Olfactory dysfunction in Parkinson's disease

Objective: To characterize the olfactory dysfunction in 50 Parkinson's disease (PD) patients with the University of Pennsylvania 12 smell identification test (UPSIT), establishing a comparison with 76 age-matched healthy controls, and associate with clinical and epidemiologic picture. Method: The PD group was evaluated in phase "on" through United Parkinson's disease rating scale, UPSIT, and Hoehn and Yahr stage and the control group with the UPSIT. Results: The mean UPSIT score was 5.7 in PD patients and 9 in the control group. Patients that presented initially resting tremor and those that currently have tremor, rigidity and bradykinesia had a significant lower scores. There were negative correlation between patients' age and PD stage with the UPSIT scores. There were no correlation between olfactory scores, age at the initial PD symptoms and disease duration. Conclusion: Among PD patients 80% had olfactory deficit and, therefore, smell evaluation may be a tool to make PD differential diagnosis.653A64765

OLFACTION AND ESSENTIAL TREMOR

Objective: To characterize the olfactory identification in 40 essential tremor (ET) patients, with the University of Pennsylvania 12 Smell Identification Test (UPSIT), to correlate UPSIT scores to clinical and epidemiological data and to compare it to 89 aged matched controls. Method: Patients were assessed using ET Clinical Scale of Evaluation and UPSIT. Results: Inpatients with ET, the UPSIT medium score was 9.10, similar to the control group (9.11), which was also observed in all age groups. ET severity did not correlate to UPSIT scores. Conclusion:This study demonstrated normality of olfactory identification on ET, qualifying UPSIT to be an important tool on tremor differential diagnosis of undetermined origin.671212

Macular phototoxicity after corneal cross-linking

Paulo Rodolfo Tagliari Barbisan,1 Marina Gonçalves Monteiro Viturino,1 Fernanda Maria Silveira Souto,1 Bo Tian,2,3 Roberto Damian Pacheco Pinto,1 Lucas Barasnevicius Quagliato,1 Maurício Abujamra Nascimento,1 Rosane Silvestre de Castro,1 Carlos Eduardo Leite Arieta1 1Department of Ophthalmology, State University of Campinas, Campinas, São Paulo, Brazil; 2Angiogenesis Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA; 3Department of Ophthalmology and Visual Sciences, University of Massachusetts Medical School, Worcester, MA, USA Purpose: To assess potential vascular, structural, and functional changes to the macula in patients with keratoconus that underwent ultraviolet A (UVA)–riboflavin-mediated corneal collagen cross-linking (CXL) therapy.Patients and methods: Seventeen eyes from 17 patients of age 16 years or older with keratoconus undergoing CXL treatment were studied. The same eye served as its own control (before CXL vs after CXL). Eyes were evaluated in terms of best-corrected visual acuity (BCVA), refractive error, intraocular pressure, Amsler grid, retinography, fluorescein angiography, autofluorescence, and spectral domain optical coherence tomography (SD-OCT) prior to CXL and 7 and 30 days after treatment. Multifocal electroretinography (mfERG) was recorded prior to and 7 days after CXL.Results: Mean (SD) BCVA by logMAR chart was 0.47 (±0.12) pre-CXL, 0.55 (±0.15) 7 days post-CXL (P=0.57), and 0.46 (±0.10) 30 days post-CXL (P=0.87). Mean (SD) SD-OCT central macular thickness (µm) was 253.62 (±20.9) pre-CXL, 260.5 (±18.7) 7 days post-CXL (P=0.48), and 256.44 (±21.6) 30 days post-CXL (P=0.69). In 12 eyes, mfERG revealed a statistically significant increase (P=0.0353) in P1 latency (ms) of ring four from the pre-CXL period (39.45±2.05) to 7 days post-CXL (41.04±1.28) period. Regression analysis showed that the increase in P1 latency was correlated with the increase in central macular thickness (P=0.027). Furthermore, nine patients experienced a significant decrease in P1 amplitudes of rings 1 (P=0.0014), 2 (P=0.0029), 3 (P=0.0037), 4 (P=0.0014), and 5 (P=0.0012) from pre-CXL to 7 days post-CXL.Conclusion: In this pilot study, most of the patients exhibited slight changes in their mfERG parameters and OCT thickness, despite a lack of vascular abnormalities observed on fluorescein angiography/autofluorescence imaging, no alteration in BCVA, and no reports of symptoms. These changes could, therefore, be categorized as a mild subclinical effect of the corneal cross-linking procedure. Keywords: keratoconus, light damage, multifocal electroretinogram, UVA, phototoxicity, crosslinkin