10 research outputs found
Imaging of tangential traction types in lamellar macular holes
No full textPURPOSE:
To determine the best imaging procedure for the definition of tangential tractions generated by epiretinal membranes in lamellar macular holes.
METHODS:
Inclusion criteria were a diagnosis of lamellar macular hole with tractional epiretinal membranes based upon fundus autofluorescence (FAF), and spectral-domain optical coherence tomography (SD-OCT) imaging (HRA + OCT Spectralis, Heidelberg Engineering, Heidelberg, Germany). Tangential tractions were evaluated with infrared reflectance (IR; 820 nm) and OCT en face (193 B-scans, 30 × 20°pattern size, 31 μm between two consecutive B-scans). Three different categories of tangential traction were previously defined: 1) unidirectional, 2) pluridirectional, and 3) concentric. Two independent masked physicians evaluated the images in order to categorize the type of tangential traction either with IR and OCT (en face) for every single patient. Cohen's kappa statistic was used to evaluate inter-observer and inter-instrument agreement.
RESULTS:
Twenty eyes of 19 patients were included in the study. Inter-observer OCT test showed almost perfect agreement between examiners (κ = 0.86). Inter-observer IR test showed substantial agreement (κ = 0.7). Inter-instrument agreement was fair for both observers, respectively κ = 0.35 for observer 1 and κ = 0.22 for observer 2. Intra-observer agreement was almost perfect for OCT (κ = 0.93) and substantial for IR (κ = 0.78).
CONCLUSION:
Tangential traction associated with epiretinal membranes in lamellar macular holes can be successfully evaluated by OCT en face and IR reflectance. Inter-observer concordance is high for both instruments. However, high inter-instrument discordance is present. Therefore, the gold standard imaging technique for differentiating the different types of contraction in epiretinal membranes has still to be determined
Choroidal Thickness in Patients Diagnosed with Human Immunodeficiency Virus Infection : Results from Two Populations of Different Ethnicities
No full textPURPOSE:
To measure the choroidal thickness among subjects with human immunodeficiency virus (HIV) infection from two diverse ethnic populations and to compare it with healthy controls.
METHODS:
Subjects with HIV infection and healthy controls were enrolled in two referring centers in Italy and India. Clinical data were collected. All subjects underwent enhanced-depth imaging optical coherence tomography and measurement of choroidal thickness.
RESULTS:
A total of 68 eyes from 68 patients with HIV (44 Caucasian, 24 Indians) and 60 eyes from 60 healthy volunteers (36 Caucasian, 24 Indians) were included. Mean choroidal thickness was significantly higher in HIV patients compared to controls (312.91 ± 65 μm vs. 266.57 ± 47 μm; p < 0.001). Choroidal thickness was higher among subjects with HIV-related retinopathy compared to HIV without retinopathy (285 ± 30 μm vs. 352 ± 17 μm; p < 0.01).
CONCLUSIONS:
Patients with HIV infection, especially with HIV microangiopathy, have thicker choroid compared to age- and gender-matched healthy control subjects. These changes may be related to HIV-associated choroidal vascular dysfunction
Progression of lamellar hole-associated epiretinal proliferation and retinal changes during long-term follow-up
No full textPurpose: To report on progression of lamellar hole-associated epiretinal proliferation (LHEP) in eyes with lamellar macular holes (LMH) using spectral-domain optical coherence tomography (SD-OCT), and to correlate with intraretinal changes and visual function.Methods: From a retrospectively reviewed series of 167 eyes with non-full-thickness macular holes, we exclusively included a subgroup of 34 eyes with LMH and LHEP by SD-OCT evaluation. In these eyes, area of LHEP, intraretinal changes of defect diameter, central retinal thickness, defects of the ellipsoid zone and occurrence of a contractive epiretinal membrane were analysed. Additionally, clinical data were documented.Results: Area of LHEP significantly increased during a mean follow-up period of 40.5 months (median 52 months). Analysing intraretinal changes, a significant enlargement of minimum and maximum horizontal lamellar hole diameter was found that correlated with the area of LHEP. Defects of the ellipsoid zone were seen in 65% of the eyes at baseline and in 85% at the end of follow-up. Increase of maximum horizontal hole diameter and ellipsoid zone defects correlated with a decline of visual acuity. Fifty per cent of patients with LMH and LHEP also demonstrated extrafoveal typical contractive epiretinal membranes with retinal folds.Conclusions: Long-term follow-up revealed an increase of the area of LHEP in eyes with LMH that correlated with the enlargement of lamellar hole diameter and ellipsoid zone defects. Our data delineate the progression of intraretinal changes in association with a decline of visual function in this subgroup of LMH eyes
Maximum Principle for Boundary Control Problems Arising in Optimal Investment with Vintage Capital
No full textThe paper concerns the study of the Pontryagin Maximum Principle for an infinite dimensional and infinite horizon boundary control problem for linear partial differential equations. The optimal control model has already been studied both in finite and infinite horizon with Dynamic Programming methods in a series of papers by the same author et al. [26, 27, 28, 29, 30]. Necessary and sufficient optimality conditions for open loop controls are established. Moreover the co-state variable is shown to coincide with the spatial gradient of the value function evaluated along the trajectory of the system, creating a parallel between Maximum Principle and Dynamic Programming. The abstract model applies, as recalled in one of the first sections, to optimal investment with vintage capital.Linear convex control, Boundary control, Hamilton–Jacobi–Bellman equations, Optimal investment problems, Vintage capital
Analysis of Retinochoroidal Vasculature in Human Immunodeficiency Virus Infection Using Spectral-Domain OCT Angiography
No full textPurpose: To describe the retinochoroidal vascular alterations in patients with human immunodeficiency virus (HIV) infection using en face OCT angiography (OCTA).
Design: Cross-sectional study.
Participants: Twenty-six patients with HIV infection (5 women, with and without HIV retinopathy) were included in the study. Nineteen healthy participants (7 women) with no known ocular disease were recruited as healthy controls.
Methods: Multimodal imaging was performed using OCTA (Optovue RTVue XR Avanti; Optovue, Inc, Fre- mont, CA), enhanced-depth imaging OCT (Heidelberg Spectralis; Heidelberg Engineering, Heidelberg, Germany), color fundus photography, and fluorescein angiography (FA). Vessel flow density (VFD) was calculated auto- matically by the OCTA software. Morphologic changes in the retinochoroidal vasculature in the posterior pole on OCTA were assessed by 2 trained independent graders and were compared with the findings on clinical ex- amination and other imaging techniques.
Main Outcome Measures: Prevalence of microvascular alterations on OCTA among patients with HIV and differences in the VFD in different macular sectors compared with healthy controls.
Results: Among all eyes with clinically detectable HIV retinopathy, there was evidence of retinal vascular telangiectasia, capillary loops, and increased intercapillary spacing. The mean VFD values were lower among patients with HIV retinopathy compared with those with HIV and no retinopathy and healthy controls (both P < 0.05). Foveal avascular zone area was abnormally enlarged among patients with HIV compared with healthy controls (P 1⁄4 0.05). Five eyes (23.53%) without clinical or angiographic evidence of retinopathy demonstrated retinal vascular telangiectasia and increased intercapillary spacing on OCTA. The inner choroidal vasculature appeared to be mostly unaffected in HIV.
Conclusions: OCT angiography provides noninvasive high-resolution imaging of the retinochoroidal vascular network in patients with HIV. Compared with conventional imaging, OCTA can demonstrate precise microvas- cular structural alterations in the retinal vessels and seems to be a sensitive tool in detecting HIV retinopathy
Ship- And island-based atmospheric soundings from the 2020 EUREC4A field campaign
No full textTo advance the understanding of the interplay among clouds, convection, and circulation, and its role in climate change, the Elucidating the role of clouds-circulation coupling in climate campaign (EUREC4A) and Atlantic Tradewind Ocean-Atmosphere Mesoscale Interaction Campaign (ATOMIC) collected measurements in the western tropical Atlantic during January and February 2020. Upper-air radiosondes were launched regularly (usually 4-hourly) from a network consisting of the Barbados Cloud Observatory (BCO) and four ships within 6-16°N, 51-60°W. From 8 January to 19 February, a total of 811 radiosondes measured wind, temperature, and relative humidity. In addition to the ascent, the descent was recorded for 82 % of the soundings. The soundings sampled changes in atmospheric pressure, winds, lifting condensation level, boundary layer depth, and vertical distribution of moisture associated with different ocean surface conditions, synoptic variability, and mesoscale convective organization. Raw (Level 0), quality-controlled 1 s (Level 1), and vertically gridded (Level 2) data in NetCDF (Stephan et al., 2020) are available to the public at AERIS (https://doi.org/10.25326/137 https://doi.org/10.25326/137). The methods of data collection and post-processing for the radiosonde data set are described here.Atmospheric Remote Sensin
Normative Data for Retinal-Layer Thickness Maps Generated by Spectral-Domain OCT in a White Population
No full textReal-World Use of Oral Semaglutide in Adults with Type 2 Diabetes: The PIONEER REAL Switzerland Multicentre, Prospective, Observational Study
No full text
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Italian regional health service costs for diagnosis and 1-year treatment of ADHD in children and adolescents
No full textThe main aim of this study was to estimate the costs associated with diagnostic assessment and 1-year therapy in children and adolescents enrolled in 18 ADHD reference centres. Data concerning 1887 children and adolescents from the mandatory ADHD registry database during the 2012-2014 period were analysed. The overall diagnostic and treatment costs per patient amounts to €574 and €830, respectively. The ADHD centre, the school as sender, and the time to diagnosis constitute cost drivers. Non-pharmacological therapy resulted as being more expensive for patients concomitantly treated with drugs (€929) compared to those treated with psychological interventions alone (€590; p=0.006). This study gives the first and reliable estimate of the costs associated with both diagnosis and treatment of ADHD in Italy. Although costs associated with mental disorders are difficult to estimate, continuing efforts are need to define costs and resources to guarantee appropriate care, also for ADHD
