Tibial Periosteum For The Surgical Perforation

Purpose: Report a successful case of scleral perforation repair, refractive to treatment with bank-scleral graft, using pretibial periosteum graft patch. Case Report: A patient who suffered a traumatic scleral perforation was treated unsuccessfully with bank-scleral patch graft. An autologous pretibial periosteal patch graft was then obtained and sutured to the scleral rupture with the osteogenic layer facing the sclera. The periosteum patch was covered by amniotic membrane and conjunctiva. Results: Early vascularization was observed in the first seven days postoperative. The autologous periosteal patch graft and conjunctiva remained stable over a follow-up period of 6 months. Conclusion: An autologous periosteal patch graft could be a good alternative after a non-successful bank-scleral patch repair of a scleral perforatio

〈初期軍記〉における戦闘被害の表現-女の描かれ方をめぐって-

軍記・語り物研究会第374回例会(平成19年7月22日・於:法政大学)共同討議「初期軍記」研究の検証と展開-新たな「状況」と「変容」を探る-における基調報

Neuro-Ophthalmologic Evaluation as a Biomarker for Diagnosis and Progression in Parkinson Disease

Objectives: The purpose of current neuro-ophthalmologic research is to evaluate visual dysfunction and its correlation with structural changes in the retina of patients with Parkinson’s disease and to examine whether there is an association between retinal thinning and disease progression

An unusual case of testicular disorder in sex development of arabian mare (64,xx sry-negative)

A 3-year-old Arabian mare underwent medical examinations due to the presence of abnormalities of the reproductive apparatus and stallion behavior (nervous temperament, aggressiveness, masculine attitude). During the clinical visit, an anovulvar distance shorter than normal was observed; moreover, vulvar lips were dorsally fused except for the lower neckline, showing a blind ending from which a penis-like structure protruded. The ultrasound examination revealed the presence of a cervix and corpus of a uterus, hypoplastic uterine horns, and small gonads with an echogenicity similar to a testis. Blood testosterone levels ranged from 0.4 to 0.6 ng/mL. Cytogenetic analysis showed a normal female karyotype (2n = 64,XX), while PCR amplification of SRY and ZFY genes revealed the absence of a Y chromosome. At necroscopic examination, internal genitalia arising from the genital ridge in the form of masculine type structures were found, while those deriving from the Mullerian ducts were of feminine type. In addition, an infundibular portion of the salpinx at the cranial pole of the gonads was found. This is the first case in equine species of DSD 2n = 64,XX SRY-negative, with the simultaneous presence of male (hypoplastic testicles, epididymal portions, and a penis-like structure) and female (cervix, horn and body of a hypoplastic uterus) genital structures

Physiological changes in retinal layers thicknesses measured with swept source optical coherence tomography

Purpose To evaluate the physiological changes related with age of all retinal layers thickness measurements in macular and peripapillary areas in healthy eyes. Methods Wide protocol scan (with a field of view of 12x9 cm) from Triton SS-OCT instrument (Topcon Corporation, Japan) was performed 463 heathy eyes from 463 healthy controls. This protocol allows to measure the thickness of the following layers: Retina, Retinal nerve fiber layer (RNFL), Ganglion cell layer (GCL +), GCL++ and choroid. In those layers, mean thickness was compared in four groups of ages: Group 1 (71 healthy subjects aged between 20 and 34 years); Group 2 (65 individuals aged 35–49 years), Group 3 (230 healthy controls aged 50–64 years) and Group 4 (97 healthy subjects aged 65–79 years). Results The most significant thinning of all retinal layers occurs particularly in the transition from group 2 to group 3, especially in temporal superior quadrant at RNFL, GCL++ and retinal layers (p=0.001), and temporal superior, temporal inferior, and temporal half in choroid layer (p<0.001). Curiously group 2 when compared with group 1 presents a significant thickening of RNFL in temporal superior quadrant (p = 0.001), inferior (p<0.001) and temporal (p = 0.001) halves, and also in nasal half in choroid layer (p = 0.001). Conclusions Excepting the RNFL, which shows a thickening until the third decade of life, the rest of the layers seem to have a physiological progressive thinning. Copyright

Diagnostic ability and capacity of optical coherence tomography-angiography to detect retinal and vascular changes in patients with fibromyalgia

Background. To evaluate the neuroretina and retinal vasculature of fibromyalgia (FM) patients and calculate a linear discriminant function (LDF) to improve retinal parameters’ contribution to FM diagnosis. Methods. Fifty FM patients and 232 healthy controls underwent retinal evaluation using swept-source optical coherence tomography (SS-OCT) angiography (Triton plus; Topcon) and spectral domain OCT (SD-OCT) (Spectralis; Heidelberg). The macular (m) and peripapillary (p) retinal nerve fibre layer (RNFL) and ganglion cell layer (GCL) were assessed, as was the macular vascular density. A logistic regression analysis was performed, and an LDF was calculated to evaluate OCT’s contribution to FM diagnosis. Results. With Triton OCT, the patients presented pRNFL thinning in the temporal sector (). Spectralis OCT measurements showed decreased pRNFL in patients in the following sectors: superonasal, ; nasal, ; inferonasal, ; temporal, ; and inferotemporal, . No significant differences were observed in the macular vascular plexus between patients and controls. However, vascular density in the superior sector showed a strong inverse correlation with disease duration (r = −0.978, ). The LDF calculated for Spectralis OCT yielded an area under the ROC curve of 0.968. Conclusions. FM patients present RNFL thinning observable using SS- and SD-OCT. However, these patients show similar vascular density in the macular area to healthy controls. The LDF that combines several RNFL parameters obtained using Spectralis OCT gives this device a powerful ability to differentiate between healthy individuals and individuals with FM

Functional Evaluation of the Visual Pathway in Patients with Multiple Sclerosis Using a Multifunction Stimulator Monitor

Objectives. To assess the capability of the vision monitor unit Monpack One of detecting visual function alterations in patients with multiple sclerosis (MS) and to evaluate the correlation between structural retinal parameters and functional measurements obtained with this device. Methods. Forty-eight patients with MS and 46 healthy controls were included in a cross-sectional study. All participants underwent a complete functional evaluation of the visual pathway, which included low-contrast visual acuity (LCVA), contrast sensitivity vision (CSV), automated perimetry, multifocal visual evoked potentials (mfVEPs), and pattern electroretinogram (ERG). All tests were performed using the vision monitor unit Monpack One (Metrovision, France), a multifunction stimulator device. Retinal structural measurements were obtained in all subjects using Triton swept source optical coherence tomography (Topcon, Japan). Results. Patients with MS presented reduced low-contrast VA (p<0.001) and reduced CSV at medium (p=0.001, p=0.013) and low (p=0.001, p=0.002) spatial frequencies. All visual field parameters were found to be altered in MS patients compared with controls (<= 0.001). Patients with MS presented lower amplitude of the P100 waveform of the mfVEP in areas corresponding to central (p<0.001), inferonasal (p=0.001), and inferotemporal (p=0.003) retina. The pattern ERG did not show significant differences. Significant correlations were observed between structural retinal measurements and functional parameters, especially between the inner macular areas and measurements corresponding to contrast sensitivity and perimetry indexes. Conclusions. Patients with MS present visual dysfunction detectable with the vision monitor unit Monpack One. This device may be a fast and useful tool to provide a full evaluation of axonal damage in patients with multiple sclerosis

Actualización sobre alteraciones de función visual y espesores coriorretinianos en la enfermedad de Parkinson

La enfermedad de Parkinson (EP) es un proceso neurodegenerativo que afecta a unos 7, 5 millones de personas en el mundo. Desde 2004, varios estudios han demostrado cambios en el espesor de diversas capas de la retina en la EP utilizando tomografía de coherencia óptica (OCT). Sin embargo, existen resultados contradictorios entre los diferentes estudios. Algunos de ellos relacionan los espesores retinianos con la severidad o duración de la enfermedad, lo cual convierte a las mediciones de la OCT en biomarcadores de progresión de la EP, inocuos y de fácil adquisición. También existen estudios que demuestran pérdida de capacidad o función visual desde fases tempranas de la enfermedad. Por último, los estudios más recientes que utilizan OCT de tecnología Swept Source demuestran aumento del espesor coroideo en la EP y aportan nueva información relacionada con el proceso degenerativo retiniano en esta enfermedad. Este trabajo pretende revisar la bibliografía existente sobre OCT y EP con el fin de determinar los parámetros retinianos y coroideos alterados en la EP y su posible utilidad clínica, así como analizar cuáles son las disfunciones visuales más relevantes en estos pacientes. Parkinson''s disease (PD) is a neurodegenerative process that affects 7.5 million people around the world. Since 2004, several studies have demonstrated changes in various retinal layers in PD using optical coherence tomography (OCT). However, there are some discrepancies in the results of those studies. Some of them have correlated retinal thickness with the severity or duration of the disease, demonstrating that OCT measurements may be an innocuous and easy biomarker for PD progression. Other studies have demonstrated visual dysfunctions since early phases of the disease. Lastly, the most recent studies that use Swept Source OCT technology, have found choroidal thickness increase in PD patients and provide new information related to the retinal degenerative process in this disease. The aim of this paper is to review the literature on OCT and PD, in order to determine the altered retinal and choroidal parameters in PD and their possible clinical usefulness, and also the visual dysfunctions with higher impact in these patients

Visual dysfunction and its correlation with retinal changes in patients with Parkinson’ s disease: an observational cross-sectional study

Objectives: To evaluate visual dysfunction and its correlation with structural changes in the retina in patients with Parkinson’s disease (PD). Methods: Patients with PD (n=37) and controls (n=37) were included in an observational cross- sectional study, and underwent visual acuity (VA), colour vision (using the Farnsworth and Lanthony desaturated D15 colour tests) and contrast sensitivity vision (CSV; using the Pelli-Robson chart and CSV 1000E test) evaluation to measure visual dysfunction. Structural measurements of the retinal nerve fibre layer (RNFL), and macular and ganglion cell layer (GCL) thicknesses, were obtained using spectral domain optical coherence tomography (SD-OCT). Comparison of obtained data, and correlation analysis between functional and structural results were performed. Results: VA (in all different contrast levels) and all CSV spatial frequencies were significantly worse in patients with PD than in controls. Colour vision was significantly affected based on the Lanthony colour test. Significant GCL loss was observed in the minimum GCL+inner plexiform layer. A clear tendency towards a reduction in several macular sectors (central, outer inferior, outer temporal and superior (inner and outer)) and in the temporal quadrant of the RNFL thickness was observed, although the difference was not significant. CSV was the functional parameter most strongly correlated with structural measurements in PD. Colour vision was associated with most GCL measurements. Macular thickness was strongly correlated with macular volume and functional parameters (r>0.70, p<0.05). Conclusions: Patients with PD had visual dysfunction that correlated with structural changes evaluated by SD-OCT. GCL measurements may be reliable indicators of visual impairment in patients with PD

Quantification of progressive retinal thinning in patients with fibromyalgia syndrome over a period of 5 years

Purpose: To quantify changes in visual function parameters and the macular neuroretina of patients with Fibromyalgia (FM) over 5 years, compared with controls. Methods: Eighty patients with FM and 38 healthy subjects were included in a prospective observational study and underwent visual acuity (VA) evaluation with ETDRS chart, contrast sensitivity vision (CSV) with CSV 1000E test, and retinal evaluation using Spectralis Optical coherence tomography (OCT). All subjects were re-evaluated after 5 years to quantify changes in visual function parameters and ganglion cell layer (GCL) and retinal nerve fiber layer (RNFL) thickness. The relationship between progressive structural, functional and disease severity changes was analysed. Additionally, patients were classified into three different groups to analyse progression depending on the disease phenotype. Results: When compared with controls, patients with FM presented worse low contrast VA (p=0.024), and low frequency CSV (p=0.004) after a 5-year follow up. A progressive decrease affecting the GCL thickness (nasal 1, p=0.004; temporal 1, p<0.001; inferior 1, p=0.001) and the RNFL (nasal 1 and 2, p<0.001; superior 1, p<0.001; and inferior 1, p=0.002) was observed in patients over the monitoring time. Changes affecting the GCL were correlated with progression in disease severity scores (EQ-5D, r=0.560, p<0.001; FIQ, r=-0.470, p=0.003). Correlations between structural changes and disease severity scores were only observed in the atypical and biologic phenotypes. Conclusions: Progressive visual dysfunction and retinal neurodegeneration was detected in FM patients. The evaluation of visual parameters and GCL/ RNFL thickness using SD-OCT can be useful to monitor FM progression