by Raman spectroscopy are described. The second example is concerned with FT-IR studies on the ocular tissues contain ing collagen nondestructive identification of Type I and IV collagen in the tissues and their structural differences elucidated by infrared spectroscopy are discussed. 1 .
Firth, A Y
Aim: To highlight the changes that may take place in\\ud the visual system of the class A drug abuser.\\ud \\ud \\ud Methods: A literature review was carried out of\\ud ocular/visual sequelae of the more common class A\\ud drugs. These include stimulants (cocaine and crack\\ud cocaine), narcotics (heroin, morphine, methadone)\\ud and hallucinogenics (ecstasy, lysergic acid diethylamide,\\ud magic mushrooms, mescaline, phencyclidine).\\ud \\ud \\ud Results: Ocular sequelae affecting visual acuity, the\\ud ...
Wang, Jenny; Sramek, Christopher; Paulus, Yannis M.; Lavinsky, Daniel; Schuele, Georg; Anderson, Dan; Dewey, David; Palanker, Daniel V.
Application of femtosecond lasers to cataract surgery has added unprecedented precision and reproducibility but ocular safety limits for the procedure are not well-quantified. We present an analysis of safety during laser cataract surgery considering scanned patterns, reduced blood perfusion, and light scattering on residual bubbles formed during laser cutting. Experimental results for continuous-wave 1030 nm irradiation of the retina in rabbits are used to calibrate damage threshold temperatures and perfusion rate for our computational model of ocular heating. Using conservative estimates for each safety factor, we compute the limits of the laser settings for cataract surgery that optimize procedure speed within the limits of retinal safety.
Duarte, Marco António Gouveia
Introdução: O trauma ocular é uma importante causa de cegueira, reconhecida internacionalmente e sobre a qual não existem dados em Portugal. Afecta principalmente a população activa e dele advêm consequências económicas e sociais graves. Objectivos: Caracterizar, de uma forma retrospectiva, a epidemiologia e os factores de risco associados ao trauma ocular, admitidos no Serviço de Urgência dos Hospitais da Universidade de Coimbra no ano de 2009. Metodologia: Foram analisados 3698 regis...
Nara Lúcia Poli Botelho
ão fortalecidos. A prótese exerce dupla função, pois de um lado devolve ao paciente sua auto-imagem e auto-estima, possibilitando sua reintegração psicossocial, enquanto por outro lado, pode tornar-se um instrumento que afasta a possibilidade da perda ser vivenciada em sua totalidade, contribuindo para que esses indivíduos adotem atitudes de repressão diante da realidade instalada. Não há relação direta entre o resultado estético obtido com o grau de satisfação do paciente. O preconceito é outro fator importante, pois pode interferir ou não na reabilitação do sujeito, dependendo do comportamento que apresente diante da sociedade.PURPOSE: To evaluate psychological disturbances caused by acquired unilateral anophthalmia, the struggle for aesthetic recuperation on use of the ocular prosthesis, as well as involved interpersonal factors and psychosocial reintegration of these patients. METHOD: Thirty (30 patients with acquired unilateral anophthalmia without any other deformities in the orbital region and users of ocular prosthesis (16 males, 14 females aged between 12 and 66 years, mean age 31.6 years, were submitted to an ophthalmic examination and psychological evaluation through a standardized questionnaire focusing on 66 questions lasting two hours in the period from January, 2000 to March, 2001. RESULT: The highest incidence of acquired anophthalmia (47% was in the age ranging from 0 to 6 years old. Seventy (70% of the patients are in the process of elaboration of their loss (n=21. The most used mechanisms of defense in the current situation were rationalization, repression, denial and displacement. Thirty (30% accept the present situation. After the triggering event (TE 36% manifested a depressive state 64% of whom got over the symptoms of depression. Sixty percent (60% adapted the ocular prosthesis right after the surgical treatment while 40% adapted it two or more years after the TE. Aesthetically 70% are satisfied while 30% are unsatisfied. Fifty-three (53
M. Liset Rietman
Full Text Available The objective of this study was to identify new candidate genes involved in experience-dependent plasticity. To this aim, we combined previously obtained data from recombinant inbred BXD strains on ocular dominance (OD plasticity and gene expression levels in the neocortex. We validated our approach using a list of genes which alter OD plasticity when inactivated. The expression levels of one fifth of these genes correlated with the amount of OD plasticity. Moreover, the two genes with the highest relative inter-strain differences were among the correlated genes. This suggests that correlation between gene expression levels and OD plasticity is indeed likely to point to genes with a causal role in modulating or generating plasticity in the visual cortex. After this validation on known plasticity genes, we identified new candidate genes by a multi-step approach. First, a list was compiled of all genes of which the expression level in BXD strains correlate with the amount of OD plasticity. To narrow this list to the more promising candidates, we took its cross-section with a list of genes co-regulated with the sensitive period for OD plasticity and a list of genes associated with pathways implicated in OD plasticity. This analysis resulted in a list of 32 candidate genes. The list contained unproven, but not surprising, candidates, such as the genes for IGF-1, NCAM1, NOGO-A, the gamma2 subunit of the GABA(A receptor, acetylcholine esterase and the catalytic subunit of cAMP-dependent protein kinase A. This was indicative of the viability of our approach, but more interesting were the novel candidate genes: Akap7, Akt1, Camk2d, Cckbr, Cd44, Crim1, Ctdsp2, Dnajc5, Gnai1, Itpka, Mapk8, Nbea, Nfatc3, Nlk, Npy5r, Phf21a, Phip, Ppm1l, Ppp1r1b, Rbbp4, Slc1a3, Slit2, Socs2, Spock3, St8sia1, Zfp207. The possible role of some of these candidates is discussed in the article.
J. Goumans (Janine); M. Houben (Mark); J. Dits (Joyce); J. van der Steen (Hans)
textabstractThe three-dimensional vestibulo-ocular reflex (3D VOR) ideally generates compensatory ocular rotations not only with a magnitude equal and opposite to the head rotation but also about an axis that is collinear with the head rotation axis. Vestibulo-ocular responses only partially fulfill
Goumans, J.; Houben, M.M.J.; Dits, J.; Steen, J. van der
The three-dimensional vestibulo-ocular reflex (3D VOR) ideally generates compensatory ocular rotations not only with a magnitude equal and opposite to the head rotation but also about an axis that is collinear with the head rotation axis. Vestibulo-ocular responses only partially fulfill this ideal
J. Goumans (Janine); M. Houben (Mark); J. Dits (Joyce); J. van der Steen (Johannes)
textabstractThe three-dimensional vestibulo-ocular reflex (3D VOR) ideally generates compensatory ocular rotations not only with a magnitude equal and opposite to the head rotation but also about an axis that is collinear with the head rotation axis. Vestibulo-ocular responses only partially fulfill
W.P.A. Kelders (Willem)
textabstractThe cervico-ocular reflex (COR) is an ocular stabilization reflex that is elicited by rotation of the neck. It works in conjunction with the vestibulo-ocular reflex (VOR) and the optokinetic reflex (OKR) in order to prevent visual slip over the retina due to self motion. The VOR
W.P.A. Kelders (Willem); G.J. Kleinrensink (Gert Jan); J.N. van der Geest (Jos); L. Feenstra (Louw); C.I. de Zeeuw (Chris); M.A. Frens (Maarten)
textabstractThe cervico-ocular reflex (COR) is an ocular stabilization reflex that is elicited by rotation of the neck. It works in conjunction with the vestibulo-ocular reflex (VOR) and the optokinetic reflex (OKR) in order to prevent visual slip over the retina due to self-motion
Moore, Steven T; Cohen, Bernard; Raphan, Theodore; Berthoz, Alain; Clément, Gilles
On Earth, eye velocity of horizontal optokinetic nystagmus (OKN) orients to gravito-inertial acceleration (GIA), the sum of linear accelerations acting on the head and body. We determined whether adaptation to micro-gravity altered this orientation and whether ocular pursuit exhibited similar properties. Eye movements of four astronauts were recorded with three-dimensional video-oculography. Optokinetic stimuli were stripes moving horizontally, vertically, and obliquely at 30 degrees/s. Ocular pursuit was produced by a spot moving horizontally or vertically at 20 degrees/s. Subjects were either stationary or were centrifuged during OKN with 1 or 0.5 g of interaural or dorsoventral centripetal linear acceleration. Average eye position during OKN (the beating field) moved into the quick-phase direction by 10 degrees during lateral and upward field movement in all conditions. The beating field did not shift up during downward OKN on Earth, but there was a strong upward movement of the beating field (9 degrees) during downward OKN in the absence of gravity; this likely represents an adaptation to the lack of a vertical 1-g bias in-flight. The horizontal OKN velocity axis tilted 9 degrees in the roll plane toward the GIA during interaural centrifugation, both on Earth and in space. During oblique OKN, the velocity vector tilted towards the GIA in the roll plane when there was a disparity between the direction of stripe motion and the GIA, but not when the two were aligned. In contrast, dorsoventral acceleration tilted the horizontal OKN velocity vector 6 degrees in pitch away from the GIA. Roll tilts of the horizontal OKN velocity vector toward the GIA during interaural centrifugation are consistent with the orientation properties of velocity storage, but pitch tilts away from the GIA when centrifuged while supine are not. We speculate that visual suppression during OKN may have caused the velocity vector to tilt away from the GIA during dorsoventral centrifugation
Cabrera, Michelle T.; Winn, Bryan J.; Porco, Travis; Strominger, Zoe; Barkovich, A. James; Hoyt, Creig S.; Wakahiro, Mari; Sherr, Elliott H.
This study reports a large case series of children with Aicardi syndrome. A new severity scoring system is established to assess sidedness of ocular and brain lesions. Thirty-five children were recruited from Aicardi syndrome family conferences. All children received dilated ophthalmologic exams, and brain MRI’s were reviewed. Ocular and brain MRI Aicardi lesion severity scores were devised. A linear mixed model was used to compare each side for the ocular and brain MRI severity scores of Aicardi associated disease. Twenty-six children met inclusion criteria for the study. All subjects were female, ages 3 months to 19 years. Rates per child of optic nerve coloboma, severe lacunae, and microphthalmos in one or both eyes (among those with complete fundus exams available) were 10/24 (42%), 8/22 (36%), and 7/26 (27%), respectively. Ocular and brain MRI asymmetry was found in 18% (4/22) and 58% (15/26) of subjects, respectively, with more right sided brain lesions than left (V=52, P=0.028). A significant correlation between sidedness of brain disease and microphthalmos was seen (T = 2.54, P = 0.02). This study substantiates the range and severity of Aicardi syndrome associated ophthalmologic and brain MRI lesions from prior smaller case series. PMID:21824560
Groen, E.L.; Bos, J.E.; Nacken, P.F.M.; Graaf, B. de
A new, automatic method for determination of human ocular torsion (OT) was devel-oped based on the tracking of iris patterns in digitized video images. Instead of quanti-fying OT by means of cross-correlation of circular iris samples, a procedure commonly applied, this new method automatically selec
Li, Xinyang; Guan, Cuntai; Zhang, Haihong; Ang, Kai Keng
Electrooculogram (EOG) artifact contamination is a common critical issue in general electroencephalogram (EEG) studies as well as in brain computer interface (BCI) research. It is especially challenging when dedicated EOG channels are unavailable or when there are very few EEG channels available for ICA-based ocular artifact removal. It is even more challenging to avoid loss of the signal of interest during the artifact correction process, where the signal of interest can be multiple magnitudes weaker than the artifact. To address these issues, we propose a novel discriminative ocular artifact correction approach for feature learning in EEG analysis.Without extra ocular movement measurements, the artifact is extracted from raw EEG data, which is totally automatic and requires no visual inspection of artifacts. Then, artifact correction is optimized jointly with feature extraction by maximizing oscillatory correlations between trials from the same class and minimizing them between trials from different classes. We evaluate this approach on a real world EEG data set comprising 68 subjects performing cognitive tasks. The results showed that the approach is capable of not only suppressing the artifact components but also improving the discriminative power of a classifier with statistical significance. We also demonstrate that the proposed method addresses the confounding issues induced by ocular movements in cognitive EEG study.
Full Text Available Primary open angle glaucoma (POAG is a multifactorial disease characterized by progressive retinal ganglion cell death and visual field loss. It is known that alterations in intraocular pressure (IOP, blood pressure (BP, and ocular perfusion pressure (OPP can play a significant role in the pathogenesis of the disease. Impaired autoregulatory capacity of ocular blood vessels may render tissues vulnerable to OPP changes and potentially harmful tissue ischemia-reperfusion damage. Vascular risk factors should be considered more important in a subgroup of patients with POAG, and especially in patients with normal tension glaucoma (NTG with evidence of unphysiological BP response. For example, reduction of BP during the nighttime has an influence on OPP, and increased circadian OPP fluctuation, which might stand for unstable ocular blood flow, has been found to be the consistent risk factor for NTG development and progression. Central visual field may be affected more severely than peripheral visual field in NTG patients with higher 24-hour fluctuation of OPP. This review will discuss the current understanding of allegedly major systemic and ocular hemodynamic risk factors for glaucoma including systemic hypertension, arterial stiffness, antihypertensive medication, exaggerated nocturnal hypotension, OPP, and autonomic dysregulation.
Maranhão, Eliana T; Maranhão-Filho, Péricles
The authors highlights the importance of the vestibulo-ocular reflex examination through the head impulse test as a diagnostic method for vestibular dysfunction as well as, and primarily, a bedside semiotic resource capable of differentiating between acute peripheral vestibulopathy and a cerebellar or brainstem infarction in emergency rooms.
Eleonora M. Lad
Conclusions and importance: To our knowledge, this is the first report of ophthalmological and ocular pathology observations in an EEE patient. Interestingly, the inflammatory findings in the retina are reminiscent of the central nervous system effects of EEE virus. These findings are relevant given the recent epidemic of microcephaly and ophthalmic complications secondary to another arboviral virus, the Zika virus.
Grech, Reuben; Cornish, Kurt Spiteri; Galvin, Patrick Leo; Grech, Stephan; Looby, Seamus; O’Hare, Alan; Mizzi, Adrian; Thornton, John; Brennan, Paul
Orbital pathology often presents a diagnostic challenge to the reporting radiologist. The aetiology is protean, and clinical input is therefore often necessary to narrow the differential diagnosis. With this manuscript, we provide a pictorial review of adult ocular and orbital pathology. PMID:24967016
Full Text Available PURPOSE: To describe the ocular manifestations of congenital rubella syndrome (CRS, a common cause of congenital cataracts in developing countries. METHODS: Retrospective analysis of case records of 46 sero-positive infants under 12 months of age who presented at Aravind Eye Hospital, Madurai between July 1993 and February 2001. The ocular and systemic examination details were recorded. RESULTS: Both eyes were affected in 41 (89% patients. Cataract was present in 81 (93.1% eyes; most of them were nuclear cataract (79, 97.5%. Other common ocular presentations included microphthalmos in 74 (85.1% eyes, iris abnormalities in 51 (58.6% eyes, and pigmentary retinopathy in 33 (37.9% eyes. Cataract, microphthalmos and iris hypoplasia was a common combination present in 49 (56.3% eyes. Systemic manifestations included cardiac anomalies in 23 (50% and neurological anomalies in 16 (34% children. Multi-system involvement was present in 32 (70% children. Low birth weight (below 2 kg was seen in 30% infants. CONCLUSION: CRS may present with a wide spectrum of ocular and systemic findings and requires a high index of suspicion for diagnosis. Any sick infant with unilateral or bilateral congenital cataract should be investigated thoroughly for CRS.
Rushood, A A; Azmat, S; Shariq, M; Khamis, A; Lakho, K A; Jadoon, M Z; Sial, N; Rushood, A A; Kamil, E A
From December 2005 to June 2007, a total screening of all 1418 government primary schools in Khartoum State, Sudan, was performed to estimate ocular problems among children aged 6-15 years. We screened 671,119 children (56.7% males) for significant refractive error and other eye ailments. Ocular problems were found in 20,321 (3.03%) children. The 3 localities with highest ocular pathology were Karary (26.2%), Ummbada (21.0%) and Jabal Awlia (15.7%). The overall prevalence of refractive error was 2.19%. Myopia was found in 10,064 (1.50%) children while 4661 (0.70%) were hyperopic. Other ocular problems included vernal keratoconjunctivitis, vitamin A deficiency, microbial conjunctivitis, strabismus and corneal opacity. Only 288 (0.04%) children were diagnosed with active trachoma: 86.5% of these were from Ummbada locality, on the periphery ofthe State, where transportation facilities are poor and poverty is widespread. Overall, 99% of the eye ailments identified are either treatable or preventable. To reduce these and to achieve the goals of Vision 2020, an effective and efficient school health programme is needed.
Badhu, Badri P; Bhattarai, Balkrishna; Sangraula, Himal P
The objective of this study was to review the available literature on the drugs causing ocular hypertension and glaucoma. Electronic literature search was carried out using the Web sites www.pubmed.gov and www.google.com published through the year 2011. The search words were "drug induced ocular hypertension" and "drug induced glaucoma" used in combination. The articles published or translated into English were studied. Quite a significant number of drugs commonly prescribed by various physicians of different specialties can induce ocular hypertension or glaucoma. A brief account of various drugs that can induce ocular hypertension has been given in this article. Those drugs are parasympatholytics; steroids; anticholinergics, adrenergics, and antidepressants; cholinomimetics; antineoplastic agents; antipsychotic and antiparkinsonism agents; H1 and H2 receptor blockers; botulinum toxin, cardiac agents, and anticoagulants; silicone oil; sulfa drugs; and anesthetic agents. Rational use of these drugs and knowledge of their potential adverse effects can help prevent the devastating complications resulting in loss of vision and compromised quality of life.
Brémond-Gignac, D; Copin, H; Elmaleh, M; Milazzo, S
Congenital ocular malformations are uncommon and require prenatal diagnosis. Severe anomalies are more often detected by trained teams and minor anomalies are more difficult to identify and must be systematically sought, particularly when multiple malformations or a family and maternal history is known. The prenatal diagnosis-imaging tool most commonly used is ultrasound but it can be completed by magnetic resonance imaging (MRI), which contributes crucial information. Fetal dysmorphism can occur in various types of dysfunction and prenatal diagnosis must recognize fetal ocular anomalies. After systematic morphologic ultrasound imaging, different abnormalities detected by MRI are studied. Classical parameters such as binocular and interorbital measurements are used to detect hypotelorism and hypertelorism. Prenatal ocular anomalies such as cataract microphthalmia, anophthalmia, and coloboma have been described. Fetal MRI added to prenatal sonography is essential in detecting cerebral and general anomalies and can give more information on the size and morphology of the eyeball. Fetal abnormality detection includes a detailed family and maternal history, an amniotic fluid sample for karyotype, and other analyses for a better understanding of the images. Each pregnancy must be discussed with all specialists for genetic counseling. With severe malformations, termination of pregnancy is proposed because of risk of blindness and associated cerebral or systemic anomalies. Early prenatal diagnosis of ocular malformations can also detect associated abnormalities, taking congenital cataracts that need surgical treatment into account as early as possible. Finally, various associated syndromes need a pediatric check-up that could lead to emergency treatment.
Eliana T. Maranhão
Full Text Available The authors highlights the importance of the vestibulo-ocular reflex examination through the head impulse test as a diagnostic method for vestibular dysfunction as well as, and primarily, a bedside semiotic resource capable of differentiating between acute peripheral vestibulopathy and a cerebellar or brainstem infarction in emergency rooms.
Jean B Kassem
Full Text Available Ocular pulse amplitude (OPA is defined as the difference between maximum and minimum intraocular pressure (IOP during a cardiac cycle. Average values of OPA range from 1 to 4 mmHg. The purpose of this investigation is to determine the source of an irregular IOP waveform with elevated OPA in a 48-year-old male. Ocular pressure waveforms had an unusual shape consistent with early ventricular contraction. With a normal IOP, OPA was 9 mmHg, which is extraordinarily high. The subject was examined by a cardiologist and was determined to be in ventricular bigeminy. In addition, he had bounding carotid pulses and echocardiogram confirmed aortic insufficiency. After replacement of the aortic valve, the bigeminy resolved and the ocular pulse waveform became regular in appearance with an OPA of 1.6-2.0 mmHg. The ocular pressure waveform is a direct reflection of hemodynamics. Evaluating this waveform may provide an additional opportunity for screening subjects for cardiovascular anomalies and arrhythmias.
Virender S Sangwan
Full Text Available It has only been a quarter of a century since the discovery of adult stem cells at the human corneo-scleral limbus. These limbal stem cells are responsible for generating a constant and unending supply of corneal epithelial cells throughout life, thus maintaining a stable and uniformly refractive corneal surface. Establishing this hitherto unknown association between ocular surface disease and limbal dysfunction helped usher in therapeutic approaches that successfully addressed blinding conditions such as ocular burns, which were previously considered incurable. Subsequent advances in ocular surface biology through basic science research have translated into innovations that have made the surgical technique of limbal stem cell transplantation simpler and more predictable. This review recapitulates the basic biology of the limbus and the rationale and principles of limbal stem cell transplantation in ocular surface disease. An evidence-based algorithm is presented, which is tailored to clinical considerations such as laterality of affliction, severity of limbal damage and concurrent need for other procedures. Additionally, novel findings in the form of factors influencing the survival and function of limbal stem cells after transplantation and the possibility of substituting limbal cells with epithelial stem cells of other lineages is also discussed. Finally this review focuses on the future directions in which both basic science and clinical research in this field is headed.
Norel, J. van
This thesis investigates the accumulation of fluid in the yellow spot (macular edema) in ocular inflammation (uveitis). Macular edema may result in definitive loss of vision.Two methods of imaging of macular edema are fluorescein angiography (FA) and optical coherence tomography (OCT). The first met
Cattini, Stefano; Staurenghi, Giovanni; Gatti, Antonietta; Rovati, Luigi
Diffuse correlation spectroscopy (DCS) measurements in vivo recorded from rabbits' ocular fundus are presented. Despite the complexity of these ocular tissues, we provide a clear and simple demonstration of the DCS abilities to analyze variations in physiological quantities of clinical interest. Indeed, the reported experimental activities demonstrate that DCS can reveal both choroidal-flow and temperature variations and detect nano- and micro-aggregates in ocular fundus circulation. Such abilities can be of great interest both in fundamental research and practical clinical applications. The proposed measuring system can be useful in: (a) monitoring choroidal blood flow variations, (b) determining the end-point for photo-dynamic therapy and transpupillary thermo therapy and, (c) managing the dye injection and determining an end-point for dye-enhanced photothrombosis. Moreover, it could allow both diagnoses when the presence of nano- and micro-aggregates is related to specific diseases and verifying the effects of nanoparticle injection in nanomedicine. Even though the reported results demonstrate the applicability of DCS to investigate ocular fundus, a detailed and accurate investigation of the limits of detection is beyond the scope of this article.
Giblin, Jonathan P; Comes, Nuria; Strauss, Olaf; Gasull, Xavier
The eye is the sensory organ of vision. There, the retina transforms photons into electrical signals that are sent to higher brain areas to produce visual sensations. In the light path to the retina, different types of cells and tissues are involved in maintaining the transparency of avascular structures like the cornea or lens, while others, like the retinal pigment epithelium, have a critical role in the maintenance of photoreceptor function by regenerating the visual pigment. Here, we have reviewed the roles of different ion channels expressed in ocular tissues (cornea, conjunctiva and neurons innervating the ocular surface, lens, retina, retinal pigment epithelium, and the inflow and outflow systems of the aqueous humor) that are involved in ocular disease pathophysiologies and those whose deletion or pharmacological modulation leads to specific diseases of the eye. These include pathologies such as retinitis pigmentosa, macular degeneration, achromatopsia, glaucoma, cataracts, dry eye, or keratoconjunctivitis among others. Several disease-associated ion channels are potential targets for pharmacological intervention or other therapeutic approaches, thus highlighting the importance of these channels in ocular physiology and pathophysiology.
Itulescu, T C M; Alexandrescu, Cristina; Voinea, Liliana-Mary
Spondyloarthrites (SPA) represent a group of heterogenous rheumatic diseases (ankylosing spondylitis/SA, psoriatic arthritis/PsA, reactive arthritis/ReA, spondyloarthritis in bowel inflammatory diseases/BID, undifferentiated spondyloarthritis/undif SpA) with distinct clinical features and common genetic predisposition (HLA-B27). SpA may also affect other organs, ocular involvement, represented by uveitis and conjunctivitis, being one of the most important extraskeletal manifestations. Pathogenic mechanisms of ocular involment in SpA are not entirely known; nevertheless, the inflammatory process which characterizes the main rheumatic diseases seems to be responsible for this extraskeletal manifestation. SpA treatment targeted at clinical remission has a favourable effect not only on articular but also on ocular involvement. The discovery of new pathogenic mechanisms of both rheumatic and eye disease in SpA have contributed to identification of new pathogenic therapies. The interdisciplinary team work of rheumatologists and ophtalmologists have prove essential for the management of SpA patients with ocular manifestations.
Full Text Available BACKGROUND HIV/AIDS is a multi system disorder with ocular involvement is about 70-80% of HIV patient occupational exposure to HIV is a significant health hazard for the treating clinicians including Eye Surgeons. AIM To study and evaluation of ocular manifestation in HIV patients attending out patient. MATERIALS AND METHODS It is observational study of 104 HIV+ve cases for a period of 1 year those patients who attended ophthalmic out patient department. RESULTS 73 were males (70.19% and 31 were females (29.80%. Majority of the patients belongs to age group of 15-50 years. Out of 104 patients 83(79.80% were married and 21(20.20% were unmarried. HIV was predominantly seen in labourers 41(32.42%. The predominant mode of transmission of sexual (Hetero Sexual transmission. HIV infection was predominantly seen in uneducated patients 64(61.53%. Total No. of ocular findings in 51 cases out of 75 with anterior Uveitis, Conjunctival microvasculopathy, Herpes Simplex Keratitis and Conjunctivitis are the most common anterior segment manifestation. CMV retinitis, HIV Microvasculopathy are the most common posterior segment manifestation. CONCLUSIONS Ophthalmologists should be familiar with common and uncommon ocular manifestations of AIDS+ve cases and their diagnosis and treatment, as early and proper treatment can Salvage their vision and improve the quality of life.
Sędzikowska, Aleksandra; Osęka, Maciej; Grytner-Zięcina, Barbara
The purpose of this study was to determine subjective ocular symptoms occurring in patients infested with Demodex. The number of Demodex mites in the obtained material that correlated with the appearance of ocular symptoms was estimated. The study material were eyelashes collected from 1499 patients. The material were observed under a light microscope. T-test, the logistic regression method, and Pearson correlation coefficient were used for the analysis. Demodex mites were detected in 47% patients. The mean ages of infected women and men were 64 and 59 years, respectively. 64% infected patients complained of one or more ophthalmological symptoms. The most commonly reported symptoms included itching (28%), redness of eyelids (21%), and watery eyes (15%). Positive correlation was found between itching, redness, pain, purulence or eyelash loss and the presence of Demodex. The mentioned symptoms increase the probability of Demodex infestation in a statistically significant manner (pDemodex was revealed by the study. The threshold average number of seven Demodex mites per eight collected eyelashes with which the risk of the occurrence of an ocular symptom increases significantly was defined. In patients with a low number of Demodex mites, symptoms may be absent. The risk of the occurrence of ocular symptom in patients with demodicosis increases with the increase in the average number of Demodex mites.
Nagao, Miki; Saito, Takashi; Doi, Shoichi; Hotta, Gou; Yamamoto, Masaki; Matsumura, Yasufumi; Matsushima, Aki; Ito, Yutaka; Takakura, Shunji; Ichiyama, Satoshi
Ocular candidiasis is a major complication of Candida bloodstream infection (BSI). This study was performed to reveal the clinical characteristics of ocular candidiasis. Of the 220 patients with Candida BSI, 204 cases received ophthalmology consultations between January 2005 and December 2011 at 2 teaching hospitals. Fifty-four (26.5%) cases had findings consistent with the diagnosis of ocular candidiasis. Of these 54 cases, 43 (79.6%) were diagnosed within 7 days after a positive blood culture. Among ocular candidiasis cases, more cases were due to Candida albicans (P =0.034 odds ratio [OR]; 3.68 95% confidence interval [CI] 1.11-12.2) and had higher β-d-glucan values (P = 0.001 OR; 9.99 95% CI 2.60-21.3). We need to consider fundoscopic examination to be performed within the first 7 days of therapy, especially for those patients who have C. albicans BSIs and higher β-d-glucan values. Additionally, follow-up fundoscopic examination should be considered before stopping therapy for high-risk patients.
Full Text Available Cheryl A Arcinue,1,2 Khayyam Durrani,1–3 Pichaporn Artornsombudh,1,2 Alaa Radwan,1,2 Ravi Parikh,1,2 Ana M Suelves,1,2 Sana S Siddique,1,2 Ian Chang,1,2 Janine M Preble,1,2 Charles Stephen Foster1–3 1Massachusetts Eye Research and Surgery Institution, 2Ocular Immunology and Uveitis Foundation, Cambridge, 3Department of Ophthalmology, Harvard Medical School, Boston, MA, USA Objective: To evaluate the efficacy and safety of adalimumab in the management of ocular inflammation at our institution. Methods: We performed a review of all patients with active ocular inflammation treated with adalimumab at our institution. Results: Seventy eyes of 49 patients were reviewed. The mean duration of follow-up was 19.6 months. Therapy with an average of 2.1 immunomodulatory agents had been attempted prior to adalimumab therapy. At 1-year follow-up, adalimumab was effective in achieving quiescence in 33 eyes (47%. The most common side effects were injection-site reactions, arthralgias, and nausea, occurring in two patients each. Adalimumab was discontinued due to side effects in 12 patients. Conclusion: These results suggest that adalimumab is an effective and safe therapeutic modality in ocular inflammation. Keywords: uveitis, biologic response modifier, TNF-α, adverse effects, therapeutic outcomes, scleritis, peripheral ulcerative keratitis
Groen, E.; Graaf, B. de; Bles, W.; Bos, J.E.
To assess a possible otolith contribution to effects observed following prolonged expo-sure to hyper gravity, we used video-oculography to measure ocular torsion during static and dynamic conditions of lateral body tilt (roll) before and after one hour of centrifugation with a Gx-load of 3G. Static
Full Text Available OSSN describes a spectrum of neoplastic lesions, originating from squamous epithelium ranging from simple dysplasia to invasive squamous cell carcinoma (SCC, involving the conjunctiva, limbus and the cornea. Impression cytology refers to the technique by which superficial layers of the ocular surface are removed through application of cellulose acetate filter material onto the ocular surface AIM: To Assess the Sensitivity of Impression Cytology in the Diagnosis of Ocular Surface Squamous Neoplasia Using Millipore Filter Paper. MATERIALS AND METHODS: This is a Prospective Observational and Interventional Study conducted at Sarojini Devi Eye Hospital and Gandhi Medical College/Hospital, Hyderabad. Study was conducted from July2013 to Feb2015 and included 50patients presenting with conjunctival mass at the limbus or on the conjunctiva Hospital ethics committee approval was obtained No financials involved in the study. RESULTS: A total of 50Excision biopsies of 50patients suspected for OSSN were performed there were 40 males and 10females Excision biopsy confirmed the Impression Cytology results in 44 cases. In 6 cases there was poor correlation among which 4cases showed mild dysplasia in Impression Cytology while HPE showed Invasive Squamous cell carcinoma in 2cases few dysplastic cells were noted in Impression cytology but HPE showed Carcinoma in situ. CONCLUSION: This study shows that Impression Cytology has a promising role in diagnosing Ocular Surface Squamous Neoplasia for its high positive predictive accuracy (95.65% compared with tissue histology.
Full Text Available PURPOSE: To evaluate and compare a stereo-biomicroscopic technique of ocular torsion measurement with fundus photographic technique. METHODS: This prospective masked observational study included 72 eyes of 36 consecutive subjects with normal ocular motility. The disc-foveal angle was measured by two masked investigators using a slitlamp stereo-biomicroscopic and fundus photographic technique. RESULTS: The mean age was 13.7 years (6 - 44 years, and 15 (41.6% were males. The average torsion using the slitlamp technique was 5.5 3.3o and 6.1 4.3o with fundus photographic technique. Clinical agreement between the two techniques for 5o and 6o torsion was 81% and 90% respectively. The average difference between the two techniques was 3.0 2.6o. The mean inter-ocular difference was 3.3 2.7o (SD, 2.77 and 5.5 4.6o using the slitlamp and fundus photographic technique respectively. The Pearson correlation coefficient (r2 was 0.5 CONCLUSION: The fundus photographic technique remains the gold standard test for the measurement of ocular torsion. The slitlamp biomicroscopic method can be useful where a fundus camera is unavailable. Further studies are required to test the repeatability of these tests.
Full Text Available OBJETIVO: A prevalência de conjuntivite alérgica (CA não foi estabelecida. Estimativas sugerem que alergias oculares afetam de 15 a 20% da população mundial, ainda que a maioria dos estudos epidemiológicos abranjam sintomas de alergia nasal e ocular e não sejam específicos a respeito da CA. O objetivo deste estudo foi verificar a prevalência de sintomas, comorbidades e o impacto da alergia ocular em adolescentes. MÉTODOS: Os adolescentes foram selecionados de uma amostra de escolas e preencheram, em sala de aula, um questionário previamente validado sobre os sintomas da CA. O seu diagnóstico foi considerado quando mais de três episódios de prurido ocular foram relatados nos últimos 12 meses. Sintomas relacionados, como lacrimejamento, fotofobia, sensação de corpo estranho, impacto sobre as atividades diárias e diagnóstico de conjuntivite alérgica, foram analisados. RESULTADOS: Foram obtidos questionários de 3.120 adolescentes (média de 13,3±1,1 ano. Nos últimos 12 meses, 1.592 (51% adolescentes tiveram prurido ocular. O sintoma relacionado mais frequente foi lacrimejamento (74%, seguido de fotofobia (50,1% e sensação de corpo estranho (37,1%. A prevalência de conjuntivite alérgica foi de 20,7%, afetando mais pessoas do sexo feminino do que do masculino (56,1% em comparação a 45,9%; p = 0,01. O risco de um adolescente com alergia ocular apresentar asma, rinite e eczema atópico foi (RC = 5,7; IC de 95%: 4,5 a 7,1; (RC = 3,6; IC de 95%: 3,0 a 4,3 e (RC = 2,6; IC de 95%: 2,0 a 3,5, respectivamente. Uma interferência grave nas atividades diárias foi relatada por 30,5%. CONCLUSÕES: Sintomas de alergia ocular são comuns, frequentemente relacionados a outras doenças alérgicas, e causam impacto sobre as atividades diárias de adolescentes.
Full Text Available BACKGROUND Headache or cephalgia is one of the commonest symptoms causing pain in head above eyes or the ears, behind the head in the occipital region or in the back of the upper neck causing pain as well as disability to an individual. WHO reports around 47% of adults worldwide will have experienced headache in the last year. Headache maybe primary or secondary. Tension headache is more common type of primary headache. Almost, 90% of adults have tension headache and it is more common in females than males. Migraine headache is third most prevalent disorder worldwide and ranked as seventh highest cause of disability. Migraine headaches are the second most common type of primary headaches, whereas cluster headache, a relatively uncommon type of primary headache affecting less than 1 in every 1000 adults. 1 Many people suffer from mixed headache disorder in which tension headache or secondary headache may trigger migraine. Headache on 15 or more days in every month affects 1.7-4% of the world adult population. Hospital-based studies of migraine shows India is home over 16% of world inhabitants suffering from migraine. MATERIALS AND METHODS In our study, total screening of 1200 cases was done with headache symptomatology reported to Eye OPD directly as well as referred from ENT, Medical, NeuroMedical, Surgical, Neurosurgical, Psychiatry, Orthopaedics and Trauma Ward. A detailed clinical examination and ophthalmological examination was done in 1200 cases. RESULTS Sexual prevalence in our study indicated female with increased prevalence of 46.67% compared to male of 36%. Among 30 cases of migrainous headache with or without aura, the sexual prevalence in our study has female-to-male ratio as 2:1 (female - 20 cases and male - 10 cases. No cluster headache disorder was reported in our study. Among the tension headache presented with ocular manifestations like association of the refractive error, redness, burning sensation, the female prevalence among
Lu, Jing; Gu, Boyu; Wang, Xiaolin; Zhang, Yuhua
We present an adaptive optics parallel near-confocal scanning ophthalmoscope (AOPCSO) using a digital micromirror device (DMD). The imaging light is modulated to be a line of point sources by the DMD, illuminating the retina simultaneously. By using a high-speed line camera to acquire the image and using adaptive optics to compensate the ocular wave aberration, the AOPCSO can image the living human eye with cellular level resolution at the frame rate of 100 Hz. AOPCSO has been demonstrated with improved spatial resolution in imaging of the living human retina compared with adaptive optics line scan ophthalmoscopy.
María Cecilia Juri
Full Text Available El penfigoide cicatrizal ocular (PCO es una enfermedad ampollar autoinmune que produce daño conjuntival grave. Se conoce poco acerca de la respuesta del PCO al tratamiento inmunosupresor. Describimos un grupo de 76 pacientes con PCO, 62 mujeres y 14 hombres. La edad media al diagnóstico fue de 67 ± 14 años, con un retraso de 7.5 ± 10 años. Sesenta se siguieron en nuestro servicio por 19 ± 21 meses. De 51 en quienes se describe la gravedad de la enfermedad al inicio del tratamiento, fue leve en 19 pacientes, moderada en 19, grave en cinco y muy grave en ocho. Las drogas mayormente prescriptas fueron dapsona en 35 pacientes, de los que 23 la discontinuaron por efectos adversos, y metotrexate en 42, de los que nueve lo suspendieron. Otros recibieron azatioprina, ciclofosfamida y ciclosporina. A 17 se les indicaron corticoides orales, además del inmunosupresor. Cuatro combinaron dos drogas para controlar la enfermedad. Tres pacientes refractarios recibieron gammaglobulina EV con buena respuesta. De 48 evaluados, 39 mostraron mejoría, ocho no tuvieron cambios y uno progresó. En nuestra experiencia, metotrexate y azatioprina son efectivos, con baja toxicidad. Dapsona es útil en casos leves, con efectos adversos frecuentes. La gammaglobulina EV fue efectiva en casos refractarios.Ocular cicatricial pemphigoid (OCP is a blistering autoimmune disease that can produce severe conjunctival damage. Its response to immunosuppressive treatment is poorly known. We describe a group of 76 patients, 62 women and 14 men. Mean age at diagnosis was 67±14 years old, with a delay to diagnosis of 7.5±10 years. Sixty patients continued their follow up in our services for 19±21 months. Nineteen out of 51 had mild disease, 19 moderate, 5 severe and 8 very severe at onset of treatment. The more frequently prescribed drugs were dapsone, in 35 (23 discontinued it because of adverse effects, and methotrexate in 42 patients, nine of them stopped it. Other patients
Oray, Merih; Önal, Sumru; Koç Akbay, Aylin; Tuğal Tutkun, İlknur
Objectives: To describe ocular manifestations, diagnosis, and treatment of cat scratch disease. Materials and Methods: Clinical records of patients with ocular cat scratch disease were reviewed. Results: Thirteen eyes of 10 patients (7 female, 3 male) with a mean age of 26.9±18.5 years were included. Nine patients had a history of cat contact and had systemic symptoms associated with cat scratch disease 2-90 days prior to the ocular symptoms. Ocular signs were: neuroretinitis in 4 eyes (associated with serous retinal detachment in the inferior quadrant in 1 eye), optic neuropathy in 2 eyes (1 papillitis and optic disc infiltration, 1 optic neuritis), retinal infiltrates in 6 eyes, retinochoroiditis in 1 eye, branch retinal arteriolar occlusion in 3 eyes, and endophthalmitis in 1 eye. Visual acuities at presentation were 1.0 in 7 eyes, 0.3 in 1 eye, ≤0.1 in 4 eyes, and light perception in 1 eye. Bartonella henselae immunoglobulin (Ig) M and/or IgG were positive in all patients. Systemic antibiotic therapy was administered in all patients. Systemic corticosteroid treatment (15-40 mg/day) was added to the therapy in 4 patients, following 5 days of intravenous pulse methylprednisolone in 2 patients. Treatment was ongoing for 1 patient and the mean treatment duration of the other 9 patients was 47±14.5 days. Visual acuities at final visit were 1.0 in 9 eyes, 0.8 in 1 eye, 0.4 in 1 eye, and no light perception in 1 eye. Conclusion: Cat scratch disease may present with different ocular signs and should be considered in the differential diagnosis in patients with such presentations. PMID:28182175
Mustafa, Ms; Montgomery, J; Atta, Hr
Ocular ultrasound is now in increasing demand in routine ophthalmic clinical practice not only because it is noninvasive but also because of ever-advancing technology providing higher resolution imaging. It is however a difficult branch of ophthalmic investigations to grasp, as it requires a high skill level to interface with the technology and provide accurate interpretation of images for ophthalmic diagnosis and management. It is even more labor intensive to teach ocular ultrasound to another fellow clinician. One of the fundamental skills that proved difficult to learn and teach is the need for the examiner to "mentally convert" 2-dimensional B-scan images into 3-dimensional (3D) interpretations. An additional challenge is the requirement to carry out this task in real time. We have developed a novel approach to teach ocular ultrasound by using a novel 3D ocular model. A 3D virtual model is built using widely available, open source, software. The model is then used to generate movie clips simulating different movements and orientations of the scanner head. Using Blender, Quicktime motion clips are choreographed and collated into interactive quizzes and other pertinent pedagogical media. The process involves scripting motion vectors, rotation, and tracking of both the virtual stereo camera and the model. The resulting sequence is then rendered for twinned right- and left-eye views. Finally, the twinned views are synchronized and combined in a format compatible with the stereo projection apparatus. This new model will help the student with spatial awareness and allow for assimilation of this awareness into clinical practice. It will also help with grasping the nomenclature used in ocular ultrasound as well as helping with localization of lesions and obtaining the best possible images for echographic diagnosis, accurate measurements, and reporting.
Carlow, T J
An increased compendium of drugs useful in ocular motor system dysfunction has expanded our capacity to treat selected ocular motility disorders. Adjunctive therapeutic modes (e.g., Fresnel prisms and orthoptic exercises) can also be beneficial. PAN and see-saw nystagmus can be treated with baclofen. Downbeat nystagmus may respond to clonazepam therapy, and prisms may help if the nystagmus can be modified with convergence. Congenital nystagmus may respond minimally to drugs (e.g., baclofen), but prisms or surgical procedures, or both, are still the primary treatment modalities. Innovar may be helpful in patients with severe, incapacitating vestibular disorders, and scopolamine alone or in combination with promethazine may be beneficial in patients with milder ambulatory acute peripheral vestibular disorders. Benign positional vertigo is best treated initially with positional exercises before drug therapy is instituted. Opsoclonus and ocular flutter have been treated successfully with corticosteroids, propranolol, and clonazepam, while microflutter, an extremely rare disorder, can resolve with baclofen. Although therapy with carbamazepine, 5-hydroxtryptophan, and scopolamine has been useful in selected patients with ocular palatal myoclonus, most do not respond to drug treatment. It is not usually necessary to treat voluntary nystagmus, but Fresnel prism lenses should be remembered in refractory patients. Potentially reversible and pseudointernuclear ophthalmoplegias also were discussed. Orthoptic exercises can be beneficial in posttraumatic internuclear ophthalmoplegia. Selected supranuclear palsies can be improved completely with the proper drug regimen. Lastly, superior oblique myokymia can be treated successfully with carbamazepine, with tight surveillance for possible adverse side effects. Descriptive phenomenology and pathophysiological localization must be correlated with brain stem neurochemistry and neuropharmacology to medically treat additional ocular
Boadi-Kusi, Samuel Bert; Hansraj, Rekha; Kumi-Kyereme, Akwasi; Mashige, Khathutshelo Percy; Awusabo-Asare, Kofi; Ocansey, Stephen; Kyei, Samuel
Cocoa farming provides employment for over 800,000 households in rural Ghana, with the country currently touted as the second largest producer of cocoa worldwide. Agriculture is one of the riskiest occupations for the eyes due to the numerous ocular hazards on farms. The authors conducted an ocular health assessment among cocoa farmers at Mfuom, a rural community in the Central Region of Ghana, to examine the ocular health status and the ocular safety measures used by cocoa farmers. A structured questionnaire was used to evaluate demographic characteristics, ocular injuries, and utilization of eye care services and ocular protection, and a clinical examination was used to evaluate their ocular status. Cocoa farmers were at high risk for ocular injuries and farm-related vision disorders and utilized eye care services and ocular protection poorly. Ocular condition identified were mainly refractive error (28.6%), cataract (20.0%), glaucoma (11.7%), conjunctivitis (13%), pterygium (2.7%), and cornea opacity (2.2%). There is a need for the introduction of an interventional eye care program to help address the ocular health challenges identified among the farmers. This can be done through collaborative efforts by educational institutions, government, and other role players in the agricultural industry to improve the quality of life of the vulnerable cocoa farmers in rural Ghana.
Yungang Ding; Wenxin Zhang; Xiaohui Liu; Jianxian Lin; Jianliang Zheng; Yongping Li
Ocular pathology serves as one vital branch subject of histopathology, and also as a basic ocular science analysing the pathogenesis of eye disease,the regular pattern of disease progress,and ocular morphology,tissue metabolism and functional changes noted during the onset of ocular diseases.The underlying purpose lies in revealing and investigating the mechanism of such diseases and the nature of lesions,providing essential theoretical evidence to diagnosis and treatment of eye diseases.ocular pathology acts as a bridge connecting basic and clinical medical science1.Clinical ophthalmologists,especially junior house staff,should attach importance to ocular pathology,understand,be familiar with,and master basic knowledge in ocular pathological subject to cultivate sound clinical thinking and analytical ability and to improve comprehensive diagnosis and treatment efficacy in clinical setting.
Begeer, Sander; Dik, Marjolein; voor de Wind, Marieke J.; Asbrock, Doreen; Brambring, Michael; Kef, Sabina
Introduction: Delays in theory of mind (ToM) of children who are congenitally blind have often been attributed to the absence of visual and social experiences. However, these delays could also be partly due to neural factors. In some children, the blindness itself has neural causes (ocular-plus blindness). Children whose blindness has an…
Petersen, Kjell Yngve; Søndergaard, Karin; Kongshaug, Jesper
Adaptive Lighting Adaptive lighting is based on a partial automation of the possibilities to adjust the colour tone and brightness levels of light in order to adapt to people’s needs and desires. IT support is key to the technical developments that afford adaptive control systems. The possibilities...... offered by adaptive lighting control are created by the ways that the system components, the network and data flow can be coordinated through software so that the dynamic variations are controlled in ways that meaningfully adapt according to people’s situations and design intentions. This book discusses...... differently into an architectural body. We also examine what might occur when light is dynamic and able to change colour, intensity and direction, and when it is adaptive and can be brought into interaction with its surroundings. In short, what happens to an architectural space when artificial lighting ceases...
Jeffery, Nathan; Cox, Philip G
The spatial arrangement of the semicircular canals and extraocular muscles of the eye has been of considerable interest, particularly to researchers working on adaptations of the vestibulo-ocular reflex. Here we offer the first, extensive comparative analysis of the spatial relationships between each extraocular muscle and the canal providing its primary excitatory stimulus. The sample consisted of 113 specimens, representing 51 extant mammalian species. Hypotheses tested included that variations in the spatial alignments are linked with differences of skull morphology and with differences of agility during locomotion. Internal morphologies were visualized with magnetic resonance imaging and were measured with landmark-based vectors and planes. Values for body mass and agility were taken from the existing literature. Data were investigated for trends and associations with standard bivariate and multivariate statistical methods as well as with phylogenetically adjusted bivariate methods. The findings clearly show that species differences in the alignment of each extraocular muscle relative to the canal providing its primary excitatory stimulus are closely associated with changes of orbit morphology. The results also indicate that the actions of the oblique muscles interchange with those of the superior and inferior recti muscles when comparing lateral-eyed (rabbit) with frontal-eyed species (cat). There was only weak evidence to support the notion that canal-muscle alignments differ significantly among species according to how agile they are. The results suggest that semicircular canal morphology is arranged primarily for detecting head movements and then secondarily, if at all, for diminishing the burden of transforming vestibulo-ocular reflex signals in the most agile species.
Luciana Duarte Rodrigues
Full Text Available OBJETIVO: Descrever um caso de tumor vasoproliferativo associado à tuberculose ocular tratado com crioterapia e injeção de triancinolona intravítrea. DESENHO DO ESTUDO/PACIENTES E MÉTODOS: Relato de caso intervencional. Paciente do sexo feminino, 42 anos, referia inflamação do olho direito havia 1 ano, não diagnosticada, tratada com prednisona oral por 30 dias. Relatava baixa visão com o olho direito (OD desde a infância. Negava antecedentes pessoais e familiares. Ao exame ocular, apresentava acuidade visual menor que 20/400 com o OD. Não apresentava alterações à biomicroscopia e a pressão intra-ocular era normal em ambos os olhos. A fundoscopia do OD mostrava lesão vascularizada, elevada, associada ao descolamento seroso e exsudatos duros, localizada na periferia inferior da retina. A lesão era cercada por extensa área de pontos de hiperplasia do epitélio pigmentar. A mácula apresentava diminuição do reflexo foveal. No exame de ultra-som ocular, a lesão apresentava altura igual a 2,25mm e consistência sugestiva de lesão vascularizada. Foram solicitados exames sorológicos, hemograma, RX tórax e PPD. Os exames foram normais, com exceção do PPD, considerado forte reator. A paciente foi encaminhada ao infectologista, que diagnosticou tuberculose após exame de pesquisa de BK no escarro. Em face do quadro clínico, foi feito o diagnóstico de tumor vasoproliferativo da retina associado à tuberculose ocular presumida. Iniciou-se o tratamento com esquema tríplice (rifampicina, isoniazida e piridoxina. Optou-se por tratar o tumor com crioterapia e injeção intravítrea de triancinolona (4 mg/ml. Após 30 dias, a paciente apresentava diminuição do descolamento seroso e áreas atróficas na lesão tumoral. O aspecto angiofluoresceinográfico mostrava algumas áreas de enchimento precoce da trama vascular com discreto extravasamento tardio do contraste, sem áreas de oclusão capilar. A maior parte da lesão apresentava
Thygesen, John; Aaen, Kim; Theodorsen, F.;
ophthalmology, open-angle glaucoma, ocular hypertension, glaucoma therapy, latanoprost, timolol, Rose-Bengal test, break-up time, Schirmer-1-test, conjunctival impression cytology......ophthalmology, open-angle glaucoma, ocular hypertension, glaucoma therapy, latanoprost, timolol, Rose-Bengal test, break-up time, Schirmer-1-test, conjunctival impression cytology...
Cagnini Didier Q
Full Text Available Abstract Background Reports of neoplasms in Panthera species are increasing, but they are still an uncommon cause of disease and death in captive wild felids. The presence of two or more primary tumor in large felids is rarely reported, and there are no documented cases of ocular melanoma and mammary mucinous carcinoma in African lions. Case presentation An ocular melanoma and a mammary mucinous carcinoma are described in an African lion (Panthera leo. The first tumour was histologically characterized by the presence of epithelioid and fusiform melanocytes, while the latter was composed of mucus-producing cells with an epithelial phenotype that contained periodic acid-Schiff (PAS and Alcian blue staining mucins. Metastases of both tumor were identified in various organs and indirect immunohistochemistry was used to characterize them. Peribiliary cysts were observed in the liver. Conclusions This is the first description of these tumor in African lions.
Sen, D K; Sarin, G S
Serum levels of muramidase activity were measured in 162 patients with different ocular diseases and 84 healthy subjects by electro-immuno-diffusion technique. We demonstrated for the first time that electro-immuno-diffusion technique could be successfully applied for the estimation of serum muramidase concentrations. Serum muramidase was found to be high in significant number of cases with granulomatous uveitis, tuberculous keratitis, central serous retinopathy and Eales' disease. Tuberculosis was presumed to be the cause in them by the process of exlusion. Patients with high serum muramidase activity were subjected to anti-tubercular treatment with a marked clinical improvement. It is suggested that high serum muramidase could be an useful parameter in deciding the line of treatment in patients with ocular diseases of uncertain etiology. Serum muramidase concentrations showed return to normal levels with the clinical improvement of the diseases with treatment. It increased again with the re-appearance of the activity of the diseases.
N. H. Zavgorodnya
Full Text Available Aim. In case of retinal detachment atrophic processes lead to irreversible loss of functions within 4–6 days, it happens on underlying low ocular blood flow. In order to evaluate the degree of violation of regional hemodynamics in patients with retinal detachment two groups of patients were examined: the main group (52 patients with rhegmatogenous retinal detachment and the control group (24 myopic patients with lattice form of peripheral chorioretinal dystrophy. Methods and results. Doppler and reography results had been compared, significant decrease of blood flow in patients with retinal detachment was found. No differences between affected and fellow eye in these patients, close negative correlation between the level of ocular blood flow and the degree of myopia in the control group. Conclusion. This demonstrates the feasibility of actions to improve regional blood flow in patients operated on for retinal detachment.
Salman, Michael S
Infantile-onset saccade initiation delay, also known as congenital ocular motor apraxia, typically presents in early infancy with horizontal head thrusts once head control is achieved. Defective initiation of horizontal saccades and saccade hypometria with normal saccadic velocity are characteristic findings. Isolated impairment of vertical saccades is rare. Impaired smooth ocular pursuit may be seen. Other relatively common features include developmental delay, hypotonia, ataxia, or clumsiness. Brain MRI may be normal or show a diverse range of abnormalities, most commonly involving the cerebellum. Defective slow phases of the optokinetic response are commonly associated with brain MRI abnormalities. Isolated defect of vertical saccade initiation may indicate supratentorial brain abnormalities on MRI. Joubert syndrome, a developmental midbrain-hindbrain malformation, and ataxia telangiectasia are both commonly associated with defective volitional and reflexive saccade initiation, saccade hypometria, and head thrusts. Both horizontal and vertical saccades are impaired in these two disorders.
D.V. Singh, Yog Raj Sharma, R.V. Azad, Dinesh Talwar, Rajpal
Full Text Available This prospective study reveals the epidemiological profile of ocular trauma referred to a tertiary eyecentre over one year. All consecutive patients referred to Vitreo-retina service during 1 year periodwere examined.Out of total 523 eyes registered large proportion was 1 week after injury. The incidenceof intraocular foreign body and retinal detachment was 17.4, and 11.3% respectively. Diagnosis ofpost traumatic endophthalmitis was made in 20.5% of open globe injuries. Development ofendophthalmitis correlated with younger age, rural setting, illiteracy, presence of foreign body andlens disruption. Ocular trauma requiring tertiary care commonly affects young students, labourersand factory workers. Younger, rural and illiterate patients are more likely to develop infection especiallyif they have lens injury or intraocular foreign body.
Tsukahara, Naoki; Tani, Yuri; Kikuchi, Hideyuki; Sugita, Shoei
Differences in the ultraviolet (UV) cutoff of ocular media between birds and mammals have been revealed by spectrophotometric measurements of the transmission of light wavelengths by the cornea, lens and vitreous body in chickens, crows, quails, rats, rabbits and pigs. The light transmission values of the cornea were shown to be above 50% for wavelengths of 330-800 nm in birds, 300-800 nm in rat and 310-800 nm in mammals except for rat. For the lens, the light transmission values were shown to be above 50% for wavelengths of 320-800 nm in birds and rat and 390-800 nm in mammals except for rat. Thus, among the ocular media, the cornea in birds and the lens in mammals except for rat may play a role as a major UV cutoff filter.
Li, Longfei; Henshaw, W D; King-Smith, P E
Fluorescein is perhaps the most commonly used substance to visualize tear film thickness and dynamics; better understanding of this process aids understanding of dry eye syndrome which afflicts millions of people. We study a mathematical model for tear film flow, evaporation, solutal transport and fluorescence over the exposed ocular surface during the interblink. Transport of the fluorescein ion by fluid flow in the tear film affects the intensity of fluorescence via changes in concentration and tear film thickness. Evaporation causes increased osmolarity and potential irritation over the ocular surface; it also alters fluorescein concentration and thus fluorescence. Using thinning rates from in vivo measurements together with thin film equations for flow and transport of multiple solutes, we compute dynamic results for tear film quantities of interest. We compare our computed intensity distributions with in vivo observations. A number of experimental features are recovered by the model.
Ushizima, Daniela; Cuadros, Jorge
Automated analysis of ocular fundus images is a common procedure in countries as England, including both nonemergency examination and retinal screening of patients with diabetes mellitus. This involves digital image capture and transmission of the images to a digital reading center for evaluation and treatment referral. In collaboration with the Optometry Department, University of California, Berkeley, we have tested computer vision algorithms to segment vessels and lesions in ground-truth data (DRIVE database) and hundreds of images of non-macular centric and nonuniform illumination views of the eye fundus from EyePACS program. Methods under investigation involve mathematical morphology (Figure 1) for image enhancement and pattern matching. Recently, we have focused in more efficient techniques to model the ocular fundus vasculature (Figure 2), using deformable contours. Preliminary results show accurate segmentation of vessels and high level of true-positive microaneurysms.
Liu, Ke; Zou, Chang; Qin, Bo
Nuclear hormone receptors (NRs) are one of the most abundant transcription factors in the human cells. They regulate expression of genes via interactions with corresponding ligands, co-activators, and co-repressors. These molecular pathways play important roles in the development, cell differentiation, and physiologic and metabolic processes. Increasingly, targeting nuclear receptors is becoming a promising strategy for new drug development. The aim of this review is to discuss the association between nuclear receptors and eye development, and expand their role in various ocular diseases such as keratitis, cataract, glaucoma, uveitis, retinopathy, and ophthalmic tumors. Recent studies in this area are highlighted as well as future research directions and potential clinical applications. Finally, various strategies will be elucidated to inspire more targeted therapies for ocular diseases through the use of nuclear receptors.
@@ Sudden deafness is a commonly encountered otological disease. The etiology and pathogenesis are still unknown, and therefore no ideal treatment is available. In clinical, the disease is treated to recover the cellular functions by improving the microcirculation of the inner ear and nourishing the nerves. To seek a more effective method, we conducted a trial with ocular needling in 40 patients from May 1998 to April 2000. The therapeutic results were satisfactory as reported in the following.
Brennan, Rachel C. [St. Jude Children' s Research Hospital, Department of Oncology, Memphis, TN (United States); University of Tennessee Health Sciences Center, College of Medicine, Department of Ophthalmology, Memphis, TN (United States); University of Tennessee Health Sciences Center, College of Medicine, Department of Pediatrics, Memphis, TN (United States); Wilson, Matthew W. [St. Jude Children' s Research Hospital, Departments of Surgery and Pathology, Memphis, TN (United States); University of Tennessee Health Sciences Center, College of Medicine, Department of Ophthalmology, Memphis, TN (United States); Kaste, Sue; McCarville, M.B. [St. Jude Children' s Research Hospital, Department of Radiological Sciences, Memphis, TN (United States); University of Tennessee Health Sciences Center, College of Medicine, Department of Radiology, Memphis, TN (United States); Helton, Kathleen J. [St. Jude Children' s Research Hospital, Department of Radiological Sciences, Memphis, TN (United States)
We review our experience with unusual ocular pathologies, some mimicking retinoblastoma, that were referred to our institution during the past two decades. After presenting the imaging anatomy of the normal eye, we discuss pertinent clinical and pathological features, and illustrate the US and MRI appearance of retinoblastoma, medulloepithelioma, uveal melanoma, persistent fetal vasculature, Coats disease, corneal dermoid, retinal dysplasia and toxocara granuloma. Features useful in discriminating among these entities are emphasized. (orig.)
Full Text Available PURPOSE: To investigate the contribution of the individual ocular components, i.e. anterior chamber depth, lens thickness and vitreous chamber depth, to total axial length in patients with esotropic amblyopia. METHODS: The study population consisted of 74 children, aged between 5 and 8 years: thirty-seven patients with esotropic amblyopia and 37 healthy volunteers (control group. The participants underwent a comprehensive ophthalmological examination, including cycloplegic refraction and A-scan ultrasonography. Anterior chamber depth, lens thickness, vitreous chamber depth and total axial length were recorded. Paired Student's t-tests were used to compare biometric measurements between amblyopic eyes and their fellow eyes and between right and left eyes in the control group. To evaluate the contribution of the ocular components to the total axial length, we report the individual components as a percentage of total axial length. RESULTS: The comparison between amblyopic and fellow eyes regarding the individual contribution from ocular components to the total axial length revealed greater contribution from lens thickness (P=0.001 and smaller contribution from vitreous chamber depth (P=0.001 in amblyopic eyes, despite similar contribution from anterior chamber depth (P=0.434. The comparison between right and left eyes in the control group showed similar contributions from anterior chamber depth (P=0.620, lens thickness (P=0.721, and vitreous chamber depth (P=0.483. CONCLUSIONS: This study shows differences between amblyopic and non-amblyopic eyes when the total axial length is broken down into the individual contribution from the ocular components.
Karaçorlu, M A; Sürel, Z; Cakiner, T; Hanyaloğlu, E; Saylan, T; MAT, C.
Ocular complications of leprosy patients often develop insidiously and with few if any symptoms. This study involves measurement of the pupil cycle time (PCT) to evaluate the autonomic nerve system of the iris to determine the presence of subclinical intraocular involvement. The study included 19 lepromatous (LL), 19 borderline lepromatous (BL), and five borderline tuberculoid (BT) leprosy patients and involved 25 healthy volunteers, 10 patients with pulmonary tuberculosis and eight with Duhr...
Renan Albert Mendonça Rodrigues; Heloisa Moraes do Nascimento; Cristina Muccioli
Here we report the occurrence of pale yellowish perivascular preretinal dots in 12 patients with ocular syphilis. A case series of these patients was examined between March and October 2012 at the Uveitis Sector of Universidade Federal de São Paulo. After diagnostic confirmation of syphilis, fundus photographs and optical coherence tomography (OCT) were performed to verify the localization of the dots, and patients were treated with IV crystalline penicillin for 14 days. The study comprised 1...
Surov, Alexey; Behrmann, Curd; Koesling, Sabrina [Martin Luther University of Halle-Wittenberg, Department of Radiology, Halle (Germany); Holzhausen, Hans-Juergen [Martin Luther University of Halle-Wittenberg, Department of Pathology, Halle (Germany)
The involvement of extra-ocular muscles in malignant diseases has been described only sporadically. The purpose of this study was to estimate the prevalence of orbital muscle lymphoma and metastases and to analyse their radiological findings. In the time period from January 2000 to January 2010, 11 patients with extra-ocular muscle malignancies (EOMM) were retrospectively identified in the radiological database of our institution. There were four women and seven men with a median age of 58 years (range, 47 to 72 years). In three patients non-Hodgkin lymphoma (NHL), in seven cases intramuscular metastases of solid tumours and in one patient plasmacytoma of orbital muscles were diagnosed. In all, magnetic resonance imaging (MRI) was performed on 11 patients using a 1.5-T MRI scanner (Magnetom Vision Sonata Upgrade, Siemens, Germany). The diagnosis of EOMM was confirmed histopathologically by muscle biopsy in all cases. The prevalence of orbital muscle involvement in plasmacytoma was 0.3%, in NHL 0.4% and in carcinomas 0.1%. Clinically, EOMM presented as painless proptosis and motility disturbance. Medial and lateral rectus muscles were involved in most patients. On T2-weighted images, the lesions were isointense or mixed iso-to-hyperintense in comparison to the unaffected musculature. On T1-weighted images, all tumours were homogeneously isointense. After intravenous administration of contrast medium, most lesions showed moderate heterogeneous enhancement. Lymphomas and metastases are rare lesions of the extra-ocular musculature with a prevalence below 0.5%. Their radiological and clinical signs are non-specific and include painless muscle enlargement or masses. They should be considered in the differential diagnosis of diseases of extra-ocular muscles. (orig.)
Retinochoroiditis is the most common ocular manifestation of congenital toxoplasmosis, but other associated ophthalmological pathologies can also occur. Ophthalmologists are rarely able to distinguish between toxoplasmic retinochoroiditis due to infection acquired before or after birth, unless other clinical or serological indications are present. This article reports a case of a 3-year-old boy with abnormalities suggestive of congenital toxoplasmosis. The clinical and complementary examinati...
Osaka, Miho; Ishikawa, Aoi; Yamada, Shigehito; Uwabe, Chigako; Imai, Hirohiko; Matsuda, Tetsuya; Yoneyama, Akio; Takeda, Tohoru; Takakuwa, Tetsuya
The present study aimed to describe the positional changes of the ocular organs during craniofacial development; moreover, we examined the relationships among the ocular organs and other internal structures. To do this, we traced the positions of the ocular organs in 56 human early fetal samples at different stages of development using high-resolution magnetic resonance imaging and phase-contrast X-ray computed tomography. The eyes were located on the lateral side in the ventral view at Carnegie stage (CS) 16, and then changed their positions medially during development. The eyes remained in the neurocranium until CS17. However, the eyes changed their positions medially and caudally in the viscerocranium after CS18. The positional relationship between the eyes and pituitary gland changed in the lateral view as development progressed. Specifically, they were close to each other at CS17, but moved apart during the later stages of development. These positional changes were also demonstrated quantitatively with morphometric analyses. Based on the present data, the positional changes of the eyes can be categorized into phases, as follows: phase 1, dramatic positional changes (early fetal period until CS23); and phase 2, mild positional changes (stabilized; early fetal period after CS23). Notably, all absolute lengths measured in the present study linearly increased as the crown-rump length increased irrespective of the phase, while features of the measured angles and ratios differentially changed in phases 1 and 2. The present data may help improve our understanding of both the normal and abnormal development of the ocular organs and craniofacial area. This article is protected by copyright. All rights reserved.
In Vivo Release Study 13 C.3. Instrumental Analysis 15 C.3. 1. High Performance Liquid Chromatography ( HPLC ) 15 C.3.2 Fourier Transform Infrared (FTIR...Release Study and Selection of One Gel-Forming System 16 D.2. Main In Vitro Release Studies 17 D.2. 1. Development of the HPLC Analytical Protocol of...a carrier for ocular delivery of 5-fluorouracil and mitomycin C in glaucoma filtering surgery (Merkli et al, 1993, 1994). To assess the
Jing-Xue; Zhang; Ning-Li; Wang; Qing-Jun; Lu
Retinal degenerative diseases pose a serious threat to eye health, but there is currently no effective treatment available. Recent years have witnessed rapid development of several cutting-edge technologies, such as gene therapy, stem cell therapy, and tissue engineering. Due to the special features of ocular structure, some of these technologies have been translated into ophthalmological clinic practice with fruitful achievements, setting a good example for other fields. This paper reviews the development of the gene and stem cell therapies in ophthalmology.
National Aeronautics and Space Administration — Advanced Diagnostics and Prognostics Testbed (ADAPT) Project Lead: Scott Poll Subject Fault diagnosis in electrical power systems Description The Advanced...
Full Text Available Prosthesis is an artificial substitute that is implanted into, or integrated onto a human body part to replace the missing natural organ, for the purpose of restoring a specific function or a group of related functions so that the patient may return to normal life as quickly as possible. The replaced function doesn’t necessarily have to be related to life support, but often is. The agony overthe loss of a body part such as an eye, ear, nose or a finger has a crippling effect on the psychology and behavior of a person. Prosthesis is probably the only alternative in such cases to help and rehabilitate such patients. Fabricating an ocular prosthesis in heat-polymerizing acrylic resin material(resin requiring external heat for curing for an ocular defect is undoubtedly a challenging attempt as we have to replace a vital organ with an artificial prosthesis so as to improve the psychological and social well being of the patient. A case of a patient treated with custom-made ocular prosthesis is presented here.
Messina, Maria Francesca; Valenzise, Mariella; Aversa, Salvatore; Arrigo, Teresa; De Luca, Filippo
A boy aged 7.6 years presented to our Unit of Paediatric Endocrinology for evaluation of obesity. Progressive weight gain (10 kg) started 6 months earlier after an accidental penetrating orbital injury on the right eye. During this period the child has been treated with oral betamethasone (0.5 mg/day) for 1 month and dexamethasone 2% ocular drops (2 hourly by day) for 6 months. Physical examination showed he was 113.5 cm in height (-1.5 SD), weight 36.0 kg, blood pressure 110/90 mmHg (90th centile), body mass index 28 (+5 SD), truncal obesity, buffalo hump, "moon-face", increased lanugo hair and supraclavicular fullness. Endocrinological work-up revealed undetectable levels of basal adrenocorticotropic hormone (ACTH), basal and ACTH-stimulated cortisol and 24 h urine excretion cortisol, confirming the diagnosis of iatrogenic Cushing syndrome. The abrupt withdrawal of ocular glucocorticoids by the parents evoked two adrenal crises; 4 months later the patient recovered. In conclusion, we would alert doctors that every formulation of glucocorticoids, no ocular drops excluded, can determine severe systemic side effects and iatrogenic Cushing syndrome.
Rodrigues da Silva, Gisele [Federal University of Sao Joao Del Rei, School of Pharmacy, Divinopolis, Minas Gerais (Brazil); Silva-Cunha, Armando da [Federal University of Minas Gerais, School of Pharmacy, Belo Horizonte, Minas Gerais (Brazil); Behar-Cohen, Francine [INSERM, Physiopathology of ocular diseases: Therapeutic innovations, Institut des Cordeliers, Paris (France); Laboratoire d' Innovations Therapeutiques, Fondation Rothschild, Paris (France); Universite Rene Descartes, Hotel Dieu University Hospital, Paris (France); Ayres, Eliane [Federal University of Minas Gerais, Department of Metallurgical and Materials Engineering, Belo Horizonte, Minas Gerais (Brazil); Orefice, Rodrigo L., E-mail: email@example.com [Federal University of Minas Gerais, Department of Metallurgical and Materials Engineering, Belo Horizonte, Minas Gerais (Brazil)
The treatment of posterior segment ocular diseases, such as uveitis, by using eye drops and oral drugs is usually not effective due to the body's natural barriers to drug penetration. In this study, ocular implants to treat uveitis were synthesized by incorporating dexamethasone acetate, an important type of corticoid used in the treatment of some uveitis, into a biodegradable polyurethane containi clay nanoparticles. Biodegradable polyurethane nanocomposites having poly(caprolactone) oligomers as soft segments were obtained by delaminating clay particles within a polyurethane aqueous dispersion. The drug was incorporated into the polymer by dispersing it in the waterborne polyurethane followed by a drying step. Nanoparticles derived from clay were demonstrated to be able to tailor the mechanical properties of polyurethanes to achieve values that can match the properties of ocular soft tissues. Infrared spectra (FTIR) showed that the presence of clay particles was able to change the microphase separation process typical of polyurethanes. X-ray diffraction and small angle x-ray scattering (SAXS) results were explored to show that the incorporation of both dexamethasone acetate and nanocomponents derived from clay led to a less defined two-phase polyurethane. The presence of clay nanoparticles increased the rate of drug release measured in vitro. Human retinal pigment epithelial cells (ARPE-19) were cultured in contact with polyurethanes and polyurethane nanocomposites, and the viability of them (evaluated by using MTT assay after 7 days) showed that no toxic components were released from polyurethanes containing no drugs during the test.
Kuiper, J. J. W.; Beretta, L.; Nierkens, S.; van Leeuwen, R.; Ten Dam-van Loon, N. H.; Ossewaarde-van Norel, J.; Bartels, M. C.; de Groot-Mijnes, J. D. F.; Schellekens, P.; de Boer, J. H.; Radstake, T. R. D. J.
Retinal diseases generally are vision-threatening conditions that warrant appropriate clinical decision-making which currently solely dependents upon extensive clinical screening by specialized ophthalmologists. In the era where molecular assessment has improved dramatically, we aimed at the identification of biomarkers in 175 ocular fluids to classify four archetypical ocular conditions affecting the retina (age-related macular degeneration, idiopathic non-infectious uveitis, primary vitreoretinal lymphoma, and rhegmatogenous retinal detachment) with one single test. Unsupervised clustering of ocular proteins revealed a classification strikingly similar to the clinical phenotypes of each disease group studied. We developed and independently validated a parsimonious model based merely on three proteins; interleukin (IL)-10, IL-21, and angiotensin converting enzyme (ACE) that could correctly classify patients with an overall accuracy, sensitivity and specificity of respectively, 86.7%, 79.4% and 92.5%. Here, we provide proof-of-concept for molecular profiling as a diagnostic aid for ophthalmologists in the care for patients with retinal conditions.
Karnati, Roy; Talla, Venu; Peterson, Katherine; Laurie, Gordon W
Advantage may be taken of macroautophagy ('autophagy') to promote ocular health. Autophagy continually captures aged or damaged cellular material for lysosomal degradation and recyling. When autophagic flux is chronically elevated, or alternatively deficient, health suffers. Chronic elevation of flux and stress are the consequence of inflammatory cytokines or of dry eye tears but not normal tears invitro. Exogenous tear protein lacritin transiently accelerates flux to restore homeostasis invitro and corneal health invivo, and yet the monomeric active form of lacritin appears to be selectively deficient in dry eye. Tissue transglutaminase-dependent cross-linking of monomer decreases monomer quantity and monomer affinity for coreceptor syndecan-1 thereby abrogating activity. Tissue transglutaminase is elevated in dry eye. Mutation of arylsulfatase A, arylsulfatase B, ceroid-lipofuscinosis neuronal 3, mucolipin, or Niemann-Pick disease type C1 respectively underlie several diseases of apparently insufficient autophagic flux that affect the eye, including: metachromatic leukodystrophy, mucopolysaccharidosis type VI, juvenile-onset Batten disease, mucolipidosis IV, and Niemann-Pick type C associated with myelin sheath destruction of corneal sensory and ciliary nerves and of the optic nerve; corneal clouding, ocular hypertension, glaucoma and optic nerve atrophy; accumulation of 'ceroid-lipofuscin' in surface conjunctival cells, and in ganglion and neuronal cells; decreased visual acuity and retinal dystrophy; and neurodegeneration. For some, enzyme or gene replacement, or substrate reduction, therapy is proving to be successful. Here we discuss examples of restoring ocular surface homeostasis through alteration of autophagy, with particular attention to lacritin.
Full Text Available PURPOSE: To investigate the types and causes of non-tuberculous ocular infections and study their response to topical antibiotic therapy. METHOD: A single center, retrospective review of 18 patients with non-tuberculous mycobacterial ocular infections, seen over a 3 year period was done. Laboratory diagnosis was established by growth on blood agar, LJ medium and Ziehl-Nielsen acid fast stain. RESULTS: Out of 18 patients, six had post corneal graft infection, six had corneal ulcers, three had endogenous endophthalmitis, one had post operative endophthalmitis and two cases were of post surgical wound infection. History of trauma was reported in two cases and surgery in nine cases. M.chelonae was grown in blood agar for all patients. For corneal infections fortified genatmicin and fortified amikacin topical eye drops were given while the cases of endophthalmitis received intravitreal amikacin. Response to treatment was poor in 16 cases (88.9%. Only two cases of corneal ulcer improved after prolonged treatment. There was a misdiagnosis of Corynebacterium spp. on Gram stain in the initial cases. Majority of the isolates were sensitive to gentamicin (72.2% followed by amikacin (44.4%. CONCLUSIONS: Early clinical recognition and prompt laboratory diagnosis together with aggressive topical antibiotic therapy may shorten morbidity and improve the clinical outcome of non-tuberculous mycobacterial ocular infection.
Actis, Alessandro G; Rolle, Teresa
Ocular Surface Disease (OSD) is prevalent among medically treated patients with glaucoma. This is basically related to three key-points: OSD and glaucoma are both prevalent in elderly and are common comorbidities in the same patient; the role of the active ingredient of the medical antiglaucomatous therapy; the role of the preservative agent of this medical therapy. Considering the actual state of literature we can state that the active glaucoma agent have a role in OSD, but the main cause seems to be the preservative agent, in particular referring to benzalkonium chloride, BAK. In the clinical evaluation of dry eye patients there is no actually established gold standard. Since the ocular surface injury not only causes dry eye, red eye, eye itching, photophobia and other discomforts, but also increases the risk of failure of glaucoma surgery in patients, it becomes fundamental a complete and good clinical evaluation of OSD (considering Schirmer's test, tear breakup time, corneal and conjunctival staining) together with a good evaluation of patients' quality of life (with validated questionnaires). Development of complex preparations, preservative-free and/or novel preservative preparations for glaucoma therapy could provide a promising approach in the prevention of ocular surface injuries.
Al-Akily, Saleh A.; Bamashmus, Mahfouth A.
Objectives The objective of this study was to assess the ocular complications and visual loss among patients with severe vernal keratoconjunctivitis (VKC). Methods Four hundred and thirty-one patients with VKC seen at Ibn Al-Haitham Eye Center were the study group. This is a retrospective non-comparative observational study between 01 January 2002 and 31 December 2002. Visual acuity was measured with the standard Snellen visual acuity chart and for children under 5 years of age Kay pictures were used. Visual impairment was assessed by means of the World Health Organization criteria for visual disabilities. Cases with severe VKC that developed ocular complications leading to blindness and severe visual impairment were analyzed. Results The majority of VKC patients were males (75.9%) with a male:female ratio of 3.1:1. A total of 68 (15.7%) patients (54 boys and 14 girls) had severe VKC. The ocular findings among 20 patients with severe VKC that led to blindness and severe visual impairment included keratoconus (7); steroid-induced cataract (5), central corneal scars (5) and steroid-induced glaucoma (3). Two of the keratoconus cases developed acute hydrops. Conclusion Severe VKC in developing countries including Yemen is a potentially blinding disease. Visual loss may be due to keratoconus and corneal scars, as well as complications of the unsupervised use of topically administered corticosteroids. PMID:23960939
Nicholls, Stephen G; Oakley, Carmen L; Tan, Andrea; Vote, Brendan J
Demodex brevis and Demodex folliculorum are likely ubiquitous organisms associated with human eyelashes. However, they have also been implicated in the pathogenesis of external ocular diseases. This article reviews the current literature in regards to life cycle, morphology, pathogenesis and treatment of underlying Demodex spp. infestation and outlines the previously undescribed in vivo behaviour of the mites. Images were obtained from the epilation of lashes from 404 patients seen in clinical practice. Epilated lashes were placed on a microscope slide which had been coated with optically clear hypromellose/carbomer gel (Genteal gel, Novartis pharmaceuticals corporation, East Hanover, New Jersey). Adults were identified with either dark field or standard transmission microscopy at 40-100×. Eggs and other life-cycle stages were examined at 250× magnification, with transmission microscopy giving the best image resolution. The life cycle of the mite has been reviewed and simplified according to clinical observations. Clinical signs suggestive of underlying Demodex spp. infestation have been described, and their pathogenesis was explained based on the micrographic digital images obtained. The problem of symptomatic Demodex spp. disease likely reflects an imbalance in the external ocular ecology; however, the role of Demodex spp. as a commensal should not be overlooked. Treatment should not be aimed at total eradication of the mite but rather restoring the ocular ecology to a balanced state. By revisiting the life cycle of the mite, we can identify areas where possible intervention may be effective.
WANG Yu-lan; SHENG Yao-hua; YE Xiang-yu
Objective To compare ocular biometric values in angle closure glaucoma and cataract in senile population.Methods Ocular biometry was performed in eyes classified to have angle closure glaucoma (29 eyes) and senile cataract (31 eyes). Ocular biometry readings between two groups were compared and analyzed statistically. Intraocular pressure was also recorded before and after lens extraction.Results Anterior chamber depth was shallower in patients with angle closure glaucoma group [(1.79±0.56) mm] compared with senile cataract group [(2.69±0.40) mm] (P<0.01). Lens thickness was greater in angle closure glaucoma group [(5.30±0.61) mm] than that in senile cataract group [(3.84±0.61) mm] (P<0.01). Phacoemusification was performed in 5 patients with persistent acute attack of angle closure glaucoma. IOPs were controlled in all five cases after lens extraction.Conclusion Eyes with angle closure glaucoma seems to have significantly shallow anterior chamber and greater lens thickness compared to senile cataract eyes in the same age. Lens extraction might be effective in those cases with such anatomy features.
Kuiper, J. J. W.; Beretta, L.; Nierkens, S.; van Leeuwen, R.; ten Dam-van Loon, N. H.; Ossewaarde-van Norel, J.; Bartels, M. C.; de Groot-Mijnes, J. D. F.; Schellekens, P.; de Boer, J. H.; Radstake, T. R. D. J.
Retinal diseases generally are vision-threatening conditions that warrant appropriate clinical decision-making which currently solely dependents upon extensive clinical screening by specialized ophthalmologists. In the era where molecular assessment has improved dramatically, we aimed at the identification of biomarkers in 175 ocular fluids to classify four archetypical ocular conditions affecting the retina (age-related macular degeneration, idiopathic non-infectious uveitis, primary vitreoretinal lymphoma, and rhegmatogenous retinal detachment) with one single test. Unsupervised clustering of ocular proteins revealed a classification strikingly similar to the clinical phenotypes of each disease group studied. We developed and independently validated a parsimonious model based merely on three proteins; interleukin (IL)-10, IL-21, and angiotensin converting enzyme (ACE) that could correctly classify patients with an overall accuracy, sensitivity and specificity of respectively, 86.7%, 79.4% and 92.5%. Here, we provide proof-of-concept for molecular profiling as a diagnostic aid for ophthalmologists in the care for patients with retinal conditions. PMID:28128370
Full Text Available Mariko Itakura,1 Hirotaka Itakura,1,2 Tomoyuki Kashima,2 Hideo Akiyama,2 Shoji Kishi21Department of Ophthalmology, Maebashi Red Cross Hospital, Maebashi, Japan; 2Department of Ophthalmology, Gunma University, School of Medicine, Maebashi, JapanAbstract: Administration of topical rebamipide improves the ocular surface in dry eye. We consecutively studied seven eyes in seven cases (three males and four females with mild lagophthalmos (three cases after eyelid surgery, two cases of incomplete facial nerve palsy, and two cases of senile ectropion during the treatment of corneal disorders with rebamipide eye drops four times daily for 2 weeks. The fluorescein corneal staining (FCS score, tear film break-up time (TBUT, Schirmer's test, and decimal visual acuity were examined. Ocular symptoms were examined and scored by questioning each patient before and after administration of the drug. In all seven eyes, inferior corneal erosion decreased or disappeared within 2 weeks after administration of topical rebamipide. The FCS score was significantly improved (P < 0.05. The TBUT was significantly extended from 2.9 ± 0.5 seconds to 5.2 ± 0.4 seconds (P < 0.05. The scores of ocular symptoms, such as eye pain, dryness, blurred vision, and foreign body sensations, were significantly improved (P < 0.05.Topical rebamipide was effective for corneal disorders in mild lagophthalmos. This drug may provide a novel approach to treat lagophthalmos.Keywords: dry eye, ectropion, eyelid surgery, facial nerve palsy, lagophthalmos, rebamipide
González-Peñas, E; Aldana, I; Esteras, A; Bruseghini, L; Gazzaniga, A; Gianesello, W
Sodium diclofenac (DCF, CAS 1507-79-6) is a non-steroidal anti-inflammatory drug whose activity is mainly due to an inhibitory effect on the synthesis of the prostaglandins. At present, a tendency towards its topical use in the treatment of the inflammatory state of the anterior segment of the eye as an alternative to the steroid drugs is observed. The pharmacokinetics of DCF was studied in rabbits by assessing the ocular and systemic absorption of DCF after administering DCF eye drops. The chromatographic methods available were not sensitive enough to quantify the extremely low drug concentrations which appeared in the biological fluids after ocular treatment. For this reason, the concentrations of DCF in plasma and aqueous humor were evaluated by a coupled liquid chromatography/gas chromatography (LC/GC) method. DCF was absorbed well through the cornea with the aqueous humor concentration peak being 757.8 ng/ml at 120 min. This good ocular absorption of DCF was confirmed by the concentrations observed in plasma. The presence of tramazoline (TMZ, CAS 74195-73-6) in the eye drops increases the levels of DCF in aqueous humor.
Kathleen T Berg
Full Text Available Kathleen T Berg, Andrew R Harrison, Michael S LeeDepartment of Ophthalmology, University of Minnesota, Minneapolis, MN, USAAbstract: Incidence estimates for perioperative vision loss (POVL after nonocular surgery range from 0.013% for all surgeries up to 0.2% following spine surgery. The most common neuro-ophthalmologic causes of POVL are the ischemic optic neuropathies (ION, either anterior (AION or posterior (PION. We identified 111 case reports of AION following nonocular surgery in the literature, with most occurring after cardiac surgery, and 165 case reports of PION following nonocular surgery, with most occurring after spine surgery or radical neck dissection. There were an additional 526 cases of ION that did not specify if the diagnosis was AION or PION. We also identified 933 case reports of central retinal artery occlusion (CRAO, 33 cases of pituitary apoplexy, and 245 cases of cortical blindness following nonocular surgery. The incidence of POVL following ocular surgery appears to be much lower than that seen following nonocular surgery. We identified five cases in the literature of direct optic nerve trauma, 47 cases of AION, and five cases of PION following ocular surgery. The specific pathogenesis and risk factors underlying these neuro-ophthalmic complications remain unknown, and physicians should be alert to the potential for loss of vision in the postoperative period.Keywords: perioperative, postoperative, vision loss, ocular surgery, nonocular surgery
Wood, Scott J.; Clarke, A. H.; Rupert, A. H.; Harm, D. L.; Clement, G. R.
Two joint ESA-NASA studies are examining changes in otolith-ocular reflexes and motion perception following short duration space flights, and the operational implications of post-flight tilt-translation ambiguity for manual control performance. Vibrotactile feedback of tilt orientation is also being evaluated as a countermeasure to improve performance during a closed-loop nulling task. Data is currently being collected on astronaut subjects during 3 preflight sessions and during the first 8 days after Shuttle landings. Variable radius centrifugation is utilized to elicit otolith reflexes in the lateral plane without concordant roll canal cues. Unilateral centrifugation (400 deg/s, 3.5 cm radius) stimulates one otolith positioned off-axis while the opposite side is centered over the axis of rotation. During this paradigm, roll-tilt perception is measured using a subjective visual vertical task and ocular counter-rolling is obtained using binocular video-oculography. During a second paradigm (216 deg/s, less than 20 cm radius), the effects of stimulus frequency (0.15 - 0.6 Hz) are examined on eye movements and motion perception. A closed-loop nulling task is also performed with and without vibrotactile display feedback of chair radial position. Data collection is currently ongoing. Results to date suggest there is a trend for perceived tilt and translation amplitudes to be increased at the low and medium frequencies on landing day compared to pre-flight. Manual control performance is improved with vibrotactile feedback. One result of this study will be to characterize the variability (gain, asymmetry) in both otolith-ocular responses and motion perception during variable radius centrifugation, and measure the time course of post-flight recovery. This study will also address how adaptive changes in otolith-mediated reflexes correspond to one's ability to perform closed-loop nulling tasks following G-transitions, and whether manual control performance can be improved
Kijlstra, Aize; Petersen, Eskild
Despite large advances in the field of ocular toxoplasmosis, large gaps still exist in our knowledge concerning the epidemiology and pathophysiology of this potentially blinding infectious disease. Although ocular toxoplasmosis is considered to have a high health burden, still little is known about its exact prevalence and how it affects the quality of life. The epidemiology of toxoplasmosis depends on local habits throughout the globe, and changes are likely in view of increased meat consumption in developing countries and demands for higher animal welfare in the Western world. Water is increasingly seen as an important risk factor and more studies are needed to quantitate and control the role of water exposure (drinking, swimming). Tools are now becoming available to study both the human host as well as parasite genetic factors in the development of ocular toxoplasmosis. Further research on the role of Toxoplasma strains as well as basic studies on parasite virulence is needed to explain why Toxoplasma associated eye disease is so severe in some countries, such as Brazil. Although genetic analysis of the parasite represents the gold standard, further developments in serotyping using peptide arrays may offer practical solutions to study the role of parasite strains in the pathogenesis of Toxoplasma retinochoroiditis. More research is needed concerning the pathways whereby the parasite can infect the retina. Once in the retina further tissue damage may be due to parasite virulence factors or could be caused by an aberrant host immune response. Local intraocular immune responses are nowadays used for diagnostic procedures. Future developments may include the use of Raman technology or the direct visualization of a Toxoplasma cyst by optical coherence tomography (OCT). With the availability of ocular fluid specimens obtained for diagnostic purposes and the development of advanced proteomic techniques, a biomarker fingerprint that is unique for an eye with
Full Text Available MS Mustafa1, J Montgomery2, HR Atta11Department of Ophthalmology, Aberdeen Royal Infirmary, UK; 2Medi-CAL, College of Life Sciences and Medicine, University of Aberdeen, Foresterhill, Aberdeen, UKAbstract: Ocular ultrasound is now in increasing demand in routine ophthalmic clinical practice not only because it is noninvasive but also because of ever-advancing technology providing higher resolution imaging. It is however a difficult branch of ophthalmic investigations to grasp, as it requires a high skill level to interface with the technology and provide accurate interpretation of images for ophthalmic diagnosis and management. It is even more labor intensive to teach ocular ultrasound to another fellow clinician. One of the fundamental skills that proved difficult to learn and teach is the need for the examiner to “mentally convert” 2-dimensional B-scan images into 3-dimensional (3D interpretations. An additional challenge is the requirement to carry out this task in real time. We have developed a novel approach to teach ocular ultrasound by using a novel 3D ocular model. A 3D virtual model is built using widely available, open source, software. The model is then used to generate movie clips simulating different movements and orientations of the scanner head. Using Blender, Quicktime motion clips are choreographed and collated into interactive quizzes and other pertinent pedagogical media. The process involves scripting motion vectors, rotation, and tracking of both the virtual stereo camera and the model. The resulting sequence is then rendered for twinned right- and left-eye views. Finally, the twinned views are synchronized and combined in a format compatible with the stereo projection apparatus. This new model will help the student with spatial awareness and allow for assimilation of this awareness into clinical practice. It will also help with grasping the nomenclature used in ocular ultrasound as well as helping with localization of
Hedges, T.R. III; Pozzi-Mucelli, R.; Char, D.H.; Newton, T.H.
The computed tomographic features of calcification in the eye were correlated with clinical and pathological findings in a variety of ophthalmic and systemic disorders. These consisted of ocular neoplasms, trauma and inflammation of the eye, idiopathic ocular lesions, and disorders of calcium metabolism. Computed tomographic documentation of ocular clarification was found to be useful in the differential diagnosis and management of patients with these disorders.
Hydrogel is a kind of attractive drug carriers because of its good biocompatibility and transparency. But traditional hydrogel showed some restrictions in its application in ocular drug delivery. A simple surface modification technique based on layer-by-layer (LbL) self-assembled multilayer for ocular drug delivery was developed in this work. Polycarboxymethyl-β-cyclodextrin (poly(CM-β-CD))/poly-l-lysine (PLL) multilayer film was designed and constructed for ocular drug delivery, since β-CD s...
Fomda B; Ahmad Z; Khan N; Tanveer S; Wani S
Toxocariasis is an important zoonotic disease caused by the second stage larva of Toxocara canis or Toxocara cati . The typical clinical syndromes of toxocariasis in humans are visceral and ocular toxocariasis. Ocular toxocariasis may presents as peripheral inflammatory mass, posterior pole granuloma and endophthalmitis. We report a serologically confirmed case of ocular toxocariasis in 12-year-old female. The diagnosis was confirmed by detection of anti- Toxocara antibodies in aqueous an...
Full Text Available Stem cells hold promise for treating a wide variety of diseases, including degenerative disorders of the eye. The eye is an ideal organ for stem cell therapy because of its relative immunological privilege, surgical accessibility, and its being a self-contained system. The eye also has many potential target diseases amenable to stem cell-based treatment, such as corneal limbal stem cell deficiency, glaucoma, age-related macular degeneration (AMD, and retinitis pigmentosa (RP. Among them, AMD and glaucoma are the two most common diseases, affecting over 200 million people worldwide. Recent results on the clinical trial of retinal pigment epithelial (RPE cells from human embryonic stem cells (hESCs and induced pluripotent stem cells (iPSCs in treating dry AMD and Stargardt’s disease in the US, Japan, England, and China have generated great excitement and hope. This marks the beginning of the ocular stem cell therapy era. The recent Zhongshan Ophthalmic Center Ocular Stem Cell Symposium discussed the potential applications of various stem cell types in stem cell-based therapies, drug discoveries and tissue engineering for treating ocular diseases.
Gottlieb, Chloe C; Mishra, Aditya; Belliveau, Dan; Green, Peter; Heathcote, J Godfrey
Sweet syndrome (acute febrile neutrophilic dermatosis) is a dermatologic disorder with accompanying features of systemic inflammation. It is commonly associated with conjunctivitis, but a variety of types of ocular inflammation have been reported. The ocular manifestations of Sweet syndrome include periorbital and orbital inflammation, dacryoadenitis, conjunctivitis, episcleritis, scleritis, limbal nodules, peripheral ulcerative keratitis, iritis, glaucoma, and choroiditis. The ocular inflammation appears concurrently with skin lesions. An overview of Sweet syndrome is presented with a review of cases in the literature describing ocular involvement. We report two additional cases of ocular involvement, one with conjunctivitis and a second with iritis, peripheral ulcerative keratitis, and episcleritis. Of the 20 cases, half were bilateral. Thirteen cases occurred in the setting of classical or idiopathic Sweet syndrome and seven in association with malignancy. Biopsies of ocular tissue were infrequent, but, in the seven cases where ocular tissue was analyzed, the histopathology was similar to that of the cutaneous lesions. The ocular complications of Sweet syndrome resolved with systemic administration of corticosteroid or cyclosporine. Topical ocular steroid treatment was frequently used in conjunction with oral steroid but may not have been valuable.
Fatih Mehmet Türkcü
Full Text Available Objective: The aim of this study was to evaluate the demographiccharacteristics of Behcet’s disease (BD patientswith and without ocular involvement.Methods: In this retrospective study BD patients followedup between 2009 and 2013 years in ophthalmology anddermatology clinics were reviewed. Patients were dividedinto 2 groups according to the ocular involvement asocular or non-ocular BD. For each patient, age of onset,gender, family history, and systemic involvement were examined.The frequency of these data was analyzed.Results: Of the 295 patients 177 were ocular BD and 118were non-ocular BD. Ocular involvement were seen morefrequently in male patients than in females. There wasno change between the groups in terms of age at onsetof the disease, a history of thrombophlebitis or gastrointestinal,pulmonary and joint involvement. Pathergy testpositivity and the presence of genital ulcers had more frequentin non-ocular BD.Conclusion: In this study clinical and demographic characteristicsof ocular and non-ocular BD patients in theSoutheast Anatolian Region of Turkey were presented. Asimilar study was not performed previously in our regiontherefore we believe that those data will be useful for diagnosisand follow-up of BD patients. J Clin Exp Invest2013; 4 (3: 339-342Key words: Behçet disease, eye involvement, demographic characteristics
... imaging devices, measurement devices, and EHRs. Documentation of the typical ophthalmology examination in... site and search for the ``Ocular Imaging Challenge''. Access the ONC Investing in Innovation...
Noia,Luciana da Cruz; Araújo,Ana Helena Garcia de; Moraes, Nilva S. Bueno De [UNIFESP
Introdução: Queimaduras oculares químicas podem produzir danos importantes à superfície ocular, resultando em incapacidade visual transitória ou permanente. Objetivos: Levantar dados acerca da epidemiologia e do tratamento inicial aplicado aos pacientes vítimas de queimaduras oculares químicas que chegam a um hospital-escola. Métodos: Foi realizado exame oftalmológico em 47 pacientes vítimas de queimaduras oculares químicas no pronto- socorro do Hospital São Paulo - Escola Paulista de Medicin...
Toguri, James T.; Caldwell, Meggie; Kelly, Melanie E. M.
The endocannabinoid system (ECS) has emerged as an important regulator of both physiological and pathological processes. Notably, this endogenous system plays a key role in the modulation of pain and inflammation in a number of tissues. The components of the ECS, including endocannabinoids, their cognate enzymes and cannabinoid receptors, are localized in the eye, and evidence indicates that ECS modulation plays a role in ocular disease states. Of these diseases, ocular inflammation presents a significant medical problem, given that current clinical treatments can be ineffective or are associated with intolerable side-effects. Furthermore, a prominent comorbidity of ocular inflammation is pain, including neuropathic pain, for which therapeutic options remain limited. Recent evidence supports the use of drugs targeting the ECS for the treatment of ocular inflammation and pain in animal models; however, the potential for therapeutic use of cannabinoid drugs in the eye has not been thoroughly investigated at this time. This review will highlight evidence from experimental studies identifying components of the ocular ECS and discuss the functional role of the ECS during different ocular inflammatory disease states, including uveitis and corneal keratitis. Candidate ECS targeted therapies will be discussed, drawing on experimental results obtained from both ocular and non-ocular tissue(s), together with their potential application for the treatment of ocular inflammation and pain. PMID:27695415
Hansen, Grith Lssrkholm; Kofoed, Peter Kristian; Munch, Inger Christine;
with ocular ischaemic syndrome (OIS) and 20 control eyes from subjects with carotid artery stenosis but without signs of ocular ischaemia. Analyses of video fluorescein angiograms extracting time intervals for the time delay between specific phases of the angiogram were performed. Time delay was compared...... and a correlation between flow and ocular perfusion pressure. While angiographic flowmetry proved effective in discriminating between groups of individuals, it can only be used to support the diagnosis of the ocular ischaemic syndrome in patients with extreme flow reduction....
J. Thomas Toguri
Full Text Available The endocannabinoid system (ECS has emerged as an important regulator of both physiological and pathological processes. Notably, this endogenous system plays a key role in the modulation of pain and inflammation in a number of tissues. The components of the ECS, including endocannabinoids, their cognate enzymes and cannabinoid receptors, are localized in the eye, and evidence indicates that ECS modulation plays a role in ocular disease states. Of these diseases, ocular inflammation presents a significant medical problem, given that current clinical treatments can be ineffective or are associated with intolerable side-effects. Furthermore, a prominent comorbidity of ocular inflammation is pain, including neuropathic pain, for which therapeutic options remain limited. Recent evidence supports the use of drugs targeting the ECS for the treatment of ocular inflammation and pain in animal models; however, the potential for therapeutic use of cannabinoid drugs in the eye has not been thoroughly investigated at this time. This review will highlight evidence from experimental studies identifying components of the ocular ECS and discuss the functional role of the ECS during different ocular inflammatory disease states, including uveitis and corneal keratitis. Candidate ECS targeted therapies will be discussed, drawing on experimental results obtained from both ocular and non-ocular tissue(s, together with their potential application for the treatment of ocular inflammation and pain.
Ayanniyi, A A; Mahmoud, O A; Olatunji, F O; Ayanniyi, R O
To report the pattern of ocular trauma among school pupils in Ilorin, Nigeria, a cross sectional survey of primary school children in 10 randomly selected primary schools within Ilorin, Nigeria was carried out between July 2005 and January 2006. Relevant ocular history and basic ocular examinations were carried out on the children that were selected from a multi-stage sampling process. Diagnosis of ocular trauma was based on historical recollection together with corroborating ocular signs among affected pupils. Ocular trauma was found among 11 (8 boys and 3 girls) out of 1393 (0.8%) pupils and their ages ranged from 5 to 13 years. The trauma related ocular pathology found among the 11 pupils included unilateral phthisis bulbi (2, 0.14%), couching (1, 0.07%) and retinal detachment (1, 0.07%) all leading to blindness in the affected eyes. There was also a unilateral visual impairment caused by traumatic optic atrophy. Others included eyelid bruises (2, 0.14%) and one pupil (0.07%) each with hyphema, eyelid ecchymosis, eyelid laceration, and subconjunctival haemorrhage. The ocular trauma occurred following unsupervised play (4, 36.40%), corporal punishment at school and at home (3, 27.30%), fight (2, 18.20%), home accident (1, 9.10%) and couching (1, 9.10%). School pupils can lose vision to preventable traumatic eye injuries both at school and at home. Measures to minimize ocular trauma both in the home and at school are advocated.
Soumya Swarup Chattopadhyay
Full Text Available Ocular trauma is a major cause of vision loss. The circumstances and agents implicated in such injuries are diverse. We present an unusual case of penetrating ocular trauma with the nozzle of a pressure cooker lid in a 32-year-old housewife causing deep laceration of the upper eye lid and sclera. The impacted metallic nozzle was removed on an emergency basis. Autoevisceration of ocular contents due the high velocity impact resulted in the final decision to surgically complete the evisceration and implant a glass ball implant. This case highlights the propensity of grievous ocular trauma in a domestic environment.
Tudor, Poliana; Bădicu, Adina; Mateescu, Romaniţa; Tudor, Niculae; Mateescu, Cosmin; Ionaşcu, Iuliana
Ocular thelaziosis by Thelazia callipaeda is a vector-borne disease that infects domestic and wild carnivores as well as humans. In this paper, we present two cases of ocular thelaziosis in dogs that had never traveled outside Romania. Both presented with moderate conjunctivitis and ocular discharge. In total, 41 adult nematodes were removed from the conjunctival sacs of both dogs; these were identified via morphology as T. callipaeda. To the best of our knowledge, this is the first report of canine ocular thelaziosis caused by T. callipaeda from the Muntenia Region of Romania.
Full Text Available Toxocariasis is an important zoonotic disease caused by the second stage larva of Toxocara canis or Toxocara cati . The typical clinical syndromes of toxocariasis in humans are visceral and ocular toxocariasis. Ocular toxocariasis may presents as peripheral inflammatory mass, posterior pole granuloma and endophthalmitis. We report a serologically confirmed case of ocular toxocariasis in 12-year-old female. The diagnosis was confirmed by detection of anti- Toxocara antibodies in aqueous and vitreous sample by enzyme-linked immunosorbent assay. We suggest that ophthalmologist in this region should include ocular toxocariasis in differential diagnosis particularly in children and young adults.
Wood, S. J.; Reschke, M. F.
The vestibulo-ocular reflex (VOR) is mediated by integration of canal and otolith inputs to generate compensatory eye movements during head movements. We hypothesized that adaptive change in vestibular processing of gravitoinertial cues would be reflected by plane specific modification of the VOR during passive whole-body rotation during and after spaceflight. Using a repeated measures design, the VOR was assessed in four payload crewmembers in yaw, pitch and roll planes during multiple sessions before, during and after an 8 day orbital mission (STS-42). Rotation was about an earth-vertical axis during ground tests, with the head located off-axis by up to 45cm during pitch and roll rotation (peak acceleration less than 0.2g). The motion profiles included sum-of-sinusoids between 0.02 - 1.39 Hz (yaw), single sinusoids between 0.05-1.25 Hz (yaw and pitch) and velocity steps (yaw, pitch and roll). Eye movements were recorded with both video and electro-oculographic techniques. As expected, VOR gain changes were greater in pitch than in yaw. During pitch rotation, there was a progressive shift in the axis of eye movements during the flight, which was also present during the early post-flight period. This increased horizontal component during pitch, most prevalent at 0.2 Hz, was interpreted as an increase in a translational vergence response elicited during eccentric rotation as subjects imagined a wall fixed target. There was also an increased horizontal component during the eccentric roll step runs performed on flight day 7. These results are consistent with a frequency-dependent increase in otolith-mediated translational VOR responses following adaptation to microgravity. We conclude that the adaptive changes in the VOR are likely to be greatest in the frequency range where there is a cross-over of otolith-mediated tilt and translation responses.
Objetivos: correlacionar pressão de perfusão ocular e amplitude do pulso ocular em três grupos: glaucomatosos, hipertensos oculares e normais; e avaliar a relação de parâmetros de pressão arterial com a pressão intraocular. Métodos: foram recrutados 90 indivíduos para a pesquisa, sendo 30 recém-diagnosticados com glaucoma, sem história prévia de tratamento antiglaucomatoso; 30 apresentavam hipertensão ocular (HO) sem sinais característicos de glaucoma na avaliação do disco óptico e no exame d...
of several smaller time delays within the system ( Silverton , 1994). The components of overall system time delay include tracker delay (sensing...display response time and display decay time). Silverton (1994) provides a detailed analysis of each component of overall system time delay within...CRT displays have fast response time and short persistence ( Silverton , 1994). However, even the refresh rate can effect system time delay (see
Full Text Available Objective To investigate the current global status of military ocular injury for the purpose of improving the level of domestic epidemiological investigation,in order to improve treatment strategies,and to prevent and reduce the incidence of military ocular injury in Chinese PLA.Methods The epidemiological literature concerning military ocular injury occurring in our country and abroad in recent five years was retrieved by information research;the problems and experiences in the aspects of epidemiological survey,registry,data collection,systematic treatment and prevention of military ocular injury existed in PLA were also summarized and analyzed.Results There were currently no systematic epidemiological data about ocular injury in PLA.A few articles about epidemiological study on ocular injury showed that servicemen were the high risk population of ocular injury.Both in peacetime or wartime the ocular injury was the primary cause leading to monocular blindness of soldiers.As to the ocular injury,in 51.55% of the patients,it occurred in the military operations and work,and 30.31% in military training.The incidence of ocular injury was different in various services,for example,the incidence in the internal security forces of armed police could be as high as 78.85% due to training of martial arts and boxing and wrestling.The deficiency of microsurgery equipments and untimely evacuation were the main causes affecting prognosis during treatment course in primary military hospitals.Conclusions Military affairs,physical training,military maneuver and defense constructions are the main causes of ocular injury in servicemen,and young male soldiers are the main group for prevention and treatment for military ocular injury.More attention should be paid to the epidemiological survey of military ocular injury to find out the causes leading to ocular injury,to improve treatment strategies,to formulate feasible protective measures and then military ocular
Full Text Available BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA infection is an important public health issue. The study aimed to determine the prevalence of ocular infections caused by MRSA and to identify the clinical characteristics and antibiotic susceptibility of ocular MRSA infections by comparing those of ocular methicillin-sensitive S. aureus (MSSA infections. METHODOLOGY/PRINCIPAL FINDINGS: The medical records of the patients (n = 519 with culture-proven S. aureus ocular infections seen between January 1, 1999 and December 31, 2008 in Chang Gung Memorial Hospital were retrospectively reviewed. Two hundred and seventy-four patients with MRSA and 245 with MSSA ocular infections were identified. The average rate of MRSA in S. aureus infections was 52.8% and the trend was stable over the ten years (P value for trend = 0.228. MRSA ocular infections were significantly more common among the patients with healthcare exposure (P = 0.024, but 66.1% (181/274 patients with MRSA ocular infections had no healthcare exposure. The most common clinical presentation for both MRSA and MSSA ocular infections was keratitis; MRSA and MSSA caused a similar disease spectrum except for lid infections. MRSA was significantly more resistant than MSSA to clindamycin, erythromycin and sulfamethoxazole/trimethoprim (all P<0.001. CONCLUSIONS/SIGNIFICANCE: We demonstrated a paralleled trend of ocular MRSA infection in a highly prevalent MRSA country by hospital-based survey. Except for lid disorder, MRSA shared similar spectrum of ocular pathology with MSSA. Since S. aureus is a common ocular pathogen, our results raise clinician's attention to the existence of highly prevalent MRSA.
Full Text Available Purpose: To study the ocular manifestations in multiple transfused beta-thalassemia major patients and assess the ocular side-effects of iron chelating agents. Materials and Methods: In this prospective observational study, 45 multiple transfused beta-thalassemia major children between six months and 21 years of age were enrolled and assigned groups according to the treatment regimens suggested. Group A received only blood transfusions, Group B blood transfusions with subcutaneous desferrioxamine, Group C blood transfusions with desferrioxamine and oral deferriprone and Group D blood transfusions with deferriprone. Ocular status at the time of enrolment was documented. Subjects were observed quarterly for one year for changes in ocular status arising due to the disease process and due to iron chelation therapy. Children with hemoglobinopathies other than beta-thalassemia major, congenital ocular anomalies and anemia due to other causes were excluded. Results: Ocular involvement was observed in 58% of patients. Lenticular opacities were the most common ocular finding (44%, followed by decreased visual acuity (33%. An increased occurrence of ocular changes was observed with increase of serum ferritin and serum iron levels as well as with higher number of blood transfusions received. Desferrioxamine seemed to have a protective influence on retinal pigment epithelium (RPE mottling. Occurrence of lenticular opacities and RPE degeneration correlated positively with use of desferrioxamine and deferriprone respectively. Follow-up of patients for one year did not reveal any change in ocular status. Conclusion: Regular ocular examinations can aid in preventing, delaying or ameliorating the ocular complications of thalassemia.
Exceptional Parent, 1987
Suggestions are presented for helping disabled individuals learn to use or adapt toothbrushes for proper dental care. A directory lists dental health instructional materials available from various organizations. (CB)
Møller Larsen, Marcus; Lyngsie, Jacob
We investigate why some exchange relationships terminate prematurely. We argue that investments in informal governance structures induce premature termination in relationships already governed by formal contracts. The formalized adaptive behavior of formal governance structures and the flexible a...
People live in a world in which they are surrounded by potential disgust elicitors such as ``used'' chairs, air, silverware, and money as well as excretory activities. People function in this world by ignoring most of these, by active avoidance, reframing, or adaptation. The issue is particularly striking for professions, such as morticians, surgeons, or sanitation workers, in which there is frequent contact with major disgust elicitors. In this study, we study the ``adaptation'' process to d...
Andersen, Torben Juul
This article provides an overview of theoretical contributions that have influenced the discourse around strategic adaptation including contingency perspectives, strategic fit reasoning, decision structure, information processing, corporate entrepreneurship, and strategy process. The related...... concepts of strategic renewal, dynamic managerial capabilities, dynamic capabilities, and strategic response capabilities are discussed and contextualized against strategic responsiveness. The insights derived from this article are used to outline the contours of a dynamic process of strategic adaptation...
Full Text Available This study was used to evaluate the degenerative effects on the retina and eye-cup sections after experimental induction of acute ocular hypertension on animal models. In particular, vascular events were directly focused in this research in order to assess the vascular remodeling after transient ocular hypertension on rat models. After local anaesthesia by administration of eye drops of 0.4% oxibuprocaine, 16 male adult Wistar rats were injected in the anterior chamber of the right eye with 15 µL of methylcellulose (MTC 2% in physiological solution. The morphology and the vessels of the retina and eye-cup sections were examined in animals sacrificed 72 h after induction of ocular hypertension. In retinal fluorescein angiographies (FAGs, by means of fluorescein isothiocyanate-coniugated dextran (FITC, the radial venules showed enlargements and increased branching, while the arterioles appeared focally thickened. The length and size of actually perfused vessels appeared increased in the whole superficial plexus. In eye-cup sections of MTC-injected animals, in deep plexus and connecting layer there was a bigger increase of vessels than in controls. Moreover, the immunolocalization of astrocytic marker glial fibrillary acidic protein (GFAP revealed its increased expression in internal limiting membrane and ganglion cell layer, as well as its presence in Müller cells. Finally, the pro-angiogenic factor vascular endothelial growth factor (VEGF was found to be especially expressed by neurones of ganglion cell layer, both in control and in MTC-injected eyes. The data obtained in this experimental model on the interactions among glia, vessels and neurons should be useful to evaluate if also in glaucomatous patients the activation of vessel-adjacent glial cells might play key roles in following neuronal dysfunction.
Parke III DW
Full Text Available D Wilkin Parke III, Robert A Sisk, Samuel K Houston, Timothy G MurrayDepartment of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, FL, USAObjective: To evaluate the effect of adjunctive intravitreal triamcinolone (IVTA on intraocular pressure (IOP in the setting of combined vitrectomy with phacoemulsification.Design: Retrospective case series.Participants: One hundred thirty-one consecutive eyes undergoing nonemergent vitrectomy with phacoemulsification and IVTA were reviewed and included in the analysis. All 131 eyes received 4 mg IVTA at the end of surgery.Methods: Pre- and postoperative IOP, use of pressure-lowering medications, and rate of glaucoma surgery were analyzed. Pre-operative risk factors were analyzed.Main outcome measures: IOP, glaucoma medications, or glaucoma surgery.Results: Secondary ocular hypertension (defined as IOP ≥25 mmHg was found in 28 eyes (21%, the majority during postoperative day 1 only. Twelve eyes (9% had an elevated IOP measurement noted at a visit after the first postoperative day. Five (4% had an IOP rise of ≥10 mmHg over baseline at any time after postoperative day 1. Six (5% required glaucoma medications. One eye required a glaucoma drainage implant for diabetic neovascular angle closure glaucoma, and one eye required enucleation for intractable neovascular glaucoma due to radiation retinopathy. Elevated postoperative IOP was statistically associated with higher baseline IOP and presence of preoperative glaucoma.Conclusions: Therapeutic intravitreal triamcinolone with combined vitrectomy and phacoemulsification causes infrequent and usually mild secondary ocular hypertension. Secondary ocular hypertension is associated with preoperative glaucoma and high IOP.Keywords: glaucoma, cataract, inflammation
Mario Alfredo Parra
Full Text Available Introducción: El análisis cuantitativo de los movimientos oculares en el dominio digital ha permitido incrementar la cantidad de información fisiológica que se puede extraer durante la interpretación de las señales oculográficas. En el terreno de las neurociencias, esto posibilita profundizar en el estudio de los mecanismos fisiopatológicos responsables de las afecciones oculomotoras. Objetivos: La finalidad de estos métodos de análisis es reducir el componente subjetivo que se introduce durante la clasificación visual de registros de actividad eléctrica, reduciendo además la experiencia requerida para hacer una correcta evaluación de patrones funcionales. Material y métodos: En el presente trabajo, se estudió la respuesta de persecución visual en 27 sujetos normales aplicando métodos de análisis cuantitativo tanto en el dominio del tiempo como en el dominio de la frecuencia. Se determinó un conjunto de variables que actúa como descriptores cuantitativos de la ejecución oculomotora durante tareas que activan al sistema motor ocular. Resultados: Demuestran que las variables estudiadas en ambos dominios pueden ser de gran utilidad para incrementar el conocimiento de los mecanismos subyacentes a la ejecución oculomotora. La cantidad de información extraída por estos métodos, supera 80% del total de la posible a extraer. Conclusiones: Se deben dirigir estudios posteriores para evaluar el comportamiento de estas variables en afecciones del sistema nervioso donde el sistema motor ocular muestre algún grado de compromiso funcional.
Medina, Carlos A; Plesec, Thomas; Singh, Arun D
Optical coherence tomography (OCT) has become pivotal in the practice of ophthalmology. Similar to other ophthalmic subspecialties, ophthalmic oncology has also incorporated OCT into practice. Anterior segment OCT (AS-OCT), ultra-high resolution OCT (UHR-OCT), spectral domain OCT (SD-OCT) and enhanced depth imaging OCT (EDI-OCT), have all been described to be helpful in the diagnosis, treatment planning and monitoring response of ocular and periocular tumours. Herein we discuss the role of OCT including the advantages and limitations of its use in the setting of common intraocular and adnexal tumours. PMID:24599420
Mansouri, Mohammad Reza; Tabatabaei, Seyed Ali; Soleimani, Mohammad; Kiarudi, Mohammad Yaser; Molaei, Saber; Rouzbahani, Mehdi; Mireshghi, Meysam; Zaeferani, Mohsen; Ghasempour, Mehrbod
AIM To evaluate demographic variables and visual outcomes, among patients with ocular injuries involving the posterior segment, managed with pars plana vitrectomy. METHODS The records of patients were studied retrospectively from March to September 2010, to determine the age, gender, place of occurrence of trauma, visual acuity, anatomical site, nature of injury, wound length, the presence of an afferent pupillary defect, and the timing of vitrectomy. The Ocular Trauma Score was measured. The minimum follow-up from presentation was 6mo. RESULTS Ninety patients (77 males, 13 females), with a mean age of 32.7±15.8y were included over the 6-month period. The majority of cases occurred in the workplace (47 patients), followed by home (14 patients). The mean visual acuity (logMAR) of patients significantly improved from 2.36±0.72 preoperatively to 1.50±1.14 postoperatively. Twenty-three patients had preoperative vision better than 2.0 logMAR, the postoperative visual acuity was significantly better among these patients than patients with worse than 2.0 logMAR (P7d) was not significantly different (P=0.66). Postoperative visual acuity was not significantly different between patients with injury in Zone I and II (P=0.64), but patients with injury in Zone III had significantly poorer visual acuity (P=0.02). Patients with relative afferent pupillary defect had significantly poorer postoperative visual acuity (P=0.02). Preoperative visual acuity, the difference of preoperative and postoperative visual acuity, and postoperative visual acuity were significantly different between groups with different ocular trauma scores (P<0.001). CONCLUSION Trauma is more likely to occur in men under 40y of age and in the workplace. The favorable final visual outcome is associated with the absence of afferent pupillary defect, ocular trauma score and presenting visual acuity as well as the zone of injury, and not associated with the timing of vitrectomy. PMID:27275432
Ranjbaran, Mina; Galiana, Henrietta L
The vestibulo-ocular reflex (VOR) plays an important role in our daily activities by enabling us to fixate on objects during head movements. Modeling and identification of the VOR improves our insight into the system behavior and helps in diagnosing various disorders. However, the switching nature of eye movements, including the VOR, makes the dynamic analysis challenging. In this work we are using integration of subspace and prediction error methods to analyze VOR dynamics. The performance of the method is evaluated using simulation studies and experimental data.
The purpose of this review is to give the general reader a brief overview of the current state of the field of non-viral ocular gene therapy. For multiple reasons the eye is an excellent organ for gene therapy application and while non-viral gene therapy modalities have been around for quite some time; they have only been applied to the eye in the last few years. This review will cover the exciting current trends in non-viral gene therapy and their application to the eye in addition to a brie...
María Cecilia Juri; Diego S. Fernández Romero; Martín H. Devoto; Daniel Georgiett; Jorge O. Zárate; Alejandro Malbrán
El penfigoide cicatrizal ocular (PCO) es una enfermedad ampollar autoinmune que produce daño conjuntival grave. Se conoce poco acerca de la respuesta del PCO al tratamiento inmunosupresor. Describimos un grupo de 76 pacientes con PCO, 62 mujeres y 14 hombres. La edad media al diagnóstico fue de 67 ± 14 años, con un retraso de 7.5 ± 10 años. Sesenta se siguieron en nuestro servicio por 19 ± 21 meses. De 51 en quienes se describe la gravedad de la enfermedad al inicio del tratamiento, fue leve ...
Full Text Available Acquired and congenital toxoplasmosis are frequently complicated by ocular toxoplasmosis. The diagnosis relies on clinical aspects, response to specific treatment and results of biological assays. The incidence and the prevalence of this complication are difficult to establish precisely and depend on the prevalence of the parasite infection in the general population, and are affected by factors such as type of exposure to the parasite, genetic backgrounds of the parasite and the host, and type of immune response elicited by the parasite.
Rajkumar Manojkumar Singh
Full Text Available This is a case report of asymptomatic human ocular thelaziasis that was discovered accidentally just before a planned cataract surgery. A 69-year-old farmer from a rural area presented to the outpatient department of Ophthalmology with diminished vision in both the eyes, which was diagnosed as bilateral cataract. On the day of operation of the right eye, after instillation of 4% lignocaine hydrochloride eyedrops, a small, motile, chalky white, translucent worm was removed from the conjunctiva. It was morphologically identified as a female Thelazia callipaeda (T. callipaeda.
Full Text Available A 29-year-old lady receiving repeated blood transfusions for β thalassemia since childhood, presented with rapidly deteriorating symptoms of night blindness and peripheral visual field loss. She was recently commenced on high-dose intravenous desferrioxamine for reducing the systemic iron overload. Clinical and investigative findings were consistent with desferrioxamine-related pigmentary retinopathy and optic neuropathy. Recovery was partial following cessation of desferrioxamine. This report highlights the ocular side-effects of desferrioxamine mesylate and the need to be vigilant in patients on high doses of desferrioxamine.
Shoroghi, Mehrdad; Farahbakhsh, Farshid; Sheikhvatan, Mehrdad; Sheikhfathollahi, Mahmood; Abbasi, Ali; Talebi, Azam
Purpose: To investigate anesthesia recovery and hemodynamic status in patients under thiopental infusion or halothane maintenance anesthesia undergoing ocular surgery. Methods: Fifty-nine voluntary patients undergoing ocular surgery in Farabi hospital were allocated to one of two maintenance anesthe
Thais Flores Nogueira Diniz
Full Text Available The article begins by historicizing film adaptation from the arrival of cinema, pointing out the many theoretical approaches under which the process has been seen: from the concept of “the same story told in a different medium” to a comprehensible definition such as “the process through which works can be transformed, forming an intersection of textual surfaces, quotations, conflations and inversions of other texts”. To illustrate this new concept, the article discusses Spike Jonze’s film Adaptation. according to James Naremore’s proposal which considers the study of adaptation as part of a general theory of repetition, joined with the study of recycling, remaking, and every form of retelling. The film deals with the attempt by the scriptwriter Charles Kaufman, cast by Nicholas Cage, to adapt/translate a non-fictional book to the cinema, but ends up with a kind of film which is by no means what it intended to be: a film of action in the model of Hollywood productions. During the process of creation, Charles and his twin brother, Donald, undergo a series of adventures involving some real persons from the world of film, the author and the protagonist of the book, all of them turning into fictional characters in the film. In the film, adaptation then signifies something different from itstraditional meaning. The article begins by historicizing film adaptation from the arrival of cinema, pointing out the many theoretical approaches under which the process has been seen: from the concept of “the same story told in a different medium” to a comprehensible definition such as “the process through which works can be transformed, forming an intersection of textual surfaces, quotations, conflations and inversions of other texts”. To illustrate this new concept, the article discusses Spike Jonze’s film Adaptation. according to James Naremore’s proposal which considers the study of adaptation as part of a general theory of repetition
Gisele dos Santos Pereira
Full Text Available Objetivo: Avaliar a eficácia da placa neuromiorrelaxante em reduzir a sintomatologia oftalmológica de pacientes com disfunção temporo-mandibular (DTM e constatar a possível correlação entre DTM e sintomatologia ocular. Métodos: Foi realizada uma análise comparativa da evolução das sintomatologias da DTM e oculares em uma amostra de dezenove pacientes com DTM, sinais e sintomas oftalmológicos e ausência de patologia ocular. Esses pacientes foram submetidos a uma terapia reversível por meio do uso da placa neuromiorrelaxante. Resultados: Observou-se que após o uso da placa durante um período maior (60 dias, o número de pacientes que apresentaram melhora de 100% ou que apresentaram sintomatologia discreta, tanto para DTM quanto para ocular, foi estatisticamente significativo. Já em intervalos de tempo menores (7-15, 15-30, 30-60 dias, o efeito da placa não foi significativo estatisticamente para reduzir a sintomatologia da DTM e ocular. A sintomatologia oftalmológica mais freqüente (84,2% encontrada nos pacientes com DTM da presente amostra foi dor ocular. Conclusão: Há correlação entre DTM e sintomatologia ocular, visto que pacientes portadores desta disfunção que fizeram uso da terapia reversível, obtiveram melhora do quadro clínico tanto da DTM quanto da sintomatologia ocular num intervalo de tempo maior (7-60 dias.Purpose: To evaluate if the neuromuscular relaxing plate is effective in reducing the ophthalmic symptoms of patients with temporomandibular dysfunction (TMD and to observe the possible correlation between TMD and ocular symptoms. Methods: A comparative analysis of TMD symptoms and ocular symptoms was performed in a sample of nineteen patients with TMD, ophthalmic signs and symptoms and absence of ocular diseases. Those patients were submitted to a reversible therapy using a neuromuscular relaxing plate. Results: It was observed that after the use of the plate during a longer period of time (60 days the
Full Text Available Objetivo: Analizar cómo se realiza, desde el punto de vista pericial, la valoración de las lesiones y secuelas oculares de los accidentes de tráfico en nuestro medio. Método: Hemos realizado un estudio retrospectivo de 127 informes sobre lesiones oculares realizados en la Sección de Oftalmología de la Clínica Médico Forense de Madrid durante cinco años (del 2002 al 2006, analizando las siguientes variables: la proporción que representan los accidentes de tráfico (ATF, el tipo de lesión producida en el ATF, la duración media de la baja, las secuelas más frecuentes y la puntuación total media asignada a estas secuelas oculares. Resultados: Los ATF son la causa de la cuarta parte de las secuelas oculares que vemos. Las lesiones más frecuentemente producidas son traumatismos cráneo-encefálicos, contusiones oculares directas y esguinces cervicales. Hemos hallado un alto porcentaje de casos (22%, en los que no encontramos lesiones objetivas que justifiquen las molestias alegadas por el lesionado, o bien estas no guardan relación evidente con el accidente de tráfico sufrido. Conclusiones: Que los ATF son una de las causas más frecuentes de secuelas oculares (diplopias, disminuciones de agudeza visual…, con una puntuación media de 15 puntos y una duración media de la baja de 71 días, hay un importante porcentaje de reclamaciones injustificadas. Considera necesario revisar el actual Baremo de la Ley 34/2003, subsanando los errores y deficiencias que presenta, e incluyendo secuelas oculares típicamente postraumáticas que actualmente no recoge, para facilitar la valoración de las secuelas oculares.Aim: To analyse how it is performed, from expert evidence view point, the assessment of ocular injuries and after-effects due to traffic accidents in our area. Method: We have accomplished a retrospective study of 127 reports on ocular injuries, carried out in the Ophthalmologic Section of the Medical Forensic Clinic of Madrid for
Matteoli, Sara; Vannetti, Federica; Finocchio, Lucia
vasoconstriction might be detected by measuring the ocular surface temperature. The ocular surface temperature was evaluated in a group of 38 healthy young subjects (28 males and 10 females; mean age: 25.4 6 4.1 years) by infrared thermography. For each subject, the experimental procedure consisted of two...
Ongkosuwito, J.V.; Kortbeek, L.M.; Lelij, van der A.; Molicka, E.; Kijlstra, A.; Smet, de M.D.; Suttrop-Schulten, M.S.A.
Aim. To investigate whether presumed ocular histoplasmosis syndrome in the Netherlands is caused by Histoplasma capsulatum and whether other risk factors might play a role in the pathogenesis of this syndrome. Methods. 23 patients were clinically diagnosed as having presumed ocular histoplasmosis sy
A.M. van Alphen (Arjan); J.S. Stahl (J.); C.I. de Zeeuw (Chris)
textabstractIn the present study the optokinetic reflex, vestibulo-ocular reflex and their interaction were investigated in the mouse, using a modified subconjunctival search coil technique. Gain of the ocular response to sinusoidal optokinetic stimulation was relatively constant for peak velocities
Beek, van L.M.; Keizer, de R.J.W.; Polak, B.C.P.; Elzenaar, P.R.; Haeringen, van N.J.; Kijlstra, A.
Background - Several ocular side effects including uveitis, have been reported following topical β blocker treatment for glaucoma and ocular hypertension. The incidence of these side effects was investigated in the Netherlands. Methods - A prospective observational design was used whereby monthly qu
Mamikonian, V R; Galoian, N S; Sheremet, N L; Kazarian, E E; Kharlap, S I; Shmeleva-Demir, O A; Andzhelova, D V; Tatevosian, A A
Characteristics of ocular hemodynamics in ischemic optic neuropathy (ION) outcome and normal tension glaucoma (NTG), the conditions that are difficult to be differentially diagnosed, have been investigated. The study enrolled 32 patients (40 eyes) with ION outcome, 26 patients (46 eyes) with NTG, and 20 patients (32 eyes) with no ocular pathology. Besides the standard ophthalmological examination, color Doppler imaging of ocular vessels, evaluation of ocular blood flow volume and individual normal range of intraocular pressure (flowmetry) were performed in all cases. The results showed that an excess of the actual intraocular pressure (IOP) over the individual normal range was much higher in patients with NTG than in patients with ION (39% and 14.5% correspondingly). It was also found that NTG is associated with a more significant decrease of ocular blood flow volume (30.1% in average) in comparison to ION outcome (11%). In both conditions a decrease in velocity parameters of the blood flow in main ocular vessels was registered, however, ocular hemodynamics changes appeared to be more severe in patients with glaucomatous optic neuropathy. A statistically reliable correlation between volumetric and velocity parameters of ocular blood flow has been discovered.
LUO Rong-jiang; LIU Shao-rui; LI Xiao-min; ZHUO Ye-hong; TIAN Zhen
Background The blood supply to the eye comes from the retinal central vascular system of the ophthalmic artery and the ciliary vascular system. The ophthalmic artery stems from the ipsilateral internal carotid artery. If occlusion or stenosis occurs in the carotid artery, the blood perfusion to the ophthalmic artery becomes insufficient, leading to signs and symptoms of anterior and posterior ocular ischemia. The objective of this study was to evaluate the clinical characteristics and risk factors of ocular ischemic diseases caused by carotid artery stenosis.Methods This study was a retrospective review of 145 patients with carotid artery stenosis. Fifty-eight patients who had symptoms of ocular ischemic disease caused by carotid artery stenosis formed group A and the other 87 patients who only had carotid artery stenosis formed group B. We analyzed the causes and course of disease, and relative risk factors,by comparing the two groups.Results The degree of carotid artery stenosis in group A was higher than that in group B. And group A had a greater decrease of ophthalmic artery flow. Male, hypertension, hyperlipidemia, and smoking were significantly related to carotid artery stenosis. Amaurosis fugax was the most common ocular symptom in group A. The ocular ischemic diseases mainly included ischemic optic neuropathy, central/branch retinal artery occlusion, ophthalmoplegia externa, and ocular ischemic syndrome.Conclusions Carotid artery stenosis correlates with ocular ischemic diseases. Ophthalmologists must observe for ocular symptoms, which were the onset symptoms in some patients.
Bagger, Mette; Tebering, Jens F; Kiilgaard, Jens F
To determine the applicability and ocular morbidity of the 25-gauge transvitreal retinochoroidal biopsy technique in the management of intraocular tumors.......To determine the applicability and ocular morbidity of the 25-gauge transvitreal retinochoroidal biopsy technique in the management of intraocular tumors....
Beelen, E. van; Leijendeckers, J.M.; Huygen, P.L.M.; Admiraal, R.J.C.; Hoefsloot, L.H.; Lichtenbelt, K.D.; Stobe, L.; Pennings, R.J.E.; Leuwer, R.; Snik, A.F.M.; Kunst, H.P.M.
OBJECTIVE: To evaluate hearing impairment and cochlear function in non-ocular Stickler syndrome. STUDY DESIGN: Multifamily study. PATIENTS & METHODS: Ten patients from two different families with non-ocular Stickler syndrome (Stickler syndrome type 3) were included. Six members of the first family a
Wisse, R. P. L.; Bijlsma, W. R.; Stilma, J. S.
Aim To provide a systematic review on ocular firework trauma with emphasis on incidence and patient demographics, the extent of ocular trauma and visual function loss, and firework regulation effects on injury rates. Methods A literature search was performed using predetermined inclusion and exclusi
... Ocular Therapeutics Utilizing the Peptide C16Y and Related Peptides AGENCY: National Institutes of Health... C16Y and related peptides in the treatment of ocular disease.'' DATES: Only written comments and/or... exclusive license relates to a protein designated C16Y and variations thereof. C16Y is an engineered...
The subject of investigation was the influence of ocular fixation on acquisition of habituation in experimental rotatory test in pigeons. The habituation training was performed in the three difference conditions: with full ocular fixation, fixation partly reduced and fixation excluded. Author confirmed that habituation with fixation excluded gave the best results of habituation of postural reflexes and head nystagmus in pigeons in rotatory training.
Munch-Petersen, Helga D; Rasmussen, Peter K; Coupland, Sarah E
IMPORTANCE: The clinical features of diffuse large B-cell lymphoma (DLBCL) subtype of ocular adnexal lymphoma have not previously been evaluated in a large cohort to our knowledge. OBJECTIVE: To investigate the clinical features of ocular adnexal DLBCL (OA-DLBCL). DESIGN, SETTING, AND PARTICIPANT...
Miriam García Fernández
Full Text Available ABSTRACT El síndrome de isquemia ocular es una patología rara, secundaria a hipoperfusión debido a estenosis o oclusión de las arterias carótidas común o interna. Varón, de 78 años, que acudió por disminución de agudeza visual progresiva, de meses de evolución, en su ojo derecho (OD. La Mejor Agudeza Visual Corregida (MAVC en su OD era de no percepción de luz. La exploración biomicroscópica del polo anterior en OD reveló la presencia de microhipema y neovascularización iridiana en los 360º. La presión intraocular era normal. Mediante la exploración funduscópica y la angiografía fluoresceínica, se confirmó la presencia de signos de isquemia retiniana y coroidea, todo ello compatible con un posible síndrome de isquemia ocular. Se realizó panretinofotocoagulación, y se solicitó Eco-Doppler de Troncos Supraaórticos y angio-TC que confirmaron la presencia de una obstrucción completa en la arteria carótida interna derecha, no susceptible de tratamiento quirúrgico. A los 7 meses, el paciente permanece estable clínicamente, desde el punto de vista ocular y sistémico. En estos casos, es de gran trascendencia la evaluación sistémica del paciente, incluyendo realización de Eco-Doppler de TSA o angio-TC, y el abordaje multidisciplinar, pues un adecuado y precoz diagnóstico puede condicionar no solo el pronóstico visual, infausto en nuestro caso, sino también la supervivencia del paciente. ABSTRACT Ocular ischemic syndrome is a rare condition, secondary to hypoperfusion due to stenosis or occlusion of the common or internal carotid artery. A 78 year-old male, who complained of progressive acuity visual loss, in his right eye (RE. His Best Corrected Visual Acuity (BCVA in RE was No light perception. Biomicroscopic exploration of anterior segment revealed the presence of microhyphema and iris neovascularization in 360 degrees. Intraocular pressure was normal. Fundoscopy and fluorescein angiography confirmed the presence
Mantelli, Flavio; Moretti, Costanzo; Macchi, Ilaria; Massaro-Giordano, Giacomina; Cozzupoli, Grazia Maria; Lambiase, Alessandro; Bonini, Stefano
Polycystic ovary syndrome (PCOS) is the most common endocrine abnormality in women of reproductive age. Although its clinical consequences have been known for a long time to extend beyond the reproductive system, with type-2 diabetes and obesity being the most common, the involvement of the ocular surface in PCOS has been described only more recently. The ocular surface is a morphofunctional unit comprising eyelid margin, tear film, cornea, and conjunctiva. Increasing evidence indicates that these structures are under a sex hormone control and relevant diseases such as ocular allergy and dry eye are often caused by alterations in circulating or local steroid hormones levels. Novel treatments targeting sex hormone receptors on ocular surface epithelial cells are also being developed. In this review we aim to describe the current knowledge on the effects of sex hormones at the ocular surface, with a special focus on the effects of androgen imbalance in PCOS.
Rodríguez Villanueva, Javier; Navarro, Manuel Guzmán; Rodríguez Villanueva, Laura
Dendrimers have called the attention of scientists in the area of drug and gene delivery over the last two decades for their versatility, complexity and multibranching properties. Some strategies for optimizing drug pharmacokinetics and site-specific targeting using dendrimers have been proposed. Among them, those related to treating and managing ocular diseases are of special interest. Ocular therapies suffer from significant disadvantages, including frequent administration, poor penetration and/or rapid elimination. This review provides an overview of the recent and promising progress in the dendrimers field, focusing on both the anterior and posterior segments of the eye ocular targets, the use of dendrimers as a strategy for overcoming obstacles to the traditional treatment of ocular diseases and an outlook on future directions. Finally, a first approach to ocular safety with dendrimers is intended that accounts for the state-of-the-art science to date.
Amornvit, Pokpong; Rokaya, Dinesh; Shrestha, Binit; Srithavaj, Theerathavaj
Ocular trauma can be caused by road traffic accidents, falls, assaults, or work-related accidents. Enucleation is often indicated after ocular injury or for the treatment of intraocular tumors, severe ocular infections, and painful blind eyes. Rehabilitation of an enucleated socket without an intraocular implant or with an inappropriately sized implant can result in superior sulcus deepening, enophthalmos, ptosis, ectropion, and lower lid laxity, which are collectively known as post-enucleation socket syndrome. This clinical report describes the rehabilitation of post-enucleation socket syndrome with a modified ocular prosthesis. Modifications to the ocular prosthesis were performed to correct the ptosis, superior sulcus deepening, and enophthalmos. The rehabilitation procedure produced satisfactory results.
Iigo, Masayuki; Ikeda, Emi; Sato, Masaru; Kawasaki, Shigekatsu; Noguchi, Fumitaka; Nishi, Genjirou
Using in vivo and in vitro methods we studied the regulation of ocular melatonin rhythms in the wrasse Halichoeres tenuispinnis, by either light or the circadian clock. Rhythmic changes in ocular melatonin levels under light-dark (LD) cycles were persistent under constant darkness (DD), and had a circadian periodicity of approximately 24h. However, ocular melatonin levels remained low under constant light conditions. When wrasse were exposed to a single 6-h light pulse at three different circadian phases under DD, phase-dependent phase shifts in the circadian rhythms of ocular melatonin were observed. When eyecups were prepared during mid-light periods or at the onset of darkness, and incubated in vitro in either light or dark periods, both time and light conditions affected melatonin release. These results indicate that the melatonin rhythms in the wrasse eye are driven by an ocular circadian clock that is entrained to LD cycles via local photoreceptors.
De Marchi, Sergio Umberto; Cecchin, Emanuela; De Marchi, Sergio
Red eye and relapsing conjunctivitis-blepharitis are among the most common ocular disease in elderly patients. In these cases the search for causes is difficult and frustrating. We report the case of a 79-year-old woman with a long history of red eye and relapsing conjunctivitis-blepharitis caused by ocular rosacea. In this patient the proper diagnosis was performed after 10 years of ocular disease, and repeated evaluations by general practitioners and clinical specialists, only after the appearance of facial signs of erythematotelangiectatic rosacea. Adequate therapy with oral doxycycline led to the improvement of the clinical picture that previously had shown a poor response to several topical treatments. The possibility of ocular rosacea should be considered in evaluating an elderly patient with persistent red eye and relapsing conjunctivitis-blepharitis. Making the proper diagnosis is crucial because ocular rosacea does not respond as expected to topical therapy and may lead to severe corneal involvement.
Conclusions: SH significantly improved both symptoms and signs of ocular surface damage in patients with BAC-preserved anti-glaucoma medications treatment. SH could be proposed as a new attempt to reduce ocular surface toxicity, and alleviate symptoms of ocular surface damage in BAC-preserved anti-glaucoma medications treatment.
Objective: To observe the ocular histopathological changes aftereyeball enucleation induced by corneal trauma.Methods: Light microscopic examination was done on 117 eyeball specimens enucleated after corneal trauma (18 with corneal fissure and 99 with corneal perforating trauma).Results: Acute, subacute or chronic inflammatory changes, and fibrous membrane formation were observed in well-closed corneal wounds, whereas inflammation, atrophy and scar were observed in the focal tissues. But at the late period, secondary glaucoma, retinal detachment, endophthalmitis and eyeball atrophy resulted in blindness. Corneal fistula was observed in those with inadequate cure of wounds caused by ingrowth of corneal epithelium, embedment of iris and vitreous body, and large area of centrally located tissue deficiency of the corneal. A high incidence of endophthalmitis was noted due to the presence of corneal fistula. Severe inflammation was observed in the anterior segmental tissues with fibrous infiltration in the anterior chamber, which might result in rapid destruction of the eyeballs.Conclusions: Ocular pathology varies with the difference of the position, form, size and closing conditions of the corneal laceration after trauma.
Full Text Available INTRODUCTION: Amniotic membrane is the innermost layer of the f etal membranes. It has a stromal matrix, a collagen layer, and an overlying basement membrane with a single layer of epithelium. (1 Amniotic membrane has unique properties including an ti-adhesive effects, bacterio-static properties, wound protection, pain redu ction, and epithelialisation effects. Another characteristic of amniotic membrane is the lack of imunogenicity. (2 Amniotic membranes have been used as a dressing to promote he aling of chronic ulcers of the leg and as a biological dressing for burned skin and skin woun ds. (3, 4 It has also been used in surgical reconstruction of artificial vagina, for repairing o mphaloceles, and to prevent tissue adhesion in surgeries of the abdomen, head, or pelvis. (5, 6 Amniotic membrane has been successfully used in ocular conditions like persistent epithelial defects (7, pterygium, (8 Symblepharon (9 and for ocular surface reconstruction. (10, 11 The purpose of this study was to evaluate the use of cryo- preserved Human amniotic membrane graft( HAMT, with or without limbal autograft transplantation (LAT in patients with previous and fr esh chemical eye injuries respectively. Institutional ethical committee approval was obtained .
Bruna Lana Ducca
Full Text Available Purposes: To objectively evaluate the torsional effect of the superior oblique muscle-weakening surgery using the tenectomy technique proposed by Souza-Dias. Methods: The present prospective study included 10 patients (20 eyes with horizontal strabismus, bilateral superior oblique overaction and A-pattern of 15 to 30 prism diopters who underwent superior oblique tenectomy. Objective assessment of ocular torsion was performed by retinography immediately before and one month after surgery. The amount of ocular torsion was determined by measuring the angle formed by a horizontal line drawn across the geometric center of the optic disc and a second line connecting this point to the fovea. Results: The median preoperative angle was 5.56° in the right eyes and -3.43° in the left eyes. The median postoperative angle was 1.84° in the right eyes and -3.12° in the left eyes. The angle variation was statistically significant in both eyes (p=0.012 and p=0.01, respectively. Conclusion: The present study suggests that superior oblique tenectomy has an extorter effect, decreasing the intorsion detected on overaction of this muscle.
Sophia R. Balderman
Full Text Available Essential monoclonal gammopathy is usually an asymptomatic condition, the characteristics of which have been defined over approximately 70 years of study. It has a known population-attributable risk of undergoing clonal evolution to a progressive, symptomatic B-cell neoplasm. In a very small fraction of patients, the monoclonal immunoglobulin has biophysical characteristics that can lead to tissue deposition syndrome (e.g. Fanconi renal syndrome or, by chance, have characteristics of an autoantibody that may inactivate critical proteins (e.g. acquired von Willebrand disease. In this report, we describe the very uncommon forms of ocular injury that may accompany essential monoclonal gammopathy, which include crystalline keratopathy, crystal-storing histiocytosis, hypercupremic keratopathy, and maculopathy. The first three syndromes result from uncommon physicochemical alterations of the monoclonal immunoglobulin that favor crystallization or exaggerated copper binding. The last-mentioned syndrome is of uncertain pathogenesis. These syndromes may result in decreased visual acuity. These ocular findings may lead, also, to the diagnosis of monoclonal gammopathy.
Sahu, Roshan Kumar; Singh, Bhupendra; Saraf, Shubhini A; Kaithwas, Gaurav; Kishor, Kamal
The present investigation was undertaken to evaluate the possible ocular phototoxicity of drugs used in ophthalmic formulations. Sulphacetamide, ketoconazole, voriconazole, diclofenac, and ketorolac were assessed in the concentrations available in the market for their ocular use. The suitable models viz Hen's Egg Test Chorioallantoic Membrane (HET-CAM) test, Isolated Chicken Eye (ICE) test, and Red Blood Cell (RBC) haemolysis test as recommended by ECVAM, ICCVAM, and OECD guidelines were performed. Results of HET-CAM and ICE tests suggest that sulphacetamide is moderately toxic in the presence of light/UV-A and very slightly irritant without irradiation. Ketoconazole and voriconazole were found slightly irritant in presence of light/UV-A and non-irritant in dark. Diclofenac and ketorolac demonstrated slight irritancy in the light and were found to be non-irritant in dark. The results suggest that some of the drugs have potential toxic effect in the presence of light. The extent of phototoxicity might get extended when used for longer time. The recommendation is that these drugs should be stored and used in the dark for a specified time and be labelled with specific instructions for patients, especially for those working longer in the sunlight.
Full Text Available Designing an ophthalmic drug delivery system is one of the most difficult challenges for the researchers. The anatomy and physiology of eye create barriers like blinking which leads to the poor retention time and penetration of drug moiety. Some conventional ocular drug delivery systems show shortcomings such as enhanced pre-corneal elimination, high variability in efficiency, and blurred vision. To overcome these problems, several novel drug delivery systems such as liposomes, nanoparticles, hydrogels, and in situ gels have been developed. In situ-forming hydrogels are liquid upon instillation and undergo phase transition in the ocular cul-de-sac to form viscoelastic gel and this provides a response to environmental changes. In the past few years, an impressive number of novel temperature, pH, and ion-induced in situ-forming systems have been reported for sustain ophthalmic drug delivery. Each system has its own advantages and drawbacks. Thus, a combination of two drug delivery systems, i.e., nanoparticles and in situ gel, has been developed which is known as nanoparticle laden in situ gel. This review describes every aspects of this novel formulation, which present the readers an exhaustive detail and might contribute to research and development.
Mocanu, Carmen; Olaru, Andrei; Popa, Denissa; Deca, Andreea; Barascu, Doina
Chronic ischemia related to a manifest ophthalmic artery stenosis, determines extremely rare ischemic chronic modifications at the level of the optic nerve, with progressive optic atrophy and visual fun ction alteration. It is presented the case of a 59 years patient, who was hospitalized in Clinic of Ophthalmology, Emergency Clinic Districtual Hospital, for decreased vision of the left eye. Fundus eye examination reveals normal aspect of papilla of the right eye and glaucomatous like modification of the left eye, confirmed by perimetry and OCT exams, which present typical glaucomatous lesions. Doppler examination revealed an enormous thrombus at the level of the left internal carotid, with more than 90% stenosis. In this context the diagnosis was chronic ocular ischemia, atypical form. lschemic ocular syndrome presents polymorphic clinic aspects, the most frequent are the ischemic lesions of posterior pole of the eye: retinal hemorrhages, neovascularization, ischemic edema, red cherry macula, cotton-wool spots. lschemic optic neuropathy is less frequent presented, and pseudo-glaucomatous lesion of optic nerve with papillary excavation is exceptional.
Smith, S T; Curthoys, I S; Moore, S T
Recent results by Wearne [(1993) Ph.D. thesis] using the scleral search-coil method of measuring eye position indicate that changes in ocular torsion position (OTP) occur during yaw angular acceleration about an earth vertical axis. The present set of experiments, using an image processing method of eye movement measurement free from the possible confound of search coil slippage, demonstrates the generality and repeatability of this phenomenon and examines its possible causes. The change in torsion position is not a linear vestibulo-ocular reflex (LVOR) response to interaural linear acceleration stimulation of the otoliths, but rather the effect is dependent on the characteristics of the angular acceleration stimulus, commencing at the onset and decaying at the offset of the angular acceleration. In the experiments reported here, the magnitude of the angular acceleration stimulus was varied and the torsion position response showed corresponding variations. We consider that the change in torsion position observed during angular acceleration is most likely to be due to activity of the semicircular canals.
Korhonen, Eveliina; Rönkkö, Seppo; Hillebrand, Satu; Riikonen, Joakim; Xu, Wujun; Järvinen, Kristiina; Lehto, Vesa-Pekka; Kauppinen, Anu
Porous silicon (PSi) is a promising material for the delivery and sustained release of therapeutic molecules in various tissues. Due to the constant rinsing of cornea by tear solution as well as the short half-life of intravitreal drugs, the eye is an attractive target for controlled drug delivery systems, such as PSi microparticles. Inherent barriers ensure that PSi particles are retained in the eye, releasing drugs at the desired speed until they slowly break down into harmless silicic acid. Here, we have examined the in vitro cytotoxicity of positively and negatively charged thermally oxidized (TOPSi) and thermally carbonized (TCPSi) porous silicon microparticles on human corneal epithelial (HCE) and retinal pigment epithelial (ARPE-19) cells. In addition to ocular assessment under an inverted microscope, cellular viability was evaluated using the CellTiter Blue™, CellTiter Fluor™, and lactate dehydrogenase (LDH) assays. CellTiter Fluor proved to be a suitable assay but due to non-specific and interfering responses, neither CellTiter Blue nor LDH assays should be used when evaluating PSi particles. Our results suggest that the toxicity of PSi particles is concentration-dependent, but at least at concentrations less than 200μg/ml, both positively and negatively charged PSi particles are well tolerated by human corneal and retinal epithelial cells and therefore applicable for delivering drug molecules into ocular tissues.
Martín, Maria B C; Santos-Lozano, Alejandro; Martín-Hernández, Juan; López-Miguel, Alberto; Maldonado, Miguel; Baladrón, Carlos; Bauer, Corinna M; Merabet, Lotfi B
Cortical/cerebral visual impairment (CVI) is clinically defined as significant visual dysfunction caused by injury to visual pathways and structures occurring during early perinatal development. Depending on the location and extent of damage, children with CVI often present with a myriad of visual deficits including decreased visual acuity and impaired visual field function. Most striking, however, are impairments in visual processing and attention which have a significant impact on learning, development, and independence. Within the educational arena, current evidence suggests that strategies designed for individuals with ocular visual impairment are not effective in the case of CVI. We propose that this variance may be related to differences in compensatory neuroplasticity related to the type of visual impairment, as well as underlying alterations in brain structural connectivity. We discuss the etiology and nature of visual impairments related to CVI, and how advanced neuroimaging techniques (i.e., diffusion-based imaging) may help uncover differences between ocular and cerebral causes of visual dysfunction. Revealing these differences may help in developing future strategies for the education and rehabilitation of individuals living with visual impairment.
Moradi, Farshad; Heeger, David J
The brain combines visual information from the two eyes and forms a coherent percept, even when inputs to the eyes are different. However, it is not clear how inputs from the two eyes are combined in visual cortex. We measured fMRI responses to single gratings presented monocularly, or pairs of gratings presented monocularly or dichoptically with several combinations of contrasts. Gratings had either the same orientation or orthogonal orientations (i.e., plaids). Observers performed a demanding task at fixation to minimize top-down modulation of the stimulus-evoked responses. Dichoptic presentation of compatible gratings (same orientation) evoked greater activity than monocular presentation of a single grating only when contrast was low (presentation of orthogonal gratings evoked greater activity than monocular presentation of a single grating for all contrasts. However, activity evoked by dichoptic plaids was equal to that evoked by monocular plaids. Introducing an onset asynchrony (stimulating one eye 500 ms before the other, which under attentive vision results in flash suppression) had no impact on the results; the responses to dichoptic and monocular plaids were again equal. We conclude that when attention is diverted, inter-ocular suppression in V1 can be explained by a normalization model in which the mutual suppression between orthogonal orientations does not depend on the eye of origin, nor on the onset times, and cross-orientation suppression is weaker than inter-ocular (same orientation) suppression.
Rossi, Francesca; Pini, Roberto; Menabuoni, Luca; Lenzetti, Ivo; Russo, Sheila; Menciassi, Arianna; Fortuna, Damiano
Minimally invasive surgery has recently been improved by the use of robot-assisted procedures in several medical fields. Among the ocular surgeries there are a few examples of sophisticated vitreoretinal procedures, while robotic-assisted surgery of the anterior eye segment is still under study. In this paper we propose a new approach to the robotic assisted ocular surgery: a CO2 laser system is equipped with a micromanipulator and scanner, and it is proposed to induce photothermal effects for the removal of neoformations. A sensorized tool is connected to the patient eye and to the robotic arm. This tool is equipped with force and position sensors: by the use of the spatial information from the robotic console and from the patient it is possible to control the position of the target itself and to block it in the correct position for performing surgery. The system is provided by a feedback alarm that remove the block of the patient head in any moment. The optimized robotic consolle can be used in performing scleral cuts and in the treatment of pterigium or neoformations.
Yam, Gary Hin-Fai; Peh, Gary Swee-Lim; Singhal, Shweta; Goh, Bee-Tin; Mehta, Jodhbir S
Regenerative medicine using patient's own stem cells (SCs) to repair dysfunctional tissues is an attractive approach to complement surgical and pharmacological treatments for aging and degenerative disorders. Recently, dental SCs have drawn much attention owing to their accessibility, plasticity and applicability for regenerative use not only for dental, but also other body tissues. In ophthalmology, there has been increasing interest to differentiate dental pulp SC and periodontal ligament SC (PDLSC) towards ocular lineage. Both can commit to retinal fate expressing eye field transcription factors and generate rhodopsin-positive photoreceptor-like cells. This proposes a novel therapeutic alternative for retinal degeneration diseases. Moreover, as PDLSC shares similar cranial neural crest origin and proteoglycan secretion with corneal stromal keratoctyes and corneal endothelial cells, this offers the possibility of differentiating PDLSC to these corneal cell types. The advance could lead to a shift in the medical management of corneal opacities and endothelial disorders from highly invasive corneal transplantation using limited donor tissue to cell therapy utilizing autologous cells. This article provides an overview of dental SC research and the perspective of utilizing dental SCs for ocular regenerative medicine.
Ciocâlteu, Alina Mihaela; Ardeleanu, S; Checheriţă, I A
Ophthalmology is one of the specialties that have particularly benefited from the contribution of ultrasonography exam as a method of investigation. Ultrasonography is very much essential for diagnostic to complement other clinical and laboratory investigations, providing images in real time. The basic principle of diagnostic ultrasound is to study and to interpret the changes they undergo when crossing ultrasonic waves diverse biological properties different sound, and such injuries can be traced in the dynamics or can be documented on photographic paper and thus can diagnose correct certain eye diseases. The indications for performing ultrasound consist in: measurement of distances and volumes, examine difficult or inaccessible case of opaque media; ophthalmoscopic view of a mass lesion, examine the orbit or optic nerve. The advantages of ultrasound for orbital-ocular tumors are represented by the fact that ultrasound is a noninvasive method, safe, well tolerated, less expensive that the advantage of determining the position and distance from structures ocular tumor. High frequency ultrasound provides excellent resolution of 0-1 to 0.01 mm, and serial scans allow tracking progress and measuring lesion diameters tumor while allowing monitoring and evaluation of stereotactic radiation treatments applied to small tumors. In conclusion ultrasound allows not only early diagnosis of eye tumors, but accurate assessment of the proposed therapy and of the evolution of detected mass lesions or tumors.
Full Text Available Magdalini Triantafylla,1 Horace F Massa,2 Doukas Dardabounis,1 Zisis Gatzioufas,2 Vassilios Kozobolis,1 Konstantinos Ioannakis,1 Irfan Perente,1,3 Georgios D Panos1,21Department of Ophthalmology, University General Hospital of Alexandroupolis, School of Medicine, University of Thrace, Alexandroupolis, Greece; 2Department of Ophthalmology, Geneva University Hospitals, Faculty of Medicine, University of Geneva, Switzerland; 3Beyoglou Eye Research and Teaching Hospital, Istanbul University, Istanbul, TurkeyAbstract: Degenerative ocular conditions, such as age-related macular degeneration, diabetic retinopathy, retinal vein occlusions, and myopic degeneration, have become a major public health problem and a leading cause of blindness in developed countries. Anti-vascular endothelial growth factor (VEGF drugs seem to be an effective and safe treatment for these conditions. Ranibizumab, a humanized monoclonal antibody antigen-binding fragment, which inhibits all biologically active isoforms of VEGF-A, is still the gold standard treatment for the majority of these pathological entities. In this review, we present the results of the most important clinical trials concerning the efficacy and safety of ranibizumab for the treatment of degenerative ocular conditions.Keywords: age-related macular degeneration, diabetic macular edema, retinal vein occlusion, anti-VEGF, safety, efficacy, quality of life
Zhang, Xueyong; Ma, Jianguo; Lu, Rongsheng; Xia, Ruixue
Considering the potential clinical importance, the surface tension of ocular cornea under the action of normal physiological intraocular pressure is estimated, and a novel technique and a simple mechanical model for determining the tension are also presented in this paper. An instrument embodying mainly a CCD camera, an optical staff gauge and a manometer was developed primarily to measure both the surface point displacement and intraocular pressure of the cornea. A simple theoretical model was used to characterize the tensions of the ocular corneas under the action of the intraocular pressure. Due to the difficulty in obtaining the human cornea, laboratory experiments were carried out on porcine cornea specimens. The thickness of the specimens was accurately measured by optical coherence tomography. The matrix and collagen properties within the corneal tissue were manifested in the experiment. Experimental results on porcine corneas showed that the present technique is applicable to estimate the surface tension. In the normal physiological intraocular pressure range, both meridian and circumference tensions of the porcine corneas along the radial coordinate distribute are not uniform.
Abdulkabir A Ayanniyi
Full Text Available Aims: To determine awareness and knowledge of ocular cancers in a resource-limited setting. Material and Methods: A descriptive cross-sectional survey (2009 of 1,887 Nigerians using interviewer-administered questionnaire. Results: Respondents were 55.6% males, and mean age was 30 years, SD 9.5. Most respondents (77.8% had at least secondary education. Fewer respondents were aware of eye cancers (57.1% compared to cancers in general (73.7% (P<.001. Despite the male preponderance there were no associations between gender and awareness of ocular cancers (P=0.07 and cancers in general (P=0.85. However, education was associated with awareness of ocular cancers (P<.001 and cancers in general (P<.001. Ocular cancers were thought to be caused by corrosives 33.2%, trauma 21.4%, witchcraft 18.6%, genetic transmission 15.7%, sunlight 8.0%, radiations 2.5% and infections 0.6% (n = 883. Of 280 respondents, 41.1% based their knowledge of patients having ocular cancers on sources other than hospital diagnosis. Of 148 respondents, 16.2% were related to ′patients′ they knew had ocular cancers. There were 202 respondents who indicated challenges to accessing orthodox medical eye care services by ocular cancer patients as high cost 55.5%, long waiting period 23.3%, long distance 15.4% and poor attitude of health workers 5.9%. Conclusion: Awareness of ocular cancers compared to other cancers is low. Misconceptions on the causes of ocular cancers exist. Public ocular cancers health education can enhance awareness. The need to address barriers to accessing eye care is underscored.
Costa, Alberto C S
Down syndrome (DS), the most common genetically defined cause of intellectual disability, is the phenotypic consequence of a supernumerary chromosome 21. Persons with DS commonly display deficits in visuomotor integration, motor coordination, and balance. Despite the key roles of the optokinetic and vestibular systems in these submodalities of motor function, a systematic investigation into the optokinetic nystagmus (OKN) and vestibulo-ocular reflex (VOR) in persons with DS was lacking in the literature. Accordingly, this study generated quantitative data on oculomotor function in persons with DS under vestibular stimulation (an accompanying work describes results on the analysis of optokinetic function in the same cohort of participants). Experiments involved 32 participants with DS (14-36 years old, equally divided by gender) and 32 chronological age- and gender-matched typically developing controls. Eye movements were recorded by binocular video-oculography, and a servo-controlled rotary chair produced vestibular stimulation. Participants were assessed for VOR during step, ramp, and sinusoidal stimulations; inhibition of the VOR by visual target fixation; and VOR adaptation to conflicting visual input. Individuals with DS displayed small alterations in the VOR gain and dynamics compared to controls. In contrast, the number of VOR nystagmus beats and the ability to inhibit the VOR by visual target fixation were markedly and robustly smaller in persons with DS. Significantly increased VOR adaptation was observed in men with DS. These findings may have implications to the understanding of the neurological basis of the motor dysfunction that affects performance in many practical tasks persons with DS encounter in their everyday lives.
Kjeldsen, Lars Peter; Rose, Mette
Artikelen er en evaluering af de adaptive tests, som blev indført i folkeskolen. Artiklen sætter særligt fokus på evaluering i folkeskolen, herunder bidrager den med vejledning til evaluering, evalueringsværktøjer og fagspecifkt evalueringsmateriale.......Artikelen er en evaluering af de adaptive tests, som blev indført i folkeskolen. Artiklen sætter særligt fokus på evaluering i folkeskolen, herunder bidrager den med vejledning til evaluering, evalueringsværktøjer og fagspecifkt evalueringsmateriale....
Clement, Gilles; Denise, Pierre; Reschke, Millard; Wood, Scott J.
Ocular counter-rolling (OCR) induced by whole body tilt in roll has been explored after spaceflight as an indicator of the adaptation of the otolith function to microgravity. It has been claimed that the overall pattern of OCR responses during static body tilt after spaceflight is indicative of a decreased role of the otolith function, but the results of these studies have not been consistent, mostly due to large variations in the OCR within and across individuals. By contrast with static head tilt, off-vertical axis rotation (OVAR) presents the advantage of generating a sinusoidal modulation of OCR, allowing averaged measurements over several cycles, thus improving measurement accuracy. Accordingly, OCR and the sense of roll tilt were evaluated in seven astronauts before and after spaceflight during OVAR at 45 /s in darkness at two angles of tilt (10 and 20 ). There was no significant difference in OCR during OVAR immediately after landing compared to preflight. However, the amplitude of the perceived roll tilt during OVAR was significantly larger immediately postflight, and then returned to control values in the following days. Since the OCR response is predominantly attributed to the shearing force exerted on the utricular macula, the absence of change in OCR postflight suggests that the peripheral otolith organs function normally after short-term spaceflight. However, the increased sense of roll tilt indicates an adaptation in the central processing of gravitational input, presumably related to a re-weigthing of the internal representation of gravitational vertical as a result of adaptation to microgravity.
Full Text Available Rabia Aman,1 Stephanie B Engelhard,1 Asima Bajwa,1 James Patrie,2 Ashvini K Reddy1 1Department of Ophthalmology, 2Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA Purpose: To assess ocular hypertension (OHT and hypotony as outcomes of uveitis in patients managed in a mid-Atlantic tertiary care center. Methods: Retrospective, observational study of uveitis patients seen at the University of Virginia from 1984 to 2014. Results: A total of 442 patients (582 eyes with uveitis were identified and included in the study. The patient population was 57.0% female. Overall, 61.9% were Caucasian and 26.6% were African American. Mean age was 46.8 years. Overall, 11.5% of the eyes had OHT at initial visit, and 7.9% had OHT at final visit (P=0.035. For each additional decade of life, the odds that an eye had OHT were elevated by a factor of 1.15 (95% confidence interval [CI]: [1.02, 1.30], P=0.027 at initial visit and by a factor of 1.15 (95% CI: [1.00, 1.32], P=0.055 at final visit. The odds that an anterior uveitis eye had OHT were greater by a factor of 2.50 (95% CI: [1.22, 5.14], P=0.013 than the odds for a nonanterior uveitis eye at initial visit and greater by a factor of 2.61 (95% CI: [1.24, 5.50], P=0.011 at final visit. For each additional 0.5 logarithm of the minimum angle of resolution increase in initial visual acuity, the odds that an affected eye had OHT were elevated by a factor of 1.18 (95% CI: [1.00, 1.39], P=0.047 at initial visit and 1.23 (95% CI: [0.99, 1.54], P=0.065 at final visit. Overall, 21 of 582 eyes (3.6% were hypotonous initially, while 24 of 582 eyes (4.1% were hypotonous at final follow-up (P=0.631. Conclusion: OHT was associated with increasing age, anterior uveitis, and poor presenting visual acuity. Ocular hypotony was more common in anterior uveitis than in nonanterior uveitis. Fluctuations in intraocular pressure are an important cause of visual impairment in patients with uveitis
Adhin, Malti R; Grunberg, Meritha G; Labadie-Bracho, Mergiory; Pawiroredjo, Jerrel
Herpes simplex virus (HSV) infection of the corneal stroma is the most prominent cause of scar formation impairing visual acuity and HSV keratitis is the leading cause of corneal opacity throughout the world. Suriname lacked test systems for microbial causes of ocular disease, therefore a polymerase chain reaction-based Herpes virus assay was introduced, enabling prompt recognition, and timely treatment, preventing progressive eye damage. The incidence and epidemiology of Herpes simplex virus type 1 (HSV-1), type 2 (HSV-2), and varicella zoster virus (VZV) in ocular disease in Suriname was assessed. In a cross-sectional prospective study, ocular swabs were collected from 91 patients with a presumptive α-Herpes virus ocular infection attending the Academic Hospital between November 2008 and August 2010 and were tested by a PCR-based α-Herpes virus assay. Alpha-Herpes virus ophthalmic infections were caused predominantly by HSV-1 with a prevalence of 31%. The prevalences of VZV, HSV-2, and a mixed HSV-1/HSV-2 infection were 4%, 3%, and 2%, respectively. The first reported annual incidence of herpetic induced ocular disease in Suriname was estimated at 11.4 per 100,000 person-years (95% CI, 4.8-18.1). No clear age, ethnic or gender dependent difference in incidence was observed. The information obtained on α-Herpes virus positive ocular infections and the distribution of subtypes provided the first insight in the South American situation of α-Herpes virus induced ocular disease.
Full Text Available OBJECTIVE : Snake bite is an environmental hazard associated with significant ocular morbidity and some have sight threatening complications . Objective of this study was to determine the ocular manifestations and long standing visual impairment fo llowing snake bite and to acquaint the ophthalmologists and related health professionals about the sight threatening ocular complications related to snake bite . METHODS : Prospective data was collected from the Dept . of Internal Medicine , Burdwan Medical Co llege , a rural based tertiary care hospital in eastern India . All snake bite patients admitted in the Department of Internal Medicine were examined and all patients with ocular manifestations were included in the study . RESULTS : Out of 245 cases of snake b ite , 51 ( 27 . 27% cases of venomous snake bite with ocular findings were included in this study . Thirty three ( 64 . 71% out of 51 were vasculotoxic and 18 ( 35 . 29% were neurotoxic in nature . Commonest ocular manifestation of neurotoxic bite was ptosis , followed by diplopia , ophthalmoplegia and optic neuritis . In vasculotoxic snake bites retinal and vitreous hemorrhage ( 36 . 36% was most common followed by subconjunctival hemorrhage and chemosis ( 27 . 28% , lid oedema ( 18 . 18% , hyphaema ( 12 . 12% and anterior uveitis ( 6 . 06% . Causes of long standing visual impairment were retinal hemorrhage in one patient and vitreous hemorrhage in two patients . CONCLUSIONS : Ocular morbidity following snake bite were more common among young males . Majority of long standing vis ual impairment were associated with vasculotoxic snake bite and required long term follow - up .
Tashakori-Sabzevar, Faezeh; Mohajeri, Seyed Ahmad
Recently, significant advances have been made in order to optimize drug delivery to ocular tissues. The main problems in ocular drug delivery are poor bioavailability and uncontrollable drug delivery of conventional ophthalmic preparations (e.g. eye drops). Hydrogels have been investigated since 1965 as new ocular drug delivery systems. Increase of hydrogel loading capacity, optimization of drug residence time on the ocular surface and biocompatibility with the eye tissue has been the main focus of previous studies. Molecular imprinting technology provided the opportunity to fulfill the above-mentioned objectives. Molecularly imprinted soft contact lenses (SCLs) have high potentials as novel drug delivery systems for the treatment of eye disorders. This technique is used for the preparation of polymers with specific binding sites for a template molecule. Previous studies indicated that molecular imprinting technology could be successfully applied for the preparation of SCLs as ocular drug delivery systems. Previous research, particularly in vivo studies, demonstrated that molecular imprinting is a versatile and effective method in optimizing the drug release behavior and enhancing the loading capacity of SCLs as new ocular drug delivery systems. This review highlights various potentials of molecularly imprinted contact lenses in enhancing the drug-loading capacity and controlling the drug release, compared to other ocular drug delivery systems. We have also studied the effects of contributing factors such as the type of comonomer, template/functional monomer molar ratio, crosslinker concentration in drug-loading capacity, and the release properties of molecularly imprinted hydrogels.
Ma, Junshui; Bayram, Sevinç; Tao, Peining; Svetnik, Vladimir
After a review of the ocular artifact reduction literature, a high-throughput method designed to reduce the ocular artifacts in multichannel continuous EEG recordings acquired at clinical EEG laboratories worldwide is proposed. The proposed method belongs to the category of component-based methods, and does not rely on any electrooculography (EOG) signals. Based on a concept that all ocular artifact components exist in a signal component subspace, the method can uniformly handle all types of ocular artifacts, including eye-blinks, saccades, and other eye movements, by automatically identifying ocular components from decomposed signal components. This study also proposes an improved strategy to objectively and quantitatively evaluate artifact reduction methods. The evaluation strategy uses real EEG signals to synthesize realistic simulated datasets with different amounts of ocular artifacts. The simulated datasets enable us to objectively demonstrate that the proposed method outperforms some existing methods when no high-quality EOG signals are available. Moreover, the results of the simulated datasets improve our understanding of the involved signal decomposition algorithms, and provide us with insights into the inconsistency regarding the performance of different methods in the literature. The proposed method was also applied to two independent clinical EEG datasets involving 28 volunteers and over 1000 EEG recordings. This effort further confirms that the proposed method can effectively reduce ocular artifacts in large clinical EEG datasets in a high-throughput fashion.