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Purpose To study the spatial retinal distribution of electroretinographic (ERG) responses that reflect signals in the L-/M-cone-opponent and luminance post-receptoral pathways. Methods ERG recordings to heterochromatic stimuli (sinusoidal counter-phase modulation of red and green LED light sources) were performed, while varying fractions of red and green modulation. Two temporal frequencies of the stimuli were employed: 12 Hz to record ERGs that reflect L-/M-cone-opponent signal and 36 Hz for recording ERG signals sensitive to stimulus luminance. Stimuli were about 20° in diameter and projected on various retinal locations: the fovea and four eccentricities (10°, 19°, 28° and 35°), each presented nasally, temporally, inferiorly and superiorly from the fovea. Results The 36 Hz stimuli elicited responses that strongly varied with red fraction and were minimal at iso-luminance. Moreover, response phases changed abruptly at the minimum by 180°. In contrast, the responses to the 12 Hz stimuli had amplitudes and phases that changed more gradually with red fraction. The 36 Hz response amplitudes were maximal close to the fovea and sharply decreased with increasing distance from the fovea. The responses to 12 Hz stimuli were more broadly distributed across the retina. Conclusions In the present study, it was found that retinal eccentricity and direction from the fovea have distinct effects on ERGs reflecting different post-receptoral mechanisms. The results are in accord with previous findings that ERGs to 12 Hz stimuli are predominantly determined by the red–green chromatic content of the stimuli, thus reflecting activation in the L-/M-cone-opponent pathway, while responses to 36 Hz stimuli manifest post-receptoral luminance-dependent activation. We found that the response in the cone-opponent pathway is broadly comparable across the retina; in comparison, response amplitude of the luminance pathway strongly depends on retinal stimulus position.

BACKGROUND Posterior segment eye diseases, such as glaucoma and retinal diseases (such as diabetic retinopathy, age-related macular degeneration, and retinal detachment), are chronic diseases that are among the major causes of visual impairment. OBJECTIVE We investigated the prevalence of anxiety disorders, depressive disorders, and common mental disorders in these patients and also the incidence of depression. METHODS We examined baseline (2008-2010) and follow-up (2012-2014) data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). We used the Clinical Interview Schedule-Revised (CIS-R) to perform International Classification of Diseases-10-based diagnoses of anxiety and depressive disorders. Common mental disorder was defined as a Clinical Interview Schedule-Revised >11. We used multinomial logistic regression models to investigate associations between eye diseases and mental disorders, adjusted by age, gender, educational level, self-reported ethnicity, cardiovascular conditions, and self-reported quality of vision. RESULTS Out of 10,775 subjects, 249 (2.3%), 303 (2.8%), and 30 (0.3%) reported having retinal diseases, glaucoma, or both, respectively. Patients with retinal diseases and those with glaucoma and retinal diseases presented a higher prevalence of common mental disorders (relative-risk ratios of 1.7 and 3.7, respectively, P

To evaluate color vision changes and retinal processing of chromatic and luminance pathways in subjects with Alzheimer disease (AD) and mild cognitive impairment (MCI) compared with a matched control group and whether such changes are associated with impaired brain glucose metabolism and β-amyloid deposition in the brain.We evaluated 13 patients with AD (72.4 ± 7.7 years), 23 patients with MCI (72.5 ± 5.5 years), and 18 controls of comparable age (P = 0.44) using Cambridge color test and the heterochromatic flicker ERG (HF-ERG). The Cambridge color test was performed using the trivector protocol to estimate the protan, deutan and tritan color confusion axes. HF-ERG responses were measured at a frequency of 12 Hz, which ERGs reflect chromatic activity, and at 36 Hz, reflecting luminance pathway. A study subsample was performed using neuropsychological assessments and positron emission tomography.Patients with AD presented higher mean values indicating poorer color discrimination for protan (P = 0.04) and deutan (P = 0.001) axes compared with the controls. Along the tritan axis, both patients with AD and patients with MCI showed decreased color vision (P = 0.001 and P = 0.001) compared with controls. The analyses from the HF-ERG protocol revealed no differences between the groups (P = 0.31 and P = 0.41). Diffuse color vision loss was found in individuals with signs of neurodegeneration (protan P = 0.002, deutan P = 0.003 and tritan P = 0.01), but not in individuals with signs of β-amyloid deposition only (protan P = 0.39, deutan P = 0.48, tritan P = 0.63), regardless of their clinical classification.Here, patients with AD and patients with MCI present acquired color vision deficiency that may be linked with impaired brain metabolism.

Glaucoma, cataracts, and cognitive decline are most common in older ages. Although cross-sectional studies showed that these disorders are associated, follow-up studies are lacking. To investigate this issue, baseline and follow-up data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) were employed. We evaluated participants ≥ 55 years-old at follow-up without diagnosis of dementia, stroke, and other eye conditions except for glaucoma and cataracts. Cognition was evaluated using delayed word recall, verbal fluency, and trail making (version B) tests. Regression models were employed to investigate associations between glaucoma and cognition, adjusted by several confounders. Out of 3,867 participants, 379 and 118 presented cataracts and glaucoma, respectively. Only glaucoma was apredictor of lower verbal fluency (B = -0.23, 95% CI -035 to -012, p 0.001). Other associations were not significant (ps0.57). Our results suggest that glaucoma may be related to declining cognition.

Recent evidence suggests that glaucoma and Alzheimer's disease are neurodegenerative diseases sharing common pathophysiological and etiological features, although findings are inconclusive. We sought to investigate whether self-reported glaucoma patients without dementia present poorer cognitive performance, an issue that has been less investigated. We employed cross-sectional data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) and included participants ≥50 years of age without a known diagnosis of dementia and a self-reported glaucoma diagnosis. We excluded those with previous stroke, other eye conditions, and using drugs that could impair cognition. We evaluated cognition using delayed word recall, phonemic verbal fluency, and trail making (version B) tests. We used multinomial linear regression models to investigate associations between self-reported glaucoma with cognition, adjusted by several sociodemographic and clinical variables. Out of 4,331 participants, 139 reported glaucoma. Fully-adjusted models showed that self-reported glaucoma patients presented poorer performance in the verbal fluency test (β=-0.39, 95%CI=-0.64 to -0.14, P=0.002), but not in the other cognitive assessments. Thus, our results support the hypothesis that self-reported glaucoma is associated with poor cognitive performance; however, longitudinal data are necessary to corroborate our findings.

Purpose The purpose of this study was to characterize changes in the full-field flash electroretinogram (ERG) in association with psychophysical dark-adapted visual thresholds in patients with genetically characterized Duchenne muscular dystrophy (DMD) either lacking Dp427 (Up 30) or at least Dp260 in addition to Dp427 (Down 30). Methods Twenty-one patients with DMD and 27 age-similar controls participated in this study. Dark-adapted (0.01, 3.0, and 10 cd.s/m² flashes) and light-adapted (3.0 cd.s/m² flash) ERGs were recorded following International Society for Clinical Electrophysiology of Vision (ISCEV) standard protocols. Visual detection thresholds to 625-nm (cone function) and 527-nm (rod function) light-emitting diode (LED) flashes (2 degree diameter) were measured during a dark adaptation period after a 1-minute exposure to a bleaching light (3000 cd/m²). Initially, 8 minutes of interleaved 625-nm and 527-nm thresholds were measured. After an additional 5 minutes of dark-adaptation, a second set of threshold measurements to 527-nm stimuli was performed during the subsequent 6 minutes. Results Dark-adapted b-wave amplitude was significantly reduced to all strengths of flash and a-wave in response to the strong flash stimulus was delayed (15.6 vs. 14.7 ms, P < 0.05) in patients with Down 30 compared with controls. Dark-adapted cone thresholds did not differ among the groups (−2.0, −1.8, and −1.7 log cd/m² for Down 30, Up 30, and controls, respectively, P = 0.21). In contrast, dark-adapted rod thresholds were elevated (F(2,36) = 8.537, P = 0.001) in patients with Down 30 (mean = −3.2 ± 1.1 log cd/m²) relative to controls (mean = −4.2 ± 0.3 log cd/m²). Dark-adapted b-wave amplitudes were correlated with dark-adapted rod sensitivity in patients with DMD (Spearman Rho = 0.943, P = 0.005). The changes were much smaller or absent in patients with intact Dp260. Conclusions Dp260 is particularly required for normal rod-system function in dark adaptation.

Purpose To follow the visual acuity development of children exposed to or infected with the Zika virus (ZIKV) during gestation and to relate potential visual acuity deficits to their clinical condition. Methods In this prospective study, visual acuity was measured via Teller Acuity Cards in three groups of children: (1) those with confirmed ZIKV exposure (ZE) through the mother only, (2) those with confirmed infection (ZI), and (3) unaffected controls. Visual acuity was measured 2-4 times in each child during the first 30 months of age. Results The study included 22 children in the ZE group, 11 in the ZI group, and 27 controls. Visual acuity developed normally in both patient groups, including infected patients (ZI) that did not manifest clinical symptoms. In a small subgroup of patients with characteristics consistent with congenital Zika syndrome (CZS), visual acuity was within normative values, with the exception of single child with chorioretinal atrophy. Conclusions In this southeastern Brazil study cohort, visual acuity development seemed to progress normally in infected children without CZS symptoms.

Purpose To evaluate visual acuity and visual acuity development in children from the state of Sao Paulo, Brazil, who were exposed to the Zika virus (ZIKV) gestationally. Methods Children who had been exposed to ZIKV during gestation and age-matched control subjects received visual acuity and funduscopic examination. ZIKV exposure was confirmed by maternal quantitative polymerase chain reaction testing or serology assay. The ZIKV group was divided into two subgroups: Zika - exposed (ZE), with only the mother having confirmed ZIKV-infection, and Zika-infected (ZI), with confirmed infection. Visual acuity development was compared with prior norms and quantified by measuring visual acuity correlation with age. Results A total of 110 children were included: 47 who had been exposed to ZIKV (ZE, 23; ZI, 24) and 63 controls. Abnormal visual acuity was found in 5 of 24 ZI children. Of the 4 children with microcephaly, only 2 had visual acuity loss (only 1 also had abnormal funduscopic findings). There was significant correlation between age and visual acuity in both the control group ( R 2 = 0.8; P R 2 = 0.6; P R 2 = 0.04; P = 0.38). Furthermore, the increment in octaves/month was much lower in the ZI subgroup. Conclusions Our data indicates that visual acuity losses only occur in infants who suffered gestational-infection, not simply exposure. Lack of correlation between age and visual acuity in the ZI subgroup suggests a slowing of visual development even in the absence of microcephaly. This result may have broad implications for the deleterious effects of ZIKV on the central nervous system.

PURPOSE To evaluate in patients with primary open-angle glaucoma (POAG) the contribution of the inner and outer retinal photoreceptors to the pupillary light responses (PLRs) correlated with both functional (color vision and visual field perimetry) and morphologic (optical coherence tomography) parameters. METHODS In total, 45 patients with POAG and 25 healthy control participants were evaluated. The PLR was measured as pupil diameter with an eye tracker; stimuli were presented in a Ganzfeld. Pupil responses were measured monocularly, to 1 second blue (470 nm) and red (640 nm) flashes with -3, -2, -1, 0, 1, 2, and 2.4 log cd/m luminance levels. Color vision was evaluated with the Cambridge Color Test, visual field was measured by standard automatic perimetry, and retinal nerve fiber layer thickness was evaluated by optical coherence tomography. RESULTS Patients with moderate and severe POAG have a significantly decreased PLR that depends on the severity of POAG, for both the 470 and 640 nm stimuli, revealing the reduction of the contributions of the rods, cones, and intrinsically photosensitive retinal ganglion cells to PLR. A significant loss of color discrimination along the blue-yellow axis was observed in all stages of POAG. Correlations among standard automatic perimetry, retinal nerve fiber layer thickness, Cambridge Color Test, PLR, and melanopsin parameters were found. CONCLUSIONS The results provide evidence that in moderate and severe stages of POAG, both the inner and outer retinal contributions to PLR are affected. Also, a worsening in color vision was correlated with reduced PLR responses at high-intensity stimuli. These findings may enhance the clinical management of POAG patients.

Purpose To investigate the impact of obstructive sleep apnea (OSA) on the contribution of inner and outer retinal photoreceptors to the pupillary light response (PLR). Methods Ninety-three eyes from 27 patients with OSA and 25 healthy controls were tested. OSA severity was graded according to the apnea-hypopnea index. PLR was measured monocularly with an eye tracker in a Ganzfeld in response to 1-second blue (470 nm) and red (640 nm) flashes at -3, -2, -1, 0, 1, 2, and 2.4 log cd/m2. Peak pupil constriction amplitude, peak latency, and the postillumination pupil response were measured. The Cambridge Colour Test, standard automatic perimetry, spectral domain optical coherence tomography, polysomnography, and the Pittsburgh Sleep Quality Index were used. Results OSA patients have a significantly decreased peak pupil constriction amplitude for blue stimuli at -3, -2, -1, 1 log cd/m2 and at all red flash luminances (P < 0.050), revealing reduction of outer retina contributions to PLR. OSA patients showed reduced peak latency for blue (-2, 0, 2, 2.4 log cd/m2) and red stimuli (-2, 0 log cd/m2; P < 0.040). No significant difference was found in the melanopsin-mediated PLR. Conclusions This study is the first to evaluate the inner and outer retinal contributions to PLR in OSA patients. The results showed that the outer retinal photoreceptor contributions to PLR were affected in moderate and severe OSA patients. In contrast, the inner retina contributions to PLR are preserved.

Sao Paulo Research Foundation (FAPESP) [2014/26818-2, 2014/50457-0, 2016/04538-3, 2014/06457-5, 2015/22227-2, 2016/22007-5] National Council for Scientific and Technological Development (CNPq) [480428/2013-4, 470785/2014-4, 404239/2016-1] CAPES [3263/2013] Janos Bolyai Scholarship of the Hungarian Academy of Sciences PURPOSE: Smith-Magenis syndrome (SMS) causes sleep disturbance that is related to an abnormal melatonin profile. It is not clear how the genomic disorder leads to a disturbed synchronization of the sleep/wake rhythm in SMS patients. To evaluate the integrity of the intrinsically photosensitive retinal ganglion cell (ipRGC)/melanopsin system, the transducers of the light-inhibitory effect on pineal melatonin synthesis, we recorded pupillary light responses (PLR) in SMS patients. METHODS: Subjects were SMS patients (n = 5), with molecular diagnosis and melatonin levels measured for 24 hours and healthy controls (n = 4). Visual stimuli were 1-second red light flashes (640 nm insignificant direct ipRGC activation), followed by a 470-nm blue light, near the melanopsin peak absorption region (direct ipRGC activation). Blue flashes produce a sustained pupillary constriction (ipRGC driven) followed by baseline return, while red flashes produce faster recovery. RESULTS: Pupillary light responses to 640-nm red flash were normal in SMS patients. In response to 470-nm blue flash, SMS patients had altered sustained responses shown by faster recovery to baseline. SMS patients showed impairment in the expected melatonin production suppression during the day, confirming previous reports. CONCLUSIONS: SMS patients show dysfunction in the sustained component of the PLR to blue light. It could explain their well-known abnormal melatonin profile and elevated circulating melatonin levels during the day. Synchronization of daily melatonin profile and its photoinhibition are dependent on the activation of melanopsin. This retinal dysfunction might be related to a deficit in melanopsin-based photoreception, but a deficit in rod function is also possible. Univ Sao Paulo, Dept Expt Psychol, Inst Psychol, Sao Paulo, Brazil Semmelweis Univ, Dept Ophthalmol, Budapest, Hungary Univ Sao Paulo, Dept Neurol, Fac Med, Sao Paulo, Brazil Budapest Univ Technol & Econ, Dept Mechatron Opt & Engn Informat, Budapest, Hungary Univ Texas San Antonio, Dept Cellular & Struct Biol, San Antonio, TX USA Univ Fed Sao Paulo, Dept Physiol, Sao Paulo, Brazil Univ Sao Paulo, Dept Physiol & Biophys, Inst Biomed Sci, Av Lineu Prestes 1524, BR-05508000 Sao Paulo, SP, Brazil Univ Fed Sao Paulo, Dept Physiol, Sao Paulo, Brazil FAPESP [2014/26818-2, 2014/50457-0, 2016/04538-3, 2014/06457-5, 2015/22227-2, 2016/22007-5] CNPq [480428/2013-4, 470785/2014-4, 404239/2016-1] CAPES [3263/2013] Web of Science

INTRODUCTION: The objective of this work is to describe a conservative surgical technique as an alternative to classic penile amputations, aiming the local control of the disease, in addition to trying to preserve the patient's sexual function. SURGICAL TECHNIQUE: After a circular incision of the skin around the penis, the subfascial plane is developed until the base of the organ. The dorsal neurovascular bundle and the urethra are isolated in their distal extremities. The neurovascular bundle is sectioned distally. A retrocoronal dissection plane is developed between the glans and the corpora cavernosa. When this stage is complete, the glans is fixed only to the urethra, which is distally sectioned as well. The neurovascular bundle is fixed to the dorsal albuginea. Following the spatulation of the urethra, a neomeatus is created using the overlay skin of the penis. Between January 2001 and July 2002, we employed this technique in 6 patients who had epidermoid carcinoma of the penis, which were limited to the glans, superficial, well or moderately differentiated and measuring up to 3 cm. COMMENTS: Several conservative surgical methods for treatment of carcinoma of the penis aim the organ's preservation, in an attempt of improving the quality of life of patients, however the indexes of local recurrence and failure in disease control are significant. The described technique showed to be safe and effective for disease control, in addition to preserving sexual function in all patients who were treated, representing, thus, a quite appealing conservative surgical alternative in selected cases.

O objetivo deste estudo foi descrever a distribuição dos neurofilamentos (NFs) e da proteína associada ao microtúbulo do tipo 2 (MAP-2) em retinas humanas e murinas. Para isso, usamos camundongos C57BL/6, submetidos à cirurgia estereotáxica para realização de lesão eletrolítica no colículo superior direito provocando degeneração retrógrada de células ganglionares da retina. Utilizamos ensaios de imunohistoquímica e PCR em tempo real (qPCR) para a caracterização dessas proteínas nas duas espécies. Na retina humana, observou-se que NFs e MAP-2 estão presentes nas células ganglionares do tipo M. No modelo animal, houve diminuição dos NFs e aumento de MAP-2, na análise de imuno-histoquímica. Já o ensaio com qPCR mostrou um aumento e diminuição da expressão dos NFs e MAP-2, respectivamente. Assim, concluímos que houve alterações na expressão do RNAm e na marcação dos NFs e do MAP-2 nas retinas murinas, e esses resultados podem ser extrapolados para os seres humanos, uma vez que essas proteínas estão presentes nas células M que são inicialmente afetadas no glaucoma. This study aimed to describe the distribution of NFs and type 2 protein associated with microtubule (MAP-2) in human retinas of these proteins and evaluate a model of retrograde retinal ganglion cell degeneration in murine retinas. To achieve this, we submitted C57bl/6 to a stereotaxic surgery for superior colliculus electrolytic lesion in the right side. The characterization of these proteins was obtained through immunohistochemical essays and real-time PCR (qPCR). The results revealed that both proteins are present in the ganglion cell M in the human retina. In the experimental animal model the immunohistochemical essays demonstrated decrease of NFs and increased MAP-2. However, the qPCR analysis demonstrated increased NFs and decreased MAP-2 expression. We can conclude that there was variation of mRNA expression and structural protein levels in the experimental retina. And, the results related to NFs and MAP-2 in this animal model can be extrapolated to humans, as these proteins are also present in the human ganglion cell that are affected early in glaucoma.

PURPOSE: To evaluate the retinal nerve fiber layer measurements with time-domain (TD) and spectral-domain (SD) optical coherence tomography (OCT), and to test the diagnostic ability of both technologies in glaucomatous patients with asymmetric visual hemifield loss. METHODS: 36 patients with primary open-angle glaucoma with visual field loss in one hemifield (affected) and absent loss in the other (non-affected), and 36 age-matched healthy controls had the study eye imaged with Stratus-OCT (Carl Zeiss Meditec Inc., Dublin, California, USA) and 3 D OCT-1000 (Topcon, Tokyo, Japan). Peripapillary retinal nerve fiber layer measurements and normative classification were recorded. Total deviation values were averaged in each hemifield (hemifield mean deviation) for each subject. Visual field and retinal nerve fiber layer "asymmetry indexes" were calculated as the ratio between affected versus non-affected hemifields and corresponding hemiretinas. RESULTS: Retinal nerve fiber layer measurements in non-affected hemifields (mean [SD] 87.0 [17.1] µm and 84.3 [20.2] µm, for TD and SD-OCT, respectively) were thinner than in controls (119.0 [12.2] µm and 117.0 [17.7] µm, P

Bimatoprost and the fixed combination of latanoprost with timolol maleate are 2 medications widely used to treat glaucoma and ocular hypertension (OHT). The aim of the study is to compare the efficacy of these 2 drugs in reducing intraocular pressure (IOP) after 8 weeks of treatment in patients with primary open angle glaucoma (POAG) or OHT.In this randomized, open-label trial, 44 patients with POAG or OHT were allocated to receive either bimatoprost (1 drop QD) or latanoprost/timolol (1 drop QD). Primary outcome was the mean diurnal IOP measurement at the 8th week, calculated as the mean IOP measurements taken at 8:00 am, 10:00 am, and 12:00 pm Secondary outcomes included the baseline change in IOP measured 3 times a day, after the water-drinking test (performed after the last IOP measurement), and the assessment of side effects of each therapy.The mean IOP levels of latanoprost/timolol (13.83, SD = 2.54) was significantly lower than of bimatoprost (16.16, SD = 3.28; P0.0001) at week 8. Also, the change in mean IOP values was significantly higher in the latanoprost/timolol group at 10:00 am (P = 0.013) and 12:00 pm (P = 0.01), but not at 8:00 am (P = ns). During the water-drinking test, there was no significant difference in IOP increase (absolute and percentage) between groups; however, there was a significant decrease in mean heart rate in the latanoprost/timolol group. Finally, no significant changes in blood pressure and lung spirometry were observed in either groups.The fixed combination of latanoprost/timolol was significantly superior to bimatoprost alone in reducing IOP in patients with POAG or OHT. Further studies with large sample sizes should be taken to support the superior efficacy of latanoprost/timolol, as well as to better assess its profile of side effects.

Connexin (Cx) channels and hemichannels are involved in essential processes during nervous system development such as apoptosis, propagation of spontaneous activity and interkinetic nuclear movement. In the first part of this study, we extensively characterized Cx gene and protein expression during retinal histogenesis. We observed distinct spatio-temporal patterns among studied Cx and an overriding, ubiquitous presence of Cx45 in progenitor cells. The role of Cx-mediated communication was assessed by using broad-spectrum (carbenoxolone, CBX) and Cx36/Cx50 channel-specific (quinine) blockers. In vivo application of CBX, but not quinine, caused remarkable reduction in retinal thickness, suggesting changes in cell proliferation/apoptosis ratio. Indeed, we observed a decreased number of mitotic cells in CBX-injected retinas, with no significant changes in the expression of PCNA, a marker for cells in proliferative state. Taken together, our results pointed a pivotal role of Cx45 in the developing retina. Moreover, this study revealed that Cx-mediated communication is essential in retinal histogenesis, particularly in the control of cell proliferation.

A Degeneração Macular Relacionada à Idade (DMRI) é a principal causa de cegueira e perda de visão central em pessoas acima dos 50 anos nos países desenvolvidos. O diagnóstico da DMRI é geralmente realizado em consulta de rotina na qual, através da biomicroscopia de fundo, é detectada a presença de drusas, exsudatos subrretinianos ou atrofias geográficas na retina. Embora o diagnóstico seja razoavelmente simples, sua fisiopatologia é complexa, não está totalmente elucidada e envolve os sistemas antioxidante, imune e vascular, afetando principalmente a mácula, área responsável pela acuidade visual e visão de cores. Assim, nosso objetivo foi avaliar a atividade dos fotorreceptores em pacientes com DMRI através de testes psicofísicos e eletrofisiológicos. Para isto, foram incluídos 49 participantes, 19 no grupo controle (71,6 ± 4,8 anos) e 30 no grupo com DMRI seca (69,2 ± 7,7 anos). Os participantes foram submetidos a teste de visão de cores (Cambridge Colour Test - CCT), a pupilometria cromática para verificar a integridade da retina externa e interna e eletrorretinografia (ERG) com flicker heterocromático. Os resultados obtidos no CCT apresentaram uma pior discriminação de cores nos eixos Protan, Deutan e Tritan dos sujeitos portadores de DMRI comparados com os controles. Na pupilometria cromática, constatamos integridade da retina externa, mas houve redução da amplitude da resposta do estímulo às células ipRGC da retina interna. No ERG, não foram observadas diferenças nas respostas correspondentes a atividade das vias magno- e parvocelular. Estes resultados indicam que há preservação de função das vias magno- e parvocelulares na DMRI inicial, assim como das respostas pupilares mediadas pelos fotorreceptores, e que a discriminação de cores pode ser um instrumento sensível para revelar alterações iniciais na DMRI Age Related Macular Degeneration (AMD) is the leading cause of blindness and loss of central vision in people over 50 in developed countries. The AMD diagnosis is usually performed in a routine examination in which the presence of drusen, subretinal exudates or geographic atrophy in the retina is detected through background biomicroscopy. Although the diagnosis is simple, its pathophysiology is complex, not fully elucidated and involves the antioxidant, immune and vascular systems, mainly affecting the macula, region responsible for visual acuity and color vision. Thus, our objective was to evaluate the photoreceptor activity in patients with AMD through psychophysical and electrophysiological tests. For this, 49 participants were included, 19 in the control group (71.6 ± 4.8 years) and 30 in the dry AMD group (69.2 ± 7.7 years). Participants underwent color vision test (Cambridge Colour Test - CCT), chromatic pupilometry to verify the integrity of the external and internal retina, and electroretinography (ERG) with heterochromatic flicker. The results in the CCT showed worse color discrimination in the Protan, Deutan and Tritan axes of subjects with AMD compared to controls. The Tritan results is positively correlated to alteration on EPR-Bruchs membrane. In chromatic pupilometry, we observed external retinal integrity, but there was a reduction in the response amplitude of the stimulus to ipRGC cells of the internal retina. On ERG, no differences were observed between the groups in the activity of the magno- and parvocellular pathways. These results indicate preservation of magno- and parvocellular pathways function in initial AMD, as well as photoreceptors-mediated pupillary responses, and that color discrimination might a sensitive instrument to reveal initial changes in AMD

Alterações macro e microvasculares ocorrem no Diabetes Mellitus (DM). A Retinopatia Diabética (RD) é uma complicação bem prevalente do DM e resulta de microangiopatia generalizada no tecido retiniano que, em diferentes estágios da doença, se observa como edema local, exsudatos, formação de neovasos e hemorragias, sendo a principal causa de cegueira na faixa etária de 20 a 74 anos. Alguns fatores angiogênicos são apontados como possíveis mediadores no desenvolvimento das alterações microvasculares no DM. Dentre eles, a Eritropoietina (EPO), hormônio glicoproteico, possui expressão mediada por alelos específicos do gene EPO. Determinados perfis genéticos para três SNPs-single nucleotide polymorphisms do gene EPO (rs1617640, rs507392, rs551238) encontram-se associados com maiores concentrações de EPO no humor vítreo de pacientes diabéticos com RD, o que pode ser indicativo da relação entre determinado genótipo de risco (TTA) e o desenvolvimento de tal comorbidade. O presente trabalho pretendeu investigar a associação entre o genótipo considerado de risco para o desenvolvimento de RD e alterações funcionais na visão de cores de pessoas com diagnóstico de DM. Tal estudo contou com uma amostra de 95 diabéticos (49 mulheres e 46 homens, média de idade: 48,33 anos; DP: 16,90), com um total de 31 DM tipo 1 e 64 tipo 2 e 114 controles (73 mulheres e 41 homens, média de idade: 38,38 anos; DP: 12,81). Foi realizada avaliação através de teste psicofísico (Cambridge Colour Test CCT), que visou medir o limiar de discriminação nos três eixos de confusão de cores e sequenciamento genético, a partir de amostras de sangue. Para os diabéticos, no eixo de confusão protan, os resultados mostraram uma piora de desempenho para o genótipo TTA/GCC (p= 0,048), com relação aos controles. No eixo de confusão deutan, não houve diferença para qualquer dos genótipos (p= 0,0207), enquanto que para o eixo tritan, o genótipo TTA/GCC esteve associado a uma piora de desempenho (p=0,014). Para os controles, não houve diferença entre os genótipos. Assim, os resultados mostraram uma piora na visão de cores de pacientes DM, associada ao haplótipo TTA/GCC Diabetic Retinopathy (DR), a prevalent complication of diabetes, is the leading cause of blindness among those aged 20-74 years. Micro and macrovascular changes occur in Diabetes Mellitus (DM) with DR being the most common among these vascular complications, resulting in generalized retinal microgangiopathy. At different stages of the disease, localized edema, exudates and hemorrhages occur. Several pro-angiogenic factors have been suggested as possible mediators in the development of these microvascular changes. Among them is erythropoietin (EPO), a glycoprotein hormone whose expression is mediated by specific alleles of the EPO gene. Specific genetic profiles for three single nucleotide polymorphisms (SNPs) in the EPO gene (rs1617640, rs507392, rs551238) are associated with larger EPO concentrations in the vitreous humor of diabetic patients with RD. This association indicates a possible relationship between the identified genotypes (TTA) and the comorbidity´s development. This work aimed to investigate the association between genotypes considered at risk for the development of DR and functional changes in color vision among individuals diagnosed with DM. Thus, this study included a sample of 95 diabetic patients (49 women and 46 men, average age: 48.33 years; SD: 16.90), with a total of 31 DM type 1 and 64 type 2 and 114 controls (73 women and 41 men, average age: 38.38 years; SD: 12.81). Evaluation was performed using a psychophysical test (Cambridge Colour Test -CCT), to measure the discrimination threshold in three-color confusion axes in addition to genetic sequencing. In the protan axis of confusion color, performance among diabetics with the TTA/GCC genotype was significantly lower (p=0.048) than those in the control group. The results showed a poorer performance among those with the TTA / GCC genotype (p = 0.048), compared to controls. In deutan axis confusion, there was no difference among any of the genotypes (p = 0.0207), while for the tritan axis, the TTA / GCC genotype was associated with a poorer performance (p = 0.014). For the controls, there was no difference between genotypes. Thus, the results showed a worsening in color vision among DM patients associated with TTA / GCC haplotype