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Anna Maria Comberiati,1 Chiara Lomartire,1 Mariaelena Malvasi,1 Raffaele Migliorini,1 Fernanda Pacella,2 Vito Maurizio Malvasi,3 Paolo Turchetti,4 Elena Pacella1 1Department of Sense Organs, Sapienza University of Rome, Rome, Italy; 2Department of Ophthalmology, Carlo Poma Hospital, Mantua, Italy; 3Department of Odontostomatological and Maxillo-Facial Sciences, Sapienza University of Rome, Rome, Italy; 4National Institute for Health, Migration and Poverty (INMP/NIHMP), Rome, ItalyCorrespondence: Mariaelena Malvasi, Department of Sense Organs, University of Rome, “Sapienza” via Del Policlinico 155, Rome, 00161, Italy, Tel +393402114859, Email mariaelena.malvasi@uniroma1.itPurpose: To evaluate ocular motility (OM) disorders and strabismus in a sample of patients with retinitis pigmentosa (RP) and a control sample.Methods: In this cross-sectional retrospective analysis, we studied a sample of RP patients with a mean age of 48.74 years and an average visual acuity of 7/10 based on Snellen optotype and a sample of control patients with similar mean age (49 years [men], 47 years [women]) and sex and an average visual acuity of 9.9/10, with the aim of assessing correlations between alteration of OM and strabismus in RP patients based on age, high refractive defect, or severely impaired binocular vision. The examination followed a protocol of testing for anamnesis and best-corrected visual acuity, as well as a complete eye examination, corneal reflex, cover test, OM, Hess screen, and Lang test.Results: At the first orthoptic evaluation, 45.16% of patients showed strabismus, 41.93% exotropia (25% of cases intermittent), 3.22% esotropia, and 6.45% vertical deviation. Later evaluation showed strabismus in 25.80% of patients, exotropia in 19.35% (9.67% intermittent), esotropia in 3.22%, and vertical deviation in 3.22%. Assessment of eye motility study showed 51.6% overaction of the inferior oblique and hypofunction of the superior rectus, and 18% overaction of the lateral rectus and hypofunction of the medial rectus. According to our results, alterations in OM and strabismus in RP patients are not correlated with age or high refractive defect. Therefore, motility disorders and strabismus are attributed to a genetic factor to which men are more susceptible.Conclusion: The incidence of OM disorder was 77.42%, and strabismus was present in 45.16% of patients.Keywords: retinitis pigmentosa, orthoptic evaluation, strabismus, genetic factor, ocular motility

Raffaele Migliorini,1 Anna Maria Comberiati,1 Fernanda Pacella,1 Anna Rosy Longo,1 Daniela Messineo,2 Edoardo Trovato Battagliola,1 Mariaelena Malvasi,1 Elena Pacella,1 Loredana Arrico1 1Department of Sense Organs, University Sapienza, Rome, Italy; 2Department of Radiology, Oncology, and Anatomopathological, University Sapienza, Rome, ItalyCorrespondence: Elena PacellaDepartment of Sense Organs, University Sapienza, Policlinico Umberto I, Viale del Policlinico 155, Rome, 00161, ItalyTel +39 336783409Email elena.pacella@uniroma1.itPurpose: Determine the usefulness of ocular motility testing to detect the presence of muscle entrapment.Materials and Methods: Cross-sectional study of patients with symptoms of diplopia secondary to facial trauma. Inclusion criteria: age between 20 and 80 years; symptoms of diplopia following facial trauma; presence of orbital floor fracture confirmed radiologically; presence of muscle entrapment confirmed at the time of surgery; best-corrected visual acuity of 0.6 or more. Exclusion criteria: muscle entrapment visible on computed tomography; candidate for immediate surgical correction; prior history of strabismus surgery. Outcome measures: Abnormal Head Position (AHP), Hirschberg Corneal Reflexes (CR), Cover/Uncover and Alternating Cover Test, Hertel exophthalmometry, Near Point of Convergence (NPC), Kestenbaum Limbus test, Red Filter test, and Hess screen test.Results: Forty-six subjects (38 males, 8 females, mean age 27 ± 3.3 SD years). Pre-operative assessment: forty-six (100%) reported diplopia on the Red Filter test and showed some degree of abnormality on the Hess Screen test. Forty-two (91%) showed AHP. Forty-one (89%) had exophthalmometry values that differed 2 mm or more between the two eyes and insufficient NPC. Thirty-two (69.6%) showed deficits of 3 mm or more on the Kestenbaum Limbus test. Sixteen (35%) had abnormal Hirschberg corneal reflexes. Eleven (24%) demonstrated constant or intermittent strabismus.Conclusion: Ocular motility testing can differentiate non-invasively, pre-operatively, and cost-effectively the presence of muscle entrapment even when this is not visible on computed tomography.Keywords: orbital blow-out fractures, orbital floor fracture, ocular motility, trauma, delayed surgical repair, muscle entrapment, traumatic diplopia

Objective. Prematurity often results in important developmental sequelae of brain structures, particularly those involved in processing visual information, such as the optic nerve, primary visual cortex and visuomotor integration areas. The aim of this study is to analyse the functionality of the sensory and motor pathways of the visual system by means of an orthoptic-ophthalmological assessment. Materials and methods. In this retrospective study, 151 records were examined, covering a period from 2000 to 2020, of preterm patients with gestational age < 32 weeks and birth weight ≤ 1,500 g up to an average age of about 8 years, referred to the Centre for Paediatric Ophthalmology and Strabology of the Ophthalmology Clinic of the Policlinico Umberto I, La Sapienza University of Rome, who underwent a complete ophthalmological and orthoptic assessment including the following tests measurement of ocular deviations according to the Hirschberg method, Lang I-II test, Titmus Stereotest, objective convergence assessment and ocular motility examination. Results. From the charts reviewed, 24.5% (37/151) of patients had Retinopathy of the Premature (ROP); while 38% of the whole sample (57/151) had strabismic amblyopia, of the latter only 31.5% (18/57) had ROP. In 8% of patients (12/151) the stereoscopic sense was absent, in 45% (8/151) stereopsis was gross (> 60 seconds of arc). In addition, 20.52 % (31/151) had a manifest eye deviation. 7.28% (11/151) had hypermetropia in the right eye (RE); 7.95% (12/151) hypermetropia in the left eye (OS); 3.31% of the patients (5/151) had myopia in the RE; 2% (3/151), myopia in the left eye (LE). In addition, the study of ocular motility revealed varying degrees of alteration poorly correlated with prematurity status. Conclusion. It was found that amblyopia, stereopsis and objective convergence are more affected by ROP than strabismus, refractive defects and ocular motility, indicating that premature children are particularly susceptible to ophthalmological and orthoptical alterations. [ABSTRACT FROM AUTHOR]

R Migliorini, R Malagola, M Mafrici, R Spena, L ArricoDepartment of Sense Organs, University of Rome "La Sapienza", Rome, ItalyAbstract: Hyoscine-N-butyl bromide is a widely used antispasmodic belonging to the belladonna alkaloid class of semisynthetic quaternary ammonium compounds. These compounds exert a spasmolytic action on the smooth muscles of the bile-gastrointestinal tract, genitourinary tract, salivary glands (xerostomia), and also on the visual apparatus – in particular, the irido-ciliary complex. As a consequence, they provoke collateral effects such as mydriasis and accommodation disturbances. We report the case of a 23-year-old woman who complained of not only "dry mouth" but also "cloudy vision" and a "diplopia", both of temporary type, 2 hours after oral administration of hyoscine-N-butyl bromide.Keywords: hyoscine-N-butyl bromide, accommodation disorders, temporary diplopia, fusion alteration, vertical strabismus

Purpose. Outcomes Research Study on patients suffering from anisometropia or isoametropia associated with amblyopia and microstrabismus to show the impact of late occlusion treatment on therapeutic prognosis. Materials and methods. Enrollment of all the eligible patients presenting to recruiting centers at the Department of Pediatric Ophthalmology and Strabismus - Ophthalmological Clinic - Policlinico Umberto I - Rome. At baseline, all patients will undergo an opthalmologic evaluation. Recruited patients will be followed for a 2-year period. Our test group was composed of 31 patients, 11 with bilateral and 20 with monolateral amblyopia, totalling 42 amblyopic eyes, and it was assessed - always by the same examiner - with the help of the following orthoptic examinations: Wirt test, Irvine-Jampolsky test (4 dioptre fixation task), Visuscope, Cover Test, Bagolini striated glasses, and Worth lights test. We assessed pre-post treatment variations observed in the overall group of amblyopic eyes, regardless of the differences between RE and LE. Outcomes. Of the 31 children, 58.1% were males and 41.9% female, average age between 6 and 14 years. Of the 42 amblyopic eyes, after daily occlusion of 8 hours ± 2.30 SD, we recorded an improvement of 71.4%, and visual acuity increased from an average of 0.4 LogMAR to 0.1 LogMAR. Conclusion. Late anti-amblyopic occlusion treatment proved effective in the long term for children 6 to 12 years, specifically regarding visual acuity, fixation, stereopsis, and binocular collaboration in patients suffering from anisometropia or isoametropia and microstrabismus. [ABSTRACT FROM AUTHOR]

Studies on resource utilization by carnivores are essential to assess the role of the species in the ecosystem. These studies help us to understand the mechanisms that influence vertebrate community structure and the relationships between predators and prey. The aims of this study were to compare and describe the food habits of the sympatric Pampas fox (Lycalopex gymnocercus) and crab‐eating fox (Cerdocyon thous) in the Brazilian Pampa, and to evaluate the food niche overlap between them, and infer aspects of habitat preferences on the basis of their prey. For the diet analyses, 25 stomach contents of Pampas foxes and 33 of crab‐eating foxes were collected. We identified 80 prey items (49 for the Pampas fox and 63 for the crab‐eating fox) and grouped them into eight main categories. Mammals and invertebrates were the most frequent items in the diets of both canids, followed by fruits. The trophic niche breadth of the Pampas fox (Bsta = 0.56) was larger than that of the crab‐eating fox (Bsta = 0.47). The diet overlap between them was Ojk = 0.58. However, a PERMANOVA test showed that diets did not differ between species or season. Our results showed that both L. gymnocercus and C. thous had generalist diets, with a great diversity of prey, but based on similar main food items. Items that contributed the most to the diet of the Pampas fox were insects (Gryllotalpidae and Scarabaeidae) and cavies (Cavia aperea) and those that contributed the most to the diet of the crab‐eating fox were fruits of Syagrus romanzoffiana, beetles (Scarabaeidae), amphibians (Leptodactylus spp.) and cavies. This is the first study to describe and compare the food habits of these two species, occurring in sympatry in the Brazilian Pampa. Interspecific competition for food is a critical factor that determines species coexistence in carnivores. In this study we compare and describe the food habits of two sympatric foxes in southern Neotropics, the Pampas fox (Lycalopex gymnocercus) and the crab‐eating fox (Cerdocyon thous). Our results showed that both species had generalist diets, with a great diversity of prey, but based on similar main food items. The foraging strategies of these canids could be associated with the exploration of different microhabitats. This plasticity may be important for the survival of these species under the constant loss of their natural environments, persecution, and other sources of mortality. [ABSTRACT FROM AUTHOR]

Purpose. Randomized controlled trial aimed at comparing surgical outcomes in a group of patients suffering from hyperfunction of the inferior oblique (IO) muscle with abnormal head position (AHP). The surgical techniques being compared are Recession and (thread) Controlled Myotomy. Materials and Methods. The group of 20 patients suffering from medium-high hyperfunction of the IO was assessed through an ophthalmological and orthoptic examination. 10 patients underwent traditional Recession (Group  A) and 10 were treated with Controlled Myotomy (Group  B). Results. The average age was 19 years ± 10.7 SD. After 1 year, 20% of Group  A showed a small Vertical Deviation associated with a small AHP, while 80% had orthophoria and 40% of them had a small AHP. 80% of Group  B showed a small Vertical Deviation associated with an equally small AHP, while 20% had orthophoria with a full resolution of AHP. Conclusion. Based on the results obtained and the fewer intrasurgical risks involved, thread Controlled Myotomy proved to be a valid alternative to Recession. Furthermore, in case of Recession, over the long period a small residual AHP remained in the patients who had orthophoria, unlike Myotomy which led to a total resolution. [ABSTRACT FROM AUTHOR]

Objective To evaluate the incidence and the strategy of management of syncope admitted urgently to a general hospital. Background The management of patients with syncope is not standardized. Methods The study was a prospective observational registry from a sample of 28 general hospitals in Italy and enroled all consecutive patients referred to their emergency rooms from November 5th 2001 to December 7th 2001 who were affected by transient loss of consciousness as the principal symptom. Results The incidence of syncope was 0.95% (996 of 105,173 patients attending). Forty-six percent were hospitalized, mostly in the Department of Internal Medicine. The mean in-hospital stay was 8.1±5.9 days. A mean of 3.48 tests was performed per patient. A definite diagnosis was made in 80% of cases, neurally-mediated syncope being the most frequent. The findings of each of the 28 hospitals participating in the survey were separately evaluated. We observed great inter-hospital and inter-department heterogeneity regarding the incidence of emergency admission, in-hospital pathways, most of the examinations performed and the final assigned diagnosis. For example, the execution of carotid sinus massage ranged from 0% in one hospital to 58% in another (median 12.5%); tilt testing ranged from 0 to 50% (median 5.8%); the final diagnosis of neurally-mediated syncope ranged from 10 to 78.6% (median 43.3%). Conclusion Great inter-hospital and inter-department heterogeneity in the incidence and management of syncope was observed in general hospitals. As a consequence, we were unable to describe a uniform strategy for the management of syncope in everyday practice. [ABSTRACT FROM PUBLISHER]

Investigates the effect of brown adipose tissue (BAT) sympathetic hemidenervation on the activity of glycerokinase (GyK) in different physiological conditions. Possible sources of glycerol-3-phosphate for acylation and triacylglycerols formation; Situations in which the sympathetic outflow to BAT is activated; Result of the adaptation to the high-protein diet in the activity of BAT GyK.