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Purpose. To report visual function and self-reported satisfaction of patients with glaucoma and dry age-related macular degeneration (dAMD) implanted with multifocal intraocular lenses (MIOL). Methods. Patients with glaucoma or dAMD as well as healthy individuals implanted with MIOL were invited to participate. Explorations performed were uncorrected and corrected distance visual acuity (UDVA and CDVA), low-contrast visual acuity (LCVA), binocular contrast sensitivity, and defocus curves. Patients completed the Catquest-9 questionnaire and reported on the presence of dysphotopsias and the need for spectacles. Results. 38 subjects were included: 11 in the healthy/control group and 9 each in the preperimetric glaucoma, perimetric glaucoma, and dAMD groups. Controls had statistically better monocular UDVA, CDVA, and LCVA than patients with glaucoma and dAMD, as well as better binocular acuity in the defocus curves between −2.00 D and +0.50 D. Differences between controls and patients with preperimetric glaucoma were not statistically significant. Between −3.0 D and +0.5 D, all groups except dAMD achieved acuities better than 0.2 logMAR. Patients with dAMD had worse contrast sensitivity than all others for 3 cycles per degree (cpd), and patients with glaucoma had worse values than all others for 12 cpd; other differences did not reach statistical significance. Healthy subjects and patients with preperimetric glaucoma perceived halos more often than patients with glaucoma or dAMD, while suffering less from glare. Patients with glaucoma and dAMD found more difficulties when driving at night and required spectacles for near more often than the other subjects. Patients with dAMD were less satisfied with their vision. Conclusions. MIOLs may be implanted in patients with preperimetric glaucoma with little fear of patient dissatisfaction. In glaucoma and dAMD, MIOLs might be considered with caution, after explaining the increased risk of glare and the higher need for spectacle correction for reading. [ABSTRACT FROM AUTHOR]

Introduction. During femtosecond laser-assisted cataract surgery (FLACS), there is a significant increase in intraocular pressure, which might lead to ganglion cell damage. We aimed to determine whether there were differences in the changes produced in the ganglion cell complex (GCC) and peripapillary retinal nerve fiber layer (pRNFL) thickness, as evaluated with optical coherence tomography (OCT), between phacoemulsification and FLACS, after implantation of a trifocal intraocular lens (IOL). Methods. Patients with no coexistent pathologies undergoing cataract surgery with implantation of a PanOptix IOL were explored with the Cirrus-OCT before and three months after surgery. GCC values were obtained from the built-in software. The differences between pre- and postoperative GCC and pRNFL thicknesses after phacoemulsification were compared to differences after FLACS. Results. A total of 171 eyes were included, 74 undergoing FLACS and 97 phacoemulsification. For both groups, there was a statistically significant increase in GCC values after cataract surgery, except for the inferior and inferonasal sectors. There were no statistically significant differences between FLACS and phacoemulsification. Mean change in average GCC and minimum GCC were 1.08 ± 1.40 µm (range −1 to +6 µm) and 1.69 ± 2.54 µm (range −3 to +11 µm) after FLACS and 0.99 ± 1.67 µm (range −5 to +6 µm) and 2.02 ± 3.54 µm (−6 to +18 µm) after phacoemulsification. These values are similar to those previously reported after phacoemulsification with monofocal IOL implantation. No significant changes after surgery were detected for the pRNFL, with no differences between groups. Discussion. There were no differences in the changes produced by FLACS and phacoemulsification in either GCC or pRNFL values. Although mean change was small, the range of variation was wide. Therefore, it is necessary to establish a new baseline for GCC and pRNFL thicknesses after cataract surgery in order to monitor any subsequent changes. [ABSTRACT FROM AUTHOR]

Optical coherence tomography (OCT) has become essential to evaluate axonal/neuronal integrity, to assess disease progression in the afferent visual pathway and to predict visual recovery after surgery in compressive optic neuropathies. Besides that OCT testing is considered a powerful biomarker of neurodegeneration and a promising outcome measure for neuroprotective trials in multiple sclerosis (MS). Currently, spectral-domain OCT (SD-OCT) technology allows quantification of retinal individual layers. The Ganglion Cell layer (GCL) investigation has become one of the most useful tools from a neuro-ophthalmic perspective. It has a high correlation with perimetry, is predictive of future progression and is a highly sensitive, specific of several neuro-ophthalmic pathologies. Moreover the superior correlation with clinical measures compared to peripapillary retinal nerve fiber layer (pRNFL) suggests that GCL analysis might be a better approach to examine MS neurodegeneration. In disorders with optic disk edema, such as ischemic optic neuropathy, papillitis and papilledema, reduction in RNFL thickness caused by axonal atrophy is difficult to distinguish from a swelling resolution. In this setting, and in buried optic nerve head drusen (ONHD), GCL analysis may provide more accurate information than RNFL analysis and it might be an early structural indicator of irreversible neuronal loss. Enhanced depth imaging OCT (EDI-OCT) provides in vivo detail of ONHD, allowing to evaluate and quantify the drusen dimensions. OCT is improving our knowledge in hereditary optic neuropathies. Furthermore, there is growing evidence about the role of OCT as an adjunctive biomarker of disorders such as Alzheimer and Parkinson’s disease. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to assess the immediate effect of a sciatic nerve slider technique added to sustained hamstring stretching on lumbar and lower quadrant flexibility. Design: This was a randomized controlled pilot study. Subjects: Eight (8) healthy male soccer players (21 ± 3 years) were randomly assigned to 2 groups. Interventions: Group A received 5 minutes of bilateral sustained hamstring stretching. Group B additionally received 60 seconds of a sciatic nerve slider technique for each leg. Outcomes: Pre- and postintervention outcomes taken by an assessor blinded to the treatment allocation of the participants included metric distance on finger-to-floor, sit and reach, and the modified Schöber tests and goniometric range of each hip for the straight-leg raise and each knee for seated slump test. Baseline between-group differences were examined with an independent t test and a two-way repeated-measures analysis of variance with p < 0.05 and p < 0.025 analyzed effects of the interventions. Results: There were no significant between-group baseline differences ( p > 0.2). There was a significant effect for time on all outcomes ( p < 0.01) other than the sit and reach test ( p = 0.8). A significant interaction between group · time with greater improvements in group B was found for the modified Schöber test ( F = 5.5; p < 0.05), left straight-leg raise ( F = 6.1; p < 0.05) and slump test in either leg (left F = 28.7; p = 0.002; right F = 4.9; p < 0.05). Conclusions: Adding a sciatic nerve slider technique to sustained hamstring stretching led to greater immediate increases in both lumbar and lower quadrant flexibility in young healthy soccer players as measured by four of the seven outcomes used. Study limitations and suggestions for future studies are discussed. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 56-year-old woman with sudden onset of left-ptosis. dizziness, and imbalance. Diagnosis of the patient revealed sudden asymmetric bilateral ptosis as stroke onset. Magnetic resonance (MR) scan of the brain showing the patient's isolated periaqueductal signal abnormality is also offered.

Purpose: To evaluate the ability of the papillomacular bundle (PMB) retinal nerve fiber layer and macular inner retinal layer thickness measurements with Spectralis optical coherence tomography (OCT) to differentiate eyes with nonarteritic anterior ischemic optic neuropathy (NAION) from uninvolved eyes and to evaluate whether their thicknesses correlate with visual acuity., Methods: An observational, cross-sectional study was performed, including 29 eyes with NAION and 29 uninvolved eyes from 29 patients. Eyes underwent scanning with Cirrus OCT (peripapillary and macular scanning) and Spectralis OCT (N-site axonal peripapillary scan and a new automated segmentation macular scan to measure individual retinal layers) in both eyes., Results: The NAION eyes showed significant thinning versus uninvolved eyes in the macular retinal nerve fiber (P < 0.05), ganglion cell layer (GCL; P < 0.001), and inner plexiform layer (IPL; P < 0.01) by Spectralis and in the GCL-IPL by Cirrus (P < 0.02). Average and sectors of peripapillary retinal nerve fiber layer (pRNFL) and total macular thickness (TMT) were significantly reduced in NAION eyes, with both Spectralis and Cirrus OCT (P < 0.05). Spectralis temporal (ρSpearman = -0.768; P < 0.001) and PMB pRNFL thicknesses (ρSpearman = -0.675; P < 0.001), as well as central macular IPL thickness (ρSpearman = -0.735; P < 0.001), correlated strongly with best corrected visual acuity (BCVA). Quadratic regression using outer nasal TMT by Cirrus OCT and temporal pRNFL thickness by Spectralis were the best models to predict BCVA., Conclusions: Macular segmentation by Spectralis and Cirrus OCT revealed inner retinal layer atrophy in NAION eyes. The temporal and PMB pRNFL thicknesses and central macular IPL thickness by Spectralis-OCT and outer nasal TMT by Cirrus were strongly correlated with BCVA in NAION eyes., (Copyright 2015 The Association for Research in Vision and Ophthalmology, Inc.)

Background: Ocular dipping (OD), or inverse ocular bobbing, consists of slow, spontaneous downward eye movements with rapid return to the primary position. It has been mainly reported following hypoxic-ischemic encephalopathy, but has also been described in association with other types of diffuse or multifocal encephalopathies and structural brainstem damage., Case Report: We report the case of a previously asymptomatic 66-year-old woman who presented with confusion, recent memory disturbances, and abnormal involuntary movements, followed by a coma. Abnormal spontaneous vertical eye movements consistent with OD developed from the fourth day after admission, and the patient died 20 days later. The pathological examination of the brain confirmed the diagnosis of Creutzfeldt-Jakob disease., Conclusions: The precise location of damage causing OD is unknown. In contrast to ocular bobbing, OD has no localizing value itself, but structural brainstem damage is likely when it appears combined with other spontaneous vertical eye movements.