Light-distortion analysis as a possible indicator of visual quality after refractive lens exchange with diffractive multifocal intraocular lenses

METHODS: Refractive lens exchange was performed with implantation of an AT Lisa 839M (trifocal) or 909MP (bifocal toric) IOL, the latter if corneal astigmatism was more than 0.75 diopter (D). The postoperative visual and refractive outcomes were evaluated. A prototype light-distortion analyzer was used to quantify the postoperative light-distortion indices. A control group of eyes in which a Tecnis ZCB00 1-piece monofocal IOL was implanted had the same examinations. RESULTS: A trifocal or bifocal toric IOL was implanted in 66 eyes. The control IOL was implanted in 18 eyes. All 3 groups obtained a significant improvement in uncorrected distance visual acuity (UDVA) (P < .001) and corrected distance visual acuity (CDVA) (P Z .001). The mean uncorrected near visual acuity (UNVA) was 0.123 logMAR with the trifocal IOL and 0.130 logMAR with the bifocal toric IOL. The residual refractive cylinder was less than 1.00 D in 86.7% of cases with the toric IOL. The mean light-distortion index was significantly higher in the multifocal IOL groups than in the monofocal group (P < .001), although no correlation was found between the light-distortion index and CDVA. CONCLUSIONS: The multifocal IOLs provided excellent UDVA and functional UNVA despite increased light-distortion indices. The light-distortion analyzer reliably quantified a subjective component of vision distinct from visual acuity; it may become a useful adjunct in the evaluation of visual quality obtained with multifocal IOLs.

Transformando o espaço educativo numa comunidade de aprendizagem

Relatório de estágio de mestrado em Educação Pré-Escolar e Ensino do 1º Ciclo do Ensino Básico

Para uma semiótica da luz. Da visão mítica aos regimes escópicos da contemporaneidade

Tese de Doutoramento em Ciências da Comunicação

Perceções de docentes do ensino básico e secundário sobre o papel da supervisão pedagógica enquanto contexto de desenvolvimento profissional: um estudo com professores de geografia

Tese de Doutoramento em Ciências da Educação (área de especialização em Supervisão Pedagógica)

Peripheral refraction with eye and head rotation with contact lenses

Purpose: To evaluate the impact of eye and head rotation in the measurement of peripheral refraction with an open-field autorefractometer in myopic eyes wearing two different center-distance designs of multifocal contact lenses (MFCLs). Methods: Nineteen right eyes from 19 myopic patients (average central M ± SD = −2.67 ± 1.66 D) aged 20–27 years (mean ± SD = 23.2 ± 3.3 years) were evaluated using a Grand-Seiko autorefractometer. Patients were fitted with one multifocal aspheric center-distance contact lens (Biofinity Multifocal D®) and with one multi-concentric MFCL (Acuvue Oasys for Presbyopia). Axial and peripheral refraction were evaluated by eye rotation and by head rotation under naked eye condition and with each MFCL fitted randomly and in independent sessions. Results: For the naked eye, refractive pattern (M, J0 and J45) across the central 60◦ of the horizontal visual field values did not show significant changes measured by rotating the eye or rotating the head (p > 0.05). Similar results were obtained wearing the Biofinity D, for both testing methods, no obtaining significant differences to M, J0 and J45 values (p > 0.05). For Acuvue Oasys for presbyopia, also no differences were found when comparing measurements obtained by eye and head rotation (p > 0.05). Multivariate analysis did not showed a significant interaction between testing method and lens type neither with measuring locations (MANOVA, p > 0.05). There were significant differences in M and J0 values between naked eyes and each MFCL. Conclusion: Measurements of peripheral refraction by rotating the eye or rotating the head in myopic patients wearing dominant design or multi-concentric multifocal silicone hydrogel contact lens are comparable.

Strategies to regulate myopia progression with contact lenses: a review

Purpose: Higher myopic refractive errors are associated with serious ocular complications that can put visual function at risk. There is respective interest in slowing and if possible stopping myopia progression before it reaches a level associated with increased risk of secondary pathology. The purpose of this report was to review our understanding of the rationale(s) and success of contact lenses (CLs) used to reduce myopia progression. Methods: A review commenced by searching the PubMed database. The inclusion criteria stipulated publications of clinical trials evaluating the efficacy of CLs in regulating myopia progression based on the primary endpoint of changes in axial length measurements and published in peerreviewed journals. Other publications from conference proceedings or patents were exceptionally considered when no peer-review articles were available. Results: The mechanisms that presently support myopia regulation with CLs are based on the change of relative peripheral defocus and changing the foveal image quality signal to potentially interfere with the accommodative system. Ten clinical trials addressing myopia regulation with CLs were reviewed, including corneal refractive therapy (orthokeratology), peripheral gradient lenses, and bifocal (dual-focus) and multifocal lenses. Conclusions: CLs were reported to be well accepted, consistent, and safe methods to address myopia regulation in children. Corneal refractive therapy (orthokeratology) is so far the method with the largest demonstrated efficacy in myopia regulation across different ethnic groups. However, factors such as patient convenience, the degree of initial myopia, and non-CL treatments may also be considered. The combination of different strategies (i.e., central defocus, peripheral defocus, spectral filters, pharmaceutical delivery, and active lens-borne illumination) in a single device will present further testable hypotheses exploring how different mechanisms can reinforce or compete with each other to improve or reduce myopia regulation with CLs.

Desenvolvimento de rede neuronal artificial para o diagnóstico de doenças neurodegenerativas

Dissertação de mestrado integrado em Engenharia Eletrónica Industrial e Computadores

Mineralizações associadas a shear zone networking na vertente oriental da Serra de Arga (Minho, Portugal)

Dissertação de mestrado em Ordenamento e Valorização de Recursos Geológicos

Os manuais e a reforma do ensino liceal de 1936 em Portugal. Um prólogo para a história do manual único

[Excerto] Na presente reflexão pretendemos sondar os objetivos que foram sendo propostos para o ensino secundário após o golpe militar de 28 de maio de 1926. A um primeiro momento, designado de Ditadura Militar, sucedeu a configuração do denominado Estado Novo, sendo este período pautado, no essencial, pela sistemática explicitação do modo como se constituiu a lapidar e necessária educação nacionalista, neste clima, o Liceu é concebido como o espaço de afirmação e de formação das elites do regime. Os princípios conservadores, totalitários e de estancamento da mobilidade social, foram expressos numa progressiva definição, cada vez mais radical, nos seus enunciados1. Para darmos conta desta trajetória, dividiremos a nossa reflexão em duas partes (...).

Cognitive functioning and efficacy of cognitive intervention in Multiple Sclerosis

Tese de Doutoramento em Psicologia Clínica / Psicologia

“Learning through Radio, Learning for Life!”: Notas sobre o desenvolvimento de uma rádio participativa online

(Excerto) Olhando para o percurso do RadioActive, há uma ideia que parece ser transversal a todo o projeto. Referimo-nos a um princípio que chamaríamos de “identificação” e que foi determinante – é determinante – nos processos de investigação participativa. Falamos da identificação dos investigadores com os princípios da investigação-ação, da identificação das intervenções com as particularidades de cada contexto. Da imprescindível e progressiva identificação dos participantes com o projeto. Na verdade, sem esta multifacetada identificação é impossível pensar em resultados sustentáveis e persistentes. Investigadores e demais participantes têm de sentir que o projeto é “seu”, que os objetivos são “seus”, embora o façam necessariamente a velocidades diferentes. A aprendizagem, neste âmbito, expande-se sempre de dentro para fora, emerge dos interesses do sujeito e não de uma estrutura pré-concebida e imposta pelos que chegam (Ravenscroft et al., 2011), neste caso, os investigadores. Uma das diferenças das pesquisas participativas em relação às tradicionais é, precisamente, a atuação coletiva e não solitária do investigador. Os pesquisadores fazem parte de um processo participatório em que estão envolvidos numa estrutura (Cammarota & Fine, 2008: 5). Paulo Freire é o autor primordial em todos os projetos e países onde a RA101 foi aplicada. As suas concepções em torno da investigação-ação participativa tentam apontar sempre para uma ação e também para uma reflexão sobre os processos.