Retinal vessel oxygen saturation is affected in uveitis associated with Vogt-Koyanagi-Harada disease

2019 ◽  
pp. bjophthalmol-2018-313719
Author(s):  
Ahmed M Abu El-Asrar ◽  
Abdulrahman F AlBloushi ◽  
Priscilla W Gikandi ◽  
Sveinn Hákon Hardarson ◽  
Einar Stefánsson
Keyword(s):  
Oxygen Saturation ◽  
Retinal Vessel ◽  
Oxygen Metabolism ◽  
Posterior Uveitis ◽  
Exudative Retinal Detachment ◽  
Healthy Controls ◽  
Chorioretinal Atrophy ◽  
Sunset Glow Fundus ◽  
And Gender ◽  
Vkh Disease

AimsTo discover whether retinal vessel oxygen metabolism is affected in uveitis associated with Vogt-Koyanagi-Harada (VKH) disease.Methods41 patients with VKH disease (82 eyes) and 12 healthy subjects (24 eyes) matched in age and gender were prospectively evaluated. Retinal oxygen saturation and vessel calibre were measured with a non-invasive spectrophotometric retinal oximeter (Oxymap T1).ResultsIn healthy controls, mean arteriolar oxygen saturation (%) was 93.8±5.9 and venular saturation was 60.1±5.8. In acute VKH uveitic phase associated with exudative retinal detachment (n=12), arteriolar and venular oxygen saturation values were 104.7±7.8 and 67.9±7.7, respectively, and both are significantly higher than the healthy group (p<0.001; p=0.001, respectively). In patients with VKH disease who recovered after immunosuppressive therapy and restored normal anatomy without ‘sunset glow fundus’ (n=13), oximetry values were 96.4±9.6 and 61.6±7.5, respectively, similar to healthy controls. In patients with ‘sunset glow fundus’ and chorioretinal atrophy (n=16), saturation levels were 88.6±7.8 and 50.0±13.1, respectively, significantly lower than healthy controls (p=0.02; p=0.003, respectively). These patients also had significantly smaller diameter of retinal arterioles and venules compared with controls (p=0.035; p=0.001, respectively).ConclusionsRetinal oxygen metabolism is altered in uveitis associated with VKH disease. Oxygen saturation profile is abnormal in acute uveitic phase of the disease and returns to normal in those who recover with normal fundus appearance, but not in eyes that suffer permanent anatomical damage with ‘sunset glow fundus’ and chorioretinal atrophy. Retinal oximetry may be of value in evaluating vascular and metabolic aspects of posterior uveitis.

scholarly journals Pseudotumoral and Multiple Retinal Pigment Epithelium Proliferation in Vogt-Koyanagi-Harada Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Juan B. Yepez ◽  
Felipe Murati ◽  
Michele Petitto ◽  
J. Fernando Arevalo
Keyword(s):  
Retinal Pigment Epithelium ◽  
Clinical Presentation ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Exudative Retinal Detachment ◽  
Peripheral Area ◽  
Subretinal Fibrosis ◽  
Sunset Glow Fundus ◽  
High Index Of Suspicion ◽  
Vkh Disease

We report a case of pseudotumoral retinal pigment epithelium (RPE) proliferation in Vogt-Koyanagi-Harada (VKH) disease, in a 50-year-old female who presented with a juxtapapillary and peripheral subretinal hyperpigmented lesions in the left eye and “sunset glow fundus,” hyperpigmented striae, and multiple atrophic chorioretinal spots in the periphery. The darkly pigmented exuberant larger subretinal mass extended to the periphery with associated subretinal fibrosis. This patient demonstrated the entire clinical presentation of VKH disease, which tends to course with a chronic, bilateral, granulomatous panuveitis and exudative retinal detachment associated with poliosis, vitiligo, alopecia, and central nervous system and auditory signs. Our case is unique for the presence of exuberant, pseudotumoral RPE proliferation at the juxtapapillary region and peripheral area. Although this complication has rarely been reported, a high index of suspicion is warranted for early diagnosis and avoids unnecessary treatments of a pseudotumor.

RETINAL IMAGING AND ANALYSIS USING MACHINE LEARNING WITH INFORMATION FUSION OF THE FUNCTIONAL AND STRUCTURAL FEATURES BASED ON A DUAL-MODAL FUNDUS CAMERA

2021 ◽  
pp. 2150030
Author(s):  
PENG DOU ◽  
YANG ZHANG ◽  
RUI ZHENG ◽  
YU YE ◽  
JIANBO MAO ◽  
...  
Keyword(s):  
Machine Learning ◽  
Deep Learning ◽  
Oxygen Saturation ◽  
Retinal Vessel ◽  
Structural Features ◽  
Support Vector ◽  
Healthy Controls ◽  
Fundus Camera ◽  
Or Methodology ◽  
Vascular Structures

Retinal diseases and systemic diseases, such as diabetic retinopathy (DR) and Alzheimer’s disease, may manifest themselves in the retina, changing the retinal oxygen saturation ([Formula: see text]) level or the retinal vascular structures. Recent studies explored the correlation of diseases with either retina vascular structures or [Formula: see text] level, but not both due to the lack of proper instrument or methodology. In this study, we applied a dual-modal fundus camera and developed a deep learning-based analysis method to simultaneously acquire and quantify the [Formula: see text] and vascular structures. Deep learning was used to automatically locate the optic discs and segment arterioles and venules of the blood vessels. We then sought to apply machine learning methods, such as random forest (RF) and support vector machine (SVM), to fuse the [Formula: see text] level and retinal vessel parameters as different features to discriminate against the disease from the healthy controls. We showed that the fusion of the functional (oxygen saturation) and structural (vascular parameters) features offers better performance to classify diseased and healthy subjects. For example, we gained a 13.8% and 2.0% increase in the accuracy with fusion using the RF and SVM to classify the nonproliferative DR and the healthy controls.

scholarly journals Physical Activity and Quality of Life in Hemodialysis Patients and Healthy Controls: A Cross-Sectional Study

2021 ◽  
Vol 18 (4) ◽  
pp. 1978
Author(s):  
Tjaša Filipčič ◽  
Špela Bogataj ◽  
Jernej Pajek ◽  
Maja Pajek
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Everyday Life ◽  
Habitual Physical Activity ◽  
Healthy Controls ◽  
Age And Gender ◽  
Comorbidity Score ◽  
Sf 36 ◽  
And Gender

Hemodialysis (HD) patients have lower functional abilities compared to healthy people, and this is associated with lower physical activity in everyday life. This may affect their quality of life, but research on this topic is limited. Therefore, the present study aimed to determine the relationship between habitual physical activity and quality of life in HD patients and healthy controls. Ninety-three HD patients and 140 controls participated in the study. Quality of life was assessed using a 36-item medical outcomes study short-form health survey (SF-36). Human Activity Profile (HAP) was used to assess habitual physical activity. The adjusted activity score (AAS) from HAP, age, gender, fat tissue index (FTI), lean tissue index (LTI), and Davies comorbidity score were analyzed as possible predictors of the Physical Component Summary (PCS) of the SF-36. Three sequential linear models were used to model PCS. In Model 1, PCS was regressed by gender and age; in Model 2 the LTI, FTI, and Davies comorbidity scores were added. Model 3 also included AAS. After controlling for age and gender (ModelHD 1: p = 0.056), LTI, FTI, and Davies comorbidity score effects (ModelHD 2: p = 0.181), the AAS accounted for 32% of the variation in PCS of HD patients (ModelHD 3: p < 0.001). Consequently, the PCS of HD patients would increase by 0.431 points if the AAS increased by one point. However, in healthy controls, AAS had a lower impact than in the HD sample (B = 0.359 vs. 0.431), while the corresponding effects of age and gender (ModelH 1: p < 0.001), LTI, FTI, and Davies comorbidity score (ModelH 2: p < 0.001) were adjusted for. The proportion of variation in PCS attributed to AAS was 14.9% (ModelH 3: p < 0.001). The current study results showed that physical activity in everyday life as measured by the HAP questionnaire is associated to a higher degree with the quality of life of HD patients than in healthy subjects. Routine physical activity programs are therefore highly justified, and the nephrology community should play a leading role in this effort.

Reduced cranial parasympathetic tone during the remission phase of cluster headache

Cephalalgia ◽  
2014 ◽  
Vol 35 (6) ◽  
pp. 469-477 ◽  
Author(s):  
Hilde K Ofte ◽  
Therese von Hanno ◽  
Karl B Alstadhaug
Keyword(s):  
Cluster Headache ◽  
Superficial Temporal Artery ◽  
Retinal Vessel ◽  
Temporal Artery ◽  
Healthy Controls ◽  
Cranial Autonomic Symptoms ◽  
Pupillary Constriction ◽  
Central Origin ◽  
Parasympathetic Tone ◽  
Remission Phase

Background Cluster headache (CH) attacks are accompanied by cranial autonomic symptoms indicative of parasympathetic hyperactivity and sympathetic dysfunction ipsilateral to the pain. We aimed to assess cranial autonomic function in CH patients during the remission phase of cluster headache. Materials and methods During a remission phase, 38 episodic CH patients underwent the following: dynamic pupillometry, measurement of the superficial temporal artery diameter by ultrasound, and measurement of the retinal vessel diameters from digital retinal photographs. Pupillometry was also performed on 30 age- and sex-matched healthy controls. Results Thirty patients were included (27 men, three women, mean age 50.2 years ± 12.6). Seven patients reported occasional side shift of their headache, but with a clear predominating side. Significantly reduced average pupillary constriction velocity and retinal venular diameter on the CH pain side were found. There was no asymmetry of the superficial temporal artery diameters. Compared to healthy controls, cluster patients displayed bilaterally reduced pupillary average and maximum constriction velocities, reduced constriction in percentage and increased latency of the light reflex. Conclusions The present findings indicate a bilaterally reduced cranial parasympathetic tone in CH patients in remission phase, with significant lateralization to the CH pain side. This implies a central origin, and a central pathophysiological model of CH is discussed.

Retinal vessel oxygen saturation and vessel diameter in high myopia

2015 ◽  
Vol 35 (5) ◽  
pp. 562-569 ◽  
Author(s):  
Qishan Zheng ◽  
Yao Zong ◽  
Li Li ◽  
Xia Huang ◽  
Leilei Lin ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
High Myopia ◽  
Retinal Vessel ◽  
Vessel Diameter

scholarly journals Respiratory changes in Parkinson's disease may be unrelated to dopaminergic dysfunction

2012 ◽  
Vol 70 (11) ◽  
pp. 847-851 ◽  
Author(s):  
Luciana Ulhôa Guedes ◽  
Juliana Melo Rodrigues ◽  
Aline Andrioni Fernandes ◽  
Francisco E. Cardoso ◽  
Verônica Franco Parreira
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Statistical Analysis ◽  
Healthy Controls ◽  
Maximal Inspiratory Pressure ◽  
Age And Gender ◽  
Dopaminergic Dysfunction ◽  
And Gender ◽  
Student’S T ◽  
Student’S T Test

OBJECTIVE: To investigate the maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) in patients with Parkinson's disease (PD) during the on and off periods of levodopa and to compare with healthy controls. METHODS: Twenty-six patients were analyzed with Hoehn and Yahr scores (2-3) and 26 age and gender matched-controls. Statistical analysis was performed with Student's t-test for paired and independent samples. RESULTS: MIP and MEP values in patients were significantly lower than the values obtained in controls both for off and on stages -excepted for MIP in women (p=0.28). For patients with PD, the studied parameters did not differ between stages on and off, with the exception of MEP in women (p=0.00). CONCLUSIONS: Patients with PD have respiratory pressure lower than controls, even in early stages of the disease, and dopamine replacement has little impact over these respiratory pressures. These findings suggest that respiratory changes in PD may be unrelated to dopaminergic dysfunction.

scholarly journals New Perspectives on the Immunopathogenesis and Treatment of Uveitis Associated With Vogt-Koyanagi-Harada Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Ahmed M. Abu El-Asrar ◽  
Jo Van Damme ◽  
Sofie Struyf ◽  
Ghislain Opdenakker
Keyword(s):  
B Cells ◽  
Autoimmune Response ◽  
Therapeutic Window ◽  
High Dose ◽  
Exudative Retinal Detachment ◽  
Granulomatous Uveitis ◽  
Systemic Corticosteroids ◽  
Initial Onset ◽  
Vkh Disease

Uveitis associated with Vogt-Koyanagi-Harada (VKH) disease is a bilateral, chronic, granulomatous autoimmune disease associated with vitiligo, poliosis, alopecia, and meningeal and auditory manifestations. The disease affects pigmented races with a predisposing genetic background. Evidence has been provided that the clinical manifestations are caused by a T-lymphocyte-mediated autoimmune response directed against antigens associated with melanocytes in the target organs. Alongside of T lymphocytes, autoreactive B cells play a central role in the development and propagation of several autoimmune diseases. The potential role of B lymphocytes in the pathogenesis of granulomatous uveitis associated with VKH disease is exemplified within several studies. The early initial-onset acute uveitic phase typically exhibits granulomatous choroiditis with secondary exudative retinal detachment and optic disc hyperemia and swelling, subsequently involving the anterior segment if not adequately treated. The disease eventually progresses to chronic recurrent granulomatous anterior uveitis with progressive posterior segment depigmentation resulting in “sunset glow fundus” appearance and chorioretinal atrophy if not properly controlled. Chronically evolving disease is more refractory to treatment and, consequently, vision-threatening complications have been recognized to occur in the chronic recurrent phase of the disease. Conventional treatment with early high-dose systemic corticosteroids is not sufficient to prevent chronic evolution. Addition of immunomodulatory therapy with mycophenolate mofetil as first-line therapy combined with systemic corticosteroids in patients with acute initial-onset disease prevents progression to chronic evolution, late complications, vitiligo, and poliosis. Furthermore, patients under such combined therapy were able to discontinue treatment without relapse of inflammation. These findings suggest that there is a therapeutic window of opportunity for highly successful treatment during the early initial-onset acute uveitic phases, likely because the underlying disease process is not fully matured. It is hypothesized that early and aggressive immunosuppressive therapy will prevent remnant epitope generation in the initiation of the autoimmune process, the so-called primary response. B cell depleting therapy with the anti-CD20 monoclonal antibody rituximab is effective in patients with refractory chronic recurrent granulomatous uveitis. The good response after rituximab therapy reinforces the idea of an important role of B cells in the pathogenesis or progression of chronic recurrent uveitis associated with VKH disease.

scholarly journals Improvement of Gait in Patients with Stroke Using Rhythmic Sensory Stimulation: A Case-Control Study

2022 ◽  
Vol 11 (2) ◽  
pp. 425
Author(s):  
Yungon Lee ◽  
Sunghoon Shin
Keyword(s):  
Sensory Stimulation ◽  
Chronic Stroke ◽  
Gait Variability ◽  
Healthy Controls ◽  
Normal Walking ◽  
Somatosensory Stimulation ◽  
Stroke Group ◽  
And Gender ◽  
Reduced Mobility ◽  
Control Study

Patients with stroke suffer from impaired locomotion, exhibiting unstable walking with increased gait variability. Effects of rhythmic sensory stimulation on unstable gait of patients with chronic stroke are unclear. This study aims to determine the effects of rhythmic sensory stimulation on the gait of patients with chronic stroke. Twenty older adults with stroke and twenty age- and gender-matched healthy controls walked 60 m under four conditions: normal walking with no stimulation, walking with rhythmic auditory stimulation (RAS) through an earphone in the ear, walking with rhythmic somatosensory stimulation (RSS) through a haptic device on the wrist of each participant, and walking with rhythmic combined stimulation (RCS: RAS + RSS). Gait performance in the stroke group significantly improved during walking with RAS, RSS, and RCS compared to that during normal walking (p < 0.008). Gait variability significantly decreased under the RAS, RSS, and RCS conditions compared to that during normal walking (p < 0.008). Rhythmic sensory stimulation is effective in improving the gait of patients with chronic stroke, regardless of the type of rhythmic stimuli, compared to healthy controls. The effect was greater in patients with reduced mobility, assessed by the Rivermead Mobility Index (RMI).

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