Three-dimensional organization of otolith-ocular reflexes in rhesus monkeys. III. Responses To translation

The three-dimensional (3-D) properties of the translational vestibulo-ocular reflexes (translational VORs) during lateral and fore-aft oscillations in complete darkness were studied in rhesus monkeys at frequencies between 0.16 and 25 Hz. In addition, constant velocity off-vertical axis rotations extended the frequency range to 0.02 Hz. During lateral motion, horizontal responses were in phase with linear velocity in the frequency range of 2-10 Hz. At both lower and higher frequencies, phase lags were introduced. Torsional response phase changed more than 180 degrees in the tested frequency range such that torsional eye movements, which could be regarded as compensatory to "an apparent roll tilt" at the lowest frequencies, became anticompensatory at all frequencies above approximately 1 Hz. These results suggest two functionally different frequency bandwidths for the translational VORs. In the low-frequency spectrum (<0.5 Hz), horizontal responses compensatory to translation are small and high-pass-filtered whereas torsional response sensitivity is relatively frequency independent. At higher frequencies however, both horizontal and torsional response sensitivity and phase exhibit a similar frequency dependence, suggesting a common role during head translation. During up-down motion, vertical responses were in phase with translational velocity at 3-5 Hz but phase leads progressively increased for lower frequencies (>90 degrees at frequencies <0.2 Hz). No consistent dependence on static head orientation was observed for the vertical response components during up-down motion and the horizontal and torsional response components during lateral translation. The frequency response characteristics of the translational VORs were fitted by "periphery/brain stem" functions that related the linear acceleration input, transduced by primary otolith afferents, to the velocity signals providing the input to the velocity-to-position neural integrator and the oculomotor plant. The lowest-order, best-fit periphery/brain stem model that approximated the frequency dependence of the data consisted of a second order transfer function with two alternating poles (at 0.4 and 7.2 Hz) and zeros (at 0.035 and 3.4 Hz). In addition to clearly differentiator dynamics at low frequencies (less than approximately 0.5 Hz), there was no frequency bandwidth where the periphery/brain stem function could be approximated by an integrator, as previously suggested. In this scheme, the oculomotor plant dynamics are assumed to perform the necessary high-frequency integration as required by the reflex. The detailed frequency dependence of the data could only be precisely described by higher order functions with nonminimum phase characteristics that preclude simple filtering of afferent inputs and might be suggestive of distributed spatiotemporal processing of otolith signals in the translational VORs.     

Effects of motor programming on the power spectral density function of finger and wrist movements.

Power spectral density analysis was applied to the frequency content of the acceleration signal of pen movements in line drawing using 10 right-handed college students. The relative power in frequency bands between 1 and 32 Hz was measured as a function of motoric and anatomic task demands. Results showed a decrease of power at the lower frequencies (1–4 Hz) of the spectrum and an increase in the middle (9–22 Hz) with increasing motor demands. These findings evidence the inhibition of visual control and the disinhibition of physiological tremor under conditions of increased programming demands. Adductive movements displayed less power than abductive movements in the lower end of the spectrum, with a simultaneous increase at the higher frequencies. The relevance of the method for the measurement of neuromotor noise as a possible origin of delays in motor behavior is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dynamics and kinematics of the angular vestibulo-ocular reflex in monkey: effects of canal plugging

Dynamics and kinematics of the angular vestibulo-ocular reflex in monkey: effects of canal plugging. J. Neurophysiol. 80: 3077-3099, 1998. Horizontal and roll components of the angular vestibulo-ocular reflex (aVOR) were elicited by sinusoidal rotation at frequencies from 0.2 Hz (60 degrees/s) to 4.0 Hz ( approximately 6 degrees/s) in cynomolgus monkeys. Animals had both lateral canals plugged (VC, vertical canals intact), both lateral canals and one pair of the vertical canals plugged (RALP, right anterior and left posterior canals intact; LARP, left anterior and right posterior canal intact), or all six semicircular canal plugged (NC, no canals). In normal animals, horizontal and roll eye velocity was in phase with head velocity and peak horizontal and roll gains were approximately 0.8 and 0.6 in upright and 90 degrees pitch, respectively. NC animals had small aVOR gains at 0.2 Hz, and the temporal phases were shifted approximately 90 degrees toward acceleration. As the frequency increased to 4 Hz, aVOR temporal gains and phases tended to normalize. Findings were similar for the LARP, RALP, and VC animals when they were rotated in the planes of the plugged canals. That is, they tended to normalize at higher frequencies. A model was developed incorporating the geometric organization of the canals and first order canal-endolymph dynamics. Canal plugging was modeled as an alteration in the low frequency 3-db roll-off and corresponding dominant time constant. The shift in the low-frequency 3-dB roll-off was seen in the temporal responses as a phase lead of the aVOR toward acceleration at higher frequencies. The phase shifted toward stimulus velocity as the frequency increased toward 4.0 Hz. By incorporating a dynamic model of the canals into the three-dimensional canal system, the spatial responses were predicted at all frequencies. Animals were also stimulated with steps of velocity in planes parallel to the plugged lateral canals. This induced a response with a short time constant and low peak velocity in each monkey. Gains were normalized for step rotation with respect to time constant as (steady state eye velocity)/(stimulus acceleration x time constant). Using this procedure, the gains were the same in canal plugged as in normal animals and corresponded to gains obtained in the frequency analysis. The study suggests that canal plugging does not block the afferent response to rotation, it merely shifts the dynamic response to higher frequencies.     

Three-dimensional organization of otolith-ocular reflexes in rhesus monkeys. I. Linear acceleration responses during off-vertical axis rotation

1. The dynamic properties of otolith-ocular reflexes elicited by sinusoidal linear acceleration along the three cardinal head axes were studied during off-vertical axis rotations in rhesus monkeys. As the head rotates in space at constant velocity about an off-vertical axis, otolith-ocular reflexes are elicited in response to the sinusoidally varying linear acceleration (gravity) components along the interaural, nasooccipital, or vertical head axis. Because the frequency of these sinusoidal stimuli is proportional to the velocity of rotation, rotation at low and moderately fast speeds allows the study of the mid-and low-frequency dynamics of these otolith-ocular reflexes. 2. Animals were rotated in complete darkness in the yaw, pitch, and roll planes at velocities ranging between 7.4 and 184 degrees/s. Accordingly, otolith-ocular reflexes (manifested as sinusoidal modulations in eye position and/or slow-phase eye velocity) were quantitatively studied for stimulus frequencies ranging between 0.02 and 0.51 Hz. During yaw and roll rotation, torsional, vertical, and horizontal slow-phase eye velocity was sinusoidally modulated as a function of head position. The amplitudes of these responses were symmetric for rotations in opposite directions. In contrast, mainly vertical slow-phase eye velocity was modulated during pitch rotation. This modulation was asymmetric for rotations in opposite direction. 3. Each of these response components in a given rotation plane could be associated with an otolith-ocular response vector whose sensitivity, temporal phase, and spatial orientation were estimated on the basis of the amplitude and phase of sinusoidal modulations during both directions of rotation. Based on this analysis, which was performed either for slow-phase eye velocity alone or for total eye excursion (including both slow and fast eye movements), two distinct response patterns were observed: 1) response vectors with pronounced dynamics and spatial/temporal properties that could be characterized as the low-frequency range of "translational" otolith-ocular reflexes; and 2) response vectors associated with an eye position modulation in phase with head position ("tilt" otolith-ocular reflexes). 4. The responses associated with two otolith-ocular vectors with pronounced dynamics consisted of horizontal eye movements evoked as a function of gravity along the interaural axis and vertical eye movements elicited as a function of gravity along the vertical head axis. Both responses were characterized by a slow-phase eye velocity sensitivity that increased three- to five-fold and large phase changes of approximately 100-180 degrees between 0.02 and 0.51 Hz. These dynamic properties could suggest nontraditional temporal processing in utriculoocular and sacculoocular pathways, possibly involving spatiotemporal otolith-ocular interactions. 5. The two otolith-ocular vectors associated with eye position responses in phase with head position (tilt otolith-ocular reflexes) consisted of torsional eye movements in response to gravity along the interaural axis, and vertical eye movements in response to gravity along the nasooccipital head axis. These otolith-ocular responses did not result from an otolithic effect on slow eye movements alone. Particularly at high frequencies (i.e., high speed rotations), saccades were responsible for most of the modulation of torsional and vertical eye position, which was relatively large (on average +/- 8-10 degrees/g) and remained independent of frequency. Such reflex dynamics can be simulated by a direct coupling of primary otolith afferent inputs to the oculomotor plant. (ABSTRACT TRUNCATED)     

Gaze stabilization by optokinetic reflex (OKR) and vestibulo-ocular reflex (VOR) during active head rotation in man

Vestibulo-ocular reflex (VOR)-optokinetic reflex (OKR) interaction was studied in normal human subjects during active sine-like head movements in the horizontal plane for a variety of vestibular-optokinetic stimulus combinations (frequency range, 0.05-1.6 Hz). At low to mid frequencies (< 0.2 Hz) the eyes tended to be stabilized on the optokinetic pattern, independently of whether the head, the pattern, or both were rotated. At higher frequencies, the OKR gain was attenuated and, in each of the differing stimulus combinations, the eyes became increasingly stabilized in space. Qualitatively similar results were obtained when, for the same visual-vestibular combinations, the head was passively rotated at 0.05 and 0.8 Hz. The data could be simulated by a model which assumes a linear interaction of vestibular and optokinetic signals. It considers the OKR with its negative feedback loop of primordial importance for image stabilization on the retina and the VOR only as a useful addition which compensates for the limited bandwidth of the OKR during high frequency/velocity head rotations in a stationary visual environment.     

Combined eye-head gaze shifts produced by electrical stimulation of the superior colliculus in rhesus monkeys

1. We electrically stimulated the intermediate and deep layers of the superior colliculus (SC) in two rhesus macaques free to move their heads both vertically and horizontally (head unrestrained). Stimulation of the primate SC can elicit high-velocity, combined, eye-head gaze shifts that are similar to visually guided gaze shifts of comparable amplitude and direction. The amplitude of gaze shifts produced by collicular stimulation depends on the site of stimulation and on the parameters of stimulation (frequency, current, and duration of the stimulation train). 2. The maximal amplitude gaze shifts, produced by electrical stimulation at 56 sites in the SC of two rhesus monkeys, ranged in amplitude from approximately 7 to approximately 80 deg. Because the head was unrestrained, stimulation-induced gaze shifts often included movements of the head. Head movements produced at the 56 stimulation sites ranged in amplitude from 0 to approximately 70 deg. 3. The relationships between peak velocity and amplitude and between duration and amplitude of stimulation-induced head movements and gaze shifts were comparable with the relationships observed during visually guided gaze shifts. The relative contributions of the eyes and head to visually guided and stimulation-induced gaze shifts were also similar. 4. As was true for visually guided gaze shifts, the head contribution to stimulation-induced gaze shifts depended on the position of the eyes relative to the head at the onset of stimulation. When the eyes were deviated in the direction of the ensuing gaze shift, the head contribution increased and the latency to head movement onset was decreased. 5. We systematically altered the duration of stimulation trains (10-400 ms) while stimulation frequency and current remained constant. Increases in stimulation duration systematically increased the amplitude of the evoked gaze shift until a site specific maximal amplitude was reached. Further increases in stimulation duration did not increase gaze amplitude. There was a high correlation between the end of the stimulation train and the end of the evoked gaze shift for movements smaller than the site-specific maximal amplitude. 6. Unlike the effects of stimulation duration on gaze amplitude, the amplitude and duration of evoked head movements did not saturate for the range of durations tested (10-400 ms), but continued to increase linearly with increases in stimulation duration. 7. The frequency of stimulation was systematically varied (range: 63-1,000 Hz) while other stimulation parameters remained constant. The velocity of evoked gaze shifts was related to the frequency of stimulation; higher stimulation frequencies resulted in higher peak velocities. The maximal, site-specific amplitude was independent of stimulation frequency. 8. When stimulating a single collicular site using identical stimulation parameters, the amplitude and direction of stimulation-induced gaze shifts, initiated from different initial positions, were relatively constant. In contrast, the amplitude and direction of the eye component of these fixed vector gaze shifts depended upon the initial position of the eyes in the orbits; the endpoints of the eye movements converged on an orbital region, or "goal," that depended on the site of collicular stimulation. 9. When identical stimulation parameters were used and when the eyes were centered initially in the orbits, the gaze shifts produced by caudal collicular stimulation when the head was restrained were typically smaller than those evoked from the same site when the head was unrestrained. This attenuation occurred because stimulation drove the eyes to approximately the same orbital position when the head was restrained or unrestrained. Thus movements produced when the head was restrained were reduced in amplitude by approximately the amount that the head would have contributed if free to move. 10. When the head was restrained, only the eye component of the intended gaze shift     

Reopening of macular holes after initially successful repair

OBJECTIVE: To evaluate the frequency and prognosis of reopening of a macular hole after initially successful repair in a defined patient cohort. DESIGN: Retrospective consecutive noncomparative case series. PARTICIPANTS: Seventeen cases of reopened macular holes among 390 cases of idiopathic macular holes that previously had undergone macular hole surgery were studied. MAIN OUTCOME MEASURES: Assessment of demographics, visual acuity, preoperatively, postoperatively, after reopening of macular hole and after reoperation, if applicable, and precipitating factors. RESULTS: There were 17 (4.8%) of 353 cases in which the macular hole reopened after initial successful surgical closure. The mean visual acuity before reopening was 20/48 and was 20/133 after reopening. Twelve eyes underwent reoperation with improvement to a mean visual acuity of 20/54. The five eyes that were not reoperated on maintained a mean visual acuity of 20/200. Ten of the eyes had undergone cataract surgery between macular hole surgeries, but in only one did the reopening appear to occur in association with this procedure. CONCLUSIONS: Reopening of a previously successfully operated macular hole is uncommon and seems to be a spontaneous event. Reoperation generally yields results similar to those present before the reopening. Reopening of a macular hole associated with cataract surgery is rare.     

Vestibulo-ocular reflex function as measured with the head autorotation test

The vestibulo-ocular reflex (VOR) of 125 healthy subjects was examined over the frequency range of 0.5-5 Hz with the head autorotation test (HART). During the HART the subjects fixated at a steady target while moving their heads horizontally from side to side with increasing frequencies according to auditory signals. The gain was determined as the ratio between the amplitude of the eye and head movements in five frequency bands between 0.5 and 5 Hz. The phase difference between the eye and head movements was determined in both degrees and milliseconds. The ability to reach high-frequency bands was evaluated. The mean gain was close to unity up 5 Hz, when it decreased to 0.91. The mean phase difference showed a lead of approximately 5 degrees at frequencies below 2 Hz, and at frequencies above 2 Hz there was no phase difference within the resolution of the test. The frequency band of 5 Hz was reached by 78% of the subjects, and that of 4 Hz was reached by 94% of the subjects. In summary, the HART is a new approach with which to study VOR function and determine accurately the VOR for healthy subjects. The normal upper frequency limit is 4 Hz in the HART.     

Hyperopia correction by noncontact holmium:YAG laser thermal keratoplasty: U.S. phase IIA clinical study with 2-year follow-up

PURPOSE: This study was performed to determine the long-term efficacy, safety, and stability of noncontact holmium:yttrium aluminum garnet (Ho:YAG) laser thermal keratoplasty (LTK) for correction of low-to-moderate hyperopia. METHODS: The authors treated 1 eye each of 28 patients for correction of low-to-moderate hyperopia (up to +3.88 diopters [D] refractive error) using the Sun 1000 Corneal Shaping System (Sunrise Technologies, Inc., Fremont, CA). Treatments were performed with one or two rings of eight spots per ring with centerline diameters of 6 mm (one ring) or 6 and 7 mm (two rings), ten pulses of laser light at 5-Hz pulse repetition frequency, and pulse energies ranging from 208 to 242 mJ. Follow-up was 2 years. RESULTS: At 2 years after surgery, uncorrected distance visual acuity was improved by 1 or more lines of Snellen visual acuity in 19 (73%) of 26 of the treated eyes. The mean lines gained was 2.5 +/- 2.2/3.3 +/- 2.7 for one- and two-ring treatment groups, respectively. The mean change in spherical equivalent of the subjective manifest refraction was -0.53 +/- 0.33 D/-1.48 +/- 0.58 D for one- and two-ring treatment groups. Regression between 1 and 2 years was 0.01 D and 0.16 D, respectively. In the one-ring treatment group (18 eyes), 13 eyes (72%) had refractive corrections (range, -0.38 to -1.13 D), and 5 eyes (29%) were unchanged (within +0.25 D) relative to their preoperative measurements. In the two-ring treatment group, all eight eyes (100%) had reductions in their hyperopia (range of corrections, -0.38 to -2.25 D). None of the eyes lost two or more lines of spectacle-corrected distance visual acuity. There were no sight-threatening complications. CONCLUSIONS: This initial U.S. clinical study indicates that noncontact laser thermal keratoplasty treatment of low hyperopia is safe and produces modest but persistent corrections with 2-year follow-up. Expanded studies of this treatment method are warranted.     

Functional cortico-muscular coupling during upright standing in athletes and nonathletes: A coherence electroencephalographic-electromyographic study.

We tested the hypothesis that functional cortico-muscular coupling of brain rhythms is implied in the control of lower limb muscles for upright standing. Electroencephalographic (EEG; Be-plus Eb-Neuro) and electromyographic (EMG) data were recorded in 18 fencing and 19 karate elite athletes, 14 karate amateurs, and 9 non-athletes, during quiet upright standing with open and closed eyes conditions. Cortico-muscular coupling was evaluated by computing EEG-EMG spectral coherence and directed transfer function (DTF). Body sway area did not differ among the groups. In non-athletes, the EEG-EMG coherence (gastrocnemius lateralis) at centro-parietal and parasylvian alpha rhythms (about 8-12 Hz) was higher during the open than closed eyes condition. This was not true in the elite athletes. At the same alpha rhythms, the sport amateurs presented values halfway between the non-athletes and elite athletes. Finally, the DTF was higher for cortico-muscular than muscular-cortical direction. These results suggest that visual information affects cortico-muscular coherence at 8-12 Hz in non-athletes and amateur athletes but not in elite athletes. In elite athletes, this might be due to a long training for the control of equilibrium based on proprioceptive and tactile inputs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Human vestibuloocular reflex and its interactions with vision and fixation distance during linear and angular head movement

Human vestibuloocular reflex and its interactions with vision and fixation distance during linear and angular head movement. J. Neurophysiol. 80: 2391-2404, 1998. The vestibuloocular reflex (VOR) maintains visual image stability by generating eye movements that compensate for both angular (AVOR) and linear (LVOR) head movements, typically in concert with visual following mechanisms. The VORs are generally modulated by the "context" in which head movements are made. Three contextual influences on VOR performance were studied during passive head translations and rotations over a range of frequencies (0.5-4 Hz) that emphasized shifting dynamics in the VORs and visual following, primarily smooth pursuit. First, the dynamic characteristics of head movements themselves ("stimulus context") influence the VORs. Both the AVOR and LVOR operate with high-pass characteristics relative to a head velocity input, although the cutoff frequency of the AVOR (<0.1 Hz) is far below that of the LVOR ( approximately 1 Hz), and both perform well at high frequencies that exceed, but complement, the capabilities of smooth pursuit. Second, the LVOR and AVOR are modulated by fixation distance, implemented with a signal related to binocular vergence angle ("fixation context"). The effect was quantified by analyzing the response during each trial as a linear relationship between LVOR sensitivity (in deg/cm), or AVOR gain, and vergence (in m-1) to yield a slope (vergence influence) and an intercept (response at 0 vergence). Fixation distance (vergence) was modulated by presenting targets at different distances. The response slope rises with increasing frequency, but much more so for the LVOR than the AVOR, and reflects a positive relationship for all but the lowest stimulus frequencies in the AVOR. A third influence is the context of real and imagined targets on the VORs ("visual context"). This was studied in two ways-when targets were either earth-fixed to allow visual enhancement of the VOR or head-fixed to permit visual suppression. The VORs were assessed by extinguishing targets for brief periods while subjects continued to "fixate" them in darkness. The influences of real and imagined targets were most robust at lower frequencies, declining as stimulus frequency increased. The effects were nearly gone at 4 Hz. These properties were equivalent for the LVOR and AVOR and imply that the influences of real and imagined targets on the VORs generally follow low-pass and pursuit-like dynamics. The influence of imagined targets accounts for roughly one-third of the influence of real targets on the VORs at 0.5 Hz.     

Plasmin enzyme-assisted vitrectomy in traumatic pediatric macular holes

OBJECTIVE: This study aimed to evaluate the benefit of plasmin enzyme-assisted macular hole surgery on a consecutive series of pediatric patients with traumatic macular holes. DESIGN: Prospective noncomparative case series operated on at William Beaumont Hospital between July 13, 1996, and November 16, 1996, and observed for at least 6 months. PARTICIPANTS: During this interval, the authors operated on four eyes from four consecutive patients who were 14 years of age or younger with traumatic macular holes. INTERVENTION: The patients underwent plasmin enzyme-assisted pars plana vitrectomy with membrane peeling, fluid-gas exchange, and postoperative positioning. The enzyme used was 0.4 international unit (IU) of autologous plasmin enzyme. MAIN OUTCOME MEASURES: Snellen lines of improvement in visual acuity and rate of final visual acuity of 20/40 or greater, and incidence of complications and reoperations were measured. RESULTS: All four macular holes were closed successfully. Follow-up was from 6 to 12 months. There were no reoperations. Visual acuity improved from four to eight lines in all eyes. Three eyes (75%) achieved a postoperative visual acuity of 20/40 or better. Three eyes (75%) had transient, posterior, subcapsular cataracts develop: two of the eyes after surgery and one as a result of the initial injury. CONCLUSION: The treatment of pediatric traumatic macular holes with plasmin enzyme-assisted vitrectomy, membrane peeling, and gas-fluid exchange resulted in closure of the macular holes with significant visual improvement.     

Optimization of preparation of mitochondria from 25-100 mg skeletal muscle

We measured the gain and phase of vertical vergence in response to disjunctive vertical oscillations of dichoptic textured displays. The texture elements were m-scaled to equate visibility over the area of the display and were aperiodic and varied in shape so as to avoid spurious binocular matches. The display subtended 65 degrees and oscillated through peak-to-peak amplitudes from 18 arc min to 4 degrees at frequencies from 0.05 to 2 Hz - larger ranges than used in previous investigations. The gain of vergence was near 1 when the stimulus oscillated at 18 arc min at a frequency of 0.1 Hz or less. As the amplitude of stimulus oscillation increased from 18 arc min to 4 degrees, vergence gain decreased at all frequencies, which is evidence of a nonlinearity. Gain declined with increasing stimulus frequency but was still about 0.5 at 2 Hz for an amplitude of 18 arc min. Phase lag increased from less than 10 degrees at a stimulus frequency of 0.05 Hz to between 100 degrees and 145 degrees at 2 Hz. Overall, the dynamics of vertical vergence resemble the dynamics of horizontal vergence and cyclovergence.     

Topography of diabetic macular edema with optical coherence tomography

OBJECTIVE: This study aimed to develop a protocol to screen and monitor patients with diabetic macular thickening using optical coherence tomography (OCT), a technique for high-resolution cross-sectional imaging of the retina. DESIGN: A cross-sectional pilot study was conducted. PARTICIPANTS: A total of 182 eyes of 107 patients with diabetic retinopathy, 55 eyes from 31 patients with diabetes but no ophthalmoscopic evidence of retinopathy, and 73 eyes from 41 healthy volunteers were studied. INTERVENTION: Six optical coherence tomograms were obtained in a radial spoke pattern centered on the fovea. Retinal thickness was computed automatically from each tomogram at a total of 600 locations throughout the macula. Macular thickness was displayed geographically as a false-color topographic map and was reported numerically as averages in each of nine regions. MAIN OUTCOME MEASURES: Correlation of OCT with slit-lamp biomicroscopy, fluorescein angiography, and visual acuity was measured. RESULTS: Optical coherence tomography was able to quantify the development and resolution of both foveal and extrafoveal macular thickening. The mean +/- standard deviation foveal thickness was 174 +/- 18 microns in normal eyes, 179 +/- 17 microns in diabetic eyes without retinopathy, and 256 +/- 114 microns in eyes with nonproliferative diabetic retinopathy. Foveal thickness was highly correlated among left and right eyes of normal eyes (mean +/- standard deviation difference of 6 +/- 9 microns). Foveal thickness measured by OCT correlated with visual acuity (r2 = 0.79). A single diabetic eye with no slit-lamp evidence of retinopathy showed abnormal foveal thickening on OCT. CONCLUSIONS: Optical coherence tomography was a useful technique for quantifying macular thickness in patients with diabetic macular edema. The topographic mapping protocol provided geographic information on macular thickness that was intuitive and objective.     

Correlation of pituitary hormones in serum of male patients with fertility problems

The advent of the excimer laser has brought about the potential for improved vision in many individuals with myopia and astigmatism. However, photoastigmatic refractive keratectomy (PARK) remains a matter of controversy. The purpose of our study was to determine the predictability of VISX 20/20 excimer laser photorefractive keratectomy in the treatment of myopic astigmatism. PATIENTS AND METHODS: Our study comprised 31 eyes of 22 patients with myopic astigmatism. All patients underwent treatment with a VISX 20/20 excimer laser and were followed up for 6 months. Complete 12-month follow-up data were available from 18 eyes. Park was performed in eyes with myopia between -1.5 and -10.0 D and with astigmatism between -0.5 and -5.5 D. Thus, the corresponding spherical equivalent ranged from -1.75 to -10.5 D. RESULTS: Six months postoperatively, 21/31 (62%) eyes were within +/- 1.0 D of the target refraction and 13/31 (42%) within +/- 0.5 D of the target refraction. In 13 of 15 eyes (87%) with myopia less than -6.0 D, an uncorrected visual acuity of at least 0.8 was noted. In eyes with myopia greater than -6.0 D, 9/16 (56%) showed an uncorrected visual acuity of at least 0.5. Six months after PARK, an increase of one line on the Snellen Visual Acuity Chart was observed in 8/31 (26%) and an increase of two lines was noted in eyes 3/31 (10%). One of 31 eyes (3%) showed an increase of three lines. A decrease in visual acuity of 1 line on the Snellen Visual Acuity Chart was found in 4/31 (13%), and in 3/31 eyes (10%) a decrease of 2-4 lines was noted. Overall, we observed a statistically significant reduction of astigmatism from 1.93 +/- 1.43 D to 0.93 +/- 0.63 D. Reduction of corneal astigmatism less than -1.25 D was not statistically significant. In eyes with astigmatism ranging from -1.25 to -2.5 D or greater than -2.75 D, a significant reduction of the mean astigmatism was noted. The postoperative regression of astigmatic correction was low. However, an axis shift of more than 15 degrees was found in 42%/35% of eyes by subjective refraction (miosis/cycloplegia) and in 33% in corneal topography. No central islands were noted. CONCLUSION: Photoastigmatic refractive keratectomy (PARK) constitutes a potential means of correcting myopic astigmatism. In eyes with astigmatism greater than -1.0 D a significant reduction of 60% of the mean astigmatism was noted. However, the considerable proportion of eyes with a postoperative axis shift greater than 15 degrees and a decrease in visual acuity of two or more lines indicates that further research is needed on excimer laser surgery to improve the reliability and safety.     

Workplace smoking policies in the United States: results from a national survey of more than 100,000 workers

To investigate the activity of cortical regions in the control of movement, we studied event-related desynchronization/synchronization (ERD/ERS), event-related coherence (ERC), and phase coherence in 29-channel EEGs from 9 subjects performing self-paced movements of the right index finger. Movement preparation and execution produced ERD over the sensorimotor areas at 10 Hz and 20 Hz, followed by ERS. ERD corresponded spatiotemporally to an increase in coherence over the frontocentral areas. For both frequency bands, ERD began over the left sensorimotor areas and became bilateral at the time of movement onset. The coherence increase with frontal areas began in the left central areas and became symmetrical after EMG onset. The ERD and coherence increase was longer at 10 Hz than at 20 Hz. Phase coherence at 10 Hz showed a lead of anterior regions to posterior regions throughout the time period, and at 20 Hz showed a tendency toward zero phase delay corresponding with the movement. EEG desynchronization parallels functional coupling over sensorimotor and frontal areas. Event-related coherence and phase coherence findings implicate the frontal lobes in control of movement planning and execution. The involvement of different frequency bands with different timings may represent parallel changes in the cortical network.     

The results of vitreous surgery for chronic macular holes

PURPOSE: To evaluate the visual and anatomic results of macular hole surgery in eyes that have had symptoms of a macular hole for 2 years or longer. METHODS: Fifty-one eyes with chronic macular holes (> or = 2 years' duration) were treated in a retrospective analysis of the results of vitrectomy, 16% perfluoropropane gas tamponade, and one of three adjunctive agents (bovine transforming growth factor beta-2, recombinant transforming growth factor beta-2, or autologous platelet extract). Of 51 eyes, 45 (88.2%) were examined 3 months after surgery. Visual acuity of these 45 eyes was measured preoperatively and 3 months postoperatively using the Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity chart. Twenty-eight eyes (62.2%) had no prior vitrectomy and 17 eyes (37.8%) had a prior vitrectomy for the macular hole that failed. RESULTS: The macular holes had a mean duration of 3.7 years and were successfully closed in 32 of 51 total eyes (62.7%) and 32 of 45 eyes (71.1%) that were examined 3 months after surgery. The mean preoperative visual acuity was 20/100 -2 and the mean visual acuity at 3 months was 20/80 for a mean gain of 6.6 ETDRS letters (+ 1.3 lines). Of 45 eyes, 17 (37.8%) were 20/63 or better 3 months after surgery; 21 (46.7%) gained 2 or more ETDRS lines. There was no statistically significant difference in macular hole closure (P = 0.311) or visual acuity change (P = 0.095) in eyes with or without prior vitreous surgery. Eyes with macular holes between 2-2.99 years experienced a somewhat better anatomic and functional result overall than eyes with macular hole from 3-14 years, duration, but the visual acuity change was not statistically significant (P = 0.187). There was substantial variability in visual improvement among eyes with successful closure of the chronic macular hole. CONCLUSIONS: Macular holes of > or = 2 years' duration may be more difficult to close successfully than are more recent macular holes, and the visual improvement appears to be less favorable. Many eyes with chronic macular holes in our study gained substantial visual acuity, so vitreous surgery can be considered in selected eyes with chronic macular holes based on visual needs.     

Clear lensectomy and implantation of a low-power posterior chamber intraocular lens for correction of high myopia: a four-year follow-up

PURPOSE: To evaluate the 4-year postoperative outcomes of patients who are highly myopic who underwent clear lensectomy via phacoemulsification and low power posterior chamber intraocular lens implantation. METHODS: The authors performed surgery in 52 eyes of 30 patients in which prophylactic retinal treatment, clear lensectomy, and posterior chamber intraocular lens implantation were used to treat high myopia of 12 diopters (D) or greater. A total of 49 eyes of 28 patients were evaluated at the 4-year postoperative timeframe. Visual acuity, complications, and refractive stability were assessed. RESULTS: The incidence of retinal detachment through 4 years was 1.9%. No new macular complications were observed. Two patients had posterior vitreous detachment without clinical impact between 1 and 4 years after surgery. The incidence of neodymium:YAG (Nd:YAG) capsulotomy was 36.7%. The mean postoperative spherical equivalent was -0.92 D. Four patients had a myopic shift of 0.50 D to 1.00 D from the 1- to 4-year timeframe. Corrected visual acuity of 20/40 or better was achieved in 82% of eyes that had undergone Nd:YAG capsulotomy versus 56% of untreated eyes. Uncorrected visual acuity of 20/100 or better was achieved in 82% of eyes treated with the Nd:YAG laser versus 62% of untreated eyes. CONCLUSION: Visual acuity and refractive outcomes with clear lensectomy are favorable. Retinal detachment remains the major concern of this procedure. Continuous follow-up of these patients is necessary.     

Standing on a continuously moving platform: is body inertia counteracted or exploited?

We describe the characteristics of displacement of the head and hip in normal young subjects standing on a moving platform undergoing continuous sinusoidal horizontal translation in the antero-posterior direction, at frequencies ranging from 0.1-1 Hz. The head, hip and malleolus were marked by light-emitting diodes (LEDs), and the displacement of each LED was quantified by (1) the measure of the shift during each cycle of translation, (2) the standard deviation (SD) of the path travelled during the whole trial, (3) the power spectrum (PS) of the signal and (4) the cross-correlation (CC) between pairs of LED signals. At each frequency of translation, with eyes open (EO), the displacement of head was smaller than that of hip, and the displacement of hip was smaller than that of malleolus. With eyes closed (EC), this order was reversed. The peak value of the CC functions of the pairs malleolus/head, malleolus/hip and hip/head decreased by passing from low to high frequency of translation, under both visual conditions, and decreased more for the pair malleolus/head than malleolus/hip. The lags between body segment displacements ranged between 30 ms and 150 ms, on average, the former segment of each pair preceding the latter. The fast Fourier transformation of hip and head displacement showed a power spectrum peak at the frequency imposed by the platform translation. The peak was larger with EC than EO. With EC, another peak appeared at 0.2 Hz, possibly corresponding to the respiratory frequency. We conclude that, when vision was allowed, subjects behaved as a non-rigid, noninverted pendulum, and stabilised head in space. When vision was denied, head oscillated more than the platform, especially at low translation frequencies. Therefore, the strategy of balance control shifted from a pendulum to an inverted-pendulum behaviour, passing from active head-and-trunk control to maximal body compliance to the perturbation.     

Stimulus duration, neural adaptation, and sweep visual evoked potential acuity estimates

PURPOSE: Results in several studies have suggested that the visual evoked potential (VEP) amplitude can vary with stimulus duration. The purpose of this study was to determine whether acuity estimates obtained by extrapolation of the sweep VEP are altered by this adaptation effect. METHODS: Sweep VEP data were obtained from 16 healthy observers under binocular viewing conditions. Data were acquired with a commercially available VEP unit using standard electrode recording techniques. Three sweeps (high spatial frequencies, medium spatial frequencies, and low spatial frequencies) were run. The subjects' visual acuity at the monitor distance was 6/6 for the high spatial frequency sweep. For the medium and low spatial frequency sweeps, the subjects were dioptrically blurred to 6/15 (medium spatial frequencies) or 6/30 (low spatial frequencies) at the monitor distance. Each sweep consisted of six spatial frequencies (contrast 80%; temporal frequency (TF) = 7.5 Hz; screen luminance = 100 candela [cd]/m2). For each spatial frequency, the stimulus duration was 8 seconds, partitioned into 1-second bins. A minimum of eight sweeps were obtained per subject. An acuity estimate was obtained for each second's data by fitting a line to the high spatial frequencies (excluding noise) and extrapolating this line to the x-axis. With this technique, estimates could not be obtained for 29 of 384 possible acuities. RESULTS: The sweep VEP acuities for the 16 subjects did not change significantly over the 8 seconds of data collection for the high, medium, or low spatial frequency sweep (repeated measures analysis of variance [ANOVA]: high, P = 0.25; medium, P = 0.50; low, P = 0.23). In any given subject, there was a 1- to 2-octave range in acuity estimates over the 8 seconds of stimulus presentation (high, 1.23+/-0.417 octaves; medium, 1.41+/-0.593 octaves; low, 1.52+/-0.475 octaves; mean +/- SD). CONCLUSIONS: These results suggest that there is not a significant change in sweep VEP acuity estimates over an 8-second stimulus presentation. Thus, neural adaptation does not significantly affect the clinical use of the sweep VEP.