Modified Corneal Collagen Crosslinking (CXL) Reduces Corneal Edema and Diurnal Visual Fluctuations in Fuchs' Dystrophy

Purpose: Crosslinking of corneal collagen with riboflavin and ultraviolet-A irradiation (CXL) induces crosslinks within and between collagen fibers. CXL increases corneal biomechanical and biochemical stability and is currently used clinically to treat keratectasia. CXL also significantly reduces the stromal swelling capacity. We investigated whether a modified CXL treatment protocol would be beneficial in early Fuchs' dystrophy with various degrees of corneal edema and diurnal variations in visual acuity. Methods: CXL was performed as published previously with the following modification: in cases where the stroma was thicker than 450 µm after abrasion and 30 minutes of instillation of isoosmolar riboflavin solution, glycerol 70% solution was applied every 5 seconds for two minutes, and central corneal thickness (CCT) was measured using ultrasound pachymetry. Glycerol 70% solution was administered repeatedly until the target corneal thickness of 370-430 µm was reached. During irradiation, CCT was monitored by ultrasound pachymetry every five minutes and glycerol 70% solution was applied, if necessary. Results: Three eyes in two patients were treated using the modified CXL protocol. Representative case: a 50-year-old woman with Fuchs' dystrophy and a history of 3 years of diurnal visual fluctuations was referred to us in March 2008. Preoperative best spectacle-corrected visual acuity (BSCVA) was 20/50. We performed modified CXL in the left eye. At one month after CXL, Scheimpflug analysis of CCT showed a reduction of more than 100 µm, and the Corneal Thickness Spatial Profile (CTSP) and Percentage of Increase in Thickness (PIT) showed a regularization of the "flattening" typical for Fuchs' dystrophy. Accordingly, diurnal analysis of corneal thickness showed a distinct postoperative reduction in CCT at all time points measured. At one month after CXL, the patient reported a reduction of diurnal visual fluctuations and we measured an increase in BSCVA to 20/32. The patient showed stable topographical and visual acuity at the three months follow-up. Conclusions: We saw a distinct reduction in CCT, an improvement of the corneal thickness spatial profile (CTSP) and an increase in BSCVA at one month after treatment, which remained stable at the three months follow-up. Patients with early Fuchs' dystrophy and disturbing diurnal visual fluctuations represent a novel application for CXL. Although CXL may not prevent the outcome of the dystrophy, it may increase the patients' visual comfort until keratoplasty becomes necessary.

White Cane Update, Winter 2008

The White Cane Update newsletter includes information about the latest happenings at the Iowa Department for the Blind.

Independent Living Program, Vol. 1, 2008

The Iowa Department for the Blind is the state agency that serves Iowans with vision loss. Services are free, confidential and available statewide. "There are no limitations to what you can do with training and a positive attitude." (All quotes in this newsletter are from former training participants). At the Iowa Department for the Blind, we believe in a positive approach to blindness. Vision loss alone should not prevent anyone from being independent. For this reason, we offer a wide variety of opportunities to obtain the skills necessary for independence.

Independent Living Program, Vol. 2, 2008

The Iowa Department for the Blind is the state agency that serves Iowans with vision loss. Services are free, confidential and available statewide. "There are no limitations to what you can do with training and a positive attitude." (All quotes in this newsletter are from former training participants). At the Iowa Department for the Blind, we believe in a positive approach to blindness. Vision loss alone should not prevent anyone from being independent. For this reason, we offer a wide variety of opportunities to obtain the skills necessary for independence.

Independent Living Program, Vol. 3, 2008

The Iowa Department for the Blind is the state agency that serves Iowans with vision loss. Services are free, confidential and available statewide. "There are no limitations to what you can do with training and a positive attitude." (All quotes in this newsletter are from former training participants). At the Iowa Department for the Blind, we believe in a positive approach to blindness. Vision loss alone should not prevent anyone from being independent. For this reason, we offer a wide variety of opportunities to obtain the skills necessary for independence.

Open Door Newsletter of the Library, Spring 2008

The Open Door newsletter is produced by the Iowa Commission for the Blind. It is published twice a year with information about the library programs and what is going on.

Orientation Center Newsletter, Vol. 28, no. 1, Summer 2008

The Orientation Center newsletter is produced three times a year, and includes articles written by students, staff, and former students. It also contains news about what is happening to other students who have been in the Center.

Orientation Center Newsletter, Vol. 28, no. 2, November-December 2008

The Orientation Center newsletter is produced three times a year, and includes articles written by students, staff, and former students. It also contains news about what is happening to other students who have been in the Center.

Iowa Arts Council: Strategic Plan 2008-2011.

Goals and strategies for the strategic plan.

Integral Bridge Abutment-to-Approach Slab Connection Final Report, June 2008

The Iowa Department of Transportation has long recognized that approach slab pavements of integral abutment bridges are prone to settlement and cracking, which manifests as the “bump at the end of the bridge”. A commonly recommended solution is to integrally attach the approach slab to the bridge abutment. Two different approach slabs, one being precast concrete and the other being cast-inplace concrete, were integrally connected to side-by-side bridges and investigated. The primary objective of this investigation was to evaluate the approach slab performance and the impacts the approach slabs have on the bridge. To satisfy the research needs, the project scope involved a literature review, survey of Midwest Department of Transportation current practices, implementing a health monitoring system on the bridge and approach slab, interpreting the data obtained during the evaluation, and conducting periodic visual inspections. Based on the information obtained from the testing the following general conclusions were made: The integral connection between the approach slabs and the bridges appear to function well with no observed distress at this location and no relative longitudinal movement measured between the two components; Tying the approach slab to the bridge appears to impact the bridge; The two different approach slabs, the longer precast slab and the shorter cast-in-place slab, appear to impact the bridge differently; The measured strains in the approach slabs indicate a force exists at the expansion joint and should be taken into consideration when designing both the approach slab and the bridge; The observed responses generally followed an annual cyclic and/or short term cyclic pattern over time.

Us explico un conte? Ús de llibres il·lustrats per a la didàctica de l'educació visual i plàstica

L'objectiu d'aquest article és promoure la incorporació de llibres il-lustrats a l'espai docent, tot defensant la interacció entre escola i entorn. Amb aquesta intenció es presenta una experiència docent que es du a terme a les classes de Didàctica de l'Educació Visual i Plàstica (UB), en la formació inicial del professorat d'educació primària, que empra el llibre il-lustrat com a eina docent. Es tracta d'un corpus d'obres de gran qualitat, la temàtica dels quals està relacionada amb el fet artístic i la seva didàctica. Amb l'ús a les aules universitàries d'aquest tipus de llibres es volen aconseguir principalment tres objectius: donar-los a conèixer als futurs mestres per a la seva formació i perquè els puguin compartir amb els seus futurs alumnes a les aules d'Educació Primària; tractar temes específics de l'àrea de plàstica, i fomentar la reflexió sobre la pràctica docent o altres temes específics.

Dins el bosc de la cultura visual. Apunts per a una actualització pedagògica

L'era de la comunicació acara la comunitat educativa davant de nous reptes, especialment en l'àmbit de la cultura visual. La cultura visual es manifesta avui arreu i no hi ha àmbit ni familiar ni social ni educatiu que no en participi. Més enllà de la visualització i experimentació d'alguns procediments artístics canònics, l'ensenyament de les arts visuals i plàstiques observa la necessitat d'ampliar el seu radi d'acció, reflexió i anàlisi de manera coparticipada. Un repàs a la trajectòria històrica de l'aprenentatge artístic dóna peu a algunes preguntes rellevants com ara, quins aprenentatges per a quines competències? Per a quina societat i amb quins instruments cal educar els infants? Quines inèrcies i teories s¿hereten del passat i quin lloc cal que tinguin en el futur? Quines aportacions cognitives o empíriques permetrien una renovació positiva en l'àmbit de l¿educació visual i plàstica? Són preguntes difícils però peremptòries si no es vol girar l'esquena a l'evidència dels canvis comunicatius i socials del nostre temps.

Guia de Camtasia Studio

Aquest document és una introducció a l’eina Camtasia Studio. L’aplicació està especialitzada, entre d’altres, a elaborar vídeos de contingut docent accessible a partir de presentacions preparades en Microsoft PowerPoint.