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This article presents an overview of information on macular degeneration for professionals who help persons with the disease adjust to their visual loss. It covers the types of macular degeneration, the etiology of the disease, and current treatment. In addition, it presents a composite case study, drawn from recent research, on the psychosocial problems and other difficulties that persons with age-related macular degeneration face.

Abdullah Kaya,1 Yakup Aksoy,2 Yıldıray Yildirim,3 Murat Sonmez3 1Department of Ophthalmology, Anittepe Military Dispensary, Ankara, Turkey; 2Department of Ophthalmology, Girne Military Hospital, Girne, Cyprus; 3Department of Ophthalmology, GATA Haydarpasa Training Hospital, Istanbul, TurkeyWe read with great interest the article titled "Value of optical coherence tomography in the detection of macular pathology before the removal of silicone oil" by Rashad et al.1 The authors have evaluated the optical coherence tomography (OCT) findings before the removal of silicone oil (SiO). We congratulate the authors for this well-organized study and would like to contribute to their findings.View original paper by Rashad and colleagues.

Understanding age-related macular degeneration
Tunde Peto, Professor of Clinical Ophthalmology at Queen's University Belfast, describes the symptoms, causes and treatments for age-related macular degeneration and how the prevalence of the disease could be reduced. Imagine living your life without being able to see the face of your loved ones, being able to read your phone, book a show, rebook a cancelled flight, or read the labels in the supermarket. Such tasks we do without giving these much thought until suddenly, one day, we realise that we cannot do them. Age-related macular degeneration (AMD) can lead to the loss of central vision, causing sight loss or even legal blindness. This disease is the most common cause of blindness in those over 65, (1) and while it is genetically driven in most cases, not everyone will get the disease, even if they are at risk. Its effect can be devastating, especially for those with multiple comorbidities, who have no immediate social support and for whom reading, writing, or watching television or the birds might have been the major contributor to maintaining good mental health.(2)

Age-related macular degeneration (AMD) is a major cause of disability in the elderly, substantially degrades the quality of their lives, and is a risk factor for depression. Rates of depression in AMD are substantially greater than those found in the general population of older people, and are on par with those of other chronic and disabling diseases. This article discusses the effect of depression on vision-related disability in patients with AMD, suggests methods for screening for depression, and summarizes interventions for preventing depression in this high-risk group.

Laser devices are widely used for medical, military, industrial and entertainment purposes. This extensive and unregulated use of lasers can cause a variety of maculopathies that can result in permanent vision loss. Uncontrolled and inappropriate use of laser instruments should be prevented with strict rules. We strongly emphasize the importance of changing the general misperception that lasers are safe to use for entertainment purposes. In this study we aim to report the clinical features of three patients with a history of maculopathy caused by exposure to laser light in an entertainment venue.

Age-related macular degeneration (AMD) leads to irreversible visual loss, therefore, early intervention is desirable, but due to its multifactorial nature, diagnosis of early disease might be challenging. Identification of early markers for disease development and progression is key for disease diagnosis. Suitable biomarkers can potentially provide opportunities for clinical intervention at a stage of the disease when irreversible changes are yet to take place. One of the most metabolically active tissues in the human body is the retina, making the use of hypothesis-free techniques, like metabolomics, to measure molecular changes in AMD appealing. Indeed, there is increasing evidence that metabolic dysfunction has an important role in the development and progression of AMD. Therefore, metabolomics appears to be an appropriate platform to investigate disease-associated biomarkers. In this review, we explored what is known about metabolic changes in the retina, in conjunction with the emerging literature in AMD metabolomics research. Methods for metabolic biomarker identification in the eye have also been discussed, including the use of tears, vitreous, and aqueous humor, as well as imaging methods, like fluorescence lifetime imaging, that could be translated into a clinical diagnostic tool with molecular level resolution. © 2019, MDPI AG. All rights reserved. ; Funding: This review article was supported by a Department for Education PhD studentship to C.N.B. and the Eye-Risk project funded by the European Union's Horizon 2020 research and innovation programme [634479]. ; https://dx.doi.org/10.3390/metabo9010004

O estudo da identidade cruzada tomou um novo impulso no país em 1997, depois da liberação, pelo Conselho Federal de Medicina, da ci­ rurgia de transgenitalização. Este trabalho tem co mo objetivo a análise de um transexual da cidade de Mirasso l, 30 anos e que tem sob sua guar­ da um menino de 7 anos. A análise do caso foi feita através de visitas domiciliares, entrevi stas individuais e familiares, realizadas pelo depar­ tamento de Psiquiatria e Psicologia Médica da Famerp de São José do Rio Preto. Foi possível verificar através do estudo que o presente caso apresenta os principais fundamentos teóricos do estudo da transexuali­ dade: isto é, a questão da identidade, da orientação sexual e dos papéis sócio-sexuais.

This article reviews the research literature on driving and age-related macular degeneration, which is motivated by the link between driving and the quality of life of older adults and their increased collision rate. It addresses the risk of crashes, driving performance, driving difficulty, self-regulation, and interventions to enhance, safety, and considers directions for future research.

This article describes longitudinally the psychosocial adjustment to visual impairment of patients with age related macular degeneration (AMD). As part of a larger randomized controlled trial (RCT), the present study design consisted of the use of prospective qualitative diaries completed over 12 months by patients with AMD who were newly referred to a low vision clinic. Out of the patients recruited (n = 226), the completion rate of a full set of four diaries (n = 37) and one three-month diary (n = 194) was very good. Vision related to daily life in patients with AMD appears to decline over 12 months with limited psychosocial adjustment to visual loss. Seven themes were generated from the patients' accounts of their experiences, as recorded in the diaries: safety, loss of independence, isolation, support mechanisms, mood, effects of the media and psychosocial adjustment. There was little evidence in the diaries of psychosocial adjustment to visual loss. The relevance of the theory of grieving and cognitive and rational-emotional theory in the context of AMD is explored in detail.

Resumo: A cirurgia bariátrica, realizada predominantemente em mulheres (80% no Brasil e 77% no contexto mundial), representa, além da prevenção de riscos aos agravos de saúde, uma promessa de bem-estar subjetivo. Neste trabalho, analisou-se, a partir da perspectiva de teorias feministas e psicodinâmicas, associadas à literatura da saúde, narrativas e expressões não verbais de um grupo de mulheres na iminência de tal cirurgia. Os resultados obtidos mostraram que aquele grupo de mulheres buscava a cirurgia como um dispositivo para alcançar a magreza como o padrão feminino idealizado socialmente. O corpo gordo foi reconhecido como uma condição não humana e a cirurgia simbolizada como a libertação dessa condição e o resgate da sexualidade. Concluiu-se, portanto, que as questões de gênero devem ser reconhecidas para apoiarem as equipes de saúde a fim de se mitigar expectativas irreais e melhorar o desfecho do tratamento da obesidade grave.

Background: Inherited macular dystrophies constitute a group of diseases characterized by bilateral central visual loss with symmetrical macular abnormalities usually presenting in the first two decades of life. The aim of this study were to find out the demographic characteristics and disease pattern of inherited retinal dystrophies in subjects attending retina outpatient department in a tertiary care center. Methods: An observational study among twenty-six participants diagnosed as macular dystrophy visiting a tertiary care centre in Nepal, during January 2018 to June 2018 were included in the study. Detailed history, slit lamp examination, dilated fundus examination, coloured fundus photography, full field electroretinogram, multifocal electroretinogram, automated visual field and colour vision were done. Results: A total of 52 eyes of 26 subjects were diagnosed with macular dystrophy. The male to female ratio was 1:1. The mean age of presentation was 28.38 years. Most common symptom was blurring of vision seen in 96.15%.The mean visual acuity was 0.67 log mar units in right eye and 0.71 log mar units in the left eye. The most common macular dystrophy was cone dystrophy followed by adult vitelliform macular dystrophy and Stargardts dystrophy. Conclusions: Cone dystrophy is the most common followed by Stargardt's disease and adult vitelliform macular dystrophy. Most presented in the first two decades of life and the most common presenting symptom was blurring of vision. Keywords: Adult vitelliform macular dystrophy; best disease; cone dystrophy; macular dystrophy; occult macular dystrophy; stargardt's disease

This article reports on a study of the psychosocial adjustment to age-related macular degeneration of 30 elderly persons by comparing the responses of subjects with this condition to those from age- and sex-matched controls on four psychosocial scales: life satisfaction, daily hassles, social support, and self-esteem. The subjects with the condition reported significantly poorer life satisfaction and greater stress, perhaps as a result of poor social support.

This qualitative article describes the impact of age-related macular degeneration (ARMD) among 15 participants: how a person makes sense of ARMD, the effect of ARMD on the person's quality of life, the psychological disturbances associated with the limitations of ARMD, and the influence of ARMD on social interactions. Such in-depth appreciation of the impact of ARMD will assist in the design of specific and appropriate rehabilitation programs to minimize limitations and enhance participation in people with ARMD.

Trata-se de um estudo transversal, descritivo e de abordagem quantitativa que analisou o conhecimento de estudantes de uma instituição de ensino superior (IES) com sede em Brasília (D.F.) sobre a CB. Foram entrevistados quatrocentos (400) estudantes, sendo que 48% (n=192) cursavam "enfermagem", 24% (n=96) cursavam "nutrição", 15,50% (n=62) cursavam "medicina", 8,25% (n=33) cursavam "biomedicina" e 4,25% (n=17) cursavam "biologia". O perfil dos atores sociais participantes do presente estudo se constituiu de 78,75% (n=315) pessoas do sexo feminino, 87,75% (n=351) solteiras, 70,75% (n=283) não desenvolvem atividade remunerada, 93,25% (n=373) negam enfermidade(s), 94,50% (n=378) negam tabagismo, 78% (n=312) negam consumo medicamentoso, 93% (n=372) negam etilismo, 99,25% (n=397) negam hipertensão arterial (HA), 100% (n=400) negam diabetes mellitus (DM), 81,50% (n=326) negam sobrepeso e 95% (n=380) negam obesidade. Foi identificado ainda reduzido conhecimento dentre os entrevistados, apenas na categoria analítica relacionada a necessidade de suplementação alimentar utilizando polivitamínicos após a realização da CB.