Vagus nerve stimulation (VNS) is currently Food and Drug Administration-approved for treatment of both medically refractory partial-onset seizures and severe, recurrent refractory depression, which has failed to respond to medical interventions. Because of its ability to regulate mechanisms well-studied in neuroscience, such as norepinephrine and serotonin release, the vagus nerve may play an important role in regulating cerebral blood flow, edema, inflammation, glutamate excitotoxicity, and neurotrophic processes. There is strong evidence that these same processes are important in stroke pathophysiology. We reviewed the literature for the role of VNS in improving ischemic stroke outcomes by performing a systematic search for publications in Medline (1966–2014) with keywords “VNS AND stroke” in subject headings and key words with no language restrictions. Of the 73 publications retrieved, we identified 7 studies from 3 different research groups that met our final inclusion criteria of research studies addressing the role of VNS in ischemic stroke. Results from these studies suggest that VNS has promising efficacy in reducing stroke volume and attenuating neurological deficits in ischemic stroke models. Given the lack of success in Phase III trials for stroke neuroprotection, it is important to develop new therapies targeting different neuroprotective pathways. Further studies of the possible role of VNS, through normally physiologically active mechanisms, in ischemic stroke therapeutics should be conducted in both animal models and clinical studies. In addition, recent advent of a non-invasive, transcutaneous VNS could provide the potential for easier clinical translation.

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Declines of the PERG amplitude suggest subclinical retinal ganglion cell dysfunction in asymptomatic G11778A subjects, which is progressive.

Purpose To evaluate macular and extramacular retinal anatomy in patients and carriers of X-linked retinoschisis (XLRS) utilizing a wide-field spectral-domain optical coherence tomography (SD-OCT) imaging technique. Design Case series Participants Six XLRS affected males and three XLRS female carriers. Methods The subjects prospectively underwent XLRS DNA genotyping and comprehensive ophthalmic examination including Visual acuity, 30-2 Humphrey visual field, fundus photography, and wide-field SD-OCT, a montage technique to generate SD-OCT images spanning approximately 50° horizontally and 35° vertically of the posterior pole. Main Outcome Measures distribution and location of schisis cavities Results Among affected XLRS males, asymmetric bilateral schisis was seen in all eyes imaged with montage SD-OCT (11 eyes). Wide-field OCT images demonstrated schisis cavities only in the central macula in 6 eyes (55%), throughout the macula extending to the outside of the temporal arcades in 3 eyes (27%), and throughout the macula extending nasal to the optic nerve in 2 eyes (18%). Cystoid spaces accounting for macular splitting were present in the inner nuclear layer (INL) in all 11 eyes and also in the outer nuclear layer (ONL) in 4 eyes. A few small cysts were seen parafoveally in the ganglion cell layer and/or nerve fiber layer (GCL/NFL) in 4 eyes. Subclinical extramacular schisis spaces were seen (n=5 eyes) within the INL in 1 eye, ONL in 1 eye, INL/GCL/NFL in 1 eye, ONL/GCL/NFL in 1 eye, and in the INL/ONL/GCL/NFL in 1 eye. Schisis was rarely seen nasal to the optic nerve (2 eyes). Central/paracentral visual field defects were seen in 9 eyes. Female carriers did not show schisis on exam or OCT. Conclusions Wide-field SD-OCT is a useful tool for evaluating complex retinal anatomy. In XLRS patients, the foveomacular schisis was seen most frequently in the INL. Subclinical extramacular schisis was seen in 45% eyes and was equally prevalent in the INL, ONL, and GCL/FNL. GCL/FNL cystoid spaces were very small and were seen near the fovea and the arcades only. Carriers were schisis-free.

The purpose of this study was to determine the feasibility of a slit-lamp-adapted ultra-high resolution optical coherence tomography device with improved image resolution for imaging the retinal nerve fiber layer. The authors described the system configuration, build-up, and test results of a small sample of human subjects. The comparison with a commercially available device was also included.