The Visual System: Central Visual Pathways
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Symptoms of Age Related Macular Degeneration
WHAT IS MACULAR DEGENERATION? wavy or crooked, visual distortions, doorway and the choroid are interrupted causing waste or street signs seem bowed, or objects may deposits to form. Lacking proper nutrients, the light- Age related macular degeneration (AMD) is appear smaller or farther away than they sensitive cells of the macula become damaged. a disease that may either suddenly or gradually should, decrease in or loss of central vision, and The damaged cells can no longer send normal destroy the macula’s ability to maintain sharp, a central blurry spot. signals from the macula through the optic nerve to central vision. Interestingly, one’s peripheral or DRY: Progression with dry AMD is typically slower your brain, and consequently your vision becomes side vision remains unaffected. AMD is the leading de-gradation of central vision: need for increasingly blurred cause of “legal blindness” in the United States for bright illumination for reading or near work, diffi culty In either form of AMD, your vision may remain fi ne persons over 65 years of age. AMD is present in adapting to low levels of illumination, worsening blur in one eye up to several years even while the other approximately 10 percent of the population over of printed words, decreased intensity or brightness of eye’s vision has degraded. Most patients don’t the age of 52 and in up to 33 percent of individuals colors, diffi culty recognizing faces, gradual increase realize that one eye’s vision has been severely older than 75. The macula allows alone gives us the in the haziness of overall vision, and a profound drop reduced because your brain compensates the bad ability to have: sharp vision, clear vision, color vision, in your central vision acuity. -
Permeability of the Retina and RPE-Choroid-Sclera to Three Ophthalmic Drugs and the Associated Factors
pharmaceutics Article Permeability of the Retina and RPE-Choroid-Sclera to Three Ophthalmic Drugs and the Associated Factors Hyeong Min Kim 1,†, Hyounkoo Han 2,†, Hye Kyoung Hong 1, Ji Hyun Park 1, Kyu Hyung Park 1, Hyuncheol Kim 2,* and Se Joon Woo 1,* 1 Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea; [email protected] (H.M.K.); [email protected] (H.K.H.); [email protected] (J.H.P.); [email protected] (K.H.P.) 2 Department of Chemical and Biomolecular Engineering, Sogang University, Seoul 04107, Korea; [email protected] * Correspondence: [email protected] (H.K.); [email protected] (S.J.W.); Tel.: +82-2-705-8922 (H.K.); +82-31-787-7377 (S.J.W.); Fax: +82-2-3273-0331 (H.K.); +82-31-787-4057 (S.J.W.) † These authors contributed equally to this work. Abstract: In this study, Retina-RPE-Choroid-Sclera (RCS) and RPE-Choroid-Sclera (CS) were prepared by scraping them off neural retina, and using the Ussing chamber we measured the average time– concentration values in the acceptor chamber across five isolated rabbit tissues for each drug molecule. We determined the outward direction permeability of the RCS and CS and calculated the neural retina permeability. The permeability coefficients of RCS and CS were as follows: ganciclovir, 13.78 ± 5.82 and 23.22 ± 9.74; brimonidine, 15.34 ± 7.64 and 31.56 ± 12.46; bevacizumab, 0.0136 ± 0.0059 and 0.0612 ± 0.0264 (×10−6 cm/s). -
FUS-Mediated Functional Neuromodulation for Neurophysiologic Assessment in a Large Animal Model Wonhye Lee1*, Hyungmin Kim2, Stephanie D
Lee et al. Journal of Therapeutic Ultrasound 2015, 3(Suppl 1):O23 http://www.jtultrasound.com/content/3/S1/O23 ORALPRESENTATION Open Access FUS-mediated functional neuromodulation for neurophysiologic assessment in a large animal model Wonhye Lee1*, Hyungmin Kim2, Stephanie D. Lee1, Michael Y. Park1, Seung-Schik Yoo1 From Current and Future Applications of Focused Ultrasound 2014. 4th International Symposium Washington, D.C, USA. 12-16 October 2014 Background/introduction element FUS transducer with radius-of-curvature of Focused ultrasound (FUS) is gaining momentum as a 7 cm) was transcranially delivered to the unilateral sen- new modality of non-invasive neuromodulation of regio- sorimotor cortex, the optic radiation (WM tract) as well as nal brain activity, with both stimulatory and suppressive the visual cortex. An acoustic intensity of 1.4–15.5 W/cm2 potentials. The utilization of the method has largely Isppa, tone-burst-duration of 1 ms, pulse-repetition fre- been demonstrated in small animals. Considering the quency of 500 Hz (i.e. duty cycle of 50%), sonication dura- small size of the acoustic focus, having a diameter of tion of 300 ms, were used for the stimulation. A batch of only a few millimeters, FUS insonification to a larger continuous sonication ranging from 50 to 150 ms in dura- animal’s brain is conducive to examining the region- tion were also given. Evoked electromyogram responses specific neuromodulatory effects on discrete anatomical from the hind legs and electroencephalogram from the Fz areas, including the white matter (WM) tracts. The and Oz-equivalent sites were measured. The histology of study involving large animals would also establish preli- the extracted brain tissue (within one week and 2 months minary safety data prior to its translational research in post-sonication) was obtained. -
How Clean Is Your Capsule?
Eye (1989) 3, 678-684 How Clean is Your Capsule? W. T. GREEN and D. L. BOASE Portsmouth Summary Proliferation of residual lens epithelial cells is believed to be the major cause of pos terior capsule opacification following extracapsular cataract extraction. During sur gery these cells can be visualised with appropriate illumination facilitating their mechanical removal with the McIntyre cannula. When flat preparations of the anterior capsule are examined by light microscopy, the areas 'cleaned' of cells in this way appear transparent but scanning electron microscopy reveals tufts of remaining debris which may represent points of cellular attachment to the capsule. Control of lens epithelial cell proliferation is important for the future development of cataract surgery. The undoubted advantages of extracapsular and also on human cadaver eyes. A horizontal cataract extraction are offset in many patients capsulotomy in the upper part of the lens by posterior capsule opacification requiring allowed nucleus removal. Irrigation and caps ulotomy. Not only is this disappointing aspiration of the cortical lens material was for the patient, but the procedure carries a then carried out using a McIntyre cannula risk of serious complications. with Hartman's irrigation solution. During in The major cause of posterior capsule opac vitro surgery this was aided by first removing ification is proliferation of residual lens epi the entire cornea and iris to improve visual thelial cells. I If these cells could be removed at isation and explore different methods of the time of surgery we believe that the inci illumination. dence of posterior capsule opacification and The importance of illumination was first the need for subsequent capsulotomy would suspected when it was observed, during rou be reduced. -
Structure and Function of Visual Area MT
AR245-NE28-07 ARI 16 March 2005 1:3 V I E E W R S First published online as a Review in Advance on March 17, 2005 I E N C N A D V A Structure and Function of Visual Area MT Richard T. Born1 and David C. Bradley2 1Department of Neurobiology, Harvard Medical School, Boston, Massachusetts 02115-5701; email: [email protected] 2Department of Psychology, University of Chicago, Chicago, Illinois 60637; email: [email protected] Annu. Rev. Neurosci. Key Words 2005. 28:157–89 extrastriate, motion perception, center-surround antagonism, doi: 10.1146/ magnocellular, structure-from-motion, aperture problem by HARVARD COLLEGE on 04/14/05. For personal use only. annurev.neuro.26.041002.131052 Copyright c 2005 by Abstract Annual Reviews. All rights reserved The small visual area known as MT or V5 has played a major role in 0147-006X/05/0721- our understanding of the primate cerebral cortex. This area has been 0157$20.00 historically important in the concept of cortical processing streams and the idea that different visual areas constitute highly specialized Annu. Rev. Neurosci. 0.0:${article.fPage}-${article.lPage}. Downloaded from arjournals.annualreviews.org representations of visual information. MT has also proven to be a fer- tile culture dish—full of direction- and disparity-selective neurons— exploited by many labs to study the neural circuits underlying com- putations of motion and depth and to examine the relationship be- tween neural activity and perception. Here we attempt a synthetic overview of the rich literature on MT with the goal of answering the question, What does MT do? www.annualreviews.org · Structure and Function of Area MT 157 AR245-NE28-07 ARI 16 March 2005 1:3 pathway. -
Neuroanatomy Crash Course
Neuroanatomy Crash Course Jens Vikse ∙ Bendik Myhre ∙ Danielle Mellis Nilsson ∙ Karoline Hanevik Illustrated by: Peder Olai Skjeflo Holman Second edition October 2015 The autonomic nervous system ● Division of the autonomic nervous system …………....……………………………..………….…………... 2 ● Effects of parasympathetic and sympathetic stimulation…………………………...……...……………….. 2 ● Parasympathetic ganglia ……………………………………………………………...…………....………….. 4 Cranial nerves ● Cranial nerve reflexes ………………………………………………………………….…………..…………... 7 ● Olfactory nerve (CN I) ………………………………………………………………….…………..…………... 7 ● Optic nerve (CN II) ……………………………………………………………………..…………...………….. 7 ● Pupillary light reflex …………………………………………………………………….…………...………….. 7 ● Visual field defects ……………………………………………...................................…………..………….. 8 ● Eye dynamics …………………………………………………………………………...…………...………….. 8 ● Oculomotor nerve (CN III) ……………………………………………………………...…………..………….. 9 ● Trochlear nerve (CN IV) ………………………………………………………………..…………..………….. 9 ● Trigeminal nerve (CN V) ……………………………………………………................…………..………….. 9 ● Abducens nerve (CN VI) ………………………………………………………………..…………..………….. 9 ● Facial nerve (CN VII) …………………………………………………………………...…………..………….. 10 ● Vestibulocochlear nerve (CN VIII) …………………………………………………….…………...…………. 10 ● Glossopharyngeal nerve (CN IX) …………………………………………….……….…………...………….. 10 ● Vagus nerve (CN X) …………………………………………………………..………..…………...………….. 10 ● Accessory nerve (CN XI) ……………………………………………………...………..…………..………….. 11 ● Hypoglossal nerve (CN XII) …………………………………………………..………..…………...…………. -
Real Time Measurement and Processing of Pupillary Light Reflex for Early Detection of Disease
Journal of Computers Real Time Measurement and Processing of Pupillary Light Reflex for Early Detection of Disease Ippei Torii*, Takahito Niwa Aichi Institute of Technology, Dept. of Information Science, 1247 Yachigusa, Yakusa-cho, Toyota, Aichi, Japan. * Corresponding author. Tel.: 81-565-48-8121; email: mac[aitech.ac.jp Manuscript submitted January 10, 2019; accepted March 8, 2019. doi: 10.17706/jcp.14.3.161-169 Abstract: Recently, pupillary measurements have begun to be considered effective in the diagnosis of various physical conditions. Apart from optic neuropathy and retinal disorders, which are ocular diseases, diversions can be expected in the diagnosis of autonomic disturbance due to sympathetic and parasympathetic nerve disorders, cranial nerve disorders, cerebral infarction, depression, and diabetes. In this study, we have developed a real-time pupil diameter measuring system that is inexpensive and does not require a complicated device. When strong light is projected onto the eyeball, this system can measure the reaction time until the start of miosis, the time to achieve maximal miosis, and the difference in reaction speed of the left and right eyes. With this system, the status of a disease can be judged based on the distance from the threshold value. Key words: Real time measurement, eye movement, early detection of disease, image processing. 1. Introduction There are approximately one hundred million photoreceptor cells in the retina of human eyes. Light that shines on those cells is converted to nerve signals, which transmit the information to the brain, resulting in the visual recognition of objects. When light is radiated onto the eye, the pupillary light reflex is triggered, causing the pupillary diameter to decrease with a time delay of less than 1 sec. -
Visual Cortex in Humans 251
Author's personal copy Visual Cortex in Humans 251 Visual Cortex in Humans B A Wandell, S O Dumoulin, and A A Brewer, using fMRI, and we discuss the main features of the Stanford University, Stanford, CA, USA V1 map. We then summarize the positions and proper- ties of ten additional visual field maps. This represents ã 2009 Elsevier Ltd. All rights reserved. our current understanding of human visual field maps, although this remains an active field of investigation, with more maps likely to be discovered. Finally, we Human visua l cortex comprises 4–6 billion neurons that are organ ized into more than a dozen distinct describe theories about the functional purpose and functional areas. These areas include the gray matter organizing principles of these maps. in the occi pital lobe and extend into the temporal and parietal lobes . The locations of these areas in the The Size and Location of Human Visual intact human cortex can be identified by measuring Cortex visual field maps. The neurons within these areas have a variety of different stimulus response proper- The entirety of human cortex occupies a surface area 2 ties. We descr ibe how to measure these visual field on the order of 1000 cm and ranges between 2 and maps, their locations, and their overall organization. 4 mm in thickness. Each cubic millimeter of cortex contains approximately 50 000 neurons so that neo- We then consider how information about patterns, objects, color s, and motion is analyzed and repre- cortex in the two hemispheres contain on the order of sented in these maps. -
Sclera and Retina Suturing Techniques 9 Kirk H
Chapter 9 Sclera and Retina Suturing Techniques 9 Kirk H. Packo and Sohail J. Hasan Key Points 9. 1 Introduction Surgical Indications • Vitrectomy Discussion of ophthalmic microsurgical suturing tech- – Infusion line niques as they apply to retinal surgery warrants atten- – Sclerotomies tion to two main categories of operations: vitrectomy – Conjunctival closure and scleral buckling. Th is chapter reviews the surgical – Ancillary techniques indications, basic instrumentation, surgical tech- • Scleral buckles niques, and complications associated with suturing – Encircling bands techniques in vitrectomy and scleral buckle surgery. A – Meridional elements brief discussion of future advances in retinal surgery Instrumentation appears at the end of this chapter. • Vitrectomy – Instruments – Sutures 9.2 • Scleral buckles Surgical Indications – Instruments – Sutures Surgical Technique 9.2.1 • Vitrectomy Vitrectomy – Suturing the infusion line in place – Closing sclerotomies Typically, there are three indications for suturing dur- • Scleral buckles ing vitrectomy surgery: placement of the infusion can- – Rectus muscle fi xation sutures nula, closure of sclerotomy, and the conjunctival clo- – Suturing encircling elements to the sclera sure. A variety of ancillary suturing techniques may be – Suturing meridional elements to the sclera employed during vitrectomy, including the external – Closing sclerotomy drainage sites securing of a lens ring for contact lens visualization, • Closure of the conjunctiva placement of transconjunctival or scleral fi xation su- Complications tures to manipulate the eye, and transscleral suturing • General complications of dislocated intraocular lenses. Some suturing tech- – Break in sterile technique with suture nee- niques such as iris dilation sutures and transretinal su- dles tures in giant tear repairs have now been replaced with – Breaking sutures other non–suturing techniques, such as the use of per- – Inappropriate knot creation fl uorocarbon liquids. -
Structural Brain Abnormalities in Patients with Primary Open-Angle Glaucoma: a Study with 3T MR Imaging
Glaucoma Structural Brain Abnormalities in Patients with Primary Open-Angle Glaucoma: A Study with 3T MR Imaging Wei W. Chen,1–3 Ningli Wang,1,3 Suping Cai,3,4 Zhijia Fang,5 Man Yu,2 Qizhu Wu,5 Li Tang,2 Bo Guo,2 Yuliang Feng,2 Jost B. Jonas,6 Xiaoming Chen,2 Xuyang Liu,3,4 and Qiyong Gong5 PURPOSE. We examined changes of the central nervous system CONCLUSIONS. In patients with POAG, three-dimensional MRI in patients with advanced primary open-angle glaucoma revealed widespread abnormalities in the central nervous (POAG). system beyond the visual cortex. (Invest Ophthalmol Vis Sci. 2013;54:545–554) DOI:10.1167/iovs.12-9893 METHODS. The clinical observational study included 15 patients with bilateral advanced POAG and 15 healthy normal control subjects, matched for age and sex with the study group. Retinal rimary open angle glaucoma (POAG) has been defined nerve fiber layer (RNFL) thickness was measured by optical formerly by intraocular morphologic changes, such as coherence tomography (OCT). Using a 3-dimensional magne- P progressive retinal ganglion cell loss and defects in the retinal tization-prepared rapid gradient-echo sequence (3D–MP-RAGE) nerve fiber layer (RNFL), and by corresponding psychophysical of magnetic resonance imaging (MRI) and optimized voxel- abnormalities, such as visual field loss.1 Recent studies by based morphometry (VBM), we measured the cross-sectional various researchers, however, have suggested that the entire area of the optic nerve and optic chiasm, and the gray matter visual pathway may be involved in glaucoma.2–23 Findings from volume of the brain. -
The Pupillary Light Reflex in the Critically Ill Patient
light must be high for the iris to be seen, which reduces Editorials the step increase induced by the penlight).6 If the pupillary light reflex amplitude is less than 0.3 mm and the maximum constriction velocity is less than 1 mm/s, the reflex is unable to be detected using a The pupillary light reflex in penlight.6 In conscious patients with Holmes-Adie and Argyll-Robertson pupils with ‘absent’ pupillary light the critically ill patient reflexes, small light reflexes have been detected using infrared pupillometry.7 Also in post-resuscitation non- brain dead critically ill patients with ‘absent’ pupillary The pupillary response to light is controlled by the reflexes, the reflex has been demonstrated using a autonomic nervous system. The direct pupillary light portable infrared pupillometer.6 reflex refers to miosis that occurs in the stimulated eye; In this issue of Critical Care and Resuscitation, the consensual pupillary light reflex refers to miosis that Thomas8 describes a case of Guillain Barré syndrome occurs in the other eye. The reflex has a latent period presenting with weakness and fixed dilated pupils who with length of the period, amplitude of the response, and subsequently became ‘locked in’ with absence of any the speed of the pupillary constriction dependent on the clinical response to external stimuli. A positive brain intensity of the stimulus employed.1 For the reflex to be stem auditory evoked response was used to indicate truly tested, an intense stimulus and close observation normal brain stem function. In another recent report, a are required. The reflex has afferent, efferent and central case of ‘reversible fixed dilated pupils’ was associated connections; therefore non-response to light (i.e. -
Isolated Relative Afferent Pupillary Defect Secondary to Contralateral Midbrain Compression
OBSERVATION Isolated Relative Afferent Pupillary Defect Secondary to Contralateral Midbrain Compression Cheun Ju Chen, MD; Mia Scheufele, MD; Maushmi Sheth, MD; Amir Torabi, MD; Nick Hogan, MD, PhD; Elliot M. Frohman, MD, PhD Background: Relative afferent pupillary defects are typi- accounts for the relative afferent pupillary defect con- cally related to ipsilateral lesions within the anterior vi- tralateral to the described lesion. sual pathways. Result: Magnetic resonance imaging of the brain revealed a pineal tumor compressing the right rostral midbrain. Objective: To describe a patient who had a workup for headache and was found to have an isolated left relative Conclusion: While rare, a relative afferent pupillary de- afferent pupillary defect without any other neurological fect can occasionally occur secondary to lesions in the findings. postchiasmal pathways. In these circumstances, the pu- pillary defect will be observed to be contralateral to the Design: We review the neuroanatomy of the pupil- side of the lesion. lary light reflex pathway and emphasize the nasotem- poral bias of decussating fiber projections, which Arch Neurol. 2004;61:1451-1453 RELATIVE AFFERENT PUPIL- though retinal fibers concerned with this lary defect (RAPD) is char- reflex transmit information to both the ip- acterized by pupillary dila- silateral and contralateral midbrain, there tion upon illuminating the is a slight crossing bias, with about 53% of eye during the swinging the fibers crossing in the optic chiasm Aflashlight test. The presence of this sign sig- (chiefly derived from the nasal retina) and nifies an abnormality in the transmission 47% remaining ipsilateral. This anatomi- of light information within the pupillary cal organization of the pupillary constric- light constrictor pathway from the retina tor pathway results in the possibility of pro- to the rostral midbrain circuitry involved ducing an RAPD during illumination of the in this reflex.