Individuals with and without normal tension glaucoma exhibit comparable performance on tests of cognitive function

AIM:To evaluate aspects of cognition impacted by individuals with and without normal tension glaucoma.METHODS:Fifty normal tension glaucoma(NTG)and 50 control patients≥50 y of age were recruited from the UCSF Department of Ophthalmology.Demographic data and glaucoma parameters were extracted from electronic medical records for both groups.Tests of executive function[Executive Abilities:Measures and Instruments for Neurobehavioral Evaluation and Research(EXAMINER)]and learning and memory[California Verbal Learning Test–Second Edition(CVLT-II)]were administered to both NTG and controls.Race,handedness,best-corrected visual acuity,maximum intraocular pressure,optic nerve cup-todisc ratio,visual field and optic nerve optical coherence tomography parameters,and a measure of general health(Charlson Comorbidity Index)were compared between NTG and controls as well as within NTG subgroups.Multivariate linear regression was used to compare group performances on the EXAMINER battery and CVLT-II while controlling for age,sex,and years of education.RESULTS:NTG and controls were comparable with respect to age,sex,race,education,handedness,and the Charlson Comorbidity Index(P>0.05 for all).Performance on the EXAMINER composite score and the CVLT-II did not differ between NTG and controls(P>0.05 for both).CONCLUSION:This is the first prospective study in which the cognitive function of subject with NTG were evaluated using a comprehensive,computerized neurocognitive battery.Subjects with NTG do not perform worse than unaffected controls on tests of executive function,learning,and memor y.Results do not suppor t the hypothesis that individuals with NTG are at higher risk for cognitive dysfunction and/or dementia.

Spatial distribution of leprosy in India:an ecological study

Background:As leprosy elimination becomes an increasingly realistic goal,it is essential to determine the factors that contribute to its persistence.We evaluate social and economic factors as predictors of leprosy annual new case detection rates within India,where the majority of leprosy cases occur.Methods:We used correlation and linear mixed effect regressions to assess whether poverty,illiteracy,nighttime satellite radiance(an index of development),and other covariates can explain district-wise annual new case detection rate and Grade 2 disability diagnoses.Results:We find only weak evidence of an association between poverty and annual new case detection rates at the district level,though illiteracy and satellite radiance are statistically significant predictors of leprosy at the district level.We find no evidence of rapid decline over the period 2008-2015 in either new case detection or new Grade 2 disability.Conclusions:Our findings suggest a somewhat higher rate of leprosy detection,on average,in poorer districts;the overall effect is weak.The divide between leprosy case detection and true incidence of clinical leprosy complicates these results,particularly given that the detection rate is likely disproportionately lower in impoverished settings.Additional information is needed to distinguish the determinants of leprosy case detection and transmission during the elimination epoch.