Age norms for grating acuity and contrast sensitivity in children using eye tracking technology.

KEY MESSAGES: Visual acuity is the most used method to assess visual function in children. Contrast sensitivity complements the information provided for visual acuity, but it is not commonly used in clinical practice. Digital devices are increasingly used as a method to evaluate visual function, due to multiple advantages. Testing with these devices can improve the evaluation of visual development in children from a few months of age. Visual acuity and contrast sensitivity tests, using eye tracking technology, are able to measure visual function in children across a wide range of ages, objectively, quickly and without need of an experienced examiner. PURPOSE: To report age-normative values for grating visual acuity and contrast sensitivity in healthy children using a digital device with eye tracking technology and to validate the grating acuity test. METHODS: In the first project of the study, we examined healthy children aged between 6 months and 7 years with normal ophthalmological assessment. Grating visual acuity (VA) and contrast sensitivity (CS) were assessed using a preferential gaze paradigm with a DIVE (Device for an Integral Visual Examination) assisted with eye tracking technology to provide age norms. For the validation project, we compared LEA grating test (LGT) with DIVE VA in a group of children aged between 6 months and 4 years with normal and abnormal visual development. RESULTS: Fifty-seven children (2.86 ± 1.55 years) were examined with DIVE VA test and 44 successfully completed DIVE CS test (3.06 ± 1.41 years). Both, VA and CS values increased with age, mainly along the first two years of life. Sixty-nine patients (1.34 ± 0.61 years) were included in the DIVE VA test validation. The mean difference between LGT and DIVE VA was - 1.05 ± 4.54 cpd with 95% limits of agreement (LoA) of - 9.95-7.84 cpd. Agreement between the two tests was higher in children younger than 1 year with a mean difference of - 0.19 ± 4.02 cpd. CONCLUSIONS: DIVE is an automatic, objective and reliable tool to assess several visual function parameters in children, and it has good agreement with classical VA tests, especially for the first stage of life.

Efectos de la exposición prenatal a alcohol, tabaco y otras drogas de abuso sobre el desarrollo retiniano / Effects of prenatal exposure to alcohol, tobacco and other drugs of abuse on retinal development

Objetivo: Evaluar la estructura retiniana mediante tomografía de coherencia óptica (OCT) en niños con antecedentes de exposición prenatal a tóxicos. Métodos: Se exploraron 49niños expuestos a tóxicos prenatalmente, de edades comprendidas entre 5 y 18años. De ellos, 25 tenían antecedentes de exposición prenatal a tabaco, 20 fueron expuestos durante el embarazo a alcohol y 4 a otras drogas de abuso. Todos los niños fueron sometidos a una exploración oftalmológica completa incluyendo la realización de una OCT. Se realizó una comparación frente a un grupo control, pareado por edad, de 25niños con embarazos controlados sin exposición a tóxicos. Resultados: Los niños expuestos prenatalmente a tóxicos presentan una reducción significativa del espesor medio de la capa de fibras nerviosas de la retina (CFNR) en comparación con los no expuestos (81,5 vs. 99,7; p < 0,005), así como de sus cuatro cuadrantes (CFNR superior: 97,5 vs. 127,5; p < 0,005; CFNR nasal: 61,5 vs. 72,3; p = 0,005; CFNR inferior: 99,8 vs. 128,6; p < 0,005, CFNR temporal: 58,3 vs. 68,2; p<0,005). También se objetivó una disminución significativa en el espesor medio de la capa de células ganglionares (72,9 vs. 85,9; p < 0,005). De las diferentes exposiciones prenatales estudiadas, en los niños expuestos a drogas de abuso se encontró la mayor disminución en el grosor de CFNR (CFNR espesor medio = 72), seguidos de los expuestos a alcohol (CFNR espesor medio = 72,9) y, en tercer lugar, el grupo de expuestos a tabaco durante el embarazo (CFNR espesor medio = 94,6). Conclusiones: La exposición a tóxicos durante la gestación interfiere en el desarrollo de la retina. Estos resultados refuerzan la evidencia de las recomendaciones acerca de evitar el consumo de cualquier tipo de tóxicos durante el embarazo

Purpose: To assess structural changes in the retina using optical coherence tomography (OCT) in children prenatally exposed to toxic substances. Methods: The study included a total of 49 infants, aged between 5 and 18 years, exposed to toxic substances during pregnancy. Among the exposed children, 25 were exposed to tobacco, 20 were exposed to alcohol, and 4 children were exposed to other drugs of abuse. All children underwent a complete ophthalmology examination, including an OCT. The results were compared against a control group composed of 25 infants, age matched with controlled pregnancy, and not exposed to toxic substances. Results: Children prenatally exposed to toxic substances showed significantly thinner average retinal nerve fibre layer (RNFL) compared with control children (81.5 vs. 99.7μm; P < .005), as well as RNFL thinning in its four quadrants (superior RNFL: 97.5 vs. 127.5μm; P < .005; nasal RNFL: 61.5 vs. 72.3μm; P < .005; inferior RNFL: 99.8 vs. 128.6μm; P < .005, temporal RNFL: 58.3 vs. 68.2μm; P < .005). Exposed children also exhibited a thinner ganglion cell layer (72.9 vs. 85.9; P < .005). Greater RNFL thinning was observed in children exposed to drugs of abuse (RNFL thinner average = 72), followed by children exposed to alcohol (RNFL thinner average = 72.9), and finally the least affected were those children exposed to tobacco during pregnancy (RNFL = 94.6). Conclusion: Toxic substances during pregnancy interfere in retinal development. These results strengthen the evidence about the avoidance of any toxic substance during pregnancy

Effects of prenatal exposure to alcohol, tobacco and other drugs of abuse on retinal development. / Efectos de la exposición prenatal a alcohol, tabaco y otras drogas de abuso sobre el desarrollo retiniano.

PURPOSE: To assess structural changes in the retina using optical coherence tomography (OCT) in children prenatally exposed to toxic substances. METHODS: The study included a total of 49 infants, aged between 5 and 18years, exposed to toxic substances during pregnancy. Among the exposed children, 25 were exposed to tobacco, 20 were exposed to alcohol, and 4 children were exposed to other drugs of abuse. All children underwent a complete ophthalmology examination, including an OCT. The results were compared against a control group composed of 25 infants, age matched with controlled pregnancy, and not exposed to toxic substances. RESULTS: Children prenatally exposed to toxic substances showed significantly thinner average retinal nerve fibre layer (RNFL) compared with control children (81.5 vs. 99.7µm; P<.005), as well as RNFL thinning in its four quadrants (superior RNFL: 97.5 vs. 127.5µm; P<.005; nasal RNFL: 61.5 vs. 72.3µm; P<.005; inferior RNFL: 99.8 vs. 128.6µm; P<.005, temporal RNFL: 58.3 vs. 68.2µm; P<.005). Exposed children also exhibited a thinner ganglion cell layer (72.9 vs. 85.9; P<.005). Greater RNFL thinning was observed in children exposed to drugs of abuse (RNFL thinner average=72), followed by children exposed to alcohol (RNFL thinner average=72.9), and finally the least affected were those children exposed to tobacco during pregnancy (RNFL=94.6). CONCLUSION: Toxic substances during pregnancy interfere in retinal development. These results strengthen the evidence about the avoidance of any toxic substance during pregnancy.

Innovation, systemic appropriation and prevention in the granite mining sector: The case of humidification.

BACKGROUND: This research was conducted in the Brazilian granite mining sector. After epidemiological studies, it was established that professional pneumoconiosis is related to the inhalation of dust. Therefore, the Brazilian mining health and safety regulatory standard made it compulsory to provide humidification throughout the extraction and mineral treatment processes. OBJECTIVE: To develop the concept of systemic appropriation of the technological innovations that aim to protect the worker's health. Until now, appropriation has usually been presented in its individual dimensions. In this article, the focus is placed on the collective and organizational aspects of this appropriation. METHODS: Two methodological approaches were used: interviews with the different individuals involved in order to report the history of the implementation of technical devices which meet the humidification norm; and ergonomic analysis of the work of the operators who used these devices. RESULTS: The appropriation of the technical devices occurred at two distinct levels: 1) Individual, related to the direct contact of the operator with the instrument; 2) Systemic, as the effects of the innovation propagated through the system affecting interdependent tasks, adaptation of the work organization and new production strategies. CONCLUSIONS: The implementation of prevention norms require innovations which are necessarily accompanied by transformations in the companies' techniques, work and management.

Face recognition impairment in small for gestational age and preterm children.

BACKGROUND: Infants born prematurely or with low birth weight are at increased risk of visual perceptual impairment. Face recognition is a high-order visual ability important for social development, which has been rarely assessed in premature or low birth weight children. AIMS: To evaluate the influence of prematurity and low birth weight on face recognition skills. METHODS: Seventy-seven children were evaluated as part of a prospective cohort study. They were divided into premature and term birth cohorts. Children with a birth weight below the 10th centile were considered small for gestational age. All children underwent a full ophthalmologic assessment and evaluation of face recognition skills using the Facial Memory subtest from the Test of Memory and Learning. RESULTS: Premature infants scored worse on immediate face recognition compared to term infants. However, after adjusting for birth weight, prematurity was not associated with worse outcomes. Independent of gestational age, outcomes of low birth weight children were worse than those of appropriate birth weight children, for immediate face recognition (odds ratio [OR], 5.14; 95% confidence interval [CI], 1.32-21.74) and for face memory (OR, 4.48; 95% CI, 1.14-16.95). CONCLUSIONS: Being born small for gestational age is associated with suboptimal face recognition skills, even in children without major neurodevelopmental problems.

Effect of prematurity and low birth weight in visual abilities and school performance.

BACKGROUND: Prematurity and low birth weight are known risk factors for cognitive and developmental impairments, and school failure. Visual perceptual and visual motor skills seem to be among the most affected cognitive domains in these children. AIMS: To assess the influence of prematurity and low birth weight in visual cognitive skills and school performance. METHODS: We performed a prospective cohort study, which included 80 boys and girls in an age range from 5 to 13. Subjects were grouped by gestational age at birth (preterm, <37 weeks; term, 37-42 weeks) and birth weight (small for gestational age (SGA), <10th centile; appropriate weight for gestational age (AGA), ≥10th centile). Each child underwent full ophthalmologic assessment and standardized testing of visual cognitive abilities (Test of Visual Perceptual Skills and Test of Visual Analysis Skills). Parents completed a questionnaire on school performance in children. RESULTS: Figure-ground skill and visual motor integration were significantly decreased in the preterm birth group, compared with term control subjects (figure-ground: 45.7 vs 66.5, p=0.012; visual motor integration, TVAS: (9.9 vs 11.8, p=0.018), while outcomes of visual memory (29.0 vs 47.7, p=0.012), form constancy (33.3 vs 52.8, p=0.019), figure-ground (37.4 vs 65.6, p=0.001), and visual closure (43.7 vs 62.6 p=0.016) testing were lower in the SGA (vs AGA) group. Visual cognitive difficulties corresponded with worse performance in mathematics (r=0.414, p=0.004) and reading (r=0.343, p=0.018). CONCLUSION: Specific patterns of visual perceptual and visual motor deficits are displayed by children born preterm or SGA, which hinder mathematics and reading performance.

Síndrome visual de la prematuridad / Visual syndrome of prematurity

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Pathways of neuronal and cognitive development in children born small-for-gestational age or late preterm.

OBJECTIVE: To assess the effects of late small-for-gestational-age (SGA) birth and late prematurity on cognitive outcomes and structural changes in the central nervous system at primary school age, using a novel approach to examine changes in neuronal integrity of the retina. METHODS: We conducted a cross-sectional study of 347 children aged 6-13 years, including in the analysis only infants born after 34 weeks' gestation. We recorded all perinatal outcomes through a survey of parents. Neuronal damage was evaluated using optical coherence tomography of the retina. In a subgroup of 112 children aged 6-8 years, visuospatial perception was evaluated with the Children's Bender Visual Motor Gestalt Test. RESULTS: The proportions of SGA and late preterm children were 11.8 and 6.3%, respectively. Prematurity and SGA were simultaneously present in five children. When compared with controls, SGA children showed significantly lower than average retinal nerve fiber layer (RNFL) thickness (94.1 vs 98.8 µm; P = 0.007) and an increased percentage of abnormal Bender scores (27.3 vs 6.2%; P = 0.017) (odds ratio 5.6 (95% CI, 1.2-26.8)). These differences increased when late SGA infants with a birth weight below the 3(rd) percentile were compared with SGA infants with a birth weight between the 3(rd) and 10(th) percentiles and with controls, for RNFL thickness (92.5 vs 94.6 and 98.8 µm, respectively; P = 0.021) and abnormal Bender tests (33.3 vs 25.0 and 6.2%, respectively; P = 0.036). However, no differences were found in retinal structure and visuomotor performance between late preterm and term infants. CONCLUSIONS: These data suggest that late SGA and late prematurity induce a distinct neuronal pattern of structural changes that persist at school age. Late-onset SGA infants are at increased risk for axonal loss in the retina and present specific visuomotor difficulties.

Bilateral choroidal metastases as presentation of dissemination of cutaneous malignant melanoma.

Case Report. A 47-year-old man presented with blurred vision in the right eye. Ophthalmoscopic examination showed several placoid, pigmented lesions in the posterior pole and midperiphery of the retina of both eyes. Results. Patient referred a cutaneous malignant melanoma on the back skin removed 6 years ago. A systemic workup revealed multiple metastases in liver and spleen. After an exhaustive study we concluded that it was a dissemination of a cutaneous malignant melanoma with bilateral choroidal metastases, liver and spleen metastases. The patient obtained clinical ocular improvement after palliative chemotherapy, although he died in the following months. Pathological examination of the lesions confirmed the diagnosis of choroidal metastases from a malignant cutaneous melanoma. Conclusions. Monitoring patients who have had cutaneous malignant melanoma is very important, since melanoma metastases may occur even many years after the diagnosis of the primary tumor. Choroidal metastases from cutaneous melanoma are uncommon but we should be aware because their appearance worsens prognosis.

Axonal loss and cognitive deficits in term infants with normal umbilical artery Doppler born small-for-gestational age.

OBJECTIVE: To assess cognitive outcomes and structural changes in the central nervous system, the latter using a novel approach to examine changes in neuronal integrity of the optic nerve, in children at 5-6½ years of age who were born small-for-gestational age (SGA) at term having shown normal umbilical artery (UA) Doppler. METHODS: We compared neuronal damage, cognitive deficits and visuospatial perception in two cohorts of infants, one born SGA (n = 40) and one born appropriate-for-gestational age (AGA) (n = 39) in weight. Neuronal damage was evaluated using optical coherence tomography (OCT) of the optic nerve. Cognitive deficits were assessed with the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) test. Visuospatial perception was evaluated with Rey-Osterreich Complex Figure (ROCF) tasks. RESULTS: Children from the SGA group had a significantly thinner average retinal nerve fiber layer (RNFL) compared with those from the AGA group (98.2 vs 104.5 µm, P = 0.012). Children from the SGA group exhibited impaired performance in copy tasks on the ROCF (3.27 vs 3.56, P = 0.036) and a higher rate of suboptimal WPPSI test performance intelligence quotient scores (15% vs 0%; P = 0.025) compared with those from the AGA group. CONCLUSION: Term infants with normal UA Doppler born SGA are at increased risk for cognitive deficits and axonal loss in the RNFL at the age of 5-6½ years.

Activity at work, innovation and sustainable development.

The aim of this paper is to present and discuss a French-Brazilian project (CAPES-COFECUB) centered on the relations between sustainable development, innovation and changes in work activities that accompany these innovations for sustainable development. Sustainable development calls for an integrated approach of three dimensions: social equity, economic viability and environmental sustainability. In order to achieve this integration, considerable innovations efforts are required. However, the work, understood as a productive act, is deeply lacking in the current researches. Starting from the idea that work is a "fundamental need" the goal of this project is to propose innovative methods that can be used for designing production systems from the perspective of sustainable development.

Effect of optic neuritis on progressive axonal damage in multiple sclerosis patients.

OBJECTIVE: The objective of this research was to study the effect of optic neuritis (ON) on axonal damage in multiple sclerosis (MS) patients. Specifically, we compared changes over 2 years in the retinal nerve fibre layer (RNFL) between affected and contralateral eyes in MS patients with a prior history of ON. METHODS: Thirty-four patients with one unilateral definitive episode of ON were included and underwent a complete ophthalmic examination, optical coherence tomography (OCT), scanning laser polarimetry, visual evoked potentials (VEP) and pattern electroretinogram (pERG). All patients were re-evaluated at 12 and 24 months. Parameters were compared between ON-affected and contralateral eyes in an initial exploration and over the course of the follow-up. Correlations between parameter changes were analysed. RESULTS: RNFL thickness and functional parameters showed more affection in ON eyes (p ≤ 0.05), but changes in measurements during the study were similar between both groups of eyes. CONCLUSIONS: Progressive axonal loss can be detected in the optic nerve, but ON is not a risk factor for increased chronic damage in MS patients without ophthalmic relapses. Loss of the RNFL is caused by progressive degeneration associated with the disease.

Comparison of imiquimod 5% cream versus radiotherapy as treatment for eyelid basal cell carcinoma.

BACKGROUND: To compare the efficacy, cosmesis and tolerance of two non-surgical treatments-imiquimod (IMQ) 5% cream and radiotherapy (RT)-to combat periocular nodular basal cell carcinoma (BCC). METHODS: Twenty-seven patients with clinical and histopathological diagnosis of nodular BCC on the eyelid were included and randomly selected: 15 patients were treated with IMQ 5% cream once daily, 5 days/week for 6 weeks, and 12 patients were treated with RT. RESULTS: All tumours showed histopathological remission within 3 months of the treatment, and sustained clinical remission was documented in each patient after 24 months' follow-up. Treatment tolerability was rated as moderate with IMQ and good with RT. Functional results were better in patients treated with IMQ. Loss of eyelashes was reported for most of the patients treated with RT. CONCLUSIONS: IMQ and RT therapies are effective for treating eyelid nodular BCCs. Cosmesis and functional results were better with IMQ, while tolerability was higher with RT.

[Effect of treatment in loss of retinal nerve fibre layer in multiple sclerosis patients]. / Influencia del tratamiento en la pérdida de fibras nerviosas de la retina en pacientes con esclerosis múltiple.

OBJECTIVE: To evaluate the effect of pathogenic treatments in the reduction of the retinal nerve fibre layer (RNFL) in patients with Multiple Sclerosis (MS) by means of ocular imaging technologies. MATERIAL AND METHODS: A total 155 eyes of 79 patients with MS were enrolled in this study. All patients underwent a complete ophthalmic examination including best corrected visual acuity using Snellen chart, colour vision using Ishihara pseudoisochromatic plates, visual field examination, optical coherence tomography (OCT), scanning laser polarimetry (GDx) and visual evoked potentials. The patients were re-evaluated after a one year period and changes were assessed in order to detect differences between treatments using the Anova statistical test. The patients were divided into four groups: 1) Patients without treatment, 2) Patients treated with interferon beta-1a, 3) Subjects who received interferon beta-1b, 4) Patients treated using glatiramer acetate. RESULTS: There were no statistically significant differences between patients with or without treatment and between the four groups (P>0.05, t test), but functional and structural parameters showed greater loss in RNFL thickness in non-treated patients. Temporal quadrant RNFL thickness measured by OCT was the parameter with the highest variation (reduction of 4.97µm in patients without treatment vs 1.08µm in treated patients). CONCLUSIONS: MS pathogenic treatment may be a protective factor in the RNFL loss that is associated to the disease progression. More studies are needed.

Bilateral Internuclear Ophthalmoplegia in a Patient with Devic's Neuromyelitis Optica.

An unusual presentation of Devic's neuromyelitis optica (NMO) disease associated with bilateral internuclear ophthalmoplegia (INO) is described. A 32-year-old pregnant patient was diagnosed with NMO. First symptoms were headache and sudden visual loss in her right eye (RE). Eighteen months ago, she reported other neurologic symptoms such as paresthesia. Based on her visual field, fundoscopy and Ishihara test, she was diagnosed with retrobulbar neuritis of the RE. After delivery, new neurologic symptoms resembling transverse myelitis appeared. She was treated with methylprednisolone and plasmapheresis, which improved her visual acuity; however, a sudden bilateral INO appeared, with adduction defect and nystagmus with abduction in both eyes. No improvement was obtained after treatment with azathioprine and rituximab. Paresis of the legs and the right arm persisted, but double vision and OIN gradually disappeared. At the end, the patient had a residual exophoria in the RE and nystagmus with abduction in the left eye. Prevalence of NMO is lower than one case per one million inhabitants, and it is not likely to affect the encephalic trunk; furthermore, bilateral INO in NMO is rare. Two major criteria and at least two of the three minor ones are required to confirm a NMO diagnosis, and our patient fulfilled these diagnosis criteria.

[Ability of Heidelberg Retina Tomograph III to predict progression in patients with early glaucoma or suspected primary open-angle glaucoma]. / Valor predictivo del Heidelberg Retina Tomograph III en pacientes con glaucoma incipiente o sospecha de glaucoma.

PURPOSE: To study the ability of Heidelberg Retina Tomography III (HRT 3) measurements to predict perimetry changes in patients with early glaucoma or suspected primary open-angle glaucoma. MATERIAL AND METHODS: One hundred and thirty two eyes with early glaucoma or suspected glaucoma with no changes in basal perimetry were prospectively selected and periodically evaluated over five years. The eyes were divided in two groups depending on the presence or absence of progression (changes in glaucoma perimetry). The association between morphometric parameters and baseline HRT 3 indices, glaucoma probability score (GPS) and Moorefield's Regression Analysis (MRA), and perimetry progression were studied using Cox multivariate regression analyses. Kaplan-Meier curves were used to illustrate the results. RESULTS: Forty-eight eyes (36.36%) showed perimetry progression. Perimetry progression showed higher correlations with the disc area (p = 0.001), the cup area (p = 0.002) and the vertical cup disc area (p = 0.001). Multivariate regression analyses showed that eyes with baseline MRA or baseline GPA changes were at a higher risk of having perimetry abnormalities and a faster progression. CONCLUSIONS: MRA and GPA indices are useful to predict perimetry progression in patients with early primary open-angle glaucoma or suspected glaucoma. These indices can be used as risk markers of functional progression in glaucoma.

Correlation between functional and structural assessments of the optic nerve and retina in multiple sclerosis patients.

OBJECTIVE: The aim of this study was to evaluate the correlation between functional eye examinations (visual evoked potentials: VEPs; pattern electroretinogram: PERG) and structural measurements of the optic nerve (optical coherence tomography: OCT; scanning laser polarimetry: GDx) in patients with multiple sclerosis (MS). METHODS: Patients with definite MS and disease-free controls were enrolled in the study. VEPs and PERG were recorded in all subjetcs. Ophthalmologic examination, including visual acuity, visual field determination, OCT and GDx were performed. RESULTS: Nineteen MS patients and 19 age- and sex-matched controls were included in the study. Significant differences between both groups were observed with respect to VEP (P100 latency and amplitude), PERG (N95 amplitude and N95/P50 ratio) and OCT parameters (average, temporal and macular volume). There were a statistically significant correlation between VEP or PERG parameters and OCT or GDx results. CONCLUSIONS: In MS patients, axonal loss in ganglion cells can be detected with OCT and GDx. PERG is a useful complementary tool to identify this damage.

Influencia del tratamiento en la pérdida de fibras nerviosas de la retina en pacientes con esclerosis múltiple / Effect of treatment in loss of retinal nerve fibre layer in multiple sclerosis patients

ObjetivosEvaluar el efecto del tratamiento patogénico de la esclerosis múltiple (EM) sobre la pérdida de fibras nerviosas de la retina (CFNR) mediante técnicas de análisis digital de imagen.Material y métodoSe incluyeron 155 ojos de 79 pacientes con EM, a los que se exploró la agudeza visual medida con optotipos de Snellen, el defecto de refracción y la visión de colores, y se realizó perimetría automatizada, tomografía de coherencia óptica (OCT), polarimetría láser (GDx) y potenciales evocados visuales (PEV). Este protocolo se repitió al año y los cambios observados fueron comparados según el tratamiento asignado mediante el test de Anova; para lo que se dividió la población en 4 grupos en función del tratamiento recibido: 1) sin tratamiento 2) interferón beta 1a, 3) interferón beta 1b, 4) acetato de glatirámero.ResultadosNo se detectaron diferencias significativas (test t, p>0,05) entre los pacientes con o sin tratamiento ni entre los 4 grupos, pero la mayoría de los parámetros funcionales y estructurales mostraron una tendencia a presentar mayores reducciones de la CFNR en el grupo sin tratamiento. La mayor variación apareció en el cuadrante temporal de la CFNR en la OCT (redución de 4,97μm en pacientes sin tratamiento vs 1,08μm en los tratados).ConclusiónEl tratamiento patogénico de la EM puede ser un factor protector para la reducción del espesor de la CFNR que se produce con la progresión de la enfermedad. Se necesitan más estudios(AU)

ObjectiveTo evaluate the effect of pathogenic treatments in the reduction of the retinal nerve fibre layer (RNFL) in patients with Multiple Sclerosis (MS) by means of ocular imaging technologies.Material and methodsA total 155 eyes of 79 patients with MS were enrolled in this study. All patients underwent a complete ophthalmic examination including best corrected visual acuity using Snellen chart, colour vision using Ishihara pseudoisochromatic plates, visual field examination, optical coherence tomography (OCT), scanning laser polarimetry (GDx) and visual evoked potentials. The patients were re-evaluated after a one year period and changes were assessed in order to detect differences between treatments using the Anova statistical test. The patients were divided into four groups: 1) Patients without treatment, 2) Patients treated with interferon beta-1a, 3) Subjects who received interferon beta-1b, 4) Patients treated using glatiramer acetate.ResultsThere were no statistically significant differences between patients with or without treatment and between the four groups (P>0.05, t test), but functional and structural parameters showed greater loss in RNFL thickness in non-treated patients. Temporal quadrant RNFL thickness measured by OCT was the parameter with the highest variation (reduction of 4.97μm in patients without treatment vs 1.08μm in treated patients).ConclusionsMS pathogenic treatment may be a protective factor in the RNFL loss that is associated to the disease progression. More studies are needed(AU)