scholarly journals Visual electrophysiology in the assessment of toxicity and deficiency states affecting the visual system

Eye ◽  
2021 ◽  
Author(s):  
Emily K. O’Neill ◽  
Richard Smith

AbstractVisual disturbance or visual failure due to toxicity of an ingested substance or a severe nutritional deficiency can present significant challenges for diagnosis and management, for instance, where an adverse reaction to a prescribed medicine is suspected. Objective assessment of visual function is important, particularly where structural changes in the retina or optic nerve have not yet occurred, as there may be a window of opportunity to mitigate or reverse visual loss. This paper reviews a number of clinical presentations where visual electrophysiological assessment has an important role in early diagnosis or management alongside clinical assessment and ocular imaging modalities. We highlight the importance of vitamin A deficiency as an easily detected marker for severe combined micronutrient deficiency.

2015 ◽  
Vol 357 ◽  
pp. e50
Author(s):  
A. Cronemberger-Andrade ◽  
H.R. Soares-Neto ◽  
A.F.P. Pouza ◽  
D.D. de-Faria ◽  
L. Dongyang ◽  
...  

2020 ◽  
Vol 27 (1) ◽  
pp. 46-49
Author(s):  
Ji Soo Lee ◽  
Jeong Hwan Yang ◽  
Joong Seob Lee

Endoscopic sinus surgery (ESS) is widely used as standard surgical treatment for chronic rhinosinusitis. Orbital complications of varying degrees occurred during ESS have been widely reported. If the orbital symptoms occurred immediately after surgery, ocular damage associated with surgery is suspected if the patient’s preoperative ocular function was patent. If immediate action is not taken, permanent visual loss might develop, so it is very important to diagnose orbital complications and take appropriate action. In our case, there was no definite intraorbital hemorrhage when sudden visual loss was noted. The symptoms were fully recovered without further treatment and it is clinically suspected to be caused by transient ocular muscle toxicity of local anesthetics.


2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19527-e19527
Author(s):  
Nicolas Anthony Othieno-Abinya ◽  
Andrew Oluoch Odhiambo ◽  
Mohammed Shabbir Ezzi ◽  
Peter Omondi Oyiro

e19527 Background: CML commonly presents with abdominal pain and swelling, and in up to about 50% of cases it is discovered incidentally due to abnormally elevated white blood cell (wbc) counts in circulation. Some present with bleeding tendency, others nusual presentations including hearing and visual loss whose pathogenesis is poorly understood also occur. Priapism presents rarely, attributed to hyperviscosity complicating wbc counts ≥ 250x109/litre. Nonspecific symptoms also present. We wanted to interrogate the link between baseline myeloid elements in circulation, bone marrow blasts, and BCR-ABL values with clinical manifestations. Methods: Patients attending the Glivec International Patient Assistance Clinic at the Nairobi Hospital had records prospectively collected, and analyzed. These included demographic profiles, physical examination, and laboratory values. Absolute, range, median and mean counts for wbcs, absolute neutrophil counts (ANC), platelets, haemoglobin and BCR-ABL values, were tested against each of the clinical presentations. Results: There were 583 patients, males 322 (55.2%) and females 261 (44.8); mean age 39.8 years. Commonest symptom was abdominal swelling in 235 cases (40.3%); 70 (12%) experienced abdominal pain. Priapism occurred in 4 males (1.2%), blindness and deafness in 8 patients (1.4%). Splenomegaly was more common among males than females; [Pearson Chi2 (1) = 5.9545, ( Pr = 0.015)]. Patients aged ≤ 20 years were more likely to be in heart failure, [Pearson Chi2 (3) = 8.8255,( Pr = 0.032)], leg swelling more in those with high platelet counts; [Ranksum test, (p = 0.023)]. Unclear presentation was more common in those with high wbc counts; [Ranksum test, (p = 0.015)]. Total wbc counts and BCR-ABL levels were higher among younger patients; [Kruskal-Wallis test (p = 0.036, and 0.025 respectively)]. Patients with leg swelling had lower BCR-ABL levels; [Ranksum test (p = 0.005)], those in heart failure had significantly higher BCR-ABL levels at baseline compared with the rest; [Ranksum test (p = 0.037)]. Patients with lymphadenopathy were more likely to have lower ANCs; [Ranksum test (p = 0.035)]. Conclusions: Clinical manifestations of CML cannot be explained merely by haematologic values. Complex biologic factors should be interrogated further.


2017 ◽  
Vol 78 (01) ◽  
pp. e20-e25 ◽  
Author(s):  
Shuhei Kawabata ◽  
Shingo Toyota ◽  
Tetsuya Kumagai ◽  
Tetsu Goto ◽  
Kanji Mori ◽  
...  

Background Progressive visual loss after coil embolization of a large internal carotid ophthalmic aneurysm has been widely reported. It is generally accepted that the primary strategy for this complication should be conservative, including steroid therapy; however, it is not well known as to what approach to take when the conservative therapy is not effective. Case Presentation We report a case of a 55-year-old female presenting with progressive visual loss after the coiling of a ruptured large internal carotid ophthalmic aneurysm. As the conservative therapy had not been effective, we performed neck clipping of the aneurysm with optic canal unroofing, anterior clinoidectomy, and partial removal of the embolized coils for the purpose of optic nerve decompression. After the surgery, the visual symptom was improved markedly. Conclusions It is suggested that direct surgery for the purpose of optic nerve decompression may be one of the options when conservative therapy is not effective for progressive visual disturbance after coil embolization.


2021 ◽  
Vol 10 (9) ◽  
pp. 1861
Author(s):  
Hyun Chul Jung ◽  
Sang-Yoon Lee ◽  
Chang Ki Yoon ◽  
Un Chul Park ◽  
Jang Won Heo ◽  
...  

Intraocular foreign bodies (IOFBs) are critical ophthalmic emergencies that require urgent diagnosis and treatment to prevent blindness or globe loss. This study aimed to examine the various clinical presentations of IOFBs, determine the prognostic factors for final visual outcomes, establish diagnostic protocols, and update treatment strategies for patients with IOFBs. We retrospectively reviewed patients with IOFBs between 2005 and 2019. The mean age of the patients was 46.7 years, and the most common mechanism of injury was hammering (32.7%). The most common location of IOFBs was the retina and choroid (57.7%), and the IOFBs were mainly metal (76.9%). Multivariate regression analysis showed that poor final visual outcomes (<20/200) were associated with posterior segment IOFBs (odds ratio (OR) = 11.556, p = 0.033) and retinal detachment (OR = 4.781, p = 0.034). Diagnosing a retained IOFB is essential for establishing the management of patients with ocular trauma. To identify IOFBs, ocular imaging modalities, including computed tomography or ultrasonography, should be considered. Different strategies should be employed during the surgical removal of IOFBs depending on the material, location, and size of the IOFB.


2009 ◽  
Vol 24 (10) ◽  
pp. 1288-1289 ◽  
Author(s):  
Gary N. McAbee ◽  
Debra M. Prieto ◽  
Janet Kirby ◽  
Ann Marie Santilli ◽  
Rajendra Setty

2020 ◽  
Vol 50 (1) ◽  
pp. 124-139
Author(s):  
Larisa Mayurnikova ◽  
Arkadiy Koksharov ◽  
Tatyana Krapiva ◽  
Sergey Novoselov

Introduction. The problem of micronutrient deficiency remains a relevant issue all over the world. However, it is mostly developed countries that practice food fortification. The FAO and the WHO accumulate related experience and summarize it in various documents. Yet some aspects of the problem can be solved on state level. The present research featured micronutrient deficit and preventive measures in several countries taking into account local food traditions. Since 1920, a number of industrially developed northern countries have started developing and implementing various food fortification programs. Similar programs are being introduced in East, Central, and South Africa and Southeast Asia. For 40 years, Russia has been taking various measures to prevent micronutrient deficiency and related diseases. Results and discussion. The research revealed the social and economic measures of food fortification that were found lacking in these countries. The main problem proved to be iodine, iron, and vitamin A deficiency. However, lack of other micronutrients also remains a burning issue. The present paper gives an overview of iodine, selenium, and iron deficiencies in several countries. The authors proposed several solutions, e.g. food group selection, food additives (mono or premix), various ways of fortification, etc. The article also contains a list of main Russian regulatory documents that control the production and turnover of food fortification. The authors showed advantages of food fortification of mass consumption products, e.g. the low cost of processing, the affordability of enriched products, their availability for different social population, the well-developed regulation standards, the good social effect of food fortification projects, their economic efficiency, etc. Taking into consideration the environmental changes and various geopolitical and economic factors that negatively affect nutrition and population health, the authors recommend to continue evidence-based research in this direction to develop new technologies and food supplements. Conclusion. The novelty of the research lies in the fact that it reveals priority areas for prospective scientific research in food fortification based on a thorough analysis of the existing experience. From the point of view of practical application, the research offers a deeper understanding of the problem, stresses its relevance, sets goals and objectives of future studies, and offers some ideas for preventive programs.


Author(s):  
A.A. Ivanova ◽  
N.I. Obukhova

The article considers the main directions of municipal reforms carried out in the Udmurt Republic that are relevant for the modern organization of municipal management. The authors identify fundamental issues that need to be addressed in order to effectively organize the municipal government. The stages of municipal reform are considered in detail and specific examples are given. The authors focus on the need to consistently implement structural changes in local government. For an objective assessment of the situation in the Udmurt Republic, the following areas are considered: territorial organization of local self-government, formation of local self-government bodies, legal support for municipal reform, and others. The article examines the features and problems of municipal reform, taking into account historical and other conditions and factors. The authors put forward constructive proposals for effective organization of municipal administration.


Vision ◽  
2021 ◽  
Vol 5 (3) ◽  
pp. 38
Author(s):  
Yu Jeat Chong ◽  
Susan P. Mollan ◽  
Abison Logeswaran ◽  
Alexandra B. Sinclair ◽  
Benjamin R. Wakerley

Retinal migraine was first formally described in 1882. Various terms such as “ocular migraine” and “ophthalmic migraine” have since been used interchangeably in the literature. The lack of a consistent consensus-based definition has led to controversy and potential confusion for clinicians and patients. Retinal migraine as defined by the International Classification of Headache Disorders (ICHD) has been found to be rare. The latest ICHD defined retinal migraine as ‘repeated attacks of monocular visual disturbance, including scintillation, scotoma or blindness, associated with migraine headache’, which are fully reversible. Retinal migraine should be considered a diagnosis of exclusion, which requires other causes of transient monocular visual loss to be excluded. The aim of this narrative review is to summarize the literature on retinal migraine, including: epidemiology and risk factors; proposed aetiology; clinical presentation; and management strategies. It is potentially a misnomer as its proposed aetiology is different from our current understanding of the mechanism of migraine


Author(s):  
David R. Just ◽  
Julius J. Okello ◽  
Gnel Gabrielyan ◽  
Souleimane Adekambi ◽  
Norman Kwikiriza ◽  
...  

AbstractChildren’s diets can have major implications for a wide range of diseases and their development outcomes. In Africa, micronutrient deficiency remains a major challenge and affects the health and development of vulnerable populations, especially children. A major effort to combat micronutrient deficiency has targeted biofortification of staple foods, with greatest potential being registered in the enrichment of, among others, sweetpotato with beta carotene—a precursor for vitamin A. However, overcoming vitamin A deficiency is made all the more complicated by children’s general resistance to unfamiliar foods. We report the results of a field experiment in Nigerian schools designed to use behavioral techniques to promote consumption of an unfamiliar food: the pro-vitamin A rich orange-fleshed sweetpotato. We find that children eat more, on average, when the sweetpotato is introduced alongside behavioral nudges such as songs or association with aspirational figures. These results appear to conform to results found in a developed country context.


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