Discrepancy between Visual Acuity and Microperimetry in AMD Patients: Visual Acuity Appears as an Inadequate Parameter to Test Macular Function.

BACKGROUND: Best corrected visual acuity (BCVA) of 0.8 or above in AMD patients can sometimes correspond to poor macular function inducing a serious visual handicap. Microperimetry can be used to objectivize this difference. PATIENTS AND METHODS: A retrospective study was undertaken on 233 files of AMD patients of whom 82 had had a microperimetry. BCVA was compared with microperimetry performance. All examinations were performed in an identical setting by the same team of 3 persons. RESULTS: Among the 82 patients included, 32 (39.0%) had a BCVA equal to or above 0.8 even though their microperimetry performance was lower than 200/560 db. 10 of them (12.2% of total) had an even poorer microperimetry below 120/560 db indicating poor macular function. CONCLUSIONS: More than a third of the AMD patients had a bad or very bad microperimetry performance in parallel with a good visual acuity. Microperimetry is a valuable tool to assess and follow real macular function in AMD patients when visual acuity alone can be misleading.

Impact of examinees' stereopsis and near visual acuity on laparoscopic virtual reality performance.

PURPOSE: Laparoscopic surgery represents specific challenges, such as the reduction of a three-dimensional anatomic environment to two dimensions. The aim of this study was to investigate the impact of the loss of the third dimension on laparoscopic virtual reality (VR) performance. METHODS: We compared a group of examinees with impaired stereopsis (group 1, n = 28) to a group with accurate stereopsis (group 2, n = 29). The primary outcome was the difference between the mean total score (MTS) of all tasks taken together and the performance in task 3 (eye-hand coordination), which was a priori considered to be the most dependent on intact stereopsis. RESULTS: The MTS and performance in task 3 tended to be slightly, but not significantly, better in group 2 than in group 1 [MTS: -0.12 (95 % CI -0.32, 0.08; p = 0.234); task 3: -0.09 (95 % CI -0.29, 0.11; p = 0.385)]. The difference of MTS between simulated impaired stereopsis between group 2 (by attaching an eye patch on the adominant eye in the 2nd run) and the first run of group 1 was not significant (MTS: p = 0.981; task 3: p = 0.527). CONCLUSION: We were unable to demonstrate an impact of impaired examinees' stereopsis on laparoscopic VR performance. Individuals with accurate stereopsis seem to be able to compensate for the loss of the third dimension in laparoscopic VR simulations.

Niños y niñas soldado: consecuencias psicológicas e intervención.

La participación activa de menores en situaciones de conflicto armado se da en diversos países del mundo, considerándose un problema global que afecta a cientos de miles de niños y niñas. Sin embargo, los estudios realizados en cuanto a los efectos que pueden tener los conflictos bélicos sobre la salud mental de los niños y niñas soldado son todavía escasos. El objetivo de este trabajo es ofrecer una revisión actualizada de las publicaciones sobre las principales consecuencias psicológicas halladas y los programas de intervención propuestos en relación con el tema de los menores soldado. Los resultados muestran que la realidad de los niños y niñas soldado sigue siendo dramática a nivel internacional. Una de las principales conclusiones a resaltar es la necesidad de contextualización,tanto como sea posible, de los programas de intervención en la cultura de los niños con los que se va a trabajar.

Visual Measurement and Modelling of Tool Wear in Rough Turning

Huolimatta korkeasta automaatioasteesta sorvausteollisuudessa, muutama keskeinen ongelma estää sorvauksen täydellisen automatisoinnin. Yksi näistä ongelmista on työkalun kuluminen. Tämä työ keskittyy toteuttamaan automaattisen järjestelmän kulumisen, erityisesti viistekulumisen, mittaukseen konenäön avulla. Kulumisen mittausjärjestelmä poistaa manuaalisen mittauksen tarpeen ja minimoi ajan, joka käytetään työkalun kulumisen mittaukseen. Mittauksen lisäksi tutkitaan kulumisen mallinnusta sekä ennustamista. Automaattinen mittausjärjestelmä sijoitettiin sorvin sisälle ja järjestelmä integroitiin onnistuneesti ulkopuolisten järjestelmien kanssa. Tehdyt kokeet osoittivat, että mittausjärjestelmä kykenee mittaamaan työkalun kulumisen järjestelmän oikeassa ympäristössä. Mittausjärjestelmä pystyy myös kestämään häiriöitä, jotka ovat konenäköjärjestelmille yleisiä. Työkalun kulumista mallinnusta tutkittiin useilla eri menetelmillä. Näihin kuuluivat muiden muassa neuroverkot ja tukivektoriregressio. Kokeet osoittivat, että tutkitut mallit pystyivät ennustamaan työkalun kulumisasteen käytetyn ajan perusteella. Parhaan tuloksen antoivat neuroverkot Bayesiläisellä regularisoinnilla.

Visual realism enhances realistic response in an immersive virtual environment

Participants in an immersive virtual environment interact with the scene from an egocentric point of view that is, where there bodies appear to be located rather than from outside as if looking through a window. People interact through normal body movements, such as head-turning,reaching, and bending, and within the tracking limitations move through the environment or effect changes within it in natural ways.

Visual realism enhances realistic response in an immersive virtual environment - Part2

Does realistic lighting in an immersive virtual reality application enhance presence, where participants feel that they are in the scene and behave correspondingly? Our previous study indicated that presence is more likely with real-time ray tracing compared with ray casting, but we could not separate the effects of overall quality of illumination from the dynamic effects of real-time shadows and reflections. Here we describe an experiment where 20 people experienced a scene rendered with global or local illumination. However, in both conditions there were dynamically changing shadows and reflections. We found that the quality of illumination did not impact presence, so that the earlier result must have been due to dynamic shadows and reflections. However, global illumination resulted in greater plausibility - participants were more likely to respond as if the virtual events were real. We conclude that global illumination does impact the responses of participants and is worth the effort.

Electrostimulation mapping of comprehension of auditory and visual words.

In order to spare functional areas during the removal of brain tumours, electrical stimulation mapping was used in 90 patients (77 in the left hemisphere and 13 in the right; 2754 cortical sites tested). Language functions were studied with a special focus on comprehension of auditory and visual words and the semantic system. In addition to naming, patients were asked to perform pointing tasks from auditory and visual stimuli (using sets of 4 different images controlled for familiarity), and also auditory object (sound recognition) and Token test tasks. Ninety-two auditory comprehension interference sites were observed. We found that the process of auditory comprehension involved a few, fine-grained, sub-centimetre cortical territories. Early stages of speech comprehension seem to relate to two posterior regions in the left superior temporal gyrus. Downstream lexical-semantic speech processing and sound analysis involved 2 pathways, along the anterior part of the left superior temporal gyrus, and posteriorly around the supramarginal and middle temporal gyri. Electrostimulation experimentally dissociated perceptual consciousness attached to speech comprehension. The initial word discrimination process can be considered as an "automatic" stage, the attention feedback not being impaired by stimulation as would be the case at the lexical-semantic stage. Multimodal organization of the superior temporal gyrus was also detected since some neurones could be involved in comprehension of visual material and naming. These findings demonstrate a fine graded, sub-centimetre, cortical representation of speech comprehension processing mainly in the left superior temporal gyrus and are in line with those described in dual stream models of language comprehension processing.

Programa educativo sobre el cuidado de espalda en niños de 4º de primaria y su posterior valoración a lo largo de 6 años.

Introducción: Según la bibliografía encontrada no está claro de donde procede concretamente el dolor de espalda en la infancia, pero según los últimos estudios realizados se inclinan hacia el factor psicosocial. Aun así no descartan en ningún momento que se deba de realizar una educación desde todos los aspectos, ya que hay varios factores que pueden ayudar a su aparición y perpetuación. Los estudios relacionados con el tema indican que en los programas educativos llevados a cabo los conocimientos se mantienen a lo largo de 2 años. En estas intervenciones no se incluye el lado psicosocial de las personas, sino que se centran solamente en el aspecto mecánico y con muy pocas sesiones o en su mayoría solamente teóricas. Objetivo: valorar la adquisición de conocimientos sobre el cuidado de espalda en 4º de primaria y a lo largo de 6 años. Metodología: para llevar a cabo este proyecto se incluirán dos colegios de Pamplona con alumnos de 4º primaria. Uno de ellos será de control y en el otro se impartirá un programa educativo sobre el cuidado de espalda. Antes de comenzar con el programa se pasarán las encuestas para valorar los conocimientos, la escala de valoración del estado anímico y dolor “face rating scale”. Una vez acabas con ellas, empezará la intervención de 5 semanas, dos clases por semana. Las clases serán de una hora, dos horas por semana, una teórica y otra práctica. Una vez acabado el programa se volverán a pasar las tres encuestas en los dos colegios y a continuación a lo largo de los 6 años que dura el estudio para valorar cómo evolucionan los conocimientos adquiridos.

Eficacia del kinesiotape como terapia complementaria en niños que presentan espasticidad.

¿Se obtiene una mejora de resultados añadiendo Kinesiotape a sujetos que presentan PCI espástica comparado con un tratamiento convencional de fisioterapia? Objetivos: Evaluar la efectividad del Kinesiotape en cuanto a disminución de espasticidad y tono muscular, mejora de calidad de vida y aumento del rango articular. Material y métodos: se buscará una muestra de 238 sujetos con PCI espástica entre 5 y 20 años y que presenten una sinergia flexora en extremidad superior. Como criterios de exclusión se consideran: cualquier contraindicación del Kinesiotape, intervención quirúrgica de extremidad superior, consumo de neurotoxinas, bloqueantes nerviosos con agentes neurolíticos, relajantes musculares y pacientes que hayan sido tratados mediante Toxina Botulínica en extremidad superior. Los sujetos serán aleatoriamente distribuidos en dos grupos; un grupo control (n = 119) el cual realiza tratamiento específico de Bobath y un grupo experimental (n = 119) el cual realiza el tratamiento específico de Bobath añadiendo el Kinesiotape en la musculatura del bíceps braquial. Esta intervención durará ocho semanas y se reevaluarán los resultados en un periodo de seis meses y a los doce meses. Para ello se utilizaran las siguientes escalas: para la espasticidad se utilizarán las escalas de Tardieu - Held y la de Aswhorth modificada. Para medir la independencia del niño se emplearán la escala Pediatric Evaluation of Disability Inventory (PEDI), para conocer el rango articular se utilizarán un goniómetro de brazos y para determinar la actividad eléctrica del tono muscular la electromiografía (EMG).

Evaluating the impact of summer vacation on the visual acuity of AMD patients treated with ranibizumab.

PurposeTo evaluate the impact of traditional French summer vacation on visual acuity and spectral domain-optical coherence tomography (SD-OCT) of Wet AMD patients being treated with intravitreal Ranibizumab.MethodsThis was a consecutive, comparative, single-centre, prospective analysis. All patients who were being treated with intravitreal injection of 0.5 mg ranibizumab at Cergy Pontoise Hospital, Department of Ophthalmology between July 2013 and September 2014 were included. Patients were divided into two groups: (A) patients who skipped one ranibizumab intravitreal injection during holidays, and (B) patients who received injection during their holidays. Evaluations occurred prior to traditional holiday (baseline) and 2 months later, consisting of BCVA using ETDRS, and a complete ophthalmic examination that included slit-lamp biomicroscopy, fundus examination, fluorescein angiography (FA), indocyanine green angiography (ICGA), and spectral domain-optical coherence tomography (SD-OCT). All patients were being treated with PRN anti-VEGF regimen and criteria for reinjection included a visual acuity loss >5 ETDRS letters and/or an increase of central retinal thickness, presence of subretinal fluid, intraretinal fluid, or pigment epithelium detachment. If reinjection criteria were not met, patients were advised to return in 4 weeks.ResultsThe mean visual acuity change was -0.071±0.149 (LogMAR) in group A and +0.003±0.178 in group B (P=0.041). At the second visit (2 months after preholidays visit), 61.8% of patients in group A had SRF and/or intraretinal cysts, and only 27.6% of patients in group B. There was a significant difference in the persistence of fluid between the two groups (P=0.007, χ(2)-test).ConclusionThis cases series demonstrated the detrimental impact of holidays on visual acuity in patients treated with ranibizumab for AMD, which, in spite of their treatment regimen, still leave in vacation. Therefore, it is important to convey the message of treatment adherence to patients, despite their need of holidays.

Comparison of acute non-visual bright light responses in patients with optic nerve disease, glaucoma and healthy controls.

This study examined the effect of optic nerve disease, hence retinal ganglion cell loss, on non-visual functions related to melanopsin signalling. Test subjects were patients with bilateral visual loss and optic atrophy from either hereditary optic neuropathy (n = 11) or glaucoma (n = 11). We measured melatonin suppression, subjective sleepiness and cognitive functions in response to bright light exposure in the evening. We also quantified the post-illumination pupil response to a blue light stimulus. All results were compared to age-matched controls (n = 22). Both groups of patients showed similar melatonin suppression when compared to their controls. Greater melatonin suppression was intra-individually correlated to larger post-illumination pupil response in patients and controls. Only the glaucoma patients demonstrated a relative attenuation of their pupil response. In addition, they were sleepier with slower reaction times during nocturnal light exposure. In conclusion, glaucomatous, but not hereditary, optic neuropathy is associated with reduced acute light effects. At mild to moderate stages of disease, this is detected only in the pupil function and not in responses conveyed via the retinohypothalamic tract such as melatonin suppression.

Visual performance in preterm infants with brain injuries compared with low-risk preterm infants

Background: Neonatal brain injuries are the main cause of visual deficit produced by damage to posterior visual pathways.While there are several studies of visual function in low-risk preterm infants or older children with brain injuries, research in children of early age is lacking. Aim: To assess several aspects of visual function in preterm infants with brain injuries and to compare them with another group of low-risk preterm infants of the same age. Study design and subjects: Forty-eight preterm infants with brain injuries and 56 low-risk preterm infants. Outcome measures: The ML Leonhardt Battery of Optotypes was used to assess visual functions. This test was previously validated at a post-menstrual age of 40 weeks in newborns and at 30-plus weeks in preterm infants. Results: The group of preterminfants with brain lesions showed a delayed pattern of visual functions in alertness, fixation, visual attention and tracking behavior compared to infants in the healthy preterm group. The differences between both groups, in the visual behaviors analyzed were around 30%. These visual functions could be identified from the first weeks of life. Conclusion: Our results confirm the importance of using a straightforward screening test with preterminfants in order to assess altered visual function, especially in infants with brain injuries. The findings also highlight the need to provide visual stimulation very early on in life.

Spinal cord injury affects the interplay between visual and sensorimotor representations of the body.

The brain integrates multiple sensory inputs, including somatosensory and visual inputs, to produce a representation of the body. Spinal cord injury (SCI) interrupts the communication between brain and body and the effects of this deafferentation on body representation are poorly understood. We investigated whether the relative weight of somatosensory and visual frames of reference for body representation is altered in individuals with incomplete or complete SCI (affecting lower limbs' somatosensation), with respect to controls. To study the influence of afferent somatosensory information on body representation, participants verbally judged the laterality of rotated images of feet, hands, and whole-bodies (mental rotation task) in two different postures (participants' body parts were hidden from view). We found that (i) complete SCI disrupts the influence of postural changes on the representation of the deafferented body parts (feet, but not hands) and (ii) regardless of posture, whole-body representation progressively deteriorates proportionally to SCI completeness. These results demonstrate that the cortical representation of the body is dynamic, responsive, and adaptable to contingent conditions, in that the role of somatosensation is altered and partially compensated with a change in the relative weight of somatosensory versus visual bodily representations.