PURPOSE. Visual impairments are frequent in Parkinson's disease (PD) and impact normal functioning in daily activities. Visual contrast sensitivity is a powerful nonmotor sign for discriminating PD patients from controls. However, it is usually assessed with static visual stimuli. Here we examined the interaction between perception and eye movements in static and dynamic contrast sensitivity tasks in a cohort of mildly impaired, early-stage PD patients. METHODS.Patients (n ¼ 13) and healthy age-matched controls (n ¼ 12) viewed stimuli of various spatial frequencies (0-8 cyc/deg) and speeds (08/s, 108/s, 308/s) on a computer monitor. Detection thresholds were determined by asking participants to adjust luminance contrast until they could just barely see the stimulus. Eye position was recorded with a videobased eye tracker. RESULTS.Patients' static contrast sensitivity was impaired in the intermediate spatial-frequency range and this impairment correlated with fixational instability. However, dynamic contrast sensitivity and patients' smooth pursuit were relatively normal. An independent component analysis revealed contrast sensitivity profiles differentiating patients and controls.CONCLUSIONS. Our study simultaneously assesses perceptual contrast sensitivity and eye movements in PD, revealing a possible link between fixational instability and perceptual deficits. Spatiotemporal contrast sensitivity profiles may represent an easily measurable metric as a component of a broader combined biometric for nonmotor features observed in PD.

Purpose: Acanthamoeba keratitis is a rare, vision-threatening disease. Commercially available antiamoebics are poorly cysticidal and highly toxic, and therapeutic keratoplasties can be complicated by recurrence or graft failure. We aimed to discuss the use of oral miltefosine for treatment of recalcitrant Acanthamoeba keratitis. Methods: A 44-year-old contact lens wearer presented with a 2-week history of red painful eye and decreasing vision. After poorly responding to topical corticosteroid on the presumptive diagnosis of anterior uveitis, she developed radial keratoneuritis. Corneal scraping was positive for Acanthamoeba. No clinical response to treatment was observed with topical chlorhexidine 0.02%, polyhexamethylene biguanide 0.02%, and oral voriconazole. She then underwent 2 therapeutic keratoplasties with prompt recurrence of the disease in the keratoplasty graft. Results: Oral miltefosine was added to the treatment. She underwent a third penetrating keratoplasty 8 months later. The excised button was negative for amoeba. She continued miltefosine for 3 more months. No recurrence was observed after 30 months. Conclusions: This case shows resolution of recalcitrant Acanthamoeba keratitis with oral miltefosine in an immunocompetent patient. Further clinical evidence would be needed to possibly incorporate this medication in the antiamoebic armamentarium.

FIG. 4. Microscopic examination shows immature neuroepithelial tissue (A), mature brain (asterisk) and peripheral nerve tissue (arrowhead) (B), intestinal tissue (black arrowheads), cartilage (white arrowheads) and simple cysts (asterisk) (C), and bone (D) consistent with an immature teratoma. All panels hematoxylin and eosin stains. A B, 40× magnification. C and D, 17× magnification. FIG. 5. Postoperative MRI and clinical photograph. A, Short Tau inversion recovery axial MRI of the orbits showing resolution of right proptosis with stable mild heterogeneity in the orbit and no evidence of local tumor recurrence. B, Clinical photograph of the child at age 5 months with aligned eyes and normal vision.

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