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Purpose: To compare the anxiety levels related to visual field testing and optical coherence tomography (OCT) in patients with glaucoma. Methods: This prospective, comparative study was conducted on patients with glaucoma. The participants' anxiety traits were assessed using the State-Trait Anxiety Inventory [STAI]. Before visual field testing on Humphrey visual field analyzer (HVF) and retinal nerve fiber analysis on OCT, the participants completed Form Y1 to measure the current pretest level or 'State' anxiety [pretest anxiety]. Immediately after testing, participants were administered the Form Y1 questionnaire to assess the induced anxiety level during the testing [Intratest anxiety]. Results: A total of 228 patients were enrolled with 152 participants in the HVF group and 76 in the OCT group. The mean age of the participants in the HVF group was 57.2 ± 20.8 years and in the OCT group was 56.8 ± 20 years. There was no significant difference in trait and pretest anxiety between the HVF group and the OCT group (P = 0.971 and P = 0.716). Intratest test anxiety score was slightly higher in the HVF group (HVF: 42.13 ± 10.63, OCT: 40.71 ± 9.76; P = 0.33). The anxiety scores were higher when the experience of previous HVF tests was

Cytomegalovirus (CMV) retinitis is a vision-threatening condition seen with CD4+ count below 50/μL. In the presence of systemic lymphoma, CMV retinitis may pose a diagnostic dilemma due to similar clinical features with intraocular lymphoma. We, hereby, report a rare case of bilateral CMV retinitis in a patient with normal CD4+ counts and a past history of diffuse large B-cell lymphoma (DLBCL). A 51-year-old male presented with sudden-onset painless diminution of vision in the right eye (RE) for a 2-week duration. He had a past history of DLBCL and had been treated with chemotherapy. On examination, his best-corrected visual acuity was perception of light in RE and 20/20 in the left eye (LE). RE fundus examination showed yellowish-white deep retinal lesions with scanty superficial retinal hemorrhages and perivascular exudates. LE fundus examination showed only one focal area of yellowish-white deep retinal lesions along the inferotemporal arcade. A provisional diagnosis of bilateral intraocular lymphoma was made based on the past history of systemic lymphoma. RE vitreous tap was done, and intravitreal injection of methotrexate was given. Vitreous sample revealed CMV DNA on polymerase chain reaction but no evidence of malignant cells on cytology. CD4 count was 393 cells/μl. The patient was subsequently treated with intravenous ganciclovir and oral valganciclovir for bilateral CMV retinitis. This case report highlights the importance of vitreous sample analysis in patients of systemic lymphoma presenting with atypical retinal necrotic lesions to establish an accurate diagnosis and to differentiate between closely mimicking lesions of intraocular lymphoma and viral retinitis.

In mobile ad hoc networks (MANETs), the reliability of nodes, quality of data and access control cannot be achieved successfully for various network functionalities through traditional cryptographic security, which makes MANET vulnerable to illegitimate node behaviour changes. These node misbehaviours, referred as soft security threats, need to be detected and prevented in order to protect against the accumulation of false measurements with selfish and malicious intentions. Trust has been employed as a powerful tool to handle the soft security threats and to provide security among uncertain and dynamic nodes effectively in MANET. Therefore, it is of great importance that efficient trust management mechanisms should be developed in a public key infrastructure (PKI), in order to verify the identities on the ad hoc networks for reliable and secure group communication. However, the independent nature of nodes and the computational complexities make the trust management a challenging one in MANET. In this paper, we present an efficient distributed trust computation and misbehaviour verification method with Bayesian and Evidence theorem, on hexagonally clustered MANET. Besides, a secured PKI system is designed in the paper by applying the proposed trust management scheme in terms of certificate revocation, which is an important functionality of PKI cryptosystem. The uncertainty impacts the node’s anticipation of neighbour’s behaviour and decisions during communication; we include uncertainty in the trust management system. An efficient method to reduce the uncertainty is to exploit the mobility characteristics of MANET that accelerates the trust convergence. The simulation results reveal a better performance against adversaries in creating considerable untrustworthy transactions with a mobility-aware cluster guarantee. Moreover, the proposed trust application shows its betterment in the revocation process in terms of revocation rate and time. Thus, the proposed scheme provides an effective security solution that incorporates the optimistic features of trust mechanisms and hierarchical Voronoi clustering. [ABSTRACT FROM AUTHOR]