Kjellin syndrome: first case with retinal changes in carriers.
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Adult↗
Biomedical subjects
Frank A Proudlock
Publications and source records attributed to Frank A Proudlock.
A randomized controlled trial of unilateral strabismic and mixed amblyopia using occlusion dose monitors to record compliance.
PURPOSE: To investigate compliance with patching therapy and the dose-effect relationship in occlusion therapy in amblyopia by recording the effective patching time using occlusion dose monitors (ODMs). METHODS: Fifty-two children with strabismic or mixed amblyopia (Snellen equivalent, 6/12-6/48) were given optimal refractive correction and randomly allocated for 12 weeks into three treatment groups: group 1, no patching; group 2, prescribed patching for 3 hours; and group 3, prescribed patching for 6 hours. The effective time of occlusion was monitored with ODMs continuously. Visual acuity (VA) was measured every 3 weeks with LogMAR (logarithm of the minimum angle of resolution) Crowded Tests. RESULTS: In the 3- and 6-hour groups, mean (SD) compliance was 57.5% (30.8%) and 41.2% (30.9%), respectively, and mean effective patching time per day was 1 hour 43 minutes (55 minutes) and 2 hours 33 minutes (1 hour 52 minutes), respectively. The mean (SD) improvement in logMAR VA of amblyopic eyes was 0.24 (0.17), 0.29 (0.14), and 0.34 (0.19) in groups 1, 2, and 3, respectively. There was no significant difference in compliance with the prescribed patching between the 3- and 6-hour groups. VA outcomes in the 3- and 6-hour groups were not significantly better than 0-hour patching. However, the VA of patients with eyes effectively patched for more than 3 hours improved significantly. A dose-effect relationship was observed. Age at treatment did not influence the visual outcome. CONCLUSIONS: Poor compliance with prescribed occlusion explains discrepancies in previous studies. No differences in the effect between the different prescribed patching periods were found. The dose-effect relationship observed should encourage development of methods such as educational intervention to improve visual outcome by increasing effective patching time.
Amblyopia↗
Tremor in the human hand following peripheral nerve transection and reinnervation.
Slow movements and position holding by the digits are both characterised by 8-10 Hz tremor which appears to be centrally generated. Denervation and subsequent reinnervation lead to significant alterations in peripheral connectivity and reflex organisation. We have tested the hypothesis that 8-10 Hz tremor is present in the digits of subjects following a complete nerve lesion. The frequency content of abduction and adduction movements was recorded in 12 index fingers and nine little fingers reinnervated subsequent to a complete ulnar nerve transection. An optical position laser transducer was used to measure digital movements, minimising mechanical interference to the system. Concurrently, surface electromyograms (EMG) were also recorded from first dorsal interosseus muscles (1DI) and abductor digiti minimi brevis (ADMB) muscles for index and little fingers, respectively. The maximal voluntary contraction (MVC) of the reinnervated muscles varied from 5.9% to 100% of those of the unimpaired, contralateral hands. The subjects performed abduction-adduction movements of the index and little fingers and a position holding task. Significant peaks in PSD curves of acceleration and rectified integrated EMG traces were identified. Tremor in the 8-10 Hz range was evident in both the acceleration and EMG signals for the majority of digits during both the slow movement and position holding tasks. These findings demonstrate the robust nature of these 8-10 Hz oscillations, even following the significant changes in peripheral connectivity of muscle and nerve resulting from nerve transection and reinnervation.
Adult↗
Oscillopsia without nystagmus caused by head titubation in a patient with multiple sclerosis.
Oscillopsia in patients who have brain stem disorders but not nystagmus is attributed to a failure of the vestibular-ocular reflex (VOR) to compensate for head movements. We report a patient who had marked head titubation and oscillopsia in aggressive multiple sclerosis but no nystagmus. Her severe head titubation precluded our ability to measure a VOR accurately. Because oscillopsia has also been described after rapid voluntary head oscillations in normal subjects, we queried whether the oscillopsia in our patient could be ascribed to the head movement alone. Six normal control subjects did not experience oscillopsia while shaking their heads at the same frequency as the patient's titubation. We conclude that the oscillopsia in our patient was probably the result of an impaired VOR or an alternative compensatory mechanism.
Adult↗
Age-related changes in head and eye coordination.
The effect of ageing upon head movements during gaze shifts is unknown. We have investigated age-related changes in head and eye coordination in a group of healthy volunteers. Horizontal head and eye movements were recorded in 53 subjects, aged between 20 and 83 years, during the performance of saccades, antisaccades, smooth pursuit and a reading task. The subjects were divided into three groups, young subjects (20-40 years), middle-aged subjects (41-60 years) and older subjects (over 60 years). Logarithmic transformations of the head gain were significantly greater in the older subjects compared to the young subjects during the saccadic task (P=0.001), antisaccadic task (P=0.004), smooth pursuit at 20 degrees/s (P=0.001) and 40 degrees/s (P=0.005), but not reading. For saccadic and antisaccadic tasks, the increase in transformed head gain was non-linear with significant differences between older and middle-aged subjects but not middle-aged and young subjects. Head movement tendencies were highly consistent for related tasks. Head movement gain during gaze shifts significantly increases with age, which may contribute to dizziness and balance problems experienced by the elderly.
Adult↗