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Sample records for included macular hole

  1. Delayed Macular Hole Closure

    Directory of Open Access Journals (Sweden)

    Peter Distelmaier

    2014-04-01

    Full Text Available Purpose: The presented case raises questions regarding the favorable scheduling of planned postoperative care and the ideal observation interval to decide for reoperations in macular hole surgery. Furthermore a discussion about the use of short- and long-acting gas tamponades in macular hole surgery is encouraged. Methods: We present an interventional case report and a short review of the pertinent literature. Results: We report a case of spontaneous delayed macular hole closure after vitreoretinal surgery had been performed initially without the expected success. A 73-year-old male Caucasian patient presented at our clinic with a stage 2 macular hole in his left eye. He underwent 23-gauge pars plana vitrectomy and internal limiting membrane peeling with a 20% C2F6-gas tamponade. Sixteen days after the procedure, an OCT scan revealed a persistent stage 2 macular hole, and the patient was scheduled for reoperation. Surprisingly, at the date of planned surgery, which was another 11 days later, the macular hole had resolved spontaneously without any further intervention. Conclusions: So far no common opinion exists regarding the use of short- or long-acting gas in macular hole surgery. Our case of delayed macular hole closure after complete resorption of the gas tamponade raises questions about the need and duration of strict prone positioning after surgery. Furthermore short-acting gas might be as efficient as long-acting gas. We suggest to wait with a second intervention at least 4 weeks after the initial surgery, since a delayed macular hole closure is possible.

  2. [Macular serpiginous choroiditis complicated by macular hole].

    Science.gov (United States)

    Brănişteanu, D; Moraru, Andreea

    2014-01-01

    Macular serpiginouschoroiditis is a rare variant of serpiginous choroiditis characterized by a severe recurrent inflammation of both central choroid and retinal pigment epithelium. Visual prognosis is severe due to subsequent distruction of retinal structures. Permanent central visual loss is the consequence of retinal pigment epithelium hyper or hypoplasia and/or subretinal neovascularization leading to fibrous scarring. This article reports the unusual case of rapid development of a macular hole soon after the onset of characteristic clinical features. Despite anti-inflammatory treatment and successful macular hole surgery the visual function remained significantly impaired by secondary central retinal pigment epithelium changes.

  3. Correlation between choroidal thickness and macular hole

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    Li-Li Wang

    2018-01-01

    Full Text Available AIM:To explore the correlation between choroidal thickness and macular hole, and to provide a theoretical basis for diagnosis and treatment of macular hole. METHODS: This study included 40 cases of monocular idiopathic macular hole patients who were treated in ophthalmology of our hospital from June 2015 to June 2016 and 40 cases of healthy people. Sicked eyes of idiopathic macular hole patients(40 eyeswere set as the Group A, uninjured side eyes(40 eyeswere set as the Group B, eyes of 40 cases of healthy people(40 normal eyeswere set as the Group C. Choroidal thickness of macular fovea, macular fovea 1mm, 3mm at 9 points, 4 directions in the upper, lower, nasal and temporal regions were measured through coherent optical tomography of enhanced deep imaging(enhanced depth image optical coherence tomography, EDI-OCT. They were recorded as SFCT, SCT1mm, SCT3mm, ICT1mm, ICT3mm, NCT1mm, NCT3mm, TCT1mm, TCT3mm, and correlation analysis between SFCT and age was analyzed. RESULTS: Average SFCT of Group A, B had no significant difference, data of the Group C was significantly higher than those of the Group A, B, there was statistical significance(P1mm, SCT3mm, ICT1mm, ICT3mm, NCT1mm, NCT3mm, TCT1mm, TCT3mm of the Group A, B had no significant difference(P>0.05, and choroidal thickness at each point of the Group C was significantly higher than that of Group A and B, there was statistical significance(Pr=-0.065, P=0.148; r=-0.057, P=0.658, SFCT of the Group C was negatively correlated with age(r=-0.343, P=0.041. CONCLUSION: The pathogenesis of idiopathic macular hole may be related to the sharp decrease of choroidal thickness, choroidal thickness of uninjured side eyes reduces more sharply than normal population and choroidal vascular metabolism reduces may be pathogenic.

  4. Optimal management of idiopathic macular holes

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    Madi HA

    2016-01-01

    Full Text Available Haifa A Madi,1,* Ibrahim Masri,1,* David H Steel1,2 1Sunderland Eye Infirmary, Sunderland, 2Institute of Genetic Medicine, Newcastle University, International Centre for Life, Newcastle, UK *These authors contributed equally to this work Abstract: This review evaluates the current surgical options for the management of idiopathic macular holes (IMHs, including vitrectomy, ocriplasmin (OCP, and expansile gas use, and discusses key background information to inform the choice of treatment. An evidence-based approach to selecting the best treatment option for the individual patient based on IMH characteristics and patient-specific factors is suggested. For holes without vitreomacular attachment (VMA, vitrectomy is the only option with three key surgical variables: whether to peel the inner limiting membrane (ILM, the type of tamponade agent to be used, and the requirement for postoperative face-down posturing. There is a general consensus that ILM peeling improves primary anatomical hole closure rate; however, in small holes (<250 µm, it is uncertain whether peeling is always required. It has been increasingly recognized that long-acting gas and face-down positioning are not always necessary in patients with small- and medium-sized holes, but large (>400 µm and chronic holes (>1-year history are usually treated with long-acting gas and posturing. Several studies on posturing and gas choice were carried out in combination with ILM peeling, which may also influence the gas and posturing requirement. Combined phacovitrectomy appears to offer more rapid visual recovery without affecting the long-term outcomes of vitrectomy for IMH. OCP is licensed for use in patients with small- or medium-sized holes and VMA. A greater success rate in using OCP has been reported in smaller holes, but further predictive factors for its success are needed to refine its use. It is important to counsel patients realistically regarding the rates of success with

  5. Outcomes of chronic macular hole surgical repair

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    Shripaad Y Shukla

    2014-01-01

    Full Text Available Purpose: To report visual and anatomic outcomes of chronic macular hole surgery, with analysis of pre-operative OCT-based hole size and post-operative closure type. Settings and Design: An IRB-approved, retrospective case series of 26 eyes of 24 patients who underwent surgery for stage 3 or 4 idiopathic chronic macular holes at a tertiary care referral center. Statistical Analysis: Student′s t-test. Results: Nineteen of 26 eyes (73% had visual improvement after surgery on most recent exam. Twenty-one of 26 eyes (81% achieved anatomic closure; 16 of 26 eyes (62% achieved type 1, and five of 26 eyes (19% achieved type 2 closure. Post-operative LogMAR VA for type 1 closure holes (0.49 was significantly greater than for type 2 closure and open holes (1.26, P < 0.003 and 1.10, P < 0.005, respectively, despite similar pre-operative VA (P = 0.51 and 0.68, respectively. Mean pre-operative hole diameter for eyes with type 1 closure, type 2 closure, and holes that remained open were 554, 929, and 1205 microns, respectively. Mean pre-operative hole diameter was significantly larger in eyes that remained open as compared to eyes with type 1 closure (P = 0.015. Conclusion: Vitrectomy to repair chronic macular holes can improve vision and achieve long-term closure. Holes of greater than 3.4 years duration were associated with a greater incidence of remaining open and type 2 closure. Larger holes (mean diameter of 1205 microns were more likely to remain open after repair.

  6. [Factors related to intraoperative retinal breaks in macular hole surgery].

    Science.gov (United States)

    Kumagai, K; Ogino, N; Demizu, S; Atsumi, K; Kurihara, H; Iwaki, M; Ishigooka, H; Tachi, N

    2001-02-01

    To evaluate the factors of intraoperative retinal breaks in macular hole surgery. This study included 558 eyes of 506 patients who underwent idiopathic macular hole surgery by one surgeon. Multiple regression was performed using the variables of gender, age, affected eye, lens status, stage, duration of symptoms, hole size, axial length, and lattice degeneration. The rate of retinal breaks was higher in stage 3 (16.0%) than in stage 4 (8.2%) (p = 0.014). In eyes with lattice degeneration intraoperative retinal breaks occurred in about 40% of the cases. Major factors were as follows: lattice degeneration (r = 0.24, p lattice degeneration, and gender (r = -0.18, p = 0.035) in eyes of stage 4 without lattice degeneration. The factors of intraoperative retinal breaks in macular hole surgery were lattice degeneration in all eyes and stage 3 in eyes without lattice degeneration. The high incidence of intraoperative retinal breaks in stage 3 was mainly due to the occurrence of posterior vitreous detachment. Male gender was a significant factor associated with intraoperative retinal breaks.

  7. [Macular hole--a rare complication of toxocariasis].

    Science.gov (United States)

    Voinea, Liliana; Podoleanu, Elena; Ion, Daniela; Grădinaru, Sînziana; Ungureanu, E; Covaliu, Nicoleta; Tecuceanu, Andreea; Alexandrescu, Cristina; Simionescu, Ruxandra; Popescu, Viorela; Panca, Aida; Dascalu, Ana Maria; Vrapciu, Alexandra; Voicu, Mădălina

    2007-01-01

    Macular hole is a condition that characterizes older patients, being rare in adolescent patients and exceptionally at children. The etiopathogenic mechanism of most macular holes in children and adolescent is idiopathic. The suggested etiopathogenic mechanism is vitreoretinal traction due to a toxocara granuloma for a 9 years old girl.

  8. Quantification of metamorphopsia in patients with macular hole

    DEFF Research Database (Denmark)

    Kroyer, K.; Christensen, U.; Larsen, M.

    2008-01-01

    .001). CONCLUSIONS. The level of metamorphopsia declined as a function of eccentricity and affected the central 10 of visual field. Macular hole size had an independent effect on interocular disparity. These results confirm reports that visuospatial distortion in the presence of macular hole is primarily the result...

  9. RETINA EXPANSION TECHNIQUE FOR MACULAR HOLE APPOSITION REPORT 2: Efficacy, Closure Rate, and Risks of a Macular Detachment Technique to Close Large Full-Thickness Macular Holes.

    Science.gov (United States)

    Wong, Roger; Howard, Catherine; Orobona, Giancarlo Dellʼaversana

    2018-04-01

    To describe the safety and efficacy of a technique to close large thickness macular holes. A consecutive retrospective interventional case series of 16 patients with macular holes greater than 650 microns in "aperture" diameter were included. The technique involves vitrectomy, followed by internal limiting membrane peeling. The macula is detached using subretinal injection of saline. Fluid-air exchange is performed to promote detachment and stretch of the retina. After this, the standard fluid-air exchange is performed and perfluoropropane gas is injected. Face-down posturing is advised. Adverse effects, preoperative, and postoperative visual acuities were recorded. Optical coherence tomography scans were also taken. The mean hole size was 739 microns (SD: 62 microns; mean base diameter: 1,311 microns). Eighty-three percent (14 of 16) of eyes had successful hole closure after the procedure. At 12-month follow-up, no worsening in visual acuity was reported, and improvement in visual acuity was noted in 14 of 16 eyes. No patients lost vision because of the procedure. It is possible to achieve anatomical closure of large macular holes using RETMA. No patients experienced visual loss. The level of visual improvement is likely limited because of the size and chronicity of these holes.

  10. Hyperautofluorescent ring in eyes with macular holes

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    Sato T

    2013-08-01

    Full Text Available Tatsuhiko Sato, Kazuyuki Emi, Yui Osawa, Hajime Bando Osaka Rosai Hospital Clinical Research Center for Occupational Sensory Organ Disability, Sakai, Japan Background: Fundus autofluorescence studies in eyes with macular holes (MHs have shown a hyperautofluorescent spot corresponding to the hole and a hypoautofluorescent ring corresponding to the fluid cuff surrounding the hole. The purpose of this report is to present three cases of MH with a different fundus autofluorescence pattern. Case reports: Case 1 was a 62-year-old woman who did not know the duration of the MH in her left eye. Her decimal best-corrected visual acuity (BCVA was 0.08. The left eye had a one-half disc diameter MH with a depigmented ring surrounding the area of the fluid cuff. Fundus autofluorescence showed a hyperautofluorescent ring corresponding to the depigmented ring. After vitrectomy, fundus autofluorescence showed the same size hyperautofluorescent ring despite the decreased size of the opened MH. Case 2 was a 69-year-old woman who had been diagnosed with MH in the right eye 13 years earlier. Her decimal BCVA was 0.1. The right eye had a one-half disc diameter MH with a depigmented ring surrounding the area of the fluid cuff. Fundus autofluorescence showed a hyperautofluorescent ring corresponding to the depigmented ring. Postoperative fundus autofluorescence showed the same size hyperautofluorescent ring despite the hole being closed. The decimal BCVA was 0.2 in her right eye 6 months after vitrectomy. Case 3 was a 71-year-old woman who had been diagnosed with MH in the right eye 15 years earlier. Her decimal BCVA was 0.1. The right eye had a one-half disc diameter MH with a depigmented ring which corresponded with a hyperautofluorescent ring. Postoperative fundus autofluorescence showed the same size hyperautofluorescent ring despite the hole being closed. The decimal BCVA was 0.2 in her right eye 6 months after vitrectomy. Conclusion: Our findings suggest that a

  11. Prognostic significance of delayed structural recovery after macular hole surgery

    DEFF Research Database (Denmark)

    Christensen, Ulrik C; Krøyer, Kristian; Sander, Birgit

    2009-01-01

    clinical trial. PARTICIPANTS: Participants were recruited from a randomized clinical trial evaluating internal limiting membrane (ILM) peeling in macular hole surgery. The study included 74 eyes in which a contiguous retinal surface or a full attachment with a flat neuroretinal rim had been reestablished...... after 12 months compared with eyes with a fully attached fovea at 3 months (70.9 letters vs. 72.0 letters; P = 0.59). Receiver operating characteristics curve analysis identified persistent photoreceptor layer discontinuity of a diameter of more than 1477 microm after 3 months to be associated...

  12. Single night postoperative prone posturing in idiopathic macular hole surgery.

    LENUS (Irish Health Repository)

    2012-02-01

    Purpose. To evaluate the role of postoperative prone posturing for a single night in the outcome of trans pars plana vitrectomy (TPPV) with internal limiting membrane (ILM) peel and 20% perfluoroethane (C2F6) internal tamponade for idiopathic macular hole. Methods. This prospective trial enrolled 14 eyes in 14 consecutive patients with idiopathic macular hole. All eyes underwent TPPV with vision blue assisted ILM peeling with and without phacoemulsification and intraocular lens (IOL) for macular hole. Intraocular gas tamponade (20% C2F6) was used in all cases with postoperative face-down posturing overnight and without specific posturing afterwards. LogMAR visual acuity, appearance by slit-lamp biomicroscopy, and ocular coherence tomography (OCT) scans were compared preoperatively and postoperatively to assess outcome. Results. Among 14 eyes recruited, all eyes were phakic; 50% of patients underwent concurrent phacoemulsification with IOL. The macular holes were categorized preoperatively by OCT appearance, 4 (28.57%) were stage 2, 7 (50%) were stage 3, and 3 (21.43%) were stage 4. Mean macular hole size was 0.35 disk diameters. Symptoms of macular hole had been present for an average of 6.5 months. All holes (100%) were closed 3 and 6 months postoperatively. Mean visual acuity (logMAR) was improved to 0.61 at 3 months and was stable at 6 months after the surgery. None of the eyes had worse vision postoperatively. Conclusions. Vitrectomy with ILM peeling and 20% C2F6 gas with a brief postoperative 1 night prone posturing regimen is a reasonable approach to achieve anatomic closure in idiopathic macular hole. Concurrent cataract extraction did not alter outcomes and was not associated with any additional complications.

  13. NONSUPINE POSITIONING IN MACULAR HOLE SURGERY

    DEFF Research Database (Denmark)

    Alberti, Mark; la Cour, Morten

    2016-01-01

    PURPOSE: To determine whether nonsupine positioning (NSP) is noninferior to face-down positioning (FDP) in full-thickness macular hole (FTMH) surgery. METHODS: This is a single-center, open-label, randomized controlled trial. Between October 2013 and October 2014, pseudophakic participants...... positioning groups: 33/34 (97.1%; 95% confidence interval: 84.7-99.9). Closure rates in the ≥400-μm FTMH subgroup were similar, 93.8% and 100.0% in the FDP and NSP groups, respectively (P = 0.43). Final visual acuity did not differ significantly between the groups (P = 0.60). Median gas fill was 78% (range......: 57-86) in the FDP group and 76% (range: 56-85) in the NSP group (P = 0.51). Gas fill in closed FTMHs was significantly higher than in unclosed FTMHs (P = 0.02). CONCLUSION: Nonsupine positioning is noninferior to FDP in FTMH surgery. Furthermore, results suggest that the degree of gas fill affects...

  14. Long-term changes of macular retinal thickness after idiopathic macular hole surgery

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    Yan Yang

    2014-12-01

    Full Text Available AIM:To determine the changes of regional macular retinal thickness(RTwith spectral domain optical coherence tomography(SD-OCTafter successful pars plana vitrectomy(PPVsurgery with inner limiting membrane(ILMpeeling in patients with idiopathic macular hole.METHODS:A non-randomized retrospective case study on 17 patients(17 eyeswho were hospitalized between March 1, 2011 and June 30, 2013. All 17 eyes had been diagnosed with idiopathic macular hole and thereafter underwent 25G-PPV surgeries performed by the same surgeon with ILM peeling and short-term gas tamponade. In the 6mo-plus follow-up after surgery, these eyes were found to have successful closure in the macular hole. The macular RT of the nine areas in the Early Treatment Diabetic Retinopathy Study was measured by SD-OCT. All patients were applied by SD-OCT with linear scan of the macular. At least four examinations on the operated eye were conducted in contrast to the other normal eye: before the surgery, 3~5wk after the surgery(stage A, 2~3mo after the surgery(stage B, and >6mo after the surgery(stage C.RESULTS:In stage A, the macular RT of operated eyes in the areas of C, IS, II, IN, OS, OI, ON(263.00±39.48, 313.92±18.35, 311.00±18.02, 335.67±19.91, 280.83±33.74, 269.92±23.32, 307.00±28.40were significantly thicker than the corresponding areas of the normal fellow eyes(220.51±23.94, 292.08±21.93, 282.50±20.30, 288.33±20.76, 251.25±17.60, 247.75±21.48, 265.17±24.76μm(PP>0.01. In Stage B, the macular RT in the areas of II, IN, OS(335.67±19.20,319.75±19.20, 273.50±16.89μmwere significantly thicker than the corresponding areas of the normal fellow eyes(286.33±20.46, 293.42±17.64, 252.50±16.32μm(PP> 0.01. In Stage C, the macular RT of operated eyes with the areas of IN(321.17±19.71μmwere significantly thicker than the corresponding areas of the normal fellow eyes(296.25±19.57μm(PP>0.01. Moreover, the macular RT of operated eyes in the areas of ON, IT(307.00±28

  15. Clinical observation on vitreous surgery in treating idiopathic macular hole

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    Min Liu

    2013-12-01

    Full Text Available AIM: To observe the surgical effect and influential factors of idiopathic macular hole(IMHtreated with vitrectomy and internal limiting membrane peeling combined with intravitreal gas tamponade.METHODS: The clinical data of 22 IMH patients(23 eyeswere retrospectively analyzed. All the patients were diagnosed with IMH by optical coherence tomography(OCTand their macular hole patterns were measured before and after surgery by OCT in addition to the routine examinations. All patients were treated with vitrectomy, internal limiting membrane peeling combined with gas injection(air or inert gas. The postoperative visual acuity, macular hole closure rate and the incidence of surgical complications were observed. The correlation between the patients' age, course of disease, preoperative best corrected visual acuity(BCVA, macular hole diameter, the type of vitreous cavity filling gas, the postoperative BCVA, and the macular hole closure rate was analyzed with SPSS 13.0 statistical software.RESULTS: Postoperative OCT examination results showed that the macular hole closure rate was 100%. The macular hole closure rate was 79%(11 eyes of 14 eyesafter the first intravitreal air injection and 100%(9 eyesafter fist intravitreal inert gas injection(100mL/L C3F8. There was no significant difference between the air injection and inert gas injection(χ2=2.1214, P>0.05. The mean preoperational BCVA was 0.11±0.05 and the mean postoperative BCVA 0.23±0.12; there was a statistically significant difference between them(t=4.023,Pt=3.92, PPr=-0.415, P=0.256, duration of disease(r=0.193, P= 0.498, preoperative VA(r=0.152, P=0.673had no significant influence on IMH visual outcomes.CONCLUSION: The vitrectomy combined with internal limiting membrane peeling and intravitreal gas tamponade is an effective treatment for IMH; the macular hole diameter is the major influence factor in the postoperative closure and visual prognosis of IMH; while the preoperative visual acuity

  16. Vitrectomy with Internal Limiting Membrane Peeling versus No Peeling for Idiopathic Full-Thickness Macular Hole

    DEFF Research Database (Denmark)

    Spiteri Cornish, Kurt; Lois, Noemi; Scott, Neil W

    2014-01-01

    under the auspices of the Cochrane Eyes and Vision Group. Only randomized controlled trials (RCTs) were included. PARTICIPANTS AND CONTROLS: Patients with idiopathic stage 2, 3, and 4 FTMH undergoing vitrectomy with or without ILM peeling. INTERVENTION: Macular hole surgery, including vitrectomy and gas......) and final (after >1 surgery) macular hole closure; need for additional surgical interventions; intraoperative and postoperative complications; patient-reported outcomes (PROs) (EuroQol-5D and Vision Function Questionnaire-25 scores at 6 months); and cost-effectiveness. RESULTS: Four RCTs were identified...

  17. Refractive changes after vitrectomy and phacovitrectomy for macular hole and epiretinal membrane

    DEFF Research Database (Denmark)

    Hamoudi, Hassan; La Cour, Morten

    2013-01-01

    Several studies have described changes in refraction toward myopia in eyes having vitrectomy and phacovitrectomy. This article reviews studies of the refractive outcome in phakic and pseudophakic eyes after vitrectomy and phacovitrectomy for macular hole or epiretinal membrane. Several factors play...... a role in refraction, including measurement of the axial length, changes in the effective lens position and the anterior chamber depth, the use of intraocular gas tamponade, the formula for intraocular lens (IOL) power calculation, and the IOL type. Most phakic eyes with macular hole or epiretinal...

  18. Metamorphopsia assessment before and after vitrectomy for macular hole

    DEFF Research Database (Denmark)

    Krøyer, Kristian; Christensen, Ulrik; la Cour, Morten

    2009-01-01

    PURPOSE: To evaluate the degree of metamorphopsia in 42 patients before and 6 months after vitrectomy for idiopathic unilateral macular hole. METHODS: Semicircular test and reference stimuli of variable diameters were applied in a binocular test that measured interocular size disparity in patient...

  19. Pathology of the macular hole rim in flat-mounted internal limiting membrane specimens.

    Science.gov (United States)

    Gandorfer, Arnd; Scheler, Renate; Haritoglou, Christos; Schumann, Ricarda; Nentwich, Martin; Kampik, Anselm

    2009-09-01

    The purpose of this study was to image the pathology of vitreoretinal adhesion and cellular proliferation at the macular hole rim for a better understanding of macular hole formation. Internal limiting membrane (ILM) peeling, ILM flat-mount preparation, phase contrast and interference microscopy, transmission electron microscopy, and immunocytochemistry of the macular hole rim were performed in 10 eyes with idiopathic macular holes. Phase contrast and interference microscopy showed cellular proliferation on the vitreal side of the ILM in all specimens. There were single cells in three eyes, cell clusters in six eyes, and continuous proliferation in one eye. Surrounding the macular hole, only a few cells were present. Cellular proliferation started at a distance of 80 mum to 940 mum from the macular hole edge. Transmission electron microscopy showed vitreous adhesion at the macular hole rim. In ultrastructural terms, there was a continuous insertion of vitreous collagen fibers into the ILM. Immunocytochemistry was positive for collagen type II, laminin, and fibronectin in the area of vitreous attachment. Cells were stained with markers for glial cells, retinal pigment epithelial cells, and hyalocytes. There is ultrastructural evidence that macular hole formation is caused by an insertion of the cortical vitreous into the foveal ILM. Vitreous collagen fibers may exert vitreofoveal traction, resulting in a foveal tear. Cellular proliferation is not continuously distributed surrounding the macular hole but separated from the macular hole edge and seems to originate from cell clusters forming centers of proliferation distant from the macular hole rim.

  20. Macular morphology and visual acuity after macular hole surgery with or without internal limiting membrane peeling

    DEFF Research Database (Denmark)

    Christensen, U.C.; Kroyer, K.; Sander, B.

    2010-01-01

    Aim: To examine postoperative macular morphology and visual outcome after 12 months in relation to internal limiting membrane (ILM) peeling versus no peeling, indocyanine green (ICG) staining and re-operation in eyes that achieved macular hole closure after surgery. Methods: Seventy-four eyes...... tomography was used to assess central foveal thickness, central photoreceptor layer thickness (CPRT), central photoreceptor layer discontinuity (PRD) and relative reflectivity of the outer nuclear layer. Outcomes were correlated with best corrected visual acuity (BCVA) 12 months after surgery. Results: BCVA...

  1. MACULAR HOLE CLOSURE OVER RESIDUAL SUBRETINAL FLUID BY AN INVERTED INTERNAL LIMITING MEMBRANE FLAP TECHNIQUE IN PATIENTS WITH MACULAR HOLE RETINAL DETACHMENT IN HIGH MYOPIA.

    Science.gov (United States)

    Okuda, Tetsuhiko; Higashide, Tomomi; Kobayashi, Koh; Ikuno, Yasushi; Sugiyama, Kazuhisa

    2016-01-01

    To describe the closure of a macular hole over residual subretinal fluid in patients with macular hole retinal detachment in high myopia who had been treated using an inverted internal limiting membrane flap technique. Three patients with macular hole retinal detachment in high myopia underwent pars plana vitrectomy using the inverted internal limiting membrane flap technique. One patient received a silicone oil injection, and the other two patients received a long-acting gas injection at the end of the surgery. After surgery, spectral domain ocular coherence tomography examination was performed. In the patient with the silicone oil injection, spectral domain optical coherence tomography revealed that the macular hole was sealed with an inverted internal limiting membrane flap in the presence of subretinal fluid 1 day after surgery. The inner retinal layers gradually regained a more physiologic configuration over the residual subretinal fluid. In all patients, macular holes were completely closed over the subretinal fluid, which was gradually absorbed. Using the inverted internal limiting membrane flap technique, macular holes were closed over residual subretinal fluid in patients with macular hole retinal detachment. The results indicate that reattachment of the retina may not be necessary for closure of macular holes.

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

    Science.gov (United States)

    Pak, Kang Yeun; Park, Keun Heung; Kim, Kyong Ho; Park, Sung Who; Byon, Ik Soo; Kim, Hyun Woong; Chung, In Young; Lee, Joo Eun; Lee, Sang Joon; Lee, Ji Eun

    2017-04-01

    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 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.

  3. Macular hole: 10 and 20-MHz ultrasound and spectral-domain optical coherence tomography

    Directory of Open Access Journals (Sweden)

    Juliana Mantovani Bottós

    2012-12-01

    Full Text Available PURPOSE: Optical coherence tomography (OCT is valuable for macula evaluation. However, as this technique relies on light energy it cannot be performed in the presence of opaque media. In such cases, the ultrasound (US may predict some macular features. The aim of this study was to characterize images obtained by ultrasound with 10 and 20-MHz transducers comparing to OCT, as well as to analyze the relationship between the vitreous and retina in eyes with macular hole (MH. METHODS: 29 eyes of 22 patients with biomicroscopic evidence of MH at different stages were included. All patients were evaluated using ultrasonography with 10 and 20-MHz transducers and OCT. RESULTS: OCT identified signs of MH in 25 of 29 eyes. The remaining 4 cases not identified by US were pseudoholes caused by epiretinal membranes. In MH stages I (2 eyes and II (1 eye, both transducers were not useful to analyze the macular thickening, but suggestive findings as macular irregularity, operculum or partial posterior vitreous detachment (PVD were highlighted. In stages III (14 eyes and IV (5 eyes, both transducers identified the double hump irregularity and thickening. US could measure the macular thickness and other suggestive findings for MH: operculum, vitreomacular traction and partial or complete PVD. In cases of pseudoholes, US identified irregularities macular contour and a discrete depression. CONCLUSION: 10-MHz US was useful for an overall assessment of the vitreous body as well as its relationship to the retina. The 20-MHz transducer allowed valuable information on the vitreomacular interface and macular contour. OCT provides superior quality for fine morphological study of macular area, except in cases of opaque media. In these cases, and even if OCT is not available, the combined US study is able to provide a valid evaluation of the macular area improving therapeutic approach.

  4. Bilateral macular holes in X-linked retinoschisis: Now the spectrum is wider

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    Manoj Gautam

    2011-01-01

    Full Text Available Bilateral occurrence of macular hole in X-linked retinoschisis is an extremely rare event. Spectral domain optical coherence tomography (OCT findings revealed that formation of a macular hole is secondary to the retinoschisis process alone. Bilateral macular holes should be added to the spectrum of X-linked retinoschisis variations and the retinoschisis process alone should be accounted for their formation.

  5. Prevention of visual field defects after macular hole surgery.

    LENUS (Irish Health Repository)

    Cullinane, A B

    2012-02-03

    BACKGROUND\\/AIM: The pathogenesis of visual field loss associated with macular hole surgery is uncertain but a number of explanations have been proposed, the most convincing of which is the effect of peeling of the posterior hyaloid, causing either direct damage to the nerve fibre layer or to its blood supply at the optic nerve head. The purpose of this preliminary prospective study was to determine the incidence of visual field defects following macular hole surgery in cases in which peeling of the posterior hyaloid was confined only to the area of the macula. METHODS: 102 consecutive eyes that had macular hole surgery had preoperative and postoperative visual field examination using a Humphrey\\'s perimeter. A comparison was made between two groups: I, those treated with vitrectomy with complete posterior cortical vitreous peeling; and II, those treated with a vitrectomy with peeling of the posterior hyaloid in the area of the macula but without attempting a complete posterior vitreous detachment. Specifically, no attempt was made to separate the posterior hyaloid from the optic nerve head. Eyes with stage II or III macular holes were operated. Autologous platelet concentrate and non-expansile gas tamponade was used. Patients were postured prone for 1 week. RESULTS: In group I, 22% of patients were found to have visual field defects. In group II, it was possible to separate the posterior hyaloid from the macula without stripping it from the optic nerve head and in these eyes no pattern of postoperative visual field loss emerged. There were no significant vision threatening complications in this group. The difference in the incidence of visual field loss between group I and group II was significant (p=0.02). The anatomical and visual success rates were comparable between both groups. CONCLUSION: The results from this preliminary study suggest that the complication of visual field loss after macular surgery may be reduced if peeling of the posterior hyaloid is

  6. Postoperative eccentric macular holes after vitrectomy and internal limiting membrane peeling.

    Science.gov (United States)

    Brouzas, Dimitrios; Dettoraki, Maria; Lavaris, Anastasios; Kourvetaris, Dimitrios; Nomikarios, Nikolaos; Moschos, Marilita M

    2017-06-01

    The purpose of this study was to describe the incidence, clinical characteristics, and outcome of eccentric macular holes presenting after vitrectomy and internal limiting membrane (ILM) peeling for the treatment of macular pathology and discuss the pathogenesis of holes formation. A retrospective, noncomparative, interventional case-series study of five patients who developed eccentric macular holes postoperatively following vitrectomy in 198 consecutive patients who underwent ILM peeling for idiopathic macular hole and epiretinal membrane formation between 2008 and 2015. Five patients (2.5 %) developed full-thickness eccentric macular holes postoperatively. Three patients presented with a single eccentric macular hole, one patient had an eccentric hole after a failed idiopathic macular hole surgery and one patient developed four eccentric macular holes. The mean diameter of the holes was 584 μm (range 206-1317 μm) and the average time of holes formation after vitrectomy was 27.7 weeks (range 1-140 weeks). Postoperative best-corrected visual acuity ranged from "counting fingers" to 20/25. The eyes with the holes distant from the fovea had the best final visual acuity. No further intervention was attempted and no complications occurred. The mean follow-up time was 26.8 months. The postoperative macular holes after vitrectomy and ILM peeling were variable in number, size, and time of appearance but remained stable and were not associated with any complications. The pathogenesis of macular holes is most consistent with contraction of the residual ILM or secondary epimacular proliferation probably stimulated by ILM peeling.

  7. Lamellar Hole-Associated Epiretinal Proliferation in Comparison to Epiretinal Membranes of Macular Pseudoholes.

    Science.gov (United States)

    Compera, Denise; Entchev, Enrico; Haritoglou, Christos; Scheler, Renate; Mayer, Wolfgang J; Wolf, Armin; Kampik, Anselm; Schumann, Ricarda G

    2015-08-01

    To compare immunocytochemical and ultrastructural characteristics of "lamellar hole-associated epiretinal proliferation" in lamellar macular holes with "conventional epiretinal membrane" in macular pseudoholes. A consecutive observational case series, laboratory investigation. We analyzed surgically excised flat-mounted internal limiting membrane specimens and epiretinal membrane specimens removed from 25 eyes of 25 patients with lamellar macular holes (11 eyes) and macular pseudoholes (14 eyes) using interference and phase-contrast microscopy, immunocytochemistry, and transmission electron microscopy. By spectral-domain optical coherence tomography, epiretinal material of homogenous reflectivity without contractive properties was categorized as lamellar hole-associated epiretinal proliferation, whereas tractional epiretinal membranes presenting contractive properties were termed conventional epiretinal membrane. Lamellar hole-associated epiretinal proliferation was seen in 73% of eyes with lamellar macular hole. Eyes with macular pseudohole presented with conventional epiretinal membrane. In lamellar hole-associated epiretinal proliferation, positive immunoreactivity for anti-glial fibrillary acidic protein, hyalocyte markers, and anti-collagen type I and III was seen. In contrast, specimens of macular pseudoholes were positive for α-smooth muscle actin and anti-glial fibrillary acidic protein, predominantly. Cellular ultrastructure showed that lamellar hole-associated epiretinal proliferation of lamellar macular holes mainly consisted of fibroblasts and hyalocytes, whereas myofibroblasts dominated in conventional epiretinal membranes of macular pseudoholes. Cells within lamellar hole-associated epiretinal proliferation appear to originate from vitreous and possess less contractive properties than cells of conventional epiretinal membranes. Our findings point to differences in pathogenesis in a subgroup of lamellar macular holes presenting lamellar hole

  8. Visual and anatomical outcome after macular buckling for macular hole with associated foveoschisis in highly myopic eyes.

    Science.gov (United States)

    Burés-Jelstrup, Anniken; Alkabes, Micol; Gómez-Resa, Maria; Rios, Jose; Corcóstegui, Borja; Mateo, Carlos

    2014-01-01

    Macular hole (MH) with associated foveoschisis is very specific to highly myopic eyes with a pronounced posterior staphyloma. A high axial length increases the risk of foveoschisis, MH formation and retinal detachment secondary to a macular hole (MHRD). These highly myopic MH show poor surgical outcomes after vitrectomy and internal limiting membrane peeling compared with non-myopic MH. The posterior staphyloma seems to play an important role, and thus macular buckling could prove useful to improve both visual and anatomical results. Sixteen highly myopic eyes with MH and associated foveoschisis that underwent macular buckling were studied. Vitrectomy combined with macular buckling was performed in all 16 eyes. Optical coherence tomography was performed to confirm MH closure in all cases. Combined vitrectomy and macular buckling resulted in MH closure in all patients. Best-corrected visual acuity (BCVA) improved in 13 out of 16 eyes (81.25%), remained stable in 2 eyes (12.5%) and worsened in 1 eye (6.25%). Mean preoperative BCVA was 20/125, whereas mean postoperative BCVA was 20/50. Combined vitrectomy and macular buckling is a safe and effective approach to achieve primary closure of MH in eyes with posterior staphyloma and associated foveoschisis. Eyes with a high axial length show a less favourable prognosis, which can be partially overcome by means of macular buckling.

  9. Role of Lamellar Hole-Associated Epiretinal Proliferation in Lamellar Macular Holes.

    Science.gov (United States)

    dell'Omo, Roberto; Virgili, Gianni; Rizzo, Stanislao; De Turris, Serena; Coclite, Giovanni; Giorgio, Dario; dell'Omo, Ermanno; Costagliola, Ciro

    2017-03-01

    To compare the morphologic and functional characteristics and response to surgery of lamellar macular holes (LMHs) with and without lamellar hole-associated epiretinal proliferation (LHEP) and standard epiretinal membrane (ERM). Retrospective observational case series. Setting: Vitreoretinal clinical practice. Eigthy-four eyes of 84 patients. The included eyes must present an irregular foveal contour and schitic or cavitated lamellar separation of neurosensory retina on spectral-domain optical coherence tomography (SDOCT) and an area of increased autofluorescence on blue fundus autofluorescence (B-FAF). Twenty-six eyes underwent pars plana vitrectomy (PPV). Logarithm of minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) and evolution of morphologic characteristics. Standard ERM alone, LHEP alone, and concomitant ERM and LHEP were found in 51.2%, 13.1%, and 35.7% of the cases, respectively. A substantial stability of functional and morphologic parameters throughout the follow-up period was observed in the eyes that did not undergo surgery indipendently from the associated epiretinal material. The most significant change, observed in the preoperative period, in the eyes that underwent surgery, was the thinning of the central foveal thickness (CFT, P < .001). In the operated eyes, logMAR BCVA continuosly improved during the postoperative period (P = .006), CFT was found increased, and diameters of the hole were found reduced since the first month after operation (P < .001). In eyes with LMHs, presence of LHEP without any trace of standard ERM is rare. The presence of LHEP does not seem to influence the natural course of the disease and the response to surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. [Internal limiting membrane role in primary surgery of the macular hole].

    Science.gov (United States)

    Brănişteanu, D; Moraru, Andreea

    2013-01-01

    To assess the anatomical result after primary macular hole surgery with or without internal limiting membrane (ILM) peeling. To assess the safety and stability results; Prospective, comparative, interventional case study of 47 eyes with stage 3 or 4 macular hole treated by pars-plana vitrectomy between 2006 and 2011. In 19 cases (40.42%) only posterior hyaloid was removed (control group) while in the other 28 cases (59.57%) additional ILM peeling was performed. All cases had gas endotamponade. Postoperatively the cases were followed-up at least 6 months clinically and by OCT. Statistical analysis was performed using ANOVA and Wilcoxon tests. The mean age of patients in the study was 54, 47 +/- 4, 83 years (ranging from 47 to 74 years). In 36 cases (76.59%) the macular hole was idiopathic. After surgery, the macular hole closed in 22 out of 28 cases with ILM peeling (78.57%) as compared to only 13 out of 19 cases from the control group (68.42%). No intraoperative complications were noted. Main postoperative complications were cataract augmentation and macular hole enlargement in 4 out of 12 failed cases (33.33%). No recurrence was noted if macular hole closed after surgery. These results confirm the stability, safety and efficacy of both techniques but with a significant higher success rate if ILM is peeled. The main postoperative complication was macular hole enlargement if surgery failed.

  11. Positioning In Macular hole Surgery (PIMS): statistical analysis plan for a randomised controlled trial.

    Science.gov (United States)

    Bell, Lauren; Hooper, Richard; Bunce, Catey; Pasu, Saruban; Bainbridge, James

    2017-06-13

    The treatment of idiopathic full-thickness macular holes involves surgery to close the hole. Some surgeons advise patients to adopt a face-down position to increase the likelihood of successful macular hole closure. However, patients often find the face-down positioning arduous. There is a lack of conclusive evidence that face-down positioning improves the outcome. The 'Positioning In Macular hole Surgery' (PIMS) trial will assess whether advice to position face-down after surgery improves the surgical success rate for the closure of large (≥400 μm) macular holes. The PIMS trial is a multicentre, parallel-group, superiority clinical trial with 1:1 randomisation. Patients (n = 192) with macular holes (≥400 μm) will be randomised after surgery to either face-down positioning or face-forward positioning for at least 8 h (which can be either consecutive or nonconsecutive) a day, for 5 days following surgery. Inclusion criteria are: presence of an idiopathic full-thickness macular hole ≥400 μm in diameter, as measured by optical coherence tomography (OCT) scans, on either or both eyes; patients electing to have surgery for a macular hole, with or without simultaneous phacoemulsification and intraocular lens implant; ability and willingness to position face-down or in an inactive face-forward position; a history of visual loss suggesting a macular hole of 12 months' or less duration. The primary outcome is successful macular hole closure at 3 months post surgery. The treatment effect will be reported as an odds ratio with 95% confidence interval, adjusted for size of macular hole and phakic lens status at baseline. Secondary outcome measures at 3 months are: further surgery for macular holes performed or planned (of those with unsuccessful closure); patient-reported experience of positioning; whether patients report they would still have elected to have the operation given what they know at follow-up; best-corrected visual acuity (BCVA) measured

  12. Subretinal tissue plasminogen-assisted vitrectomy for posttraumatic full-thickness macular hole with submacular hemorrhage

    Science.gov (United States)

    Kumar, Pradeep; Kumar, Vinod; Ravani, Raghav; Agarwal, Sahil

    2018-01-01

    A young male presented with diminution of vision left eye, attributable to full-thickness macular hole, and submacular hemorrhage, following closed globe injury 2 weeks ago. The patient was managed successfully with 25-gauge vitrectomy, subretinal injection of tissue plasminogen activator and aspiration of liquefied blood through the macular hole, internal limiting membrane peeling, short-acting gas tamponade, and prone positioning. This resulted in good visual improvement, type 1 macular hole closure, and restoration of foveal architecture. The outcome and rationale of treatment in this unique scenario is discussed. PMID:29480275

  13. Quantifying metamorphopsia with M-CHARTS in patients with idiopathic macular hole

    Directory of Open Access Journals (Sweden)

    Wada I

    2017-09-01

    Full Text Available Iori Wada, Shigeo Yoshida, Yoshiyuki Kobayashi, Yedi Zhou, Keijiro Ishikawa, Shintaro Nakao, Toshio Hisatomi, Yasuhiro Ikeda, Tatsuro Ishibashi, Koh-hei Sonoda Department of Ophthalmology, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan Purpose: The purpose of this study was to determine the degree of metamorphopsia using M-CHARTS™ in patients with idiopathic macular hole before and after pars plana vitrectomy and internal limiting membrane (ILM peeling. Patients and methods: The records of 22 eyes of 22 patients with a full-thickness macular hole who underwent pars plana vitrectomy and ILM peeling were reviewed. All patients underwent a complete ophthalmic examination including spectral-domain optical coherence tomography (OCT. Horizontal metamorphopsia (MH and vertical metamorphopsia (MV scores were determined using M-CHARTS at the same time. The time course of changes in metamorphopsia and the relationship between best-corrected visual acuity (BCVA and OCT parameters were assessed. Results: Sealing of the macular hole was noted in all eyes after surgery. BCVA improved significantly from 1 month after surgery (P<0.001. The MV score was significantly higher than the MH score before surgery (P<0.05 and improved significantly from 1 month after surgery (P<0.03. The MH score improved significantly at 6 months after surgery (P<0.001. The postoperative MV and MH scores became closer to one another from 1 month after surgery. Moreover, the MV score was higher than the MH score at all postoperative assessments. There was a significant correlation between the MV and MH scores at all follow-up assessments. There was no significant correlation between BCVA and the MV or MH score at any follow-up assessment. Conclusion: The satisfaction of the patients with macular hole after surgery cannot be necessarily measured by BCVA alone, because M-scores were not correlated to BCVA in postoperative evaluation. Therefore, evaluation of

  14. Bilateral macular hole secondary to remote lightning strike

    Directory of Open Access Journals (Sweden)

    Rao Krishna

    2009-01-01

    Full Text Available We report a case of a 16-year-old girl, who was struck by lightning, and experienced blurred vision in the right eye (RE immediately following the episode. She reported for ophthalmic evaluation two months later. Examination revealed relative afferent pupillary defect in the RE. Posterior subcapsular cataract was noted in both eyes. Fundus examination revealed macular holes and multiple areas of RPE hyperpigmentation in the periphery in both eyes. Fundus fluorescein angiography showed increased choroidal transmission with early fluorescence and late fading in the foveal region and retinal pigment epithelium (RPE stippling in the periphery in both eyes. This is the first case report of such nature in India to the best of our knowledge.

  15. Outcomes of 23-gauge pars plana vitrectomy and internal limiting membrane peeling with brilliant blue in macular hole

    Directory of Open Access Journals (Sweden)

    Nohutcu A

    2011-08-01

    Full Text Available Huseyin Sanisoglu1, Mehmet Sahin Sevim1, Betul Aktas1, Semra Sevim2, Ahmet Nohutcu11Haydarpasa Numune Education and Research Hospital, Department of Ophthalmology, 2Uskudar State Hospital, Eye Clinic, Istanbul, TurkeyPurpose: The evaluation of anatomic and visual outcomes in macular hole cases treated with internal limiting membrane (ILM peeling, brilliant blue (BB, and 23-gauge pars plana vitrectomy (PPV.Materials and methods: Fifty eyes of 48 patients who presented between July 2007 and December 2009 with the diagnosis of stage 2, 3, or 4 macular holes according to Gass Classification who had undergone PPV and ILM peeling were included in this study. Pre- and postoperative macular examinations were assessed with spectral-domain optical coherence tomography. 23 G sutureless PPV and ILM peeling with BB was performed on all patients.Results: The mean age of patients was 63.34 ± 9.6 years. Stage 2 macular hole was determined in 17 eyes (34%, stage 3 in 24 eyes (48%, and stage 4 in 9 eyes (18%. The mean follow-up time was 13.6 ± 1.09 months. Anatomic closure was detected in 46/50 eyes (92%, whereas, in four cases, macular hole persisted and a second operation was not required due to subretinal fluid drainage. At follow-up after 2 months, persistant macular hole was detected in one case and it was closed with reoperation. At 12 months, an increase in visual acuity in 41 eyes was observed, while it remained at the same level in six eyes. In three eyes visual acuity decreased. There was a postoperative statistically significant increase in visual acuity in stage 2 and 3 cases (P < 0.05, however, no increase in visual acuity in stage 4 cases was observed.Conclusion: PPV and ILM peeling in stage 2, 3, and 4 macular hole cases provide successful anatomic outcomes, however, in delayed cases, due to photoreceptor loss, it has no effect on functional recovery. BB, used for clarity of ILM, may be beneficial due to its low retinal toxicity.Keywords: macular

  16. Clinical effect of 23G transconjunctival sutureless vitrectomy for idiopathic macular hole

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    Wei Cao

    2014-06-01

    Full Text Available AIM: To observe the clinical effects of 23-gauge(23Gtransconjunctival sutureless vitrectomy for idiopathic macular hole.METHODS: In this retrospective study, 28 eyes of 28 consecutive patients who underwent 23-gauge transconjunctival sutureless vitrectomy for idiopathic macular hole between January 2013 and October 2013 in our hospital were evaluated. The follow-up time was 3-12mo. The operation effects were analyzed.RESULTS: The macular hole was closed in 27 eyes of 28 eyes which underwent 23G transconjunctival sutureless vitrectomy and not closed in 1 eye after surgery. Best-corrected visual acuity at postoperative 1, 3mo was significantly improved compared to pre-operation(χ2=8.65, P=0.003; χ2=10.33, P=0.001. The macular hole was closed as shown by OCT. Intraoperative incision was sutured in 5 cases(18%. There was no statistically significant difference in intraocular pressure between pre-operation and post-operation. No post-operative complications such as endophthalmitis, retinal detachment, vitreous hemorrhage came up. CONCLUSION: 23G transconjunctival sutureless vitrectomy is observed to be safe and effective technique in the treatment of macular hole. It is therefore our preferred system for straightforward macular surgery.

  17. ADJUSTABLE MACULAR BUCKLING FOR FULL-THICKNESS MACULAR HOLE WITH FOVEOSCHISIS IN HIGHLY MYOPIC EYES: Long-Term Anatomical and Functional Results.

    Science.gov (United States)

    Cacciamani, Andrea; Lazzeri, Stefano; Rossi, Tommaso; Scarinci, Fabio; Parravano, Mariacristina; Ripandelli, Guido; Pileri, Marco A G; Nardi, Marco; Stirpe, Mario

    2016-04-01

    To assess functional and structural outcome after adjustable macular buckling for the treatment of foveoschisis (FS), associated with full-thickness macular hole (FTMH) in highly myopic eyes. Eighteen consecutive patients who underwent adjustable macular buckling for FS associated with FTMH were included in this prospective study. Three cases were not included in the analysis due to short follow-up period (less than 3 months). Outcome measures included anatomical success rate with FS resolution and FTMH closure, best-corrected visual acuity, mean retinal sensitivity, central retinal thickness, and fixation site and stability. Foveoschisis resolution and FTMH closure were observed in all cases between 1 month to 3 months after surgery. At 24 months of follow-up visit visual acuity improved in 13/15 eyes (86.7%) and remained stable in 2 (13.3%). Mean retinal sensitivity showed significant improvement from baseline 5.69 ± 3.52 dB to final 8.35 ± 3.86 dB; P buckling exoplant may represent an effective surgical option for the treatment of FS associated with FTMH in highly myopic eyes. Adjustable macular buckling showed high closure rate and virtually no tendency to recur. Functional results and safety are also interesting because vision improved and retinal thickness did not reduce significantly at 24 months of follow-up.

  18. Spontaneous Closure of a Fully Developed Macular Hole in a Severely Myopic Eye

    Directory of Open Access Journals (Sweden)

    C. Bruè

    2014-01-01

    Full Text Available Purpose. Myopic macular holes can be difficult to close with surgery and are frequently associated with retinal detachment. We report on a case of a macular hole in a severely myopic eye that underwent spontaneous closure. Methods. An observational case study. Results. A 55-year-old female was referred to Ophthalmology for a central scotoma and metamorphopsia in the right eye. Visual acuity was 1/20 in both eyes. Fundus examination showed loss of the foveal depression, with a small yellow ring in the center of the fovea in the right eye, and a tilted optic disc and peripapillary staphyloma bilaterally. Spectral domain optical coherence tomography (SD-OCT revealed a fully developed macular hole with a rim of thickened and slightly elevated retina in the right eye. The patient refused surgery. After 4 years of follow-up, her visual acuity improved to 20/40 in the right eye, and SD-OCT revealed spontaneous sealing of the macular hole without bare retinal pigment epithelium. Conclusions. Myopic macular holes represent a challenge regarding their management, and the prognosis is often poor.

  19. Macular hole formation, progression, and surgical repair: case series of serial optical coherence tomography and time lapse morphing video study

    Science.gov (United States)

    2010-01-01

    Background To use a new medium to dynamically visualize serial optical coherence tomography (OCT) scans in order to illustrate and elucidate the pathogenesis of idiopathic macular hole formation, progression, and surgical closure. Case Presentations Two patients at the onset of symptoms with early stage macular holes and one patient following repair were followed with serial OCTs. Images centered at the fovea and at the same orientation were digitally exported and morphed into an Audiovisual Interleaving (avi) movie format. Morphing videos from serial OCTs allowed the OCTs to be viewed dynamically. The videos supported anterior-posterior vitreofoveal traction as the initial event in macular hole formation. Progression of the macular hole occurred with increased cystic thickening of the fovea without evidence of further vitreofoveal traction. During cyst formation, the macular hole enlarged as the edges of the hole became elevated from the retinal pigment epithelium (RPE) with an increase in subretinal fluid. Surgical repair of a macular hole revealed initial closure of the macular hole with subsequent reabsorption of the sub-retinal fluid and restoration of the foveal contour. Conclusions Morphing videos from serial OCTs are a useful tool and helped illustrate and support anterior-posterior vitreofoveal traction with subsequent retinal hydration as the pathogenesis of idiopathic macular holes. PMID:20849638

  20. [Traumatic macular hole with central retinal detachment and choroidal rupture with ora serrata dialysis].

    Science.gov (United States)

    Fiorentzis, M; Seitz, B; Viestenz, A

    2015-08-01

    Closed ocular trauma is associated with various retinal complications, such as Berlin's edema, peripheral retinal tears, retinal hemorrhage, choroidal rupture, subretinal bleeding and macular holes. Traumatic macular holes (TMH) are rare and surgical intervention is controversial due to possible spontaneous closure. The positive development in the patient described here indicates that a pars plana vitrectomy with drainage of subretinal hemorrage combined with peeling of the internal limiting membrane (ILM) for a penetrating traumatic macular hole with choroidal rupture can lead to the restoration of visual acuity. The anti-vascular endothelial growth factor (VEGF) therapy (under silicone oil with avastin 0.02 ml) can successfully lead to limitation of posttraumatic choroidal neovascularization (CNV). Patients with ocular contusion require extensive long-term ophthalmological follow-up. Furthermore, prevention, education and information is essential to prevent serious injuries.

  1. INVERTED INTERNAL LIMITING MEMBRANE FLAP TECHNIQUE FOR MACULAR HOLE SURGERY WITHOUT EXTRA MANIPULATION OF THE FLAP.

    Science.gov (United States)

    Casini, Giamberto; Mura, Marco; Figus, Michele; Loiudice, Pasquale; Peiretti, Enrico; De Cillà, Stefano; Fuentes, Taiusha; Nasini, Francesco

    2017-11-01

    To determine whether surgical manipulation steps of the internal limiting membrane (ILM) flap, such as ILM trimmed, ILM tuck inside the hole, ILM massage, are mandatory to obtain satisfactory outcomes for the repair of large stage IV idiopathic macular hole using the inverted ILM flap technique. In this interventional comparative prospective single-masked study, 81 eyes were randomized into 2 treatments groups. In Group 1 (41 eyes), the classic inverted ILM flap technique was performed. In Group 2 (40 eyes), a modified procedure was used: after ILM peeling, no extra flap manipulation was performed. The macular hole was covered by the inverted ILM flap because of the air pressure at the time of the fluid-air exchange. At 12 months, macular hole closure was observed in 40 eyes (97.6%) in Group 1 and in 39 eyes in Group 2 (97.5%). U-shape closure rate, ellipsoid zone defects, and external limiting membrane defects were similar in both groups. The results indicate no statistical difference in anatomical and functional success between both groups. The macular hole closure rate, improved visual acuity, and no extra complications indicate noninferiority of the modified inverted ILM technique. Internal limiting membrane finishing, tucking, and massage may not be required to obtain surgical success.

  2. Partial-thickness macular hole in vitreomacular traction syndrome: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Al Sabti Khalid

    2010-01-01

    Full Text Available Abstract Introduction Vitreomacular traction syndrome has recently been recognized as a distinct clinical condition. It may lead to many complications, such as cystoid macular edema, macular pucker formation, tractional macular detachment, and full-thickness macular hole formation. Case presentation We report a case of vitreomacular traction syndrome with eccentric traction at the macula and a partial-thickness macular hole in a 63-year-old Pakistani Punjabi man. The patient was evaluated using optical coherence tomography, and he underwent a successful pars plana vitrectomy. After the operation, his foveal contour regained normal configuration, and his visual acuity improved from 20/60 to 20/30. Conclusions Pars plana vitrectomy prevents the progression of a partial thickness macular hole in vitreomacular traction syndrome. The relief of traction by vitrectomy restores foveal anatomy and visual acuity in this condition.

  3. Face-down positioning versus non-supine positioning in macular hole surgery

    DEFF Research Database (Denmark)

    Alberti, Mark; Dornonville de la Cour, Morten

    2015-01-01

    AIM: To evaluate the full thickness macular hole (FTMH) closure rate in patients positioning non-supine (NSP) compared with patients positioning face-down (FDP). METHODS: We retrospectively reviewed two FTMH case series-postoperative positioning was FDP and NSP, respectively. All eyes were...... 122 eyes were included in this study, 66 eyes in the FDP group and 56 eyes in the NSP group. Closure rates were 95.5% and 96.4% in the FDP group and the NSP group, respectively. Median postoperative visual acuity at 6 months was 69 ETDRS letters in both positioning groups (p=0.64). Neither positioning...... group fully complied with the recommended positioning protocol. CONCLUSIONS: Results from consistent FTMH repair indicate similar anatomical success rates in FDP and NSP groups, suggesting that FDP is unnecessary. Objective monitoring of positioning would be beneficial in future FTMH studies to be able...

  4. Microperimetric Biofeedback Training Improved Visual Acuity after Successful Macular Hole Surgery

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    Tomoko Ueda-Consolvo

    2015-01-01

    Full Text Available Purpose. To evaluate the efficacy of setting a preferred retinal locus relocation target (PRT and performing Macular Integrity Assessment (MAIA biofeedback training in patients showing insufficient recovery of best corrected visual acuity (BCVA despite successful closure of an idiopathic macular hole (MH. Methods. Retrospective interventional case series. Nine eyes of 9 consecutive patients with the decimal BCVA of less than 0.6 at more than 3 months after successful MH surgery were included. A PRT was chosen based on MAIA microperimetry and the patients underwent MAIA biofeedback training. BCVA, reading speed, fixation stability, and 63% bivariate contour ellipse area (BCEA were evaluated before and after the training. Statistical analysis was carried out using paired Student’s t-test. Results. PRT was chosen on the nasal side of the closed MH fovea in 8 patients. After the MAIA training, BCVA improved in all patients. The mean logMAR value of BCVA significantly improved from 0.33 to 0.12 (p=0.007. Reading speed improved in all patients (p=0.29, fixation stability improved in 5 patients (p=0.70, and 63% BCEA improved in 7 patients (p=0.21, although these improvements were not statistically significant. Conclusion. MAIA biofeedback training improved visual acuity in patients with insufficient recovery of BCVA after successful MH surgery.

  5. GLIAL CELLS AND COLLAGENS IN EPIRETINAL MEMBRANES ASSOCIATED WITH IDIOPATHIC MACULAR HOLES

    NARCIS (Netherlands)

    Bu, Shao-Chong; Kuijer, Roelof; van der Worp, Roelofje J.; Huiskamp, Eveline A.; De Lavalette, Victor W. Renardel; Li, Xiao-Rong; Hooymans, Johanna M. M.; Los, Leonoor I.

    Purpose: To investigate the identity of collagens and cellular components in the epiretinal membrane (ERM) associated with full-thickness idiopathic macular hole and their clinical relevance. Methods: Pars plana vitrectomy with the peeling of internal limiting membrane and ERM was performed by 2

  6. Influences of OCT image on the prognosis of visual outcomes among patients with idiopathic macular holes

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    Jian-Ping Gao

    2013-11-01

    Full Text Available AIM:To observe the optical coherence tomography(OCTimages of idiopathic macular hole(IMHon patients before and after vitrectomy and internal limiting membrane peeling(ILMPsurgery, and to analyze the relationship between the macular hole configuration and the postoperative best corrected visual acuity so as to offer a potential index to effectively predict visual outcome in eyes with idiopathic macular holes. METHODS: A total of 32 consecutive patients of IMH(7 males, 25 femalesreceiving the operation of PPV and ILMP were performed with routine ophthalmologic and OCT examination before and after the operation. The best-corrected visual acuity(BCVAin the follow-up period was recorded. The minimum diameter, the base diameter, the hole height before the operation, and the macular retinal thickness before and after the operation were measured respectively by the analytical model of OCT. The correlation between macular hole index(MHIand BCVA post operation was analyzed using SPSS 13.0.RESULTS: The negative correlation was observed between the post operative BCVA and the minimum diameter and the base diameter before the operation(r=-0.524, -0.610, Pr=-0.064, 0.003, P>0.05. The positive correlation was observed between the postoperative BCVA and the MHI before operation(r=0.457, PU=30.0, W=135, PCONCLUSION: The smaller the minimum diameter and the base diameter is, the better the post operative BCVA. The MHI is easy to calculate, and patients of MHI ≥0.5 have a better postoperative BCVA, MHI can be used as clinical evaluation-index for operation selection. The PPV combined with IMLP can effectively treat the IMH based on the OCT result.

  7. Does ocriplasmin affect the RPE-photoreceptor adhesion in macular holes?

    Science.gov (United States)

    Hager, A; Seibel, I; Riechardt, A; Rehak, M; Joussen, A M

    2015-05-01

    To evaluate the anatomical outcome of patients after vitrectomy due to persisting symptomatic vitreomacular traction (VMT), including full-thickness macular holes (FTMHs) of less than 400 µm, after ocriplasmin treatment. Retrospective, single centre, consecutive interventional case series. Patients were treated with a single intravitreal injection of ocriplasmin (Jetrea, Thrombogenics Inc, USA, Alcon/Novartis EU). resolution of VMT, closure of FTMH and anatomical outcome of vitrectomy after unsuccessful treatment with ocriplasmin. Five patients were treated with ocriplasmin injection. VMT persisted in all but one case. Four patients underwent pars-plana vitrectomy (PPV) for treatment of persistent VMT and FTMH (n=2, size of macular hole <400 µm) in spectral-domain optical coherence tomography (SD-OCT). FTMHs were closed in both cases within the first week postoperatively. After PPV, in three eyes newly developed subretinal fluid was detected, which persisted up to several months postoperatively. Data on ocriplasmin remain controversial. We report on four cases with resolution of VMT following PPV after unsuccessful ocriplasmin treatment. Newly developed subretinal fluid has been described after ocriplasmin treatment, predominantly in cases with resolution of VMT. We also detected this newly developed subretinal fluid after vitrectomy, which persisted for several weeks up to 7 months in two cases with FTMHs. This may be attributable to loosening of the photoreceptor complex due to enzyme activity of ocriplasmin. Long-term effects of ocriplasmin are still to be evaluated using SD-OCT. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. Scleral infolding combined with vitrectomy and gas tamponade for retinal detachment with macular holes in highly myopic eyes.

    Science.gov (United States)

    Matsuo, T; Shiraga, F; Takasu, I; Okanouchi, T

    2001-01-01

    To describe the effectiveness of a surgical procedure, scleral infolding combined with vitrectomy and gas tamponade, for retinal detachment caused by macular holes in highly myopic eyes. In a pilot study, scleral infolding was performed in 5 patients with macular holes, who were selected from 10 consecutive highly myopic patients with retinal detachment caused by macular holes (8 patients) or extramacular posterior-pole holes (2 patients), treated during 1 year at Okayama University Hospital. The patients were all women, 48-77 years of age (mean = 63.4 years), who had been followed-up for 1-2 years. Selection criteria for scleral infolding were either second surgeries for reopening of macular holes (2 patients) or residual retinal detachment around macular holes after complete fluid-air exchange with drainage of subretinal fluid at the initial surgery (3 patients). Following vitrectomy and complete epiretinal membrane removal in the posterior pole, the sclera was shortened by infolding on the temporal side. Three mattress sutures with 5-0 Dacron in each quadrant, 6 sutures in total, were placed at a 7-mm anteroposterior interval with posterior sutures located as deep as possible, near vortex veins. Fluid-gas exchange was then done, with or without endophotocoagulation applied around macular holes. After scleral infolding, macular holes were closed, and the retina was totally attached in all 5 patients. The final visual acuity ranged from 20/2000 to 20/70. Scleral infolding is a simple and effective procedure for treating retinal detachment with macular holes in highly myopic eyes and could be used as an optional procedure of reoperation for a failed initial vitrectomy.

  9. Repeat gas insufflation for successful closure of idiopathic macular hole following failed primary surgery

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    Pukhraj Rishi

    2014-01-01

    Full Text Available A 65-year-old lady presented with decreased vision in left eye since seven months. Vision was 6/9 in right eye and 6/36 in left. Examination revealed idiopathic, full-thickness macular hole in left eye; confirmed by optical coherence tomography (OCT. Patient underwent phacoemulsification with intraocular lens (IOL implantation, vitrectomy, internal limiting membrane (ILM peeling and 14% C 3 F 8 gas injection. OCT repeated after six weeks revealed type II closure with cuff of subretinal fluid. Four weeks later, patient underwent fluid-gas exchange with 14% C 3 F 8 gas and postoperative positioning. OCT was repeated after two weeks, which showed complete closure of the macular hole. OCT can help in selection of eyes for re-surgery that stand a better chance for hole closure. Macular holes with cuff of subretinal fluid are probably more likely to close on re-surgery than those without. However, larger studies with longer follow-up are required to validate this finding.

  10. Evaluation of Macular Retinal Ganglion Cell-Inner Plexiform Layer Thickness after Vitrectomy with Internal Limiting Membrane Peeling for Idiopathic Macular Holes

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    Alfonso L. Sabater

    2014-01-01

    Full Text Available Purpose. To evaluate macular retinal ganglion cell-inner plexiform layer (GCIPL thickness changes after Brilliant Blue G-assisted internal limiting membrane peeling for idiopathic macular hole repair using a high-resolution spectral-domain optical coherence tomography (SD-OCT. Methods. 32 eyes from 32 patients with idiopathic macular holes who underwent vitrectomy with internal limiting membrane peeling between January 2011 and July 2012 were retrospectively analyzed. GCIPL thickness was measured before surgery, and at one month and at six months after surgery. Values obtained from automated and semimanual SD-OCT segmentation analysis were compared (Cirrus HD-OCT, Carl Zeiss Meditec, Dublin, CA. Results. No significant differences were found between average GCIPL thickness values between preoperative and postoperative analysis. However, statistical significant differences were found in GCIPL thickness at the temporal macular quadrants at six months after surgery. Quality measurement analysis performed by automated segmentation revealed a significant number of segmentation errors. Semimanual segmentation slightly improved the quality of the results. Conclusion. SD-OCT analysis of GCIPL thickness found a significant reduction at the temporal macular quadrants at 6 months after Brilliant Blue G-assisted internal limiting membrane peeling for idiopathic macular hole.

  11. Evaluation of Macular Retinal Ganglion Cell-Inner Plexiform Layer Thickness after Vitrectomy with Internal Limiting Membrane Peeling for Idiopathic Macular Holes

    Science.gov (United States)

    Velázquez-Villoria, Álvaro; Zapata, Miguel A.; Figueroa, Marta S.; Suárez-Leoz, Marta; Arrevola, Luis; Teijeiro, María-Ángeles; García-Layana, Alfredo

    2014-01-01

    Purpose. To evaluate macular retinal ganglion cell-inner plexiform layer (GCIPL) thickness changes after Brilliant Blue G-assisted internal limiting membrane peeling for idiopathic macular hole repair using a high-resolution spectral-domain optical coherence tomography (SD-OCT). Methods. 32 eyes from 32 patients with idiopathic macular holes who underwent vitrectomy with internal limiting membrane peeling between January 2011 and July 2012 were retrospectively analyzed. GCIPL thickness was measured before surgery, and at one month and at six months after surgery. Values obtained from automated and semimanual SD-OCT segmentation analysis were compared (Cirrus HD-OCT, Carl Zeiss Meditec, Dublin, CA). Results. No significant differences were found between average GCIPL thickness values between preoperative and postoperative analysis. However, statistical significant differences were found in GCIPL thickness at the temporal macular quadrants at six months after surgery. Quality measurement analysis performed by automated segmentation revealed a significant number of segmentation errors. Semimanual segmentation slightly improved the quality of the results. Conclusion. SD-OCT analysis of GCIPL thickness found a significant reduction at the temporal macular quadrants at 6 months after Brilliant Blue G-assisted internal limiting membrane peeling for idiopathic macular hole. PMID:25110679

  12. Displacement of fovea toward optic disk after macular hole surgery with internal limiting membrane peeling

    OpenAIRE

    Ohta, Kouichi; Sato, Atsuko; Senda, Nami; Fukui, Emi

    2017-01-01

    Kouichi Ohta, Atsuko Sato, Nami Senda, Emi Fukui Department of Ophthalmology, Matsumoto Dental University, Shiojiri, Nagano, Japan Purpose: The purpose of this study was to demonstrate a displacement of the foveal depression toward the optic disk after idiopathic macular hole (MH) surgery with internal limiting membrane (ILM) peeling.Methods: Two patients with a unilateral MH developed an MH in the fellow eyes. Vitrectomy with ILM peeling was performed on the fellow...

  13. Silicone Oil Reinjection without Macular Buckling for Treatment of Recurrent Myopic Macular Hole Retinal Detachment after Silicone Oil Removal

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    Hammouda Hamdy Ghoraba

    2014-01-01

    Full Text Available Purpose. To evaluate the efficacy of silicone oil (S.O reinjection without macular buckling for treatment of recurrent myopic macular hole retinal detachment (MHRD after silicone oil removal. Methods. A retrospective consecutive interventional study from medical reports on cases of myopic MHRD. Fifty-three eyes of 51 patients underwent silicone oil removal after successful repair of MHRD were reviewed. The main outcomes were the retinal status after silicone oil removal and management of recurrent cases. Results. The rate of recurrent RD (Re RD after silicone oil removal was 11.3% (6 out of 53 eyes. One case refused any other interference. In the remaining 5 eyes, 4 eyes (80% could be reattached by S.O re-injection and one eye (20% developed Re RD after S.O re-injection. Range of followup after management of recurrence was 5–53 months (mean 18.7 months. Conclusions. This case series concluded that the risk factors for recurrent RD after silicone oil removal from cases of myopic MHRD were high myopia, open flat MH, and large posterior staphyloma. Revision of vitrectomy and S.O re-injection can reattach most of recurrent cases.

  14. Resultado funcional e índice macular em portadores de buraco macular submetidos à cirurgia com remoção da membrana limitante interna Functional outcome and macular index in macular hole patients who underwent surgery with internal limiting membrane removal

    Directory of Open Access Journals (Sweden)

    José Ricardo Diniz

    2008-04-01

    Full Text Available OBJETIVOS: Avaliar o resultado funcional e o índice macular dos portadores de buraco macular submetidos à cirurgia com remoção da membrana limitante interna. MÉTODOS: Quinze olhos de 15 pacientes com buraco macular estágios 2, 3 e 4 foram incluídos no estudo. Todos foram submetidos à cirurgia de buraco macular convencional com remoção da membrana limitante interna corada pelo azul de tripan. Melhor acuidade visual com correção e cortes transversais medidos por tomografia de coerência óptica (OCT foram avaliados no pré- e pós-operatório. O índice macular (razão entre a altura e base do buraco macular foi calculado e correlacionado com o diâmetro mínimo do buraco macular e o ganho de acuidade visual pós-operatória. RESULTADOS: Obteve-se fechamento do buraco macular em todos pacientes operados. Em 86,7%, houve ganho de pelo menos três linhas de visão. O índice macular demonstrou correlação negativa significante com o diâmetro mínimo (r=0,811. Não foi observada correlação significante entre o índice macular e o ganho de acuidade visual pós-operatória (r=0,351. CONCLUSÃO: Os resultados funcionais na cirurgia do buraco macular com remoção da membrana limitante interna foram bons neste grupo de pacientes. O índice macular demonstrou ser compatível com a configuração espacial do buraco macular, porém não foi preditor de resultados visuais.PURPOSE: To evaluate the functional outcome and macular index in patients with macular hole who underwent surgery with internal limiting membrane removal. METHODS: Fifteen eyes of 15 patients with idiopathic macular hole stages 2, 3 or 4 were enrolled in this study. All patients underwent conventional macular hole surgery with trypan blue staining to remove the internal limiting membrane. The best-corrected visual acuity and cross-sectional images of macular hole measured by optical coherence tomography (OCT were evaluated pre- and postoperatively. The macular hole index

  15. Relationship between full-thickness macular hole and retinal break/lattice degeneration.

    Science.gov (United States)

    Zhang, Jinglin; Li, Yonghao; Zhao, Xiujuan; Cai, Yu; Yu, Xiling; Lu, Lin

    2015-12-01

    The purpose is to investigate the relationship between full-thickness macular hole (MH) and retinal break (RB) and/or lattice degeneration. Patients diagnosed as full-thickness MH and referred to Dr. Lin Lu from January 2009 to December 2013 were evaluated. All patients underwent general ophthalmologic examinations, fundus examination and optical coherence tomography (OCT). The RB and/or lattice degeneration were recorded. Totally 183 eyes of 167 patients were included. The sex ratio of men to women was 1:2.88. A total of 17 eyes were pseudophakic and 166 eyes were phakic. RB and/or lattice degeneration were found in 62 eyes (33.88%). The prevalence of RB and/or lattice degeneration was similar between men and women (P = 0.344 > 0.05). There was no statistical difference between the pseudophakic eyes and phakic eyes (P = 0.138 > 0.05). All of the RB and/or lattice degeneration were located near or anterior to the equator. The inferior quadrants and the vertical meridian were affected more often than the superior quadrants and the horizontal meridian. We identified a high incidence of RB/lattice degeneration in cases of full-thickness MH. Carefully examination of the peripheral retina and prophylactic treatment of RB and/or lattice degeneration are critical.

  16. Outcomes of macular hole surgery in patients treated intraoperatively for retinal breaks and/or lattice degeneration.

    Science.gov (United States)

    Hwang, John; Escariao, Paulo; Iranmanesh, Reza; Tosi, Gian Marco; Chang, Stanley

    2007-01-01

    To assess the outcome of macular hole surgery in patients treated intraoperatively for retinal breaks and/or lattice degeneration. Retrospective review of patients who underwent macular hole surgery from September 1998 to August 2005. Outcomes in eyes that received intraoperative endolaser photocoagulation for retinal breaks and/or lattice degeneration were compared to outcomes in a case-matched control group without retinal breaks or lattice degeneration. A total of 235 consecutive macular hole surgery cases were reviewed. Twenty-four eyes from 24 patients received intraoperative endolaser photocoagulation for retinal breaks and/or lattice degeneration. Macular hole closure occurred in all case and control eyes without any incidence of postoperative retinal detachment. Best-corrected visual acuity improvement of at least three Snellen lines occurred in 100% of case eyes and 92% of control eyes. Outcomes of macular hole surgery in patients with retinal breaks and/or lattice degeneration are similar to outcomes in the overall population when these conditions are treated with intraoperative endolaser photocoagulation. Postoperative retinal detachment does not appear to be correlated with treated retinal tears and greater attention should focus on detecting and managing intraoperative breaks. In our hands, routine use panoramic viewing has replaced indirect ophthalmoscopy, by saving time, and reducing the risk of contamination.

  17. Spontaneous traumatic macular hole closure in a 50-year-old woman: a case report

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    Rotsos Tryfon

    2011-07-01

    Full Text Available Abstract Introduction Traumatic macular holes (TMH are well-known complications of ocular contusion injury. Spontaneous closure occurs in approximately 50% of cases, but rarely after the age of thirty. We report a case of spontaneous closure of a full thickness macular hole due to a blunt trauma and we suggest possible mechanisms for this closure. Case presentation A 50-year-old Greek woman was referred with a history of reduced best-corrected visual acuity after blunt trauma to her right eye. Diagnosis was based on fundoscopic, optical coherence tomography as well as fluorescein angiography findings with follow-up visits at two days, 20 days and five months. Fundoscopy revealed a full-thickness TMH with a minor sub-retinal hemorrhage and posterior vitreous detachment. The presence of a coagulum in the TMH base was observed. Subsequently, TMH closure was observed. Conclusion The clot in the TMH base, potentially a hemorrhage by-product containing a significant quantity of platelets, may have simulated the clot observed after autologous serum use, thus facilitating a similar effect. This may have stimulated glial cell migration and proliferation, thus contributing to spontaneous hole closure.

  18. Utility of microscope-integrated optical coherence tomography (MIOCT) in the treatment of myopic macular hole retinal detachment.

    Science.gov (United States)

    Kumar, Atul; Kakkar, Prateek; Ravani, Raghav Dinesh; Markan, Ashish

    2017-07-14

    Macular hole-associated retinal detachment in high myopia is described as a final stage in progression of myopic traction maculopathy (MTM). 1â€"3 Shimada et al 4 described the progressive stages of MTM from macular retinoschisis to serous retinal detachment in high myopia. Stage 4 MTM is characterised as disappearance of retinoschisis with progression to retinal detachment due to macular hole formation. It is hypothesised that vitreoschisis and abnormal vitreo-retinal interface create the premacular tangential traction. 5 6 Intraoperative triamcinolone acetonide is used to visualise the residual posterior vitreous cortex (PVC). We hereby describe the utility of microscope-integrated optical coherence tomography (MIOCT) in assisting complete removal of PVC and internal limiting membrane (ILM) peeling with multilayered inverted ILM flap in the treatment of myopic macular hole retinal detachment. MIOCT helped identify vitreoschisis and confirm the position of ILM flaps over the macular hole intraoperatively. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. [Observation of single-layered inverted internal limiting membrane flap technique for macular hole with retinal detachment in high myopia].

    Science.gov (United States)

    Xu, C Z; Wu, J H; He, J W; Feng, C

    2017-05-11

    Objective: To compare the outcome of pars plana vitrectomy (PPV) with a single-layered inverted internal limiting membrane (ILM) flap versus PPV with ILM peeling for the treatment of macular hole associated retinal detachment (MHRD) in high myopia. Methods: In a retrospective cohort study, PPV with 2 kinds of adjuvant surgical procedures were used in 35 moderately high myopia eyes with MHRD. These eyes were divided into 2 groups: group 1 (17 eyes) receiving PPV and ILM peeling and group 2 (18 eyes) receiving PPV with a single-layered inverted ILM flap. Anatomical reattachment of the retina, macular hole closure, and best-corrected visual acuity (BCVA) were measured at 6 months after surgery. Results: The retina was successfully reattached in all cases. The difference of the retinal reattachment rate between the two groups was not statistically significant (Fisher's exact test, P= 1.000). The rate of macular hole closure was 47.1% in group 1 (8 eyes) and 88.9% in group 2 (16 eyes). The difference of the macular hole closure rate between the two groups was statistically significant (Fisher's exact test, P= 0.012). Significant improvement in logarithm of minimal angle of resolution (logMAR) BCVA was achieved in both groups. There was no difference in the initial, final, or improved logMAR BCVA in the 2 groups. Conclusion: Single-layered inverted ILM flap technique effectively helps close the macular hole in moderately high myopia with MHRD. This may prevent the possible redetachment from the macular hole. (Chin J Ophthalmol, 2017, 53: 338 - 343) .

  20. Full Thickness Macular Hole Closure after Exchanging Silicone-Oil Tamponade with C3F8 without Posturing

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    Tina Xirou

    2011-05-01

    Full Text Available Purpose: To report a case of macular hole closure after the exchange of a silicone-oil tamponade with gas C3F8 14%. Method: A 64-year-old female patient with a stage IV macular hole underwent a three-port pars-plana vitrectomy and internal limiting membrane peeling. Due to the patient’s chronic illness (respiratory problems, a silicone-oil tamponade was preferred. However, the macula hole was still flat opened four months postoperatively. Therefore, the patient underwent an exchange of silicone oil with gas C3F8 14%. No face-down position was advised postoperatively due to her health problems. Results: Macular hole closure was confirmed with optical coherence tomography six weeks after exchanging the silicone oil with gas. Conclusions: Macular hole surgery using a silicone-oil tamponade has been proposed as treatment of choice for patients unable to posture. In our case, the use of a long-acting gas (C3F8 14%, even without posturing, proved to be more effective.

  1. Displacement of fovea toward optic disk after macular hole surgery with internal limiting membrane peeling

    Directory of Open Access Journals (Sweden)

    Ohta K

    2017-10-01

    Full Text Available Kouichi Ohta, Atsuko Sato, Nami Senda, Emi Fukui Department of Ophthalmology, Matsumoto Dental University, Shiojiri, Nagano, Japan Purpose: The purpose of this study was to demonstrate a displacement of the foveal depression toward the optic disk after idiopathic macular hole (MH surgery with internal limiting membrane (ILM peeling.Methods: Two patients with a unilateral MH developed an MH in the fellow eyes. Vitrectomy with ILM peeling was performed on the fellow eye to close the MH. Images of spectral-domain optical coherence tomography (SD-OCT were used to measure the disk-to-fovea distances pre MH formation, after MH formation, and 6 months after the closure of the MH.Results: The disk-to-fovea distance was shorter at 6 months than after the development of the MH (4,109 µm and 4,174 µm in Case 1 and 4,001 µm and 4,051 µm in Case 2.Conclusion: These results indicate that the fovea moves nasally after the MH surgery with ILM peeling. Keywords: idiopathic macular hole, internal limiting membrane, optical coherence tomography, pars plana vitrectomy

  2. Macular Hole

    Science.gov (United States)

    ... to sight-saving treatments and plays a key role in reducing visual impairment and blindness. NEI Home Contact Us A-Z Site Map NEI on Social Media Information in Spanish (Información en español) Website, Social ...

  3. Macular hole repair by vitrectomy and internal limiting membrane peeling in highly myopic eyes.

    Science.gov (United States)

    Chuang, Lan-Hsin; Chen, Yen-Po; Wang, Nan-Kai; Yeung, Ling; Chen, Kuan-Jen; Hwang, Yih-Shiou; Wu, Wei-Chi; Chen, Tun-Lu; Lai, Chi-Chun

    2014-10-01

    To evaluate the surgical outcomes of macular hole (MH) repair by vitrectomy and internal limiting membrane peeling in highly myopic eyes. In this retrospective interventional case series, 30 highly myopic eyes with MH in 29 consecutive patients who underwent vitrectomy and internal limiting membrane peeling to repair MH were studied. The mean follow-up time was 36.4 months. The anatomical outcomes of the MH were evaluated by optical coherence tomography. The best-corrected visual acuities before and after surgery were compared as the functional outcome. Women accounted for 69% of MH in highly myopic eyes. The mean age was 49 years. The mean refraction error and mean axial length were -9.80 (± 2.93) diopter and 28.13 (± 2.41) mm, respectively. Myopic foveoschisis was observed in 3 eyes (10%). The MHs were closed by a single surgery in 26 eyes (87%), and the final closure rate was 97% (29/30 eyes). Macular hole surgery significantly improved best-corrected visual acuity from 1.20 ± 0.70 to 0.77 ± 0.51 logarithm of the minimum angle of resolution (P = 0.003). However, rhegmatogenous retinal detachment developed in 3 eyes (10%) during the follow-up. Vitrectomy with internal limiting membrane peeling is effective to repair MH in highly myopic eyes in terms of anatomical and functional outcomes, although visual acuity may continue to improve slowly until 3 years after successful MH-closing surgery. In addition, a small proportion of MH cases were associated with myopic foveoschisis. Delayed hole closure and rhegmatogenous retinal detachment may occur in these highly myopic eyes after surgery.

  4. Spontaneous closure of the idiopathic macular hole. Follow-up of this case by optical coherence tomography and microperimetry MP1

    International Nuclear Information System (INIS)

    Molina Martin, Julio Cesar; Rodriguez Rodriguez, Violeta; Mendoza Santiesteban, Carlos

    2010-01-01

    The case of spontaneous closure of a stage 4 idiopathic macular hole at followed up by Optical Coherence Tomography and microperimetry MP1 before and after the closure was presented. The spontaneous closure of a stage 4 macular hole is rare but it can occur in patients with hole upper diameters less than 150 μm. The OCT and the microperimetry MP1 are very useful tools in the diagnosis, prognosis and follow-up of this maculopathy

  5. Vitrectomy with internal limiting membrane (ILM) peeling versus vitrectomy with no peeling for idiopathic full-thickness macular hole (FTMH)

    DEFF Research Database (Denmark)

    Spiteri Cornish, Kurt; Lois, Noemi; Scott, Neil

    2013-01-01

    Several observational studies have suggested the potential benefit of internal limiting membrane (ILM) peeling to treat idiopathic full-thickness macular hole (FTMH). However, no strong evidence is available on the potential benefit(s) of this surgical manoeuvre and uncertainty remains among vitr...

  6. Value of internal limiting membrane peeling in surgery for idiopathic macular hole and the correlation between function and retinal morphology

    DEFF Research Database (Denmark)

    Christensen, Ulrik Correll

    2009-01-01

    procedure. Morphological studies of closed macular holes with contrast-enhanced optical coherence tomography (OCT) found thinning and discontinuity of the central photoreceptor layer matrix that were highly specific for predicting the likelihood of an eye having regained reading vision 12 months after...

  7. Immunocytochemical and ultrastructural evidence of glial cells and hyalocytes in internal limiting membrane specimens of idiopathic macular holes.

    Science.gov (United States)

    Schumann, Ricarda G; Eibl, Kirsten H; Zhao, Fei; Scheerbaum, Martin; Scheler, Renate; Schaumberger, Markus M; Wehnes, Helga; Walch, Axel K; Haritoglou, Christos; Kampik, Anselm; Gandorfer, Arnd

    2011-10-03

    To provide new information on epiretinal cell proliferation and the cells' origin in idiopathic macular holes and to overcome the effects of embedding and sectioning preparation procedures on cell-distribution patterns. Interference and phase-contrast microscopy, immunocytochemistry, and scanning and transmission electron microscopy were performed on surgically excised whole-mounted internal limiting membrane (ILM) specimens removed from 60 eyes with idiopathic macular holes. Cell distribution and cell morphology were correlated with immunocytochemical staining characteristics. Twelve cell type-specific antibodies were used to detect glial cells, hyalocytes, retinal pigment epithelial cells, retinal ganglion cells, and immune cells. Cell viability was analyzed. Epiretinal cell proliferation was found in all ILM specimens, irrespective of the stage of the macular hole. Cell density showed a broad variety. Immunocytochemistry frequently revealed simultaneous expression of GFAP/CD45, GFAP/CD64, GFAP/CD68, GFAP/CRALBP, and GFAP/CD90. Some cells presented with intracellular contractile filaments (anti-αSMA); others were not immunoreactive to any antibody examined. The percentage of viable cells showed a broad variety with a mean of 73% (SD 29%). Electron microscopy demonstrated glial cells, hyalocytes, and myofibroblast-like cells. The presence of epiretinal cells at the ILM in all macular hole stages strongly suggests a substantial involvement of cell migration and proliferation in the course of macular hole development. Glial cells and hyalocytes play the predominant role in epiretinal cell proliferation. Given the co-expression of glial cell and hyalocyte markers, transdifferentiation of epiretinal cells needs further elucidation, especially with respect to αSMA-positive cells leading to traction at the vitreoretinal interface.

  8. Incidence and causes of iatrogenic retinal breaks in idiopathic macular hole and epiretinal membrane.

    Science.gov (United States)

    Yagi, Fumihiko; Takagi, Seiji; Tomita, Goji

    2014-03-01

    To evaluate the incidence and cause of iatrogenic retinal breaks (RBs) and postoperative retinal detachment (RD) in cases of idiopathic macular hole (MH) and epiretinal membrane (ERM). We analyzed 79 eyes with MH and 41 eyes with ERM, the relationship between the incidence of RBs and RD, and the frequency of posterior vitreous detachment (PVD) and lattice degeneration (LD). The incidence of RBs related to the operation was significantly higher in eyes with MH. The frequency of PVD was significantly higher in eyes with ERM. The frequency of LD did not differ between groups. In the MH group, the incidence of RBs related to the operation was high in eyes without PVD, but with LD. We observed four cases of RD in the MH group. The MH group had higher incidence of RBs related to the operation, especially in eyes without PVD or with LD.

  9. Spectral versus time-domain OCT in detecting preoperative epiretinal membranes that accompany macular holes.

    Science.gov (United States)

    Rao, Prethy; Yonekawa, Yoshihiro; Thomas, Benjamin J; Drenser, Kimberly A

    2017-03-10

    To compare the sensitivities of spectral-domain optical coherence tomography (SD-OCT) versus time-domain OCT (TD-OCT) in identifying epiretinal membranes (ERM) preoperatively in patients who underwent surgery for full-thickness macular holes (FTMH). This is an interventional retrospective case series of 59 eyes diagnosed with FTMHs who underwent 25-G pars plana vitrectomy with internal limiting membrane peeling between 2009 and 2015. Preoperative OCTs were obtained by SD-OCT (Spectralis, Heidelberg, Germany) or TD-OCT (Stratus, Carl Zeiss Meditec, Dublin, CA, USA). Volume scans were reviewed for ERM accompanying the FTMH. This was compared to indocyanine green-negative staining and intraoperative findings of ERM as the gold standard. Baseline characteristics between the SD-OCT and TD-OCT groups were comparable. Mean duration of postoperative follow-up was 41.4 weeks (±49.0). Of 59 eyes, 33 (55.9%) exhibited an ERM intraoperatively. Four ERMs (SD-OCT group) compared to 12 (TD-OCT group) were not visualized on preoperative OCT (p = 0.003). Sensitivity and specificity of SD-OCT in ERM detection was 79% and 100% compared to 14% and 91% for TD-OCT. Visual acuity improved in both arms (0.5 and 0.3 logMAR units in SD-OCT and TD-OCT, respectively (p = 0.002, 0.0002). We found that SD-OCT was superior to TD-OCT in identifying the presence of ERM preoperatively in patients who underwent macular hole surgery. Since ERMs may decrease the chance of successful pharmacologic vitreolysis, we recommend using SD-OCT over TD-OCT in the evaluation of patients with FTMH to more accurately identify ERMs and allow more comprehensive treatment decisions (pharmacologic versus surgical).

  10. Drug treatment for high IOP at early stage after vitrectomy for macular hole caused by high myopia

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    Yu-Juan Zhou

    2015-12-01

    Full Text Available AIM:To study the effect of only latanoprost eye drops or combined with other medicines on lowering intraocular pressure(IOPafter early pars plana vitrectomy(PPVfor macular hole without retinal detachment caused by high myopia.METHODS:One hundred and eighty-eight cases(205 eyessuffered from macular hole caused by high myopia without reinal detachment who underwent PPV combined with C3F8 tamponade were studied retrospectively and measured the IOP at 1wk after surgeries. The patients whose IOP was 22~29mmHg were named as group A. Then they were divided randomly into two subgroups, group A1(treated by carteolol eye dropsand subgroup A2(treated by latanoprost eye drops. The patients whose IOP was 30~39mmHg were named as group B. Then they were divided randomly into two subgroups, group B1(treated by both carteolol and brimonidine tartrate eye dropsand subgroup B2(treated by both latanoprost and carteolol eye drops. The patients whose IOP was ≥40mmHg were named as group C and they were all treated by rapid intravenous injection of 20% Mannitol. Meanwhile, they were divided randomly into two subgroups, group C1(treated by carteolol,brimonidine tartrate and brinzolamide eye drops and subgroup C2(treated by carteolol,brimonidine tartrate and latanoprost eye drops. Continuous observation lasted 3d. If IOP dropped to below 21 mmHg, we considered it valid. And then,compare the effectiveness, IOP reduction and the average effective duration. RESULTS:Eighty-nine eyes met the criteria of high IOP and IOP of 70 eyes(78.6%increased within 3d after operations. There were 31 eyes in group A including 14 eyes in group A1 and 17 eyes in group A2.The number of effective cases of the two groups was 5(35.7%and 13(76.5%respectively, the difference was statistically significant(χ2=5.24,P=0.03.The IOP reduction of the two groups were 4.21±1.22mmHg(24%, 8.76±3.03mmHg(29.6%, respectively, and the difference was statistically significant(t=5.73,Pt=2.85,P=0.012.There

  11. Choroidal thickness in Malaysian eyes with full-thickness macular holes

    Directory of Open Access Journals (Sweden)

    Chew Y Tan

    2018-02-01

    Full Text Available AIM: To compare choroidal thickness at the macula in eyes with unilateral idiopathic full-thickness macular holes(FTMHwith that of unaffected fellow eyes, and eyes of normal control patients.METHODS: Cross-sectional study. Thirty patients with unilateral idiopathic FTMH and thirty age, sex, and race-matched controls were recruited. Axial lengths were measured using laser interferometry. Enhanced depth imaging optical coherence tomography images were obtained using Heidelberg spectral-domain optical coherence tomography. Choroidal thickness was measured at the fovea, and at 1 mm and 2 mm nasally, temporally, superiorly and inferiorly from the center of the fovea. Statistical analysis was performed using independent and paired t-tests, chi-square tests, and Pearson correlation tests(PRESULTS: The mean subfoveal choroidal thickness was 201.0±44.0 μm in the FTMH group, 225.3±51.4 μm in the fellow eye group and 262.3±70.3 μm in the control group. The choroid was thinner in FTMH eyes at all locations when compared to control eyes(PPP>0.05. Choroidal thickness was generally highest subfoveally and lowest nasally. Subfoveal choroidal thickness was negatively correlated with age(r=-0.278, P=0.032, and axial length(r=-0.328, P=0.011.CONCLUSION: Choroidal thickness is lower in both eyes of patients with unilateral FTMH compared to healthy control eyes.

  12. A novel segmentation algorithm for volumetric analysis of macular hole boundaries identified with optical coherence tomography.

    Science.gov (United States)

    Xu, David; Yuan, Alex; Kaiser, Peter K; Srivastava, Sunil K; Singh, Rishi P; Sears, Jonathan E; Martin, Daniel F; Ehlers, Justis P

    2013-01-07

    To demonstrate a novel algorithm for macular hole (MH) segmentation and volumetric analysis. A computer algorithm was developed for automated MH segmentation in spectral-domain optical coherence tomography (SD-OCT). Algorithm validation was performed by trained graders with performance characterized by absolute accuracy and intraclass correlation coefficient. A retrospective case series of 56 eyes of 55 patients with idiopathic MHs analyzed using the custom algorithm to measure MH volume, base area/diameter, top area/diameter, minimum diameter, and height-to-base diameter ratio. Five eyes were excluded due to poor signal quality (1), motion artifact (1), and failure of surgical closure (3) for a final cohort of 51 eyes. Preoperative MH measurements were correlated with clinical MH stage, baseline, and 6-month postoperative best-corrected Snellen visual acuity (BCVA). The algorithm achieved 96% absolute accuracy and an intraclass correlation of 0.994 compared to trained graders. In univariate analysis, MH volume, base area, base diameter, top area, top diameter, minimum diameter, and MH height were significantly correlated to baseline BCVA (P value from 0.0003-0.011). Volume, base area, base diameter, and height-to-base diameter ratio were significantly correlated to 6-month postoperative BCVA (P value from volumetric analysis of MH geometry and correlates with baseline and postoperative visual function. Further research is needed to better understand the algorithm's role in prognostication and clinical management.

  13. Rapid macular hole formation and closure in a vitrectomized eye following rhegmatogenous retinal detachment repair

    Directory of Open Access Journals (Sweden)

    Ratnesh Ranjan

    2018-01-01

    Full Text Available The development of a full-thickness macular hole (FTMH after pars plana vitrectomy (PPV for rhegmatogenous retinal detachment (RRD repair is a rare occurrence. We report the first case of rapid MH formation with internal limiting membrane (ILM-like hyper-reflective bridging membrane under silicone oil (SO meniscus, noted on the first postoperative day (POD postvitrectomy for RRD. A 57-year-old man presented with best-corrected visual acuity (BCVA of perception of light with immature cataract and total RRD in the left eye. He underwent cataract extraction with intraocular lens implantation with uneventful PPV, endolaser to primary break, and 360° periphery followed by injection of 1000 Cst SO. On the first POD, retina was attached in all quadrants with SO in situ. However, a dark red spot was noted at macula which was confirmed as FTMH with a bridging linear hyper-reflectivity under SO meniscus on optical coherence tomography (OCT. Repeat OCT, at 2 weeks and 3 months, revealed closed MH under the SO meniscus with BCVA improving to 6/60. This is the first reported case of very rapid FTMH formation with an ILM-like linear hyper-reflectivity following vitrectomy for RRD and highlights the possible contributory role of multiple nonconventional factors for rapid FTMH development and fibrinous membrane-assisted closure under SO tamponade.

  14. Wide-field laser ophthalmoscopy for imaging of gas-filled eyes after macular hole surgery

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    Nakao S

    2016-08-01

    Full Text Available Shintaro Nakao,1 Ryoichi Arita,1 Yuki Sato,2 Hiroshi Enaida,3 Akifumi Ueno,2 Takaaki Matsui,2 Hani Salehi-Had,4 Tatsuro Ishibashi,1 Koh-hei Sonoda1 1Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 2Ohshima Hospital of Ophthalmology, Fukuoka, 3Department of Ophthalmology, Faculty of Medicine, Saga University, Saga, Japan; 4Atlantis Eyecare, Huntington Beach, CA, USA Background and objective: Existing ophthalmoscopy methods are unable to obtain clear fundus autofluorescence (FAF images in gas-filled eyes. The purpose of this study was to evaluate the capability of wide-field laser ophthalmoscopy (Optos in obtaining FAF images in gas-filled eyes for the assessment of macular hole (MH closure after surgery. Methods: This was an interventional case series. Eighteen consecutive patients with unilateral MH underwent vitrectomy with internal limiting membrane peeling and 20% sulfur hexafluoride gas tamponade. FAF images using Optos were recorded preoperatively and postoperatively (days 1, 2, and 7. Results: On postoperative days 1, 2, and 7, FAF images were obtained from 11/18 (61.1%, 9/18 (50.0%, and 17/18 eyes (94.4%, respectively, using Optos. The quality of FAF images using Optos was sufficient to determine MH closure in 9/18 (50.0% of gas-filled eyes postoperatively. Quantitative analysis of FAF images was helpful in determining complete or partial closure of the MH. Conclusion: FAF imaging using Optos might be a useful adjunct to optical coherence tomography as a supportive method to guide the release from facedown posturing in some cases of MH. Keywords: Optos, fundus autofluorescence, facedown, gas, vitrectomy

  15. 20-gauge and 23-gauge phacovitrectomy for idiopathic macular holes: comparison of complications and long-term outcomes.

    Science.gov (United States)

    Krishnan, R; Tossounis, C; Fung Yang, Y

    2013-01-01

    To assess and compare the complications and long-term visual and anatomical outcomes of 20- and 23-gauge phacovitrectomy (PVT) for idiopathic macular hole repair. A retrospective, consecutive, interventional case series of 72 eyes with idiopathic macular holes were managed with 20-gauge PVT (n=36) or 23-gauge PVT (n=36). All patients underwent a posterior-chamber intra-ocular lens implantation and internal-limiting-membrane peel with the aid of either trypan blue or brilliant blue G(250) dyes. The macular hole closure rate was 97% with 20-gauge PVT and 100% with 23-gauge PVT. Mean follow-up was 24.06 (±12.83) months with 20-gauge PVT and 17.47 (±5.79) with 23-gauge PVT. Mean visual acuity improvement in LogMar was 0.41 (±0.32) with 20-gauge PVT and 0.52 (±0.25) with 23-gauge PVT (P=0.135). The incidence of retinal breaks was higher with the 20-gauge PVT compared with the 23-gauge PVT, occurring in 13 (36.1%) and 4 (11.1%) cases, respectively (P=0.025). There were no cases of retinal detachment. Postoperative intraocular pressure (IOP), at day 1, was significantly higher with 20-gauge PVT at 24.77 (±12.68) mm Hg compared with 17.20 (±6.95) mm Hg in 23-gauge PVT (P=0.0028). Operating times were longer in 20-gauge PVT at 89.36 (±15.26) min compared with the 23-gauge PVT at 79.33 (±23.82) min (P=0.04). The 20-gauge PVT compared with 23-gauge PVT for macular hole repair is a slightly longer procedure and was associated with an increased incidence of retinal breaks and short-term elevated IOP. Both techniques have comparable visual and anatomical outcomes, but the 23-gauge PVT has advantages with regard to safety profile and operating time.

  16. Comparison of outcomes between 20, 23 and 25 gauge vitrectomy for idiopathic macular hole.

    Science.gov (United States)

    Dihowm, Fatma; MacCumber, Mathew

    2015-01-01

    To compare the results of 20, 23, 25 gauge pars plana vitrectomy (PPV) with two different gas tamponades for idiopathic macular hole (MH) in a multi-surgeon vitroretinal practice. In this comparative, retrospective, interventional case series, the medical charts of 142 eyes/130 patients were reviewed. Patients who matched our inclusion criteria: eye with stage 2, 3, or 4 MH that underwent 20, 23, or 25 gauge PPV, internal limiting membrane (ILM) peeling, and fluid-gas exchange from January, 2005 to May, 2012 and had at least 6 months follow-up. The best current corrected visual acuity (VA) and anatomical status of the MH were assessed by optical coherent tomography (OCT) at 6 months, 1 year, and 2 years after vitrectomy. The MH closed successfully after primary vitrectomy in 86.5 % (20 gauge), 96.4 % (23 gauge), and 92 % (25 gauge). Preoperative VA median were 20\\126 (20 gauge), 20\\100 (23 gauge), and 20\\80 (25 gauge). At 6 months and 2 years postoperative VA did not differ significantly between the 3 groups (p = 0.570, and 0.054 respectively). However, at 12 months postoperative VA median 20\\60 (20 gauge), 20\\69 (23 gauge), and 20\\40 (25 gauge) differ significantly (p = 0.005) likely due to cataract changes. The final median postoperative VA (at 2 years) in 25 gauge PPV group was 20/40 which was better than final visual outcomes for 20, and 23 gauge PPV groups (20/50, and 20/55 respectively). The different was not a statistically significant. MH closed successfully in 96 % (C3F8), and 88.1 % (SF6) (p = 0.063). Preoperative median VA was 20/100 in both groups of gas. At 6 months, 1 year, and 2 years postoperative median VAs did not differ significant between the 2 groups (p = 0.076, 0.343, and 0.309 respectively). MH closed successfully in (96.9 %) 12-14 % C3F8, and (95.3 %) 15-16 % C3F8 (p = 0.611). MH closed in (82.1 %) 18-20 % SF6, and (96.4 %) 22-26 % SF6 (p=0.053). Based on the results of this study, 20, 23, and 25 gauge of PPV have similar MH

  17. Surgical management of macular holes: results using gas tamponade alone, or in combination with autologous platelet concentrate, or transforming growth factor beta 2.

    LENUS (Irish Health Repository)

    Minihan, M

    2012-02-03

    BACKGROUND: Vitrectomy and gas tamponade has become a recognised technique for the treatment of macular holes. In an attempt to improve the anatomic and visual success of the procedure, various adjunctive therapies--cytokines, serum, and platelets--have been employed. A consecutive series of 85 eyes which underwent macular hole surgery using gas tamponade alone, or gas tamponade with either the cytokine transforming growth factor beta 2 (TGF-beta 2) or autologous platelet concentrate is reported. METHODS: Twenty eyes had vitrectomy and 20% SF6 gas tamponade; 15 had vitrectomy, 20% SF6 gas, and TGF-beta 2; 50 had vitrectomy, 16% C3F8 gas tamponade, and 0.1 ml of autologous platelet concentrate prepared during the procedure. RESULTS: Anatomic success occurred in 86% of eyes, with 96% of the platelet treated group achieving closure of the macular hole. Visual acuity improved by two lines or more in 65% of the SF6 only group, 33% of those treated with TGF-beta 2 and in 74% of the platelet treated group. In the platelet treated group 40% achieved 6\\/12 or better and 62% achieved 6\\/18 or better. The best visual results were obtained in stage 2 holes. CONCLUSION: Vitrectomy for macular holes is often of benefit and patients may recover good visual acuity, especially early in the disease process. The procedure has a number of serious complications, and the postoperative posturing requirement is difficult. Patients need to be informed of such concerns before surgery.

  18. What Is Macular Edema?

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    Full Text Available ... diabetes—particularly if it is left untreated. Next What Causes Macular Edema? Related Ask an Ophthalmologist Answers Would a macular wrinkle cause black streaks in my vision? Oct 05, 2017 When will I be able to see after vitrectomy surgery for a macular hole? Jan 24, 2016 Can Prolensa drops help a ...

  19. What Is Macular Edema?

    Science.gov (United States)

    ... diabetes—particularly if it is left untreated. Next What Causes Macular Edema? Related Ask an Ophthalmologist Answers Would a macular wrinkle cause black streaks in my vision? Oct 05, 2017 When will I be able to see after vitrectomy surgery for a macular hole? Jan 24, 2016 Can Prolensa drops help a ...

  20. [Comparative study of the effects of sterilized air and perfluoropropane gas tamponades on recovery after idiopathic full-thickness macular hole surgery].

    Science.gov (United States)

    He, F; Zheng, L; Dong, F T

    2017-05-11

    Objective: To compare the effects of sterilized air and perfluoropropane (C(3)F(8)) tamponades on recovery after vitrectomy for the treatment of idiopathic full-thickness macular hole (IFTMH). Methods: Case control study. Seventy-three eyes of 69 consecutive cases underwent vitrectomy with air (53 eyes) or 10% C(3)F(8) gas (20 eyes) tamponade. Surgical outcomes were retrospectively analyzed between the two groups, including logarithm of the minimal angle of resolution (logMAR) and optical coherence tomography findings like the size of the macular hole and the photoreceptor layer defect. Results: Preoperatively, the mean best corrected visual acuity (BCVA) was (0.10±0.49), the mean hole diameter was (777.9±320.7) μm, and the mean diameter of the photoreceptor layer defect was (1 709.3±516.0) μm in the sterilized air group, while in the C(3)F(8) group, the mean BCVA was (0.07±0.50), the mean hole diameter was (853.9±355.0) μm, and the mean defect diameter was (1 480.5±429.9) μm. The primary closure rate was 90.6% in the sterilized air group and 95.0% in the C(3)F(8) group. One month after surgery, the mean BCVA was (0.17±0.41), and the mean diameter of the photoreceptor layer defect was (820.5±598.0) μm in the sterilized air group, while in the C(3)F(8) group, the mean BCVA was 0.12±0.49, and the mean defect diameter was (762.5±658.0) μm. There was no statistically significant difference in the closure rate (χ(2)=0.019), BCVA ( t =-1.689), hole diameter ( t =0.837) and diameter of the photoreceptor layer defect ( t =0.338) between the two groups( P >0.05). Conclusions: Vitrectomy with sterilized air tamponade is safe and effective for the treatment of IFTMH and even cases with relatively large diameters. (Chin J Ophthalmol, 2017, 53: 327 - 331) .

  1. Comparison of inverted flap and subretinal aspiration technique in full-thickness macular hole surgery: a randomized controlled study.

    Science.gov (United States)

    Iovino, Claudio; Caminiti, Giulia; Miccoli, Mario; Nasini, Francesco; Casini, Giamberto; Peiretti, Enrico

    2017-09-18

    To compare the inverted flap and the subretinal aspiration technique for full-thickness macular hole (FTMH) surgery. Forty consecutive eyes with a stage IV FTMH were randomly assigned into 2 treatment groups. After core vitrectomy and perimacular internal limiting membrane (ILM) peeling, in group A, the subretinal remnant macular fluid was aspirated with a 41-G cannula after the air-fluid exchange procedure, while in group B, the technique of an inverted ILM flap was completed. Differences in postoperative best-corrected visual acuity (BCVA) and occurrence of intraoperative or postoperative complications between the 2 groups were evaluated. All FTMHs were closed after the first surgery with no intraoperative or postoperative complications. In group A, 16 patients (80%) showed improvement of BCVA and 4 (20%) showed stabilization. In group B, 12 patients (60%) had improved BCVA, while 6 (30%) remained stable and 2 (10%) worsened. Postoperative BCVA for group A was significantly better than for group B (p = 0.022). The surgical techniques had similar rates of closure of FTMH, although BCVA outcomes were significantly better in the subretinal aspiration group.

  2. Autologous Transplantation of the Internal Limiting Membrane for Refractory Macular Hole following Ruptured Retinal Arterial Macroaneurysm: A Case Report

    Directory of Open Access Journals (Sweden)

    Yumi Iwakawa

    2018-02-01

    Full Text Available Purpose: To report a case of macular hole (MH secondary to a retinal arterial macroaneurysm (RAMA which was successfully treated with an autologous transplantation of internal limiting membrane (ILM. Case Report: An 87-year-old female presented with a sudden decrease in central vision in the right eye. A fundus examination revealed a RAMA in the superonasal macular region, a subretinal hemorrhage (SRH, involving the macula, and a sub-ILM hemorrhage. A pars plana vitrectomy (PPV was performed. Intraoperatively, an MH filled with coagulum was detected. We tried to blow off and drain the SRH with a current of BSS and a gentle suction with a 27-gauge vitreous cutter from the MH, but some amount of SRH at the bottom of the MH remained. The ILM was peeled off for 2 disc diameters around the MH. The vitreous cavity was filled with air at the end of the operation. Two weeks after the surgery, the MH was not closed. One month following the initial PPV, a second PPV was performed to achieve closure of the MH. Results: An autologous transplantation of ILM was performed as second PPV. Six months after the final surgery, the MH was successfully closed and the best-corrected decimal visual acuity was 0.6. Conclusions: Autologous ILM transplantation can be an effective treatment option for MH closure following RAMA rupture.

  3. Outer retina reflectivity changes on sd-oct after intravitreal ocriplasmin for vitreomacular traction and macular hole.

    Science.gov (United States)

    Quezada-Ruiz, Carlos; Pieramici, Dante J; Nasir, Maʼan; Rabena, Melvin; Steinle, Nathan; Castellarin, Alessandro A; Dhoot, Dilsher; Couvillion, Stephen; See, Robert F; Avery, Robert L

    2015-06-01

    To report initial experience with intravitreal ocriplasmin (IVO) and to describe outer retina reflectivity changes observed on spectral domain optical coherence tomography (SD-OCT) after IVO injection in patients with vitreomacular traction (VMT) with or without macular holes (MHs). A consecutive retrospective review of patients with VMT and MH who were treated with IVO was performed. Patients underwent complete ophthalmic evaluation, including nonstandardized Snellen visual acuity testing, and SD-OCT at baseline and follow-up visits. A total of 23 patients who received IVO for VMT and/or MH were included for analysis. Patient age ranged from 53 years to 93 years with a mean of 74 years. The mean follow-up was 174 days (range: 20-291 days). Vitreomacular traction release at Day 30 after IVO was achieved in 11 of 23 patients (47.82%), at an average of 14.54 days (range: 1-30 days) after treatment. The mean visual acuity improved from 0.50 to 0.38. At presentation, eight patients had MH associated with VMT. Closure of the MH with ocriplasmin was achieved in two patients, and six patients underwent pars plana vitrectomy for MH repair. Ten of 23 patients (43.47%) presented with changes in the outer retina reflectivity on SD-OCT after IVO, 4 patients of this group experienced a decrease in visual acuity. In 7 of these 10 patients (70%), VMT release was documented on OCT by Day 30 postinjection compared with 4 of 13 patients (30.76%) without outer retina changes post-IVO. Normalization of the outer retina reflectivity was achieved in all cases. In this case series of VMT/MH patients treated with ocriplasmin, changes in the SD-OCT outer retina reflectivity were relatively common. Within weeks, the outer retinal reflectivity on SD-OCT improved, as did the visual acuity. Further studies to investigate the association between outer retina reflectivity changes with the use of IVO and long-term visual acuity outcomes are warranted.

  4. Comparisons of foveal thickness and slope after macular hole surgery with and without internal limiting membrane peeling

    Directory of Open Access Journals (Sweden)

    Ohta K

    2018-03-01

    Full Text Available Kouichi Ohta, Atsuko Sato, Nami Senda, Emi Fukui Department of Ophthalmology, Matsumoto Dental University, Nagano, Japan Background: We have shown that the foveal contour was asymmetrical after idiopathic macular hole (MH closure by pars plana vitrectomy (PPV with internal limiting membrane (ILM peeling. The purpose of this study was to determine whether these morphological changes differ in eyes after PPV without ILM peeling. Methods: Ten eyes of 10 patients that underwent PPV without ILM peeling and 12 eyes of 11 patients with ILM peeling were studied. The MH in all eyes was <400 µm in diameter. Six months after the PPV, the macular thickness and foveal slope around the closed MH were determined by spectral-domain optical coherence tomography. The thickness of the ganglion cell complex was measured by another spectral-domain optical coherence tomography instrument >6 months after the surgery. Results: The mean parafoveal retinal thickness in the non-peeled group was 367.1 µm in the nasal (N, 353.0 µm in the temporal (T, 366.9 µm in the superior (S, and 357.3 µm in the inferior (I sectors. The T, S, and I sectors were significantly thicker than the corresponding sectors in the ILM peeled group (p=0.0008, 0.003, and 0.03, respectively. The mean ganglion cell complex was thicker not only in the N sector but also in the T sector in the non-peeled group. The mean retinal slopes in the non-peeled group (N, 40.2°; T, 37.6°; S, 41.2°; I, 39.5° were flatter than those in the peeled group (N, 52.3°; T, 43.6°; S, 50.8°; I, 51.9°; p=0.009, 0.09, 0.008, and 0.017, respectively. Conclusion: The symmetrical fovea after MH surgery in the non-ILM peeled eyes indicates that the asymmetrical fovea after ILM peeling was probably due to the ILM peeling. Keywords: idiopathic macular hole, foveal contour, internal limiting membrane, vitrectomy

  5. Correlation of increased fundus autofluorescence signals at closed macula with visual prognosis after successful macular hole surgery.

    Science.gov (United States)

    Shiragami, Chieko; Shiraga, Fumio; Nitta, Eri; Fukuda, Kouki; Yamaji, Hidetaka

    2012-02-01

    To study the significance of the increased fundus autofluorescence (FAF) signals at closed macula with spectral-domain optical coherence tomography and visual prognosis after successful surgery in eyes with idiopathic full-thickness macular holes (MHs). Seventy-eight eyes of 78 consecutive patients with full-thickness MHs underwent successful standard vitrectomy, with internal limiting membrane peeling and followed by 10% sulfur hexafluoride gas injection. Simultaneous FAF and optical coherence tomography images were recorded at 10 days, and 1, 3, and 6 months postoperatively, using a combined spectral-domain optical coherence tomography-fluorescein angiography device (Spectralis™/HRA Heidelberg Retina Angiograph 2). The appearance of increased FAF in the macula postoperatively and the relationship of FAF and optical coherence tomography findings to best-corrected visual acuity were examined. Stage 2, 3, and 4 MHs were present in 31, 29, and 18 eyes, respectively. The median patient age was 66 years, with a range of 54 to 79 years. In all patients, the MHs were successfully closed, and the preoperative increased FAF corresponding to MH disappeared 10 days after surgery. In 36 eyes (46.2%), however, hyperautofluorescence again appeared in the macular area 1 month postoperatively. This hyperautofluorescence was significantly associated with the recovery of the external limiting membrane lines at the fovea 1 month after surgery (P = 0.001, multiple logistic regression analysis). Also, this recovery of the external limiting membrane lines 1 month postoperatively was significantly associated with the recovery of photoreceptor inner and outer segment junction line 3 months postoperatively at the fovea (P macula 1 month postoperatively, the recovery of the photoreceptor inner and outer segment lines at the fovea 3 months postoperatively, and preoperative good visual acuity (P macula 1 month after successful MH surgery. This hyperautofluorescence could be a sign of good

  6. RISK FACTORS FOR DEVELOPMENT OF MACULAR HOLE RETINAL DETACHMENT AFTER PARS PLANA VITRECTOMY FOR PATHOLOGIC MYOPIC FOVEOSCHISIS.

    Science.gov (United States)

    Huang, Yao; Huang, Weilin; Ng, Danny S C; Duan, Anli

    2017-06-01

    To identify the risk factors for the development of macular hole retinal detachment (MHRD) after vitrectomy without internal limiting membrane peeling for pathologic MF. We retrospectively reviewed the records of 131 eyes (115 patients) treated with vitrectomy for pathologic MF from 2009 to 2014. The best-corrected visual acuity (BCVA), refractive error, axial length, and spectral-domain optical coherence tomography findings were analyzed. Postoperative MHRD developed in 7 eyes (5.3%). Between patients with or without secondary MHRD after vitrectomy, there were no significant differences in age, sex, axial length, preoperative BCVA, refractive error, lens status, and presence of posterior staphyloma. Spectral-domain optical coherence tomography showed all 7 eyes (100%) had foveal detachment, while only 47 patients (37.9%) of 124 eyes had foveal detachment (P = 0.004). There was no significant difference between preoperative and postoperative BCVA in the 7 eyes with MHRD. The postoperative BCVA in the 124 eyes without MHRD was significantly improved (P detachment was worse than the eyes without foveal detachment (P detachment is a risk factor for the development of MHRD after vitrectomy for pathologic MF.

  7. Evaluation of Ganglion Cell-Inner Plexiform Layer Thickness after Vitreoretinal Surgery with Internal Limiting Membrane Peeling in Cases with Idiopathic Macular Hole

    Directory of Open Access Journals (Sweden)

    Sibel Demirel

    2017-06-01

    Full Text Available Objectives: To evaluate macular retinal ganglion cell-inner plexiform layer (GCIPL thickness after vitrectomy with internal limiting membrane (ILM peeling for idiopathic macular holes using spectral domain optical coherence tomography (SD-OCT. Materials and Methods: Eighteen eyes of 18 patients with unilateral idiopathic macular hole who underwent vitrectomy with ILM peeling were retrospectively analyzed. Healthy fellow eyes of the patients and 18 eyes of 18 age-matched healthy individuals constituted the control group. The patients were evaluated at 1 day, 1 week, 1 month, and 3 months after surgery. The best corrected visual acuity (BCVA measurements, biomicroscopic examination findings and SD-OCT measurements were recorded. Ganglion cell-inner plexiform layer thickness was evaluated with ganglion cell analysis software of Cirrus HD-OCT before surgery and at 1 month and 3 months after surgery and compared with control groups. Presence of dissociated optic nerve fiber layer (DONFL was evaluated with C-scan mode. Results: Of the 18 patients, 9 were male and 9 were female with a mean age of 65.6±5.6 (55-77 years. Preoperative BCVA was 0.75±0.19 logMAR, while it was 0.44±0.17 logMAR and 0.36±0.15 logMAR at postoperative 1 and 3 months, respectively (p0.05. Conclusion: Internal limiting membrane peeling during macular hole surgery may cause functional and /or structural changes that may be associated with visual acuity. Significant GCIPL thinning and DONLF appearance may occur postoperatively.

  8. What Is Macular Edema?

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    Full Text Available ... an Ophthalmologist Answers Would a macular wrinkle cause black streaks in my vision? Oct 05, 2017 When will I be able to see after vitrectomy surgery for a macular hole? Jan 24, 2016 Can Prolensa drops help a ...

  9. What Is Macular Edema?

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    Full Text Available ... an Ophthalmologist Answers Would a macular wrinkle cause black streaks in my vision? Oct 05, 2017 When will I be able to see after vitrectomy surgery for a macular hole? Jan 24, 2016 After a person develops ocular ...

  10. A Comparative Study between Vitrectomy with Internal Tamponade and a New Modified Fiber Optic Illuminated Ando Plombe for Cases of Macular Hole Retinal Detachment in Myopic Eyes

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    Ahmed M. Bedda

    2015-01-01

    Full Text Available Aim. To compare pars plana vitrectomy (PPV with silicone tamponade or gas (Groups Ia and Ib and a new modified Ando plombe equipped with a fiber optic light (Group II for cases with macular hole retinal detachment (MHRD in high myopic eyes (axial length > 26 mm. Methods. A prospective interventional randomized case series included 60 eyes (20 in each group. Successful outcome was considered if the retina was completely attached at the end of the follow-up period. Complications were identified for each group. Results. Visual acuity improved by 37.31%, 40.67%, and 49.40% in Groups Ia, Ib, and II, respectively. The success rate was 55%, 60%, and 100% in Groups Ia , Ib, and II, respectively, with a statistically significant difference between Groups Ia, Ib, and II (p < 0.001 in Ia, p: 0.002 in Ib. Complications rates were 60%, 45%, and 20% in Groups Ia, Ib, and II, respectively, with a statistically significant difference between Groups Ia and II (p: 0.01. Conclusion. Fiber optic illuminated Ando plombe allows better positioning under the macula and consequently improves the success rate of epimacular buckling in comparison to PPV with internal tamponade in MMHRD.

  11. What Is Macular Edema?

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    Full Text Available ... the brain and interpreted as the images you see. It is the macula that is responsible for ... 05, 2017 When will I be able to see after vitrectomy surgery for a macular hole? Jan ...

  12. What Is Macular Edema?

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    Full Text Available ... the most common form of vision loss for people with diabetes—particularly if it is left untreated. ... a macular hole? Jan 11, 2016 After a person develops ocular histoplasmosis, is it common that years ...

  13. What Is Macular Edema?

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    Full Text Available ... streaks in my vision? Oct 05, 2017 When will I be able to see after vitrectomy surgery for a macular hole? Jan 24, ... Answers Free Newsletter Get ophthalmologist-reviewed tips and information about ...

  14. The Expansion of RPE Atrophy after the Inverted ILM Flap Technique for a Chronic Large Macular Hole

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    Hisanori Imai

    2014-03-01

    Full Text Available Purpose: To report a case of the expansion of submacular retinal pigment epithelium (RPE atrophy after using the inverted internal limiting membrane (ILM flap technique for a persisting, large, stage IV macular hole (MH. Case Report: A 79-year-old woman presented with a chronic large MH that remained open despite pars plana vitrectomy (PPV. The surgery was performed twice for the MH closure 14 years earlier. ILM peeling was not performed during the previous surgeries. The best-corrected visual acuity (BCVA with the Landolt ring chart was 0.08 at her visit. The minimum MH diameter was 1,240 μm. Inverted ILM flap technique with 20% SF6 gas tamponade was performed for the MH closure. For the inverted ILM flap technique, 25-gauge PPV and ILM staining with indocyanine green were used. The ILM was peeled off for 2 disc diameters around the MH, but the ILM was not removed completely. The ILM was then inverted and covered the MH. Results: One month after surgery, the MH was closed, accompanied by glial cell proliferation spreading from the inverted ILM flap (as reported before. On the other hand, the area of the submacular RPE atrophy, which was already observed 1 week after surgery, gradually increased in size. BCVA improved to 0.3 six months after the surgery. Conclusions: The inverted ILM flap technique may be promising even for persisting large MH which were not closed in previous surgeries, but long-term observation is needed because the detailed behavior of the inverted ILM and the Müller cells after surgery is not yet known.

  15. Correlation Between En Face Optical Coherence Tomography Defects of the Inner Retinal Layers and Ganglion Cell Inner Plexiform Layer Analysis After Internal Limiting Membrane Peeling for Idiopathic Full-Thickness Macular Hole.

    Science.gov (United States)

    Sabry, Dalia; El-Kannishy, Amr; Kamel, Rania; Abou Samra, Waleed

    2016-07-01

    The purpose of this study was to report en face optical coherence tomography (OCT) inner retinal changes after internal limiting membrane (ILM) peeling for idiopathic full-thickness macular hole (IFTMH) and to correlate these findings with macular ganglion cell inner plexiform layer (GC-IPL) analysis. This prospective study included 20 patients with IFTMH treated using pars plana vitrectomy with ILM peeling. All patients were analyzed using en face OCT at 6 months after surgery to determinate the effect of ILM peeling on the inner retinal layers. Correlation between the GC-IPL en face OCT findings and that obtained by three-dimensional volumetric OCT scanning also was performed. Seven patients (35%) showed defects in the retinal nerve fiber layer (RNFL) that appeared as multiple dark dots with no visible defects at the GC-IPL, either with en face OCT or 3D volumetric OCT scanning. Thirteen patients (65%) showed a similar combination of RNFL defects and well-circumscribed defects in the underlying GC-IPL. These defects could be visualized on en face OCT display, and they correlated with areas of GC-IPL thinning detected in the 3D volumetric OCT scanning. With ILM peeling, en face OCT scanning showed two forms of inner retinal layers changes. The first form was the concentric macular dark spots (CMDS) with intact GC-IPL. The second form appeared in the CMDS with evident localized defects in the underlying GC-IPL. These defects correlate with the areas of GC-IPL thinning detected using 3D volumetric OCT scanning.

  16. [Macular surgery in a new point of view].

    Science.gov (United States)

    Branişteanu, D; Moraru, Andreea

    2014-01-01

    To reveal the differences in anatomical and functional results following standard 20-gauge vitrectomy and modern transconjunctival sutureless vitrectomy in macular surface pathology. Retrospective, interventional, comparative evaluation of macular pathology cases operated by standard 20-gauge vitrectomy and transconjunctival 23 G sutureless vitrectomy. In evaluation were included a comparable number of epiretinal membranes (both idiopathic and secondary) and stage 3 and 4 macular holes. A postoperative anatomical and functional analysis was performed and also the incidence of pre-and postoperative complications was noted. Transconjunctival sutureless vitrectomy was associated with a shorter operating time and quicker anatomical and functional results. If in epiretinal membranes there was no significant difference in final results, in macular holes anatomical and functional results were better with sutureless vitrectomy. These results confirm the efficacy and safety of both surgical procedures in macular surface pathology. Better anatomical and functional results in macular holes and quicker functional rehabilitation in all cases promote sutureless vitrectomy as new standard procedure in these cases.

  17. Rehabilitación visual mediante el microperímetro MP1 en pacientes con agujero macular y baja visión Visual rehabilitation by means of MPI microperimeter in patients with macular hole and low vision

    Directory of Open Access Journals (Sweden)

    Marilyn Linares Guerra

    2011-12-01

    Full Text Available Objetivo: Evaluar los beneficios de la estimulación visual usando el microperímetro MP1 en pacientes con baja visión por agujero macular atendidos en consulta de baja visión en el Instituto Cubano de Oftalmología “Ramón Pando Ferrer” en el año 2010. Métodos: Se realizó un estudio experimental, tipo serie de casos. Fueron estudiadas, antes y después de la rehabilitación, las siguientes variables: agudeza visual mejor corregida de cerca con cartilla Zeiss y agudeza visual mejor corregida de lejos usando cartilla Feinbloom, estabilidad de la fijación y sensibilidad retiniana por medio del microperímetro MP1 y velocidad de lectura. Se realizaron 10 sesiones de estimulación de 10 minutos cada una con una frecuencia semanal, empleando el módulo de “biofeedback” del microperímetro MP1. Se realizó análisis estadístico por medio del test de student para muestras pareadas. Valores de p= 0,05 se consideraron como estadísticamente significativos. Resultados: La agudeza visual para lejos y cerca mejoró de 0,18 a 0,23, y de 0,21 a 0,51 respectivamente, la sensibilidad retiniana aumentó de 2,69 a 7,86 dB, la estabilidad de la fijación antes de la estimulación: inestable (80,77 %, relativamente inestable (15,38 % y estable (3,85 % y después de la misma: no inestable, relativamente inestable (30,77 % y estable (69,23 %. La velocidad de lectura mejoró de 35 a 104 palabras por minuto. Conclusión: La estimulación visual empleando el microperímetro MP1 mejoró el rendimiento visual de los pacientes con agujero macular y baja visión.Objective: To evaluate the benefits of visual stimulation by using the MP1 microperimeter in patients with low vision due to macular hole, who were seen at low vision service of “Ramón Pando Ferrer" Cuban Institute of Ophthalmology during 2010. Methods: An experimental, case series type study was carried out. The following variables were studied before and after the rehabilitation: best near

  18. Value of internal limiting membrane peeling in surgery for idiopathic macular hole stage 2 and 3: a randomised clinical trial

    DEFF Research Database (Denmark)

    Christensen, U C; Krøyer, K; Sander, B

    2009-01-01

    than 1 year's duration of symptoms. Eyes were randomised to (1) vitrectomy alone without retinal surface manipulation, (2) vitrectomy plus 0.05% isotonic Indocyanine Green (ICG)-assisted ILM peeling or (3) vitrectomy plus 0.15% Trypan Blue (TB)-assisted ILM peeling. Main outcomes were hole closure...... after 3 and 12 months and best-corrected visual acuity after 12 months. RESULTS: 78 eyes were enrolled. Primary closure rates were significantly higher with ILM peeling than without peeling for both stage 2 holes (ICG peeling 100%, non-peeling 55%, p = 0.014) and for stage 3 holes (ICG peeling 91%, TB...

  19. Macular hole surgery: an analysis of risk factors for the anatomical and functional outcomes with a special emphasis on the experience of the surgeon

    Directory of Open Access Journals (Sweden)

    Jenisch TM

    2017-06-01

    Full Text Available Teresa M Jenisch,1 Florian Zeman,2 Michael Koller,2 David A Märker,1 Horst Helbig,1 Wolfgang A Herrmann1,3 1Department of Ophthalmology, 2Centre for Clinical Studies, University Hospital Regensburg, 3Department of Ophthalmology, St John of God Hospital, Regensburg, Germany Purpose: The aim of this study was to evaluate risk factors for the anatomical and functional outcomes of macular hole (MH surgery with special emphasis on the experience of the surgeon. Methods: A total of 225 surgeries on idiopathic MHs (IMHs performed by 6 surgeons with a mean follow-up period of 20.5 months were reviewed in this retrospective study. Outcome parameters focused on IMH closure, complications and visual acuity improvement. The results of MH surgeries performed by experienced surgeons were compared to those of surgeons in training. Results: The average MH size was 381 µm (standard deviation [SD]=168. Brilliant blue G (BBG for internal limiting membrane (ILM staining was used in 109 (48% eyes and indocyanine green (ICG in 116 (52% eyes. As endotamponade, 20% SF6 was used in 38 (17% cases, 16% C2F6 in 33 (15% cases and 16% C3F8 in 154 (68% cases. IMH closure was achieved in 194 eyes (86%. Mean preoperative visual acuity was 0.84 logarithm of the minimum angle of resolution (log MAR; SD=0.29, range: 0.3–1.5; surgery led to a mean improvement of 0.40 (SD=0.37 log MAR. Although the MH closure rate was the same using BBG or ICG for ILM peeling, visual acuity improvement was better in eyes peeled with BBG compared to eyes peeled with ICG (log MAR: BBG: 0.38 [95% CI: 0.32, 0.44] vs ICG: 0.48 [95% CI: 0.42, 0.54], P=0.029. Surgeons with previous experience in vitreoretinal surgery of ≥6 years achieved better visual outcomes compared to surgeons with 0–3 years of experience, regardless of the MH size, preoperative visual acuity, time to follow-up or dye used for ILM peeling (0–3 years [0.27, ∆log MAR] vs ≥6 years [0.43, ∆log MAR], P=0.009. Conclusion

  20. What Is Macular Edema?

    Medline Plus

    Full Text Available ... Macular Edema Sections What Is Macular Edema? What Causes Macular Edema? Macular Edema Symptoms Macular Edema Diagnosis ... particularly if it is left untreated. Next What Causes Macular Edema? Related Ask an Ophthalmologist Answers Would ...

  1. Cierre espontáneo de agujero macular idiopático:: seguimiento por tomografía de coherencia óptica y microperimetría MP1 Spontaneous closure of the idiopathic macular hole.: Follow-up of this case by optical coherence tomography and microperimetry MP1

    Directory of Open Access Journals (Sweden)

    Julio César Molina Martín

    2010-12-01

    Full Text Available Se presenta un caso de cierre espontáneo de agujero macular idiopático seguido por tomografía de coherencia óptica y microperimetría MP1 antes y después del cierre. El cierre espontáneo de un estadio 4 no ocurre con frecuencia, sin embargo, puede aparecer fundamentalmente en pacientes con diámetro superior del agujero menor a 150 micras. La tomografía de coherencia óptica y la microperimetría constituyen herramientas útiles en el diagnóstico, pronóstico y seguimiento de esta entidad.The case of spontaneous closure of a stage 4 idiopathic macular hole at followed up by Optical Coherence Tomography and microperimetry MP1 before and after the closure was presented. The spontaneous closure of a stage 4 macular hole is rare but it can occur in patients with hole upper diameters less than 150 µm. The OCT and the microperimetry MP1 are very useful tools in the diagnosis, prognosis and follow-up of this maculopathy.

  2. Pigmentos maculares Macular pigments

    Directory of Open Access Journals (Sweden)

    Renata Canovas

    2009-12-01

    Full Text Available A luteína e a zeaxantina são pigmentos amarelos que se localizam na mácula. Devido à sua localização, diminuem e filtram a quantidade de luz principalmente azul que chega aos fotorreceptores, atuam como antioxidantes e podem melhorar a qualidade visual. Esta é uma revisão do seu mecanismo de incorporação, ação, possíveis aplicações e conhecimento científico a respeito.Lutein and Zeaxanthin are yellow pigments located at the macula. Because of your location macular pigments decrease and filter the amount of blue light that reach photoreceptors, protect the outer retina from oxidative stress and may improve the vision quality. This is a review regarding incorporation mechanism, function and knowledge update.

  3. Accurate inspiral-merger-ringdown gravitational waveforms for nonspinning black-hole binaries including the effect of subdominant modes

    Science.gov (United States)

    Mehta, Ajit Kumar; Mishra, Chandra Kant; Varma, Vijay; Ajith, Parameswaran

    2017-12-01

    We present an analytical waveform family describing gravitational waves (GWs) from the inspiral, merger, and ringdown of nonspinning black-hole binaries including the effect of several nonquadrupole modes [(ℓ=2 ,m =±1 ),(ℓ=3 ,m =±3 ),(ℓ=4 ,m =±4 ) apart from (ℓ=2 ,m =±2 )]. We first construct spin-weighted spherical harmonics modes of hybrid waveforms by matching numerical-relativity simulations (with mass ratio 1-10) describing the late inspiral, merger, and ringdown of the binary with post-Newtonian/effective-one-body waveforms describing the early inspiral. An analytical waveform family is constructed in frequency domain by modeling the Fourier transform of the hybrid waveforms making use of analytical functions inspired by perturbative calculations. The resulting highly accurate, ready-to-use waveforms are highly faithful (unfaithfulness ≃10-4- 10-2 ) for observation of GWs from nonspinning black-hole binaries and are extremely inexpensive to generate.

  4. GORE-TEX VASCULAR GRAFT FOR MACULAR BUCKLING IN HIGH MYOPIA EYES.

    Science.gov (United States)

    Wu, Pei-Chang; Sheu, Jiunn-Jye; Chen, Yi-Hao; Chen, Yung-Jen; Chen, Chih-Hsin; Lee, Jong-Jer; Huang, Chih-Ling; Chen, Chueh-Tan; Kuo, Hsi-Kung

    2017-07-01

    To evaluate a new application of an expanded polytetrafluoroethylene (Gore-Tex) vascular graft for use in macular buckling surgery for treatment of highly myopic eyes. The Gore-Tex vascular graft was used as a macular buckling material in eight consecutive cases of myopic macular diseases which included fovea detachment, foveoschisis, or macular hole retinal detachment. Retinal reattachment was achieved in all cases except one which had partial resolution (88%). The postoperative best-corrected visual acuity ranged from 20/2000 to 20/100 depending on the degree preexisting macular degeneration, and significant better than the preoperative best-corrected visual acuity (P = 0.048, paired t-test). During the follow-up period, which ranged from 8 months to 3 years, no eye developed buckle-related complications such as infection or dislocation. The initial pilot results from this series using a Gore-Tex graft for macular buckling is promising. Throughout the follow-up period, the Gore-Tex was well tolerated in the highly myopic eyes. Large scale and long-term follow-up is warranted.

  5. Macular degeneration (image)

    Science.gov (United States)

    Macular degeneration is a disease of the retina that affects the macula in the back of the eye. ... see fine details. There are two types of macular degeneration, dry and wet. Dry macular degeneration is more ...

  6. American Macular Degeneration Foundation

    Science.gov (United States)

    ... Policy Disclaimer Contact Us Donate Store The American Macular Degeneration Foundation The American Macular Degeneration Foundation (AMDF) is ... Ed Asner Video Clip An Inspiring Her-story Macular Degeneration is the leading cause of vision loss, affecting ...

  7. Dominantly inherited cystoid macular edema.

    Science.gov (United States)

    Fishman, G A; Goldberg, M F; Trautmann, J C

    1979-01-01

    Four patients of Greek ancestry had dominantly inherited cystoid macular edema. Characteristics of this syndrome include the following: an early onset and prolonged course of cystoid changes in the macula, followed by atrophy of the macula in later stages. Some patients also show leakage of fluorescein from the optic disc capillaries, subnormal EOG Lp/Dt ratios, elevated rod dark adaptation thresholds, red-green and blue-yellow color deficiencies, normal ERG findings, hyperopia, peripheral pigmentary retinopathy, and vitreous opacities. Dominantly inherited cystoid macular edema is a distinct genetic trait among the dominantly inherited macular dystrophies.

  8. Emprego das medidas anatômicas do buraco macular idiopático obtidas pela tomografia de coerência óptica como fator preditivo nos resultados visuais: um estudo piloto Use of anatomical measures of idiopathic macular hole obtained through optical coherence tomography as a predictive factor in visual results: a pilot study

    Directory of Open Access Journals (Sweden)

    Alan Diego Negretto

    2007-10-01

    Full Text Available OBJETIVO: Avaliar a anatomia do buraco macular idiopático (BMI a partir da tomografia de coerência óptica (OCT e construir índice prognóstico que possa ser correlacionado com os resultados visuais e o fechamento anatômico. MÉTODOS: Estudo prospectivo, no qual 22 olhos com BMI foram avaliados pelo OCT no pré-operatório da cirurgia do BMI. Foi criado o índice prognóstico do buraco macular (IPBM que foi correlacionado com o resultado anatômico e a acuidade visual pós-operatória seis meses após a cirurgia. RESULTADOS: Dezesseis olhos (72,7% obtiveram fechamento anatômico ao final de seis meses de acompanhamento. Na análise do IPBM, houve diferença significativa entre o grupo 1 (BM aberto e o grupo 2 (BM fechado (p=0,0018. O risco de insucesso para o fechamento anatômico é 11 vezes maior quando o diâmetro da base interna for superior a 600 µm ou o IPBM for inferior a 0,6 (p=0,0495. No que diz respeito à AV final, observou-se que o IPBM tem correlação negativa significante na AV (p=0,001. CONCLUSÃO: O IPBM se apresentou como o melhor preditor de fechamento anatômico e acuidade visual pós-operatória entre as variáveis aqui estudadas. Responde por 41% da acuidade visual pós-operatória final, nos levando a crer que outros fatores, como o tempo de história e a degeneração dos fotorreceptores nestes BM mais antigos, possam estar envolvidos nos resultados visuais.PURPOSE: To evaluate the anatomy of idiopathic macular hole (IMH using Optical Coherence Tomography (OCT and to construct a prognostic index that can be correlated with the visual outcomes and the anatomical closing. METHODS: Prospective study, in which 22 eyes with IMH had been evaluated through OCT in the daily postoperative period of IMH surgery. The Prognostic of Macular Hole Index (PMHI was created which was correlated with the anatomical result and the postoperative visual acuity (VA six months after surgery. RESULTS: Sixteen eyes (72.7% got anatomical

  9. [Therapeutic approach in persistent diabetic macular edema].

    Science.gov (United States)

    Brănişteanu, Daniel; Moraru, Andreea

    2014-01-01

    Terminology of persistent diabetic macular edema has been initially reserved to cases unresponsive to conventional laser photocoagulation according to ETDRS criteria. While knowledge about pathophysiology of macular edema evolved and new drugs became available, the terminology of persistent diabetic macular edema expanded to include resistance to most current therapies. The purpose of this paper is to review medical and surgical options in the treatment of such difficult cases according to literature data and personal experience.

  10. What Is Macular Edema?

    Medline Plus

    Full Text Available ... Edema Symptoms Macular Edema Diagnosis Macular Edema Treatment What Is Macular Edema? Leer en Español: ¿Qué es ... diabetes—particularly if it is left untreated. Next What Causes Macular Edema? Related Ask an Ophthalmologist Answers ...

  11. A model for persistent hole burned spectra and hole growth kinetics that includes photoproduct absorption: Application to free base phthalocyanine in hyperquenched glassy ortho-dichlorobenzene at 5 K

    International Nuclear Information System (INIS)

    Reinot, T.; Dang, N.C.; Small, G.J.

    2003-01-01

    Persistent nonphotochemical and photochemical hole burning of the S 0 →S 1 origin absorption bands of chromophores in amorphous hosts such as glasses, polymers and proteins at low temperatures have been used to address a number of problems that range from structural disorder and configurational tunneling to excitation energy transfer and charge separation in photosynthetic complexes. Often the hole burned spectra are interfered by photoproduct (antihole) absorption. To date there has been no systematic approach to modeling hole burned spectra and the dispersive kinetics of zero-phonon hole growth that accounts for the antihole. A 'master' equation that does so is presented. A key ingredient of the equation is a time-dependent, two-dimensional site excitation frequency distribution function (SDF) of the zero-phonon lines. Prior to hole burning (t=0) the SDF is that of the educt sites. For t>0 the SDF describes both educt and photoproduct sites and allows for burning of the latter that revert to the educt sites from which they originate (light-induced hole filling). Our model includes linear electron-phonon coupling and the three distributions that lead to dispersive hole growth kinetics, the most important of which is the distribution for the parameter λ associated with tunneling between the bistable configurations of the chromophore-host system that are interconverted by hole burning. The master equation is successfully applied to free base phthalocyanine (Pc) in hyperquenched glassy ortho-dichlorobenzene (DCB) at 5 K. The mechanism of hole burning is photochemical and involves tautomerization of the two protons at the center of the macrocycle (Pc) that occurs in the S 1 (Q x ) and/or T 1 (Q x ) state of Pc. A single set of parameter values (some of which are determined directly from the hole burned spectra) provides a satisfactory description of the dependence of the hole burned spectra and hole growth kinetics on the location of the burn frequency within the

  12. Association of age-related macular degeneration and reticular macular disease with cardiovascular disease.

    Science.gov (United States)

    Rastogi, Neelesh; Smith, R Theodore

    2016-01-01

    Age-related macular degeneration is the leading cause of adult blindness in the developed world. Thus, major endeavors to understand the risk factors and pathogenesis of this disease have been undertaken. Reticular macular disease is a proposed subtype of age-related macular degeneration correlating histologically with subretinal drusenoid deposits located between the retinal pigment epithelium and the inner segment ellipsoid zone. Reticular lesions are more prevalent in females and in older age groups and are associated with a higher mortality rate. Risk factors for developing age-related macular degeneration include hypertension, smoking, and angina. Several genes related to increased risk for age-related macular degeneration and reticular macular disease are also associated with cardiovascular disease. Better understanding of the clinical and genetic risk factors for age-related macular degeneration and reticular macular disease has led to the hypothesis that these eye diseases are systemic. A systemic origin may help to explain why reticular disease is diagnosed more frequently in females as males suffer cardiovascular mortality at an earlier age, before the age of diagnosis of reticular macular disease and age-related macular degeneration. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. What Is Macular Edema?

    Medline Plus

    Full Text Available ... Edema Symptoms Macular Edema Diagnosis Macular Edema Treatment ... macula is a very small area at the center of the retina—a thin layer of light-sensitive tissue that lines the back of the eye. Light ...

  14. What Is Macular Edema?

    Medline Plus

    Full Text Available ... Macular Edema Treatment What Is Macular Edema? Leer en Español: ¿Qué Es un Edema Macular? Dec. 01, ... common form of vision loss for people with diabetes—particularly if it is left untreated. Next What ...

  15. What Is Macular Edema?

    Medline Plus

    Full Text Available ... Is Macular Edema? Leer en Español: ¿Qué Es un Edema Macular? Dec. 01, 2010 Macular edema is ... Follow The Academy Professionals: ... Industry Medical Disclaimer Privacy Policy Terms of Service For Advertisers For Media Ophthalmology ...

  16. What Is Macular Edema?

    Medline Plus

    Full Text Available ... Tips & Prevention News Ask an Ophthalmologist Patient Stories Español Eye Health / Eye Health A-Z Macular Edema ... Edema Treatment What Is Macular Edema? Leer en Español: ¿Qué Es un Edema Macular? Dec. 01, 2010 ...

  17. What Is Macular Edema?

    Medline Plus

    Full Text Available ... remains. Macular edema is often a complication of diabetic retinopathy , and is the most common form of vision loss for people with diabetes—particularly if it is left untreated. Next What Causes Macular ... Compares Eylea, Lucentis and Avastin for Diabetic Macular Edema Jul 17, 2015 Top 5 Risk ...

  18. What Is Macular Edema?

    Medline Plus

    Full Text Available ... Tips & Prevention News Ask an Ophthalmologist Patient Stories Español Eye Health / Eye Health A-Z Macular Edema ... Edema Treatment What Is Macular Edema? Leer en Español: ¿Qué es un edema macular? Dec. 01, 2010 ...

  19. Achondroplasia and Macular Coloboma.

    Science.gov (United States)

    Ahoor, M H; Amizadeh, Y; Sorkhabi, R

    2015-01-01

    Achondroplasia is an autosomal dominant congenital disorder of enchondral ossification. It is clinically characterized by low stature, craniofacial deformity, and vertebral malformation. Associated ophthalmic features include telecanthus, exotropia, angle anomalies, and cone-rod dystrophy. A 24-year-old male presented with decreased vision bilaterally and typical achondroplasia. The best corrected visual acuity was 20/70 in both eyes. Anterior segment examination was normal. Fundus examination revealed a well-demarcated circular paramacular lesion in both eyes. As macular coloboma and achondroplasia are developmental disorders, the funduscopic examination is required in patients with achondroplasia.

  20. MACULAR BUCKLING USING A THREE-ARMED SILICONE CAPSULE FOR FOVEOSCHISIS ASSOCIATED WITH HIGH MYOPIA.

    Science.gov (United States)

    Liu, Bingqian; Ma, Wei; Li, Yonghao; Luo, Yan; Jin, Chenjin; Liang, Xiaoling; Sadda, Srinivas R; Gao, Qianying; Lu, Lin

    2016-10-01

    To investigate the safety and efficacy of a novel macular buckling technique on foveoschisis in highly myopic eyes. Highly myopic eyes with foveoschisis, posterior staphyloma, and axial length greater than 26.5 mm, but without a full-thickness macular hole, were included. Macular buckling was performed in the included eyes using a three-armed adjustable silicon capsule. Eight eyes from eight patients (five women) were enrolled in this study. The mean follow-up period was 11.6 (range 9-14) months. After surgery, the best-corrected visual acuity was improved in 7/8 (87.5%) eyes, optical coherence tomography imaging showed gradual anatomic improvement of macula over time. The final best-corrected visual acuity gained 21.5 early treatment diabetes retinopathy study letters from baseline on average (P = 0.014). Postoperatively, the most common complications were transiently elevated intraocular pressure (62.5%) and asymptomatic abduction limitation (100%), and the most serious complication was hemorrhagic choroidal detachment (25%). Macular buckling with a three-armed adjustable silicone capsule resulted in anatomic and visual improvement in eyes with myopic foveoschisis.

  1. MACULAR CHOROIDAL VOLUME CHANGES AFTER INTRAVITREAL BEVACIZUMAB FOR EXUDATIVE AGE-RELATED MACULAR DEGENERATION.

    Science.gov (United States)

    Palkovits, Stefan; Seidel, Gerald; Pertl, Laura; Malle, Eva M; Hausberger, Silke; Makk, Johanna; Singer, Christoph; Osterholt, Julia; Herzog, Sereina A; Haas, Anton; Weger, Martin

    2017-12-01

    To evaluate the effect of intravitreal bevacizumab on the macular choroidal volume and the subfoveal choroidal thickness in treatment naïve eyes with exudative age-related macular degeneration. The macular choroidal volume and the subfoveal choroidal thickness were measured using enhanced depth imaging optical coherence tomography. After a screening examination, each patient received 3 monthly intravitreal injections of 1.25 mg bevacizumab. One month after the third injection was a final assessment. Forty-seven patients with a mean age of 80 ± 6.4 years were included. The macular choroidal volume decreased significantly from median 4.1 mm (interquartile range 3.4-5.9) to median 3.9 mm (interquartile range 3.1-5.6) between the baseline and final examination (difference -0.46 mm, 95% confidence interval: -0.57 to 0.35, P macular choroidal volume at baseline and subfoveal choroidal thickness at baseline were not associated with the response to treatment. The macular choroidal volume and the subfoveal choroidal thickness decreased significantly after 3 monthly bevacizumab injections for exudative age-related macular degeneration.

  2. What Is Macular Edema?

    Medline Plus

    Full Text Available ... Macular edema is often a complication of diabetic retinopathy , and is the most common form of vision loss for people with diabetes—particularly if it is left untreated. Next What ...

  3. Corticosteroid Treatment in Diabetic Macular Edema

    Directory of Open Access Journals (Sweden)

    Burcu Nurözler Tabakcı

    2017-06-01

    Full Text Available Diabetic macular edema is the most common cause of visual impairment in patients with diabetes mellitus. The pathogenesis of macular edema is complex and multifactorial. For many years, laser photocoagulation has been considered the standard therapy for the treatment of diabetic macular edema; however, few patients achieve significant improvements in visual acuity. Today the intravitreal administration of anti-inflammatory or anti-angiogenic agents together with the use of laser photocoagulation represents the standard of care for the treatment of this complication. The intravitreal route of administration minimizes the systemic side effects of corticosteroids. Steroid-related ocular side effects are elevated intraocular pressure and cataract, while injection-related complications include endophthalmitis, vitreous hemorrhage, and retinal detachment. In order to reduce the risks and complications, intravitreal implants have been developed recently to provide sustained release of corticosteroids and reduce repeated injections for the management of diabetic macular edema. In this review, the efficacy, safety, and therapeutic potential of intravitreal corticosteroids in diabetic macular edema are discussed with a review of recent literature.

  4. ILM peeling in nontractional diabetic macular edema: review and metanalysis.

    Science.gov (United States)

    Rinaldi, M; dell'Omo, R; Morescalchi, F; Semeraro, F; Gambicorti, E; Cacciatore, F; Chiosi, F; Costagliola, C

    2017-10-31

    To evaluate the effect of internal limiting membrane (ILM) peeling during vitrectomy for nontractional diabetic macular edema. PUBMED, MEDLINE and CENTRAL were reviewed using the following terms (or combination of terms): diabetic macular edema, nontractional diabetic macular edema, internal limiting membrane peeling, vitrectomy, Müller cells. Randomized and nonrandomized studies were included. The eligible studies compared anatomical and functional outcomes of vitrectomy with or without ILM peeling for tractional and nontractional diabetic macular edema. Postoperative best-corrected visual acuity and central macular thickness were considered, respectively, the primary and secondary outcomes. Meta-analysis on mean differences between vitrectomy with and without ILM peeling was performed using inverse variance method in random effects. Four studies with 672 patients were eligible for analysis. No significant difference was found between postoperative best-corrected visual acuity or best-corrected visual acuity change of ILM peeling group compared with nonpeeling group. There was no significant difference in postoperative central macular thickness and central macular thickness reduction between the two groups. The visual acuity outcomes in patients affected by nontractional diabetic macular edema using pars plana vitrectomy with ILM peeling versus no ILM peeling were not significantly different. A larger prospective and randomized study would be necessary.

  5. Boring of full scale deposition holes at the Aespoe Hard Rock Laboratory. Operational experiences including boring performance and a work time analysis

    International Nuclear Information System (INIS)

    Andersson, Christer; Johansson, Aasa

    2002-12-01

    Thirteen experimental deposition holes similar to those in the present KBS-3 design have been bored at the Aespoe Hard Rock Laboratory, Oskarshamn, Sweden. The objective with the boring program was to test and demonstrate the current technique for boring of large vertical holes in granitic rock. Conclusions and results from this project is used in the planning process for the deposition holes that will be bored in the real repository for spent nuclear fuel. The boreholes are also important for three major projects. The Prototype Repository, the Canister Retrieval Test and the Demonstration project will all need full-scale deposition holes for their commissioning. The holes are bored in full scale and have a radius of 1.75 m and a depth of 8.5 m. To bore the holes an existing TBM design was modified to produce a novel type Shaft Boring Machine (SBM) suitable for boring 1.75 m diameter holes from a relatively small tunnel. The cutter head was equipped with two types of roller cutters: two row carbide button cutters and disc cutters. Removal of the cuttings was made with a vacuum suction system. The boring was monitored and boring parameters recorded by a computerised system for the evaluation of the boring performance. During boring of four of the holes temperature, stress and strain measurements were performed. Acoustic emission measurements were also performed during boring of these four holes. The results of these activities will not be discussed in this report since they are reported separately. Criteria regarding nominal borehole diameter, deviation of start and end centre point, surface roughness and performance of the machine were set up according to the KBS-3 design and were fulfilled with a fair margin. The average total time for boring one deposition hole during this project was 105 hours

  6. What Is Macular Edema?

    Medline Plus

    Full Text Available ... may be mild to severe, but in many cases, your peripheral (side) vision remains. Macular edema is often a complication of diabetic retinopathy , and is the most common form of vision loss for people with diabetes—particularly if it is left ... Studies Show Zika Virus May Cause More Serious Eye ...

  7. Brane holes

    International Nuclear Information System (INIS)

    Frolov, Valeri P.; Mukohyama, Shinji

    2011-01-01

    The aim of this paper is to demonstrate that in models with large extra dimensions under special conditions one can extract information from the interior of 4D black holes. For this purpose we study an induced geometry on a test brane in the background of a higher-dimensional static black string or a black brane. We show that, at the intersection surface of the test brane and the bulk black string or brane, the induced metric has an event horizon, so that the test brane contains a black hole. We call it a brane hole. When the test brane moves with a constant velocity V with respect to the bulk black object, it also has a brane hole, but its gravitational radius r e is greater than the size of the bulk black string or brane r 0 by the factor (1-V 2 ) -1 . We show that bulk ''photon'' emitted in the region between r 0 and r e can meet the test brane again at a point outside r e . From the point of view of observers on the test brane, the events of emission and capture of the bulk photon are connected by a spacelike curve in the induced geometry. This shows an example in which extra dimensions can be used to extract information from the interior of a lower-dimensional black object. Instead of the bulk black string or brane, one can also consider a bulk geometry without a horizon. We show that nevertheless the induced geometry on the moving test brane can include a brane hole. In such a case the extra dimensions can be used to extract information from the complete region of the brane-hole interior. We discuss thermodynamic properties of brane holes and interesting questions which arise when such an extra-dimensional channel for the information mining exists.

  8. [Pathopshysiological mechanisms in macular edema].

    Science.gov (United States)

    Turlea, Cristian; Zolog, Ileana; Blăjan, Codruta; Roşca, C; Turlea, Magdalena; Munteanu, Mihnea; Boruga, Ovidiu

    2014-01-01

    The treatment of diabetic macular edema has known a fast development in the last 5 years where the transition from laser monotherapy to intravitreal pharmacotherapy is becoming standard practice. Intravitreal injections therapy is in a continuous development with promising positive results. The use of intratvitreal devices in the treatment of macular edema of vascular cause has become a viable alternative also in treating diabetic macular edema. Several clinical studies have revealed the superiority of intravitreal treatment versus laser monotherapy. This article is evaluating and reviewing present and future treatments used to combat diabetic macular edema. [corrected].

  9. Age-related macular degeneration

    DEFF Research Database (Denmark)

    la Cour, Morten; Kiilgaard, Jens Folke; Nissen, Mogens Holst

    2002-01-01

    Age-related macular degeneration (AMD) is a common macular disease affecting elderly people in the Western world. It is characterised by the appearance of drusen in the macula, accompanied by choroidal neovascularisation (CNV) or geographic atrophy. The disease is more common in Caucasian...

  10. Interacting black holes

    International Nuclear Information System (INIS)

    Costa, Miguel S.; Perry, Malcolm J.

    2000-01-01

    We revisit the geometry representing l collinear Schwarzschild black holes. It is seen that the black holes' horizons are deformed by their mutual gravitational attraction. The geometry has a string like conical singularity that connects the holes but has nevertheless a well defined action. Using standard gravitational thermodynamics techniques we determine the free energy for two black holes at fixed temperature and distance, their entropy and mutual force. When the black holes are far apart the results agree with Newtonian gravity expectations. This analyses is generalized to the case of charged black holes. Then we consider black holes embedded in string/M-theory as bound states of branes. Using the effective string description of these bound states and for large separation we reproduce exactly the semi-classical result for the entropy, including the correction associated with the interaction between the holes

  11. Relevance of Retinal Thickness Changes in the OCT Inner and Outer Rings to Predict Progression to Clinical Macular Edema: An Attempt of Composite Grading of Macular Edema

    NARCIS (Netherlands)

    Vujosevic, Stela; Varano, Monica; Egan, Catherine; Sivaprasad, Sobha; Menon, Geeta; Erginay, Ali; Verbraak, Frank D.; Lund-Andersen, Henrik; Martinez, Jose P.; Jürgens, Ignasi; Smets, Erica; Coriat, Caroline; Wiedemann, Peter; Ágoas, Victor; Querques, Giuseppe; Holz, Frank G.; Nunes, Sandrina; Alves, Dalila; Neves, Catarina; Santos, Torcato; Ribeiro, Luisa; Bandello, Francesco; Tejerina, Amparo Navea; Cunha-Vaz, José

    2016-01-01

    To characterize the relevance of macular thickness changes in the inner and outer rings in the progression of macular edema in eyes/patients with diabetes type 2. A total of 374 type 2 diabetic patients with mild nonproliferative diabetic retinopathy (ETDRS levels 20-35) were included in a 12-month

  12. MACULAR DETACHMENT ASSOCIATED WITH INTRACHOROIDAL CAVITATION IN NONPATHOLOGICAL MYOPIC EYES.

    Science.gov (United States)

    Ando, Yoshimasa; Inoue, Makoto; Ohno-Matsui, Kyoko; Kusumi, Yumi; Iida, Tomohiro; Hirakata, Akito

    2015-10-01

    To report the characteristics of a macular detachment associated with peripapillary intrachoroidal cavitation (ICC) and the outcomes of vitrectomy. The medical records of 69 eyes of 61 patients who underwent vitrectomy for macular detachment or macular retinoschisis but without vitreomacular traction or optic disc pit were reviewed. Optical coherence tomography was used to determine the morphology of the ICC. The outcomes of vitrectomy including the creation of a posterior vitreous detachment and internal limiting membrane peeling were evaluated. An ICC was detected in 3 of 3 eyes without pathologic myopia but none in 66 eyes with pathologic myopia (P detachment in all eyes. Optical coherence tomography detected a connection between the vitreous cavity and the ICC in two eyes with pit-like splitting and between the subretinal space and the ICC in two eyes. The macular detachment was resolved 5 months to 6 months postoperatively with improvement of vision. A macular detachment with ICC can be present in nonpathological myopic eyes. Vitreous surgery to create a posterior vitreous detachment with internal limiting membrane peeling may help resolve the macular detachment.

  13. Black holes

    International Nuclear Information System (INIS)

    Feast, M.W.

    1981-01-01

    This article deals with two questions, namely whether it is possible for black holes to exist, and if the answer is yes, whether we have found any yet. In deciding whether black holes can exist or not the central role in the shaping of our universe played by the forse of gravity is discussed, and in deciding whether we are likely to find black holes in the universe the author looks at the way stars evolve, as well as white dwarfs and neutron stars. He also discusses the problem how to detect a black hole, possible black holes, a southern black hole, massive black holes, as well as why black holes are studied

  14. The Association Between Subretinal Drusenoid Deposits in Older Adults in Normal Macular Health and Incident Age-Related Macular Degeneration.

    Science.gov (United States)

    Huisingh, Carrie; McGwin, Gerald; Neely, David; Zarubina, Anna; Clark, Mark; Zhang, Yuhua; Curcio, Christine A; Owsley, Cynthia

    2016-02-01

    Subretinal drusenoid deposits (SDD) have been associated with the progression to late age-related macular degeneration (AMD). To determine whether SDD in eyes in normal macular health increases risk for early AMD, this study examined the association between presence of SDD at baseline in a cohort of older adults in normal macular health and incident AMD 3 years later. Subjects enrolled in the Alabama Study on Early Age-Related Macular Degeneration (ALSTAR) were assessed for the presence of SDD using color fundus photos, infrared reflectance and fundus autofluorescence images, and spectral-domain optical coherence tomography volumes. The study sample included 799 eyes from 455 participants in normal macular health per grading of color fundus photographs using the 9-step Age-Related Eye Disease Study (AREDS) classification system. Age-related macular degeneration was defined as eyes having an AREDS grade ≥2 at the 3-year follow-up. Twenty-five percent of participants had SDD in one or both eyes at baseline. At follow-up visit, 11.9% of eyes in the sample developed AMD. Compared to eyes without SDD, those with SDD were 2.24 (95% confidence interval [CI] 1.36-3.70) times more likely to have AMD at follow-up. After adjusting for age, C-reactive protein quartile, and family history of AMD, the association persisted. Results suggest that SDD in older eyes with normal macular health as defined by the AREDS scale is a risk factor for the development of early AMD. Older adults in seemingly normal macular health yet having SDD may warrant closer clinical monitoring for the possible onset of early AMD.

  15. The Thermodynamics of Black Holes

    Directory of Open Access Journals (Sweden)

    Wald Robert M.

    2001-01-01

    Full Text Available We review the present status of black hole thermodynamics. Our review includes discussion of classical black hole thermodynamics, Hawking radiation from black holes, the generalized second law, and the issue of entropy bounds. A brief survey also is given of approaches to the calculation of black hole entropy. We conclude with a discussion of some unresolved open issues.

  16. Age-related macular degeneration

    DEFF Research Database (Denmark)

    la Cour, Morten; Kiilgaard, Jens Folke; Nissen, Mogens Holst

    2002-01-01

    Age-related macular degeneration (AMD) is a common macular disease affecting elderly people in the Western world. It is characterised by the appearance of drusen in the macula, accompanied by choroidal neovascularisation (CNV) or geographic atrophy. The disease is more common in Caucasian....... Smoking is probably also a risk factor. Preventive strategies using macular laser photocoagulation are under investigation, but their efficacy in preventing visual loss is as yet unproven. There is no treatment with proven efficacy for geographic atrophy. Optimal treatment for exudative AMD requires...

  17. Current Treatments of Diabetic Macular Edema

    Directory of Open Access Journals (Sweden)

    Wei-Chun Chan

    2011-12-01

    Full Text Available Diabetic macular edema (DME is a major cause of visual impairment in diabetic patients. Laser photocoagulation is the standard management strategy for macular edema, but its results remain unsatisfactory. Several clinical trials of new treatment modalities for DME have been conducted over the past 10 years. We performed a literature search of English articles, published between 2000 and 2010, by using the PubMed database. The keywords searched included “diabetic macular edema and treatment” with limits set to include only clinical trials and review articles, over 50 articles were reviewed. Among the newer treatment modalities reviewed, therapy with anti-vascular endothelial growth factor (VEGF antibodies showed significantly better efficacy, with level I evidence. However, multiple injections were required to maintain its efficacy. Therefore, the associated complications and cost implications are the major limitations of this treatment. Several combinations of different modalities have been evaluated in the literature, but none are more efficacious than monotherapy with anti-VEGF antibodies. Since DME is a multifactorial disease, further studies involving combinations of modalities or new treatments modalities may be needed to reduce the number of injections required or improve the visual outcomes in case of DME.

  18. Risk factors of age-related macular degeneration in Argentina

    Directory of Open Access Journals (Sweden)

    María Eugenia Nano

    2013-04-01

    Full Text Available PURPOSES: To assess the risk factors of age-related macular degeneration in Argentina using a case-control study. METHODS: Surveys were used for subjects' antioxidant intake, age/gender, race, body mass index, hypertension, diabetes (and type of treatment, smoking, sunlight exposure, red meat consumption, fish consumption, presence of age-related macular degeneration and family history of age-related macular degeneration. Main effects models for logistic regression and ordinal logistic regression were used to analyze the results. RESULTS: There were 175 cases and 175 controls with a mean age of 75.4 years and 75.5 years, respectively, of whom 236 (67.4% were female. Of the cases with age-related macular degeneration, 159 (45.4% had age-related macular degeneration in their left eyes, 154 (44.0% in their right eyes, and 138 (39.4% in both eyes. Of the cases with age-related macular degeneration in their left eyes, 47.8% had the dry type, 40.3% had the wet type, and the type was unknown for 11.9%. The comparable figures for right eyes were: 51.9%, 34.4%, and 13.7%, respectively. The main effects model was dominated by higher sunlight exposure (OR [odds ratio]: 3.3 and a family history of age-related macular degeneration (OR: 4.3. Other factors included hypertension (OR: 2.1, smoking (OR: 2.2, and being of the Mestizo race, which lowered the risk of age-related macular degeneration (OR: 0.40. Red meat/fish consumption, body mass index, and iris color did not have an effect. Higher age was associated with progression to more severe age-related macular degeneration. CONCLUSION: Sunlight exposure, family history of age-related macular degeneration, and an older age were the significant risk factors. There may be other variables, as the risk was not explained very well by the existing factors. A larger sample may produce different and better results.

  19. Characterization of a quadrant diamond transmission X-ray detector including a precise determination of the mean electron-hole pair creation energy.

    Science.gov (United States)

    Keister, Jeffrey W; Cibik, Levent; Schreiber, Swenja; Krumrey, Michael

    2018-03-01

    Precise monitoring of the incoming photon flux is crucial for many experiments using synchrotron radiation. For photon energies above a few keV, thin semiconductor photodiodes can be operated in transmission for this purpose. Diamond is a particularly attractive material as a result of its low absorption. The responsivity of a state-of-the art diamond quadrant transmission detector has been determined, with relative uncertainties below 1% by direct calibration against an electrical substitution radiometer. From these data and the measured transmittance, the thickness of the involved layers as well as the mean electron-hole pair creation energy were determined, the latter with an unprecedented relative uncertainty of 1%. The linearity and X-ray scattering properties of the device are also described.

  20. Naked black holes

    International Nuclear Information System (INIS)

    Horowitz, G.T.; Ross, S.F.

    1997-01-01

    It is shown that there are large static black holes for which all curvature invariants are small near the event horizon, yet any object which falls in experiences enormous tidal forces outside the horizon. These black holes are charged and near extremality, and exist in a wide class of theories including string theory. The implications for cosmic censorship and the black hole information puzzle are discussed. copyright 1997 The American Physical Society

  1. Parainflammation, chronic inflammation, and age-related macular degeneration.

    Science.gov (United States)

    Chen, Mei; Xu, Heping

    2015-11-01

    Inflammation is an adaptive response of the immune system to noxious insults to maintain homeostasis and restore functionality. The retina is considered an immune-privileged tissue as a result of its unique anatomic and physiologic properties. During aging, the retina suffers from a low-grade chronic oxidative insult, which sustains for decades and increases in level with advancing age. As a result, the retinal innate-immune system, particularly microglia and the complement system, undergoes low levels of activation (parainflammation). In many cases, this parainflammatory response can maintain homeostasis in the healthy aging eye. However, in patients with age-related macular degeneration, this parainflammatory response becomes dysregulated and contributes to macular damage. Factors contributing to the dysregulation of age-related retinal parainflammation include genetic predisposition, environmental risk factors, and old age. Dysregulated parainflammation (chronic inflammation) in age-related macular degeneration damages the blood retina barrier, resulting in the breach of retinal-immune privilege, leading to the development of retinal lesions. This review discusses the basic principles of retinal innate-immune responses to endogenous chronic insults in normal aging and in age-related macular degeneration and explores the difference between beneficial parainflammation and the detrimental chronic inflammation in the context of age-related macular degeneration. © Society for Leukocyte Biology.

  2. Vitamin D deficiency in neovascular versus nonneovascular age-related macular degeneration.

    Science.gov (United States)

    Itty, Sujit; Day, Shelley; Lyles, Kenneth W; Stinnett, Sandra S; Vajzovic, Lejla M; Mruthyunjaya, Prithvi

    2014-09-01

    To compare 25-hydroxyvitamin D (25OHD) levels in patients with neovascular age-related macular degeneration (NVAMD) with patients with nonneovascular age-related macular degeneration and control patients. Medical records of all patients diagnosed with age-related macular degeneration and tested for serum 25OHD level at a single medical center were reviewed. Control patients were selected from patients diagnosed with pseudophakia but without age-related macular degeneration. The lowest 25OHD level available for each patient was recorded. Two hundred sixteen patients with nonneovascular age-related macular degeneration, 146 with NVAMD, and 100 non-age-related macular degeneration control patients were included. The levels of 25OHD (mean ± SD) were significantly lower in NVAMD patients (26.1 ± 14.4 ng/mL) versus nonneovascular age-related macular degeneration (31.5 ± 18.2 ng/mL, P = 0.003) and control (29.4 ± 10.1 ng/mL, P = 0.049) patients. The prevalence of vitamin D insufficiency (age-related macular degeneration. Mean 25OHD levels were lower and vitamin D deficiency was more prevalent in NVAMD patients. These associations suggest that further research is necessary regarding vitamin D deficiency as a potentially modifiable risk factor for the development of NVAMD.

  3. Dexamethasone Intravitreal Implant for Diabetic Macular Edema During Pregnancy

    DEFF Research Database (Denmark)

    Concillado, Michael; Lund-Andersen, Henrik; Mathiesen, Elisabeth R

    2016-01-01

    PURPOSE: To describe the management of diabetic macular edema during pregnancy with the use of a dexamethasone slow-release intravitreal implant. DESIGN: Retrospective, observational, consecutive case series. METHODS: The study included 5 pregnant women who presented with diabetic macular edema...... during pregnancy in the period from 2011 to 2014. Review of charts and photographs comprised best-corrected visual acuity (BCVA), foveal center field thickness assessed by optical coherence tomography, blood pressure, glycated hemoglobin, medications, and changes in such parameters after implant...... injection. RESULTS: Diabetic macular edema involving the foveal center was observed between gestational weeks 9 and 23 in 10 eyes of 5 patients. Dexamethasone intravitreal implant injection was given 10 times in 9 eyes with a mean preinjection center field retinal thickness of 535 μm (range, 239-727 μm...

  4. Intravitreal triamcinolone for intraocular inflammation and associated macular edema

    Directory of Open Access Journals (Sweden)

    Steven M Couch

    2008-11-01

    Full Text Available Steven M Couch, Sophie J BakriMayo Clinic Department of Ophthalmology, Mayo Clinic, Rochester, MN, USAAbstract: Triamcinolone acetonide (TA is a corticosteroid that has many uses in the treatment of ocular diseases because of its potent anti-inflammatory and anti-permeability actions. Intraocular inflammation broadly referred to as uveitis can result from several causes, including the immune system and after ophthalmic surgery. One of the most common reasons for vision loss with uveitis is macular edema. TA has been used for many years as an intravitreal injection for the treatment of ocular diseases. Several case control studies have been reported showing the efficacy of TA in the treatment of intraocular inflammation and associated macular edema caused by Behcet’s disease, Vogt-Koyanagi-Harada syndrome, sympathetic ophthalmia and white dot syndromes. It has also been shown efficacious in cases of pars planitis and idiopathic posterior uveitis. Some authors have reported its use in postoperative cystoid macular edema. Many of the studies on the use of TA in controlling intraocular inflammation and concomitant macular edema showed its effect to be transient in many patients requiring reinjection. Complications can arise from intravitreal injection of TA including elevated intraocular pressure and cataract. Rarely, it can be associated with infectious and non-infectious endophthalmitis. TA may be useful as an adjuvant in the treatment of uveitis and its associated macular edema, especially in patients resistant or intolerant to standard treatment.Keywords: triamcinolone acetonide, Behcet’s disease, sympathetic ophthalmia, Vogt-Koyanagi-Harada syndrome, white dot syndromes, uveitis, cataract surgery, macular edema, endophthalmitis

  5. Macular thickness and volume in the elderly

    DEFF Research Database (Denmark)

    Subhi, Yousif; Forshaw, Thomas; Sørensen, Torben Lykke

    2016-01-01

    Ageing leads to a number of changes in the body including the macula. Detailed imaging using optical coherence tomography have enabled in vivo studies of how macula changes with age. Here we systematically review 49 studies (9115 participants and 11,577 eyes) to provide an overview of how ageing...... manifests in the macula of the elderly focusing on clinical relevant measures that are thicknesses and volumes of different macular areas. Ageing seems to increase center point foveal thickness. Ageing does not seem to change the center subfield thickness significantly. Ageing decreases the inner and outer...

  6. Idiopathic horseshoe-like macular tear: a case report

    Directory of Open Access Journals (Sweden)

    Kubota M

    2016-07-01

    Full Text Available Masaomi Kubota,1 Tomohiro Shibata,1 Hisato Gunji,1 Hiroshi Tsuneoka2 1Department of Ophthalmology, The Jikei University School of Medicine Kashiwa Hospital, Chiba, 2Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan Background: Although a few cases with idiopathic horseshoe-like macular tear have been reported, the mechanism remains unknown and a standard treatment has yet to be determined. Objective: To report the outcome for a patient with idiopathic horseshoe-like macular tear who underwent vitreous surgery. Case report: A 65-year-old man with no previous injury or ophthalmic disease presented with abnormal vision in his left eye. Best-corrected visual acuity was 0.8 in the right and 0.3 in the left, and the relative afferent pupillary defect was negative. Ophthalmoscopy revealed a horseshoe-like tear on the temporal side of the macula in the left eye. The tear size was 0.75 disc diameters (DD. Optical coherence tomography showed that the focal retinal detachment reached the fovea. A few days after the first visit, there was no longer adhesion of the flap of the tear to the retina and the tear size had increased to 1.5 DD. The patient underwent vitreous surgery similar to large macular hole surgery, with the tear closure repaired using the inverted internal limiting membrane flap technique with 20% SF6 gas tamponade. Although the tear decreased to 0.5 DD after the surgery, complete closure of the tear was not achieved. Conclusion: While cases with horseshoe-like macular tear following trauma and branch retinal vein occlusion have been reported, to the best of our knowledge, this is the first reported idiopathic case. In the present case, there was expansion of the tear until the patient actually underwent surgery. If vertical vitreous traction indeed plays a role in horseshoe-like macular tears, this will need to be taken into consideration at the time of the vitreous surgery in these types of cases. Keywords

  7. 23- vs 20-gauge pars plana vitrectomy in combination with bimanual microincisional cataract surgery (b-MICS) for the treatment of macular hole and cataract as a one-step procedure.

    Science.gov (United States)

    Schönfeld, C-L

    2013-08-01

    23-gauge pars plana vitrectomy (ppv) is a new method for vitreo-retinal surgery. It may reduce operation time, the risk of complications, and patient discomfort, especially in combination with simultaneous bimanual microincisional cataract surgery (b-MICS). Seventy-five consecutive patients who underwent combined cataract surgery and ppv at our center between 1 January 2008 and 31 December 2010 were included. The first 36 patients were treated with 20-gauge ppv, the following 39 patients with 23-gauge ppv. Study end points 8 weeks after surgery were duration of the procedure, improvement of visual acuity, and occurrence of complications. Duration of surgery was reduced in 23- vs 20-gauge ppv (54.0 ± 11.6 vs 61.0 ± 19.0 min, P=0.08). Visual acuity improved significantly in both the groups (20-gauge: logMAR 0.750 ± 0.304 before and 0.369 ± 0.273 after surgery; 23-gauge: logMAR 0.663 ± 0.340 before and 0.339 ± 0.273 after surgery). There were no appreciable group differences in baseline or post-treatment visual acuity. 23-gauge ppv in combination with b-MICS is a suitable, safe, and effective method for the treatment of combined cataract and vitreo-retinal diseases. The procedure is somewhat shorter and patient discomfort during and after surgery is improved. In terms of efficacy and safety, 23-gauge ppv is equivalent with conventional 20-gauge ppv.

  8. Non-invasive in vivo measurement of macular carotenoids

    Science.gov (United States)

    Lambert, James L. (Inventor); Borchert, Mark S. (Inventor)

    2009-01-01

    A non-invasive in vivo method for assessing macular carotenoids includes performing Optical Coherence Tomography (OCT) on a retina of a subject. A spatial representation of carotenoid levels in the macula based on data from the OCT of the retina can be generated.

  9. VITREOUS INCARCERATION IN SCLEROTOMIES AFTER VALVED 23-, 25-, OR 27-GAUGE AND NONVALVED 23- OR 25-GAUGE MACULAR SURGERY.

    Science.gov (United States)

    Tosi, Gian Marco; Malandrini, Alex; Cevenini, Gabriele; Neri, Giovanni; Marigliani, Davide; Cerruto, Arianna; Virgili, Gianni

    2017-10-01

    To study the patterns of vitreous incarceration at sclerotomy sites by ultrasound biomicroscopy in patients subjected to valved or nonvalved small-gauge pars plana vitrectomy. A prospective comparative study of 88 eyes affected by epiretinal membrane and macular hole. Patients were divided into four groups: valved or nonvalved 23-gauge (16 eyes each) and valved or nonvalved 25-gauge (20 eyes each); their vitreal disposition was compared by ultrasound biomicroscopy. Vitreal disposition was also assessed in 16 eyes of 16 patients subjected to valved 27-gauge pars plana vitrectomy. Three vitreal patterns were identified: P0 (vitreous not visible or vitreous strand distant from the sclerotomy site), P1 (vitreous strand parallel to and in contact with the sclerotomy site), and P2 (vitreous strand entrapped in the sclerotomy site). The effect of valved trocar use on vitreous incarceration seemed to be somewhat beneficial, but no statistically significant effect could be shown (odds ratio: 0.85, 95% confidence interval: 0.42-1.74, P = 0.657). Similarly, no differences in vitreous incarceration were shown among vitrectomy gauges (23, 25, or 27) both in a model including valved trocars only (P = 0.858) and in a model with all available data (P = 0.935). In 23- and 25-gauge macular surgeries, postoperative vitreous incarceration does not seem to be reduced using valved cannulas and was similar to that observed in 27-gauge surgery.

  10. Comparison of efficacy and safety between transconjunctival 23-gauge and conventional 20-gauge vitrectomy systems in macular surgery.

    Science.gov (United States)

    Goncu, Tugba; Gurelik, Gokhan; Hasanreisoglu, Berati

    2012-10-01

    To compare the efficacy and safety of 23-gauge transconjunctival vitrectomy with the conventional 20-gauge method in idiopathic epiretinal membrane and macular hole surgery. Sixty-one consecutive patients undergoing vitrectomy for idiopathic epiretinal membrane and macular hole were recruited to either 20- or 23-gauge vitrectomy groups and prospectively evaluated. Surgical success rates, operating time, surgery-related complications, long-term visual outcomes, and postoperative ocular surface problems are compared in the two groups. There were 31 eyes in the 20-gauge group and 33 eyes in the 23-gauge group. The macular hole closure rate after the first surgery was 83% and 90.9% in the 20-gauge and 23-gauge groups, respectively, with no significant difference between groups (p = 0.59). The success rate for idiopathic epiretinal membranes cases was 100% in both groups. There was no statistically significant difference between overall surgical times (p = 0.90). None of the patients in either group experienced postoperative complications of severe postoperative hypotony, vitreous hemorrhage or endophthalmitis, except one eye in the 20-gauge group, which was found to have retinal detachment. In both groups, statistically significant improvement in visual acuity was achieved 1-month postoperatively (p = 0.002) and thereafter at all postoperative visits (p gauge group at all postoperative visits compared with the 20-gauge group scores (p = 0.001). Transconjunctival 23-gauge vitrectomy appears to be as effective and safe as conventional 20-gauge vitrectomy in idiopathic epiretinal membrane and macular hole surgeries.

  11. Progressive macular hypomelanosis: an overview

    NARCIS (Netherlands)

    Relyveld, Germaine N.; Menke, Henk E.; Westerhof, Wiete

    2007-01-01

    Progressive macular hypomelanosis (PMH) is a common skin disorder that is often misdiagnosed. Various authors have written about similar skin disorders, referring to them by different names, but we believe that all these similar disorders are part of the same entity.PMH is characterized by

  12. Age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Wanjiku Mathenge

    2014-12-01

    Full Text Available Age-related macular degeneration (AMD is a disease of the retina that usually develops in people aged 60 years and older. It affects about 8.7% of the world’s population and is the leading cause of blindness among people aged 50 and older in industrialised countries.

  13. Age-Related Macular Degeneration.

    Science.gov (United States)

    Mehta, Sonia

    2015-09-01

    Age-related macular degeneration (AMD) is the leading cause of vision loss in the elderly. AMD is diagnosed based on characteristic retinal findings in individuals older than 50. Early detection and treatment are critical in increasing the likelihood of retaining good and functional vision. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Subthreshold Photocoagulation Using Endpoint Management in the PASCAL® System for Diffuse Diabetic Macular Edema

    Directory of Open Access Journals (Sweden)

    Masafumi Hamada

    2018-01-01

    Full Text Available We evaluated subthreshold photocoagulation using endpoint management (EPM for the treatment of diabetic macular edema (DME. The study enrolled 10 eyes from 10 patients (6 men and 4 women with DME. The entry criteria included central macular thickness (CMT ≥ 300 μm and decimal visual acuity (VA ≤ 0.5. The primary endpoints were VA (logMAR and CMT at 6 months follow-up. Secondary endpoints included fundus autofluorescence, macular volume (MV, and macular sensitivity (MS. We used the PASCAL Streamline Yellow® (wavelength, 577 nm system to perform grid pattern laser photocoagulation at 50% of the threshold (size, 100 μm; duration, 0.015 s; spacing, 0.5; and energy, 4.5–7.8 mJ. At 6 months posttreatment, CMT was significantly decreased, while there were no significant changes in macular sensitivity, mean BCVA (logMAR, or macular volume. Autofluorescence imaging revealed no changes after treatment in 6 of 10 eyes. No eyes exhibited subjective symptoms of scotoma after photocoagulation. Optical coherence tomography showed the complete resolution of macular edema in 4 eyes (40% after a single treatment; MS was increased in all 4 of these eyes at 6 months posttreatment. In conclusion, subthreshold photocoagulation using EPM is safe and effective for DME treatment and preserves MS. This trial is registered with UMIN000012401.

  15. Introducing the Black Hole

    Science.gov (United States)

    Ruffini, Remo; Wheeler, John A.

    1971-01-01

    discusses the cosmology theory of a black hole, a region where an object loses its identity, but mass, charge, and momentum are conserved. Include are three possible formation processes, theorized properties, and three way they might eventually be detected. (DS)

  16. Technology needs for tomorrow's treatment and diagnosis of macular diseases

    Science.gov (United States)

    Soubrane, Gisèle

    2008-02-01

    Retinal imaging is the basis of macular disease's diagnosis. Currently available technologies in clinical practice are fluorescein and indocyanin green (ICG) angiographies, in addition to optical coherence tomography (OCT), which is an in vivo "histology-like" cross-sectional images of the retina. Recent developments in the field of OCT imaging include Spectral-Domain OCT. However OCT remains a static view of the macula with no direct link with dynamic observation obtained by angiographies. Adaptative optics is an encouraging perspective for fundus analysis in the future, and could be linked to OCT or angiographies. Treatments of macular disease have exploded these past few years. Pharmacologic inhibition of angiogenesis represents a novel approach in the treatment of choroidal neovascularization in eyes with age-related macular degeneration. The major action explored is the direct inhibition of the protein VEGF with antibody-like products. New anti-VEGF drugs are in development aiming at the VEGF receptors or synthesis of VEGF. But various components of the neovascular cascade, including growth factor expression, extracellular matrix modulation, integrin inhibition represent potential targets for modulation with drugs. Intra-vitreal injections are nowadays the main route of administration for these new treatments but they are potentially responsible of side effects such as endophtalmitis. Development of other routes of treatment would require new formulation of used drugs. The improvement of retinal imaging leads to a better understanding of macular disease mechanisms and will help to develop new routes and targets of treatment.

  17. A Layered Approach to Raising Public Awareness of Macular Degeneration in Australia

    Science.gov (United States)

    Heraghty, Julie; Cummins, Robert

    2012-01-01

    Between 2007 and 2011, the Australian Macular Degeneration Foundation conducted a multifaceted campaign to increase public awareness of macular degeneration. Regular national polls conducted by an independent social research company have shown that awareness of macular degeneration increased from 47% to 80% in Australians aged 16 years or older and from 58% to 92% in those aged 50 years or older. The percentage of people aged 50 years or older who reported having had their macula checked in the 2 years prior to the survey increased from 33% to 70% from 2007 to 2011. Other measures, including analysis of Medicare data, have confirmed the success of the campaign. PMID:22813341

  18. Association of HTRA1 rs11200638 with age-related macular degeneration (AMD) in Brazilian patients.

    Science.gov (United States)

    Lana, Tamires Prates; da Silva Costa, Sueli Matilde; Ananina, Galina; Hirata, Fábio Endo; Rim, Priscila Hae Hyun; Medina, Flávio MacCord; de Vasconcellos, José Paulo Cabral; de Melo, Mônica Barbosa

    2018-01-01

    Age-related macular degeneration is a multifactorial disease that can lead to vision impairment in older individuals. Although the etiology of age-related macular degeneration remains unknown, risk factors include age, ethnicity, smoking, hypertension, obesity, and genetic factors. Two main loci have been identified through genome-wide association studies, on chromosomes 1 and 10. Among the variants located at the 10q26 region, rs11200638, located at the HTRA1 gene promoter, has been associated with age-related macular degeneration in several populations and is considered the main polymorphism. We conducted a replication case-control study to analyze the frequency and participation of rs11200638 in the etiology of age-related macular degeneration in a sample of patients and controls from the State of São Paulo, Brazil, through polymerase chain reaction and enzymatic digestion. The frequency of the A allele was 57.60% in patients with age-related macular degeneration and 36.45% in controls (p value macular degeneration group compared to the control group (p = 1.21 e-07 and 0.0357, respectively). No statistically significant results were observed after stratification in dry versus wet types or advanced versus non-advanced forms. To our knowledge, this is the first time the association between rs11200638 and overall age-related macular degeneration has been reported in South America.

  19. Localized changes in Retinal Vessel Caliber after focal/grid laser treatment in Patients with Diabetic Macular Edema

    DEFF Research Database (Denmark)

    Lundberg, Lars Kristian; Kawasaki, Ryo; Sjølie, Anne K

    2013-01-01

    PURPOSE:: To compare retinal vessel caliber changes at the macula region and surrounding the optic disk after focal/grid laser treatment for diabetic macular edema. METHODS:: The study included 69 eyes from 46 patients treated with focal/grid laser for diabetic macular edema. Retinal photographs...

  20. Age-related macular degeneration

    DEFF Research Database (Denmark)

    la Cour, Morten; Kiilgaard, Jens Folke; Nissen, Mogens Holst

    2002-01-01

    cause of blindness among Caucasian individuals in developed countries. Blindness resulting from AMD rarely occurs before age 70, and most cases occur after age 80. The age-standardised 1-year incidence of legal blindness resulting from AMD is 212 cases per million. Two-thirds of AMD cases have CNV......Age-related macular degeneration (AMD) is a common macular disease affecting elderly people in the Western world. It is characterised by the appearance of drusen in the macula, accompanied by choroidal neovascularisation (CNV) or geographic atrophy. The disease is more common in Caucasian...... individuals than in pigmented races. In predominantly Caucasian populations, the age-standardised prevalence of AMD in at least one eye is 7760 cases per million. The age-standardised cumulated 1-year incidence of AMD in at least one eye is 1051 cases per million individuals. AMD is the most important single...

  1. Ranibizumab and diabetic macular oedema: after laser therapy.

    Science.gov (United States)

    2012-03-01

    Diabetic retinopathy is sometimes accompanied by macular oedema, leading to a marked decline in visual acuity. The standard treatment, in addition to glycaemic and blood pressure control, is laser photocoagulation, despite its modest efficacy. Ranibizumab (Lucentis, Novartis), a VEGF (vascular endothelial growth factor) inhibitor, was initially authorised for age-related macular degeneration (AMD) in the European Union. It is now also approved for the treatment of visual loss due to macular oedema in diabetic patients. In this setting, clinical evaluation of ranibizumab is mainly based on two double-blind randomised trials comparing ranibizumab + laser photocoagulation versus placebo + laser photo-coagulation in a total of about 1000 patients. Compared with placebo, addition of ranibizumab to laser therapy led to a marked improvement in visual acuity in approximately 15% of patients after 12 months of treatment. The improvement appeared to persist after 24 months of treatment. In a trial that included a group treated with ranibizumab alone, efficacy did not differ from that of the ranibizumab + laser combination. Uncertainties remain concerning the long-term efficacy of ranibizumab and its benefits in patients with poorly controlled diabetes or proliferative retinopathy. The adverse effect profile of ranibizumab in patients with diabetic macular oedema is similar to that reported in patients with AMD, and mainly includes ocular adverse effects such as pain, bleeding and increased intraocular pressure. A risk of systemic adverse effects, particularly cardiovascular disorders, should be kept in mind in case of long-term treatment. Ranibizumab can cause birth defects, even after intravitreal injection during pregnancy. Monthly treatment with ranibizumab is inconvenient, difficult and expensive. In practice, laser therapy remains the standard treatment for diabetic patients with significantly reduced visual acuity due to macular oedema. Ranibizumab, which requires

  2. Accretion, primordial black holes and standard cosmology

    Indian Academy of Sciences (India)

    Primordial black holes evaporate due to Hawking radiation. We find that the evaporation times of primordial black holes increase when accretion of radiation is included. Thus, depending on accretion efficiency, more primordial black holes are existing today, which strengthens the conjecture that the primordial black holes ...

  3. Diabetic macular edema: it is more than just VEGF [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Michael A. Singer

    2016-05-01

    Full Text Available Diabetic macular edema is a serious visual complication of diabetic retinopathy. This article reviews the history of previous and current therapies, including laser therapy, anti-vascular endothelial growth factor agents, and corticosteroids, that have been used to treat this condition. In addition, it proposes new ways to use them in combination in order to decrease treatment burden and potentially address other causes besides vascular endothelial growth factor for diabetic macular edema.

  4. Macular thickness and macular volume measurements using spectral domain optical coherence tomography in normal Nepalese eyes

    Directory of Open Access Journals (Sweden)

    Pokharel A

    2016-03-01

    Full Text Available Amrit Pokharel,1 Gauri Shankar Shrestha,2 Jyoti Baba Shrestha2 1Department of Ophthalmology, Kathmandu Medical College Teaching Hospital, 2B P Koirala Lions Centre for Ophthalmic Studies, Institute of Medicine, Kathmandu, Nepal Purpose: To record the normative values for macular thickness and macular volume in normal Nepalese eyes. Methods: In all, 126 eyes of 63 emmetropic subjects (mean age: 21.17±6.76 years; range: 10–37 years were assessed for macular thickness and macular volume, using spectral domain-optical coherence tomography over 6×6 mm2 in the posterior pole. A fast macular thickness protocol was employed. Statistics such as the mean, median, standard deviation, percentiles, and range were used, while a P-value was set at 0.05 to test significance. Results: Average macular thickness and total macular volume were larger in males compared to females. With each year of increasing age, these variables decreased by 0.556 µm and 0.0156 mm3 for average macular thickness and total macular volume, respectively. The macular thickness was greatest in the inner superior section and lowest at the center of the fovea. The volume was greatest in the outer nasal section and thinnest in the fovea. The central subfield thickness (r=-0.243, P=0.055 and foveal volume (r=0.216, P=0.09 did not correlate with age. Conclusion: Males and females differ significantly with regard to macular thickness and macular volume measurements. Reports by other studies that the increase in axial length reduced thickness and volume, were negated by this study which found a positive correlation among axial length, thickness, and volume. Keywords: macular thickness, macular volume, optical coherence tomography, Nepal

  5. Precursors of Age-Related Macular Degeneration

    DEFF Research Database (Denmark)

    Munch, Inger Christine; Linneberg, Allan; Larsen, Michael

    2013-01-01

    PURPOSE: To investigate associations of small, hard macular drusen and larger macular drusen with obesity-related risk factors. METHODS: Cross-sectional study of 888 subjects aged 30-60 years characterized using anthropometric measurements and blood sample analyses. Physical activity was assessed...

  6. CASE REPORT Moebius syndrome with macular hyperpigmentation ...

    African Journals Online (AJOL)

    Bilateral macular hyperpigmentation was detected in our patient on fundus examination which was not reported previously in Moebius syndrome cases. In addition there is hypoplasia of the right pectoralis major muscle. KEYWORDS Moebius syndrome; Macular hyperpigmentation; Pectoralis major muscle; Cranial nerves; ...

  7. Correlations Between Macular, Skin, and Serum Carotenoids

    Science.gov (United States)

    Conrady, Christopher D.; Bell, James P.; Besch, Brian M.; Gorusupudi, Aruna; Farnsworth, Kelliann; Ermakov, Igor; Sharifzadeh, Mohsen; Ermakova, Maia; Gellermann, Werner; Bernstein, Paul S.

    2017-01-01

    Purpose Ocular and systemic measurement and imaging of the macular carotenoids lutein and zeaxanthin have been employed extensively as potential biomarkers of AMD risk. In this study, we systematically compare dual wavelength retinal autofluorescence imaging (AFI) of macular pigment with skin resonance Raman spectroscopy (RRS) and serum carotenoid levels in a clinic-based population. Methods Eighty-eight patients were recruited from retina and general ophthalmology practices from a tertiary referral center and excluded only if they did not have all three modalities tested, had a diagnosis of macular telangiectasia (MacTel) or Stargardt disease, or had poor AFI image quality. Skin, macular, and serum carotenoid levels were measured by RRS, AFI, and HPLC, respectively. Results Skin RRS measurements and serum zeaxanthin concentrations correlated most strongly with AFI macular pigment volume under the curve (MPVUC) measurements up to 9° eccentricity relative to MPVUC or rotationally averaged macular pigment optical density (MPOD) measurements at smaller eccentricities. These measurements were reproducible and not significantly affected by cataracts. We also found that these techniques could readily identify subjects taking oral carotenoid-containing supplements. Conclusions Larger macular pigment volume AFI and skin RRS measurements are noninvasive, objective, and reliable methods to assess ocular and systemic carotenoid levels. They are an attractive alternative to psychophysical and optical methods that measure MPOD at a limited number of eccentricities. Consequently, skin RRS and MPVUC at 9° are both reasonable biomarkers of macular carotenoid status that could be readily adapted to research and clinical settings. PMID:28728169

  8. Black hole astrophysics

    International Nuclear Information System (INIS)

    Blandford, R.D.; Thorne, K.S.

    1979-01-01

    Following an introductory section, the subject is discussed under the headings: on the character of research in black hole astrophysics; isolated holes produced by collapse of normal stars; black holes in binary systems; black holes in globular clusters; black holes in quasars and active galactic nuclei; primordial black holes; concluding remarks on the present state of research in black hole astrophysics. (U.K.)

  9. [Laser scotometry in macular diseases].

    Science.gov (United States)

    Makabe, R

    1986-02-01

    Retinal sensitivity is examined by projecting the aiming beam of an argon krypton laser photocoagulator onto the fundus through a contact lens. Even at normal intensity the brightness of the projected aiming on the retina is much greater than the maximum-intensity light target in ordinary scotometry. The discrepancy between scotomata when comparing the results of ordinary and laser scotometry suggests a potential for recovery of visual function, especially in macular diseases. This examination is practicable even if there is slight opacity of the media. By setting the laser beam at sufficiently low intensity, relative scotomata can be detected.

  10. Does unintentional macular translocation after retinal detachment repair influence visual outcome?

    Science.gov (United States)

    Pandya, Vivek B; Ho, I-Van; Hunyor, Alex P

    2012-01-01

    To document the occurrence of postoperative macular translocation after retinal detachment repair and discuss its influence on visual outcome. Retrospective case series in a tertiary care setting. Five eyes of five patients presenting to our clinic with macula-off rhegmatogenous retinal detachment. All patients underwent surgical repair of the retinal detachment, with regular postoperative follow-up, including macular optical coherence tomography and fundus autofluorescence. Visual acuity and subjective visual symptoms in patients with anatomically successful retinal detachment repair, in whom inadvertent macular translocation was noted. Our series demonstrates the presence of unintentional macular translocation after retinal detachment repair, detected by fundus autofluorescence imaging. In contrast to previous reports, we document inadvertent macular translocation in one patient after scleral buckling surgery. In each case, the retina was fully reattached postoperatively and no other complications were identified. There was variability in the symptoms and objective visual outcomes after surgery. Inadvertent macular translocation can occur following repair of macula-off retinal detachment, and may be a significant contributor to poorer visual outcome after retinal detachment, despite objective surgical success. © 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists.

  11. Correlation of Macular Focal Electroretinogram with Ellipsoid Zone Extension in Stargardt Disease

    Directory of Open Access Journals (Sweden)

    Edoardo Abed

    2017-01-01

    Full Text Available Stargardt disease (STGD1 is the most common cause of inherited juvenile macular degeneration. This disease is characterized by a progressive accumulation of lipofuscin in the outer retina and subsequent loss of photoreceptors and retinal pigment epithelium. The aim of this study was to evaluate the relationship between cone photoreceptor function and structure in STGD1. Macular function was assessed by visual acuity measurement and focal electroretinogram (FERG recording while spectral domain optical coherence tomography (SD-OCT imaging was performed to evaluate the integrity of photoreceptors. FERG amplitude was significantly reduced in patients with Stargardt disease (p<0.0001. The amplitude of FERG showed a negative relationship with interruption of ellipsoid zone (EZ (R2=0.54, p<0.0001 and a positive correlation with average macular thickness (AMT. Conversely, visual acuity was only weakly correlated with central macular thickness (CMT (R2=0.12, p=0.04. In conclusion, this study demonstrates that FERG amplitude is a reliable indicator of macular cone function while visual acuity reflects the activity of the foveal region. A precise assessment of macular cone function by FERG recording may be useful to monitor the progression of STGD1 and to select the optimal candidates to include in future clinical trials to treat this disease.

  12. White holes and eternal black holes

    International Nuclear Information System (INIS)

    Hsu, Stephen D H

    2012-01-01

    We investigate isolated white holes surrounded by vacuum, which correspond to the time reversal of eternal black holes that do not evaporate. We show that isolated white holes produce quasi-thermal Hawking radiation. The time reversal of this radiation, incident on a black hole precursor, constitutes a special preparation that will cause the black hole to become eternal. (paper)

  13. Black Holes in Higher Dimensions

    Directory of Open Access Journals (Sweden)

    Reall Harvey S.

    2008-09-01

    Full Text Available We review black-hole solutions of higher-dimensional vacuum gravity and higher-dimensional supergravity theories. The discussion of vacuum gravity is pedagogical, with detailed reviews of Myers–Perry solutions, black rings, and solution-generating techniques. We discuss black-hole solutions of maximal supergravity theories, including black holes in anti-de Sitter space. General results and open problems are discussed throughout.

  14. PHOTODYNAMIC THERAPY OF MACULAR DEGENERATION

    Directory of Open Access Journals (Sweden)

    Davorin Sevšek

    2004-05-01

    Full Text Available Background. University Eye Clinic in Ljubljana began to perform a photodynamic therapy (PDT in July 2002. Up to September 2003 there were 51 PDT interventions on 36 eyes. Almost half of the eyes had one or more reinterventions. PDT was used on 29 eyes with age related macular degeneration (AMD. Just before the treatment all of them had visual acuity (VA 6/60 or better and there were predominantly classical or classical choroidal neovascular (CNV membranes. Most VA did not changed significantly in follow-up visits but diameter of CNV membranes was obviously reduced. In macular degeneration due to pathologic myopia (MMD, photodynamic therapy was performed on 7 eyes with mainly occult CNV and VA was 12/60 or better. VA was mostly better in follow-up visits than before treatment with PDT.Conclusions. There were no serious complications during and after PDT interventions. Two patients had back pain during the infusion of Verteporfin but there was no need to stop the intervention.

  15. Age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Querques G

    2011-05-01

    Full Text Available Giuseppe Querques¹, Fernando Onofrio Avellis1,2, Lea Querques1,3, Francesco Bandello³, Eric H Souied¹ ¹Service d'Ophtalmologie, Centre Hospitalier Intercommunal Créteil, Université Paris-Est Créteil, Créteil, France; ²Parma Eye Clinic University Hospital, Università degli Studi di Parma, Parma, Italy; ³Department of Ophthalmology, Università Vita-Salute San Raffaele Milano, Milano, Italy Date of preparation: March 3, 2011 Conflict of interest: None declaredClinical question: Is there any new knowledge about the pathogenesis and treatment of age-related macular degeneration (AMD?Results: We now understand better the biochemical and pathological pathways involved in the genesis of AMD. Treatment of exudative AMD is based on intravitreal injection of new antivascular endothelial growth factor drugs for which there does not yet exist a unique recognized strategy of administration. No therapies are actually available for atrophic AMD, despite some experimental new pharmacological approaches.Implementation: strategy of administration, safety of intravitreal injectionKeywords: age-related macular degeneration, antivascular endothelial growth factor, choroidal neovascularization, drusen, geographic atrophy

  16. Achondroplasia and Macular Coloboma

    OpenAIRE

    Ahoor, M. H.; Amizadeh, Y.; Sorkhabi, R.

    2015-01-01

    Achondroplasia is an autosomal dominant congenital disorder of enchondral ossification. It is clinically characterized by low stature, craniofacial deformity, and vertebral malformation. Associated ophthalmic features include telecanthus, exotropia, angle anomalies, and cone-rod dystrophy. A 24-year-old male presented with decreased vision bilaterally and typical achondroplasia. The best corrected visual acuity was 20/70 in both eyes. Anterior segment examination was normal. Fundus examinatio...

  17. [Pharmacological therapy of age-related macular degeneration based on etiopathogenesis].

    Science.gov (United States)

    Fischer, Tamás

    2015-11-15

    It is of great therapeutic significance that disordered function of the vascular endothelium which supply the affected ocular structures plays a major role in the pathogenesis and development of age-related macular degeneration. Chronic inflammation is closely linked to diseases associated with endothelial dysfunction, and age-related macular degeneration is accompanied by a general inflammatory response. According to current concept, age-related macular degeneration is a local manifestation of systemic vascular disease. This recognition could have therapeutic implications because restoration of endothelial dysfunction can restabilize the condition of chronic vascular disease including age-related macular degeneration as well. Restoration of endothelial dysfunction by pharmaacological or non pharmacological interventions may prevent the development or improve endothelial dysfunction, which result in prevention or improvement of age related macular degeneration as well. Medicines including inhibitors of the renin-angiotensin system (converting enzyme inhibitors, angiotensin-receptor blockers and renin inhibitors), statins, acetylsalicylic acid, trimetazidin, third generation beta-blockers, peroxisome proliferator-activated receptor gamma agonists, folate, vitamin D, melatonin, advanced glycation end-product crosslink breaker alagebrium, endothelin-receptor antagonist bosentan, coenzyme Q10; "causal" antioxidant vitamins, N-acetyl-cysteine, resveratrol, L-arginine, serotonin receptor agonists, tumor necrosis factor-alpha blockers, specific inhibitor of the complement alternative pathway, curcumin and doxycyclin all have beneficial effects on endothelial dysfunction. Restoration of endothelial dysfunction can restabilize chronic vascular disease including age-related macular degeneration as well. Considering that the human vascular system is consubstantial, medicines listed above should be given to patients (1) who have no macular degeneration but have risk factors

  18. Coronal Holes

    Directory of Open Access Journals (Sweden)

    Steven R. Cranmer

    2009-09-01

    Full Text Available Coronal holes are the darkest and least active regions of the Sun, as observed both on the solar disk and above the solar limb. Coronal holes are associated with rapidly expanding open magnetic fields and the acceleration of the high-speed solar wind. This paper reviews measurements of the plasma properties in coronal holes and how these measurements are used to reveal details about the physical processes that heat the solar corona and accelerate the solar wind. It is still unknown to what extent the solar wind is fed by flux tubes that remain open (and are energized by footpoint-driven wave-like fluctuations, and to what extent much of the mass and energy is input intermittently from closed loops into the open-field regions. Evidence for both paradigms is summarized in this paper. Special emphasis is also given to spectroscopic and coronagraphic measurements that allow the highly dynamic non-equilibrium evolution of the plasma to be followed as the asymptotic conditions in interplanetary space are established in the extended corona. For example, the importance of kinetic plasma physics and turbulence in coronal holes has been affirmed by surprising measurements from the UVCS instrument on SOHO that heavy ions are heated to hundreds of times the temperatures of protons and electrons. These observations point to specific kinds of collisionless Alfvén wave damping (i.e., ion cyclotron resonance, but complete theoretical models do not yet exist. Despite our incomplete knowledge of the complex multi-scale plasma physics, however, much progress has been made toward the goal of understanding the mechanisms ultimately responsible for producing the observed properties of coronal holes.

  19. Consistency of ocular coherence tomography fast macular thickness mapping in diabetic diffuse macular edema

    Energy Technology Data Exchange (ETDEWEB)

    Saraiva, Fabio Petersen; Costa, Patricia Grativol; Inomata, Daniela Lumi; Melo, Carlos Sergio Nascimento; Helal Junior, John; Nakashima, Yoshitaka [Universidade de Sao Paulo (USP), SP (Brazil). Hospital das Clinicas. Dept. de Oftalmologia]. E-mail: fabiopetersen@yahoo.com.br

    2007-07-01

    Objectives: To investigate optical coherence tomography consistency on foveal thickness, foveal volume, and macular volume measurements in patients with and without diffuse diabetic macular edema. Introduction: Optical coherence tomography represents an objective technique that provides cross-sectional tomographs of retinal structure in vivo. However, it is expected that poor fixation ability, as seen in diabetic macular edema, could alter its results. Several authors have discussed the reproducibility of optical coherence tomography, but only a few have addressed the topic with respect to diabetic maculopathy. Methods: The study recruited diabetic patients without clinically evident retinopathy (control group) and with diffuse macular edema (case group). Only one eye of each patient was evaluated. Five consecutive fast macular scans were taken using Ocular Coherence Tomography 3; the 6 mm macular map was chosen. The consistency in measurements of foveal thickness, foveal volume, and total macular volume for both groups was evaluated using the Pearson's coefficient of variation. The T-test for independent samples was used in order to compare measurements of both groups. Results: Each group consisted of 20 patients. All measurements had a coefficient of variation less than 10%. The most consistent parameter for both groups was the total macular volume. Discussion: Consistency in measurement is a mainstay of any test. A test is unreliable if its measurements can not be correctly repeated. We found a good index of consistency, even considering patients with an unstable gaze. Conclusions: Optical coherence tomography is a consistent method for diabetic subjects with diffuse macular edema. (author)

  20. Changes of macular thickness in HIV positive patients using OCT

    Directory of Open Access Journals (Sweden)

    Shang Li

    2014-10-01

    Full Text Available AIM: To assess the changes of macular thickness of acquire immunodeficiency syndrome(AIDSpatients. METHODS: The study based on the data analysis of 38 human immunodeficiency virus(HIVpositive patients(64 eyes. According to CD4 count and whether cytomegalovirus retinitis(CMVRhappened, the patients were divided into 3 groups. Group A included 16 patients(32 eyes, in which CD4 count was 50cells/μL and CMVR did not happen. Group C included 12 patients(12 eyes, in which CD4 count was RESULTS: The mean foveal thicknesses in groups A, B, C and D were 254.03±15.63μm, 263.11±17.12μm, 304.50±50.62μm and 257.64±8.54μm in order. Compared with foveal thickness in each group, there were significant differences in general(F=12.933, P=0.000. The mean foveal thickness in groups CMVR increased, which was of significant difference(P=0.000, compared with other groups.CONCLUSION: CMVR can impair the structure and function of macular, which then seriously affects the visual function of patients. It's helpful to understand the progress and prognosis of CMVR disease by observing macular structure with OCT in early time.

  1. Black Holes, Worm Holes, and Future Space Propulsion

    Science.gov (United States)

    Barret, Chris

    2000-01-01

    NASA has begun examining the technologies needed for an Interstellar Mission. In 1998, a NASA Interstellar Mission Workshop was held at the California Institute of Technology to examine the technologies required. Since then, a spectrum of research efforts to support such a mission has been underway, including many advanced and futuristic space propulsion concepts which are being explored. The study of black holes and wormholes may provide some of the breakthrough physics needed to travel to the stars. The first black hole, CYGXI, was discovered in 1972 in the constellation Cygnus X-1. In 1993, a black hole was found in the center of our Milky Way Galaxy. In 1994, the black hole GRO J1655-40 was discovered by the NASA Marshall Space Flight center using the Gamma Ray Observatory. Today, we believe we have found evidence to support the existence of 19 black holes, but our universe may contain several thousands. This paper discusses the dead star states - - both stable and unstable, white dwarfs, neutron stars, pulsars, quasars, the basic features and types of black holes: nonspinning, nonspinning with charge, spinning, and Hawking's mini black holes. The search for black holes, gravitational waves, and Laser Interferometer Gravitational Wave Observatory (LIGO) are reviewed. Finally, concepts of black hole powered space vehicles and wormhole concepts for rapid interstellar travel are discussed in relation to the NASA Interstellar Mission.

  2. Interventions for the treatment of uveitic macular edema: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Karim R

    2013-06-01

    Full Text Available Rushmia Karim,1 Evripidis Sykakis,2 Susan Lightman,3 Samantha Fraser-Bell4 1Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia; 2Department of Ophthalmology, Whipps Cross University Hospital, 3UCL Institute of Ophthalmology and Moorfields Eye Hospital, London, UK; 4University of Sydney, Clinical Ophthalmology and Eye Health, Sydney Adventist Hospital Clinical School, Sydney, NSW, Australia Background: Uveitic macular edema is the major cause of reduced vision in eyes with uveitis. Objectives: To assess the effectiveness of interventions in the treatment of uveitic macular edema. Search strategy: Cochrane Central Register of Controlled Trials, Medline, and Embase. There were no language or data restrictions in the search for trials. The databases were last searched on December 1, 2011. Reference lists of included trials were searched. Archives of Ophthalmology, Ophthalmology, Retina, the British Journal of Ophthalmology, and the New England Journal of Medicine were searched for clinical trials and reviews. Selection criteria: Participants of any age and sex with any type of uveitic macular edema were included. Early, chronic, refractory, or secondary uveitic macular edema were included. We included trials that compared any interventions of any dose and duration, including comparison with another treatment, sham treatment, or no treatment. Data collection and analysis: Best-corrected visual acuity and central macular thickness were the primary outcome measures. Secondary outcome data including adverse effects were collected. Conclusion: More results from randomized controlled trials with long follow-up periods are needed for interventions for uveitic macular edema to assist in determining the overall long-term benefit of different treatments. The only intervention with sufficiently robust randomized controlled trials for a meta-analysis was acetazolamide, which was shown to be ineffective in improving vision in eyes with uveitic

  3. What Is Age-Related Macular Degeneration?

    Science.gov (United States)

    ... Qué es la degeneración macular relacionada con la edad? Written By: Kierstan Boyd Reviewed By: Robert H ... Privacy Policy Terms of Service For Advertisers For Media Ophthalmology Job Center © American Academy of Ophthalmology 2018 ...

  4. Quantum black holes

    CERN Document Server

    Calmet, Xavier; Winstanley, Elizabeth

    2014-01-01

    Written by foremost experts, this short book gives a clear description of the physics of quantum black holes. The reader will learn about quantum black holes in four and higher dimensions, primordial black holes, the production of black holes in high energy particle collisions, Hawking radiation, black holes in models of low scale quantum gravity and quantum gravitational aspects of black holes.

  5. Intravitreal bevacizumab (Avastin treatment of diffuse diabetic macular edema in an Indian population

    Directory of Open Access Journals (Sweden)

    Kumar Atul

    2007-01-01

    Full Text Available Background: To report the anatomic and visual acuity response after intravitreal bevacizumab (Avastin in patients with diffuse diabetic macular edema. Design: Prospective, interventional case series study. Materials and Methods: This study included 20 eyes of metabolically stable diabetes mellitus with diffuse diabetic macular edema with a mean age of 59 years who were treated with two intravitreal injections of bevacizumab 1.25 mg in 0.05 ml six weeks apart. Main outcome measures were 1 early treatment diabetic retinopathy study visual acuity, 2 central macular thickness by optical coherence tomography imaging. Each was evaluated at baseline and follow-up visits. Results: All the eyes had received some form of laser photocoagulation before (not less than six months ago, but all of these patients had persistent diffuse macular edema with no improvement in visual acuity. All the patients received two injections of bevacizumab at an interval of six weeks per eye. No adverse events were observed, including endophthalmitis, inflammation and increased intraocular pressure or thromboembolic events in any patient. The mean baseline acuity was 20/494 (log Mar=1.338±0.455 and the mean acuity at three months following the second intravitreal injection was 20/295 (log Mar=1.094±0.254, a difference that was highly significant ( P =0.008. The mean central macular thickness at baseline was 492 µm which decreased to 369 µm ( P =0.001 at the end of six months. Conclusions: Initial treatment results of patients with diffuse diabetic macular edema not responding to previous photocoagulation did not reveal any short-term safety concerns. Intravitreal bevacizumab resulted in a significant decrease in macular thickness and improvement in visual acuity at three months but the effect was somewhat blunted, though still statistically significant at the end of six months.

  6. Comparison of ketorolac 0.45% versus diclofenac 0.1% for macular thickness and volume after uncomplicated cataract surgery.

    Science.gov (United States)

    Lee, Tae Hee; Choi, Won; Ji, Yong Sok; Yoon, Kyung Chul

    2016-05-01

    To compare the effects of ketorolac 0.45% and diclofenac 0.1% on macular thickness and volume after uncomplicated cataract surgery. A total of 76 eyes of 76 patients who underwent uncomplicated cataract surgery were included. Patients were treated with either diclofenac 0.1% (38 eyes) or ketorolac 0.45% (38 eyes) after surgery. The macular thickness and volume were obtained with optical coherence tomography (OCT). Central subfield thickness (CST, OCT 1 mm zone), total foveal thickness (TFT, OCT 3 mm zone), total macular thickness (TMT, OCT 6 mm zone), average macular thickness (AMT) and total macular volume (TMV) were compared between the two study groups. No significant differences between groups were found in macular thickness or volume 1 month after cataract surgery. Two months after surgery, the ketorolac group had significantly lower CST, TFT, TMT and AMT than the diclofenac group (p diclofenac group. Following uncomplicated cataract surgery, topical ketorolac 0.45% was more effective than diclofenac 0.1% in preventing increases in macular thickness and volume. © 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  7. Effects of Vitrectomy on Recurrent Macular Edema due to Branch Retinal Vein Occlusion after Intravitreal Injection of Bevacizumab

    Directory of Open Access Journals (Sweden)

    Tatsuya Yunoki

    2013-01-01

    Full Text Available Purpose. To evaluate the effects of pars plana vitrectomy (PPV on recurrent macular edema due to branch retinal vein occlusion (BRVO after intravitreal injections of bevacizumab (IVB. Methods. This retrospective study included 22 eyes of 22 patients who underwent single or multiple IVB injections for macular edema due to BRVO and showed a recurrence of macular edema. All patients then underwent PPV and were followed up for more than 6 months after the surgery with examinations of best corrected visual acuity (BCVA and optical coherence tomography (OCT. OCT parameters were central macular thickness (CMT and average retinal thickness in a 1-mm-diameter circular region at the fovea (MRT. Results. Mean BCVA, CRT, and MRT were significantly improved from the baseline after PPV. Greater improvement of BCVA, CRT, and MRT was obtained after 1 month of IVB than after 6 months of PPV. No eyes showed worsening of macular edema after the surgery. Conclusion. PPV improved BCVA and recurrent macular edema due to BRVO, but PPV that was less effective than IVB had been in the same patients. PPV may be one of the treatment options for recurrent macular edema due to BRVO after IVB.

  8. Black holes a very short introduction

    CERN Document Server

    Blundell, Katherine

    2015-01-01

    Black holes are a constant source of fascination to many due to their mysterious nature. Black Holes: A Very Short Introduction addresses a variety of questions, including what a black hole actually is, how they are characterized and discovered, and what would happen if you came too close to one. It explains how black holes form and grow—by stealing material that belongs to stars—as well as how many there may be in the Universe. It also explores the large black holes found in the centres of galaxies, and how black holes power quasars and lie behind other spectacular phenomena in the cosmos.

  9. Dexamethasone intravitreal implant in the treatment of diabetic macular edema

    Directory of Open Access Journals (Sweden)

    Dugel PU

    2015-07-01

    Full Text Available Pravin U Dugel,1,2 Francesco Bandello,3 Anat Loewenstein4 1Retinal Consultants of Arizona, Phoenix, AZ, 2Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; 3Department of Ophthalmology, University Vita-Salute Scientific Institute San Raffaele, Milan, Italy; 4Department of Ophthalmology, Tel Aviv Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Abstract: Diabetic macular edema (DME resembles a chronic, low-grade inflammatory reaction, and is characterized by blood–retinal barrier (BRB breakdown and retinal capillary leakage. Corticosteroids are of therapeutic benefit because of their anti-inflammatory, antiangiogenic, and BRB-stabilizing properties. Delivery modes include periocular and intravitreal (via pars plana injection. To offset the short intravitreal half-life of corticosteroid solutions (~3 hours and the need for frequent intravitreal injections, sustained-release intravitreal corticosteroid implants have been developed. Dexamethasone intravitreal implant provides retinal drug delivery for ≤6 months and recently has been approved for use in the treatment of DME. Pooled findings (n=1,048 from two large-scale, randomized Phase III trials indicated that dexamethasone intravitreal implant (0.35 mg and 0.7 mg administered at ≥6-month intervals produced sustained improvements in best-corrected visual acuity (BCVA and macular edema. Significantly more patients showed a ≥15-letter gain in BCVA at 3 years with dexamethasone intravitreal implant 0.35 mg and 0.7 mg than with sham injection (18.4% and 22.2% vs 12.0%. Anatomical assessments showed rapid and sustained reductions in macular edema and slowing of retinopathy progression. Phase II study findings suggest that dexamethasone intravitreal implant is effective in focal, cystoid, and diffuse DME, in vitrectomized eyes, and in combination with laser therapy. Ocular complications of

  10. The Frequency of Serous Macular Detachment in Diabetic Macular Edema

    Directory of Open Access Journals (Sweden)

    Onur Yaya

    2015-05-01

    Full Text Available Objectives: To investigate the epidemiology and frequency of serous macular detachment (SMD in patients diagnosed with diabetic macular edema (DME. Materials and Methods: Hundred and forty-three eyes of 104 patients with DME were examined retrospectively. According to the results of OCT, the patients were separated into two groups; patients diagnosed with SMD and DME (group 1 and patients diagnosed with DME (group 2. They were assessed based on demographic characteristics, average age, duration of diabetes mellitus (DM, hypertension (HT history, best-corrected visual acuity, and diabetic retinopathy stages. Results: The average age of the patients was 61±8.7 years. Forty-three patients (41.3% were female and 61 patients (58.7% were male. Fifty-four of 104 patients (51.9% had DME with SMD. 21 (38.8% patients had bilateral SMD. In group 1, 31 patients were male (57.4% and 23 patients were female (42.6%. In group 2, 30 (60% patients were male and 20 (40% patients were female. In group 1, average age was 60.2±9.6 and the average duration of DM was 12.2±7.0 years, whereas the average age was 61.9±7.6 and the average duration of DM was 14.06±6.8 years in group 2. Forty-two patients in group 1 (77.8% and 30 patients (60% in group 2 had history of HT. Before the treatment, the average best-corrected visual acuity was found to be 0.30±0.24 in group 1 and 0.32±0.25 in group 2. Conclusion: Today, it is thought that diabetic maculopathy is the leading cause of SMD and it is a determining factor of treatment applications. In our study, we aimed at investigating the frequency of SMD in DME and the risk factors for the development of SMD. Although there were some differences between the factors, only the history of HT was found statistically higher in patients with SMD (p=0.04. (Turk J Ophthalmol 2015; 45: 92-96

  11. OUTER RETINAL TUBULATION: Characteristics in Patients With Neovascular Age-Related Macular Degeneration.

    Science.gov (United States)

    Iaculli, Cristiana; Barone, Antonio; Scudieri, Marilisa; Giovanna Palumbo, Maria; Delle Noci, Nicola

    2015-10-01

    To assess the incidence, characteristics, best-corrected visual acuity (BCVA), central macular thickness (CMT), and retinal sensitivity correlations in patients with and without outer retinal tubulation (ORT) affected by subfoveal choroidal neovascularization due to neovascular age-related macular degeneration. Prospective case series including 78 eyes of 78 consecutive patients with subfoveal choroidal neovascularization due to neovascular age-related macular degeneration. Baseline and follow-up visits included BCVA, intraocular pressure, ophthalmoscopic examination, CMT as measured by spectral domain optical coherence tomography, and retinal sensitivity tested with fundus-related perimetry (MP-1). Fluorescent angiography was performed at baseline. At the end of the follow-up period, the mean BCVA and CMT of patients with ORT were statistically different from those without ORT (BCVA: 0.61 ± 0.13 vs. 0.37 ± 1.59, P macular degeneration suggest that these parameters are statistically different in patients with ORT; this may be due to the pathogenesis of ORT formation, secondary to retinal pigment epithelial tears or photoreceptor damage. MP-1 microperimeter is a noninvasive instrument that provides useful information to better characterize the functional aspect of ORT in patients with age-related macular degeneration.

  12. Accretion, primordial black holes and standard cosmology

    Indian Academy of Sciences (India)

    Abstract. Primordial black holes evaporate due to Hawking radiation. We find that the evaporation times of primordial black holes increase when accretion of radiation is included. Thus, depending on accretion efficiency, more primordial black holes are existing today, which strengthens the con- jecture that the primordial ...

  13. Black holes

    International Nuclear Information System (INIS)

    Carter, B.

    1980-01-01

    In years 1920 as a result of quantum mechanics principles governing the structure of ordinary matter, a sudden importance for a problem raised a long time ago by Laplace: what happens when a massive body becomes so dense that even light cannot escape from its gravitational field. It is difficult to conceive how could be avoided in the actual universe the accumulation of important masses of cold matter having been submitted to gravitational breaking down followed by the formation of what is called to day a black hole [fr

  14. Black holes and traversible wormholes: a synthesis

    OpenAIRE

    Hayward, Sean A.

    2002-01-01

    A unified framework for black holes and traversible wormholes is described, where both are locally defined by outer trapping horizons, two-way traversible for wormholes and one-way traversible for black or white holes. In a two-dimensional dilaton gravity model, examples are given of: construction of wormholes from black holes; operation of wormholes for transport, including back-reaction; maintenance of an operating wormhole; and collapse of wormholes to black holes. In spherically symmetric...

  15. Age related macular degeneration and visual disability.

    Science.gov (United States)

    Christoforidis, John B; Tecce, Nicola; Dell'Omo, Roberto; Mastropasqua, Rodolfo; Verolino, Marco; Costagliola, Ciro

    2011-02-01

    Age-related macular degeneration (AMD) is the leading cause of central blindness or low vision among the elderly in industrialized countries. AMD is caused by a combination of genetic and environmental factors. Among modifiable environmental risk factors, cigarette smoking has been associated with both the dry and wet forms of AMD and may increase the likelihood of worsening pre-existing AMD. Despite advances, the treatment of AMD has limitations and affected patients are often referred for low vision rehabilitation to help them cope with their remaining eyesight. The characteristic visual impairment for both forms of AMD is loss of central vision (central scotoma). This loss results in severe difficulties with reading that may be only partly compensated by magnifying glasses or screen-projection devices. The loss of central vision associated with the disease has a profound impact on patient quality of life. With progressive central visual loss, patients lose their ability to perform the more complex activities of daily living. Common vision aids include low vision filters, magnifiers, telescopes and electronic aids. Low vision rehabilitation (LVR) is a new subspecialty emerging from the traditional fields of ophthalmology, optometry, occupational therapy, and sociology, with an ever-increasing impact on the usual concepts of research, education, and services for visually impaired patients. Relatively few ophthalmologists practise LVR and fewer still routinely use prismatic image relocation (IR) in AMD patients. IR is a method of stabilizing oculomotor functions with the purpose of promoting better function of preferred retinal loci (PRLs). The aim of vision rehabilitation therapy consists in the achievement of techniques designed to improve PRL usage. The use of PRLs to compensate for diseased foveae has offered hope to these patients in regaining some function. However, in a recently published meta-analysis, prism spectacles were found to be unlikely to be of

  16. Macular and peripapillary retinal nerve fiber layer thickness in children with hyperopic anisometropic amblyopia

    Directory of Open Access Journals (Sweden)

    Shuang-Qing Wu

    2013-02-01

    Full Text Available AIM:To compare the retinal nerve fiber layer (RNFL thickness and macular thickness in the amblyopic eye with that in the sound eye of children with hyperopic anisometropic amblyopia using optical coherence tomography (OCT.METHODS: A prospective, nonrandom, intraindividual comparative cohort study includes 72 children with hyperopic anisometropic amblyopia in a single center. Macular thickness, macular foveola thickness, and peripapillary RNFL thickness were compared between the amblyopia eyes and the contralateral sound eyes.RESULTS:There were 38 male and 34 female patients, with a mean age as 9.7±1.9 years (range, 5–16 years. Hyperopic was +3.62±1.16D (range +2.00D to +6.50D in the amblyopic eyes, which was significantly higher in the control eyes with +0.76±0.90D (range 0D to +2.00D (P P = 0.02. The mean macular foveola thickness was significantly thicker in the amblyopic eyes than the contralateral sound eyes (181.4±14.2µm vs 175.2±13.3µm, P CONCLUSION:Eyes with hyperopic anisometropic amblyopia are found thicker macular foveola and peripapillary RNFL than the contralateral eyes in children.

  17. Entropy of black holes with multiple horizons

    Science.gov (United States)

    He, Yun; Ma, Meng-Sen; Zhao, Ren

    2018-05-01

    We examine the entropy of black holes in de Sitter space and black holes surrounded by quintessence. These black holes have multiple horizons, including at least the black hole event horizon and a horizon outside it (cosmological horizon for de Sitter black holes and "quintessence horizon" for the black holes surrounded by quintessence). Based on the consideration that the two horizons are not independent each other, we conjecture that the total entropy of these black holes should not be simply the sum of entropies of the two horizons, but should have an extra term coming from the correlations between the two horizons. Different from our previous works, in this paper we consider the cosmological constant as the variable and employ an effective method to derive the explicit form of the entropy. We also try to discuss the thermodynamic stabilities of these black holes according to the entropy and the effective temperature.

  18. Macular cystic changes as predictive factor for the recurrence of macular oedema in branch retinal vein occlusion.

    Science.gov (United States)

    Tilgner, Eric; Dalcegio Favretto, Maiara; Tuisl, Maria; Wiedemann, Peter; Rehak, Matus

    2017-11-01

    To evaluate the role of small cystic macular changes as a prognostic factor for the recurrence of macular oedema (ME) in patients with branch retinal vein occlusion (BRVO) treated with anti-VEGF drugs. We performed retrospective chart analysis of 116 patients treated with intravitreal injection of ranibizumab (IVR) or bevacizumab (IVB) for ME secondary to BRVO. At the baseline and monthly follow-up visits over a period of 12 months, a comprehensive ophthalmologic examination including best-corrected visual acuity (BCVA) and volume scan of macula using Spectral domain optical coherence tomography (SD-OCT) were performed. Patients without ME (CRT <250 μm) were screened for the presence of intraretinal cysts. In these patients, the changes in BCVA and CRT were evaluated over a period of 12 months and compared with the baseline. In the IVR group (41 patients), 91 events of macular cysts, without a worsening of BCVA, were detected by OCT. In 89 of 91 events (97%), BCVA and CRT deteriorated significantly (p < 0.0001) within the next 4-11 (in mean 7.1 ± 2.0) weeks. BCVA decreased from 0.38 ± 0.25 to 0.49 ± 0.27 logMAR and CRT increased significantly from 223 ± 43 to 605 ± 244 μm. In the IVB group (19 patients), 54 events of cystic changes were detected. All of these patients showed significant worsening of BCVA from 0.40 ± 0.19 to 0.57 ± 0.22 logMAR and CRT from 251 ± 17 to 490 ± 147 μm within 4-10 (in mean 7.8 ± 2.8) weeks after the first presence of small macular cysts. In BRVO patients treated with anti-VEGF drugs, the macular cystic changes may be used as an early indicator for impending recurrence of ME, with the decrease in BCVA in the following weeks. These patients should be scheduled for a next visit within 6-8 weeks. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  19. Clinical application of OCTA in observation of macular blood flow density in patients with diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Xiang Xiang

    2017-07-01

    Full Text Available AIM: Using optical coherence tomography angiography(OCTAto observe the changes and clinical significance of macular blood flow density in patients with diabetic retinopathy(DR.METHODS: Totally 47 eyes(28 patientswith diabetic retinopathy(DRwere enrolled in the DR group. According to the international clinical grading criteria of diabetic retinopathy, 30 eyes(19 patientswith non-proliferative diabetic retinopathy were classified as the NPDR group, and 17 eyes(11 patientswith proliferative diabetic retinopathy were classified as PDR group. A total of 46(27 subjectshealthy eyes with matched age were enrolled in the control group. All the subjects underwent the 3mm×3mm scanning of macular retina by optical coherence tomography angiography(OCTA, obtaining 4 levels of macular blood flow density map. The macular blood flow density at 3 levels, including superficial retinal layer, deep retinal layer and choroidal capillaries layer, were measured. RESULTS: The macular blood flow density of superfical retinal layer, deep retinal layer and choroidal capillaries layer in DR group were 0.4963±0.0840, 0.4798±0.0801 and 0.5290±0.0528, respectively. Among them, the blood flow density of each layer were 0.5064±0.0843,0.4983±0.0766,0.5345±0.0529, respectively, for the NPDR group, and were 0.4786±0.0830, 0.4473±0.0778,0.5192±0.0526, respectively, for the PDR group. For the control group, the density of each layers were 0.5919±0.0704, 0.6301±0.0527, 0.5691±0.0169, respectively. The macular blood flow density was significantly different in the superficial retinal layer, deep retinal layer and choroidal capillary layer between the control group and the NPDR group, as well as the PDR group and the DR group(total PP=0.029, but not in the superficial retina layer and choroid capillary layer(P=0.236, 0.268. CONCLUSION: Compared with the control group, the macular blood flow density of superficial retinal layer, deep retinal layer and choroidal capillary

  20. Intravitreal triamcinolone for diffuse diabetic macular oedema.

    LENUS (Irish Health Repository)

    Gibran, S K

    2012-02-03

    AIM: To evaluate the efficacy of intravitreal triamcinolone (IVTA) for the treatment of diffuse diabetic macular oedema (DME) refractory to conventional argon macular laser therapy. METHODS: A prospective, consecutive, and noncomparative case series was undertaken involving 38 eyes of 38 patients with refractory DME. Triamcinolone acetonide (4 mg) in 0.1 ml was injected intravitreally. LogMar visual acuity (VA) and macular thickness measured by ocular coherence tomography (OCT) were assessed preoperatively and postoperatively at 1, 3, and 6 months. RESULTS: All patients completed 6 months of follow up. VA (mean+\\/-SD) improved from 0.905+\\/-0.23 to 0.605+\\/-0.28, 0.555+\\/-0.29, and 0.730+\\/-0.30 at 1, 3, and 6 months, respectively. Macular thickness baseline (mean+\\/-SD) on OCT was 418.7+\\/-104.2 microm and this decreased to 276.9+\\/-72.6 microm, 250.6+\\/-53.1 microm, and 308.8+\\/-87.3 microm at 1, 3, and 6 months, respectively. CONCLUSIONS: IVTA may be a potential temporary treatment for refractory DME. It is effective in decreasing macular thickness and improving VA but the effect lasts approximately for 6 months in the majority of patients. Further investigations are required to establish the safety of IVTA for the treatment of DME.

  1. Spontaneously resolving macular cyst in an infant

    Directory of Open Access Journals (Sweden)

    Anuradha Ganesh

    2013-01-01

    Full Text Available The purpose of this study is to describe transient macular cysts in an infant and correlate their occurrence with normal development events. A newborn Caucasian girl presented with a protruding corneal mass in her left eye at birth. She underwent a complete ophthalmic examination. A keratinized staphylomatous malformation involving the entire cornea and precluding further visualization of the anterior and posterior segment was observed in the left eye. Spectral domain optical coherence tomography (SD-OCT of the right eye performed when the child was approximately 6-week-old had revealed an unexpected finding of macular cysts involving the inner nuclear and outer retinal layers. Corneal transplant in the left eye was performed a month later. Ocular examination under anesthesia just prior to surgery revealed normal intraocular pressure, anterior segment and retina in the right eye. SD-OCT was normal in both eyes and showed complete resolution of the cysts in the right eye. The patient had not been on any medications at that time. Although clinical retinal examination might be unremarkable, SD-OCT may reveal cystic spaces in the macula. In the absence of conditions known to be associated with macular edema, transient macular cysts may arise due to a developmental incompetence of the blood-retinal barrier or may represent transient spaces created during normal migration of retinal cells. Further study is warranted to delineate the entity of transient macular cysts in infancy.

  2. Caged black holes: Black holes in compactified spacetimes. I. Theory

    International Nuclear Information System (INIS)

    Kol, Barak; Sorkin, Evgeny; Piran, Tsvi

    2004-01-01

    In backgrounds with compact dimensions there may exist several phases of black objects including a black hole and a black string. The phase transition between them raises questions and touches on fundamental issues such as topology change, uniqueness, and cosmic censorship. No analytic solution is known for the black hole, and moreover one can expect approximate solutions only for very small black holes, while phase transition physics happens when the black hole is large. Hence we turn to numerical solutions. Here some theoretical background to the numerical analysis is given, while the results will appear in a subsequent paper. The goals for a numerical analysis are set. The scalar charge and tension along the compact dimension are defined and used as improved order parameters which put both the black hole and the black string at finite values on the phase diagram. The predictions for small black holes are presented. The differential and the integrated forms of the first law are derived, and the latter (Smarr's formula) can be used to estimate the 'overall numerical error'. Field asymptotics and expressions for physical quantities in terms of the numerical values are supplied. The techniques include the 'method of equivalent charges', free energy, dimensional reduction, and analytic perturbation for small black holes

  3. Quantitative analysis of macular retinal thickness and macular volume in diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Ying Zhao

    2017-12-01

    Full Text Available AIM: To evaluate and characterize the macular thickness and macular volume in patients of different stages of diabetic retinopathy with special-domain optical coherence tomography(SD-OCT. METHODS: Totally 40 patients(78 eyeswith diabetic retinopathy were recruited in the study from January 2016 to January 2017 in our hospital. According to the international clinical classification of diabetic retinopathy, 20 cases(40 eyeswere categorized as non-proliferative diabetic retinopathy(NPDRgroup and 20 cases proliferative diabetic retinopathy(PDRgroup(38 eyes. All subjects were examined and analyzed with Early Treatment Diabetic Retinopathy Study(ETDRSsubfields, which were embedded in HS(Haag-Streitwith diameter of 1, 3 and 6mm.The changes of retinal thickness and volume of the macular center were measured. RESULTS: The thickness of macular foveolar in NPDR group and PDR group were 252.57±31.36μm, 362.47±20.81μm. The retinal thickness of inner superior subfield(ISMand inner nasal subfield(INMwere the thickest; that of inner inferior subfield(IIMwas next to ISM and INM, and that of inner temporal subfield was the thinnest. Of the outer subfields, the retinal thickness of outer superior subfield(OSMwas the thickest; that of outer nasal subfield(ONMwas next to OSM, and that of outer temporal subfield(OTMand outer inferior subfield(OIMwas the thinnest. The value of macular central concave thickness and retinal thickness in each quadrant of the NPDR group were less than those of the PDR group, the difference was statistically significant(P3, 0.28±0.16mm3, the upper and nasal sides of the middle part of the partition were the largest, the inferior and the temporal side were the smallest. The nasal side of the outer loop was the largest, the upper was the second, the temporal side and the inferior were the smallest. The volume of macular central fovea and the retinal volume in each quadrant of the NPDR group were smaller than those of the PDR group, the

  4. Black hole critical phenomena without black holes

    Indian Academy of Sciences (India)

    Black holes; numerical relativity; nonlinear sigma. Abstract. Studying the threshold of black hole formation via numerical evolution has led to the discovery of fascinating nonlinear phenomena. ... Theoretical and Computational Studies Group, Southampton College, Long Island University, Southampton, NY 11968, USA ...

  5. Repeat Intravitreal Dexamethasone Implant for Refractory Cystoid Macular Edema in Syphilitic Uveitis

    Directory of Open Access Journals (Sweden)

    Cassandra C. Lautredou

    2018-01-01

    Full Text Available Purpose. To report the successful utilization of adjunctive repeat intravitreal corticosteroid therapy for the treatment of cystoid macular edema in syphilis-related uveitis. Methods/Patients. An HIV-positive patient with treated ocular syphilis who developed refractory cystoid macular edema (CME was treated with repeat intravitreal corticosteroid therapy including dexamethasone intravitreal implants. Results. Treatment led to the resolution of CME and improvement in visual acuity. Conclusions. Intravitreal corticosteroid therapy may be a viable adjunctive treatment for refractory CME in patients with treated syphilitic uveitis. Corticosteroid-induced exacerbation of infection is unlikely in patients with an adequate serologic treatment response.

  6. Tunnelling from Goedel black holes

    International Nuclear Information System (INIS)

    Kerner, Ryan; Mann, R. B.

    2007-01-01

    We consider the spacetime structure of Kerr-Goedel black holes, analyzing their parameter space in detail. We apply the tunnelling method to compute their temperature and compare the results to previous calculations obtained via other methods. We claim that it is not possible to have the closed timelike curve (CTC) horizon in between the two black hole horizons and include a discussion of issues that occur when the radius of the CTC horizon is smaller than the radius of both black hole horizons

  7. Ranibizumab vs. aflibercept for wet age-related macular degeneration

    DEFF Research Database (Denmark)

    Szabo, Shelagh M; Hedegaard, Morten; Chan, Keith

    2015-01-01

    the efficacy and safety of reduced frequency dosing for aflibercept, relative to other approved and marketed vascular endothelial growth factor inhibitors for wet AMD, over 12 months. RESEARCH DESIGN AND METHODS: Based on a systematic literature review performed according to a pre-specified protocol......OBJECTIVE: Although a reduced aflibercept (2.0 mg) injection frequency relative to the approved dosing posology is included in national treatment guidelines for wet age-related macular degeneration (AMD), there is limited evidence of its comparative efficacy. The objective was to compare...

  8. [New aspects in age related macular degeneration].

    Science.gov (United States)

    Turlea, C

    2012-01-01

    Being the leading cause of blindness in modern world Age Related Macular Degeneration has beneficiated in the last decade of important progress in diagnosis, classification and the discovery of diverse factors who contribute to the etiology of this disease. Treatments have arised who can postpone the irreversible evolution of the disease and thus preserve vision. Recent findings have identified predisposing genetic factors and also inflamatory and imunological parameters that can be modified trough a good and adequate prevention and therapy This articole reviews new aspects of patology of Age Related Macular Degeneration like the role of complement in maintaining inflamation and the role of oxidative stress on different structures of the retina.

  9. Diagnostic Accuracy of Spectralis SD OCT Automated Macular Layers Segmentation to Discriminate Normal from Early Glaucomatous Eyes.

    Science.gov (United States)

    Pazos, Marta; Dyrda, Agnieszka Anna; Biarnés, Marc; Gómez, Alicia; Martín, Carlos; Mora, Clara; Fatti, Gianluca; Antón, Alfonso

    2017-08-01

    To evaluate the accuracy of the macular retinal layer segmentation software of the Spectralis spectral-domain (SD) optical coherence tomography (OCT) device (Heidelberg Engineering, Inc., Heidelberg, Germany) to discriminate between healthy and early glaucoma (EG) eyes. Prospective, cross-sectional study. Forty EG eyes and 40 healthy controls were included. All participants were examined using the standard posterior pole and the peripapillary retinal nerve fiber layer (pRNFL) protocols of the Spectralis OCT device. Using an Early Treatment Diagnostic Retinopathy Study circle at the macular level, the automated retinal segmentation software was applied to determine thicknesses of the following parameters: total retinal thickness, inner retinal layer (IRL), macular retinal nerve fiber layer (mRNFL), macular ganglion cell layer (mGCL), macular inner plexiform layer (mIPL), macular inner nuclear layer (mINL), macular outer plexiform layer (mOPL), macular outer nuclear layer (mONL), photoreceptors (PR), and retinal pigmentary epithelium (RPE). The ganglion cell complex (GCC) was determined by adding the mRNFL, mGCL, and mIPL parameters and the ganglion cell layer-inner plexiform layer (mGCL-IPL) was determined by combining the mGCL and mIPL parameters. Thickness of each layer was compared between the groups, and the layer and sector with the best area under the receiver operating characteristic curve (AUC) were identified. Comparison of pRNFL, IRL, mRNFL, mGCL, mIPL, mGCC, mGCL-IPL, mINL, mOPL, mONL, PR, and RPE parameters and total retinal thicknesses between groups for the different areas and their corresponding AUCs. Peripapillary RNFL was significantly thinner in the EG group globally and in all 6 sectors assessed (P < 0.0005). For the macular variables, retinal thickness was significantly reduced in the EG group for total retinal thickness, mIRL, mRNFL, mGCL, and mIPL. The 2 best isolated parameters to discriminate between the 2 groups were pRNFL (AUC, 0.956) and

  10. A Lovelock black hole bestiary

    International Nuclear Information System (INIS)

    Camanho, Xián O; Edelstein, José D

    2013-01-01

    We revisit the study of (A)dS black holes in Lovelock theories. We present a new tool that allows to attack this problem in full generality. In analyzing maximally symmetric Lovelock black holes with non-planar horizon topologies, many distinctive and interesting features are observed. Among them, the existence of maximally symmetric vacua does not support black holes in vast regions of the space of gravitational couplings, multi-horizon black holes and branches of solutions that suggest the existence of a rich diagram of phase transitions. The appearance of naked singularities seems unavoidable in some cases, raising the question about the fate of the cosmic censorship conjecture in these theories. There is a preferred branch of solutions for planar black holes, as well as for non-planar black holes with high enough mass or temperature. Our study clarifies the role of all branches of solutions, including asymptotically dS black holes, and whether they should be considered when studying these theories in the context of AdS/CFT. (paper)

  11. Are LIGO's Black Holes Made From Smaller Black Holes?

    Science.gov (United States)

    Kohler, Susanna

    2017-05-01

    all the hierarchical mergers are so-called major mergers i.e., the smaller black hole of the pair is at least 70% of the mass of the larger one.Distribution of spins for 4th-generation mergers, with two different mass ratios (q= 0.7 and q= 1) and initial first-generation spins (non-spinning and maximally spinning). [Fishbach et al. 2017]The authors find that hierarchical major mergers result in a distribution of spins with a distinctive shape, peaking at a spin of a 0.7 with relatively low contribution from spins below a 0.5. Intriguingly, this distribution is universal if you include several generations of mergers, the resulting spin distribution converges to the same shape every time. This is true regardless of the details of the hierarchical merger scenario, like the exact black hole mass ratio (as long as only major mergers occur) or the initial spin distributions.Testing the ModelWhat does this tell us? Since the hierarchical merger model predicts a very specific distribution of spins for the black holes detected by LIGO, we can compare future LIGO detections to see if theyre consistent with this model.The authors calculate the statistics to show that after order 100 LIGO detections, we should be able to tell whether these black holes are consistent with a hierarchical merger formation model or not. With luck, this could mean that we will have solved this mystery within a few years of advanced LIGO operations!CitationMaya Fishbach et al 2017 ApJL 840 L24. doi:10.3847/2041-8213/aa7045

  12. Assessment of Macular Function during Vitrectomy: New Approach Using Intraoperative Focal Macular Electroretinograms.

    Directory of Open Access Journals (Sweden)

    Celso Soiti Matsumoto

    Full Text Available To describe a new technique to record focal macular electroretinograms (FMERGs during vitrectomy to assess macular function.Intraoperative FMERGs (iFMERGs were recorded in ten patients (10 eyes who undergo vitrectomy. iFMERGs were elicited by focal macular stimulation. The stimulus light was directed to the macular area through a 25 gauge (25G glass fiber optic bundle. Background light was delivered through a dual chandelier-type light fiber probe. Focal macular responses elicited with combinations of stimulus and background luminances were analyzed.A stimulus luminance that was approximately 1.75 log units brighter than the background light was able to elicit focal macular responses that were not contaminated by stray light responses. Thus, a stimulus luminance of 160 cd/m2 delivered on a background of 3 cd/m2 elicited iFMEGs from only the stimulated area. This combination of stimulus and background luminances did not elicit a response when the stimulus was projected onto the optic nerve head. The iFMERGs elicited by a 10° stimulus with a duration of 100 ms and an interstimulus interval of 150 ms consisted of an a-, b-, and d-waves, the oscillatory potentials, and the photopic negative response (PhNR.Focal ERGs with all components can be recorded from the macula and other retinal areas during vitreous surgery. This new technique will allow surgeons to assess the function of focal areas of the retina intraoperatively.

  13. The relationship between fundus fluorescein angiographic findings and serous macular detachment in diabetic macular edema.

    Science.gov (United States)

    Gungel, Hulya; Altan, Cigdem

    2013-10-01

    To investigate whether the serous macular detachment (SMD) shown by optical coherence tomography is associated with types of maculopathy, severity of retinopathy, the effect of macular and retinal photocoagulation, and retinal circulation times in diabetic macular edema. Patients were grouped as SMD+ (Group 1) and SMD- (Group 2). Fundus photography and fluorescein angiography were evaluated regarding the type of maculopathy; severity of retinopathy and also arm-retina time, arteriovenous transit time, and venous filling time; and the applied macular and panretinal laser treatment. Diffuse maculopathy was seen more frequently in eyes with SMD, whereas ischemic maculopathy was more frequent in eyes without SMD. There was no significant difference regarding severity of retinopathy and retinal circulation times between groups. The frequency of patients with complete panretinal photocoagulation and grid laser photocoagulation was found to be higher in Group 2. Serous macular detachment can occur in eyes with increased vascular permeability in macula. Serous macular detachment may be an important finding in terms of the possible existence of diffuse maculopathy and the need of additional panretinal photocoagulation, but absence of SMD may point at ischemic maculopathy.

  14. Nonisolated dynamic black holes and white holes

    International Nuclear Information System (INIS)

    McClure, M. L.; Anderson, Kaem; Bardahl, Kirk

    2008-01-01

    Modifying the Kerr-Schild transformation used to generate black and white hole spacetimes, new dynamic black and white holes are obtained using a time-dependent Kerr-Schild scalar field. Physical solutions are found for black holes that shrink with time and for white holes that expand with time. The black hole spacetimes are physical only in the vicinity of the black hole, with the physical region increasing in radius with time. The white hole spacetimes are physical throughout. Unlike the standard Schwarzschild solution the singularities are nonisolated, since the time dependence introduces a mass-energy distribution. The surfaces in the metrics where g tt =g rr =0 are dynamic, moving inward with time for the black holes and outward for the white holes, which leads to a question of whether these spacetimes truly have event horizons--a problem shared with Vaidya's cosmological black hole spacetimes. By finding a surface that shrinks or expands at the same rate as the null geodesics move, and within which null geodesics move inward or outward faster than the surfaces shrink or expand, respectively, it is verified that these do in fact behave like black and white holes

  15. Macular sensitivity and fixation patterns in patients with autosomal dominant optic atrophy

    DEFF Research Database (Denmark)

    Rönnbäck, Cecilia; Larsen, Michael

    2014-01-01

    with exon 28 (2826 delT) mutation in OPA1 (age 11.7-71.5 years, best-corrected visual acuity (BCVA) 20/24-20/13). The patients and 49 mutation-free first-degree relatives (BCVA 20/25-20/10) underwent ophthalmic examination including macular microperimetry out to 12° eccentricity with registration...

  16. Macular Amyloidosis and Epstein-Barr Virus

    Directory of Open Access Journals (Sweden)

    Yalda Nahidi

    2016-01-01

    Full Text Available Background. Amyloidosis is extracellular precipitation of eosinophilic hyaline material of self-origin with special staining features and fibrillar ultrastructure. Macular amyloidosis is limited to the skin, and several factors have been proposed for its pathogenesis. Detection of Epstein-Barr virus (EBV DNA in this lesion suggests that this virus can play a role in pathogenesis of this disease. Objective. EBV DNA detection was done on 30 skin samples with a diagnosis of macular amyloidosis and 31 healthy skin samples in the margin of removed melanocytic nevi by using PCR. Results. In patients positive for beta-globin gene in PCR, BLLF1 gene of EBV virus was positive in 23 patients (8 patients in case and 15 patients in the control group. There was no significant difference in presence of EBV DNA between macular amyloidosis (3.8% and control (23.8% groups (P=0.08. Conclusion. The findings of this study showed that EBV is not involved in pathogenesis of macular amyloidosis.

  17. Precursors of age-related macular degeneration

    DEFF Research Database (Denmark)

    Munch, Inger Christine; Toft, Ulla; Linneberg, Allan

    2016-01-01

    -sectional study of 848 subjects aged 30-60 years from the Inter99 Eye Study. Daily intake of vitamins and minerals was estimated from a 198-item food frequency questionnaire. Digital fundus photographs were recorded in red-free illumination and graded for macular drusen >63 μm and numerous (>20) small hard...

  18. Bilateral Simultaneous Macular Infarction with Spontaneous Visual ...

    African Journals Online (AJOL)

    To report the rare and dramatic event of bilateral macular infarction in a sickle cell hemoglobinopathy (SS genotype) patient, resulting in bilateral severe reduction in visual acuity. Without any intervention, the patient's vision gradually improved over the follow‑up period. Central visual field defects however persisted.

  19. Bilateral Simultaneous Macular Infarction with Spontaneous Visual ...

    African Journals Online (AJOL)

    2018-01-30

    Jan 30, 2018 ... To report the rare and dramatic event of bilateral macular infarction in a sickle cell hemoglobinopathy (SS genotype) patient, resulting in bilateral severe reduction in visual acuity. Without any intervention, the patient's vision gradually improved over the follow‑up period. Central visual field defects however ...

  20. Moebius syndrome with macular hyperpigmentation, skeletal ...

    African Journals Online (AJOL)

    Rabah M. Shawky

    2014-11-08

    Nov 8, 2014 ... Moebius syndrome with macular hyperpigmentation, skeletal anomalies, and hypoplasia of pectoralis major muscle in an Egyptian child. Rabah M. Shawky a, ... examination which was not reported previously in Moebius syndrome cases. .... or absence of middle cerebellar peduncles, depression of the.

  1. Hole-Aligning Tool

    Science.gov (United States)

    Collins, Frank A.; Saude, Frank; Sep, Martin J.

    1996-01-01

    Tool designed for use in aligning holes in plates or other structural members to be joined by bolt through holes. Holes aligned without exerting forces perpendicular to planes of holes. Tool features screw-driven-wedge design similar to (but simpler than) that of some automotive exhaust-pipe-expanding tools.

  2. Black holes. Chapter 6

    International Nuclear Information System (INIS)

    Penrose, R.

    1980-01-01

    Conditions for the formation of a black hole are considered, and the properties of black holes. The possibility of Cygnus X-1 as a black hole is discussed. Einstein's theory of general relativity in relation to the formation of black holes is discussed. (U.K.)

  3. Deburring small intersecting holes

    Energy Technology Data Exchange (ETDEWEB)

    Gillespie, L.K.

    1980-08-01

    Deburring intersecting holes is one of the most difficult deburring tasks faced by many industries. Only 14 of the 37 major deburring processes are applicable to most intersecting hole applications. Only five of these are normally applicable to small or miniature holes. Basic process capabilities and techniques used as a function of hole sizes and intersection depths are summarized.

  4. Search for black holes

    International Nuclear Information System (INIS)

    Cherepashchuk, Anatolii M

    2003-01-01

    Methods and results of searching for stellar mass black holes in binary systems and for supermassive black holes in galactic nuclei of different types are described. As of now (June 2002), a total of 100 black hole candidates are known. All the necessary conditions Einstein's General Relativity imposes on the observational properties of black holes are satisfied for candidate objects available, thus further assuring the existence of black holes in the Universe. Prospects for obtaining sufficient criteria for reliably distinguishing candidate black holes from real black holes are discussed. (reviews of topical problems)

  5. Rotating black holes in dilatonic Einstein-Gauss-Bonnet theory.

    Science.gov (United States)

    Kleihaus, Burkhard; Kunz, Jutta; Radu, Eugen

    2011-04-15

    We construct generalizations of the Kerr black holes by including higher-curvature corrections in the form of the Gauss-Bonnet density coupled to the dilaton. We show that the domain of existence of these Einstein-Gauss-Bonnet-dilaton (EGBD) black holes is bounded by the Kerr black holes, the critical EGBD black holes, and the singular extremal EGBD solutions. The angular momentum of the EGBD black holes can exceed the Kerr bound. The EGBD black holes satisfy a generalized Smarr relation. We also compare their innermost stable circular orbits with those of the Kerr black holes and show the existence of differences which might be observable in astrophysical systems.

  6. Erratic Black Hole Regulates Itself

    Science.gov (United States)

    2009-03-01

    New results from NASA's Chandra X-ray Observatory have made a major advance in explaining how a special class of black holes may shut off the high-speed jets they produce. These results suggest that these black holes have a mechanism for regulating the rate at which they grow. Black holes come in many sizes: the supermassive ones, including those in quasars, which weigh in at millions to billions of times the mass of the Sun, and the much smaller stellar-mass black holes which have measured masses in the range of about 7 to 25 times the Sun's mass. Some stellar-mass black holes launch powerful jets of particles and radiation, like seen in quasars, and are called "micro-quasars". The new study looks at a famous micro-quasar in our own Galaxy, and regions close to its event horizon, or point of no return. This system, GRS 1915+105 (GRS 1915 for short), contains a black hole about 14 times the mass of the Sun that is feeding off material from a nearby companion star. As the material swirls toward the black hole, an accretion disk forms. This system shows remarkably unpredictable and complicated variability ranging from timescales of seconds to months, including 14 different patterns of variation. These variations are caused by a poorly understood connection between the disk and the radio jet seen in GRS 1915. Chandra, with its spectrograph, has observed GRS 1915 eleven times since its launch in 1999. These studies reveal that the jet in GRS 1915 may be periodically choked off when a hot wind, seen in X-rays, is driven off the accretion disk around the black hole. The wind is believed to shut down the jet by depriving it of matter that would have otherwise fueled it. Conversely, once the wind dies down, the jet can re-emerge. "We think the jet and wind around this black hole are in a sort of tug of war," said Joseph Neilsen, Harvard graduate student and lead author of the paper appearing in the journal Nature. "Sometimes one is winning and then, for reasons we don

  7. SOCIETAL COSTS ASSOCIATED WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION IN THE UNITED STATES.

    Science.gov (United States)

    Brown, Melissa M; Brown, Gary C; Lieske, Heidi B; Tran, Irwin; Turpcu, Adam; Colman, Shoshana

    2016-02-01

    The purpose of this study was to use a cross-sectional prevalence-based health care economic survey to ascertain the annual, incremental, societal ophthalmic costs associated with neovascular age-related macular degeneration. Consecutive patients (n = 200) with neovascular age-related macular degeneration were studied. A Control Cohort included patients with good (20/20-20/25) vision, while Study Cohort vision levels included Subcohort 1: 20/30 to 20/50, Subcohort 2: 20/60 to 20/100, Subcohort 3: 20/200 to 20/400, and Subcohort 4: 20/800 to no light perception. An interviewer-administered, standardized, written survey assessed 1) direct ophthalmic medical, 2) direct nonophthalmic medical, 3) direct nonmedical, and 4) indirect medical costs accrued due solely to neovascular age-related macular degeneration. The mean annual societal cost for the Control Cohort was $6,116 and for the Study Cohort averaged $39,910 (P societal ophthalmic costs, versus 74.1% of Control Cohort societal ophthalmic costs (P societal ophthalmic costs, versus 21.3% ($1,302/$6,116) of Control Cohort costs (P societal ophthalmic costs associated with neovascular age-related macular degeneration dramatically increase as vision in the better-seeing eye decreases.

  8. Usefulness of axonal tract-dependent OCT macular sectors for evaluating structural change in normal-tension glaucoma.

    Science.gov (United States)

    Omodaka, Kazuko; Kikawa, Tsutomu; Shiga, Yukihiro; Tsuda, Satoru; Yokoyama, Yu; Sato, Haruka; Ohuchi, Junko; Matsumoto, Akiko; Takahashi, Hidetoshi; Akiba, Masahiro; Nakazawa, Toru

    2017-01-01

    To identify sectors of the optical coherence tomography (OCT) macular map that could be used to effectively assess structural progression in patients with normal-tension glaucoma (NTG). This study examined 117 eyes of 117 NTG patients to establish axonal tract-dependent macular sectors, and also examined a separate group of 122 eyes of 81 NTG patients to evaluate the ability of these sectors to reveal glaucoma progression. Longitudinal data, including macular maps from at least 5 OCT examinations performed over at least 2 years, was available for all patients in this group. Circumpapillary retinal nerve fiber layer thickness (cpRNFLT), temporal clockwise sector scans (from 7 to 11 o'clock), macular retinal nerve fiber layer thickness (mRNFLT), and macular ganglion cell layer plus inner plexiform layer thickness (mGCIPLT) were measured with spectral-domain OCT (3D OCT-2000, TOPCON). The axonal tract-dependent macular sectors were identified by calculating Spearman's rank correlation coefficient for each point on a grid overlaid on the macular map and cpRNFLT in each clockwise scan sector. Trend and event analyses for the slope of progression in each sector and macular map were performed. Visual field progression in the macula was defined by the presence of more than 2 progressive test points in the 16 central test points of the Humphrey field analyzer SITA standard 24-2 program, evaluated with Progressor software. The slope of progression in the entire macular area was -0.22 ± 0.58 μm/year for mRNFLT and -0.35 ± 0.52 μm/year for mGCIPLT. The fastest-progressing mRNFLT sector (-1.00 ± 0.84 μm/year, p OCT macular sectors could effectively reveal structural change in patients with NTG. Furthermore, mRNFLT slope was consistent with visual field progression. This method promises to open new avenues for the OCT-based evaluation of glaucoma progression.

  9. Transplantation of retinal pigment epithelial cells - a possible future treatment for age-related macular degeneration

    DEFF Research Database (Denmark)

    Wiencke, Anne Katrine

    2001-01-01

    ophthalmology, age-related macular degeneration, retinal pigment epithelial cells, transplantation, treatment......ophthalmology, age-related macular degeneration, retinal pigment epithelial cells, transplantation, treatment...

  10. Transplantation of retinal pigment epithelial cells - a possible future treatment for age-related macular degeneration

    DEFF Research Database (Denmark)

    Wiencke, Anne Katrine

    2001-01-01

    ophthalmology, age-related macular degeneration, transplantation, retinal pigment epithelial cells, treatment......ophthalmology, age-related macular degeneration, transplantation, retinal pigment epithelial cells, treatment...

  11. Retinal Vascular Caliber Changes After Topical Nepafenac Treatment for Diabetic Macular Edema.

    Science.gov (United States)

    Evliyaoğlu, Ferhat; Akpolat, Çetin; Kurt, Muhammed Mustafa; Çekiç, Osman; Nuri Elçioğlu, Mustafa

    2018-03-01

    To assess changes in retinal vascular caliber in response to short-term use of nepafenac eye drops in patients with mild diabetic macular edema. Thirty-four patients with previously untreated bilateral mild diabetic macular edema were included in this prospective study. For each participant, one eye was randomly assigned to nepafenac treatment (0.1%, three times/day) and the other eye was left untreated throughout the study. Using digital fundus photographs, retinal vascular calibers were calculated and compared in treated and untreated eyes at the baseline, week 1, and week 6. Baseline vessel diameters did not differ in treated and fellow eyes (p > 0.05). Over the 6 weeks of the study, significant vasoconstriction of the retinal arteriolar caliber was observed at weeks 1 (p  0.44). Significant macular thickness difference was only observed at week 6 (p = 0.002). Topical nepafenac has a significant narrowing effect on the retinal arteriolar diameter and a significant reductive effect on central macular thickness in eyes with mild diabetic retinopathy.

  12. TYPE 2 (SUBRETINAL) NEOVASCULARIZATION IN AGE-RELATED MACULAR DEGENERATION ASSOCIATED WITH PURE RETICULAR PSEUDODRUSEN PHENOTYPE.

    Science.gov (United States)

    Naysan, Jonathan; Jung, Jesse J; Dansingani, Kunal K; Balaratnasingam, Chandrakumar; Freund, K Bailey

    2016-03-01

    To report the association of pure type 2 neovascularization (NV) in age-related macular degeneration occurring almost exclusively in patients with reticular pseudodrusen. An observational retrospective cohort study of all eyes receiving antivascular endothelial growth factor therapy for newly diagnosed neovascular age-related macular degeneration by a single practitioner over a 6-year period. Only patients with treatment-naive, pure type 2 NV who also had either pre-neovascular imaging of the study eye or imaging of a nonneovascular fellow eye available to determine baseline characteristics including drusen type and choroidal thickness were incuded. Of 694 patients treated for neovascular age-related macular degeneration, only 8 met the inclusion criteria with pure type 2 NV. Of these, 7 (88%) had exclusively reticular pseudodrusen (5 in the nonneovascular fellow eye, 2 in the study eye before developing NV). Six (75%) patients in the affected neovascular eye and 6 (75%) in the fellow nonneovascular eye had choroidal thickness age-related macular degeneration, occurring almost exclusively in patients with reticular pseudodrusen and thin choroids.

  13. Clinical study of Conbercept intravitreal injection for the treatment of wet age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Xu-Ting He

    2015-09-01

    Full Text Available AIM: To observe the clinical curative effect of conbercept intravitreal injection for the treatment of wet age-related macular degeneration.METHODS: Sixty patients with wet age related macular degeneration were randomly divided into treatment group 30 cases and control group 30 cases according to the random number table. The treatment group was injected with Conbercept 0.05mL, the control group was injected with triamcinolone acetonide 0.1mL. The best corrected visual acuity(BCVAwas performed before and after 1d, 1 and 3mo after treatment, and the thickness of macular was detected by optical coherence tomography(OCT. The complications of patients were observed after 1d, 1 and 3mo,including inflammatory reaction, corneal edema, anterior chamber, high intraocular pressure, etc.RESULTS:In treatment group 1d, 1 and 3mo after treatment, eyesight was improved significantly better than the control group(PPCONCLUSION: Intravitreal injection of Conbercept in the treatment of wet age-related macular degeneration can improve the curative effect.

  14. Clinical and tomographic aspects of macular microholes

    International Nuclear Information System (INIS)

    Novelli, Fernando Jose de; Maia Junior, Otacilio de Oliveira; Garrido Neto, Theodomiro; Takahashi, Walter Yukihiko

    2009-01-01

    Purpose: To describe the clinical aspects and evaluate optical coherence tomography of macular microholes. Methods: Seven patients were assessed (8 eyes) with microholes of the macula. All patients underwent complete eye examination, fundus photography, fluorescent angiography and OCT-3 imaging. Results: Ages ranged from 26 to 69 years. Six patients were female (85.7%) and five of them had microhole in the right eye. The presenting symptom was decrease in visual acuity (71.3%) and central scotoma in (14.3%). Five eyes (71.4%) had no defects shown by fluorescent angiography. A defect in the outer retina was demonstrated in all eyes on optical coherence tomography. The lesions were nonprogressive. Conclusion: Macular microholes are small lamellar defects in the outer retina. The condition is nonprogressive, generally unilateral and compatible with good visual acuity. Fundus biomicroscopy associated with an optical coherence tomography are the main elements in the diagnosis and study of this pathology. (author)

  15. Black hole hair removal

    International Nuclear Information System (INIS)

    Banerjee, Nabamita; Mandal, Ipsita; Sen, Ashoke

    2009-01-01

    Macroscopic entropy of an extremal black hole is expected to be determined completely by its near horizon geometry. Thus two black holes with identical near horizon geometries should have identical macroscopic entropy, and the expected equality between macroscopic and microscopic entropies will then imply that they have identical degeneracies of microstates. An apparent counterexample is provided by the 4D-5D lift relating BMPV black hole to a four dimensional black hole. The two black holes have identical near horizon geometries but different microscopic spectrum. We suggest that this discrepancy can be accounted for by black hole hair - degrees of freedom living outside the horizon and contributing to the degeneracies. We identify these degrees of freedom for both the four and the five dimensional black holes and show that after their contributions are removed from the microscopic degeneracies of the respective systems, the result for the four and five dimensional black holes match exactly.

  16. LONG-TERM EVOLUTION OF DOME-SHAPED MACULA: Increased Macular Bulge is Associated With Extended Macular Atrophy.

    Science.gov (United States)

    Soudier, Guillaume; Gaudric, Alain; Gualino, Vincent; Massin, Pascale; Nardin, Mathieu; Tadayoni, Ramin; Speeg-Schatz, Claude; Gaucher, David

    2016-05-01

    Dome-shaped macula (DSM) may cause impaired vision. This study analyzed the long-term evolution of DSM, most particularly macular changes: serous retinal detachment, retinal pigment epithelium atrophy, and DSM bulge increase. Twenty-nine eyes presenting with DSM were retrospectively studied. Clinical data, color photographs, fluorescein angiographs, and optical coherence tomography examinations were reviewed. Patients were followed up from 6 months to 111 months (mean, 37.89 months). The height of the macular bulge, the size of retinal pigment epithelium macular atrophy, and serous retinal detachment progression were studied. Other macular changes were noted. Mean vision remained stable. Dome-shaped macula height increased significantly from 338.9 μm to 364.3 μm (P = 0.007). Serous retinal detachment was present initially in 15 of 29 eyes; it increased in 4 cases and resolved spontaneously in 7. Macular retinal pigment epithelium atrophy correlated with the bulge height (P = 0.015), and it enlarged during follow-up (1.12 vs. 1.34, P = 0.04). Other macular anomalies were present initially or appeared during follow-up: macular pucker, choroidal neovascularization (CNV), subretinal pigmentary clumps, and flat irregular pigmented epithelium detachment. A few treatments were proven in serous retinal detachment cases but were ineffective in restoring vision. In DSM, vision may be stable for years while macular changes progress: the macular bulge increases as does retinal pigment epithelium atrophy.

  17. Hidden conformal symmetry of extremal black holes

    International Nuclear Information System (INIS)

    Chen Bin; Long Jiang; Zhang Jiaju

    2010-01-01

    We study the hidden conformal symmetry of extremal black holes. We introduce a new set of conformal coordinates to write the SL(2,R) generators. We find that the Laplacian of the scalar field in many extremal black holes, including Kerr(-Newman), Reissner-Nordstrom, warped AdS 3 , and null warped black holes, could be written in terms of the SL(2,R) quadratic Casimir. This suggests that there exist dual conformal field theory (CFT) descriptions of these black holes. From the conformal coordinates, the temperatures of the dual CFTs could be read directly. For the extremal black hole, the Hawking temperature is vanishing. Correspondingly, only the left (right) temperature of the dual CFT is nonvanishing, and the excitations of the other sector are suppressed. In the probe limit, we compute the scattering amplitudes of the scalar off the extremal black holes and find perfect agreement with the CFT prediction.

  18. Information Retention by Stringy Black Holes

    CERN Document Server

    Ellis, John

    2015-01-01

    Building upon our previous work on two-dimensional stringy black holes and its extension to spherically-symmetric four-dimensional stringy black holes, we show how the latter retain information. A key r\\^ole is played by an infinite-dimensional $W_\\infty$ symmetry that preserves the area of an isolated black-hole horizon and hence its entropy. The exactly-marginal conformal world-sheet operator representing a massless stringy particle interacting with the black hole necessarily includes a contribution from $W_\\infty$ generators in its vertex function. This admixture manifests the transfer of information between the string black hole and external particles. We discuss different manifestations of $W_\\infty$ symmetry in black-hole physics and the connections between them.

  19. Charged topological black hole pair creation

    International Nuclear Information System (INIS)

    Mann, R.B.

    1998-01-01

    I examine the pair creation of black holes in space-times with a cosmological constant of either sign. I consider cosmological C-metrics and show that the conical singularities in this metric vanish only for three distinct classes of black hole metric, two of which have compact event horizons on each spatial slice. One class is a generalization of the Reissner-Nordstroem (anti-)de Sitter black holes in which the event horizons are the direct product of a null line with a 2-surface with topology of genus g. The other class consists of neutral black holes whose event horizons are the direct product of a null conoid with a circle. In the presence of a domain wall, black hole pairs of all possible types will be pair created for a wide range of mass and charge, including even negative mass black holes. I determine the relevant instantons and Euclidean actions for each case. (orig.)

  20. Sound Hole Sound

    OpenAIRE

    Politzer, David

    2015-01-01

    The volume of air that goes in and out of a musical instrument's sound hole is related to the sound hole's contribution to the volume of the sound. Helmholtz's result for the simplest case of steady flow through an elliptical hole is reviewed. Measurements on multiple holes in sound box geometries and scales relevant to real musical instruments demonstrate the importance of a variety of effects. Electric capacitance of single flat plates is a mathematically identical problem, offering an alte...

  1. Dynamics of black holes

    OpenAIRE

    Hayward, Sean A.

    2008-01-01

    This is a review of current theory of black-hole dynamics, concentrating on the framework in terms of trapping horizons. Summaries are given of the history, the classical theory of black holes, the defining ideas of dynamical black holes, the basic laws, conservation laws for energy and angular momentum, other physical quantities and the limit of local equilibrium. Some new material concerns how processes such as black-hole evaporation and coalescence might be described by a single trapping h...

  2. Black holes are hot

    International Nuclear Information System (INIS)

    Gibbons, G.

    1976-01-01

    Recent work, which has been investigating the use of the concept of entropy with respect to gravitating systems, black holes and the universe as a whole, is discussed. The resulting theory of black holes assigns a finite temperature to them -about 10 -7 K for ordinary black holes of stellar mass -which is in complete agreement with thermodynamical concepts. It is also shown that black holes must continuously emit particles just like ordinary bodies which have a certain temperature. (U.K.)

  3. Therapeutic interventions for macular diseases show characteristic effects on near and distance visual function.

    Science.gov (United States)

    Munk, Marion; Kiss, Christopher; Huf, Wolfgang; Sulzbacher, Florian; Bolz, Matthias; Sayegh, Ramzi; Eisenkölbl, Stefan; Simader, Christian; Schmidt-Erfurth, Ursula

    2013-10-01

    To compare therapy-induced reading and distance visual acuity (dVA) increases in neovascular age-related macular degeneration (nAMD) and uveitis-associated cystoid macular edema. This longitudinal study included 68 treatment-naive eyes: 39 subfoveal nAMD eyes with disrupted photoreceptor layers treated with monthly ranibizumab and 29 uveitis-associated cystoid macular edema eyes with intact photoreceptor layer treated with 1 triamcinolone injection. Patients were examined with high-definition optical coherence tomography, Early Treatment Diabetic Retinopathy Study dVA (logarithm of the minimum angle of resolution), reading acuity (logRADscore), and maximum reading speed (words per minute) over 3 months of therapy. In uveitis-associated cystoid macular edema, logarithm of the minimum angle of resolution and logRADscore improved 1 day post treatment, from 0.49 ± 0.28 to 0.39 ± 0.3 (P = 0.018) and 0.71 ± 0.53 to 0.56 ± 0.49 (P = 0.012), respectively. In nAMD, logarithm of the minimum angle of resolution improved 1 week after anti-vascular endothelial growth factor therapy from 0.59 ± 0.29 to 0.49 ± 0.24 (P = 0.002), with no change in logRADscore. One month after treatment, logRADscore improved from 1.09 ± 0.65 to 0.90 ± 0.60 (P = 0.002). In uveitis-associated cystoid macular edema, the recovery course of reading and dVA was comparable, and in nAMD, reading acuity recovery was delayed. Irrespective of disease, a small reduction in dVA resulted in a larger reading acuity decrease. Cystoid macular edema resolution was associated with rapid synchronous reading and dVA improvement, whereas nAMD was followed by faster recovery of distance than reading acuity. In both conditions, reading acuity expressed by critical angular resolution was more suppressed by active disease and recovered relatively more than distance acuity. These discrepancies indicate that reading acuity might be a more sensitive measure for vision decrease in macular diseases than dVA. Reading

  4. Correlations between M-CHARTS and PHP findings and subjective perception of metamorphopsia in patients with macular diseases.

    Science.gov (United States)

    Arimura, Eiko; Matsumoto, Chota; Nomoto, Hiroki; Hashimoto, Shigeki; Takada, Sonoko; Okuyama, Sachiko; Shimomura, Yoshikazu

    2011-01-05

    To assess the correlations between a patient's subjective perception of metamorphopsia and the clinical measurements of metamorphopsia by M-CHARTS and PreView PHP (PHP). The authors designed a 10-item questionnaire focusing on the symptoms of metamorphopsia and verified its validity with a Rasch analysis. M-CHARTS measured the minimum visual angle of a dotted line needed to detect metamorphopsia, and PHP used the hyperacuity function for detection. Subjects were 39 patients with idiopathic epiretinal membrane (ERM), 22 patients with idiopathic macular hole (M-hole), 19 patients with age-related macular degeneration (AMD), and 51 healthy controls. Rasch analysis suggested the elimination of one question. The nine-item questionnaire score significantly correlated to the M-CHARTS score in ERM (r = 0.59; P = 0.0004) but not in M-hole and to the PHP result in AMD (r = -0.29; P = 0.04) but not in ERM. Eighty percent of ERM patients with greater horizontal M-CHARTS score subjectively perceived horizontal metamorphopsia more often. M-CHARTS showed better sensitivities than PHP in both ERM (89% vs. 42%) and AMD (74% vs. 68%) and better specificity (100% vs. 71%) in healthy controls. Rasch analysis indicated that the present form of the questionnaire is better suited for moderate to severe cases of metamorphopsia than for mild cases. The questionnaire appears to be a valid assessment of patient subjective perception of metamorphopsia and can be used to supplement the clinical measurements of metamorphopsia by M-CHARTS and PHP in patients with macular diseases.

  5. Monopole black hole skyrmions

    OpenAIRE

    Moss, I.G.; Shiiki, N.; Winstanley, E.

    2000-01-01

    Charged black hole solutions with pion hair are discussed. These can be\\ud used to study monopole black hole catalysis of proton decay.\\ud There also exist\\ud multi-black hole skyrmion solutions with BPS monopole behaviour.

  6. What is black hole?

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. What is black hole? Possible end phase of a star: A star is a massive, luminous ball of plasma having continuous nuclear burning. Star exhausts nuclear fuel →. White Dwarf, Neutron Star, Black Hole. Black hole's gravitational field is so powerful that even ...

  7. Ballistic hole magnetic microscopy

    NARCIS (Netherlands)

    Haq, E.; Banerjee, T.; Siekman, M.H.; Lodder, J.C.; Jansen, R.

    2005-01-01

    A technique to study nanoscale spin transport of holes is presented: ballistic hole magnetic microscopy. The tip of a scanning tunneling microscope is used to inject hot electrons into a ferromagnetic heterostructure, where inelastic decay creates a distribution of electron-hole pairs.

  8. Optical coherence tomographic findings at the fixation point in a case of bilateral congenital macular coloboma

    Directory of Open Access Journals (Sweden)

    Abe K

    2014-05-01

    Full Text Available Kosuke Abe,1,2 Jumi Shirane,2 Masuo Sakamoto,1 Fumi Tanabe,1 Kazuki Kuniyoshi,1 Chota Matsumoto,1 Yoshikazu Shimomura11Department of Ophthalmology, Kinki University Faculty of Medicine, Osaka-Sayama, Osaka, Japan; 2Nara Hospital, Kinki University Faculty of Medicine, Ikoma, Nara, JapanBackground: Congenital macular coloboma is a rare ocular disease that consists of atrophic lesions in the macula with well-circumscribed borders. We report the findings of spectral domain optical coherence tomography (SD-OCT at the fixation point in a case of bilateral macular coloboma.Case report: The subject is a 4-year-old boy. He visited our hospital at age 1 year and 4 months for the evaluation of strabismus. The fundus examination of both eyes showed round-shaped sharply-demarcated atrophic lesions involving the macula with large choroidal vessels and bared sclera at the base. Immunologic tests including toxoplasmosis, rubella, varicella, herpes virus, and human T-cell leukemia virus were all negative. At age 4 years and 1 month, cycloplegic refraction showed insignificant refractive errors and his best corrected visual acuity was 0.6 bilaterally. The SD-OCT showed a crater-like depression accompanying atrophic neurosensory retina, and the absence of retinal pigment epithelium and choroid. Examination of the fixation behavior by visuscope showed steady fixation with an area 0.5° nasal to the nasal edge of the atrophic lesion bilaterally. The SD-OCT findings at fixation area showed remaining normal retinal structures involving inner segment-outer segment (IS/OS junction line.Conclusion: The findings of SD-OCT have been shown to be useful in the diagnosis of macular coloboma. In the fixation point, the structure of retina and choroid were well preserved.Keywords: pediatric macular disease, macular structure, strabismus

  9. The effects of intravitreal bevacizumab in infectious and noninfectious uveitic macular edema.

    Science.gov (United States)

    Al-Dhibi, Hassan; Hamade, Issam H; Al-Halafi, Ali; Barry, Maan; Chacra, Charbel Bou; Gupta, Vishali; Tabbara, Khalid F

    2014-01-01

    Background/Aims. To assess the effect of intravitreal bevacizumab injection (IVBI) for the treatment of macular edema due to infectious and noninfectious uveitides. Design. Retrospective interventional case series. Methods. A chart review was performed on all the patients who were diagnosed with uveitic macular edema (UME) and received 1.25 mg of IVBI at two referral centers in Riyadh, Saudi Arabia. All included patients had their visual acuity and macular thickness analyzed at baseline and at 1 and 3 months following IVBI and any sign of reactivation was noted. Results. The mean age of patients was 41 ± 16 years with a mean followup of 4 ± 1 months. Ten patients had idiopathic intermediate uveitis, 9 patients had Behcet's disease, 10 had idiopathic panuveitis, and twelve patients had presumed ocular tuberculosis uveitis. Following IVBI, the mean LogMAR visual acuity improved from 0.8 ± 0.8 at baseline to 0.4 ± 0.5 at 1 month and 0.3 ± 0.5 at 3 months (P < 0.002, at 3 months). The mean macular thickness was 430 ± 132 μm at baseline. Following IVBI macular thickness improved to 286 ± 93 μm at 1 month and to 265 ± 88 μm at 3 months of followup (P < 0.001, at 3 months). Conclusion. Bevacizumab was effective in the management of UME associated with both infectious and noninfectious uveitides. Intravitreal bevacizumab induced remission of UME with infectious uveitis and had no immunosuppressive effect against infectious agents.

  10. The Effects of Intravitreal Bevacizumab in Infectious and Noninfectious Uveitic Macular Edema

    Directory of Open Access Journals (Sweden)

    Hassan Al-Dhibi

    2014-01-01

    Full Text Available Background/Aims. To assess the effect of intravitreal bevacizumab injection (IVBI for the treatment of macular edema due to infectious and noninfectious uveitides. Design. Retrospective interventional case series. Methods. A chart review was performed on all the patients who were diagnosed with uveitic macular edema (UME and received 1.25 mg of IVBI at two referral centers in Riyadh, Saudi Arabia. All included patients had their visual acuity and macular thickness analyzed at baseline and at 1 and 3 months following IVBI and any sign of reactivation was noted. Results. The mean age of patients was 41±16 years with a mean followup of 4±1 months. Ten patients had idiopathic intermediate uveitis, 9 patients had Behcet’s disease, 10 had idiopathic panuveitis, and twelve patients had presumed ocular tuberculosis uveitis. Following IVBI, the mean LogMAR visual acuity improved from 0.8±0.8 at baseline to 0.4±0.5 at 1 month and 0.3±0.5 at 3 months (P<0.002, at 3 months. The mean macular thickness was 430±132 μm at baseline. Following IVBI macular thickness improved to 286±93 μm at 1 month and to 265±88 μm at 3 months of followup (P<0.001, at 3 months. Conclusion. Bevacizumab was effective in the management of UME associated with both infectious and noninfectious uveitides. Intravitreal bevacizumab induced remission of UME with infectious uveitis and had no immunosuppressive effect against infectious agents.

  11. Recovery of the neurosensory retina after macular translocation surgery is independent of preoperative macular sensitivity in neovascular age-related macular degeneration.

    Science.gov (United States)

    Mettu, Priyatham S; Sarin, Neeru; Stinnett, Sandra S; Toth, Cynthia A

    2011-09-01

    To directly assess the recovery of the retina overlying choroidal neovascularization in neovascular age-related macular degeneration and to understand the relationship between macular sensitivity and visual functional measures and retinal structural alterations as predictive factors for outcome among eyes undergoing macular translocation surgery (MT360). In a prospective, consecutive case series of 55 patients with subfoveal choroidal neovascularization undergoing MT360, we explored the relationship between macular sensitivity on the Nidek microperimeter-1 with pathologic features on optical coherence tomography and with distance and near visual acuity, reading speed, contrast sensitivity, color vision, and National Eye Institute Visual Function Questionnaire-25 composite quality-of-life (QOL) score, both before and at 1 year after MT360. On average, there was improvement in all measures of visual function, macular sensitivity, and QOL after MT360. Preoperative median retinal sensitivity score did not predict postoperative measures of visual function, macular sensitivity, and vision-related QOL. Correlation between preoperative median retinal sensitivity score and preoperative measures of visual function and vision-related QOL was generally poor, excepting modest correlation for contrast sensitivity and color vision. However, correlation between postoperative median retinal sensitivity score and postoperative measures of visual function and vision-related QOL was uniformly modest, and change in median retinal sensitivity score correlated modestly with change in most measures of visual function and QOL. Among optical coherence tomography morphologic features, preoperative retinal pigment epithelium elevation predicted reduced postoperative contrast sensitivity (P = 0.04), while preoperative epiretinal membrane or vitreomacular traction predicted increased postoperative contrast sensitivity (P = 0.05). Preoperative cystoid macular edema, subretinal fluid, and

  12. Black hole levitron

    International Nuclear Information System (INIS)

    Arsiwalla, Xerxes D.; Verlinde, Erik P.

    2010-01-01

    We study the problem of spatially stabilizing four dimensional extremal black holes in background electric/magnetic fields. Whilst looking for stationary stable solutions describing black holes placed in external fields we find that taking a continuum limit of Denef et al.'s multicenter supersymmetric black hole solutions provides a supergravity description of such backgrounds within which a black hole can be trapped within a confined volume. This construction is realized by solving for a levitating black hole over a magnetic dipole base. We comment on how such a construction is akin to a mechanical levitron.

  13. Estimating Black Hole Masses of Blazars

    Indian Academy of Sciences (India)

    2016-01-27

    Jan 27, 2016 ... Estimating black hole masses of blazars is still a big challenge. Because of the contamination of jets, using the previously suggested size–continuum luminosity relation can overestimate the broad line region (BLR) size and black hole mass for radio-loud AGNs, including blazars. We propose a new relation ...

  14. Black holes in binary stars

    NARCIS (Netherlands)

    Wijers, R.A.M.J.

    1996-01-01

    Introduction Distinguishing neutron stars and black holes Optical companions and dynamical masses X-ray signatures of the nature of a compact object Structure and evolution of black-hole binaries High-mass black-hole binaries Low-mass black-hole binaries Low-mass black holes Formation of black holes

  15. Phakic retinal detachment associated with atrophic hole of lattice degeneration of the retina.

    Science.gov (United States)

    Murakami-Nagasako, F; Ohba, N

    1983-01-01

    Forty patients with phakic nontraumatic retinal detachment caused by atrophic retinal hole of lattice degeneration were reviewed. The condition was characterized by insidious, slowly developing shallow detachment, with frequent formation of demarcation lines. Often, the patients did not recognize their visual problems until the detachment had extended to the macular region. Young patients under 40 years of age were more common than older patients. Myopic refractive errors were frequently associated. The results of surgical repair were favorable. The risk of retinal detachment in lattice degeneration with atrophic holes was estimated to be about 1 in 90 patients, and prophylactic treatment for this common anomaly is not readily recommended.

  16. Age-related macular degeneration: epidemiology and optimal treatment

    DEFF Research Database (Denmark)

    la Cour, Morten; Kiilgaard, Jens Folke; Nissen, Mogens Holst

    2002-01-01

    Age-related macular degeneration (AMD) is a common macular disease affecting elderly people in the Western world. It is characterised by the appearance of drusen in the macula, accompanied by choroidal neovascularisation (CNV) or geographic atrophy. The disease is more common in Caucasian...

  17. Prevalence of age-related macular degeneration in elderly Caucasians

    DEFF Research Database (Denmark)

    Erke, Maja G; Bertelsen, Geir; Peto, Tunde

    2012-01-01

    To describe the sex- and age-specific prevalence of drusen, geographic atrophy, and neovascular age-related macular degeneration (AMD).......To describe the sex- and age-specific prevalence of drusen, geographic atrophy, and neovascular age-related macular degeneration (AMD)....

  18. The molecular genetic basis of age-related macular degeneration ...

    Indian Academy of Sciences (India)

    Keywords. AMD; epidemiology; genes; polymorphism; risk. Abstract. Age-related macular degeneration (AMD) is a complex disorder of the eye and the third leading cause of blindness worldwide. With a multifactorial etiology, AMD results in progressive loss of central vision affecting the macular region of the eye in elderly.

  19. Effect of acute postural variation on diabetic macular oedema

    DEFF Research Database (Denmark)

    Vinten, Martin; la Cour, Morten; Lund-Andersen, Henrik

    2010-01-01

    This study aimed to study the pathophysiology of diabetic macular oedema (DMO) by analysis of concomitant changes in macular volume (MV), mean arterial blood pressure (MABP), intraocular pressure (IOP), and retinal artery and vein diameters in response to acute postural changes in patients with DMO...

  20. Cosmology with primordial black holes

    International Nuclear Information System (INIS)

    Lindley, D.

    1981-09-01

    Cosmologies containing a substantial amount of matter in the form of evaporating primordial black holes are investigated. A review of constraints on the numbers of such black holes, including an analysis of a new limit found by looking at the destruction of deuterium by high energy photons, shows that there must be a negligible population of small black holes from the era of cosmological nucleosynthesis onwards, but that there are no strong constraints before this time. The major part of the work is based on the construction of detailed, self-consistent cosmological models in which black holes are continually forming and evaporating The interest in these models centres on the question of baryon generation, which occurs via the asymmetric decay of a new type of particle which appears as a consequence of the recently developed Grand Unified Theories of elementary particles. Unfortunately, there is so much uncertainty in the models that firm conclusions are difficult to reach; however, it seems feasible in principle that primordial black holes could be responsible for a significant part of the present matter density of the Universe. (author)

  1. [Non-pharmacologic therapy of age-related macular degeneration, based on the etiopathogenesis of the disease].

    Science.gov (United States)

    Fischer, Tamás

    2015-07-12

    It has a great therapeutic significance that the disorder of the vascular endothelium, which supplies the affected ocular structures, plays a major role in the development of age-related macular degeneration. Chronic inflammation is closely linked to diseases associated with endothelial dysfuncition and age-related macular degeneration is accompanied by a general inflammatory response. The vascular wall including those in chorioids may be activated by several repeated and/or prolonged mechanical, physical, chemical, microbiological, immunologic and genetic factors causing a protracted host defence response with a consequent vascular damage, which leads to age-related macular degeneration. Based on this concept, age-related macular degeneration is a local manifestation of the systemic vascular disease. This recognition should have therapeutic implications because restoration of endothelial dysfunction can stabilize the condition of chronic vascular disease including age-related macular degeneration, as well. Restoration of endothelial dysfunction by non-pharmacological or pharmacological interventions may prevent the development or improve endothelial dysfunction resulting in prevention or improvement of age-related macular degeneration. Non-pharmacological interventions which may have beneficial effect in endothelial dysfunction include (1) smoking cessation; (2) reduction of increased body weight; (3) adequate physical activity; (4) appropriate diet (a) proper dose of flavonoids, polyphenols and kurcumin; (b) omega-3 long-chain polyunsaturated fatty acids: docosahexaenoic acid and eicosapentaenoic acid; (c) carotenoids, lutein and zeaxanthins), (d) management of dietary glycemic index, (e) caloric restriction, and (5) elimination of stressful lifestyle. Non-pharmacological interventions should be preferable even if medicaments are also used for the treatment of endothelial dysfunction.

  2. Cystoid macular edema in a patient with Danon disease

    Directory of Open Access Journals (Sweden)

    Heather G Mack

    2014-01-01

    Full Text Available To report a patient with Danon retinopathy with cystoid macular edema treated with topical dorzolamide 2% eye drops and oral acetazolamide. A 37-year-old Caucasian man with Danon disease treated with topical and oral carbonic anhydrase inhibitors participated in the study. Examinations performed before and during treatment included visual acuity (VA, spectral-domain optical coherence tomography, and electroretinography. Following total 48 weeks of treatment, VA decreased from 20/30 OD, 20/200 OS, to 20/40 OD, CF OS. The mean central retinal thickness was unchanged from baseline 263 μm OD , 226 μm OS, after treatment 283 μm OD and 202 μm OS. In our case, carbonic anydrase inhibitors were not effective. However, a general recommendation cannot be given based on a single case.

  3. Radiation Therapy for Neovascular Age-related Macular Degeneration

    Energy Technology Data Exchange (ETDEWEB)

    Kishan, Amar U. [Harvard Medical School, Boston, Massachusetts (United States); Modjtahedi, Bobeck S.; Morse, Lawrence S. [Department of Ophthalmology and Vision Sciences, University of California, Davis, Sacramento, California (United States); Lee, Percy, E-mail: percylee@mednet.ucla.edu [Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California (United States)

    2013-03-01

    In the enormity of the public health burden imposed by age-related macular degeneration (ARMD), much effort has been directed toward identifying effective and efficient treatments. Currently, anti-vascular endothelial growth factor (VEGF) injections have demonstrated considerably efficacy in treating neovascular ARMD, but patients require frequent treatment to fully benefit. Here, we review the rationale and evidence for radiation therapy of ARMD. The results of early photon external beam radiation therapy are included to provide a framework for the sequential discussion of evidence for the usage of stereotactic radiation therapy, proton therapy, and brachytherapy. The evidence suggests that these 3 modern modalities can provide a dose-dependent benefit in the treatment of ARMD. Most importantly, preliminary data suggest that all 3 can be used in conjunction with anti-VEGF therapeutics, thereby reducing the frequency of anti-VEGF injections required to maintain visual acuity.

  4. Vitamin D and Age-Related Macular Degeneration

    Directory of Open Access Journals (Sweden)

    Alfredo Garcia Layana

    2017-10-01

    Full Text Available In recent years, the relationship between vitamin D and health has received growing attention from the scientific and medical communities. Vitamin D deficiencies have been repeatedly associated with various acute and chronic diseases, including age-related macular degeneration (AMD. Its active metabolite, 1α,25-dihydoxy vitamin D, acts as a modulator of cell proliferation, differentiation and apoptosis, and cumulative data from experimental and observational studies suggest that relatively a lower vitamin D status could be a potential risk factor for the development of early and/or late AMD. Herein, we made a narrative review of the mechanisms linking a potential role of vitamin D with the current concepts of AMD pathophysiology.

  5. Effect of Supplemental Lutein and Zeaxanthin on Serum, Macular Pigmentation, and Visual Performance in Patients with Early Age-Related Macular Degeneration

    Science.gov (United States)

    Huang, Yang-Mu; Dou, Hong-Liang; Huang, Fei-Fei; Xu, Xian-Rong; Zou, Zhi-Yong

    2015-01-01

    Purpose. To compare the 2-year effect of multiple doses of lutein/zeaxanthin on serum, macular pigmentation, and visual performance on patients with early age-related macular degeneration (AMD). Methods. In this randomized, double-blinded, and placebo-controlled trial, 112 early AMD patients randomly received either 10 mg lutein, 20 mg lutein, a combination of lutein (10 mg) and zeaxanthin (10 mg), or placebo daily for 2 years. Serum concentration of lutein/zeaxanthin, macular pigment optical density (MPOD), visual functions including best-spectacle corrected visual acuity (BCVA), contrast sensitivity (CS), flash recovery time (FRT), and vision-related quality of life (VFQ25) was quantified. Results. Serum lutein concentration and MPOD significantly increased in all the active treatment groups. Supplementation with 20 mg lutein was the most effective in increasing MPOD and CS at 3 cycles/degree for the first 48 weeks. However, they both significantly increased to the same peak value following supplementation with either 10 mg or 20 mg lutein during the intervention. No statistical changes of BCVA or FRT were observed during the trial. Conclusions. Long-term lutein supplementation could increase serum lutein concentration, MPOD, and visual sensitivities of early AMD patients. 10 mg lutein daily might be an advisable long-term dosage for early AMD treatment. PMID:25815324

  6. The effect of intravitreal administration of bevacizumab on macular edema and visual acuity in age-related macular degeneration with subfoveolar choroidal neovascularisation

    Directory of Open Access Journals (Sweden)

    Ristić Dragana

    2013-01-01

    Full Text Available Background/Aim. Age-related macular degeneration (AMD is a leading cause of the loss of central visual acuity in population older than 70 years. We can distinguish wet and dry form of AMD. The aim of the study was to present our early results in treatment of the wet (neovascular form of AMD with intravitreal administration of bevacizumab. Methods. The study included 39 patients. Each patient underwent a complete ophthalmological examination, fluorescein angiography (FA and optical coherence tomography (OCT. All the patients received 1.25 mg of intravitreal bevacizumab (0.05 mL of commercial phial of Avastin®. The total of three doses was given with a one-month interval between doses. Results. Among 39 patients, 24 were women and 15 men. The average best corrected visual acuity (BCVA was improved from 0.09 before the therapy to 0.24 after the administration of all the three doses of bevacizumab (p < 0.001. The average central macular thickness (CMT measured by OCT was improved from 474 μm in the beginning to 341 μm after the administration of all the three doses of the drug (p < 0.001. There were no side effects. Conclusions. Our short-term experience indicates that intravitreal administration of three doses of bevacizumab in one-month intervals between the doses leads to a significant reduction of macular edema and improvement of BCVA in patients with neovascular AMD.

  7. Macular pigment density variation after supplementation of lutein and zeaxanthin using the Visucam®200 pigment module: Impact of age-related macular degeneration and lens status.

    Science.gov (United States)

    Azar, G; Quaranta-El Maftouhi, M; Masella, J-J; Mauget-Faÿsse, M

    2017-04-01

    To assess the evolution of macular pigment optical density (MPOD) following supplementation with various macular formulations obtained with the Visucam ® 200, and to study the factors affecting MPOD measurements. In this prospective, randomized, double-masked multicenter study, patients were divided into 2 groups: group A (patients without retinal pathology who underwent cataract surgery 1 month previously) and group B (patients with neovascular age-related macular degeneration [AMD] in one eye). In each group, half of the patients were randomly assigned to receive a food supplementation either with or without carotenoids (5mg of Lutein and 1mg of Zeaxanthin). Outcome measures included MPOD responses obtained with the Visucam ® 200 for one year. In total, 126 subjects (52 men, 74 women) with a mean age of 75.3±7.61 years were enrolled. Mean MPOD values at the time of inclusion were statistically lower in group A (0.088 density unit [DU]) compared to group B (0.163 DU, P<0.05). No statistically significant increase in MPOD was noted in either group, even after discontinuation of the supplementation. By multiple regression analysis, age, female gender, lens status and the presence of AMD seemed to significantly affect MPOD measurements. No significant improvement in MPOD seems to be detected with the Visucam ® 200 after carotenoid supplementation. The MPOD measurement seems to be highly affected by cataract extraction and the presence of AMD. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  8. 3-D components of a biological neural network visualized in computer generated imagery. I - Macular receptive field organization

    Science.gov (United States)

    Ross, Muriel D.; Cutler, Lynn; Meyer, Glenn; Lam, Tony; Vaziri, Parshaw

    1990-01-01

    Computer-assisted, 3-dimensional reconstructions of macular receptive fields and of their linkages into a neural network have revealed new information about macular functional organization. Both type I and type II hair cells are included in the receptive fields. The fields are rounded, oblong, or elongated, but gradations between categories are common. Cell polarizations are divergent. Morphologically, each calyx of oblong and elongated fields appears to be an information processing site. Intrinsic modulation of information processing is extensive and varies with the kind of field. Each reconstructed field differs in detail from every other, suggesting that an element of randomness is introduced developmentally and contributes to endorgan adaptability.

  9. Efficacy of intravitreal ranibizumab injection combined with macular grid photocoagulation for diabetic macular edema

    Directory of Open Access Journals (Sweden)

    Hu-Lin Jiang

    2014-07-01

    Full Text Available AIM:To evaluate the clinical efficacy of intravitreal injection of ranibizumab combined with macular grid photocoagulation for diabetic macular edema(DME.METHODS:Totally 60 eyes(60 patientswith DME were randomly divided into 2 groups: 30 eyes of simple injection group underwent intravitreal injection of ranibizumab, and 30 eyes of combined treatment group underwent intravitreal injection of ranibizumab and macular grid photocoagulation 1wk later. The best corrected visual acuity(BCVA, central macular thickness(CMTmeasured by optical coherence tomography(OCTand postoperative complications were observed.RESULTS:In simple injection group, the BCVA after operation were separately 0.390±0.075(4wk, 0.367±0.088(8wkand 0.319±0.064(12wk,the CMT after operation were separately 221.63±112.34μm(4wk, 337.73±99.56μm(8wkand 432.92±100.46μm(12wk, which were much better than pre-operation. But during follow-up, the BCVA presented down trend and the CMT was on the rise slowly. In combined treatment group, the BCVA after operation were separately 0.385±0.036(4wk, 0.382±0.079(8wkand 0.377±0.097(12wk,the CMT after operation were separately 249.77±106.55μm(4wk, 270.40±92.88μm(8wkand 275.84±97.34μm(12wk, which were satisfactory and steady during follow-up, better than simple injection group(PCONCLUSION:Intravitreal injection of ranibizumab can effectively improve visual acuity and decrease central foveal thickness for patients with DME, combining with macular grid photocoagulation can ensure therapeutic effects steady and permanent.

  10. Laser-Based Strategies to Treat Diabetic Macular Edema: History and New Promising Therapies

    Directory of Open Access Journals (Sweden)

    Young Gun Park

    2014-01-01

    Full Text Available Diabetic macular edema (DME is the main cause of visual impairment in diabetic patients. The management of DME is complex and often various treatment approaches are needed. At the present time, despite the enthusiasm for evaluating several new treatments for DME, including the intravitreal pharmacologic therapies (e.g., corticosteroids and anti-VEGF drugs, laser photocoagulation still remains the current standard in DME. The purpose of this review is to update our knowledge on laser photocoagulation for DME and describe the developments in laser systems. And we will also discuss the new laser techniques and review the latest results including benefits of combined therapy. In this paper, we briefly summarize the major laser therapeutics for the treatment of diabetic macular edema and allude to some future promising laser therapies.

  11. Twenty-five-gauge vitrectomy versus 23-gauge vitrectomy in the management of macular diseases: a comparative analysis through a Health Technology Assessment model.

    Science.gov (United States)

    Grosso, Andrea; Charrier, Lorena; Lovato, Emanuela; Panico, Claudio; Mariotti, Cesare; Dapavo, Giancarlo; Chiuminatto, Roberto; Siliquini, Roberta; Gianino, Maria Michela

    2014-04-01

    Small-gauge vitreoretinal techniques have been shown to be safe and effective in the management of a wide spectrum of vitreoretinal diseases. However, the costs of the new technologies may represent a critical issue for national health systems. The aim of the study is to plan a Health Technology Assessment (HTA) by performing a comparative analysis between the 23- and 25-gauge techniques in the management of macular diseases (epiretinal membranes, macular holes, vitreo-macular traction syndrome). In this prospective study, 45-80-year-old patients undergoing vitrectomy surgery for macular disease were enrolled at the Torino Eye Hospital. In the HTA model we assessed the safety, clinical effectiveness, and cost and financial evaluation of 23-gauge compared with 25-gauge vitrectomies. Fifty patients entered the study; 14 patients underwent 23-gauge vitrectomy and 36 underwent 25-gauge vitrectomy. There was no statistically significant difference in post-operative visual acuity at 1 year between the two groups. No cases of retinal detachment or endophtalmitis were registered at 1-year follow-up. The 23-gauge technique was slightly more expensive than the 25-gauge: the total surgical costs were EUR1217.70 versus EUR1164.84 (p = 0.351). We provide a financial comparison between new vitreoretinal procedures recently introduced in the market and reimbursed by the Italian National Health System and we also stimulate a critical debate about the expensive technocratic model of medicine.

  12. Intravitreal bevacizumab for macular edema due to branch retinal vein occlusion: 12-month results

    OpenAIRE

    Demir M; Oba E; Gulkilik G; Odabasi M; Ozdal E

    2011-01-01

    Mehmet Demir, Ersin Oba, Gökhan Gulkilik, Mahmut Odabasi, Erhan OzdalSisli Etfal Training and Research Hospital, Eye Clinic, Sisli, Istanbul, TurkeyPurpose: To present the functional and anatomic changes after intravitreal bevacizumab in eyes with macular edema (ME) due to branch retinal vein occlusion (BRVO).Design: The study was a retrospective study.Materials and methods: The study included 31 patients with ME due to BRVO. We compared the examination findings of patients with ME b...

  13. Astrophysical black holes

    CERN Document Server

    Gorini, Vittorio; Moschella, Ugo; Treves, Aldo; Colpi, Monica

    2016-01-01

    Based on graduate school lectures in contemporary relativity and gravitational physics, this book gives a complete and unified picture of the present status of theoretical and observational properties of astrophysical black holes. The chapters are written by internationally recognized specialists. They cover general theoretical aspects of black hole astrophysics, the theory of accretion and ejection of gas and jets, stellar-sized black holes observed in the Milky Way, the formation and evolution of supermassive black holes in galactic centers and quasars as well as their influence on the dynamics in galactic nuclei. The final chapter addresses analytical relativity of black holes supporting theoretical understanding of the coalescence of black holes as well as being of great relevance in identifying gravitational wave signals. With its introductory chapters the book is aimed at advanced graduate and post-graduate students, but it will also be useful for specialists.

  14. The Membrane Paradigm and black-hole thermodynamics

    International Nuclear Information System (INIS)

    Thorne, K.S.

    1986-01-01

    A brief overview is given of the theoretical underpinnings of the Membrane Paradigm for black-hole physics. Then those underpinnings are used to elucidate the Paradigm's view that the laws of black-hole thermodynamics (including the statistical origin of black-hole entropy) are just a special case of the laws of thermodynamics for an ordinary, rotating, thermal reservoir

  15. Evaluation of nepafenac in prevention of macular edema following cataract surgery in patients with diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Singh R

    2012-08-01

    Full Text Available Rishi Singh,1 Louis Alpern,2 Glenn J Jaffe,3 Robert P Lehmann,4 John Lim,5 Harvey J Reiser,6 Kenneth Sall,7 Thomas Walters,8 Dana Sager91Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, 2The Cataract, Glaucoma, and Refractive Surgery Center, El Paso, TX, 3Duke Eye Center, Duke Reading Center, Duke University, Durham, NC, 4Lehmann Eye Center, Nacogdoches, TX, 5Houston Eye Associates, Houston, TX, 6Eye Care Specialists, Kingston, PA, 7Sall Research Medical Center, Artesia, CA, 8Texan Eye, Austin, TX, 9Alcon Research Ltd, Fort Worth, TX, USABackground: The purpose of this study was to evaluate nepafenac ophthalmic suspension 0.1% (Nevanac®; Alcon Research Ltd in the prevention of macular edema following cataract surgery in diabetic retinopathy patients.Methods: This was a multicenter, randomized, double-masked, vehicle-controlled study of 263 adult diabetic patients with nonproliferative diabetic retinopathy requiring cataract surgery. Patients were randomized (1:1 to instill nepafenac or vehicle three times daily beginning 1 day prior to surgery through day 90. Efficacy included the percentage of patients who developed macular edema (≥30% increase in central subfield macular thickness from baseline and the percentage of patients with decreases of more than five letters in best-corrected visual acuity from day 7 to 90.Results: A significantly lower percentage of patients in the nepafenac group developed macular edema relative to patients in the vehicle group (3.2% versus 16.7%; P < 0.001. A significantly lower percentage of patients in the nepafenac group had best-corrected visual acuity decreases of more than five letters relative to patients in the vehicle group on day 30 (P < 0.001, day 60 (P = 0.002, and day 90 (P = 0.006. The mean central subfield macular thickness and mean percent change from baseline in macular volume were also significantly lower in the nepafenac group versus the vehicle group at days 14 through 90 (P

  16. SAFETY AND EFFICACY OF INTRAVITREAL DEXAMETHASONE IMPLANTS IN THE MANAGEMENT OF MACULAR EDEMA SECONDARY TO INFECTIOUS UVEITIS.

    Science.gov (United States)

    Fonollosa, Alex; Llorenç, Victor; Artaraz, Joseba; Jimenez, Beatriz; Ruiz-Arruza, Ioana; Agirrebengoa, Koldo; Cordero-Coma, Miguel; Costales-Mier, Felipe; Adan, Alfredo

    2016-09-01

    To assess the safety and efficacy of intravitreal dexamethasone implants in the treatment of macular edema secondary to infectious uveitis. We retrospectively reviewed clinical records from three uveitis referral units in Spain. The main outcome measures were rate of reactivation of infection, improvements in visual acuity and resolution of macular edema, as measured by optical coherence tomography. We included eight eyes from seven patients with a median age of 64 years (30-75). Etiologies of the infections were Herpes simplex virus-type 1, Varicela-Zoster virus, Treponema pallidum, Brucella mellitensis, Borrelia burgdorferi, Toxoplasma gondii, and cytomegalovirus. Median visual acuity was 20/160 (20/30-20/400) at baseline and 20/70 (20/25-20/200) at the last follow-up visit. Mean macular thickness was 516 μm (115) at baseline and 266.3 μm (40) at the last follow-up visit. Visual acuity improved in 100% of the eyes and none of the eyes showed macular edema at the last follow-up visit. Five patients required reinjections of the implant. Only one patient required antiglaucoma drops for a temporary increase in ocular pressure. There were no cases of reactivation of the infectious ocular disease. Median follow-up time was 18 months. In this small case series of eyes with macular edema secondary to infectious uveitis, treatment with dexamethasone intravitreal implants was not associated with reactivation of the infectious ocular disease. Furthermore, significant improvements in visual acuity and macular thickness were observed in our patients.

  17. Action growth for black holes in modified gravity

    Science.gov (United States)

    Sebastiani, Lorenzo; Vanzo, Luciano; Zerbini, Sergio

    2018-02-01

    The general form of the action growth for a large class of static black hole solutions in modified gravity which includes F (R ) -gravity models is computed. The cases of black hole solutions with nonconstant Ricci scalar are also considered, generalizing the results previously found and valid only for black holes with constant Ricci scalar. An argument is put forward to provide a physical interpretation of the results, which seem tightly connected with the generalized second law of black hole thermodynamics.

  18. Nonextremal stringy black hole

    International Nuclear Information System (INIS)

    Suzuki, K.

    1997-01-01

    We construct a four-dimensional BPS saturated heterotic string solution from the Taub-NUT solution. It is a nonextremal black hole solution since its Euler number is nonzero. We evaluate its black hole entropy semiclassically. We discuss the relation between the black hole entropy and the degeneracy of string states. The entropy of our string solution can be understood as the microscopic entropy which counts the elementary string states without any complications. copyright 1997 The American Physical Society

  19. Holes help control temperature

    Science.gov (United States)

    Chhatpar, C. K.

    1981-01-01

    Study of passive thermal control for the Solar Terrestrial Subsatellite (STSS) has found that array of "see through" holes substantially improves performance of system. Holes in payload mounting plates allow line of sight radiative heat transfer between hot and cold ends of spacecraft and between mounting plates and ends. Temperature gradients between plates are thereby reduced, as is temperature of each plate. Holes and selected exterior paints and finishes keep payload cool for all orientations and operating modes of STSS.

  20. Regular phantom black holes.

    Science.gov (United States)

    Bronnikov, K A; Fabris, J C

    2006-06-30

    We study self-gravitating, static, spherically symmetric phantom scalar fields with arbitrary potentials (favored by cosmological observations) and single out 16 classes of possible regular configurations with flat, de Sitter, and anti-de Sitter asymptotics. Among them are traversable wormholes, bouncing Kantowski-Sachs (KS) cosmologies, and asymptotically flat black holes (BHs). A regular BH has a Schwarzschild-like causal structure, but the singularity is replaced by a de Sitter infinity, giving a hypothetic BH explorer a chance to survive. It also looks possible that our Universe has originated in a phantom-dominated collapse in another universe, with KS expansion and isotropization after crossing the horizon. Explicit examples of regular solutions are built and discussed. Possible generalizations include k-essence type scalar fields (with a potential) and scalar-tensor gravity.

  1. Acute Macular Neuroretinopathy Associated With Chikungunya Fever.

    Science.gov (United States)

    Pang, Claudine E; Navajas, Eduardo V; Warner, Simon J; Heisler, Morgan; Sarunic, Marinko V

    2016-06-01

    A 47-year-old man with recent travel to the Caribbean was admitted with acute febrileillness associated with arthralgia and skin rash followed by sudden onset of bilateral visual field defects. Funduscopy revealed subtle bilateral paracentral dark lesions nasal to the fovea best seen on near infrared imaging as hyporeflective, wedge-shaped, paracentral macular lesions. Spectral-domain optical coherence tomography (SD-OCT) through the lesions revealed hyperreflective bands at the level of the outer plexiform layer and outer nuclear layer (ONL), with concomitant attenuation of the underlying external limiting membrane (ELM), ellipsoid zone (EZ), and interdigitation zone (IZ). Neither fluorescein angiography nor speckle variance OCT angiography (sv-OCTA) showed any defects in retinal circulation. Work up revealed positive Immunoglobulin M for Chikungunya virus (CHIKV). Six months later, the patient had persistent scotomas, although reduced in size. SD-OCT showed subtle ONL thinning and restoration of the ELM, although EZ and IZ remained disrupted. Chikungunya fever may manifest as bilateral acute macular neuroretinopathy (AMN). Clinicians should be aware of possible systemic associations of AMN. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:596-599.]. Copyright 2016, SLACK Incorporated.

  2. Management of pseudophakic cystoid macular edema.

    Science.gov (United States)

    Guo, Suqin; Patel, Shriji; Baumrind, Ben; Johnson, Keegan; Levinsohn, Daniel; Marcus, Edward; Tannen, Brad; Roy, Monique; Bhagat, Neelakshi; Zarbin, Marco

    2015-01-01

    Pseudophakic cystoid macular edema (PCME) is a common complication following cataract surgery. Acute PCME may resolve spontaneously, but some patients will develop chronic macular edema that affects vision and is difficult to treat. This disease was described more than 50 years ago, and there are multiple options for clinical management. We discuss mechanisms, clinical efficacy, and adverse effects of these treatment modalities. Topical non-steroidal anti-inflammatory agents and corticosteroids are widely used and, when combined, may have a synergistic effect. Intravitreal corticosteroids and anti-vascular endothelial growth factor (anti-VEGF) agents have shown promise when topical medications either fail or have had limited effects. Randomized clinical studies evaluating anti-VEGF agents are needed to fully evaluate benefits and risks. When PCME is either refractory to medical therapy or is associated with significant vitreous involvement, pars plana vitrectomy has been shown to improve outcomes, though it is associated with additional risks. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. A large genome-wide association study of age-related macular degeneration highlights contributions of rare and common variants

    NARCIS (Netherlands)

    L.G. Fritsche (Lars); W. Igl (Wilmar); J.N. Cooke Bailey (Jessica N.); F. Grassmann (Felix); S. Sengupta (Sebanti); J.L. Bragg-Gresham (Jennifer L.); Burdon, K.P. (Kathryn P.); S.J. Hebbring (Scott J.); Wen, C. (Cindy); M. Gorski (Mathias); I.K. Kim (Ivana); Cho, D. (David); Zack, D. (Donald); E.H. Souied (Eric); H.P.N. Scholl (Hendrik); E. Bala (Elisa); ELee, K. (Kristine); D. Hunter (David); Sardell, R.J. (Rebecca J.); P. Mitchell (Paul); J.E. Merriam (Joanna); F. Cipriani (Francesco); Hoffman, J.D. (Joshua D.); T. Schick (Tina); Y.T.E. Lechanteur (Yara T. E.); R.H. Guymer (Robyn); M.P. Johnson (Matthew); Y. Jiang; C.M. Stanton (Chloe); G.H.S. Buitendijk (Gabrielle); X. Zhan (Xiaowei); Kwong, A.M. (Alan M.); A. Boleda (Alexis); M. Brooks (Matthew); L. Gieser (Linn); R. Ratna Priya (Rinki); K.E. Branham (Kari); Foerster, J.R. (Johanna R.); J.R. Heckenlively (John); M.I. Othman (Mohammad); B.J. Vote (Brendan J.); Liang, H.H. (Helena Hai); E. Souzeau (Emmanuelle); McAllister, I.L. (Ian L.); T. Isaacs (Timothy); Hall, J. (Janette); Lake, S. (Stewart); D.A. Mackey (David); Constable, I.J. (Ian J.); J.E. Craig (Jamie E.); T.E. Kitchner (Terrie E.); Yang, Z. (Zhenglin); Su, Z. (Zhiguang); Luo, H. (Hongrong); Chen, D. (Daniel); Ouyang, H. (Hong); K. Flagg (Ken); Lin, D. (Danni); Mao, G. (Guanping); H.A. Ferreyra (Henry); K. Stark (Klaus); C. von Strachwitz (Claudia); Wolf, A. (Armin); C. Brandl (Caroline); Rudolph, G. (Guenther); M. Olden (Matthias); M.A. Morrison (Margaux); D.J. Morgan (Denise); M. Schu (Matthew); Ahn, J. (Jeeyun); G. Silvestri (Giuliana); E.E. Tsironi (Evangelia); Park, K.H. (Kyu Hyung); L.A. Farrer (Lindsay); A. Orlin (Anton); Brucker, A. (Alexander); X. Li (Xiaohui); C.A. Curcio (Christine A.); Mohand-Sa'd, S. (Saddek); J.-A. Sahel (José-Alain); I. Audo (Isabelle); M. Benchaboune (Mustapha); A.J. Cree (Angela); Rennie, C.A. (Christina A.); Goverdhan, S.V. (Srinivas V.); M. Grunin (Michelle); S. Hagbi-Levi (Shira); B. Campochiaro (Betsy); N. Katsanis (Nicholas); J.-B. Holz; F. Blond (Frédéric); Blanché, H. (Hél'ne); Deleuze, J.-F. (Jean-Fran'ois); R.P. Igo Jr. (Robert); B.J. Truitt (Barbara); N.S. Peachey (Neal ); S.M. Meuer (Stacy); C.E. Myers (Chelsea); Moore, E.L. (Emily L.); R. Klein (Ronald); M.A. Hauser (Michael); E.A. Postel (Eric); M.D. Courtenay (Monique D.); S.M. Schwartz (Stephen); J.L. Kovach (Jaclyn); W.K. Scott (William); Liew, G. (Gerald); Tan, A.G. (Ava G.); B. Gopinath (Bamini); J.E. Merriam (Joanna); T. Smith (Tim); J.C. Khan (Jane); M. Shahid (Mohammad); A.T. Moore (Anthony); J.A. McGrath (J Allie); R. Laux (Reneé); M.A. Brantley (Milam); A. Agarwal (Anita); L. Ersoy (Lebriz); A. Caramoy (Albert); T. Langmann (Thomas); N.T.M. Saksens (Nicole T.); Jong, E.K. (Eiko Kde); C. Hoyng (Carel); M.S. Cain (Melinda); A.J. Richardson (Andrea); T.M. Martin (Tammy M.); J. Blangero (John); D.E. Weeks (Daniel); Dhillon, B. (Bal); C.M. van Duijn (Cornelia); K.F. Doheny (Kimberly); Romm, J. (Jane); C.C.W. Klaver (Caroline); C. Hayward (Caroline); Gorin, M.B. (Michael B.); M.L. Klein (Michael); P.N. Baird (Paul); A.I. Hollander (Anneke); Fauser, S. (Sascha); WYates, J.R. (John R.); R. Allikmets (Rando); J.J. Wang (Jie Jin); D.A. Schaumberg (Debra); B.E.K. Klein (Barbara); S.A. Hagstrom (Stephanie); Y. Chowers (Yehuda); A.J. Lotery (Andrew); T. Léveillard (Thierry); K. Zhang (Kang); M.H. Brilliant (Murray H.); A.W. Hewit (Alex); A. Swaroop (Anand); Chew, E.Y. (Emily Y.); M.A. Pericak-Vance (Margaret); M.M. DeAngelis (Margaret); D. Stambolian (Dwight); J.L. Haines (Jonathan); S.K. Iyengar (Sudha); B.H.F. Weber (Bernhard); G.R. Abecasis (Gonçalo); I.M. Heid (Iris)

    2016-01-01

    textabstractAdvanced age-related macular degeneration (AMD) is the leading cause of blindness in the elderly, with limited therapeutic options. Here we report on a study of >12 million variants, including 163,714 directly genotyped, mostly rare, protein-altering variants. Analyzing 16,144 patients

  4. Autologous platelet concentrate in surgery for macular detachment associated with congenital optic disc pit

    Directory of Open Access Journals (Sweden)

    Nadal J

    2015-10-01

    Full Text Available Jeroni Nadal,1,2 Marta S Figueroa,3 Elisa Carreras,2,4 Patricia Pujol,2,4 Maria Isabel Canut,2,4,5 Rafael Ignacio Barraquer2,6 1Vitreoretinal Surgery Department at Centro de Oftalmología Barraquer, 2Universitat autónoma de Barcelona, Barcelona, 3Vissum Madrid, Madrid, 4Instituto Barraquer, 5Glaucoma Department at Centro de Oftalmología Barraquer, 6Cornea and Cataract Surgery Department at Centro de Oftalmología Barraquer, Barcelona, Spain Purpose: To evaluate the anatomical and functional results obtained with pars plana vitrectomy (PPV plus autologous platelet concentrate (APC as a treatment for macular detachment associated with optic disc pit (ODP.Methods: We performed a prospective interventional study of 19 eyes of 19 consecutive patients with posterior macular detachment due to ODP. All patients underwent PPV, posterior hyaloid peeling, fluid–air exchange, injection of 0.05 mL of APC over the ODP and 15% perfluoropropane (C3F8 endotamponade. Postoperative measures included face-up positioning for 2 hours and then avoidance of the face-up position during the ensuing 10 days. All patients underwent complete ophthalmologic examination and optical coherence tomography preoperatively at 1 month, 3 months, 6 months, 9 months, and 12 months postoperatively and then annually. Outcome measures were best corrected visual acuity (BCVA by logMAR, improvement of quality of vision, macular attachment, and resolution of intraretinal schisis-like separation.Results: Preoperatively, the median BCVA was 0.70 (range: 0.30–1.70 and all patients showed improved visual acuity after surgery; BCVA was 0.22 (range: 0.07–0.52 at 12 months follow-up. All patients showed complete reabsorption of intraretinal fluid (median time: 3.5 months [range: 2–8 months] and macular attachment at the end of follow-up (median: 60 months [range: 12–144 months], with stable or improved visual acuity. No reoperations were needed and no major adverse events were

  5. BRIDGE ARCH-SHAPED SEROUS RETINAL DETACHMENT IN AGE-RELATED MACULAR DEGENERATION.

    Science.gov (United States)

    Fajnkuchen, Franck; Cohen, Salomon Y; Thay, Nathalie; Ayrault, Sandrine; Delahaye-Mazza, Corinne; Grenet, Typhaine; Nghiem-Buffet, Sylvia; Quentel, Gabriel; Giocanti-Auregan, Audrey

    2016-03-01

    To describe bridge arch-shaped serous retinal detachment (SRD) in exudative age-related macular degeneration and evaluate its functional outcomes. In this monocentric, retrospective, noncomparative case series, patients were included. Patients with exudative age-related macular degeneration and bridge arch-shaped SRD treated with ranibizumab were included. Anatomical patterns of SRD and functional outcomes were assessed. Twenty-two eyes with bridge arch-shaped SRD of 22 patients with age-related macular degeneration were included. Serous retinal detachments were characterized by a steep angle at the junction between the retinal pigment epithelium and the sensory retina (mean, 53.45 ± 12.5°), and characterized by the presence of adhesion areas between the sensory retina and a fibrous complex developed from the choroidal neovascularization. In 15 eyes, the choroidal neovascularization was classic choroidal neovascularization and a fibrotic evolution was observed. Serous retinal detachments were compartmentalized in 14 eyes, leading to a multipocket structure. Visual acuity decreased from 49.9 ± 19.2 letters (20/100) to 40.3 ± 18.6 letters (20/160), corresponding to a mean change of -9.6 ± 19.4 letters. This was the first study to describe the specific morphologic features of bridge arch-shaped SRD, a previously undescribed type of SRD complicating exudative age-related macular degeneration. Patients with bridge arch-shaped SRD responded to intravitreal injections of ranibizumab, but their visual prognosis was unfavorable, compared with the literature. The presence of bridge arch-shaped SRD seemed to be a marker for the fibrotic evolution of the choroidal neovascularization.

  6. NNWSI [Nevada Nuclear Waste Storage Investigations] hole histories: Unsaturated zone-neutron holes: 76 boreholes drilled between May 1984 and February 1986

    International Nuclear Information System (INIS)

    1987-05-01

    This is a compilation of data from seventy-four shallow alluvial exploratory core holes and two shallow calibration core holes. The boreholes were drilled to obtain undisturbed alluvial cores, to determine vertical distribution of moisture content and water potential, and to run neutron moisture logs. Data presented in the hole histories include all locations, daily activities and review of hole conditions

  7. Subfoveal choroidal thickness predicts macular atrophy in age-related macular degeneration: results from the TREX-AMD trial.

    Science.gov (United States)

    Fan, Wenying; Abdelfattah, Nizar Saleh; Uji, Akihito; Lei, Jianqin; Ip, Michael; Sadda, SriniVas R; Wykoff, Charles C

    2018-03-01

    Our purpose was to evaluate the relationship between subfoveal choroidal thickness (SCT) and development of macular atrophy (MA) in eyes with age-related macular degeneration (AMD). This was a prospective, multicenter study. Sixty participants (120 eyes) in the TREX-AMD trial (NCT01648292) with treatment-naïve neovascular AMD (NVAMD) in at least one eye were included. SCT was measured by certified reading center graders at baseline using spectral domain optical coherence tomography (SDOCT). The baseline SCT was correlated with the presence of MA at baseline and development of incident MA by month 18. Generalized estimating equations were used to account for information from both eyes. Baseline SCT in eyes with MA was statistically significantly less than in those without MA in both the dry AMD (DAMD) (P = 0.04) and NVAMD (P = 0.01) groups. Comparison of baseline SCT between MA developers and non-MA developers revealed a statistically significant difference (P = 0.03). Receiver operating characteristic curve (ROC) analysis showed the cut-off threshold of SCT for predicting the development of MA in cases without MA at baseline was 124 μm (AUC = 0.772; Sensitivity = 0.923; Specificity = 0.5). Among eyes without MA at baseline, those with baseline SCT ≤124 μm were 4.3 times more likely to develop MA (Odds ratio: 4.3, 95% confidence interval: 1.6-12, P = 0.005) than those with baseline SCT >124 μm. Eyes with AMD and MA had less SCT than those without MA. Eyes with less baseline SCT also appear to be at higher risk to develop MA within 18 months.

  8. Differentiation of Diabetic Macular Edema From Pseudophakic Cystoid Macular Edema by Spectral-Domain Optical Coherence Tomography.

    Science.gov (United States)

    Munk, Marion R; Jampol, Lee M; Simader, Christian; Huf, Wolfgang; Mittermüller, Tamara J; Jaffe, Glenn J; Schmidt-Erfurth, Ursula

    2015-10-01

    To differentiate diabetic macular edema (DME) from pseudophakic cystoid macular edema (PCME) based solely on spectral-domain optical coherence tomography (SD-OCT). This cross-sectional study included 134 participants: 49 with PCME, 60 with DME, and 25 with diabetic retinopathy (DR) and ME after cataract surgery. First, two unmasked experts classified the 25 DR patients after cataract surgery as either DME, PCME, or mixed-pattern based on SD-OCT and color-fundus photography. Then all 134 patients were divided into two datasets and graded by two masked readers according to a standardized reading-protocol. Accuracy of the masked readers to differentiate the diseases based on SD-OCT parameters was tested. Parallel to the masked readers, a computer-based algorithm was established using support vector machine (SVM) classifiers to automatically differentiate disease entities. The masked readers assigned 92.5% SD-OCT images to the correct clinical diagnose. The classifier-accuracy trained and tested on dataset 1 was 95.8%. The classifier-accuracy trained on dataset 1 and tested on dataset 2 to differentiate PCME from DME was 90.2%. The classifier-accuracy trained and tested on dataset 2 to differentiate all three diseases was 85.5%. In particular, higher central-retinal thickness/retinal-volume ratio, absence of an epiretinal-membrane, and solely inner nuclear layer (INL)-cysts indicated PCME, whereas higher outer nuclear layer (ONL)/INL ratio, the absence of subretinal fluid, presence of hard exudates, microaneurysms, and ganglion cell layer and/or retinal nerve fiber layer cysts strongly favored DME in this model. Based on the evaluation of SD-OCT, PCME can be differentiated from DME by masked reader evaluation, and by automated analysis, even in DR patients with ME after cataract surgery. The automated classifier may help to independently differentiate these two disease entities and is made publicly available.

  9. [Summarize drug dosage forms in treatment of age-related macular degeneration disease].

    Science.gov (United States)

    Du, Mao-Bo; Liu, Shu-Zhi; Xu, Kai; Liang, Li-Na; He, Ai-Ping; Yao, Yao; Liu, Ya-Mei

    2017-02-01

    In this review, the authors summarized the drugs in treatment of the age-related macular degeneration (AMD or ARMD), including the pathogenesis of the age-related macular degeneration at home and abroad, dosage forms used in the treatment, and the drugs research and development directions in the future. AMD disease is the third largest blinding diseases all over the world, with an incidence of 6.62%. The dosage form of the traditional medicine is mostly oral formulations, playing a role in body, while the newly dosage form is topical drug delivery formulation. Traditional Chinese medicine (TCM) has certain advantages in the treatment of AMD disease and the development of topical drug delivery preparations with newly preparation technologies would have a very bright prospect in the future. Copyright© by the Chinese Pharmaceutical Association.

  10. Automated detection of age-related macular degeneration in OCT images using multiple instance learning

    Science.gov (United States)

    Sun, Weiwei; Liu, Xiaoming; Yang, Zhou

    2017-07-01

    Age-related Macular Degeneration (AMD) is a kind of macular disease which mostly occurs in old people,and it may cause decreased vision or even lead to permanent blindness. Drusen is an important clinical indicator for AMD which can help doctor diagnose disease and decide the strategy of treatment. Optical Coherence Tomography (OCT) is widely used in the diagnosis of ophthalmic diseases, include AMD. In this paper, we propose a classification method based on Multiple Instance Learning (MIL) to detect AMD. Drusen can exist in a few slices of OCT images, and MIL is utilized in our method. We divided the method into two phases: training phase and testing phase. We train the initial features and clustered to create a codebook, and employ the trained classifier in the test set. Experiment results show that our method achieved high accuracy and effectiveness.

  11. Optical coherence tomography of macular atrophy associated with microcephaly and presumed intrauterine Zika virus infection

    Directory of Open Access Journals (Sweden)

    Adriana Gondim de Moura Campos

    Full Text Available ABSTRACT This case report describes the retinal optical coherence tomography (OCT findings in a microcephalic infant with macular atrophy presumably caused by intrauterine Zika virus infection. OCT demonstrated atrophy of the outer retinal layers and choriocapillaris, including the outer nuclear layer and ellipsoid zone, associated with retinal pigment epithelium hyper-reflectivity and increased OCT penetration into deeper layers of the choroid and sclera. A major concern associated with this infection is the apparent increased incidence of microcephaly in fetuses born to mothers infected with the Zika virus. It is becoming increasingly difficult to ignore the upsurge in congenital microcephaly observed in Brazil. Recently, ocular findings in infants with microcephaly associated with intrauterine Zika virus infection have been described. This is the first report of OCT imaging of macular atrophy in a child with presumed Zika virus infection-associated microcephaly.

  12. [Physiopathology of macular edema in central vein occlusion].

    Science.gov (United States)

    Stanca, Horia T; Manea, Georgiana

    2012-01-01

    Retinal Vein Occlusions are vascular diseases affecting the Central Retinal Vein and its branches causing decreased retinal drainage resulting in significant clinical and functional pathological changes. RVO determines the increase of vascular permeability, with edema and hemorrhage and development of collateral vessels in a few weeks. Among the serious consequences of venous occlusion is the installation of macular edema to which depends long-term visual prognosis. Macular Edema is the accumulation of intraretinal serous fluid in the macular area caused by the breakdown of blood-retinal barrier.

  13. Quantum tunneling radiation from self-dual black holes

    Energy Technology Data Exchange (ETDEWEB)

    Silva, C.A.S., E-mail: calex@fisica.ufc.br [Instituto Federal de Educação Ciência e Tecnologia da Paraíba (IFPB), Campus Campina Grande, Rua Tranquilino Coelho Lemos, 671, Jardim Dinamérica I (Brazil); Brito, F.A., E-mail: fabrito@df.ufcg.edu.br [Departamento de Física, Universidade Federal de Campina Grande, Caixa Postal 10071, 58109-970 Campina Grande, Paraíba (Brazil)

    2013-10-01

    Black holes are considered as objects that can reveal quantum aspects of spacetime. Loop Quantum Gravity (LQG) is a theory that propose a way to model the quantum spacetime behavior revealed by a black hole. One recent prediction of this theory is the existence of sub-Planckian black holes, which have the interesting property of self-duality. This property removes the black hole singularity and replaces it with another asymptotically flat region. In this work, we obtain the thermodynamical properties of this kind of black holes, called self-dual black holes, using the Hamilton–Jacobi version of the tunneling formalism. Moreover, using the tools of the tunneling approach, we investigate the emission spectrum of self-dual black holes, and investigate if some information about the black hole initial state can be recovered during the evaporation process. Back-reaction effects are included.

  14. Clinical and tomographic aspects of macular microholes; Aspectos clinicos e tomograficos dos microburacos maculares

    Energy Technology Data Exchange (ETDEWEB)

    Novelli, Fernando Jose de [Hospital de Olhos Sadalla Amin Ghanem, Joinville, SC (Brazil)], e-mail: Fernando.novelli@gmail.com; Maia Junior, Otacilio de Oliveira [Fundacao Monte Tabor, Salvador, BA (Brazil). Hospital Sao Rafael; Nobrega, Mario Junqueira [Universidade da Regiao de Joinville (UNIVILLE), Joinville, SC (Brazil); Garrido Neto, Theodomiro [Universidade do Estado do Amazonas (UEA), Manaus, AM (Brazil); Takahashi, Walter Yukihiko [Universidade de Sao Paulo (USP), SP (Brazil). Hospital das Clinicas. Dept. de Oftalmologia

    2009-07-01

    Purpose: To describe the clinical aspects and evaluate optical coherence tomography of macular microholes. Methods: Seven patients were assessed (8 eyes) with microholes of the macula. All patients underwent complete eye examination, fundus photography, fluorescent angiography and OCT-3 imaging. Results: Ages ranged from 26 to 69 years. Six patients were female (85.7%) and five of them had microhole in the right eye. The presenting symptom was decrease in visual acuity (71.3%) and central scotoma in (14.3%). Five eyes (71.4%) had no defects shown by fluorescent angiography. A defect in the outer retina was demonstrated in all eyes on optical coherence tomography. The lesions were nonprogressive. Conclusion: Macular microholes are small lamellar defects in the outer retina. The condition is nonprogressive, generally unilateral and compatible with good visual acuity. Fundus biomicroscopy associated with an optical coherence tomography are the main elements in the diagnosis and study of this pathology. (author)

  15. LASER PHOTOCOAGULATION IN DIABETIC MACULAR EDEMA: EFFECTS ON VISUAL ACUITY AND MACULAR EDEMA

    Directory of Open Access Journals (Sweden)

    M.H. Dehghan

    1999-06-01

    Full Text Available Due to the importance of clinically significant macular edema in diabetic patients, this study is aimed to determine if laser photocoagulation is effective in the treatment of clinically significant diabetic macular edema. In addition, the effects of risk factors arc surveyed* This is an existing data study considering patients with clinically significant diabetic macular edema, treated with argon-green laser photocoagulation in Labbafinejad hospital, department of lasertherapy, from 1995 to 1997. in 60 (42.6% eyes the treatment method was focal, in 22 (15.6% eyes grid, and in 59 (41.84 modified grid laser photocoagulation was performed. The results are based upon deterioration of visual acuity, occurance of moderate visual loss and improvement or persistence of CSME. We studied 114 eyes from 87 patients. Two years after initial treatment, visual acuity improved in 19.1% of eyes, unchanged in 9.5% and worsened in 71.4% of eyes. After this period the rate of moderate visual loss was 28.6% and CSME was improved in 23.8% of eyes. According to our study, baseline visual acuity and retinopathy severity were two important intervening factors in response to lasertherapy. Comparing our results with natural course of diabetic macular edema, indicates that in assessing visual outcome laser photocoagulation is an effective modality in treatment of CSME, but it is not effective in maintaining or improving visual acuity, which is due to patients delay in visiting ophthalmologists and paying not enough attention to follow-up visits.

  16. MACULAR DEGENERATION AND ASPIRIN USE.

    Science.gov (United States)

    Small, Kent W; Garabetian, Christine A; Shaya, Fadi S

    2017-09-01

    To review current literature of the benefits that aspirin provides for patients' cardiovascular health compared with the risk of AMD worsening. We performed a review and critically analyzed six cardiovascular and four ophthalmological trials regarding risks and benefits of aspirin use. The prospective randomized cardiovascular trials had a cumulative 167,580 while the 3 smaller ophthalmological data sets had a cumulative 12,015 subjects. The reviewed meta-analysis literature demonstrated a statistically significant 32% reduction in the risk of nonfatal stroke with regular aspirin users. The study also documented that aspirin users decreased the risk of fatal vascular deaths by 15%. Of the three ophthalmological studies highlighting the adverse affects of aspirin association with AMD, all suggested an exacerbation of AMD without statistical significance and broad confidence bands. Overall, the number, size, and quality of the cardiovascular studies recommending aspirin use are far superior to the fewer, smaller and conflicting studies suggesting a possible adverse effect of aspirin use in relation to AMD. The benefits of aspirin usage include preserving the duration and quality of life by decreasing stroke and heart attack risk. These benefits seem to far outweigh the theoretical risks of possibly exacerbating wet AMD, which can be reasonably controlled with anti-VEGF therapy.

  17. Newborn Black Holes

    Science.gov (United States)

    Science Teacher, 2005

    2005-01-01

    Scientists using NASA's Swift satellite say they have found newborn black holes, just seconds old, in a confused state of existence. The holes are consuming material falling into them while somehow propelling other material away at great speeds. "First comes a blast of gamma rays followed by intense pulses of x-rays. The energies involved are much…

  18. Black holes are warm

    International Nuclear Information System (INIS)

    Ravndal, F.

    1978-01-01

    Applying Einstein's theory of gravitation to black holes and their interactions with their surroundings leads to the conclusion that the sum of the surface areas of several black holes can never become less. This is shown to be analogous to entropy in thermodynamics, and the term entropy is also thus applied to black holes. Continuing, expressions are found for the temperature of a black hole and its luminosity. Thermal radiation is shown to lead to explosion of the black hole. Numerical examples are discussed involving the temperature, the mass, the luminosity and the lifetime of black mini-holes. It is pointed out that no explosions corresponding to the prediction have been observed. It is also shown that the principle of conservation of leptons and baryons is broken by hot black holes, but that this need not be a problem. The related concept of instantons is cited. It is thought that understanding of thermal radiation from black holes may be important for the development of a quantified gravitation theory. (JIW)

  19. Black hole candidates

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Black hole candidates. In the case of X-ray sources such as Cyg X-1, the mass of the compact object inferred from combined optical and X-ray data, suggest M_compact object > 3.4 M_sun => Black Hole! A remarkable discovery!! Thus X-ray emitting binary systems ...

  20. Black hole Berry phase

    NARCIS (Netherlands)

    de Boer, J.; Papadodimas, K.; Verlinde, E.

    2009-01-01

    Supersymmetric black holes are characterized by a large number of degenerate ground states. We argue that these black holes, like other quantum mechanical systems with such a degeneracy, are subject to a phenomenon which is called the geometric or Berry’s phase: under adiabatic variations of the

  1. Black holes matter

    DEFF Research Database (Denmark)

    Kragh, Helge Stjernholm

    2016-01-01

    Review essay, Marcia Bartusiak, Black Hole: How an Idea Abandoned by Newtonians, Hated by Einstein, and Gambled On by Hawking Became Loved (New Haven: Yale University Press, 2015).......Review essay, Marcia Bartusiak, Black Hole: How an Idea Abandoned by Newtonians, Hated by Einstein, and Gambled On by Hawking Became Loved (New Haven: Yale University Press, 2015)....

  2. Black hole levitron

    NARCIS (Netherlands)

    Arsiwalla, X.D.; Verlinde, E.P.

    2010-01-01

    We study the problem of spatially stabilizing four dimensional extremal black holes in background electric/magnetic fields. Whilst looking for stationary stable solutions describing black holes placed in external fields we find that taking a continuum limit of Denef et al.’s multicenter

  3. Black Hole Dynamic Potentials

    Indian Academy of Sciences (India)

    2016-01-27

    Jan 27, 2016 ... In the following paper, certain black hole dynamic potentials have been developed definitively on the lines of classical thermodynamics. These potentials have been refined in view of the small differences in the equations of the laws of black hole dynamics as given by Bekenstein and those of ...

  4. Resource Letter BH-2: Black Holes

    OpenAIRE

    Gallo, Elena; Marolf, Don

    2008-01-01

    This resource letter is designed to guide students, educators, and researchers through (some of) the literature on black holes. Both the physics and astrophysics of black holes are discussed. Breadth has been emphasized over depth, and review articles over primary sources. We include resources ranging from non-technical discussions appropriate for broad audiences to technical reviews of current research. Topics addressed include classification of stationary solutions, perturbations and stabil...

  5. Lifshitz topological black holes

    International Nuclear Information System (INIS)

    Mann, R.B.

    2009-01-01

    I find a class of black hole solutions to a (3+1) dimensional theory gravity coupled to abelian gauge fields with negative cosmological constant that has been proposed as the dual theory to a Lifshitz theory describing critical phenomena in (2+1) dimensions. These black holes are all asymptotic to a Lifshitz fixed point geometry and depend on a single parameter that determines both their area (or size) and their charge. Most of the solutions are obtained numerically, but an exact solution is also obtained for a particular value of this parameter. The thermodynamic behaviour of large black holes is almost the same regardless of genus, but differs considerably for small black holes. Screening behaviour is exhibited in the dual theory for any genus, but the critical length at which it sets in is genus-dependent for small black holes.

  6. Black hole critical phenomena without black holes

    Indian Academy of Sciences (India)

    as a star or dispersing altogether. Were we engineers with advanced technology, we might attempt to find that critical amount of energy necessary to form a black hole. However, despite some fears to the contrary, such technology does not exist, so instead we investigate this critical regime numerically. The first step is to pick ...

  7. Black hole critical phenomena without black holes

    Indian Academy of Sciences (India)

    denotes the partial derivatives of . The construction of a numerical method with which ... which configurations form black holes and which disperse (the only two options in this model). The problem in picturing such a space is that it is infinite ..... 4.1 The future: Less symmetry. The work described above all assumes spherical ...

  8. Ultrastructural findings in progressive macular hypomelanosis indicate decreased melanin production

    NARCIS (Netherlands)

    Relyveld, G. N.; Dingemans, K. P.; Menke, H. E.; Bos, J. D.; Westerhof, W.

    2008-01-01

    BACKGROUND: The pathogenesis of progressive macular hypomelanosis (PMH) is unknown. Recently, Westerhof et al. (Arch Dermatol 2004; 140: 210-214) hypothesized that Propionibacterium acnes produces a depigmenting factor that interferes with melanogenesis in the skin, resulting in hypopigmented spots.

  9. Acute macular edema following intracorporeal prostaglandin injection for erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Asahi MG

    2015-07-01

    Full Text Available Masumi G Asahi, Calvin Chou, Ron P Gallemore Retina Macula Institute, Torrance, CA, USA Purpose: We aimed to describe the first case of macular edema following intracorporeal injection of alprostadil, a prostaglandin E1. Methods: This was a retrospective case report followed with optical coherence tomography, fundus photos, and fluorescein angiography images. Results: A patient developed bilateral cystoid macular edema following intracorporeal injection of alprostadil, a prostaglandin E1 for treatment of erectile dysfunction. The edema resolved following treatment with nonsteroidal anti-inflammatory drugs (NSAIDs and corticosteroids, with subsequent recovery in visual acuity. Discussion: Systemic prostaglandin administration can cause macular edema and vision loss, indicating that elevated systemic prostaglandin levels may affect visual function. This has potential implications for other systemic disorders and treatments that could affect macular function. Keywords: alprostadil, inflammation

  10. Quantification of retinal layer thickness changes in acute macular neuroretinopathy

    DEFF Research Database (Denmark)

    Munk, Marion R; Beck, Marco; Kolb, Simone

    2017-01-01

    PURPOSE: To quantitatively evaluate retinal layer thickness changes in acute macular neuroretinopathy (AMN). METHODS: AMN areas were identified using near-infrared reflectance (NIR) images. Intraretinal layer segmentation using Heidelberg software was performed. The inbuilt ETDRS -grid was moved ...

  11. Factors affecting reading speed in patients with diabetic macular edema treated with laser photocoagulation.

    Directory of Open Access Journals (Sweden)

    Elizabeth Pearce

    Full Text Available PURPOSE: To study the factors that may affect reading speed in patients with diabetic macular edema previously treated with laser photocoagulation. METHODS: Consecutive patients with type II diabetes treated with laser photocoagulation for diabetic macular edema (DME at least twelve months previously, with best corrected visual acuity of better than 65 letters (approximately 20/40 measured with Early Treatment Diabetic Retinopathy Study (ETDRS charts were included in this study. Patients previously treated with pan-retinal photocoagulation, vitrectomy, intravitreal steroid or anti-VEGF therapy were excluded. Any other ocular co-morbidities that may influence reading ability such as cataract, glaucoma or macular degeneration were also excluded. All patients were refracted by a certified examiner, the following measurements were collected: best corrected visual acuity (BCVA, contrast sensitivity with Pelli-Robson chart, reading speed with MNREAD chart, microperimetry with Nidek MP1, and central subfield thickness with Zeiss spectral domain optical coherent topography. RESULTS: The slow reading group had poorer contrast sensitivity (p = 0.001, reduced retinal sensitivity (p = 0.027 and less stable fixation (p = 0.013. Most interestingly the reduced retinal sensitivity findings were driven by the microperimetry value on the right subfield (p = 0.033, (nasal to the fovea in the right eye and temporal to the fovea in the left eye. Multiple linear regression analysis showed that contrast sensitivity is probably the most important factor that affects reading speed (p = 0.001. CONCLUSION: Reduced retinal sensitivity after laser treatment is associated with reduced reading speed in patients with diabetic macular edema.

  12. Effect of intravitreal bevacizumab on diabetic macular edema with hard exudates

    Science.gov (United States)

    Jeon, Sohee; Lee, Won Ki

    2014-01-01

    Background We evaluated the efficacy of intravitreal bevacizumab on diabetic macular edema with subfoveal and perifoveal hard exudates. Materials and methods Eleven eyes (11 patients) exhibiting diabetic macular edema with subfoveal and perifoveal hard exudates were included in this prospective, nonrandomized interventional pilot study. All patients were treated with monthly scheduled intravitreal bevacizumab injections for 6 months. Changes in the Early Treatment Diabetic Retinopathy Study best corrected visual acuity, amount of hard exudates on fundus photography, and macular edema detected by central subfield thickness on spectral domain optical coherence tomography after six serial injections, were assessed. The amount of hard exudates at each visit was evaluated as pixels in fundus photography, using an Adobe Photoshop program. Results Ten of 11 patients completed follow-up. The mean Early Treatment Diabetic Retinopathy Study best corrected visual acuity was 59.9±5.7 letters (Snellen equivalent, 20/63) at baseline evaluation. The best corrected visual acuity exhibited no significant difference at month 6 compared with at baseline (57.9±6.0 letters or 20/70 at month 6; P=0.085). At month 6, mean central subfield thickness decreased from 370.4±56.5 to 334.6±65.0 μm (P=0.009). The mean amount of hard exudates increased from 4467.1±2736.1 to 6592.4±2498.3 pixels at month 6 (P=0.022). No serious adverse events occurred. Conclusion Continuous intravitreal bevacizumab was found to have no benefit in visual acuity and amount of hard exudates, despite the improvement of macular edema at 6 months. PMID:25143708

  13. Factors affecting reading speed in patients with diabetic macular edema treated with laser photocoagulation.

    Science.gov (United States)

    Pearce, Elizabeth; Sivaprasad, Sobha; Chong, Ngaihang V

    2014-01-01

    To study the factors that may affect reading speed in patients with diabetic macular edema previously treated with laser photocoagulation. Consecutive patients with type II diabetes treated with laser photocoagulation for diabetic macular edema (DME) at least twelve months previously, with best corrected visual acuity of better than 65 letters (approximately 20/40) measured with Early Treatment Diabetic Retinopathy Study (ETDRS) charts were included in this study. Patients previously treated with pan-retinal photocoagulation, vitrectomy, intravitreal steroid or anti-VEGF therapy were excluded. Any other ocular co-morbidities that may influence reading ability such as cataract, glaucoma or macular degeneration were also excluded. All patients were refracted by a certified examiner, the following measurements were collected: best corrected visual acuity (BCVA), contrast sensitivity with Pelli-Robson chart, reading speed with MNREAD chart, microperimetry with Nidek MP1, and central subfield thickness with Zeiss spectral domain optical coherent topography. The slow reading group had poorer contrast sensitivity (p = 0.001), reduced retinal sensitivity (p = 0.027) and less stable fixation (p = 0.013). Most interestingly the reduced retinal sensitivity findings were driven by the microperimetry value on the right subfield (p = 0.033), (nasal to the fovea in the right eye and temporal to the fovea in the left eye). Multiple linear regression analysis showed that contrast sensitivity is probably the most important factor that affects reading speed (p = 0.001). Reduced retinal sensitivity after laser treatment is associated with reduced reading speed in patients with diabetic macular edema.

  14. Influence of macular choroidal thickness on visual function in highly myopic eyes.

    Science.gov (United States)

    Parravano, Mariacristina; Oddone, Francesco; Giorno, Paola; Cacciamani, Andrea; Abbate, Rosa; Caminiti, Giulia; Peiretti, Enrico; Varano, Monica

    2014-01-01

    To explore the retinal and choroidal thicknesses (RT, CT), as measured using enhanced depth imaging (EDI) optical coherence tomography (OCT, Spectralis) in highly myopic eyes and its relationship with visual function. Prospective, case-control, noninterventional clinical study. CT was measured by EDI-OCT in highly myopic eyes (≥6 dpt) without any macular diseases and age-matched control eyes. A complete ophthalmological examination, visual acuity assessment and MP1 microperimetry were obtained. 38 myopic (15 M/23 F, mean age 51 ± 8.9 years) and 21 control eyes (5 M/16 F, mean age 50 ± 5.4 years) were included. The myopic mean refractive error was -13.3 ± 4.9 dpt and axial length 29.2 ± 2.2 mm. The mean best-corrected visual acuity (BCVA) was lower in highly myopic than in control eyes (77.3 ± 9.25 vs. 84.8 ± 0.6 letters, p = 0.0001, respectively) as was the mean retinal sensitivity (MRS; 16.32 ± 2.6 vs. 19.9 ± 0.2 dB, p < 0.0001). While RT was similar between groups (291.5 ± 24.2 vs. 283.6 ± 13.9 µm, p = 0.06, respectively), subfoveal CT was thinner in highly myopic compared to control eyes (114.3 ± 78.5 vs. 272.6 ± 110.2 µm, p < 0.0001). A significant relationship was found between subfoveal CT and MRS (R(2) = 0.22; p = 0.003) and BCVA (R(2) = 0.13; p = 0.027). Macular function is reduced in highly myopic eyes without any visible macular diseases compared to controls, and a significant proportion of the macular function variability seems to be related to a reduced CT. © 2014 S. Karger AG, Basel.

  15. [Depression in Patients with Age-Related Macular Degeneration].

    Science.gov (United States)

    Narváez, Yamile Reveiz; Gómez-Restrepo, Carlos

    2012-09-01

    Age-related macular degeneration is a cause for disability in the elderly since it greatly affects their quality of life and increases depression likelihood. This article discusses the negative effect depression has on patients with age-related macular degeneration and summarizes the interventions available for decreasing their depression index. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  16. Pathology of Macular Foveoschisis Associated with Degenerative Myopia

    Directory of Open Access Journals (Sweden)

    Johnny Tang

    2010-01-01

    Full Text Available This is a clinicopathological paper on the histologic findings in myopia-associated macular foveoschisis. The findings on ophthalmic pathological study of a 73-year-old woman with high myopia are reviewed. Multiple retinoschisis cavities involving both the macula and retinal periphery were disclosed. Our paper offers tissue evidence and supports recent ocular coherence tomography reports of eyes with high myopia and associated macular foveoschisis.

  17. Bilateral coexistence of keratoconus and macular corneal dystrophy

    Directory of Open Access Journals (Sweden)

    Ghazi Al-Hamdan

    2009-01-01

    The authors hereby report a 21-year-old female who presented with the typical signs and topographic evidence of keratoconus in association with macular corneal dystrophy. Histopathologic evaluation from the excised corneal button after corneal transplant confirmed the diagnosis. To our knowledge, there is only one previous report in the literature linking the association of keratoconus and macular corneal dystrophy in the same eye bilaterally.

  18. Functional Magnetic Resonance Imaging in Patients with the Wet Form of Age-Related Macular Degeneration

    Science.gov (United States)

    Lešták, Jan; Tintěra, Jaroslav; Karel, Ivan; Svatá, Zuzana; Rozsíval, Pavel

    2013-01-01

    Abstract The study is designed to determine the relationship between the progress of the wet form of age-related macular degeneration and the activity of the visual cortex examined using functional magnetic resonance imaging. Ten patients with the wet form of age-related macular degeneration (9 female and 1 male) with a mean age of 74.7 years (58–85 years) at various stages of bilateral involvement of the disease were included. Patients did not suffer from any other ocular nor neurological disease. All the patients underwent functional magnetic resonance imaging examinations with stimulation of both eyes using a black-and-white checkerboard of size 25.8 × 16.2 degrees. The group was compared with a group of healthy subjects with an average age of 54.1 years (45–65 years). For statistical evaluation, the Mann-Whitney U test was used. Comparing the extent of visual cortex activations we found a statistically significant difference between both the groups (p = 0.0247). However, the dependence of functional magnetic resonance imaging activity on visual acuity was not statistically significant (p = 0.223). We conclude that in patients with the wet form of age-related macular degeneration, lower functional magnetic resonance imaging activity of the visual cortex was found compared with the control group of healthy subjects. Dependence of functional magnetic resonance imaging activity on visual acuity was not statistically significant. PMID:28167987

  19. Optical coherence tomographic findings at the fixation point in a case of bilateral congenital macular coloboma.

    Science.gov (United States)

    Abe, Kosuke; Shirane, Jumi; Sakamoto, Masuo; Tanabe, Fumi; Kuniyoshi, Kazuki; Matsumoto, Chota; Shimomura, Yoshikazu

    2014-01-01

    Congenital macular coloboma is a rare ocular disease that consists of atrophic lesions in the macula with well-circumscribed borders. We report the findings of spectral domain optical coherence tomography (SD-OCT) at the fixation point in a case of bilateral macular coloboma. The subject is a 4-year-old boy. He visited our hospital at age 1 year and 4 months for the evaluation of strabismus. The fundus examination of both eyes showed round-shaped sharply-demarcated atrophic lesions involving the macula with large choroidal vessels and bared sclera at the base. Immunologic tests including toxoplasmosis, rubella, varicella, herpes virus, and human T-cell leukemia virus were all negative. At age 4 years and 1 month, cycloplegic refraction showed insignificant refractive errors and his best corrected visual acuity was 0.6 bilaterally. The SD-OCT showed a crater-like depression accompanying atrophic neurosensory retina, and the absence of retinal pigment epithelium and choroid. Examination of the fixation behavior by visuscope showed steady fixation with an area 0.5° nasal to the nasal edge of the atrophic lesion bilaterally. The SD-OCT findings at fixation area showed remaining normal retinal structures involving inner segment-outer segment (IS/OS) junction line. The findings of SD-OCT have been shown to be useful in the diagnosis of macular coloboma. In the fixation point, the structure of retina and choroid were well preserved.

  20. Submacular hemorrhage in neovascular age-related macular degeneration: A synthesis of the literature.

    Science.gov (United States)

    Stanescu-Segall, Dinu; Balta, Florian; Jackson, Timothy L

    2016-01-01

    Large submacular hemorrhage, an uncommon manifestation of neovascular age-related macular degeneration, may also occur with idiopathic polypoidal choroidal vasculopathy. Submacular hemorrhage damages photoreceptors owing to iron toxicity, fibrin meshwork contraction, and reduced nutrient flux, with subsequent macular scarring. Clinical and experimental studies support prompt treatment, as tissue damage can occur within 24 hours. Without treatment the natural history is poor, with a mean final visual acuity (VA) of 20/1600. Reported treatments include retinal pigment epithelial patch, macular translocation, pneumatic displacement, intravitreal or subretinal tissue plasminogen activator, intravitreal anti-vascular endothelial growth factor (VEGF) drugs, and combinations thereof. In the absence of comparative studies, we combined eligible studies to assess the VA change before and after each treatment option. The greatest improvement occurred after combined pars plana vitrectomy, subretinal tissue plasminogen activator, intravitreal gas, and anti-vascular endothelial growth factor treatment, with VA improving from 20/1000 to 20/400. The best final VA occurred using combined intravitreal tissue plasminogen activator, gas, and anti-vascular endothelial growth factor therapy, with VA improving from 20/200 to 20/100. Both treatments had an acceptable safety profile, but most studies were small, and larger randomized controlled trials are needed to determine both safety and efficacy. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

  1. Prevention of Age-Related Macular Degeneration.

    Science.gov (United States)

    Singh, Niharika; Srinivasan, Sangeetha; Muralidharan, Vinata; Roy, Rupak; V, Jayprakash; Raman, Rajiv

    2017-01-01

    Age-related macular degeneration (AMD) compromises quality of life. However, the available therapeutic options are limited. This has led to the identification of modifiable risk factors to prevent the development or alter the natural course and prognosis of AMD. The identification and modification of risk factors has the potential for greater public health impact on reducing morbidity from AMD. Likewise, identifying the imaging clues and genetic clues could serve as a guide to recognizing the propensity for progression to severe and end stages of the disease. Several attempts, both successful and unsuccessful, have been made for interventions that could delay the progression of AMD. Of these, pharmacological interventions have shown promising results. The Age-Related Eye Disease Study 1 and 2 have shown the beneficial role of antioxidants in a selected group of patients. Copyright 2017 Asia-Pacific Academy of Ophthalmology.

  2. Accelerating and rotating black holes

    International Nuclear Information System (INIS)

    Griffiths, J B; Podolsky, J

    2005-01-01

    An exact solution of Einstein's equations which represents a pair of accelerating and rotating black holes (a generalized form of the spinning C-metric) is presented. The starting point is a form of the Plebanski-Demianski metric which, in addition to the usual parameters, explicitly includes parameters which describe the acceleration and angular velocity of the sources. This is transformed to a form which explicitly contains the known special cases for either rotating or accelerating black holes. Electromagnetic charges and a NUT parameter are included, the relation between the NUT parameter l and the Plebanski-Demianski parameter n is given, and the physical meaning of all parameters is clarified. The possibility of finding an accelerating NUT solution is also discussed

  3. Partition functions for supersymmetric black holes

    CERN Document Server

    Manschot, Jan

    2008-01-01

    This dissertation presents recent discoveries on partition functions for four-dimensional supersymmetric black holes. These partition functions are important tools to explain the entropy of black holes from a microscopic point of view within string theory and M-theory. The results are applied to two central research topics in modern theoretical physics, namely (1) the correspondence between the physics (including gravity) within an Anti-de Sitter space and conformal field theory, and (2) the relation between black holes and topological strings.

  4. Perceptual learning in patients with macular degeneration

    Directory of Open Access Journals (Sweden)

    Tina ePlank

    2014-10-01

    Full Text Available Patients with age-related macular degeneration (AMD or hereditary macular dystrophies (JMD rely on an efficient use of their peripheral visual field. We trained eight AMD and five JMD patients to perform a texture-discrimination task (TDT at their preferred retinal locus (PRL used for fixation. Six training sessions of approximately one hour duration were conducted over a period of approximately 3 weeks. Before, during and after training twelve patients and twelve age-matched controls (the data from two controls had to be discarded later took part in three functional magnetic resonance imaging (fMRI sessions to assess training-related changes in the BOLD response in early visual cortex. Patients benefited from the training measurements as indexed by significant decrease (p=.001 in the stimulus onset asynchrony (SOA between the presentation of the texture target on background and the visual mask, and in a significant location specific effect of the PRL with respect to hit rate (p=.014. The following trends were observed: (i Improvement in Vernier acuity for an eccentric line-bisection task; (ii positive correlation between the development of BOLD signals in early visual cortex and initial fixation stability (r=0.531; (iii positive correlation between the increase in task performance and initial fixation stability (r=0.730. The first two trends were non-significant, whereas the third trend was significant at p=.014, Bonferroni corrected. Consequently, our exploratory study suggests that training on the TDT can enhance eccentric vision in patients with central vision loss. This enhancement is accompanied by a modest alteration in the BOLD response in early visual cortex.

  5. [Macular Edema in Uveitis - Steroids or VEGF Inhibitors?

    Science.gov (United States)

    Heinz, Carsten; Heiligenhaus, Arnd

    2017-06-09

    Macular edema in uveitis patients is certainly the most frequent complication leading to a permanent and irreversible reduction in vision during the course of the disease. Thanks to optical coherence tomography (OCT) technology and fluorescein angiography (FAG), significantly more macular edemas are detected. Macular edema can be found in various uveitis varieties and can show different clinical patterns. All macular edema should be treated. Macular edema with active inflammation usually reacts very well to general uveitis treatment. In the case of eyes without visible inflammation, however, the response to such therapy is usually less effective. According to the latest treatment recommendations, dexamethasone implants should be used as the first intravitreal therapy. Vascular endothelial growth factor inhibitors (VEGF inhibitors) are second-line treatment regimens. The choice of therapy is, therefore, primarily based on the degree of inflammation and the individual complications, such as glaucoma, lens situation or previous increase in IOP after steroid administration. These individual complications may allow using VEGF inhibitors as first line treatment. An improvement in the macular edema can be achieved with both groups of active substances. Georg Thieme Verlag KG Stuttgart · New York.

  6. Photocoagulation treatment for clinically significant radiation macular oedema

    Energy Technology Data Exchange (ETDEWEB)

    Kinyoun, J.L.; Zamber, R.W.; Lawrence, B.S.; Barlow, W.E.; Arnold, A.M. [Washington Univ., Seattle, WA (United States)

    1995-02-01

    Macular oedema is a leading cause of vision loss in patients with radiation retinopathy. In an effort to find an effective treatment for this vision threatening complication, 12 eyes (eight patients) were treated with photocoagulation for clinically significant radiation macular oedema (CSRMO) defined as central macular thickening, exudates threatening the macular centre, or one disc area of thickening in the macula. Median visual acuity improved from 20/100 pre-operatively to 20/90 at the initial post-operative examination (mean follow up 5 months) and to 20/75 at the final post-operative examination (mean follow up 39 months). At the final post-operative examination, visual acuity had improved in eight (67%) eyes and six (50%) eyes had complete resolution of the CSRMO; two (17%) other eyes had improved anatomically in that fewer CSRMO criteria were present. These results suggest that macular photocoagulation is effective in decreasing macular oedema and improving vision in eyes with CSRMO. (author).

  7. Photocoagulation treatment for clinically significant radiation macular oedema

    International Nuclear Information System (INIS)

    Kinyoun, J.L.; Zamber, R.W.; Lawrence, B.S.; Barlow, W.E.; Arnold, A.M.

    1995-01-01

    Macular oedema is a leading cause of vision loss in patients with radiation retinopathy. In an effort to find an effective treatment for this vision threatening complication, 12 eyes (eight patients) were treated with photocoagulation for clinically significant radiation macular oedema (CSRMO) defined as central macular thickening, exudates threatening the macular centre, or one disc area of thickening in the macula. Median visual acuity improved from 20/100 pre-operatively to 20/90 at the initial post-operative examination (mean follow up 5 months) and to 20/75 at the final post-operative examination (mean follow up 39 months). At the final post-operative examination, visual acuity had improved in eight (67%) eyes and six (50%) eyes had complete resolution of the CSRMO; two (17%) other eyes had improved anatomically in that fewer CSRMO criteria were present. These results suggest that macular photocoagulation is effective in decreasing macular oedema and improving vision in eyes with CSRMO. (author)

  8. Macular micropseudocysts in early stages of diabetic retinopathy.

    Science.gov (United States)

    Tremolada, Gemma; Pierro, Luisa; de Benedetto, Umberto; Margari, Sergio; Gagliardi, Marco; Maestranzi, Gisella; Calori, Giliola; Lorenzi, Mara; Lattanzio, Rosangela

    2011-01-01

    To identify by noninvasive means early retinal abnormalities that may predict diabetic macular edema. The authors analyzed retrospectively data from consecutive patients with Type 1 (n = 16) or Type 2 (n = 23) diabetes who presented for routine follow-up of early retinopathy, had no clinical signs or symptoms of diabetic macular edema, and were evaluated with spectral-domain optical coherence tomography. Age- and gender-matched nondiabetic subjects provided normative data. Spectral-domain optical coherence tomography revealed in the macular region of diabetic patients small hyporeflective areas (median diameter, 55 μm) contained within discrete retinal layers that we named micropseudocysts (MPCs). Micropseudocysts are associated with vascular leakage. The patients showing MPCs had more frequently systemic hypertension and increased central foveal thickness than those without MPCs. The association with increased central foveal thickness was only in the patients with Type 2 diabetes. Macular MPCs in patients with mild diabetic retinopathy appear to reflect leakage and can precede macular thickening. The association of MPCs with increased central foveal thickness in patients with Type 2 diabetes, but not in patients with Type 1 diabetes, points to a greater tendency to retinal fluid accumulation in patients with Type 2 diabetes. Studies in larger cohorts will determine the usefulness of MPCs in strategies to abort diabetic macular edema.

  9. Entropy of quasiblack holes

    International Nuclear Information System (INIS)

    Lemos, Jose P. S.; Zaslavskii, Oleg B.

    2010-01-01

    We trace the origin of the black hole entropy S, replacing a black hole by a quasiblack hole. Let the boundary of a static body approach its own gravitational radius, in such a way that a quasihorizon forms. We show that if the body is thermal with the temperature taking the Hawking value at the quasihorizon limit, it follows, in the nonextremal case, from the first law of thermodynamics that the entropy approaches the Bekenstein-Hawking value S=A/4. In this setup, the key role is played by the surface stresses on the quasihorizon and one finds that the entropy comes from the quasihorizon surface. Any distribution of matter inside the surface leads to the same universal value for the entropy in the quasihorizon limit. This can be of some help in the understanding of black hole entropy. Other similarities between black holes and quasiblack holes such as the mass formulas for both objects had been found previously. We also discuss the entropy for extremal quasiblack holes, a more subtle issue.

  10. ULTRAMASSIVE BLACK HOLE COALESCENCE

    International Nuclear Information System (INIS)

    Khan, Fazeel Mahmood; Holley-Bockelmann, Kelly; Berczik, Peter

    2015-01-01

    Although supermassive black holes (SMBHs) correlate well with their host galaxies, there is an emerging view that outliers exist. Henize 2-10, NGC 4889, and NGC 1277 are examples of SMBHs at least an order of magnitude more massive than their host galaxy suggests. The dynamical effects of such ultramassive central black holes is unclear. Here, we perform direct N-body simulations of mergers of galactic nuclei where one black hole is ultramassive to study the evolution of the remnant and the black hole dynamics in this extreme regime. We find that the merger remnant is axisymmetric near the center, while near the large SMBH influence radius, the galaxy is triaxial. The SMBH separation shrinks rapidly due to dynamical friction, and quickly forms a binary black hole; if we scale our model to the most massive estimate for the NGC 1277 black hole, for example, the timescale for the SMBH separation to shrink from nearly a kiloparsec to less than a parsec is roughly 10 Myr. By the time the SMBHs form a hard binary, gravitational wave emission dominates, and the black holes coalesce in a mere few Myr. Curiously, these extremely massive binaries appear to nearly bypass the three-body scattering evolutionary phase. Our study suggests that in this extreme case, SMBH coalescence is governed by dynamical friction followed nearly directly by gravitational wave emission, resulting in a rapid and efficient SMBH coalescence timescale. We discuss the implications for gravitational wave event rates and hypervelocity star production

  11. Towards the theory of mini black holes with subplanckian mass

    International Nuclear Information System (INIS)

    Zeldovich, Y.B.

    1984-01-01

    This chapter phenomenologically examines the question of the decay (evaporation) and formation of mini black holes. Neutral black holes are considered, having neither electrical charge, nor color and weak charge, so that no long range vector field is present beyond gravitational radius. Topics considered include thermodynamic equilibrium and the formation of light black holes, the formation and decay of light black holes in the big bang, and the difficulties of the theory. It is emphasized that the existence of mini black holes has not yet been proven

  12. Black holes new horizons

    CERN Document Server

    Hayward, Sean Alan

    2013-01-01

    Black holes, once just fascinating theoretical predictions of how gravity warps space-time according to Einstein's theory, are now generally accepted as astrophysical realities, formed by post-supernova collapse, or as supermassive black holes mysteriously found at the cores of most galaxies, powering active galactic nuclei, the most powerful objects in the universe. Theoretical understanding has progressed in recent decades with a wider realization that local concepts should characterize black holes, rather than the global concepts found in textbooks. In particular, notions such as trapping h

  13. Scalarized hairy black holes

    Energy Technology Data Exchange (ETDEWEB)

    Kleihaus, Burkhard, E-mail: b.kleihaus@uni-oldenburg.de [Institut für Physik, Universität Oldenburg, Postfach 2503, D-26111 Oldenburg (Germany); Kunz, Jutta [Institut für Physik, Universität Oldenburg, Postfach 2503, D-26111 Oldenburg (Germany); Yazadjiev, Stoytcho [Department of Theoretical Physics, Faculty of Physics, Sofia University, Sofia 1164 (Bulgaria)

    2015-05-11

    In the presence of a complex scalar field scalar–tensor theory allows for scalarized rotating hairy black holes. We exhibit the domain of existence for these scalarized black holes, which is bounded by scalarized rotating boson stars and hairy black holes of General Relativity. We discuss the global properties of these solutions. Like their counterparts in general relativity, their angular momentum may exceed the Kerr bound, and their ergosurfaces may consist of a sphere and a ring, i.e., form an ergo-Saturn.

  14. Higher Contrast Requirement for Letter Recognition and Macular RGC+ Layer Thinning in Glaucoma Patients and Older Adults.

    Science.gov (United States)

    Chien, Lillian; Liu, Rong; Girkin, Christopher; Kwon, MiYoung

    2017-12-01

    Growing evidence suggests the involvement of the macula even in early stages of glaucoma. However, little is known about the impact of glaucomatous macular damage on central pattern vision. Here we examine the contrast requirement for letter recognition and its relationship with retinal thickness in the macular region. A total of 40 participants were recruited: 13 patients with glaucoma (mean age = 65.6 ± 6.6 years), 14 age-similar normally sighted adults (59.1 ± 9.1 years), and 13 young normally sighted adults (21.0 ± 2.0 years). For each participant, letter-recognition contrast thresholds were obtained using a letter recognition task in which participants identified English letters presented at varying retinal locations across the central 12° visual field, including the fovea. The macular retinal ganglion cell plus inner plexiform (RGC+) layer thickness was also evaluated using spectral-domain optical coherence tomography (SD-OCT). Compared to age-similar normal controls, glaucoma patients exhibited a significant increase in letter-recognition contrast thresholds (by 236%, P recognition contrast thresholds and a significant decrease in RGC+ layer thickness. Across all subjects, the thickness of macular RGC+ layer was significantly correlated with letter-recognition contrast thresholds, even after correcting for pupil diameter and visual acuity (r = -0.65, P recognition in central vision.

  15. Markers of lutein and zeaxanthin status in two age groups of men and women: dietary intake, serum concentrations, lipid profile and macular pigment optical density

    Science.gov (United States)

    2014-01-01

    Background & aims Lutein and zeaxanthin accumulate in retina (macular pigment). Their nutritional status can be assessed using dietary or biochemical markers and both have been associated with macular pigment optical density. We proposed to assess dietary and status markers of lutein and zeaxanthin in a group of healthy Spanish volunteers, considering the potential influence of age, gender and serum lipids to investigate the predictors of the macular pigment optical density. Methods Serum lutein and zeaxanthin concentrations, dietary intake and macular pigment optical density were determined in 108 healthy men and women (20–35 and 45–65 years), using high-performance liquid chromatography, 3-day food records and heterochromic flicker photometry, respectively. Mann–Whitney U-test, Spearman correlation coefficient and multivariate regression analysis were used for the statistical study. Results Serum concentrations and dietary intake of lutein plus zeaxanthin (p lutein (ρ = 0.452, p lutein + zeaxanthin (ρ = 0.431, p lutein and zeaxanthin were expressed in relation to serum lipids in older subjects (ρ = 0.262, p = 0.006). Multivariate regression analysis identified age and serum lutein as major predictors of macular pigment optical density (total sample), and a coefficient of determination of 29.7% for the model including lutein + zeaxathin/cholesterol + triglycerides, sex and fruit + vegetables in the older group. Conclusions The establishment of normal/reference ranges for serum lutein and zeaxanthin should consider age ranges and be expressed in relation to lipid concentrations, at least in subjects over 45 years, as this could influence macular pigment optical density. The macular pigment optical density showed age-specific correlations with lutein plus zeaxanthin expressed in relation to serum lipid concentrations as well as with the fruit and vegetable intake. PMID:24889185

  16. A NOVEL P.ASP304GLY MUTATION IN BEST1 GENE ASSOCIATED WITH ATYPICAL BEST VITELLIFORM MACULAR DYSTROPHY PHENOTYPE AND HIGH INTRAFAMILIAL VARIABILITY.

    Science.gov (United States)

    Peiretti, Enrico; Caminiti, Giulia; Forma, Gina; Carboni, Giovannella; Dhaenens, Claire-Marie; Querques, Lea; Souied, Eric; Querques, Giuseppe

    2016-09-01

    To report the atypical phenotypic characteristics of patients with a novel p.Asp304Gly mutation in BEST1. Affected individuals underwent a complete ophthalmic examination, including best-corrected visual acuity, fundus autofluorescence, spectral domain optical coherence tomography, and electrophysiologic testing. All individuals were screened for mutations in the BEST1 gene. Five patients of the same Italian family were clinically examined. All patients complained of decreased vision as the initial symptom. Best-corrected visual acuity ranged from 20/800 to 20/32. On fundus examination, all patients showed atypical Best vitelliform macular dystrophy phenotype with multifocal macular and extramacular involvement. The spectral domain optical coherence tomography characteristics of central macular and extramacular lesions varied in each patient and included "giant" choroidal excavation, extensive flat macular elevation with hyporeflective subretinal material accumulation surrounded by hyperautofluorescent spots/annulus, and extensive hypoautofluorescent extramacular atrophic areas. Electrooculogram was always abnormal with Arden ratio lower than 1.55, whereas electroretinogram was normal in the two younger patients and abnormal (low amplitude) in the three older patients. Genetic analysis revealed a novel missense mutation in BEST1, substituting aspartate for glycine at amino acid 304. We describe the atypical phenotype and high intrafamilial variability associated with a new mutation in the BEST1 gene in an Italian family affected with Best vitelliform macular dystrophy. Clinicians should consider screening the BEST1 gene even in the absence of the typical phenotype and in case of high intrafamilial variability.

  17. Colliding black hole solution

    International Nuclear Information System (INIS)

    Ahmed, Mainuddin

    2005-01-01

    A new solution of Einstein equation in general relativity is found. This solution solves an outstanding problem of thermodynamics and black hole physics. Also this work appears to conclude the interpretation of NUT spacetime. (author)

  18. Illuminating black holes

    Science.gov (United States)

    Barr, Ian A.; Bull, Anne; O'Brien, Eileen; Drillsma-Milgrom, Katy A.; Milgrom, Lionel R.

    2016-07-01

    Two-dimensional shadows formed by illuminating vortices are shown to be visually analogous to the gravitational action of black holes on light and surrounding matter. They could be useful teaching aids demonstrating some of the consequences of general relativity.

  19. Black holes with halos

    Science.gov (United States)

    Monten, Ruben; Toldo, Chiara

    2018-02-01

    We present new AdS4 black hole solutions in N =2 gauged supergravity coupled to vector and hypermultiplets. We focus on a particular consistent truncation of M-theory on the homogeneous Sasaki–Einstein seven-manifold M 111, characterized by the presence of one Betti vector multiplet. We numerically construct static and spherically symmetric black holes with electric and magnetic charges, corresponding to M2 and M5 branes wrapping non-contractible cycles of the internal manifold. The novel feature characterizing these nonzero temperature configurations is the presence of a massive vector field halo. Moreover, we verify the first law of black hole mechanics and we study the thermodynamics in the canonical ensemble. We analyze the behavior of the massive vector field condensate across the small-large black hole phase transition and we interpret the process in the dual field theory.

  20. From Black Holes to Quivers

    CERN Document Server

    Manschot, Jan; Sen, Ashoke

    2012-01-01

    Middle cohomology states on the Higgs branch of supersymmetric quiver quantum mechanics - also known as pure Higgs states - have recently emerged as possible microscopic candidates for single-centered black hole micro-states, as they carry zero angular momentum and appear to be robust under wall-crossing. Using the connection between quiver quantum mechanics on the Coulomb branch and the quantum mechanics of multi-centered black holes, we propose a general algorithm for reconstructing the full moduli-dependent cohomology of the moduli space of an arbitrary quiver, in terms of the BPS invariants of the pure Higgs states. We analyze many examples of quivers with loops, including all cyclic Abelian quivers and several examples with two loops or non-Abelian gauge groups, and provide supporting evidence for this proposal. We also develop methods to count pure Higgs states directly.

  1. Quantum black holes

    International Nuclear Information System (INIS)

    't Hooft, G.

    1987-01-01

    No particle theory can be complete without gravity. Einstein's theory of gravity is of the Euler-Lagrange form, but standard quantization procedure fails. In quantum gravity the higher order interactions have a dimensionality different form the fundamental ones, because Newton's constant G has dimensions and the renormalization procedure fails. Another problem with quantum gravity is even more mysterious. Suppose that we had regularized the gravitational forces at the small distance end in the way that the weak intermediate vector boson regularized the fundamental 4-fermion interaction vertex of the weak interactions. Then what we discover is that the gravitational forces are unstable. Given sufficiently large amount of matter, it can collapse under its own weight. Classical general relativity tells us what will happen: a black hole is formed. But how is this formulated in quantum theory. S. Hawking observed that when a field theory is quantized in the background metric of a black hole, the black hole actually emits particles in a completely random thermal way. Apparently black holes are just another form of matter unstable against Hawking decay. Unfortunately this picture cannot be complete. The problem is that the quantum version of black holes has infinite phase space, and other symptoms of a run-away solution. Black holes are the heaviest and most compact forms of matter that can be imagined. A complete particle theory can have nothing but a spectrum of black-hole like objects at it high-energy end. This is why it is believed that a resolution of the black hole problem will in time disclose the complete small-distance structure of our world. 6 references

  2. Charged Galileon black holes

    International Nuclear Information System (INIS)

    Babichev, Eugeny; Charmousis, Christos; Hassaine, Mokhtar

    2015-01-01

    We consider an Abelian gauge field coupled to a particular truncation of Horndeski theory. The Galileon field has translation symmetry and couples non minimally both to the metric and the gauge field. When the gauge-scalar coupling is zero the gauge field reduces to a standard Maxwell field. By taking into account the symmetries of the action, we construct charged black hole solutions. Allowing the scalar field to softly break symmetries of spacetime we construct black holes where the scalar field is regular on the black hole event horizon. Some of these solutions can be interpreted as the equivalent of Reissner-Nordstrom black holes of scalar tensor theories with a non trivial scalar field. A self tuning black hole solution found previously is extended to the presence of dyonic charge without affecting whatsoever the self tuning of a large positive cosmological constant. Finally, for a general shift invariant scalar tensor theory we demonstrate that the scalar field Ansatz and method we employ are mathematically compatible with the field equations. This opens up the possibility for novel searches of hairy black holes in a far more general setting of Horndeski theory

  3. Greybody factors for d-dimensional black holes

    DEFF Research Database (Denmark)

    Harmark, Troels; Natário, José; Schiappa, Ricardo

    2010-01-01

    Gravitational greybody factors are analytically computed for static, spherically symmetric black holes in d-dimensions, including black holes with charge and in the presence of a cosmological constant (where a proper definition of greybody factors for both asymptotically de Sitter and anti...... of the details of the black hole. For asymptotically de Sitter black holes the greybody factor is different for even or odd spacetime dimension, and proportional to the ratio of the areas of the event and cosmological horizons. For asymptotically Ads black holes the greybody factor has a rich structure in which...... universality is hidden in the transmission and reflection coefficients. For either charged or asymptotically de Sitter black holes the greybody factors are given by non-trivial functions, while for asymptotically Ads black holes the greybody factor precisely equals one (corresponding to pure blackbody emission)....

  4. Probing strong-field general relativity near black holes

    CERN Multimedia

    CERN. Geneva; Alvarez-Gaumé, Luís

    2005-01-01

    Nature has sprinkled black holes of various sizes throughout the universe, from stellar mass black holes in X-ray sources to supermassive black holes of billions of solar masses in quasars. Astronomers today are probing the spacetime near black holes using X-rays, and gravitational waves will open a different view in the near future. These tools give us an unprecedented opportunity to test ultra-strong-field general relativity, including the fundamental theorem of the uniqueness of the Kerr metric and Roger Penrose's cosmic censorship conjecture. Already, fascinating studies of spectral lines are showing the extreme gravitational lensing effects near black holes and allowing crude measurements of black hole spin. When the ESA-NASA gravitational wave detector LISA begins its observations in about 10 years, it will make measurements of dynamical spacetimes near black holes with an accuracy greater even than that which theoreticians can reach with their computations today. Most importantly, when gravitational wa...

  5. Macular xanthophylls, lipoprotein-related genes, and age-related macular degeneration1234

    Science.gov (United States)

    Koo, Euna; Neuringer, Martha; SanGiovanni, John Paul

    2014-01-01

    Plant-based macular xanthophylls (MXs; lutein and zeaxanthin) and the lutein metabolite meso-zeaxanthin are the major constituents of macular pigment, a compound concentrated in retinal areas that are responsible for fine-feature visual sensation. There is an unmet need to examine the genetics of factors influencing regulatory mechanisms and metabolic fates of these 3 MXs because they are linked to processes implicated in the pathogenesis of age-related macular degeneration (AMD). In this work we provide an overview of evidence supporting a molecular basis for AMD-MX associations as they may relate to DNA sequence variation in AMD- and lipoprotein-related genes. We recognize a number of emerging research opportunities, barriers, knowledge gaps, and tools offering promise for meaningful investigation and inference in the field. Overviews on AMD- and high-density lipoprotein (HDL)–related genes encoding receptors, transporters, and enzymes affecting or affected by MXs are followed with information on localization of products from these genes to retinal cell types manifesting AMD-related pathophysiology. Evidence on the relation of each gene or gene product with retinal MX response to nutrient intake is discussed. This information is followed by a review of results from mechanistic studies testing gene-disease relations. We then present findings on relations of AMD with DNA sequence variants in MX-associated genes. Our conclusion is that AMD-associated DNA variants that influence the actions and metabolic fates of HDL system constituents should be examined further for concomitant influence on MX absorption, retinal tissue responses to MX intake, and the capacity to modify MX-associated factors and processes implicated in AMD pathogenesis. PMID:24829491

  6. Correlation between macular ganglion cell-inner plexiform layer thickness and visual acuity after resolution of the macular edema secondary to central retinal vein occlusion

    Directory of Open Access Journals (Sweden)

    Hyun Ju Kim

    2018-02-01

    Full Text Available AIM: To examine the thickness of the ganglion cell-inner plexiform layer (GCIPL in eyes with resolved macular edema (ME in non-ischemic central retinal vein occlusion (CRVO, applying spectral-domain optical coherence tomography (SD-OCT, and its relationship with visual acuity. METHODS: The retrospective observational case-control study included 30 eyes of non-ischemic CRVO patients with resolved ME (ME eyes after treatment, and 30 eyes of non-ischemic CRVO patients without ME (non-ME eyes. The macular GCIPL thickness, peripapillary retinal nerve fiber layer (pRNFL thickness and central macular thickness (CMT were measured on a SD-OCT scan. Linear regression analyses were performed to determine the correlation between the thickness of each and the visual acuity (VA. RESULTS: No significant difference in average GCIPL thickness, mean pRNFL thickness and CMT were observed between ME group and non-ME group (P=0.296, 0.183, 0.846. But, minimum GCIPL thickness was reduced in ME eyes compared with non-ME eyes (P=0.022. Final VA significantly correlated with the minimum GCIPL thickness in ME eyes (r=-0.482, P=0.007, whereas no correlation was found with average GCIPL thickness, average pRNFL thickness and mean CMT. CONCLUSION: Minimum GCIPL thickness is reduced in ME eyes compared with non-ME eyes, and correlated with the VA in non-ischemic CRVO. These results propose that inner retinal damage occurring in patients with ME secondary to non-ischemic CRVO may lead to permanent visual defect after treatment.

  7. ASSOCIATION OF DRUSEN VOLUME WITH CHOROIDAL PARAMETERS IN NONNEOVASCULAR AGE-RELATED MACULAR DEGENERATION.

    Science.gov (United States)

    Balasubramanian, Siva; Lei, Jianqin; Nittala, Muneeswar G; Velaga, Swetha B; Haines, Jonathan; Pericak-Vance, Margaret A; Stambolian, Dwight; Sadda, SriniVas R

    2017-10-01

    The choroid is thought to be relevant to the pathogenesis of nonneovascular age-related macular degeneration, but its role has not yet been fully defined. In this study, we evaluate the relationship between the extent of macular drusen and specific choroidal parameters, including thickness and intensity. Spectral domain optical coherence tomography images were collected from two distinct, independent cohorts with nonneovascular age-related macular degeneration: Amish (53 eyes of 34 subjects) and non-Amish (40 eyes from 26 subjects). All spectral domain optical coherence tomography scans were obtained using the Cirrus HD-OCT with a 512 × 128 macular cube (6 × 6 mm) protocol. The Cirrus advanced retinal pigment epithelium analysis tool was used to automatically compute drusen volume within 3 mm (DV3) and 5 mm (DV5) circles centered on the fovea. The inner and outer borders of the choroid were manually segmented, and the mean choroidal thickness and choroidal intensity (i.e., brightness) were calculated. The choroidal intensity was normalized against the vitreous and nerve fiber layer reflectivity. The correlation between DV and these choroidal parameters was assessed using Pearson and linear regression analysis. A significant positive correlation was observed between normalized choroidal intensity and DV5 in the Amish (r = 0.42, P = 0.002) and non-Amish (r = 0.33, P = 0.03) cohorts. Also, DV3 showed a significant positive correlation with normalized choroidal intensity in both the groups (Amish: r = 0.30, P = 0.02; non-Amish: r = 0.32, P = 0.04). Choroidal thickness was negatively correlated with normalized choroidal intensity in both Amish (r = -0.71, P = 0.001) and non-Amish (r = -0.43, P = 0.01) groups. Normalized choroidal intensity was the most significant constant predictor of DV in both the Amish and non-Amish groups. Choroidal intensity, but not choroidal thickness, seems to be associated with drusen volume in Amish and non-Amish populations. These

  8. On Black Hole Stability in Critical Gravities

    Science.gov (United States)

    Liu, Haishan; Lü, H.; Luo, Mingxing

    We consider extended cosmological gravities with Ricci tensor and scalar squared terms in diverse dimensions. These theories admit solutions of Einstein metrics, including the Schwarzschild-Tangherlini AdS black holes, whose mass and entropy vanish at the critical point. We perform linearized analysis around the black holes and show that in general the spectrum consists of the usual spin-2 massless and ghost massive modes. We demonstrate that there is no exponentially-growing tachyon mode in the black holes. At the critical point, the massless spin-2 modes have zero energy whilst the massive spin-2 modes are replaced by the log modes. There always exist certain linear combination of massless and log modes that has negative energy. Thus the stability of the black holes requires that the log modes to be truncated out by the boundary condition.

  9. Correspondence principle for black holes and strings

    International Nuclear Information System (INIS)

    Horowitz, G.T.; Polchinski, J.

    1997-01-01

    For most black holes in string theory, the Schwarzschild radius in string units decreases as the string coupling is reduced. We formulate a correspondence principle, which states that (i) when the size of the horizon drops below the size of a string, the typical black hole state becomes a typical state of strings and D-branes with the same charges, and (ii) the mass does not change abruptly during the transition. This provides a statistical interpretation of black hole entropy. This approach does not yield the numerical coefficient, but gives the correct dependence on mass and charge in a wide range of cases, including neutral black holes. copyright 1997 The American Physical Society

  10. Black-hole masses of distant quasars

    DEFF Research Database (Denmark)

    Vestergaard, Marianne

    2011-01-01

    A brief overview of the methods commonly used to determine or estimate the black hole mass in quiescent or active galaxies is presented and it is argued that the use of mass-scaling relations is both a reliable and the preferred method to apply to large samples of distant quasars. The method uses...... that the black hole masses are very large, of order 1 to 10 billion solar masses, even at the highest redshifts of 4 to 6. The black holes must build up their mass very fast in the early universe. Yet they do not grow much larger than that: a maximum mass of about 10 billion solar masses is also observed....... Preliminary mass functions of active black holes are presented for several quasar samples, including the Sloan Digital Sky Survey. Finally, common concerns related to the application of the mass scaling relations, especially for high redshift quasars, are briefly discussed....

  11. [The age-related macular degeneration as a vascular disease/part of systemic vasculopathy: contributions to its pathogenesis].

    Science.gov (United States)

    Fischer, Tamás

    2015-03-01

    The wall of blood vessels including those in choroids may be harmed by several repeated and/or prolonged mechanical, physical, chemical, microbiological, immunologic, and genetic impacts (risk factors), which may trigger a protracted response, the so-called host defense response. As a consequence, pathological changes resulting in vascular injury (e. g. atherosclerosis, age-related macular degeneration) may be evolved. Risk factors can also act directly on the endothelium through an increased production of reactive oxygen species promoting an endothelial activation, which leads to endothelial dysfunction, the onset of vascular disease. Thus, endothelial dysfunction is a link between the harmful stimulus and vascular injury; any kind of harmful stimuli may trigger the defensive chain that results in inflammation that may lead to vascular injury. It has been shown that even early age-related macular degeneration is associated with the presence of diffuse arterial disease and patients with early age-related macular degeneration demonstrate signs of systemic and retinal vascular alterations. Chronic inflammation, a feature of AMD, is tightly linked to diseases associated with ED: AMD is accompanied by a general inflammatory response, in the form of complement system activation, similar to that observed in degenerative vascular diseases such as atherosclerosis. All these facts indicate that age-related macular degeneration may be a vascular disease (or part of a systemic vasculopathy). This recognition could have therapeutic implications because restoration of endothelial dysfunction may prevent the development or improve vascular disease resulting in prevention or improvement of age-related macular degeneration as well.

  12. ASSOCIATION BETWEEN VISUAL FUNCTION AND SUBRETINAL DRUSENOID DEPOSITS IN NORMAL AND EARLY AGE-RELATED MACULAR DEGENERATION EYES.

    Science.gov (United States)

    Neely, David; Zarubina, Anna V; Clark, Mark E; Huisingh, Carrie E; Jackson, Gregory R; Zhang, Yuhua; McGwin, Gerald; Curcio, Christine A; Owsley, Cynthia

    2017-07-01

    To examine the association between subretinal drusenoid deposits (SDDs) identified by multimodal retinal imaging and visual function in older eyes with normal macular health or in the earliest phases of age-related macular degeneration (AMD). Age-related macular degeneration status for each eye was defined according to the Age-Related Eye Disease Study (AREDS) 9-step classification system (normal = Step 1, early AMD = Steps 2-4) based on color fundus photographs. Visual functions measured were best-corrected photopic visual acuity, contrast and light sensitivity, mesopic visual acuity, low-luminance deficit, and rod-mediated dark adaptation. Subretinal drusenoid deposits were identified through multimodal imaging (color fundus photographs, infrared reflectance and fundus autofluorescence images, and spectral domain optical coherence tomography). The sample included 1,202 eyes (958 eyes with normal health and 244 eyes with early AMD). In normal eyes, SDDs were not associated with any visual function evaluated. In eyes with early AMD, dark adaptation was markedly delayed in eyes with SDDs versus no SDD (a 4-minute delay on average), P = 0.0213. However, this association diminished after age adjustment, P = 0.2645. Other visual functions in early AMD eyes were not associated with SDDs. In a study specifically focused on eyes in normal macular health and in the earliest phases of AMD, early AMD eyes with SDDs have slower dark adaptation, largely attributable to the older ages of eyes with SDD; they did not exhibit deficits in other visual functions. Subretinal drusenoid deposits in older eyes in normal macular health are not associated with any visual functions evaluated.

  13. Utilization of the irradiation holes in the core at HANARO

    International Nuclear Information System (INIS)

    Lee, Shoong Sung; Ahn, Guk Hoon

    2008-01-01

    HANARO is a multipurpose research reactor. The three hexagonal and four circular holes are reserved for the irradiation tests in the core. Twenty holes including two NTD(Neutron Transmutation Doping) holes, a LH(Large Hole) and NAA holes are located in the reflector tank. These hole have been used for radioisotope production, material and fuel irradiation tests, beam application research and neutron activation analysis. In the initial stage of normal operation, the using time of irradiation holes located in the core was less the 40% of the reactor operation day. To raise utilization of irradiation holes, the equipment and facilities have been developed such as various capsules. Another area for increasing the utilization of HANARO was the fuel irradiation tests to develop the new fuels. Various fuel irradiation tests have been performed. Recently, the usage time of the irradiation holes in the core was more than 90% of the reactor operation day. If the FTL starts an irradiation service, the irradiation holes in the core will be fully used. In this paper describes the status of utilization of irradiation holes in the core

  14. Black holes and beyond

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-02-01

    Belief in the existence of black holes is the ultimate act of faith for a physicist. First suggested by the English clergyman John Michell in the year 1784, the gravitational pull of a black hole is so strong that nothing - not even light - can escape. Gravity might be the weakest of the fundamental forces but black-hole physics is not for the faint-hearted. Black holes present obvious problems for would-be observers because they cannot, by definition, be seen with conventional telescopes - although before the end of the decade gravitational-wave detectors should be able to study collisions between black holes. Until then astronomers can only infer the existence of a black hole from its gravitational influence on other matter, or from the X-rays emitted by gas and dust as they are dragged into the black hole. However, once this material passes through the 'event horizon' that surrounds the black hole, we will never see it again - not even with X-ray specs. Despite these observational problems, most physicists and astronomers believe that black holes do exist. Small black holes a few kilometres across are thought to form when stars weighing more than about two solar masses collapse under the weight of their own gravity, while supermassive black holes weighing millions of solar masses appear to be present at the centre of most galaxies. Moreover, some brave physicists have proposed ways to make black holes - or at least event horizons - in the laboratory. The basic idea behind these 'artificial black holes' is not to compress a large amount of mass into a small volume, but to reduce the speed of light in a moving medium to less than the speed of the medium and so create an event horizon. The parallels with real black holes are not exact but the experiments could shed new light on a variety of phenomena. The first challenge, however, is to get money for the research. One year on from a high-profile meeting on artificial black holes in London, for

  15. OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY REVEALS BLOOD FLOW IN CHOROIDAL NEOVASCULAR MEMBRANE IN REMISSION PHASE OF NEOVASCULAR AGE-RELATED MACULAR DEGENERATION.

    Science.gov (United States)

    Ichiyama, Yusuke; Sawada, Tomoko; Ito, Yuka; Kakinoki, Masashi; Ohji, Masahito

    2017-04-01

    The aim of the study was to investigate blood flow in choroidal neovascular membrane in remission phase of neovascular age-related macular degeneration using optical coherence tomography (OCT) angiography. OCT angiography was obtained in eyes with remission phase of neovascular age-related macular degeneration after treatments, defined as no exudative change (such as macular edema, subretinal fluid, and subretinal hemorrhage) observed in eyes without any treatment for neovascular age-related macular degeneration within the previous 6 months. Irregular blood flows shown in the segmentation of outer retina detected by OCT angiography were considered as blood flows in choroidal neovascular membrane. The vascular area and vessel density were obtained from OCT angiography images. Twenty eyes of 20 patients were included in this analysis. The blood flows in choroidal neovascular membrane were observed in all eyes (100%) using OCT angiography. The mean vascular area was 3.81 ± 3.41 mm and the mean vessel density of lesion was 28.9 ± 8.2%. The vessel density was significantly correlated with best-corrected visual acuity and duration of remission (best-corrected visual acuity: P = 0.008, r = -0.576; duration of remission: P = 0.017, r = -0.525, respectively). Optical coherence tomography angiography revealed that blood flows in choroidal neovascular membrane remained in eyes with clinically inactive neovascular age-related macular degeneration.

  16. [Comparison of macular electroretinography and psychophysical tests in diabetic retinopathy with intraretinal edema].

    Science.gov (United States)

    Grounauer, P A; Balmer, A; Geinoz, J; Stress, S

    1978-01-01

    Short comparison between psychophysic and electrodiagnostic tests in 20 eyes with macular edema from diabetic retinopathy. De Lange's curve, the critical flicker frequency in central fixation and the macular ERG are compared with the classical EOG and global ERG data. The methodology is briefly described. It allows a new approach of the macula and the macular ERG responses confirms the clinical tests.

  17. The role of steroids in the management of uveitic macular edema

    NARCIS (Netherlands)

    de Smet, Marc D.; Julian, Karina

    2010-01-01

    Purpose. To review the role of steroids in the management of uveitic macular edema. Methods. Review of recent literature on the physiopathology of macular edema and clinical trials involving steroids as main treatment of uveitic macular edema. Results. The steroid-glucocorticoid receptor complex

  18. Surprise: Dwarf Galaxy Harbors Supermassive Black Hole

    Science.gov (United States)

    2011-01-01

    with the Hubble Space Telescope. They found a region near the center of the galaxy that strongly emits radio waves with characteristics of those emitted by super-fast "jets" of material spewed outward from areas close to a black hole. They then searched images from the Chandra X-Ray Observatory that showed this same, radio-bright region to be strongly emitting energetic X-rays. This combination, they said, indicates an active, black-hole-powered, galactic nucleus. "Not many dwarf galaxies are known to have massive black holes," Sivakoff said. While central black holes of roughly the same mass as the one in Henize 2-10 have been found in other galaxies, those galaxies all have much more regular shapes. Henize 2-10 differs not only in its irregular shape and small size but also in its furious star formation, concentrated in numerous, very dense "super star clusters." "This galaxy probably resembles those in the very young Universe, when galaxies were just starting to form and were colliding frequently. All its properties, including the supermassive black hole, are giving us important new clues about how these black holes and galaxies formed at that time," Johnson said. The astronomers reported their findings in the January 9 online edition of Nature, and at the American Astronomical Society's meeting in Seattle, WA.

  19. A Case of Diabetic Macular Edema with Prominent Chorioretinal Folds

    Directory of Open Access Journals (Sweden)

    Takaki Sato

    2017-03-01

    Full Text Available Purpose: To report a case of diabetic macular edema with prominent chorioretinal folds. Case Report: This study involved a 55-year-old male with untreated bilateral diabetic retinopathy who had undergone cataract surgery at another clinic. Following that surgery, diabetic macular edema rapidly exacerbated, accentuating marked cystoid macular edema and radial chorioretinal folds in the macula. Investigation of his medical history revealed that in addition to diabetes, he had uncontrolled hypertension and severe diabetic nephropathy. Vitreous surgery was performed on both eyes due to a resistance to a subtenon injection of triamcinolone acetonide or intravitreal injection of an antivascular endothelial growth factor agent. After surgery, the macular edema and chorioretinal folds showed a tendency towards improvement. Thereafter, kidney transplant surgery was performed for renal failure, and a mild tendency of chorioretinal folds was observed. Conclusion: In the case presented in this study, we observed remarkable cystoid macular edema in the fovea centralis and theorize that distortion with the surrounding tissue might have occurred, thus leading to the formation of chorioretinal folds around the macula.

  20. Intravitreal gas injection for the treatment of diabetic macular edema

    Directory of Open Access Journals (Sweden)

    McHugh D

    2011-10-01

    Full Text Available Dominic McHugh, Bhaskar Gupta, Manzar Saeed King's College Hospital, Denmark Hill, London, England, UK Purpose: This study investigates the efficacy of an intravitreal gas injection in inducing a posterior vitreous detachment (PVD in patients with clinically significant diabetic macular edema refractory to laser therapy. Methods: A local ethics committee-approved technique of an intravitreal injection of pure perfluoropropane gas (C3F8 was performed for all participants. After a period of prone positioning, the patients underwent regular and detailed clinical review. Main outcome measures: The induction of a PVD, change in macular thickness, change in visual acuity. Results: A PVD was induced in all five eyes with subsequent signs of reduction in macular thickness and resolution of exudates. Mean visual improvement was 11 ETDRS (Early Treatment Diabetic Retinopathy Study letters (range 4–21. Apart from a transient vitreous hemorrhage in one eye, there were no significant treatment-related complications. Conclusion: The induction of a PVD by pneumatic retinopexy appears to have a significant influence on diabetic macular edema in eyes which have not successfully responded to macular laser therapy. A randomized clinical trial is justified on the basis of the initial promising data. Keywords: optical coherence tomography, OCT, posterior vitreous detachment, perfluoropropane

  1. Estudo macular na doença de Stargardt Macula study in Stargardt's disease

    Directory of Open Access Journals (Sweden)

    Otacílio de Oliveira Maia Júnior

    2008-02-01

    Full Text Available OBJETIVO: Avaliar dano estrutural macular na doença de Stargardt por meio da tomografia de coerência óptica, correlacionando-o com acuidade visual e duração da doença. MÉTODOS: Foram incluídos portadores da doença de Stargardt, submetidos à medida da acuidade visual (logMAR e exames complementares (retinografia, angiofluoresceinografia e tomografia de coerência óptica. Todos os casos foram reexaminados para confirmação diagnóstica, sendo determinada duração da doença. O grupo controle foi composto pelo mesmo número de casos, pareados por sexo, idade e sem qualquer alteração oftalmológica. RESULTADOS: A amostra foi composta por 22 pacientes (44 olhos, sendo 11 (50% do sexo masculino e 11 (50%, do feminino. A duração da doença variou de 3 a 21 anos (média de 11,4 ± 5,3 anos. Os grupos não apresentaram diferença significante na idade (p=0,98 e no sexo. O grupo caso apresentou valores de espessura macular na tomografia de coerência óptica significativamente menores em relação ao grupo controle (pPURPOSE: To evaluate de macular structural damage in Stargardt's disease by optical coherence tomography, correlating with visual acuity and disease duration. METHODS: Patients with Stargardt's disease were included and submitted to visual acuity (logMAR measurement and complementary examinations performed were color fundus photographs, fluorescein angiography and optical coherence tomography. All cases were reexamined for diagnostic confirmation and the duration of symptoms was determined. The control group was composed of the same number of subjects, matched by sex and age, without any ophthalmologic alteration. RESULTS: The sample was composed of 22 patients (44 eyes with Stargardt's disease, 11 (50% males and 11 (50% females. The duration of the disease varied from 3 to 21 years (mean of 11.4 ± 5.3 years. The groups did not show significant differences in age (p= 0.98 and sex. Concerning the macular thickness in optical

  2. Pilot evaluation of short-term changes in macular pigment and retinal sensitivity in different phenotypes of early age-related macular degeneration after carotenoid supplementation.

    Science.gov (United States)

    Corvi, Federico; Souied, Eric H; Falfoul, Yousra; Georges, Anouk; Jung, Camille; Querques, Lea; Querques, Giuseppe

    2017-06-01

    To investigate the response of carotenoid supplementation in different phenotypes of early age-related macular degeneration (AMD) by measuring macular pigment optical density (MPOD) and retinal sensitivity. Consecutive patients with only medium/large drusen and only reticular pseudodrusen (RPD) and age-matched and sex-matched controls were enrolled. At baseline, participants underwent a complete ophthalmological examination including measurement of best-corrected visual acuity (BCVA), MPOD and retinal sensitivity. Patients were put on vitamin supplementation (lutein 10 mg/day, zeaxanthin 2 mg/day) and 3 months later underwent a repeated ophthalmological examination. Twenty patients with medium/large drusen, 19 with RPD and 15 control subjects were included. At baseline, in controls, mean MPOD and BCVA were significantly higher compared with RPD (p=0.001 and p=0.01) but similar to medium/large drusen (p=0.9 and p=0.4). Mean retinal sensitivity was significantly higher in controls compared with RPD and medium/large drusen (for all pmacular sensitivity and MPOD than controls. After supplementation, MPOD significantly increased in RPD. These results suggest different pathophysiology for RPD as compared with medium/large drusen and may open new ways to identifying further therapeutic targets in this phenotype of early AMD. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  3. Ocular Surface Temperature in Age-Related Macular Degeneration

    Directory of Open Access Journals (Sweden)

    Andrea Sodi

    2014-01-01

    Full Text Available Background. The aim of this study is to investigate the ocular thermographic profiles in age-related macular degeneration (AMD eyes and age-matched controls to detect possible hemodynamic abnormalities, which could be involved in the pathogenesis of the disease. Methods. 32 eyes with early AMD, 37 eyes with atrophic AMD, 30 eyes affected by untreated neovascular AMD, and 43 eyes with fibrotic AMD were included. The control group consisted of 44 healthy eyes. Exclusion criteria were represented by any other ocular diseases other than AMD, tear film abnormalities, systemic cardiovascular abnormalities, diabetes mellitus, and a body temperature higher than 37.5°C. A total of 186 eyes without pupil dilation were investigated by infrared thermography (FLIR A320. The ocular surface temperature (OST of three ocular points was calculated by means of an image processing technique from the infrared images. Two-sample t-test and one-way analysis of variance (ANOVA test were used for statistical analyses. Results. ANOVA analyses showed no significant differences among AMD groups (P value >0.272. OST in AMD patients was significantly lower than in controls (P>0.05. Conclusions. Considering the possible relationship between ocular blood flow and OST, these findings might support the central role of ischemia in the pathogenesis of AMD.

  4. Mechanism of Inflammation in Age-Related Macular Degeneration

    Directory of Open Access Journals (Sweden)

    Francesco Parmeggiani

    2012-01-01

    Full Text Available Age-related macular degeneration (AMD is a multifactorial disease that represents the most common cause of irreversible visual impairment among people over the age of 50 in Europe, the United States, and Australia, accounting for up to 50% of all cases of central blindness. Risk factors of AMD are heterogeneous, mainly including increasing age and different genetic predispositions, together with several environmental/epigenetic factors, that is, cigarette smoking, dietary habits, and phototoxic exposure. In the aging retina, free radicals and oxidized lipoproteins are considered to be major causes of tissue stress resulting in local triggers for parainflammation, a chronic status which contributes to initiation and/or progression of many human neurodegenerative diseases such as AMD. Experimental and clinical evidences strongly indicate the pathogenetic role of immunologic processes in AMD occurrence, consisting of production of inflammatory related molecules, recruitment of macrophages, complement activation, microglial activation and accumulation within those structures that compose an essential area of the retina known as macula lutea. This paper reviews some attractive aspects of the literature about the mechanisms of inflammation in AMD, especially focusing on those findings or arguments more directly translatable to improve the clinical management of patients with AMD and to prevent the severe vision loss caused by this disease.

  5. Evidence of macular pigment in the central macula in albinism.

    Science.gov (United States)

    Wolfson, Yulia; Fletcher, Emily; Strauss, Rupert W; Scholl, Hendrik P N

    2016-04-01

    Albinism represents a spectrum of disorders with diminished to absent amounts of melanin pigmentation including the posterior segment of the eye. Macular pigment (MP) consists of two main carotenoids, lutein and zeaxanthin, concentrated in the macula. MP serves as blue light absorbent, antioxidant, and may reduce chromatic aberration and glare. It remains unclear if albinos have detectable MP. The purpose was to investigate the distribution of MP in albino patients with psychophysical and imaging techniques. MP was measured at the eccentricity of 0.5° by heterochromatic flicker perimetry (QuantifEye(®); Tinsley Precision Instruments Ltd.) or by scanning laser ophthalmoscopy (MPOD module, MultiColor Spectralis(®), Heidelberg Engineering, Heidelberg, Germany) in four albino patients, who were also investigated with multimodal ophthalmic imaging. Visual acuity ranged from 20/32 to 20/125, nystagmus was present in three patients, and all patients showed typical foveal hypoplasia on fundus exam and optical coherence tomography. Fundus autofluorescence (FAF) demonstrated various degrees of central FAF signal attenuation. Genetic testing was available in three patients and confirmed the diagnosis. Measurable amounts of MP were detected in all four patients and ranged from 0.05 to 0.24, which is below the normal range. We conclude that MP can be demonstrated and measured in albinos. Further studies are needed to investigate MP accumulation following carotenoid supplementation and its impact on visual performance. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Bilateral Macular Roth Spots as a Manifestation of Subacute Endocarditis

    Directory of Open Access Journals (Sweden)

    Karolina Ceglowska

    2015-01-01

    Full Text Available A 42-year-old man presented with a 2-day history of impaired vision in the right eye (OD. The best corrected visual acuity (BCVA (LogMAR was 1.1 for the right eye and 0.0 for the left eye (OS. Fundus examination revealed white-centered hemorrhages resembling Roth spots in both macular regions. The spectral-domain optical coherence tomography (SD-OCT showed intraretinal pseudocysts and hyperreflective deposits in the areas corresponding to the Roth spots. Conducted blood tests revealed elevated D-dimer concentration, increased total number of neutrophils, high C-reactive protein concentration, and elevated erythrocyte sedimentation rate. Procalcitonin concentration, platelet count, and body temperature were within normal ranges. A blood culture was ordered and yielded Streptococcus mitis and intravenous antibiotics were started immediately. The patient started complaining of chest and left calf pain. The systemic examination revealed infective endocarditis accompanied by bicuspid aortic valve and paravalvular abscess formation. The patient underwent cardiac surgery with mechanical aortic valve implantation. After recovery, the patient’s visual acuities improved fully. Control ophthalmic examination, including SD-OCT, showed no abnormalities.

  7. Mechanism of Inflammation in Age-Related Macular Degeneration

    Science.gov (United States)

    Parmeggiani, Francesco; Romano, Mario R.; Costagliola, Ciro; Semeraro, Francesco; Incorvaia, Carlo; D'Angelo, Sergio; Perri, Paolo; De Palma, Paolo; De Nadai, Katia; Sebastiani, Adolfo

    2012-01-01

    Age-related macular degeneration (AMD) is a multifactorial disease that represents the most common cause of irreversible visual impairment among people over the age of 50 in Europe, the United States, and Australia, accounting for up to 50% of all cases of central blindness. Risk factors of AMD are heterogeneous, mainly including increasing age and different genetic predispositions, together with several environmental/epigenetic factors, that is, cigarette smoking, dietary habits, and phototoxic exposure. In the aging retina, free radicals and oxidized lipoproteins are considered to be major causes of tissue stress resulting in local triggers for parainflammation, a chronic status which contributes to initiation and/or progression of many human neurodegenerative diseases such as AMD. Experimental and clinical evidences strongly indicate the pathogenetic role of immunologic processes in AMD occurrence, consisting of production of inflammatory related molecules, recruitment of macrophages, complement activation, microglial activation and accumulation within those structures that compose an essential area of the retina known as macula lutea. This paper reviews some attractive aspects of the literature about the mechanisms of inflammation in AMD, especially focusing on those findings or arguments more directly translatable to improve the clinical management of patients with AMD and to prevent the severe vision loss caused by this disease. PMID:23209345

  8. Updates in the Management of Diabetic Macular Edema

    Directory of Open Access Journals (Sweden)

    Christopher Mathew

    2015-01-01

    Full Text Available Diabetes mellitus is a chronic disease which has multiple effects on different end-organs, including the retina. In this paper, we discuss updates on diabetic macular edema (DME and the management options. The underlying pathology of DME is the leakage of exudates from retinal microaneurysms, which trigger subsequent inflammatory reactions. Both clinical and imaging techniques are useful in diagnosing, classifying, and gauging the severity of DME. We performed a comprehensive literature search using the keywords “diabetes,” “macula edema,” “epidemiology,” “pathogenesis,” “optical coherence tomography,” “intravitreal injections,” “systemic treatment,” “hypertension,” “hyperlipidemia,” “anemia,” and “renal disease” and collated a total of 47 relevant articles published in English language. The main modalities of treatment currently in use comprise laser photocoagulation, intravitreal pharmacological and selected systemic pharmacological options. In addition, we mention some novel therapies that show promise in treating DME. We also review systemic factors associated with exacerbation or improvement in DME.

  9. New Computer Simulations of Macular Neural Functioning

    Science.gov (United States)

    Ross, Muriel D.; Doshay, D.; Linton, S.; Parnas, B.; Montgomery, K.; Chimento, T.

    1994-01-01

    We use high performance graphics workstations and supercomputers to study the functional significance of the three-dimensional (3-D) organization of gravity sensors. These sensors have a prototypic architecture foreshadowing more complex systems. Scaled-down simulations run on a Silicon Graphics workstation and scaled-up, 3-D versions run on a Cray Y-MP supercomputer. A semi-automated method of reconstruction of neural tissue from serial sections studied in a transmission electron microscope has been developed to eliminate tedious conventional photography. The reconstructions use a mesh as a step in generating a neural surface for visualization. Two meshes are required to model calyx surfaces. The meshes are connected and the resulting prisms represent the cytoplasm and the bounding membranes. A finite volume analysis method is employed to simulate voltage changes along the calyx in response to synapse activation on the calyx or on calyceal processes. The finite volume method insures that charge is conserved at the calyx-process junction. These and other models indicate that efferent processes act as voltage followers, and that the morphology of some afferent processes affects their functioning. In a final application, morphological information is symbolically represented in three dimensions in a computer. The possible functioning of the connectivities is tested using mathematical interpretations of physiological parameters taken from the literature. Symbolic, 3-D simulations are in progress to probe the functional significance of the connectivities. This research is expected to advance computer-based studies of macular functioning and of synaptic plasticity.

  10. Animal models of age related macular degeneration

    Science.gov (United States)

    Pennesi, Mark E.; Neuringer, Martha; Courtney, Robert J.

    2013-01-01

    Age related macular degeneration (AMD) is the leading cause of vision loss of those over the age of 65 in the industrialized world. The prevalence and need to develop effective treatments for AMD has lead to the development of multiple animal models. AMD is a complex and heterogeneous disease that involves the interaction of both genetic and environmental factors with the unique anatomy of the human macula. Models in mice, rats, rabbits, pigs and non-human primates have recreated many of the histological features of AMD and provided much insight into the underlying pathological mechanisms of this disease. In spite of the large number of models developed, no one model yet recapitulates all of the features of human AMD. However, these models have helped reveal the roles of chronic oxidative damage, inflammation and immune dysregulation, and lipid metabolism in the development of AMD. Models for induced choroidal neovascularization have served as the backbone for testing new therapies. This article will review the diversity of animal models that exist for AMD as well as their strengths and limitations. PMID:22705444

  11. Diabetic Macular Edema Pathophysiology: Vasogenic versus Inflammatory

    Directory of Open Access Journals (Sweden)

    Pedro Romero-Aroca

    2016-01-01

    Full Text Available Diabetic macular edema (DME can cause blindness in diabetic patients suffering from diabetic retinopathy (DR. DM parameters controls (glycemia, arterial tension, and lipids are the gold standard for preventing DR and DME. Although the vascular endothelial growth factor (VEGF is known to play a role in the development of DME, the pathological processes leading to the onset of this disease are highly complex and the exact sequence in which they occur is still not completely understood. Angiogenesis and inflammation have been shown to be involved in the pathogenesis of this disease. However, it still remains to be clarified whether angiogenesis following VEGF overexpression is a cause or a consequence of inflammation. This paper provides a review of the data currently available, focusing on VEGF, angiogenesis, and inflammation. Our analysis suggests that angiogenesis and inflammation act interdependently during the development of DME. Knowledge of DME etiology seems to be important in treatments with anti-VEGF or anti-inflammatory drugs. Current diagnostic techniques do not permit us to differentiate between both etiologies. In the future, diagnosing the physiopathology of each patient with DME will help us to select the most effective drug.

  12. Topology, entropy, and Witten index of dilaton black holes

    International Nuclear Information System (INIS)

    Gibbons, G.W.; Kallosh, R.E.

    1995-01-01

    We have found that for extreme dilaton black holes an inner boundary must be introduced in addition to the outer boundary to give an integer value to the Euler number. The resulting manifolds have (if one identifies imaginary time) a topology S 1 xRxS 2 and Euler number χ=0 in contrast with the nonextreme case with χ=2. The entropy of extreme U(1) dilaton black holes is already known to be zero. We include a review of some recent ideas due to Hawking on the Reissner-Nordstroem case. By regarding all extreme black holes as having an inner boundary, we conclude that the entropy of all extreme black holes, including [U(1)] 2 black holes, vanishes. We discuss the relevance of this to the vanishing of quantum corrections and the idea that the functional integral for extreme holes gives a Witten index. We have studied also the topology of ''moduli space'' of multi-black-holes. The quantum mechanics on black hole moduli spaces is expected to be supersymmetric despite the fact that they are not hyper-Kaehler since the corresponding geometry has a torsion unlike the BPS monopole case. Finally, we describe the possibility of extreme black hole fission for states with an energy gap. The energy released, as a proportion of the initial rest mass, during the decay of an electromagnetic black hole is 300 times greater than that released by the fission of a 235 U nucleus

  13. Do evaporating black holes form photospheres?

    International Nuclear Information System (INIS)

    MacGibbon, Jane H.; Carr, B. J.; Page, Don N.

    2008-01-01

    Several authors, most notably Heckler, have claimed that the observable Hawking emission from a microscopic black hole is significantly modified by the formation of a photosphere around the black hole due to QED or QCD interactions between the emitted particles. In this paper we analyze these claims and identify a number of physical and geometrical effects which invalidate these scenarios. We point out two key problems. First, the interacting particles must be causally connected to interact, and this condition is satisfied by only a small fraction of the emitted particles close to the black hole. Second, a scattered particle requires a distance ∼E/m e 2 for completing each bremsstrahlung interaction, with the consequence that it is improbable for there to be more than one complete bremsstrahlung interaction per particle near the black hole. These two effects have not been included in previous analyses. We conclude that the emitted particles do not interact sufficiently to form a QED photosphere. Similar arguments apply in the QCD case and prevent a QCD photosphere (chromosphere) from developing when the black hole temperature is much greater than Λ QCD , the threshold for QCD particle emission. Additional QCD phenomenological arguments rule out the development of a chromosphere around black hole temperatures of order Λ QCD . In all cases, the observational signatures of a cosmic or Galactic halo background of primordial black holes or an individual black hole remain essentially those of the standard Hawking model, with little change to the detection probability. We also consider the possibility, as proposed by Belyanin et al. and D. Cline et al., that plasma interactions between the emitted particles form a photosphere, and we conclude that this scenario too is not supported.

  14. Cosmological production of noncommutative black holes

    International Nuclear Information System (INIS)

    Mann, Robert B.; Nicolini, Piero

    2011-01-01

    We investigate the pair creation of noncommutative black holes in a background with a positive cosmological constant. As a first step we derive the noncommutative geometry inspired Schwarzschild-de Sitter solution. By varying the mass and the cosmological constant parameters, we find several spacetimes compatible with the new solution: positive-mass spacetimes admit one cosmological horizon and two, one, or no black hole horizons, while negative-mass spacetimes have just a cosmological horizon. These new black holes share the properties of the corresponding asymptotically flat solutions, including the nonsingular core and thermodynamic stability in the final phase of the evaporation. As a second step we determine the action which generates the matter sector of gravitational field equations and we construct instantons describing the pair production of black holes and the other admissible topologies. As a result we find that for current values of the cosmological constant the de Sitter background is quantum mechanically stable according to experience. However, positive-mass noncommutative black holes and solitons would have plentifully been produced during inflationary times for Planckian values of the cosmological constant. As a special result we find that, in these early epochs of the Universe, Planck size black holes production would have been largely disfavored. We also find a potential instability for production of negative-mass solitons.

  15. MACULAR ATROPHY FINDINGS BY OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY COMPARED WITH FUNDUS AUTOFLUORESCENCE IN TREATED EXUDATIVE AGE-RELATED MACULAR DEGENERATION.

    Science.gov (United States)

    Takasago, Yukari; Shiragami, Chieko; Kobayashi, Mamoru; Osaka, Rie; Ono, Aoi; Yamashita, Ayana; Tsujikawa, Akitaka; Hirooka, Kazuyuki

    2017-11-28

    To compare the areas of choriocapillaris (CC) nonperfusion and macular atrophy (MA) in treated exudative age-related macular degeneration. This was a prospective, observational, cross-sectional study. Forty-four eyes exhibiting MA (42 patients with age-related macular degeneration), with a dry macula, underwent fundus autofluorescence and optical coherence tomography angiography. The area of MA detected by fundus autofluorescence and CC nonperfusion detected by optical coherence tomography angiography was measured using image analysis software. The rates of concordance between the MA and CC nonperfusion areas were calculated. We qualitatively and quantitatively compared the areas of MA and CC nonperfusion in age-related macular degeneration eyes. The mean areas of MA and CC nonperfusion were 5.95 ± 4.50 mm and 10.66 ± 7.05 mm, respectively (paired t-test, P age-related macular degeneration.This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  16. Merging Black Holes

    Science.gov (United States)

    Centrella, Joan

    2012-01-01

    The final merger of two black holes is expected to be the strongest source of gravitational waves for both ground-based detectors such as LIGO and VIRGO, as well as future. space-based detectors. Since the merger takes place in the regime of strong dynamical gravity, computing the resulting gravitational waveforms requires solving the full Einstein equations of general relativity on a computer. For many years, numerical codes designed to simulate black hole mergers were plagued by a host of instabilities. However, recent breakthroughs have conquered these instabilities and opened up this field dramatically. This talk will focus on.the resulting 'gold rush' of new results that is revealing the dynamics and waveforms of binary black hole mergers, and their applications in gravitational wave detection, testing general relativity, and astrophysics

  17. Pulsation of black holes

    Science.gov (United States)

    Gao, Changjun; Lu, Youjun; Shen, You-Gen; Faraoni, Valerio

    2018-01-01

    The Hawking-Penrose singularity theorem states that a singularity forms inside a black hole in general relativity. To remove this singularity one must resort to a more fundamental theory. Using a corrected dynamical equation arising in loop quantum cosmology and braneworld models, we study the gravitational collapse of a perfect fluid sphere with a rather general equation of state. In the frame of an observer comoving with this fluid, the sphere pulsates between a maximum and a minimum size, avoiding the singularity. The exterior geometry is also constructed. There are usually an outer and an inner apparent horizon, resembling the Reissner-Nordström situation. For a distant observer the horizon crossing occurs in an infinite time and the pulsations of the black hole quantum "beating heart" are completely unobservable. However, it may be observable if the black hole is not spherical symmetric and radiates gravitational wave due to the quadrupole moment, if any.

  18. Turbulent black holes.

    Science.gov (United States)

    Yang, Huan; Zimmerman, Aaron; Lehner, Luis

    2015-02-27

    We demonstrate that rapidly spinning black holes can display a new type of nonlinear parametric instability-which is triggered above a certain perturbation amplitude threshold-akin to the onset of turbulence, with possibly observable consequences. This instability transfers from higher temporal and azimuthal spatial frequencies to lower frequencies-a phenomenon reminiscent of the inverse cascade displayed by (2+1)-dimensional fluids. Our finding provides evidence for the onset of transitory turbulence in astrophysical black holes and predicts observable signatures in black hole binaries with high spins. Furthermore, it gives a gravitational description of this behavior which, through the fluid-gravity duality, can potentially shed new light on the remarkable phenomena of turbulence in fluids.

  19. Bringing Black Holes Home

    Science.gov (United States)

    Furmann, John M.

    2003-03-01

    Black holes are difficult to study because they emit no light. To overcome this obstacle, scientists are trying to recreate a black hole in the laboratory. The article gives an overview of the theories of Einstein and Hawking as they pertain to the construction of the Large Hadron Collider (LHC) near Geneva, Switzerland, scheduled for completion in 2006. The LHC will create two beams of protons traveling in opposing directions that will collide and create a plethora of scattered elementary particles. Protons traveling in opposite directions at very high velocities may create particles that come close enough to each other to feel their compacted higher dimensions and create a mega force of gravity that can create tiny laboratory-sized black holes for fractions of a second. The experiments carried out with LHC will be used to test modern string theory and relativity.

  20. Black hole gravitohydromagnetics

    CERN Document Server

    Punsly, Brian

    2008-01-01

    Black hole gravitohydromagnetics (GHM) is developed from the rudiments to the frontiers of research in this book. GHM describes plasma interactions that combine the effects of gravity and a strong magnetic field, in the vicinity (ergosphere) of a rapidly rotating black hole. This topic was created in response to the astrophysical quest to understand the central engines of radio loud extragalactic radio sources. The theory describes a "torsional tug of war" between rotating ergospheric plasma and the distant asymptotic plasma that extracts the rotational inertia of the black hole. The recoil from the struggle between electromagnetic and gravitational forces near the event horizon is manifested as a powerful pair of magnetized particle beams (jets) that are ejected at nearly the speed of light. These bipolar jets feed large-scale magnetized plasmoids on scales as large as millions of light years (the radio lobes of extragalactic radio sources). This interaction can initiate jets that transport energy fluxes exc...

  1. Radiation treatment for age-related macular degeneration

    Energy Technology Data Exchange (ETDEWEB)

    Taniguchi, Tomoko; Mandai, Michiko; Honjo, Megumi; Matsuda, Naoko; Miyamoto, Hideki; Takahashi, Masayo; Ogura, Yuichiro; Sasai, Keisuke [Kyoto Univ. (Japan). Faculty of Medicine

    1996-11-01

    Fifteen eyes of age-related macular degeneration were treated by low-dose radiation. All the affected eyes had subfoveal neovascular membrane. Seventeen nontreated eyes with similar macular lesion served as control. Radiation was performed using photon beam at 6MV. Each eye received daily dose of 2 Gy for 5 consecutive days. When evaluated 9 to 12 months after treatment, the size of neovascular membrane had decreased in 47% of treated eyes and 7% of control eyes. The visual acuity improved by 2 lines or more in 13% of treated eyes and in none of control eyes. When the initial neovascular membrane was less than 1.5 disc diameter in size, the visual acuity had improved or remained stationary in 90% of treated eyes and in 36% of control eyes. The findings show the potential beneficial effect of radiation for age-related macular degeneration. (author)

  2. Cystoid Macular Edema Induced by Low Doses of Nicotinic Acid

    Directory of Open Access Journals (Sweden)

    Daniela Domanico

    2013-01-01

    Full Text Available Cystoid macular edema (CME is a condition that involves the macula, causing painless vision loss. In this paper, we report a case of niacin-induced bilateral cystoid macular edema (CME in a middle-age woman taking low dose of niacin (18 mg of nicotinic acid. Optical coherence tomography (OCT showed retinal thickening and cystoid spaces in both eyes, whereas fluorescein angiography (FA; HRA 2, Heidelberg Engineering revealed the absence of fluorescein leakage also in later phases. Four weeks after discontinuation of therapy there were a complete disappearance of macular edema at funduscopic examination and an improvement of visual acuity in both eyes. Furthermore OCT showed a normal retinal profile in both eyes. In our opinion considering the wide availability of niacin, medical monitoring and periodical examination should be considered during niacin administration. To our knowledge, this is the first report in the literature that described the very low-dose niacin-induced bilateral niacin maculopathy.

  3. Slowly balding black holes

    International Nuclear Information System (INIS)

    Lyutikov, Maxim; McKinney, Jonathan C.

    2011-01-01

    The 'no-hair' theorem, a key result in general relativity, states that an isolated black hole is defined by only three parameters: mass, angular momentum, and electric charge; this asymptotic state is reached on a light-crossing time scale. We find that the no-hair theorem is not formally applicable for black holes formed from the collapse of a rotating neutron star. Rotating neutron stars can self-produce particles via vacuum breakdown forming a highly conducting plasma magnetosphere such that magnetic field lines are effectively ''frozen in'' the star both before and during collapse. In the limit of no resistivity, this introduces a topological constraint which prohibits the magnetic field from sliding off the newly-formed event horizon. As a result, during collapse of a neutron star into a black hole, the latter conserves the number of magnetic flux tubes N B =eΦ ∞ /(πc(ℎ/2π)), where Φ ∞ ≅2π 2 B NS R NS 3 /(P NS c) is the initial magnetic flux through the hemispheres of the progenitor and out to infinity. We test this theoretical result via 3-dimensional general relativistic plasma simulations of rotating black holes that start with a neutron star dipole magnetic field with no currents initially present outside the event horizon. The black hole's magnetosphere subsequently relaxes to the split-monopole magnetic field geometry with self-generated currents outside the event horizon. The dissipation of the resulting equatorial current sheet leads to a slow loss of the anchored flux tubes, a process that balds the black hole on long resistive time scales rather than the short light-crossing time scales expected from the vacuum no-hair theorem.

  4. Characterizing Black Hole Mergers

    Science.gov (United States)

    Baker, John; Boggs, William Darian; Kelly, Bernard

    2010-01-01

    Binary black hole mergers are a promising source of gravitational waves for interferometric gravitational wave detectors. Recent advances in numerical relativity have revealed the predictions of General Relativity for the strong burst of radiation generated in the final moments of binary coalescence. We explore features in the merger radiation which characterize the final moments of merger and ringdown. Interpreting the waveforms in terms of an rotating implicit radiation source allows a unified phenomenological description of the system from inspiral through ringdown. Common features in the waveforms allow quantitative description of the merger signal which may provide insights for observations large-mass black hole binaries.

  5. Magnonic Black Holes.

    Science.gov (United States)

    Roldán-Molina, A; Nunez, Alvaro S; Duine, R A

    2017-02-10

    We show that the interaction between the spin-polarized current and the magnetization dynamics can be used to implement black-hole and white-hole horizons for magnons-the quanta of oscillations in the magnetization direction in magnets. We consider three different systems: easy-plane ferromagnetic metals, isotropic antiferromagnetic metals, and easy-plane magnetic insulators. Based on available experimental data, we estimate that the Hawking temperature can be as large as 1 K. We comment on the implications of magnonic horizons for spin-wave scattering and transport experiments, and for magnon entanglement.

  6. Superfluid Black Holes.

    Science.gov (United States)

    Hennigar, Robie A; Mann, Robert B; Tjoa, Erickson

    2017-01-13

    We present what we believe is the first example of a "λ-line" phase transition in black hole thermodynamics. This is a line of (continuous) second order phase transitions which in the case of liquid ^{4}He marks the onset of superfluidity. The phase transition occurs for a class of asymptotically anti-de Sitter hairy black holes in Lovelock gravity where a real scalar field is conformally coupled to gravity. We discuss the origin of this phase transition and outline the circumstances under which it (or generalizations of it) could occur.

  7. Are black holes springlike?

    Science.gov (United States)

    Good, Michael R. R.; Ong, Yen Chin

    2015-02-01

    A (3 +1 )-dimensional asymptotically flat Kerr black hole angular speed Ω+ can be used to define an effective spring constant, k =m Ω+2. Its maximum value is the Schwarzschild surface gravity, k =κ , which rapidly weakens as the black hole spins down and the temperature increases. The Hawking temperature is expressed in terms of the spring constant: 2 π T =κ -k . Hooke's law, in the extremal limit, provides the force F =1 /4 , which is consistent with the conjecture of maximum force in general relativity.

  8. Virtual Black Holes

    OpenAIRE

    Hawking, Stephen W.

    1995-01-01

    One would expect spacetime to have a foam-like structure on the Planck scale with a very high topology. If spacetime is simply connected (which is assumed in this paper), the non-trivial homology occurs in dimension two, and spacetime can be regarded as being essentially the topological sum of $S^2\\times S^2$ and $K3$ bubbles. Comparison with the instantons for pair creation of black holes shows that the $S^2\\times S^2$ bubbles can be interpreted as closed loops of virtual black holes. It is ...

  9. Partons and black holes

    International Nuclear Information System (INIS)

    Susskind, L.; Griffin, P.

    1994-01-01

    A light-front renormalization group analysis is applied to study matter which falls into massive black holes, and the related problem of matter with transplankian energies. One finds that the rate of matter spreading over the black hole's horizon unexpectedly saturates the causality bound. This is related to the transverse growth behavior of transplankian particles as their longitudinal momentum increases. This growth behavior suggests a natural mechanism to implement 't Hooft's scenario that the universe is an image of data stored on a 2 + 1 dimensional hologram-like projection

  10. Over spinning a black hole?

    Energy Technology Data Exchange (ETDEWEB)

    Bouhmadi-Lopez, Mariam; Cardoso, Vitor; Nerozzi, Andrea; Rocha, Jorge V, E-mail: mariam.bouhmadi@ist.utl.pt, E-mail: vitor.cardoso@ist.utl.pt, E-mail: andrea.nerozzi@ist.utl.pt, E-mail: jorge.v.rocha@ist.utl.pt [CENTRA, Department de Fisica, Instituto Superior Tecnico, Av. Rovisco Pais 1, 1049 Lisboa (Portugal)

    2011-09-22

    A possible process to destroy a black hole consists on throwing point particles with sufficiently large angular momentum into the black hole. In the case of Kerr black holes, it was shown by Wald that particles with dangerously large angular momentum are simply not captured by the hole, and thus the event horizon is not destroyed. Here we reconsider this gedanken experiment for black holes in higher dimensions. We show that this particular way of destroying a black hole does not succeed and that Cosmic Censorship is preserved.

  11. Growth of Primordial Black Holes

    Science.gov (United States)

    Harada, Tomohiro

    Primordial black holes have important observational implications through Hawking evaporation and gravitational radiation as well as being a candidate for cold dark matter. Those black holes are assumed to have formed in the early universe typically with the mass scale contained within the Hubble horizon at the formation epoch and subsequently accreted mass surrounding them. Numerical relativity simulation shows that primordial black holes of different masses do not accrete much, which contrasts with a simplistic Newtonian argument. We see that primordial black holes larger than the 'super-horizon' primordial black holes have decreasing energy and worm-hole like struture, suggesting the formation through quamtum processes.

  12. Spontaneous resolution of macular edema after silicone oil removal

    Directory of Open Access Journals (Sweden)

    Eyyup Karahan

    2014-12-01

    Full Text Available AIM:To investigate the macular changes in eyes filled with silicone oil (SO and course of these changes after SO removal.METHODS:A retrospective optical coherence tomography scan review was conducted for twenty-four patients who underwent uncomplicated pars plana vitrectomy with SO tamponade for complex retinal detachments were detected with optical coherence tomography before, and one week, one month and three months after SO removal.RESULTS:Mean duration of SO tamponade was 3.6±1.0mo (range:3-7mo. Cystoid macular edema (CME was detected in 3 eyes before SO removal. Submacular fluid was represented in 1 eye before silicone SO removal. Resolution of CME and submacular fluid was achieved 1mo after SO removal in all eyes. Mean best corrected visual acuity (BCVA was 1.15±0.65 (range, hand movement to 0.2 before SO removal in the eyes without macular changes. After SO removal, the mean BCVA values at 1wk and 1 and 3mo, and 0.82±0.23, 0.76±0.21, and 0.70±0.19, all of which were significantly better than baseline (P=0.030, 0.017, 0.006 respectively. In the eyes with macular CME and subretinal fluid the mean BCVA was significantly improved at 3mo after SO removal compared with baseline (P=0.037.CONCLUSION:Decreased visual acuity in eyes filled with SO could be caused by macular complications due to SO. CME and subretinal fluid may resolve without any additional macular surgery after SO removal.

  13. The Impact of Supplemental Antioxidants on Visual Function in Nonadvanced Age-Related Macular Degeneration: A Head-to-Head Randomized Clinical Trial.

    Science.gov (United States)

    Akuffo, Kwadwo Owusu; Beatty, Stephen; Peto, Tunde; Stack, Jim; Stringham, Jim; Kelly, David; Leung, Irene; Corcoran, Laura; Nolan, John M

    2017-10-01

    The purpose of this study was to evaluate the impact of supplemental macular carotenoids (including versus not including meso-zeaxanthin) in combination with coantioxidants on visual function in patients with nonadvanced age-related macular degeneration. In this study, 121 participants were randomly assigned to group 1 (Age-Related Eye Disease Study 2 formulation with a low dose [25 mg] of zinc and an addition of 10 mg meso-zeaxanthin; n = 60) or group 2 (Age-Related Eye Disease Study 2 formulation with a low dose [25 mg] of zinc; n = 61). Visual function was assessed using best-corrected visual acuity, contrast sensitivity (CS), glare disability, retinal straylight, photostress recovery time, reading performance, and the National Eye Institute Visual Function Questionnaire-25. Macular pigment was measured using customized heterochromatic flicker photometry. There was a statistically significant improvement in the primary outcome measure (letter CS at 6 cycles per degree [6 cpd]) over time (P = 0.013), and this observed improvement was statistically comparable between interventions (P = 0.881). Statistically significant improvements in several secondary outcome visual function measures (letter CS at 1.2 and 2.4 cpd; mesopic and photopic CS at all spatial frequencies; mesopic glare disability at 1.5, 3, and 6 cpd; photopic glare disability at 1.5, 3, 6, and 12 cpd; photostress recovery time; retinal straylight; mean and maximum reading speed) were also observed over time (P 0.05, for all). Statistically significant increases in macular pigment at all eccentricities were observed over time (P 0.05). Antioxidant supplementation in patients with nonadvanced age-related macular degeneration results in significant increases in macular pigment and improvements in CS and other measures of visual function. (Clinical trial, http://www.isrctn.com/ISRCTN13894787).

  14. Correlation of neutrophil/lymphocyte and platelet/lymphocyte ratio with visual acuity and macular thickness in age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Elvan Alper Sengul

    2017-05-01

    Full Text Available AIM: To investigate the place of neutrophil-to-lymphocyte ratio (NLR and platelet-to-lymphocyte ratio (PLR in the diagnosis of and prognosis for neovascular age-related macular degeneration (AMD. METHODS: One hundred AMD patients and 100 healthy controls were included in the study. Blood samples were obtained from the venous blood, which is used for routine analysis, and these samples were subjected to complete blood count. NLR was defined as the neutrophil count divided by the number of lymphocytes, and PLR was defined as the platelet count divided by the number of lymphocytes. RESULTS: No statistically significant difference was observed between the two groups under consideration in terms of demographic features (P>0.05. The average NLR in the patient group was found to be significantly higher than that in the healthy control group (P<0.05. The average PLR was significantly higher in the patient group as compared to the control group (P<0.05. As best corrected visual acuity (BCVA increased, both NLR and PLR decreased (significant negative correlations at 49.8% and 63.0%, respectively, whereas as central macular thickness (CMT increased, both NLR and PLR increased (significant positive correlations at 59.3% and 70.0%, respectively. CONCLUSION: NLR and PLR levels are higher among neovascular AMD patients as compared to healthy control group. NLR and PLR levels were found to be inversely proportional to BCVA and directly proportional to CMT.

  15. Optoelectronic device with nanoparticle embedded hole injection/transport layer

    Science.gov (United States)

    Wang, Qingwu [Chelmsford, MA; Li, Wenguang [Andover, MA; Jiang, Hua [Methuen, MA

    2012-01-03

    An optoelectronic device is disclosed that can function as an emitter of optical radiation, such as a light-emitting diode (LED), or as a photovoltaic (PV) device that can be used to convert optical radiation into electrical current, such as a photovoltaic solar cell. The optoelectronic device comprises an anode, a hole injection/transport layer, an active layer, and a cathode, where the hole injection/transport layer includes transparent conductive nanoparticles in a hole transport material.

  16. Visual Function in Asymptomatic Patients With Homozygous Sickle Cell Disease and Temporal Macular Atrophy.

    Science.gov (United States)

    Martin, Gilles C; Dénier, Charlotte; Zambrowski, Olivia; Grévent, David; Bruère, Lenaïc; Brousse, Valentine; de Montalembert, Mariane; Brémond-Gignac, Dominique; Robert, Matthieu P

    2017-10-01

    Temporal macular involvement in sickle cell disease can now easily be detected by optical coherence tomography (OCT). However, while recent studies have demonstrated its high prevalence, little is known about its potential consequences on visual function. To assess the visual function of patients with sickle cell disease with no visual symptoms despite temporal macular atrophy. This retrospective case series included data collection and explorations made in a single referral center for sickle cell disease in 2016. Three patients with sickle cell disease exhibiting preserved visual acuity but showing temporal macular retinal atrophy were included. Patients underwent the following explorations: best-corrected distance and near visual acuity evaluation; dilated fundus examination; OCT with 12 × 6-mm thickness map; horizontal, vertical, and en face sections; OCT angiography of the 6 × 6-mm perifoveal retina; 30° and 12° central visual fields; Lanthony 15-hue color vision test; automated static contrast sensitivity test; and global electroretinography. The OCT thickness maps were checked for areas of retinal thinning, appearing as blue patches. When present, these areas were compared with the areas of superficial and deep capillary flow loss on OCT angiography and with the scotomas on visual fields. Contrast sensitivity and color vision loss were quantified. All 3 patients included had homozygous sickle cell disease. They presented with a 20/20 distance visual acuity, and Parinaud 1,5 near visual acuity in both eyes. They were all followed up for a severe cerebral vasculopathy related to sickle cell disease. The areas of atrophy involved the inner retinal layers and were associated with an absence of signal in the deep capillary plexuses in OCT angiography. These patches of retinal thinning were also matching with scotomas in the automated visual fields. Color vision ability and contrast sensitivity were impaired in all patients. Global electroretinography

  17. Diabetic macular oedema quantified with spectral-domain optical coherence tomography

    DEFF Research Database (Denmark)

    Hodzic-Hadzibegovic, Delila; Sander, Birgit A; Lund-Andersen, Henrik

    2015-01-01

    causing artefacts including hard exudates (HE), epiretinal membranes (ERM), optical opacities and serous detachments. Boundary line artefacts were manually corrected and the corrected central subfield thickness (CST) and macular volume were compared with automated values. Data were compared...... with a repeatability coefficient of 25 μm. RESULTS: Boundary line artefacts were found in 51.8% of the total 342 OCT examinations and in 25.5% of the total 2052 B scans. Morphological elements that caused artefacts in the total 2052 B scans were HE (10.6%), ERM (10.3%), optical opacities (4.4%), serous detachments (1...

  18. Bilateral macular colobomata: Temporal dragging of optic disc

    Directory of Open Access Journals (Sweden)

    David J Mathew

    2015-01-01

    Full Text Available A 13-year-old male presented with decreased vision and squint from childhood. He had bilateral large colobomata at the macula in each eye, the one on the right being larger than the left. The disc was dragged temporally with straightening of the temporal retinal vessels. This is a case report of bilateral large macular coloboma and serves to report its association with a temporally dragged disc and straightened temporal retinal vessels. A dragged disc if present with a colobomatous defect at the macula may strengthen the case for diagnosis of macular coloboma and help exclude other differentials.

  19. Topical Nonsteroidal Anti-Inflammatory Drugs for Macular Edema

    Directory of Open Access Journals (Sweden)

    Andrea Russo

    2013-01-01

    Full Text Available Nonsteroidal anti-inflammatory drugs (NSAIDs are nowadays widely used in ophthalmology to reduce eye inflammation, pain, and cystoid macular edema associated with cataract surgery. Recently, new topical NSAIDs have been approved for topical ophthalmic use, allowing for greater drug penetration into the vitreous. Hence, new therapeutic effects can be achieved, such as reduction of exudation secondary to age-related macular degeneration or diabetic maculopathy. We provide an updated review on the clinical use of NSAIDs for retinal diseases, with a focus on the potential future applications.

  20. Topical nonsteroidal anti-inflammatory drugs for macular edema.

    Science.gov (United States)

    Russo, Andrea; Costagliola, Ciro; Delcassi, Luisa; Parmeggiani, Francesco; Romano, Mario R; Dell'Omo, Roberto; Semeraro, Francesco

    2013-01-01

    Nonsteroidal anti-inflammatory drugs (NSAIDs) are nowadays widely used in ophthalmology to reduce eye inflammation, pain, and cystoid macular edema associated with cataract surgery. Recently, new topical NSAIDs have been approved for topical ophthalmic use, allowing for greater drug penetration into the vitreous. Hence, new therapeutic effects can be achieved, such as reduction of exudation secondary to age-related macular degeneration or diabetic maculopathy. We provide an updated review on the clinical use of NSAIDs for retinal diseases, with a focus on the potential future applications.

  1. Bilateral macular colobomata: Temporal dragging of optic disc.

    Science.gov (United States)

    Mathew, David J

    2015-04-01

    A 13-year-old male presented with decreased vision and squint from childhood. He had bilateral large colobomata at the macula in each eye, the one on the right being larger than the left. The disc was dragged temporally with straightening of the temporal retinal vessels. This is a case report of bilateral large macular coloboma and serves to report its association with a temporally dragged disc and straightened temporal retinal vessels. A dragged disc if present with a colobomatous defect at the macula may strengthen the case for diagnosis of macular coloboma and help exclude other differentials.

  2. Acute effect of pure oxygen breathing on diabetic macular edema

    DEFF Research Database (Denmark)

    Vinten, Carl Martin; La Cour, Morten; Lund-Andersen, Henrik

    2012-01-01

    Purpose. A small-scale pilot study of the pathophysiology of diabetic macular edema (DME) was made by assessing concomitant changes in macular volume (MV), mean arterial blood pressure (MABP), intraocular pressure (IOP), retinal artery diameter (RAD), and retinal vein diameter (RVD) in response...... diameters by fundus photography, intraocular pressure by pulse-air tonometry, and arterial blood pressure by sphygmomanometry. Results. After initiation of pure oxygen breathing, reductions of 2.6% in RAD (p=0.04) and 11.5% reduction in RVD (p...

  3. THICKNESS OF THE MACULA, RETINAL NERVE FIBER LAYER, AND GANGLION CELL-INNER PLEXIFORM LAYER IN THE AGE-RELATED MACULAR DEGENERATION: The Repeatability Study of Spectral Domain Optical Coherence Tomography.

    Science.gov (United States)

    Shin, Il-Hwan; Lee, Woo-Hyuk; Lee, Jong-Joo; Jo, Young-Joon; Kim, Jung-Yeul

    2018-02-01

    To determine the repeatability of measuring the thickness of the central macula, retinal nerve fiber layer, and ganglion cell-inner plexiform layer (GC-IPL) using spectral domain optical coherence tomography (Cirrus HD-OCT) in eyes with age-related macular degeneration. One hundred and thirty-four eyes were included. The measurement repeatability was assessed by an experienced examiner who performed two consecutive measurements using a 512 × 128 macular cube scan and a 200 × 200 optic disk cube scan. To assess changes in macular morphology in patients with age-related macular degeneration, the patients were divided into the following three groups according to the central macular thickness (CMT): A group, CMT 300 μm. Measurement repeatability was assessed using test-retest variability, a coefficient of variation, and an intraclass correlation coefficient. The mean measurement repeatability for the central macular, retinal nerve fiber layer, and GC-IPL thickness was high in the B group. The mean measurement repeatability for both the central macula and retinal nerve fiber layer thickness was high in the A and C groups, but was lower for the GC-IPL thickness. The measurement repeatability for GC-IPL thickness was high in the B group, but low in the A group and in the C group. The automated measurement repeatability for GC-IPL thickness was significantly lower in patients with age-related macular degeneration with out of normal CMT range. The effect of changes in macular morphology should be considered when analyzing GC-IPL thicknesses in a variety of ocular diseases.

  4. Volcano like pattern in optical coherence tomography in chronic diabetic macular edema.

    Science.gov (United States)

    Pai, Sivakami A; Hussain, Nazimul; Hebri, Sudhira P; Lootah, Afra M; Dekhain, Moza A

    2014-04-01

    In this article we herein report an interesting vitreo-macular interface abnormality associated with chronic diabetic cystoid macular edema. It is an observational case study of three diabetic patients examined in the diabetic clinic. All the patients had proliferative diabetic retinopathy with chronic macular edema. A serial cross sectional OCT examination and tracking of both the longitudinal progression of macular thickening and vitreo-macular interface revealed cystoid macular edema with a characteristic hyperreflective vitreous shadow emerging from the vitreofoveal interface. All the patients had dehiscence of inner retinal layers. This particular morphological feature at the vitreo-foveolar interface, which we name as "volcano sign", has not been described earlier. The probable mechanism of such a finding probably could be due to slow progressive leakage of chronic cytoid fluid into the vitreous with condensation of the overlying vitreous. Vitreo-macular traction followed by posterior vitreous detachment probably would have contributed to such a morphological event.

  5. Relevance of Retinal Thickness Changes in the OCT Inner and Outer Rings to Predict Progression to Clinical Macular Edema

    DEFF Research Database (Denmark)

    Vujosevic, Stela; Varano, Monica; Egan, Catherine

    2015-01-01

    PURPOSE: To characterize the relevance of macular thickness changes in the inner and outer rings in the progression of macular edema in eyes/patients with diabetes type 2. METHODS: A total of 374 type 2 diabetic patients with mild nonproliferative diabetic retinopathy (ETDRS levels 20-35) were......: A composite OCT grading of macular edema taking into account the retinal thickness changes in the inner and outer macular rings offers a simple way to characterize macular edema, with added clinical value....

  6. When Black Holes Collide

    Science.gov (United States)

    Baker, John

    2010-01-01

    Among the fascinating phenomena predicted by General Relativity, Einstein's theory of gravity, black holes and gravitational waves, are particularly important in astronomy. Though once viewed as a mathematical oddity, black holes are now recognized as the central engines of many of astronomy's most energetic cataclysms. Gravitational waves, though weakly interacting with ordinary matter, may be observed with new gravitational wave telescopes, opening a new window to the universe. These observations promise a direct view of the strong gravitational dynamics involving dense, often dark objects, such as black holes. The most powerful of these events may be merger of two colliding black holes. Though dark, these mergers may briefly release more energy that all the stars in the visible universe, in gravitational waves. General relativity makes precise predictions for the gravitational-wave signatures of these events, predictions which we can now calculate with the aid of supercomputer simulations. These results provide a foundation for interpreting expect observations in the emerging field of gravitational wave astronomy.

  7. Twistors and Black Holes

    NARCIS (Netherlands)

    Neitzke, A.; Pioline, B.; Vandoren, S.

    2007-01-01

    Motivated by black hole physics in N = 2,D = 4 supergravity, we study the geometry of quaternionic-K¨ahler manifolds Mobtained by the c-map construction from projective special Kähler manifolds Ms. Improving on earlier treatments, we compute the Käahler potentials on the twistor space Z and Swann

  8. Black Holes and Entanglement

    International Nuclear Information System (INIS)

    Borsten, L.

    2011-01-01

    An unexpected interplay between the seemingly disparate fields of M-theory and Quantum Information has recently come to light. We summarise these developments, culminating in a classification of 4-qubit entanglement from the physics of STU black holes. Based on work done in collaboration with D. Dahanayake, M. J. Duff, H. Ebrahim, A. Marrani and W. Rubens.

  9. Black Holes and Entanglement

    Science.gov (United States)

    Borsten, L.

    2011-07-01

    An unexpected interplay between the seemingly disparate fields of M-theory and Quantum Information has recently come to light. We summarise these developments, culminating in a classification of 4-qubit entanglement from the physics of STU black holes. Based on work done in collaboration with D. Dahanayake, M. J. Duff, H. Ebrahim, A. Marrani and W. Rubens.

  10. Prevalence of age-related macular degeneration in Japanese immigrants and their descendants living in Londrina (PR - Brazil Prevalência da degeneração macular relacionada à idade em japoneses e descendentes em Londrina (PR - Brasil

    Directory of Open Access Journals (Sweden)

    Ana Paula Miyagusko Taba Oguido

    2008-06-01

    Full Text Available PURPOSE: To determine the prevalence of early and late-stage age-related macular degeneration (ARMD and its association with risk factors such as age, gender, smoking, body mass index, hypertension and diabetes history, cataracts and pseudophakia. Design: Population-based cross-sectional study in an elderly Japanese-Brazilian population from Londrina (Paraná, Brazil. METHODS: The study included 483 (80.5% of the 600 registered members of a local association for Japanese immigrants and their descendants, aged 60 years and up. The presence of early and late-stage age-related macular degeneration was determined using the standard protocol and the international classification system. RESULTS: The mean age of the study subjects was 71 years. The overall prevalence of age-related macular degeneration was 15.1% (CI 95%; 12-18.7. The prevalence of early-stage age-related macular degeneration was 13.8% (CI 95%; 10.9-17.3, geographic atrophy was present in 0.4% and neovascular age-related macular degeneration in 0.8%. Age-related macular degeneration was significantly (p=0.004 and linearly (p=0.001 associated with age. CONCLUSION: Our study population displays a prevalence of early and late-stage age-related macular degeneration and component lesions similar to those of other Western countries, and data suggest a higher prevalence than that reported for populations in Japan. Since the age-related macular degeneration prevalence tends to rise as the population ages, studies identifying risk factors and exploring prevention methods are becoming increasingly important.OBJETIVO: Identificar a prevalência da degeneração macular relacionada à idade (DMRI inicial e tardia na população de japoneses e descendentes e verificar a associação com os fatores de risco: idade, sexo, hábito de fumar, índice de massa corpórea, história de hipertensão e diabetes, catarata e pseudofacia. MÉTODOS: Realizado um estudo transversal na população de japoneses e

  11. Quantum aspects of black holes

    CERN Document Server

    2015-01-01

    Beginning with an overview of the theory of black holes by the editor, this book presents a collection of ten chapters by leading physicists dealing with the variety of quantum mechanical and quantum gravitational effects pertinent to black holes. The contributions address topics such as Hawking radiation, the thermodynamics of black holes, the information paradox and firewalls, Monsters, primordial black holes, self-gravitating Bose-Einstein condensates, the formation of small black holes in high energetic collisions of particles, minimal length effects in black holes and small black holes at the Large Hadron Collider. Viewed as a whole the collection provides stimulating reading for researchers and graduate students seeking a summary of the quantum features of black holes.

  12. Aspects of hairy black holes

    Energy Technology Data Exchange (ETDEWEB)

    Anabalón, Andrés, E-mail: andres.anabalon-at@uai.cl [Departamento de Ciencias, Facultad de Artes Liberales y Facultad de Ingeniería y Ciencias, Universidad Adolfo Ibáñez, Viña del Mar (Chile); Astefanesei, Dumitru [Instituto de Física, Pontificia Universidad Católica de Valparaíso, Casilla 4059, Valparaíso (Chile)

    2015-03-26

    We review the existence of exact hairy black holes in asymptotically flat, anti-de Sitter and de Sitter space-times. We briefly discuss the issue of stability and the charging of the black holes with a Maxwell field.

  13. Curvature invariant characterization of event horizons of four-dimensional black holes conformal to stationary black holes

    Science.gov (United States)

    McNutt, David D.

    2017-11-01

    We introduce three approaches to generate curvature invariants that transform covariantly under a conformal transformation of a four-dimensional spacetime. For any black hole conformally related to a stationary black hole, we show how a set of conformally covariant invariants can be combined to produce a conformally covariant invariant that detects the event horizon of the conformally related black hole. As an application we consider the rotating dynamical black holes conformally related to the Kerr-Newman-Unti-Tamburino-(anti)-de Sitter spacetimes and construct an invariant that detects the conformal Killing horizon along with a second invariant that detects the conformal stationary limit surface. In addition, we present necessary conditions for a dynamical black hole to be conformally related to a stationary black hole and apply these conditions to the ingoing Kerr-Vaidya and Vaidya black hole solutions to determine if they are conformally related to stationary black holes for particular choices of the mass function. While two of the three approaches cannot be generalized to higher dimensions, we discuss the existence of a conformally covariant invariant that will detect the event horizon for any higher dimensional black hole conformally related to a stationary black hole which admits at least two conformally covariant invariants, including all vacuum spacetimes.

  14. Excimer laser phototherapeutic keratectomy in conjunction with mitomycin C in corneal macular and granular dystrophies

    Directory of Open Access Journals (Sweden)

    Erdem Yuksel

    2016-04-01

    Full Text Available ABSTRACT Purpose: To evaluate the visual outcomes, recurrence patterns, safety, and efficacy of excimer laser phototherapeutic keratectomy (PTK in conjunction with mitomycin C (MMC for corneal macular and granular diystrophies. Methods: The patients were divided into two groups. Group 1 included patients with macular corneal dystrophy (MCD that caused superficial corneal plaque opacities, and Group 2 included patients with granular corneal dystrophy (GCD. Patients in both groups were pre-, peri-, and postoperatively evaluated. The groups were compared in terms of uncorrected visual acuity (VA, best spectacle-corrected VA, presence of mild or significant recurrence, and time of recurrence. Results: Eighteen eyes (nine with MCD and nine with GCD of 18 patients (10 men and eight women were included. PTK was performed for each eye that was included in this study. The mean ablation amount was 117.8 ± 24.4 µm and 83.5 ± 45.7 µm in MCD and GCD, respectively, (p=0.18. The postoperative improvement of the mean VA was similar between the two groups before recurrences (p>0.43 and after recurrences (p>0.71. There were no statistically significant differences in the recurrence rate and the recurrence-free period for any recurrence type. Conclusion: PTK was an effective, safe, and minimally invasive procedure for patients with MCD and GCD. PTK in conjunction with MMC was similarly effective for both groups in terms of recurrence and visual outcomes.

  15. Excimer laser phototherapeutic keratectomy in conjunction with mitomycin C in corneal macular and granular dystrophies.

    Science.gov (United States)

    Yuksel, Erdem; Cubuk, Mehmet Ozgur; Eroglu, Hulya Yazıcı; Bilgihan, Kamil

    2016-04-01

    To evaluate the visual outcomes, recurrence patterns, safety, and efficacy of excimer laser phototherapeutic keratectomy (PTK) in conjunction with mitomycin C (MMC) for corneal macular and granular diystrophies. The patients were divided into two groups. Group 1 included patients with macular corneal dystrophy (MCD) that caused superficial corneal plaque opacities, and Group 2 included patients with granular corneal dystrophy (GCD). Patients in both groups were pre-, peri-, and postoperatively evaluated. The groups were compared in terms of uncorrected visual acuity (VA), best spectacle-corrected VA, presence of mild or significant recurrence, and time of recurrence. Eighteen eyes (nine with MCD and nine with GCD) of 18 patients (10 men and eight women) were included. PTK was performed for each eye that was included in this study. The mean ablation amount was 117.8 ± 24.4 µm and 83.5 ± 45.7 µm in MCD and GCD, respectively, (p=0.18). The postoperative improvement of the mean VA was similar between the two groups before recurrences (p>0.43) and after recurrences (p>0.71). There were no statistically significant differences in the recurrence rate and the recurrence-free period for any recurrence type. PTK was an effective, safe, and minimally invasive procedure for patients with MCD and GCD. PTK in conjunction with MMC was similarly effective for both groups in terms of recurrence and visual outcomes.

  16. Aspectos atuais na fisiopatologia do edema macular diabético Recent aspects on physiopathology of diabetic macular edema

    Directory of Open Access Journals (Sweden)

    Mário Martins dos Santos Motta

    2008-02-01

    Full Text Available O edema macular é a principal causa de baixa visual em pacientes diabéticos. Seu mecanismo de formação é complexo e envolve alterações bioquímicas e estruturais. Os autores fazem uma revisão e atualização dos conceitos fisiopatológicos envolvidos na maculopatia diabética.Macular edema is the leading cause of poor vision in diabetic patients.The mechanism of edema formation is complex and involves biochemical and structural changes. The authors review and update the physiopathologic concepts related to diabetic maculopathy.

  17. [The Effect of Cataract Surgery on the Reproducibility and Outcome of Optical Coherence Tomography Measurements of Macular and Retinal nerve Fibre Layer Thickness].

    Science.gov (United States)

    Pašová, P; Skorkovská, K

    2016-01-01

    Optical coherence tomography (OCT) is a non-invasive imaging technique used for the examination of the macula and peripapillary retinal nerve fibre layer (RNFL), the result of which may be affected by the quality of the scanned image. The aim of our study was to assess the influence of uncomplicated cataract extraction on the measurement of macular and RNFL thickness with OCT and to determine the reproducibility of this method before and after cataract surgery in a group of healthy people. We also evaluated the effect of different intraocular lenses (IOL) (with/without yellow filter) on the reproducibility of the OCT examination. The study group included 51 eyes of 51 patients who underwent cataract surgery with posterior chamber IOL implantation. Macular and RNFL thickness were measured with spectral domain OCT (Optovue, Model RT 100) one week before surgery, and postoperatively after one and six months. Three OCT scans were performed at each visit to assess the reproducibility of the measurement. Data were statistically processed. Analysis of the changes in macular and RNFL thickness showed a significant increase in retinal thickness, with the maximum increase one month after surgery, and regression of this thickening six months after surgery. Reproducibility of OCT examination improved significantly after cataract surgery, even though the preoperative values were of low coefficient of variance and therefore of high accuracy. No difference was found in the use of different intraocular lenses on the reproducibility of the OCT examination. The presence of cataract affects the OCT measurement of macular and RNFL thickness. The reproducibility of the method significantly improves after cataract surgery. It is likely that the increase in macular and RNFL thickness after cataract removal is partly due to improvement in the quality of the scanned image and thus to the greater accuracy of the OCT examination. optical coherence tomography, glaucoma, cataract, macular

  18. EFFECT OF INTRAVITREAL RANIBIZUMAB ON GANGLION CELL COMPLEX AND PERIPAPILLARY RETINAL NERVE FIBER LAYER IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION USING SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY.

    Science.gov (United States)

    Zucchiatti, Ilaria; Cicinelli, Maria V; Parodi, Maurizio Battaglia; Pierro, Luisa; Gagliardi, Marco; Accardo, Agostino; Bandello, Francesco

    2017-07-01

    To analyze the changes in ganglion cell complex and peripapillary retinal nerve fiber layer thickness, in central macular thickness and choroidal thickness on spectral domain optical coherence tomography in patients with neovascular age-related macular degeneration treated with intravitreal ranibizumab injections. All consecutive patients with untreated neovascular age-related macular degeneration received loading phase of three monthly intravitreal ranibizumab, followed by retreatments on a pro re nata protocol for 12 months. changes in ganglion cell complex and retinal nerve fiber layer at the end of follow-up. Secondary outcome: changes in best-corrected visual acuity, central macular thickness, and choroidal thickness at the end of follow-up. Choroidal thickness was measured at 500 μm, 1000 μm, and 1,500 μm intervals nasally, temporally, superiorly, and inferiorly to the fovea, respectively, on horizontal and vertical line scans centered on the fovea. Twenty-four eyes were included. Ganglion cell complex and peripapillary retinal nerve fiber layer thickness did not show statistically significant changes through 12 months (55.6 ± 18.5 and 81.9 ± 9.9 μm at baseline, 52.7 ± 19.3 and 84.6 ± 15.5 μm at month 12, P > 0.05). Central macular thickness showed progressive decrease from baseline to month 12, with maximum reduction at month 3 (P retinal nerve fiber layer and ganglion cell complex thickness in 1-year follow-up. Choroidal thickness in papillomacular area and central macular thickness was significantly reduced at the end of treatment. Further studies, with larger sample, longer follow-up, and greater number of injections, are warranted.

  19. Mouse genetics and proteomic analyses demonstrate a critical role for complement in a model of DHRD/ML, an inherited macular degeneration

    Science.gov (United States)

    Garland, Donita L.; Fernandez-Godino, Rosario; Kaur, Inderjeet; Speicher, Kaye D.; Harnly, James M.; Lambris, John D.; Speicher, David W.; Pierce, Eric A.

    2014-01-01

    Macular degenerations, inherited and age related, are important causes of vision loss. Human genetic studies have suggested perturbation of the complement system is important in the pathogenesis of age-related macular degeneration. The mechanisms underlying the involvement of the complement system are not understood, although complement and inflammation have been implicated in drusen formation. Drusen are an early clinical hallmark of inherited and age-related forms of macular degeneration. We studied one of the earliest stages of macular degeneration which precedes and leads to the formation of drusen, i.e. the formation of basal deposits. The studies were done using a mouse model of the inherited macular dystrophy Doyne Honeycomb Retinal Dystrophy/Malattia Leventinese (DHRD/ML) which is caused by a p.Arg345Trp mutation in EFEMP1. The hallmark of DHRD/ML is the formation of drusen at an early age, and gene targeted Efemp1R345W/R345W mice develop extensive basal deposits. Proteomic analyses of Bruch's membrane/choroid and Bruch's membrane in the Efemp1R345W/R345W mice indicate that the basal deposits comprise normal extracellular matrix (ECM) components present in abnormal amounts. The proteomic analyses also identified significant changes in proteins with immune-related function, including complement components, in the diseased tissue samples. Genetic ablation of the complement response via generation of Efemp1R345W/R345W:C3−/− double-mutant mice inhibited the formation of basal deposits. The results demonstrate a critical role for the complement system in basal deposit formation, and suggest that complement-mediated recognition of abnormal ECM may participate in basal deposit formation in DHRD/ML and perhaps other macular degenerations. PMID:23943789

  20. Observing higher-dimensional black holes at the LHC

    CERN Document Server

    Sekmen, Sezen

    2005-01-01

    A new approach to spacetime proposing the existence of n compactified large extra dimensions predicts the creation of higher-dimensional black holes at the LHC of CERN. In case they form, signatures of such black holes at accelerators would be quite significant and black hole decay products would carry valuable information for particle physics and cosmology. In this study we first make a short theoretical introduction, then present the results of an analysis made on a Monte Carlo simulation modeling black hole production and decay at the LHC. This analysis includes the examination of the lepton case in black hole to Higgs decay channels, reconstruction of the black hole masses, a calculation of the Hawking temperature and a determination of the radiated jets/leptons multiplicity ratio.

  1. Global geometry of two-dimensional charged black holes

    International Nuclear Information System (INIS)

    Frolov, Andrei V.; Kristjansson, Kristjan R.; Thorlacius, Larus

    2006-01-01

    The semiclassical geometry of charged black holes is studied in the context of a two-dimensional dilaton gravity model where effects due to pair-creation of charged particles can be included in a systematic way. The classical mass-inflation instability of the Cauchy horizon is amplified and we find that gravitational collapse of charged matter results in a spacelike singularity that precludes any extension of the spacetime geometry. At the classical level, a static solution describing an eternal black hole has timelike singularities and multiple asymptotic regions. The corresponding semiclassical solution, on the other hand, has a spacelike singularity and a Penrose diagram like that of an electrically neutral black hole. Extremal black holes are destabilized by pair-creation of charged particles. There is a maximally charged solution for a given black hole mass but the corresponding geometry is not extremal. Our numerical data exhibits critical behavior at the threshold for black hole formation

  2. Quantum correction to the entropy of noncommutative BTZ black hole

    Science.gov (United States)

    Anacleto, M. A.; Brito, F. A.; Cavalcanti, A. G.; Passos, E.; Spinelly, J.

    2018-02-01

    In this paper we consider the generalized uncertainty principle (GUP) in the tunneling formalism via Hamilton-Jacobi method to determine the quantum-corrected Hawking temperature and entropy for noncommutative BTZ black hole. In our results we obtain several types of corrections including the expected logarithmic correction to the area entropy associated with the noncommutative BTZ black holes. We also show that the area entropy product of the noncommutative BTZ black holes is dependent on mass and by analyzing the nature of the specific heat capacity we have observed that the noncommutative BTZ black hole is stable at some range of parameters.

  3. Excluding black hole firewalls with extreme cosmic censorship

    Energy Technology Data Exchange (ETDEWEB)

    Page, Don N., E-mail: profdonpage@gmail.com [Department of Physics, 4-183 CCIS, University of Alberta, Edmonton, Alberta T6G 2E1 (Canada)

    2014-06-01

    The AMPS argument for black hole firewalls seems to arise not only from the assumption of local effective field theory outside the stretched horizon but also from an overcounting of internal black hole states that include states that are singular in the past. Here I propose to exclude such singular states by Extreme Cosmic Censorship (the conjectured principle that the universe is entirely nonsingular, except for transient singularities inside black and/or white holes). I argue that the remaining set of nonsingular realistic states do not have firewalls but yet preserve information in Hawking radiation from black holes that form from nonsingular initial states.

  4. Analysis of macular cone photoreceptors in a case of occult macular dystrophy

    Directory of Open Access Journals (Sweden)

    Tojo N

    2013-05-01

    Full Text Available Naoki Tojo Tomoko Nakamura Hironori Ozaki Miyako Oka Toshihiko Oiwake Atsushi HayashiDepartment of Ophthalmology, University of Toyama, Toyama, JapanPurpose: To investigate changes in cone photoreceptors with adaptive optics (AO fundus imaging and spectral domain optical coherence tomography (SD-OCT in a case of occult macular dystrophy (OMD.Patient and methods: Both eyes of a 42-year-old woman diagnosed with OMD were examined. We used an AO fundus camera to obtain images of cone photoreceptors in the macula of the OMD subject and five healthy control subjects. Correlations between the AO images and the SD-OCT images were examined. Cone photoreceptors in eight areas in the macula of OMD and healthy control subjects were analyzed and compared.Results: SD-OCT showed a loss of the cone outer-segment tips line outside of the fovea in both eyes of the subject with OMD. The left eye with decreased visual acuity showed a discontinuous photoreceptor inner-segment and outer-segment line and cone outer-segment tips line at the fovea in SD-OCT and loss of cone mosaics as a dark spot in the AO image. In panoramic AO images and cone-density maps, less cone density was observed in a ring-like region outside the fovea than in the peripheral retina. In most of the areas examined, the cone densities were lower in the OMD eyes than in the healthy control eyes.Conclusions: Cone densities in the macula of the OMD patient were greatly decreased. AO images were found to be useful to evaluate morphologic changes in cone photoreceptors in patients with OMD.Keywords: occult macular dystrophy, adaptive optics, cone photoreceptor, cone analysis, optical coherence tomography

  5. Neutrino constraints that transform black holes into grey holes

    International Nuclear Information System (INIS)

    Ruderfer, M.

    1982-01-01

    Existing black hole theory is found to be defective in its neglect of the physical properties of matter and radiation at superhigh densities. Nongravitational neutrino effects are shown to be physically relevant to the evolution of astronomical black holes and their equations of state. Gravitational collapse to supernovae combined with the Davis and Ray vacuum solution for neutrinos limit attainment of a singularity and require black holes to evolve into ''grey holes''. These allow a better justification than do black holes for explaining the unique existence of galactic masses. (Auth.)

  6. Black Holes in Our Universe

    Indian Academy of Sciences (India)

    most sensitive scientific instrument ever ... sion, expelling a lot of the mass, but leaving behind a black hole that is at least ... hole, and indeed such a phenomenon may explain the disappear- ance of a star in the galaxy N6946 [21]. The collapse of stars into black holes might account for some of the extraordinarily powerful ...

  7. Warped products and black holes

    International Nuclear Information System (INIS)

    Hong, Soon-Tae

    2005-01-01

    We apply the warped product space-time scheme to the Banados-Teitelboim-Zanelli black holes and the Reissner-Nordstroem-anti-de Sitter black hole to investigate their interior solutions in terms of warped products. It is shown that there exist no discontinuities of the Ricci and Einstein curvatures across event horizons of these black holes

  8. Prevention and treatment of age-related macular degeneration: an update for pharmacists.

    Science.gov (United States)

    Marshall, Leisa L; Roach, J Michael

    2013-11-01

    Review the current recommendations for the prevention and treatment of age-related macular degeneration (AMD). Articles indexed in PubMed (National Library of Medicine), the Cochrane Reviews and Trials, Dynamed, and Iowa Drug Information Service (IDIS) in the last 10 years using the key words macular degeneration, agerelated macular degeneration (AMD), AMD and treatment, AMD and prevention. Sixty-nine published papers were reviewed, and criteria supporting the primary objective were used to identify useful resources. The literature included practice guidelines, original research articles, review articles, product prescribing information, and supplement product information for the prevention and treatment of AMD. AMD is a leading cause of visual impairment in older adults. At present there is no cure for advanced AMD, but intravitreal vascular endothelial growth factor inhibitors minimize and even reverse vision loss in patients with AMD of the neovascular type. In the Age-Related Eye Disease Study (AREDS), participants with intermediate AMD who received a supplement combination of vitamins C and E, beta-carotene, and zinc had a greater delay in progression to advanced AMD than those participants who received a portion of these supplements. In the second AREDS, AREDS2, the addition of lutein + zeaxanthin, docosahexaenoic acid (DHA) + eicosapentaenoic acid (EPA), or lutein + zeaxanthin and DHA + EPA to the complete AREDS formulation did not further reduce the risk of progression to advanced AMD. Subgroup analyses indicated that additional research with lutein + zeaxanthin supplementation is warranted as it was beneficial in participants with low dietary intake of lutein + zeaxanthin. A formulation without beta-carotene may be best for most patients, especially smokers or former smokers. Health care professionals will want to consider patient-specific information before recommending ocular health supplements.

  9. Results of Intravitreal Ranibizumab Treatment for Exudative Age-Related Macular Degeneration

    Directory of Open Access Journals (Sweden)

    Umut Karaca

    2012-01-01

    Full Text Available Pur po se: To evaluate the efficacy and safety of intravitreal ranibizumab injection for exudative age-related macular degeneration. Ma te ri al and Met hod: In this study, we included forty-eight eyes of 43 age-related macular degeneration patients followed for at least twelve months. Mean age was 73.65±8.93 years and mean follow-up time was 14.2 months. All patients received three consecutive monthly intravitreal ranibizumab injections and then were followed up with clinical examination and optic coherence tomography monthly. Re-injection was executed as needed. Re sults: Twenty patients were male (46.5% and twenty-three patients were female (53.5%. The average number of ranibizumab injection was 3.7 (3-7 per eye. Twenty-six lesions (54.2% were classic (predominantly and minimally and twenty-two (45.8% were occult. Mean best-corrected visual acuity was 46.8 letters with ETDRS chart at the initial examination and 55.5 letters at twelfth month. Mean central foveal thickness decreased from 320 microns to 269 microns. There was a statistically significant improvement in visual acuity and central foveal thickness. On the other hand, this improvement was not significant between lesion types. During follow-up, there were no systemic or serious ocular complications determined. Dis cus si on: Intravitreal ranibizumab injection is safe and effective, both anatomically and functionally, for age-related macular degeneration. (Turk J Ophthalmol 2012; 42: 25-9

  10. Effect of ocular magnification on macular measurements made using spectral domain optical coherence tomography

    Directory of Open Access Journals (Sweden)

    Mohana Kuppuswamy Parthasarathy

    2015-01-01

    Full Text Available Aim: The aim of the present study was to study the effect of ocular magnification on macular measurements made using spectral domain optical coherence tomography (OCT. Materials and Methods: One hundred and fifty-one subjects were included from the normative study of foveal morphology carried out at our hospital. Subjects underwent comprehensive eye examination and macular scanning using Cirrus high-definition OCT and axial length (AXL measurement. Macular cube 512 × 128 scan protocol was used for scanning the macula. Automated measurements of the fovea namely foveal diameter, foveal slope (lateral measurements and foveal depth (axial measurement were taken. A correction factor for ocular magnification was done using the formula t = p × q × s, where "t0" is the corrected measurement, "p" is the magnification of OCT, "q0" is the ocular magnification, and "s" is the measurement on OCT without correction. The difference between corrected and uncorrected measurements was evaluated for statistical significance. Results: Mean AXL was 22.95 ± 0.78 mm. Refractive error ranged from −3D to +4D. Mean difference between measured and corrected foveal diameter, slope and depth was 166.05 ± 95.37 ΅m (P < 0.001, 0.81° ± 0.53° (P < 0.001 and 0.05 ± 0.49 ΅m (P = 0.178 respectively. AXL lesser than the OCT calibrated value of 24.46 mm showed an increased foveal diameter (r = 0.961, P < 0.001 and a reduced foveal slope (r = −0.863, P < 0.001 than the corrected value. Conclusion: Lateral measurements made on OCT varied with AXL s other than the OCT calibrated value of 24.46 mm. Therefore, to estimate the actual dimensions of a retinal lesion using OCT, especially lateral dimensions, we recommend correction for the ocular magnification factor.

  11. Black hole based tests of general relativity

    International Nuclear Information System (INIS)

    Yagi, Kent; Stein, Leo C

    2016-01-01

    General relativity has passed all solar system experiments and neutron star based tests, such as binary pulsar observations, with flying colors. A more exotic arena for testing general relativity is in systems that contain one or more black holes. Black holes are the most compact objects in the Universe, providing probes of the strongest-possible gravitational fields. We are motivated to study strong-field gravity since many theories give large deviations from general relativity only at large field strengths, while recovering the weak-field behavior. In this article, we review how one can probe general relativity and various alternative theories of gravity by using electromagnetic waves from a black hole with an accretion disk, and gravitational waves from black hole binaries. We first review model-independent ways of testing gravity with electromagnetic/gravitational waves from a black hole system. We then focus on selected examples of theories that extend general relativity in rather simple ways. Some important characteristics of general relativity include (but are not limited to) (i) only tensor gravitational degrees of freedom, (ii) the graviton is massless, (iii) no quadratic or higher curvatures in the action, and (iv) the theory is four-dimensional. Altering a characteristic leads to a different extension of general relativity: (i) scalar–tensor theories, (ii) massive gravity theories, (iii) quadratic gravity, and (iv) theories with large extra dimensions. Within each theory, we describe black hole solutions, their properties, and current and projected constraints on each theory using black hole based tests of gravity. We close this review by listing some of the open problems in model-independent tests and within each specific theory. (paper)

  12. Complement factor d in age-related macular degeneration

    NARCIS (Netherlands)

    Stanton, C.M.; Yates, J.R.W.; Hollander, A.I. den; Seddon, J.M.; Swaroop, A.; Stambolian, D.; Fauser, S.; Hoyng, C.B.; Yu, Y.; Atsuhiro, K.; Branham, K.; Othman, M.; Chen, W.; Kortvely, E.; Chalmers, K.; Hayward, C.; Moore, A.T.; Dhillon, B.; Ueffing, M.; Wright, A.F.

    2011-01-01

    Purpose. To examine the role of complement factor D (CFD) in age-related macular degeneration (AMD) by analysis of genetic association, copy number variation, and plasma CFD concentrations. Methods. Single nucleotide polymorphisms (SNPs) in the CFD gene were genotyped and the results analyzed by

  13. Propionibacterium acnes and the pathogenesis of progressive macular hypomelanosis

    NARCIS (Netherlands)

    Westerhof, Wiete; Relyveld, Germaine N.; Kingswijk, Melanie M.; de Man, Peter; Menke, Henk E.

    2004-01-01

    Background: Progressive macular hypomelanosis is a common hypopigmentation mainly on the central parts of the trunk, predominantly in young adults, especially women. It is often mistaken for pityriasis versicolor and pityriasis alba. It occurs in all races and has been described in many parts of the

  14. Current surgical treatment of age-related macular degeneration

    NARCIS (Netherlands)

    Ramos de Carvalho, J. Emanuel; Willig, A. J. H. E.; Chung, R.; Peiretti, E.; Mura, M.

    2014-01-01

    Age-related macular degeneration (AMD) is the leading cause of severe, irreversible central vision loss in individuals over 65 years of age throughout much of the developed world. The advent of anti-VEGF therapy has had a great impact in the long-term natural history of this condition, more

  15. Morphometric analyses of the visual pathways in macular degeneration

    NARCIS (Netherlands)

    Hernowo, Aditya T.; Prins, Doety; Baseler, Heidi A.; Plank, Tina; Gouws, Andre D.; Hooymans, Johanna M. M.; Morland, Antony B.; Greenlee, Mark W.; Cornelissen, Frans W.

    Introduction: Macular degeneration (MD) causes central visual field loss. When field defects occur in both eyes and overlap, parts of the visual pathways are no longer stimulated. Previous reports have shown that this affects the grey matter of the primary visual cortex, but possible effects on the

  16. Age-related macular degeneration in Onitsha, Nigeria | Nwosu ...

    African Journals Online (AJOL)

    Objectives: To determine the incidence, pattern and ocular morbidity associated with age-related macular degeneration (AMD) at the Guinness Eye Center Onitsha Nigeria. Materials and Methods: The case files of all new patients aged 50 years and above seen between January 1997 and December 2004 were reviewed.

  17. Identification of Age-Related Macular Degeneration Using OCT Images

    Science.gov (United States)

    Arabi, Punal M., Dr; Krishna, Nanditha; Ashwini, V.; Prathibha, H. M.

    2018-02-01

    Age-related Macular Degeneration is the most leading retinal disease in the recent years. Macular degeneration occurs when the central portion of the retina, called macula deteriorates. As the deterioration occurs with the age, it is commonly referred as Age-related Macular Degeneration. This disease can be visualized by several imaging modalities such as Fundus imaging technique, Optical Coherence Tomography (OCT) technique and many other. Optical Coherence Tomography is the widely used technique for screening the Age-related Macular Degeneration disease, because it has an ability to detect the very minute changes in the retina. The Healthy and AMD affected OCT images are classified by extracting the Retinal Pigmented Epithelium (RPE) layer of the images using the image processing technique. The extracted layer is sampled, the no. of white pixels in each of the sample is counted and the mean value of the no. of pixels is calculated. The average mean value is calculated for both the Healthy and the AMD affected images and a threshold value is fixed and a decision rule is framed to classify the images of interest. The proposed method showed an accuracy of 75%.

  18. Reproducibility of corneal, macular and retinal nerve fiber layer ...

    African Journals Online (AJOL)

    Purpose: To determine the intra-session and inter-session reproducibility of corneal, macular and retinal nerve fiber layer thickness (RNFL) measurements with the iVue-100 optical coherence tomography in normal eyes. Methods: These parameters were measured in the right eyes of 50 healthy participants with normal ...

  19. Reproducibility of corneal, macular and retinal nerve fiber layer ...

    African Journals Online (AJOL)

    in determining the utility of a device used for clinical and research purposes.2 The aim of this study was therefore to determine the reproducibility of corneal, macular and. RNFL thickness measurements in normal eyes using the. iVue-100 SD-OCT. Subjects and methods. The study was approved by the University of KwaZu-.

  20. Treatment of dry age-related macular degeneration with dobesilate

    OpenAIRE

    Cuevas, P; Outeiriño, L A; Angulo, J; Giménez-Gallego, G

    2012-01-01

    The authors present anatomical and functional evidences of dry age-macular degeneration improvement, after intravitreal treatment with dobesilate. Main outcomes measures were normalisation of retinal structure and function, assessed by optical coherence tomography, fundus-monitored microperimetry, electrophysiology and visual acuity. The effect might be related to the normalisation of the outer retinal architecture.

  1. Gene-diet interactions in age-related macular degeneration

    Science.gov (United States)

    Age-related macular degeneration (AMD) is a prevalent blinding disease, accounting for roughly 50% of blindness in developed nations. Very significant advances have been made in terms of discovering genetic susceptibilities to AMD as well as dietary risk factors. To date, nutritional supplementation...

  2. Nutritional modulation of age-related macular degeneration

    Science.gov (United States)

    Age-related macular degeneration (AMD) is the leading cause of blindness in the elderly worldwide. It affects 30-50 million individuals and clinical hallmarks of AMD are observed in at least one third of persons over the age of 75 in industrialized countries (Gehrs et al., 2006). Costs associated wi...

  3. Awareness, Knowledge, and Concern about Age-Related Macular Degeneration

    Science.gov (United States)

    Cimarolli, Verena R.; Laban-Baker, Allie; Hamilton, Wanda S.; Stuen, Cynthia

    2012-01-01

    Age-related macular degeneration (AMD)--a common eye disease causing vision loss--can be detected early through regular eye-health examinations, and measures can be taken to prevent visual decline. Getting eye examinations requires certain levels of awareness, knowledge, and concern related to AMD. However, little is known about AMD-related…

  4. Therapeutic Potential of Statins in Age-related Macular Degeneration

    African Journals Online (AJOL)

    Age-related macular degeneration (ARMD) is the leading cause of irreversible vision loss, affecting one in three people aged 75 and above. Although exciting new pharmaceuticals to treat ARMD such as endothelial growth factor (VEGF) inhibitors, are now available, they are effective only in selected group of patients, and ...

  5. on visual acuity in age related macular degeneration

    African Journals Online (AJOL)

    marine origin) in the treatment of age related macular degeneration (AMD). In a randomized double blind clinical trial 280 eyes of 280 (157 F, 123 M) patients with wet and dry AMD were randomly assigned in treatment or placebo groups. Patients in ...

  6. The molecular genetic basis of age-related macular degeneration ...

    Indian Academy of Sciences (India)

    2009-12-10

    Dec 10, 2009 ... ula of the eye and involves the retinal pigment epithelium. (RPE), Bruch's membrane (BM) and choriocapillaries (Fine .... macular or melanin pigment densities between eyes with and without early AMD (Kayatz et al. 2001). Smoking ..... Involved in lipoprotein metabolism, coagulation, and the production of.

  7. Prevalence of Age-Related Macular Degeneration in Europe

    NARCIS (Netherlands)

    Colijn, Johanna M.; Buitendijk, Gabriëlle H. S.; Prokofyeva, Elena; Alves, Dalila; Cachulo, Maria L.; Khawaja, Anthony P.; Cougnard-Gregoire, Audrey; Merle, Bénédicte M. J.; Korb, Christina; Erke, Maja G.; Bron, Alain; Anastasopoulos, Eleftherios; Meester-Smoor, Magda A.; Segato, Tatiana; Piermarocchi, Stefano; de Jong, Paulus T. V. M.; Vingerling, Johannes R.; Topouzis, Fotis; Creuzot-Garcher, Catherine; Bertelsen, Geir; Pfeiffer, Norbert; Fletcher, Astrid E.; Foster, Paul J.; Silva, Rufino; Korobelnik, Jean-François; Delcourt, Cécile; Klaver, Caroline C. W.; Ajana, Soufiane; Arango-Gonzalez, Blanca; Arndt, Verena; Bhatia, Vaibhav; Bhattacharya, Shomi S.; Biarnés, Marc; Borrell, Anna; Bühren, Sebastian; Calado, Sofia M.; Cougnard-Grégoire, Audrey; Dammeier, Sascha; de Jong, Eiko K.; de la Cerda, Berta; den Hollander, Anneke I.; Diaz-Corrales, Francisco J.; Diether, Sigrid; Emri, Eszter; Endermann, Tanja; Ferraro, Lucia L.; Garcia, Míriam; Heesterbeek, Thomas J.; Honisch, Sabina; Hoyng, Carel B.; Kersten, Eveline; Kilger, Ellen; Langen, Hanno; Lengyel, Imre; Luthert, Phil; Maugeais, Cyrille; Meester-Smoor, Magda; Monés, Jordi; Nogoceke, Everson; Peto, Tunde; Pool, Frances M.; Rodríguez, Eduardo; Ueffing, Marius; Ulrich Bartz-Schmidt, Karl U.; van Leeuwen, Elisabeth M.; Verzijden, Timo; Zumbansen, Markus; Acar, Niyazi; Anastosopoulos, Eleftherios; Azuara-Blanco, Augusto; Bergen, Arthur; Binquet, Christine; Bird, Alan; Brétillon, Lionel; Buitendijk, Gabrielle; Cachulo, Maria Luz; Chakravarthy, Usha; Chan, Michelle; Chang, Petrus; Colijn, Johanna; Cumberland, Philippa; Cunha-Vaz, José; Daien, Vincent; Deak, Gabor; Delyfer, Marie-Noëlle; den Hollander, Anneke; Dietzel, Martha; Erke, Maja Gran; Fauser, Sascha; Finger, Robert; Fletcher, Astrid; Foster, Paul; Founti, Panayiota; Göbel, Arno; Gorgels, Theo; Grauslund, Jakob; Grus, Franz; Hammond, Christopher; Helmer, Catherine; Hense, Hans-Werner; Hermann, Manuel; Hoehn, René; Hogg, Ruth; Holz, Frank; Hoyng, Carel; Jansonius, Nomdo; Janssen, Sarah; Khawaja, Anthony; Klaver, Caroline; Lamparter, Julia; Le Goff, Mélanie; Leal, Sergio; Lechanteur, Yara; Lehtimäki, Terho; Lotery, Andrew; Leung, Irene; Mauschitz, Matthias; Merle, Bénédicte; Meyer Zu Westrup, Verena; Midena, Edoardo; Miotto, Stefania; Mirshahi, Alireza; Mohan-Saïd, Sadek; Mueller, Michael; Muldrew, Alyson; Nunes, Sandrina; Oexle, Konrad; Rahi, Jugnoo; Raitakari, Olli; Ribeiro, Luisa; Rougier, Marie-Bénédicte; Sahel, José; Salonikiou, Aggeliki; Sanchez, Clarisa; Schmitz-Valckenberg, Steffen; Schweitzer, Cédric; Shehata, Jasmin; Silvestri, Giuliana; Simader, Christian; Souied, Eric; Springelkamp, Henriet; Tapp, Robyn; Verhoeven, Virginie; Von Hanno, Therese; Vujosevic, Stela; Williams, Katie; Wolfram, Christian; Yip, Jennifer; Zerbib, Jennyfer; Zwiener, Isabella

    2017-01-01

    Purpose: Age-related macular degeneration (AMD) is a frequent, complex disorder in elderly of European ancestry. Risk profiles and treatment options have changed considerably over the years, which may have affected disease prevalence and outcome. We determined the prevalence of early and late AMD in

  8. Prevalence of Age-Related Macular Degeneration in Europe

    DEFF Research Database (Denmark)

    Colijn, Johanna M; Buitendijk, Gabriëlle H S; Prokofyeva, Elena

    2017-01-01

    PURPOSE: Age-related macular degeneration (AMD) is a frequent, complex disorder in elderly of European ancestry. Risk profiles and treatment options have changed considerably over the years, which may have affected disease prevalence and outcome. We determined the prevalence of early and late AMD...

  9. Treatment of dry age-related macular degeneration with dobesilate

    Science.gov (United States)

    Cuevas, P; Outeiriño, L A; Angulo, J; Giménez-Gallego, G

    2012-01-01

    The authors present anatomical and functional evidences of dry age-macular degeneration improvement, after intravitreal treatment with dobesilate. Main outcomes measures were normalisation of retinal structure and function, assessed by optical coherence tomography, fundus-monitored microperimetry, electrophysiology and visual acuity. The effect might be related to the normalisation of the outer retinal architecture. PMID:22729337

  10. [Progression of nerve fiber layer defects in retrobulbar optic neuritis by the macular ganglion cell complex].

    Science.gov (United States)

    Hong, D; Bosc, C; Chiambaretta, F

    2017-11-01

    Recent studies with SD OCT had shown early axonal damage to the macular ganglion cell complex (which consists of the three innermost layers of the retina: Inner Plexiform Layer [IPL], Ganglion Cell Layer [GCL], Retinal Nerve Fibre layer [RNFL]) in optic nerve pathology. Retrobulbar optic neuritis (RBON), occurring frequently in demyelinating diseases, leads to atrophy of the optic nerve fibers at the level of the ganglion cell axons, previously described in the literature. The goal of this study is to evaluate the progression of optic nerve fiber defects and macular ganglion cell complex defects with the SPECTRALIS OCT via a reproducible method by calculating a mean thickness in each quadrant after an episode of retrobulbar optic neuritis. This is a prospective monocentric observational study including 8 patients at the Clermont-Ferrand university medical center. All patients underwent ocular examination with macular and disc OCT analysis and a Goldmann visual field at the time of inclusion (onset or recurrence of RBON), at 3 months and at 6 months. Patients were 40-years-old on average at the time of inclusion. After 6 months of follow-up, there was progression of the atrophy of the macular ganglion cell complex in the affected eye on (11.5% or 11μm) predominantly inferonasally (13.9% or 16μm) and superonasally (12.9% or 14μm) while the other eye remained stable. The decrease in thickness occurred mainly in the most internal 3 layers of the retina. On average, the loss in thickness of the peripapillary RNFL was predominantly inferotemporal (24.9% or 39μm) and superotemporal (21.8% or 28μm). In 3 months of progression, the loss of optic nerve fibers is already seen on macular and disc OCT after an episode of RBON, especially in inferior quadrants in spite of the improvement in the Goldmann visual field and visual acuity. Segmentation by quadrant was used here to compare the progression of the defect by region compared to the fovea in a global and reproducible

  11. Absolute and estimated values of macular pigment optical density in young and aged Asian participants with or without age-related macular degeneration.

    Science.gov (United States)

    Ozawa, Yoko; Shigeno, Yuta; Nagai, Norihiro; Suzuki, Misa; Kurihara, Toshihide; Minami, Sakiko; Hirano, Eri; Shinoda, Hajime; Kobayashi, Saori; Tsubota, Kazuo

    2017-08-29

    Lutein and zeaxanthin are suggested micronutrient supplements to prevent the progression of age-related macular degeneration (AMD), a leading cause of blindness worldwide. To monitor the levels of lutein/zeaxanthin in the macula, macular pigment optical density (MPOD) is measured. A commercially available device (MPSII®, Elektron Technology, Switzerland), using technology based on heterochromatic flicker photometry, can measure both absolute and estimated values of MPOD. However, whether the estimated value is applicable to Asian individuals and/or AMD patients remains to be determined. The absolute and estimated values of MPOD were measured using the MPSII® device in 77 participants with a best-corrected visual acuity (BCVA) > 0.099 (logMAR score). The studied eyes included 17 young (20-29 years) healthy, 26 aged (>50 years) healthy, 18 aged and AMD-fellow, and 16 aged AMD eyes. The mean BCVA among the groups were not significantly different. Both absolute and estimated values were measurable in all eyes of young healthy group. However, absolute values were measurable in only 57.7%, 66.7%, and 43.8%, of the aged healthy, AMD-fellow, and AMD groups, respectively, and 56.7% of the eyes included in the 3 aged groups. In contrast, the estimated value was measurable in 84.6%, 88.9% and 93.8% of the groups, respectively, and 88.3% of eyes in the pooled aged group. The estimated value was correlated with absolute value in individuals from all groups by Spearman's correlation coefficient analyses (young healthy: R 2  = 0.885, P = 0.0001; aged healthy: R 2  = 0.765, P = 0.001; AMD-fellow: R 2  = 0.851, P = 0.0001; and AMD: R 2  = 0.860, P = 0.013). Using the estimated value, significantly lower MPOD values were found in aged AMD-related eyes, which included both AMD-fellow and AMD eyes, compared with aged healthy eyes by Student's t-test (P = 0.02). Absolute, in contrast to estimated, value was measurable in a limited number of aged participants

  12. Statistical mechanics of black holes

    International Nuclear Information System (INIS)

    Harms, B.; Leblanc, Y.

    1992-01-01

    We analyze the statistical mechanics of a gas of neutral and charged black holes. The microcanonical ensemble is the only possible approach to this system, and the equilibrium configuration is the one for which most of the energy is carried by a single black hole. Schwarzschild black holes are found to obey the statistical bootstrap condition. In all cases, the microcanonical temperature is identical to the Hawking temperature of the most massive black hole in the gas. U(1) charges in general break the bootstrap property. The problems of black-hole decay and of quantum coherence are also addressed

  13. f(R) Black holes

    OpenAIRE

    Moon, Taeyoon; Myung, Yun Soo; Son, Edwin J.

    2011-01-01

    We study the $f(R)$-Maxwell black hole imposed by constant curvature and its all thermodynamic quantities, which may lead to the Reissner-Nordstr\\"om-AdS black hole by redefining Newtonian constant and charge. Further, we obtain the $f(R)$-Yang-Mills black hole imposed by constant curvature, which is related to the Einstein-Yang-Mills black hole in AdS space. Since there is no analytic black hole solution in the presence of Yang-Mills field, we obtain asymptotic solutions. Then, we confirm th...

  14. Black-hole thermodynamics: Entropy, information and beyond

    Indian Academy of Sciences (India)

    We review some recent advances in black-hole thermodynamics including statistical mechanical origins of black-hole entropy and its leading order corrections from the view points of various quantum gravity theories. We then examine the problem of information loss and some possible approaches to its resolution. Finally ...

  15. NNWSI [Nevada Nuclear Waste Storage Investigations] hole histories

    International Nuclear Information System (INIS)

    1986-11-01

    This report is a compilation of data from twelve boreholes drilled in Area 25 under the guidance of the Sandia National Laboratory. They were drilled to provide samples and alluvial thickness determinations for the repository surface facilities, especially with respect to foundation conditions. Data presented in the hole histories include all locations, daily activities and review of hole conditions

  16. Artificial black holes on the threshold of new physics

    CERN Multimedia

    Thaller, M

    2003-01-01

    Theorists believe that it is necessary to study black holes in order to merge the two theories of relativity and quantum physics. The next generation of accelerators, including the LHC currently under construction in Geneva, should be able to produce mini black holes on demand for scientists to study (2 pages).

  17. Hole-thru-laminate mounting supports for photovoltaic modules

    Science.gov (United States)

    Wexler, Jason; Botkin, Jonathan; Culligan, Matthew; Detrick, Adam

    2015-02-17

    A mounting support for a photovoltaic module is described. The mounting support includes a pedestal having a surface adaptable to receive a flat side of a photovoltaic module laminate. A hole is disposed in the pedestal, the hole adaptable to receive a bolt or a pin used to couple the pedestal to the flat side of the photovoltaic module laminate.

  18. Patient-reported utilities in bilateral visual impairment from amblyopia and age-related macular degeneration.

    Science.gov (United States)

    van de Graaf, Elizabeth S; Despriet, Dominiek D G; Klaver, Caroline C W; Simonsz, Huibert J

    2016-05-17

    Utility of visual impairment caused by amblyopia is important for the cost-effectiveness of screening for amblyopia (lazy eye, prevalence 3-3.5 %). We previously measured decrease of utility in 35-year-old persons with unilateral persistent amblyopia. The current observational case-control study aimed to measure loss of utility in patients with amblyopia with recent decrease of vision in their better eye. As these patients are rare, the sample was supplemented by patients with bilateral age-related macular degeneration with similar decrease of vision. From our out-patient department, two groups of patients with recent deterioration to bilateral visual acuity less than Snellen 0.5 (bilateral visual impairment, BVI) were recruited, with either persistent amblyopia and age-related macular degeneration (AMB + AMD), or with bilateral age-related macular degeneration (BAMD). To measure utility, the time trade-off method and the standard gamble method were applied through interviews. Correlations were sought between utility values and visual acuity, age and Visual Function Questionnaire-25 scores. Seventeen AMB + AMD patients (mean age 72.9 years), and 63 BAMD patients (mean age 79.6 years) were included in the study. Among AMB + AMD, 80 % were willing to trade lifetime in exchange for cure. The overall mean time trade-off utility was 0.925. Among BAMD, 75 % were willing to trade, utility was 0.917. Among AMB + AMD, 38 % accepted risk of death in exchange for cure, overall mean standard gamble utility was 0.999. Among BAMD, 49 % accepted risk of death, utility was 0.998. Utility was not related to visual acuity but it was to age (p = 0.02). Elderly patients with BVI, caused by persistent amblyopia and age-related macular degeneration (AMD) or by bilateral AMD, had an approximately 8 % loss of TTO utility. Notably, the 8 % loss in elderly with BVI differs little from the 3.7 % loss we found previously in 35-year-old persons with unilateral

  19. DIFFERENTIAL MACULAR FEATURES ON OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IN EYES WITH CHOROIDAL NEVUS AND MELANOMA.

    Science.gov (United States)

    Valverde-Megías, Alicia; Say, Emil A T; Ferenczy, Sandor R; Shields, Carol L

    2017-04-01

    To evaluate optical coherence tomography angiography (OCTA) characteristics of macular vascular details in eyes with choroidal nevus and melanoma, compared with unaffected contralateral eye. Retrospective comparative analysis comprising 70 patients with choroidal nevus and 36 patients with choroidal melanoma examined with optical coherence tomography angiography. Measurements included central macular thickness (CMT), superficial (sFAZ) and deep (dFAZ) foveal avascular zone (FAZ) area, and superficial (sCVD) and deep (dCVD) capillary vascular density (CVD). In patients with nevus, CMT (affected vs. unaffected eye) was similar (267 vs. 265 μm, P = 0.67), whereas in patients with melanoma, CMT demonstrated greater thickness in affected eye (322 vs. 259 μm, P eyes with nevus, the FAZ (affected vs. unaffected eye) showed similar values in sFAZ (0.238 vs. 0.232 mm, P = 0.72) and dFAZ (0.284 vs. 0.271 mm, P = 0.48). In eyes with melanoma, similar values for sFAZ (0.249 vs. 0.260 mm, P = 0.73) were noted, whereas dFAZ was larger in the affected eye with macular melanoma (0.530 vs. 0.252 mm, P = 0.012) and similar in eyes with extramacular melanoma (0.300 vs. 0.285, P = 0.75). Regarding CVD (affected vs. unaffected eye), eyes with nevus showed similar sCVD (54 vs. 53.9%, P = 0.81) and dCVD (60 vs. 59.4%, P = 0.19). Reduced dCVD was found in four eyes with nevus, all with three or more risk factors for growth (P eyes with melanoma, significant reduction was found in both sCVD (50.5 vs. 53.1%, P = 0.006) and dCVD (56.6% vs. 59.8%, P = 0.0003). Reduction in sCVD was related to presence of subretinal fluid (P = 0.03). Reduction in dCVD was found with subretinal fluid presence (P = 0.003) or absence (P = 0.03), with both macular (P melanoma, and with increasing tumor thickness (P = 0.005). Reduced dCVD was found in 11% of eyes with nevus versus 58% of eyes with melanoma (Chi-square test: 26.31; P eye, eyes with choroidal nevus demonstrate similar CMT, FAZ, and CVD. In contrast

  20. Clinical and genetic characterization of a Danish family with North Carolina macular dystrophy.

    Science.gov (United States)

    Rosenberg, Thomas; Roos, Ben; Johnsen, Thorkild; Bech, Niels; Scheetz, Todd E; Larsen, Michael; Stone, Edwin M; Fingert, John H

    2010-12-09

    To describe the phenotype of a family with an autosomal dominant macular dystrophy and identify the chromosomal location of the gene that causes this phenotype. Twelve members of a three-generation family underwent routine clinical examination, including fundus photography. Four of the patients underwent extended examination with Goldmann perimetry, full-field electroretinogram, dark adaptation, and color vision testing, and two patients underwent optical coherence tomography and fundus autofluorescence examination. DNA samples were obtained from 12 family members and 3 spouses and genotyped at the known North Carolina Macular Dystrophy (NCMD) locus on chromosome 6q (MCDR1: OMIM 136550) using short tandem repeat polymorphisms. DNA samples were subsequently examined with a genome-wide scan of single nucleotide polymorphisms and the genotypes that were produced were studied with linkage and haplotype analyses. The 10 affected family members had clinical findings of macular lesions that are typical for NCMD. The small drusen-like yellowish lesions of mild NCMD were hyperautofluorescent. Hyperpigmented foveal lesions were surrounded by a zone of confluent hyperautofluorescence. Linkage analysis of short tandem repeat polymorphism genetic markers excluded the NCMD locus on chromosome 6. However, analysis of single nucleotide polymorphism genotypes from a genome-wide scan showed that NCMD in our pedigree is linked to a region on chromosome 5p that overlaps the previously mapped macular dystrophy (MCDR3) locus with a maximum log of the odds (LOD) score of 2.69 at a recombination fraction of 0.00 (markers D5S406, D5S1987, and D5S2505). We report the first pedigree with NCMD from Scandinavia, and the first confirmation that a gene for this condition is located on chromosome 5p13-p15. The bright elements or lesions typical of NCMD differed from drusen in that no sign of accumulation of material between the retinal pigment epithelium and Bruch's membrane was seen. While the

  1. Aflibercept in exudative age related macular degeneration refractory to ranibizumab.

    Science.gov (United States)

    Ruiz Ramos, J; Pascual-Camps, I; Cuéllar-Monreal, M J; Dolz-Marco, R; Fenoll, M A; Font-Noguera, I; Poveda-Andrés, J L; Gallego-Pinazo, R

    2015-12-01

    The aim of this study is to determine the effectiveness, safety and cost of aflibercept in the treatment of wet age-related macular degeneration (ARMD) refractory to ranibizumab. Retrospective observational study was conducted on patients diagnosed with wet ARMD, and previously treated with ranibizumab. Efficacy variables assessed were changes in visual acuity (BCVA) and anatomical improvements in the most affected eye. Factors associated with improvement of BCVA with aflibercept were also studied. Adverse events related to the aflibercept administration were recorded. Cost analysis data were collected from the hospital perspective, and only taking the direct medical costs into account. Cost-effectiveness analysis was calculated using the aflibercept treatment cost, and effectiveness calculated as BCVA gained. A total of 50 eyes corresponding to 46 patients were included. The median follow-up period was 4.6 months (range: 1.0-6.0). Improvement in visual acuity after the first 2 doses and at the end of the follow-up period was observed in 32.0 and 28.0% of treated eyes, respectively. None of the variables studied was associated with an improvement in the BCVA after treatment. No significant differences were found in the average monthly cost between treatments. Aflibercept is shown to be an effective treatment in a significant number of patients resistant to treatment with ranibizumab, presenting a cost similar to that generated during the final stages of treatment with ranibizumab. Copyright © 2015 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  2. Macular buckling for eyes with myopic foveoschisis secondary to posterior staphyloma.

    Science.gov (United States)

    Mateo, Carlos; Burés-Jelstrup, Anniken; Navarro, Rafael; Corcóstegui, Borja

    2012-06-01

    To determine the effectiveness of macular buckling in eyes with myopic foveoschisis and describe two methods of macular buckling: hard silicone implant and Ando plombe. Sixteen eyes of 16 consecutive patients with myopic foveoschisis who underwent surgery with the macular buckling procedure were studied. Pars plana vitrectomy combined with macular buckling with hard silicone implant was used in 6 eyes, whereas the other 10 eyes underwent pars plana vitrectomy and macular buckling with the Ando macular plombe. Macular buckling, with both hard silicone implant and macular plombe resulted in reduction of retinal thickness in all patients. Best-corrected visual acuity improved in 14 of 16 eyes (87.5%), whereas it remained stable or decreased in 2 eyes (12.5%). Mean preoperative best-corrected visual acuity was 20/125 (mean logarithm of the minimal angle of resolution 0.8), whereas mean postoperative best-corrected visual acuity improved to 20/50 (mean logarithm of the minimal angle of resolution 0.39). Both methods showed a similar rate of complications, the most frequent being the development of localized areas of retinal pigment epithelium atrophy. Combined pars plana vitrectomy and macular buckling is an effective approach to treat myopic foveoschisis with both anatomical and visual improvement. Despite a similar complication rate with both buckling techniques, macular buckling with the Ando plombe was found to be technically easier with shorter surgical times.

  3. Black Holes and Firewalls

    Science.gov (United States)

    Polchinski, Joseph

    2015-04-01

    Our modern understanding of space, time, matter, and even reality itself arose from the three great revolutions of the early twentieth century: special relativity, general relativity, and quantum mechanics. But a century later, this work is unfinished. Many deep connections have been discovered, but the full form of a unified theory incorporating all three principles is not known. Thought experiments and paradoxes have often played a key role in figuring out how to fit theories together. For the unification of general relativity and quantum mechanics, black holes have been an important arena. I will talk about the quantum mechanics of black holes, the information paradox, and the latest version of this paradox, the firewall. The firewall points to a conflict between our current theories of spacetime and of quantum mechanics. It may lead to a new understanding of how these are connected, perhaps based on quantum entanglement.

  4. Black holes as lumps of fluid

    International Nuclear Information System (INIS)

    Caldarelli, Marco M.; Dias, Oscar J.C.; Emparan, Roberto; Klemm, Dietmar

    2009-01-01

    The old suggestive observation that black holes often resemble lumps of fluid has recently been taken beyond the level of an analogy to a precise duality. We investigate aspects of this duality, and in particular clarify the relation between area minimization of the fluid vs. area maximization of the black hole horizon, and the connection between surface tension and curvature of the fluid, and surface gravity of the black hole. We also argue that the Rayleigh-Plateau instability in a fluid tube is the holographic dual of the Gregory-Laflamme instability of a black string. Associated with this fluid instability there is a rich variety of phases of fluid solutions that we study in detail, including in particular the effects of rotation. We compare them against the known results for asymptotically flat black holes finding remarkable agreement. Furthermore, we use our fluid results to discuss the unknown features of the gravitational system. Finally, we make some observations that suggest that asymptotically flat black holes may admit a fluid description in the limit of large number of dimensions.

  5. BLACK HOLE FORAGING: FEEDBACK DRIVES FEEDING

    International Nuclear Information System (INIS)

    Dehnen, Walter; King, Andrew

    2013-01-01

    We suggest a new picture of supermassive black hole (SMBH) growth in galaxy centers. Momentum-driven feedback from an accreting hole gives significant orbital energy, but little angular momentum to the surrounding gas. Once central accretion drops, the feedback weakens and swept-up gas falls back toward the SMBH on near-parabolic orbits. These intersect near the black hole with partially opposed specific angular momenta, causing further infall and ultimately the formation of a small-scale accretion disk. The feeding rates into the disk typically exceed Eddington by factors of a few, growing the hole on the Salpeter timescale and stimulating further feedback. Natural consequences of this picture include (1) the formation and maintenance of a roughly toroidal distribution of obscuring matter near the hole; (2) random orientations of successive accretion disk episodes; (3) the possibility of rapid SMBH growth; (4) tidal disruption of stars and close binaries formed from infalling gas, resulting in visible flares and ejection of hypervelocity stars; (5) super-solar abundances of the matter accreting on to the SMBH; and (6) a lower central dark-matter density, and hence annihilation signal, than adiabatic SMBH growth implies. We also suggest a simple subgrid recipe for implementing this process in numerical simulations

  6. Black Hole Astrophysics The Engine Paradigm

    CERN Document Server

    Meier, David L

    2012-01-01

    As a result of significant research over the past 20 years, black holes are now linked to some of the most spectacular and exciting phenomena in the Universe, ranging in size from those that have the same mass as stars to the super-massive objects that lie at the heart of most galaxies, including our own Milky Way. This book first introduces the properties of simple isolated holes, then adds in complications like rotation, accretion, radiation, and magnetic fields, finally arriving at a basic understanding of how these immense engines work. Black Hole Astrophysics • reviews our current knowledge of cosmic black holes and how they generate the most powerful observed pheonomena in the Universe; • highlights the latest, most up-to-date theories and discoveries in this very active area of astrophysical research; • demonstrates why we believe that black holes are responsible for important phenomena such as quasars, microquasars and gammaray bursts; • explains to the reader the nature of the violent and spe...

  7. Rotating black hole and quintessence

    International Nuclear Information System (INIS)

    Ghosh, Sushant G.

    2016-01-01

    We discuss spherically symmetric exact solutions of the Einstein equations for quintessential matter surrounding a black hole, which has an additional parameter (ω) due to the quintessential matter, apart from the mass (M). In turn, we employ the Newman-Janis complex transformation to this spherical quintessence black hole solution and present a rotating counterpart that is identified, for α = -e 2 ≠ 0 and ω = 1/3, exactly as the Kerr-Newman black hole, and as the Kerr black hole when α = 0. Interestingly, for a given value of parameter ω, there exists a critical rotation parameter (a = a E ), which corresponds to an extremal black hole with degenerate horizons, while for a < a E , it describes a nonextremal black hole with Cauchy and event horizons, and no black hole for a > a E . We find that the extremal value a E is also influenced by the parameter ω and so is the ergoregion. (orig.)

  8. Internal structure of black holes

    International Nuclear Information System (INIS)

    Cvetic, Mirjam

    2013-01-01

    Full text: We review recent progress that sheds light on the internal structure of general black holes. We first summarize properties of general multi-charged rotating black holes both in four and five dimensions. We show that the asymptotic boundary conditions of these general asymptotically flat black holes can be modified such that a conformal symmetry emerges. These subtracted geometries preserve the thermodynamic properties of the original black holes and are of the Lifshitz type, thus describing 'a black hole in the asymptotically conical box'. Recent efforts employ solution generating techniques to construct interpolating geometries between the original black hole and their subtracted geometries. Upon lift to one dimension higher, these geometries lift to AdS 3 times a sphere, and thus provide a microscopic interpretation of the black hole entropy in terms of dual two-dimensional conformal field theory. (author)

  9. Beyond the black hole

    International Nuclear Information System (INIS)

    Boslough, J.

    1985-01-01

    This book is about the life and work of Stephen Hawking. It traces the development of his theories about the universe and particularly black holes, in a biographical context. Hawking's lecture 'Is the end in sight for theoretical physics' is presented as an appendix. In this, he discusses the possibility of achieving a complete, consistent and unified theory of the physical interactions which would describe all possible observations. (U.K.)

  10. Black holes in the presence of dark energy

    International Nuclear Information System (INIS)

    Babichev, E O; Dokuchaev, V I; Eroshenko, Yu N

    2013-01-01

    The new, rapidly developing field of theoretical research—studies of dark energy interacting with black holes (and, in particular, accreting onto black holes)–—is reviewed. The term 'dark energy' is meant to cover a wide range of field theory models, as well as perfect fluids with various equations of state, including cosmological dark energy. Various accretion models are analyzed in terms of the simplest test field approximation or by allowing back reaction on the black-hole metric. The behavior of various types of dark energy in the vicinity of Schwarzschild and electrically charged black holes is examined. Nontrivial effects due to the presence of dark energy in the black hole vicinity are discussed. In particular, a physical explanation is given of why the black hole mass decreases when phantom energy is being accreted, a process in which the basic energy conditions of the famous theorem of nondecreasing horizon area in classical black holes are violated. The theoretical possibility of a signal escaping from beneath the black hole event horizon is discussed for a number of dark energy models. Finally, the violation of the laws of thermodynamics by black holes in the presence of noncanonical fields is considered. (reviews of topical problems)

  11. Capture of particles from plunge orbits by a black hole

    International Nuclear Information System (INIS)

    Young, P.J.

    1976-01-01

    Photon and ''parabolic'' particle orbits around a Kerr-Newman black hole are considered, both for uncharged particles moving along geodesics and for charged particles under the influence of the Lorentz force (neglecting radiative processes). Investigation of the radial equation of motion gives conditions under which a photon or particle is captured from a ''plunge'' orbit when incident from a large distance; the cross sections and accreted angular momenta are calculated for various fluxes of particles incident on the black hole. For example, the cross section of an extreme Kerr (a = 1) black hole to an isotropic flux of particles is 0.90 of that for a Schwarzschild hole, and the accreted angular momentum per unit mass of swallowed flux is -0.828 leading to rapid spin-down of the hole. The periastra of ''escape'' orbits are considered, and also the minimum periastron corresponding to the unstable spherical orbit that divides plunge and escape orbits. The evolution of the spin and charge of a black hole accreting particles and photons is discussed, including that of primordial black holes. It is shown that such black holes may be of the Schwarzschild type having spun-down due to consumption of radiation and particles at early times and subsequent neutralization in an ionized intergalactic medium. The statistics of proton and electron capture by the smallest surviving primordial black holes, M = 10 15 g, suggests that they are most likely to be found possessing a single quantum of positive charge

  12. Thermodynamics and stability of hyperbolic charged black holes

    International Nuclear Information System (INIS)

    Cai Ronggen; Wang Anzhong

    2004-01-01

    In AdS space the black hole horizon can be a hypersurface with a positive, zero, or negative constant curvature, resulting in different horizon topology. Thermodynamics and stability of black holes in AdS spaces are quite different for different horizon curvatures. In this paper we study thermodynamics and stability of hyperbolic charged black holes with negative constant curvature horizon in the grand canonical ensemble and canonical ensemble, respectively. They include hyperbolic Reissner-Nordstroem black holes in arbitrary dimensions and hyperbolic black holes in the D=5,4,7 gauged supergravities. It is found that associated Gibbs free energies are always negative, which implies that these black hole solutions are globally stable and the black hole phase is dominant in the grand canonical ensemble, but there is a region in the phase space where the black hole is not locally thermodynamically stable with a negative heat capacity for a given gauge potential. In the canonical ensemble, the Helmholtz free energies are not always negative and heat capacities with fixed electric charge are not always positive, which indicates that the Hawking-Page phase transition may happen and black holes are not always locally thermodynamically stable

  13. Black holes and holography

    International Nuclear Information System (INIS)

    Mathur, Samir D

    2012-01-01

    The idea of holography in gravity arose from the fact that the entropy of black holes is given by their surface area. The holography encountered in gauge/gravity duality has no such relation however; the boundary surface can be placed at an arbitrary location in AdS space and its area does not give the entropy of the bulk. The essential issues are also different between the two cases: in black holes we get Hawking radiation from the 'holographic surface' which leads to the information issue, while in gauge/gravity duality there is no such radiation. To resolve the information paradox we need to show that there are real degrees of freedom at the horizon of the hole; this is achieved by the fuzzball construction. In gauge/gravity duality we have instead a field theory defined on an abstract dual space; there are no gravitational degrees of freedom at the holographic boundary. It is important to understand the relations and differences between these two notions of holography to get a full understanding of the lessons from the information paradox.

  14. Lithology and Stratigraphy of Holes Drilled in LANL-Use Areas of the Nevada Test Site

    Energy Technology Data Exchange (ETDEWEB)

    Lance B. Prothro; Sigmund L. Drellack, Jr.; Brian M. Allen

    1999-07-01

    Geologic data for ten holes drilled in areas used by Los Alamos National Laboratory at the Nevada Test Site are presented in this report. The holes include emplacement holes, instrumentation holes, and Underground Test Area wells drilled during calendar years 1991 through 1995. For each hole a stratigraphic log, a detailed lithologic log, and one or two geologic cross sections are presented, along with a supplemental data sheet containing information about the drilling operations, geology, or references. For three of the holes, graphic data summary sheets with geologic and geophysical data are provided as plates.

  15. New cosmological constraints on primordial black holes

    International Nuclear Information System (INIS)

    Carr, B. J.; Kohri, Kazunori; Sendouda, Yuuiti; Yokoyama, Jun'ichi

    2010-01-01

    We update the constraints on the fraction of the Universe going into primordial black holes in the mass range 10 9 -10 17 g associated with the effects of their evaporations on big bang nucleosynthesis and the extragalactic photon background. We include for the first time all the effects of quark and gluon emission by black holes on these constraints and account for the latest observational developments. We then discuss the other constraints in this mass range and show that these are weaker than the nucleosynthesis and photon background limits, apart from a small range 10 13 -10 14 g, where the damping of cosmic microwave background anisotropies dominates. Finally we review the gravitational and astrophysical effects of nonevaporating primordial black holes, updating constraints over the broader mass range 1-10 50 g.

  16. Scalar fields in black hole spacetimes

    Science.gov (United States)

    Thuestad, Izak; Khanna, Gaurav; Price, Richard H.

    2017-07-01

    The time evolution of matter fields in black hole exterior spacetimes is a well-studied subject, spanning several decades of research. However, the behavior of fields in the black hole interior spacetime has only relatively recently begun receiving some attention from the research community. In this paper, we numerically study the late-time evolution of scalar fields in both Schwarzschild and Kerr spacetimes, including the black hole interior. We recover the expected late-time power-law "tails" on the exterior (null infinity, timelike infinity, and the horizon). In the interior region, we find an interesting oscillatory behavior that is characterized by the multipole index ℓ of the scalar field. In addition, we also study the extremal Kerr case and find strong indications of an instability developing at the horizon.

  17. STU black holes and SgrA*

    International Nuclear Information System (INIS)

    Cvetič, M.; Gibbons, G.W.; Pope, C.N.

    2017-01-01

    The equations of null geodesics in the STU family of rotating black hole solutions of supergravity theory, which may be considered as deformations of the vacuum Kerr metric, are completely integrable. We propose that they be used as a foil to test, for example, with what precision the gravitational field external to the black hole at the centre of our galaxy is given by the Kerr metric. By contrast with some metrics proposed in the literature, the STU metrics satisfy by construction the dominant and strong energy conditions. Our considerations may be extended to include the effects of a cosmological term. We show that these metrics permit a straightforward calculation of the properties of black hole shadows.

  18. Macular Pigment Optical Density and Measures of Macular Function: Test-Retest Variability, Cross-Sectional Correlations, and Findings from the Zeaxanthin Pilot Study of Response to Supplementation (ZEASTRESS-Pilot

    Directory of Open Access Journals (Sweden)

    Alessandro Iannaccone

    2016-04-01

    Full Text Available We report on the short-term test-retest baseline variability in macular function tests in ZEASTRESS-Pilot participants (n = 18, on their cross-sectional correlation with macular pigment optical density (MPOD, and on the effects of four months (FUV4 of 20 mg/day zeaxanthin (ZX, followed by a four-month washout (FUV8; n = 24, age 50–81 years old. Outcomes included: MPOD at 0.5 and 2.0 deg eccentricity (MPOD-0.5 and -2.0; contrast sensitivity (CS; pattern-reversal electroretinogram (PERG amplitude; dark-adapted 650 nm foveal cone sensitivity (DA650-FCS; and 500 mn parafoveal rod sensitivity (DA500-PFRS. All measures of macular function showed close test-retest correlation (Pearson’s r range: 0.744–0.946 and low coefficients of variation (CV range: 1.13%–4.00%. MPOD correlated in a complex fashion with macular function. Following supplementation, MPOD-0.5 and MPOD-2.0 increased at both FUV4 and FUV8 (p ≤ 0.0001 for all measures. Continued, delayed MPOD increase and a small, but significant (p = 0.012, CS increase was seen at FUV8 only in females. PERGs increased significantly at FUV4 (p = 0.0006, followed by a partial decline at FUV8. In conclusion, following ZX supplementation, MPOD increased significantly. There was no effect on DA-650 FCS or DA-500 PFRS. Both CS and PERG amplitudes increased following supplementation, but the effect varied between males and females. Additional studies appear warranted to confirm and characterize further these inter-gender differences.

  19. Triamcinolona subtenoniana en el edema macular diabético Subtenon triamcinolone in the diabetic macular edema

    Directory of Open Access Journals (Sweden)

    Eddy Mesa Hernández

    2009-12-01

    Full Text Available INTRODUCCIÓN: La prevalencia de la retinopatía diabética está determinada por el tipo de diabetes mellitus y por el tiempo de evolución de la enfermedad. El edema macular es la principal causa de la disminución de la agudeza visual en el paciente diabético. Un diagnóstico precoz y certero de esta enfermedad, unido al establecimiento de un tratamiento adecuado es crucial en el esfuerzo por reducir la incapacidad visual. El propósito de este trabajo fue determinar la efectividad de la triamcinolona subtenoniana como tratamiento del edema macular en un grupo de pacientes diabéticos. MÉTODOS: Se realizó un estudio descriptivo-prospectivo de caso control. La muestra estuvo formada por 30 pacientes diabéticos que fueron atendidos en el Hospital Clínicoquirúrgico "Dr. Miguel Enríquez, desde enero a junio de 2007, con diagnóstico de edema macular diabético que cumplieron con los criterios de inclusión. RESULTADOS: Predominó el sexo femenino, el grupo de edades más frecuentes fue de 55 a 65 años. Se relacionó el tiempo de evolución con la presencia de edema macular, se evidenció una involución de esta patología, así como una mejoría en la agudeza visual después de aplicado el tratamiento y no se presentaron complicaciones graves. CONCLUSIONES: El tratamiento con acetato de triamcinolona por vía subtenoniana posterior es una alternativa efectiva en el tratamiento de el edema macular.INTRODUCTION: Prevalence of diabetic retinopathy is determined by type of diabetes mellitus and the length of development of the disease. Macular edema is the main cause of reduction in visual acuity of the diabetic patient. An early exact diagnosis of the disease together with an adequate treatment is essential to decrease visual disability. The objective of this paper was to evaluate the effectiveness of subtenon triamcinolone as therapy for macular edema in a group of diabetics. METHODS: A prospective descriptive case-control study was

  20. Visual and anatomical success with short-term macular tamponade and autologous platelet concentrate.

    LENUS (Irish Health Repository)

    Mulhern, M G

    2012-02-03

    BACKGROUND: This study aimed to determine whether, in eyes treated for macular hole by vitrectomy and autologous platelet injection, short-term tamponade with SF6 gas was as effective as longer tamponade with C3F8 gas. METHODS: Patients in group 1 (n=31) had vitrectomy, injection of platelet concentrate, and 16% C3F8 gas\\/air exchange. Patients in group 2 (n=31) were similarly treated, except that 23% SF6 gas was used. Group 1 patients were required to posture prone for 2-4 weeks, group 2 for 6 days. RESULTS: All patients had 3 months\\' follow-up. Postoperatively, visual acuity improved faster in group 2. However, the final mean improvement in logMAR acuity was similar in both groups. Intraocular pressure (IOP) spikes occurred in 12 patients in group 2 and in 17 patients in group 1. Posterior subcapsular cataract (PSCC) occurred in 55% of cases in group 1 and in just 37% in group 2. The rate of anatomical success in group 1 was 96.7%, and in group 2, 93.5% (P=1.0). CONCLUSIONS: The combination of SF6 gas, platelet concentrate, and short-term prone posturing gave a degree of anatomical and visual success comparable to that of the group which had longer tamponade. Although no differences were statistically significant, several trends did emerge; in group 2, patients recovered visual acuity faster, had fewer IOP spikes, and there were fewer cases of PSCC formation.

  1. Correlative Microscopy of Lamellar Hole-Associated Epiretinal Proliferation

    Directory of Open Access Journals (Sweden)

    Denise Compera

    2015-01-01

    Full Text Available Purpose. To describe morphology of lamellar hole-associated epiretinal proliferation (LHEP removed from eyes with lamellar macular holes (LMH. Methods. Based on optical coherence tomography data, 10 specimens of LHEP were removed from 10 eyes with LMH during standard vitrectomy. Specimens were prepared for correlative light and electron microscopy (CLEM using an immunonanogold particle of 1.4 nm diameter that was combined with a fluorescein moiety, both having been attached to a single antibody fragment. As primary antibodies, we used antiglial fibrillary acidic protein (GFAP, anti-CD45, anti-CD64, anti-α-smooth muscle actin (α-SMA, and anticollagen type I and type II. Results. In LHEP, GFAP-positive cells possess ultrastructural characteristics of fibroblasts and hyalocytes. They represent the major cell types and were densely packed in cell agglomerations on vitreous collagen strands. Epiretinal cells of LHEP rarely demonstrated contractive properties as α-SMA-positive myofibroblasts were an infrequent finding. Conclusion. CLEM indicates that epiretinal cells in LHEP might originate from the vitreous and that remodelling processes of vitreous collagen may play an important role in pathogenesis of eyes with LMH.

  2. The prevalence of microcystic macular changes on optical coherence tomography of the macular region in optic nerve atrophy of non-neuritis origin : a prospective study

    NARCIS (Netherlands)

    Pott, J. W. R.; de Vries-Knoppert, W. A. E. J.; Petzold, A.

    2015-01-01

    Background Microcystic macular changes, also called microcystic macular oedema, have recently been reported in patients with multiple sclerosis, particularly after optic neuritis. But it has since emerged that the finding is not specific for optic neuritis. This study was designed to prospectively

  3. Durable recovery of the macular architecture and functionality of a diagnosed age-related macular degeneration 1 year after a single intravitreal injection of dobesilate

    Science.gov (United States)

    Cuevas, P; Outeiriño, L A; Azanza, C; Giménez-Gallego, G

    2013-01-01

    Among the age-related diseases that affect vision, age-related macular degeneration is the most frequent cause of blindness in patients older than 60 years. In this communication, we report the full anatomical and functional recovery of a patient diagnosed with wet age-related macular degeneration 1 year after a single intravitreal injection of dobesilate. PMID:24225910

  4. Black holes and compact objects: Quantum aspects

    Indian Academy of Sciences (India)

    This is a summary of the papers presented in session W2 on a fairly wide-ranging variety of topics in the area of black hole physics and quantum aspects of gravity, including quantum field and string theory in curved spacetimes. In addition, experts in a couple of topical subjects were invited to present short surveys on the ...

  5. The Hole in the Ozone Layer.

    Science.gov (United States)

    Hamers, Jeanne S.; Jacob, Anthony T.

    This document contains information on the hole in the ozone layer. Topics discussed include properties of ozone, ozone in the atmosphere, chlorofluorocarbons, stratospheric ozone depletion, effects of ozone depletion on life, regulation of substances that deplete the ozone layer, alternatives to CFCs and Halons, and the future of the ozone layer.…

  6. Macular ganglion cell complex and retinal nerve fiber layer comparison in different stages of age-related macular degeneration.

    Science.gov (United States)

    Zucchiatti, Ilaria; Parodi, Maurizio Battaglia; Pierro, Luisa; Cicinelli, Maria Vittoria; Gagliardi, Marco; Castellino, Niccolò; Bandello, Francesco

    2015-09-01

    To employ optical coherence tomography (OCT) to analyze the morphologic changes in the inner retina in different categories of age-related macular degeneration (AMD). Observational cross-sectional study. Single-center study. Inclusion criteria were age over 50, diagnosis of Age-Related Eye Disease Study (AREDS) category 2 and 3, naïve neovascular AMD, and atrophic AMD. Healthy patients of similar age acted as a control group. Primary outcome measures were the changes in ganglion cell complex (GCC) and retinal nerve fiber layer (RNFL). Secondary outcomes included modifications of rim area and cup-to-disc ratio. One hundred and thirty eyes of 130 patients were recruited: 26 eyes for AREDS category 2, 26 for AREDS category 3, 26 for neovascular AMD, 26 with atrophic AMD, and 26 controls. Mean peripapillary RNFL thickness was significantly lower in neovascular AMD, compared to controls (P = .004); peripapillary RNFL did not significantly vary among AREDS category 2 and 3 and atrophic AMD groups, compared to controls. Mean GCC thickness was higher in the control group, becoming progressively thinner up to neovascular and atrophic AMD groups (P < .0001). Rim area was significantly thinner in the neovascular AMD group compared with controls (P = .047); cup-to-disc ratio was higher in the neovascular AMD group compared with the control group (P = .047). This study demonstrates that eyes with neovascular AMD display reduced RNFL and GCC thickness. RNFL is partially spared in atrophic advanced AMD. The identification of alteration in RNFL and GCC thickness may reveal useful for future therapeutic implications. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Change in macular thickness in a case of refractory diabetic macular edema with dexamethasone intravitreal implant in comparison to intravitreal bevacizumab: A case report

    Directory of Open Access Journals (Sweden)

    Ashish Sharma

    2012-01-01

    Full Text Available We report on the significant improvement of central macular thickness in a case of clinically significant macular edema after dexamethasone 0.7 mg sustained-release intravitreal implant (Ozurdex®; Allergan, Inc, Irvine, CA, USA. Patient presented to us with persistent clinically significant macular edema (CSME in both eyes. Right eye received dexamethasone implant and left eye received two intravitreal bevacizumab injections 1.25 mg/0.05 mL (Avastin®; Genentech Inc., South San Francisco, CA, USA with an interval of four weeks. After six weeks of follow-up, dexamethasone implant in the right eye showed normal macular thickness whereas persistent macular edema (ME was found even after second intravitreal bevacizumab injection in the left eye.

  8. [Lack of correlation between retinal variables before treatment and poor functional response after focal photocoagulation in diabetic macular oedema].

    Science.gov (United States)

    Ávila-Alcaraz, Yoloxochilth; Razo Blanco-Hernández, Dulce Milagros; García-Rubio, Yatzul Zuhaila; Lima-Gómez, Virgilio

    2016-01-01

    Although photocoagulation reduces the incidence of moderate visual loss in eyes with focal diabetic macular oedema, some eyes may lose some vision after treatment. The proportion of eyes with poor functional response after photocoagulation, and whether any retinal variable is associated with this, is unknown. To determine the proportion of eyes with diabetic macular oedema that have a poor functional response after focal photocoagulation, and their associated features. A non-experimental, longitudinal, comparative and retrospective study was conducted. The proportion and 95% confidence intervals (CI) of diabetics with macular oedema that had a poor functional response after focal photocoagulation (any visual loss after 6 weeks) were identified. The means of retinal variables before treatment were compared between eyes with and without a poor functional response using the Student t test for independent means. The study included 115 eyes of patients aged 59.3 (SD 9.24) years. Visual acuity was greater than or equal to 0.5 in 63 eyes (54.8%). A total of 33 eyes had a poor functional response after photocoagulation (28.7%, 95% CI: 13.3 to 44.1). The comparison between retinal variables and visual acuity before treatment did not show any differences between eyes with or without a poor functional response and eyes. Retinal thickening and visual acuity improved or did not change in 71.3% of eyes with diabetic macular oedema with a single photocoagulation procedure. Retinal variables that are usually evaluated were unable to identify the remaining 28.7%, which could lose vision after that treatment, and would require additional interventions. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  9. Normative spectral domain optical coherence tomography data on macular and retinal nerve fiber layer thickness in Indians

    Directory of Open Access Journals (Sweden)

    Bindu Appukuttan

    2014-01-01

    Full Text Available Aim: To provide the normative data of macular and retinal nerve fiber layer (RNFL thickness in Indians using spectral domain OCT (Spectralis OCT, Heidelberg Engineering, Germany and to evaluate the effects of age, gender, and refraction on these parameters. Design: Observational, cross-sectional study. Materials and Methods: The eyes of 105 healthy patients aged between 20-75 years, with no ocular disease and best corrected visual acuity of 20/20, were scanned using standard scanning protocols by a single examiner. Exclusion criteria included glaucoma, retinal diseases, diabetes, history of prior intraocular surgery or laser treatment. The mean macular and RNFL thickness were recorded, and the effects of age, gender, and refraction on these parameters were evaluated. This data was compared with published literature on Caucasians to assess the ethnic variations of these parameters. Results: The normal central foveal thickness in healthy Indian eyes measured using Spectralis OCT was 260.1 ± 18.19 ΅m. The nasal inner quadrant showed maximum retinal thickness (338.88 ± 18.17 ΅m.The mean RNFL thickness was 101.43 ± 8.63 ΅m with maximum thickness in the inferior quadrant. The central foveal thickness showed a gender-based difference (P = 0.005 but did not correlate significantly with age (P = 0.134, whereas the parafoveal, perifoveal thickness, macular volume, and RNFL thickness showed significant negative correlation with age. Conclusions: Our study provides the normative database for Indians on Spectralis OCT. It also suggests that age should be considered while interpreting the macular thickness and RNFL, whereas gender should also be given consideration in central foveal thickness.

  10. NATURAL COURSE OF PATIENTS DISCONTINUING TREATMENT FOR AGE-RELATED MACULAR DEGENERATION AND FACTORS ASSOCIATED WITH VISUAL PROGNOSIS.

    Science.gov (United States)

    Kim, Jae Hui; Chang, Young Suk; Kim, Jong Woo

    2017-12-01

    To evaluate the 24-month natural course of visual changes in patients discontinuing treatment despite persistent or recurrent fluid and factors predictive of visual prognosis. This retrospective, observational study included 35 patients (35 eyes) who initially received anti-vascular endothelial growth factor treatment for neovascular age-related macular degeneration (AMD), but discontinued treatment despite persistent or recurrent fluid. The best-corrected visual acuity (BCVA) at treatment discontinuation was determined and compared with the 24-month BCVA, which was then compared between polypoidal choroidal vasculopathy and other neovascular age-related macular degeneration subtypes. Baseline characteristics predictive of visual outcome and the degree of visual change were also analyzed. The mean number of anti-vascular endothelial growth factor injections before treatment discontinuation was 4.0 ± 1.6. The mean logarithm of minimal angle of resolution of BCVA at treatment discontinuation and that at 24 months were 1.02 ± 0.20 (Snellen equivalents = 20/209) and 1.60 ± 0.56 (20/796), respectively (P macular degeneration subtypes (P = 0.803). The type of fluid (intraretinal fluid vs. no intraretinal fluid) was predictive of 24-month BCVA (P = 0.004) and the degree of changes in BCVA (P = 0.043). Marked deterioration in visual acuity was noted in patients discontinuing treatment, regardless of neovascular age-related macular degeneration subtypes. The presence of intraretinal fluid was associated with worse visual prognosis, suggesting that patients with intraretinal fluid should be strongly warned about their poor prognosis before they decide to discontinue treatment.

  11. Rare and common variants in extracellular matrix gene Fibrillin 2 (FBN2) are associated with macular degeneration

    Science.gov (United States)

    Ratnapriya, Rinki; Zhan, Xiaowei; Fariss, Robert N.; Branham, Kari E.; Zipprer, David; Chakarova, Christina F.; Sergeev, Yuri V.; Campos, Maria M.; Othman, Mohammad; Friedman, James S.; Maminishkis, Arvydas; Waseem, Naushin H.; Brooks, Matthew; Rajasimha, Harsha K.; Edwards, Albert O.; Lotery, Andrew; Klein, Barbara E.; Truitt, Barbara J.; Li, Bingshan; Schaumberg, Debra A.; Morgan, Denise J.; Morrison, Margaux A.; Souied, Eric; Tsironi, Evangelia E.; Grassmann, Felix; Fishman, Gerald A.; Silvestri, Giuliana; Scholl, Hendrik P.N.; Kim, Ivana K.; Ramke, Jacqueline; Tuo, Jingsheng; Merriam, Joanna E.; Merriam, John C.; Park, Kyu Hyung; Olson, Lana M.; Farrer, Lindsay A.; Johnson, Matthew P.; Peachey, Neal S.; Lathrop, Mark; Baron, Robert V.; Igo, Robert P.; Klein, Ronald; Hagstrom, Stephanie A.; Kamatani, Yoichiro; Martin, Tammy M.; Jiang, Yingda; Conley, Yvette; Sahel, Jose-Alan; Zack, Donald J.; Chan, Chi-Chao; Pericak-Vance, Margaret A.; Jacobson, Samuel G.; Gorin, Michael B.; Klein, Michael L.; Allikmets, Rando; Iyengar, Sudha K.; Weber, Bernhard H.; Haines, Jonathan L.; Léveillard, Thierry; Deangelis, Margaret M.; Stambolian, Dwight; Weeks, Daniel E.; Bhattacharya, Shomi S.; Chew, Emily Y.; Heckenlively, John R.; Abecasis, Gonçalo R.; Swaroop, Anand

    2014-01-01

    Neurodegenerative diseases affecting the macula constitute a major cause of incurable vision loss and exhibit considerable clinical and genetic heterogeneity, from early-onset monogenic disease to multifactorial late-onset age-related macular degeneration (AMD). As part of our continued efforts to define genetic causes of macular degeneration, we performed whole exome sequencing in four individuals of a two-generation family with autosomal dominant maculopathy and identified a rare variant p.Glu1144Lys in Fibrillin 2 (FBN2), a glycoprotein of the elastin-rich extracellular matrix (ECM). Sanger sequencing validated the segregation of this variant in the complete pedigree, including two additional affected and one unaffected individual. Sequencing of 192 maculopathy patients revealed additional rare variants, predicted to disrupt FBN2 function. We then undertook additional studies to explore the relationship of FBN2 to macular disease. We show that FBN2 localizes to Bruch′s membrane and its expression appears to be reduced in aging and AMD eyes, prompting us to examine its relationship with AMD. We detect suggestive association of a common FBN2 non-synonymous variant, rs154001 (p.Val965Ile) with AMD in 10 337 cases and 11 174 controls (OR = 1.10; P-value = 3.79 × 10−5). Thus, it appears that rare and common variants in a single gene—FBN2—can contribute to Mendelian and complex forms of macular degeneration. Our studies provide genetic evidence for a key role of elastin microfibers and Bruch′s membrane in maintaining blood–retina homeostasis and establish the importance of studying orphan diseases for understanding more common clinical phenotypes. PMID:24899048

  12. Analysis of macular and nerve fiber layer thickness in multiple sclerosis patients according to severity level and optic neuritis episodes.

    Science.gov (United States)

    Soler García, A; Padilla Parrado, F; Figueroa-Ortiz, L C; González Gómez, A; García-Ben, A; García-Ben, E; García-Campos, J M

    2016-01-01

    Quantitative assessment of macular and nerve fibre layer thickness in multiple sclerosis patients with regard to expanded disability status scale (EDSS) and presence or absence of previous optic neuritis episodes. We recruited 62 patients with multiple sclerosis (53 relapsing-remitting and 9 secondary progressive) and 12 disease-free controls. All patients underwent an ophthalmological examination, including quantitative analysis of the nerve fibre layer and macular thickness using optical coherence tomography. Patients were classified according to EDSS as A (lower than 1.5), B (between 1.5 and 3.5), and C (above 3.5). Mean nerve fibre layer thickness in control, A, B, and C groups was 103.35±12.62, 99.04±14.35, 93.59±15.41, and 87.36±18.75μm respectively, with statistically significant differences (Pmultiple sclerosis patients is related to the EDSS level. Patients with previous optic neuritis episodes have a thinner retinal nerve fibre layer than patients with no history of these episodes. Mean macular thickness is not correlated to EDSS level. Copyright © 2014 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. MACULAR TELANGIECTASIA TYPE 2: Quantitative Analysis of a Novel Phenotype and Implications for the Pathobiology of the Disease.

    Science.gov (United States)

    Okada, Mali; Egan, Catherine A; Heeren, Tjebo F C; Tufail, Adnan; Fruttiger, Marcus; Maloca, Peter M

    2018-01-01

    To investigate retinal microcystoid spaces in macular telangiectasia type 2 with spectral domain optical coherence tomography. Retrospective review of 135 patients enrolled in the MacTel Natural History Observation and Registry Study at Moorfields Eye Hospital, United Kingdom. One hundred seventy-two eyes from 86 patients who had a comparable scan protocol of at least 30 μm interval were included for analysis. Retinal microcystoid spaces were identified and segmented and metrics analyzed. From 172 eyes of 86 patients, microcystoid spaces were found in 11 eyes (6.4%) from 8 patients (9.3%). The mean number of microcystoid spaces per eye was 12.9 ± 18.2. Most were located in the inner nuclear layer. The inferonasal quadrant of the macula was the least commonly affected region. Microcystoid spaces were distributed entirely within the assumed macular telangiectasia area on blue light reflectance in all but 2 eyes (4 of 142 microcysts). The median diameter of the microcystoid spaces was 31 μm (range 15 μm-80 μm). Microcystoid spaces as a phenotype of macular telangiectasia should be considered in the differentials for microcystic edema. Understanding the pathogenesis of these lesions may provide further insight into the role of Müller cell dysfunction in this disorder.

  14. Statistical black-hole thermodynamics

    International Nuclear Information System (INIS)

    Bekenstein, J.D.

    1975-01-01

    Traditional methods from statistical thermodynamics, with appropriate modifications, are used to study several problems in black-hole thermodynamics. Jaynes's maximum-uncertainty method for computing probabilities is used to show that the earlier-formulated generalized second law is respected in statistically averaged form in the process of spontaneous radiation by a Kerr black hole discovered by Hawking, and also in the case of a Schwarzschild hole immersed in a bath of black-body radiation, however cold. The generalized second law is used to motivate a maximum-entropy principle for determining the equilibrium probability distribution for a system containing a black hole. As an application we derive the distribution for the radiation in equilibrium with a Kerr hole (it is found to agree with what would be expected from Hawking's results) and the form of the associated distribution among Kerr black-hole solution states of definite mass. The same results are shown to follow from a statistical interpretation of the concept of black-hole entropy as the natural logarithm of the number of possible interior configurations that are compatible with the given exterior black-hole state. We also formulate a Jaynes-type maximum-uncertainty principle for black holes, and apply it to obtain the probability distribution among Kerr solution states for an isolated radiating Kerr hole

  15. Combination of Anti-VEGF and Laser Photocoagulation for Diabetic Macular Edema: A Review

    Directory of Open Access Journals (Sweden)

    Laura N. Distefano

    2017-01-01

    Full Text Available Diabetic macular edema (DME is the most common cause of vision loss in diabetic patients. Thirty years ago, the Early Treatment Diabetic Retinopathy Study (ETDRS demonstrated that focal/grid laser photocoagulation reduces moderate vision loss from DME by 50% or more; thus, macular photocoagulation became the gold standard treatment for DME. However, with the development of anti-VEGF drugs (bevacizumab, ranibizumab, and aflibercept, better outcomes were obtained in terms of visual acuity gain and decrease in macular thickness in some studies when antiangiogenic drugs were administered in monotherapy. Macular laser therapy may still play an important role as an adjuvant treatment because it is able to improve macular thickness outcomes and reduce the number of injections needed. Here, we review some of the clinical trials that have assessed the efficacy of macular laser treatment, either as part of the treatment protocol or as rescue therapy.

  16. [Neovascular form of age-related macular degeneration --current management in Poland and in Europe].

    Science.gov (United States)

    Teper, Sławomir; Nowińska, Anna; Lyssek-Boroń, Anita; Wylegała, Edward

    2014-07-01

    Currently in Poland neovascular form of age-related macular degeneration (AMD) is treated with vascular endothelial growth factor (VEGF) inhibitors--ranibizumab, aflibercept and bevacizumab. Photodynamic therapy is still refunded, although it is very rarely used. It can be estimated that only small minority (about 5-10%) of cases are properly treated due to mainly refunding restrictions in Poland. In countries with wider access to treatment 50% reduction in AMD-related blindness incidence was noted. Low-cost off-label anti-VEGF agent bevacizumab is almost inaccessible in Polish public health system because of law regulations. In order to increase availability of anti-VEGF injections vials of all mentioned drugs are divided which raises safety concerns. Despite new potent drug in the market aflibercept, cost of treatment remains very high. The optimal treatment regimen includes three monthly injections, after which is usually used pro re nata therapy based primarily on the outcome of macular optical coherence tomography. Routinely recommended antibiotic prophylaxis of injection-related endophthalmitis probably has no meaning apart from the generation of resistance.

  17. The preferred retinal locus in macular disease: toward a consensus definition.

    Science.gov (United States)

    Crossland, Michael D; Engel, Stephen A; Legge, Gordon E

    2011-11-01

    Eccentric viewing in macular disease has been described for half a century. However, a clear definition of eccentric viewing and preferred retinal locus (PRL) does not exist. Here, we determine how the PRL in macular disease is defined by researchers active in this field and, based on the responses received, propose a standardized definition of the preferred retinal locus. A literature review of articles describing the PRL or eccentric viewing was performed. The first and senior authors of all identified publications were contacted and were asked to define the preferred retinal locus. Themes of responses were identified using inductive qualitative research techniques. Frequently recurring themes related to the definition of the PRL included 1) it is a retinal area used for fixation, 2) it is task specific, 3) more than one PRL can be used, 4) it is a well-defined region of retina, and 5) the same PRL is used on repeated testing. Based on the responses received, a consensus definition of the PRL is proposed. It is suggested that researchers define the PRL carefully in experimental reports and an instrument that images the retina is used to define the location of the PRL.

  18. A STUDY TO COMPARE FUNDUS FLUORESCEIN ANGIOGRAPHY AND OPTICAL COHERENCE TOMOGRAPHY IN AGE RELATED MACULAR DEGENERATION

    Directory of Open Access Journals (Sweden)

    Rani Sujatha

    2016-02-01

    Full Text Available PURPOSE To compare the diagnostic accuracy of optical coherence tomography with Fundus Fluorescein Angiography in diagnosing Age related macular degeneration. METHODS A total 25 patients newly diagnosed as Age related macular degeneration were included in the study. The study was done during the time period between August 2013 to November 2015 this is a prospective randomized hospital based study. RESULTS Maximum no of patients affected belonged to the age group of 50-70 years and 60% were females. The most common symptom was defective vision accounting for 92%. Hypertension and hyperlipidemia were the most common risk factors. 12% of the cases had unilateral disease and 88% had bilateral disease. 6% of eyes were normal in both FFA and OCT. 62% of the eyes by FFA and 61% of the eyes by OCT had dry ARMD and 32 % of the eye by FFA and 33 % by OCT had wet ARMD. CONCLUSION Fundus Fluorescein Angiography is the gold standard tool for screening ARMD and OCT is more specific in detecting early subretinal neovascular membrane and also to assess the activity of the neovascular membranes. Hence OCT is superior to FFA in diagnosing early wet ARMD and thus helps in early management of patients with ARMD.

  19. Systemic Associations with Residual Subretinal Fluid after Ranibizumab in Diabetic Macular Edema

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    Meng-Ju Tsai

    2017-01-01

    Full Text Available Purpose. To investigate the impact of systemic diseases on the occurrence of subretinal fluid (SRF in diabetic macular edema (DME and prognostic factors for residual SRF following three consecutive monthly intravitreal ranibizumab. Methods. Ninety-seven eyes from 68 patients with DME who completed 3 consecutive monthly injections of ranibizumab were enrolled. Systemic parameters mainly included chronic kidney disease (CKD, hypertension, HbA1c, and insulin dependence. Renal parameters for CKD were serum creatinine, estimated glomerular filtration rate (eGFR, and serum albumin. Ocular factors were baseline central macular thickness (CMT, severity of diabetic retinopathy (DR, and status of panretinal photocoagulation (PRP. Results. Chronic kidney disease had significant correlation with baseline SRF (R=0.397, p<0.001 after partial correlation with adjustment for age and DR severity. As for CKD, lower serum albumin, but not eGFR or serum creatinine, was associated with baseline presence of SRF (p=0.026, p=0.08 and p=0.53, resp., after adjustment for age and DR severity. Overall, lower eGFR and lower HbA1c values, contrary to popular belief, predicted the presence of residual SRF following intravitreal injections (p=0.016 and p<0.001, resp.. Conclusions. Tight sugar control and poorer baseline kidney function may slow the resorption of SRF after anti-VEGF injections in patients with DME in the short term.

  20. Nicotine promotes blood retinal barrier damage in a model of human diabetic macular edema.

    Science.gov (United States)

    Maugeri, Grazia; D'Amico, Agata Grazia; Rasà, Daniela Maria; La Cognata, Valentina; Saccone, Salvatore; Federico, Concetta; Cavallaro, Sebastiano; D'Agata, Velia

    2017-10-01

    More than 1 billion world's population actively smokes tobacco containing the bioactive component nicotine (NT). The biological role of this molecule is mediated through the activation of nicotinic cholinergic receptors, widely distributed in various human tissues including retinal pigmented epithelium. The long-term assumption of NT contributes to several diseases development such as diabetic retinopathy. The major complication of this pathology is the diabetic macular edema (DME), characterized by macular area thinning and blood-retinal barrier (BRB) breakdown. Retinal hyperglycemic/hypoxic microenvironment represents one of the main factors favoring DME progression by eliciting the hypoxia-inducible factors (HIFs) expression. The latter induce new vessels formation by stimulating cellular secretion of vascular endothelial growth factor (VEGF). The etiology of DME is multifactorial, but little is known about the risk factors linked to cigarette smoking, in particular to nicotine's contribution. In the present study, we have investigated the NT role in a model, in vitro, of DME, by evaluating its effect on outer BRB permeability and HIFs/VEGF expression following exposure to hyperglycemic/hypoxic insult. Our results have demonstrated that this compound alters outer BRB integrity exposed to high glucose and low oxygen pressure microenvironment by upregulating HIF-1α/HIF-2α, VEGF expression and ERK1/2 phosphorylation. These data have suggested that NT may play a negative role in active smokers affected by DME. Copyright © 2017 Elsevier Ltd. All rights reserved.