Anterior Boundary Research Articles

Dynamic stability in runners with and without plantar fasciitis

BackgroundPlantar fasciitis (PF) is a common overuse injury experienced by runners. PF may decrease the ability of the plantar fascia to create tension and reduce stability of the foot. Stability of the foot is necessary for whole-body dynamic stability during running which consists of cyclical periods of single leg stance. Given that a major risk factor for running-related injury is previous injury, evaluating dynamic stability in runners with PF, runners with resolved PF, and healthy runners may elucidate differences between these individuals and clarify risk for secondary injury in these groups. Research questionIs dynamic stability reduced in runners with PF and runners with resolved PF compared to healthy runners? MethodsThirty runners were recruited for this retrospective comparative study based on mileage and injury status: current PF (PF), resolved PF (RPF), or healthy (CON). Kinematic and kinetic data were collected during running and dynamic stability was determined by time-to-contact (TtC) analysis for early, mid, and late stance to the anterior, posterior, medial, and lateral boundary of the foot. Dynamic stability was compared between groups one-way ANOVAs (α = 0.05) and Tukey post-hoc tests conducted when appropriate. Cohen’s d effect sizes (d) were reported for all TtC comparisons (small = 0.20, medium = 0.50, large = 0.80). ResultsTtC values were shorter in PF compared to the other groups to all boundaries during mid-stance. TtC was significantly greater in PF compared to RPF to the anterior boundary during late stance. SignificanceShorter TtC observed in PF compared to the other groups during midstance may indicate reduced dynamic stability during the most stable portion of running which may lead to increased injury risk.

Eye-specific 3D modeling of factors influencing oxygen concentration in the lamina cribrosa

Our goal was to identify the factors with the strongest influence on the minimum lamina cribrosa (LC) oxygen concentration as potentially indicative of conditions increasing hypoxia risk. Because direct measurement of LC hemodynamics and oxygenation is not yet possible, we developed 3D eye-specific LC vasculature models. The vasculature of a normal monkey eye was perfusion-labeled post-mortem. Serial cryosections through the optic nerve head were imaged using fluorescence and polarized light microscopy to visualize the vasculature and collagen, respectively. The vasculature within a 450 μm-thick region containing the LC – identified from the collagen, was segmented, skeletonized, and meshed for simulations. Using Monte Carlo sampling, 200 vascular network models were generated with varying vessel diameter, neural tissue oxygen consumption rate, inflow hematocrit, and blood pressures (arteriole, venule, anterior boundary, and posterior boundary). Factors were varied over ranges of baseline ±20% with uniform probability. For each model we first obtained the blood flow, and from this the neural tissue oxygen concentration. ANOVA was used to identify the factors with the strongest influence on the minimum (10th percentile) oxygen concentration in the LC. The three most influential factors were, in ranked order, vessel diameter, neural tissue oxygen consumption rate, and arteriole pressure. There was a strong interaction between vessel diameter and arteriole pressure whereby the impact of one factor was larger when the other factor was small. Our results show that, for the eye analyzed, conditions that reduce vessel diameter, such as vessel compression due to elevated intraocular pressure or gaze-induced tissue deformation, may particularly contribute to decreased LC oxygen concentration. More eyes must be analyzed before generalizing.

Evolutionary Transition in the Regulation of Vertebrate Pronephros Development: A New Role for Retinoic Acid.

The anterior-posterior (AP) axis in chordates is regulated by a conserved set of genes and signaling pathways, including Hox genes and retinoic acid (RA), which play well-characterized roles in the organization of the chordate body plan. The intermediate mesoderm (IM), which gives rise to all vertebrate kidneys, is an example of a tissue that differentiates sequentially along this axis. Yet, the conservation of the spatiotemporal regulation of the IM across vertebrates remains poorly understood. In this study, we used a comparative developmental approach focusing on non-conventional model organisms, a chondrichthyan (catshark), a cyclostome (lamprey), and a cephalochordate (amphioxus), to assess the involvement of RA in the regulation of chordate and vertebrate pronephros formation. We report that the anterior expression boundary of early pronephric markers (Pax2 and Lim1), positioned at the level of somite 6 in amniotes, is conserved in the catshark and the lamprey. Furthermore, RA, driving the expression of Hox4 genes like in amniotes, regulates the anterior pronephros boundary in the catshark. We find no evidence for the involvement of this regulatory hierarchy in the AP positioning of the lamprey pronephros and the amphioxus pronephros homolog, Hatschek’s nephridium. This suggests that despite the conservation of Pax2 and Lim1 expressions in chordate pronephros homologs, the responsiveness of the IM, and hence of pronephric genes, to RA- and Hox-dependent regulation is a gnathostome novelty.

Evaluation of the Cranial Aperture of the Optic Canal on Cone-Beam Computed Tomography Images and its Clinical Implications for the Transcranial Approaches.

This study aimed to investigate morphometric properties of the cranial aperture (CA) of the optic canal. Cone-beam computed tomography images of 400 individuals (200 males and 200 females) aged 37.32 ± 15.87 years were retrospectively examined to assess the morphometry and morphology of the CA. The height and width of CA were found as 4.22 ± 0.74 mm and 7.27 ± 1.15 mm, respectively. The distances between the CA and the midsagittal line, the anterior and lateral boundaries of the anterior skull base were measured as 5.77 ± 1.32 mm, 64.97 ± 6.36 mm, and 41.00 ± 4.05, respectively. The angle of the optic canal in the sagittal plane was measured as 7.57° ± 3.95°, whereas in the horizontal plane as 38.96° ± 4.36°. The aperture shape was defined as the tear-drop (413 foramina, 51.62%), triangular (180 foramina, 22.50%), oval (158 foramina, 19.75%), round (30 foramina, 3.75%), and polygonal (19 foramina, 2.38%). The authors observed that the diameters, and angulations of the CA may change relative to gender and the shape. The anatomic features of CA are important for the positioning of the patient's head, the choice of the appropriate surgical approach or equipment, and the detection of anatomical landmarks during interventions. In this context, our dataset may be beneficial for surgeons helpful as a reference for radiological evaluations.

Modified lateral gastrocnemius myocutaneous flap with extended anterior and/or inferior boundary

There is little information regarding the boundaries of the lateral gastrocnemius myocutaneous (LGM) flap. The aim of this study was to introduce the modified technique of the LGM flap with extended anterior and/or inferior boundaries and its anatomical basis. Five fresh lower limb specimens were perfused and radiographed. Between December 2003 and August 2018, 27 modified LGM flaps with extended anterior and/or inferior boundaries were raised in 27 patients to reconstruct the soft tissue defects over the middle and upper leg, knee, and lower thigh. Both the lateral popliteal cutaneous artery and musculocutaneous perforators from the lateral sural artery had rich linked arteries communicating with the chain-linked arterial network around both the posterolateral intermuscular septum and the sural nerve, and they also had rich transverse communicating arteries connecting with the perifascial arterial network overlying the anterior compartment in the upper and middle calf. Continuous fascial arterial networks were extended up to the level at the intermalleolar line. Twenty-three flaps survived uneventfully, 2 flaps displayed distal de-epithelialization, and 2 flaps (7.41%) developed partial necrosis. Osteomyelitis was cured successfully in all patients, and no relapse of infection was encountered during the follow-up period. Multiple feeder arteries are the arterial anatomic basis of the modified LGM flap. The modified LGM flap with extended anterior and/or inferior boundaries is feasible, and the modified flap with extended anterior boundaries is safe and reliable.

Defining Reference Values for the Anatomical Axis of Syndesmosis and Landmark for the Clamp Placement to Minimize Malreduction

Category:Ankle; Sports; TraumaIntroduction/Purpose:Malreduction of the fibula within the incisura is often caused by an eccentric clamp or screw placement and short fibular length. Weightbearing computed tomography (WBCT) has proven to be a reliable method to diagnose syndesmotic instability and can be used as a template to determine the syndesmotic axis and optimal position to place the clamp. We aimed to determine the anatomic axis of the syndesmosis, or the trans-syndesmotic angle (TSA) in healthy individuals on WBCT, and to see if side-to-side and gender based variations exist. We also aimed to determine the clamp's medial tine placement along the trans-syndesmotic axis.Methods:The study group was made up of patient population without ankle injury who underwent bilateral foot and ankle WBCT imaging (n = 100; 200 ankles). Measurements on bilateral WBCT images included: 1) TSA at 1cm, 2cm, and 3cm proximal to tibial plafond, respectively; 2) Medial tine of the clamp positioning at 1cm and 2 cm along the syndesmotic axis. The medial tine clamp position was described in terms of the percentage of anterior to posterior tibial diameter from the anterior cortical boundary. In addition, the aforementioned TSA measurements were compared to historically defined 30 degrees of syndesmotic axis. Paired t-test was used to compare side to side and gender based differences. A p-value < 0.05 was considered statistically significant.Results:In the uninjured healthy population, the mean trans-syndesmotic angles were 17.60, 21.60, and 24.10 at 1cm, 2cm, and 3cm proximal to the tibial plafond respectively. The clamp's medial tine should be positioned 24.7% and 21.3% of the AP tibial cortical distance, posterior to the anterior tibial cortex at 1cm and 2 cm proximal to the tibial plafond. There was no significant side to side or gender based differences for any of the measurements. Additionally, all three weightbearing TSA measurements were significantly larger than the historically defined syndesmotic angle of 30 degrees (p<0.001).Conclusion:Preoperative WBCT imaging provides a reliable template to determine TSA and to plan optimal clamp tine positioning along the syndesmotic axis. Our study has established normal ranges for cross-sectional syndesmotic axis measurements during weight-bearing and established that no differences exist between laterality and gender in patients without syndesmotic injury.

HES1 is a novel downstream modifier of the SHH-GLI3 Axis in the development of preaxial polydactyly.

Sonic Hedgehog/GLI3 signaling is critical in regulating digit number, such that Gli3-deficiency results in polydactyly and Shh-deficiency leads to digit number reductions. SHH/GLI3 signaling regulates cell cycle factors controlling mesenchymal cell proliferation, while simultaneously regulating Grem1 to coordinate BMP-induced chondrogenesis. SHH/GLI3 signaling also coordinates the expression of additional genes, however their importance in digit formation remain unknown. Utilizing genetic and molecular approaches, we identified HES1 as a downstream modifier of the SHH/GLI signaling axis capable of inducing preaxial polydactyly (PPD), required for Gli3-deficient PPD, and capable of overcoming digit number constraints of Shh-deficiency. Our data indicate that HES1, a direct SHH/GLI signaling target, induces mesenchymal cell proliferation via suppression of Cdkn1b, while inhibiting chondrogenic genes and the anterior autopod boundary regulator, Pax9. These findings establish HES1 as a critical downstream effector of SHH/GLI3 signaling in the development of PPD.

Frizzled3 inhibits Vangl2-Prickle3 association to establish planar cell polarity in the vertebrate neural plate.

The orientation of epithelial cells in the plane of the tissue, known as planar cell polarity (PCP), is regulated by interactions of asymmetrically localized PCP protein complexes. In the Xenopus neural plate, Van Gogh-like2 (Vangl2) and Prickle3 (Pk3) proteins form a complex at the anterior cell boundaries, but how this complex is regulated in vivo remains largely unknown. Here, we use proximity biotinylation and crosslinking approaches to show that Vangl2-Pk3 association is inhibited by Frizzled3 (Fz3, also known as Fzd3), a core PCP protein that is specifically expressed in the neuroectoderm and is essential for the establishment of PCP in this tissue. This inhibition required Fz3-dependent Vangl2 phosphorylaton. Consistent with our observations, the complex of Pk3 with nonphosphorylatable Vangl2 did not polarize in the neural plate. These findings provide evidence for in vivo regulation of Vangl2-Pk3 complex formation and localization by a Frizzled receptor.

Hox gene expression predicts tetrapod-like axial regionalization in the skate, Leucoraja erinacea

The axial skeleton of tetrapods is organized into distinct anteroposterior regions of the vertebral column (cervical, trunk, sacral, and caudal), and transitions between these regions are determined by colinear anterior expression boundaries of Hox5/6, -9, -10, and -11 paralogy group genes within embryonic paraxial mesoderm. Fishes, conversely, exhibit little in the way of discrete axial regionalization, and this has led to scenarios of an origin of Hox-mediated axial skeletal complexity with the evolutionary transition to land in tetrapods. Here, combining geometric morphometric analysis of vertebral column morphology with cell lineage tracing of hox gene expression boundaries in developing embryos, we recover evidence of at least five distinct regions in the vertebral skeleton of a cartilaginous fish, the little skate (Leucoraja erinacea). We find that skate embryos exhibit tetrapod-like anteroposterior nesting of hox gene expression in their paraxial mesoderm, and we show that anterior expression boundaries of hox5/6, hox9, hox10, and hox11 paralogy group genes predict regional transitions in the differentiated skate axial skeleton. Our findings suggest that hox-based axial skeletal regionalization did not originate with tetrapods but rather has a much deeper evolutionary history than was previously appreciated.

What is the Orbital Volume of African-Americans?

PurposeMeasurements of orbital volume (OV) are important for reconstructive operations of orbits such as congenital deformities, trauma, and pathology. Successful orbital reconstruction relies on an accurate restoration of OV. The purpose of this study was to identify the OV in the African-American (AA) population. The specific aims were to compare OV of AAs to Caucasians and right-to-left OV in the same racial group. This is the first project in available literature that calculates these OVs. Materials and methodsThe authors implemented a retrospective observational study of successive subjects who received a maxillofacial computed tomography (CT) scan at Grady Memorial Hospital between 2017 and 2020. The primary predictor variable was race. The primary outcome was orbital volume. Two independent examiners calculated OV with an open access OsiriX MD software (version 10.0.5; Pixmeo, Switzerland). All CT scans were acquired using a departmental-based max-face CT scan protocol; 0.6mm slice thickness, 0.5mm slice increment, 100-120kV, 80-440mA, 200-220 FOV, 0.656 Pitch, and a 512 × 512 image matrix. All CT scan data sets were anonymized. The CT images was exported in the digital imaging and communication in medicine (DICOM) format file from Philips Intellispace PACS Enterprise 4.4 software to an external hard drive WD My Passport for Mac. Computer-assisted manual segmentation of OV was performed using an open-access OsiriX MD (software version 10.0.5 [Pixmeo, Switzerland]). The anterior and posterior boundary of the orbit was defined by posterior lacrimal crest and anterior aspect of the optic canal, respectively. Inter-rater reliability was calculated. Differences in means between races, genders, and sides were tested using an independent samples T-test. ResultsSixty subjects (120 orbits) with an average age of 36.7 years (range 22 to 78) met the inclusion criteria. Male-to-female ratio was 1:1. Racial distribution represented 30 AA (50%) and 30 Caucasian patients (50%). Inter-examiner reliability was 0.973. The mean OV of AA and Caucasians was 22.375 cm3 and 23.225 cm3, respectively (P = .07). The mean OV in AA and Caucasian males was 23.919 cm3 and 24.168 cm3, respectively (P = .71). The mean OV in AA and Caucasian females was 20.832 cm3 and 22.282cm3, respectively (P = .013). Gender analysis revealed that AA males had a statistically significant larger OV than AA females (P = <.0001). ConclusionIn conclusion, this study showed that the mean OV for AAs was 22.38 cm3 (male 23.919 cm3; female 20.832 cm3). Caucasian males and females had a larger OV than AA males and females. Caucasian and AA males had a larger OV than Caucasian and AA females. The study findings provide normative values for race and gender between AA and Caucasians. Understanding the average value for OV based on race and gender will assist in preoperative surgical planning of orbital trauma repair and therefore will improve surgical outcome.

Automatic Quantification of Anterior Lamina Cribrosa Structures in Optical Coherence Tomography Using a Two-Stage CNN Framework.

In this study, we propose a new intelligent system to automatically quantify the morphological parameters of the lamina cribrosa (LC) of the optical coherence tomography (OCT), including depth, curve depth, and curve index from OCT images. The proposed system consisted of a two-stage deep learning (DL) model, which was composed of the detection and the segmentation models as well as a quantification process with a post-processing scheme. The models were used to solve the class imbalance problem and obtain Bruch’s membrane opening (BMO) as well as anterior LC information. The detection model was implemented by using YOLOv3 to acquire the BMO and LC position information. The Attention U-Net segmentation model is used to compute accurate locations of the BMO and LC curve information. In addition, post-processing is applied using polynomial regression to attain the anterior LC curve boundary information. Finally, the numerical values of morphological parameters are quantified from BMO and LC curve information using an image processing algorithm. The average precision values in the detection performances of BMO and LC information were 99.92% and 99.18%, respectively, which is very accurate. A highly correlated performance of R2 = 0.96 between the predicted and ground-truth values was obtained, which was very close to 1 and satisfied the quantification results. The proposed system was performed accurately by fully automatic quantification of BMO and LC morphological parameters using a DL model.

Variations of stress field and stone fracture produced at different lateral locations in a shockwave lithotripter field

During clinical procedures, the lithotripter shock wave (LSW) that is incident on the stone and resultant stress field is often asymmetric due to the respiratory motion of the patient. The variations of the LSW-stone interaction and associated fracture pattern were investigated by photoelastic imaging, phantom experiments, and three-dimensional fluid-solid interaction modeling at different lateral locations in a lithotripter field. In contrast to a T-shaped fracture pattern often observed in the posterior region of the disk-shaped stone under symmetric loading, the fracture pattern gradually transitioned to a tilted L-shape under asymmetric loading conditions. Moreover, the model simulations revealed the generation of surface acoustic waves (SAWs), i.e., a leaky Rayleigh wave on the anterior boundary and Scholte wave on the posterior boundary of the stone. The propagation of SAWs on the stone boundary is accompanied by a progressive transition of the LSW reflection pattern from regular to von Neumann and to weak von Neumann reflection near the glancing incidence and, concomitantly, the development and growth of a Mach stem, swirling around the stone boundary. The maximum tensile stress and stress integral were produced by SAWs on the stone boundary under asymmetric loading conditions, which drove the initiation and extension of surface cracks into the bulk of the stone that is confirmed by micro-computed tomography analysis.

A New Method for Anterior Boundary Demarcation of the Nasopharynx in Three-Dimensional Analysis

Three-dimensional (3D) measurements of the upper airway have been extensively applied and researched, but the division of the airway is carried out in various ways, especially when demarcating the anterior boundary of the nasopharynx. The present study was to propose a new method based on the anatomical definition for the anterior boundary demarcation of the nasopharynx used in three-dimensional analysis. Twenty computed tomography scans (age 9.5 ± 2.5 years, 11 males, and 9 females) of head and neck were randomly selected and transferred to Materialism's interactive medical image control system 19.0 for segmentation of the nasopharynx. Precise localization of the reference points that determining the nasopharyngeal anterior and inferior boundaries was managed by recording their coordinates in the interface of the software. The area of the anterior and the inferior boundaries, and the volume of the nasopharynx were measured and repeated with a 2-week interval for the consistency test. Both the interobserver reliability as well as the intra-observer reliability were very high (intraclass correlation coefficients, 0.985-0.997). Paired t test showed no significant difference between the first and the second examinations. This new simple method proposed for demarcation of the nasopharyngeal anterior boundary was based on the innate anatomical boundary, which was statistically reliable, technically convenient, and clinically reasonable.

Diagnostic value of necrotic lesion boundary in bone collapse of femoral head osteonecrosis.

Our research developed a novel approach to quantitatively evaluate the boundary of necrotic lesions in osteonecrosis of the femoral head (ONFH) and to explore its diagnostic value in predicting bone collapse of the femoral head. A retrospective cross-sectional study was conducted in our institution, and 146 hips (121 cases) identified as ONFH were recruited. The anterior and lateral boundaries of each enrolled subject were measured in standard anteroposterior (AP) view and frog-leg (FL) view of plain radiographic images, the intact rate of which was then calculated and presented as the anteroposterior view intact ratio (APIR) and frog-leg view intact ratio (FLIR), respectively. Univariate and multivariate logistic regression analyses were performed to identify risk factors for collapse. A receiver operating characteristic (ROC) curve analysis was performed to determine the sensitivity, specificity and cutoff value of the APIR and FLIR. A Kaplan-Meier (K-M) analysis was applied to calculate the survival rate of the femoral head, and bone collapse of the femoral head was regarded as the endpoint. Femoral head collapse was observed in 61 hips during the follow-up period. Patients with or without femoral head collapse were categorized into the collapse group and non-collapse group, respectively. The mean follow-up time was 3.7years (2-9) for the collapse group and 7.7years (5-20) for the non-collapse group. Univariate and multivariate logistic regression analysis and ROC analysis showed that APIR (< 25.61%) and FLIR (< 24.43%) were significantly associated with femoral head collapse. The K-M survival curves indicated that the overall survival rate of APIR (≥ 25.61%) was 94.8% at 7.5years and 76.6% at 10years, while that of FLIR (≥ 24.43%) was 87.3% at 7.5years and ten years. The present study demonstrates that APIR and FLIR are of high diagnostic value in the early and middle stages of ONFH. APIR and FLIR can be used to predict the occurrence of femoral head collapse in patients with JIC classification types B and C1. The measurement of these two parameters in plain radiography images may contribute to the selection of a proper hip preservation strategy.

Transoral Endoscopic Localization of the Parapharyngeal Internal Carotid Artery.

Objectives To define transoral endoscopic surgical landmarks for the parapharyngeal segment of the internal carotid artery (ppICA) using cadaveric dissection. Methods Ten fresh cadaveric heads were dissected to demonstrate the parapharyngeal space anatomy and course of the ppICA as seen in a transoral approach. Anatomical measurements of the distance between the ppICA and bony landmarks were recorded and analyzed. Results The stylohyoid ligament, styloglossus, and stylopharyngeus could be considered to be the safe anterior boundary of the ppICA in the transoral approach; among them, the styloid ligament was the most rigid tissue. Dissection between the stylopharyngeus muscle and superior pharyngeal constrictor muscle provides direct access to the ppICA. At the level of the skull base, the distance from the root of the styloid process to the lateral margin of the external aperture of the carotid canal on the left side and on the right side was 8.57 ± 1.97 and 8.80 ± 1.21 mm, respectively. At the level of the maxillary tuberosity, the distance from the ppICA to the maxillary tuberosity on the left side and on the right side was 31.48 ± 2.24 and 31.01 ± 2.88 mm, respectively. Conclusion The endoscopic-assisted transoral approach can facilitate exposure of the ppICA. The root of the styloid process, styloid ligament, and maxillary tuberosity are critical landmarks in the identification of the ppICA in the transoral approach.

Peripapillary sclera exhibits a v-shaped configuration that is more pronounced in glaucoma eyes

AimsTo compare the shape of the anterior surface of the peripapillary sclera (PPS) between glaucoma and healthy subjects.Methods88 primary open angle glaucoma (POAG), 98 primary angle closure glaucoma (PACG) and...

Anatomic features of the cranial aperture of the optic canal in children: a radiologic study.

This study aimed to peruse anatomic features of the cranial aperture of the optic canal (CAOC) for obtaining an extended morphometric dataset in children. Computed tomography images of 200 children were included in this retrospective work to analyze the shape, location and diameters of the CAOC. The CAOC area, width and height were observed as 17.53 ± 2.80mm2, 6.12 ± 0.84mm, and 4.35 ± 0.64mm, respectively. The angle of the optic canal in axial plane was found as 39.28 ± 5.13°, while in sagittal plane as 16.01 ± 6.76°. The distance between the CAOC and the midsagittal line was 7.17 ± 1.48mm. The CAOC was measured as 54.04 ± 5.23mm and 42.55 ± 3.28mm away from the anterior and lateral boundary of the anterior skull base, respectively. The CAOC shape was described as the tear-drop (186 foramina, 46.5%), triangular (156 foramina, 39%), oval (47 foramina, 11.8%), and round (11 foramina, 2.8%). The depth, angle and diameter measurements belonging to the CAOC were changing according to its shape or demographic data (e.g., sex and age). Therefore, preoperative radiologic evaluation containing the shape, location and size of the CAOC should be considered by multidisciplinary operating teams in terms of surgical interventions such as implant positioning.

Anterior chamber angle imaging with swept-source optical coherence tomography: comparison between CASIAII and ANTERION

This study compared the test–retest variabilities and measurement agreement of anterior chamber angle (ACA) dimensions measured by two anterior segment swept-source optical coherence tomography (SS-OCT)—the ANTERION (Heidelberg Engineering, Heidelberg, Germany) and CASIAII (Tomey, Nagoya, Japan). Thirty-eight subjects, 18 patients with primary angle closure and 20 healthy participants with open angles, were included. The mean age was 54.7 ± 15.8 years (range: 26–75 years). One eye of each subject was randomly selected for anterior segment imaging by ANTERION and CASIAII, using the same scan pattern (6 evenly spaced radial scans across the anterior segment for three times) in the same visit. The between- and within-instrument agreement and repeatability coefficients of angle open distance (AOD500), trabecular-iris space area (TISA500), lens vault (LV), scleral spur-scleral spur distance (SSD), anterior chamber depth (ACD), and pupil diameter (PD) were measured. The anterior and posterior boundaries of the cornea, iris, and lens were automatically segmented by the SS-OCT instruments; the scleral spur was manually located by a single masked observer. There were significant differences between ANTERION and CASIAII measurements; the SSD, PD, and ACD were smaller whereas AOD500 and TISA500 were greater in ANTERION compared with CASIAII (P < 0.001). Anterior segment measurements obtained from the two SS-OCT instruments showed strong associations (R2 ranged between 0.866 and 0.998) although the between-instrument agreement was poor; the spans of 95% limits of between-instrument agreement were ≥ 1.5-folds than the within-instrument agreement for either instrument. Whereas both SS-OCT instruments showed low test–retest measurement variabilities, the repeatability coefficients of AOD500, TISA500, ACD, and PD were slightly smaller for CASIAII than ANTERION (P ≤ 0.012).

Dynamic Stability In Runners With Plantar Fasciitis

Plantar fasciitis (PF) is a common running injury associated with low arch height, and excessive loading and pronation. Research has shown gait alterations in individuals with PF including increased rearfoot eversion, forefoot plantarflexion, and MTPJ dorsiflexion, and reduced center of pressure (COP) duration at the heel. Changes in kinematics and COP trajectory may affect dynamic stability. Therefore, dynamic stability as measured by time to contact (TtC) may be reduced in runners with PF. PURPOSE: To determine differences in dynamic stability during the stance phase of running in individuals with PF. METHODS: Twenty runners were separated into two groups based on injury status (1: PF; 2: healthy). Kinematic and kinetic data were collected at 200 and 1000 Hz, respectively, as participants ran at 3.5 m/s ±5%. TtC of the COP to the medial and anterior boundaries of the base of support were calculated over the stance phase. Minimum TtC values were determined for each portion of stance per trial, averaged across five trials per participant and across participants per group. Differences in TtC between groups during early, middle, and late stance were determined using one-way ANOVAs with alpha level set at 0.05. RESULTS: Group demographics were similar. TtC was similar between groups during early and late stance and different during mid-stance (Table 1). CONCLUSION: TtC was similar between runners with and without PF during early and late stance which may be related to inherent instability in transition phases. Runners with PF had reduced TtC during mid-stance suggesting a more rigid control strategy reflecting the injured state and increased potential for loss of balance.Table 1: Results for demographics and time to contact (TtC) for runners with and without plantar fasciitis (PF). * = significant difference (α=0.05).

CORRELATION OF SUBRETINAL HYPERREFLECTIVE MATERIAL MORPHOLOGY AND VISUAL ACUITY IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION.

To evaluate the association of subretinal hyperreflective material (SHRM) morphological features with visual acuity in eyes with neovascular age-related macular degeneration. Retrospective analysis of treatment-naïve patients with neovascular age-related macular degeneration enrolled in randomized anti-vascular endothelial growth factor (VEGF) and anti-platelet-derived growth factor clinical trials. Standardized spectral domain optical coherence tomography images were graded at baseline, 12-week, and 24-week follow-up visits. Masked readers evaluated the morphology of SHRM (reflectivity, shape, anterior, and posterior boundaries) and measured SHRM height, width, and area at the fovea, within the center 1 mm, and outside the center 1 mm. Baseline SHRM characteristics that correlated with worse visual acuity at 12 and 24 weeks included layered appearance (P = 0.006, 0.001), hyperreflective spots in SHRM (P = 0.001, 0.011), and separation between SHRM and outer retina (P = 0.03, 0.019). The disappearance of SHRM correlated with better visual acuity at Weeks 12 and 24 (P < 0.001). Layered appearance of SHRM at baseline was significantly associated with increased reflectivity at Weeks 12 and 24 (P = 0.009, 0.003). Decreasing reflectivity of SHRM lesion at Weeks 12 and 24 correlated with better visual acuity (P < 0.01, 0.01). Increased width and area of baseline SHRM at the foveal center correlated with worse visual acuity at 12 (P < 0.001, <0.001) and 24 weeks (<0.001, <0.001). Several attributes of SHRM including, layered appearance, increased reflectivity, larger size, and hyperreflective spots correlated with worse visual acuity at 12- and 24-week follow-ups. Baseline SHRM characteristics can help practitioners predict visual and morphological prognosis and guide therapy.