Visual dysfunction and its correlation with retinal changes in patients with Alzheimer's disease.

AimTo evaluate visual dysfunction and its correlation with structural changes in the retina in patients with Alzheimer's disease (AD).MethodsPatients with AD (n=24) and controls (n=24) underwent evaluation of visual acuity (VA), color vision (using the Farnsworth and L'Anthony desaturated (D) 15 color tests), and contrast sensitivity vision (CSV; using the Pelli-Robson chart and CSV-1000E test) to measure visual dysfunction. Structural measurements of the retinal nerve fiber layer (RNFL) and macular thickness were obtained using spectral domain-optical coherence tomography (SD-OCT).ResultsCSV at three of the four spatial frequencies was significantly worse in AD patients than in controls. Color vision was significantly affected in AD patients based on the Farnsworth color test. Compared with controls, macular thinning was detected in all sectors except the fovea, and the RNFL exhibited significant thinning in the superior quadrant and lower average thickness (P<0.05). CSV was the functional parameter most strongly correlated with structural measurements in patients with AD. Color vision was strongly associated with macular volume (r>0.70, P<0.05). VA at different levels of contrast was associated with macular and RNFL thickness.ConclusionsPatients with AD had visual dysfunction that correlated with structural changes evaluated by SD-OCT. Macular measurements may be reliable indicators of visual impairment in AD patients.

Visual dysfunction and its correlation with retinal changes in patients with Parkinson's disease: an observational cross-sectional study.

OBJECTIVES: To evaluate visual dysfunction and its correlation with structural changes in the retina in patients with Parkinson's disease (PD). METHODS: Patients with PD (n=37) and controls (n=37) were included in an observational cross-sectional study, and underwent visual acuity (VA), colour vision (using the Farnsworth and Lanthony desaturated D15 colour tests) and contrast sensitivity vision (CSV; using the Pelli-Robson chart and CSV 1000E test) evaluation to measure visual dysfunction. Structural measurements of the retinal nerve fibre layer (RNFL), and macular and ganglion cell layer (GCL) thicknesses, were obtained using spectral domain optical coherence tomography (SD-OCT). Comparison of obtained data, and correlation analysis between functional and structural results were performed. RESULTS: VA (in all different contrast levels) and all CSV spatial frequencies were significantly worse in patients with PD than in controls. Colour vision was significantly affected based on the Lanthony colour test. Significant GCL loss was observed in the minimum GCL+inner plexiform layer. A clear tendency towards a reduction in several macular sectors (central, outer inferior, outer temporal and superior (inner and outer)) and in the temporal quadrant of the RNFL thickness was observed, although the difference was not significant. CSV was the functional parameter most strongly correlated with structural measurements in PD. Colour vision was associated with most GCL measurements. Macular thickness was strongly correlated with macular volume and functional parameters (r>0.70, p<0.05). CONCLUSIONS: Patients with PD had visual dysfunction that correlated with structural changes evaluated by SD-OCT. GCL measurements may be reliable indicators of visual impairment in patients with PD.

Retinal thinning and correlation with functional disability in patients with Parkinson's disease.

AIMS: To determine whether there is an association between retinal thinning and functional rating scales in patients with Parkinson's disease (PD). MATERIALS AND METHODS: Patients with PD (n=153) and controls (n=242) underwent evaluations of the macula and retinal nerve fibre layer (RNFL) using two new-generation Fourier domain optical coherence tomography (OCT) devices (Cirrus, Carl Zeiss Meditec, Dublin, California, USA; Spectralis, Heidelberg Engineering, Heidelberg, Germany). PD severity was assessed using the Schwab-England Activities of Daily Living scale, the Unified Parkinson Disease Rating Scale, the Hoehn and Yahr (HY) scale. Retinal and RNFL thicknesses were compared between patients and controls. Correlations between structural parameters and the scores of the neurologic scales were evaluated. RESULTS: RNFL parameters were significantly reduced in patients with PD, especially when using the Spectralis OCT device. All macular parameters, except for foveal thickness, differed significantly between controls and patients with PD (p<0.001). HY scores were significantly and inversely correlated with all macular parameters when measured with the Spectralis OCT device (p<0.05) and with RNFL thickness when measured with the Cirrus OCT device (nasal quadrant, sectors 2 and 5). CONCLUSIONS: The neurodegeneration caused by PD can be detected using Fourier domain OCT. RNFL and macular thicknesses correlate with PD severity.

[Finding of retinal nerve fiber layer hypertrophy in ataxia of Charlevoix-Saguenay patients]. / Hallazgo de hipertrofia de la capa de fibras nerviosas de la retina en pacientes con ataxia de Charlevoix-Saguenay.

PURPOSE/METHODS: To present the neuro-ophthalmology examination in 5 spastic ataxia of Charlevoix-Saguenay (ARSACS) patients showing significant increases in retinal nerve fiber layer (RNFL) thickness. RESULTS/CONCLUSIONS: All patients showed abnormal visual fields, normal optic discs with increased visibility of RNFL in color stereo-photographs, normal examination with Heidelberg Retina Tomography instrument, and moderate to markedly increased RNFL thickness in Cirrus Optical Coherence Tomography evaluation (average thickness: 119 to 220 microns). We found evidence that RNFL hypertrophy may be an alternative funduscopic finding to the hypermyelinated retinal fibers in previous reports. A revision of ARSACS diagnostic criteria, particularly with regard to retinal alterations, is necessary.

Paciente con coloración cutaenomucosa anaranjada y dolor abdominal inespecífico / Patient with orange muco-cutaneous discoloration and nonspecific abdominal pain

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MRI evaluation of soft tissue hydatid disease.

Infestation in soft tissue by Echinococcus granulosus is not a common disease, and its diagnosis is based on clinical, laboratory data and radiological findings. The aim of our retrospective study is to give an overview of the different signs and patterns shown by MRI that can be useful in characterizing soft tissue hydatid disease. The MRI images obtained in seven patients with soft tissue and subcutaneous hydatidosis were reviewed. Typical signs of hydatidosis were multivesicular lesions with or without hypointense peripheral ring ("rim sign"). Related to the presence and absence, respectively,of viable scolices in the microscopic exam, daughter cysts were presented either as high signal intensity or low signal intensity on T2-weighted images. Low-intensity detached layers within the cyst and peripheral enhancement with gadolinium-DTPA were also presented. Atypical signs were presented in an infected muscular cyst, a subcutaneous unilocular cyst and several unilocular cysts. Knowledge of the different patterns in MRI of soft tissue hydatid disease can be useful in diagnosing this entity. We observed that the "rim sign" is not as common as in other locations, and in addition, MRI seems to be of assistance when evaluating the vitality of the cysts.

Cardiac rhabdomyosarcoma: diagnosis by MR imaging.

We report a case of cardiac rhabdomyosarcoma the initial clinical features of which were pericardial effusion, clinical symptoms of congestive heart failure and probable pulmonary thromboembolism, in which echocardiography constituted the first approach to the diagnosis of cardiac tumor and MRI confirmed it, precisely delimiting the tumoral extension and possible infiltration of pericardiac structures. A brief literature review of this entity is given, the MRI findings obtained in our case are described, and we discuss the advantages and limitations of this technique as compared with other alternatives of image diagnosis.

[The evaluation of a self-measurement arterial pressure monitor: the OMRON-HM 722C]. / Validación de un monitor de automedida de la presión arterial: OMRON-HM 722C.

OBJECTIVE: To evaluate a self-measuring blood pressure (BP) monitor, the OMRON-HM 722C. DESIGN: Based on the protocol of the British Hypertension Society (BHS). SETTING: Urban health centre. PARTICIPANTS: A sample of 120 people (69 women) excluded those with a brachial perimeter under 24 centimetres or over 32. MEASUREMENTS AND MAIN RESULTS: Each subject had four BP measurements in succession, separated by a minute: a) Manually, with a mercury sphygmomanometer (MSM); b) with self-measurement monitor; c) with self-measurement monitor; d) with MSM. Means and SD of systolic and diastolic pressures, means and SD of the differences and a graphic representation of these by the Bland and Altman method, were calculated. The cumulative percentages of differences the same as or below 5, 10 and 15 mm Hg were calculated. 89.1% of systolic BPs, and 92.5% of diastolic BPs, showed mean differences between monitor and observer equal to or below 5 mm Hg. The size of the differences was grade A in both cases, according to the BHS criteria. CONCLUSION: The OMRON-HM 722C self-measuring monitor could be useful for self-measurement of BP at home by primary care patients.

Atomic-absorption spectrometric determination of trace metals in zirconium and zircaloy by discrete sample nebulization.

A discrete sample nebulization technique was employed to determine trace metals in nuclear grade zirconium and Zircaloy by flame atomic-absorption spectrometry. With 10% (w v ) sample solutions, detection limits for Cd, Cu, Mn, Ni, and Pb were 0.6, 2, 1,3, and 10 mug g . Micro standard-addition procedures and background correction were employed to minimize matrix interferences produced by the high salt content of the aspirated solutions.