Tomography Parameters Research Articles

Objective Changes in the Contralateral Eye after Unilateral Cataract Surgery

Purpose: This study evaluated the objective changes in the contralateral eye after unilateral cataract surgery.Methods: The study was designed as retrospective observational study. It included 44 patients who underwent unilateral cataract surgery. Collected data were uncorrected and corrected visual acuity, spherical equivalent, intraocular pressure, contrast sensitivity (CS), stereoacuity, and anterior segment optical coherence tomography parameters. Data were collected preoperatively, and 1 week and 1 month postoperatively for each eye.Results: Following unilateral cataract surgery, the pupil size of the fellow eye decreased from 3.46 mm to 3.17 mm (postoperative week 1, <i>p</i> = 0.003) and 3.08 mm (postoperative month 1, <i>p</i> < 0.001). Anterior chamber depth of the fellow eye increased significantly from 3.16 mm to 3.27 mm (postoperative week 1, <i>p</i> = 0.005) and 3.26 mm (postoperative month 1, <i>p</i> = 0.001). Uncorrected distance visual acuity (UDVA) of the fellow eye improved significantly at postoperative week 1 (<i>p</i> = 0.042) and postoperative month 1 (<i>p</i> = 0.044). Change of UDVA of the fellow eye at postoperative month 1 was significantly correlated with that of the treated eye (<i>p</i> = 0.039).Conclusions: Anterior chamber structures changed and UDVA improved in the contralateral eye after unilateral cataract surgery in our cohort. Because fellow eyes were positively affected by monocular cataract surgery, it would be good information if planning for unilateral cataract surgery due to inevitable reasons.

Enhancing early detection of keratoconus suspects using interocular corneal tomography asymmetry.

To evaluate corneal tomography asymmetry of both eyes in keratoconus (KC), keratoconus suspects (KCS), and normal (NL) eyes, and to introduce an interocular asymmetry index (IAI) for early diagnosis of keratoconus. This prospective case-control study included 210 NL eyes, 140 eyes with KCS, and 40 eyes with KC. New Scheimpflug imaging scans were performed to obtain corneal tomographic parameters. Based on the high and low values of tomographic parameters, each eye was categorized as "worse" or "better." Intragroup correlation coefficients (ICC) were used to compare interocular asymmetry. Logistic regression indices were constructed using interocular differences. Receiver operating characteristic (ROC) curves were used to analyze the sensitivity, specificity, and cutoff values of the IAI. In the KC group, 86.7% of the parameters significantly differed between the worse and better eyes. In the KCS group, 66.7% of the parameters showed significant differences between the worse and better eyes, with high consistency between the central and thinnest corneal thickness groups (ICC > 0.6). Strong intragroup correlations were observed in the NL group (ICC > 0.6). IAI effectively distinguished the NL from the KCS group (area under the ROC [AUROC] = 0.891), reaching 67.1% sensitivity and 97.1% specificity at a cutoff value of 0.494. At a cutoff value of 0.778, the IAI reached 95.0% sensitivity and 96.2% specificity in distinguishing NL from KC (AUROC = 0.954). Interocular asymmetry in keratoconus suspects can be detected in the early stages, with increased asymmetry compared to NL eyes observed as keratoconus progresses. Interocular asymmetry can complement monocular diagnostic parameters.

Prognostic predictors in constrictive pericarditis, 19-year experience at a tertiary care hospital

Abstract Introduction Constrictive pericarditis is a chronic inflammatory entity that may progress with thickening and calcification in the pericardial tissue, resulting in decreased pericardial elasticity and subsequent increase in ventricular filling pressures1,2. This rare treatable cause of HFpEF, is associated with various aetiologies, depending on the development level of the countries. Several algorithms have been developed for the diagnosis, whereas studies evaluating the prognostic factors are limited3–6. Our study aimed to examine the clinical, laboratory, electrocardiographic, imaging and catheterization parameters that determine the prognosis of constrictive pericarditis. Methods 60 patients diagnosed with constrictive pericarditis based on echocardiography, computed tomography and right heart catheterization parameters were included retrospectively in the study. Clinical presentation, laboratory, and electrocardiographic findings were assessed. Volumetric measurement, tissue Doppler, mitral inflow velocity analysis, and pericardial evaluation were made via 2D echocardiography. Pericardial thickness, effusion, and calcium score were obtained via thorax CT, while right-sided pressure measurements were acquired via catheterization. The primary clinical outcome was determined as mortality, and the effect of these parameters was evaluated by Cox regression analysis. Results Median follow-up was 3.5 years (0-19) and mean age was 52.7 ±17.5 years. 38 of the patients (63.3%) were male, the most common aetiologies were malignancy (21.4%) and other systemic diseases (21.4%). 7 patients were lost to follow-up and 18 (31.6%) patients died during the process. When different models were evaluated with Cox regression analysis, ascites, hemoglobin and elevated proBNP values were prognostic predictors (HR 10.991 p-value 0.006, HR 0.513 p-value 0.010 and HR 3.904 p-value 0.045, respectively). ROC analysis indicated the highest AUC value for the model that included hemoglobin (AUC 0.953). Conclusion Constrictive pericarditis is one of the treatable causes of HFpEF. While imaging and catheterization parameters play a crucial role in the diagnosis, clinical and laboratory parameters affect the prognosis.

Prognostic 18F-flotufolastat PET parameters for outcome assessment of 177Lu-labeled PSMA-targeted radioligand therapy in metastatic castration-resistant prostate cancer.

This retrospective analysis evaluates baseline 18F-flotufolastat positron emission tomography (PET) parameters as prognostic parameters for treatment response and outcome in patients with metastatic castration-resistant prostate cancer (mCRPC) undergoing treatment with [177Lu]Lu-PSMA-I&T. A total of 188 mCRPC patients with baseline 18F-flotufolastat PET scans were included. Tumor lesions were semiautomatically delineated, with imaging parameters including volume-based and standardized uptake value (SUV)-based metrics. Outcome measures included prostate-specific antigen (PSA) response, PSA-progression-free survival (PSA-PFS), and overall survival (OS). Univariate and multivariate regression analyses assessed the impact of baseline imaging and pretherapeutic clinical parameters on outcome. Event time distributions were estimated with the Kaplan-Meier method, and groups were compared with log-rank tests. Significant prognostic parameters for PSA response and PSA-PFS included log-transformed whole-body SUVmax (odds ratio (OR), 3.26, 95% confidence interval (CI), 2.01-5.55 and hazard ratio (HR), 0.51, 95% CI, 0.4-0.66; both p < 0.001) and prior chemotherapy (OR 0.3, 95% CI, 0.12-0.72 and HR 1.64, 95% CI, 1.07-2.58; p = 0.008 and p = 0.028, respectively). For OS, significant prognosticators were the following log-transformed parameters: number of lesions (HR 1.38, 95% CI, 1.24-1.53; p < 0.001), TTV (HR 1.27, 95% CI, 1.18-1.37; p < 0.001), and ITLV (HR 1.24, 95% CI, 1.16-1.33; p < 0.001), with log-transformed TTV (HR 1.15, 95% CI, 1.04-1.27; p = 0.008) remaining significant in multivariate analysis. At baseline, SUV-based 18F-flotufolastat PET metrics (e.g., whole-body SUVmax) serve as significant positive prognosticators for short-term outcomes (PSA response and PSA-PFS). In contrast, volume-based metrics (e.g., TTV) are significant negative prognosticators for long-term outcome (OS), in mCRPC patients treated with [177Lu]Lu-PSMA-I&T.

Anterior segment optical coherence tomography (AS-OCT) assisted analysis of characteristics of graft dehiscence after Descemet membrane endothelial keratoplasty (DMEK) for failed penetrating keratoplasty.

To analyse anterior segment optical coherence tomography (AS-OCT) parameters of graft dehiscence after Descemet membrane endothelial keratoplasty (DMEK) for graft failure post penetrating keratoplasty (PK). Retrospective evaluation of AS-OCT images of 142 dehiscences post-DMEK in 75 eyes. Dehiscences' size, depth, location, correlation with graft-host interface (GHI) override and step at GHI were assessed. The majority of patients were male (58.7%) and mean age was 67 ± 13.6 years. Multiple dehiscences were observed in 49.3% eyes. Rebubbling was required once in 72% and multiple times in 24% eyes. Among 142 dehiscences, crossing over GHI was noted in 53.5%. The median distance of peripheral edge of dehiscences from GHI was 0.21 mm. Steps at GHI were noted in 41.5% where 22.5% dehiscences with step crossed the GHI. For dehiscences crossing versus not crossing GHI, no significant difference was noted in median depth (p = 0.268) and size (p = 0.206). For dehiscences crossing over GHI with presence versus absence of step, median depth (p = 0.23) and size (p = 0.196) showed no significant difference. No significant difference was noted in dehiscences' median depth (p = 0.16) and size (p = 0.926) among different step sizes. Incidence of dehiscence with or without steps (p = 0.8853) and graded as per size of steps, showed no significant difference. Size and depth of dehiscence were not influenced by their crossing over GHI or the presence and size of steps. Dehiscences typically occurred in close vicinity to GHI, suggesting that DMEK graft should be placed 0.25 mm centrally from the prior PK interface, independent of GHI irregularities.

Treatment Response Evaluation in Necrotizing Otitis Externa Using 18F-FDG-PET Imaging.

This study aims to identify 18F-FDG-PET imaging features for improving treatment response evaluation in patients with necrotizing otitis externa (NOE), aiding in the difficult differentiation between sterile inflammation and active infection. Retrospective cohort study. Tertiary hospital. Patients diagnosed with NOE between 2011 and 2022. NOE criteria included otalgia, otorrhea, granulation, and radiological features consistent with osteomyelitis. 18F-FDG-PET/computed tomography (CT) parameters were derived from manually delineated regions of interest and were evaluated on both pretreatment and end-of-treatment scans. Recurrent disease of NOE after end-of-treatment 18F-FDG-PET scans. This study comprised 20 NOE patients, including 5 (25%) experiencing recurrent disease after the end-of-treatment scan. The end-of-treatment 18F-FDG-PET parameters of maximal and peak standardized uptake value (SUVmax and SUVpeak) were significantly higher in recurrent cases (p = 0.025 and p = 0.025, respectively). Both parameters demonstrated good discrimination ability in predicting recurrence, with optimal cutoffs yielding 100% sensitivity and 67% specificity. Other parameters, including mean SUV and total lesion glycolysis (TLG), did not yield significant results, neither did the calculated difference in uptake between end-of-treatment and pretreatment scans. SUVpeak on 18F-FDG-PET was the preferred parameter for treatment response evaluation of NOE at the end-of-treatment scan. A high residual SUVpeak may adequately detect patients at risk for recurrent disease, which may necessitate prolonged treatment, while low SUVpeak is found in patients with low risk for recurrent disease permitting safe treatment cessation.

Predictive factors of final visual outcome in patients with leber hereditary optic neuropathy treated with lenadogene nolparvovec gene therapy

Aims/Purpose: To identify the predictive factors of final best‐corrected visual acuity (BCVA) in patients with Leber hereditary optic neuropathy (LHON) due to the m.11778G &gt; A MT‐ND4 mutation who received lenadogene nolparvovec gene therapy in clinical studies.Methods: The following covariates were studied to identify those that might influence final BCVA: age, gender, timing of treatment, baseline BCVA value and baseline optical coherence tomography (OCT) parameters. Univariate analyses were performed from three phase 3 studies (RESCUE, REVERSE and REFLECT), using BCVA at 1.5 years post‐treatment as the dependent variable. In RESCUE and REVERSE, ND4‐LHON patients received an injection of gene therapy in one eye and a sham injection in the other. In REFLECT, the first‐affected eye received gene therapy, while the other eye was randomly injected with gene therapy or placebo.Results: In 290 untreated/treated eyes, the covariates statistically significantly associated with an improvement in final BCVA were a longer time from vision loss to treatment (p &lt; 0.05), and thicker optical coherence tomography (OCT) parameters at baseline: ganglion cell layer (GCL) temporal outer segment, GCL superior outer segment, GCL nasal outer segment, and GCL inferior outer segment at ETDRS analysis, and retinal nerve fiber layer (RNFL) inferior quadrant, RNFL nasal quadrant and RNFL superior quadrant (p &lt; 0.05). The greatest effects [95% confidence interval] were observed for the thickness of the inferior and superior outer GCL segments at baseline (‐0.1 [‐0.163; ‐0.037] and ‐0.09 [‐0.146; ‐0.033], respectively; both p = 0.002). A worse baseline BCVA was associated with a worse final BCVA (p &lt; 0.0001).Conclusions: Timing of treatment administration, baseline BCVA value and baseline thickness of OCT parameters are predictive of the BCVA 1.5 years after treatment in patients with MT‐ND4 LHON who received lenadogene nolparvovec.

Impact of residual stromal thickness on the outcomes of manual deep anterior lamellar keratoplasty

Aims/Purpose: To analyze how postoperative outcomes of manual deep anterior lamellar keratoplasty (DALK) are influenced by the thickness of the residual stromal bed of the recipient, and to explore predictive factors for this parameter.Methods: This is a retrospective case series of patients affected by keratoconus undergone manual DALK. Best spectacle‐corrected visual acuity (BSCVA) and tomographic parameters were evaluated preoperatively (T0) and postoperatively after complete suture removal (1 year, T1). The residual stromal bed of the recipient at T1 was assessed using the “flap thickness” module of CASIA SS‐1000 optical coherence tomography (Tomey, Tokyo, Japan). Measurements were performed at the center of the graft and at 12 peripheral points, 2 mm inside the margin of the corneal graft, along 6 different meridians equally spaced at 30 degrees. Then, mean peripheral thickness was calculated.Results: Data from 40 eyes undergone manual DALK were evaluated. BSCVA significantly improved at T1 (1.11 ± 0.55 LogMAR [95% CI, 0.94‐1.28] vs 0.17 ± 0.16 LogMAR [95% CI, 0.12‐0.22]). A significant linear correlation was found between postoperative BSCVA and the mean apical thickness of the residual stromal bed (72.85 ± 27.77 μm [95% CI, 64.24‐81.46]; r = 0.48, p = 0.002), but not with the mean peripheral thickness of the residual stromal bed (78.47 ± 25.32 μm [95% CI, 70.62‐86.31]; r = 0.28, p = 0.09). Multivariate regression analysis found mean posterior and anterior keratometry (K) readings of the axial power map to be the strongest predictive factors for the apical thickness of the residual stromal bed (R2 = 0.32, p &lt; 0.001).Conclusions: Postoperative BSCVA is significantly correlated with the apical thickness of the residual stromal bed. The preoperative mean posterior and anterior K readings may be predictors of the postoperative apical thickness of the residual stromal bed.

Correlation between motor symptoms, cognitive function, and optical coherence tomography findings in Parkinson's disease.

This study aimed to evaluate the total macular thickness as well as the thickness of the inner and outer retinal layers in patients with Parkinson's disease. It also aimed to verify the correlation of these parameters with motor symptoms and cognitive function. A total of 46 eyes of 23 patients with Parkinson's disease and 40 eyes of 20 healthy controls were included in the study. The patients' cognitive, functional, and nonmotor symptoms were evaluated using the Katz Index of Independence and Pfeffer's Activities of Daily Living, Mini-Mental State Examination, Frontal Assessment Battery, Schwab and England Staging Scales, and Movement Disorders Society Nonmotor Symptoms Scale. The macular thickness measurements obtained via total, inner, and outer optical coherence tomography were recorded. Furthermore, the correlation of the parameters of optical coherence tomography with cognitive, functional, and nonmotor symptoms was assessed. The scores of the Katz Index of Independence and Pfeffer's Activities of Daily Living as well as the Movement Disorders Society Nonmotor Symptoms Scale were significantly lower in patients with Parkinson's disease than in healthy controls. Moreover, the former had greater total macular thickness. The temporal and inferior outer sectors were significantly greater for the ganglion cell complex thickness in patients. A significant correlation was observed between the total macular thickness and the Movement Disorder Society-Unified Parkinson's Disease Rating Scale, Parte III (MDS-UPDRS-III) values. Contrarily, there was a negative correlation between the outer macular thickness and the MDS-UPDRS-III values. Meanwhile, the total macular thickness and ganglion cell complex thickness were significantly correlated with the scores of the Mini-Mental State Examination, Schwab and England Staging Scale, Frontal Assessment Battery, and Katz Index of Independence and Pfeffer's Activities of Daily Living. In addition, the Schwab and England scale was correlated with the outer macular thickness. The total and inner macular thicknesses at the temporal and inferior outer sectors were greater in patients with Parkinson's disease than in the control group. These findings indicate that macular thickness may be greater in those with Parkinson's disease, particularly when associated with mild motor symptoms. In addition, the parameters of the total, inner, and outer optical coherence tomography were significantly associated with motor and nonmotor symptoms as well as cognitive function impairment.

Anterior segment optical coherence tomography assisted analysis of characteristics of graft dehiscence after descemet membrane endothelial keratoplasty for failed penetrating keratoplasty

Aims/Purpose: To analyze anterior segment optical coherence tomography (AS‐OCT) parameters of graft dehiscence after Descemet membrane endothelial keratoplasty (DMEK) performed due to graft failure post penetrating keratoplasty (PK).Methods: All cases with available AS‐OCT images after DMEK performed due to previously failed PK graft were retrospectively analyzed. In total 142 dehiscences after DMEK in 75 eyes could be identified. The size, depth, location of dehiscence and its correlation between presence of graft‐host interface (IF) override and presence of step at the IF was assessed.Results: Majority of the patients were male (58.7%) and average age at presentation was 67 ± 13.6 years. Multiple areas of dehiscence were noted in 49.3% of eyes. Rebubbling was required once in 72% and multiple times in 24% cases. Dehiscence was noted to cross over the IF in 53.5%. Steps at the IF was noted in 41.5%, and 22.5% of the dehiscences with step crossed the IF. No significant difference was noted when median depth and size of the dehiscences crossing over the IF were compared with those not crossing over the IF (p = 0.268 and p = 0.206, respectively). Comparison between the median depth and size of the dehiscences crossing over the IF with presence and absence of step showed no significant difference (p = 0.23 and p = 0.196, respectively). Also, presence and/or size of step at the IF did not have a significant effect on depth, size and incidence of dehiscence.Conclusions: In our study, dehiscence of DMEK grafts occurred in close vicinity to the PK graft‐host interface. However, size and depth of the dehiscence were not affected by crossing of the dehiscence over the graft‐host junction interface. Also, presence of step and its size did not seem to affect the depth, size and incidence of the dehiscence. Our evaluation suggests that the edge of the DMEK graft should have a distance to the PK interface, independent of the regularity of the PK graft‐host junction.

INDICATORS OF COMPUTED TOMOGRAPHY OF ORBITS FOR CALCULATING THE RISK OF EXOPHTHALMOS IN AUTOIMMUNE OPHTHALMOPATHY

Background. Computed tomography (CT) in autoimmune ophthalmopathy provides a detailed assessment of the anatomical and tomographic features of the bony part of the orbit, which are necessary for determining the risk factors for exophthalmos. The aim of the study was to determine the tomographic parameters of the bony part of the orbit, allowing to calculate the probability of developing exophthalmos in autoimmune ophthalmopathy. Material and methods. CT of the orbits was performed for 90 patients with autoimmune ophthalmopathy, who were divided into two groups based on the results of exophthalmometry according to Hertel: Group I (n=42) – patients with exophthalmos from ≥ 18 to ≤ 23 mm; Group II (n=48) – patients with exophthalmos &gt; 23 mm. Results. The correlation analysis established a relationship between the ethmoidal labyrinth width and the probability of exophthalmos development. Higher mathematics and applied statistics methods were used to obtain a unified empirical formula. Conclusions. The obtained formula for calculating the probability of exophthalmos development based on the ethmoidal labyrinth width in clinical practice will help to promptly diagnose the disease at early stages before the development of severe complications. The proposed method can be recommended to radiologists, endocrinologists, and ophthalmologists.

Control over the training performance of quantum state tomography with reservoir computing networks

The evaluation of unknown states for a given quantum system is one of the key problems in quantum information processing. The most efficient method of state characterization is quantum state tomography (QST), where the full-density matrices are reconstructed from the experimental measurements or numerical simulations performed on quantum states. The improvement of the computational performance in quantum state tomography and its related problems is a challenging task for modern theoretical physics. The general scheme of computing deals with the input information that goes into a quantum reservoir through a recurrent evolution. After the evolution, the final output is obtained as the linear combination of the readout elements. In our approach, the quantum reservoir is modeled with the Lindbladian equation. The control over performance is made by the coherent coupling parameter between the input quantum state and the reservoir. The control feedback algorithm is represented with the set of Kolesnikov’s target attractor algorithm to drive certain parameters of quantum state tomography, particularly, the outputs for the density matrix. Here we formulate the target attractor feedback in a discrete form to improve the training performance of QST and then develop a basic example of the state tomography for the quantum system of spin 1/2. We conclude by mentioning the basic features of our algorithm and its possible development.

Preoperative clinical and contrasted-enhanced CT features to predict perineural invasion in gallbladder carcinoma: focus on clinical T3-4 stage.

To investigate the utility of combining clinical and contrasted-enhanced tomography (CECT) parameters for the preoperative evaluation of perineural invasion (PNI) in gallbladder carcinoma (GBC). A total of 134 patients with GBC (male/female, 52/82; age, 64.4 ± 9.7 years) were divided into PNI-positive (n = 63) and PNI-negative groups (n = 71). Clinical characteristics (demographic information, liver function indicators and tumor markers) and CECT parameters (tumor type, tumor size, gallbladder stone, invasion of gallbladder neck/cystic duct, clinical T stage and N stage) were collected and compared between two groups. Binary logistic regression analysis, receiver operating characteristic curves analyses and Delong test were used in further statistical analyses in clinical T3-4 stage (cT3-4) GBC patients. Overall survival (OS) rates after surgery were compared between PNI-negative group and PNI-positive group of cT3-4 GBC patients. The majority of GBC patients with PNI were classified as cT3-4 (61/63, 96.8%), while only 3.2% (2/63) of PNI-positive cases were identified at cT1-2. Among cT3-4 GBC, OS was significantly lower in the PNI-positive group than the PNI-negative group after surgery (HR,1.661; 95% CI, 1.044-2.643; P = 0.032). Gender and gallbladder neck/cystic duct invasion were independent predictive factors for cT3-4 GBC patients with PNI. A combination of gender and gallbladder neck/cystic duct invasion showed the best diagnostic performance than that of individual parameters (all P < 0.05). Preoperative T staging using CECT enables the initial assessment of PNI status in GBC patients. A combination of gender and gallbladder neck/cystic duct invasion may effectively predict PNI in GBC, particularly in cT3-4 GBC.

Comparison of peripapillary and macular Optical Coherence Tomography parameters between children and young adults.

To compare the retinal nerve fiber layer (RNFL), ganglion cell-inner plexiform layer thickness, central subfield thickness (CSFT), and parafoveal and perifoveal thickness in children of different age groups with young adult controls by using spectral-domain optical coherence tomography. This cross-sectional study included children aged 6-17 years and adult controls (18-22 years) - group 1: 6-9 years (57 eyes), group 2: 10-13 years (116 eyes), group 3: 14-17 years (66 eyes), and group 4 (controls): 18-22 years (61 eyes). A mixed-effects model was used to compare the OCT parameters among the groups, along with multivariable analysis. Analysis of 300 eyes of 152 patients was done. Group 2 (99.7 ± 1.1 μm, P = 0.03) and group 3 (100.4 ± 1.5 μm, P = 0.03) had thicker RNFL on average as compared to group 4 (95.6 ± 1.6 μm) on multivariable analysis. In pairwise comparison, group 2 (129.8 ± 2.5 μm, P = 0.02) and group 3 (132.6 ± 2.4 μm, P = 0.004) had thicker inferior RNFL compared to adult controls (122.4 ± 2.5 μm); superior RNFL was thicker in group 2 (129.6 ± 2.0 μm, P = 0.01) and group 3 (131.2 ± 2.6 μm, P = 0.008) compared to group 1 (120.9 ± 2.8 μm). On multivariable analysis, adult controls had thicker CSFT (236.5 ± 2.6 μm) than group 1 (222.7 ± 3.1 μm) and group 2 (229.6 ± 2.3 μm). Similarly, on pairwise comparison, adult controls had thicker parafoveal superior quadrants (320.5 ± 2.5 μm) and inferior quadrants (317.5 ± 2.3 μm) when compared with groups 1 and 2. RNFL thickness seems to increase up to 17 years and then starts reducing, unlike CSFT, which increases with age from 6 to 22 years. A differential growth occurs in the different quadrants of RNFL and macula with age with some quadrants increasing in thickness as compared to the others.

Functional and Anatomical Outcomes of Pars Plana Vitrectomy for Lamellar Macular Hole: Long-Term Follow-Up

Background: To investigate functional and anatomical outcomes after pars plana vitrectomy (PPV) for lamellar macular hole (LMH) with a long-term follow-up. Methods: An interventional study on 14 patients (16 eyes) with LMH was conducted. The inclusion criteria included a minimum 36-month follow-up after PPV. The preoperative and postoperative best-corrected visual acuity (BCVA) and spectral domain optical coherence tomography parameters were examined. Results: Preoperatively, the mean BCVA was 0.46 ± 0.22 LogMAR. Epiretinal proliferation (ERP) was visible in 81.25% of eyes. Outer retinal disruption was present in 31.25% of LMH cases. The average central foveal thickness (CFT) measured 183.68 ± 61.73 microns. The mean BCVA improved at each follow-up time point: it was 0.24 ± 0.16 LogMAR at 1 month, 0.18 ± 0.15 LogMAR at 6 months, and 0.09 ± 0.11 LogMAR at the last follow-up. There was a statistically significant improvement between BCVA at 1 month and BCVA at 6 months and between BCVA at 6 months and BCVA at the last follow-up (p &lt; 0.001). BCVA improved in all eyes, with 87.5% achieving at least 0.3 LogMAR improvement. The mean CFT at the 1-month follow-up was 211.45 ± 43.55 microns, increased to 248.81 ± 48.51 microns at 6 months, and further increased to 278.37 ± 45.50 microns at the last follow-up. Foveal contour restoration was achieved in all eyes, and those with preoperative ellipsoid zone alterations demonstrated a complete repair of the external retinal layers. No intra or postoperative complications were recorded. Conclusions: In our series, PPV had a high success rate and was associated with a substantial functional improvement in LMH treatment, and this result was maintained and kept increasing until the last follow-up. Long-term follow-up is crucial for a comprehensive evaluation of the healing process and to assess the benefits of the surgical intervention.

Post-CAR T-Cell Therapy Failure Metabolic Parameters Predict Survival and Response in Large B-Cell Lymphoma.

18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET/CT) parameters have shown a significant prognostic role in relapsed/refractory large B-cell lymphoma (LBCL) patients undergoing CD19-targeted chimeric antigen receptor (CAR) T-cell therapy. While a substantial body of evidence exists on the prognostic value of PET/CT parameters in peri-CAR T setting, data available on the prognostic value of PET/CT parameters following CAR T-cell therapy failure is lacking. Therefore, we sought to analyze the PET/CT scans of LBCL patients who experienced post-CAR T relapsed/progressive disease and subsequently received salvage therapies. Thirty-three LBCL patients who had PET-CT scans done demonstrating post-CAR T failure and then received salvage therapies [as a first salvage modality: RT alone, nine patients; combined modality therapy (CMT), seven patients; systemic therapy (ST) alone, 17 patients] were analyzed. The median follow-up after CAR T-cell infusion was 11.7months [interquartile range (IQR): 5.1-24.4months], and the median follow-up after post-CAR T salvage therapy was 7.3months (IQR: 2.7-19.1months). The median timeframe for the PET scan showing post-CAR T failure was 2.4months (IQR: 0.96-5.0months). On univariable analysis from salvage therapy start date, high metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were associated with inferior overall survival (OS) (Hazard ratio -HR=8.4, p<0.0001; HR=3.2, p=0.01, respectively). High MTV was associated with a non-significant trend of inferior progression-free survival (PFS) (HR=3.5, p=0.09). High maximum standardized uptake value (SUVmax) was not associated with inferior OS or inferior PFS. On multivariable analysis from salvage therapy start date, high MTV (HR=4.6, 95% CI: 1.5-14.3, p=0.009) was identified to be an independent prognostic factor for inferior OS. High International Prognostic Index (IPI) (≥ 3) at the time of salvage therapy (HR=2.5, 95% CI: 1.1-5.6, p=0.02) was significantly associated with inferior PFS. Our study shows that semiquantitative PET/CT metrics, especially MTV, are significant prognostic indicators of overall survival in this highly refractory population after CAR T-cell therapy failure, potentially refining prognostic and treatment approaches beyond conventional parameters like IPI.

Characterization of peripapillary hyperreflective ovoid mass-like structures (PHOMS) in a broad spectrum of neurological disorders.

Peripapillary hyperreflective ovoid mass-like structures (PHOMS) have been identified in ophthalmological and neurological diseases. Since PHOMS were found more frequently in these cohorts compared to healthy controls, it is assumed that the presence of PHOMS reflects a secondary disease marker of unknown significance. The extent to which disease-specific differences are reflected in PHOMS has not yet been sufficiently investigated. Monocentric, retrospective study. We analyzed a large cohort of persons with a broad spectrum of neurological disorders, including neuroimmunological diseases (NI, N=237), epilepsy (EPI, N=153), movement disorders (MD, N=44), intracranial hypertension (IH, N=13), and inborn errors of metabolism (IEM, N=90). We analyzed the prevalence, location, volume, and intensity of PHOMS. PHOMS volumes were correlated with demographic and other optical coherence tomography (OCT) parameters. Prevalence, location, volume, and intensity of PHOMS. We identified PHOMS in 7% of the analyzed eyes. PHOMS were detected in all cohorts, and their location was predominantly nasal. The median volume of all PHOMS was 0.06mm3. However, it was significantly increased in persons with IH compared to NI (p=0.009), EPI (p=0.038) and MD (p=0.027). The PHOMS volume correlated positively with the opening of the Bruch membrane and negatively with the age of the cohort after the exclusion of IH patients. Overall, PHOMS intensity was comparable to that of the optic nerve. Since larger PHOMS volumes were found in individuals with IH, a mechanistic link to increased intracranial pressure can be assumed. It remains unclear whether this explanation also applies to individuals with other neurological disorders with PHOMS. Since PHOMS have a relevant influence on OCT parameters, their presence should also be considered in non-ophthalmologic scientific studies in the future.

A novel tool to predict lymph node metastasis in patients with prostate cancer based on clinical and 68Ga-PSMA PET/CT parameters.

We sought to develop a model that predicts lymph node invasion (LNI) in patients with intermediate- and high-risk prostate cancer incorporating preoperative clinical and 68Ga-prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) parameters. A cohort of 413 consecutive patients diagnosed with prostate cancer who underwent 68Ga- PSMA PET/CT prior to radical prostatectomy from 2015-2020 was used to develop and validate the model. The cohort was split into a learning (70%) and a validation group (30%). The former was used to identify clinical and 68Ga-PSMA PET/CT parameters (number and diameter of PET-positive lymph nodes) for prediction of pathologic LNI by applying multivariable logistic regression analyses. The discrimination ability of the model was evaluated using the area under the receiver operating characteristic (ROC) curve and internal validation was performed using the validation cohort. One-hundred sixty-three men (39%) were categorized as high-risk, 168 (41%) as unfavorable-intermediate-risk, and 82 (20%) as favorable-intermediate-risk. Thirty-one patients (7.5%) had LNI on final pathology. All underwent extended lymph node dissection. Clinical stage, the presence of PET-positive lymph nodes, and diameter of the largest PET-positive node were included in the final predictive model. Four different categories were defined for estimating the risk for LNI. Internal validation was completed after applying the four-tire classification on both the learning and validation groups and achieving similar results. The sensitivity, specificity, positive predictive value, and negative predictive value of the model were 97%, 54%, 15%, and 99%, respectively, and area under the ROC curve was 0.906 (95% confidence interval 0.83-0.95, p<0.001). Using a 5% cutoff as a threshold for performing lymph node dissection, only one patient with LNI on final pathology would have been classified erroneously as node negative, while 206 (50%) men would have been spared an unwarranted lymph node dissection. We present a novel prediction model for LNI that incorporates clinical staging and molecular imaging data. Pending further validation, this model may improve the risk stratification and patient selection for lymph node dissection at time of radical prostatectomy.

Importance of parametric and molecular imaging for therapeutic management of breast cancer

In recent years, various magnetic resonance (MRI) and positron emission tomography (PET) parameters have been investigated in breast cancer. Parametric imaging focuses on the visualization and quantification of biological, physiological, and pathological processes at the cellular and molecular level. It therefore provides important insights into the key processes in carcinogenesis and tumor progression. This article aims to illustrate the importance for the management of breast cancer. Based on the current literature, an overview of the current state of parametric breast imaging and its importance in therapy management is given. Moreover, future opportunities and challenges are highlighted. Parametric imaging in breast cancer includes MRI, nuclear medicine procedures such as PET, the combination of different techniques (PET-CT, PET-MRI) and the use of specific radiotracers. Parametric MRI of the breast mainly uses T2 and diffusion-weighted imaging (DWI) as well as dynamic contrast-enhanced MRI (CM-MRI). Quantitative and qualitative imaging biomarkers provide insights into tumor biology and allow conclusions to be drawn about the molecular subtype or prognosis. Recently, parametric imaging has become established in breast diagnostics. It is constantly evolving and will continue to gain in importance in the forthcoming years. It offers the opportunity to improve the diagnosis and treatment management of breast cancer.

Utility of Fundus Autofluorescence and Optical Coherence Tomography in Measuring Retinal Vascular Thickness, Macular Density, and Ophthalmic Manifestations in Women with Gestational Diabetes Mellitus.

Background: Gestational diabetes mellitus (GDM) is a transient elevation of blood glucose during pregnancy. It is typically not associated with diabetic retinopathy. However, certain investigators revealed retinal microvascular injury. In this study, we aimed to assess the ophthalmic findings, optical coherence tomography (OCT) parameters, and retinal vascular thickness and macular density through fundus autofluorescence (FAF). Methods: Prospectively, women diagnosed with GDM were enrolled in this study. All the participants underwent comprehensive ophthalmic examination. Furthermore, macular OCT with analysis of the central subfield thickness (CST) and total thickness was carried out. Moreover, FAF was performed, and the macular density and retinal vascular thickness were extracted using ImageJ software. Results: Thirty-four women were enrolled. The mean maternal age was 32.7 years. No participant had diabetic retinopathy, nine eyes had early cataract, and two eyes had keratoconus. Higher levels for the 1 h oral glucose tolerance test (OGTT) were associated with a drop in the CST and total thickness. Moreover, women who underwent CS had higher levels of total thickness. Higher levels for the fasting OGTT were associated with a thinner inferior temporal retinal artery. Pregnant women with miscarriages had lower macular density on FAF, as represented by lower values of integrated density and mean gray values. Higher levels for the fasting OGTT were associated with higher values of integrated density. Conclusions: Although GDM is typically not associated with diabetic retinopathy, microscopic changes involving the microvascular environment and the macula may occur. Regular ophthalmic screening for women with GDM may be advised. Larger studies with more investigations may reveal further findings.