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At least 451 records · Page 25Linked to original sources

Management of traumatic optic neuropathy.

Visual loss caused by trauma to the optic nerve is a well-recognized sequela to cranio-maxillofacial trauma. The authors reviewed their experience with 90 patients with pure traumatic optic neuropathy and optic nerve trauma with concomitant maxillofacial injuries. All patients were treated with intravenous steroids. Those not improving underwent extracranial optic canal decompression. Patients with initial visual acuity of 20/100 or better all responded favorably with improvement in visual acuity or visual field to a course of intravenous megadose corticosteroids. Patients with initial vision of 20/200 or worse who failed to respond to corticosteroids may have improved visual function after undergoing extracranial optic canal decompression. Preoperative and postoperative computed tomography scans on 6 patients enhanced with intrathecal iopamidol indicate the site of optic nerve compression to be at the optic canal. This article discusses the diagnosis and the medical and surgical treatment of pure and complex optic nerve injuries.

Adult↗

[Orbital reconstruction with tabula externa for correction of post-traumatic enophthalmos].

In general the posttraumatic enophthalmos results from an enlargement of the orbit mainly in its dorsal part. The surgical correction must be performed in this particular part and calvarian bone grafts are very suitable for the procedure. In 20 patients the aesthetic appearance could significantly be approved. Anyhow functional aspects, mainly the binocular vision, must not be neglected.

Bone Transplantation↗

[Computer-based determination of red/green color vision defects].

A commonly used method of investigating colour vision, that is, the ability of the human visual system to discriminate colours, is based on the use of isochromatic colour plates, such as those used in the Ishihara test. The present paper describes a new computer-based method of determining red/green colour vision deficiencies. The method involves the presentation of Ishihara colour plates on a computer monitor. It has been verified experimentally that, despite the differences between the spectral emission of the computer screen and the daylight reflected by the Ishihara plates, the method is capable of distinguishing between subjects with from those without colour vision deficiencies. For screening purposes, the use of a reduced number of plates is suggested. This suggestion makes use of nine instead of 14 plates, and the criterion of two incorrectly recognized plates to determine a colour vision deficiency.

Adult↗

Bilateral posterior dislocation of the crystalline lens after a head injury sustained during a seizure.

This article presents a case of bilateral posterior dislocations of the crystalline lens in a patient with epilepsy who presented with reduced vision and anisocoria 2 weeks after having sustained head injuries during a seizure. The possibility of lens dislocation was raised only at this time, and subsequently confirmed on computed tomography. Such patients may require prompt referral to the ophthalmologist to treat complications such as functional aphakia, uveitis and more seriously pupillary block glaucoma. This case highlights the importance of ocular examination of head injuries to rule out possible ophthalmological pathology.

Emergencies↗

ACE16k: a 128x128 focal plane analog processor with digital I/O.

This paper presents a new generation 128x128 Focal-Plane Analog Programmable Array Processor -FPAPAP, from a system level perspective. It has been manufactured in a 0.35 microm standard digital 1P-5M CMOS technology. It has been designed to achieve the high-speed and moderate-accuracy -8b- requirements of most real time -early-vision applications. External data interchange and control are completely digital. The chip contains close to four million transistors, 90% of them working in analog mode. It achieves peak computing values of 0.33TeraOPS while keeping power consumption at reasonable limits -82.5GOPS/W. Preliminary experimental results are also provided in the paper.

Computers, Analog↗

3-D model of vascular network in rat skin obtained by stereo vision techniques.

The quantitative analysis of the depth of injury, penetration of therapeutic agents in tissues, and the regeneration of vascular patency after a graded degree of thermal injury requires a knowledge of the shape and spatial configuration of the vascular networks in the tissue. We have applied computational stereo vision techniques to describe the 3-D configuration of microvessels in full thickness rat skin vascular casts produced by perfusion of Yellow Microfil latex solution through the aorta. The principal concern is to describe the 3-D structure of vascular networks using a set of 3-D space curves. This representation is computed by integrating monocular and binocular processing; the 2-D curve representation of blood vessels computed through monocular analysis is integrated with disparity data to yield a space curve representation for each vessel. A connection diagram is also computed to indicate the connections existing among the computed space curve representations.

Algorithms↗

Changes in colour contrast sensitivity associated with operating argon lasers.

A new test of colour vision using computer graphics has been used to obtain quantitative estimates of colour contrast sensitivity in ophthalmologists before and after they have treated patients by argon laser retinal photocoagulation. The colour vision of all subjects is normal when tested with the 100-hue test and HRR (Hardy, Rittler, Rand) plates, but colour contrast sensitivity measured along a tritan colour confusion line is selectively impaired after a treatment session. No such change occurs after a medical session spent examining patients with a fundus camera. In younger ophthalmologists the sensitivity recovers several hours after the treatment session ends, but in some persons there is a prolonged and possibly permanent elevation of threshold.

Adult↗

Enterogenous cyst of the orbital apex and superior orbital fissure.

BACKGROUND: Enterogenous cysts of the central nervous system are rare congenital tumors with a single layer of mucin-secreting epithelial cells resembling gastrointestinal epithelium. The tumor is located most commonly at lower cervical and cervicothoracic spinal levels; only 22 intracranial cases have been reported. To the authors knowledge, this entity has not been described in the orbit. METHODS: A 23-year-old woman with painful loss of vision and ophthalmoplegia in the left eye was treated with oral and intravenous corticosteroids for presumed orbital inflammation. After a cystic lesion in the left orbital apex was demonstrated on computed tomographic scan and magnetic resonance imaging, various diagnoses, including optic nerve tumor, granulomatous inflammation, lymphoma, vascular anomaly, and pseudotumor, were considered until transcranial biopsy established the correct diagnosis. The tumor subsequently recurred twice. RESULTS: More than 3 years after the last recurrence, the patient has no pain but had unilateral optic atrophy, significant visual field loss, limited motility, and an anesthetic cornea in the left eye. CONCLUSION: The diagnosis of enterogenous cyst is difficult without adequate biopsy because the radiologic and clinical presentation of this rare tumor may be confused with other lesions. Previous attempts to explain intracranially placed enterogenous cysts offer no explanation for an orbital occurrence nor do they adequately describe a mechanism for an intracranial location in general. An embryologically based explanation that takes into account the occurrence of this entity from the caudal to rostral extent of the neuraxis is described. This theory suggests that the orbit is the most rostral possible location for an enterogenous cyst.

Adult↗

Orbital compartment syndrome caused by intraorbital bacitracin ointment after endoscopic sinus surgery.

PURPOSE: To present an unusual case of orbital compartment syndrome after endoscopic sinus surgery. METHODS: Case report. RESULTS: Acute proptosis, chemosis, decreased vision, and ophthalmoplegia were found immediately after endoscopic sinus surgery. Ophthalmologic evaluation showed a tense orbit, and intraocular pressure increased to 54 mm Hg. Treatment was initiated and the intraocular pressure dropped. Computed tomography (CT) revealed the presence of bacitracin ointment in the orbit. CONCLUSION: Ophthalmic complications after sinus surgery are well identified. Postoperative orbital compartment syndrome may be caused by retrobulbar hemorrhage, edema, air (emphysema), or foreign material. In this case, the findings were caused by inadvertent injection of bacitracin ointment into the orbit.

Aged↗

Visual object agnosia, prosopagnosia, achromatopsia, loss of visual imagery, and autobiographical amnesia following recovery from cortical blindness: case M.H.

A number of higher visual deficits accompanied by severe retrograde autobiographical memory loss following bilateral medial occipital infarctions are described in case M.H. Assessment of M.H.'s visual object agnosia and prospagnosia suggested that he was unable to integrate the elements of a percept to form a meaningful whole. This deficit may occur at the level the percept is encoded into the visual buffer and inspected. M.H. also describes a loss of visual memories, and it is hypothesized that this may similarly be a result of an inability to integrate the elements of the visual representation (e.g. of an object or face) following its generation from long-term visual memory store into the visual buffer. M.H.'s retrograde autobiographical memory loss is postulated to be a consequence of the severe impoverishment of episodic memories that must occur when events originally stored multimodally, must be recalled without any visual component.

Adult↗

Dysthyroid optic neuropathy. The crowded orbital apex syndrome.

The authors have reviewed the clinical presentation, visual fields, color vision testing, visual-evoked potentials, and computed tomographic (CT) findings of 58 patients (95 eyes) with dysthyroid optic neuropathy. The authors compared these findings to a control group of 60 patients (119 eyes) with thyroid eye disease who underwent CT scanning and did not exhibit evidence of optic neuropathy. Clinically, dysthyroid optic neuropathy is an insidious disease; when compared with the usual Graves' orbitopathy patient, the optic neuropathy group presented at a later age and with a later onset of thyroid eye disease. The patients in this group were more likely to be male and/or diabetic, and often presented with desaturation of color vision. Asymmetrical extraocular muscle restriction and vertical tropias were more frequent in the optic neuropathy group. The most sensitive indicators of optic nerve dysfunction appeared to be visual-evoked potentials and color vision. Computed tomographic studies confirmed that apical orbital crowding was a characteristic feature of optic neuropathy. These findings should alert the clinician to a more aggressive approach to these patients.

Adult↗

Normal vision despite narrowing of the optic canal in fibrous dysplasia.

BACKGROUND: Fibrous dysplasia of bone frequently involves the anterior base of the cranium and results in encasement of the optic-nerve canals. It has been assumed that such encasement leads to constriction and eventual blindness. There is controversy about whether patients should be regularly monitored or whether they should undergo prophylactic decompression of the optic nerve. This question is of particular concern in patients with normal vision, since the risks associated with surgical decompression include blindness. METHODS: We studied 38 patients with fibrous dysplasia of the lesser wing of the sphenoid bone. The patients underwent a detailed neuro-ophthalmologic examination and computed tomography of the face and skull, reformatted to measure the extent of involvement of the optic canal and the area of the canals. The results were compared with those of 38 age- and sex-matched controls. RESULTS: Of the 38 patients, 15 were male and 23 female, and their mean age was 26 years. Twelve had polyostotic fibrous dysplasia, and 26 had the McCune-Albright syndrome. Sixty-seven optic canals were affected by fibrous dysplasia; in 49 of them (73 percent) there was complete encasement. The mean (+/-SD) areas of the right and left canals were 9.6+/-3.8 mm2 and 9.9+/-3.6 mm2, respectively, in the patients, as compared with 12.0+/-2.9 mm2 and 11.9+/-2.7 mm2 in the controls (P=0.009 for the comparison of the right areas and P=0.03 for the comparison of the left areas by the paired t-test). In all but two of the patients, the results of neuro-ophthalmologic examination were normal. In the two patients with monocular visual impairment, the areas of the optic canals were similar on the normal and abnormal sides. CONCLUSIONS: Encasement of the optic canal in fibrous dysplasia causes narrowing of the canal, but that in itself does not result in visual loss. Therefore, prophylactic decompression of the optic nerve does not appear to be indicated on the basis of the presence of fibrous dysplasia on diagnostic images alone, since it does not correlate with visual loss.

Adolescent↗