Contrast Sensitivity Testing in Age-Related Macular Degeneration Using Motion Diamond Stimulus

Purpose

This study was performed to characterize changes in contrast sensitivity (CS) that occur in patients with age-related macular degeneration (AMD) using a novel test, the motion diamond stimulus (MDS).

Methods

This was a cross-sectional study in which 20 subjects with unilateral exudative AMD (eAMD) and contralateral dry AMD received 3 assessments: the Pelli-Robson (PR) CS Chart, the MDS test, and a visual function questionnaire-25 (VFQ-25). CS results from the PR, and MDS tests were compared across 3 groups: eyes with eAMD vs dry AMD, eAMD vs control, dry AMD vs control. Healthy, undilated eyes from another study served as the control group. Significance was determined using ANOVA analysis for the MDS output parameters (α: overall contrast threshold, β: adaptability of the visual system) and PR logCS. Patients were also administered the VFQ-25 to assess vision-related quality of life.

Results

The ANOVA of the MDS data demonstrated a significant difference in visual function according to the β parameter of the 3 groups, but no significant difference in the α parameter. PR CS results for the 3 groups were significantly different, further supporting the MDS results. Post-hoc analysis showed a significant difference in β and PR log CS between the eAMD and control eyes.

Conclusion

The MDS test is valuable in discerning CS impairments in patients with AMD. It can provide further insight into the visual changes experienced by patients with AMD and has potential to quantify visual function changes that are not found on visual acuity testing alone.

Contrast Sensitivity Testing in Retinal Vein Occlusion Using a Novel Stimulus

Purpose

This study evaluated a novel tool known as the motion diamond stimulus (MDS), which utilizes contrast-generated illusory motion in dynamic test regions to determine contrast sensitivity (CS).

Methods

Patients with treated unilateral retinal vein occlusions (RVOs) underwent three assessments: the MDS, the Pelli-Robson (PR), and the National Eye Institute's Visual Function Questionnaire (VFQ-25). The MDS assessment produced two data end points, α and β. The α value represents the overall contrast threshold level and the β value serves to quantify the adaptability of the visual contrast system. The CS parameters from the MDS and log CS PR output values were used to compare RVO eyes (n = 20) to control eyes (n = 20).

Results

The study participants had a mean composite VFQ-25 score of 89.5 ± 10.4 on the VFQ-25. A significant difference was observed between the RVO eyes and the control eyes in PR log CS scores (P value = 0.0001) and in MDS α value (P value = 0.01). No difference in MDS β value was found between the study groups (P value = 0.39).

Conclusions

The results for the MDS assessment's α parameter corroborated the PR scores, suggesting contrast sensitivity threshold impairment in patients with RVO. No significant difference in β value was observed, suggesting that adaptability of the visual system is maintained in treated RVO eyes.

Translational Relevance

Currently, visual complaints cannot be entirely identified by Snellen visual acuity alone. The MDS offers potentially a more complete look at visual function, by including contrast sensitivity and may be able to quantify changes otherwise overlooked in retinal disease progression.

The Association of Dietary Lutein plus Zeaxanthin and B Vitamins with Cataracts in the Age-Related Eye Disease Study: AREDS Report No. 37

PURPOSE

To evaluate whether dietary intake of luteiin/zeaxanthin and B vitamins is associated with cataract prevalence and incidence.

DESIGN

Clinic-based, baseline cross-sectional and prospective cohort study designs.

PARTICIPANTS

Three thousand one hundred fifteen patients (6129 eyes) enrolled in the Age-Related Eye Disease Study 55 to 80 years of age followed up for mean of 9.6 years.

METHODS

Participants completed baseline food frequency questionnaires. Baseline and annual lens photographs were graded centrally. Multivariate models controlling for previously identified risk factors for cataracts tested for the association of cataracts with reported dietary intake, using the lowest quintile as reference.

MAIN OUTCOME MEASURES

Cataract surgery, cataract status (type and severity) at baseline, and development of cataracts.

RESULTS

At baseline, increased dietary riboflavin and B12 were associated inversely with nuclear and cortical lens opacities. In comparisons of persons with and without cataract, persons with the highest riboflavin intake versus those with the lowest intake had the following associations: mild nuclear cataract: odds ratio (OR), 0.78; 95% confidence interval (CI), 0.63-0.97; moderate nuclear cataract: OR, 0.62; 95% CI, 0.43-0.90; and mild cortical cataract: OR, 0.80; 95% CI, 0.65-0.99. For B12, the results were: mild nuclear cataract: OR, 0.78; 95% CI, 0.63-0.96; moderate nuclear cataract: OR, 0.62; 95% CI, 0.43-0.88; and mild cortical cataract: OR, 0.77; 95% CI, 0.63-0.95. Highest dietary B6 intake was associated with a decreased risk of moderate nuclear lens opacity developing compared with the lowest quintile (OR, 0.67; 95% CI, 0.45-0.99). Highest dietary intake levels of niacin and B12 were associated with a decreased risk of development of mild nuclear or mild cortical cataracts in participants not taking Centrum (Pfizer, New York, NY) multivitamins. For participants taking multivitamins during the study, the highest intake of dietary folate was associated with an increased risk of mild posterior subcapsular lens opacity development. No statistically significant associations were found between lutein plus zeaxanthin intake and presence at baseline or development of nuclear or cortical lens opacity outcomes.

CONCLUSIONS

These findings are consistent with earlier studies suggesting that dietary intake of B vitamins may affect the occurrence of age-related lens opacities. Further investigations are warranted.

Comparison of wide-field fluorescein angiography and 9-field montage angiography in uveitis

PURPOSE

To compare qualitatively and quantitatively Optos fundus camera fluorescein angiographic images of retinal vascular leakage with 9-field montage Topcon fluorescein angiography (FA) images in patients with uveitis. We hypothesized that Optos images reveal more leakage in patients with uveitis.

DESIGN

Retrospective, observational case series.

METHODS

Images of all patients with uveitis imaged with same-sitting Optos FA and 9-field montage FA during a 9-month period at a single institution (52 eyes of 31 patients) were graded for the total area of retinal vascular leakage. The main outcome measure was area of fluorescein leakage.

RESULTS

The area of apparent FA leakage was greater in Optos images than in 9-field montage images (median 22.5 mm(2) vs 4.8 mm(2), P < 0.0001). Of the 49 (45%) eyes with gradable photos, 22 had at least 25% more leakage in the Optos image than in the montage image; 2 (4.1%) had at least 25% less leakage in Optos; and 25 (51%) were similar in the 2 modalities. There were 2 eyes that had no apparent retinal vascular leakage in 9-field montage but were found to have apparent leakage in Optos images. Of the 49 eyes, 23 had posterior pole leakage, and of these, 17 (73.9%) showed more posterior pole leakage in the Optos image. A single 200-degree Optos FA image captured a mean 1.50× the area captured by montage photography.

CONCLUSIONS

More retinal vascular pathology, in both the periphery and the posterior pole, is seen with Optos FA in patients with uveitis when compared with 9-field montage. The clinical implications of Optos FA findings have yet to be determined.

Longitudinal analysis of retinal hemangioblastomatosis and visual function in ocular von Hippel-Lindau disease

OBJECTIVE

Characterization of the structural and functional progression of ocular von Hippel-Lindau (VHL) disease and analysis of patient factors influencing disease progression.

DESIGN

Retrospective analysis of a case series from a longitudinal, observational study.

PARTICIPANTS

Two hundred forty-nine participants with clinically defined systemic VHL disease and more than 2 years of ophthalmic follow-up.

METHODS

Standardized scoring of ocular phenotype and systemic characteristics was performed at each study visit and was analyzed longitudinally to determine progression of ocular VHL disease.

MAIN OUTCOME MEASURES

Measures evaluated include: visual acuity, features of ocular VHL disease (presence, location, number, and extent of retinal capillary hemangioblastomas [RCHs]), germline mutation in the VHL gene, demographics (age, gender, age at onset of ocular disease), and patient characteristics (smoking status, body mass index).

RESULTS

Most participants demonstrated relative anatomic and functional stability in ocular VHL disease status over a mean follow-up of 8.2 ± 4.0 years. Approximately three quarters (73%) of participants without ocular VHL disease at baseline remained disease free at the end of follow-up. Among eyes with ocular VHL disease at baseline, 88% did not demonstrate RCHs in a new retinal location, 70% remained stable in RCH number, and 79% remained stable in the extent of RCH involvement. Mean visual acuity for all study eyes (n = 498) decreased by 5.1 ± 0.6 letters across follow-up, with 16.1% of study eyes decreasing by more than 10 letters in visual acuity. Among eyes affected at baseline, greater vision loss was associated with the presence of juxtapapillary RCHs, development of RCH in a new location, and increase in peripheral RCH number and extent. Younger baseline age, younger age at onset of ocular VHL disease, involvement of the fellow eye with ocular VHL disease, and missense or protein-truncating germline mutations were associated significantly with increased anatomic involvement and functional deterioration.

CONCLUSIONS

Patients with ocular VHL disease maintain relative anatomic and functional stability, with only a minority demonstrating marked anatomic progression and vision loss. Systemic and ocular risk factors for anatomic progression and vision loss can help practitioners identify patients with a higher risk profile for counseling, closer follow-up, and proactive treatment.

FINANCIAL DISCLOSURE(S)

The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Differential transcriptional expression following thidiazuron-induced callus differentiation developmental shifts in rice

Very little is known about molecular events associated with callus differentiation in indica rice. The genes expressed differentially during shoot meristem initiation were identified on genomic arrays applied to efficiently regenerating rice calli. A thidiazuron (TDZ; N-phenyl-N-thiadiazol-1,2,3-5,ylurea)-dependent regeneration protocol was developed for efficient embryogenesis in indica rice. The regenerating embryogenic calli induced by TDZ for 10 days showed transcriptional modulation of a number of genes associated with photosynthesis, hormone metabolism, plant development, signal transduction, light response, and plant defense. Eighteen candidate miRNAs were predicted to target the genes expressed differentially in the embryogenic calli grown in TDZ-containing medium. The majority of the photosynthesis-related genes up-regulated in differentiating calli were not expressed or were down-regulated in developing seeds and inflorescences. Most of the genes down-regulated in differentiating calli were up-regulated in developing seeds. The transcriptome of differentiating callus most closely resembled that of the germinating whole seed.

Anticonvulsant and neurotoxicity evaluation of some 6-substituted benzothiazolyl-2-thiosemicarbazones

Various 6-substituted benzothiazolyl-2-thiosemicarbazones were synthesized and screened for anticonvulsant activity in maximal electroshock induced seizure (MES) and subcutaneous pentylenetetrazole (scPTZ) induced seizure models in mice. The neurotoxicity was assessed using the rotorod method. The 6-methyl benzothiazolyl-2-thiosemicarbazones showed anticonvulsant activity in both mice i.p. and rat oral MES screen. The 6-nitro benzothiazolyl thiosemicarbazone derivative 1a emerged as the most promising one with anti-MES activity in mice i.p., rat i.p. and rat p.o. evaluations. All the compounds exhibited lesser or no neurotoxicity compared to phenytoin. The isatinimino derivatives had shown better activity when compared to the benzylidene or acetophenone derivatives.

Glutathione depletion and oxidative damage in mitochondria following exposure to cadmium in rat liver and kidney

The dose-dependent effects of cadmium (Cd) on mitochondria and post-mitochondrial supernatant (PMS) of liver and kidney were investigated in adult male albino rats. Two groups of rats were injected intraperitoneally with 0.1 mg Cd/kg body weight and 1 mg/kg body weight, respectively, for a period of 3 months (5 days/week). This resulted in a significant decrease in total glutathione (GSH) levels, irrespective of the doses, in mitochondrial as well as in PMS fractions of liver and kidney. In contrast, end products of lipid and protein were significantly increased in a dose-dependent manner in subcellular fractions of liver and kidney. These results suggest that the depletion of tissue glutathione levels is not a primary reason of the observed oxidative damage in liver and kidney caused by Cd.

Effect of pyrethroid-based liquid mosquito repellent inhalation on the blood-brain barrier function and oxidative damage in selected organs of developing rats

Pesticides have been implicated in various neurological disorders in humans and experimental animals. Our earlier studies have demonstrated a high vulnerability of developing blood-brain barrier (BBB) towards very low level exposure of quinalphos, cypermethrin and lindane. Earlier it has been observed that a cypermethrin-induced increase in the BBB permeability of neonatal rats was found to be persistent, requiring a longer period of withdrawal for complete recovery. These observations lead us to investigate the effect of a commonly available liquid mosquito repellent (MR) containing a pyrethroid compound, allethrin (3.6% w/v), on the functional integrity of the developing BBB and on certain parameters of oxidative damage in brain, liver and kidney. Two-day-old rat pups were allowed to inhale the MR (18 h per day) for 8 days (postnatal days (PND) 2-9). Rats exposed to MR were further withdrawn from the exposure for 8 days (PND 10-17) to study whether the changes induced following inhalation are reversible. Results of the study have shown a significant increase in the BBB permeability (45%) of the MR-exposed rat pups to a micromolecular tracer, sodium fluorescein (mol. wt. 376), used for the quantitative assessment of the BBB permeability, suggesting a delayed maturity of the BBB system. Brain glutathione (GSH) levels were also decreased (17%) in the exposed individuals. The oxidatively damaged end-products of lipids, measured as lipid hydroperoxides and conjugated dienes, were found to be increased in brain (42%, 16%), liver (34%, 20%) and kidney (68%, 29%), respectively. The oxidative product of protein, measured as protein carbonyls, was also increased significantly in liver (43%) and kidney (16%) of the MR-exposed rat pups as compared to age-matched controls. The biochemical changes that occurred in the BBB permeability and the oxidatively damaged end-products following MR inhalation in neonatal rats were, however, found to be completely recovered except for an increase in brain GSH (28%) level. The results suggest the possibility of health risk due to exposure to pesticide-based mosquito repellents, especially when exposure takes place in individuals at an early age.

Profile of reactive oxygen species generation and antioxidative mechanisms in the maturing rat kidney

The antioxidative potential and reactive oxygen species generation were assessed in rat kidney during early critical periods of development and maturation. Superoxide anion generation was found to be low in kidney during early postnatal days of development, whereas hydrogen peroxide levels remained unaltered during development. The levels of thiobarbituric acid reactive substances and protein carbonyls in developing kidney were higher during early postnatal days, up to 26 days after birth, compared to the adult levels. Kidney sulphydryl contents were significantly less during early periods (9 days postnatally) of development compared to adults but attain adult value by postnatal day 26. The levels of ascorbic acid and ceruloplasmin were also higher in developing kidney than in adults. Among enzymic antioxidants, the levels of glutathione peroxidase (GPx) enzyme in developing kidney were high during the early developmental period of the study as compared to adults; however, superoxide dismutase (SOD), catalase (CAT) and glutathione reductase (GR) were found to be significantly low at early postnatal days up to 16 days of age, which subsequently attained maturational level by the age of 26 days. The levels of antioxidant enzymes and sulphydryl contents in the developing kidney during early periods after birth are low but they increase subsequently with increasing age. Therefore, the present finding suggests that immature kidneys are in a highly dynamic stage of development during the early period and are equipped with antioxidative defence mechanisms that may have a predominant role in protecting against oxidative challenge.