Tibial Periosteum For The Surgical Perforation

Purpose: Report a successful case of scleral perforation repair, refractive to treatment with bank-scleral graft, using pretibial periosteum graft patch. Case Report: A patient who suffered a traumatic scleral perforation was treated unsuccessfully with bank-scleral patch graft. An autologous pretibial periosteal patch graft was then obtained and sutured to the scleral rupture with the osteogenic layer facing the sclera. The periosteum patch was covered by amniotic membrane and conjunctiva. Results: Early vascularization was observed in the first seven days postoperative. The autologous periosteal patch graft and conjunctiva remained stable over a follow-up period of 6 months. Conclusion: An autologous periosteal patch graft could be a good alternative after a non-successful bank-scleral patch repair of a scleral perforatio

Visual dysfunction and its correlation with retinal changes in patients with Parkinson’ s disease: an observational cross-sectional study

Objectives: To evaluate visual dysfunction and its correlation with structural changes in the retina in patients with Parkinson’s disease (PD). Methods: Patients with PD (n=37) and controls (n=37) were included in an observational cross- sectional study, and underwent visual acuity (VA), colour vision (using the Farnsworth and Lanthony desaturated D15 colour tests) and contrast sensitivity vision (CSV; using the Pelli-Robson chart and CSV 1000E test) evaluation to measure visual dysfunction. Structural measurements of the retinal nerve fibre layer (RNFL), and macular and ganglion cell layer (GCL) thicknesses, were obtained using spectral domain optical coherence tomography (SD-OCT). Comparison of obtained data, and correlation analysis between functional and structural results were performed. Results: VA (in all different contrast levels) and all CSV spatial frequencies were significantly worse in patients with PD than in controls. Colour vision was significantly affected based on the Lanthony colour test. Significant GCL loss was observed in the minimum GCL+inner plexiform layer. A clear tendency towards a reduction in several macular sectors (central, outer inferior, outer temporal and superior (inner and outer)) and in the temporal quadrant of the RNFL thickness was observed, although the difference was not significant. CSV was the functional parameter most strongly correlated with structural measurements in PD. Colour vision was associated with most GCL measurements. Macular thickness was strongly correlated with macular volume and functional parameters (r>0.70, p<0.05). Conclusions: Patients with PD had visual dysfunction that correlated with structural changes evaluated by SD-OCT. GCL measurements may be reliable indicators of visual impairment in patients with PD

Understanding the impact of diet and nutrition on symptoms of Tourette Syndrome: A Scoping Review

This document is the accepted manuscript version. The final, definitive version of this paper has been published in Journal of Child Health Care, December 2017, published by SAGE Publishing, doi:https://doi.org/10.1177/1367493517748373.Anecdotal reports frequently suggest some dietary involvement in the maintenance of tics in children with Tourette syndrome (TS). This scoping review aimed to (1) understand the possible influence of diet as a trigger of tics and (2) map out the existing studies documenting dietary interventions in children with TS. Current evidence suggests no single diet to benefit individuals with TS. However, reports from parents of children with TS suggest that certain allergens in food may exacerbate tic-related symptoms. For example, an increase in tics has been related to the consumption of caffeine and refined sugar. Moreover, oligoantigenic diets and sugar-free diets have been identified as significantly reducing tics. More research is urgently needed to develop more accurate guidance for parents and children with TS, as many have reported using dietary and nutritional supplements, despite the lack of evidence detailing any benefits, side effects and recommended doses.Peer reviewedFinal Accepted Versio

Relationship between visual dysfunction and retinal changes in patients with multiple sclerosis.

Aim To evaluate structural changes in the retina and their correlation with visual dysfunction in patients with multiple sclerosis. Methods Patients with multiple sclerosis (n = 84) and healthy controls (n = 84) underwent structural eval- uation of the retinal nerve fiber layer, and macular and ganglion cell layer thicknesses using Spectral domain optical coherence tomography (SD-OCT). All subjects underwent high and low contrast visual acuity, color vision (using the Farnsworth and L ´Anthony desaturated D15 color tests), and contrast sensitivity vision using the Pelli Robson chart and CSV 1000E test. Results Macular, retinal nerve fiber layer, and ganglion cell layer thinning was observed in multiple sclerosis patients compared to healthy controls (p<0.05). High- and low-contrast visual acu- ity and contrast sensitivity vision at four different spatial frequencies were significantly reduced in comparison with healthy subjects (p<0.05). Macular, retinal nerve fiber layer and ganglion cell layer measurements correlated with high and low contrast visual acuity, and contrast sensitivity vision. Contrast sensitivity vision was the functional parameter that most strongly correlated with the structural measurements in multiple sclerosis and was associ- ated with ganglion cell layer measurements. The L ´Anthony color vision score (age-cor- rected color confusion index) was associated with macular measurements. Conclusions Patients with multiple sclerosis had visual dysfunction that correlated with structural changes evaluated by SD-OCT. Macular and ganglion cell layer measurements may be good indicators of visual impairment in multiple sclerosis patients