Refractive and Visual Outcomes After Bilateral Implantation of a Trifocal Intraocular Lens in a Large Population.

PURPOSE: To review refractive, visual acuity, defocus curve and contrast sensitivity results after bilateral implantation of a trifocal intraocular lens (IOL) in a large population. SETTING: One site in Santiago, Chile. DESIGN: Single arm, non-randomized retrospective chart review. METHODS: This was a single-arm retrospective chart review of clinical outcomes after bilateral implantation of a trifocal IOL (Panoptix®), both toric and non-toric versions. Binocular visual acuity at 4 m, 60 cm and 40 cm was tested. Other tests included refraction, mesopic and photopic contrast sensitivity, and defocus curve measurement. RESULTS: The review included 500 eyes of 250 patients implanted with the trifocal IOL and 200 eyes of 100 patients implanted with the trifocal toric IOL, with no clinically significant differences between groups. Ninety-six percent of all eyes were within 0.50D of the intended spherical equivalent correction. In the toric group, 94% of eyes (187/200) had a residual refractive cylinder ≤0.50D, compared to 81% of eyes (406/500) in the non-toric group. Four out of five patients (80.6%, 282/350) had a binocular uncorrected VA of 0.1 logMAR (20/25) at all test distances. Mean defocus was 0.1 logMAR or better from vergences from 0.00 to -3.00 D (corresponding to vision from distance to about 33 cm). With a cutoff of 0.2 logMAR, 96% of patients had a range of vision 2.5 D or greater. Contrast sensitivity was similar between the toric and non-toric lenses, and similar to age-matched normal results. CONCLUSION: The non-toric and toric trifocal IOLs provided good distance, intermediate and near vision to patients, with a wide range of vision and good contrast sensitivity.

Status epilepticus induces region-specific changes in dendritic spines, dendritic length and TrkB protein content of rat brain cortex.

Induction of status epilepticus (SE) with kainic acid results in a large reorganization of neuronal brain circuits, a phenomenon that has been studied primarily in the hippocampus. The neurotrophin BDNF, by acting through its receptor TrkB, has been implicated in such reorganization. In the present work we investigated, by Western blot and immunohistochemistry, whether regional changes of TrkB expression within the rat brain cortex are correlated with altered neuronal morphology and/or with apoptotic cell death. We found that the full-length TrkB protein decreased within the cortex when measured 24 h to 1 week after induction of SE. Analysis by immunohistochemistry revealed that TrkB staining diminished within layer V of the retrosplenial granular b (RSGb) and motor cortices, but not within the auditory cortex. In layer II/III, differential changes were also observed: TrkB decreased in the motor cortex, did not change within the RSGb but increased within the auditory cortex. Reduced TrkB was associated with dendritic atrophy and decreased spine density in pyramidal neurons within layer V of the RSGb. No correlation was observed between regional and cellular changes of TrkB protein and apoptosis, measured by the TdT-mediated dUTP nick end labeling (TUNEL) method. The global decrease of TrkB within the neocortex and the associated dendritic atrophy may counteract seizure propagation in the epileptic brain but may also underlie cognitive impairment after seizures.

Chronic stress induces upregulation of brain-derived neurotrophic factor (BDNF) mRNA and integrin alpha5 expression in the rat pineal gland.

Chronic stress affects brain areas involved in learning and emotional responses. These alterations have been related with the development of cognitive deficits in major depression. Moreover, stress induces deleterious actions on the epithalamic pineal organ, a gland involved in a wide range of physiological functions. The aim of this study was to investigate whether the stress effects on the pineal gland are related with changes in the expression of neurotrophic factors and cell adhesion molecules. Using reverse transcription-polymerase chain reaction (RT-PCR) and Western blot, we analyzed the effect of chronic immobilization stress on the BDNF mRNA and integrin alpha5 expression in the rat pineal gland. We found that BDNF is produced in situ in the pineal gland. Chronic immobilization stress induced upregulation of BDNF mRNA and integrin alpha5 expression in the rat pineal gland but did not produce changes in beta-actin mRNA or in GAPDH expression. Stressed animals also evidenced an increase in anxiety-like behavior and acute gastric lesions. These results suggest that BDNF and integrin alpha5 may have a counteracting effect to the deleterious actions of immobilization stress on functionally stimulated pinealocytes. Furthermore, this study proposes that the pineal gland may be a target of glucocorticoid damage during stress.