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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.

The combination of solid-phase microextraction (SPME) with comprehensive two-dimensional gas chromatography is evaluated here for fatty acid (FA) profiling of the glycerophospholipid fraction from human buccal mucosal cells. A base-catalyzed derivatization reaction selective for polar lipids such as glycerophospholipid was adopted. SPME is compared to a miniaturized liquid-liquid extraction procedure for the isolation of FA methyl esters produced in the derivatization step. The limits of detection and limits of quantitation were calculated for each sample preparation method. Because of its lower values of limits of detection and quantitation, SPME was adopted. The extracted analytes were separated, detected, and quantified by comprehensive two-dimensional gas chromatography with flame ionization detection (FID). The combination of SPME and comprehensive two-dimensional gas chromatography with FID, using a selective derivatization reaction in the preliminary steps, proved to be a simple and fast procedure for FA profiling, and was successfully applied to the analysis of adult human buccal mucosal cells.

Objetivo: Avaliar os efeitos da desnutrição intra-uterina na acuidade visual (AV) de resolução de grades pelo Potencial Visual Evocado de Varredura (PVEv) e Cartões de Acuidade de Teller (CAT). Método: Avaliamos a AV de resolução de grades, binocularmente, de 41 recém-nascidos com idade estacional 37 semanas, destes 23 nasceram com o peso adequado para a idade gestacional (AIG - Idade: 14,3 ± 7,5 semanas) e 18 nasceram pequenos para a idade gestacional (PIG - Idade: 10,7 ± 4,1semanas). A AV foi determinada usando ambas as técnicas psicofísica (CAT) e eletrofisiológica (PVEv). Durante o teste dos CAT foram apresentados cartões contendo em um dos lados grades de ondas quadradas pretas e brancas com freqüência espacial entre 0,23 e 19 ciclos por grau de ângulo visual a 55 cm do participante. O teste iniciou com o cartão com a freqüência espacial mais baixa com orientação randômica desconhecida pelo experimentador. Cartões contendo freqüências espaciais mais altas foram apresentados gradativamente até que uma resposta incorreta ocorresse, então o cartão anterior era apresentado novamente. A AV foi definida pela média aritmética das freqüências espaciais contidas nos cartões para 4 reversões. Para o registro do PVEv, o sistema PowerDiva (Brosnahan et al., 1998) foi usado para gerar todos os estímulos e analisar as repostas provocadas. Estímulos de grades senoidais em reversão de fase em 3, 6 ou 10 Hz foram apresentados em monitor de vídeo monocromático de 21 polegadas com luminância média de 161,13 cd/m2. Registramos o eletroencefalograma com três eletrodos ativos (O1, Oz, O2) relacionados ao eletrodo de referência no vertex. Durante cada tentativa com duração de 10 segundos, resentávamos uma faixa de freqüência espacial que aumentava linearmente. Para cada condição (freqüência temporal - FT) foram usadas no mínimo três tentativas para estimar o limiar. Consideramos o canal que registrou a AV mais alta com boa razão sinal-ruído (SNR>3:1), fase constante e critério estatístico. Resultados: Não encontramos diferenças significativas na AV entre os grupos para nenhum dos métodos. Para o PVEv, não encontramos diferenças significativas na AV, amplitude, ruído ou SNR entre os grupos para nenhuma das FT. Análises intra-grupos mostraram que os valores de amplitude, SNR e ruído foram significativamente diferentes entre as freqüências temporais apenas para os PIG. Entretanto, os PIG até 8 semanas de idade mostraram uma tendência para amplitudes e SNR mais altas para a FT de 3 Hz comparadas aos AIG. Esses mesmos PIG mostraram uma tendência para valores de fase maiores respostas lentas) em comparação aos AIG. Entretanto, a taxa de desenvolvimento da fase foi maior para os PIG do que para os AIG em todas as FT. Conclusão. Não há alteração significativa na AV de recém-nascidos PIG, entretanto as informações de medidas supra-limiares são consistentes com a hipótese que a desnutrição intra-uterina torna as respostas visuais mais lentas entre a retina e o córtex visual. Os dados também sugerem de forma sutil que tais efeitos são passageiros afetando primariamente o grupo de recém-nascidos mais jovens e que o sistema visual dos PIG tem plasticidade suficiente para atingir rapidamente os níveis normais. Mais dados serão necessários para validar esta interpretação. Objective: To evaluate the effects of intra-uterine malnutrition on grating visual acuity (VA) using Sweep VEP and Teller Acuity Cards (TAC). Method: Binocular grating acuity was evaluated in 41 newborns with gestational age 37 weeks. Twentythree were born with appropriate weight for gestational age (AGA age: 14.3 ± 7.5 weeks) and 18 were born small for gestational age (SGA age: 10.7 ± 4.1 weeks). Visual acuity was determined using both psychophysical (Teller Acuity Cards) and electrophysiological (sVEP) techniques. For the TAC evaluation, cards having calibrated black and white square waves gratings at spatial frequencies (SFs) between 0.23 and 19 cycles/degree were presented 55 cm from the subject. The test began with the lowest SF card in random orientation to which the experimenter was blind. Subsequent cards were presented in order of increasing SF until an incorrect response was made, at which time the prior (lower-SF) card was presented again. Visual acuity was defined as the average of the SF values for 4 reversals. For the sVEP recordings, the PowerDIVA VEP system (Brosnahan et al., 1998) was used to generate all stimuli and analyze the evoked responses. Stimuli were spatial luminance sinewave gratings presented on a 21-inch monochromatic high-resolution monitor (1600x1200 pixels) with an average luminance of 161.1 cd/m2. Gratings were phase-reversed at either 3, 6 or 10 Hz. The electroencephalogram was recorded using 3 active electrodes (O1,Oz,O2) related to the reference electrode at vertex. During each 10-sec sVEP trial a linear sweep of increasing SF was presented. Sweep ranges were selected according to the subjects age. For each condition (each TF), a minimum of 3 trials were used to estimate thresholds, but the majority of measures were the result of a vector average of 5 to 10 trials. For each condition, the acuity estimate used derived from the channel with the highest acuity with statistically significant signal-to-noise ratio (>3:1) and stable phase during the high-SNR portion of the response. Results: There were no statistical differences in visual acuity between the two groups (SGA and AGA) for either method (sVEP or TAC). For the sVEP, acuities were not statistically different for the different TFs. There were also no statistical differences between groups for the sVEP measures of amplitude, phase, noise or signal-to-noise ratio. Intra-group analysis of the sVEP measures at the three TFs revealed statistical differences for amplitude, noise and signal-to-noise ratio, but only for SGA group. However, the SGA subjects less than or equal to 8 weeks of age showed a tendency for higher amplitudes and SNR for 3Hz temporal frequency compared to AGA subjects, and these same SGA subjects showed tendency for larger phase values (slower responses) compared to AGA. However, phase development rate was faster for SGA than for AGA for all temporal frequencies. Conclusion: There were no significant alterations of visual acuity in SGA babies, but the data from suprathreshold measures are consistent with the hypothesis that intrauterine malnutrition results in slower visual responses between retina and cortex. The data obtained so far suggest that such affects are transient, affecting primarily the younger group of infants, and that the visual system in SGA infants has sufficient plasticity to recover rapidly to normal levels. More data is needed to validate this interpretation of the results.

Background: In Brazil, where there are difficulties in accessing health services, the increasing number of comorbidities in preterm survivors diagnosed with bronchopulmonary dysplasia (BPD) necessitate the creation of a tool to effectively evaluate aspects of visual function in a short time. The objective of this study was to develop a simple protocol to evaluate the oculomotor system in newborns with BPD. Methods: Our study compared two groups of preterm-born infants: those who were oxygen-dependent for longer than 28 days were included in the BPD group (BG), while babies given oxygen for a maximum of 10 days were included in the premature group (PG). Exclusion criteria were: babies under mechanical ventilation and/or vasoactive drugs, those with intracranial hemorrhage, retinopathy of prematurity, motor and/or neurological malformation. Assessments were performed while the baby was comfortably seated and evaluated four eye movement types: saccadic movements (SAC), smooth pursuit (SP), vestibulo-ocular reflex (VOR), and optokinetic nystagmus (OKN). Results: Fifty-two infants were evaluated and of these, 22 were included in the BPD group and 30 in the premature group. Birth weight, gestational age and Apgar score at one and five minutes did not differ significantly between the two groups. Infants with BPD demonstrated the absence of three of the four eye movements types; according to a Chi-square test, this was statistically significant when compared with the premature group. Conclusions: The protocol considered in this study was sufficient to evaluate the oculomotor system in newborns diagnosed with BPD. Ocular motility in these infants was found to be impaired when compared to babies without a BPD diagnosis.

O objetivo deste trabalho foi utilizar o método psicofísico da escolha forçada para mensurar a função de sensibilidade ao contraste para freqüências espaciais (FSC) na faixa de 0,25 a 2 cpg, em crianças pré-escolares. Foram estimados limiares de contraste para 15 participantes (10 crianças e cinco adultos). Os resultados mostraram que as curvas de sensibilidade (FSC) de crianças de 4 e 5 anos e adultos apresentam perfis gerais semelhantes, embora sejam diferentes entre si. Estes resultados sugerem que o método psicofísico da escolha forçada pode ser utilizado para mensurar a FSC de crianças a partir dos 4 anos.

O objetivo deste estudo foi comparar curvas de sensibilidade ao contraste para estímulos radiais (FSCr) e grades senoidais (FSC) de 0,25, 0,5, 1 e 2 cpg em crianças de 6 a 13 anos. Foram mensurados limiares de contraste para 40 crianças, utilizando o método psicofísico da escolha forçada e níveis baixos de luminância. Todas estavam livres de doenças oculares e tinham acuidade visual normal. Os resultados mostraram que a sensibilidade das crianças foi maior para grades senoidais (FSC) do que para estímulos radiais (FSCr). Esses resultados sugerem que esses estímulos podem ser processados por áreas visuais distintas. The aim of this work was to compare contrast sensitivity curves for radial (rCSF) and sine-wave gratings (CSF) stimuli of 0.25, 0.5, 1 and 2 cpd in 6 to 13 year-old-children. It was measured the contrast thresholds of 40 children using the psychophysical forced-choice method and low luminance levels. All children were free of identifiable ocular diseases and had normal acuity. The results showed that contrast sensitivity of the children was higher for spatial frequencies (CSF) than radial frequencies (rCSF). The results suggest that these stimuli can be processed by different visual cortical areas.

O objetivo deste trabalho foi determinar a função de sensibilidade ao contraste para freqüências espaciais de 0,25; 0,5; 1,0 e 2,0 ciclos por grau em crianças de 4 a 13 anos. Foram estimados limiares de contraste para 60 participantes (50 crianças e 10 adultos jovens), utilizando o método psicofísico da escolha forçada e nível baixo de luminância. Todos os participantes apresentavam acuidade visual normal e se encontravam livres de doenças oculares identificáveis. Os resultados mostraram que a função de sensibilidade ao contraste de crianças de 4-5, 6-7, 8-9, 10-11 e 12-13 anos melhora significativamente com a idade. Os resultados mostraram ainda que a função de sensibilidade ao contraste de crianças de 12-13 anos é semelhante à de adultos jovens (19-22 anos). Estes resultados sugerem que o desenvolvimento da função de sensibilidade ao contraste para grade senoidal em nível baixo de luminância melhora até os 12-13 anos. The aim of this study was to measure contrast sensitivity function for spatial frequencies of 0.25, 0.5, 1.0 and 2.0 cycles per degree in children between the ages of 4 and 13. We measured the contrast thresholds of 60 participants (50 children and 10 young adults) using the psychophysical forced-choice method and low luminance levels. All subjects were free from any identifiable ocular disease and had normal acuity. Results showed that contrast sensitivity function, in children in the 4-5, 6-7, 8-9, 10-11 and 12-13 age ranges, improved significantly with age. The results also showed that, by 12-13 years of age, the contrast sensitivity function was similar to that of a young adult (19-22 years). These results suggest that the development of contrast sensitivity function for sine-wave grating at low luminance levels attains adult-like values by about 12-13 years of age.

Em termos gerais, a FSC tem sido usada para caracterizar o desenvolvimento da percepção visual da forma de crianças. O objetivo do presente estudo foi mensurar e comparar curvas de sensibilidade ao contraste para estímulos radiais (FSCr) e grades senoidais (FSC) em crianças pré-escolares com o método psicofísico da escolha forçada- senoidais de 0,25; 0,5; 1 e 2 cpg em crianças pré-escolares (4 e 5 anos) e adultos jovens com o método psicofísico da escolha forçada. Participaram 15 voluntários com a acuidade visual normal ou corrigida distribuídos igualmente nas três faixas etárias. Os resultados mostraram que a sensibilidade melhora com o desenvolvimento e que a sensibilidade de todos os participantes foi maior para as grades senoidais do que para as freqüências radiais. Estes resultados sugerem que os estímulos radiais e as grades senoidais são processados por áreas visuais diferentes. In general the FSC is used to characterise the development of the visual perception of material by children. The aim of the present work was to mensure and compare contrast the sensitivity curves to differ then of the radical stimuly (FSCr) and sine-wave gratings (FSC) in pré-school children, usind the psychophysical method of choice-forced for radial and sine-wave gratings stimuli of 0.25; 0.5; 1 and 2 cpd in 4-5 yearold preschool children and young adults using the psychophysical forced-choice staircase method. Fifteen volunteers with corrected-to-normal visual acuity, five in each age range, participated in the experiments. The results showed that the sensitivity improves with the development and that in for all participants the sensitivity was higher for sine-wave gratings than the radial frequencies. These results suggest that the radial and the sine-wave gratings stimuli are processed by different visual areas.

O objetivo deste trabalho foi medir curvas de sensibilidade ao contraste de 10 crianças ouvintes e de 10 crianças com surdez pré-lingual, de 7 a 12 anos, utilizando frequências radiais circularmente concêntricas (FSCr) de 0,25-2,0 cpg em níveis baixos de luminância (0,7 cd/m²). Todos os participantes apresentavam acuidade visual normal e estavam livres de doenças oculares identificáveis. A FSCr foi medida com o método psicofísico da escolha forçada. Os resultados mostraram sensibilidade máxima na faixa de frequência radial de 0,25 cpg para os dois grupos. Os resultados mostraram ainda diferenças significantes entre as curvas de FSCr de crianças ouvintes e de crianças com surdez pré-lingual. Isto é, as crianças ouvintes precisaram de menos contraste do que as crianças surdas para detectar as frequências radiais. Esses resultados sugerem que, em níveis baixos de luminância, a FSCr das crianças ouvintes foi melhor do que a das crianças com surdez pré-lingual. The aim of this work was to measure contrast sensitivity curves in 10 hearing children and 10 children with prelingual deafness (from 7 to 12 years old), using concentric circular patterns with radial frequencies (rCSF) of 0.25-2.0 cpd at low levels of luminance (0.7 cd/m²). All participants were free from identifiable ocular disease and had normal visual acuity. The rCSF was measured with the psychophysical forced-choice method. The results showed maximum sensitivity in the frequency range of 0.25 cpd for the two groups. The results showed yet significant differences between the rCSF of deaf and hearing children. That is, hearing children needed less contrast than deaf children to detect radial frequencies. These results suggest that at low levels of luminance the rCSF of hearing children was better than the rCSF of children with prelingual deafness.