Superior Sectors Research Articles

Preperimetric Glaucoma Prospective Study (PPGPS): Predicting Visual Field Progression With Basal Optic Nerve Head Blood Flow in Normotensive PPG Eyes.

PurposeTo investigate the site specificity of visual field changes in eyes with normotensive preperimetric glaucoma (PPG), and to determine factors influencing visual field progression.MethodsThis prospective study comprised 84 eyes of 84 normotensive PPG patients followed for at least 16 months. Optic nerve head (ONH) blood flow was assessed with tissue-area mean blur rate (MBRT), derived from laser speckle flowgraphy. Total deviation (TD) was measured in each sector of the Garway-Heath map to evaluate the site specificity of visual field loss. Subjects with a TD slope in the first quartile were classified as progressive, and other subjects as nonprogressive. Linear and multiple regression analyses were performed to determine factors affecting visual field progression.ResultsTD in the superior sector significantly decreased in the subjects overall during the follow-up periods (−0.48 ± 1.92 dB/y, P = 0.025). Linear regression analysis showed that basal MBRT-inferior was correlated significantly with TD-superior slope (r = 0.332, P = 0.002). Furthermore, basal MBRT was significantly lower in this sector in the progressive than the nonprogressive group (P = 0.010). Multiple linear regression analysis revealed that basal MBRT-inferior was the only predictive factor for TD-superior slope (β = 0.329, P = 0.005).ConclusionsThese findings suggest that superior-sector visual field progression is most common in normotensive PPG eyes, and that reduced basal ONH blood flow is associated with visual field progression.Translational RelevanceThese findings provide new insight into the involvement of ONH blood flow impairment in glaucoma pathogenesis, and demonstrate the importance of assessing ONH blood flow to determine visual field progression in normotensive PPG.

IMPACT ON ECONOMIC SECTOR DEVELOPMENT TO POTENTIAL CONFLICT IN DELTA MAHAKAM FPMU (PRODUCTION) AND SUNGAI BERAM HITAM FPMU (PROTECTION)

Regional economic growth is determined by the potential of existing natural resources, including for fisheries and mining. The development of the two sectors also opens up potential for conflict with other sectors. The aim of the study is to determine the role of the sectors and the impact of economic growth to potential conflict in the research area. This research was conducted at Delta Mahakam Forest Production Management Unit (FPMU) and Sungai Beram Hitam Forest Protection Management Unit (FPMU) . Base sector approach was conducted to determine the superior sector by Location Quotient (LQ) using GDP variable. The results showed that at Delta Mahakam, mining sector was the dominant, and the second largest was fisheries with LQ ≥1. While at the Sungai Beram Hitam fisheries sector was the dominant sector, and the mining sector was non base since its value ≤1. Process of forest area utilization for mining in Jambi was done through leasing of forest lands, but not in East Kalimantan. Conflict resolution between mining and fisheries sector with community was done through compensation. FMU status and position can be enhanced by granting authority on the leasing of forest area for strategic sector development and national interests.

Analisis Keunggulan Komparatif Sektor Peternakan Di Kabupaten Hulu Sungai Utara

This study aims to discuss the application of Location Quotient (LQ) method in identifying superior commodities of livestock sector of each sub-district in Hulu Sungai Utara Regency. The research method used is descriptive quantitative research method, the data collected in this research is secondary data, this research will identify and analyze superior commodity sector or livestock base. Data analysis using Location Quotient method. The results showed that the livestock population is said to be superior or base if it meets the criteria of basic commodities. Leading commodities of the livestock sector in Hulu Sungai Utara Regency cover buffalo cattle and ducks in Paminggir District

ANALISIS SEKTOR UNGGULAN DAN PENGEMBANGAN WILAYAH DI KABUPATEN BOLAANG MONGONDOW TIMUR

This study aims to (1) identify the leading sectors in the economic structure of East Bolaang Mongondow Regency as information and consideration in (2) formulating regional development strategies. This study uses time series data from Gross Regional Domestic Product (PDRB) of East Bolaang Mongondow Regency and North Sulawesi Province in 2010 - 2016. The analysis tool used in this research is Klassen Tipology, Location Quotient (LQ), and Shift Share analysis to determine the leading sectors and SWOT analysis. The result of per sector analysis based on these three analytical tools shows that which is the leading sector in East Bolaang Mongondow Regency with criteria of advanced and fast growing sector, basic and competitive sector, there are 2 sectors: (a) agriculture, forestry and fishery sector, (b) mining and quarrying sectors. To formulate regional development strategy used SWOT analysis tool. Based on the SWOT analysis, the strategy of regional development at East Bolaang Mongondow Regency with the superior sector is in quadrant III so that the appropriate strategy is turn around strategy. The Weakness Opportunity Strategy in Quadrant III, means minimizing weaknesses by taking advantage of opportunities.

Functional organization of face processing in the human superior temporal sulcus: a 7T high-resolution fMRI study.

The superior temporal sulcus (STS) is a major component of the human face perception network, implicated in processing dynamic changeable aspects of faces. However, it remains unknown whether STS holds functionally segregated subdivisions for different categories of facial movements. We used high-resolution functional magnetic resonance imaging (fMRI) at 7T in 16 volunteers to compare STS activation with faces displaying angry or happy expressions, eye-gaze shifts and lip-speech movements. Combining univariate and multivariate analyses, we show a systematic topological organization within STS, with gaze-related activity predominating in the most posterior and superior sector, speech-related activity in the anterior sector and emotional expressions represented in the intermediate middle STS. Right STS appeared to hold a finer functional segregation between all four types of facial movements, and best discriminative abilities within the face-selective posterior STS (pSTS). Conversely, left STS showed greater overlap between conditions, with a lack of distinction between mouth movements associated to speech or happy expression and better discriminative abilities (for gaze and speech vs emotion conditions) outside pSTS. Differential sensitivity to upper (eye) or lower (mouth) facial features may contribute to, but does not appear to fully account for, these response patterns.

Economic and Mathematical Model of Business Struggle with a Vertically Integrated Company in the Market

The paper contains an analysis of the market structure when the inferior process chain company supplies the superior company with input resources and at the same time is vertically integrated with one of the superior companies. The possible anticompetitive effects of such vertically integrated structures are analyzed as well as the influence of information flows between inferior and superior enterprises of the sector on drivers of innovation and national welfare. These issues are relevant, if important information, in particular, information technology, design and specific characteristics of the product is available to inferior and superior sector enterprises. This situation is typical for high-tech sectors in which the inferior and superior product information exchange needs ensuring compatibility of products and preventing the additional costs of adjustment and increased functionality. The problem of assessing the appropriateness of imposing a ban on various divisions of a vertically integrated company to exchange non-public information received by one of its divisions from external sources is important. In the case of such a restriction, the inferior organizational division of a vertically integrated company may use personal information of the superior competitor only within the powers of its supplier, and cannot make it public for its superior organizational division as an example. The aim of the research is to develop an economic and mathematical model of business struggle with a vertically integrated company in the market. The paper contains the hypotheses and supporting evidence.

Quantitative changes in flow density in patients with adult-onset foveomacular vitelliform dystrophy: an OCT angiography study.

To quantitatively compare the flow density, the retinal thickness, and the area of the foveal avascular zone (FAZ) between patients with adult-onset foveomacular vitelliform dystrophy (AOFVD) and a healthy controls. Thirteen eyes (eight patients) with AOFVD and 13 matched eyes (13 patients) without any ocular pathology were included in this study. A 6×6mm optical coherence tomography angiography (OCTA) scan was performed for every included eye. The flow density (superficial retinal vascular layer, deep retinal vascular layer and choriocapillary layer), retinal thickness and FAZ (superficial retinal vascular layer and deep retinal vascular layer) were subsequently analyzed. The mean flow density was decreased in the AOFVD patients in all measured vascular layers. The difference from the control group was statistically significant in the parafoveal sector of the deep retinal vascular layer (P=0.02), and a clear trend was found in the superficial retinal vascular layer (P=0.05). Both groups had comparable FAZs in the superficial and deep retinal vascular layers. The retinal thickness values were higher in the fovea (P=0.840) and lower in the parafoveal sectors (P=0.125). The difference was significant in the superior parafoveal sector (P=0.034). Flow densities as measured by OCTA are decreased in the superficial retinal vascular layer and the deep retinal vascular layer in patients with AOFVD. These findings could be helpful for diagnosing and understanding the pathogenesis of this disease.

ANALYSIS OF ECONOMIC PERFORMANCE AND ECONOMIC POTENTIAL OF EAST JAVA PROVINCE

This study aimed to investigate economic growth, regional economic pattern and structure of East Java Province. Other than that, this study also identified anddetermined superior sectors in East Java Province to give an illustration on which superior economic activities to be developed to improve the economic potential in East Java Province. Data employed in this study was secondary data in six years’ time series form 2010 until 2015 about GDP (Gross Domestic Product) for Indonesia, RGDP (Regional Gross Domestic Product) for East Java Province, total population in Indonesia, total population in East Java Province, the number of people living in poverty in Indonesia, and the number of people living in poverty in East Java Province. Data was obtained from Central Statistics Institution Indonesia, National Planning and Development Institution, Central Statistics Institution of East Java Province, and Regional Planning and Development Institution of East Java Province. Analysis tools used in this study included economic performance analysis, ShiftShare, Location Quotient (LQ), Growth Ratio Model (MRP) and Overlay analysis. The results of the study showed that: (1) economic performance index of East Java Province was quite good because during 2011-2015 the province got average economic performance index 0.847; (2) shift-share analysis showed that East Java Province economic showed an improvement during 2010-2015 by 340.769,50 billion rupiahs. Those economic performance improvements in East Java Province could be seen from the positive value of 16 (sixteen) economic activity sectors; (3) according to Location Quotient (LQ) analysis, there were five superior sectors in East Java Province, they were processing industry sector, water procurement sector, waste and recycle management sector, wholesale and retail, auto car and motorcycle reparation sector, accommodation and foods providing sector, and information and communication sector; (4) Growth Ratio Model analysis showed that sectors which had dominants growth and big contribution were construction sector, wholesale and retail, auto car and motorcycle reparation sector, transportation and warehousing sector, accommodation and foods providing sector, information and communication sector financial and insurance service sector, real estate sector, education service sector, health service and social activity sector; (5) Overlay analysis showed that potential economic sector in East Java Province included wholesale and retail, auto car andmotorcycle reparation sector, accommodation and foods providing sector, and information and communication sector; (6) weighing result according to Shift-Share Location Quotient (LQ), and Growth Ratio Model analysis were five sectors based on the highest rank of the most potential weighing result, they were accommodation and foods providing sector, processing industry sector, wholesale and retail, auto car and motorcycle reparation sector, information and communication sector, and construction sector.
 
 JEL Classification : P47, O47, C02, C02, C02, C02

Macular thickness changes using spectral‐domain optical coherence tomography automated layer segmentation in multiple sclerosis

PurposeWe aim to study the role of automated layer segmentation in MS patients’ management.MethodsRetrospective study that included 39 patients (78 eyes) with confirmed diagnosis of MS and 35 healthy age‐matched controls. Macular spectral‐domain optical coherence tomography scans (SD‐OCT, Heidelberg Engineering, Heidelberg, Germany) were obtained followed by automated retinal layer segmentation at the center of fovea and at a radius of 3–6 mm from the superior, inferior, temporal and nasal sectors (ETDRS grid). Patients with MS were subdivided into two groups: (1) with known previous ON, (2) not known previous ON. Statistical analysis using two sample t‐test was made to calculate significant results between groups with 95% confidence interval.ResultsTotal central and inner layers macular thickness was significantly reduced in MS patients compared to control group (p < 0.05) predominantly due to retinal nerve fibre (RNFL), ganglion cell (GCL) and inner plexiform layers (IPL) reduction in foveal, parafoveal and perifoveal sectors with exception of RFNL temporal sector. GCL and IPL were significantly reduced in foveal and parafoveal sectors between group 1 and 2 (p < 0.05) while no significant RNFL reduction was observed between these groups.ConclusionsReductions in total central and inner layers macular thickness can be detected in MS eyes with or without a previous history of known ON. As many ON episodes are not clinically detected, OCT may act as CNS imaging tool documenting neuronal degeneration in MS patients.

Macular thickness after intraocular pressure reduction following trabeculectomy

PurposeThe aim of the study was to assess changes of macular thickness after trabeculectomy and compare them in respect to the usage of preoperative prostaglandins and status of diabetes mellitus.MethodsThe prospective observational study included 93 glaucomatous eyes (90 patients) that underwent trabeculectomy. 81 (87.1%) patients were on prostaglandins treatment preoperatively. 5 (5.38%) patients had type 2 diabetes. The foveal and sectoral macular thicknesses were measured preoperatively, 1 week, 6 months and 12 months after the surgery using spectral domain optical coherence tomography. Retinal thickness was compared across the follow‐up visits and in respect to the preoperative use of prostaglandins and diabetes.ResultsThere was a reduction in mean ± SD intraocular pressure of 18.5 ± 8.6mmHg 1 week, 15.4 ± 7.9 mmHg 6 months and 14.4 ± 8.3 mmHg 12 months after trabeculectomy (p < 0.001). 1 week postoperatively retinal thickening was observed in all macular subfields (p < 0.001); the central macular thickness increased from 267.23 ± 19.20 μm at baseline to 271.12 ± 19.59 μm. 6 months postoperatively macula remained slightly thicker in central, nasal, inner superior and outer temporal sectors (2.10 ± 5.97 μm, p < 0.001 in central subfield). 12 months after trabeculectomy retina showed thinning in the outer nasal and superior subfields (‐3.54 ± 8.57 μm; ‐1.94 ± 7.02; p < 0.01, respectively). There were no differences in the changes of macular thickness when compared in respect to preoperative prostaglandins (p > 0.05). The retinal changes did not differ between diabetic and nondiabetic patients (p > 0.05).ConclusionsTrabeculectomy induced mild macular thickening, more pronounced in the early postoperative period. Neither diabetes nor the use of prostaglandins before surgery had impact on these changes regardless their potency to increase vascular permeability.

Inner retina changes in hydroxychloroquine patients

PurposeTo study if hydroxychloroquine (HCQ) patients with apparent no retinal toxicity will show lower retinal thickness in inner layers as compared to healthy controls.MethodsRetrospective study of 43 patients (86 eyes) evaluated for HCQ macular toxicity with spectral‐domain OCT (SD‐OCT) and with no OCT signs of maculopathy were subdivided into two groups: (1) no blunting of the foveal contour (foveal splaying), (2) with foveal splaying. Age and sex‐matched controls were used for comparison. Automated retinal layer segmentation at the center of fovea and at a radius of 3 (parafoveal) to 6mm (perifoveal) from the superior, inferior, temporal and nasal sectors was performed. Statistical analysis using two sample t‐test was made to calculate significant results between groups.ResultsCenter macular and internal retinal layers thickness in all parafoveal sectors, particularly in the retinal nerve fibre (RNFL) and ganglion cell layer (GCL), was statistically reduced when compared to control group (p < 0.05) and differed between group 1 and 2. RNFL thickness was also reduced in all perifoveal sectors but temporal sector (p < 0.05) and inner plexiform layer and inner nuclear layer thickness showed only significant reduction in foveal and nasal parafoveal sector (p < 0.05) in HCQ eyes. No significant differences in outer layers was observed between groups.ConclusionsSmall changes in inner retinal layers thickness have been described with HCQ use and conflicting correlation with HCQ toxicity is present in the literature. This study supports that inner retina at the fovea and parafovea is thinner in patients with no outer retinal OCT signs of HCQ toxicity. Further investigation is needed to assess if an inner retinal thickness reduction threshold could serve as valuable tool for identifying patients with increased risk of HCQ maculopathy.

The volume of peripapillary vessels within the retinal nerve fibre layer: an optical coherence tomography angiography study of normal subjects

Background/aimsTo investigate the contribution of vascular volume calculated by optical coherence tomography angiography (OCTA) to the measurement of peripapillary retinal nerve fibre layer (RNFL) thickness.MethodsWe used OCTA scans to build...

OCT in Alzheimer's disease: thinning of the RNFL and superior hemiretina.

Peripapillary retinal nerve fiber layer (pRNFL) and internal macular layer thinning have been demonstrated in Alzheimer's disease (AD) with optical coherence tomography (OCT) studies. The purpose of this study is to compare the pRNFL thickness and overall retinal thickness (RT) in AD patients with non-AD patients, using spectral domain optical coherence tomography (SD-OCT) and determine the sectors most characteristically affected in AD. A cross-sectional study was performed to determine the pRNFL and overall macular RT thicknesses in AD and non-AD patients, attending a tertiary hospital center. For pRNFL, the global and six peripapillary quadrants were calculated, and for overall RT values, the nine Early Treatment Diabetic Retinopathy Study (ETDRS) areas were used. A multiple regression analysis was applied to assess the effects of disease, age, gender, spherical equivalent, visual acuity, intraocular pressure, axial length and blood pressure on pRNFL and overall macular RT. A total of 202 subjects, including 50 eyes of 50 patients with mild AD (mean age 73.10; SD = 5.36 years) and 152 eyes of 152 patients without AD (mean age 71.03; SD = 4.62 years). After Bonferroni correction, the pRNFL was significantly thinner for the AD group globally and in the temporal superior quadrant (10.76 μm and 20.09 μm mean decrease, respectively). The RT thickness was also decreased in superior sectors S3 and S6 (mean thinning of 9.92 μm and 11.65 μm, respectively). Spearman's correlation coefficient showed a direct association between pRNFL in the temporal superior quadrant and RT in superior S6 and S3 sectors (rS = 0.41; p < 0.001 and rS = 0.28; p < 0.001, respectively). Patients with AD showed a significant thickness reduction in global and temporal superior quadrants in pRNFL and in superior pericentral and peripheral sectors of RT. These findings may reflect a peripapillary and retinal changes characteristic of AD, suggesting the importance of SD-OCT as a potential adjuvant in early diagnosis of AD. Further studies are needed to understand which retinal layers and macular sectors are more useful as potential ocular biomarker over time in AD.

Microvascular changes after vitrectomy with internal limiting membrane peeling: an optical coherence tomography angiography study

To evaluate superficial capillary plexus (SCP) changes occurring after internal limiting membrane (ILM) peeling for the treatment of idiopathic epiretinal membrane (ERM). A total of 15 eyes of 15 patients affected by idiopathic ERM (eight males and seven females; mean age 59.8±9.6years) were enrolled in the study. Patients were treated with pars plana vitrectomy followed by ERM and ILM peeling. Subjects were evaluated at baseline and at the week-1 and month-1 follow-up visits. At each visit, patients were evaluated with a complete ophthalmologic evaluation, which included imaging with optical coherence tomography angiography. Overall, the SCP vessel density was 43.0±3.0% at baseline and was stable throughout the follow-up (40.0±4.0% at week-1 and 41.0±4.0% at month-1 follow-up visits; p=0.087 and p=0.426, respectively). Nevertheless, the SCP vessel density was reduced at week-1 visit in both the superior and inferior sectors. In these sectors, the superficial vessel density was still reduced at the month-1 follow-up visit. We observed a reduction in the SCP vessel density occurring after pars plana vitrectomy with ILM peeling. The reduction is referred to those areas where other changes (e.g., swelling of the arcuate nerve fiber layer) have been already described. In theory, superficial vessel density modifications may be due to the direct surgical trauma to the inner retina, where the superficial plexus is contained, during the ILM grasping.

Structural and Functional Analyses in Nonarteritic Anterior Ischemic Optic Neuropathy: Optical Coherence Tomography Angiography Study.

Retinal and optic disc perfusion in nonarteritic anterior ischemic optic neuropathy (NAION) is incompletely understood. Our aim was to investigate the characteristics of the microvascular structures at the peripapillary area and optic disc, and their associations with retinal structure and function in patients with NAION. We conducted a prospective, observational case series study. Thirty-four eyes, consisting of 15 NAION eyes and 19 normal eyes, were included. Optical coherence tomography (OCT) angiography was used to measure the vessel densities in the peripapillary superficial retina and whole-depth mode inside the optic disc. Measurement of circumpapillary retinal nerve fiber layer (cpRNFL) thickness was performed using OCT. Sectorial division analysis of cpRNFL was performed by eliminating the influences of the difference in disc rotation between OCT images and OCT angiography images. The vessel densities of peripapillary retina and inside the optic disc were significantly reduced in the NAION compared to the normal (both P < 0.001). Both the severity of visual field defect and cpRNFL thinning were significantly associated with the peripapillary vessel density (P = 0.006, P = 0.046), but not with the optic disc vessel density (P = 0.981, P = 0.856). cpRNFL and peripapillary vessel density showed reduction predominantly in the superior sectors, corresponding to the visual field defect. However, the correlations showed discrepancy of the sectors. The microvascular structures in the peripapillary retina and optic disc were reduced, but the cpRNFL thinning was associated with vessel density only in the peripapillary retina, indicating that the vessel densities in the peripapillary retina and optic disc may be differently affected in the pathological process of NAION.

KAJIAN MANAJEMEN KUNJUNGAN DI KAWASAN WISATA: STUDI KASUS DESTINASI WISATA KALIURANG

Tourism has become an industry that can enhance the economic growth in Indonesia. The develop of tourism sector as superior sector in Sleman District has supported by many tourism products. As one of the main tourist destinations in Yogyakarta, Kaliurang has many attractions that can be offered to satisfy the traveller’s need. Recognizing the potential of Kaliurang, it is necessary followed by optimizing condition of Kaliurang. Development of good visit management concept would optimize the traveller deployment in visiting all the attractions. Visit management is an opportunity to influence the movement of visitors, meet the needs of visitors, encouraging the spread of visits evenly and provide the best travel experience.&#x0D; Keywords: tourism, visit management, tourism product

Retinal nerve fibre layer thickness is reduced in metabolic syndrome

To investigate retinal nerve fibre layer (RNFL) thickness in people with metabolic syndrome (MetS) and healthy controls. A cross-sectional study was performed from March 2014 to January 2016. All participants underwent anthropometric and serological biochemical measurements, ophthalmological examination, and spectral-domain optical coherence tomography (SD-OCT). Individuals with elevated intraocular pressure, glaucoma, diabetic retinopathy and other ocular disorders were excluded. T-test, Chi square and general linear modelswere used to analyse the data. In total, 278 eyes from 139 participants were investigated [median (interquartile range) age: 37 (32-43)years]. RNFL thickness was lower in the nasal superior (107.8±19.5μm) and temporal superior (135.7±18.9μm) sectors in MetS group compared with the control group (114.6±22.4μm, P=0.013 and 140.7±18.2μm, P=0.027, respectively). After multiple adjustments for age, gender and the side of the examined [right (OD)/left (OS)] eye, MetS was independently associated with a lower RFNL thickness in the nasal superior (β=0.20, P=0.009) and temporal superior (β=0.14, P=0.048) sectors. RNFL thickness was significantly reduced in participants with higher numbers of metabolic abnormalities, independent of age, gender and the side of the examined eye (P=0.043). Our findings demonstrate that MetS is independently associated with reduced RNFL thickness, suggesting that neurodegeneration is implicated in pathogenesis of MetS.

Ketebalan Lapisan Serabut Saraf dan Sel Ganglion Retina pada Pasien dengan Bilik Mata Depan Sudut Tertutup Primer

Decreased thickness of retina nerve fiber layer (RNFL) and ganglion cells of inner plexifom layer (GLIPL) in patients with glaucoma suspect can represent early detection of retina nerve defect. This retrospective study aims to determine the thickness of GLCIPL of patients with primary angle closure suspect (PACS), primary angle closure (PAC), and primary angle closure glaucoma (PACG). All patients who came to Department of Ophthalmology Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital from July to September 2015 were examined for the thickness of RNFL and GLIPL with ocular coherence tomography. Mann Whitney test was performed to analyse the thickness of RNFL and GLCIPL among 3 groups. Seventy six eyes form 40 patients within 75% female were enrolled with the distribution of 23 eyes with PACS, 15 eyes with PAC and 38 eyes with PACG. The mean (standard deviation) thickness of superior RNFL in PACS, PAC and PACG were 120.1(22.2)μm, 119.41(21.05)μm and 88.44(20.02) μm. Significant difference was found between PAC and PACG (p<0.001). The mean (SD) thickness of GLCIPL in the superior sector of PACS, PAC, and PACG were 82.1(6.2)μm, 80.50(6.4)μm and 69.5(4.3)μm, which the GLCIPL thickness between PAC and PACG was significant different (p<0.001). Primary angle closure glaucoma eyes showed the RNFL and GLCIPL was the thinnest, mean while in PAC eyes tend to thinner than PACS. Closed observation should be carried out in PAC eyes, especially in risk factors patients.

Associations between volume changes and spatial dose metrics for the urinary bladder during local versus pelvic irradiation for prostate cancer

Background: Inter-fractional variation in urinary bladder volumes during the course of radiotherapy (RT) for prostate cancer causes deviations between planned and delivered doses. This study compared planned versus daily cone-beam CT (CBCT)-based spatial bladder dose distributions, for prostate cancer patients receiving local prostate treatment (local treatment) versus prostate including pelvic lymph node irradiation (pelvic treatment).Material and Methods: Twenty-seven patients (N = 15 local treatment; N = 12 pelvic treatment) were treated using daily image-guided RT (1.8 Gy@43-45 fx), adhering to a full bladder/empty rectum protocol. For each patient, 9-10 CBCTs were registered to the planning CT, using the clinically applied translations. The urinary bladder was manually segmented on each CBCT, 3 mm inner shells were generated, and semi and quadrant sectors were created using axial/coronal cuts. Planned and delivered DVH metrics were compared across patients and between the two groups of treatment (t-test, p < .05; Holm–Bonferroni correction). Associations between bladder volume variations and the dose-volume histograms (DVH) of the bladder and its sectors were evaluated (Spearman’s rank correlation coefficient, rs).Results: Bladder volumes varied considerably during RT (coefficient of variation: 16–58%). The population-averaged planned and delivered DVH metrics were not significantly different at any dose level. Larger treatment bladder volumes resulted in increased absolute volume of the posterior/inferior bladder sector receiving intermediate-high doses, in both groups. The superior bladder sector received less dose with larger bladder volumes for local treatments (rs ± SD: −0.47 ± 0.32), but larger doses for pelvic treatments (rs ± SD: 0.74 ± 0.24).Conclusions: Substantial bladder volume changes during the treatment course occurred even though patients were treated under a full bladder/daily image-guided protocol. Larger bladder volumes resulted in less bladder wall spared at the posterior-inferior sector, regardless the treatment received. Contrary, larger bladder volumes meant larger delivered doses to the superior bladder sector for pelvic RT but smaller doses for local treatments.

TOPOGRAPHIC CHANGES OF THE MACULA AFTER CLOSURE OF IDIOPATHIC MACULAR HOLE.

To investigate retinal displacement in the macula after surgical closure of idiopathic macular hole and to identify factors correlated with displacement. This retrospective multicenter study included 73 eyes of 73 patients having idiopathic macular hole. A custom program was developed to compare the position of the retinal vessels in the macula between preoperative and postoperative photographs. En face images of a 6 mm × 6 mm optical coherence tomography volume scans were registered to calculate the scale. A grid comprising 16 sectors in 2 rings (inner; 2-4 mm and outer; 4-6 mm) was superimposed. The displacement of the retinal vessels was measured as a vector value by comparing the location of the retinal vessels in each sector. The correlation between displacement and various clinical parameters was analyzed. The average displacement was 57.2 μm at an angle of -3.3° (nasal and slightly inferior). Displacement was larger in the inner ring (79.2 μm) than in the outer ring (35.3 μm, P < 0.001), and larger in the temporal sectors than in the corresponding nasal sectors (P ≤ 0.008). Inferior and superior displacement was noted in the superior and inferior sectors, respectively. Multiple regression analysis revealed that basal horizontal macular hole diameter and size of internal limiting membrane removal were independent factors of displacement. The macula was displaced centripetally, nasally, and slightly inferiorly after surgical closure of idiopathic macular hole. Hole closure, contraction of the nerve fiber layer, and gravity are the suggested mechanisms of macular displacement caused by internal limiting membrane peeling.