Disc Changes Research Articles

A Rare Case of Posterior Ischemic Optic Neuropathy after Appendicectomy

Ischemic optic neuropathy is classified into anterior and posterior ischemic optic neuropathy depending upon the part of optic nerve involved. In anterior optic neuropathy, optic nerve head is involved and in posterior ischemic optic neuropathy(PION) retrobulbar portion is involved. There is sudden loss of vision in both the entities but there are optic disc changes in anterior optic neuropathy while in posterior ischemic optic neuropathy optic disc is normal initially. Etiologically, posterior ischemic optic neuropathy is divided into non arteritic non-surgical, arteritic and perioperative non arteritic posterior ischemic optic neuropathy.

671 Examining Degenerative Disease Adjacent to Lumbosacral Transitional Vertebrae: A Retrospective Cohort Study

INTRODUCTION: Bertolotti syndrome is a clinical diagnosis given to patients with lower back pain arising from a lumbosacral transitional vertebra (LSTV). LSTVs cause altered biomechanics at the lumbosacral junction and adjacent segments, predisposing these patients to degenerative disease. Signs of degenerative disease can manifest on magnetic resonance imaging (MRI) as signal changes in the intervertebral discs and facet joints, as well as spinal stenosis and spondylolisthesis, all of which may contribute to a patient’s symptoms. METHODS: This is a retrospective analysis of patients with Bertolotti syndrome and anatomically normal controls who received care at a single institution between 2010 and 2020. The control group consisted of patients presenting with lower back pain without an LSTV. Patients with a history of prior trauma, laminectomy, or fusion were excluded. Degree of spinal stenosis and spondylolisthesis, as well as signs of degenerative changes in the intervertebral disc and facet joints, were assessed using sagittal and axial magnetic resonance grading criteria established in prior literature. RESULTS: A total of 173 patients were included in the study, 104 with Bertolotti syndrome and 69 controls. On two-tailed t-test, mean L4-L5 spinal stenosis grade was shown to be significantly different between patients with Bertolotti syndrome (1.00) and control patients (1.47) (p = .002). The difference in mean L4-L5 facet grade (p = .32), mean L4-L5 spondylolisthesis grade (p = .13), and mean L4-L5 disk grade (p=.33) were not significantly different on two-tailed t-test (p = .32). CONCLUSIONS: Patients with Bertolotti Syndrome may be more likely to develop spinal stenosis above the lumbosacral junction than patients without an LSTV. More research needs to be done to determine whether Bertolotti Syndrome patients are at an increased risk to develop clinically-significant lumbar spondylosis.

EVALUATION OF OPTIC DISK AND MACULAR VASCULARITY CHANGES IN CRVO USING OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY.

To quantify changes in optic disk and macular vasculature in patients with central retinal vein occlusion using optical coherence tomography angiography and detect its correlation with visual acuity. The study included 20 eyes of 20 patients with treatment-naive central retinal vein occlusion and 20 age-matched controls. Optical coherence tomography and optical coherence tomography angiographywere performed on the macula and optic disk. Central 1-mm subfield foveal thickness was measured. Vessel densities (VD) of superficial and deep macular capillary plexuses with whole disk VD, inside disk VD, and radial peripapillary capillary plexus were analyzed. Macular ischemia was evaluated by fundus fluorescein angiography. Visual acuity was correlated with measured parameters. All measured macular and disk VDs differed significantly between cases and controls except inside disk VD. Visual acuity showed a highly significant negative correlation with whole disk VD ( P = 0.005) and radial peripapillary capillary ( P = 0.002), borderline correlation with central subfield foveal thickness ( P = 0.06), and insignificant correlation with macular VDs. Radial peripapillary capillary VD showed a significant correlation with deep parafoveal ( P = 0.04), and superficial and deep perifoveal VDs ( P = 0.01). Optic disk VD could provide more accurate indication of retinal blood supply than macular VD in cases of central retinal vein occlusion with severe macular edema.

Radiological outcomes of PEEK rods in patients with lumbar degenerative diseases: A minimum 5-year follow-up.

To determine the long-term radiological outcomes of PEEK rods in patients with lumbar degenerative diseases. Radiological outcomes of cohort cases with lumbar degenerative diseases following PEEK rods were retrospectively studied. Disc height index (DHI) and range of motion (ROM) were measured by x-rays. The CT scans and reconstruction were used to determine screw breakage, rods fracture, screw loosening and intervertebral bony fusion status. The MRI scans were used to evaluate the changes of intervertebral discs at the non-fusion segments and adjacent segments in terms of Pfirrmann Classification. A total of 40 patients completed the mean of 74.8 ± 9.6 months follow-up, with 32 patients undergoing hybrid surgery and 8 patients undergoing non-fusion surgery. The mean DHI changed from preoperative 0.34 to 0.36 at the final follow-up and the ROM declined from 8.8° preoperatively to 3.2° at the final visit, however, both had no statistical differences. Of the 40 levels underwent non-fusion procedure, 9 levels showed disc rehydration with 7 patients from Grade 4 to Grade 3 and 2 patients from Grade 3 to Grade 2. The other 30 cases did not show distinctive change. No screw loosening or rods breakage were detected during the follow-up periods. PEEK rods have obvious protective effects on degenerated intervertebral disc of non-fusion segments and the incidence of complications related to internal fixation is low. PEEK rods pedicle screw system is safe and effective in the treatment of lumbar degenerative diseases.

FOXO3-Activated circFGFBP1 Inhibits Extracellular Matrix Degradation and Nucleus Pulposus Cell Death via miR-9-5p/BMP2 Axis in Intervertebral Disc Degeneration In Vivo and In Vitro

(1) Background: intervertebral disc degeneration (IVDD) defined as the degenerative changes in intervertebral disc is characterized by extracellular matrix (ECM) degradation and death in nucleus pulposus (NP) cells. (2) Methods: The model of IVDD was established in male Sprague Dawley rats using a puncture of a 21-gauge needle at the endplates located in the L4/5 intervertebral disc. Primary NP cells were stimulated by 10 ng/mL IL-1β for 24 h to mimic IVDD impairment in vitro. (3) Results: circFGFBP1 was downregulated in the IVDD samples. circFGFBP1 upregulation inhibited apoptosis and extracellular matrix (ECM) degradation and promoted proliferation in IL-1β-stimulated NP cells. Additionally, circFGFBP1 upregulation mitigated the loss of NP tissue and the destruction of the intervertebral disc structure in vivo during IVDD. FOXO3 could bind to the circFGFBP1 promoter to enhance its expression. circFGFBP1 upregulated BMP2 expression in NP via sponging miR-9-5p. FOXO3 enhanced the protection of circFGFBP1 in IL-1β-stimulated NP cells, whereas a miR-9-5p increase partly reversed the protection. miR-9-5p downregulation contributed to the survival of IL-1β-stimulated NP cells, which was partially reversed by BMP2 silence. (4) Conclusions: FOXO3 could activate the transcription of circFGFBP1 via binding to its promoter, which resulted in the enhancement of BMP2 via sponging miR-9-5p and then inhibited apoptosis and ECM degradation in NP cells during IVDD.

Differentiating Glaucomatous Optic Neuropathy From Non-glaucomatous Optic Neuropathies Using Deep Learning Algorithms

A deep learning framework to differentiate glaucomatous optic disc changes due to glaucomatous optic neuropathy (GON) from non-glaucomatous optic disc changes due to non-glaucomatous optic neuropathies (NGONs). Cross-sectional study. A deep-learning system was trained, validated, and externally tested to classify optic discs as normal, GON, or NGON, using 2183 digital color fundus photographs. A Single-Center data set of 1822 images (660 images of NGON, 676 images of GON, and 486 images of normal optic discs) was used for training and validation, whereas 361 photographs from 4 different data sets were used for external testing. Our algorithm removed the redundant information from the images using an optic disc segmentation (OD-SEG) network, after which we performed transfer learning with various pre-trained networks. Finally, we calculated sensitivity, specificity, F1-score, and precision to show the performance of the discrimination network in the validation and independent external data set. For classification, the algorithm with the best performance for the Single-Center data set was DenseNet121, with a sensitivity of 95.36%, precision of 95.35%, specificity of 92.19%, and F1 score of 95.40%. For the external validation data, the sensitivity and specificity of our network for differentiating GON from NGON were 85.53% and 89.02%, respectively. The glaucoma specialist who diagnosed those cases in masked fashion had a sensitivity of 71.05% and a specificity of 82.21%. The proposed algorithm for the differentiation of GON from NGON yields results that have a higher sensitivity than those of a glaucoma specialist, and its application for unseen data thus is extremely promising.

Optical Coherence Tomography Angiography Demonstrates Strain and Volume Effects on Optic Disk and Peripapillary Vasculature Caused by Horizontal Duction

Purpose The optic nerve mechanically loads the eye during ocular rotation, thus altering the configuration of the disk and peripapillary tissues. We used optical coherence tomography (OCT) angiography (OCTA) to investigate mechanical strains and volume changes in disk and peripapillary blood vessels during horizontal duction. Methods Structural OCT and OCTA were performed centered on optic disks; imaging was repeated in central gaze, and in 30° ab- and adduction. By an algorithm employing point-set registration of 3 D features, we developed a novel approach for measuring disk strains, and strains and volumes of the blood vessels associated with horizontal duction. Repeatability was demonstrated in each gaze position. Results 19 eyes of 10 healthy adults of average age 37 ± 15 (standard deviation, SD) years were imaged. The method was validated by demonstrating numerically consistent vascular volumes and strains for repeated imaging under identical conditions. Compared with central gaze, vascular volume increased by 5.2 ± 4.1% in adduction. Adduction and abduction caused strains of 3.0 ± 1.6% and 2.6 ± 1.8% in the optic disk, whereas blood vessels showed greater strains of 8.1 ± 1.3% and 8.2 ± 1.7%. Decomposition of strain components depending on directionality and regions demonstrated that adduction induces significant net tensile strains, suggesting traction exerted by the optic nerve. The decomposition also showed that nasotemporal compressive strains are larger in temporal hemidisks than nasal hemidisks. The Bruch’s membrane opening was significantly compressed horizontally in adduction by 1.1% (p = .009). Conclusion This novel analysis combining structural OCT and OCTA demonstrates that optic disk compression during adduction is associated with disk and vascular strains much larger than reported for intraocular pressure elevation and pulsatile perfusion, as well as compressing the disk and increasing peripapillary vascular volume. These changes may be relevant to the pathogenesis of optic nerve and retinal vascular disorders.

A systematic morphology study on the effect of high glucose on intervertebral disc endplate degeneration in mice

To explore the relationship between diabetes and intervertebral disc degeneration in mice and the associated underlying mechanism. Four-week-old male Kunming mice were used to model diabetes using a high-fat diet combined with streptozotocin injection. After 6 months, morphological and pathological changes in L4-L6 intervertebral discs were detected by magnetic resonance imaging, micro-CT and histological staining. Immunostaining of CD31, F4/80 and CD16/32 receptors was used to detect vascular invasion and inflammatory infiltration in endplates; the exact changes were then explored by the transmission electron microscopy. The nucleus pulposus of the control and the diabetic group had a clear boundary and regular shape without collapse, while endplate calcification and chondrocyte abnormality in the diabetic group were more obvious. Immunofluorescence confirmed that compared to control, expression levels of CD31 (vascular endothelial marker) and F4/80 (monocyte/macrophage marker) in the diabetic group were significantly increased (P < 0.05), with an elevated number of F4/80 (+)/CD16/32 (+) cells (P < 0.05). The morphology of endplates was observed by transmission electron microscopy, which showed monocytes/macrophage accumulation in the endplate of the diabetic group, accompanied by increased vascular density, collagen fiber distortion and chondrocyte abnormality. In a conclusion, diabetes promotes endplate degeneration with vascular invasion, monocyte/macrophage infiltration and inflammation in mice.

The role of endplate injury in intervertebral disc degeneration after vertebral augmentation in OVCF patients.

Whether vertebral augmentation can induce or aggravate the degeneration of adjacent intervertebral discs remains controversial. The purpose of this study is to explore the role of endplate injury in intervertebral disc degeneration after vertebral augmentation. The imaging data of patients with single-segment osteoporotic vertebral compression fractures (OVCFs) were retrospectively analyzed. The upper and lower discs of the fractured vertebrae were defined as cranial and caudal discs, and the discs adjacent to the cranial discs were defined as control discs. According to the integrity of the cranial and caudal endplates, they were divided into an injury group and a noninjury group. At follow-up, the increase in the modified Pfirrmann score on MRI compared with the baseline grade was defined as the occurrence of a degenerative disc change (DDC). The changes in the disc height and the number of DDC cases on MRI during the follow-up in each group were analyzed. A total of 56 patients with OVCFs were included in this study, with an average follow-up time of 18.8 ± 14.1 months (3-62 months). In the cranial and caudal discs, the number of DDC cases in the endplate injury group was significantly higher than that in the noninjury group (P = 0.007 and P = 0.018). However, the number of DDC cases in the whole endplate injury group (including the cranial and caudal endplates) was significantly higher than that of the whole noninjury group (P = 0.000) and the control group (P = 0.000). The number of DDC cases in the whole noninjury group was not different from that of the control group (P = 0.192). At follow-up, the disc height of the cranial and caudal endplate injury group was significantly lower than the baseline (P = 0.000 and P = 0.001), but the disc height of the noninjury group was not significantly lower than the baseline (P = 0.074 and P = 0.082). Endplate injury is associated with adjacent intervertebral disc degeneration in OVCF patients after vertebral augmentation. Evaluation of endplate damage before vertebral enhancement in OVCF patients has an important reference value for predicting the outcome of adjacent intervertebral discs after surgery.

Predictability of degenerative disc disease by lumbar sagittal alignment on conventional radiograph in comparison with cross-sectional magnetic resonance imaging

Background: Degenerative disc disease (DDD) affects approximately 80% of the population. Changes in the magnitude of lumbar lordosis significantly change the weight-bearing patterns in lumbar facet joints and intervertebral discs. It is essential to understand the contribution of hypo and hyperlordosis toward the development of disc degeneration disease. Materials and Methods: A retrospective study of X-ray and magnetic resonance imaging (MRI) of the lumbosacral spine of 200 patients with chronic low back ache. The lumbar lordotic angle was measured in a standing lateral radiograph using Cobb's method (between the lines drawn along the inferior end plate of D12 and the superior end plate of S1 vertebrae). DDD was assessed on MRI based on the Pfirrmann grading system. The correlation between the lordosis measured on the radiograph and DDD on MRI was assessed. Results: We analyzed the lumbar sagittal alignment effect on the degree of disc degenerative disease. Out of 200 patients, 70 had no disc degenerative disease (Grade I, II) whose Cobb's angle was 45°–75°. The remaining 130 patients showed disc changes (Grades III-V) on MRI and had Cobb's angle <45° or >75°. There was a statistically significant difference between Cobb's angle in normal and DDD patients with P = 0.009 (P < 0.05). Conclusion: DDD correlated with deviation from an optimal lumbar lordotic angle (Cobb's angle) of 45° to 75°. Deviation from optimal values would compromise the optimal weight-bearing conditions on the lumbar spine resulting in DDD. These results may well have implications for the diagnosis, prevention, treatment, and rehabilitation of DDD.

Predictors of visual outcome following surgery in sellar lesions

ABSTRACT Purpose: The purpose of the study is to find out the factors affecting visual outcome after surgery in patients with sellar lesions. Methods: We prospectively analyzed 36 patients diagnosed with sellar tumors who underwent surgery between July 2018 and January 2020. Clinical and demographic data including age, sex, pre- and post-operative visual acuity, visual field, and fundus examination was done in these patients. Size of the tumor was also measured radiologically. The size of the tumor was categorized as &lt;2 and ≥2 cm. Results: Larger tumors had significant association with optic disc changes and visual field defects. The mean visual acuity (LogMAR) and field defects (mean deviation) improved postsurgery (paired t-test). Five of the six patients with peripheral constriction showed an improvement in the visual fields after surgery while only one of 15 patients with temporal hemianopia showed improvement in visual fields after surgery (P = 0.009). Patients with a tumor size &lt;2 cm had statistically significant improvement in visual acuity (paired t-test P &lt; 0.001) and visual fields (paired t-test P = 0.008. Conclusion: Tumor size &lt;2 cm was found to be a good predictor of visual outcome after surgery.

Determinants for Anemic Retinopathy.

To study the prevalence of fundus lesions in anaemics and define the hematological risk factors for retinopathy using the receiver operating characteristic curve analysis. For this retrospective study, patients ≥18 years and diagnosed with anemia with dilated fundus examination by a retina specialist from May 2019-April 2020 were included. Anemic retinopathy (AR) was present if hemorrhages in different layers of the retina, Roth's spots, exudates, cotton wool spots, retinal edema, and optic disc changes were noted. Patients with secondary anemia were excluded. Two groups were identified: Group 1: Patients with AR; Group 2: Patients with no AR with normal fundus. Demographic features, fundus findings, and hematological parameters were noted. 38 (30%) eyes of 23 patients had AR; 90 (70%) eyes of 47 patients had no AR. The mean age in Group 1 and Group 2 was 54.7±18.9 and 58.6±15.3 years, respectively. Low hemoglobin (Hb) [mean = 7.82±1.64 gm/dl, p=<0.001] and hematocrit [mean = 26.93±5.22 %, p=0.002] values were noted in the AR group. AUC values for Hb (0.737) and hematocrit (0.719) were higher for the AR group. Hb < 8.95g/dl could predict AR with 85.8% sensitivity and 68.9% specificity, and hematocrit < 30.5% could predict AR with 80% sensitivity and 53.2% specificity. On regression analysis, Hb (p<0.001) and hematocrit (p=0.000) were associated with AR. Retinopathy is frequently seen in severe anemic patients. It is recommended that patients having low anemia should undergo a retinal examination.

MORFOMETRIA DE RM DE DISCOS LOMBARES E CORPOS VERTEBRAIS EM CORRELAÇÃO COM O NÍVEL SÉRICO DE VITAMINA D

ABSTRACT Introduction: The knowledge of the intervertebral disc morphology and its relation with the vertebrae is vital for managing degenerative spine disease. It is imperative to study the role of preventable and treatable causes, such as Vitamin D deficiency, so that standard guidelines can be framed for apt management. Objective: To evaluate the correlation between serum vitamin D levels and MRI morphometry of lumbar intervertebral discs. Methods: A total of 100 subjects (20-40 years) underwent an MRI of the lumbosacral spine. Intervertebral disc and vertebral body heights were measured, and disc degenerative changes were noted. Serum vitamin D levels were correlated with disc changes using the Pearson/Spearman rank correlation coefficient. A p-value of &lt;0.05 was considered significant. Results: Vitamin D deficiency showed a high prevalence in patients with disc degenerative diseases, even in young adults and females with more severe vitamin D deficiency than males (p-value &lt; 0.001). However, a significant relationship between vitamin D levels and disc or vertebral body heights could not be established. Conclusion: Vitamin D deficiency is more prevalent in patients with disc degenerative changes; however, its effect on disc and vertebral body heights needs to be extrapolated further in larger studies. Level of Evidence I; Cross-Sectional, Observational Study.

Impact of Selected Processing Methods of High-Level Cyanide in Cassava on Optic Neuropathy in Wistar Albino Rats—An Experimental Study

Background: Cassava tuber crop is a staple food rich in carbohydrates and utilized in various forms by millions of Nigerians. The storage root of the cassava contains linamarin, a cyanogenic glycoside that is easily hydrolyzed to release cyanide salt compounds which is toxic to the nervous system especially the optic nerve, sometimes leading to optic neuropathy and visual impairment. Aim: The aim of this study is to find out the impact of selected processing methods of high-level cyanide in cassava on optic neuropathy in Wistar albino rats. Methodology: Twenty-four Wistar albino rats were fed with different concentration and duration of predetermined high-cyanide content cassava root cultivar which was processed using different processing methods adopted by various communities in Rivers State, Nigeria (for human consumption). A control group of 3 Wistar albino rats was fed with normal “Growth Mesh” meals. The pre and post weights of the animals and the fundoscopic optic nerve status of the rats were evaluated after 30 and 60 days. SPSS Version 25 was employed for descriptive and inferential statistical analyses. A p-value of ≤0.05 was considered statistically significant. Results: The Cassava species available in Rivers State have high cyanide content (2336.79 mg CN-/kg dry weight of cassava). There was statistically significant reduction in the cyanide content (p = 0.000) depending on the various common processing methods (into garri for human consumption): 24 hours, 48 hours, fermentation; with and without red palm oil additive. The individual weights as well as the mean weight of the 24 rats in the experimental group increased gradually from the first week to the 9th week with a slight weight reduction on the third and fourth weeks which was not statistically significant (p = 0.092). However, there was a steady increase in the weights of the animals in the control group throughout the 9 weeks. Varying degrees of optic neuropathy occurred, worse with the rats that had 24-hour fermented cassava twice daily for 60 days. The intra and inter group differences in the optic disc changes was statistically significant (p = 0.000). Conclusion: Longer duration of processing cassava roots into garri for human consumption reduces its cyanide content and minimizes the adverse impact on the optic nerve.

MORPHOMETRIC FEATURES OF EYE STRUCTURES ACCORDING TO OCT AND CHANGES IN HEMODYNAMICS IN PATIENTS WITH ANTERIOR UVEITIS COMPLICATED BY OPTIC NEURITIS

Aim. Identify changes in the optic disc and vascular membrane by OCT, as well as features of hemodynamics and the possibility of communication between these parameters. Materials and methods. In 150 patients with idiopathic monolateral anterior uveitis, ophthalmic (visometry, refractometry, tonometry, perimetry, biomicroscopy, direct, reverse ophthalmoscopy), examination, rheophthalmography (ROG) and optical coherence tomography (OCT) of structures were performed. Patients received treatment according to the protocol, including, if necessary, antibacterial, antiviral, steroidal and nonsteroidal anti-inflammatory, immunosuppressive, desensitizing, vasodilating, immunomodulatory drugs. Statistical analysis was performed using Statistica 10.0 using Student's coefficient, pairwise correlation and Spearman's rank correlation Research results. The OCT results of the eyes of patients with optic neuritis on the background of anterior uveitis showed a significant increase in the thickness of the layer of peripapillary nerve fibers and vascular membrane by 34.3 and 38.9% relative to the data in anterior uveitis without complications. ROG revealed a significant increase in the tone of small and large vessels of the eye in neuritis on the background of anterior uveitis by 14.2 and 17.2% compared to those without neuritis. There was a direct significant strong relationship between the thickness of peripapillary fibers and the thickness of the vascular membrane with volumetric pulse blood filling, the volume of volumetric blood filling, tonic properties of large and small vessels (r = 0,699-0,909); average - between the diameter of the optic nerve at the entrance to the orbit and the parameters of the ROG (r = 0,647-0,797); weak - determined in the retrobulbar and middle department (r = 0.241-0.453). The development of neuritis in uveitis is accompanied by an increase in the thickness of the peripapillary fibers and vascular membrane, the diameter of the optic nerve at the entrance to the orbit, in the retrobulbar and middle department, as well as volumetric pulse blood filling, volumetric connection in all cases (Spearman r 0.421-0.754). Conclusions 1. The results of OCT of the eyes with optic neuritis on the background of anterior uveitis showed a significant increase in the thickness of the layer of peripapillary nerve fibers and vascular membrane relative to the data in persons with anterior uveitis without complications. 2. The horn of the tonic properties of the vessels revealed a significant increase in the tone of small and large vessels of the eye with optic neuritis on the background of anterior uveitis relative to those without neuritis. 3. The direct strong reliable correlation of indicators of thickness of peripheral fibers and a vascular cover with volume pulse blood filling, speed of volume blood filling, tonic properties of large and small vessels is revealed. Average connection - between the diameter of the optic nerve at the entrance to the orbit and the parameters of the ROG, weak connection with the diameter of the optic nerve in the retrobulbar and middle department. 4. The development of optic neuritis against the background of anterior uveitis is accompanied by an increase in the thickness of the peripheral fibers and choroid, the diameter of the optic nerve at the entrance to the orbit, in the retrobulbar and middle section. The tonic properties of large and small vessels, volumetric pulse blood filling, and the speed of volumetric blood filling, as indicated by the presence of a significant direct correlation. Key words: chronic anterior idiopathic uveitis, optic neuritis, OCT, eye hemodynamics.

Changes of Optic Disc and Macular Vessel Perfusion Density in Primary Angle Closure Glaucoma: A Quantitative Study Using Optical Coherence Tomography Angiograph

Introduction: This study aims to investigate the changes of retinal vascular system in primary angle closure glaucoma (PACG) and acute primary angle closure (APAC) by optical coherence tomography (OCT) angiograph (OCTA) and to evaluate the diagnostic ability of changes of vessel density (VD) in different sectors and layers of optic disc and macular area in APAC and PACG. Methods: In this cross-sectional, observational study, 21 APAC patients (22 eyes) and 21 PACG patients (27 eyes) along with 17 healthy people were enrolled from August 2018 to March 2019. Optic disc region and macular region were imaged using swept-source OCTA system. VD of the macular region was quantified by Image J (1.52a, USA) and Matlab 2018a. The circumpapillary retinal nerve fiber layer (cpRNFL) thickness and ganglion cell complex thickness were obtained by spectral-domain OCT. Results: Compared with the healthy group, the cpRNFL thickness in superior sector was thicker in the APAC group, and this area had the most diffuse microvascular dropout as well. The difference in the macular superficial capillary plexus (SCP) VD between APAC and the control group was not statistically significant. The area under the ROC curves (AUC) of the total optic disc VD in the radial peripapillary capillary (RPC) layer was higher than the AUC of the papillary VD in the optic nerve head (ONH) layer. Compared to the control group, the total optic disc VD, peripapillary VD, and each quadrant of peripapillary VD were decreased in PACG (p < 0.01). In PACG macular region, SCP VD, and deep capillary plexus (DCP) VD, parafovea VD (except temporal sectors) decreased (p < 0.01). The PACG eyes had a greater decrease percentage of VD in total ONH than total macula. The diagnostic value of the VD in the ONH layer and the RPC layer was similar. The diagnostic value of the SCP VD in the macula was greater than the DCP VD in the macula. The AUC was no significant difference between cpRNFL thickness and the total optic disc VD AUC. Conclusion: Elevated intraocular pressure preferentially affects vascular perfusion in the optic disc region more than the macular region in APAC and PACG. In the APAC eyes, there was a perfusion defect in the optic disc region and an increase in RNFL thickness. In this study, the OCTA vascular parameters have similar performance to the OCT structural parameters for glaucoma diagnosis in PACG.

Magnetic resonance imaging texture analysis of the temporomandibular joint for changes in the articular disc in individuals with migraine headache

Objective: the aim of this study was to analyse the performance of the technique of texture analysis (TA) with magnetic resonance imaging (MRI) scans of temporomandibular joints (TMJs) as a tool for identification of possible changes in individuals with migraine headache (MH) by relating the findings to the presence of internal derangements. Material and Methods: thirty MRI scans of the TMJ were selected for study, of which 15 were from individuals without MH or any other type of headache (control group) and 15 from those diagnosed with migraine. T2-weighted MRI scans of the articular joints taken in closed-mouth position were used for TA. The co-occurrence matrix was used to calculate the texture parameters. Fisher’s exact test was used to compare the groups for gender, disc function and disc position, whereas Mann-Whitney’s test was used for other parameters. The relationship of TA with disc position and function was assessed by using logistic regression adjusted for side and group. Results: the results indicated that the MRI texture analysis of articular discs in individuals with migraine headache has the potential to determine the behaviour of disc derangements, in which high values of contrast, low values of entropy and their correlation can correspond to displacements and tendency for non-reduction of the disc in these individuals. Conclusion: the TA of articular discs in individuals with MH has the potential to determine the behaviour of disc derangements based on high values of contrast and low values of entropy KEYWORDSTexture Analysis; Migraine disorders; Temporomandibular disorders; Radiomics; Temporomandibular Joint Disc.

Correlation of the degenerative stage of a disc with magnetic resonance imaging, chemical content, and biomechanical properties of the nucleus pulposus.

Intervertebral disc degeneration (IDD) is closely related to changes in the intervertebral disc (IVD) composition and the resulting viscoelastic properties. IDD is a severe condition because it decreases the disc's ability to resist mechanical loads. Our research aims to understand IDD at the cellular level, specifically the changes in the viscoelastic properties of the nucleus pulposus (NP), which are poorly understood. This study employed a system integrating nanoindentation with Raman spectrometry to correlate biomechanics with subtle changes in the biochemical makeup of the NP. The characterization was, in turn, correlated with the degenerative severity of IVD as assessed using magnetic resonance imaging (MRI) of different patients with spinal stenosis, degenerative spondylolisthesis, and degenerative scoliosis. It is shown that there is an increase in the crosslinking ratio in collagen, a reduction in proteoglycan, and a build-up of minerals upon the rise in the severity level of the disc damage in the NP. Assessment of mechanical characteristics reveals that the increasing disc degeneration makes the NP lose its elasticity, becoming more viscous. This shows that the tissue undergoes abnormalities in weight-bearing ability, which contributes to spinal instability. The correlation of the individual discs shows that grades III and IV have similarities in the changes of Amide I and III toward the storage modulus. In contrast, grades IV and V correlate with mineralization toward the storage modulus. Reduction of proteoglycan has the highest impact on the changes of the storage modulus in all grades of IDD. Connecting compositional alterations to IVD micromechanics at various degrees of degeneration expands our understanding of tissue behavior and provides critical insight into clinical diagnostics, treatment, and tissue engineering.

Comparison of magnetic resonance imaging findings in 880 temporomandibular disorder patients of different age groups: a retrospective study

BackgroundMagnetic resonance imaging (MRI) findings of temporomandibular joint (TMJ) in temporomandibular disorder (TMD) patients of different ages are still unclear. The aim of this study was to analyze and compare the characteristics of MRI features of TMJs in different age groups.MethodsA total of 1760 TMJs from 880 patients were included in the study and divided into three groups: ≤ 18Y (n = 195, 14.89 ± 2.35Y); 19-30Y (n = 475, 24.09 ± 3.23Y); and > 30Y (n = 210, 41.73 ± 10.45Y). T2-weighted image (T2WI) of MRI was obtained to evaluate the relationship between age and disc morphology, the degree of disc displacement, joint effusion, joint movement and changes of condylar bone morphology. Data were analyzed by Pearson Chi square test and Spearman correlation coefficient.ResultsThere was no statistical difference between left and right sides in all age groups. Except condylar morphology (χ2 = 0.943, P = 0.624), there were significant differences in the distribution of disc morphology, disc position, joint effusion and joint motion among different age groups (χ2 = 24.450, χ2 = 24.829, χ2 = 19.855, χ2 = 39.259, respectively). There were significant differences in the distribution of the degree of anterior disc displacement, condyle morphology and joint effusion in different types of disc morphology among the different age groups (except for joint effusion in > 30Y), among which the first two were significantly correlated with the disc morphology.ConclusionsThe morphology and position of the articular disc changed significantly with age, but the proportion of abnormal condylar bone remained about 50%. The greater the degree of disc folding, the more prone to bone abnormalities.Trial registration This study was retrospectively registered on 28/03/2022 and endorsed by the Ethics committee (LCYJ2022014).

Interventional surgery effectiveness in treatment of the cervical spine and shoulder joint chronic pain

Relevance. Degenerative diseases of the spine are among the most common pathologies that cause significant medical, social and economic losses. Thus, a retrospective analysis of the Humana database from 2008 to 2014 indicates a sharp increase in discogenic neurocompression lesions of the cervical spine, which is 42 %. Degenerative processes are characterized by metabolic and structural changes in the intervertebral discs (IVD), which lead to the loss of its properties. The aim of the study was to analyze the results of intervertebral disc nucleoplasty and radiofrequency denervation of the facet joints in patients with cervical joint hernias. Materials and Methods . Intervertebral disc nucleoplasty and radiofrequency denervation of the facet joints in patients with hernias of the cervical spine was performed in 55 patients aged 18 to 74 years (mean age 36.28 ± 2.19 years), of which 56.36 % (31 patients) were men and 43.64 % (24 people) were women. Results and Discussion. The results demonstrate a significant improvement (p0.001) in VAS and ODI in patients after treatment. The majority of patients (45.45 %) rated their health status as “good”, 41.82 % of respondents believe that after the intervention, their health status can be assessed as “excellent”. Only 3 patients (5.45 %) indicated an unsatisfactory condition, which may be due to individual psychological characteristics, comorbidities, or a reduced sensitivity threshold. Conclusion. Nucleoplasty of the intervertebral disc and radiofrequency denervation of the facet joints is an effective and safe method for the treatment of intervertebral hernias of the cervical spine.