Background
Series of patients with SARS‐CoV‐2 infection report headache in 6%‐15% of cases, although some data suggest that the actual frequency is higher, and that headache is not associated with fever. No study published to date has analyzed the characteristics of headache in these patients.
Objective
To analyze the characteristics of COVID‐19 related headaches.
Methods
We conducted a survey of Spaniard healthcare professionals who have been infected by SARS‐CoV‐2 and presented headache during the course of the disease. The survey addressed respondents’ medical history and headache characteristics, and we analyzed the association between both.
Results
We analyzed the responses of a sample of 112 healthcare professionals. History of migraine was reported by 20/112 (17.9%) of respondents, history of tension‐type headache by 8/112 (7.1%), and history of cluster headache was reported by a single respondent; 82/112(73.2%) of respondents had no history of headache. Headache presented independently of fever, around the third day after symptom onset. The previous history of migraine was associated with a higher frequency of pulsating headache (20% in patients with previous migraine vs 4.3% in those with no history of migraine, P = .013).
Conclusion
Headache is often holocranial, hemicranial, or occipital, pressing, and worsens with physical activity or head movements. Because the characteristics of the headache and the associated symptoms are heterogeneous in our survey, we suggest that several patterns with specific pathophysiological mechanisms may underlie the headache associated with COVID‐19.
PurposeDevelop the first normative database of the thickness of every inner retinal layer in the macular area in a healthy, Caucasian population between 18 to 87 years old, using Spectralis Optical Coherence Tomography (OCT).MethodsOn this transversal, observational study, 300 patients between 18 to 87 years old and without an ophthalmological condition were recruited. Macular OCT scans were performed on all patients (Spectralis OCT, Heidelberg Engineering). An axial length measurement, and keratometry were performed using an optical biometer. The volume and thickness of the different macular sectors of the inner retinal layers (retinal nerve fiber layer (RNFL), ganglion cells layer (CGL) and inner plexiform layer (IPL)) were analyzed with the Spectralis OCT segmentation software. An eye was randomly selected for each patient.Results297 patients (179 females and 118 males) were included in the study. The mean age was 56.07 years (range: 40.50–72). The multivariate analysis showed a positive correlation between the RNFL thickness and the axial length (p < 0.001). The mean central retinal thickness was 278.2 μm (range: 266–291), the mean central RNFL thickness was 12.61 μm (range: 11–14), the mean central CGL thickness was 17.63 μm (range: 14–21) and the mean central IPL thickness was 22.02 μm (range: 20–25). The multivariate analysis showed a negative correlation between age and CGL thickness and inner IPL thickness (p< 0.001).ConclusionThis study provides a normative database of the volume of each of the inner retinal layers on a Caucasian population.
Malingering in children is very frequent. We can make the diagnosis with simple tests. It is not necessary to perform imaging and electrophysiologic testing, thus avoiding unnecessary examinations as well as absenteeism from work for parents and health care costs.
Purpose
Charles Bonnet syndrome (CBS) is a condition characterized by development of visual hallucinations in patients with no cognitive impairment and significant loss of vision mainly caused by age-related macular degeneration (AMD) or glaucoma.
Methods
This was a study of prevalence and characteristics of CBS diagnosed at the Neuroophthalmic Unit within the Ophthalmology Department of Hospital Clínico San Carlos (HCSC), Madrid, Spain.
Results
The CBS prevalence in patients from HCSC Madrid is 0.47%, rising to 15% in patients with low vision. Women over 80 years of age comprised 58.3% of the patients, who mainly had AMD (58.3%). Main characteristics of hallucinations included animals (50%), color (58.3%), moving (75%), 6- to 12-month evolution (50%), three times a day frequency (75%), and 3- to 5-minute duration (50%).
Conclusions
Charles Bonnet syndrome is a complex process that must be treated jointly by ophthalmologists, neurologists, and psychiatrists in order to ensure accurate diagnosis and adequate management. New studies are needed in order to improve awareness of clinical manifestation of this condition, the incidence of which is underestimated due to patients' fear of being branded mentally ill, as well as physicians' lack of knowledge about CBS.
Healthy subjects and glaucoma patients differ significantly in terms of mean overall corneal thickness and thicknesses of the corneal zones I to VI defined here. The variables mean corneal thickness and mean thicknesses of zones IV and VI are able to discriminate between subjects with or without glaucoma.
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