Outer Layer Research Articles

Reconstruction of 2 Independent Facial Defects Using A Single Paramedian Forehead Flap

Background: The paramedian forehead flap (PMFF) has been well established for use in reconstruction limited to a single nasal outer layer defect and has recently gained recognition as an acceptable alternative to traditional methods of lower eyelid reconstruction. The use of a single, pedicled PMFF for the reconstruction of more than one defect has yet to be described. Methods: A 59-year-old male patient was originally diagnosed with large squamous cell carcinoma resulting in radical resection and ipsilateral neck dissection. Postoperative final pathology was read as basal cell carcinoma; due to close margins, the patient required adjuvant radiation therapy. Immediate reconstruction at index surgery included radial forearm free flap; however, the patient subsequently developed left eye symptoms due to lid retraction and nasal symptoms with a left alar defect. The authors report the use of a single pedicled PMFF to reconstruct 2 distinct ipsilateral defects in a radiated patient—nasal ala and lower eyelid. Results: At 6 months post-secondary reconstruction, both recipient sites of the single PMFF appear viable and in adequate position without contraction. The patient has persistent but much improved symptoms related to his eye and nasal defects. Conclusion: A single PMFF can be safely and effectively used in the reconstruction of 2 distinct facial defects in the appropriate patient.

A cross-sectional study of fundus lesion characteristics in patients with acute visual impairment caused by COVID-19 infection.

To investigate the characteristics of acute visual dysfunction and fundus lesions in patients with COVID-19 pneumonia. A retrospective case series study was conducted. Data from 48 patients (96 eyes) with COVID-19 infection who presented to our ophthalmology department with acute onset visual disturbance between December 5, 2022, and February 28, 2023 were collected. Asymptomatic patients and those who had already recovered were excluded. Data collected included patient demographics, ophthalmic examinations, multicolor imaging (MCI), infrared autofluorescence (IR), spectral-domain optical coherence tomography (OCT), fundus fluorescein angiography (FFA). Of the 48 patients, 15 were male and 33 were female, with a mean age of 32 years. All patients had bilateral involvement. OCT showed hyperreflective signals in the outer plexiform layer and outer nuclear layer of the macular region in all 96 eyes of 48 patients (100%). Additionally, 66 eyes of 33 patients (68.8%) of eyes demonstrated abnormal reflectivity in the ellipsoid and interdigitation zones. MCI revealed petaloid or wedge-shaped hyperreflective areas in the macula in 46 (47.9%) of eyes, corresponding to hyporeflective areas on IR. Cotton-wool spots were observed in the peripapillary or posterior pole area in 54 (56.3%) of eyes. COVID-19 infection can lead to acute, bilateral, symmetric, and widespread retinal damage. Characteristic findings can be observed in ophthalmological examinations such as OCT, MCI, and IR.

3D anatomy and dorsoventral asymmetry of the mature Marchantia polymorpha meristem develops from a symmetrical gemma meristem.

Meristems are three-dimensional generative structures that contain stem cells and produce new organs and tissues. Meristems develop in all land plants, however we know little about the spatial and temporal regulation of meristem structure in lineages such as bryophytes. Here we describe the three-dimensional meristem anatomy during the development of the liverwort, Marchantia polymorpha. We show that the apical stem cell of the mature meristem is sub-apical, ventral, and in the outer cell layer. Mature meristem anatomy is therefore asymmetrical in the dorsoventral axis, which is reflected by the domain specific protein localisation of Class III and Class IV Homeodomain-Leucine-Zippers (MpC3HDZ and MpC4HDZ) and promoter activity of MpYUCCA2. The dorsoventral asymmetry that defines the mature meristem is absent in the juvenile meristems of asexual propagules known as gemmae. We discovered that anatomical dorsoventral asymmetry of the meristem forms after one to two days of gemmaling growth and is accompanied by expression of the dorsal identity reporter, MpC3HDZ. We conclude that the gemma meristem has arrested development and undergoes anatomical rearrangement to develop the three-dimensional meristem structure of the mature plant.

Topographic and quantitative correlation of structure and function using deep learning in subclinical biomarkers of intermediate age-related macular degeneration.

To examine the morphological impact of deep learning (DL)-quantified biomarkers on point-wise sensitivity (PWS) using microperimetry (MP) and optical coherence tomography (OCT) in intermediate AMD (iAMD). Patients with iAMD were examined by OCT (Spectralis). DL-based algorithms quantified ellipsoid zone (EZ)-thickness, hyperreflective foci (HRF) and drusen volume. Outer nuclear layer (ONL)-thickness and subretinal drusenoid deposits (SDD) were quantified by human experts. All patients completed four MP examinations using an identical custom 45 stimuli grid on MP-3 (NIDEK) and MAIA (CenterVue). MP stimuli were co-registered with corresponding OCT using image registration algorithms. Multivariable mixed-effect models were calculated. 3.600 PWS from 20 eyes of 20 patients were analyzed. Decreased EZthickness, decreased ONLthickness, increased HRF and increased drusen volume had a significant negative effect on PWS (all p < 0.001) with significant interaction with eccentricity (p < 0.001). Mean PWS was 26.25 ± 3.43dB on MP3 and 22.63 ± 3.69dB on MAIA. Univariate analyses revealed a negative association of PWS and SDD (p < 0.001). Subclinical changes in EZintegrity, HRF and drusen volume are quantifiable structural biomarkers associated with reduced retinal function. Topographic co-registration between structure on OCT volumes and sensitivity in MP broadens the understanding of pathognomonic biomarkers with potential for evaluation of quantifiable functional endpoints.

Influence of Nitrogen Content on the Microstructure Evolution and Oxidation Resistance toward Ambient Air of CrAlSiN Coatings Deposited by FCVAD Technique.

In this study, CrAlSiN coatings with nitrogen contents ranging from approximately 42 to 54 at. % were deposited and subsequently exposed to temperatures of 700 or 900 °C for 2 h in ambient air to investigate the impact of nitrogen content on the microstructure evolution and high-temperature oxidation resistance. It was found that the CrAlSiN coating with nitrogen content of 42-45 at. % exhibited an amorphous/nanocrystalline hybrid structure, comprising pure metallic Cr and (Al,Cr)N phases within the matrix, as determined by the TEM, XRD, and XPS analysis. In contrast, as the nitrogen content exceeded 52 at. %, the coatings transformed to a dominantly columnar structure featuring solely Cr(Al)N phase. The CrAlSiN coating with a nitrogen content of ∼52 at. % retained amorphous fraction of around 20% but demonstrated superior oxidation resistance with the lowest parabolic rate constant of 1.1 × 10-14 cm2/s at 900 °C compared to other coatings. This enhanced performance was primarily attributed to the high stability of Cr(Al)N phase and formation of a fine-columnar/amorphous microstructure devoid of metallic Cr, resulting in a significantly thin (∼60 nm) yet dense Al2O3-rich monolayer atop the coating surface during the oxidation. Conversely, substoichiometric CrAlSiN coatings with N content ≤45 at. % would form a thick Cr2O3 outer layer over an underlying Al2O3 layer. Additionally, elemental segregation of Cr, Si, and Al was observed in all CrAlSiN coatings after exposure to 900 °C for 2 h, which was induced by the spinodal decomposition of the ternary nitride phases.

A new helcionelloid mollusc from the Cambrian of Green land and Idaho (Laurentia)

Ressericonella gen. nov., a new genus of helcionelloid mollusc, characterized by a narrow shell with a shallowly convex dorsal surface and flat to shallowly concave lateral areas, is described from the Cambrian of Greenland and Idaho. The type species is Helcionella aequa Resser, 1939 from the Langston Formation (Naomi Peak Limestone Member) of early middle Cambrian age (Miaolingian Series, Wuliuan Stage, Albertella Biozone). Ressericonella pipalukae gen. et sp. nov. occurs in the latest early Cambrian (Cambrian Series 2, Stage 4, Bonnia–Pagetides elegans Biozone) of southern Freuchen Land, North Greenland. Silicified specimens of Ressericonella pipalukae from North Greenland preserve two-layered shell structure in which an inner layer with a transverse fibrous pattern similar to lamello-fibrillar structure is overlain by an outer layer with fine threads radiating from the apex.

Cell-Inspired Microreactor with Compartmentalized Active Sites for Development of Cascade Catalysis System in Biosensing.

Enzymatic cascade reactions with high activity and specificity in living cells always benefit from multicompartmentalized organelles that provide separately confined spaces for enzymes, avoiding their mutual interference to ensure the high-efficiency operation of necessary vital movements. Inspired by this, we designed a 3D spherical microreactor (Au@H-APF@Pt) with biomimetic cascade catalysis for glucose detection. First, ultrasmall gold nanoparticles were immobilized in situ on the internal cavities of hollow 3-aminophenol formaldehyde resin (H-APF) nanospheres, along with glucose oxidase activity. Then, platinum nanoparticles (PtNPs) with peroxide-like activity were reduced surrounding the outer layer of the H-APF nanospheres. Similar to the cell structure, different metal sites in this bifunctional microreactor operated independently, bringing higher catalytic activity and selectivity and thus being synergistically capable of a cascade reaction to catalyze the substrate for glucose detection. This cell-mimicking microreactor (Au@H-APF@Pt) was successfully applied in glucose colorimetric detection, showing a 1.9-fold activity enhancement compared to direct mixing (Au/Pt). The observed low catalytic activity was attributed to the extended time for transferring hydrogen peroxide (H2O2) from Au NPs to the solution and then to PtNPs. Integrating a smartphone APP, a real-time, visual, and Au@H-APF@Pt-based hydrogel sensor for glucose detection was also proposed. Satisfactory results highlight that this cell-mimicking microreactor offers a very successful strategy to improve the efficiency of cascade catalysis systems in biosensing.

Single-cell transcriptomics unveils skin cell specific antifungal immune responses and IL-1Ra- IL-1R immune evasion strategies of emerging fungal pathogen Candida auris.

Candida auris is an emerging multidrug-resistant fungal pathogen that preferentially colonizes and persists in skin tissue, yet the host immune factors that regulate the skin colonization of C. auris in vivo are unknown. In this study, we employed unbiased single-cell transcriptomics of murine skin infected with C. auris to understand the cell type-specific immune response to C. auris. C. auris skin infection results in the accumulation of immune cells such as neutrophils, inflammatory monocytes, macrophages, dendritic cells, T cells, and NK cells at the site of infection. We identified fibroblasts as a major non-immune cell accumulated in the C. auris infected skin tissue. The comprehensive single-cell profiling revealed the transcriptomic signatures in cytokines, chemokines, host receptors (TLRs, C-type lectin receptors, NOD receptors), antimicrobial peptides, and immune signaling pathways in individual immune and non-immune cells during C. auris skin infection. Our analysis revealed that C. auris infection upregulates the expression of the IL-1RN gene (encoding IL-1R antagonist protein) in different cell types. We found IL-1Ra produced by macrophages during C. auris skin infection decreases the killing activity of neutrophils. Furthermore, C. auris uses a unique cell wall mannan outer layer to evade IL-1R-signaling mediated host defense. Collectively, our single-cell RNA seq profiling identified the transcriptomic signatures in immune and non-immune cells during C. auris skin infection. Our results demonstrate the IL-1Ra and IL-1R-mediated immune evasion mechanisms employed by C. auris to persist in the skin. These results enhance our understanding of host defense and immune evasion mechanisms during C. auris skin infection and identify potential targets for novel antifungal therapeutics.

Morphological characteristics of the unique periodontal structure in dolphins.

Although toothed whales have dentition peculiar to mammals, little attention has been paid to the periodontal tissues that support these characteristic teeth. In this study, we clarified the anatomical characteristics of the periodontal tissue in several species of Delphinidae through three-dimensional observation using micro-computed tomography, histological observations using decalcified sections, and immunohistochemical analysis. The results indicated that the teeth and the periodontal tissues of dolphins are morphologically unique among mammals. The alveolar bone was both crude and spongy. The lamina dura, a radiopaque line observed in the alveolar bone of common mammals, was thin in dolphins, and the teeth were attached to the trabeculae with the periodontal ligament (PDL). The alveolar sockets were massive for the size of the teeth. The PDL, a collagen fiber that fills the periodontal space, was well-developed and peculiarly divided into two layers. The inner layer fibers radially spread out from the cementum, similar to the PDL in common mammals. However, the outer layer fibers penetrate the spongy bone in a complicated manner. The interstitial space between the inner and outer layers contained nerve fiber bundles that were thicker than those found in the PDL of other mammals. Sensory receptor-like structures were observed at the terminal ends of the nerve fibers. These findings indicated that the dolphin PDL is more sensitive to dental stimuli than those of other mammals, suggesting that the dolphin dentition plays a functional role as a sensory receptor, similar to tactile hair.

Prolonged Photobiomodulation with Deep Red Light Mitigates Incipient Retinal Deterioration in a Mouse Model of Type 2 Diabetes

Diabetic retinopathy is a prevalent complication of type 2 diabetes mellitus, characterized by progressive damage to the retinal structure and function. Photobiomodulation therapy, using red or near-infrared light, has been proposed as a non-invasive intervention to mitigate retinal damage, but has been tested generally with short-term stimuli. This study aimed to evaluate the effects of prolonged photobiomodulation with deep red light on retinal structure and function in a type 2 diabetes mouse model. Transgenic LepRdb/J (db/db) mice were exposed to photobiomodulation therapy via LED devices emitting 654 nm light for 12 h daily over ten weeks and compared to untreated mice. Retinal function was evaluated by flash electroretinography, while structural changes were assessed through histology and immunohistochemistry to detect astro- and microgliosis. At 33 weeks of age, db/db mice were obese and severely diabetic, but exhibited only incipient indicators of retinal deterioration. Electroretinogram b-wave peak latencies were prolonged at intermediate flash intensities, while the outer plexiform layer displayed significantly elevated IBA1 expression. Photobiomodulation therapy prevented these two markers of early retinal deterioration but had no effect on other morphological and functional parameters. Photobiomodulation is well-tolerated and maintains potential as a complementary treatment option for diabetic retinopathy but requires further optimization of therapeutic settings and combinatory treatment approaches.

Micellar solubility and co-solubilization of fragrance raw materials in sodium dodecyl sulfate and polysorbate 20 surfactant systems.

The aim of this work was to investigate the solubility and co-solubilization of fragrance raw materials (FRMs) in sodium dodecyl sulfate (SDS) and polysorbate 20 (P20) surfactant micellar systems, which can advance our knowledge of multi-solute micellar solubilization and fragrance olfactory performance from product matrices containing the surfactants. The transfer of individual FRMs and binary FRM mixtures into micellar phases was quantified by UV-VIS differential spectroscopy and evaluated in terms of the standard Gibbs free energy change and micelle-water partition coefficient. Co-solubilization effects were further evaluated by the deviation ratio. Anionic SDS was found overall to be a more efficient solubilizer than nonionic P20. On an individual basis, micellar solubilization generally increased with solute lipophilicity but was additionally impacted by solute rigidity and steric effects. Micellar solubilization was favoured for more rigid structures and less favoured for FRMs that exhibited larger molecular rotation and steric hindrance. For multi-solute systems, three co-solubilization effects were observed: (i) inhibitive effect in which micellar partitioning of both solutes decreased, (ii) an inverse effect where partitioning of one solute increased while the other decreased and (iii) synergistic effect in which partitioning of both solutes increased. During co-solubilization in P20 micelles, many FRMs competed for solubilization between the polyoxyethylene chains in the outer layer of the micelle, thereby resulting in an inhibitory effect for both solutes. Co-solubilization of FRM binary mixtures in SDS micelles often resulted in a synergistic increase in micellar solubility, possibly due to micellar swelling, thereby facilitating partitioning of additional solutes into the micelle. An inverse effect in which the micellar solubility of one solute increased, while the other decreased was observed in both surfactant systems with varying degrees of partitioning depending on the composition of the FRM mixture. The results of this study provide valuable insights into the impact of FRM composition on multi-solute partitioning behaviour and the impact of surfactant type on co-solubilization in micellar solutions.

Anion-Tailored EDLInduced Triple-Layer SEIon High-Capacity Anodes Enabling Fast-Charging and Durable Sodium-Storage.

High-capacity electrodes facea great challengeofcyclingstability due to particle fragmentation induced conductive network failure and accompanied by sustainedelectrolyte decompositionfor repeatedly build solid electrolyte interphase (SEI).Herein,Se-solubility induced Sex2-as self-adjustment electrolyte additive to regulate electric double layer (EDL) for constructingnovel triple-layer SEI(inner layer:Se; medium layer: inorganic; outer layer: organic) on high-capacityFeS2anode as an example for achievingstable and fast sodium storage. In detail, Sex2-in-situgeneratedat 1.30V (vs.Na+/Na)andwas preferentially adsorbedonto EDLof anode,then convertedto Se0asinner layer of SEI. In addition, the Sex2-causesanion-enhanced Na+solvation structure couldproduce more inorganic (Se0, NaF)andless organic SEI components.The uniquetriple-layer SEIwith layer-by-layer dense structure alleviate the excessive electrolyte consumption with less gas evolution. As a result, the anode delivered long-lifespan at 10 A g-1(383.7 mAh g-1, 6000 cycles, 93.1%, 5 min/cycle). TheSe-induced triple-layer SEIcould be also be formed on high-capacity SnS2anode.This work provides a novel SEI modelby anion-tailored EDL towards stable sodium-storage of high-capacity anode forfast-charging.

Ultra-thin C/Si Shell Pieces as Amphiphilic Janus Materials for Efficient Oxidation Desulfurization.

Constructing favorable morphology is considered to be an effective strategy to enhance the amphiphilic performance of materials. The directional alignment of ultra-thin lamellar materials significantly facilitates utilization of active sites at the bi-phase interface. Herein, an ultra-thin amphiphilic C/Si shell pieces Janus material (d = 10.4nm) prepared by graphene oxide and SiO2 is reported. The outer SiO2 layer is associated with hydrophilicity, while the inner C layer exhibits hydrophobicity. A Pickering emulsion interface catalyst for fuel oil oxidative desulfurization is constructed by impregnating an amino-modified C/Si Janus material with keggin-type HPW. The results demonstrate that amphiphilic catalyst with an ultra-thin C/Si shell pieces exhibits superior performance in terms of emulsification rate (100%) and desulfurization rate (99.62%) in the O/W emulsion formed by n-octane/acetonitrile. The catalyst demonstrates the advantages of easy recovery and regeneration, maintains a higher activity after oxidative desulfurization (ODS) process, and has higher industrial application value.

The Potential of Micro-Dictum Preparation in Surface Water Reclamation Subject to Strong Anthropogenic Pressure

The aim of this research was to analyze the potential of e micro-dictum preparation containing compositions of beneficial microorganisms using this product in surface water reclamation. The experiments were carried out in 2016. The scope of this research included the analysis of the physical and chemical properties of a solid preparation; tests of the microbiological parameters of micro-dictum; an analysis of the spread of microorganisms in the aquatic environment; a study of water quality with the solid preparation; and tests of the formulation in real conditions and its potential in the reclamation of surface waters. Tests on the produced formulation were carried out in the laboratory in containers and under real conditions. Laboratory tests have shown that the analyzed preparation may introduce certain amounts of nitrogen and phosphorus into the water. However, they are not important in the case of water reclamation. Analyses of the micro-dictum preparation showed that the content of lactic acid bacteria in the center of the ball is lower compared to the outer layers. The results describing an increase in the number of lactic acid bacteria correlate with a decrease in pH and oxygen dissolved in the water with the preparation. The tests showed no negative impact on changes in the physical and chemical properties of water at the site of application. Changes in physical parameters were recorded, in particular dissolved oxygen and pH at the bottom, where the greatest microbiological activity occurred.

Mechanical characterization of natural fiber composites prepared with untreated and treated ficus religiosa root fibers

Surface modification techniques are used to modify the surface of the natural fibers in order to improve the surface characteristics; in turn other relevant significant properties of the fiber and its composites. In the present work, epoxy composites have been prepared with the untreated and treated F. religiosa root fiber samples at 5, 10, 15, 20, and 25 wt.% fiber loading. Mechanical properties such as tensile, flexural and impact strength of the prepared composite specimens have been tested as per the ASTM standards. From the results, it has been identified that the strength of the proposed composites increases with the increase in fiber loading, and the composites made up of 20 wt.% of the NaOH solution treated fiber sample exhibits better properties under mechanical characterization study. Alkalization filled the holes, cracks, and pores on the outer layer of fibers and significantly improved the surface roughness, which was reflected in the improvement of the proposed composites.

Thin Zinc Electrodes Stabilized with Organobromine‐Partnered H2O−Zn−MeOH Cluster Ions for Practical Zinc‐Metal Pouch Cells

AbstractThe utilization of thin zinc (Zn) anodes with a high depth of discharge is an effective strategy to increase the energy density of aqueous Zn metal batteries (ZMBs), but challenged by the poor reversibility of Zn electrode due to the serious Zn‐consuming side reactions at the Zn||electrolyte interface. Here, we introduce 2‐bromomethyl‐1,3‐dioxolane (BDOL) and methanol (MeOH) as electrolyte additive into aqueous ZnSO4 electrolyte. In the as‐formulated electrolyte, BDOL with a strong electron‐withdrawing group (−CH2Br) tends to pair with the H2O−Zn−MeOH complex, leading to the formation of organobromine‐partnered H2O−Zn−MeOH cluster ions. During the Zn electrodeposition process, the formed ZnO‐dominated by‐products induce the polymerization of BDOL monomers, which are previously adsorbed on the electrode. As a result, a uniform dual‐layer SEI with ZnO‐dominated outer layer and polyether‐dominated inner layer is built on the surface of Zn electrode. With such an in situ formed dual‐layer SEI, the Zn||Mg0.9Mn3O7 ⋅ 2.7H2O pouch cell using a 10‐um Zn anode (corresponding to a low negative to positive areal capacity ratio of 3.56) successfully operated for 300 cycles with a high capacity retention of 86 %, promising a high practical energy density of &gt;120 Wh/kg (based on the total mass of Zn and Mg0.9Mn3O7 ⋅ 2.7H2O).

Tomato Sorting Machine Design

This design is based on the existing fruit sorting mechanism, and the sorting mechanism has been improved by using a spiral roller to design a tomato sorting machine. Based on the size of tomatoes, this tomato sorter can classify tomatoes into three categories to meet the needs of different occasions for different sizes of tomatoes, improve the utilization rate of tomatoes, and also speed up the rate of tomato sorting. The threads on the outer layer of the drum push the tomatoes forward while the drum rotates, and the tomatoes fall through the corresponding drum gaps to complete this sorting stage, with the largest grade going all the way to the end of the drum for grading. And the whole machine is equipped with sponge as a cushioning material in the parts of tomatoes that are easy to be impacted to prevent tomatoes from being damaged and to facilitate storage and sale of tomatoes. The sorter is inexpensive, easy to maintain and suitable for small-scale farmers.

Simpler and safer anastomosis by pancreaticogastrostomy using a linear stapler after pancreaticoduodenectomy.

Postoperative pancreatic fistula (POPF) remains a major and serious problem after pancreaticoduodenectomy (PD). In its presence, pancreatic juice may leak from the main duct or branches of the pancreatic stump. To prevent this, we have applied a newly modified anastomosis of pancreaticogastrostomy (PG) using a linear stapler (stapled PG). Clinical records of 30 consecutive patients who underwent PD were reviewed between 2013 and 2023 at our community hospital. Regarding procedures, 12 stapled PGs and eighteen pancreaticojejunostomies (PJs) were performed after PD, from 2018 to 2023 and from 2013 to 2017, respectively. The pancreas was transected for long compression by a linear stapler, involving: pre-compression for 5 min, stapling for 5 min, and dissection for 5 min. After removal of the staples at the main duct opening of the pancreatic stump, PG anastomosis was performed. The outer layer was anastomosed by a straight single row pancreas-transfixing suture with the posterior gastric wall, and inner layer duct-to-mucosa anastomosis was also performed in a radial axis manner. Anastomosis of PJ was conducted without using a linear stapler. POPF was defined as a clinical manifestation of POPF (grade B/C) based on the ISGPF (International Study Group of Pancreatic Fistula) criteria. None of the 12 patients who had undergone stapled PG developed clinically relevant POPF, whereas 5 (27%) patients who had received PJ developed POPF. Three patients showed POPF grade B and 2 patients exhibited POPF grade C. Stapled PG after PD may reduce clinically relevant POPF. Because our sample size was small, the further accumulation of cases is required to validate this method.

Structural effects of intraretinal cysts on outer retinal layers in eyes with diabetic macular edema

BackgroundDiabetic macular edema (DME) is the main cause of visual loss in individuals with diabetic retinopathy (DR). This study aims to investigate the effects of central macular intraretinal cysts on the underlying outer retinal layer (ORL) in patients with diabetic macular edema (DME).MethodsIn this retrospective and cross-sectional study, diabetic patients with or without DR were categorized into three groups: without DME (group 1), with DME but without any cyst featuring a plateau in the lower region (group 2), and patients with cyst featuring an inferior cyst plateau (group 3), defined as a flat conformation at its posterior aspect. Variables such as central macular intraretinal cyst height, inferior cyst plateau, and ORL thickness were measured, and ellipsoid zone (EZ) disruption was assessed via Spectral-domain optical coherence tomography (SD-OCT) and compared between groups. Correlations between OCT-measured variables and best-corrected visual acuity (BCVA) were investigated.ResultsA total of 164 eyes were included: 48 in group 1, 47 in group 2 and 69 in group 3. Compared with Groups 1 and 2, Group 3 presented a greater intraretinal cyst height (p < 0.001), a thinner mean ORL beneath the cysts (p < 0.0001) and more frequent EZ disruption (p < 0.0001), which was associated with lower BCVA values. Cyst height, cyst plateau and ORL thickness were significantly correlated with BCVA (p < 0.0001). EZ disruption was associated with the cyst height, the cyst plateau and the underlying ORL thickness. Correlations were observed between cyst height and ORL thickness (r = − 0.32, p < 0.001), between cyst height and cyst plateau (r = 0.60, p < 0.001), and between cyst plateau and ORL thickness (r = − 0.56, p < 0.001). Every increase of 10 μm in plateau width and in cyst height results in reductions of 0.16 μm and 0.29 μm in ORL thickness, respectively, independent of the other parameters. The optimal cutoff point for cyst height that best discriminates plateau formation was determined to be 130.5 μm, with a sensitivity of 89.9% and specificity of 83%.ConclusionsIn patients with DME, large central intraretinal cysts may assume a flat configuration in their lower region, termed a plateau, and are associated with photoreceptor damage due to compression, which can result in visual impairment. These findings can be understood based on modified Hertz’s mechanical contact theory.

Reduced contrast sensitivity function and outer retina thickness in convalescent Vogt-Koyanagi-Harada disease.

To evaluate contrast sensitivity function (CSF) in convalescent Vogt-Koyanagi-Harada (VKH) disease and investigate the relationship between CSF and chorioretinal thickness in VKH patients with and without sunset glow fundus (SGF). This is a cross-sectional study. Seventy-six eyes of VKH patients and 56 eyes of normal controls were evaluated. Patients were divided into SGF and non-SGF groups. The best-corrected visual acuity (BCVA) of all the participants was ≤0.0 logMAR. Their CSF and macular chorioretinal thickness were measured with quantitative CSF (qCSF) and Optical Coherence Tomography (OCT) and compared using repeated measures analysis of variance at the group level. Relationships between CSF and macular chorioretinal thickness were evaluated using generalized estimating equations. The CSF was significantly impaired in the SGF group compared to that in the control group (p = 0.001), especially at medium and high spatial frequencies. No significant CSF difference was found between the non-SGF group and control group, nor between the SGF and non-SGF groups. Compared to the controls, outer retinal thickness (ORT) in both VKH subgroups was significantly reduced (P < 0.001 or 0.005, respectively), although their outer nuclear layer thickness (ONLT) and choroidal thickness (CT) were not significantly different (both P = 1.000, P = 0.829 or 0.112, respectively). We found no significant correlation between CSF metrics and outer retinal thickness. Despite good recovery of visual acuity, reduced CSF and outer retina thickness were found in convalescent VKH patients. CSF may be an important and sensitive metric to evaluate functional vision in VKH disease.