Repeatability of wavefront aberration measured by adaptive optics visual simulator and agreement of OPD-Scan Ⅲ / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To assess the repeatability and agreement of higher-order aberration obtained by adaptive optics visual simulator(VAO)compared with OPD-Scan Ⅲ.METHODS: A cross-sectional study was conducted from August to September 2023, including a total of 204 patients(204 eyes)with myopia whose right eyes were measured. The examinations were performed by the same skilled examiner using both devices separately. The VAO device was used to measure higher order aberrations of orders 3 to 6 at a pupil diameter of 4.5 mm, while both the VAO and OPD-Scan Ⅲ devices were utilized to measure total higher-order aberration(tHOA), spherical aberration(SA), coma aberration(Coma), and trefoil aberration(Trefoil)of the entire eye at pupil diameters ranging from 3 to 6 mm. Furthermore, the repeatability of whole eye aberration measurements obtained with the VAO device was evaluated and the agreement of the two devices was assessed.RESULTS: The whole-eye higher-order aberrations measured by VAO demonstrated excellent repeatability(0.767≤ICC≤0.941, Sw<0.01 μm, TRT<0.1 μm). There was no statistically significant difference in Coma measured by VAO or OPD-Scan Ⅲ for pupil diameters ranging from 4 to 6 mm(P>0.05), while a statistically significant difference was observed in whole-eye tHOA of other pupil diameters(all P<0.05). The agreement of aberration measurements for each order between VAO and OPD-Scan Ⅲ for 3 mm pupil diameters, SA at 4 and 5 mm pupil diameter and Coma at 4 mm pupil diameter showed a 95% limit of agreement(LoA)<0.1, indicating good agreement; however, poor agreement was found for the remaining aberration measurements at different pupil diameters, with a 95%LoA>0.1, and there were significant differences in higher-order aberrations measured by two devices under a pupil diameter of 3 mm(r=0.218-0.317, P<0.01), 4 mm(r=0.406-0.672, P<0.01), 5 mm(r=0.538-0.839, P<0.01 and r=0.030-0.109, P>0.01)and 6 mm(r=0.369-0.766, P<0.01).CONCLUSION: The VAO demonstrates favorable repeatability when assessing whole-eye higher order aberration under pupil diameters of 3-6 mm. However, there is inadequate agreement and interchangeability in whole-eye higher order aberration at 3-6 mm pupil diameter between VAO and OPD-Scan Ⅲ for clinical purposes.

Observation on the distribution of macular cone in healthy adult using adaptive optics scanning laser ophthalmoscope system / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To observe the distribution of cone in the macular of healthy adult in different ages using adaptive optics scanning laser ophthalmoscope(AO-SLO)system, and analyze its relationship with age.METHODS: A total of 100 healthy examinees(200 eyes)in our hospital from June to July 2023 were selected, and they were divided into four groups according to their age, with 25 cases(50 eyes)in each group, including 18-30 years in group A, 31-40 years in group B, 41-50 years in group C, 51-65 years in group D. AO-SLO was performed in both eyes and cone density was measured.RESULTS: The density of cone in the foveal eccentricity of 3° and 2.4°×2.4° in each group was different(P<0.001), and the cone density in each area showed a relatively regular distribution characteristics, with the highest density in the temporal side, and the temporal>nasal>inferior>superior sides from high to low. The mean cone density in the macular area of both eyes was 14 144.38±1 082.40, 13 241.24±535.32, 12 930.29±727.73, and 10 907.50±490.86 cell/mm2, respectively(P<0.001), indicating that the cone density decreased with age. The correlation analysis showed that the mean cone density in the macular area was negatively correlated with age(r=-0.578, P<0.001).CONCLUSION: AO-SLO is a quantitative non-invasive detection of cones, and there is a negative correlation between cone density and age in healthy human. Furthermore, density of cone in healthy people over 50 years was significantly decreased.

Los tecnólogos en Optometría y Óptica y su desempeño profesional

Introducción: Esta investigación se articula en el modelo de educación superior y el modelo sanitario que se aplica en Cuba, acorde con las necesidades cada vez más crecientes del hombre en relación directa con su entorno socioeconómico, cultural, científico-tecnológico y ecológico. Objetivo: Valorar el estado actual del desempeño profesional de los tecnólogos en Optometría y Óptica de La Habana. Materiales y métodos: La investigación es cuantitativa, no experimental, observacional y prospectiva. Se trabajó con 200 tecnólogos en Optometría y Óptica, que constituyen el 100 % de la población. Para el desarrollo se identificaron cuatro dimensiones, entre las que se encuentran la aplicación de los procederes tecnológicos ópticos y optométricos; producción intelectual: se establece la actuación manifestada en la expresión de conocimientos y habilidades actualizados; comportamiento ético: se entiende por la actuación manifestada en la expresión de habilidades comunicativas y valores; y crecimiento profesional, referido a la actuación manifestada en la expresión de habilidades investigativas. Resultados: El 100 % aborda las funciones en la asistencia, y solo el 10 % declara tener tiempo para investigar; 25 % de ellos han participado en algún curso, el 12 % en diplomado, y solo cuatro poseen maestría; 25 % establece tener dominio en la manipulación de los equipos; entre el 10 y el 20 % no presentan problemas. Conclusiones: Se identificaron insuficiencias en las dimensiones que se establecieron relacionadas con la superación y la aplicación de los procederes tecnológicos.

Introduction: This research is articulated in the higher education model and the health model that is applied in Cuba, in accordance with the increasingly growing needs of man in direct relation with his socioeconomic, cultural, scientific, technological and ecological environment. Objective: To assess the current status of the professional performance of technologists in Optometry and Optics of Havana. Materials and methods: The research is quantitative, not experimental, observational and prospective. The authors worked with 200 technologists in Optometry and Optics, who were 100% of the population. Four dimensions were identified for the development, among which are the application of optical technological procedures and optometric; intellectual production: the performance manifested in the expression of updated knowledge and skills is established; ethical behaviour means the action expressed in the expression of communicative skills and values; and professional growth, referring to the performance manifested in the expression of investigative skills. Results: 100% address the functions in assistance and only 10% declare they have time to research[ 25% of them have participated in some course, 12% in a diploma and only four have a master's degree; 25% state that they have mastery in handling the equipment, between 10% and 20% do not present problems. Conclusions: Insufficiencies were identified in the dimensions that were established related to improvement and the application of technological procedures.

Origen y evolución de la optometría y la óptica en Cuba y en el mundo

Al revisar la historia de la optometría y la óptica se encuentra que ha tenido procesos de cambio y evolución, debido a la preocupación por la salud visual que ha venido deteriorándose al transcurrir de los años. Para mostrar dichos cambios se realizó una revisión teórica-histórica del origen y la evolución de la optometría y la óptica. Se tuvo en cuenta los datos que han sido de avance científico, tecnológico y humanístico, no solo en la antigüedad sino también en la actualidad, los cuales han servido para mejorar el desarrollo de nuestra actividad profesional y consecuentemente al mejoramiento del bienestar social. Fueron innumerables los hombres que enriquecieron nuestros conocimientos con sus aportes, por lo cual se ha necesitado de muchos siglos de lenta y progresiva evolución para llegar a ser lo que es hoy en día, una ciencia con todas las bases de la óptica, la anatomía y la fisiología de la visión la cual se rige por leyes que nos permiten un conocimiento más exacto de ella. El objetivo es valorar el proceso de origen y evolución de la optometría y la óptica en Cuba y el mundo.

When reviewing the history of optometry and optics, it is found that it has undergone processes of change and evolution, due to the concern for visual health that has been deteriorating over the years. In order to show these changes, a theoretical-historical review of the origin and evolution of optometry and optics was carried out. We took into account the data that have been of scientific, technological and humanistic progress, not only in ancient times but also at present, which have served to improve the development of our professional activity and consequently to the improvement of social welfare. There were countless men who enriched our knowledge with their contributions, so it has taken many centuries of slow and progressive evolution to become what it is today, a science with all the bases of optics, anatomy and physiology of vision which is governed by laws that allow us a more accurate knowledge of it. The objective is to evaluate the process of origin and evolution of optometry and optics in Cuba and the world.

Superación profesional del tecnólogo en optometría y óptica en el Tomógrafo de Coherencia Óptica Spectralis / The Professional Upgrading of the Technologist in Optometry and Optics with the Spectralis Optical Coherence Tomography

En la actualidad, se vive en una sociedad en la que el conocimiento es el principal motor de desarrollo y crecimiento económico. Para que una persona tenga capacidad de producir conocimientos y de aprendizaje permanente, se requiere tener habilidades en el uso de tecnología avanzada, las cuales se logran con la superación profesional para poder aplicarlos en beneficio de toda la sociedad. La superación profesional posibilita a los profesionales estar actualizados y actualizables en las tecnologías avanzadas que facilitan mantenerse competentes y competitivos en cualquiera de los escenarios. En ese sentido, el desarrollo de las habilidades en el uso de tecnología avanzada significa aprender un lenguaje único, incorporar nuevas reglas y utilizar nuevas experiencias para aprender a interaccionar con eficacia en ese mundo. La tecnología de la salud requiere de profesionales con un perfil amplio e integrador, los cuales, mediante la superación profesional, se apropien de conocimientos y desarrollen habilidades en el uso de tecnología avanzada(AU)

Nowadays, life is experienced in a society in which knowledge is the main engine of development and economic growth. In order for a person to have the capacity to produce knowledge and learn permanently, it is necessary to have skills in the use of advanced technology, achieved through professional upgrading in order to apply them for the benefit of society as a whole. Professional upgrading makes it possible for professionals to be updated and updatable in advanced technologies that make it easier for them to remain competent and competitive in any of the scenarios. In that respect, the development of skills in the use of advanced technology means learning a unique language, incorporating new rules and using new experiences to learn how to interact effectively in this world. Health technology requires professionals with a broad and integrative profile, who, through professional upgrading, appropriate knowledge for themselves and develop skills in the use of advanced technology(AU)

Evaluation of retinal function and morphology in isoametropic amblyopia

Purpose: To observe the photoreceptor anomalies in cases of ametropic amblyopia. Methods: A prospective study with 25 isoametropic amblyopic children in the age group of 5–14 years and 25 age?matched controls was done. Examination included refraction, best?corrected visual acuity (BCVA), and color vision. Adaptive optics (AO) and multifocal electroretinogram (mf?ERG) were done to assess the anatomy and function of photoreceptors. The subgroup analysis of the improved and non?improved groups was done. Results: The mean cone density in cases and control in the superior, temporal, and nasal quadrants was respectively as follows (21640 ± 5713, 24040 ± 3386, P = 0.01) (19755 ± 6282, 21832 ± 2911, P = 0.03) (19897 ± 5418, 22171 ± 3660, P = 0.01) (20768 ± 4799, 22819 ± 3241, P = 0.01). The amplitude of N1 wave and P1 wave in cases was significantly low compared to the controls. Cases with subnormal color vision had reduced BCVA (0.55 ± 0.018) in comparison to the children with normal response (0.350 ± 0.014). Cone density was also significantly reduced in children with subnormal color vision. Sixteen out of 25 cases showed BCVA improvement with spectacles. Baseline cone density was found to be significantly higher in the improved group. There was no correlation between BCVA and AO parameters. Conclusion: Patients with ametropic amblyopia show subnormal photoreceptor properties than controls. Low cone density may be associated with defective color vision and poor prognosis in these cases

Advancements in the application of adaptive optics-based retinal imaging technology / 国际眼科杂志(Guoji Yanke Zazhi)

Adaptive optics(AO)is a technique used to optimize the functionality of optical systems through the reduction of wavefront distortion and optical aberrations. AO-based retinal imaging reduces the occurrence of optical aberrations in the refractive system, consequently improving the resolution and overall quality of retinal imaging. As a result, AO-based retinal imaging has potential wide-ranging application in ophthalmology. A combination of AO, fundus camera, scanning laser ophthalmoscope, optical coherence tomography technique and optical coherence tomography angiography, can be applied to observe the distribution, morphology and function of retinal cone cells in the healthy retinal, and to comprehend the shape and perfusion of retinal vessels in the fine vascular layer. With this technique, it can also possible to perform qualitative and quantitative analysis of the number and shape of cells in the ocular fundus, the cribriform plate, and the microscopic structures of the retinal microvascular system and nerve tissue. It can be expected as a novel tool for the early diagnosis, follow-up of therapy effects, and identification of progression of ophthalmic diseases such as diabetic retinopathy, age-related macular degeneration, glaucoma and hereditary retinal diseases.

An insight into the altered ophthalmic dynamics during the COVID-19 pandemic

Purpose: The objective of this survey?based study was to examine the effects of personal protective measures taken at the level of instrument and surgeon during the pandemic on the optics in ophthalmology. Methods: The study involved an online questionnaire of 24 questions which was distributed to ophthalmologists practicing in several hospitals, including residents and fellows undergoing training in ophthalmology in India. The responses were collected through an online data collection tool (Google forms). The participants could choose from multiple options provided to them in each question. Results: A total of 285 participants out of 296 had used modified methods for examining and performing surgical procedures during the pandemic, while 78.7% (265) of the participants acknowledged having encountered difficulty in interpreting the ocular findings of patients while examining in personal protective equipment. Moreover, 58.7% (198) of our study respondents also reported that there was significant worsening of the quality of ophthalmological examination with pandemic?appropriate measures and 84.8% (286) of our study participants also felt that these measures have significantly added to the time of examination, hence increasing the risk of exposure to both patient and doctor. Conclusion: The workplace study has highlighted the crucial aspects of optics in ophthalmology during the pandemic. The protective measures taken during the pandemic have significantly worsened the quality of ophthalmological examination and increased the time taken to perform outpatient department?based and surgical procedures in ophthalmology

Adaptive optics scanning laser ophthalmoscopy may support early diagnosis of glaucoma

Purpose: To compare image characteristics of retinal nerve fiber layer (RNFL) between glaucoma patients and healthy controls using adaptive optics scanning laser ophthalmoscopy (AOSLO). Methods: This was a cross-sectional pilot study with two groups: a glaucoma group with patients with moderate or severe glaucoma as per the Hodapp–Parrish–Anderson classification system and a control group with healthy individuals. The optic nerve damage in moderate glaucoma was predominantly located in only one hemisphere; the other hemisphere was un- or minimally affected on optical coherence tomography and automated perimetry and is referred to as early glaucoma. The structure of RNFL bundles and gain (%) in RNFL images with mean pixel values between 15 and 35 were analyzed. Imaging was performed one degree away from the optic disc margin at two and four cardinal clock positions in the glaucoma and control groups, respectively. The field of view was 1.3° at 2.3 ? resolution. We studied one eye per participant. Results: There were 11 glaucoma patients and 7 healthy controls. Imaging was successful at 88% of the locations in controls and early glaucoma; the reflectivity differed significantly (0.51 and 0.56, respectively, P < 0.001) but not the structure of RNFL bundles (Cohen’s Kappa 0.11) between them. In patients with moderate and severe glaucoma, imaging was successful only at 46% of the locations; RNFL bundles were not discernible, and RNFL reflectivity did not differ from those with early glaucoma (P < 0.11). Conclusion: The recorded gain (%) of RNFL images obtained using AOSLO could be an objective indicator of early glaucoma

Progress of application of adaptive optics in ophthalmology / 中华实验眼科杂志

Adaptive optics (AO) can measure and correct wavefront aberrations in real time, which enables the optical system to adapt to external changes and maintain excellent optical performance, and has been gradually paid attention in the field of ophthalmology.AO technology can carry out optometry according to wavefront aberrations to improve the efficiency and accuracy of subjective and objective refraction, eliminate the influence of ocular aberrations on retinal imaging, provide more accurate data for the evaluation of optic nerve function, improve the effectiveness of visual perception training and provide vision care and treatment for special people, as well as simulate and predict postoperative visual outcome and give personalized schemes for refractive surgery and intraocular lens implantation.Moreover, AO combined with optical coherence tomography, optical scanning laser ophthalmoscope, and confocal scanning laser ophthalmoscope, can realize fundus imaging and retinal vascular imaging in real time, provide better sensitivity and resolution of retinal detection, distinguish fine details of retinal vessels and cone cells, and characterize retinal pigment epithelium topology and deformation, the application of which in posterior segment laser surgery, glaucoma diagnosis and follow-up, color blindness and retinal physiological activity research has been attracting attention.In this article, the principle and application of AO in ophthalmology were briefly reviewed.

Agreement evaluation between adaptive optics visual simulator and conventional refraction methods / 中华实验眼科杂志

Objective:To evaluate the difference and agreement of cycloplegic refraction between adaptive optics visual simulator (VAO) and conventional refraction methods.Methods:A diagnostic test study was conducted.Thirty-one eyes of 31 healthy subjects including 15 males and 16 females were enrolled in November, 2019 in Affiliated Hospital of North Sichuan Medical College.Mean age of the subjects was (20.1±1.0) years, and the right eye was taken for data analysis.Cycloplegic refraction was measured by VAO and conventional refraction methods, respectively.Spherical power, cylindrical power, Jackson cross-cylinder power at axis 90° and 180° (J 0) and Jackson cross-cylinder power at axis 45° and 135° (J 45) vector powers were recorded.Paired t-test was used to compare the refractive parameters between different refraction methods, and the intraclass correlation coefficient (ICC) and Bland-Altman plots were used to evaluate the agreement between VAO and conventional refraction methods.This study adhered to the Declaration of Helsinki, and the research protocal was approved by an Ethics Committee of Affiliated Hospital of North Sichuan Medical College (No.2020ER[A]018). Written informed consent was obtained from each subject prior to any medical examination. Results:For subjective refraction, the ICC for spherical power, cylindrical power, J 0 and J 45 between VAO and phoropter were 0.97, 0.75, 0.84 and 0.09, respectively.For objective refraction, the ICC for spherical power, cylindrical power, J 0 and J 45 between VAO and autorefractor were 0.98, 0.70, 0.74 and 0.61, respectively.The mean differences in spherical power, cylindrical power, J 0 and J 45 between VAO and phoropter were (0.05±0.32), (-0.23±0.28), (-0.10±0.14) and (-0.04±0.16)D, respectively, and the differences in cylindrical power and J 0 were statistically significant (both at P<0.01), whereas no significant differences in spherical power and J 45 were found ( P=0.41, 0.18). The mean differences in spherical power, cylindrical power, J 0 and J 45 measured by VAO and autorefractor were (-0.70±0.26), (-0.07±0.46), (-0.03±0.27) and (0.01±0.12)D, respectively, and the spherical power measurement by VAO was significantly more negative than the autorefractor ( t=15.09, P<0.01), while no significant differences in cylindrical power, J 0 and J 45 were found ( P=0.39, 0.59, 0.63). No significant difference values in spherical power, cylindrical power, J 0 and J 45 were found between the two objective refraction methods and phoropter subjective refraction (all at P>0.05). Conclusions:With cycloplegia, spherical power obtained by VAO objective refraction is more negative compared with autorefractor.There is a good agreement of spherical power and astigmatism vector values measured by VAO and phoropter subjective refraction, and the measurement differences are clinically acceptable.

Successful rescue with videolaryngoscopy after failed fibroscopy in anticipated difficult airway: case series / Rescate exitoso con videolaringoscopia luego de fibroscopia fallida en vía aérea difícil anticipada: serie de casos

Abstract Introduction: In the management of the anticipated difficult airway (DA), awake intubation is the strategy of choice. In this context, flexible fibroscopy is the tool most widely used as the first choice. However, there is always the rare case where it may fail. Important findings: Six successful rescue cases using videolaryngoscopy following failed fibroscopy in patients with anticipated DA, and 1 case of rescued extubation of an airway previously secured with fiberoptic bronchoscopy. Conclusion: Videolaringoscopy may be an adequate tool to use as a backup plan for the management of an anticipated DA.

Resumen Introducción: En el manejo de vía aérea difícil anticipada la estrategia de elección es la intubación con el paciente despierto. En este contexto, la fibroscopia flexible es la herramienta más utilizada como plan A; sin embargo, en raras ocasiones puede fallar. Hallazgos importantes: Se presentan seis casos de rescates exitosos con videolaringoscopia luego de fibroscopia fallida en pacientes con vía aérea difícil anticipada, y un caso de rescate de extubación de vía aérea asegurada previamente con fibrobroncoscopio. Conclusión: La videolaringoscopia puede ser una adecuada herramienta como plan B para el manejo de la vía aérea difícil anticipada.

Research progress of contrast sensitivity detection / 国际眼科杂志(Guoji Yanke Zazhi)

@#Contrast sensitivity(CS)has been widely studied in the research of ophthalmology and optometry. Compared with visual acuity(VA)test, CS assessment can fully and accurately reveal the state of visual function, which has become an important indicator for the prediction, diagnosis of eye diseases and for the evaluation of the disease progression and therapeutic effect. To improve the accuracy of CS measurement, CS detection methods have been constantly improved and innovated, mainly including objective examination and subjective psychophysical examination. Both methods have their advantages and limitations and the main target population is slightly different. With the development of the current Internet Plus, the CS detect software based on computer technology has been successively developed by many research institutions, which provide more convenient detection methods. Therefore, this paper reviews the visual standard design, measurement requirements and main applicable characteristics of common CS detection.

Morphometric analysis of retinal arterioles in control and hypertensive population using adaptive optics imaging

Purpose: To measure the wall-to-lumen ratio (WLR) and the vascular wall cross-sectional area (WCSA) of retinal arterioles by an Adaptive Optics (AO) retinal camera using semi-automated software and comparing them between control and hypertensive population. Methods: This was a cross-sectional observational study including a hypertensive group and a control group. Subjects were examined and their medical history recorded. Retinal arteriolar morphometry was assessed by rtx1 AO retinal camera using AOdetect Artery semiautomated software. Main Outcome Measures: WLR and WCSA were measured on the basis of retinal arteriolar wall thickness (W1, W2), lumen diameter (LD) and vessel diameter (VD). Influence of age and arterial hypertension on the WLR and WCSA were examined. Results: A total of 150 human subjects were included out of which 110 were controls and 40 were hypertensives under treatment. There was statistically significant difference in the age, systolic and diastolic blood pressures between the control and hypertensive groups (P < 0.01). We found no significant correlation between age and WLR (R2 = 0.049, P > 0.05) or age and WCSA (R2 = 0.045, P > 0.05). We observed a significant difference in WLR and WCSA measurements between control and hypertensive groups (P < 0.01). On measuring intra-observer variability (IOV) we found excellent consistency. Conclusion: AO retinal imaging allows a direct measurement of the retinal vessel wall and LD with excellent IOV. WLR and WCSA reflect the remodelling process and can be used to further aid the early detection and monitoring of systemic hypertension.

Structural-functional correlation using adaptive optics, visual fields, optical coherence tomography and multifocal electroretinogram in a case of torpedo maculopathy

We present a case of a 37-year-old gentleman with a rare diagnosis of Torpedo maculopathy (TM). We describe the multimodal imaging features of torpedo maculopathy using adaptive optics, visual fields, OCT and multifocal ERG, and understand the clinical and structural-functional correlation in TM. According to us, this is the first case report to describe the adaptive optics imaging findings in Torpedo maculopathy in English Medical literature.

In-the-bag dislocation of polyfocal full-optics accommodative intraocular lens: A case report

Herein, we report a case of in-the-bag dislocation of a WIOL-CF® polyfocal full-optics intraocular lens (IOL), without a history of trauma. A 56-year-old man was referred to our hospital with the chief complaint of sudden-onset visual disturbance in his left eye. He had undergone uneventful phacoemulsification with WIOL-CF® IOL implantation in the left eye at the local clinic 7 years prior. In fundus examination, IOL-capsular bag complex dislocated into the posterior vitreous was observed. We believe this is the first report of in-the-bag dislocation of a WIOL-CF® IOL that has been subluxated or dislocated in a characteristic pattern, not an in-the-bag pattern.

The clinical applications of adaptive optics scanning laser ophthalmoscope / 中华眼底病杂志

Adaptive optics (AO) is a technique to improve the performance of optical systems by reducing the influence of optical aberrations. Combined with scanning laser ophthalmoscope (AOSLO), the aberration of human refractive system can be corrected. Thus, the resolution and quality of imaging can be greatly improved to the cellular level in vivo retina (such as photoreceptor, nerve fibers, vascular parietal cell), therefore the earlier changes of the diseases can be detected. At the same time, microstructure changes of retinal can also be observed during the follow-up of the disease. Due to inherent technical defects of AOSLO, its wide application in clinical practice is limited. With the continuous progress of AO technology and the further improvement of related software functions, the function of the system will become more stronger and will play a more and more important role in scientific research and clinic.

The clinical applications of adaptive optics scanning laser ophthalmoscope / 中华眼底病杂志

Adaptive optics (AO) is a technique to improve the performance of optical systems by reducing the influence of optical aberrations.Combined with scanning laser ophthalmoscope (AOSLO),the aberration of human refractive system can be corrected.Thus,the resolution and quality of imaging can be greatly improved to the cellular level in vivo retina (such as photoreceptor,nerve fibers,vascular parietal cell),therefore the earlier changes of the diseases can be detected.At the same time,microstructure changes of retinal can also be observed during the follow-up of the disease.Due to inherent technical defects of AOSLO,its wide application in clinical practice is limited.With the continuous progress of AO technology and the further improvement of related software functions,the function of the system will become more stronger and will play a more and more important role in scientific research and clinic.

Características mecânicas e ópticas de resinas bulk-fill: revisão de literatura / Mechanical and optics characteristics of bulk-fill resins: literature review

Objetivo: realizar uma análise descritiva das característicasmecânicas e ópticas das resinas bulk-fill com baseem dados da literatura. Revisão da literatura: para arealização do estudo, foram utilizados artigos extraídosdas bases de dados PubMed, SciELO e Lilacs. As palavras-chave utilizadas para busca foram: resina bulk-fill,resina composta, polimerização, grau de conversão,caracterização, dureza, rugosidade, resistência à flexão,translucidez, propriedades ópticas. Os compostosbulk-fill são basicamente formados por matriz orgânicae partículas de alumínio, silício e bário, medindo de0,1 µm a 1 µm. Tratam-se de resinas translúcidas quepodem ser polimerizadas adequadamente em camadasespessas, possuem propriedades mecânicas aceitáveis,porém inferiores às resinas nano e micro-híbridas, e têmbaixo grau de contração volumétrica e menor tensão decontração do que as resinas compostas convencionais.Considerações finais: as resinas bulk-fill são indicadaspara restauração de cavidades com fator de contraçãocavitário desfavorável. A cobertura dessas resinas com2 mm de resina composta convencional em área oclusalé recomendável. (AU)

Objective: the objective of this work was, based on literature data, to describe mechanical and optical characteristics of bulk-fill resins. Literature review: articles were selected at PubMed, SciELO and Lilacs. Search was performed using the keywords: bulk-fill resin, composite resin, polymerization, degree of conversion, characterization, hardness, roughness, flexural strength, translucency, optical properties. Bulk-fill composites are basically formed by organic matrix and particles of aluminium, silicon and barium, measuring from 0.1 µm to 1 µm. They are translucent resins that can be polymerized in thick layers, with acceptable mechanical properties, but with inferior performance than nano and microhybrid resins. The material presents volumetric lower shrinkage and residual stresses than conventional composite resins. Final considerations: bulk-fill resins are indicated for the restoration of cavities with an unfavorable contraction factor. A 2 mm-thick layer of conventional composite resin at the occlusal area over the bulk-fill resins is recommended. (AU)

Cefaleia Trigêmino-autonômica e Neuromielite Óptica / Trigemino-autonomic Headache and Neuromyelitis Optica

As cefaleias trigêmino-autonômicas compartilham os aspectos clínicos da cefaleia, além de proeminentes sintomas disautonômicos crânio faciais. A Neuromielite Óptica (NMO) ou Doença de Devic é uma doença inflamatória grave, desmielinizante e auto-imune do sistema nervoso central que acomete, preferencialmente, os nervos ópticos e a medula espinhal, causando neurite óptica aguda, uni ou bilateral, e mielite transversa. O objetivo desse trabalho é relatar um caso clínico de NMO, cuja manifestação inicial é atípica. Uma revisão de literatura com as palavras-chaves Neuromielite Óptica e Cefaleia Trigêminoautonômica foi realizada no PubMed e foram selecionados os artigos e relatos de casos mais relevantes sobre o assunto. Conclui-se que estas duas doenças podem ter em comum uma alteração hipotalâmica e uma doença desmielinizante grave pode se iniciar com uma cefaleia trigêmino-autonômica. (AU)

The Trigeminal-autonomic headaches share the clinical features of headache, as well as prominent facial skull disautonomic symptoms. The Neuromyelitis Optica (NMO) or Devic's disease is a severe inflammatory disease, demyelinating and autoimmune of the central nervous system that affects mainly the optic nerves and spinal cord, causing acute optic neuritis, unilateral or bilateral, and transverse myelitis. The objective of this study is to report a case of NMO, whose initial manifestation is atypical. A literature review with keywords Neuromyelitis Optica and Trigeminal-autonomic Headache has conducted in PubMed and we have selected the most relevant articles and case reports on the subject. In conclusion, these two diseases may have a common hypothalamic disturbance and a severe demyelinating disease can start with a trigeminal-autonomic headache. (AU)