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A 29-year-old girl presented complaining of acute bilateral visual loss associated with mild headache and retrobulbar pain. She was diagnosed with chiasmal optic neuritis caused by multiple sclerosis. Her visual acuity and visual field defect promptly improved after steroid therapy. However optical coherence tomography angiography showed a progressive reduction of superficial capillary plexus density of the retina and optic nerve consistent with the progressive impairment of the retinal ganglionar cell layer. Contrary to chiasmal compression, in chiasmal optic neuritis, the superficial capillary plexus density reduction is diffuse and does not reflect the peculiar anatomy of the chiasm.

In the last three decades, benthic foraminiferal ecology has been intensively investigated to improve the potential application of these marine organisms as proxies of the effects of climate change and other global change phenomena. It is still challenging to define the most important factors affecting foraminiferal communities and derived faunistic parameters. In this study, we examined the abiotic-biotic relationships of foraminiferal communities in the central-southern area of the Adriatic Sea using modern machine learning techniques. We combined gradient forest (Gf) and structural equation modeling (SEM) to test hypotheses about determinants of benthic foraminiferal assemblages. These approaches helped determine the relative effect of sizes of different environmental variables responsible for shaping living foraminiferal distributions. Four major faunal turnovers (at 13–28 m, 29–58 m, 59–215 m, and >215 m) were identified along a large bathymetric gradient (13–703 m water depth) that reflected the classical bathymetric distribution of benthic communities. Sand and organic matter (OM) contents were identified as the most relevant factors influencing the distribution of foraminifera either along the entire depth gradient or at selected bathymetric ranges. The SEM supported causal hypotheses that focused the factors that shaped assemblages at each bathymetric range, and the most notable causal relationships were direct effects of depth and indirect effects of the Gf-identified environmental parameters (i.e., sand, pollution load Index–PLI, organic matter–OM and total nitrogen–N) on foraminifera infauna and diversity. These results are relevant to understanding the basic ecology and conservation of foraminiferal communities.

Bottom trawl fisheries often catch several species simultaneously. However, most studies addressing the catch performance and selectivity of a specific trawl focus on a few commercially important or most vulnerable species requiring management measures. By contrast, the present study considers the multispecies nature of Mediterranean bottom trawl fisheries through a holistic approach that accounts for the full species community in the catches. Specifically, we evaluated and compared the catch performance of the two codends allowed for this fishery, made of 40 mm square (SM40) and 50 mm diamond (DM50) meshes. Results showed that 50 and 80% of the catch in weight and count numbers, respectively, consisted of species without commercial value, demonstrating that large proportions of the catch are not considered when using the existing approach to evaluate the ecological impact of the fishing activity. Significant differences in catch profiles between the two codends were observed, especially for two commercial flatfish species, Arnoglossus laterna and Citharus linguatula, with larger contributions in the SM40. Further, the SM40 codend had a significantly higher retention, compared to DM50 codend, for specific sizes of Merluccius merluccius and Mullus barbatus. The outcomes of the study can be useful for the Mediterranean bottom trawl fisheries management.

An otherwise healthy 72-year-old Chinese patient diagnosed with exudative age-related macular degeneration and decreased vision in left eye was fully investigated. The retrospective analysis of past multimodal imaging revealed bilateral severe choroidal neovascularization and choroiditis associated with a positive tuberculin skin testing and interferon-gamma release assay (QuantiFERON-TB Gold – Cellestis®, Chadstone, VIC, Australia) suggestive of latent ocular tuberculosis. The variable presentation and tests’ results interpretation represent the greatest limitations in understanding and treating intraocular TB (IOTB). This may present without any other systemic symptoms, the intraocular tissues are of limited access to biopsies and other tests, including imaging and immunological tests, are of relative value. This case highlights how variable may be the presentation of IOTB, which can be easily misdiagnosed leading to a delayed treatment and worse prognosis.

Passive acoustics are widely used to monitor the presence of dolphins in the marine environment. This study aims to introduce a low-cost and homemade approach for assembling a complete underwater microphone (i.e., the hydrophone), employing cheap and easy to obtain components. The hydrophone was assembled with two piezo disks connected in a balanced configuration and encased in a plastic container filled with plastic foam. The hydrophone’s performance was validated by direct comparison with the commercially available AS-1 hydrophone (Aquarian Hydrophones, Anacortes, U.S.) on different underwater acoustic signals: artificial acoustic signals (ramp and multitone signals) and various dolphin vocalizations (whistle, echolocation clicks, and burst pulse signals). The sensitivity of the device’s performance to changes in the emission source position was also tested. The results of the validation procedure on both artificial signals and real dolphin vocalizations showed that the significant cost savings associated with cheap technology had a minimal effect on the recording device’s performance within the frequency range of 0–35 kHz. At this stage of experimentation, the global cost of the hydrophone could be estimated at a few euros, making it extremely price competitive when compared to more expensive commercially available models. In the future, this effective and low-cost technology would allow for continuous monitoring of the presence of free-ranging dolphins, significantly lowering the total cost of autonomous monitoring systems. This would permit broadening the monitored areas and creating a network of recorders, thus improving the acquisition of data.

Purpose: To describe a case of fulminant idiopathic intracranial hypertension (IIH) in a child with “malignant” presentation. Case report: A 16-year-old, previously healthy, girl presented with bilateral visual loss and bilateral global limitation of eye movements in the absence of headache. Extensive laboratory evaluation for infectious, inflammatory, autoimmune, and neoplastic conditions was negative. Magnetic resonance imaging (MRI) of the brain and lumbar puncture findings were consistent with a diagnosis of IIH. Extraocular motility improved in the next few days as well as optic disc edema but visual acuity remained poor. Conclusion: The authors believe that the acute, severe, and fulminant (“malignant”) presentation with markedly elevated intracranial pressure may produce the unique presentation of severe vision loss and bilateral complete ophthalmoplegia. Interestingly, there was no headache. To our knowledge this is the first such case to be reported in the English language ophthalmic literature.

Primary productivity in the Ross Sea region is characterized by intense phytoplankton blooms whose temporal and spatial distribution are driven by changes in environmental conditions as well as interactions with the bacterioplankton community. However, the number of studies reporting the simultaneous diversity of the phytoplankton and bacterioplankton in Antarctic waters are limited. Here, we report data on the bacterial diversity in relation to phytoplankton community structure in the surface waters of the Ross Sea during the Austral summer 2017. Our results show partially overlapping bacterioplankton communities between the stations located in the Terra Nova Bay (TNB) coastal waters and the Ross Sea Open Waters (RSOWs), with a dominance of members belonging to the bacterial phyla Bacteroidetes and Proteobacteria. In the TNB coastal area, microbial communities were characterized by a higher abundance of sequences related to heterotrophic bacterial genera such as Polaribacter spp., together with higher phytoplankton biomass and higher relative abundance of diatoms. On the contrary, the phytoplankton biomass in the RSOW were lower, with relatively higher contribution of haptophytes and a higher abundance of sequences related to oligotrophic and mixothrophic bacterial groups like the Oligotrophic Marine Gammaproteobacteria (OMG) group and SAR11. We show that the rate of diversity change between the two locations is influenced by both abiotic (salinity and the nitrogen to phosphorus ratio) and biotic (phytoplankton community structure) factors. Our data provide new insight into the coexistence of the bacterioplankton and phytoplankton in Antarctic waters, suggesting that specific rather than random interaction contribute to the organic matter cycling in the Southern Ocean.

Sediments represent a critical compartment of marine coastal ecosystems due to the toxic and long-lasting effects of the contaminants buried therein. Here, we investigated the properties of surficial sediments in front of the Southern Marche Region coast (Central Adriatic Sea, Italy). The grain size of the surficial sediments was determined by X-ray sedigraphy. TN and OC contents were determined by elemental analysis. The concentrations of Al, Fe, Mg, K, S, Ca, Ti, P, Na, Mn, Mg, Li, As, Ba, Ga, Pb, Sr, and Zn were determined by ICP-OES to evaluate their spatial patterns and temporal trends. A Q-mode Factor Analyses was applied and resulted in the identification of three compositional facies (Padanic, Coastal, and Residual) characterized by common biogeochemical, mineralogical, sedimentological properties, transport pathway, and source. Some pollution indicators, such as the enrichment factor, the geoaccumulation index, and the pollution load index were calculated to assess the deviation from the natural background levels. The results showed a pollution by As and Ba due to the human activities in the 20th century. Furthermore, a general decreasing of Al, Ti, P, Co, Cr, Cu, Ga, Ni, Pb, Sc, V, and Y concentrations from the background levels suggested a change in the sedimentation processes during the last decades.

This paper evaluates the effect of changing from a diamond mesh codend (T0) to a 90° turned mesh codend (T90) on the size selectivity of seven commercially important species in the Mediterranean bottom trawl fishery. In sea trials conducted in the north-western Adriatic, two experimental codends made of 54 mm nominal mesh size netting and differing only in mesh configuration were alternately mounted on the same trawl. Overall, the T90 mesh significantly improved codend size selection for all the species analysed. The difference in the predicted average L50 values between the T90 and T0 codend was particularly marked in European hake ( Merluccius merluccius , 21.26 vs 11.26 cm total length), common squid ( Loligo vulgaris , 12.06 vs 7.88 cm mantle length) and mantis shrimp ( Squilla mantis , 20.78 vs 13.35 mm carapace length). Both codends showed an excessive size selectivity, which involves a commercial loss, especially for red mullet ( Mullus barbatus ), Mediterranean horse mackerel ( Trachurus mediterraneus ) and whiting ( Merlangius merlangus ). These findings demonstrate the efficiency of the T90 configuration in excluding undersized specimens, especially of hake, whose average L50 was above the minimum conservation reference size of 20 cm. The adoption of this practical and inexpensive solution can contribute to improve the management of the demersal resources targeted by the Mediterranean bottom trawl fishery.

Plastic debris in aquatic environments is colonized by microbes, yet factors influencing biofilm development and composition on plastics remain poorly understood. Here, we explored the microbial assemblages associated with different types of plastic debris collected from two coastal sites in the Mediterranean Sea. All plastic samples were heavily colonized by prokaryotes, with abundances up to 1.9×107 cells/cm2. Microbial assemblages on plastics significantly differed between the two geographic areas but not between polymer types, suggesting a major role of the environment as source for the plastisphere composition. Nevertheless, plastic communities differed from those in the surrounding seawater and sediments, indicating a further selection of microbial taxa on the plastic substrates. The presence of potential pathogens on the plastic surface reflected the levels of microbial pollution in the surrounding environment, regardless of the polymer type, and confirmed the role of plastics as carriers for potentially pathogenic microorganisms across the coastal ocean, deserving further investigations.

Hydrocarbon seepage is overlooked in the marine environment, mostly due to the lack of high-resolution exploration data. This contribution is about the set-up of a relocatable and cost-effective monitoring system, which was tested on two seepages in the Central Adriatic Sea. The two case studies are an oil spill at a water depth of 10 m and scattered biogenic methane seeps at a water depth of 84 m. Gas plumes in the water column were detected with a multibeam system, tightened to sub-seafloor seismic reflection data. Dissolved benthic fluxes of nutrients, metals and Dissolved Inorganic Carbon (DIC) were measured by in situ deployment of a benthic chamber, which was used also for the first time to collect water samples for hydrocarbons characterization. In addition, the concentration of polycyclic aromatic hydrocarbons, as well as major and trace elements were analyzed to provide an estimate of hydrocarbon contamination in the surrounding sediment and to make further inferences on the petroleum system.

Bivalve molluscs fishery is of great importance along the Italian coasts, both in economic and landing terms, and different edible bivalve species are harvested both in Adriatic and Tyrrhenian Seas. A medium-term assessment of the impact of the hydraulic dredges targeting razor clam Ensis minor on macro-benthic community was made during two surveys carried out in winter 2017 and late spring – summer 2018 in central Tyrrhenian Sea, which represents the main fishing ground for this species. The study area was located between 1 and 4 m depth, within 0.3 nautical miles from the coast. A net sampler (40 cm width, 18 cm height, and 14 mm mesh size) was mounted on a commercial dredge (3 m width) and enabled to collect specimens of the smallest sizes for the entire community present in the areas. A control area was identified where fishing does not occur, in order to compare exploited and not exploited sea bottoms. The results show that benthic assemblages found in dredged areas are characterized by species living in high-energy habitat, due to the closeness to the shore, and thus showing a high resilience at medium-term disturbs. Differences in species richness were not clearly evident both for the entire community and for the mollusc assemblages evaluated over the two surveys, among the control and the impacted areas, with few exceptions mainly depending on local conditions and anthropic pressure. Thus, even if the benthic community is typical of a moderately disturbed environment, the effects of fishing on the community structure are still discernible over and above the natural variation.

To evaluate the anthropogenic impact in surface sediments of the Northern and Central Adriatic Sea, dissolved fluxes at the sediment water interface of heavy metals and nutrients on the sea bottom in front of the Po River mouths and along the western side of the Northern and Central Adriatic Sea have been determined. The fluxes have been measured by benthic chamber deployments and calculated by pore water modelling. Pore waters composition have been used also to understand the early diagenesis processes generating the benthic fluxes.Benthic chamber deployments and sediment core collection for pore water extraction have been carried out in three cruises in spring and autumn 2013 and autumn 2014.The study stations have been chosen on the base of previous research results indicating a decreasing heavy metal and organic matter surface content leaving from the Po River mouths (Pérez-Albaladejo et al., 2016). The data obtained have been compared with previous studies carried in the Adriatic Sea (Spagnoli et al. 2010).Results of the 2013 and 2014 cruises and of previous investigations indicate a consistent and rapid dissolved benthic flux decreasing going away from the Po River mouths both southward, eastward and northward.The decreasing regards the final electron acceptors and the organic matter degradation products and some heavy metals.On the whole, different early diagenesis environments have been recognized in the Northern and Central Adriatic Sea: they embrace two end members: from the Po River Prodelta to the Mid Adriatic Depression (MAD) (Spagnoli et al., 2014). In front of the Po River sediments are characterized by high sedimentation rate and by high inputs of fresh marine organic matter, continental organic matter and Fe-oxyhydroxides. These inputs produce high concentrations of organic matter degradation products, strong anoxic environment in the pore waters and high dissolved benthic fluxes. In the MAD the diagenetic environments are characterized by low sedimentation rate and low inputs of reactive organic matter that produce low concentrations of pore-water organic matter degradation products with oxic conditions near the surface and weak benthic fluxes.As regard the two major metals involved in the early diagenesis processes (Fe and Mn), they too show dissolved benthic fluxes decreases from the Po River mouths. Also in this case, this trend is attributed to the high Po River dissolved and particulate, anthropogenic and natural, metal inputs that deposit in the surface sediments of the Po Prodelta (Spagnoli and Bergamini, 1997).The dissolved benthic fluxes of trace heavy metals (Co, Ni, Zn, Cu, Cd, Pb) indicate that some elements, such as Co and Pb, are clearly adsorbed by the sediment that act, for these two elements as sink. Other elements, such as Cu, don’t show a clear north–south trend s, while other elements, such as Cd, indicate a southward decreasing trend suggesting a behavior affected by the Po River inputs and Fe-Mn-oxyhydroxide cycle.

Mercury contents were determined in surface sediments from the Central and Southern Adriatic Sea to gain insight into the processes, factors, and variables affecting its distribution. Mercury concentration was measured by thermal decomposition amalgamation atomic absorption spectrometry in samples collected by box-corer from Ancona to Santa Maria di Leuca during the CNR-PERTRE cruise (16/9-4/10/2016). Sediments were also evaluated for chemical-physical parameters (pH, Eh), biogeochemical composition (total carbon, inorganic carbon, total organic carbon, organic matter) and grain size. The average mercury concentration in the Adriatic Sea sediment was 0.053 mg/Kg (d.w.), range 0.011&ndash, 0.12 mg/Kg (d.w.). Mercury content was mainly affected by grain size and organic matter (OM) distribution, whereas anthropic factors exerted a limited influence. Concentrations followed the distribution of sediment types (clay &gt, silt &gt, sand) due to Adriatic Sea hydrodynamics and were well below the regulatory limits in all samples.

This work discusses the sedimentological and geochemical features of surface sediment of the Central and Southern Adriatic Sea. A total of 107 samples from the cruise PERTRE2016 project were analysed for grainsize, major and trace elements and organic matter content. The aim of this work was to identify sedimentary facies based on geochemical and biogeochemical features and to describe their spatial distribution to recognize regional patterns of sediment dispersal, geochemical signals for provenance and eventually local features. In this work a Q-mode factor analysis of grain-size, geochemical (major and trace elements) and biochemical (organic carbon) properties of surface and sub-surface sediments has been used to identify the sedimentary facies. The statistical processing of the sediment properties made it possible to identify five factors that can be interpreted as different sedimentological, geochemical and biogeochemical facies and to evaluate their surface distribution: 1) Clayey component, made up of clayey and clayey-silty sediments, originated from the contribution of the Po River and the Apennine rivers and that are redistributed by the Adriatic circulation in a SE direction; 2) sandy component, made up of sandy-silty sediments with silicate minerals and enriched in Magnesium; this facies is more abundant along the Italian coastline; 3) coarse carbonatic component, made up of sandy-gravel sediments; this facies is more abundant in the outer areas of the Adriatic Basin, coinciding with the depositional areas of the relict sands; 4) silty component with heavy minerals, characterized by silty sediments enriched in heavy minerals resulting from the action of waves and coastal currents; 5) component of sediment provenance, useful to identify the origin of sediments. This component shows high values in different areas mainly located offshore of northern Gargano Promontory and is due to sediment features mainly controlled by geochemistry rather than grain-size. The characterization and distribution of the above describe facies allowed understanding in more detail the present hydrodynamic, sedimentological, geochemical and biogeochemical processes occurring in the Central and Southern Adriatic Sea and to identify the main sediment source areas.

The aim of this research was to investigate the mercury content in the superficial sediments of the western Adriatic Sea in relation to the present depositional processes and to the Holocene evolution. To do this, other the mercury analysis of in the surface sediment, the data of the biogeochemical composition (TC, IC, TOC, TN, OM, major and minor elements) and of the sediment grain-size were considered

Rapporto delle attività di campagna, Campagna RID16 (18-20 aprile 2016). Istituto di Scienze Marine, novembre 2016. 17 pp.

Tra gli scopi della "PROPOSTA TECNICO-ECONOMICA PER STUDI DI CARATTERE AMBIENTALE VOLTI A VALUTARE LE DINAMICHE E GLI EFFETTI AMBIENTALI DEI SEDIMENTI MARINI PROVENIENTI DA ESCAVI PORTUALI" è compresa la quantificazione delle "variazioni dei flussi di sostanze disciolte naturali, come i nutrienti, o di sostanze di origine antropica, come i metalli pesanti, eventualmente indotte dai lavori di escavo, al fine di valutare la loro influenza sul chimismo della colonna d'acqua e sulle biocenosi delle aree marine interessate". Tali indagini sono necessarie sia per una migliore definizione degli impatti ambientali, sia per stabilire eventuali misure di mitigazione da inserire nelle fasi operative di dragaggio e sversamento. La proposta di studio prevede la quantificazione dei flussi bentici in tre diversi tempi: prima dell'esecuzione dei lavori di dragaggio nel porto di Ancona (fase ante-operam), durante l'esecuzione dei lavori di dragaggio e dopo la fine dei lavori di dragaggio (post-operam). Le misure dovevano essere eseguite nell'area interessata dal dragaggio commissionato dall'Autorità Portuale di Ancona (Fig. 1). Con la presente relazione sono presentati i risultati della prima fase di indagine, vale a dire prima della fase di escavo (fase ante-operam). Tale indagine è servita per quantificare i flussi bentici di sostanze disciolte rilasciate o assorbite dal fondale in condizioni normali, vale dire in condizioni non perturbate dall'attività di dragaggio. Tali valori, detti valori di "bianco" o valori di "fondo" o valori di "background", saranno confrontati con i valori misurati durante la fase di escavo e dopo la fine delle operazioni di dragaggio per valutare le alterazioni indotte nella colonna d'acqua dal fondale del bacino interessato dal dragaggio. In questo modo si potranno quantificare le variazioni dei flussi di sostanze disciolte naturali, come i nutrienti, o di sostanze di origine antropica, come i metalli pesanti, al fine di valutare la loro influenza sul chimismo della colonna d'acqua e sulle biocenosi delle aree marine interessate. L'approccio sopra descritto è giustificato dal fatto che i sedimenti marini, ricevendo il particolato, organico ed inorganico, autoctono ed alloctono, naturale e di origine antropica, sono sede di intensi processi biogeochimici e di attività biologica nei primi centimetri; questi processi, detti di diagenesi precoce, modificano profondamente le proprietà fisiche e chimiche e la struttura biocenotica dei sedimenti superficiali. Tali processi, biotici ed abiotici, danno origine a dei flussi di sostanze disciolte, da e verso il sedimento, detti flussi bentici. I flussi bentici possono essere, sia in qualità sia in intensità, naturali o condizionati da stress antropici. I fondali marini sono quindi oggetto di flussi bentici di sostanze disciolte di origine naturale o antropica che influenzano il chimismo e l'ecologia della colonna d'acqua sovrastante, in particolare alle basse profondità. Nel caso di interventi antropici che hanno come oggetto la modifica del fondale marino, sia mediante la rimozione del sedimento superficiale sia mediante lo scarico in mare di sedimenti, è di primaria importanza, al fine di una corretta valutazione dell'intervento di modifica dell'ambiente marino, misurare le variazioni dei flussi bentici indotte dall'azione umana; ciò permette di valutare l'influenza dei flussi bentici sulla struttura biocenotica del sedimento e sul chimismo e, di conseguenza, sull'ecologia, della colonna d'acqua. In particolare, il dragaggio dei fondali marini causa l'affioramento di sedimenti caratterizzati da proprietà chimico-fisiche molto diverse rispetto a quelle dei sedimenti superficiali presenti nella fase ante-operam, ciò può portare al rilascio di sostanze naturali ma potenzialmente pericolose per l'ambiente, come i metalli, il metano, l'anidride carbonica e l'acido solfidrico, oppure al veloce assorbimento di ossigeno che può provocare eventi di anossia. L'importanza di un'indagine riguardante le alterazioni dei flussi bentici in aree portuali è testimoniata da una notevole bibliografia internazionale (Klinkhammer e Bender, 1981; Chen et al., 1997; Fichet et al., 1999; Apitz et al., 2008; Hammerschmidt et al., 2008; Benoit et al., 2009) e, a livello italiano, anche dal fatto che nell'area portuale di Trieste è stata realizzata, per opera dell'OGS di Trieste e dell'ISMAR di Ancona, nel 2013, la prima campagna di misura di flussi bentici rivolta a valutare gli effetti della movimentazione di sedimenti marini portuali (Spagnoli F., dati non pubblicati).

The study compared visual evoked potentials of patients with uncomplicated Graves' ophthalmopathy, patients with ophthalmopathy and elevated intraocular pressure or suspect glaucoma, and patients with dysthyroid optic neuropathy (DON). The aim of the study was to investigate the clinical potential for the visual evoked potentials (VEP) in the differential diagnosis among the groups. The VEPs were obtained from 43 subjects with endocrine ophthalmopathy. Group I included patients with uncomplicated ophthalmopathy (30 eyes); group II included patients with ophthalmopathy, intraocular pressure ≥ 23 mmHg with and without early visual field defects, and no evidence of apical crowding on coronal computed tomography scan (28 eyes); group III included patients with DON (28 eyes). Amplitude and latency of major component of pattern VEP were obtained at three visual angles (60', 30', 15'). Data from each group was compared with data from age-matched normal subjects. Disturbances of VEP were found mainly in patients of Group II and Group III. Control Group had normal VEP. About the differential diagnosis between Group II and Group III the most important parameter was the N75-P100 amplitude for 15' of pattern stimulation. Only for this visual angle, Group II and Group III had not overlapped N75-P100 amplitude. This study shows that VEP detect visual function abnormalities noninvasively in patients with complicated Graves' ophthalmopathy. Results also indicate the clinical potential for VEP in the differential diagnosis between patients suffering from ophthalmopathy complicated by ocular hypertension or suspect glaucoma and patients with dysthyroid optic neuropathy.

The present study compares contrast sensitivity functions of patients with uncomplicated Graves' ophthalmopathy, patients with ophthalmopathy and elevated intraocular pressure or suspect glaucoma, and patients with dysthyroid optic neuropathy (DON). Aim of the study was to investigate the clinical potential for the contrast sensitivity functions (CSF) in distinguish between the groups. Contrast sensitivity measurements were obtained from twenty-seven subjects with endocrine ophthalmopathy. Group I included patients with uncomplicated ophthalmopathy (n=20 eyes); group II included patients with ophthalmopathy, intraocular pressure > or = 24 mmHg with and without early visual field defects, and no evidence of apical crowding on coronal computed tomography scan (n=14 eyes); group III included patients with DON (n=12 eyes). Contrast thresholds were determined for stationary and 6.87 Hz phase-alternating gratings at eight spatial frequencies from 0.18 to 15.7 c/deg. Data from each group was compared with data from age-matched normal subjects. Observers with uncomplicated ophthalmopathy had normal CSFs. Eyes affected with DON showed contrast sensitivity disruption at overall intermediate-high spatial frequencies. Eyes with elevated intraocular pressure or suspect glaucoma had pronounced sensitivity loss in the low frequency range (0.18-0.70 c/deg) as compared to eyes with DON. This study shows that CSF detects visual function abnormalities noninvasively in patients with complicated Graves' ophthalmopathy. Results also indicate that the clinical potential for CSF in distinguish between patients suffering from ophthalmopathy complicated by ocular hypertension or suspect glaucoma and patients with DON improves when a temporal modulation of 6.87 Hz and gratings of low spatial frequency (< 1 c/deg) are used.

To report a case of massive spontaneous choroidal hemorrhage in a patient with chronic renal failure and coronary artery disease treated with clopidogrel bisulfate (Plavix).Case report.A 75-year-old man presented with pain and loss of vision in the left eye for 1 week. His medical history was remarkable for systemic hypertension, chronic renal failure, and artery coronary disease. For 6 months, he had been taking 75 mg/day of Plavix after coronary angioplasty. Ocular examination revealed the patient to be in angle closure. Ultrasonography and computed tomography scan revealed a massive choroidal hemorrhage pushing the iris-lens diaphragm forward. Pain and intraocular pressure were treated successfully with evacuative sclerotomies, but the final exitus after 6 months was bulbar phthisis.Massive spontaneous choroidal hemorrhage is an extremely rare event that usually has been described in older patients (65-87 years old) receiving anticoagulants or thrombolytic agents. Systemic hypertension, generalized atherosclerosis, and age-related macular degeneration are additional risk factors. In the present case, massive choroidal hemorrhage was associated with use of clopidogrel bisulfate (Plavix) in a patient with chronic renal failure. Our report indicates that Plavix should be administered with caution in patients with chronic renal failure owing to the risk of serious choroidal bleeding. Chronic renal failure should be also included in the list of risk factors for massive spontaneous choroidal hemorrhage. Evacuative sclerotomies may have value in the relief of pain and elevated intraocular pressure but has not been shown to be beneficial in visual and anatomic outcomes.

The study compared visual evoked potentials of patients with uncomplicated Graves' ophthalmopathy, patients with ophthalmopathy and elevated intraocular pressure or suspect glaucoma, and patients with dysthyroid optic neuropathy (DON). The aim of the study was to investigate the clinical potential for the visual evoked potentials (VEP) in the differential diagnosis among the groups. The VEPs were obtained from 43 subjects with endocrine ophthalmopathy. Group I included patients with uncomplicated ophthalmopathy (30 eyes); group II included patients with ophthalmopathy, intraocular pressureor = 23 mmHg with and without early visual field defects, and no evidence of apical crowding on coronal computed tomography scan (28 eyes); group III included patients with DON (28 eyes). Amplitude and latency of major component of pattern VEP were obtained at three visual angles (60', 30', 15'). Data from each group was compared with data from age-matched normal subjects. Disturbances of VEP were found mainly in patients of Group II and Group III. Control Group had normal VEP. About the differential diagnosis between Group II and Group III the most important parameter was the N75-P100 amplitude for 15' of pattern stimulation. Only for this visual angle, Group II and Group III had not overlapped N75-P100 amplitude. This study shows that VEP detect visual function abnormalities noninvasively in patients with complicated Graves' ophthalmopathy. Results also indicate the clinical potential for VEP in the differential diagnosis between patients suffering from ophthalmopathy complicated by ocular hypertension or suspect glaucoma and patients with dysthyroid optic neuropathy.

BACKGROUND: To date, Snellen visual acuity and postoperative refraction have been used to evaluate the results of photorefractive keratectomy. However, other parameters, such as contrast sensitivity function and glare, may be affected by refractive surgery and lead to unsatisfactory visual performance. This prospective study is aimed at evaluating the effect of photorefractive keratectomy on contrast sensitivity function and glare. SUBJECTS AND METHODS: Static contrast sensitivity function, dynamic contrast sensitivity function, and glare sensitivity were evaluated in 22 myopic eyes before as well as 1, 3, and 6 months after photorefractive keratectomy. The eyes tested were divided into three groups, according to the amount of myopia: group I, from - 4.00 to - 8.00 diopters (D); group II, from -8.25 to -11.00 D; group ??, from -11.25 to -20.00 D. RESULTS: Both static and dynamic contrast sensitivity function at the intermediate spatial frequencies were altered at 1 month after photorefractive keratectomy, with a trend toward recovery at 3 and 6 months postoperatively. Glare sensitivity was not significantly affected by surgery. CONCLUSIONS: Contrast sensitivity function and glare testing may show abnormalities in the presence of optimal visual and refractive results. These tests may result especially important for the evaluation of new refractive surgical procedures. [J Refract Corneal Surg. 1994;10:129-136.]