Superior Sectors Research Articles

OCT-Angiography of deep and superficial retinal vascular density changes in diabetes without diabetic retinopathy

To analyze the vascular density values (VD) in the superficial and the deep retinal network and in all perimacular sectors of diabetic eyes without clinical retinopathy, comparing them to that of healthy, nondiabetic control eyes. We investigated the factors that may influence these values. This was a cross-sectional study including diabetics without diabetic retinopathy and healthy control subjects. All subjects underwent OCTA examination (RTVue-XR Avanti; Optovue, Fremont, CA, USA). The scanned area was 3×3mm and centered on the fovea. In the superficial and deep capillary plexus, we evaluated the total VD, parafoveal, temporal, nasal, superior and inferior sectors, as well as the superior and inferior hemi-sector VD. The sectors with the greatest area under the curve (AUC) were determined. We evaluated the correlation between certain risk factors and VD values. VD values in all sectors of the superficial capillary plexus layer and deep capillary plexus layer in the diabetic group were significantly lower than in the control group. Among all the parameters, the superficial total VD and superficial parafoveal VD had the greatest AUC (0.992 and 0.991 respectively). The sector with the greatest AUC was the temporal sector in both the SCP (0.990) and DCP (0.976). Age, creatinine clearance and hyperlipemia correlated with vascular density. Superficial and deep retinal VD are both decreased in diabetic patients without diabetic retinopathy. Our results suggest that OCTA might be a promising tool for diabetic retinopathy screening. Quantitative microvascular changes might precede clinical damage.

Subchondral fatigue fracture of the femoral head in young military recruits: Potential risk factors.

Subchondral fatigue fracture of the femoral head (SFFFH) mainly occurs in young military recruits and might be confused with osteonecrosis of the femoral head. However, less research focuses on the risk factor for SFFFH. To evaluate the intrinsic risk factors for SFFFH in young military recruits. X-ray and magnetic resonance imaging data were used for analysis. Acetabular anteversion of the superior acetabulum, acetabular anteversion of the center of the acetabulum (AVcen), anterior acetabular sector angle (AASA), posterior acetabular sector angle, superior acetabular sector angle, neck-shaft angle (NSA), inferior iliac angle (IIA), and ischiopubic angle were calculated. Then, logistic regression, receiver operating characteristic curve analysis, and independent samples t-test were performed to identify the risk factors for SFFFH. Based on the results of logistic regression, age [odds ratio (OR): 1.33; 95% confidence interval (95%CI): 1.12-1.65; P = 0.0031] and treatment timing (OR: 0.86; 95%CI: 0.75-0.96; P = 0.015) could be considered as the indicators for SFFFH. AVcen (P = 0.0334), AASA (P = 0.0002), NSA (P = 0.0007), and IIA (P = 0.0316) were considered to have statistical significance. Further, AVcen (OR: 1.41; 95%CI: 1.04-1.95) and AASA (OR: 1.44; 95%CI: 1.21-1.77), especially AASA (area under curve: 66.6%), should be paid much more attention due to the higher OR than other indicators. We have for the first time unveiled that AASA and age could be key risk factors for SFFFH, which further verifies that deficient anterior coverage of the acetabulum might be the main cause of SFFFH.

Retinal Thinning as a Marker of Disease Severity in Progressive Supranuclear Palsy.

Progressive supranuclear palsy (PSP) involves a variety of visual symptoms that are thought to be partially caused by structural abnormalities of the retina. However, the relationship between retinal structural changes, disease severity, and intracranial alterations remains unknown. We investigated distinct retinal thinning patterns and their relationship with clinical severity and intracranial alterations in a PSP cohort. We enrolled 19 patients with PSP (38 eyes) and 20 age-matched healthy controls (40 eyes). All of the participants underwent peripapillary and macular optical coherence tomography. Brain 11C-2β-carbomethoxy-3β-(4-fluorophenyl) tropane (11C-CFT) and 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography imaging were also performed in patients with PSP. We investigated the association between retinal thickness changes and clinical features, striatal dopamine transporter availability, and cerebral glucose metabolism. The peripapillary retinal nerve fiber layer (pRNFL) and macula were significantly thinner in patients with PSP than in controls. The thickness of the superior sector of the pRNFL demonstrated a significant negative relationship with the Movement Disorder Society-Unified Parkinson's Disease Rating Scale part III and Hoehn and Yahr staging scale scores. A significant negative correlation was found between outer inferior macular thickness and disease duration. Outer temporal macular thickness was positively correlated with Montreal Cognitive Assessment scores. In PSP, lower outer temporal macular thickness was also positively correlated with decreased dopamine transporter binding in the caudate. The pRNFL and macular thinning may be candidate markers for monitoring disease severity. Additionally, macular thinning may be an in vivo indicator of nigrostriatal dopaminergic cell degeneration in PSP patients.

Testing for pharmacogenomic predictors of ppRNFL thinning in individuals exposed to vigabatrin.

The anti-seizure medication vigabatrin (VGB) is effective for controlling seizures, especially infantile spasms. However, use is limited by VGB-associated visual field loss (VAVFL). The mechanisms by which VGB causes VAVFL remains unknown. Average peripapillary retinal nerve fibre layer (ppRNFL) thickness correlates with the degree of visual field loss (measured by mean radial degrees). Duration of VGB exposure, maximum daily VGB dose, and male sex are associated with ppRNFL thinning. Here we test the hypothesis that common genetic variation is a predictor of ppRNFL thinning in VGB exposed individuals. Identifying pharmacogenomic predictors of ppRNFL thinning in VGB exposed individuals could potentially enable safe prescribing of VGB and broader use of a highly effective drug. Optical coherence topography (OCT) and GWAS data were processed from VGB-exposed individuals (n = 71) recruited through the EpiPGX Consortium. We conducted quantitative GWAS analyses for the following OCT measurements: (1) average ppRNFL, (2) inferior quadrant, (3) nasal quadrant, (4) superior quadrant, (5) temporal quadrant, (6) inferior nasal sector, (7) nasal inferior sector, (8) superior nasal sector, and (9) nasal superior sector. Using the summary statistics from the GWAS analyses we conducted gene-based testing using VEGAS2. We conducted nine different PRS analyses using the OCT measurements. To determine if VGB-exposed individuals were predisposed to having a thinner RNFL, we calculated their polygenic burden for retinal thickness. PRS alleles for retinal thickness were calculated using published summary statistics from a large-scale GWAS of inner retinal morphology using the OCT images of UK Biobank participants. The GWAS analyses did not identify a significant association after correction for multiple testing. Similarly, the gene-based and PRS analyses did not reveal a significant association that survived multiple testing. We set out to identify common genetic predictors for VGB induced ppRNFL thinning. Results suggest that large-effect common genetic predictors are unlikely to exist for ppRNFL thinning (as a marker of VAVFL). Sample size was a limitation of this study. However, further recruitment is a challenge as VGB is rarely used today because of this adverse reaction. Rare variants may be predictors of this adverse drug reaction and were not studied here.

Analisis Sektor Unggulan Sebagai Daya Saing Dalam Pembangunan Wilayah Kabupaten

The basic sectors or leading sectors of a region need to be explored optimally to increase economic competitiveness. Measuring competitiveness can be done by identifying basic sectors, Shift-Share analysis and also Klassen typology analysis. The aim of this research is to analyze the leading sectors in Purbalingga Regency based on Gross Regional Domestic Product (GRDP) data in order to obtain basic sectors, classification of economic growth and changes and shifts in the economic structure. This research is a quantitative research using Location Quotient (LQ) analysis tools, Shift-Share analysis and Klassen Typology analysis. The result is that based on the LQ analysis, there are three superior out of fourteen superior GRDP sectors, namely the Agriculture, Forestry and Fisheries sectors, the Mining and Excavation sector and the Water Supply, Waste Management, Waste and Recycling sectors. Furthermore, the five sectors that are included in the advanced and rapidly growing sector include the Transportation and Warehousing sector, the Government Administration, Defense and Mandatory Social Security sectors, the Mining and Quarrying sector, the Education Services sector and the Agriculture, Forestry and Fisheries sectors. The results of the Shift-Share analysis show that there are six sectors that fall into the basic category which is superior, namely the Construction sector, the Electricity and Gas Procurement sector, the Transportation and Warehousing sector, the Accommodation and Food and Drink Provision sector, the Health Services and Social Activities sector and the Other Services sector

The Relationship Between Artificial Intelligence–Assisted OCT Angiography–Derived Foveal Avascular Zone Parameters and Visual-Field Defect Progression in Eyes with Open-Angle Glaucoma

To investigate clinical factors associated with foveal avascular zone (FAZ) parameters obtained using OCT angiography (OCTA) with assistance from a previously developed artificial intelligence (AI) platform in eyes with open-angle glaucoma (OAG). Retrospective longitudinal. This study followed up 885 eyes of 558 patients with OAG for ≥ 2 years; all eyes underwent≥ 5 Humphrey visual-field (VF) tests and had 3.0×3.0 mm macular OCTA scans available. Average total deviation (TD) in the superior, superocentral, inferocentral, and inferior sectors of the Humphrey 24-2 program was calculated. We collected 3.0×3.0 mm macular OCTA images from each patient and used a previously developed AI platform with these images to obtain FAZ parameters, including FAZ area, FAZ circularity index (CI), and FAZ perimeter. Multivariable linear mixed-effects models were used to analyze the relationship between FAZ parameters, TD or TD slope in each quadrant, and systemic factors, adjusting for potential confounding factors, including axial length. Ophthalmic and systemic variables, FAZ parameters, and TD or TD slope in each quadrant. The multivariable model showed that FAZ parameters were correlated with both TD and TD slope in the inferocentral quadrant (β=-0.244 - 0.168, P < 0.001). Both upper-half and lower-half FAZ parameters were better associated with TD-inferocentral and TD-inferocentral slope than TD-superocentral or TD-superocentral slope in terms of β size and statistical significance, indicating that there was no evident vertical anatomical correspondence between TD in the central quadrant and FAZ parameters. Foveal avascular zone area enlargement was associated with female gender (β=0.242, P= 0.003). Loss of FAZ circularity was associated with both aging and comorbid sleep apnea syndrome (SAS) (yes: 1, no: 0) (β=-0.188, P < 0.001; β=-0.261, P= 0.031, respectively). Foveal avascular zone perimeter elongation was associated with aging and female gender (β=0.084, P= 0.040; β=0.168, P= 0.042, respectively). Artificial intelligence-assisted OCTA-measured FAZ enlargement and irregular shape might be good markers ofocular hypoperfusion and associated inferocentral VF defect progression in eyes with OAG. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

The preliminary study of diabetic retinopathy detection based on intensity parameters with optical coherence tomography angiography

In this study, the diagnostic abilities of intensity parameters of optical coherence tomography angiography (OCTA) images in the early detection of diabetic retinopathy (DR) were determined. 78 normal healthy eyes, 10 diabetic eyes with mild non-proliferative diabetic retinopathy (NPDR), and 10 diabetic eyes with moderate NPDR were employed. Four retinal vascular plexuses were generated by using OCTA, which included the nerve fiber layer vascular plexus (NFLVP), superficial vascular plexus (SVP), intermediate capillary plexus (ICP) and deep capillary plexus (DCP). The parafoveal zone in each OCTA image was divided into four sectors which were the superior, temporal, inferior, and nasal sectors. Five intensity parameters including the mean, median, variance, skewness, and kurtosis of intensities were calculated for each sector. The factor of aging was evaluated among normal healthy subgroups. The diagnostic abilities of intensity parameters were evaluated between normal healthy subjects and diabetic patients with DR. Our results showed that the variance of intensities in superior sector in ICP achieved the highest AUROC value of 0.95 with the sensitivity of 0.87 and the specificity of 1.000 when comparing the diabetic patients with the mild NPDR to normal healthy subjects. The mean intensity in superior sector in ICP achieved the second highest AUROC value of 0.95 with the sensitivity of 0.90 and the specificity of 0.90 when comparing the diabetic patients with the moderate NPDR to normal healthy subjects. The proposed approach could offer a simple way to differentiate diabetic patients with early DR from normal healthy subjects without performing the relatively complicated image processing techniques.

Assessment interocular symmetry of peripapillary vessel density in young myopes with optical coherence tomographic angiography

PurposeThe purpose of our study was to evaluate the interocular symmetry and distribution of peripapillary vessel density in young myopic eyes.MethodsA cross-sectional observational study was designed. A total of 174 eyes of 87 young myopic patients were recruited in this study. According to spherical equivalent (SE), 48 eyes were classified as mild myopia with a mean SE of − 2.12D (SD 0.66D), 66 as moderate myopia with a mean SE of − 4.50D (SD 0.87D), and 60 as high myopia with a mean SE of − 7.39D (SD 1.30D). Optical coherence tomography angiography (OCTA) was used to measure the vessel density. The distribution and interocular symmetry of peripapillary vessel densities were analyzed.ResultsThe vessel densities in the whole image, peripapillary, superior and inferior sectors were significantly lower in the high myopia group than in the mild or moderate myopia group (All P < 0.001), and the density in the nasal sector was significantly lower in the high myopia group than in the mild group. And most interesting, the vessel densities in the inside disc and temporal sector showed no difference among the three myopic groups (All P > 0.05). By Pearson correlation analysis, the vessel densities in the whole image, peripapillary, superior, inferior and nasal sectors were negatively correlated with axial length (AL) and SE (All P < 0.001), but vessel densities in the inside disc and temporal sector did not show this correlation (All P > 0.05). Interocular symmetry was observed in all the vascular parameters through paired-samples t-tests (All P > 0.05), intraclass correlation coefficient (ICC) and Pearson correlation analysis (All P < 0.001).ConclusionThe density of radial peripapillary capillaries decreased in the myopic eye with axial elongation, and optical vascular parameters showed significant interocular symmetry among young myopic eyes.

OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY BIOMARKERS AND MICROPERIMETRY FEATURES IN BEHÇET'S UVEITIS.

To evaluate the parafoveal macular microvasculature and the macular function in patients with retinal vasculitis associated with Behçet's uveitis. In 14 patients with inactive Behçet's uveitis and 26 control individuals (13 with nonocular Behçet's syndrome and 13 healthy subjects), we analyzed the retinal nerve fiber layer, ganglion cell layer, full retinal thickness, foveal avascular zone area and sectorial parafoveal vascular density in the superficial vascular plexus, intermediate capillary plexus, and deep capillary plexus using SPECTRALIS optical coherence tomography (OCT) 2 and OCT angiography. Macular sensitivity was analyzed using an MP-3 microperimeter. Eighteen eyes (78%) had a best-corrected visual acuity ≥ 20/25. Significant differences were found in Behçet's uveitis in comparison with the controls on the OCT and OCT angiography: 14.8%, 22.4%, and 14.9% ganglion cell layer thinning in the global, nasal, and inferior sectors, respectively; 6%, 13.2%, and 7.5% full retinal thickness thinning in the superior, nasal, and inferior sectors; and 16.8%, 14.9%, 23.6%, 15.8%, and 12.6% mean deep capillary plexus density reduction in the global, superior, nasal, inferior, and temporal sectors. Microperimetry data demonstrated significant mean reductions of 21% and 23.6% in central and average macular sensitivities and 28.8%, 40.4%, 27.7%, and 24.2% in the superior, nasal, inferior, and temporal sectors, respectively. Outer plexiform layer elevations were observed in Behçet's uveitis (69.6%). Behçet's uveitis presented structural and functional macular damage despite good best-corrected visual acuity, mainly affecting the nasal sector and the deep capillary plexus. On OCT and OCT angiography, quantitative and qualitative changes can be valuable biomarkers of ocular involvement in Behçet's syndrome.

Analysis of Peripapillary Retinal Nerve Fiber Layer Thickness in Acute Anterior Uveitis among Children with HLA-B27-Positive Juvenile Idiopathic Arthritis.

The aim of this study was to evaluate changes in the thickness of the peripapillary retinal nerve fiber layer (pRNFL) in children with a diagnosis of juvenile idiopathic arthritis (JIA) who were positive for human leukocyte antigen (HLA)-B27, treated for the first episode of unilateral acute anterior uveitis (AAU). This retrospective study included 41 children (aged 5 to 14 years; mean age 8.32 ± 2.4 years) with HLA-B27 positivity and unilateral JIA-AAU, and 40 healthy children. Optical coherence tomography (OCT) imaging was performed during active inflammation and subsequent noninflammatory phases (6 months after the resolution of inflammatory symptoms in the anterior segment of the eye). There was a marked difference in mean pRNFL thickness between eyes with AU in the active phase, unaffected fellow eyes and the control group (110.22 ± 5.95 μm, 102.39 ± 4.39 μm and 95.83 ± 8.84 μm, respectively; p < 0.001). The thickness of pRNFL in eyes with AU in the active phase in all sectors was greater compared to unaffected fellow eyes (p < 0.001) and normal eyes (p < 0.001). In addition, it was demonstrated that pRNFL thickness was significantly increased in the superior and temporal sectors in the unaffected fellow eyes compared to the control group (128.73 ± 13.16 μm vs. 121.48 ± 13.35 μm and 71.37 ± 4.02 μm vs. 64.98 ± 9.12 μm, respectively). Even during the inactive phase, eyes with AU, compared to the healthy control group, had significantly greater pRNFL thickness in the inferior sector (129.78 ± 11.98 μm vs. 122.3 ± 14.59 μm; p = 0.018), along with the temporal sector (70.88 ± 5.48 μm vs. 64.98 ± 9.12 μm; p = 0.001). An increase in pRNFL thickness in children with unilateral JIA-AAU who were positive for HLA-B27 antigen can be observed in both eyes compared to healthy controls, and this change may persist even after the inflammatory symptoms have resolved. Measurements of pRNFL thickness resulting from JIA-AU-associated glaucoma should be performed during quiescent periods to avoid subclinical changes in pRNFL thickness caused by inflammation. However, when reviewing the results, it should be noted that changes in pRNFL parameters may be present despite evidence of a resolution of inflammation.

Structural measurements and vessel density of spectral-domain optic coherence tomography in early, moderate, and severe primary angle-closure glaucoma.

To compare the macular ganglion cell-inner plexiform layer (GCIPL) thickness, retinal nerve fiber layer (RNFL) thickness, optic nerve head (ONH) parameters, and retinal vessel density (VD) measured by spectral-domain optical coherence tomography (SD-OCT) and analyze the correlations between them in the early, moderate, severe primary angle-closure glaucoma (PACG) and normal eyes. Totally 70 PACG eyes and 20 normal eyes were recruited for this retrospective analysis. PACG eyes were further separated into early, moderate, or severe PACG eyes using the Enhanced Glaucoma Staging System (GSS2). The GCIPL thickness, RNFL thickness, ONH parameters, and retinal VD were measured by SD-OCT, differences among the groups and correlations within the same group were calculated. The inferior and superotemporal sectors of the GCIPL thickness, rim area of ONH, average and inferior sector of the retinal VD were significantly reduced (all P<0.05) in the early PACG eyes compared to the normal and the optic disc area, cup to disc ratio (C/D), and cup volume were significantly higher (all P<0.05); but the RNFL was not significant changes in early and moderate PACG. In severe group, the GCIPL and RNFL thickness were obvious thinning with retinal VD were decreasing as well as C/D and cup volume increasing than other three groups (all P<0.01). In the early PACG subgroup, there were significant positive correlations between retinal VD and GCIPL thickness (except superonasal and inferonasal sectors, r=0.573 to 0.641, all P<0.05), superior sectors of RNFL thickness (r=0.055, P=0.049). More obvious significant positive correlations were existed in moderate PACG eyes between retinal VD and superior sectors of RNFL thickness (r=0.650, P=0.022), and temporal sectors of RNFL thickness (r=0.740, P=0.006). In the severe PACG eyes, neither GCIPL nor RNFL thickness was associated with retinal VD. The ONH damage and retinal VD loss appears earlier than RNFL thickness loss in PACG eyes. As the PACG disease progressed from the early to the moderate stage, the correlations between the retinal VD and RNFL thickness increases.

Comparison of the retinal microvasculature between compressive and glaucomatous optic neuropathy.

To compare the patterns of retinal microvasculature change in the peripapillary and macular region between compressive optic neuropathy (CON) and glaucomatous optic neuropathy (GON), and to assess the ability of optical coherence tomography angiography (OCTA) in differentiating the two conditions. This cross-sectional study included 108 participants (108 eyes), 36 with CON, 36 with GON, and 36 healthy controls. The CON and GON eyes were matched by the average peripapillary retinal nerve fiber layer (pRNFL) thickness (1:1). Optical coherence tomography (OCT) and OCTA were performed to compare the structural and vascular change of the peripapillary and macular region between groups. Both CON and GON eyes showed more severe structural and vascular damage than the control eyes. The CON eyes had lower pRNFL thickness than the GON eyes in the temporal and nasal quadrants, and thicker pRNFL thickness in the inferior quadrant. The average GCC thickness did not differ between the two groups. The peripapillary vessel density of the CON group was significantly higher in the inferior sectors than that of the GON group. In the macular region, the CON group had significantly higher vessel density in the whole image, the temporal sector in parafovea region, and the temporal, superior, and inferior sectors in perifovea region. To a similar degree of structural damage, CON had less retinal vascular impairment than GON, especially in the macular region, and the significance of the finding needs further evaluation.

Analysis of Base And Non-Base Sectors in The Economic Development of Jayawijaya Regency

Jayawijaya Regency is the economic center for the central mountainous region in Papua Province. As an economic center, there is a growing gap between economic sectors, uneven income distribution, and a very high poverty rate in Jayawijaya Regency. Therefore, this research was conducted with the aim of 1) knowing the base and non-base economic sectors in the economic development of Jayawijaya Regency, and 2) knowing the projected changes and competitive advantages of the Jayawijaya Regency economic sectors. The location of the study is determined purposively. The data type is secondary data in the form of Gross Regional Domestic Product (GRDP) of Jayawijaya Regency at 2010 Constant Market Prices by Industry for the period 2010-2019. The source of the data comes from BPS (Berau Central of Statistics) Jayawijaya Regency and Papua Province. The data were analyzed using LQ and DLQ analysis methods. The results showed that there are 15 base or superior economic sectors and 2 non-base or potential economic sectors from 17 economic sectors in Jayawijaya Regency. Non-base economic sectors are the mining and quarrying industry; and water supply, sewerage, waste management and remediation activities. Projections of changes and competitive advantages of the economic sector show that repositioning occurs in the water supply, sewerage, waste management and remediation activities, while the mining and quarrying industries have not undergone changes with low competitiveness

Rice Planting Decision Support System Using the Fuzzy Simple Additive Weighting (SAW) Method

In the era of evolution 4.0 currently has very rapid technological advances. This technological advancement is very useful in several sectors including the agricultural sector. The agricultural sector in Indonesia is the most superior sector because it is the livelihood of the population in Indonesia as farmers. Human resources are important to improve the social or economic quality in society. Gadingsari Village is one of 4 villages in the Sanden sub-district which is located in the westernmost area which has potential in the agricultural sector. Most residents of Gadingsari village depend on work as farmers. Therefore, it can be said that the agricultural sector has a major role in the economy and welfare of the people of Gadingsari village. Using the FSAW method, it can assist in determining quality yields. This study aims to analyze rice cultivation in Gadingsari village which can help local communities to find out information about planting rice correctly and can produce quality rice. The result of this research is a website to analyze the best rice yields with the criteria of rice varieties, rice seeds, planting, fertilizers, harvesting age, and pests.

ANALISIS SEKTOR EKONOMI UNGGULAN DI KABUPATEN SUMBAWA

This study aims to know and analyze the leading sectors of the economy in Sumbawa District, which are competitive in economic growth. The type of this study was qualitative study. The data used was secondary data obtained from the Gross Regional Domestic Product of Sumbawa district and West Nusa Tenggara (NTB) Province in 2012-2017. The data analysis tool used was the analysis technique of Growth Ratio Model (MRP) and Klassen Typology. The results of the study showed based on Growth Ratio Model analysis (GRM) showed that there were several sectors that had positive growth in the study area and reference area, including the Wholesale and Retail Trade sector, Car and Motorcycle Repair and the information and communication sector. Meanwhile, the results of the Klassen typology showed that the economic sectors classified as superior sectors were the agriculture, forestry and fishery sectors; electricity and gas procurement sector; wholesale and retail trade, repair and maintenance of cars and motorcycles; and the education services sector. So, based on the results of the two analytical tools used, the conclusion were that the leading sectors in Sumbawa district were prominent sectors and the advanced sectors are agriculture, forestry and fisheries; wholesale and retail trade, repair of cars and motorcycles; electricity and gas procurement sector; and the education services sector.

Comparative study of the efficacy of lens extraction and laser peripheral iridotomy in primary anterior chamber angle closure

PURPOSE. To compare the anatomical and functional effectiveness of lensectomy (LE) and laser peripheral iridotomy (LPI) in patients with primary anterior chamber angle closure.METHODS. This prospective study included 120 patients aged 41 to 80 years (60 eyes — primary angle closure (PAC), 30 — primary angle closure suspects (PACs), 30 eyes — without ophthalmic pathology). 30 PAC eyes were treated using LE with intraocular lens implantation, and 30 eyes with LPI. All subjects underwent swept source optical coherence tomography (SS-OCT). The following parameters were analyzed: spherical equivalent (SE), uncorrected and corrected distance visual acuity, intraocular pressure (IOP), Shaffer grade of angle opening, lens opacity, goniosyne chiae, choroidal thickness in the macular region, axial length (AL) of the eye, anterior chamber depth (ACD), lens vault (LV), iris curvature (ICurv), iris thickness at 750 µm from scleral spur (IT750), angle opening distance (AOD500, AOD750), iridotrabecular space area (TISA500, TISA750). Along with standard descriptive statistics methods, machine learning methods were used, including Data Driven Soft Independent Modelling of Class Analogies (DD-SIMCA).RESULTS. Every third eye with PAC had reached control group values after LE (DD-SIMCA specificity 0.67), which was not the case after LPI (DD-SIMCA specificity 1.0) with the probability of getting into the control group estimated as 0.01. After LE, all parameters of the anterior chamber angle did not significantly differ from the norm (p&gt;0.05 for all), while ACD, ICurv even exceeded the norm (p=0.000). After LPI, there was a deepening of the ACD (from 2.34±0.28 mm to 2.36±0.280 mm, p=0.000) and a decrease in LV (from 0.864±0.120 µm to 0.843±0.110 µm, p=0.000), however, the result comparable to control was achieved only in ICurv (p=1.000). After LE in PAC, all parameters, including uncorrected visual acuity, SE, ACD, LV, iris profile, Shaffer grade of angle opening, and AOD500, AOD750, TISA500, TISA750 parameters in the superior and inferior sectors had advantages over those in PACs without treatment (p&lt;0.05). After LPI, an improvement in a number of pa rameters was also achieved compared to LPI: ICurv, Shaffer grade of angle opening, AOD500, AOD750, TISA500, TISA750 in the superior sectors and AOD500 in the inferior sector (p&gt;&lt;0.05).CONCLUSION. The effectiveness of LE in PAC is higher than LPI due to the better postoperative anterior chamber topography and lower IOP. Both treatments, especially LE, improve these parameters compared to PACs. Lens extraction is the treatment of choice at the early stages of primary angle closure.

Anatomical and topographical characteristics of the eye in the early stages of primary angle closure disease

PURPOSE. To determine the anatomical and topographic features of the anterior and posterior segments of the eye in primary angle closure (PAC) and compare them with those in the primary angle closure suspects (PACs) and in controls.METHODS. This prospective study included 120 patients aged 41 to 80 years (60 eyes — PAC, 30 — PACs, 30 eyes — without ophthalmic pathology). The studied parameters included spherical equivalent (SE), intraocular pressure (IOP), choroidal thickness in the fovea (CTf), axial length (AL), anterior chamber depth (ACD), lens volume (LV), iris curvature and its thickness, anterior chamber angle profile: AOD500, AOD750, TISA500, TISA750.RESULTS. The PAC eyes differed from the control eyes by increased SE, LV, IOP, iris curvature, CTf, reduced ACD, AL, and the anterior chamber profile (AOD500, AOD750, TISA500, TISA750) in vertical sectors (p&lt;0.01). Iris thickness was comparable between the groups.The PAC eyes differed from the PACs by increased SE, LV, IOP, reduced ACD, AL, AOD500 in the superior sector, and the profile of the anterior chamber angle in the inferior sector (p&lt;0.01). Iris thickness, its curvature, as well as the profile of the anterior chamber in the upper sector and CTf were comparable.Threshold values that distinguish the PAC eyes and the PACs were determined: LV — 0.656 mm, AOD500 — 0.131 mm, TISA500 — 0.051 mm2, TISA750 — 0.093 mm2 in the lower sector and IOP 21 mm Hg. In the multifactor model adjusted for age, gender and AL, a negative correlation of iris thickness with CTf was established both in the PAC eyes and the PACs (all p&lt;0.01), but not in the controls (all p&gt;0.01). CONCLUSION. Parameters of the PAC eyes and the PACs significantly differ from the norm. LV and the anterior chamber profile in the inferior sector are the most informative for differentiating the PAC eyes from the PACs. Negative correlation between the iris and the choroidal thickness suggests that the choroid plays a role in the pathogenesis of primary angle closure disease.

BUSINESS PROCESS REENGINEERING SUPPLY CHAIN MANAGEMENT SYSTEM BASED BLOCKCHAIN USING BPR LC

The agricultural sector in Indonesia is a superior sector compared to other sectors. The red onion commodity in Indonesia has the highest household consumption rate. Nowadays, technological developments are widely used to support existing agriculture to get maximum results. One of the technologies that can be used in agriculture is blockchain. The application of blockchain has gained importance in information systems and information technology research in the agricultural sector. However, in Indonesia, precisely in Central Java, there is no red onion supply chain management that uses blockchain technology for data storage, data security and data transparency. The author has a goal to re-engineer to overcome these problems by implementing blockchain technology using the Hyperledger Fabric and modeling business processes with Business Process Modeling Notation (BPMN). This research uses the Business Process Re-Engineering Life Cycle method in which this research produces red onion supply chain management with a new business process that is described by Business Process Modeling Notation (BPMN) and produces blockchain applications with various features and testing has been carried out using the Black box testing method with the result that existing features can run well without problems and the web application is running according to user needs to support supply chain management deficiencies so that they become more optimal and transparent in data storage.

Choroidal and Retinal Vascular Findings in Patients with COVID-19 Complicated with Pneumonia: Widefield Imaging

The purpose of this study was to analyze choroidal and retinal vascular alterations of both the macula and midperiphery areas in patients hospitalized for COVID-19 infection complicated with pneumonia within 30 days from discharge. A total of 46 eyes of 23 subjects with a history of symptomatic COVID-19 infection and recent hospitalization for pneumonia were enrolled in this observational study. Patients had not been previously vaccinated against COVID-19. A group of patients homogenous for age and sex was enrolled as controls. Microvascular retinal and choroidal features of the enrolled patients were studied with widefield optical coherence tomography angiography (OCT-A). Perfusion parameters in terms of the vessel density (VD) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) and the choroidal vascularity index (CVI) on enhanced depth imaging (EDI) mode OCT scans were analyzed. Our cohort of patients showed a trend of reduction in VD, significantly in the SCP VD of the superior and inferior midperiphery sectors, whereas the CVI did not show significant differences between the cases and controls. Moreover, a positive correlation between CVI and vessel density in the deep capillary plexus in the macular area (VD-DCP-MAC) was found. The systemic disease due to COVID-19 can also involve the retina and choroid with multiple mechanisms: ischemic and inflammatory. Our study showed changes in perfusion occurring in the eyes of patients with a recent hospitalization for COVID-19 complicated with pneumonia and without any possible ocular effect due to the vaccines. There is still the need to better comprise how long COVID-19 actually affects vascular changes in the eye.

Comparing the structure-function relationship between the visual fields measured with variational Bayes linear regression and SITA standard.

We recently constructed an algorithm to measure visual field (VF) using the variational Bayes linear regression (VBLR). This algorithm enabled a faster VF measurement than the Swedish interactive thresholding algorithm (SITA) standard while maintaining the test-retest reproducibility (Murata H, et al. Br J Ophthalmol 2021). The current study aimed to compare the structure-function relationship between the SITA standard and VBLR. In 78 eyes of 56 patients with primary open-angle glaucoma, VF measurements were conducted using both SITA standard and VBLR VF, as well as spectral-domain optical coherence tomography. The structure-function relationship was investigated between visual sensitivity and circumpapillary retinal nerve fiber layer in the whole VF. This analysis was repeated for each of the 12 sectors (30 degrees). The strength of the structure-function relationship was evaluated using the second-order bias-corrected Akaike Information Criterion (AICc) index. In the whole VF, AICc values of SITA standard and VBLR were 601.6 and 597.3, respectively. The relative likelihood that VBLR had a better structure-function relationship than the SITA standard was 88.2% (when the entire field was averaged) or 99.9% (when all test points were analyzed in the pointwise manner). With the sector-wise analysis, SITA standard had a better structure-function relationship than VBLR in 1 sector (Superior sector in the retina), whereas VBLR had a better structure-function relationship than SITA standard in 4 sectors (Supero-Nasal, Infero-Nasal, Inferior, and Infero-Temporal sectors) with >95% relative likelihood. Although it depends on locations and similar between SITA standard and VBLR-VF, but VBLR-VF had a better structure-function relationship than the SITA standard overall.