To determine the frequency and severity of further visual loss experienced by patients within ten weeks from diagnosis of acute nonarteritic anterior ischemic optic neuropathy (NAION).PURPOSETo ...determine the frequency and severity of further visual loss experienced by patients within ten weeks from diagnosis of acute nonarteritic anterior ischemic optic neuropathy (NAION).Retrospective case series.DESIGNRetrospective case series.Electronic medical records (EMR) at an academic neuro-ophthalmology practice were searched for diagnosis of "NAION" and all identified charts were reviewed to determine eligibility. Patients diagnosed with acute NAION between February 2014 and December 2023 who presented within four weeks of symptom onset and were seen in follow-up within ten weeks were included. Clinically significant decline in best corrected visual acuity (BCVA) and peripheral VF were defined as decline of BCVA ≥2 Snellen lines and decrease of ≥2 decibels (dB) in mean deviation (MD) on perimetric testing.METHODSElectronic medical records (EMR) at an academic neuro-ophthalmology practice were searched for diagnosis of "NAION" and all identified charts were reviewed to determine eligibility. Patients diagnosed with acute NAION between February 2014 and December 2023 who presented within four weeks of symptom onset and were seen in follow-up within ten weeks were included. Clinically significant decline in best corrected visual acuity (BCVA) and peripheral VF were defined as decline of BCVA ≥2 Snellen lines and decrease of ≥2 decibels (dB) in mean deviation (MD) on perimetric testing.Forty-nine eyes met inclusion and exclusion criteria. Sixty-seven percent of patients were male and average age at presentation was 66 years. Twenty-two percent of eyes demonstrated worsening of BCVA by ≥2 lines. Of these, 55% worsened by ≥4 lines and 27% by ≥8 lines. In 27% of eyes MD on perimetry worsened by ≥2 dB and in 18% by ≥4 dB. In total, 41% of eyes demonstrated clinically significant worsening of BCVA or VF.RESULTSForty-nine eyes met inclusion and exclusion criteria. Sixty-seven percent of patients were male and average age at presentation was 66 years. Twenty-two percent of eyes demonstrated worsening of BCVA by ≥2 lines. Of these, 55% worsened by ≥4 lines and 27% by ≥8 lines. In 27% of eyes MD on perimetry worsened by ≥2 dB and in 18% by ≥4 dB. In total, 41% of eyes demonstrated clinically significant worsening of BCVA or VF.Subacute deterioration of BCVA and/or VF following acute NAION is not uncommon while optic disc edema is present, with sizeable proportion of patients experiencing dramatic visual decline. Deterioration in visual function within the first 10 weeks of presentation does not exclude the diagnosis of NAION and further investigations should only be performed if additional clinical features are discordant with this diagnosis.CONCLUSIONSSubacute deterioration of BCVA and/or VF following acute NAION is not uncommon while optic disc edema is present, with sizeable proportion of patients experiencing dramatic visual decline. Deterioration in visual function within the first 10 weeks of presentation does not exclude the diagnosis of NAION and further investigations should only be performed if additional clinical features are discordant with this diagnosis.
Bitemporal hemianopia is usually caused by chiasmal pathology. Rarely, chorioretinal lesions may develop symmetrically in both eyes and mimic chiasmopathy.
This case series included three patients ...who presented to a tertiary neuro-ophthalmology centre with bitemporal hemianopic defects between 2021 and 2023 and were subsequently diagnosed with bilateral chorioretinopathy. All patients received comprehensive examinations from a fellowship-trained neuro-ophthalmologist and uveitis specialist to rule out other causes of visual dysfunction.
Three males aged 64, 62, and 72 years were included. All patients showed bitemporal hemianopic defects crossing the vertical midline on automated perimetry and binasal thinning of the macular ganglion cell complex on spectral-domain optical coherence tomography (OCT). Fundus autofluorescence (FAF) showed classical features of acute zonal occult outer retinopathy (AZOOR) in two patients and central serous chorioretinopathy (CSCR) in another. AZOOR diagnosis was preceded by neuroimaging in both cases, whereas the patient with CSCR had longstanding, electroretinography-confirmed lesions and did not require neuroimaging. Fundus appearance and visual field defects remained stable in all patients across 3–6 months of follow-up.
Bilateral chorioretinopathy should be considered in the differential diagnosis of bitemporal hemianopia in specific cases, including when visual field defects cross the vertical midline and when neuroimaging fails to reveal chiasmal pathology. FAF and macular OCT have high diagnostic yield as initial investigations.
•Bitemporal hemianopia is rarely caused by bilateral, symmetric chorioretinopathy.•A multimodal approach to imaging is required to rule out chorioretinopathy.•Fundus autofluorescence and optical coherence tomography are the most useful tests.•Uveitis specialist consultation should be sought when chorioretinopathy is suspected.•Costly investigations are unnecessary when imaging is classic of chorioretinopathy.
Positive schizotypy can uniquely predict the development of psychosis with suspiciousness/paranoia having emerged as a key risk factor, pointing to significant worth in reducing this aspect in ...individuals with high positive schizotypy. Reduced paranoia in the general population following brief online mindfulness training has been previously reported. This study investigated the feasibility of a 40-day online mindfulness-based intervention (MBI) ( n = 12) in the individuals with high positive schizotypy characterized by high suspiciousness/paranoia and to estimate its effect on paranoia as compared with an active control condition using reflective journaling ( n = 12). The outcome measures were self-reported trait and VR-induced state paranoia, completed at baseline, after 10 days and post-intervention. The feasibility criteria included retention, adherence, engagement, and acceptability. There was 100% retention, excellent adherence to content and engagement, with an average MBI session completion rate of 91%. Acceptability, indexed by a self-rated motivation to continue practice post-intervention, was also high. No MBI effect on trait paranoia was observed; however, the MBI group showed a reduction in the VR-induced state paranoia with a medium-to-large effect ( d = 0. 63). The findings support conducting larger-scale randomized controlled trials to evaluate the effects of online MBIs on reducing suspiciousness/paranoia to mitigate psychosis risk in individuals with high positive schizotypy. Clinical Trial Registration: https://www.isrctn.com/ , identifier ISRCTN78697391.
This paper reviews a way of investigating health and welfare problems in captive wild animals (e.g., those in zoos, aviaries, aquaria, or aquaculture systems) that has great potential, but to date ...has been little used: systematically comparing species with few or no health and welfare issues to those more prone to problems. Doing so empirically pinpoints species‐typical welfare risk and protective factors (such as aspects of their natural behavioral biology): information which can then be used to help prevent or remedy problems by suggesting new ways to improve housing and husbandry, and by identifying species intrinsically best suited to captivity. We provide a detailed, step‐by‐step “how to” guide for researchers interested in using these techniques, including guidance on how to statistically control for the inherent similarities shared by related species: an important concern because simple, cross‐species comparisons that do not do this may well fail to meet statistical assumptions of non‐independence. The few relevant studies that have investigated captive wild animals’ welfare problems using this method are described. Overall, such approaches reap value from the great number and diversity of species held in captivity (e.g., the many thousands of species held in zoos); can yield new insights from existing data and published results; render previously intractable welfare questions (such as “do birds need to fly?” or “do Carnivora need to hunt?”) amenable to study; and generate evidence‐based principles for integrating animal welfare into collection planning.
Objective Cell therapy has received much attention for its potential to regenerate ischemic organs, but initial clinical trials in aged patients did not replicate the dramatic benefits recorded in ...preclinical studies with young animals. This study was designed to improve our understanding of age-related changes in the response to ischemic injury and the regenerative capacity of implanted cells in the context of cell therapy for older recipients. Methods and Results Restoration of regional perfusion after hind limb femoral artery ligation was impaired ( P < .05) in old (vs young) rats, reflecting approximately 50% reductions in circulating endothelial progenitor cells and the release of vascular endothelial growth factor/basic fibroblast growth factor. Bone marrow stromal cells from young or old donors implanted into the ischemic hind limbs of young or old rats restored regional perfusion. Specifically, we documented significantly greater ( P < .05) angiogenic potential in young (vs old) donor cells when recipient age was controlled and greater ( P < .05) regenerative responses in young (vs old) recipients when donor cell age was controlled. Contributing to these differences were significantly greater survival in young (vs old) donor cells (in vitro and after implantation) and about 2-fold more production of vascular endothelial growth factor/basic fibroblast growth factor and mobilization of endogenous endothelial progenitor cells in young (vs old) rats in response to ischemia. Conclusions The outcome of cell therapy in older recipients is determined by a combination of age effects on the donor cells and on the recipients' endogenous responses. Donor cell age and recipient age are equally important contributors to the outcome of cell therapy; thus, novel biointerventions will need to target both components of the process.
Research suggests that the ingestion or aroma of rosemary enhances cognitive ability in both rodents and humans. However, how rosemary facilitates cognition and the precise therapeutic impacts on ...information processing remains unclear.
This pilot study used the temporal precision of event-related potentials (ERPs) to examine the cognitive-enhancing benefits of a rosemary drink. Neural markers of sustained attention were used as indices to explore whether rosemary facilitates concentration in general or the allocation of resources to task-relevant information only.
In a between-subject design (rosemary vs water control drink), 48 adults performed a 3-stimulus visual oddball task. Participants differentiated between rare target stimuli (index of task-relevant attentional processes; P3b ERP) embedded in a train of frequent stimuli. The presentation of an infrequent novel stimulus was also included (index of task-irrelevant stimulus processing; P3a ERP). Throughout the session, electroencephalograms (EEG) were collected and time-locked to the presentation of the target (P3b) and novel (P3a) stimulus types.
The primary analyses revealed facilitation of the P3a in particular with a medium Cohen's effect size reported. The investigation of the P3b component, although less reliable, also had a medium effect. The subsidiary consideration of the association between behaviour and the ERPs provided a further level of explanation regarding the therapeutic effect of rosemary on cognition. Indeed, the pattern of associations was suggestive of strategy differences during the performance of the task across the treatment group., although these data should be treated with caution.
These pilot data provide critical insights into the utility of rosemary to facilitate different aspects of attention. In particular, data are consistent with rosemary providing additional attentional resources to enhance the processing of stimuli we encounter, irrespective of task relevance. Indeed, the enhancement of both P3a and P3b components following rosemary administration may indicate that the herb enhances the processing of all stimuli in the environment. We argue for the use of both behavioural and EEG methods to explore the therapeutic effects of herbal compounds.
Understanding why some species thrive in captivity, while others struggle to adjust, can suggest new ways to improve animal care. Approximately half of all Psittaciformes, a highly threatened order, ...live in zoos, breeding centres and private homes. Here, some species are prone to behavioural and reproductive problems that raise conservation and ethical concerns. To identify risk factors, we analysed data on hatching rates in breeding centres (115 species, 10 255 pairs) and stereotypic behaviour (SB) in private homes (50 species, 1378 individuals), using phylogenetic comparative methods (PCMs). Small captive population sizes predicted low hatch rates, potentially due to genetic bottlenecks, inbreeding and low availability of compatible mates. Species naturally reliant on diets requiring substantial handling were most prone to feather-damaging behaviours (e.g. self-plucking), indicating inadequacies in the composition or presentation of feed (often highly processed). Parrot species with relatively large brains were most prone to oral and whole-body SB: the first empirical evidence that intelligence can confer poor captive welfare. Together, results suggest that more naturalistic diets would improve welfare, and that intelligent psittacines need increased cognitive stimulation. These findings should help improve captive parrot care and inspire further PCM research to understand species differences in responses to captivity.
The free bilamellar autograft (FBA) procedure involves harvesting a free, full-thickness section of eyelid tissue from one of the patient's healthy eyelids to reconstruct a large defect of the ...involved eyelid. No vascular augmentation is employed. The purpose of this study was to determine the structural and cosmetic results of this procedure.
A case series was performed, looking at patients who underwent the FBA procedure for large, full-thickness eyelid defects (>50% eyelid length) between 2009 and 2020 at a single oculoplastic surgical centre. Basal cell carcinomas most frequently met criteria for the procedure. OHSN-REB waived ethics approval. All surgeries were performed by one surgeon. A single operation, with surgical steps reported in detail, was completed with follow-up documentation at ideally 1 day, 1 week, 1 month, 3 months, 6 months, and 1 year. The mean follow-up period was 28 months.
Thirty-one patients (17 males, 14 females, mean age 78-years-old) were included in the case series. Comorbidities included diabetes and smoking. Most patients had known basal cell carcinomas removed from the upper or lower eyelid. The mean widths of the recipient and donor sites were 18.8 and 11.5 mm, respectively. All 31 FBA surgeries resulted in structurally functional, cosmetically pleasing, and viable eyelids. Six patients developed minor graft dehiscence, 3 developed an ectropion, and 1 developed mild superficial graft necrosis secondary to frostbite, which fully recovered. Three healing phases were identified.
This case series adds to the currently sparse data on the free bilamellar autograft procedure. The surgical technique is clearly articulated and illustrated. The FBA procedure is a simple and efficient alternative to current surgical techniques in the reconstruction of full-thickness upper and lower eyelid defects. The FBA provides functional and cosmetic success, despite the absence of an intact blood supply, with decreased operative time and faster recovery.
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