Light Perception Research Articles

Retinal focal nodular gliosis have varied clinical courses requiring tailored management: a case series

Purpose: Retinal focal nodular gliosis (FNG), also known as vasoproliferative tumors (VPTs), are rare, benign vascular tumors associated with exudation with no current consensus on management. Herein, we describe the varied clinical course and management of three patients with retinal focal nodular gliosis, one of whom is associated with retinitis pigmentosa. Observations: Case 1 is a 76-year-old female who presented with reduced vision and distortion secondary to a vitreous hemorrhage and epiretinal membrane (ERM) as complications of a known small peripheral retinal focal nodular gliosis. She underwent vitrectomy for the hemorrhage to relieve vascular traction and the ERM peel and the tumor was kept under observation. Case 2 is a 24-year-old female with genetically uncharacterized retinitis pigmentosa-like phenotype who presented with gradual loss of central vision in one eye due to cystoid macular oedema (CMO). She was found to have two peripheral retinal areas of focal nodular gliosis located inferonasally. Tumors were treated with cryotherapy and adjuvant intraocular steroid implant to control the CMO. Case 3 is a 28-year-old female with retinitis pigmentosa secondary to genetically confirmed variant in CRB1 gene who presented with intractable right eye cystoid macular oedema and localized inferior serous retinal detachment secondary to a large inferotemporal focal nodular gliosis. Her left eye has no light perception vision due to previous extensive serous retinal detachment and anterior segment ischemia. The right eye tumor was managed with multiple rounds of cryotherapy and laser therapy to control the serous detachment. Despite this, the condition progressed and was ultimately treated with plaque brachytherapy. Unfortunately, this resulted in an extensive retinal inflammation causing annular tractional retinal detachment which was treated with combined pars plana vitrectomy and scleral buckle. Conclusions: We characterized the retinal phenotype of three patients with retinal focal nodular gliosis (vasoproliferative tumors) and found them to have varied clinical courses requiring tailored surgical management. The case associated with retinitis pigmentosa had a known pathogenic variant in Crumbs homolog-1 (CRB1) gene affecting retinal structure and exhibited a more severe clinical course. It is therefore important for patients with retinal dystrophies to undergo thorough peripheral examinations and detect FNG early as they may require prompt, aggressive treatment.

Prognostic factors and clinical features of rhino-orbital-mucormycosis cases: an update for patient and visual survivals.

To determine the frequency of patients' vision survival and prognostic factors and evaluate clinical features in rhino-orbital mucormycosis. Forty-three eyes of 43 patients followed up with orbital mucormycosis infections were included in the study. Demographic characteristics of the patients, symptoms at admission, ophthalmologic and non-ophthalmologic examination findings, clinical findings during follow-up, medical and surgical procedures, and complications were recorded. Patient survival was determined by assessing the incidence of mortality, and vision survival was defined as achieving a final visual acuity of at least light perception. Twenty-seven (62.8%) patients were male, and 16 (37.2%) were female. When the underlying disease status of the patients was examined, it was observed that all patients had an underlying disease and diabetes constituted the majority (65.2%). Periorbital swelling (69.8%) and ophthalmoplegia (53.5%) were the most common symptoms and findings at the admission of patients with mucormycosis infection. The disease resulted in death in 22 (51.2%) patients. The presence of fever and shorter duration of antifungal therapy were associated with lower patient survival. Exenteration surgery was not found to be associated with the survival of the patients. Frozen eye, loss of pupillary light reflex, and development of central retinal artery occlusion were associated with lower vision survival. This study presents one of the most extensive patient series in the literature on rhino-orbital mucormycosis. Knowing the patients' symptoms at the time of admission and the clinical findings during the infection process will increase awareness about the disease.

Do not stumble over the same “stone” twice: a case series of endogenous endophthalmitis secondary to severe systemic diseases

BackgroundEndogenous endophthalmitis (EE) is a rare but highly destructive eye emergency secondary to systemic infection. Acute endophthalmitis can lead to irreversible vision impairment or even loss of the whole eye, unless being diagnosed and treated promptly.Case presentationThis study reports three typical EE cases of endogenous endophthalmitis secondary to different severe systemic diseases. Patients were recruited from the Department of ophthalmology at Zhongnan hospital of Wuhan University and the Department of ophthalmology at the Second Affiliated Hospital of Fujian Medical University. Patients were followed up for up to 60 days. Among these cases, the eye symptoms is the initial manifestations while secondary to original different special systemic conditions. Patients have been treated under dynamically prompt response undergoing systemic treatment and eye treatment at the same time. Best corrected visual acuity were 20/40, 20/60 and light perception during follow-up evaluation.ConclusionsOur observation suggest that prompt identification and treatment could save patients’ vision from EE.

Altered States of Consciousness are Prevalent and Insufficiently Supported Clinically: A Population Survey

Abstract Objectives Adoption of potentially consciousness-altering practices may be leading to a rise in emergent phenomena (EP): sudden unusual mental or somatic experiences often interpreted as spiritual, mystical, energetic, or magical in nature. It is unclear how frequently these altered states of consciousness occur and what the clinical implications may be. Anecdotal accounts and prior literature suggest that EP may be common, under-reported, and followed by either positive or negative changes to well-being. We sought to supplement prior evidence on the prevalence and effects of EP among general populations with large-scale quantitative measurements. Method We measured the prevalence of EP, while not on mind-altering substances, through completion of online surveys by representative samples from three international communities (n = 3135). The communities sampled were UK Qualtrics online panelists, US-based MTurk workers, and the readers of a popular rationalist blog. Samples were broadly representative of underlying populations. Results Forty-five percent of participants reported experiencing non-pharmacologically induced EP at least once in their lives, including derealization (17%), unitive experiences (15%), ecstatic thrills (15%), vivid perceptions (11%), changes in perceived size (10%), bodily heat or electricity (9%), out-of-body experiences (8%), and perception of non-physical lights (5%). Respondents reported a mix of positive and negative well-being outcomes following EP, with 13% claiming moderate or greater suffering and 1.1% claiming life-threatening suffering. Of those who experienced suffering, 63% did not seek help. Conclusions EP are widespread among the studied populations with potential for both positive and negative outcomes, the latter of which do not appear to be adequately addressed through recourse to clinical practice.

Coexistence of severe peripheral ulcerative keratitis and lichen planus. Case Report

Introduction and Importance: Ocular involvement in lichen planus is highly uncommon, primarily affecting the eyelids, conjunctiva, and less frequently, the cornea. Peripheral Ulcerative Keratitis (PUK), a rare subtype form of corneal lichen planus, has been reported only once in the literature. Case Presentation: We report details of a 34-year-old man with confirmed cutaneous lichen planus who developed severe peripheral ulcerative keratitis (PUK), a rare ocular manifestation of lichen planus. Despite initial worsening with corticosteroids, successful resolution of PUK was achieved with topical Cyclosporin and azathioprine over two months but with a final visual acuity limited to light perception. Clinical Discussion: To the best of our knowledge, very rare cases have been reported of the Coexistence of Severe Peripheral Ulcerative Keratitis and Lichen Planus. Lichen planus should be considered in any case of peripheral ulcerative keratitis associated with cutaneous-mucosal manifestations Cyclosporin and azathioprine are crucial for effective management and favorable outcomes in such cases. Conclusion: This case aims to show the importance of dermatological examination in the presence of any peripheral ulcerative keratitis. it also sheds light on the therapeutic difficulties and the prognosis of this rare form of ocular lichen planus.

Regression Approach in the Evaluation of White’s Effect Magnitude in Comparison to Lightness

In the achromatic White's grid, the grey patches between the grey lines are perceived as darker while the same elements inserted between white lines are perceived lighter than their true measured values. A number of authors attempted to calculate the magnitude and direction of this effect using mathematical models based on multiple spatial filters. This paper uses different mathematical model, based on regression analysis, which has shown itself as an excellent tool for prediction of direction and magnitude of White's effect. The psychophysical visual experiment was conducted on 38 subjects of both genders. The differences in lightness perception ∆L00 were calculated in CIE ∆E_2000 system. This paper determined the functional dependence of White's effect magnitude ∆L00 to the lightness L of rectangular elements in White's achromatic grid. The results gave the square polynomial of very high quality (R2 = 0,974). Regression polynomials were also found. The gave numerical values ∆L00 of difference in perception of left and right elements in comparison to their physical values (left R2 = 0,943, right R2 = 0,938) in dependence to variation of lightness parameter L. Results of the research clearly show the mathematical pattern of White's effect based on the lightness of rectangular elements.

Levels of photoactivated phototropin modulate signal transmission during the chloroplast accumulation response.

Chloroplasts accumulate in regions of plant cells exposed to irradiation to maximize light reception for efficient photosynthesis. This response is mediated by the blue-light receptor phototropin. Upon the perception of blue light, phototropin is photoactivated, an unknown signal is transmitted from the photoactivated phototropin to distant chloroplasts, and the chloroplasts begin their directional movement. How activated phototropin initiates this signal transmission is unknown. Here, using the liverwort Marchantia polymorpha, we analysed whether increased photoactive phototropin levels mediate signal transmission and chloroplast behaviour during the accumulation response. The signal transmission rate was higher in transgenic cells overexpressing phototropin than in wild-type cells. However, the chloroplast directional movement was similar between wild-type and transgenic cells. Consistent with the observation, increasing the amount of photoactivated phototropin through higher blue-light intensity also accelerated signal transmission but did not affect chloroplast behaviour in wild-type cells. Photoactivation of phototropin under weak blue-light led to the greater protein level of phosphorylated phototropin in cells overexpressing phototropin than in wild-type cells, whereas the autophosphorylation level within each phototropin molecule was similar. These results indicate that the abundance of photoactivated phototropin modulates the signal transmission rate to distant chloroplasts but does not affect chloroplast behaviour during the accumulation response.

Formation of Three-Dimensional Thinking as one of the Significant Professional Qualities of an Architect

The article touches upon the problems of the professional formation of an architect, the development of his three-dimensional thinking in the process of studying the disciplines of the artistic cycle. The architect's vision must meet the strict requirements imposed by the specifics of visual activity, the laws of figurative literacy and the tasks of a particular stage of work, correlate with the ultimate ideals and purpose of creative activity. In the study of light as a means of artistic expression, an important role must be given to the psychology of the perception of light in nature and in the image. Only having a developed three-dimensional thinking a student can convincingly and accurately convey the character of a three-dimensional shape, its plasticity and movement.The recognition of three-dimensional forms, including natural objects based on three-dimensional vision of images, through an accurate assessment of light and shadow gradations, adequate transfer of color phenomena of reality to the possibilities of the visual sphere and skillful modeling of forms depicted by light and shadow, becomes an emphasis in the training of an architect. The position of color in the image of shapes in space is no less significant.Pedagogical techniques for the formation of three-dimensional thinking of students and the development of their graphic skills in drawing three-dimensional objects, including architectural ones, are based on scientific discoveries of scientists, scientists and artists since the Renaissance.The integrity of perception, attention to detail, the study of space, understanding of form, possession of means of shaping and the image of a three-dimensional object in a two-dimensional format are becoming universal criteria that allow us to talk about the high-quality training of future architects.

Solar Azo‐Switches for Effective E→Z Photoisomerization by Sunlight

Natural photoactive systems have evolved to harness broad‐spectrum light from solar radiation for critical functions such as light perception and photosynthetic energy conversion. Molecular photoswitches, which undergo structural changes upon light absorption, are artificial photoactive tools widely used for developing photoresponsive systems and converting light energy. However, photoswitches generally need to be activated by light of specific narrow wavelength ranges for effective photoconversion, which limits their ability to directly work under sunlight and to efficiently harvest solar energy. Here, focusing on azo‐switches—the most extensively studied photoswitches, we demonstrate effective solar E→Zphotoisomerization with photoconversions exceeding 80% under unfiltered sunlight. These sunlight‐driven azo‐switches are developed by rendering the absorption of E isomers overwhelmingly stronger than that of Z isomers across a broad ultraviolet to visible spectrum. This unusual type of spectral profile is realized by a simple yet highly adjustable molecular design strategy, enabling the fine‐tuning of spectral window that extends light absorption beyond 600 nm. Notably, back‐photoconversion can be achieved without impairing the forward solar isomerization, resulting in unique light‐reversible solar switches. Such exceptional solar chemistry of photoswitches provides unprecedented opportunities for developing sustainable light‐driven systems and efficient solar energy technologies.

Solar Azo‐Switches for Effective E→Z Photoisomerization by Sunlight

Natural photoactive systems have evolved to harness broad‐spectrum light from solar radiation for critical functions such as light perception and photosynthetic energy conversion. Molecular photoswitches, which undergo structural changes upon light absorption, are artificial photoactive tools widely used for developing photoresponsive systems and converting light energy. However, photoswitches generally need to be activated by light of specific narrow wavelength ranges for effective photoconversion, which limits their ability to directly work under sunlight and to efficiently harvest solar energy. Here, focusing on azo‐switches—the most extensively studied photoswitches, we demonstrate effective solar E→Zphotoisomerization with photoconversions exceeding 80% under unfiltered sunlight. These sunlight‐driven azo‐switches are developed by rendering the absorption of E isomers overwhelmingly stronger than that of Z isomers across a broad ultraviolet to visible spectrum. This unusual type of spectral profile is realized by a simple yet highly adjustable molecular design strategy, enabling the fine‐tuning of spectral window that extends light absorption beyond 600 nm. Notably, back‐photoconversion can be achieved without impairing the forward solar isomerization, resulting in unique light‐reversible solar switches. Such exceptional solar chemistry of photoswitches provides unprecedented opportunities for developing sustainable light‐driven systems and efficient solar energy technologies.

Clinical and genetic characteristics and natural history of Finnish families with familial exudative vitreoretinopathy due to pathogenic FZD4 variants.

To report clinical and genetic characteristics of familial exudative vitreoretinopathy (FEVR) in the Finnish population. Detailed clinical and genetic data of 35 individuals with heterozygous pathogenic variants in FZD4 were gathered and analysed. Thirty-two individuals with FZD4 c.313A>G variant and three individuals with FZD4 c.40_49del were included in the study. The clinical phenotype was variable even among family members with the same FZD4 variant. Only 34% (N = 12/35) of variant-positive individuals had been clinically diagnosed with FEVR. The median age of the onset of symptoms was 2.3 years, ranging between 0 to 25 years. Median visual acuity was 0.1 logMAR (0.8 Snellen decimal), ranging between light perception and -0.1 logMAR (1.25 Snellen decimal). Most (N = 33/35, 94%) were classified as not visually impaired. Despite unilateral visual loss present in some, they did not meet the criteria of visual impairment according to the WHO classification. Two study patients (N = 2/35, 6%) had severe visual impairment. The most common FEVR stage in study patient's eyes (N = 28/70 eyes, 40%) was FEVR stage 1, that is, avascular periphery or abnormal vascularisation. Most of FZD4-variant-positive study patient's eyes (N = 31/50 eyes, 62%) were myopic. Two individuals presented with persistent hyperplastic primary vitreous expanding the phenotypic spectrum of FEVR. Shared haplotypes extending approximately 0.9 Mb around the recurrent FZD4 c.313A>G variant were identified. Most study patients were unaffected or had mild clinical manifestations by FEVR. Myopia seemed to be overly common in FZD4-variant-positive individuals.

40S Ribosomal Protein S6 Kinase Integrates Daylength Perception and Growth Regulation in Arabidopsis thaliana.

Plant growth occurs via the interconnection of cell growth and proliferation in each organ following specific developmental and environmental cues. Therefore, different photoperiods result in distinct growth patterns due to the integration of light and circadian perception with specific Carbon (C) partitioning strategies. In addition, the TARGET OF RAPAMYCIN (TOR) kinase pathway is an ancestral signaling pathway that integrates nutrient information with translational control and growth regulation. Recent findings in Arabidopsis (Arabidopsis thaliana) have shown a mutual connection between the TOR pathway and the circadian clock. However, the mechanistical network underlying this interaction is mostly unknown. Here, we show that the conserved TOR target, the 40S ribosomal protein S6 kinase (S6 K) is under circadian and photoperiod regulation both at the transcriptional and post-translational level. Total S6 K (S6K1 and S6K2) and TOR-dependent phosphorylated-S6 K protein levels were higher during the light period and decreased at dusk especially under short day conditions. Using chemical and genetic approaches we found that the diel pattern of S6 K accumulation results from 26S proteasome-dependent degradation and is altered in mutants lacking the circadian F-box protein ZEITLUPE (ZTL), further strengthening our hypothesis that S6 K could incorporate metabolic signals via TOR, which are also under circadian regulation. Moreover, under short days when C/energy levels are limiting, changes in S6K1 protein levels affected starch, sucrose and glucose accumulation and consequently impacted root and rosette growth responses. In summary, we propose that S6K1 constitutes a missing molecular link where day-length perception, nutrient availability and TOR pathway activity converge to coordinate growth responses with environmental conditions.

Light‐adaptive Mimicking Retina with In Situ Image Memorization via Resistive Switching Photomemristor Arrays

AbstractArtificial visual memory systems have been of particular interest since the development of machine vision and bionic robots. Ordinarily, the conventional system architecture requires the complex integration of two functional modules, a photo‐sensor and a memory device, which greatly limits the operating efficiency and increases the extra energy consumption. Nonetheless, other simply configured optoelectronics memory devices generally face challenges of adaption in complex light environments. Here, a resistive switching (RS) perovskite‐based photomemristor is presented that mimics the retina function. The dual function of light perception and in situ storage are both achieved. In the dark condition, it exhibits impressive memory performance with a high ON/OFF ratio of 104, a long retention time of over 104 s, and a low operating voltage of 0.38 V. With illumination, it shows self‐powered, broadband photo‐detecting characteristics with responsivity of 70 mA W−1 and detectivity of 7.5 × 1010 Jones. More importantly, benefiting from the material dual‐phase configuration, the highly steady photo‐adjusted RS windows are achieved. Its light‐adaptive memory application in dynamic environments is further demonstrated using the mimicking retina for a machine eye. This work can provide a strategy for enhanced RS photomemristor and its application in changing and varied scenarios.

Screening for Autism Spectrum Disorder in children and adolescents with Leber's congenital amaurosis

PurposeTo investigate autism spectrum disorder (ASD) indicators in children with Leber congenital amaurosis (LCA). MethodsCross-sectional, correlational, and prospective study. Participants included patients aged 2 to 16 years with LCA confirmed by genetic testing. There were 20 individuals with ciliopathies (LCA cilio) and 26 with other gene mutations (LCA other). The instrument used for ASD screening was the Autism Behavior Checklist (ABC). Marginal descriptive analyses, non-parametric tests, and a linear regression model were conducted. ResultsOf the 46 participants, 6 had ASD scores. There was no statistically significant correlation between the different groups (LCA cilio and LCA other) (p=0.438). There was no statistically significant correlation between age and ASD (p=0.308). However, there was a statistically significant correlation between visual acuity and ASD (p=0.008) and between male gender and ASD (p=0.025). ConclusionsThis study suggests that there is no correlation between LCA cilio, LCA other and ASD. These findings bring new insights to the existing literature, which previously lacked robust data on the relationship between LCA and ASD. These data demonstrate that visual acuity plays a crucial role in the development of children with visual impairment as poorer visual acuity is associated with a higher incidence of ASD. Based on this study, early interventions can be designed, especially for individuals without light perception, with the aim of maximizing their developmental outcomes. Furthermore, such data indicates that any improvement in visual acuity outcomes in treatment clinical trials become relevant for child development.

NO EFFECT OF REAL-WORLD UNIVERSAL FACE MASKING ON POST-INTRAVITREAL INJECTION ENDOPHTHALMITIS RATE AT A SINGLE TERTIARY ACADEMIC CENTER.

To determine whether universal masking during COVID-19 altered rate and outcomes of postinjection endophthalmitis. Retrospective, single-site, comparative, cohort study. Eyes diagnosed with endophthalmitis within 4 weeks of intravitreal injection at the University of Michigan from August 1, 2012, to November 15, 2022, were identified. Cases were considered "masking" between March 15, 2020, and November 15, 2022. Endophthalmitis rate, visual acuity, and microbial spectrum were investigated. There were 20 postinjection endophthalmitis cases out of 72,194 injections (0.028%; one in 3,571 injections) premasking and 10 of 38,962 with universal masking (0.026%; one in 3,846 injections; odds ratio 0.9; 95% [confidence interval]: 0.4-2.0). Referral from the community was unchanged with 32 cases referred premasking (0.35 cases/month) and 10 cases with masking (0.31 cases/month). Presenting mean the logarithm of the minimum angle of resolution visual acuity with masking of all postinjection endophthalmitis cases trended worse (2.35 ± 0.40) compared with premasking (2.09 ± 0.48; P = 0.05) with light perception visual acuity more common with masking (31.6% vs. 10.9%, P = 0.06). There was no delay in time from procedure to initial treatment ( P = 0.36), no difference in the rate of initial treatment with tap and inject (T/I), and similar positive-culture rates ( P = 0.77) between the cohorts. Visual acuity after 30 days of follow-up was clinically unchanged (∼20/500 vs. 20/400; P = 0.59). Universal masking had no effect on postinjection endophthalmitis rate or on the rate of culture-positive cases. Although presenting visual acuity appeared worse with masking, this was not statistically significant, and current treatment paradigms resulted in similar visual outcomes.

The molecular basis of COP1 action during photomorphogenesis.

COP1 (CONSTITUTIVE PHOTOMORPHOGENIC1), a repressor of seedling photomorphogenesis, is tightly controlled by light. In Arabidopsis, COP1 primarily acts as a part of large E3 ligase complexes and targets key light-signaling factors for ubiquitination and degradation. Upon light perception, the action of COP1 is precisely modulated by active photoreceptors. During seedling development, light plays a predominant role in modulating seedling morphogenesis, including inhibition of hypocotyl elongation, cotyledon opening and expansion, and chloroplast development. These visible morphological changes evidently are resulted from networks of molecular action. In this review, we summarize the current knowledge about the molecular role of COP1 in mediating light-controlled seedling development.

Headache and Vision Loss as Initial Symptoms for an Acute Invasive Rhino-orbital-cerebral Mucormycosis

Background: Acute invasive rhino-orbital-cerebral mucormycosis (ROCM) is a rare fungal infection commonly caused by Rhizopus species. It occurs in immune- compromised individuals who have acquired immune deficiency syndrome (AIDS), leukemia, uncontrolled diabetes mellitus, or organ transplant patients who are on immunosuppressive therapy. Diagnosing invasive ROCM is challenging because its clinical presentation can be nonspecific, and it is not frequently observed in ophthalmic practices. Case Report: A 66-year-old Hispanic male with poorly controlled diabetes mellitus presented with the complaint of severe headache and retrobulbar pain in the right eye. An ophthalmic examination revealed normal ocular health in both eyes. Computerized tomography scan showed mild inflammatory mucosal thickening in the sinuses. Initially, he was diagnosed and treated for giant cell arteritis. The patient’s vision deteriorated to no light perception in the right eye with persistent 10 out of 10 headache and eye pain despite various treatments. Further evaluation revealed ROCM involving the sphenoid sinus. This was confirmed by a positive smear and culture of Rhizopus species from the sinus and from the patient’s symptoms improving with antifungal treatment. Conclusion: Sphenoid sinusitis is an unusual site of involvement with ROCM. The absence of nasal drainage adds to the difficulty of diagnosis without contrast imaging. Although rare, acute invasive ROCM should always be considered in any uncontrolled diabetic or immunosuppressed patient with acute headache and vision loss.

Septic Cavernous Sinus Thrombosis: Clinical Characteristics, Management, and Outcomes.

Septic cavernous sinus thrombosis (CST) is a rare condition traditionally associated with high morbidity and mortality. More recent case series report more favorable outcomes, including full functional recovery. A comprehensive assessment of the clinical characteristics and prognostic factors of visual and survival outcomes in septic CST is warranted to contemporize current understanding and help guide management. A multicentered retrospective cohort study was conducted at 2 tertiary care centers using an electronic medical record search of the term, "thrombosis of cavernous venous sinus" between January 1, 2000, and December 31, 2021. Inclusion criteria consisted of active infection and radiographic evidence of associated CST. Demographic and clinical data extracted included age at presentation, sex, infection type and extent, and ophthalmic examination findings at presentation-best-corrected visual acuity (BCVA), presence of relative afferent pupillary defect (RAPD), intraocular pressure (IOP), and extraocular motility (EOM) limitation. Management data collected consisted of type and length of antimicrobial therapy, type and length of anticoagulation administration, and surgical intervention. Primary outcomes assessed were ophthalmic examination findings at final evaluation and same-hospitalization mortality. A total of 27 patients with imaging-confirmed septic CST were identified at 2 tertiary care centers. At presentation, 2 (8.7%) patients had no light perception (NLP) vision, 8 (29.6%) patients had RAPD, 17 (73.9%) patients had EOM limitation, and 13 (54.2%) had IOP >21 mm Hg. All patients received antimicrobial therapy, with vancomycin being the most common agent. Fifteen patients (55.6%) received anticoagulation, and 21 (81.5%) patients underwent surgical intervention. Same-hospitalization mortality was 3 (11.1%). Among the 21 patients with ophthalmic data at follow-up, 3 (16.7%) had NLP vision, 5 (23.8%) had a persistent RAPD, 7 (31.8%) had persistent EOM limitation, and no patients had IOP elevated above 21 mm Hg. Patients with RAPD at presentation had significantly worse BCVA at final evaluation (logMAR BCVA 1.43 higher on average, P = 0.01) and a significantly higher mortality rate (37.5% vs. 0.0%, P < 0.01) than non-RAPD patients. Demographic features, BCVA at presentation, EOM limitation at presentation, elevated IOP at presentation, and comorbid orbital cellulitis were not associated with worse visual or mortality outcomes. Septic CST may result in permanent ophthalmic functional deficit in almost one-third of cases and mortality in approximately 11% of patients under contemporary management. New RAPD at presentation may indicate higher risk of poor visual and survival outcomes.

Ocular morbidity profiles of out-of-school children in a North Indian urban slum.

This study evaluates the recent trends in ocular morbidities and vision-related practices in "out-of-school" children in urban slums of Gurugram in North India. In this observational study, a validated questionnaire was administered to 161 students from two nonformal slum schools. Sociocultural, demographic data, vision-related practices, and visual acuity with subjective refraction of the children were recorded. A total of 80 boys and 81 girls (9.17 ± 2.58 years) participated in this study. About 40% of the children were from lower socioeconomic status. The visual acuity recorded for all the children, except three children, was 6/6 in both eyes. One child had a pre-phthisical eye with no light perception, following a childhood trauma, with the other eye having 6/6 vision. Two children had refractive errors (myopia and compound myopic astigmatism), with a best corrected visual acuity (BCVA) of 6/6. Thirteen children (8%) had Bitot's spots and 67 (35.4%) had allergic conjunctivitis. Eight (5%) children complained of dry eye-related symptoms like redness and watering of eyes, while 19 (11.8%) had diffuse headache. Average number of years spent in school for these children was less than 1.7 years (range: 1 month-6 years). Only 10.5% of the children gave the history of watching television more than 30 h/week. Significant association was found between the income of father and use of digital devices in children below 10 years (P = 0.003) and children playing outdoors (P = 0.001). There was a significant association noted for age and use of digital devices (P = 0.037). The prevalence of refractive errors in "out-of-school" children of urban slum was much less than the national average. Almost one in three children suffered from eye allergies, while 8% children had Bitot's spots. The data about the prevalence of ocular comorbidities in underserved areas like urban slums can be used to update and strategize eye health-care delivery models for out-of-school children.

Long-Term Follow-up of Patients With Cytomegalovirus Retinitis Treated With a Ganciclovir Implant

Purpose: To assess the long-term safety and clinical outcomes of a ganciclovir intravitreal implant in patients with cytomegalovirus (CMV) retinitis. Methods: A retrospective study was performed of patients with CMV retinitis treated with a ganciclovir intravitreal implant. Results: The study included 13 patients (16 eyes) previously treated with a ganciclovir intravitreal implant. The mean time since the last implant placement was 21.3 years and the mean total duration of follow-up, 22.7 years. Visual acuity (VA) ranged from 20/25 to light perception, with 56% of eyes maintaining a VA of 20/60 or better at the most recent follow-up examination. Common ocular complications included epiretinal membrane (38%), macular fibrosis/scarring (25%), retinal detachment (RD) (25%), implant dislocation (25%), and immune reactivation uveitis (19%). Intraocular surgery was required in 10 eyes (63%), with the most frequent being cataract extraction (31%), pars plana vitrectomy (PPV) for implant removal (19%), and PPV for RD (13%). Conclusions: Results show the long-term safety of the ganciclovir intravitreal implant despite its residual inactive inert shell. Complication rates are consistent with those expected from infectious sequelae.