Degraded visual and auditory input individually impair audiovisual emotion recognition from speech-like stimuli, but no evidence for an exacerbated effect from combined degradation

Emotion recognition requires optimal integration of the multisensory signals from vision and hearing. A sensory loss in either or both modalities can lead to changes in integration and related perceptual strategies. To investigate potential acute effects of combined impairments due to sensory information loss only, we degraded the visual and auditory information in audiovisual video-recordings, and presented these to a group of healthy young volunteers. These degradations intended to approximate some aspects of vision and hearing impairment in simulation. Other aspects, related to advanced age, potential health issues, but also long-term adaptation and cognitive compensation strategies, were not included in the simulations. Besides accuracy of emotion recognition, eye movements were recorded to capture perceptual strategies. Our data show that emotion recognition performance decreases when degraded visual and auditory information are presented in isolation, but simultaneously degrading both modalities does not exacerbate these isolated effects. Moreover, degrading the visual information strongly impacts recognition performance and on viewing behavior. In contrast, degrading auditory information alongside normal or degraded video had little (additional) effect on performance or gaze. Nevertheless, our results hold promise for visually impaired individuals, because the addition of any audio to any video greatly facilitates performance, even though adding audio does not completely compensate for the negative effects of video degradation. Additionally, observers modified their viewing behavior to degraded video in order to maximize their performance. Therefore, optimizing the hearing of visually impaired individuals and teaching them such optimized viewing behavior could be worthwhile endeavors for improving emotion recognition.

Central scotoma after indocyanine green assisted fovea-sparing internal limiting membrane peeling

Purpose

To report a case with myopic traction maculopathy (MTM) that underwent fovea-sparing internal limiting membrane (ILM) peeling and developed a central scotoma with a nasal visual field defect postoperatively.

Observations

A 63-year-old man diagnosed with foveoschisis and a small outer lamellar macular hole underwent 25-gauge, 3-port pars plana vitrectomy and fovea-sparing ILM peeling using indocyanine green (ICG) staining. One year after the vitrectomy, optical coherence tomography (OCT) revealed a resolution of the macular retinoschisis and an intact ellipsoid zone at the fovea. However, macular edema was present over the area of the residual ILM, and the visual acuity had worsened to 20/200. Goldmann perimetry showed a central scotoma and a constriction of the nasal visual field. OCT angiography detected abnormal blood flow in the inner retina corresponding to the area of the residual foveal ILM. The multifocal electroretinograms were reduced in the central area.

Conclusion

The findings suggest that functional abnormalities of the fovea induced by ICG toxicity may have been manifested by a central scotoma. Therefore, surgeons need to consider the toxic effects of dyes such as ICG.

Presumed mast cell choroidal infiltrate in aggressive systemic mastocytosis

Purpose

To report a rare case of a unilateral choroidal mast cell infiltration in a patient with aggressive systemic mastocytosis (ASM).

Observations

The patient is a man in his fifties with a diagnosis of ASM. He developed visual complaints in the right eye associated with an area of subretinal fluid on fundus examination. Visual acuity at presentation was 20/150 in the right eye and 20/25 in the left eye. After ophthalmic and radiologic imaging workup, the patient was diagnosed with presumed choroidal mast cell infiltrate. The index of suspicion was high due to the prior ASM diagnosis. External beam radiation and intravitreal injection treatments were offered but the patient declined. The patient was switched from interferon to a new targeted systemic therapy for ASM, midostaurin. Despite some mixed, temporary response in systemic symptoms/signs of ASM at four months, the choroidal lesion and subretinal fluid were stable with visual acuity at 20/125.

Conclusion and importance

Mast cell choroidal infiltration in ASM should be considered as part of the differential with acute/subacute vision changes. Diagnosis requires exclusion of other possibilities with ocular imaging and in this case, monitoring for development of other malignancies in which there were none. Midostaurin's ocular response was not on par with systemic response. Additional localized ocular therapies may be required.

Bilateral retinitis after influenza virus infection in a case report

Purpose

To report 2 years’ longitudinal retinal changes using spectral domain optical coherence tomography (SD-OCT) images in a case of retinitis after influenza virus infection.

Observations

A 48-year-old female complained of scotoma in the central visual field after influenza virus infection. Her best visual acuity was 20/16, her fundus examination was normal, and fluorescein angiography demonstrated no evident leakage in either the retina or the optic disc. However, SD-OCT images showed a disrupted, blurred inner-segment ellipsoid zone in the macula of both eyes. Two steroid pulse therapy sessions in the first 3 months showed temporary improvement of the central scotoma. However, atrophy of the photoreceptor layer at the juxta fovea gradually progressed in OCT images during the follow-up period. In contrast, the fovea itself was mostly intact and visual acuity was maintained in the 2-year period.

Conclusions and importance

We experienced a unique case of retinitis after influenza infection, in whom progressive atrophy of the photoreceptor layer was observed in SD-OCT images.

Dengue Stings the Eye!

Dengue is a vector borne viral fever and has varied ocular affections. We report two cases of Dengue Associated Maculopathy (DAM). The first patient was a 22-year-old lady with dengue fever, presented with diminution of vision in the left eye with best corrected visual acuity of 20/40. Fundus revealed soft exudates and streak haemorrhages at the macula in the left eye. Optical Coherence Tomography (OCT) showed cystoid macular oedema. She recovered completely within four days. The second patient was a 33-year-old lady with dengue, with blurred vision in the left eye and with a visual acuity of 20/80. Fundus examination in the left eye revealed elevated fovea with a yellow well circumscribed lesion with surrounding striations. OCT showed features suggestive of foveolitis. She improved spontaneously over the next 21 days to a visual acuity of 20/20p. DAM is usually a self-limiting condition with favourable prognosis. This report highlights the importance of anticipating visual morbidity in patients with dengue and a thorough evaluation and follow-up in spite of its benign behaviour. Also, this report highlights the importance of OCT in differentiating various presentations of DAM.

Clofazimine-induced premaculopathy in a vitiliginous patient

A 26-year-old male vitiliginous patient presented with decreased visual acuity because of a central scotoma in the left eye with no significant retinal changes on fundus examination. In this case report, a diagnosis of possible drug-induced premaculopathy was made, and the drugs were withdrawn. On the follow-up, after 3 months, the visual acuity in the left eye gradually improved. Early suspicion of drug-induced maculopathy and withdrawal of the drug may prevent the progression of maculopathy.