Therapeutic Actions Sun Gazing (Chromotherapeutic Principle)

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Correlation of macular structure and function in a boy with primary foveomacular retinitis and sequence of changes over 5 years.

Related Articles Correlation of macular structure and function in a boy with primary foveomacular retinitis and sequence of changes over 5 years. Doc Ophthalmol. 2017 Apr 27;: Authors: Badhani A, Padhi TR, Panda GK, Mukherjee S, Das T, Jalali S Abstract PURPOSE: To describe the clinical characteristics, macular structure and function, and to document sequential changes over 5 years in a 10-year-old boy with bilateral primary foveomacular retinitis. METHODS: A 10-year-old boy presented with sudden onset scotoma in both eyes, experienced after getting up from bed on a non-eclipse day. He persistently denied direct sun-gazing. He neither had any significant systemic illness, nor was using any medications. In addition to a detailed examination at presentation that included fundus fluorescein angiogram (FFA), electroretinogram (ERG), pattern ERG and electrooculogram (EOG), he was examined periodically for 5 years with Humphrey visual field (HVF), spectral domain optical coherence tomogram (SDOCT), Amsler grid charting and multifocal ERG. The macular structure and functions were analyzed over the years and correlated with the symptoms. RESULTS: All findings were bilaterally symmetrical at each visit. At presentation, his corrected visual acuity was 20/25 with subfoveal yellow dot similar to solar retinopathy, central scotoma with reduced foveal threshold in HVF 24-2, micropsia in Amsler grid, missing of two plates on Ishihara color vision chart, transfoveal full thickness hyper-reflective band on SD OCT, unremarkable FFA and normal foveal peak in mfERG. The flash ERG and EOG were unremarkable. A month later, his VA improved to 20/20, he had relative scotoma in Amsler grid, no scotoma in HVF (10-2), restoration of the inner segment of the photoreceptors with sharp defect involving ellipsoid and photoreceptor interdigitation zone in SDOCT and blunting of foveal peaks in mfERG. Three months later, his corrected VA was 20/20 with relative scotoma in Amsler grid, normal color vision, no scotoma in HVF 10-2 and unchanged SDOCT findings. In subsequent examinations at 6, 9, 14, 29, 39 and 60 months, he was symptomless with VA 20/20, unremarkable fundus, normal Amsler grid and HVF (normal foveal threshold), unchanged SDOCT findings and the reduced foveal peaks on mfERG in both eyes got normalized only at 60 months. CONCLUSION: Presented here is a case of bilaterally symmetrical idiopathic foveomacular retinitis that had a clinical appearance similar to solar retinopathy. The fundus changes persisted for 4 weeks, the symptoms and changes in Amsler grid lasted for 3 months, and the foveal threshold in visual fields normalized within 3 months. Maximum change in the SDOCT defect occurred within a month, and the extrafoveal defect in the ellipsoid and photoreceptor interdigitation line persisted despite resolution of symptoms and resolution of the visual field defect and normal distance vision. Probably, the foveal lesion detected on SDOCT was too small to cause a reduction in the distance visual acuity or show up in the visual field and mfERG later. PMID: 28451988 [PubMed - as supplied by publisher]

Backward-gazing method for measuring solar concentrators shape errors.

Related Articles Backward-gazing method for measuring solar concentrators shape errors. Appl Opt. 2017 Mar 01;56(7):2029-2037 Authors: Coquand M, Henault F, Caliot C Abstract This paper describes a backward-gazing method for measuring the optomechanical errors of solar concentrating surfaces. It makes use of four cameras placed near the solar receiver and simultaneously recording images of the sun reflected by the optical surfaces. Simple data processing then allows reconstructing the slope and shape errors of the surfaces. The originality of the method is enforced by the use of generalized quad-cell formulas and approximate mathematical relations between the slope errors of the mirrors and their reflected wavefront in the case of sun-tracking heliostats at high-incidence angles. Numerical simulations demonstrate that the measurement accuracy is compliant with standard requirements of solar concentrating optics in the presence of noise or calibration errors. The method is suited to fine characterization of the optical and mechanical errors of heliostats and their facets, or to provide better control for real-time sun tracking. PMID: 28248404 [PubMed - in process]

[A New Way to Look Up. Solar Retinopathy Risks and Methods of Prevention Prior to the 2015 Solar Eclipse].

Related Articles [A New Way to Look Up. Solar Retinopathy Risks and Methods of Prevention Prior to the 2015 Solar Eclipse]. Klin Monbl Augenheilkd. 2016 Sep 19; Authors: Tsatsos M, MacGregor C, Gousia D, Moschos M, Detorakis E Abstract A solar eclipse is an impressive natural phenomenon that was last experienced in Europe in 2006. Last year, on March 20th 2015, a solar eclipse was visible in much of Europe. Solar retinopathy is a recognised potentially sight threatening condition that has been associated with direct or unprotected sun gazing. Public education has been shown to improve behaviour and attitudes that could influence the development of solar retinopathy during an eclipse. We have performed a study through newspapers prior to the 2015 solar eclipse in different European countries, in order to determine the level of public health awareness and attitudes to protection. Methods: 31 online editions of national newspapers were reviewed from six countries where the eclipse was most visible. Solar retinopathy, potential warnings, safe methods of viewing an eclipse and assessment of use and dangers of modern technologies were assessed. Results: All 25 newspapers examined mentioned the solar eclipse and risk to eyesight. Safe methods for viewing the eclipse were discussed in all newspapers. Eclipse eyeglasses were mentioned in 29 of the 31 newspapers reviewed. Children were identified as a high-risk group but advice for children viewing the eclipse varied between countries. Conclusion: Since the solar eclipse of 2006, there has been an increase in the level of education available in the media. Although the safe methods for viewing an eclipse have not changed in recent years, emerging technologies, such as camera phones and the "selfie" trend, have potentially increased the risk of eclipse-associated retinopathy. PMID: 27643600 [PubMed - as supplied by publisher]

[Unilateral Solar Maculopathy after Gazing at Solar Eclipse].

Related Articles [Unilateral Solar Maculopathy after Gazing at Solar Eclipse]. Klin Monbl Augenheilkd. 2016 Jun;233(6):749-52 Authors: Mehlan J, Linke SJ, Wagenfeld L, Steinberg J Abstract A 43-year-old male patient with unilateral metamorphosia presented after gazing at an eclipse with only one eye. Damage of the macula was demonstrated funduscopically, with OCT and angiography. Six weeks after initial presentation and oral methylprednisolone therapy (40 mg/d for 10 days), the symptoms and the morphological changes decreased. Solar retinopathy is a photochemical alteration of the retina, usually seen after sun gazing. In younger patients, it mostly presents as bilateral solar maculopathy. Some patients exhibit partial or total recovery. PMID: 27055491 [PubMed - in process]

Retinal vascular tortuosity in DiGeorge syndrome complicated by solar retinopathy.

Related Articles Retinal vascular tortuosity in DiGeorge syndrome complicated by solar retinopathy. Retin Cases Brief Rep. 2013;7(4):343-6 Authors: De Niro JE, Randhawa S, McDonald HR Abstract PURPOSE: To report a case of vascular tortuosity associated with DiGeorge syndrome that was complicated by solar retinopathy. METHODS: Case report and literature review. RESULTS: A 56-year-old woman with DiGeorge syndrome with secondary schizophrenia and developmental delay presented with decreased vision that was worse in her left eye. Ocular examination revealed bilateral retinal vascular tortuosity involving both the arteries and veins. Both eyes had an abnormal foveal light reflex with a central yellowish hue, which was more pronounced in the left eye. Optical coherence tomography showed disruption of the photoreceptor inner segment-outer segment junction and retinal pigment epithelium centrally, which was also more prominent in the left eye. CONCLUSION: DiGeorge syndrome is associated with retinal vascular tortuosity in a large percentage of patients. The patient's decreased vision is likely caused by solar retinopathy (prolonged sun gazing as a result of the secondary schizophrenia and developmental delay). PMID: 25383826 [PubMed]

Solar retinopathy: a multimodal analysis.

Related Articles Solar retinopathy: a multimodal analysis. Case Rep Ophthalmol Med. 2013;2013:906920 Authors: Bruè C, Mariotti C, De Franco E, Fisher Y, Guidotti JM, Giovannini A Abstract Purpose. Solar retinopathy is a rare clinical disturbance, for which spectral-domain optical coherence tomography (SD-OCT) findings are not always consistent. We report on two cases of solar retinopathy and discuss its differential diagnosis. Methods. This is an observational case study. Results. A 12-year-old female was referred to ophthalmology for bilateral scotoma. Visual acuity was 20/50 in both eyes. Fundus examination was unremarkable, except for slight yellowish material in the central macula, bilaterally. SD-OCT revealed juxtafoveal microcystic cavities in the outer retina, interruption of the external limiting membrane and the inner and outer segment junctions, with disorganized material in the vitelliform space. Fundus autofluorescence showed hypoautofluorescence surrounded by a relatively hyperautofluorescent ring, bilaterally. Similar clinical and morphological findings were detected in a 27-year-old male. Conclusions. Solar retinopathy has a subtle presentation and patients often deny sun-gazing. SD-OCT and fundus autofluorescence are noninvasive and useful tools for its diagnosis. PMID: 23476848 [PubMed]

Solar retinopathy secondary to sungazing.

Related Articles Solar retinopathy secondary to sungazing. BMJ Case Rep. 2013 Jan 25;2013: Authors: Moran S, O'Donoghue E Abstract A young woman presented with a 2-day history of bilateral central scotoma and metamorphopsia following an episode of direct sun-gazing lasting 1-2 min. On examination, visual acuity was reduced to 6/9 bilaterally. Fundal examination revealed discrete yellow lesions at both maculae consistent with solar burns. Optical coherence tomography revealed retinal pigment epithelial defects at both fovea, which improved over time. The patient was managed conservatively. There was full resolution of symptoms in the left eye; however, a central scotoma persisted in the right eye at follow-up 1 year later. PMID: 23355595 [PubMed - indexed for MEDLINE]

Unusual optical coherence tomography and fundus autofluorescence findings of eclipse retinopathy.

Related Articles Unusual optical coherence tomography and fundus autofluorescence findings of eclipse retinopathy. Indian J Ophthalmol. 2012 Nov-Dec;60(6):561-3 Authors: Li KH, Chen SN, Hwang JF, Lin CJ Abstract A 63-year-old female patient complained of dimness in the central field of vision in the left eye after viewing an annular partial eclipse without adequate eye protection on 22 July 2009. Fundoscopy showed a wrinkled macular surface. Fundus autofluorescence study revealed well-demarcated hyperautofluorescence at the fovea. Optical coherence tomography demonstrated tiny intraretinal cysts. Fluorescein angiography and indocyanine green angiography were unremarkable. Epimacular membrane developed in the following month with deteriorated vision. Vitrectomy, epiretinal membrane and internal limiting membrane peeling were performed. Vision was restored to 20/20 after the operation. Direct sun-gazing may damage the retinal structures resulting in macular inflammation and increased focal metabolism, which explains the hyperautofluorescence. It may also induce epimacular membrane. Fundus autofluorescence might represent a useful technique to detect subtle solar-induced injuries of the retina. The visual prognosis is favorable but prevention remains the mainstay of treatment. Public health education is mandatory in reducing visual morbidity. PMID: 23202400 [PubMed - indexed for MEDLINE]

Optical radiation and the eyes with special emphasis on children.

Related Articles Optical radiation and the eyes with special emphasis on children. Prog Biophys Mol Biol. 2011 Dec;107(3):389-92 Authors: Söderberg PG Abstract The Sun is the most abundant source of optical radiation for the child eye. New hand-held visible lasers are a threat to the child eye. Some scientific data suggest that near infrared radiation may cause cumulative damage in the ocular lens. The child eye usually is exposed to ambient solar radiation, gazing at the horizon. Ambient Sun ultraviolet radiation (UVR) exposure to the child is complex due to atmospheric scattering and strong dependence on background reflection. Solar exposure causes biological damage, only by photochemical mechanisms. UVR exposure to a child eye is mainly a threat to the anterior segment of the eye, but also age dependently to the retina. Above threshold exposure to UVR, for short delay onset of damage, causes a toxic reaction on the surface of the eye, snow blindness, and cataract. Sub-threshold daily exposure to UVR over decades is associated with several ocular surface pathologies and eye lid cancer. Visible radiation is a threat to the retina. A single above threshold exposure, for short delay onset of damage to the retina causes immediate photochemical Type II retinal damage, Sun blindness. A single exposure of the retina to a very high intensity laser beam may cause thermal or thermo-mechanical damage in the retina. In environments with high irradiance of optical radiation, the child eye should be protected. Legislation and public information is required for avoidance of damage from high intensity laser systems. More research is urgently needed to exclude the potential hazard of near infrared radiation. PMID: 21946042 [PubMed - indexed for MEDLINE]

Solar spectral lines ("solar halo")--healing or harmful for the retina?

Related Articles Solar spectral lines ("solar halo")--healing or harmful for the retina? Coll Antropol. 2010 Apr;34 Suppl 2:127-9 Authors: Vojniković B, Njirić S Abstract The sungazing method has been known for thousands of years as healing method based on chromotherapeutic principle. Our examinations on the island of Rab show that it is acceptable only if applied 10 min before the sunset. Gazing has to be directed towards the green-yellow part of the spectrum, since the remaining part of the sun halo contains harmful energy. However, authors suggest that it would be preferable to use spectacles with medical filters transmitting wavelight of green-yellow colour, especially for treatment of macular degeneration. PMID: 21302711 [PubMed - indexed for MEDLINE]

Frequency recognition in an SSVEP-based brain computer interface using empirical mode decomposition and refined generalized zero-crossing.

Related Articles Frequency recognition in an SSVEP-based brain computer interface using empirical mode decomposition and refined generalized zero-crossing. J Neurosci Methods. 2011 Mar 15;196(1):170-81 Authors: Wu CH, Chang HC, Lee PL, Li KS, Sie JJ, Sun CW, Yang CY, Li PH, Deng HT, Shyu KK Abstract This paper presents an empirical mode decomposition (EMD) and refined generalized zero crossing (rGZC) approach to achieve frequency recognition in steady-stated visual evoked potential (SSVEP)-based brain computer interfaces (BCIs). Six light emitting diode (LED) flickers with high flickering rates (30, 31, 32, 33, 34, and 35 Hz) functioned as visual stimulators to induce the subjects' SSVEPs. EEG signals recorded in the Oz channel were segmented into data epochs (0.75 s). Each epoch was then decomposed into a series of oscillation components, representing fine-to-coarse information of the signal, called intrinsic mode functions (IMFs). The instantaneous frequencies in each IMF were calculated by refined generalized zero-crossing (rGZC). IMFs with mean instantaneous frequencies (f(GZC)) within 29.5 Hz and 35.5 Hz (i.e., 29.5≤f(GZC)≤35.5 Hz) were designated as SSVEP-related IMFs. Due to the time-locked and phase-locked characteristics of SSVEP, the induced SSVEPs had the same frequency as the gazing visual stimulator. The LED flicker that contributed the majority of the frequency content in SSVEP-related IMFs was chosen as the gaze target. This study tests the proposed system in five male subjects (mean age=25.4±2.07 y/o). Each subject attempted to activate four virtual commands by inputting a sequence of cursor commands on an LCD screen. The average information transfer rate (ITR) and accuracy were 36.99 bits/min and 84.63%. This study demonstrates that EMD is capable of extracting SSVEP data in SSVEP-based BCI system. PMID: 21194547 [PubMed - indexed for MEDLINE]

Subtle solar retinopathy detected by fourier-domain optical coherence tomography.

Related Articles Subtle solar retinopathy detected by fourier-domain optical coherence tomography. J Chin Med Assoc. 2010 Jul;73(7):396-8 Authors: Kung YH, Wu TT, Sheu SJ Abstract Solar retinopathy is a retinal injury caused by direct or indirect sun-gazing and solar eclipse observation without protection. Subtle changes in the retinal damage might not be evident on fundus photography and fluorescein angiography. A 40-year-old veteran suffered from paracentral scotoma in his left eye shortly after unprotected solar eclipse observation about 1 month earlier. His visual acuity was 6/5 in the right eye and 6/6 in the left. Anterior segments were normal bilaterally. Dilated fundus examination, fluorescein angiography, and central visual field testing did not reveal any abnormal findings. Fourier-domain optical coherence tomography was used for evaluation, and a focal defect in the inner and outer segments of the photoreceptor layer band was noted in the paracentral region of the fovea in the left eye, with central foveal thickness of 198 microm. Solar retinopathy is preventable with adequate eye protection. Education should be reinforced to the public. In mildly affected individuals with subtle retinal damage, Fourier-domain optical coherence tomography could be a useful imaging tool to detect the disease. PMID: 20688308 [PubMed - indexed for MEDLINE]

Ocular manifestations of torture: solar retinopathy as a result of forced solar gazing.

Related Articles Ocular manifestations of torture: solar retinopathy as a result of forced solar gazing. Br J Ophthalmol. 2010 Oct;94(10):1406-7 Authors: Polat J, Feinberg E, Crosby SS PMID: 20576780 [PubMed - indexed for MEDLINE]

[Solar retinopathy: follow-up examinations with optical coherence tomography (OCT) and microperimetry].

Related Articles [Solar retinopathy: follow-up examinations with optical coherence tomography (OCT) and microperimetry]. Klin Monbl Augenheilkd. 2007 Nov;224(11):862-6 Authors: Koinzer SO, Treumer F, Elsner H, Roider J Abstract BACKGROUND: Solar retinopathy is a phototoxic damage to the central retina. It may cause visual deterioration and a central scotoma with reading difficulties, that usually fade with time. Morphological and functional changes can be very subtle and are often inadequately detected by standard examinations. PATIENTS AND METHODS: The more affected, left eye of a 41-year-old female patient was examined clinically, by optical coherence tomography (OCT 3) and by MP 1-microperimetry during a 6-month follow up after gazing at a partial eclipse. RESULTS: At all times visual acuity was reduced to 0.7 causing visual deterioration. OCT examinations showed a subfoveal damage of decreasing extent, which was still detectable after 6 months. The retinal affection resulted in a persistent microscotoma of decreasing depth. CONCLUSION: OCT 3 and MP 1-microperimetry are able to detect the morphological and the functional damages in solar retinopathy at a level of sensitivity good enough to produce correlating results which allow the detection of subtle changes during follow-up. PMID: 18034403 [PubMed - indexed for MEDLINE]

Foveomacular retinitis and associated optical coherence tomography findings.

Related Articles Foveomacular retinitis and associated optical coherence tomography findings. Ophthalmic Surg Lasers Imaging. 2007 Jul-Aug;38(4):333-5 Authors: Topouzis F, Koskosas A, Pappas T, Anastasopoulos E, Raptou A, Psilas K Abstract A 45-year-old man presented with clinical manifestations of foveomacular retinitis, including visual symptoms and foveal lesions characteristic of solar retinopathy, but repeated questions failed to elicit a history of sun gazing. Cross-sectional retinal images produced by optical coherence tomography revealed localized loss of retinal pigment epithelium cells in both eyes. A different pattern of reflectivity at the level of the photoreceptor layer was observed between the right and left eye, reflecting asymmetry in tissue damage. This case is described to provide additional evidence that solar retinopathy and foveomacular retinitis are the same entity and may also have common optical coherence tomography findings. PMID: 17674927 [PubMed - indexed for MEDLINE]

[Did Leon Wyczókowski suffer from solar maculopathy?].

Related Articles [Did Leon Wyczókowski suffer from solar maculopathy?]. Klin Oczna. 2006;108(10-12):489-92 Authors: Kałuiny J, Markowski D, Kałuzny BJ, Sikorski B Abstract Noted Polish painter, Leon Wyczółkowski, during his long-standing in Ukraine used to paint pictures gazing directly at the sun in order to intensify visual sensations. Damage to the eyes caused by sunlight induced him to become a patient of a famous ophthalmologist in Kiev. Past disease led to blue color vision impairment just like it happens to people who previously suffered from solar maculopathy. We suppose, it could gradually force the artist to resign from color painting and to take up drawing. PMID: 17455734 [PubMed - indexed for MEDLINE]

[Optical coherence tomography follow-up of a case of solar maculopathy].

Related Articles [Optical coherence tomography follow-up of a case of solar maculopathy]. J Fr Ophtalmol. 2007 Mar;30(3):276-80 Authors: Macarez R, Vanimschoot M, Ocamica P, Kovalski JL Abstract Solar maculopathy is caused by sun-gazing without protection and in most cases appears to be reversible. Retinal damage may be caused by photochemical changes combined with a rise in temperature at the time of sun observation. We report a case of bilateral solar retinopathy following direct sun gazing after observation of the partial eclipse on 3 October 2005. A 25-year-old Caucasian man presented 24 h after watching the eclipse with symptoms of blurred vision and a bright positive central scotoma. Total direct viewing time was approximately 5 min. While observing the eclipse, the patient kept both eyes open. On presentation, his visual acuity was 20/25 in his right eye and 20/32 in his left eye. Ophthalmoscopic examination revealed a bilateral yellowish-white spot in the center of the foveal region. Static visual field examination did not disclose any absolute scotoma but a decrease in the foveal threshold was noted in both eyes. Optical coherence tomography (OCT) examination revealed a bilateral increased reflectivity of the inner foveal retina that was greater in the left eye. This finding was associated with a hyporeflective area of the underlying retinal pigment epithelium: choriocapillaris complex and an increase in retinal thickness. Eight days later, visual acuity was 20/20 in each eye. Funduscopy showed the yellow lesion had vanished. Four months after exposure, funduscopy was normal and OCT scan showed normal reflectivity of all retinal layers in the fovea. However, static visual field examination disclosed a decreased foveal threshold on the left eye. We compare the OCT findings in this patient with the data reported in the literature. Indeed, various OCT findings have been reported depending on the intensity and frequency of sun exposure. This observation demonstrates that OCT appears to be potentially useful in the evolutive follow-up of solar maculopathy, and emphasizes the importance of eye safety during solar eclipse observation. PMID: 17417154 [PubMed - indexed for MEDLINE]

Solar retinopathy and associated optical coherence tomography findings.

Related Articles Solar retinopathy and associated optical coherence tomography findings. Clin Exp Optom. 2004 Nov;87(6):390-3 Authors: Chen JC, Lee LR Abstract Solar retinopathy is a rare but well-recognised clinical entity of macular damage, caused by viewing a solar eclipse or direct sun-gazing. Visual deterioration from solar retinopathy typically ranges from 6/9 to 6/60 and in most cases the visual loss is reversible. We present a case of solar retinopathy following direct sun-gazing and illustrate the damage within the retinal structure with optical coherence tomographic (OCT) findings. The visual prognosis of solar retinopathy is usually favourable but prevention remains the mainstay of treatment. The optometrist may play an important role in patient education and reassurance, as well as differentiating solar retinopathy from other likely macular abnormalities. PMID: 15575813 [PubMed - indexed for MEDLINE]

Solar retinopathy in Benin City, Nigeria.

Related Articles Solar retinopathy in Benin City, Nigeria. West Afr J Med. 2003 Dec;22(4):356-7 Authors: Ukponmwan CU, Dawodu OA, Ayanru JO Abstract The case reports of three patients who were seen at the University of Benin Teaching Hospital Benin City with a diagnosis of solar maculopathy are presented. There was good visual recovery in two of the patients. This report shows the effect on the retina of direct sun gazing. The need to use protective filters is emphasized. PMID: 15008308 [PubMed - indexed for MEDLINE]

Optical coherence tomography of chronic solar retinopathy.

Related Articles Optical coherence tomography of chronic solar retinopathy. Am J Ophthalmol. 2004 Feb;137(2):351-4 Authors: Garg SJ, Martidis A, Nelson ML, Sivalingam A Abstract PURPOSE: To describe the optical coherence tomographic findings in eight eyes of four patients with chronic solar retinopathy. All patients had a history of sun gazing months to years prior to presentation. DESIGN: Retrospective case series. METHODS: Patients were examined using biomicroscopy performed by two or more experienced vitreoretinal specialists. All eight eyes had optical coherence tomography performed at the time of initial examination. RESULTS: All patients had a history of sun gazing and decreased vision in both eyes. On biomicroscopy, all eyes had a small, irregularly-shaped lamellar defect in the foveal center. No posterior vitreous detachment was present in any eye. Optical coherence tomography revealed a hyporeflective space at the level of the outer neurosensory retina and retinal pigment epithelium in all eyes. CONCLUSION: Optical coherence tomography demonstrates a characteristic hyporeflective space in the outer retina in patients with chronic solar retinopathy. These findings correlate with the histopathology of this condition and may be a useful clinical tool in confirming its diagnosis. PMID: 14962431 [PubMed - indexed for MEDLINE]
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