Macular Hole Progression after Intravitreal Bevacizumab for Hemicentral Retinal Vein Occlusion

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Manish Nagpal

2011-01-01

Full Text Available Macular edema secondary to retinal vein occlusion is commonly being treated with off-label intravitreal bevacizumab with good outcomes. A significant reduction in macular edema and improvement in visual acuity is seen following such a treatment with no serious adverse effects. In the reported case, a full-thickness macular hole was noticed one month after intravitreal bevacizumab for macular edema secondary to hemicentral retinal vein occlusion. On a detailed review of the pre- and postoptical coherence tomography scans, it was realized that there was a preexisting stage 2-3 macular hole which was masked by the hemorrhages and edema at the fovea and the macular hole had progressed following the injection.

Multiple extrafoveal macular holes following internal limiting membrane peeling.

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Hussain, Nazimul; Mitra, Sandip

2018-01-01

Internal limiting membrane (ILM) peeling has been the standard of treatment for macular holes. Besides, causing retinal nerve fiber layer surface abnormality, postoperative extrafoveal multiple retinal holes is a rare phenomenon following ILM peeling. We report an unusual complication of eight extrafoveal macular holes occurring following ILM peeling. A 60-year-old male presented with complaints of decreased and distorted vision in the right eye. He was diagnosed as having epiretinal membrane with lamellar macular hole. He underwent 23G pars plana vitrectomy, brilliant blue assisted ILM peeling and fluid gas exchange. Intraoperatively, ILM was found to be adherent to the underlying neurosensory retina. One month after cataract surgery, he underwent YAG capsulotomy in the right eye. He complained of visual distortion. His fundus evaluation in the right eye showed multiple (eight) extrafoveal retinal holes temporal to the macula clustered together. This case demonstrated that peeling of ILM, especially when it is adherent to the underlying neurosensory retina, may cause unwanted mechanical trauma to the inner retina. Glial apoptosis and neuronal degeneration may presumably play a role in delayed appearance of multiple (eight) extrafoveal macular holes, which has not been reported earlier.

[Indications and surgical approach for lamellar macular holes and pseudoholes].

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Haritoglou, C; Schumann, R G

2017-12-01

This article presents a discussion on the indications for surgical interventions of lamellar macular holes and pseudoholes. What are the criteria for deciding on the surgical intervention for lamellar macular holes and pseudoholes? The article is based on a literature search in PubMed RESULTS: Lamellar macular holes and pseudoholes are subdivided into degenerative and tractive alterations. Both entities are associated with relatively specific morphological and functional criteria, which correlate with the expected functional and morphological results of the surgical intervention. Patients with pseudoholes therefore profit more from a surgical intervention because alterations to the outer retina are less pronounced in these cases. The indications for surgery of lamellar macular holes and pseudoholes are established by the type of lamellar defect and the morphological and functional alterations associated with this condition.

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...... with closed stage 2 or 3 macular holes were recruited from a randomised clinical trial comparing: (1) vitrectomy without ILM peeling; (2) vitrectomy with 0.05% isotonic ICG-assisted ILM peeling; and (3) vitrectomy with 0.15% trypan blue-assisted ILM peeling. Contrast-enhanced Stratus optical coherence...... between subgroups. Conclusions: Poor vision after 12 months despite macular hole closure was associated with attenuation and disruption of the foveolar photoreceptor matrix. The extent of attenuation and disruption was independent of peeling and staining....

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

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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.

Anatomical and Functional Results of Lamellar Macular Holes Surgery.

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Papadopoulou, D; Donati, G; Mangioris, G; Pournaras, C J

2016-04-01

To determine the long-term surgical findings and outcomes after vitrectomy for symptomatic lamellar macular holes. We studied 28 patients with lamellar macular holes and central visual loss or distortion. All interventions were standard 25 G vitrectomy with membranectomy of the internal limiting membrane (ILM), peeling and gas tamponade with SF6 20 %. Operations were performed by a single experienced surgeon within the last 3 years. Best corrected visual acuity and optical coherence tomography appearance were determined preoperatively and postoperatively. Following the surgical procedure, all macular holes were closed; however, in 3 eyes, significant foveal thinning was associated with changes in the retinal pigment epithelium changes. The mean best-corrected visual acuity improved postoperatively in the majority of the patients (n: 21, mean 0.3 logMAR), stabilised in 4 patients and decreased in 3 patients (mean 0.4 logMAR). Spectral Domain-Optical coherence tomography (SD-OCT) showed resolution of the lamellar lesion and improved macular contour in all cases. We demonstrated improvement in postoperative vision and the anatomical reconstruction of the anatomical contour of the fovea in most eyes with symptomatic lamellar holes. These findings indicate that vitrectomy, membranectomy and ILM peeling with gas tamponade is a beneficial treatment of symptomatic lamellar macular holes. Georg Thieme Verlag KG Stuttgart · New York.

Ocriplasmin for treatment of stage 2 macular holes: early clinical results.

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Miller, John B; Kim, Leo A; Wu, David M; Vavvas, Demetrios G; Eliott, Dean; Husain, Deeba

2014-01-01

To review clinical and structural outcomes of ocriplasmin for treatment of stage 2 macular holes. A retrospective review of the first patients with stage 2 macular holes to be treated with ocriplasmin at Massachusetts Eye and Ear Infirmary. All patients were imaged with spectral-domain optical coherence tomography (SD-OCT). Eight patients with stage 2 macular holes received a single injection of 125 μg of ocriplasmin. One patient (12.5%) demonstrated macular hole closure. The posterior hyaloid separated from the macula in six eyes (75%). All seven holes that remained open showed enlargement in hole diameters (narrowest, apical, and basal) at 1 week and 1 month. All seven were successfully closed with surgery. Ellipsoid zone disruptions were observed by OCT in four eyes (50%) and persisted throughout follow-up (more than 6 months on average). In early clinical results, the authors found a lower macular hole closure rate with ocriplasmin than previously reported. Enlargement was observed in all holes that failed to close with ocriplasmin. The authors found ellipsoid zone disruptions that persisted through 6 months of follow-up after ocriplasmin injection. Further work is needed to investigate the cause for these ellipsoid zone changes. Copyright 2014, SLACK Incorporated.

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.

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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.

Monitoring macular pigment changes in macular holes using fluorescence lifetime imaging ophthalmoscopy.

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Sauer, Lydia; Peters, Sven; Schmidt, Johanna; Schweitzer, Dietrich; Klemm, Matthias; Ramm, Lisa; Augsten, Regine; Hammer, Martin

2017-08-01

To investigate the impact of macular pigment (MP) on fundus autofluorescence (FAF) lifetimes in vivo by characterizing full-thickness idiopathic macular holes (MH) and macular pseudo-holes (MPH). A total of 37 patients with MH and 52 with MPH were included. Using the fluorescence lifetime imaging ophthalmoscope (FLIO), based on a Heidelberg Engineering Spectralis system, a 30° retinal field was investigated. FAF decays were detected in a short (498-560 nm; ch1) and long (560-720 nm; ch2) wavelength channel. τ m , the mean fluorescence lifetime, was calculated from a three-exponential approximation of the FAF decays. Macular coherence tomography scans were recorded, and macular pigment's optical density (MPOD) was measured (one-wavelength reflectometry). Two MH subgroups were analysed according to the presence or absence of an operculum above the MH. A total of 17 healthy fellow eyes were included. A longitudinal FAF decay examination was conducted in nine patients, which were followed up after surgery and showed a closed MH. In MH without opercula, significant τ m differences (p hole area (MHa) and surrounding areas (MHb) (ch1: MHa 238 ± 64 ps, MHb 181 ± 78 ps; ch2: MHa 275 ± 49 ps, MHb 223 ± 48 ps), as well as between MHa and healthy eyes or closed MH. Shorter τ m , adjacent to the hole, can be assigned to areas with equivalently higher MPOD. Opercula containing MP also show short τ m . In MPH, the intactness of the Hele fibre layer is associated with shortest τ m . Shortest τ m originates from MP-containing retinal layers, especially from the Henle fibre layer. Fluorescence lifetime imaging ophthalmoscope (FLIO) provides information on the MP distribution, the pathogenesis and topology of MH. Macular pigment (MP) fluorescence may provide a biomarker for monitoring pathological changes in retinal diseases. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Macular Buckling Surgery for Retinal Detachment Associated with Macular Hole in High Myopia Eye

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Kenan Sönmez

2017-12-01

Full Text Available A 68-year-old woman presented to our clinic with a 1-month history of central scotoma and visual loss in her right eye. The best corrected visual acuity (BCVA was hand motion in her right eye. Fundus examination showed myopic chorioretinal degeneration in association with posterior staphyloma and the retina was slightly elevated throughout the macula. Optical coherence tomography (OCT revealed retinal detachment involving the posterior pole with a macular hole and staphyloma. The patient underwent pars plana vitrectomy, internal limiting membrane peeling, macular buckling, and perfluoropropane gas tamponade. At 3-month follow-up, her BCVA was improved to counting fingers at 1 meter and flattened retina with closed macular hole was observed by OCT. Myopic macular hole with retinal detachment associated with posterior staphyloma represent a challenge regarding their management and several surgical techniques have been described. Although satisfactory anatomical improvement is achieved in these eyes after surgery, the visual acuity outcomes may be poorer than expected due to the chorioretinal atrophy at the posterior pole.

INDUCTION OF MACULAR DETACHMENT FOR THE TREATMENT OF PERSISTENT OR RECURRENT IDIOPATHIC MACULAR HOLES.

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Szigiato, Andrei-Alexandru; Gilani, Fatimah; Walsh, Mark K; Mandelcorn, Efrem D; Muni, Rajeev H

2016-09-01

To analyze the efficacy of induced macular detachment for the treatment of persistent or recurrent idiopathic macular holes after treatment with one or more standard pars plana vitrectomies (PPVs) with internal limiting membrane peeling. This study is a retrospective consecutive case series of 10 patients who underwent a PPV with subretinal balanced salt solution injection from 2011 to 2014 to treat persistent or recurrent idiopathic macular holes. All patients had previously undergone PPV with internal limiting membrane peeling. Visual acuity, ocular examination findings, and optical coherence tomographic images were reviewed preoperatively and postoperatively to assess the anatomical and visual outcomes of this procedure. Nine of the 10 patients who underwent the procedure had closure of their macular holes postoperatively (90%) and remained closed 6 months postoperatively. Most patients reported a subjective visual improvement. A mean objective visual improvement of 16 letters (Early Treatment Diabetic Retinopathy Study, 0.324 logMAR) was seen between preoperative and 6-month postoperative assessments of all patients (pre = 1.490, post = 1.166; P = 0.022). Subgroup analysis of patients with successful closure revealed 20 letters of improvement (0.398 logMAR) in visual acuity (pre = 1.491, post = 1.093; P = 0.004). There were no intraoperative or postoperative complications. In eyes with persistent or recurrent idiopathic macular holes after standard PPV with internal limiting membrane peeling, repeat PPV with subretinal balanced salt solution injection to create a macular detachment may be a viable surgical treatment option. Our results show improved anatomical and visual outcomes postoperatively that compare favorably to other case series describing various surgical treatments for these challenging cases.

Prognostic significance of delayed structural recovery after macular hole surgery

DEFF Research Database (Denmark)

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

2009-01-01

was used; however, secondary macular hole surgery had a significant influence on diameter of photoreceptor layer discontinuity at 3 months. CONCLUSIONS: Structural recovery in the form of photoreceptor layer discontinuity with a diameter of more than approximately 1500 microm 3 months after macular hole...

Does Internal Limiting Membrane Peeling in Macular Hole Surgery Improve Reading Vision?

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Das Taraprasad

2003-01-01

Full Text Available Purpose: To document the effect of internal limiting membrane (ILM peeling in macular hole closure and reading vision. Method: Fifty-four patients with idiopathic and traumatic macular hole underwent standard vitreous surgery and received either ILM peeling (n= 25 or no ILM peeling (n= 29. The hole closure, and Snellen acuity (distant and near were recorded 12 weeks after surgery and statistically analysed. Results: The macular hole closure rate was 96% (24 of 25 and 72.4% (21 of 29 with and without ILM peeling respectively (P = 0.028. Distant vision improvement of two or more lines was recorded in 64% (16 of 25 and 51.7% (15 of 29 eyes (P = 0.417 with and without ILM peeling respectively. Near vision improvement of two or more lines was seen in 68% (17 of 25 and 41.2% (12 of 29 eyes (P = 0.048 with and without ILM peeling respectively. Conclusion: ILM peeling in macular hole surgery improves the macular hole closure rate and reading vision.

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

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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

The Intravitreal Autologous Platelet Concentrate Injection as an Adjunct of Vitrectomy for the Treatment of Refractory Macular Holes

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2014-03-06

Macular Hole With High Myopia (Spherical Equivalent ≤ -6.0 Diopters) or,; Large Size Macular Hole (Diameter > 600 Microns) or; Recurred or Failed Macular Hole From Previous Surgery; or Chronic Macular Hole (Symptom Duration > 6 Months)

Vitrectomy with internal limiting membrane peeling for macular hole in high myopia eyes

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Chun-Mei Deng

2015-08-01

Full Text Available AIM: To compare the clinical effects between pars plana vitrectomy(PPVand PPV with internal limiting membrane peeling(ILMPfor macular hole in high myopia eyes. METHODS:The clinical data of 33 high myopia with macular hole patients(36 eyeswith or without retinal detachment caused by macular hole were retrospectively analyzed. The patients were divided into two groups according to different operation methods: 15 eyes in groupⅠhad undergone PPV; 21 eyes in groupⅡhad undergone PPV with ILMPP peeling. According to different conditions of patients,different auxiliary methods were accepted, such as silicone oil tamponade, C3F8 tamponade, photocoagulation, condensation, etc. The follow-up period was 3～12mo. Best corrected visual acuity(BCVA, macular hole closure rate and retinal reattachment rate were continuous checked after operation. Then we evaluated the outcome in the two groups by statistical analysis.RESULTS: The postoperative mean BCVA increased by 0.167 in group Ⅰand 0.456 in group Ⅱ than preoperative, the difference was significant(t=2.46,6.753; P=0.027,0.000. And the difference of BCVA improvement was significant between those two groups(t=-2.943, P=0.006. The macular hole closed in 7 eyes(46.67%in group Ⅰ,and 18 eyes(85.71%in group Ⅱ; The difference was significant between those two groups(χ2=6.287,P=0.025.Retinal reattachment was found in 11 eyes(91.67%in group Ⅰ and 19 eyes(94.73%in group Ⅱ. The difference was not significant between the two groups(χ2=0.856, P=0.418. CONCLUSION: PPV with ILMPP peeling for macular hole in high myopia eyes can obviously improve closure of macular hole and postoperative visual acuity. But the difference of retinal reattachment rate was not significant between peeling and unpeeling of ILMP.

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

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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.

Long-term Follow-up and Outcomes in Traumatic Macular Holes.

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Miller, John B; Yonekawa, Yoshihiro; Eliott, Dean; Kim, Ivana K; Kim, Leo A; Loewenstein, John I; Sobrin, Lucia; Young, Lucy H; Mukai, Shizuo; Vavvas, Demetrios G

2015-12-01

To review presenting characteristics, clinical course, and long-term visual and anatomic outcomes of patients with traumatic macular holes at a tertiary referral center. Retrospective case series. Twenty-eight consecutive patients with traumatic macular holes at a single tertiary referral center were reviewed. In addition to visual acuities and treatments throughout the clinical course, specific dimensions of the macular hole, including diameters, height, configuration, shape, and the presence of a cuff of fluid, were examined using spectral-domain optical coherence tomography (OCT). Twenty-eight patients were identified with a mean initial visual acuity (VA) of logMAR 1.3 (20/400) and a mean follow-up of 2.2 years. Eleven holes (39.3%) closed spontaneously in median 5.7 weeks. Eleven underwent vitrectomy with a median time to intervention of 35.1 weeks. Median time to surgery for the 5 eyes with successful hole closure was 11.0 weeks vs 56.3 weeks for the 6 eyes that failed to close (P = .02). VA improved in closed holes (P holes that did not close (P = .22). There was no relation between initial OCT dimensions and final hole closure status, although there was a trend, which did not reach statistical significance, toward small dimensions for those that closed spontaneously. A fairly high spontaneous closure rate was observed, with a trend toward smaller OCT dimensions. We found no relationship between hole closure and the OCT characteristics of the hole. Surgical intervention was less successful at hole closure when elected after 3 months. Copyright © 2015 Elsevier Inc. All rights reserved.

IMPACT OF INTERNAL LIMITING MEMBRANE PEELING ON MACULAR HOLE REOPENING: A Systematic Review and Meta-Analysis.

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Rahimy, Ehsan; McCannel, Colin A

2016-04-01

To assess the literature regarding macular hole reopening rates stratified by whether the internal limiting membrane (ILM) was peeled during vitrectomy surgery. Systematic review and meta-analysis of studies reporting on macular hole reopenings among previously surgically closed idiopathic macular holes. A comprehensive literature search using the National Library of Medicine PubMed interface was used to identify potentially eligible publications in English. The minimum mean follow-up period for reports to be included in this study was 12 months. Analysis was divided into eyes that underwent vitrectomy with and without ILM peeling. The primary outcome parameter was the proportion of macular hole reopenings among previously closed holes between the two groups. Secondary outcome parameters included duration from initial surgery to hole reopening and preoperative and postoperative best-corrected correct visual acuities among the non-ILM peeling and ILM peeling groups. A total of 50 publications reporting on 5,480 eyes met inclusion criteria and were assessed in this meta-analysis. The reopening rate without ILM peeling was 7.12% (125 of 1,756 eyes), compared with 1.18% (44 of 3,724 eyes) with ILM peeling (odds ratio: 0.16; 95% confidence interval: 0.11-0.22; Fisher's exact test: P peeling during macular hole surgery reduces the likelihood of macular hole reopening.

RECURRENT MACULAR HOLES IN THE ERA OF SMALL-GAUGE VITRECTOMY: A Review of Incidence, Risk Factors, and Outcomes.

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Abbey, Ashkan M; Van Laere, Lily; Shah, Ankoor R; Hassan, Tarek S

2017-05-01

To evaluate the preoperative features, intraoperative management, and postoperative outcomes of recurrent macular holes that developed after initial successful repair with small-gauge vitrectomy techniques. We retrospectively reviewed 392 eyes with idiopathic macular holes successfully treated with small-gauge vitrectomy. Thirteen of these eyes underwent reoperation after macular hole reopening. We assessed patient demographics, visual acuity, postoperative anatomical success, potential precipitating clinical factors of hole reopening, and details of the surgical repairs of these eyes. Macular hole reopening occurred in 13 (3.3%) of 392 eyes in a mean of 28 months (range, 1-120 months) after initial repair. All 13 recurrent holes closed after a second vitrectomy, but 4 (31%) holes reopened again and had vitrectomy. Of these, 2 reopened a third time. Ultimately, 11 (85%) holes were closed at the most recent follow-up. The mean best-corrected visual acuity was 20/81 before initial repair, 20/148 after the first reopening, 20/115 after repair of the first reopening, and 20/55 after repair of >1 reopening. Ten of 13 (77%) patients had, or later developed, macular holes in the other eye during follow-up. Reoperation successfully achieved hole closure and ultimate visual improvement in most eyes with recurrent macular holes. Most patients with recurrent holes previously had, or later developed, full-thickness macular holes in the other eye.

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

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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.

[Long-term outcome of vitrectomy combined with internal limiting membrane peeling for idiopathic macular holes].

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Yamamoto, Kaori; Hori, Sadao

2011-01-01

To elucidate the long-term outcome of internal limiting membrane (ILM) peeling on visual function during vitrectomy for idiopathic macular holes using scanning laser ophthalmoscope (SLO) microperimetry. Prospective uncontrolled study. We studied 31 eyes (29 patients) with idiopathic macular holes. All patients underwent vitrectomy with ILM peeling. The SLO microperimetry was performed preoperatively, and once a year for 3 years postoperatively to detect scotomas in and around the macular holes, and both within and in close vicinity to the areas of ILM peeling. Closure of macular holes after one surgery was confirmed in all cases except for 2 with second surgery. The visual acuity by logarithmic minimum angle of resolution (logMAR) averaged 0.71 +/- 0.36 before surgery, 0.23 +/- 0.31 one year, 0.14 +/- 0.27 two years and 0.12 +/- 0.26 three years after surgery. There was significant improvement up to 2 years after the surgery. All scotomas detected before surgery in the holes, and 77.4% of those detected around the holes decreased gradually. No scotomas were detected in or around the area of ILM peeling either before or after surgery. ILM peeling in vitrectomy for idiopathic macular holes successfully improved visual acuity and did not influence retinal sensitivity in and around the area of ILM peeling. The scotomas detected in and around the holes before surgery gradually reduced or disappeared.

Short-Acting Gas Tamponade with Strict Face-Down Posturing for the Treatment of Idiopathic Macular Hole.

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Gotzaridis, Stratos; Liazos, Efstathios; Petrou, Petros; Georgalas, Ilias

2017-01-01

A retrospective consecutive case series to evaluate the safety and efficacy of 25 gauge pars plana vitrectomy, ILM peeling, 20% SF 6 gas tamponade and strict posturing for the treatment of idiopathic full-thickness macular holes. We report the results of 106 consecutive eyes that underwent standard 25-gauge pars plana vitrectomy, brilliant peel-assisted internal limiting membrane peel, fluid:gas exchange with 20% SF 6 and strict posturing for one week. All patients were followed up at one week, one month, three months, and nine months postoperatively. Biomicroscopy at day 1 and biomicroscopy and OCT at week 1, months 1, 3, and 9 were used to assess macular hole status postoperatively. Pre- and postoperative logMAR visual acuity was compared. The macular hole was closed in 102/106 eyes postoperatively (96.2%). Four eyes showed unclosed macular holes and underwent additional SF 6 intravitreal injection and strict posturing for 10 days. All macular holes were eventually closed without the need of a second surgical procedure. Mean visual acuity improved from 0.63 logMAR preoperatively to 0.39 logMAR postoperatively. One case of retinal toxicity was reported due to accidental intravitreal injection of antibiotic. 25-gauge vitrectomy, ILM peel, and short-acting gas tamponade are highly effective for the treatment of macular holes. Additional intravitreal gas injection followed by strict posturing seems to be a simple and effective treatment for unclosed holes.

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

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

conducted a randomized clinical trial including 78 pseudophakic patients with idiopathic macular hole stages 2 and 3. Patients were randomly assigned to macular hole surgery consisting of (i) vitrectomy alone without instrumental retinal surface contact (non-peeling), (ii) vitrectomy plus 0.05% isotonic ICG...... rate than surgery without ILM peeling (95% versus 45%). The overall functional results confirm that surgery for macular hole generally leads to favourable visual results, with two-thirds of eyes regaining reading vision (>or=20/40). Macular hole surgery can be considered a safe procedure with a low...... incidence of sight-threatening adverse events; the retinal detachment rate was 2.2%. Visual outcomes in eyes with primary hole closure were not significantly different between the intervention groups; however, for the stage 2 subgroup with primary macular hole closure, there was a trend towards a better...

Macular hole surgery with short-acting gas and short-duration face-down positioning

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Xirou T

2012-07-01

Full Text Available Tina Xirou,1 Panagiotis G Theodossiadis,2 Michael Apostolopoulos,3 A Stamatina Kabanarou,1 Elias Feretis,1 Ioannis D Ladas,3 Chrysanthi Koutsandrea31Vitreoretinal Unit, Red Cross Hospital, 2B Department of Ophthalmology, University of Athens, Greece; 3A Department of Ophthalmology, University of Athens, GreecePurpose: To report on the outcomes of vitrectomy and sulfur hexafluoride (SF6 gas tamponade for idiopathic macular holes with 2 days of face-down positioning.Patients and methods: This was a prospective, nonrandomized, observational sequential case-series study on 23 consecutive patients receiving macular hole surgery using 20% SF6 and advised to stay in a face-down position for 2 days postoperatively (SF6 group. These patients were compared to 23 consecutive patients who had previously undergone macular hole surgery, had received 14% C3F8, and were advised to maintain a face-down position for 2 days (C3F8 group. Patients in both groups underwent vitrectomy, internal limiting membrane peeling, and fluid gas exchange using either SF6 or C3F8. Preoperative and postoperative data included best corrected visual acuity recorded in LogMAR units, slit-lamp biomicroscopy, and optical coherence tomography.Results: At a 6-month follow-up, macular hole closure was noted in 23/23 eyes (100% and in 22/23 eyes (96% in the SF6 and C3F8 groups, respectively. The improvement in visual acuity (measured through Snellen acuity lines both preoperatively until 6 months postoperatively was 4.08 ± 2.31 (95% confidence interval [CI]: 3.08–5.08 for the SF6 group and 2.87 ± 2.30 (95% CI: 1.87–3.86 for the C3F8 group; this difference was not statistically significant (P = 0.06.Conclusion: Vitrectomy with internal limiting membrane peeling and a short-acting gas tamponade using SF6 with posture limitation for 2 days may give a high success rate in macular hole surgery.Keywords: idiopathic macular holes, SF6 gas tamponade, C3F8 gas tamponade

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

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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.

Photoreceptor Outer Segment on Internal Limiting Membrane after Macular Hole Surgery: Implications for Pathogenesis.

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Grinton, Michael E; Sandinha, Maria T; Steel, David H W

2015-01-01

This report presents a case, which highlights key principles in the pathophysiology of macular holes. It has been hypothesized that anteroposterior (AP) and tangential vitreous traction on the fovea are the primary underlying factors causing macular holes [Nischal and Pearson; in Kanski and Bowling: Clinical Ophthalmology: A Systemic Approach, 2011, pp 629-631]. Spectral domain optical coherence tomography (OCT) has subsequently corroborated this theory in part but shown that AP vitreofoveal traction is the more common scenario [Steel and Lotery: Eye 2013;27:1-21]. This study was conducted as a single case report. A 63-year old female presented to her optician with blurred and distorted vision in her left eye. OCT showed a macular hole with a minimum linear diameter of 370 µm, with persistent broad vitreofoveal attachment on both sides of the hole edges. The patient underwent combined left phacoemulsification and pars plana vitrectomy, internal limiting membrane (ILM) peel and gas injection. The ILM was examined by electron microscopy and showed the presence of a cone outer segment on the retinal side. Post-operative OCT at 11 weeks showed a closed hole with recovery of the foveal contour and good vision. Our case shows the presence of a photoreceptor outer segment on the retinal side of the ILM and reinforces the importance of tangential traction in the development of some macula holes. The case highlights the theory of transmission of inner retinal forces to the photoreceptors via Müller cells and how a full thickness macular hole defect can occur in the absence of AP vitreomacular traction.

Comparisons of retinal nerve fiber layer thickness changes after macular hole surgery

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Nelson Chamma Capelanes

Full Text Available ABSTRACT Purpose: To compare postoperative changes in retinal nerve fiber layer thickness in patients with macular holes treated with vitrectomy with Brilliant Blue-assisted internal limiting membrane peeling. Methods: Twenty-two eyes of 20 patients with macular holes were studied. Each eye was selected to undergo Brilliant Blue-assisted internal limiting membrane peeling. The circumferential retinal nerve fiber layer thickness was determined using spectral domain optical coherence tomography preoperatively and 2 months postoperatively. Mean overall and sectoral retinal nerve fiber layer thicknesses were obtained for each patient. Results: There was no statistically significant difference (p≥0.05 between the pre- and post-treatment measurements in relation to each CFN variable, i.e., on average, pre-treatment measures were the same as post-treatment measures. Furthermore, despite the differences between the pre- and post-treatment measures always being positive (pre-post >0, they are not statistically significant. Conclusions: This study showed no significant decrease in retinal nerve fiber layer thickness measurements after macular holes surgery, regardless of age or sex.

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.

PIMS (Positioning In Macular hole Surgery) trial - a multicentre interventional comparative randomised controlled clinical trial comparing face-down positioning, with an inactive face-forward position on the outcome of surgery for large macular holes: study protocol for a randomised controlled trial.

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Pasu, Saruban; Bunce, Catey; Hooper, Richard; Thomson, Ann; Bainbridge, James

2015-11-17

Idiopathic macular holes are an important cause of blindness. They have an annual incidence of 8 per 100,000 individuals, and prevalence of 0.2 to 3.3 per 1000 individuals with visual impairment. The condition occurs more frequently in adults aged 75 years or older. Macular holes can be repaired by surgery in which the causative tractional forces in the eye are released and a temporary bubble of gas is injected. To promote successful hole closure individuals may be advised to maintain a face-down position for up to 10 days following surgery. The aim of this study is to determine whether advice to position face-down improves the surgical success rate of closure of large (>400 μm) macular holes, and thereby reduces the need for further surgery. This will be a multicentre interventional, comparative randomised controlled clinical trial comparing face-down positioning with face-forward positioning. At the conclusion of standardised surgery across all sites, participants still eligible for inclusion will be allocated randomly 1:1 to 1 of the 2 treatment arms stratified by site, using random permuted blocks of size 4 or 6 in equal proportions. We will recruit 192 participants having surgery for large macular holes (>400 μm); 96 in each of the 2 arms of the study. The primary objective is to determine the impact of face-down positioning on the likelihood of closure of large (≥400 μm) full-thickness macular holes following surgery. This will be the first multicentre randomised control trial to investigate the value of face-down positioning following macular hole standardised surgery. UK CRN: 17966 (date of registration 26 November 2014).

Morphision: A method for subjective evaluation of metamorphopsia in patients with unilateral macular pathology (i.e., full thickness macular hole and epiretinal membrane

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Marta Ugarte

2013-01-01

Full Text Available Background: Lack of clinical tests to quantify spatial components of distortion in patients with full thickness macular holes (FTMH and epiretinal membranes (ERM. Aim: To develop a test for subjective evaluation of visual distortion in the central visual field around fixation in patients with unilateral FTMH or ERM. Settings and Design: Prospective case-control study carried out at tertiary referral center. Materials and Methods: Twenty-five patients with unilateral macular disease (13 macular epiretinal membranes, 12 full-thickness macular holes, and nine controls (without ocular pathology underwent ophthalmological examination with logMAR ETDRS visual acuity, near vision and contrast sensitivity assessed. Macular optical coherence tomography and metamorphopsia assessment using Morphision test was also carried out. This test consists of a set of modified Amsler charts for detection, identification, and subjective quantification of visual distortion in the central visual field around fixation. Morphision test content and construct validity, and reliability (test-retest method were evaluated. Sixteen patients completed an unstructured survey on test performance and preference. Results: Every patient with unilateral FTMH or ERM identified a particular chart using Morphision test (content validity. None of the normal subjects without symptoms of metamorphopsia identified any distortion (construct validity. Test-retest showed a 100% consistency for frequency and 67% for amplitude. The mean amplitude difference between measurements was 0.02 degrees (SD = 0.038. The coefficient of repeatability was 0.075. There was a correlation between Morphision amplitude score and visual acuity and contrast sensitivity, individually. Conclusions: Morphision test allowed detection and subjective quantification of metamorphopsia in the clinical setting in our patients with unilateral macular epiretinal membranes and full thickness macular holes.

Optimal management of idiopathic macular holes.

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Madi, Haifa A; Masri, Ibrahim; Steel, David H

2016-01-01

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 (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 intravitreal OCP and its potential complications. Expansile gas can be considered as a further option in small holes with VMA; however, larger studies are required to provide guidance on its use.

Association between fundus autofluorescence and visual outcome in surgically closed macular holes.

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Lee, Young Seob; Yu, Seung-Young; Cho, Nam Suk; Kim, Moo Sang; Kim, Young Gyun; Kim, Eung Suk; Kwak, Hyung Woo

2013-06-01

To investigate the association between fundus autofluorescence (FAF) and visual acuity, recovery of foveal microstructure, and FAF in surgically closed macular holes. Twenty-six eyes with surgically closed macular hole were classified into two groups based on foveal FAF: normal autofluorescence (NAF) or increased autofluorescence (IAF). The association between foveal FAF and visual acuity was analyzed. In addition, we examined the relationship between recovery of the foveal microstructure assessed by spectral domain optical coherence tomography and FAF after macular hole surgery. At 1 month and 6 months after surgery, there were 9 NAF eyes and 17 IAF eyes. There were no differences between NAF and IAF eyes at 1 month and 6 months after surgery. Preoperative best-corrected visual acuity (logarithm of the minimum angle of resolution) did not differ between groups. Best-corrected visual acuity was significantly higher in the NAF group than in the IAF group at 1 month postoperatively (0.59 ± 0.34 vs. 0.91 ± 0.36, P = 0.044) and tended to be higher at 6 months (0.37 ± 0.38 vs. 0.69 ± 0.53, P = 0.126). Restoration of photoreceptor external limiting membrane differed significantly in 8 NAF eyes (89%) and 4 IAF eyes (24%) at postoperation 1 month (P = 0.001). After 6 months, external limiting membrane was restored in all 9 NAF eyes (100%) and in only 11 IAF eyes (65%) (P = 0.042). Fundus autofluorescence findings observed in surgically closed macular holes correlated with visual improvement and photoreceptor status. Eyes with visual improvement had restoration of normal foveal autofluorescence and retinal microstructure, whereas eyes with persistent foveal hyperautofluorescence did not achieve complete restoration of the retinal microstructure, and visual improvement was not as significant.

Krypton yellow laser for the treatment of macular hole in high myopia without retinal detachment.

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Cai, Ji-Ping; Cheng, Jin-Wei; Ma, Xiao-Ye; Li, Yu-Zhen; Li, You; Wei, Rui-Li

2008-12-01

To evaluate the prophylactic effect of krypton yellow laser for the treatment of macular holes in high myopic eyes in order to reduce the risk of retinal detachment. Twenty-seven eyes of 27 patients with high myopia and macular holes were randomly assigned to two groups. Fifteen patients (group A, 15 eyes) were subject to laser photocoagulation around the hole margin along with an oral placebo (vitamin B1), while 12 patients (group B, 12 eyes) were only given the oral placebo (vitamin B1). The incident rate of retinal detachment due to macular hole and the mean best-corrected visual acuity of the two groups before and after treatment were measured. The data were statistically tested by X2 test and Student's t test. The incident rates of retina1 detachment in group A and group B were 20%(3/15) and 58.3%(7/12), respectively (X2=4.201, P0.05). The mean BCVA of group B on the initial examination was 24/200, while the mean BCVA at the final follow-up was 30/200 (P>0.05). No significant difference in initial visual acuity (P>0.05) or final visual acuity (P>0.05) was found between the two groups. Krypton yellow laser photocoagulation could reduce the incidence of retinal detachment due to a macular hole in high myopia with acceptable functional results in this study.

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

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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

Progressive atrophy of retinal pigment epithelium after trypan-blue-assisted ILM peeling for macular hole surgery

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Sachin Jain

2013-01-01

Full Text Available We report a case of progressive atrophy of the retinal pigment epithelium (RPE after trypan-blue-assisted peeling of internal limiting membrane (ILM for macular hole surgery. A 68-year-old Caucasian female underwent a 20-g pars plana vitrectomy for a chronic stage-3 macular hole. The ILM was stained with 0.06% trypan blue (VisionBlue™, DORC Netherlands for 2 min after fluid air exchange. Dye was reapplied for another 2 min due to poor staining. The ILM was completely removed around the macular hole with forceps. RPE atrophy was noticed at the edge of the hole 1 month after surgery. It progressively increased in intensity and enlarged over 2 years. Her final visual acuity was counting fingers, significantly worse compared to her presenting visual acuity of 20/200. Progressive atrophy of RPE in our patient was most likely due to the toxicity of trypan blue. Reapplication of the dye may increase the likelihood of toxicity.

Surgical treatment and optical coherence tomographic evaluation for accidental laser-induced full-thickness macular holes.

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Qi, Y; Wang, Y; You, Q; Tsai, F; Liu, W

2017-07-01

PurposeTo report OCT appearance and surgical outcomes of full-thickness macular holes (MHs) accidentally caused by laser devices.Patients and methodsThis retrospective case series included 11 eyes of 11 patients with laser-induced MHs treated by pars plana vitrectomy, internal limiting membrane (ILM) peeling, and gas or silicone oil tamponade. Evaluations included a full ophthalmic examination, macular spectral-domain optical coherence tomography (SD-OCT), and fundus photography. Main outcome measures is MH closure and final visual acuity; the secondary outcome was the changes of retinal pigment epithelium and photoreceptor layer evaluated by sequential post-operative SD-OCT images.ResultsFive patients were accidentally injured by a yttrium aluminum garnet (YAG) laser and six patients by handheld laser. MH diameters ranged from 272 to 815 μm (mean, 505.5±163.0 μm) preoperatively. Best-corrected visual acuity (BCVA) improved from a mean of 0.90 logMAR (range, counting finger-8/20) preoperatively to a mean of 0.34 logMAR (range, a counting finger-20/20) postoperatively (P=0.001, t=4.521). Seven of 11 patients (63.6%) achieved a BCVA better than 10/20. Ten patients had a subfoveal hyperreflectivity and four patients had a focal choroidal depression subfoveal preoperatively. At the last follow-up, all 11 eyes demonstrated the following: closure of the macular hole, variable degrees of disruption of external limiting membrane (ELM) and outer photoreceptor ellipsoid and interdigitation bands. In 10 eyes, the disruption was in the form of focal defects in the outer retina. After surgery, the subfoveal hyperreflectivity and focal choroidal depression remained.ConclusionAccidental laser-induced full-thickness macular holes can be successfully closed with surgery. Inadvertent retinal injury from laser devices, especially handheld laser injury has occurred with increasing frequency in recent years. However, there is a paucity of data regarding these types of injuries

SURGICAL OUTCOMES AFTER INVERTED INTERNAL LIMITING MEMBRANE FLAP VERSUS CONVENTIONAL PEELING FOR VERY LARGE MACULAR HOLES.

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Narayanan, Raja; Singh, Sumit R; Taylor, Stanford; Berrocal, Maria H; Chhablani, Jay; Tyagi, Mudit; Ohno-Matsui, Kyoko; Pappuru, Rajeev R; Apte, Rajendra S

2018-04-23

To evaluate the anatomical and visual outcomes of inverted flap technique of peeling of internal limiting membrane (ILM) versus standard peeling of ILM for macular holes of basal diameter more than 800 μm. Patients with very large idiopathic macular holes more than 800 μm in basal diameter (ranging from 243 μm to 840 μm in minimum diameter) were retrospectively included in the study. In Group A, 18 eyes of 18 patients underwent ILM peeling using the inverted flap technique. In Group B, 18 eyes of 18 patients underwent conventional ILM peeling. The primary endpoint was the rate of hole closure at 6 months after surgery. The secondary outcome measure was the change in best-corrected visual acuity at 6 months after surgery. There were no significant differences in ocular characteristics of the study groups at baseline except for the age distribution. Mean macular hole diameter was 1,162.8 ± 206.0 μm and 1,229.6 ± 228.1 μm in Group A and Group B, respectively. The hole closure rate was 88.9% (16/18) in Group A and 77.8% (14/18) in Group B (P = 0.66). The mean gain in best-corrected visual acuity was higher in Group A than in Group B (P = 0.12) at 6 months, but this was not statistically significant. There were no severe ocular adverse events in either group. In this multicenter series, inverted ILM flap technique did not lead to significantly higher anatomical closure rates than conventional ILM peeling in large macular holes more than 800 μm in diameter.

Nonarteritic anterior ischemic optic neuropathy following pars plana vitrectomy for macular hole treatment: case report.

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Cunha, Leonardo Provetti; Cunha, Luciana Virgínia Ferreira Costa; Costa, Carolina Ferreira; Monteiro, Mário Luiz Ribeiro

2016-01-01

Herein, we report a case of nonarteritic anterior ischemic optic neuropathy (NAION) following uneventful pars plana vitrectomy for macular hole treatment. A 56-year-old previously healthy woman presented with a full-thickness macular hole in right eye (OD) and small cup-to-disc ratios in both eyes. Five days after surgery, she noticed sudden painless loss of vision in OD and was found to have an afferent pupillary defect and intraocular pressure of 29 mmHg. Fundus examination showed right optic disc edema and the resolution of a macular hole with an inferior altitudinal visual field defect. Erythrocyte sedimentation rate, C-reactive protein levels, and general physical examination findings were normal. She was treated with hypotensive eyedrops and oral prednisone, resulting in mild visual improvement and a pale optic disc. A combination of face-down position and increased intraocular pressure due to a small optic disc cup were considered as potential mechanisms underlying NAION in the present case. Vitreoretinal surgeons should be aware of NAION as a potentially serious complication and be able to recognize associated risk factors and clinical findings.

Macular hole-associated retinal detachment in Best vitelliform dystrophy: Series of two cases and literature review

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Tewari, Ruchir; Kumar, Vinod; Ravani, Raghav; Dubey, Devashish; Chandra, Parijat; Kumar, Atul

2018-01-01

Two eyes of 2 patients with macular hole-associated retinal detachment in clinically diagnosed vitelliruptive stage of Best vitelliform dystrophy were surgically managed by 25-gauge sutureless pars plana vitrectomy, internal limiting membrane (ILM) peeling with inverted ILM flap, and short-acting (SF6) gas tamponade. The patients were assessed with respect to best-corrected visual acuity, color fundus photographs, shortwave fundus autofluorescence, and swept source optical coherence tomography. Surgical intervention led to Type 1 closure of macular hole, resolution of retinal detachment, and improvement in vision in both patients. PMID:29676326

Macular hole-associated retinal detachment in Best vitelliform dystrophy: Series of two cases and literature review

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Ruchir Tewari

2018-01-01

Full Text Available Two eyes of 2 patients with macular hole-associated retinal detachment in clinically diagnosed vitelliruptive stage of Best vitelliform dystrophy were surgically managed by 25-gauge sutureless pars plana vitrectomy, internal limiting membrane (ILM peeling with inverted ILM flap, and short-acting (SF6 gas tamponade. The patients were assessed with respect to best-corrected visual acuity, color fundus photographs, shortwave fundus autofluorescence, and swept source optical coherence tomography. Surgical intervention led to Type 1 closure of macular hole, resolution of retinal detachment, and improvement in vision in both patients.

Vitrectomy with internal limiting membrane peeling vs no peeling for Macular Hole-induced Retinal Detachment (MHRD): a meta-analysis.

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Su, Jing; Liu, Xinquan; Zheng, Lijun; Cui, Hongping

2015-06-20

we conducted our meta-analysis of published studies to assess existing evidence about the efficacy and safety of vitrectomy with ILM peeling vs. that of vitrectomy with no ILM peeling for Macular hole-induced retinal detachment. Databases, including Pubmed, Cochrane Library, Ovid, Web of Science, Wanfang and CNKI, were searched to identify studies comparing outcomes following vitrectomy with ILM peeling and that with no ILM peeling for macular hole-induced retinal detachment. The meta-analysis was performed by RevMan 5.1. Six comparative studies comprising 180 eyes were identified. It was indicated that the rate of retinal reattachment (Odds ratio (OR) = 3.03, 95 % Confidence interval (CI):1.35 to 6.78; P = 0.007) and macular hole closure (OR = 6.74, 95 % CI:3.26 to 13.93; P peeling than that in the group of vitrectomy with no ILM peeling. However, the improved BCVA (Weighted mean difference (WMD) = 0.14, 95 % CI: -0.20 to 0.47; P = 0.42) and the rate of postoperative complications were similar between the two groups. Vitrectomy with internal limiting membrane peeling is an efficient and safe procedure for macular hole-induced retinal detachment.

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

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

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

DEFF Research Database (Denmark)

Hamoudi, Hassan; La Cour, Morten

2013-01-01

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...

What Is Macular Edema?

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Full Text Available ... be able to see after vitrectomy surgery for a macular hole? Jan 24, 2016 Can Prolensa drops help a macular hole? Jan 11, 2016 After a person develops ocular histoplasmosis, ...

Delayed, spontaneous conversion of type 2 closure to type 1 closure following surgery for traumatic macular hole associated with submacular hemorrhage

Directory of Open Access Journals (Sweden)

Pukhraj Rishi

2012-01-01

Full Text Available A 45-year-old man presented with diminution of vision in the left eye following a firecracker injury. Best corrected visual acuity (BCVA was 20/20 in the right eye and 20/125 in the left eye. Fundus examination revealed vitreous hemorrhage, a macular hole, and submacular hemorrhage in the left eye. The patient underwent vitrectomy, tissue plasminogen activator (tPA-assisted evacuation of the submacular hemorrhage, internal limiting membrane (ILM peeling, and 14% C3F8 gas insufflation. After two months, the BCVA remained 20/125 and optical coherence tomography (OCT showed type 2 macular hole closure. On a follow-up, seven months after surgery, BCVA improved to 20/80, N6, with type 1 closure of the macular hole. The clinical findings were confirmed on OCT. Delayed and spontaneous conversion of the traumatic macular hole could occur several months after the primary surgery and may be associated with improved visual outcome. Larger studies are required to better understand the factors implicated in such a phenomenon.

Two Cases of Severe Degeneration of the Macula Following Vitrectomy with Indocyanine Green-Assisted Internal Limiting Membrane Peeling for Idiopathic Macular Hole

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Inoue, Junji; Sakuma, Toshiro; Kiyokawa, Masatoshi; Kobayashi, Yasuhiko; Takebayashi, Hiroshi; Mizota, Atsushi; Tanaka, Minoru

2008-01-01

We describe three eyes of two cases of severe degeneration of the macula following vitrectomy with indocyanine green-assisted internal limiting membrane peeling for idiopathic macular hole. We need to remember the possibility of these complications and have to select the procedures that are safest to use for macular hole surgery.

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

OBJECTIVE: To determine whether internal limiting membrane (ILM) peeling improves anatomic and functional outcomes of full-thickness macular hole (FTMH) surgery when compared with the no-peeling technique. DESIGN: Systematic review and individual participant data (IPD) meta-analysis undertaken...... 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...... endotamponade with or without ILM peeling. MAIN OUTCOME MEASURES: Primary outcome was best-corrected distance visual acuity (BCdVA) at 6 months postoperatively. Secondary outcomes were BCdVA at 3 and 12 months; best-corrected near visual acuity (BCnVA) at 3, 6, and 12 months; primary (after a single surgery...

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

Science.gov (United States)

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

2017-01-01

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. 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. 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). These results indicate that the fovea moves nasally after the MH surgery with ILM peeling.

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

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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.

Vitrectomy for optic disk pit with macular schisis and outer retinal dehiscence.

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Shukla, Dhananjay; Kalliath, Jay; Tandon, Manish; Vijayakumar, Balakrishnan

2012-07-01

To describe the outcomes of vitrectomy for optic disc pit-related maculopathy with central outer retinal dehiscence. This prospective interventional case series included seven patients with optic disc pit with macular schisis and central outer retinal dehiscence who underwent vitrectomy with internal limiting membrane peeling, barrage laser photocoagulation, and gas tamponade and were followed for at least 6 months. The surgical outcomes in terms of restoration of macular anatomy and visual improvement were recorded at each visit by fundus photography and optical coherence tomography. The mean age of the patients was 21.3 ± 8.6 years (range, 10-35 years), and the mean duration of defective vision was 6.7 ± 8.5 months (range, 1-24 months). Preoperatively, the median best-corrected visual acuity (BCVA) was 20/60 (range, 20/40 to 20/120). Full-thickness macular holes were noticed in 4 patients 1 month postoperatively. Gas tamponade was repeated in two patients with large macular holes. By the final follow-up, macular holes had closed and BCVA improved in all patients except one. Final mean central macular thickness was 176.83 ± 55.74 μ, the range being 109 μ to 256 μ. The median postoperative BCVA was 20/30 (range, 20/20 to 20/80). Six of 7 patients (85.7%) had improvement in BCVA postoperatively (mean, +2 lines; range, 1-4 lines). Five patients (71%) achieved a postoperative BCVA of ≥20/30. Best-corrected visual acuity dropped by one line in the patient with persistent macular hole. Vitrectomy with internal limiting membrane peeling can achieve excellent final surgical outcomes in optic pit maculopathy with outer retinal dehiscence despite the potential for macular hole formation.

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.

Efficacy of vitrectomy with triamcinolone assistance versus internal limiting membrane peeling for highly myopic macular hole retinal detachment.

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Wei, Yong; Wang, Ningli; Zu, Zhongqiao; Bi, Chuncao; Wang, Huaizhou; Chen, Fenghua; Yang, Xingguang

2013-06-01

To compare the outcomes of pars plana vitrectomy (PPV) with or without the adjuvant surgical procedures: triamcinolone acetonide (TA) assistance and/or internal limiting membrane (ILM) peeling for the treatment of highly myopic macular hole retinal detachment (MHRD). Case-control study. Pars plana vitrectomy combined with 2 kinds of adjuvant surgical procedures were used on 96 highly myopic eyes with MHRD. These eyes were assigned to 4 groups randomly: Group 1, non-TA-assisted PPV and without ILM peeling; Group 2, non-TA-assisted PPV with ILM peeling; Group 3, TA-assisted PPV and without ILM peeling; Group 4, TA-assisted PPV with ILM peeling. Anatomical reattachment of the retina, macular hole closure, and best-corrected visual acuity were measured. The rates of both retinal reattachment and macular hole closure were higher in Group 2 (84.0 and 44.0%) and Group 3 (80.8 and 46.2%) than Group 1 (73.9 and 17.4%); however, there were no differences between Group 2 and Group 3 (P > 0.05). The rates of macular hole closure were extremely low in Group 1 and also in eyes with extreme long axial lengths (≥29.0 mm), "severe" chorioretinal atrophy, and posterior staphyloma. Pars plana vitrectomy with either TA assistance or ILM peeling was effective for the treatment of highly myopic MHRD. If you peel the ILM, adding TA does not affect closure rates; and if TA is used to visualize the vitreous, ILM peeling may not be necessary in MHRD. There was a lower anatomical success rate in MHRD with extreme long axial lengths, severe chorioretinal atrophy, and posterior staphyloma.

Bilateral macular hole secondary to remote lightning strike

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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.

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

AIM: To determine the effect of internal limiting membrane (ILM) peeling on anatomical and functional success rates in stage 2 and 3 idiopathic macular hole surgery (MHS). METHODS: Randomised clinical trial of stage 2 and 3 idiopathic macular hole without visible epiretinal fibrosis and with less...... 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...

[Functional and Anatomic Outcomes of Primary and Secondary Internal Limiting Membrane Transplantation in Large and Persistent Macular Holes].

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Hess, Jelka A; Michels, Stephan; Becker, Matthias D

2017-11-20

Background The gold standard therapy for full-thickness macular holes (FTMH) is vitrectomy (PPV) with peeling of the internal limiting membrane (ILM), gas tamponade of the vitreous cavity and postoperative face-down positioning. Nevertheless, eyes with large macular holes (> 400 µm) and surgical failures remain difficult to manage. Recently, ILM transplantation (ILM-TX) techniques were developed with acceptable results, advocating different mechanisms of hole closure: in such a setting, the ILM could serve as a scaffold for neuronal tissue in the pedicle ILM flap technique or the ILM could induce a contraction of the FTMH rims through shrinking of a folded ILM plug. Patients/Material and Methods This retrospective study evaluates the functional and anatomic outcomes following ILM-TX for large FTMH and failed FMTH surgery. Large holes (group 1) were treated by the pedicle flap and the plug technique. Persistent holes following vitrectomy and ILM peeling (group 2) were treated with the plug technique. All ILM-TX were performed under perfluorocarbon liquid (PFCL) with a subsequent silicone oil tamponade. Results In group 1 (6 eyes), three eyes had a free ILM graft and three eyes underwent a pedunculated ILM-TX. The mean best corrected visual acuity (BCVA, LogMar) before primary ILM-TX was 1.18 ± 0.54 with a mean initial hole size of 681 ± 106 µm and a photoreceptor defect (PRD) of 1829 ± 474 µm. Five of six eyes showed a postoperative anatomical macular hole closure (83%). The mean BCVA after a mean follow-up of 9.3 ± 5.1 months was 0.83 ± 0.31 after a free ILM graft and 0.95 ± 0.79 after a pedunculated ILM flap. The PRD reduced to 1781 ± 713 µm after a free ILM graft and 1148 ± 378 µm after a pedunculated ILM flap. In group 2 (7 eyes), all patients had failed initial macular hole surgery closure. Prior to free ILM-TX BCVA was 1.05 ± 0.41, the hole size was 433 ± 183 µm and PRD was 2012 ± 718�

Tomographic Structural Changes of Retinal Layers after Internal Limiting Membrane Peeling for Macular Hole Surgery.

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Faria, Mun Yueh; Ferreira, Nuno P; Cristóvao, Diana M; Mano, Sofia; Sousa, David Cordeiro; Monteiro-Grillo, Manuel

2018-01-01

To highlight tomographic structural changes of retinal layers after internal limiting membrane (ILM) peeling in macular hole surgery. Nonrandomized prospective, interventional study in 38 eyes (34 patients) subjected to pars plana vitrectomy and ILM peeling for idiopathic macular hole. Retinal layers were assessed in nasal and temporal regions before and 6 months after surgery using spectral domain optical coherence tomography. Total retinal thickness increased in the nasal region and decreased in the temporal region. The retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), and inner plexiform layer (IPL) showed thinning on both nasal and temporal sides of the fovea. The thickness of the outer plexiform layer (OPL) increased. The outer nuclear layer (ONL) and outer retinal layers (ORL) increased in thickness after surgery in both nasal and temporal regions. ILM peeling is associated with important alterations in the inner retinal layer architecture, with thinning of the RNFL-GCL-IPL complex and thickening of OPL, ONL, and ORL. These structural alterations can help explain functional outcome and could give indications regarding the extent of ILM peeling, even though peeling seems important for higher rate of hole closure. © 2017 S. Karger AG, Basel.

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.

Clinical and cost-effectiveness of internal limiting membrane peeling for patients with idiopathic full thickness macular hole. Protocol for a Randomised Controlled Trial: FILMS (Full-thickness macular hole and Internal Limiting Membrane peeling Study

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Cook Jonathan

2008-11-01

Full Text Available Abstract Background A full-thickness macular hole (FTMH is a common retinal condition associated with impaired vision. Randomised controlled trials (RCTs have demonstrated that surgery, by means of pars plana vitrectomy and post-operative intraocular tamponade with gas, is effective for stage 2, 3 and 4 FTMH. Internal limiting membrane (ILM peeling has been introduced as an additional surgical manoeuvre to increase the success of the surgery; i.e. increase rates of hole closure and visual improvement. However, little robust evidence exists supporting the superiority of ILM peeling compared with no-peeling techniques. The purpose of FILMS (Full-thickness macular hole and Internal Limiting Membrane peeling Study is to determine whether ILM peeling improves the visual function, the anatomical closure of FTMH, and the quality of life of patients affected by this disorder, and the cost-effectiveness of the surgery. Methods/Design Patients with stage 2–3 idiopathic FTMH of less or equal than 18 months duration (based on symptoms reported by the participant and with a visual acuity ≤ 20/40 in the study eye will be enrolled in this FILMS from eight sites across the UK and Ireland. Participants will be randomised to receive combined cataract surgery (phacoemulsification and intraocular lens implantation and pars plana vitrectomy with postoperative intraocular tamponade with gas, with or without ILM peeling. The primary outcome is distance visual acuity at 6 months. Secondary outcomes include distance visual acuity at 3 and 24 months, near visual acuity at 3, 6, and 24 months, contrast sensitivity at 6 months, reading speed at 6 months, anatomical closure of the macular hole at each time point (1, 3, 6, and 24 months, health related quality of life (HRQOL at six months, costs to the health service and the participant, incremental costs per quality adjusted life year (QALY and adverse events. Discussion FILMS will provide high quality evidence on the

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...... 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...

HEMI-TEMPORAL INTERNAL LIMITING MEMBRANE PEELING IS AS EFFECTIVE AND SAFE AS CONVENTIONAL FULL PEELING FOR MACULAR HOLE SURGERY.

Science.gov (United States)

Shiono, Akira; Kogo, Jiro; Sasaki, Hiroki; Yomoda, Ryo; Jujo, Tatsuya; Tokuda, Naoto; Kitaoka, Yasushi; Takagi, Hitoshi

2018-05-09

To investigate the efficacy of hemi-temporal internal limiting membrane (ILM) peeling for idiopathic macular hole. The medical records of patients with macular holes who had undergone vitrectomy with ILM peeling were studied. Forty-two eyes with macular hole were divided into 2 groups based on surgical procedure (hemi-temporal ILM peeling [hemi group]: 15 eyes; 360° ILM peeling [360° group]: 27 eyes). The closure rates and distances between the optic disc and the intersection of two retinal vessels most closely located nasally or temporally to the macular hole were compared. The primary closure rates were not significantly different between the two groups (hemi group: 93.3%; 360° group: 92.5%, P = 0.92). The temporal retinal vessels in the hemi group were displaced 120.5 ± 102.0 µm toward the optic disc at 1 week postoperatively, which did not differ significantly from the 360° group (136.1 ± 106.1 µm) (P = 0.107). However, the nasal retinal vessels in the hemi group were displaced by 42.4 ± 42.9 µm at 1 week postoperatively, which was significantly less than the 90.1 ± 77.3 µm displacement seen in the 360° group (P = 0.040). Hemi-temporal ILM peeling may be preferable to 360° ILM peeling because of less displacement of the retina and greater safety.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Vitrectomy with internal limiting membrane peeling versus inverted internal limiting membrane flap technique for macular hole-induced retinal detachment: a systematic review of literature and meta-analysis.

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Yuan, Jing; Zhang, Ling-Lin; Lu, Yu-Jie; Han, Meng-Yao; Yu, Ai-Hua; Cai, Xiao-Jun

2017-11-28

To evaluate the effects on vitrectomy with internal limiting membrane (ILM) peeling versus vitrectomy with inverted internal limiting membrane flap technique for macular hole-induced retinal detachment (MHRD). Pubmed, Cochrane Library, and Embase were systematically searched for studies that compared ILM peeling with inverted ILM flap technique for macular hole-induced retinal detachment. The primary outcomes are the rate of retinal reattachment and the rate of macular hole closure 6 months later after initial surgery, the secondary outcome is the postoperative best-corrected visual acuity (BCVA) 6 months later after initial surgery. Four studies that included 98 eyes were selected. All the included studies were retrospective comparative studies. The preoperative best-corrected visual acuity was equal between ILM peeling and inverted ILM flap technique groups. It was indicated that the rate of retinal reattachment (odds ratio (OR) = 0.14, 95% confidence interval (CI):0.03 to 0.69; P = 0.02) and macular hole closure (OR = 0.06, 95% CI:0.02 to 0.19; P peeling. However, there was no statistically significant difference in postoperative best-corrected visual acuity (mean difference (MD) 0.18 logarithm of the minimum angle of resolution; 95% CI -0.06 to 0.43 ; P = 0.14) between the two surgery groups. Compared with ILM peeling, vitrectomy with inverted ILM flap technique resulted significantly higher of the rate of retinal reattachment and macular hole closure, but seemed does not improve postoperative best-corrected visual acuity.

Decreased retinal sensitivity after internal limiting membrane peeling for macular hole surgery.

Science.gov (United States)

Tadayoni, Ramin; Svorenova, Ivana; Erginay, Ali; Gaudric, Alain; Massin, Pascale

2012-12-01

To compare the retinal sensitivity and frequency of microscotomas found by spectral domain optical coherence tomography (SD-OCT) combined with scanning laser ophthalmoscopy (SLO) microperimetry after idiopathic macular hole closure, in eyes that underwent internal limiting membrane (ILM) peeling and eyes that did not. This was a retrospective, non-randomised, comparative study. Combined SD-OCT and SLO microperimetry was performed in 16 consecutive eyes after closure of an idiopathic macular hole. A customised microperimetry pattern with 29 measurement points was used. The ILM was peeled in 8/16 eyes. The main outcome measure was mean retinal sensitivity. Mean retinal sensitivity (in dB) was lower after peeling: 9.80 ± 2.35 dB with peeling versus 13.19 ± 2.92 without (p=0.0209). Postoperative microscotomas were significantly more frequent after ILM peeling: 11.3 ± 6.6 points with retinal sensitivity below 10 dB in eyes that underwent peeling versus 2.9 ± 4.6 in those that did not (p=0.0093). These results suggest that ILM peeling may reduce retinal sensitivity, and significantly increase the incidence of microscotomas. Until a prospective trial confirming or not these results, it seems justified to avoid peeling the ILM when its potential benefit seems minor or unproved, and when peeling is carried out, to limit the surface peeled to the bare minimum.

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 ...

Relationship between Peeled Internal Limiting Membrane Area and Anatomic Outcomes following Macular Hole Surgery: A Quantitative Analysis

Directory of Open Access Journals (Sweden)

Yasin Sakir Goker

2016-01-01

Full Text Available Purpose. To quantitatively evaluate the effects of peeled internal limiting membrane (ILM area and anatomic outcomes following macular hole surgery using spectral domain optical coherence tomography (SD-OCT. Methods. Forty-one eyes in 37 consecutive patients with idiopathic, Gass stage 3-4 macular hole (MH were enrolled in this retrospective comparative study. All patients were divided into 2 groups according to anatomic success or failure. Basal MH diameter, peeled ILM area, and MH height were calculated using SD-OCT. Other prognostic parameters, including age, stage, preoperative BCVA, and symptom duration were also assessed. Results. Thirty-two cases were classified as anatomic success, and 9 cases were classified as anatomic failure. Peeled ILM area was significantly wider and MH basal diameter was significantly less in the anatomic success group (p=0.024 and 0.032, resp.. Other parameters did not demonstrate statistical significance. Conclusion. The findings of the present study show that the peeled ILM area can affect the anatomic outcomes of MH surgery.

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...... vitreoretinal surgeons about the indication for peeling the ILM, whether to use it in all cases or in long-standing and/or larger holes. ...

Automated framework for intraretinal cystoid macular edema segmentation in three-dimensional optical coherence tomography images with macular hole

Science.gov (United States)

Zhu, Weifang; Zhang, Li; Shi, Fei; Xiang, Dehui; Wang, Lirong; Guo, Jingyun; Yang, Xiaoling; Chen, Haoyu; Chen, Xinjian

2017-07-01

Cystoid macular edema (CME) and macular hole (MH) are the leading causes for visual loss in retinal diseases. The volume of the CMEs can be an accurate predictor for visual prognosis. This paper presents an automatic method to segment the CMEs from the abnormal retina with coexistence of MH in three-dimensional-optical coherence tomography images. The proposed framework consists of preprocessing and CMEs segmentation. The preprocessing part includes denoising, intraretinal layers segmentation and flattening, and MH and vessel silhouettes exclusion. In the CMEs segmentation, a three-step strategy is applied. First, an AdaBoost classifier trained with 57 features is employed to generate the initialization results. Second, an automated shape-constrained graph cut algorithm is applied to obtain the refined results. Finally, cyst area information is used to remove false positives (FPs). The method was evaluated on 19 eyes with coexistence of CMEs and MH from 18 subjects. The true positive volume fraction, FP volume fraction, dice similarity coefficient, and accuracy rate for CMEs segmentation were 81.0%±7.8%, 0.80%±0.63%, 80.9%±5.7%, and 99.7%±0.1%, respectively.

[Anatomical and functional results of macular hole surgery with internal limiting membrane peeling after 10-year follow-up].

Science.gov (United States)

Foveau, P; Conart, J-B; Hubert, I; Selton, J; Berrod, J-P

2016-09-01

To evaluate the anatomical and functional results of macular hole surgery with internal limiting membrane (ILM) peeling after 10 years follow-up. Monocentric retrospective study of patients who had undergone macular hole surgery between 2003 and 2005 in the Nancy University Medical Center and still followed in the department in 2014. All patients underwent pars plana vitrectomy and ILM peeling without staining. Clinical examination at ten years including determination of best-corrected visual acuity (BCVA), evaluation of quality of life and spectral domain optical coherence tomography was performed. Four men and six women with mean age of 64±8 years were included. The mean diameter of the MH was 395±133μm. The mean best corrected visual acuity improved significantly from 0.90±0.22 logMAR to 0.14±0.14 logMAR after 10 years with a satisfactory quality of life in 90 % of patients. The integrity of the IS/OS layer was preserved in 9 eyes. Inner retinal dimples located in the temporal quadrant related to ILM peeling initiation were observed in 8 eyes. No significant RNFL or ganglion cell complex changes were found compared to the contralateral eye. Macular hole surgery with ILM peeling in this series resulted in a visual acuity gain of 8 ETDRS lines and persistent improvement in quality of life after a 10-year follow-up. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Vitrectomy with internal limiting membrane peeling versus no peeling for idiopathic full-thickness macular hole.

Science.gov (United States)

Spiteri Cornish, Kurt; Lois, Noemi; Scott, Neil W; Burr, Jennifer; Cook, Jonathan; Boachie, Charles; Tadayoni, Ramin; la Cour, Morten; Christensen, Ulrik; Kwok, Alvin K H

2014-03-01

To determine whether internal limiting membrane (ILM) peeling improves anatomic and functional outcomes of full-thickness macular hole (FTMH) surgery when compared with the no-peeling technique. Systematic review and individual participant data (IPD) meta-analysis undertaken under the auspices of the Cochrane Eyes and Vision Group. Only randomized controlled trials (RCTs) were included. Patients with idiopathic stage 2, 3, and 4 FTMH undergoing vitrectomy with or without ILM peeling. Macular hole surgery, including vitrectomy and gas endotamponade with or without ILM peeling. Primary outcome was best-corrected distance visual acuity (BCdVA) at 6 months postoperatively. Secondary outcomes were BCdVA at 3 and 12 months; best-corrected near visual acuity (BCnVA) at 3, 6, and 12 months; primary (after a single surgery) 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. Four RCTs were identified and included in the review. All RCTs were included in the meta-analysis; IPD were obtained from 3 of the 4 RCTs. No evidence of a difference in BCdVA at 6 months was detected (mean difference, -0.04; 95% confidence interval [CI], -0.12 to 0.03; P=0.27); however, there was evidence of a difference in BCdVA at 3 months favoring ILM peeling (mean difference, -0.09; 95% CI, -0.17 to-0.02; P=0.02). There was evidence of an effect favoring ILM peeling with regard to primary (odds ratio [OR], 9.27; 95% CI, 4.98-17.24; Ppeeling was found to be highly cost-effective. Available evidence supports ILM peeling as the treatment of choice for patients with idiopathic stage 2, 3, and 4 FTMH. Copyright © 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Complications of Macular Peeling

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Asencio-Duran, Mónica; Manzano-Muñoz, Beatriz; Vallejo-García, José Luis; García-Martínez, Jesús

2015-01-01

Macular peeling refers to the surgical technique for the removal of preretinal tissue or the internal limiting membrane (ILM) in the macula for several retinal disorders, ranging from epiretinal membranes (primary or secondary to diabetic retinopathy, retinal detachment…) to full-thickness macular holes, macular edema, foveal retinoschisis, and others. The technique has evolved in the last two decades, and the different instrumentations and adjuncts have progressively advanced turning into a safer, easier, and more useful tool for the vitreoretinal surgeon. Here, we describe the main milestones of macular peeling, drawing attention to its associated complications. PMID:26425351

Cost-effectiveness of internal limiting membrane peeling versus no peeling for patients with an idiopathic full-thickness macular hole: results from a randomised controlled trial.

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Ternent, Laura; Vale, Luke; Boachie, Charles; Burr, Jennifer M; Lois, Noemi

2012-03-01

To determine whether internal limiting membrane (ILM) peeling is cost-effective compared with no peeling for patients with an idiopathic stage 2 or 3 full-thickness macular hole. A cost-effectiveness analysis was performed alongside a randomised controlled trial. 141 participants were randomly allocated to receive macular-hole surgery, with either ILM peeling or no peeling. Health-service resource use, costs and quality of life were calculated for each participant. The incremental cost per quality-adjusted life year (QALY) gained was calculated at 6 months. At 6 months, the total costs were on average higher (£424, 95% CI -182 to 1045) in the No Peel arm, primarily owing to the higher reoperation rate in the No Peel arm. The mean additional QALYs from ILM peel at 6 months were 0.002 (95% CI 0.01 to 0.013), adjusting for baseline EQ-5D and other minimisation factors. A mean incremental cost per QALY was not computed, as Peeling was on average less costly and slightly more effective. A stochastic analysis suggested that there was more than a 90% probability that Peeling would be cost-effective at a willingness-to-pay threshold of £20,000 per QALY. Although there is no evidence of a statistically significant difference in either costs or QALYs between macular hole surgery with or without ILM peeling, the balance of probabilities is that ILM Peeling is likely to be a cost-effective option for the treatment of macular holes. Further long-term follow-up data are needed to confirm these findings.

Effect of the perfluorodecalin residue on macular subretinal treated by internal limiting membrane peeling combined with 38G casing needle

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Xiao-Bo Wang

2014-11-01

Full Text Available AIM: To observe the effect of the treatment to the perfluorodecalin residue on macular subretinal by internal limiting membrane(ILMpeeling combined with 38G casing needle.METHODS: Twenty-nine cases(29 eyesof retinal reattachment and with perfluorodecalin residual on the macular subretinal, selected in Xiamen Eye Center from January 2008 to October 2013, were divided into group A(14 cases, 14 eyesand group B(15 cases, 15 eyesrandomly. In group A, after removal of silicone oil, perfluorodecalin liquids at the macular subretinal directly were aspirated by 38G casing needle. In group B, after removal of silicone oil, ILM was dyed and peeled completely to the range of 4PD approximately. Then the perfluorodecalin liquids at the macular subretinal were aspirated by 38G casing needle. All cases of both groups were filled with filtered air. After 1wk, the case with macular hole found by OCT was exchanged by air-fluid and filled with 16% C3F8. The best corrected visual acuity(BCVAof two groups of patients was observed after 4, 8, 24wk. OCT was reviewed to observe whether there were perfluorodecalin residue on the macular subretinal, formation of macular hole and macular morphological changes, retinal detachment.RESULTS: BCVA was improved in both groups after 4, 8, 24wk. And the value of BCVA improvedin group B was better than that in group A(PCONCLUSION: ILM peeling combined with 38G casing needle can aspirate completely the perfluorodecalin residual on macular. There were not caused macular hole and retinal detachment. This method is an safe, effective and minimally invasive surgical technique to protect the macular function.

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

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Spiteri Cornish, Kurt; Lois, Noemi; Scott, Neil; Burr, Jennifer; Cook, Jonathan; Boachie, Charles; Tadayoni, Ramin; la Cour, Morten; Christensen, Ulrik; Kwok, Alvin

2013-06-05

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 vitreoretinal surgeons about the indication for peeling the ILM, whether to use it in all cases or in long-standing and/or larger holes.  To determine whether ILM peeling improves anatomical and functional outcomes of macular hole surgery compared with the no-peeling technique and to investigate the impact of different parameters such as presenting vision, stage/size of the hole and duration of symptoms in the success of the surgery. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) which contains the Cochrane Eyes and Vision Group Trials Register (The Cochrane Library 2013, Issue 2), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE, (January 1950 to February 2013), EMBASE (January 1980 to February 2013), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to February 2013), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We searched the reference lists of included studies for any additional studies not identified by the electronic searches. We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 28 February 2013.We searched reference lists of the studies included in the review for information about other studies on ILM peeling in macular hole surgery. We searched Proceedings for the following conferences up to February 2013: American Academy of Ophthalmology (AAO), Annual Meeting of the American Society of Retina Specialists

The Case Mix of Patients Presenting with Full-Thickness Macular Holes and Progression before Surgery: Implications for Optimum Management.

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Madi, Haifa A; Dinah, Christiana; Rees, Jon; Steel, David H W

2015-01-01

Analysis of pre-operative spectral domain optical coherence tomography (SD-OCT) characteristics of full-thickness macular holes (FTMH) and effect on optimum management. We retrospectively reviewed SD-OCT characteristics of a consecutive cohort of patients waitlisted for FTMH surgery and categorized them by current evidence-based treatments. Out of the 106 holes analysed, 36 were small, 40 medium and 30 large. Initially, 33 holes had vitreomacular adhesion (VMA). 41 holes were analysed for change in characteristics with a median duration of 8 weeks between the scans. The number of small or medium holes decreased from 20 to 6 and that of large holes doubled. The number of holes with VMA halved. Smaller hole size (p = 0.014) and being phakic (p = 0.048) were associated with a larger increase in size. The strongest predictor of hole progression into a different surgical management category was the presence of VMA. FTMH characteristics can change significantly pre-operatively and affect optimal treatment choice.

PREVALENCE OF FOVEOLAR LUCENCY WITH DIFFERENT GAS TAMPONADES IN SURGICALLY CLOSED MACULAR HOLES ASSESSED BY SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY.

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Zarranz-Ventura, Javier; Ellabban, Abdallah A; Sim, Dawn A; Keane, Pearse A; Kirkpatrick, James N; Sallam, Ahmed A B

2017-07-07

To evaluate the prevalence of foveolar lucency (FL) in surgically closed macular holes by spectral domain optical coherence tomography. One hundred forty-two eyes of 132 patients underwent pars plana vitrectomy, internal limiting membrane peeling, and gas tamponade in a 60-month time frame. Anatomical success and FL rates assessed by spectral domain optical coherence tomography, mean preoperative, and postoperative best-measured visual acuity and surgical details were retrospectively analyzed. Spectral domain optical coherence tomography confirmed closed holes with FL in 33.7% (34/101) of eyes at 1 month, 7.3% (9/123) at 3 months, 4.6% (6/129) at 6 months, and 3% (4/133) at 12 months. Prevalence of FL in closed holes at Month 1 was lower in C3F8-treated eyes (9.5%, 2/21) compared with C2F6 (40.9%, 18/44, P = 0.03) and SF6-treated eyes (38.9%, 14/36, P = 0.05). No differences were observed at Month 3. No differences in best-measured visual acuity change were observed between closed holes with or without FL at Month 1 (-0.14 ± 0.19 vs. -0.11 ± 0.23, P = 0.48) or any of the other time points. Temporary FL is a highly prevalent feature in successfully closed macular holes. Eyes treated with C3F8 gas had lower rates of FL at Month 1 than C2F6 and SF6-treated eyes. The presence of FL in closed holes does not seem to have any effect on the visual outcomes.

Refractive changes after lens-sparing vitrectomy for macular hole and epiretinal membrane

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Muto T

2017-08-01

Full Text Available Tetsuya Muto,1 Tomoharu Nishimura,1 Takefumi Yamaguchi,2 Makoto Chikuda,1 Shigeki Machida1 1Department of Ophthalmology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Japan; 2Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Japan Purpose: Cataract progression after lens-sparing vitrectomy might differ according to original posterior segment diseases. Our objective was to analyze the refractive values after lens-sparing vitrectomy for macular hole (MH and epiretinal membrane (ERM. Materials and methods: We reviewed the medical records of 25 MH patients (25 eyes and 23 ERM patients (23 eyes who underwent lens-sparing vitrectomy. Refractive changes in both groups were compared. All patients underwent 20-gauge three-port pars plana vitrectomy. Fluid–air exchange was performed during vitrectomy only in the MH group. The results were analyzed using the unpaired t-test, chi-square test, or Fisher exact probability test, and multivariate analysis. Results: There were no significant differences in the patient’s age (P=0.45. The myopia progression rate (D/month was higher in the MH group after surgery than that in the ERM group (P=0.035. MH group had more females (P=0.043, longer surgical time (P<0.001, and higher frequencies of surgical adjuvants use (triamcinolone acetonide, P=0.019; brilliant blue G, P<0.001. The myopia progression rate in the MH group (R=0.568, P<0.001 correlated with female gender. However, no correlation was observed between longer surgical time and the use of surgical adjuvants. Conclusion: The rate of myopia progression was higher in the MH group. Fluid–air exchange and gender may affect the rate of myopia progression. Keywords: cataract, vitrectomy, macular hole, epiretinal membrane

A meta-analysis of vitrectomy with or without internal limiting membrane peeling for macular hole retinal detachment in the highly myopic eyes.

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Gao, Xinxiao; Guo, Jia; Meng, Xin; Wang, Jun; Peng, Xiaoyan; Ikuno, Yasushi

2016-06-13

To evaluate the anatomical and visual outcomes by par plana vitrectomy with or without internal limiting membrane (ILM) peeling in highly myopic eyes with macular hole retinal detachment (MHRD). MEDLINE (Ovid, PubMed) and EMBASE were used for data collection up to September 30, 2015. The parameters of anatomical success, macular hole closure and improved best corrected visual acuity (BCVA) at or beyond 6 months after operation were assessed as the primary outcome measurement. The meta-analysis was performed with the fixed-effects model. Seven comparative analyses involving a total of 373 patients were included in the present meta-analysis. Statistically the pooled data showed significant relative risk (RR) in terms of primary reattachment between ILM peeling and non-peeling groups (RR, 1.19; 95 % CI, 1.04 to 1.36; P = 0.012). An effect favoring ILM peeling with regard to macular hole closure was also detected (RR, 1.71; 95 % CI, 1.20 to 2.43; P = 0.003). However, no statistically significant difference was found in the improved BCVA (logarithm of the minimum angle of resolution) at 6 months or more (95 % CI, -0.31 to 0.44; P = 0.738). There is no proved benefit of postoperative visual improvement. However, the available evidences from this study suggested a superiority of ILM peeling over no peeling for myopic patients with MHRD.

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

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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.

Macular retinoschisis in eyes with glaucomatous optic neuropathy: Vitrectomy and natural course.

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Yoshikawa, Tadanobu; Yamanaka, Chihiro; Kinoshita, Takamasa; Morikawa, Shohei; Ogata, Nahoko

2018-02-01

Our purpose was to determine the effectiveness of vitrectomy in resolving the macular retinoschisis in an eye with glaucomatous optic neuropathy and also to determine the natural course of macular retinoschisis. This was a retrospective case series of patients who were diagnosed with macular retinoschisis and glaucomatous optic neuropathy. Fourteen eyes of 13 patients were studied. Patients with high myopia, vitreomacular traction syndrome, and the pit macular syndrome were excluded. There were three men and ten women, and 12 had unilateral and one had bilateral macular retinoschisis. Vitrectomy was performed for a serous retinal detachment, macular hole, or severe visual loss in five eyes. The mean follow-up time was 68.8 months in these five eyes, and the macular retinoschisis was resolved and the best-corrected visual acuity (BCVA) at the final visit was significantly improved in all eyes (P = 0.007). However, two of these fiv e eyes developed a macular hole and required a second vitrectomy. Of the nine eyes without treatment with a mean follow-up time of 29.0 months, the BCVA at the final visit remained unchanged from the baseline BCVA in all eyes. The macular retinoschisis was resolved or reduced in three eyes without treatment. Vitrectomy was effective for the resolution of macular retinoschisis in eyes with glaucomatous optic neuropathy and serous retinal detachment or macular hole or severe reduction of the BCVA. Macular retinoschisis can be resolved without a reduction of the BCVA in some cases without treatment.

Black-hole-regulated star formation in massive galaxies

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Martín-Navarro, Ignacio; Brodie, Jean P.; Romanowsky, Aaron J.; Ruiz-Lara, Tomás; van de Ven, Glenn

2018-01-01

Supermassive black holes, with masses more than a million times that of the Sun, seem to inhabit the centres of all massive galaxies. Cosmologically motivated theories of galaxy formation require feedback from these supermassive black holes to regulate star formation. In the absence of such feedback, state-of-the-art numerical simulations fail to reproduce the number density and properties of massive galaxies in the local Universe. There is, however, no observational evidence of this strongly coupled coevolution between supermassive black holes and star formation, impeding our understanding of baryonic processes within galaxies. Here we report that the star formation histories of nearby massive galaxies, as measured from their integrated optical spectra, depend on the mass of the central supermassive black hole. Our results indicate that the black-hole mass scales with the gas cooling rate in the early Universe. The subsequent quenching of star formation takes place earlier and more efficiently in galaxies that host higher-mass central black holes. The observed relation between black-hole mass and star formation efficiency applies to all generations of stars formed throughout the life of a galaxy, revealing a continuous interplay between black-hole activity and baryon cooling.

Black-hole-regulated star formation in massive galaxies.

Science.gov (United States)

Martín-Navarro, Ignacio; Brodie, Jean P; Romanowsky, Aaron J; Ruiz-Lara, Tomás; van de Ven, Glenn

2018-01-18

Supermassive black holes, with masses more than a million times that of the Sun, seem to inhabit the centres of all massive galaxies. Cosmologically motivated theories of galaxy formation require feedback from these supermassive black holes to regulate star formation. In the absence of such feedback, state-of-the-art numerical simulations fail to reproduce the number density and properties of massive galaxies in the local Universe. There is, however, no observational evidence of this strongly coupled coevolution between supermassive black holes and star formation, impeding our understanding of baryonic processes within galaxies. Here we report that the star formation histories of nearby massive galaxies, as measured from their integrated optical spectra, depend on the mass of the central supermassive black hole. Our results indicate that the black-hole mass scales with the gas cooling rate in the early Universe. The subsequent quenching of star formation takes place earlier and more efficiently in galaxies that host higher-mass central black holes. The observed relation between black-hole mass and star formation efficiency applies to all generations of stars formed throughout the life of a galaxy, revealing a continuous interplay between black-hole activity and baryon cooling.

Successful closure of treatment-naïve, flat edge (Type II, full-thickness macular hole using inverted internal limiting membrane flap technique

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Hussain N

2016-10-01

Full Text Available Nazimul Hussain,1 Anjli Hussain2 1Department of Ophthalmology, Al Zahra Hospital, 2Al Zahra Medical Center, Dubai, United Arab Emirates Objective: The objective of this study was to present the outcome of the internal limiting membrane (ILM peeling flap technique for a treatment-naïve, flat edge (Type II, full-thickness macular hole (MH. Methods: A 52-year-old man presented with complaints of decreased vision and seeing black spot. He was diagnosed to have a flat edge, full-thickness MH, which was confirmed by optical coherence tomography (OCT. He underwent 23G vitrectomy with brilliant blue G-assisted inverted ILM peeling with an inverted flap over the hole followed by fluid gas exchange. Results: Postoperative follow-up until 3 months showed successful closure of the MH, which was confirmed by OCT. The best-corrected visual acuity improved from baseline 6/60 to 6/12 at the final follow-up. Conclusion: Using the inverted ILM flap technique, a treatment-naïve, flat edge (Type II, full thickness MH achieved successful anatomical and functional outcomes. Keywords: macular hole, inverted ILM, optical coherence tomography

INTERNAL LIMITING MEMBRANE PEELING IN MACULAR HOLE SURGERY; WHY, WHEN, AND HOW?

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Chatziralli, Irini P; Theodossiadis, Panagiotis G; Steel, David H W

2018-05-01

To review the current rationale for internal limiting membrane (ILM) peeling in macular hole (MH) surgery and to discuss the evidence base behind why, when, and how surgeons peel the ILM. Review of the current literature. Pars plana vitrectomy is an effective treatment for idiopathic MH, and peeling of the ILM has been shown to improve closure rates and to prevent postoperative reopening. However, some authors argue against ILM peeling because it results in a number of changes in retinal structure and function and may not be necessary in all cases. Furthermore, the extent of ILM peeling optimally performed and the most favorable techniques to remove the ILM are uncertain. Several technique variations including ILM flaps, ILM scraping, and foveal sparing ILM peeling have been described as alternatives to conventional peeling in specific clinical scenarios. Internal limiting membrane peeling improves MH closure rates but can have several consequences on retinal structure and function. Adjuvants to aid peeling, instrumentation, technique, and experience may all alter the outcome. Hole size and other variables are important in assessing the requirement for peeling and potentially its extent. A variety of evolving alternatives to conventional peeling may improve outcomes and need further study.

What Is Macular Edema?

Medline Plus

Full Text Available ... a macular hole? Jan 11, 2016 After a person develops ocular histoplasmosis, is it common that years or even decades pass before the person notices the vision changes and the disease is ...

What Is Macular Edema?

Medline Plus

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 ...

What Can We Learn About Black-Hole Formation from Black-Hole X-ray Binaries?

NARCIS (Netherlands)

Nelemans, G.A.

2007-01-01

I discuss the effect of the formation of a black hole on a (close) binary and show some of the current constraints that the observed properties of black hole X-ray binaries put on the formation of black holes. In particular, I discuss the evidence for and against asymmetric kicks imparted on the

Indocyanine green-assisted internal limiting membrane peeling in macular hole surgery: a meta-analysis.

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Yan Wu

Full Text Available BACKGROUND: The opinion of application of indocyanine green (ICG in the macular hole surgery was contradictory. Here we conducted a meta-analysis to evaluate the effect of in internal limiting membrane (ILM peeling for macular hole surgery. METHODS AND FINDINGS: We searched electronic databases for comparative studies published before July 2012 of ILM peeling with and without ICG. Twenty-two studies including 1585 eyes were included. Visual acuity (VA improvement, including the postoperative rate of ≥20/40 VA gained (OR, 0.65; 95% CI, 0.43 to 0.97; P = 0.033 and increased LogMAR (WMD, -0.09; 95% CI, -0.16 to -0.02; P = 0.011, was less in the ICG group. The risk of visual field defects was greater in the ICG group than in the non-ICG group. There was no significant difference in the rate of anatomical outcomes between ILM peeling procedures performed with and without ICG. RPE changes and other postoperative complications were not significantly different between the ICG and non-ICG groups. An additional analysis showed that the VA improvement of the ICG group was less than the non-ICG group only within the first year of follow up. A subgroup analysis showed that the rate of VA improvement was lower in the ICG group than in other adjuncts group. A higher rate of secondary closure and less VA improvement were observed in a high proportion (>0.1% of the ICG group. A sensitivity analysis after the randomized-controlled trials were excluded from the meta-analysis demonstrated no differences compared with the overall results. CONCLUSIONS: This meta-analysis demonstrated that there is no evidence of clinical superiority in outcomes for ICG-assisted ILM peeling procedure over the non-ICG one. The toxicity of ICG should be considered when choosing the various staining methods.

Clinical and histological evaluation of large macular hole surgery using the inverted internal limiting membrane flap technique

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Kase S

2016-12-01

Full Text Available Satoru Kase, Wataru Saito, Shohei Mori, Michiyuki Saito, Ryo Ando, Zhenyu Dong, Tomohiro Suzuki, Kousuke Noda, Susumu Ishida Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan Purpose: The aims of this study were to analyze optical coherence tomography (OCT imaging of large macular holes (MHs treated with inverted internal limiting membrane (ILM flap technique and to perform a histological examination of an ILM-like membrane tissue obtained during vitrectomy.Patients and methods: This is a retrospective observational case study. Nine patients, comprising of five males and four females, showing large and myopic MHs, underwent pars plana vitrectomy (PPV with inverted ILM flap technique assisted by brilliant blue G (BBG staining. Ophthalmological findings including visual acuity and OCT were investigated based on medical records. Formalin-fixed paraffin-embedded tissue section of an ILM-like membrane was submitted for immunohistochemistry with glial fibrillary acidic protein (GFAP.Results: ILM was clearly stained with BBG in eight patients, whereas the ILM in one case revealed no staining with BBG during PPV. Visual acuities improved to >0.2 LogMAR in six patients. The complete closure of MH following PPV with inverted ILM technique was eventually achieved in all patients determined by OCT imaging (100%. Only one patient showed recovery of ellipsoid zone and interdigitation zone following the surgery. Elongation of outer nuclear layer was noted in three eyes. The ILM-like membrane not stained with BBG histologically revealed an amorphous structure admixed with GFAP-positive mononuclear cell infiltration.Conclusion: PPV with inverted ILM flap technique achieved 100% closure rates with favorable configuration at an initial surgery in large MHs. Our histopathological data also suggest that even BBG staining-negative membrane may be a useful material for autologous transplantation to the hole. Keywords

Macular Hole Surgery with Internal Limiting Membrane Peeling Facilitated by Membrane-Blue® versus Membrane-Blue-Dual®: A Retrospective Comparative Study

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Uri Soiberman

2016-01-01

Full Text Available Background. This study aims to compare the outcome of macular hole (MH surgery with internal limiting membrane (ILM peeling facilitated by two different vital dyes. Methods. This was a retrospective chart review. The group designated “group-MB” underwent pars plana vitrectomy with ILM peeling facilitated by Membrane-Blue (MB, whereas in “group-MBD,” the vital dye used was Membrane-Blue-Dual (MBD. Results. Seventy-four eyes comprised the study population: 53 in group-MB and 21 in group-MBD. There was no difference in the rate of macular hole closure in group-MB or group-MBD: 71.2% closed MHs compared to 66.7%, respectively (p=0.7. Postoperative visual improvement was of a higher magnitude in the MBD group compared to the MB group: −0.34±0.81 logMAR versus 0.01±0.06 logMAR, respectively (p=0.003. Conclusions. In this study, MBD led to better visual results that may be related to better staining characteristics or lesser toxicity compared to MB.

Low-mass black holes as the remnants of primordial black hole formation.

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Greene, Jenny E

2012-01-01

Bridging the gap between the approximately ten solar mass 'stellar mass' black holes and the 'supermassive' black holes of millions to billions of solar masses are the elusive 'intermediate-mass' black holes. Their discovery is key to understanding whether supermassive black holes can grow from stellar-mass black holes or whether a more exotic process accelerated their growth soon after the Big Bang. Currently, tentative evidence suggests that the progenitors of supermassive black holes were formed as ∼10(4)-10(5) M(⊙) black holes via the direct collapse of gas. Ongoing searches for intermediate-mass black holes at galaxy centres will help shed light on this formation mechanism.

Black hole formation in a contracting universe

Energy Technology Data Exchange (ETDEWEB)

Quintin, Jerome; Brandenberger, Robert H., E-mail: jquintin@physics.mcgill.ca, E-mail: rhb@hep.physics.mcgill.ca [Department of Physics, McGill University, 3600 rue University, Montréal, QC, H3A 2T8 Canada (Canada)

2016-11-01

We study the evolution of cosmological perturbations in a contracting universe. We aim to determine under which conditions density perturbations grow to form large inhomogeneities and collapse into black holes. Our method consists in solving the cosmological perturbation equations in complete generality for a hydrodynamical fluid. We then describe the evolution of the fluctuations over the different length scales of interest and as a function of the equation of state for the fluid, and we explore two different types of initial conditions: quantum vacuum and thermal fluctuations. We also derive a general requirement for black hole collapse on sub-Hubble scales, and we use the Press-Schechter formalism to describe the black hole formation probability. For a fluid with a small sound speed (e.g., dust), we find that both quantum and thermal initial fluctuations grow in a contracting universe, and the largest inhomogeneities that first collapse into black holes are of Hubble size and the collapse occurs well before reaching the Planck scale. For a radiation-dominated fluid, we find that no black hole can form before reaching the Planck scale. In the context of matter bounce cosmology, it thus appears that only models in which a radiation-dominated era begins early in the cosmological evolution are robust against the formation of black holes. Yet, the formation of black holes might be an interesting feature for other models. We comment on a number of possible alternative early universe scenarios that could take advantage of this feature.

Black hole formation in a contracting universe

International Nuclear Information System (INIS)

Quintin, Jerome; Brandenberger, Robert H.

2016-01-01

We study the evolution of cosmological perturbations in a contracting universe. We aim to determine under which conditions density perturbations grow to form large inhomogeneities and collapse into black holes. Our method consists in solving the cosmological perturbation equations in complete generality for a hydrodynamical fluid. We then describe the evolution of the fluctuations over the different length scales of interest and as a function of the equation of state for the fluid, and we explore two different types of initial conditions: quantum vacuum and thermal fluctuations. We also derive a general requirement for black hole collapse on sub-Hubble scales, and we use the Press-Schechter formalism to describe the black hole formation probability. For a fluid with a small sound speed (e.g., dust), we find that both quantum and thermal initial fluctuations grow in a contracting universe, and the largest inhomogeneities that first collapse into black holes are of Hubble size and the collapse occurs well before reaching the Planck scale. For a radiation-dominated fluid, we find that no black hole can form before reaching the Planck scale. In the context of matter bounce cosmology, it thus appears that only models in which a radiation-dominated era begins early in the cosmological evolution are robust against the formation of black holes. Yet, the formation of black holes might be an interesting feature for other models. We comment on a number of possible alternative early universe scenarios that could take advantage of this feature.

[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) .

Macular Hole Associated with Vogt-Koyanagi-Harada Disease at the Acute Uveitic Stage

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Masaharu Mizuno

2015-09-01

Full Text Available We describe a case with macular hole (MH associated with Vogt-Koyanagi-Harada (VKH disease. A 71-year-old Japanese woman presented with visual loss and headaches. The best-corrected visual acuity (BCVA was 0.02 in the right eye (RE and 0.1 in the left eye (LE. The patient was diagnosed with VKH based on circumferential choroidal detachments, multiple serous retinal detachments, and optic disc hyperemia. The multiple serous retinal detachments improved with high-dose corticosteroid therapy and gradual tapering. The BCVA was recovered to 1.2/0.7 in the RE/LE. Six weeks after the initial administration of steroid, vitreomacular traction was found by optical coherence tomography in the LE, which progressed to stage 4 MH with the BCVA of 0.2 in the LE. Twenty-three weeks after the initial treatment, vitrectomy was performed with the standard surgical procedures, including inner limiting membrane peeling around the fovea and air tamponade. The MH was closed successfully and the BCVA was 0.4 in the LE 5 weeks after the vitrectomy. This is the first report of a case with MH secondary to the acute uveitic stage of VKH. Successful closure of MH was achieved with the standard surgical intervention for an idiopathic MH. To conclude, at the early stage of VKH, there is a possibility of MH formation due to the rapid progress of vitreous traction following the inflammation, and the surgical procedure could be effective to resolve this secondary disorder.

Retinal thinning after internal limiting membrane peeling for idiopathic macular hole.

Science.gov (United States)

Imamura, Yutaka; Ishida, Masahiro

2018-03-01

To determine the changes in retinal thickness and whether they correlate with the size of the macular hole (MH) after vitrectomy with internal limiting membrane peeling. Retrospective, interventional case series METHODS: Consecutive patients with an MH and undergoing pars plana vitrectomy with internal limiting membrane peeling were studied. The retinal thicknesses in the inner 4 sectors as defined by the Early Treatment of Diabetic Retinopathy Study were measured using spectral-domain optical coherence tomography (SD-OCT) before and at 2 weeks and 1, 3, 6, and 12 months after the surgery. The basal and minimum diameters of the MHs were measured. The correlations between the retinal thicknesses and the size of the MH were determined. Thirty-three eyes of 32 consecutive patients (18 women; mean age, 64.2 ± 8.8 years) with an MH were studied. Thirteen eyes had a stage-2 MH; 12 eyes, a stage-3 MH; and 8 eyes, a stage-4 MH. The mean retinal thickness in the temporal sector was 362.8 ± 29.9 µm preoperatively, 337.9 ± 20.6 µm at 2 weeks postoperatively, and 307.6 ± 20.2 µm at 12 months postoperatively (P peeling.

An Assessment of Vitreous Degeneration in Eyes with Vitreomacular Traction and Macular Holes

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Quraish Ghadiali

2017-01-01

Full Text Available Purpose. To compare the stages of vitreous degeneration in patients with vitreomacular traction (VMT and macular holes (MH. Methods. A retrospective study was performed analyzing stages of vitreous degeneration of eyes with VMT or MH using swept-source optical coherence tomography (SS-OCT and spectral-domain optical coherence tomography (SD-OCT. An analogous review was performed on a control group of eyes with contralateral posterior vitreous detachments. Thirty-four eyes with VMT/MH and 39 control eyes were reviewed. Results. Twenty-seven VMT/MH eyes and 31 control eyes were included. Eyes with VMT/MH demonstrated significantly earlier stages of vitreous degeneration when compared to the control group (p=0.048 despite significantly greater age (p=0.032. Conclusions. Vitreoretinal interface disease is more often associated with a formed vitreous and an intact premacular bursa. This is contrary to previous assumptions implicating degeneration of vitreous as a precipitating factor of interface disease when in conjunction with abnormal vitreomacular separation.

A New Model of Black Hole Formation

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Thayer G. D.

2013-10-01

Full Text Available The formation of a black hole and its event horizon are described. Conclusions, which are the result of a thought experiment, show that Schwarzschild [1] was correct: A singularity develops at the event horizon of a newly-formed black hole. The intense gravitational field that forms near the event horizon results in the mass-energy of the black hole accumulating in a layer just inside the event horizon, rather than collapsing into a central singularity.

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.

Choroidal thickness in Malaysian eyes with full-thickness macular holes

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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.

The Formation of Supermassive Black Holes in the First Galaxies

NARCIS (Netherlands)

Schleicher, Dominik R. G.; Banerjee, Robi; Sur, Sharanya; Glover, Simon C. O.; Spaans, Marco; Klessen, Ralf S.

2010-01-01

We discuss the formation of supermassive black holes in the early universe, and how to probe their subsequent evolution with the upcoming mm/sub-mm telescope ALMA. We first focus on the chemical and radiative conditions for black hole formation, in particular considering radiation trapping and

The Formation of Supermassive Black Holes in the First Galaxies

NARCIS (Netherlands)

Schleicher, Dominik R. G.; Banerjee, Robi; Sur, Sharanya; Glover, Simon C. O.; Spaans, Marco; Klessen, Ralf S.

We discuss the formation of supermassive black holes in the early universe, and how to probe their subsequent evolution with the upcoming mm/sub-mm telescope ALMA. We first focus on the chemical and radiative conditions for black hole formation, in particular considering radiation trapping and

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.

Formation of black hole and emission of gravitational waves.

Science.gov (United States)

Nakamura, Takashi

2006-12-01

Numerical simulations were performed for the formation process of rotating black holes. It is suggested that Kerr black holes are formed for wide ranges of initial parameters. The nature of gravitational waves from a test particle falling into a Kerr black hole as well as the development of 3D numerical relativity for the coalescing binary neutron stars are discussed.

Supermassive Black Holes as the Regulators of Star Formation in Central Galaxies

Energy Technology Data Exchange (ETDEWEB)

Terrazas, Bryan A.; Bell, Eric F. [Department of Astronomy, University of Michigan, Ann Arbor, MI 48109 (United States); Woo, Joanna; Henriques, Bruno M. B. [Department of Physics, Institute for Astronomy, ETH Zurich, 8093 Zurich (Switzerland)

2017-08-01

We present the relationship between the black hole mass, stellar mass, and star formation rate (SFR) of a diverse group of 91 galaxies with dynamically measured black hole masses. For our sample of galaxies with a variety of morphologies and other galactic properties, we find that the specific SFR is a smoothly decreasing function of the ratio between black hole mass and stellar mass, or what we call the specific black hole mass. In order to explain this relation, we propose a physical framework where the gradual suppression of a galaxy’s star formation activity results from the adjustment to an increase in specific black hole mass, and accordingly, an increase in the amount of heating. From this framework, it follows that at least some galaxies with intermediate specific black hole masses are in a steady state of partial quiescence with intermediate specific SFRs, implying that both transitioning and steady-state galaxies live within this region that is known as the “green valley.” With respect to galaxy formation models, our results present an important diagnostic with which to test various prescriptions of black hole feedback and its effects on star formation activity.

Supermassive Black Holes as the Regulators of Star Formation in Central Galaxies

International Nuclear Information System (INIS)

Terrazas, Bryan A.; Bell, Eric F.; Woo, Joanna; Henriques, Bruno M. B.

2017-01-01

We present the relationship between the black hole mass, stellar mass, and star formation rate (SFR) of a diverse group of 91 galaxies with dynamically measured black hole masses. For our sample of galaxies with a variety of morphologies and other galactic properties, we find that the specific SFR is a smoothly decreasing function of the ratio between black hole mass and stellar mass, or what we call the specific black hole mass. In order to explain this relation, we propose a physical framework where the gradual suppression of a galaxy’s star formation activity results from the adjustment to an increase in specific black hole mass, and accordingly, an increase in the amount of heating. From this framework, it follows that at least some galaxies with intermediate specific black hole masses are in a steady state of partial quiescence with intermediate specific SFRs, implying that both transitioning and steady-state galaxies live within this region that is known as the “green valley.” With respect to galaxy formation models, our results present an important diagnostic with which to test various prescriptions of black hole feedback and its effects on star formation activity.

Optic neuropathy causing vertical unilateral hemianopsia after pars plana vitrectomy for a macular hole: A case report.

Science.gov (United States)

Kawashima, Hirohiko; Nagai, Norihiro; Shinoda, Hajime; Tsubota, Kazuo; Ozawa, Yoko

2018-04-01

Recent progress in medical technology has resulted in improved surgical outcomes of pars plana vitrectomy (PPV); with microincision systems, the incidence of procedure-related complications during surgery has been reduced. However, unpredictable visual field defects after PPV remain an unresolved issue. A few reports have shown that damage to the retinal neurofibers owing to dry-up during air/fluid exchange or retinal neurotoxicity of the dye used to visualize the internal limiting membrane (ILM), as well as unintentional removal of retinal neurofibers during ILM peeling, are responsible for such visual field disorders. In this report, we present a case of extensive visual field defect due to optic neuropathy exhibiting vertical hemianopsia after PPV. A 50-year-old woman underwent PPV and cataract surgery for a macular hole and mild cataract under retrobulbar anesthesia with 3.5 mL of xylocaine. At the time of opening an infusion cannula for PPV, the intraocular lens was herniating, with an acute increase in pressure from the posterior eyeball; thus, intraocular pressure configuration level had to be decreased from the default level, whereas the other procedures including 20% SF6 injection were performed without any modification. The macular hole was closed postoperatively. However, the patient experienced nasal hemianopsia, which turned out to be optic neuropathy, as assessed via electric physiological examinations. The pattern of the visual field defect was not typical for glaucoma or anterior ischemic optic neuropathy. Her optic nerve head was pale at the temporal side soon after the surgery, and her blood pressure was low, suggesting that there may have been a congestion of the optic nerve feeder vessels because of the relatively high pressure in the orbit. The space occupancy with xylocaine and extensively stretched and plumped out eye ball with infusion during PPV may have pressed the surrounding tissue of the optic nerve and the feeder vessels. PPV is safe

ILLUMINATING BLACK HOLE BINARY FORMATION CHANNELS WITH SPINS IN ADVANCED LIGO

Energy Technology Data Exchange (ETDEWEB)

Rodriguez, Carl L. [MIT-Kavli Institute for Astrophysics and Space Research, 77 Massachusetts Avenue, 37-664H, Cambridge, MA 02139 (United States); Zevin, Michael; Pankow, Chris; Kalogera, Vasilliki; Rasio, Frederic A. [Center for Interdisciplinary Exploration and Research in Astrophysics (CIERA) and Department of Physics and Astronomy, Northwestern University, 2145 Sheridan Road, Evanston, IL 60208 (United States)

2016-11-20

The recent detections of the binary black hole mergers GW150914 and GW151226 have inaugurated the field of gravitational-wave astronomy. For the two main formation channels that have been proposed for these sources, isolated binary evolution in galactic fields and dynamical formation in dense star clusters, the predicted masses and merger rates overlap significantly, complicating any astrophysical claims that rely on measured masses alone. Here, we examine the distribution of spin–orbit misalignments expected for binaries from the field and from dense star clusters. Under standard assumptions for black hole natal kicks, we find that black hole binaries similar to GW150914 could be formed with significant spin–orbit misalignment only through dynamical processes. In particular, these heavy-black hole binaries can only form with a significant spin–orbit anti -alignment in the dynamical channel. Our results suggest that future detections of merging black hole binaries with measurable spins will allow us to identify the main formation channel for these systems.

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.

The formation of stellar black holes

Science.gov (United States)

Mirabel, Félix

2017-08-01

It is believed that stellar black holes (BHs) can be formed in two different ways: Either a massive star collapses directly into a BH without a supernova (SN) explosion, or an explosion occurs in a proto-neutron star, but the energy is too low to completely unbind the stellar envelope, and a large fraction of it falls back onto the short-lived neutron star (NS), leading to the delayed formation of a BH. Theoretical models set progenitor masses for BH formation by implosion, namely, by complete or almost complete collapse, but observational evidences have been elusive. Here are reviewed the observational insights on BHs formed by implosion without large natal kicks from: (1) the kinematics in three dimensions of space of five Galactic BH X-ray binaries (BH-XRBs), (2) the diversity of optical and infrared observations of massive stars that collapse in the dark, with no luminous SN explosions, possibly leading to the formation of BHs, and (3) the sources of gravitational waves (GWs) produced by mergers of stellar BHs so far detected with LIGO. Multiple indications of BH formation without ejection of a significant amount of matter and with no natal kicks obtained from these different areas of observational astrophysics, and the recent observational confirmation of the expected dependence of BH formation on metallicity and redshift, are qualitatively consistent with the high merger rates of binary black holes (BBHs) inferred from the first detections with LIGO.

Incidence and distribution of paravascular lamellar holes and their relationship with macular retinoschisis in highly myopic eyes using spectral-domain oct.

Science.gov (United States)

Vela, José I; Sánchez, Fernando; Díaz-Cascajosa, Jesús; Mingorance, Ester; Andreu, David; Buil, José A

2016-04-01

The purpose of the study is to determine the incidence and distribution of paravascular lamellar holes (PLH) around retinal vessels in highly myopic eyes and their relationship with macular retinoschisis (MR). We examined 306 eyes of 178 patients with high myopia, performing multiple scans of the posterior pole within the retinal vascular arcades using spectral-domain OCT. Type of staphyloma was determined. PLH were divided into three groups: holes only (group 1), holes extending below vessels (group 2), and holes in an area of paravascular retinoschisis (group 3). OCT showed that 96/306 eyes (31.4 %) had PLH mainly along the infero-temporal arcade (39.9 %). Type V and IX staphylomas had a higher proportion of PLH in the infero-temporal arcade than other staphylomas. Group 3 eyes presented higher rates of myopia and staphyloma. MR was detected in 10/27 eyes (37 %) in Group 3, but only in 2/33 eyes (6.1 %) in Group 1. No MR was found in Group 2. PLH are relatively common in highly myopic eyes and mainly distributed in the inferior temporal arcade. Findings from this descriptive study suggest that distribution of PLH might be related to the type of staphyloma. Further studies are needed to evaluate the relevance of PLH in the pathogenesis of MR.

The Formation and Evolution of the First Massive Black Holes

OpenAIRE

Haiman, Zoltan; Quataert, Eliot

2004-01-01

The first massive astrophysical black holes likely formed at high redshifts (z>10) at the centers of low mass (~10^6 Msun) dark matter concentrations. These black holes grow by mergers and gas accretion, evolve into the population of bright quasars observed at lower redshifts, and eventually leave the supermassive black hole remnants that are ubiquitous at the centers of galaxies in the nearby universe. The astrophysical processes responsible for the formation of the earliest seed black holes...

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

Directory of Open Access Journals (Sweden)

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

Satellite hole formation during dewetting: experiment and simulation

International Nuclear Information System (INIS)

Neto, Chiara; Jacobs, Karin; Seemann, Ralf; Blossey, Ralf; Becker, Juergen; Gruen, Guenther

2003-01-01

The dewetting of thin polymer films on solid substrates has been studied extensively in recent years. These films can decay either by nucleation events or by spinodal dewetting, essentially only depending on the interface potential describing the short- and long-range intermolecular interactions between the interfaces and the initial film thickness. Here, we describe experiments and simulations concerned with the decay of polystyrene thin films. The rupture of the film occurs by the formation of a correlated pattern of holes ('satellite holes') along the liquid rims accumulating at the channel borders. The development of this complex film rupture process, which is neither simply spinodal nor nucleation dewetting, can be mimicked precisely by making use of a novel simulation code based on a rigorous mathematical treatment of the thin film equation and on the knowledge of the effective interface potential of the system. The conditions that determine the appearance and the position of the satellite holes around pre-existing holes are discussed

Can macular xanthophylls replace cholesterol in formation of the liquid-ordered phase in lipid-bilayer membranes?

Science.gov (United States)

Subczynski, Witold K; Wisniewska-Becker, Anna; Widomska, Justyna

2012-01-01

Lateral organization of membranes made from binary mixtures of dimyristoylphosphatidylcholine (DMPC) or dipalmitoylphosphatidylcholine (DPPC) and macular xanthophylls (lutein or zeaxanthin) was investigated using the saturation-recovery (SR) EPR spin-labeling discrimination by oxygen transport (DOT) method in which the bimolecular collision rate of molecular oxygen with the nitroxide spin label is measured. This work was undertaken to examine whether or not lutein and zeaxanthin, macular xanthophylls that parallel cholesterol in its function as a regulator of both membrane fluidity and hydrophobicity, can parallel other structural functions of cholesterol, including formation of the liquid-ordered phase in membranes. The DOT method permits discrimination of different membrane phases when the collision rates (oxygen transport parameter) differ in these phases. Additionally, membrane phases can be characterized by the oxygen transport parameter in situ without the need for separation, which provides information about the dynamics of each phase. In gel-phase membranes, two coexisting phases were discriminated in the presence of macular xanthophylls - namely, the liquid-ordered-like and solid-ordered-like phases. However, in fluid-phase membranes, xanthophylls only induce the solitary liquid-ordered-like phase, while at similar concentrations, cholesterol induces coexisting liquid-ordered and liquid-disordered phases. No significant differences between the effects of lutein and zeaxanthin were found.

THE ARDUOUS JOURNEY TO BLACK HOLE FORMATION IN POTENTIAL GAMMA-RAY BURST PROGENITORS

International Nuclear Information System (INIS)

Dessart, Luc; O'Connor, Evan; Ott, Christian D.

2012-01-01

We present a quantitative study on the properties at death of fast-rotating massive stars evolved at low-metallicity—objects that are proposed as likely progenitors of long-duration γ-ray bursts (LGRBs). We perform one-dimensional+rotation stellar-collapse simulations on the progenitor models of Woosley and Heger, and critically assess their potential for the formation of a black hole and a Keplerian disk (namely, a collapsar) or a proto-magnetar. We note that theoretical uncertainties in the treatment of magnetic fields and the approximate handling of rotation compromise the accuracy of stellar-evolution models. We find that only the fastest rotating progenitors achieve sufficient compactness for black hole formation while the bulk of models possess a core density structure typical of garden-variety core-collapse supernova (SN) progenitors evolved without rotation and at solar metallicity. Of the models that do have sufficient compactness for black hole formation, most of them also retain a large amount of angular momentum in the core, making them prone to a magneto-rotational explosion, therefore preferentially leaving behind a proto-magnetar. A large progenitor angular-momentum budget is often the sole criterion invoked in the community today to assess the suitability for producing a collapsar. This simplification ignores equally important considerations such as the core compactness, which conditions black hole formation, the core angular momentum, which may foster a magneto-rotational explosion preventing black hole formation, or the metallicity and the residual envelope mass which must be compatible with inferences from observed LGRB/SNe. Our study suggests that black hole formation is non-trivial, that there is room for accommodating both collapsars and proto-magnetars as LGRB progenitors, although proto-magnetars seem much more easily produced by current stellar-evolutionary models.

THE ARDUOUS JOURNEY TO BLACK HOLE FORMATION IN POTENTIAL GAMMA-RAY BURST PROGENITORS

Energy Technology Data Exchange (ETDEWEB)

Dessart, Luc [Laboratoire d' Astrophysique de Marseille, Universite Aix-Marseille and CNRS, UMR7326, 38 rue Frederic Joliot-Curie, 13388 Marseille (France); O' Connor, Evan; Ott, Christian D., E-mail: Luc.Dessart@oamp.fr, E-mail: evanoc@tapir.caltech.edu, E-mail: cott@tapir.caltech.edu [TAPIR, Mailcode 350-17, California Institute of Technology, Pasadena, CA 91125 (United States)

2012-07-20

We present a quantitative study on the properties at death of fast-rotating massive stars evolved at low-metallicity-objects that are proposed as likely progenitors of long-duration {gamma}-ray bursts (LGRBs). We perform one-dimensional+rotation stellar-collapse simulations on the progenitor models of Woosley and Heger, and critically assess their potential for the formation of a black hole and a Keplerian disk (namely, a collapsar) or a proto-magnetar. We note that theoretical uncertainties in the treatment of magnetic fields and the approximate handling of rotation compromise the accuracy of stellar-evolution models. We find that only the fastest rotating progenitors achieve sufficient compactness for black hole formation while the bulk of models possess a core density structure typical of garden-variety core-collapse supernova (SN) progenitors evolved without rotation and at solar metallicity. Of the models that do have sufficient compactness for black hole formation, most of them also retain a large amount of angular momentum in the core, making them prone to a magneto-rotational explosion, therefore preferentially leaving behind a proto-magnetar. A large progenitor angular-momentum budget is often the sole criterion invoked in the community today to assess the suitability for producing a collapsar. This simplification ignores equally important considerations such as the core compactness, which conditions black hole formation, the core angular momentum, which may foster a magneto-rotational explosion preventing black hole formation, or the metallicity and the residual envelope mass which must be compatible with inferences from observed LGRB/SNe. Our study suggests that black hole formation is non-trivial, that there is room for accommodating both collapsars and proto-magnetars as LGRB progenitors, although proto-magnetars seem much more easily produced by current stellar-evolutionary models.

Supersonic gas streams enhance the formation of massive black holes in the early universe.

Science.gov (United States)

Hirano, Shingo; Hosokawa, Takashi; Yoshida, Naoki; Kuiper, Rolf

2017-09-29

The origin of super-massive black holes in the early universe remains poorly understood. Gravitational collapse of a massive primordial gas cloud is a promising initial process, but theoretical studies have difficulty growing the black hole fast enough. We report numerical simulations of early black hole formation starting from realistic cosmological conditions. Supersonic gas motions left over from the Big Bang prevent early gas cloud formation until rapid gas condensation is triggered in a protogalactic halo. A protostar is formed in the dense, turbulent gas cloud, and it grows by sporadic mass accretion until it acquires 34,000 solar masses. The massive star ends its life with a catastrophic collapse to leave a black hole-a promising seed for the formation of a monstrous black hole. Copyright © 2017 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

The formation and gravitational-wave detection of massive stellar black hole binaries

International Nuclear Information System (INIS)

Belczynski, Krzysztof; Walczak, Marek; Buonanno, Alessandra; Cantiello, Matteo; Fryer, Chris L.; Holz, Daniel E.; Mandel, Ilya; Miller, M. Coleman

2014-01-01

If binaries consisting of two ∼100 M ☉ black holes exist, they would serve as extraordinarily powerful gravitational-wave sources, detectable to redshifts of z ∼ 2 with the advanced LIGO/Virgo ground-based detectors. Large uncertainties about the evolution of massive stars preclude definitive rate predictions for mergers of these massive black holes. We show that rates as high as hundreds of detections per year, or as low as no detections whatsoever, are both possible. It was thought that the only way to produce these massive binaries was via dynamical interactions in dense stellar systems. This view has been challenged by the recent discovery of several ≳ 150 M ☉ stars in the R136 region of the Large Magellanic Cloud. Current models predict that when stars of this mass leave the main sequence, their expansion is insufficient to allow common envelope evolution to efficiently reduce the orbital separation. The resulting black hole-black hole binary remains too wide to be able to coalesce within a Hubble time. If this assessment is correct, isolated very massive binaries do not evolve to be gravitational-wave sources. However, other formation channels exist. For example, the high multiplicity of massive stars, and their common formation in relatively dense stellar associations, opens up dynamical channels for massive black hole mergers (e.g., via Kozai cycles or repeated binary-single interactions). We identify key physical factors that shape the population of very massive black hole-black hole binaries. Advanced gravitational-wave detectors will provide important constraints on the formation and evolution of very massive stars.

Method of calculating pilestrip foundations in case of karst hole formation

Directory of Open Access Journals (Sweden)

Gotman Al'fred Leonidovich

2014-02-01

Full Text Available The paper presents pile strip foundations in the areas with karst risk. The analysis of karst hole formation mechanism shows the lateral soil pressure on the piles caused by the downfallen soil on the hole rims, which transfers around the hole edges during karst hole formation. In this case, the horizontal pressure of the pile reactive force in the area of the pile connection with the raft is transferred to the raft. Pile failure at the hole boundaries will lead to the increase of the raft bearing distance above the karst hole. The inadequate raft bearing capacity can provoke the emergency situation. The existing Codes on karst protective foundations design do not contain the analysis of pile and raft horizontal pressure under the downfallen soil.The goal of this work is to develop the method of pile strip foundations analysis in the areas with karst risk in case of karst hole formation. The analysis of stress-strain state of the system “foundation soil — pile foundation” was carried out using numerical modeling in geotechnical program MIDAS GTS. As a result of numerical investigations, the diagrams of lateral soil pressure onto the piles and the raft are plotted. The pile pressure is approximated with the linear or bilinear function in dependence on geometrical dimensions of the karst hole and strength characteristics of soil that generates the horizontal pressure.In the Codes, the analysis of a pile under lateral soil pressure is given for a pile with the free end. In the problem examined, the pile head has the hinged bearing in place of the connection with the raft. In view of the given boundary data, the pile design scheme is plotted. The inner forces and displacements of the pile are determined by integrating the differential equation of a pile bending. The consistent integrations are evaluated out of the boundary conditions. The boundary values of inner forces and displacements are evaluated from the equality conditions of

Primordial black hole formation during the QCD epoch

International Nuclear Information System (INIS)

Jedamzik, K.

1997-01-01

We consider the formation of horizon-size primordial black holes (PBH close-quote s) from pre-existing density fluctuations during cosmic phase transitions. It is pointed out that the formation of PBH close-quote s should be particularly efficient during the QCD epoch due to a substantial reduction of pressure forces during adiabatic collapse, or equivalently, a significant decrease in the effective speed of sound during the color-confinement transition. Our considerations imply that for generic initial density perturbation spectra PBH mass functions are expected to exhibit a pronounced peak on the QCD-horizon mass scale ∼1M circle-dot . This mass scale is roughly coincident with the estimated masses for compact objects recently observed in our galactic halo by the MACHO Collaboration. Black holes formed during the QCD epoch may offer an attractive explanation for the origin of halo dark matter evading possibly problematic nucleosynthesis and luminosity bounds on baryonic halo dark matter. copyright 1997 The American Physical Society

Direct formation of supermassive black holes via multi-scale gas inflows in galaxy mergers.

Science.gov (United States)

Mayer, L; Kazantzidis, S; Escala, A; Callegari, S

2010-08-26

Observations of distant quasars indicate that supermassive black holes of billions of solar masses already existed less than a billion years after the Big Bang. Models in which the 'seeds' of such black holes form by the collapse of primordial metal-free stars cannot explain the rapid appearance of these supermassive black holes because gas accretion is not sufficiently efficient. Alternatively, these black holes may form by direct collapse of gas within isolated protogalaxies, but current models require idealized conditions, such as metal-free gas, to prevent cooling and star formation from consuming the gas reservoir. Here we report simulations showing that mergers between massive protogalaxies naturally produce the conditions for direct collapse into a supermassive black hole with no need to suppress cooling and star formation. Merger-driven gas inflows give rise to an unstable, massive nuclear gas disk of a few billion solar masses, which funnels more than 10(8) solar masses of gas to a sub-parsec-scale gas cloud in only 100,000 years. The cloud undergoes gravitational collapse, which eventually leads to the formation of a massive black hole. The black hole can subsequently grow to a billion solar masses on timescales of about 10(8) years by accreting gas from the surrounding disk.

Dynamical Formation and Merger of Binary Black Holes

Science.gov (United States)

Stone, Nicholas

2017-01-01

The advent of gravitational wave (GW) astronomy began with Advanced LIGO's 2015 discovery of GWs from coalescing black hole (BH) binaries. GW astronomy holds great promise for testing general relativity, but also for investigating open astrophysical questions not amenable to traditional electromagnetic observations. One such question concerns the origin of stellar mass BH binaries in the universe: do these form primarily from evolution of isolated binaries of massive stars, or do they form through more exotic dynamical channels? The best studied dynamical formation channel involves multibody interactions of BHs and stars in dense globular cluster environments, but many other dynamical scenarios have recently been proposed, ranging from the Kozai effect in hierarchical triple systems to BH binary formation in the outskirts of Toomre-unstable accretion disks surrounding supermassive black holes. The BH binaries formed through these processes will have different distributions of observable parameters (e.g. mass ratios, spins) than BH binaries formed through the evolution of isolated binary stars. In my talk I will overview these and other dynamical formation scenarios, and summarize the key observational tests that will enable Advanced LIGO or other future detectors to determine what formation pathway creates the majority of binary BHs in the universe. NCS thanks NASA, which has funded his work through Einstein postdoctoral grant PF5-160145.

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

[Posterior vitrectomy with gas endotamponade and retinal laser therapy in treatment of patients with macular complications of the optic disc pit].

Science.gov (United States)

Cywiński, Adam; Kałużny, Jakub; Ferda, Daniela; Piwońska-Lobermajer, Anna

2015-01-01

Retrospective evaluation of functional and anatomical treatment outcomes in patients with macular cornplications of optic disc pit. 9 patients (eyes) underwent central posterior vitrectomy in conjunction with posterior vitreous detachment, retinal laser therapy to the optic disc pit area and endotamponade with expansile gas. It was followed by the patient's forced positioning (recommended for a few days especially at night), which ended the treatment protocol. Improved anatomical relationships, accompanied by functional improvement were achieved in each reported case. The resolution of macular lesions was slow, lasting even for several months. Too long delay in performing the surgery (over 5 months since the onset of visual impairment) was associated with the development of retinal complications, mainly macular hole formation, most likely caused by the long-term ischemia. The central posterior vitrectomy combined with posterior vitreous detachment, laser therapy, andd expansile gas tamponade offers good outcomes in patients with retinal complications of optic disc pit. Surgery performed shortly after the onset of visual dysfunction gives the best functional outcomes. Restoration of normal anatomical relationships is a long-term process. In some cases, though, these abnormalities may not resolve completely.

Quantum hoop conjecture: Black hole formation by particle collisions

Energy Technology Data Exchange (ETDEWEB)

Casadio, Roberto, E-mail: casadio@bo.infn.it [Dipartimento di Fisica e Astronomia, Università di Bologna, via Irnerio 46, 40126 Bologna (Italy); I.N.F.N., Sezione di Bologna, viale Berti Pichat 6/2, 40127 Bologna (Italy); Micu, Octavian, E-mail: octavian.micu@spacescience.ro [Institute of Space Science, Bucharest, P.O. Box MG-23, RO-077125 Bucharest-Magurele (Romania); Scardigli, Fabio, E-mail: fabio@phys.ntu.edu.tw [Dipartimento di Matematica, Politecnico di Milano, Piazza L. da Vinci 32, 20133 Milano (Italy); Yukawa Institute for Theoretical Physics, Kyoto University, Kyoto 606-8502 (Japan)

2014-05-01

We address the issue of (quantum) black hole formation by particle collision in quantum physics. We start by constructing the horizon wave-function for quantum mechanical states representing two highly boosted non-interacting particles that collide in flat one-dimensional space. From this wave-function, we then derive a probability that the system becomes a black hole as a function of the initial momenta and spatial separation between the particles. This probability allows us to extend the hoop conjecture to quantum mechanics and estimate corrections to its classical counterpart.

Quasar Formation and Energy Emission in Black Hole Universe

Directory of Open Access Journals (Sweden)

Zhang T. X.

2012-07-01

Full Text Available Formation and energy emission of quasars are investigated in accord with the black hole universe, a new cosmological model recently developed by Zhang. According to this new cosmological model, the universe originated from a star-like black hole and grew through a supermassive black hole to the present universe by accreting ambient matter and merging with other black holes. The origin, structure, evolution, expansion, and cosmic microwave background radiation of the black hole universe have been fully ex- plained in Paper I and II. This study as Paper III explains how a quasar forms, ignites and releases energy as an amount of that emitted by dozens of galaxies. A main sequence star, after its fuel supply runs out, will, in terms of its mass, form a dwarf, a neutron star, or a black hole. A normal galaxy, after its most stars have run out of their fuels and formed dwarfs, neutron stars, and black holes, will eventually shrink its size and collapse towards the center by gravity to form a supermassive black hole with billions of solar masses. This collapse leads to that extremely hot stellar black holes merge each other and further into the massive black hole at the center and meantime release a huge amount of radiation energy that can be as great as that of a quasar. Therefore, when the stellar black holes of a galaxy collapse and merge into a supermassive black hole, the galaxy is activated and a quasar is born. In the black hole universe, the observed dis- tant quasars powered by supermassive black holes can be understood as donuts from the mother universe. They were actually formed in the mother universe and then swallowed into our universe. The nearby galaxies are still very young and thus quiet at the present time. They will be activated and further evolve into quasars after billions of years. At that time, they will enter the universe formed by the currently observed distant quasars as similar to the distant quasars entered our universe

Displacement of foveal area toward optic disc after macular hole surgery with internal limiting membrane peeling.

Science.gov (United States)

Kawano, K; Ito, Y; Kondo, M; Ishikawa, K; Kachi, S; Ueno, S; Iguchi, Y; Terasaki, H

2013-07-01

To determine whether there is a displacement of the fovea toward the optic disc after successful macular hole (MH) surgery with internal limiting membrane (ILM) peeling. The medical records of 54 eyes of 53 patients that had undergone pars plana vitrectomy with ILM peeling and gas or air tamponade for an idiopathic MH were evaluated. Spectral-domain optical coherence tomography (OCT) had been performed before and >6 months after the surgery. The preoperative distances between the center of the MH and the optic disc (MH-OD), center of the MH and the bifurcation or crossing of retinal vessels (MH-RV) were measured in the OCT images. In addition, the postoperative distance between the center of the fovea and optic disc (F-OD) and the center of the fovea and the same bifurcation or crossing of retinal vessels (F-RV) were measured in the OCT images. The F-OD was 2.67±0.33 disc diameters (DD), which was significantly shorter than that of the MH-OD of 2.77±0.33 DD (Pdisplacement of the center of the macula toward the optic disc.

Satellite hole formation during dewetting: experiment and simulation

CERN Document Server

Neto, C; Seemann, R; Blossey, R; Becker, J; Grün, G

2003-01-01

The dewetting of thin polymer films on solid substrates has been studied extensively in recent years. These films can decay either by nucleation events or by spinodal dewetting, essentially only depending on the interface potential describing the short- and long-range intermolecular interactions between the interfaces and the initial film thickness. Here, we describe experiments and simulations concerned with the decay of polystyrene thin films. The rupture of the film occurs by the formation of a correlated pattern of holes ('satellite holes') along the liquid rims accumulating at the channel borders. The development of this complex film rupture process, which is neither simply spinodal nor nucleation dewetting, can be mimicked precisely by making use of a novel simulation code based on a rigorous mathematical treatment of the thin film equation and on the knowledge of the effective interface potential of the system. The conditions that determine the appearance and the position of the satellite holes around ...

Prevalence of macular abnormalities assessed by optical coherence tomography in patients with Usher syndrome.

Science.gov (United States)

Testa, Francesco; Melillo, Paolo; Rossi, Settimio; Marcelli, Vincenzo; de Benedictis, Antonella; Colucci, Raffaella; Gallo, Beatrice; Brunetti-Pierri, Raffaella; Donati, Simone; Azzolini, Claudio; Marciano, Elio; Simonelli, Francesca

2018-01-01

To investigate the prevalence of macular abnormalities in patients affected by Usher syndrome (USH), by comparing the clinical findings between two types (i.e., USH1 and USH2). A retrospective study was performed by reviewing optical coherence tomography (OCT) in 134 USH patients to determine the presence of macular abnormalities, including cystoid macular edema (CME), epiretinal membrane (ERM), vitreo-macular traction syndrome (VMT), and macular hole (MH). Macular abnormalities were observed in 126/268 (47.0%) examined eyes. The most frequent abnormality was ERM observed in 51 eyes (19%), followed by CME observed in 42 eyes (15.7%). Moreover, CME was significantly (p < 0.05) associated with younger age (CME: 30.1 ± 11.1 years; without CME: 36.9 ± 14.9 years), whereas VMT and full thickness MH were associated with older age (p < 0.05). Moreover, a significantly (p < 0.05) decreased best-corrected visual acuity was associated with MH compared to eyes without MH. Finally, CME was more frequent in USH1 compared to USH2. Our study, for the first time in the literature, showed the distribution of all macular abnormalities assessed by SD-OCT in a large USH cohort, comparing USH1 and USH2 patients. We observed that ocular abnormalities are highly prevalent in USH patients compared to general population, with ERM and CME being the most common alterations. Based on these findings, OCT screening in USH patients is recommended for early detection of macular changes and early treatment.

What Is Macular Edema?

Science.gov (United States)

... Español Eye Health / Eye Health A-Z Macular Edema Sections What Is Macular Edema? What Causes Macular ... Edema Diagnosis Macular Edema Treatment What Is Macular Edema? Leer en Español: ¿Qué es un edema macular? ...

What Is Macular Edema?

Medline Plus

Full Text Available ... Español Eye Health / Eye Health A-Z Macular Edema Sections What Is Macular Edema? What Causes Macular ... Edema Diagnosis Macular Edema Treatment What Is Macular Edema? Leer en Español: ¿Qué es un edema macular? ...

The macular xanthophylls.

Science.gov (United States)

Ahmed, Shazia S; Lott, McGregor N; Marcus, Dennis M

2005-01-01

The macular pigments are predominantly composed of three carotenoids: lutein, zeaxanthin, and meso-zeaxanthin. These carotenoids are concentrated and distributed in a selective manner. The properties of these pigments are further explored along with their methods of uptake, stabilization, and storage. The dual nature of these pigments as filters and antioxidants are elaborated upon in relation to their protective effects upon the macula, specifically in age-related macular degeneration. Evidence suggests that increased levels of macular pigment are correlated with a decreased risk of age-related macular degeneration. Many have sought to exploit this therapeutic relation. Studies reveal that oral supplementation with lutein and zeaxanthin can increase the levels of macular pigments in the retina and plasma. The effects of such supplementation on actual ocular function have yet to be fully addressed. New and standardized methods of assessing macular pigment density are discussed and future areas of research to further our understanding of macular xanthophylls as they pertain to age-related macular degeneration are highlighted.

The formation and disruption of black hole jets

CERN Document Server

Gabuzda, Denise; Kylafis, Nikolaos

2015-01-01

This book reviews the phenomenology displayed by relativistic jets as well as the most recent theoretical efforts to understand the physical mechanisms at their origin. Relativistic jets have been observed and studied in Active Galactic Nuclei (AGN) for about half a century and are believed to be fueled by accretion onto a supermassive black hole at the center of the host galaxy. Since the first discovery of relativistic jets associated with so-called "micro-quasars" much more recently, it has seemed clear that much of the physics governing the relativistic outflows in stellar X-ray binaries harboring black holes and in AGN must be common, but acting on very different spatial and temporal scales. With new observational and theoretical results piling up every day, this book attempts to synthesize a consistent, unified physical picture of the formation and disruption of jets in accreting black-hole systems. The chapters in this book offer overviews accessible not only to specialists but also to graduat...

Value of optical coherence tomography in the detection of macular pathology before the removal of silicone oil

Directory of Open Access Journals (Sweden)

Rashad MA

2016-01-01

Full Text Available Mohammad Ahmad Rashad, Ahmed Abdel Aliem Mohamed, Asmaa Ismail Ahmed Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, Egypt Purpose: To assess the pathological macular changes with optical coherence tomography (OCT before the removal of silicone oil (SiO in eyes that had undergone pars plana vitrectomy for complicated forms of retinal detachment (RD.Patients and methods: Subjects included 48 patients (51 eyes with complicated RD including proliferative vitreoretinopathy, proliferative diabetic retinopathy, recurrent RD, penetrating trauma, uveitis, giant retinal tears, and macular holes. All the eyes had undergone SiO injection. Furthermore, all eyes had been planned for the removal of SiO 6–12 months after the primary surgery. Finally, all eyes had a fundus examination and OCT examination before the silicone oil removal.Results: OCT findings indicated epiretinal membrane in 41% of the eyes, macular edema in 17%, macular detachment in 13.5%, macular thinning in 13.5%, macular holes in 10%, and subretinal membranes in 2%. Preoperative OCT was normal in only 12% of the eyes, while a clinical fundus examination was normal in 43% (P<0.001. Eyes with normal OCT had significantly better mean logMAR (0.35 than eyes with pathological changes detected through OCT (1.28; P<0.001. Surgical modifications were made during the removal of SiO in 74.5% of the eyes.Conclusion: OCT detected significantly more pathological changes than a clinical fundus examination. This had an impact on both surgical step modification during the removal of SiO and predictability of visual outcome after the removal of SiO. Keywords: optical coherence tomography, silicone oil, pars plana vitrectomy, proliferative vitreoretinopathy, proliferative diabetic retinopathy

Formation and evaporation of an electrically charged black hole in conformal gravity

Energy Technology Data Exchange (ETDEWEB)

Bambi, Cosimo [Fudan University, Center for Field Theory and Particle Physics and Department of Physics, Shanghai (China); Eberhard-Karls Universitaet Tuebingen, Theoretical Astrophysics, Tuebingen (Germany); Modesto, Leonardo [Southern University of Science and Technology, Department of Physics, Shenzhen (China); Porey, Shiladitya [Novosibirsk State University, Novosibirsk (Russian Federation); Rachwal, Leslaw [Universidade de Brasilia, Instituto de Fisica, Brasilia, DF (Brazil)

2018-02-15

Extending previous work on the formation and the evaporation of black holes in conformal gravity, in the present paper we study the gravitational collapse of a spherically symmetric and electrically charged thin shell of radiation. The process creates a singularity-free black hole. Assuming that in the evaporation process the charge Q is constant, the final product of the evaporation is an extremal remnant with M = Q, which is reached in an infinite amount of time. We also discuss the issue of singularity and thermodynamics of black holes in Weyl's conformal gravity. (orig.)

Distinguishing Between Formation Channels for Binary Black Holes with LISA

Science.gov (United States)

Breivik, Katelyn; Rodriguez, Carl L.; Larson, Shane L.; Kalogera, Vassiliki; Rasio, Frederic A.

2017-01-01

The recent detections of GW150914 and GW151226 imply an abundance of stellar-mass binary-black-hole mergers in the local universe. While ground-based gravitational-wave detectors are limited to observing the final moments before a binary merges, space-based detectors, such as the Laser Interferometer Space Antenna (LISA), can observe binaries at lower orbital frequencies where such systems may still encode information about their formation histories. In particular, the orbital eccentricity and mass of binary black holes in the LISA frequency band can be used together to discriminate between binaries formed in isolation in galactic fields and those formed in dense stellar environments such as globular clusters. In this letter, we explore the orbital eccentricity and mass of binary-black-hole populations as they evolve through the LISA frequency band. Overall we find that there are two distinct populations discernible by LISA. We show that up to ~90% of binaries formed either dynamically or in isolation have eccentricities measurable by LISA. Finally, we note how measured eccentricities of low-mass binary black holes evolved in isolation could provide detailed constraints on the physics of black-hole natal kicks and common-envelope evolution.

What Is Macular Edema?

Medline Plus

Full Text Available ... Ophthalmology/Strabismus Ocular Pathology/Oncology Oculoplastics/Orbit Refractive Management/Intervention Retina/Vitreous Uveitis ... Macular Edema Sections What Is Macular Edema? What Causes Macular Edema? Macular ...

Black hole formation and classicalization in ultra-Planckian 2→N scattering

Directory of Open Access Journals (Sweden)

G. Dvali

2015-04-01

Full Text Available We establish a connection between the ultra-Planckian scattering amplitudes in field and string theory and unitarization by black hole formation in these scattering processes. Using as a guideline an explicit microscopic theory in which the black hole represents a bound-state of many soft gravitons at the quantum critical point, we were able to identify and compute a set of perturbative amplitudes relevant for black hole formation. These are the tree-level N-graviton scattering S-matrix elements in a kinematical regime (called classicalization limit where the two incoming ultra-Planckian gravitons produce a large number N of soft gravitons. We compute these amplitudes by using the Kawai–Lewellen–Tye relations, as well as scattering equations and string theory techniques. We discover that this limit reveals the key features of the microscopic corpuscular black hole N-portrait. In particular, the perturbative suppression factor of a N-graviton final state, derived from the amplitude, matches the non-perturbative black hole entropy when N reaches the quantum criticality value, whereas final states with different value of N are either suppressed or excluded by non-perturbative corpuscular physics. Thus we identify the microscopic reason behind the black hole dominance over other final states including non-black hole classical object. In the parameterization of the classicalization limit the scattering equations can be solved exactly allowing us to obtain closed expressions for the high-energy limit of the open and closed superstring tree-level scattering amplitudes for a generic number N of external legs. We demonstrate matching and complementarity between the string theory and field theory in different large-s and large-N regimes.

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.

THE BLACK HOLE FORMATION PROBABILITY

International Nuclear Information System (INIS)

Clausen, Drew; Piro, Anthony L.; Ott, Christian D.

2015-01-01

A longstanding question in stellar evolution is which massive stars produce black holes (BHs) rather than neutron stars (NSs) upon death. It has been common practice to assume that a given zero-age main sequence (ZAMS) mass star (and perhaps a given metallicity) simply produces either an NS or a BH, but this fails to account for a myriad of other variables that may effect this outcome, such as spin, binarity, or even stochastic differences in the stellar structure near core collapse. We argue that instead a probabilistic description of NS versus BH formation may be better suited to account for the current uncertainties in understanding how massive stars die. We present an initial exploration of the probability that a star will make a BH as a function of its ZAMS mass, P BH (M ZAMS ). Although we find that it is difficult to derive a unique P BH (M ZAMS ) using current measurements of both the BH mass distribution and the degree of chemical enrichment by massive stars, we demonstrate how P BH (M ZAMS ) changes with these various observational and theoretical uncertainties. We anticipate that future studies of Galactic BHs and theoretical studies of core collapse will refine P BH (M ZAMS ) and argue that this framework is an important new step toward better understanding BH formation. A probabilistic description of BH formation will be useful as input for future population synthesis studies that are interested in the formation of X-ray binaries, the nature and event rate of gravitational wave sources, and answering questions about chemical enrichment

The Black Hole Formation Probability

Science.gov (United States)

Clausen, Drew; Piro, Anthony L.; Ott, Christian D.

2015-02-01

A longstanding question in stellar evolution is which massive stars produce black holes (BHs) rather than neutron stars (NSs) upon death. It has been common practice to assume that a given zero-age main sequence (ZAMS) mass star (and perhaps a given metallicity) simply produces either an NS or a BH, but this fails to account for a myriad of other variables that may effect this outcome, such as spin, binarity, or even stochastic differences in the stellar structure near core collapse. We argue that instead a probabilistic description of NS versus BH formation may be better suited to account for the current uncertainties in understanding how massive stars die. We present an initial exploration of the probability that a star will make a BH as a function of its ZAMS mass, P BH(M ZAMS). Although we find that it is difficult to derive a unique P BH(M ZAMS) using current measurements of both the BH mass distribution and the degree of chemical enrichment by massive stars, we demonstrate how P BH(M ZAMS) changes with these various observational and theoretical uncertainties. We anticipate that future studies of Galactic BHs and theoretical studies of core collapse will refine P BH(M ZAMS) and argue that this framework is an important new step toward better understanding BH formation. A probabilistic description of BH formation will be useful as input for future population synthesis studies that are interested in the formation of X-ray binaries, the nature and event rate of gravitational wave sources, and answering questions about chemical enrichment.

Optical coherence tomography of the photoreceptor layer in the healthy eye and in eyes with hereditary macular dystrophy

International Nuclear Information System (INIS)

Stur, M.; Hermann, B.; Drexler, W.; Unterhuber, A.; Sattmann, H.; Ergun, E.; Wirtitsch, M.

2007-01-01

Optical coherence tomography is primarily used for the evaluation of pronounced alterations of the retinal architecture, such as in macular holes, epiretinal gliosis, intra- and subretinal fluid accumulation as well as retinal atrophy. Ultrahigh resolution OCT devices also allow the assessment of discrete alterations of the photoreceptor layer and the retinal pigment epithelium. On the basis of cases from two different macular dystrophies, the importance of the evaluation of the photoreceptor layer and its correlation with visual acuity is demonstrated.(author) [de

Utility of Pars Plana Vitrectomy with Internal Limiting Membrane Dissection, in the Surgical Treatment of Macular Hole and Diabetic Macular Edema. Clinic-Pathological Correlation

OpenAIRE

Castro de Sousa, João Paulo

2006-01-01

ObjetivosEstudiar el papel de la extracción de la membrana limitante interna (MLI) durante la vitrectomía posterior por vía pars plana (VPP), en el tratamiento quirúrgico de lo agujero macular (AM) y de lo edema macular crónico diabético (EMCD). Hemos estudiado las tasas de éxito clínico de la extracción de la MLI durante la VPP. Además hemos analizado el procedimiento técnico de extracción de la MLI, el aporte de la extracción de la MLI en la resolución clínica del EMCD después de la VPP y e...

Computer simulation of the formation of Langmuir solitons and holes in a cylindrical magnetized plasma column

International Nuclear Information System (INIS)

Turikov, V.A.

1978-06-01

Nonlinear plasma oscillations in a cylindrical plasma resulting from a short localized external excitation are examined by means of a particle-in-cell simulation scheme. Computer calculations are performed for describing the experimental results obtained in a single-ended Q-machine plasma in a cylindrical waveguide. It is assumed that there is a strong magnetic field in the direction of the column axis. When the amplitude of the excitation potential is close to the kinetic energy of electrons having a phase velocity of the electron plasma wave, the formation is observed of solitons and holes in phase space. After formation, the solitons and holes move with constant velocities. The velocities of solitons are close to the wave-phase velocity, while holes move with smaller velocities. When the external potential amplitude is increased, there is a tendency that the number of holes grows. The potential amplitude of the self-consistent field in the soliton region damps in time with increasing soliton width. The potential profile of the hole does not change after its formation. (Auth.)

Primordial black hole and wormhole formation by domain walls

Energy Technology Data Exchange (ETDEWEB)

Deng, Heling; Garriga, Jaume; Vilenkin, Alexander, E-mail: heling.deng@tufts.edu, E-mail: garriga@cosmos.phy.tufts.edu, E-mail: vilenkin@cosmos.phy.tufts.edu [Institute of Cosmology, Tufts University, 574 Boston Ave, Medford, MA, 02155 (United States)

2017-04-01

In theories with a broken discrete symmetry, Hubble sized spherical domain walls may spontaneously nucleate during inflation. These objects are subsequently stretched by the inflationary expansion, resulting in a broad distribution of sizes. The fate of the walls after inflation depends on their radius. Walls smaller than a critical radius fall within the cosmological horizon early on and collapse due to their own tension, forming ordinary black holes. But if a wall is large enough, its repulsive gravitational field becomes dominant much before the wall can fall within the cosmological horizon. In this ''supercritical'' case, a wormhole throat develops, connecting the ambient exterior FRW universe with an interior baby universe, where the exponential growth of the wall radius takes place. The wormhole pinches off in a time-scale comparable to its light-crossing time, and black holes are formed at its two mouths. As discussed in previous work, the resulting black hole population has a wide distribution of masses and can have significant astrophysical effects. The mechanism of black hole formation has been previously studied for a dust-dominated universe. Here we investigate the case of a radiation-dominated universe, which is more relevant cosmologically, by using numerical simulations in order to find the initial mass of a black hole as a function of the wall size at the end of inflation. For large supercritical domain walls, this mass nearly saturates the upper bound according to which the black hole cannot be larger than the cosmological horizon. We also find that the subsequent accretion of radiation satisfies a scaling relation, resulting in a mass increase by about a factor of 2.

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.

What Is Macular Edema?

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Full Text Available ... Eye Health A-Z Symptoms Glasses & Contacts Tips & Prevention News Ask an Ophthalmologist Patient Stories Español Eye ... Macular Edema Symptoms Macular Edema Diagnosis Macular Edema Treatment What Is Macular Edema? Leer en Español: ¿Qué ...

FORMATION OF BLACK HOLE X-RAY BINARIES IN GLOBULAR CLUSTERS

International Nuclear Information System (INIS)

Ivanova, N.; Heinke, C. O.; Woods, T. E.; Chaichenets, S.; Fregeau, J.; Lombardi, J. C.

2010-01-01

Inspired by the recent identification in extragalactic globular clusters of the first candidate black hole-white dwarf (BH-WD) X-ray binaries, where the compact accretors may be stellar-mass black holes (BHs), we explore how such binaries could be formed in a dynamical environment. We provide analyses of the formation rates via well-known formation channels like binary exchange and physical collisions and propose that the only possibility of forming BH-WD binaries is via coupling these usual formation channels with subsequent hardening and/or triple formation. In particular, we find that the most important mechanism for the creation of a BH-WD X-ray binary from an initially dynamically formed BH-WD binary is mass transfer induced in a triple system via the Kozai mechanism. Furthermore, we find that BH-WD binaries that evolve into X-ray sources can be formed by exchanges of a BH into a WD-WD binary or possibly by collisions of a BH and a giant star. If BHs undergo significant evaporation from the cluster or form a completely detached subcluster of BHs, then we cannot match the observationally inferred production rates even using the most optimistic estimates of formation rates. To explain the observations with stellar-mass BH-WD binaries, at least 1% of all formed BHs, or presumably 10% of the BHs present in the core now, must be involved in interactions with the rest of the core stellar population.

THE BLACK HOLE FORMATION PROBABILITY

Energy Technology Data Exchange (ETDEWEB)

Clausen, Drew; Piro, Anthony L.; Ott, Christian D., E-mail: dclausen@tapir.caltech.edu [TAPIR, Walter Burke Institute for Theoretical Physics, California Institute of Technology, Mailcode 350-17, Pasadena, CA 91125 (United States)

2015-02-01

A longstanding question in stellar evolution is which massive stars produce black holes (BHs) rather than neutron stars (NSs) upon death. It has been common practice to assume that a given zero-age main sequence (ZAMS) mass star (and perhaps a given metallicity) simply produces either an NS or a BH, but this fails to account for a myriad of other variables that may effect this outcome, such as spin, binarity, or even stochastic differences in the stellar structure near core collapse. We argue that instead a probabilistic description of NS versus BH formation may be better suited to account for the current uncertainties in understanding how massive stars die. We present an initial exploration of the probability that a star will make a BH as a function of its ZAMS mass, P {sub BH}(M {sub ZAMS}). Although we find that it is difficult to derive a unique P {sub BH}(M {sub ZAMS}) using current measurements of both the BH mass distribution and the degree of chemical enrichment by massive stars, we demonstrate how P {sub BH}(M {sub ZAMS}) changes with these various observational and theoretical uncertainties. We anticipate that future studies of Galactic BHs and theoretical studies of core collapse will refine P {sub BH}(M {sub ZAMS}) and argue that this framework is an important new step toward better understanding BH formation. A probabilistic description of BH formation will be useful as input for future population synthesis studies that are interested in the formation of X-ray binaries, the nature and event rate of gravitational wave sources, and answering questions about chemical enrichment.

Methoxsalen-induced macular toxicity

Directory of Open Access Journals (Sweden)

Aditya Maitray

2017-01-01

Full Text Available Psoralen compounds such as methoxsalen are photosensitizer agents used in conjunction with ultraviolet A (UVA radiation exposure as photochemotherapy (Psoralens and ultraviolet-A therapy [PUVA therapy] for certain epidermal skin disorders such as psoriasis and vitiligo. Methoxsalen has been shown to be associated with premature cataract formation by forming adducts with lens proteins following oral administration and subsequent UVA exposure. Hence, the use of UV-filtering glasses is recommended during PUVA therapy sessions. Ocular tissues can be exposed to its photosensitizing effect with subsequent UV radiation exposure through sunlight if the patient was to be without protective eye glasses, potentially causing macular toxicity. Till date, there have been no reports in the literature of any posterior segment ocular toxicity arising from methoxsalen use. Here, we describe a case of a bilateral macular toxicity in a middle-aged male treated with methoxsalen for vitiligo.

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.

What Is Macular Edema?

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Full Text Available ... Macular Edema Treatment What Is Macular Edema? Leer en Español: ¿Qué es un edema macular? Dec. 01, 2010 Macular edema is swelling or thickening of the eye's macula, the part of your eye responsible for detailed, central vision. The macula is a very small area ...

Constraining stellar binary black hole formation scenarios with eLISA eccentricity measurements

Science.gov (United States)

Nishizawa, Atsushi; Sesana, Alberto; Berti, Emanuele; Klein, Antoine

2017-03-01

A space-based interferometer such as the evolved Laser Interferometer Space Antenna (eLISA) could observe a few to a few thousands of progenitors of black hole binaries (BHBs) similar to those recently detected by Advanced LIGO. Gravitational radiation circularizes the orbit during inspiral, but some BHBs retain a measurable eccentricity at the low frequencies where eLISA is the most sensitive. The eccentricity of a BHB carries precious information about its formation channel: BHBs formed in the field, in globular clusters, or close to a massive black hole (MBH) have distinct eccentricity distributions in the eLISA band. We generate mock eLISA observations, folding in measurement errors, and using a Bayesian model selection, we study whether eLISA measurements can identify the BHB formation channel. We find that a handful of observations would suffice to tell whether BHBs were formed in the gravitational field of an MBH. Conversely, several tens of observations are needed to tell apart field formation from globular cluster formation. A 5-yr eLISA mission with the longest possible armlength is desirable to shed light on BHB formation scenarios.

The Formation and Growth of Black Holes in the Universe: New cosmological clues

CERN Multimedia

CERN. Geneva

2004-01-01

In the last few years a change of paradigm occurred in the field of black hole research. We now believe, that stellar mass black holes are created in powerful gamma ray bursts. Stellar remnants of the first generation of stars have very likely been the seeds of supermassive black holes, which we find dormant in the centers of most nearby galaxies - including our own Milky Way. A tight correlation between black hole mass and the global properties of their host galaxies indicates a co-formation and evolution of black holes and galaxies. The X-ray sky is dominated by a diffuse extragalactic background radiation, which our team, together with others, was able to resolve almost completely into discrete sources using the X-ray satellites ROSAT, Chandra and XMM-Newton. Optical and NIR follow-up identifications showed, that we observe the growth phase of the population of supermassive black holes throughout the history of the Universe. The accretion history derived from X-ray observations shows, that the black holes ...

The Formation and Growth of Black Holes in the Universe New cosmological clues

CERN Multimedia

CERN. Geneva; Landua, Rolf

2004-01-01

In the last few years a change of paradigm occurred in the field of black hole research. We now believe, that stellar mass black holes are created in powerful gamma ray bursts. Stellar remnants of the first generation of stars have very likely been the seeds of supermassive black holes, which we find dormant in the centers of most nearby galaxies - including our own Milky Way. A tight correlation between black hole mass and the global properties of their host galaxies indicates a co-formation and evolution of black holes and galaxies. The X-ray sky is dominated by a diffuse extragalactic background radiation, which our team, together with others, was able to resolve almost completely into discrete sources using the X-ray satellites ROSAT, Chandra and XMM-Newton. Optical and NIR follow-up identifications showed, that we observe the growth phase of the population of supermassive black holes throughout the history of the Universe. The accretion history derived from X-ray observations shows, that the black holes ...

Suppressing star formation in quiescent galaxies with supermassive black hole winds.

Science.gov (United States)

Cheung, Edmond; Bundy, Kevin; Cappellari, Michele; Peirani, Sébastien; Rujopakarn, Wiphu; Westfall, Kyle; Yan, Renbin; Bershady, Matthew; Greene, Jenny E; Heckman, Timothy M; Drory, Niv; Law, David R; Masters, Karen L; Thomas, Daniel; Wake, David A; Weijmans, Anne-Marie; Rubin, Kate; Belfiore, Francesco; Vulcani, Benedetta; Chen, Yan-mei; Zhang, Kai; Gelfand, Joseph D; Bizyaev, Dmitry; Roman-Lopes, A; Schneider, Donald P

2016-05-26

Quiescent galaxies with little or no ongoing star formation dominate the population of galaxies with masses above 2 × 10(10) times that of the Sun; the number of quiescent galaxies has increased by a factor of about 25 over the past ten billion years (refs 1-4). Once star formation has been shut down, perhaps during the quasar phase of rapid accretion onto a supermassive black hole, an unknown mechanism must remove or heat the gas that is subsequently accreted from either stellar mass loss or mergers and that would otherwise cool to form stars. Energy output from a black hole accreting at a low rate has been proposed, but observational evidence for this in the form of expanding hot gas shells is indirect and limited to radio galaxies at the centres of clusters, which are too rare to explain the vast majority of the quiescent population. Here we report bisymmetric emission features co-aligned with strong ionized-gas velocity gradients from which we infer the presence of centrally driven winds in typical quiescent galaxies that host low-luminosity active nuclei. These galaxies are surprisingly common, accounting for as much as ten per cent of the quiescent population with masses around 2 × 10(10) times that of the Sun. In a prototypical example, we calculate that the energy input from the galaxy's low-level active supermassive black hole is capable of driving the observed wind, which contains sufficient mechanical energy to heat ambient, cooler gas (also detected) and thereby suppress star formation.

Formation of massive seed black holes via collisions and accretion

Science.gov (United States)

Boekholt, T. C. N.; Schleicher, D. R. G.; Fellhauer, M.; Klessen, R. S.; Reinoso, B.; Stutz, A. M.; Haemmerlé, L.

2018-05-01

Models aiming to explain the formation of massive black hole seeds, and in particular the direct collapse scenario, face substantial difficulties. These are rooted in rather ad hoc and fine-tuned initial conditions, such as the simultaneous requirements of extremely low metallicities and strong radiation backgrounds. Here, we explore a modification of such scenarios where a massive primordial star cluster is initially produced. Subsequent stellar collisions give rise to the formation of massive (104-105 M⊙) objects. Our calculations demonstrate that the interplay among stellar dynamics, gas accretion, and protostellar evolution is particularly relevant. Gas accretion on to the protostars enhances their radii, resulting in an enhanced collisional cross-section. We show that the fraction of collisions can increase from 0.1 to 1 per cent of the initial population to about 10 per cent when compared to gas-free models or models of protostellar clusters in the local Universe. We conclude that very massive objects can form in spite of initial fragmentation, making the first massive protostellar clusters viable candidate birth places for observed supermassive black holes.

Primary black holes

International Nuclear Information System (INIS)

Novikov, I.; Polnarev, A.

1981-01-01

Proves are searched for of the formation of the so-called primary black holes at the very origin of the universe. The black holes would weigh less than 10 13 kg. The formation of a primary black hole is conditional on strong fluctuations of the gravitational field corresponding roughly to a half of the fluctuation maximally permissible by the general relativity theory. Only big fluctuations of the gravitational field can overcome the forces of the hot gas pressure and compress the originally expanding matter into a black hole. Low-mass black holes have a temperature exceeding that of the black holes formed from stars. A quantum process of particle formation, the so-called evaporation takes place in the strong gravitational field of a black hole. The lower the mass of the black hole, the shorter the evaporation time. The analyses of processes taking place during the evaporation of low-mass primary black holes show that only a very small proportion of the total mass of the matter in the universe could turn into primary black holes. (M.D.)

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.)

Small polaron formation and motion of holes in a-SiO2

International Nuclear Information System (INIS)

Hughes, R.C.; Emin, D.

1978-01-01

X-ray generated holes in SiO 2 are observed to be reduced to low mobility in times of the order of vibrational periods, 10 -12 s. The temperature dependence, electric field dependence and magnitude of this mobility for times up to about 100 ns are consistent with those of hole-like small polarons. The circumstances which favor the occurrence of rapid small polaron formation are a large effective mass (narrow valence band), the presence of the long-range hole-lattice interaction characteristic of an ionic material and the presence of disorder, all of which are found in amorphous SiO 2 . An alternative explanation involving trapping requires an extremely large localized state density and fortuitous temperature and field dependences of the hopping rates

Formation Rates of Black Hole Accretion Disk Gamma-Ray Bursts

International Nuclear Information System (INIS)

Fryer, Chris L.; Woosley, S. E.; Hartmann, Dieter H.

1999-01-01

The cosmological origin of at least an appreciable fraction of classical gamma-ray bursts (GRBs) is now supported by redshift measurements for a half-dozen faint host galaxies. Still, the nature of the central engine (or engines) that provide the burst energy remains unclear. While many models have been proposed, those currently favored are all based upon the formation of and/or rapid accretion into stellar-mass black holes. Here we discuss a variety of such scenarios and estimate the probability of each. Population synthesis calculations are carried out using a Monte Carlo approach in which the many uncertain parameters intrinsic to such calculations are varied. We estimate the event rate for each class of model as well as the propagation distances for those having significant delay between formation and burst production, i.e., double neutron star (DNS) mergers and black hole-neutron star (BH/NS) mergers. One conclusion is a 1-2 order of magnitude decrease in the rate of DNS and BH/NS mergers compared to that previously calculated using invalid assumptions about common envelope evolution. Other major uncertainties in the event rates and propagation distances include the history of star formation in the universe, the masses of the galaxies in which merging compact objects are born, and the radii of the hydrogen-stripped cores of massive stars. For reasonable assumptions regarding each, we calculate a daily event rate in the universe for (1) merging neutron stars: ∼100 day-1; (2) neutron star-black hole mergers: ∼450 day-1; (3) collapsars: ∼104 day-1; (4) helium star black hole mergers: ∼1000 day-1; and (5) white dwarf-black hole mergers: ∼20 day-1. The range of uncertainty in these numbers, however, is very large, typically 2-3 orders of magnitude. These rates must additionally be multiplied by any relevant beaming factor (f Ω <1) and sampling fraction (if the entire universal set of models is not being observed). Depending upon the mass of the host

Black hole formation in AdS Einstein-Gauss-Bonnet gravity

Energy Technology Data Exchange (ETDEWEB)

Deppe, Nils [Cornell Center for Astrophysics and Planetary Science andDepartment of Physics, Cornell University,122 Sciences Drive, Ithaca, New York 14853 (United States); Kolly, Allison [Department of Atmospheric and Oceanic Sciences, McGill University,805 Sherbrooke Street West, Montréal, Québec H3A 0B9 (Canada); Frey, Andrew R.; Kunstatter, Gabor [Department of Physics and Winnipeg Institute for Theoretical Physics, University of Winnipeg,515 Portage Avenue, Winnipeg, Manitoba R3B 2E9 (Canada)

2016-10-17

AdS spacetime has been shown numerically to be unstable against a large class of arbitrarily small perturbations. In http://dx.doi.org/10.1103/PhysRevLett.114.071102, the authors presented a preliminary study of the effects on stability of changing the local dynamics by adding a Gauss-Bonnet term to the Einstein action. Here we provide further details as well as new results with improved numerical methods. In particular, we elucidate new structure in Choptuik scaling plots. We also provide evidence of chaotic behavior at the transition between immediate horizon formation and horizon formation after the matter pulse reflects from the AdS conformal boundary. Finally, we present data suggesting the formation of naked singularities in spacetimes with ADM mass below the algebraic bound for black hole formation.

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.

What Is Macular Edema?

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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 ...

What Is Age-Related Macular Degeneration?

Science.gov (United States)

... Eye Health / Eye Health A-Z Age-Related Macular Degeneration Sections What Is Macular Degeneration? How is AMD ... What Does Macular Degeneration Look Like? What Is Macular Degeneration? Leer en Español: ¿Qué es la degeneración macular ...

Formation of Black Hole X-Ray Binaries with Non-degenerate Donors in Globular Clusters

Energy Technology Data Exchange (ETDEWEB)

Ivanova, Natalia; Rocha, Cassio A. da; Van, Kenny X.; Nandez, Jose L. A., E-mail: nata.ivanova@ualberta.ca [Department of Physics, University of Alberta, Edmonton, AB T6G 2E7 (Canada)

2017-07-10

In this Letter, we propose a formation channel for low-mass X-ray binaries with black hole accretors and non-degenerate donors via grazing tidal encounters with subgiants. We estimate that in a typically dense globular cluster with a core density of 10{sup 5} stars pc{sup −3}, the formation rates are about one binary per Gyr per 50–100 retained black holes. The donors—stripped subgiants—will be strongly underluminous when compared to subgiant or giant branch stars of the same colors. The products of tidal stripping are underluminous by at least one magnitude for several hundred million years when compared to normal stars of the same color, and differ from underluminous red stars that could be produced by non-catastrophic mass transfer in an ordinary binary. The dynamically formed binaries become quiescent LMXBs, with lifetimes of about a Gyr. The expected number of X-ray binaries is one per 50–200 retained black holes, while the expected number of strongly underluminous subsubgiant is about half this. The presence of strongly underluminous stars in a GC may be indicative of the presence of black holes.

Formation of Black Hole X-Ray Binaries with Non-degenerate Donors in Globular Clusters

International Nuclear Information System (INIS)

Ivanova, Natalia; Rocha, Cassio A. da; Van, Kenny X.; Nandez, Jose L. A.

2017-01-01

In this Letter, we propose a formation channel for low-mass X-ray binaries with black hole accretors and non-degenerate donors via grazing tidal encounters with subgiants. We estimate that in a typically dense globular cluster with a core density of 10 5 stars pc −3 , the formation rates are about one binary per Gyr per 50–100 retained black holes. The donors—stripped subgiants—will be strongly underluminous when compared to subgiant or giant branch stars of the same colors. The products of tidal stripping are underluminous by at least one magnitude for several hundred million years when compared to normal stars of the same color, and differ from underluminous red stars that could be produced by non-catastrophic mass transfer in an ordinary binary. The dynamically formed binaries become quiescent LMXBs, with lifetimes of about a Gyr. The expected number of X-ray binaries is one per 50–200 retained black holes, while the expected number of strongly underluminous subsubgiant is about half this. The presence of strongly underluminous stars in a GC may be indicative of the presence of black holes.

Formation and Coalescence of Electron Solitary Holes

DEFF Research Database (Denmark)

Saeki, K.; Michelsen, Poul; Pécseli, H. L.

1979-01-01

Electron solitary holes were observed in a magnetized collisionless plasma. These holes were identified as Bernstein-Green-Kruskal equilibria, thus being purely kinetic phenomena. The electron hole does not damp even though its velocity is close to the electron thermal velocity. Two holes attract...

Ion hole formation and nonlinear generation of electromagnetic ion cyclotron waves: THEMIS observations

Science.gov (United States)

Shoji, Masafumi; Miyoshi, Yoshizumi; Katoh, Yuto; Keika, Kunihiro; Angelopoulos, Vassilis; Kasahara, Satoshi; Asamura, Kazushi; Nakamura, Satoko; Omura, Yoshiharu

2017-09-01

Electromagnetic plasma waves are thought to be responsible for energy exchange between charged particles in space plasmas. Such an energy exchange process is evidenced by phase space holes identified in the ion distribution function and measurements of the dot product of the plasma wave electric field and the ion velocity. We develop a method to identify ion hole formation, taking into consideration the phase differences between the gyromotion of ions and the electromagnetic ion cyclotron (EMIC) waves. Using this method, we identify ion holes in the distribution function and the resulting nonlinear EMIC wave evolution from Time History of Events and Macroscale Interactions during Substorms (THEMIS) observations. These ion holes are key to wave growth and frequency drift by the ion currents through nonlinear wave-particle interactions, which are identified by a computer simulation in this study.

Cystoid macular edema

Directory of Open Access Journals (Sweden)

Tryfon G Rotsos

2008-10-01

Full Text Available Tryfon G Rotsos1, Marilita M Moschos21Medical Retina Service, Moorfields Eye Hospital, London, UK; 2Department of Ophthalmology, University of Athens, GreeceAbstract: We review the epidemiology, pathophysiology, and etiology of cystoid macular edema (CME. Inflammatory, diabetic, post-cataract, and macular edema due to age-related macular degeneration is described. The role of chronic inflammation and hypoxia and direct macular traction is evaluated in each case according to different views from the literature. The different diagnostic methods for evaluating the edema are described. Special attention is given to fluoroangiography and the most modern methods of macula examination, such as ocular coherence tomography and multifocal electroretinography. Finally, we discuss the treatment of cystoid macular edema in relation to its etiology. In this chapter we briefly refer to the therapeutic value of laser treatment especially in diabetic maculopathy or vitrectomy in some selected cases. Our paper is focused mainly on recent therapeutic treatment with intravitreal injection of triamcinolone acetonide and anti-VEGF factors like bevacizumab (Avastin, ranibizumab (Lucentis, pegaptamid (Macugen, and others. The goal of this paper is to review the current status of this treatment for macular edema due to diabetic maculopathy, central retinal vein occlusion and post-cataract surgery. For this reason the results of recent multicenter clinical trials are quoted, as also our experience on the use of intravitreal injections of anti-VEGF factors and we discuss its value in clinical practice.Keywords: cystoid macular edema, anti-VEGF, fluoroangiography, OCT, multifocal electroretinography

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

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

Retinal displacement toward optic disc after internal limiting membrane peeling for idiopathic macular hole.

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Ishida, Masahiro; Ichikawa, Yoshikazu; Higashida, Rieko; Tsutsumi, Yorihisa; Ishikawa, Atsushi; Imamura, Yutaka

2014-05-01

To examine the retinal displacement following successful macular hole (MH) surgery with internal limiting membrane (ILM) peeling and gas tamponade, and to determine the correlation between the extent of displacement and the basal MH size. Retrospective, interventional, observational case series. The medical records of consecutive patients with an idiopathic MH that had undergone vitrectomy with ILM peeling and gas tamponade were studied. The distances between the optic disc and the intersection of 2 retinal vessels located nasal or temporal to the fovea were measured manually preoperatively (A), and 2 weeks and 1, 3, 6, and 12 months postoperatively (B), on the fundus autofluorescence or near-infrared images. The basal and minimum diameters of the MHs were measured in the spectral-domain optical coherence tomographic images. The correlations between the ratio of the retinal displacement (A - B/A) and basal diameters of the MHs were determined. Twenty-one eyes of 21 patients (9 men, mean age: 64.6 ± 8.4 years) were studied. Ten eyes (47.6%) had stage 2 MH, 9 eyes (42.9%) had stage 3 MH, and 2 eyes (9.5%) had stage 4 MH. The temporal retinal vessels were displaced 260.8 ± 145.8 μm toward the optic disc at 2 weeks postoperatively, which was significantly greater than the 91.1 ± 89.7 μm of the nasal retinal vessels (paired t test, P displacement in the temporal field at 2 weeks was significantly correlated with the basal diameter of the MH (Spearman's rank correlation coeffieient = -0.476, P = .033. The greater displacement of the temporal retina than the nasal retina toward the optic disc postoperatively suggests that the temporal retina is more flexible and can be retracted toward the optic disc during the MH closure. Copyright © 2014 Elsevier Inc. All rights reserved.

Variations of current profiles in tokamaks. Formation mechanism and confinement property of current-hole configuration

International Nuclear Information System (INIS)

Takizuka, Tomonori

2003-01-01

The formation mechanism of the current hole in tokamak plasmas is reviewed. Experimental results of JT-60U are shown. Increase of the off-central noninductive current is a key factor for the current-hole formation. The internal Transport Barrier (ITB), which generates large bootstrap current, plays an important role. The central current density in the hole stays nearly 0. The idea of a new equilibrium for a tokamak plasma with a current hole is introduced. This equilibrium configuration called Axisymmetric Tri-Magnetic-Islands (ATMI) equilibrium', has three islands along the R direction (a central-negative-current island and side-positive-current islands). The equilibrium is stable with the elongation coils when the current in the ATMI region is limited to a small amount. The confinement properties of a current-hole configuration with box-type ITB is described. A scaling of the core poloidal beta inside the ITB, β p,core , is given as ε f β p,core approx. = 1, which suggests the equilibrium limit (ε f : inverse aspect ratio at the ITB foot). Though the core stored energy is little dependent on the heating power, the estimated heat diffusivity in the ITB region moderately correlates with a neoclassical diffusivity. (author)

Formation of quasistationary vortex and transient hole patterns through vortex merger

International Nuclear Information System (INIS)

Ganesh, R.; Lee, J.K.

2002-01-01

Collection of point-like intense vortices arranged symmetrically outside of a uniform circular vortex patch, both enclosed in a free-slip circular boundary, are numerically time evolved for up to 10-15 patch turnover times. These patterns are found to merge with the patch by successively inducing nonlinear dispersive modes (V-states) on the surface of the patch, draw off fingers of vorticity (filamentation), trap the irrotational regions as the fingers symmetrize under the shear flow of the patch and point-like vortices (wave breaking) followed by the vortex-hole capture. While the hole patterns are observed to break up over several turnover periods the vortex patterns appear to evolve into quasistationary patterns for some cases of an initial number of point-like vortices N pv . The bounded V-states, filamentation, and vortex (hole) pattern formation are discussed in some detail and their possible connection to recently observed vortex 'crystals' is pointed out

REPRODUCIBILITY OF MACULAR PIGMENT OPTICAL DENSITY MEASUREMENT BY TWO-WAVELENGTH AUTOFLUORESCENCE IN A CLINICAL SETTING.

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You, Qi Sheng; Bartsch, Dirk-Uwe G; Espina, Mark; Alam, Mostafa; Camacho, Natalia; Mendoza, Nadia; Freeman, William R

2016-07-01

Macular pigment, composed of lutein, zeaxanthin, and meso-zeaxanthin, is postulated to protect against age-related macular degeneration, likely because of filtering blue light and its antioxidant properties. Macular pigment optical density (MPOD) is reported to be associated with macular function evaluated by visual acuity and multifocal electroretinogram. Given the importance of macular pigment, reliable and accurate measurement methods are important. The main purpose of this study is to determine the reproducibility of MPOD measurement by two-wavelength autofluorescence method using scanning laser ophthalmoscopy. Sixty-eight eyes of 39 persons were enrolled in the study, including 11 normal eyes, 16 eyes with wet age-related macular degeneration, 16 eyes with dry age-related macular degeneration, 11 eyes with macular edema due to diabetic mellitus, branch retinal vein occlusion or macular telangiectasia, and 14 eyes with tractional maculopathy, including vitreomacular traction, epiretinal membrane, or macular hole. MPOD was measured with a two-wavelength (488 and 514 nm) autofluorescence method with the Spectralis HRA + OCT after pupil dilation. The measurement was repeated for each eye 10 minutes later. The analysis of variance and Bland-Altman plot were used to assess the reproducibility between the two measurements. The mean MPOD at eccentricities of 1° and 2° was 0.36 ± 0.17 (range: 0.04-0.69) and 0.15 ± 0.08 (range: -0.03 to 0.35) for the first measurement and 0.35 ± 0.17 (range: 0.02-0.68) and 0.15 ± 0.08 (range: -0.01 to 0.33) for the second measurement, respectively. The difference between the 2 measurements was not statistically significant, and the Bland-Altman plot showed 7.4% and 5.9% points outside the 95% limits of agreement, indicating an overall excellent reproducibility. Similarly, there is no significant difference between the first and second measurements of MPOD volume within eccentricities of 1°, 2°, and 6° radius, and the Bland

Analysis of the formation mechanism of the slug and jet center hole of axisymmetric shaped charges

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Baoxiang, Ren; Gang, Tao; Peng, Wen; Changxing, Du; Chunqiao, Pang; Hongbo, Meng

2018-06-01

In the jet formation process of axisymmetric shaped charges, the slug is also formed. There is always a central hole in the symmetry axis of the jet and slug. The phenomenon was rarely mentioned and analyzed by the classical theory of shaped charges. For this problem, this paper attempts to explain the existence of the central hole in the jet and slug. Based on the analysis of recovery slug, we know that the jet and slug are in solid state in the process of formation. Through the analysis of X-flash radiographs of the stretching jet and particulation fracture, it is confirmed that the center holes in the jet are also present. Meanwhile, through the analysis of the microstructure of the recovered slug, it is found that there is a wave disturbance near the surface of the central hole. It can be speculated that the wave disturbance also exist in the jet. This effect may be one of the reasons for jet breakup. Due to the presence of the central hole in the jet, the density deficit of the jet obtained by other tests is very reasonable.

[Vitreomacular adhesion in HD-OCT images in the age-related macular degeneration].

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Latalska, Małgorzata; Swiech-Zubilewicz, Anna; Mackiewicz, Jerzy

2013-01-01

The aim of this study was to evaluate an incidence of the vitreomacular adhesion in patients with age-related macular degeneration. We examined 472 eyes in 241 patients (136 W/ 105 M) in age of 54-92 years (mean 62.6 years +/- 8.5) with dry or wet age-related macular degeneration using Cirrus HD-OCT (Zeiss) macular cube 512x128 program or 5-line pro-gram. Vitreomacular adhesion was observed in 139 eyes with dry age-related macular degeneration (29.4%, p=0.000*), in 101 eyes with drusen (21.4%, p=0.000*), in 38 eyes with retinal pigment epithelium alterations (8%, p=0.202), in 278 eyes with wet age-related macular degeneration (58.9%, p=0.001*), in 21 eyes with pigment epithelial detachment (4.4%, p=0.303), in 161 eyes with choroidal neovascularzation (34. 1%, p=0.031*/ and in 96 eyes with scar (20.4%, p=0.040*). Probably, vitreomacular adhesion alone is not able to induce age-related macular degeneration, but it may be associated with choroidal neovascularization development, it can contribute to exudate formation and choroidal neovascularization, it may induces or sustains a chronic low-grade inflammation in the macula region.

Galaxy Formation from the Primordial Black Holes

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Morikawa, Masahiro

2017-12-01

Supermassive black hole (SMBH) of size MBH = 106-10M⊙ is common in the Universe and it defines the center of the galaxy. A galaxy and the SMBH are generally thought to have co-evolved. However, the SMBH cannot evolve so fast as commonly observed even at redshift z > 6. Therefore, we explore a natural hypothesis that the SMBH has been already formed mature at z ⪆ 10 before stars and galaxies. The SMBH forms energetic jets and out-flows which trigger massive star formation in the ambient gas. They eventually construct globular clusters and classical bulge as well as the body of elliptical galaxies. We propose simple models which implement these processes. We point out that the globular clusters and classical bulges have a common origin but are in different phases. The same is true for the elliptical and spiral galaxies. Physics behind these phase division is the runaway star formation process with strong feedback to SMBH. This is similar to the forest-fire model that displays self-organized criticality.

Galaxy Formation from the Primordial Black Holes

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Morikawa Masahiro

2017-01-01

Full Text Available Supermassive black hole (SMBH of size MBH = 106-10M⊙ is common in the Universe and it defines the center of the galaxy. A galaxy and the SMBH are generally thought to have co-evolved. However, the SMBH cannot evolve so fast as commonly observed even at redshift z > 6. Therefore, we explore a natural hypothesis that the SMBH has been already formed mature at z ⪆ 10 before stars and galaxies. The SMBH forms energetic jets and out-flows which trigger massive star formation in the ambient gas. They eventually construct globular clusters and classical bulge as well as the body of elliptical galaxies. We propose simple models which implement these processes. We point out that the globular clusters and classical bulges have a common origin but are in different phases. The same is true for the elliptical and spiral galaxies. Physics behind these phase division is the runaway star formation process with strong feedback to SMBH. This is similar to the forest-fire model that displays self-organized criticality.

Can macular xanthophylls replace cholesterol in formation of the liquid-ordered phase in lipid-bilayer membranes?

OpenAIRE

Subczynski, Witold K.; Wisniewska, Anna; Widomska, Justyna

2012-01-01

Lateral organization of membranes made from binary mixtures of dimyristoylphosphatidylcholine (DMPC) or dipalmitoylphosphatidylcholine (DPPC) and macular xanthophylls (lutein or zeaxanthin) was investigated using the saturation-recovery (SR) EPR spin-labeling discrimination by oxygen transport (DOT) method in which the bimolecular collision rate of molecular oxygen with the nitroxide spin label is measured. This work was undertaken to examine whether or not lutein and zeaxanthin, macular xant...

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

International Nuclear Information System (INIS)

Saraiva, Fabio Petersen; Costa, Patricia Grativol; Inomata, Daniela Lumi; Melo, Carlos Sergio Nascimento; Helal Junior, John; Nakashima, Yoshitaka

2007-01-01

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)

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)

Macular degeneration (image)

Science.gov (United States)

... macula in the back of the eye. The macula is important for clear central vision, allowing an individual to see fine details. There are two types of macular degeneration, dry and wet. Dry macular degeneration is more ...

Efficacy of Diacetate Esters of Macular Carotenoids: Effect of Supplementation on Macular Pigment

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Richard A. Bone

2018-01-01

Full Text Available The accumulation of the carotenoids lutein, zeaxanthin, and mesozeaxanthin in the center of the human retina, and known as the macula lutea or macular pigment, is believed to protect the retina from age-related macular degeneration. Since the macular pigment is of dietary origin, supplements containing the relevant carotenoids are readily available. In this study, we compared the changes in macular pigment over a 24-week supplementation period for two groups of 24 subjects each assigned to either of two supplement formulations, 20 mg/day of lutein or 20 mg equivalent free carotenoids of a combination of diacetate esters of the macular carotenoids. The latter group responded with a larger increase (0.0666 ± 0.0481 in macular pigment optical density than the former group (0.0398 ± 0.0430, driven largely by the older subjects. The difference was statistically significant (p=0.0287. There was a general trend towards smaller increases in macular pigment for those subjects whose baseline value was high. However, the trend was only significant (p<0.05 for subjects in the diacetate group. No differences in response could be attributed to the gender of the subjects. We also observed no indication that the use of statin drugs by a few of the older subjects influenced their responses.

Disentangling formation of multiple-core holes in aminophenol molecules exposed to bright X-FEL radiation

International Nuclear Information System (INIS)

Zhaunerchyk, V; Squibb, R J; Eland, J H D; Kamińska, M; Mucke, M; Piancastelli, M N; Frasinski, L J; Grilj, J; Koch, M; McFarland, B K; Sistrunk, E; Gühr, M; Coffee, R N; Bostedt, C; Bozek, J D; Salén, P; Meulen, P v d; Linusson, P; Thomas, R D; Larsson, M

2015-01-01

Competing multi-photon ionization processes, some leading to the formation of double core hole states, have been examined in 4-aminophenol. The experiments used the linac coherent light source (LCLS) x-ray free electron laser, in combination with a time-of-flight magnetic bottle electron spectrometer and the correlation analysis method of covariance mapping. The results imply that 4-aminophenol molecules exposed to the focused x-ray pulses of the LCLS sequentially absorb more than two x-ray photons, resulting in the formation of multiple core holes as well as in the sequential removal of photoelectrons and Auger electrons (so-called PAPA sequences). (paper)

Clinical analysis of intravitreal injection of triamcinolone acetonide combined macular grid photocoagulation treatment for macular edema

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Xian-Hua Jing

2014-10-01

Full Text Available AIM: To investigate the clinical efficacy and safety of intravitreal injection of triamcinolone combined macular grid photocoagulation treatment for macular edema. METHODS: Totally 150 cases(150 eyeswith macular edema in our hospital from July 2009 to November 2013 were selected, which were randomly divided into study group(75 cases, 75 eyesand control group(75 cases, 75 eyes. The cases in control group were treated with macular grid photocoagulation treatment, those in the study group used triamcinolone acetonide combined macular grid photocoagulation treatment. Best corrected visual acuity(BCVA, parallel optical coherence tomography(OCTand fundus fluorescein angiography(FFAwere detected before treatment, after treatment 7d, 1, 3, and 9mo. RESULTS:After the treatment, patients' vision were significantly improved in two groups(PPPP>0.05. Fovea macular neurosensory retinal thickness in the study group was significantly lower than that in control group(PCONCLUSION: Triamcinolone acetonide combined macular grid photocoagulation treatment is accurate, can effectively improve the visual acuity, reduce macular edema, it is safe and reliable, and suitable for clinical application.

Black hole formation and space-time fluctuations in two dimensional dilaton gravity and complementarity

International Nuclear Information System (INIS)

Das, S.R.; Mukherji, S.

1994-01-01

We study black hole formation in a model of two dimensional dilaton gravity and 24 massless scalar fields with a boundary. We find the most general boundary condition consistent with perfect reflection of matter and the constraints. We show that in the semiclassical approximation and for the generic value of a parameter which characterizes the boundary conditions, the boundary starts receding to infinity at the speed of light whenever the total energy of the incoming matter flux exceeds a certain critical value. This is also the critical energy which marks the onset of black hole formation. We then compute the quantum fluctuations of the boundary and of the rescaled scalar curvature and show that as soon as the incoming energy exceeds this critical value, and asymptotic observer using normal time resolutions will always measure large quantum fluctuations of space-time near the horizon, even though the freely falling observer does not. This is an aspect of black hole complementarity relating directly to quantum gravity effects. (author). 30 refs, 4 figs

Comment on self-consistent model of black hole formation and evaporation

International Nuclear Information System (INIS)

Ho, Pei-Ming

2015-01-01

In an earlier work, Kawai et al. proposed a model of black-hole formation and evaporation, in which the geometry of a collapsing shell of null dust is studied, including consistently the back reaction of its Hawking radiation. In this note, we illuminate the implications of their work, focusing on the resolution of the information loss paradox and the problem of the firewall.

Analysis of Macular Drusen and Blood Test Results in 945 Macaca fascicularis.

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Koji M Nishiguchi

Full Text Available Age-dependent formation of macular drusen caused by the focal accumulation of extracellular deposits beneath the retinal pigment epithelium precede the development of age-related macular degeneration (AMD, one of the leading causes of blindness worldwide. It is established that inflammation contributes to the pathogenesis of drusen and AMD. However, development of a preemptive therapeutic strategy targeting macular drusen and AMD has been impeded by the lack of relevant animal models because most laboratory animals lack macula, an anatomic feature present only in humans and a subset of monkeys. Reportedly, macular drusen and macular degeneration develop in monkeys in an age-dependent manner. In this study, we analyzed blood test results from 945 Macaca fascicularis, 317 with and 628 without drusen. First, a trend test for drusen frequency (the Cochran-Armitage test was applied to the quartile data for each parameter. We selected variables with an increasing or decreasing trend with higher quartiles at P < 0.05, to which multivariate logistic regression analysis was applied. This revealed a positive association of age (odds ratio [OR]: 1.10 per year, 95% confidence interval [CI]: 1.07-1.12 and white blood cell count (OR: 1.01 per 1 × 103/μl, 95% CI: 1.00-1.01 with drusen. When the monkeys were divided by age, the association between drusen and white blood cell count was only evident in younger monkeys (OR: 1.01 per 1 × 103/μl, 95% CI: 1.00-1.02. In conclusion, age and white blood cell count may be associated with drusen development in M. fascicularis. Systemic inflammation may contribute to drusen formation in monkeys.

Macular Edema Formation and Deterioration of Retinal Function after Intravitreal Bevacizumab Injection for Proliferative Diabetic Retinopathy

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Hisanori Imai

2011-09-01

Full Text Available Purpose: To report a case of proliferative diabetic retinopathy (PDR showing transient macular edema (ME and deteriorated retinal function after intravitreal bevacizumab injection (IVB. Methods and Results: A 53-year-old man received IVB (1.25 mg/0.05 ml in both eyes for the treatment of PDR. There was no treatment-related complication. However, he complained of photopsia in both eyes 6 h after the injection. Slit-lamp examination revealed mild cellular infiltrations (1+ in the anterior chamber in both eyes. Optical coherence tomography showed ME formation in the left eye. Both full-field and multifocal electroretinography (ERG revealed the deterioration of all parameters in both eyes compared with pretreatment. The inflammation in the anterior segment and ME disappeared 1 day after the injection. ERG parameters were improved 9 days after the injection, except for the N1 and P1 amplitude of multifocal ERG in the left eye. Conclusion: We propose that patients who undergo IVB should be carefully informed and followed up for possible complications including temporal ME formation and retinal function deterioration.

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

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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.

GLOBULAR CLUSTER FORMATION EFFICIENCIES FROM BLACK HOLE X-RAY BINARY FEEDBACK

Energy Technology Data Exchange (ETDEWEB)

Justham, Stephen [The Key Laboratory of Optical Astronomy, National Astronomical Observatories, The Chinese Academy of Sciences, Datun Road, Beijing 100012 (China); Peng, Eric W. [Department of Astronomy, Peking University, Beijing 100871 (China); Schawinski, Kevin, E-mail: sjustham@nao.cas.cn [Institute for Astronomy, ETH Zurich, Wolfgang-Pauli-Strasse 27, 8093 Zurich (Switzerland)

2015-08-10

We investigate a scenario in which feedback from black hole X-ray binaries (BHXBs) sometimes begins inside young star clusters before strong supernova (SN) feedback. Those BHXBs could reduce the gas fraction inside embedded young clusters while maintaining virial equilibrium, which may help globular clusters (GCs) to stay bound when SN-driven gas ejection subsequently occurs. Adopting a simple toy model with parameters guided by BHXB population models, we produce GC formation efficiencies consistent with empirically inferred values. The metallicity dependence of BHXB formation could naturally explain why GC formation efficiency is higher at lower metallicity. For reasonable assumptions about that metallicity dependence, our toy model can produce a GC metallicity bimodality in some galaxies without a bimodality in the field-star metallicity distribution.

Formation of electrostatic double-layers and electron-holes in a low pressure mercury plasma column

International Nuclear Information System (INIS)

Petraconi, G; Maciel, Homero S

2003-01-01

Experimental studies of the formation of electrostatic double layers (DLs) and electron-holes (e-holes) are reported. The measurements were performed in the positive column of a mercury arc discharge operating in the low-pressure range of (2.0-14.0) x 10 -2 Pa with current density in the range of (3.0-8.0) x 10 3 A m -2 . Stable and unstable modes of the discharge were identified as the current was gradually increased, keeping constant the vapour pressure. The discharge remains stable until a critical current from which a slight increase of the current leads to an unstable regime characterized by high discharge impedance and strong oscillations. This mode ceased after a DL was formed in the plasma column. To induce the DL formation and to transport it smoothly along the discharge column, a low intensity B-field (7-10) x 10 -3 T produced by a movable single coil was used. The B-field locally increases the electron current density and makes the DL form at the centre of the magnetic constriction where it remained at rest. Electrostatic potential structures compatible with ordinary DLs and multiple-layers could be formed in the plasma column by dealing with the combined effects of the operational parameters of the discharge. It is noticeable that a pure e-hole, which is a symmetric triple-layer having a bell shape potential profile, could easily be formed by means of this experimental technique. A partial kinetic description, based on the space charge structure derived from an experimental e-hole, is presented in order to infer the charged particle populations that could contribute to the space charge of the e-hole. Evidence is shown that strong e-hole formation might be driven by an ion beam, therefore it could not be formed in isolation since its formation requires a nearby ion accelerating potential structure. Probe measurements of the plasma properties, at various radial positions of the stable positive column, are also presented. In the stable mode, prior to

Using Black Hole Mergers to Explore Structure Formation

Science.gov (United States)

Alicea-Munoz, E.; Miller, M. Coleman

2009-01-01

Observations of gravitational waves from massive black hole mergers will open a new window into the era of structure formation in the early universe. Past efforts have concentrated on calculating merger rates using different physical assumptions, resulting in merger rate estimates that span a wide range (0.1 - 10(exp 4) mergers/year). We develop a semi-analytical, phenomenological model of massive black hole mergers that includes plausible combinations of several physical parameters, which we then turn around to determine how well observations with the Laser Interferometer Space Antenna (LISA) will be able to enhance our understanding of the universe during the critical z approximately equal to 5-30 epoch. Our approach involves generating synthetic LISA observable data (total BH masses, BH mass ratios, redshifts, merger rates), which are then analyzed using a Markov Chain Monte Carlo method, thus finding constraints for the physical parameters of the mergers. We find that our method works well at estimating merger parameters and that the number of merger events is a key discriminant among models, therefore making our method robust against observational uncertainties. Our approach can also be extended to more physically-driven models and more general problems in cosmology. This work is supported in part by the Cooperative Education Program at NASA/GSFC.

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

Science.gov (United States)

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

2018-01-01

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. 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 6 months after the surgery. 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). 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.

Critical appraisal of ranibizumab in the treatment of diabetic macular edema

Directory of Open Access Journals (Sweden)

Stewart MW

2013-06-01

Full Text Available Michael W StewartDepartment of Ophthalmology, Mayo School of Medicine, Jacksonville, FL, USAAbstract: Diabetic retinopathy is the leading cause of blindness among individuals of working age in industrialized nations, with most of the vision loss resulting from diabetic macular edema (DME. The formation of DME depends on the action of several growth factors and inflammatory mediators, but vascular endothelial growth factor (VEGF appears to be critical for breaking down the blood-retinal barrier and promoting the accumulation of macular edema. Laser photocoagulation has been the standard-of-care for three decades, and although it stabilizes vision, significant gains in visual acuity after treatment are unusual. Several VEGF inhibitors (pegaptanib, aflibercept, and ranibizumab have been initially developed and tested for the treatment of age-related macular degeneration and subsequently for DME. In Phase I, II, and III trials for DME, ranibizumab has been shown to be superior to macular laser photocoagulation and intraocular triamcinolone acetonide injections for improving visual acuity and drying the macula. As a result, ranibizumab is the only anti-VEGF drug that has been approved by the United States Food and Drug Administration for the treatment of DME. Most experts now consider intravitreal anti-VEGF therapy to be standard-of-care for DME involving the fovea.Keywords: aflibercept, bevacizumab, diabetic macular edema, diabetic retinopathy, ranibizumab, vascular endothelial growth factor

Gravitational collapse of dark energy field configurations and supermassive black hole formation

International Nuclear Information System (INIS)

Jhalani, V.; Kharkwal, H.; Singh, A.

2016-01-01

Dark energy is the dominant component of the total energy density of our Universe. The primary interaction of dark energy with the rest of the Universe is gravitational. It is therefore important to understand the gravitational dynamics of dark energy. Since dark energy is a low-energy phenomenon from the perspective of particle physics and field theory, a fundamental approach based on fields in curved space should be sufficient to understand the current dynamics of dark energy. Here, we take a field theory approach to dark energy. We discuss the evolution equations for a generic dark energy field in curved space-time and then discuss the gravitational collapse for dark energy field configurations. We describe the 3 + 1 BSSN formalism to study the gravitational collapse of fields for any general potential for the fields and apply this formalism to models of dark energy motivated by particle physics considerations. We solve the resulting equations for the time evolution of field configurations and the dynamics of space-time. Our results show that gravitational collapse of dark energy field configurations occurs and must be considered in any complete picture of our Universe. We also demonstrate the black hole formation as a result of the gravitational collapse of the dark energy field configurations. The black holes produced by the collapse of dark energy fields are in the supermassive black hole category with the masses of these black holes being comparable to the masses of black holes at the centers of galaxies.

Gravitational collapse of dark energy field configurations and supermassive black hole formation

Energy Technology Data Exchange (ETDEWEB)

Jhalani, V.; Kharkwal, H.; Singh, A., E-mail: anupamsingh.iitk@gmail.com [L. N. Mittal Institute of Information Technology, Physics Department (India)

2016-11-15

Dark energy is the dominant component of the total energy density of our Universe. The primary interaction of dark energy with the rest of the Universe is gravitational. It is therefore important to understand the gravitational dynamics of dark energy. Since dark energy is a low-energy phenomenon from the perspective of particle physics and field theory, a fundamental approach based on fields in curved space should be sufficient to understand the current dynamics of dark energy. Here, we take a field theory approach to dark energy. We discuss the evolution equations for a generic dark energy field in curved space-time and then discuss the gravitational collapse for dark energy field configurations. We describe the 3 + 1 BSSN formalism to study the gravitational collapse of fields for any general potential for the fields and apply this formalism to models of dark energy motivated by particle physics considerations. We solve the resulting equations for the time evolution of field configurations and the dynamics of space-time. Our results show that gravitational collapse of dark energy field configurations occurs and must be considered in any complete picture of our Universe. We also demonstrate the black hole formation as a result of the gravitational collapse of the dark energy field configurations. The black holes produced by the collapse of dark energy fields are in the supermassive black hole category with the masses of these black holes being comparable to the masses of black holes at the centers of galaxies.

Serous Macular Detachments

Directory of Open Access Journals (Sweden)

Hakan Özdemir

2012-03-01

Full Text Available Serous macular detachment has only recently been recognized to occur in a significant number of eyes with macular pathology including diabetic retinopathy, retinal vein occlusion, Behçet disease, Irvine-Gass syndrome and pars planitis. These serous retinal detachments associated with retinal vascular leakage are not suspected clinically or angiographically but can be diagnosed with optical coherence tomography (OCT beneath the edematous neurosensory retina. The detection of shallow foveal detachment may be helpful in better understanding the pathogenesis of these disorders. In addition, the detection of serous macular detachment may also help to better guide and assess the results of therapy in the future. (Turk J Oph thal mol 2012; 42: 146-9

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....... 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...

Interaction of poly(amidoamine) dendrimers with supported lipid bilayers and cells: hole formation and the relation to transport.

Science.gov (United States)

Hong, Seungpyo; Bielinska, Anna U; Mecke, Almut; Keszler, Balazs; Beals, James L; Shi, Xiangyang; Balogh, Lajos; Orr, Bradford G; Baker, James R; Banaszak Holl, Mark M

2004-01-01

We have investigated poly(amidoamine) (PAMAM) dendrimer interactions with supported 1,2-dimyristoyl-sn-glycero-3-phosphocholine (DMPC) lipid bilayers and KB and Rat2 cell membranes using atomic force microscopy (AFM), enzyme assays, flow cell cytometry, and fluorescence microscopy. Amine-terminated generation 7 (G7) PAMAM dendrimers (10-100 nM) were observed to form holes of 15-40 nm in diameter in aqueous, supported lipid bilayers. G5 amine-terminated dendrimers did not initiate hole formation but expanded holes at existing defects. Acetamide-terminated G5 PAMAM dendrimers did not cause hole formation in this concentration range. The interactions between PAMAM dendrimers and cell membranes were studied in vitro using KB and Rat 2 cell lines. Neither G5 amine- nor acetamide-terminated PAMAM dendrimers were cytotoxic up to a 500 nM concentration. However, the dose dependent release of the cytoplasmic proteins lactate dehydrogenase (LDH) and luciferase (Luc) indicated that the presence of the amine-terminated G5 PAMAM dendrimer decreased the integrity of the cell membrane. In contrast, the presence of acetamide-terminated G5 PAMAM dendrimer had little effect on membrane integrity up to a 500 nM concentration. The induction of permeability caused by the amine-terminated dendrimers was not permanent, and leaking of cytosolic enzymes returned to normal levels upon removal of the dendrimers. The mechanism of how PAMAM dendrimers altered cells was investigated using fluorescence microscopy, LDH and Luc assays, and flow cytometry. This study revealed that (1) a hole formation mechanism is consistent with the observations of dendrimer internalization, (2) cytosolic proteins can diffuse out of the cell via these holes, and (3) dye molecules can be detected diffusing into the cell or out of the cell through the same membrane holes. Diffusion of dendrimers through holes is sufficient to explain the uptake of G5 amine-terminated PAMAM dendrimers into cells and is consistent

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 ... 2016 Study Compares Eylea, Lucentis and Avastin for Diabetic Macular Edema Jul 17, 2015 Top 5 Risk ...

GALAXY FORMATION WITH SELF-CONSISTENTLY MODELED STARS AND MASSIVE BLACK HOLES. I. FEEDBACK-REGULATED STAR FORMATION AND BLACK HOLE GROWTH

International Nuclear Information System (INIS)

Kim, Ji-hoon; Abel, Tom; Wise, John H.; Alvarez, Marcelo A.

2011-01-01

There is mounting evidence for the coevolution of galaxies and their embedded massive black holes (MBHs) in a hierarchical structure formation paradigm. To tackle the nonlinear processes of galaxy-MBH interaction, we describe a self-consistent numerical framework which incorporates both galaxies and MBHs. The high-resolution adaptive mesh refinement (AMR) code Enzo is modified to model the formation and feedback of molecular clouds at their characteristic scale of 15.2 pc and the accretion of gas onto an MBH. Two major channels of MBH feedback, radiative feedback (X-ray photons followed through full three-dimensional adaptive ray tracing) and mechanical feedback (bipolar jets resolved in high-resolution AMR), are employed. We investigate the coevolution of a 9.2 x 10 11 M sun galactic halo and its 10 5 M sun embedded MBH at redshift 3 in a cosmological ΛCDM simulation. The MBH feedback heats the surrounding interstellar medium (ISM) up to 10 6 K through photoionization and Compton heating and locally suppresses star formation in the galactic inner core. The feedback considerably changes the stellar distribution there. This new channel of feedback from a slowly growing MBH is particularly interesting because it is only locally dominant and does not require the heating of gas globally on the disk. The MBH also self-regulates its growth by keeping the surrounding ISM hot for an extended period of time.

The cosmic MeV neutrino background as a laboratory for black hole formation

Energy Technology Data Exchange (ETDEWEB)

Yüksel, Hasan, E-mail: hyuksel@gmail.com [Theoretical Division, Los Alamos National Laboratory, Los Alamos, NM 87544 (United States); Lawrence Berkeley National Laboratory, Berkeley, CA 94720 (United States); Department of Physics, Mimar Sinan Fine Arts University, Bomonti 34380, İstanbul (Turkey); Kistler, Matthew D. [Lawrence Berkeley National Laboratory, Berkeley, CA 94720 (United States); Department of Physics, University of California, Berkeley, CA 94720 (United States)

2015-12-17

Calculations of the cosmic rate of core collapses, and the associated neutrino flux, commonly assume that a fixed fraction of massive stars collapse to black holes. We argue that recent results suggest that this fraction instead increases with redshift. With relatively more stars vanishing as “unnovae” in the distant universe, the detectability of the cosmic MeV neutrino background is improved due to their hotter neutrino spectrum, and expectations for supernova surveys are reduced. We conclude that neutrino detectors, after the flux from normal SNe is isolated via either improved modeling or the next Galactic SN, can probe the conditions and history of black hole formation.

The cosmic MeV neutrino background as a laboratory for black hole formation

Directory of Open Access Journals (Sweden)

Hasan Yüksel

2015-12-01

Full Text Available Calculations of the cosmic rate of core collapses, and the associated neutrino flux, commonly assume that a fixed fraction of massive stars collapse to black holes. We argue that recent results suggest that this fraction instead increases with redshift. With relatively more stars vanishing as “unnovae” in the distant universe, the detectability of the cosmic MeV neutrino background is improved due to their hotter neutrino spectrum, and expectations for supernova surveys are reduced. We conclude that neutrino detectors, after the flux from normal SNe is isolated via either improved modeling or the next Galactic SN, can probe the conditions and history of black hole formation.

The cosmic MeV neutrino background as a laboratory for black hole formation

Science.gov (United States)

Yüksel, Hasan; Kistler, Matthew D.

2015-12-01

Calculations of the cosmic rate of core collapses, and the associated neutrino flux, commonly assume that a fixed fraction of massive stars collapse to black holes. We argue that recent results suggest that this fraction instead increases with redshift. With relatively more stars vanishing as ;unnovae; in the distant universe, the detectability of the cosmic MeV neutrino background is improved due to their hotter neutrino spectrum, and expectations for supernova surveys are reduced. We conclude that neutrino detectors, after the flux from normal SNe is isolated via either improved modeling or the next Galactic SN, can probe the conditions and history of black hole formation.

Hole localization, migration, and the formation of peroxide anion in perovskite SrTiO3

Science.gov (United States)

Chen, Hungru; Umezawa, Naoto

2014-07-01

Hybrid density functional calculations are carried out to investigate the behavior of holes in SrTiO3. As in many other oxides, it is shown that a hole tend to localize on one oxygen forming an O- anion with a concomitant lattice distortion; therefore a hole polaron. The calculated emission energy from the recombination of the localized hole and a conduction-band electron is about 2.5 eV, in good agreement with experiments. Therefore the localization of the hole or self-trapping is likely to be responsible for the green photoluminescence at low temperature, which was previously attributed to an unknown defect state. Compared to an electron, the calculated hole polaron mobility is three orders of magnitude lower at room temperature. In addition, two O- anions can bind strongly to form an O22- peroxide anion. No electronic states associated with the O22- peroxide anion are located inside the band gap or close to the band edges, indicating that it is electronically inactive. We suggest that in addition to the oxygen vacancy, the formation of the O22- peroxide anion can be an alternative to compensate acceptor doping in SrTiO3.

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...... by questionnaire. Digital grayscale fundus photographs were recorded in red-free illumination and graded for the presence of macular drusen >63µm in either eye and the presence of 20 or more small, hard macular drusen as a mean of both eyes. RESULTS: Macular drusen >63µm were associated with the level of physical...... activity, the age- and sex adjusted odds ratio being 0.33 (95% confidence interval 0.13-0.82, P=0.016) for participants who were physically active more than 7 h/week compared with participants active 0-2 h/week. In women, macular drusen >63µm were associated with higher serum triglycerides (P=0...

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.

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

Vertical transmission of macular telangiectasia type 2.

Science.gov (United States)

Delaere, Lien; Spielberg, Leigh; Leys, Anita M

2012-01-01

The purpose of this study was to report vertical transmission of macular telangiectasia type 2 and type 2 diabetes mellitus in 3 families. In this retrospective interventional case series, the charts of patients with inherited macular telangiectasia type 2 were reviewed. A large spectrum of presentations of macular telangiectasia type 2 was observed and has been studied with different techniques including best-corrected visual acuity, microperimetry, confocal blue reflectance fundus autofluorescence, fluorescein angiography, and time domain and spectral domain optical coherence tomography. Vertical transmission of macular telangiectasia type 2 and associated type 2 diabetes mellitus is described in 3 families. Symptomatic as well as asymptomatic eyes with macular telangiectasia type 2 were identified. In 2 families, a mother and son experienced visual loss and were diagnosed with macular telangiectasia type 2. All 4 patients had type 2 diabetes. Diabetic retinopathy was observed in one mother and her son. In the third family, the index patient was diagnosed macular telangiectasia type 2 after complaints of metamorphopsia. She and her family members had type 2 diabetes mellitus, and further screening of her family revealed familial macular telangiectasia type 2. None of the patients were treated for macular telangiectasia type 2. Macular telangiectasia type 2 may be more common than previously assumed, as vision can remain preserved and patients may go undiagnosed. Screening of family members is indicated, and detection of mild anomalies is possible using fundus autofluorescence and spectral domain optical coherence tomography.

miRNAs in the vitreous humor of patients affected by idiopathic epiretinal membrane and macular hole.

Directory of Open Access Journals (Sweden)

Andrea Russo

Full Text Available The aim of the present study was to assess the expression of miRNAs in the Vitreous Humor (VH of patients with Macular Hole (MH and Epiretinal Membrane (ERM compared to a control group.In this prospective, comparative study, 2-ml of VH was extracted from the core of the vitreous chamber in consecutive patients who underwent standard vitrectomy for ERM and MH. RNA was extracted and TaqMan® Low Density Arrays (TLDAs were used to profile the transcriptome of 754 miRNAs. Results were validated by single TaqMan® assays. Finally, we created a biological network of differentially expressed miRNA targets and their nearest neighbors.Overall 10 eyes with MH, 16 eyes with idiopathic ERM and 6 controls were enrolled in the study. Profiling data identified 5 miRNAs differentially expressed in patients affected by MH and ERM with respect to controls. Four were downregulated (miR-19b, miR-24, miR-155, miR-451 and 1 was downregulated (miR-29a; TaqMan® assays of the VH of patients affected by MH and ERM, with respect to controls, showed that the most differentially expressed were miR-19b (FC -9.13, p:<0.00004, mir-24 (FC -7.52, p:<0.004 and miR-142-3p (FC -5.32, p:<0.011. Our network data showed that deregulation of differentially expressed miRNAs induces an alteration of several pathways associated with genes involved in both MH and ERM.The present study suggests that disregulation of miR-19b, miR-24 and miR-142-3p, might be related to the alterations that characterize patients affected by MH and ERM.

Efficacy of non-fovea-sparing ILM peeling for symptomatic myopic foveoschisis with and without macular hole.

Science.gov (United States)

Al-Badawi, Amer Hamad; Abdelhakim, Mohamad Amr Salah Eddin; Macky, Tamer Ahmed; Mortada, Hassan Aly

2018-04-30

To study anatomical and visual outcomes of pars plana vitrectomy (PPV) with non-fovea-sparing (entire) internal limiting membrane (ILM) peeling in eyes with myopic foveoschisis (MF). Prospective interventional case series of eyes undergoing PPV with entire ILM peeling for symptomatic MF. Preoperative spectral domain optical coherence tomography (SD - OCT) epiretinal membrane, anomalous posterior vitreous detachment, vitreoschisis and postoperative changes in SD-OCT central foveal thickness (CFT), ellipsoid zone defect, foveal detachment (FD), macular hole (MH) diameter (if present) and best-corrected visual acuity (BCVA) in logarithm of the minimum angle of resolution (logMAR). This study included 21 eyes (21 patients) with mean age 60.4±13.1, 15 females (71.4%). All patients achieved complete postoperative reattachment by SD-OCT (no FD) 6 months post vitrectomy, with no iatrogenic intraoperative or postoperative MH, and with significant improvement in final BCVA from 1.6±0.30 to1.0±0.2 logMAR, and in CFT from 918.2±311.4 to182.3±33.1 µm. Patients were subdivided into subgroup A: 11 eyes without MH; and subgroup B: 10 eyes with MH, the latter had significant improvement in MH diameter (p=0.005). Preoperative BCVA was a significant risk factor for visual gain, while preoperative FD and CFT were significant for CFT change. Vitrectomy with non-fovea-sparing (entire) ILM peeling resulted in a significant functional and anatomical improvement in eyes with MF with/without MH with no reported complications. Results are comparable to fovea-sparing ILM peeling. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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

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

Directory of Open Access Journals (Sweden)

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.

Statistical clustering of primordial black holes

Energy Technology Data Exchange (ETDEWEB)

Carr, B J [Cambridge Univ. (UK). Inst. of Astronomy

1977-04-01

It is shown that Meszaros theory of galaxy formation, in which galaxies form from the density perturbations associated with the statistical fluctuation in the number density of primordial black holes, must be modified if the black holes are initially surrounded by regions of lower radiation density than average (as is most likely). However, even in this situation, the sort of effect Meszaros envisages does occur and could in principle cause galactic mass-scales to bind at the conventional time. In fact, the requirement that galaxies should not form prematurely implies that black holes could not have a critical density in the mass range above 10/sup 5/ M(sun). If the mass spectrum of primordial black holes falls off more slowly than m/sup -3/ (as expected), then the biggest black holes have the largest clustering effect. In this case the black hole clustering theory of galaxy formation reduces to the black hole seed theory of galaxy formation, in which each galaxy becomes bound under the gravitational influence of a single black hole nucleus. The seed theory could be viable only if the early Universe had a soft equation of state until a time exceeding 10/sup -4/ s or if something prevented black hole formation before 1 s.

Galaxy Formation with Self-Consistently Modeled Stars and Massive Black Holes. I: Feedback-Regulated Star Formation and Black Hole Growth

Energy Technology Data Exchange (ETDEWEB)

Kim, Ji-hoon; Wise, John H.; /KIPAC, Menlo Park /Stanford U., Phys. Dept. /Princeton U., Astrophys. Sci. Dept.; Alvarez, Marcelo A.; /Canadian Inst. Theor. Astrophys.; Abel, Tom; /KIPAC, Menlo Park /Stanford U., Phys. Dept.

2011-11-04

There is mounting evidence for the coevolution of galaxies and their embedded massive black holes (MBHs) in a hierarchical structure formation paradigm. To tackle the nonlinear processes of galaxy-MBH interaction, we describe a self-consistent numerical framework which incorporates both galaxies and MBHs. The high-resolution adaptive mesh refinement (AMR) code Enzo is modified to model the formation and feedback of molecular clouds at their characteristic scale of 15.2 pc and the accretion of gas onto an MBH. Two major channels of MBH feedback, radiative feedback (X-ray photons followed through full three-dimensional adaptive ray tracing) and mechanical feedback (bipolar jets resolved in high-resolution AMR), are employed. We investigate the coevolution of a 9.2 x 10{sup 11} M {circle_dot} galactic halo and its 10{sup 5} {circle_dot} M embedded MBH at redshift 3 in a cosmological CDM simulation. The MBH feedback heats the surrounding interstellar medium (ISM) up to 10{sup 6} K through photoionization and Compton heating and locally suppresses star formation in the galactic inner core. The feedback considerably changes the stellar distribution there. This new channel of feedback from a slowly growing MBH is particularly interesting because it is only locally dominant and does not require the heating of gas globally on the disk. The MBH also self-regulates its growth by keeping the surrounding ISM hot for an extended period of time.

Seeding black holes in cosmological simulations

Science.gov (United States)

Taylor, P.; Kobayashi, C.

2014-08-01

We present a new model for the formation of black holes in cosmological simulations, motivated by the first star formation. Black holes form from high density peaks of primordial gas, and grow via both gas accretion and mergers. Massive black holes heat the surrounding material, suppressing star formation at the centres of galaxies, and driving galactic winds. We perform an investigation into the physical effects of the model parameters, and obtain a `best' set of these parameters by comparing the outcome of simulations to observations. With this best set, we successfully reproduce the cosmic star formation rate history, black hole mass-velocity dispersion relation, and the size-velocity dispersion relation of galaxies. The black hole seed mass is ˜103 M⊙, which is orders of magnitude smaller than that which has been used in previous cosmological simulations with active galactic nuclei, but suggests that the origin of the seed black holes is the death of Population III stars.

Blob/hole formation and zonal-flow generation in the edge plasma of the JET tokamak

DEFF Research Database (Denmark)

Xu, G.S.; Naulin, Volker; Fundamenski, W.

2009-01-01

The first experimental evidence showing the connection between blob/hole formation and zonal-flow generation was obtained in the edge plasma of the JET tokamak. Holes as well as blobs are observed to be born in the edge shear layer, where zonal-flows shear off meso-scale coherent structures......, leading to disconnection of positive and negative pressure perturbations. The newly formed blobs transport azimuthal momentum up the gradient of the azimuthal flow and drive the zonal-flow shear while moving outwards. During this process energy is transferred from the meso-scale coherent structures...

Vascular Displacement in Idiopathic Macular Hole after Single-layered Inverted Internal Limiting Membrane Flap Surgery.

Science.gov (United States)

Lee, Jae Jung; Lee, In Ho; Park, Keun Heung; Pak, Kang Yeun; Park, Sung Who; Byon, Ik Soo; Lee, Ji Eun

2017-08-01

To compare vascular displacement in the macula after surgical closure of idiopathic macular hole (MH) after single-layered inverted internal limiting membrane (ILM) flap technique and conventional ILM removal. This retrospective study included patients who underwent either vitrectomy and ILM removal only or vitrectomy with single-layered inverted ILM flap for idiopathic MH larger than 400 μm from 2012 to 2015. A customized program compared the positions of the retinal vessels in the macula between preoperative and postoperative photographs. En face images of 6 × 6 mm optical coherence tomography volume scans were registered to calculate the scale. Retinal vessel displacement was measured as a vector value by comparing its location in 16 sectors of a grid partitioned into eight sectors in two rings (inner, 2 to 4 mm; outer, 4 to 6 mm). The distance and angle of displacement were calculated as an average vector and were compared between the two groups for whole sectors, inner ring, outer ring, and for each sector. Twenty patients were included in the ILM flap group and 22 in the ILM removal group. There were no statistical differences between the groups for baseline characteristics. The average displacement in the ILM flap group and the ILM removal group was 56.6 μm at -3.4° and 64.9 μm at -2.7°, respectively, for the whole sectors (p = 0.900), 76.1 μm at -1.1° and 87.3 μm at -0.9° for the inner ring (p = 0.980), and 37.4 μm at -8.2° and 42.7 μm at -6.3° for the outer ring (p = 0.314). There was no statistical difference in the displacement of each of the sectors. Postoperative topographic changes showed no significant differences between the ILM flap and the ILM removal group for idiopathic MH. The single-layered ILM flap technique did not appear to cause additional displacement of the retinal vessels in the macula. © 2017 The Korean Ophthalmological Society

VITRECTOMY FOR INTERMEDIATE AGE-RELATED MACULAR DEGENERATION ASSOCIATED WITH TANGENTIAL VITREOMACULAR TRACTION: A CLINICOPATHOLOGIC CORRELATION.

Science.gov (United States)

Ziada, Jean; Hagenau, Felix; Compera, Denise; Wolf, Armin; Scheler, Renate; Schaumberger, Markus M; Priglinger, Siegfried G; Schumann, Ricarda G

2018-03-01

To describe the morphologic characteristics of the vitreomacular interface in intermediate age-related macular degeneration associated with tangential traction due to premacular membrane formation and to correlate with optical coherence tomography (OCT) findings and clinical data. Premacular membrane specimens were removed sequentially with the internal limiting membrane from 27 eyes of 26 patients with intermediate age-related macular degeneration during standard vitrectomy. Specimens were processed for immunocytochemical staining of epiretinal cells and extracellular matrix components. Ultrastructural analysis was performed using transmission electron microscopy. Spectral domain optical coherence tomography images and patient charts were evaluated in retrospect. Immunocytochemistry revealed hyalocytes and myofibroblasts as predominant cell types. Ultrastructural analysis demonstrated evidence of vitreoschisis in all eyes. Myofibroblasts with contractile properties were observed to span between folds of the internal limiting membrane and vitreous cortex collagen. Retinal pigment epithelial cells or inflammatory cells were not detected. Mean visual acuity (Snellen) showed significant improvement from 20/72 ± 20/36 to 20/41 ± 20/32 (P age-related macular degeneration predominantly consists of vitreous collagen, hyalocytes, and myofibroblasts with contractile properties. Vitreoschisis and vitreous-derived cells appear to play an important role in traction formation of this subgroup of eyes. In patients with intermediate age-related macular degeneration and contractile premacular membrane, release of traction by vitrectomy with internal limiting membrane peeling results in significantly functional and anatomical improvement.

FFA STUDY OF MACULAR LESIONS

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K. Vinayagamurthy

2017-08-01

Full Text Available BACKGROUND Macula is an important portion of retina that occupies the posterior pole of retina. Any disease that affects macula results in significant loss of central vision, form vision and colour vision to an extent. Macular lesions can be hereditary as well as acquired. Macular lesions occur in both younger and older individuals. Anatomically, a macular lesions can vary from a simple lesion like an RPF defect to a vision-threatening lesions like choroidal neovascular membrane. Many screening tests that are sensitive and specific are available to assess the functioning of macula called as ‘macular function test’. But, the greater understanding of the retinal vascular led to the usage of fluorescein angiogram in the detection and screening of macular, retinovascular and optic disc lesions. Through fundus fluorescein angiogram is a thirty-year-old procedure; it is still in vogue in almost all parts of the world. It has its own merits. The aim of the study is to study the role of fluorescein angiography in the evaluation of macular lesions. MATERIALS AND METHODS A hospital-based prospective randomised study was done, which included 50 patients. Detailed patient history was taken and thorough ocular and systemic examination was done. All patients were examined by ophthalmoscopy (direct and indirect and slit-lamp examination with 90D followed by fluorescein angiography. Ophthalmoscopic and fluorescein angiography findings were analysed and categorised. Patients were advised proper ocular and systemic treatment and follow up. RESULTS 50 cases with macular lesions were analysed and categorised into conditions like ARMD, CSR, macular oedema, CME, degenerations and dystrophies and miscellaneous conditions. FFA altered the diagnosis in 8% cases and categorised the cases in all cases. 16% patients developed adverse reactions like allergy, vomiting and nausea. On statistical analysis, FFA proved to be cheap and superior diagnostic tool in confirming

Simulation of magnetic holes formation in the magnetosheath

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Ahmadi, Narges; Germaschewski, Kai; Raeder, Joachim

2017-12-01

Magnetic holes have been frequently observed in the Earth's magnetosheath and are believed to be the consequence of the nonlinear evolution of the mirror instability. Mirror mode perturbations mainly form as magnetic holes in regions where the plasma is marginally mirror stable with respect to the linear instability criterion. We present an expanding box particle-in-cell simulation to mimic the changing conditions in the magnetosheath as the plasma is convected through it that produces mirror mode magnetic holes. We show that in the initial nonlinear evolution, where the plasma conditions are mirror unstable, the magnetic peaks are dominant, while later, as the plasma relaxes toward marginal stability, the fluctuations evolve into deep magnetic holes. While the averaged plasma parameters in the simulation remain close to the mirror instability threshold, the local plasma in the magnetic holes is highly unstable to mirror instability and locally mirror stable in the magnetic peaks.

Effective photon mass from black-hole formation

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Slava Emelyanov

2017-06-01

Full Text Available We compute the value of effective photon mass mγ at one-loop level in QED in the background of small (1010 g≲M≪1016 g spherically symmetric black hole in asymptotically flat spacetime. This effect is associated with the modification of electron/positron propagator in presence of event horizon. Physical manifestations of black-hole environment are compared with those of hot neutral plasma. We estimate the distance to the nearest black hole from the upper bound on mγ obtained in the Coulomb-law test. We also find that corrections to electron mass me and fine structure constant α at one-loop level in QED are negligible in the weak gravity regime.

Evaluation of secondary surgery to enlarge the peeling of the internal limiting membrane following the failed surgery of idiopathic macular holes.

Science.gov (United States)

Che, Xin; He, Fanglin; Lu, Linna; Zhu, Dongqing; Xu, Xiaofang; Song, Xin; Fan, Xianqun; Wang, Zhiliang

2014-03-01

The aim of the present study was to evaluate the clinical results of pars plana vitrectomy (PPV) combined with the surgical enlargement of internal limiting membrane (ILM) peeling in patients who had previously undergone failed idiopathic macular hole (IMH) surgery. In the study, 134 eyes from 130 IMH patients who had received PPV combined with ILM peeling surgery (2 disk diameters) were analyzed. Within this cohort, 14 eyes had IMHs that were not closed, of which 13 eyes underwent a second surgery involving enlargement of the ILM peeling. The extent of the ILM peeling was increased to the vascular arcades of the posterior fundus in the secondary surgery. Of the 13 eyes that underwent secondary surgery, five were in stage III and nine were in stage IV. The second surgery successfully achieved IMH closure in 61.5% (8/13) of the eyes. The IMH was completely closed following surgery and the logMAR vision increased from 0.98 to 0.84 (P=0.013) in the 8 successfully treated cases. The surgical enlargement of ILM peeling closed the IMHs and improved vision in the majority of patients. In addition, the procedures were safe. Therefore, the results of the present study indicate that enlargement of ILM peeling may be an effective therapy for patients who have previously undergone the failed surgical correction of an IMH.

Macular thickness after glaucoma filtration surgery.

Science.gov (United States)

Sesar, Antonio; Cavar, Ivan; Sesar, Anita Pusić; Geber, Mia Zorić; Sesar, Irena; Laus, Katia Novak; Vatavuk, Zoran; Mandić, Zdravko

2013-09-01

The aim of present study was to analyze early postoperative changes in the macular area using optical coherence tomography (OCT) after uncomplicated glaucoma filtration surgery. This prospective study included 32 patients (34 eyes) with open-angle glaucoma, which underwent trabeculectomy with or without use of mitomycin C. Exclusion criteria were macular edema, uveitis, age-related macular degeneration, blurred optical media, secondary glaucoma and angle-closure glaucoma. All standard clinical examinations were made before surgery, at the 2nd day, 1 week and 1 month after surgery. Tomography of the macula was performed during every examination using Cirrus HD OCT for the analysis of central subfield thickness. Results show that thickening of the macula was slightly higher 1 week and 1 month after operation in comparison with baseline end 2nd day postoperativelly. There was no significant difference in the change of macular thickness in patients who have used topical prostaglandins compared with those who have used other topical medications. Also, there was no difference in macular changes between patients treated with or without mitomycin C. In conclusion, we found a slight subclinical increase in macular thickness after uncomplicated trabeculectomy, for which we considered that was the result in reduction of intraocular pressure after glaucoma surgery. Macular thickening after glaucoma filtering surgery could be a physiological reaction to the stress of the retina caused by a sudden reduction of intraocular pressure and it is the consequence of altered relationship between capillary pressure and interstitial fluid pressure.

The statistical clustering of primordial black holes

International Nuclear Information System (INIS)

Carr, B.J.

1977-01-01

It is shown that Meszaros theory of galaxy formation, in which galaxies form from the density perturbations associated with the statistical fluctuation in the number density of primordial black holes, must be modified if the black holes are initially surrounded by regions of lower radiation density than average (as is most likely). However, even in this situation, the sort of effect Meszaros envisages does occur and could in principle cause galactic mass-scales to bind at the conventional time. In fact, the requirement that galaxies should not form prematurely implies that black holes could not have a critical density in the mass range above 10 5 M(sun). If the mass spectrum of primordial black holes falls off more slowly than m -3 (as expected), then the biggest black holes have the largest clustering effect. In this case the black hole clustering theory of galaxy formation reduces to the black hole seed theory of galaxy formation, in which each galaxy becomes bound under the gravitational influence of a single black hole nucleus. The seed theory could be viable only if the early Universe had a soft equation of state until a time exceeding 10 -4 s or if something prevented black hole formation before 1 s. (orig.) [de

Black Holes at the LHC: Progress since 2002

International Nuclear Information System (INIS)

Park, Seong Chan

2008-01-01

We review the recent noticeable progresses in black hole physics focusing on the up-coming super-collider, the LHC. We discuss the classical formation of black holes by particle collision, the greybody factors for higher dimensional rotating black holes, the deep implications of black hole physics to the 'energy-distance' relation, the security issues of the LHC associated with black hole formation and the newly developed Monte-Carlo generators for black hole events.

Presentación de tres casos de distrofia macular de North Carolina Presentation of three cases with North Carolina macular dystrophy

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Mavys Soto García

2012-06-01

Full Text Available Se presentan las características oftalmológicas de tres pacientes, dos hermanos varones y su padre con diagnóstico de distrofia macular de North Carolina. Este es un trastorno genético que produce degeneración macular congénita o de inicio precoz. Se caracteriza por una herencia autosómica dominante, con penetrancia completa, genéticamente mapeados en el cromosoma 6q16. Las lesiones son principalmente estacionarias. Las manifestaciones fundoscópicas varían. En estos pacientes predomina la lesión disciforme en área macular, disminución del grosor macular correspondiente con el coloboma macular, con idénticas particulares en los tres pacientes. La agudeza visual varía en rango de 0,6 a 0,2 en estos pacientes.The ophthalmological characteristics of three patients, two male siblings and their father, with diagnosis of North Carolina macular dystrophy were presented. This is a genetic dysfunction that causes congenital or early onset macular degeneration. It is characterized by a dominant autosomal heredity, with complete penetrance, genetically mapped in the chromosome 6q16. The lesions are mainly stationary. The funduscopic manifestations vary. The type of lesion is mainly stationary whereas funduscopic manifestations are varied. The dysciform lesion in the macular area and decrease of the macular thicness according to the macular coloboma prevailed, with identical particularities in the three patients. The visual acuity varied from 0.6 to 0.2.

Occult Macular Dystrophy

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Işıl Sayman Muslubaş

2016-04-01

Full Text Available Occult macular dystrophy is an inherited macular dystrophy characterized by a progressive decline of bilateral visual acuity with normal fundus appearance, fluorescein angiogram and full-field electroretinogram. This case report presents a 20-year-old female patient with bilateral progressive decline of visual acuity for six years. Her visual acuity was 3-4/10 in both eyes. Anterior segment and fundus examination, fluorescein angiogram and full-field electroretinogram were normal. She could read all Ishihara pseudoisochromatic plates. Fundus autofluorescence imaging was normal. There was a mild central hyporeflectance on fundus infrared reflectance imaging in both eyes. Reduced foveal thickness and alterations of the photoreceptor inner and outer segment junction were observed by optical coherence tomography in both eyes. Central scotoma was also found by microperimetry and reduced central response was revealed by multifocal electroretinogram in both eyes. These findings are consistent with the clinical characteristics of occult macular dystrophy

Macular laser photocoagulation guided by spectral-domain optical coherence tomography versus fluorescein angiography for diabetic macular edema

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Gallego-Pinazo R

2011-05-01

Full Text Available Roberto Gallego-Pinazo1,2, Ana Marina Suelves-Cogollos1, Rosa Dolz-Marco1, J Fernando Arevalo3, Salvador García-Delpech1, J Luis Mullor4, Manuel Díaz-Llopis1,2,51Department of Ophthalmology, Hospital Universitario La Fe, Valencia, Spain; 2Centro de Investigación Biomédica en Red de Enfermedades Raras, Valencia, Spain; 3Retina and Vitreous Service, Clinical Ophthalmology Center, Caracas, Venezuela; 4Unit of Experimental Ophthalmology, Hospital Universitario La Fe, Valencia, Spain; 5University of Valencia, Faculty of Medicine, Valencia, SpainBackground: The aim of this study was to compare the efficacy of spectral-domain optical coherence tomography (SD-OCT and fluorescein angiography (FA in the guidance of macular laser photocoagulation for diabetic macular edema.Methods: This was a prospective interventional clinical comparative pilot study. Forty eyes from 24 consecutive patients with diabetic macular edema were allocated to receive laser photocoagulation guided by SD-OCT or FA. Best-corrected visual acuity (BCVA, central macular thickness, and retinal volume were assessed at baseline and two months after treatment.Results: Subjects treated using FA-guided laser improved BCVA from the logarithm of the minimum angle of resolution (logMAR 0.52 ± 0.2 to 0.37 ± 0.2 (P < 0.001, and decreased mean central macular thickness from 397.25 ± 139.1 to 333.50 ± 105.7 µm (P < 0.001 and retinal volume from 12.61 ± 1.6 to 10.94 ± 1.4 mm3 (P < 0.001. Subjects treated using SD-OCT guided laser had improved BCVA from 0.48 ± 0.2 to 0.33 ± 0.2 logMAR (P < 0.001, and decreased mean central macular thickness from 425.90 ± 149.6 to 353.4 ± 140 µm (P < 0.001 and retinal volume from 12.38 ± 2.1 to 11.53 ± 1.1 mm3 (P < 0.001. No significant differences between the groups were found in two-month BCVA (P = 0.505, two-month central macular thickness (P = 0.660, or two-month retinal volume (P = 0.582.Conclusion: The short-term results of this pilot study

Curvature profiles as initial conditions for primordial black hole formation

International Nuclear Information System (INIS)

Polnarev, Alexander G; Musco, Ilia

2007-01-01

This work is part of an ongoing research programme to study possible primordial black hole (PBH) formation during the radiation-dominated era of the early universe. Working within spherical symmetry, we specify an initial configuration in terms of a curvature profile, which represents initial conditions for the large amplitude metric perturbations, away from the homogeneous Friedmann-Robertson-Walker model, which are required for PBH formation. Using an asymptotic quasi-homogeneous solution, we relate the curvature profile with the density and velocity fields, which at an early enough time, when the length scale of the configuration is much larger than the cosmological horizon, can be treated as small perturbations of the background values. We present general analytic solutions for the density and velocity profiles. These solutions enable us to consider in a self-consistent way the formation of PBHs in a wide variety of cosmological situations with the cosmological fluid being treated as an arbitrary mixture of different components with different equations of state. We obtain the analytical solutions for the density and velocity profiles as functions of the initial time. We then use two different parametrizations for the curvature profile and follow numerically the evolution of initial configurations

Constraining stellar binary black hole formation scenarios with eLISA eccentricity measurements

OpenAIRE

Nishizawa, Atsushi; Sesana, Alberto; Berti, Emanuele; Klein, Antoine

2016-01-01

A space-based interferometer such as eLISA could observe few to few thousands progenitors of black hole binaries (BHBs) similar to those recently detected by Advanced LIGO. Gravitational radiation circularizes the orbit during inspiral, but some BHBs retain a measurable eccentricity at the low frequencies where eLISA is most sensitive. The eccentricity of a BHB carries precious information about its formation channel: BHBs formed in the field, in globular clusters, or close to a massive black...

A quasi-static approach to structure formation in black hole universes

International Nuclear Information System (INIS)

Durk, Jessie; Clifton, Timothy

2017-01-01

Motivated by the existence of hierarchies of structure in the Universe, we present four new families of exact initial data for inhomogeneous cosmological models at their maximum of expansion. These data generalise existing black hole lattice models to situations that contain clusters of masses, and hence allow the consequences of cosmological structures to be considered in a well-defined and non-perturbative fashion. The degree of clustering is controlled by a parameter λ, in such a way that for λ ∼ 0 or 1 we have very tightly clustered masses, whilst for λ ∼ 0.5 all masses are separated by cosmological distance scales. We study the consequences of structure formation on the total net mass in each of our clusters, as well as calculating the cosmological consequences of the interaction energies both within and between clusters. The locations of the shared horizons that appear around groups of black holes, when they are brought sufficiently close together, are also identified and studied. We find that clustering can have surprisingly large effects on the scale of the cosmology, with models that contain thousands of black holes sometimes being as little as 30% of the size of comparable Friedmann models with the same total proper mass. This deficit is comparable to what might be expected to occur from neglecting gravitational interaction energies in Friedmann cosmology, and suggests that these quantities may have a significant influence on the properties of the large-scale cosmology.

A quasi-static approach to structure formation in black hole universes

Energy Technology Data Exchange (ETDEWEB)

Durk, Jessie; Clifton, Timothy, E-mail: j.durk@qmul.ac.uk, E-mail: t.clifton@qmul.ac.uk [School of Physics and Astronomy, Queen Mary University of London, Mile End Road, London (United Kingdom)

2017-10-01

Motivated by the existence of hierarchies of structure in the Universe, we present four new families of exact initial data for inhomogeneous cosmological models at their maximum of expansion. These data generalise existing black hole lattice models to situations that contain clusters of masses, and hence allow the consequences of cosmological structures to be considered in a well-defined and non-perturbative fashion. The degree of clustering is controlled by a parameter λ, in such a way that for λ ∼ 0 or 1 we have very tightly clustered masses, whilst for λ ∼ 0.5 all masses are separated by cosmological distance scales. We study the consequences of structure formation on the total net mass in each of our clusters, as well as calculating the cosmological consequences of the interaction energies both within and between clusters. The locations of the shared horizons that appear around groups of black holes, when they are brought sufficiently close together, are also identified and studied. We find that clustering can have surprisingly large effects on the scale of the cosmology, with models that contain thousands of black holes sometimes being as little as 30% of the size of comparable Friedmann models with the same total proper mass. This deficit is comparable to what might be expected to occur from neglecting gravitational interaction energies in Friedmann cosmology, and suggests that these quantities may have a significant influence on the properties of the large-scale cosmology.

A quasi-static approach to structure formation in black hole universes

Science.gov (United States)

Durk, Jessie; Clifton, Timothy

2017-10-01

Motivated by the existence of hierarchies of structure in the Universe, we present four new families of exact initial data for inhomogeneous cosmological models at their maximum of expansion. These data generalise existing black hole lattice models to situations that contain clusters of masses, and hence allow the consequences of cosmological structures to be considered in a well-defined and non-perturbative fashion. The degree of clustering is controlled by a parameter λ, in such a way that for λ ~ 0 or 1 we have very tightly clustered masses, whilst for λ ~ 0.5 all masses are separated by cosmological distance scales. We study the consequences of structure formation on the total net mass in each of our clusters, as well as calculating the cosmological consequences of the interaction energies both within and between clusters. The locations of the shared horizons that appear around groups of black holes, when they are brought sufficiently close together, are also identified and studied. We find that clustering can have surprisingly large effects on the scale of the cosmology, with models that contain thousands of black holes sometimes being as little as 30% of the size of comparable Friedmann models with the same total proper mass. This deficit is comparable to what might be expected to occur from neglecting gravitational interaction energies in Friedmann cosmology, and suggests that these quantities may have a significant influence on the properties of the large-scale cosmology.

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

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

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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

Corticosteroid Treatment in Diabetic Macular Edema

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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.

Reproducibility of Macular Pigment Optical Density Measurement by Two-wave Length Auto-fluorescence in a Clinical Setting

Science.gov (United States)

You, Qi-Sheng; Bartsch, Dirk-Uwe G.; Espina, Mark; Alam, Mostafa; Camacho, Natalia; Mendoza, Nadia; Freeman, William

2015-01-01

Purpose Macular pigment, composed of lutein, zeaxanthin, and meso-zeaxanthin, is postulated to protect against age-related macular degeneration (AMD), likely due to filtering blue light and its antioxidant properties. Macular pigment optical density (MPOD) is reported to be associated with macular function evaluated by visual acuity and multifocal electroretinogram. Given the importance of macular pigment, reliable and accurate measurement methods are important. The main purpose of current study is to determine the reproducibility of MPOD measurement by two-wave length auto-fluorescence method using scanning laser ophthalmoscopy. Methods Sixty eight eyes of 39 persons were enrolled in the study, including 11 normal eyes, 16 eyes with wet AMD, 16 eyes with dry AMD, 11 eyes with macular edema due to diabetic mellitus, branch retinal vein occlusion or macular telangiectasia and 14 eyes with tractional maculopathy including vitreomacular traction, epiretinal membrane or macular hole. MPOD was measured with a two-wavelength (488 and 514 nm) auto-fluorescence method with the Spectralis HRA+OCT after pupil dilation. The measurement was repeated for each eye 10 minutes later. The Analysis of variance (ANOVA) and Bland-Altman plot were used to assess the reproducibility between the two measurements. Results The mean MPOD at eccentricities of 1° and 2° was 0.36±0.17 (range: 0.04–0.69) and 0.15±0.08(range: −0.03, 0.35) for the first measurement and 0.35±0.17 (range: 0.02, 0.68) and 0.15±0.08 (range: −0.01, 0.33) for the second measurement respectively. The difference between the two measurements was not statistically significant, and the Bland-Altman plot showed 7.4% and 5.9% points outside the 95% limits of agreement, indicating an overall excellent reproducibility. Similarly, there is no significant difference between the first and second measurements of MPOD volume within eccentricities of 1°, 2° and 6° radius, and the Bland-Altman plot showed 8.8%, 2.9% and

Effects of turbulence and rotation on protostar formation as a precursor of massive black holes

DEFF Research Database (Denmark)

Van Borm, C.; Bovino, S.; Latif, M. A.

2014-01-01

Context. The seeds of the first supermassive black holes may have resulted from the direct collapse of hot primordial gas in ≳104 K haloes, forming a supermassive or quasi-star as an intermediate stage. Aims. We explore the formation of a protostar resulting from the collapse of primordial gas...

Effects of turbulence and rotation on protostar formation as a precursor of massive black holes

NARCIS (Netherlands)

Van Borm, C.; Bovino, S.; Latif, M. A.; Schleicher, D. R. G.; Spaans, M.; Grassi, T.

2014-01-01

Context. The seeds of the first supermassive black holes may have resulted from the direct collapse of hot primordial gas in ≳104 K haloes, forming a supermassive or quasi-star as an intermediate stage. Aims: We explore the formation of a protostar resulting from the collapse of primordial gas in

Glimpses of black hole formation/evaporation in highly inelastic, ultra-planckian string collisions

CERN Document Server

Addazi, Andrea; Veneziano, Gabriele

2017-02-22

We revisit possible glimpses of black-hole formation by looking at ultra-planckian string-string collisions at very high final-state multiplicity. We compare, in particular, previous results using the optical theorem, the resummation of ladder diagrams at arbitrary loop order, and the AGK cutting rules, with the more recent study of $2 \\rightarrow N$ scattering at $N \\sim s M_P^{-2} \\gg 1$. We argue that some apparent tension between the two approaches disappears once a reinterpretation of the latter's results in terms of suitably defined infrared-safe cross sections is adopted. Under that assumption, the typical final state produced in an ultra-planckian collision does indeed appear to share some properties with those expected from the evaporation of a black hole of mass $\\sqrt{s}$, although no sign of thermalization is seen to emerge at this level of approximation.

Etched-hole formation in LR-115 cellulose nitrate detector irradiated with fast neutrons

International Nuclear Information System (INIS)

Sawamura, Teruko; Yamazaki, Hatsuo

1988-01-01

This paper deals with the neutron detection sensitivity of LR-115 cellulose nitrate by counting the etched holes of α-tracks produced by the (n,α) reactions of the constituent nuclei of the cellulose nitrate. A formula for the etched-hole formation efficiency is derived, and applied to obtain the efficiency for each of the (n,α) reactions of 14 N, 16 O and 12 C by using an experimental expression relating the track-to-bulk etch-rate ratio to the residual range of the α-particle. From the efficiencies obtained, and the reaction cross sections, the neutron detection sensitivity is evaluated against neutron energy up to 11 MeV, and compared with the experimental values in the energy region between 2.2 and 5 MeV; the agreement is fairly good in the region. (author)

Intraretinal hemorrhages in cystoid macular edema.

Science.gov (United States)

Bovino, J A; Kelly, T J; Marcus, D F

1984-08-01

Retinal hemorrhages can be associated with typical cystoid macular edema. We examined the fundus photographs and fluorescein angiograms of 313 eyes of 264 patients with documented cystoid macular edema to establish the incidence and characteristics of associated intraretinal hemorrhages. As we wanted to study only those hemorrhages unique to cystoid macular edema, we excluded 86 eyes because the patients had diseases known to be associated with retinal hemorrhages. These diseases included diabetes mellitus, branch retinal vein occlusion, hypertensive retinopathy, venous stasis retinopathy, and perifoveal telangiectasia. Of the remaining 227 eyes with cystoid macular edema, 56 (24.7%) were identified with retinal hemorrhages not associated with systemic disease. The hemorrhages were characteristically oval, round, or linear and frequently filled or partially filled the intraretinal cystoid space. In many patients, a blood-fluid level was observed.

Primordial black holes formation from particle production during inflation

International Nuclear Information System (INIS)

Erfani, Encieh

2016-01-01

We study the possibility that particle production during inflation can source the required power spectrum for dark matter (DM) primordial black holes (PBH) formation. We consider the scalar and the gauge quanta production in inflation models, where in the latter case, we focus in two sectors: inflaton coupled i) directly and ii) gravitationally to a U(1) gauge field. We do not assume any specific potential for the inflaton field. Hence, in the gauge production case, in a model independent way we show that the non-production of DM PBHs puts stronger upper bound on the particle production parameter. Our analysis show that this bound is more stringent than the bounds from the bispectrum and the tensor-to-scalar ratio derived by gauge production in these models. In the scenario where the inflaton field coupled to a scalar field, we put an upper bound on the amplitude of the generated scalar power spectrum by non-production of PBHs. As a by-product we also show that the required scalar power spectrum for PBHs formation is lower when the density perturbations are non-Gaussian in comparison to the Gaussian density perturbations

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

Retinal thickness after vitrectomy and internal limiting membrane peeling for macular hole and epiretinal membrane

Science.gov (United States)

Kumagai, Kazuyuki; Ogino, Nobuchika; Furukawa, Mariko; Hangai, Masanori; Kazama, Shigeyasu; Nishigaki, Shirou; Larson, Eric

2012-01-01

Purpose To determine the retinal thickness (RT), after vitrectomy with internal limiting membrane (ILM) peeling, for an idiopathic macular hole (MH) or an epiretinal membrane (ERM). Also, to investigate the effect of a dissociated optic nerve fiber layer (DONFL) appearance on RT. Methods A non-randomized, retrospective chart review was performed for 159 patients who had successful closure of a MH, with (n = 148), or without (n = 11), ILM peeling. Also studied were 117 patients who had successful removal of an ERM, with (n = 104), or without (n = 13), ILM peeling. The RT of the nine Early Treatment Diabetic Retinopathy Study areas was measured by spectral domain optical coherence tomography (SD-OCT). In the MH-with-ILM peeling and ERM-with-ILM peeling groups, the RT of the operated eyes was compared to the corresponding areas of normal fellow eyes. The inner temporal/inner nasal ratio (TNR) was used to assess the effect of ILM peeling on RT. The effects of DONFL appearance on RT were evaluated in only the MH-with-ILM peeling group. Results In the MH-with-ILM peeling group, the central, inner nasal, and outer nasal areas of the retina of operated eyes were significantly thicker than the corresponding areas of normal fellow eyes. In addition, the inner temporal, outer temporal, and inner superior retina was significantly thinner than in the corresponding areas of normal fellow eyes. Similar findings were observed regardless of the presence of a DONFL appearance. In the ERM-with-ILM peeling group, the retina of operated eyes was significantly thicker in all areas, except the inner and outer temporal areas. In the MH-with-ILM peeling group, the TNR was 0.86 in operated eyes, and 0.96 in fellow eyes (P peeling group, the TNR was 0.84 in operated eyes, and 0.95 in fellow eyes (P peeling group was 0.98, which was significantly greater than that of the MH-with-ILM peeling group (P peeling group was 0.98, which was significantly greater than that of ERM-with-ILM peeling

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).

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)

Degeneração macular relacionada à idade: novas perspectivas Age-related macular degeneration: new perspectives

Directory of Open Access Journals (Sweden)

Marcio Bittar Nehemy

2006-12-01

Full Text Available A degeneração macular relacionada à idade (DMRI é a principal causa de cegueira legal em indivíduos acima de 50 anos de idade. Embora estudos recentes tenham mostrado que o fator genético é significativo, a patogênese da degeneração macular relacionada à idade permanece obscura, e os fatores de risco não estão ainda completamente estabelecidos. Estudos multicêntricos randomizados, publicados nos últimos anos, demonstraram que uma combinação de vitaminas e minerais é eficaz na redução do risco de desenvolvimento de neovascularização e de progressão para os estágios mais avançados da degeneração macular relacionada à idade. De maneira análoga, a terapia fotodinâmica (PDT e a terapia antiangiogênica também tiveram sua eficácia comprovada no tratamento de membrana neovascular coroideana subfoveal associada à degeneração macular relacionada à idade. Ambas reduzem o risco de perda de visão e, eventualmente, permitem melhora temporária da acuidade visual. Outras modalidades de tratamento, tais como fotocoagulação a laser, remoção cirúrgica da membrana e termoterapia transpupilar (TTT, podem beneficiar apenas um pequeno subgrupo de pacientes. Uma melhor compreensão dos mecanismos fisiopatológicos e dos eventos moleculares nas diversas fases da doença deverão propiciar, em futuro próximo, melhores estratégias para o controle e tratamento da degeneração macular relacionada à idade.Age-related macular degeneration (ARMD is a major source of legal blindness in individuals older than 50 years. Even though recent reports suggest that genetics plays an important role, its pathogenesis remains puzzling and the risk factors for its occurrence are not completely established. Vitamin and mineral supplementation reduced the risk of development of choroidal neovascularization (CNV or progression to the most advanced stages of age-related macular degeneration. Photodynamic therapy (PDT and antiangiogenic therapy

Dark Candles of the Universe: Black Hole Observations

Science.gov (United States)

Aykutalp, Aycin

2016-03-01

In 1916, when Karl Schwarzschild solved the Einstein field equations of general relativity for a spherically symmetric, non-rotating mass no one anticipated the impact black holes would have on astrophysics. I will review the main formation channels for black hole seeds and their evolution through cosmic time. In this, emphasis will be placed on the observational diagnostics of astrophysical black holes and their role on the assembly of galaxy formation and evolution. I then review how these observations put constrain on the seed black hole formation theories. Finally, I present an outlook for how future observations can shed light on our understanding of black holes. This work is supported by NSF Grant AST-1333360.

Individual Test Point Fluctuations of Macular Sensitivity in Healthy Eyes and Eyes With Age-Related Macular Degeneration Measured With Microperimetry.

Science.gov (United States)

Barboni, Mirella Telles Salgueiro; Szepessy, Zsuzsanna; Ventura, Dora Fix; Németh, János

2018-04-01

To establish fluctuation limits, it was considered that not only overall macular sensitivity but also fluctuations of individual test points in the macula might have clinical value. Three repeated measurements of microperimetry were performed using the Standard Expert test of Macular Integrity Assessment (MAIA) in healthy subjects ( N = 12, age = 23.8 ± 1.5 years old) and in patients with age-related macular degeneration (AMD) ( N = 11, age = 68.5 ± 7.4 years old). A total of 37 macular points arranged in four concentric rings and in four quadrants were analyzed individually and in groups. The data show low fluctuation of macular sensitivity of individual test points in healthy subjects (average = 1.38 ± 0.28 dB) and AMD patients (average = 2.12 ± 0.60 dB). Lower sensitivity points are more related to higher fluctuation than to the distance from the central point. Fixation stability showed no effect on the sensitivity fluctuation. The 95th percentile of the standard deviations of healthy subjects was, on average, 2.7 dB, ranging from 1.2 to 4 dB, depending on the point tested. Point analysis and regional analysis might be considered prior to evaluating macular sensitivity fluctuation in order to distinguish between normal variation and a clinical change. S tatistical methods were used to compare repeated microperimetry measurements and to establish fluctuation limits of the macular sensitivity. This analysis could add information regarding the integrity of different macular areas and provide new insights into fixation points prior to the biofeedback fixation training.

Glimpses of black hole formation/evaporation in highly inelastic, ultra-planckian string collisions

Energy Technology Data Exchange (ETDEWEB)

Addazi, Andrea [Dipartimento di Fisica, Università di L’Aquila,67010 Coppito, L’Aquila (Italy); LNGS, Laboratori Nazionali del Gran Sasso,67010 Assergi (Italy); Bianchi, Massimo [Dipartimento di Fisica, Università di Roma Tor Vergata andI.N.F.N. Sezione di Roma Tor Vergata, Via della Ricerca Scientifica 1, 00133 Roma (Italy); Veneziano, Gabriele [Collége de France,11 place M. Berthelot, 75005 Paris (France); Theory Division, CERN,CH-1211 Geneva 23 (Switzerland); Dipartimento di Fisica, Università di Roma La Sapienza,00185 Roma (Italy)

2017-02-22

We revisit possible glimpses of black-hole formation by looking at ultra-planckian string-string collisions at very high final-state multiplicity. We compare, in particular, previous results using the optical theorem, the resummation of ladder diagrams at arbitrary loop order, and the AGK cutting rules, with the more recent study of 2→N scattering at N∼sM{sub P}{sup −2}≫1. We argue that some apparent tension between the two approaches disappears once a reinterpretation of the latter’s results in terms of suitably defined infrared-safe cross sections is adopted. Under that assumption, the typical final state produced in an ultra-planckian collision does indeed appear to share some properties with those expected from the evaporation of a black hole of mass √s, although no sign of thermalization is seen to emerge at this level of approximation.

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

Changes in macular pigment optical density after membrane peeling.

Science.gov (United States)

Romano, Mario R; Cennamo, Gilda; Grassi, Piergiacomo; Sparnelli, Federica; Allegrini, Davide; Cennamo, Giovanni

2018-01-01

To highlight the differences in macular pigment optical density (MPOD) between eyes with vitreoretinal interface syndrome and healthy control eyes, to assess the changes in MPOD in eyes treated with macular peeling, to investigate the relationships between MPOD changes and measures of retinal sensitivity such as best corrected visual acuity (BCVA) and microperimetry. In this cross-sectional comparative study, 30 eyes affected by idiopathic epiretinal membrane (iERM, 15eyes) or full-thickness macular hole (FTMH, 15eyes) were compared with 60 eyes from 30 healthy age-matched patients. MPOD values (mean MPOD, maximum MPOD, MPOD area, and MPOD volume) were measured in a range of 4°-7° of eccentricity around the fovea, using the one-wavelength reflectometry method (Visucam 200, Carl-Zeiss Meditec). Patients affected by iERM and FTMH were treated with vitrectomy and epiretinal membrane-inner limiting membrane (ERM-ILM) peeling, with follow-up examinations performed preoperatively and 6 months postoperatively. The main outcome measures were the differences in MPOD between eyes with vitreoretinal interface syndrome and healthy eyes, changes in MPOD after ERM-ILM peeling, and relationships between MPOD and functional changes. Mean MPOD differed significantly between control eyes and those with iERM (P = .0001) or FTMH (P = .0006). The max MPOD and MPOD area increased, but not significantly. After peeling, the only significant change in MPOD was in MPOD volume (P = .01). In the ERM group, postoperative mean MPOD correlated significantly with best-corrected visual acuity (r = .739, P = .002). MPOD was reduced in patients with iERM or FTMH compared with healthy eyes. We found a significant correlation between the mean postoperative MPOD and postoperative BCVA, hypothesizing that the postoperative increase in mean MPOD could be due to a change in distribution for unfolding and expansion of the fovea after the peeling. MOPD may be considered as a prognostic factor associated

Bond Formation in Diatomic Transition Metal Hydrides: Insights from the Analysis of Domain-Averaged Fermi Holes

Czech Academy of Sciences Publication Activity Database

Cooper, D.L.; Ponec, Robert

2013-01-01

Roč. 113, č. 2 (2013), s. 102-111 ISSN 0020-7608 R&D Projects: GA ČR GA203/09/0118 Institutional support: RVO:67985858 Keywords : transition metal hydrides * bond formation * analysis of domain averaged Fermi holes Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 1.166, year: 2013

Black Hole Formation in Randall-Sundrum II Braneworlds.

Science.gov (United States)

Wang, Daoyan; Choptuik, Matthew W

2016-07-01

We present the first numerical study of the full dynamics of a braneworld scenario, working within the framework of the single brane model of Randall and Sundrum. In particular, we study the process of gravitational collapse driven by a massless scalar field which is confined to the brane. Imposing spherical symmetry on the brane, we show that the evolutions of sufficiently strong initial configurations of the scalar field result in black holes that have finite extension into the bulk. Furthermore, we find preliminary evidence that the black holes generated form a unique sequence, irrespective of the details of the initial data. The black hole solutions we obtain from dynamical evolutions are consistent with those previously computed from a static vacuum ansatz.

Macular Amyloidosis and Epstein-Barr Virus

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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.

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.

BLACK HOLE FORMATION IN FAILING CORE-COLLAPSE SUPERNOVAE

International Nuclear Information System (INIS)

O'Connor, Evan; Ott, Christian D.

2011-01-01

We present results of a systematic study of failing core-collapse supernovae and the formation of stellar-mass black holes (BHs). Using our open-source general-relativistic 1.5D code GR1D equipped with a three-species neutrino leakage/heating scheme and over 100 presupernova models, we study the effects of the choice of nuclear equation of state (EOS), zero-age main sequence (ZAMS) mass and metallicity, rotation, and mass-loss prescription on BH formation. We find that the outcome, for a given EOS, can be estimated, to first order, by a single parameter, the compactness of the stellar core at bounce. By comparing protoneutron star (PNS) structure at the onset of gravitational instability with solutions of the Tolman-Oppenheimer-Volkof equations, we find that thermal pressure support in the outer PNS core is responsible for raising the maximum PNS mass by up to 25% above the cold NS value. By artificially increasing neutrino heating, we find the critical neutrino heating efficiency required for exploding a given progenitor structure and connect these findings with ZAMS conditions, establishing, albeit approximately, for the first time based on actual collapse simulations, the mapping between ZAMS parameters and the outcome of core collapse. We also study the effect of progenitor rotation and find that the dimensionless spin of nascent BHs may be robustly limited below a* = Jc/GM 2 = 1 by the appearance of nonaxisymmetric rotational instabilities.

Binary pairs of supermassive black holes - Formation in merging galaxies

Energy Technology Data Exchange (ETDEWEB)

Valtaoja, L.; Valtonen, M.J.; Byrd, G.G. (Turku Univ. (Finland); Alabama Univ., Tuscaloosa (USA))

1989-08-01

A process in which supermassive binary blackholes are formed in nuclei of supergiant galaxies due to galaxy mergers is examined. There is growing evidence that mergers of galaxies are common and that supermassive black holes in center of galaxies are also common. Consequently, it is expected that binary black holes should arise in connection with galaxy mergers. The merger process in a galaxy modeled after M87 is considered. The capture probability of a companion is derived as a function of its mass. Assuming a correlation between the galaxy mass and the blackholes mass, the expected mass ratio in binary black holes is calculated. The binary black holes formed in this process are long lived, surviving longer than the Hubble time unless they are perturbed by black holes from successive mergers. The properties of these binaries agree with Gaskell's (1988) observational work on quasars and its interpretation in terms of binary black holes. 39 refs.

Macular degeneration

Science.gov (United States)

The macula is the part of the retina that distinguishes fine details at the center of the field of vision. Macular degeneration results from a partial breakdown of the insulating layer between the retina and the choroid layer of ...

Hyperbaric oxygen therapy for the treatment of radiation-induced macular ischemia

Directory of Open Access Journals (Sweden)

Shamim A Haji

2010-05-01

Full Text Available Shamim A Haji1,2, Ronald EP Frenkel1,2,31Eye Research Foundation, Stuart, FL, USA; 2East Florida Eye Institute, Stuart, FL, USA; 3Bascom Palmer Eye Institute, Miami, FL, USAPurpose: To report a case of radiation-induced macular ischemia where vision and macular perfusion improved after hyperbaric oxygen (HBO therapy.Methods: A 62-year-old male patient developed radiation-induced macular ischemia after he was treated with radiation for brain glioma. The patient presented with best spectacle-corrected visual acuity (BSCVA acuity of 20/400 in his right eye. Optical coherence tomography (OCT showed central macular thickness of 468 μm. The patient received focal laser, intravitreal triamcinolone, and HBO therapy.Results: The patient’s vision improved from 20/400 to 20/100 after focal laser and intravitreal triamcinolone. His central macular thickness improved from 468 μm to 132 μm. After receiving HBO therapy, his VA improved to 20/50 and fluorescein angiography showed improvement in macular perfusion.Conclusion: HBO therapy improves macular perfusion in patients with radiation-induced macular ischemia.Keywords: macular ischemia, visual acuity, hyperbaric oxygen therapy, macular perfusion

Macular edema in uveitis with emphasis on ocular sarcoidosis

NARCIS (Netherlands)

Norel, J. van

2015-01-01

This thesis investigates the accumulation of fluid in the yellow spot (macular edema) in ocular inflammation (uveitis). Macular edema may result in definitive loss of vision.Two methods of imaging of macular edema are fluorescein angiography (FA) and optical coherence tomography (OCT). The first

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.

Macular xanthophylls and ω-3 long-chain polyunsaturated fatty acids in age-related macular degeneration: a randomized trial.

Science.gov (United States)

Arnold, Christin; Winter, Lisa; Fröhlich, Kati; Jentsch, Susanne; Dawczynski, Jens; Jahreis, Gerhard; Böhm, Volker

2013-05-01

It has been shown that the functionality of the macula lutea depends on the nutritional uptake of lutein and zeaxanthin and that it is inversely associated with the risk of age-related macular degeneration (AMD). Additionally, ω-3 long-chain polyunsaturated fatty acids (LC-PUFAs) may also be protective. To investigate the effect of a 12-month intervention with macular xanthophylls and ω-3 LC-PUFAs on xanthophylls and fatty acids in plasma, antioxidant capacity, and optical density of the macular pigment of patients with nonexudative AMD. The LUTEGA study was a randomized, double-blind, placebo-controlled, parallel clinical trial that was conducted for 12 months. University Eye Hospital and Institute of Nutrition, Friedrich Schiller University Jena, Germany. A total of 172 individuals with nonexudative AMD. Individuals were enrolled and randomly divided as follows: placebo group, group 1 (a capsule containing 10 mg of lutein, 1 mg of zeaxanthin, 100 mg of docosahexaenoic acid, and 30 mg of eicosapentaenoic acid administered each day), and group 2 (same substances but twice the dose used in group 1). One hundred forty-five participants completed the study successfully. Plasma xanthophyll concentrations and fatty acid profiles, optical density of the macular pigment, and antioxidant capacity in plasma (6-hydroxy-2,5,7,8-tetramethylchroman-2-carboxylic acid [Trolox] equivalent antioxidant capacity and photochemiluminescence). The concentrations of the administered carotenoids in plasma as well as the optical density of the macular pigment increased significantly in the groups randomized to receive supplementary macular xanthophylls and ω-3 LC-PUFAs after 1 month of intervention and remained at this level through the end of the study. Use of the double dose resulted in a beneficial alteration of the fatty acid profile in the plasma of patients with AMD in comparison with the dose in group 1. The lipophilic antioxidant capacity in plasma was significantly elevated

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

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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.

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

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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.

Green laser induced foveal cyst sustained in a recreational laser light show

Directory of Open Access Journals (Sweden)

Rukiye Aydin

2017-04-01

Full Text Available We report the case of a 9-year-old boy complained of visual loss in his right eye after watching green laser light show being hit by a ray of a laser at shopping center before five days ago. The laser had a maximum power rating of 30 mW (US Food and Drug Administration class IIIB. Best-corrected visual acuity in his right eye was 0.2 with Snellen at 5 days after the injury. Dilated fundoscopic examination demonstrated a macular hole appearance in the right eye. Spectral domain optical coherence tomography (OCT, Spectralis, Heidelberg Engineering, Heidelberg, Germany demonstrates a steep fovea contour, a thickening of the macular edges, intraretinal cysts, disruption of the photoreceptor inner segment/outer segment layer and macular pseudohole formation. Central foveal thickness (515 µm was increased. Two months after the injury, the patient's visual acuity improved to 0.9 in the right eye without any ocular treatment. Spectral domain OCT revealed the closure of the macular hole with the resolution of the cystic spaces. At 6-months follow-up, visual function had fully recovered and macular assessment was normal.

Visual loss related to macular subretinal fluid and cystoid macular edema in HIV-related optic neuropathy

DEFF Research Database (Denmark)

Gautier, David; Rabier, Valérie; Jallet, Ghislaine

2012-01-01

Optic nerve involvement may occur in various infectious diseases, but is rarely reported after infection by the human immunodeficiency virus (HIV). We report the atypical case of a 38-year-old patient in whom the presenting features of HIV infection were due to a bilateral optic neuropathy associ...... associated with macular subretinal fluid and cystoid macular edema, which responded well to antiretroviral therapy....

Modern diagnostic and treatment aspects of diabetic macular edema

Directory of Open Access Journals (Sweden)

Alexander Viktorovich Doga

2014-10-01

Full Text Available Diabetic macular oedema (DMO is the leading cause of vision loss and disability in working-age people with diabetes mellitus. This literature review describes pathogenetic mechanisms, concepts, diagnostic techniques and capabilities of novel laser technologies in the treatment of DMO. In recent years, the role of cytokines and growth factors in retinal neurodegeneration has been actively investigated. Modern diagnostic techniques for the treatment of diabetic macular oedema, in addition to conventional techniques, include optical coherence tomography, autofluorescence and microperimetry. These techniques allow the visualization of retinal structures and its functional condition, and they can be used to detect DMO at early stages and to provide the most effective treatment. The evolution of laser technology resulted in the formation of new approaches to DMO treatment. Subthreshold micropulse laser (SML treatment, in conjunction with conventional photocoagulation, has pronounced therapeutic effects. SML shows high selectivity towards retinal pigment epithelium while avoiding neurosensory retina injury. Owing to the chronic nature of DMO and pathogenetic mechanisms recently discovered, further elaboration of the SML technique appears to be a very promising treatment.

Autofluorescence Imaging for Diagnosis and Follow-up of Cystoid Macular Edema

Directory of Open Access Journals (Sweden)

Nazanin Ebrahimiadib

2012-01-01

Full Text Available Lipofuscin results from digestion of photoreceptor outer segments by the retinal pigment epithelium (RPE and is the principal compound that causes RPE fluorescence during autofluorescence imaging. Absorption of the 488-nanometer blue light by macular pigments, especially by the carotenoids lutein and zeaxanthin, causes normal macular hypo-autofluorescence. Fundus autofluorescence imaging is being increasingly employed in ophthalmic practice to diagnose and monitor patients with a variety of retinal disorders. In macular edema for example, areas of hyper-autofluorescence are usually present which are postulated to be due to dispersion of macular pigments by pockets of intraretinal fluid. For this reason, the masking effect of macular pigments is reduced and the natural autofluorescence of lipofuscin can be observed without interference. In cystic types of macular edema, e.g. cystoid macular edema due to retinal vein occlusion, diabetic macular edema and post cataract surgery, hyperautofluorescent regions corresponding to cystic spaces of fluid accumulation can be identified. In addition, the amount of hyper-autofluorescence seems to correspond to the severity of edema. Hence, autofluorescence imaging, as a noninvasive technique, can provide valuable information on cystoid macular edema in terms of diagnosis, followup and efficacy of treatment.

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.

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.

Black hole formation in perfect fluid collapse

International Nuclear Information System (INIS)

Goswami, Rituparno; Joshi, Pankaj S

2004-01-01

We construct here a special class of perfect fluid collapse models which generalizes the homogeneous dust collapse solution in order to include nonzero pressures and inhomogeneities into evolution. It is shown that a black hole is necessarily generated as the end product of continued gravitational collapse, rather than a naked singularity. We examine the nature of the central singularity forming as a result of endless collapse and it is shown that no nonspacelike trajectories can escape from the central singularity. Our results provide some insights into how the dynamical collapse works and into the possible formulations of the cosmic censorship hypothesis, which is as yet a major unsolved problem in black hole physics

Static Formation Temperature Prediction Based on Bottom Hole Temperature

Directory of Open Access Journals (Sweden)

Changwei Liu

2016-08-01

Full Text Available Static formation temperature (SFT is required to determine the thermophysical properties and production parameters in geothermal and oil reservoirs. However, it is not easy to determine SFT by both experimental and physical methods. In this paper, a mathematical approach to predicting SFT, based on a new model describing the relationship between bottom hole temperature (BHT and shut-in time, has been proposed. The unknown coefficients of the model were derived from the least squares fit by the particle swarm optimization (PSO algorithm. Additionally, the ability to predict SFT using a few BHT data points (such as the first three, four, or five points of a data set was evaluated. The accuracy of the proposed method to predict SFT was confirmed by a deviation percentage less than ±4% and a high regression coefficient R2 (>0.98. The proposed method could be used as a practical tool to predict SFT in both geothermal and oil wells.

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.

Numerical simulation of responses for cased-hole density logging

International Nuclear Information System (INIS)

Wu, Wensheng; Fu, Yaping; Niu, Wei

2013-01-01

Stabilizing or stimulating oil production in old oil fields requires density logging in cased holes where open-hole logging data are either missing or of bad quality. However, measured values from cased-hole density logging are more severely influenced by factors such as fluid, casing, cement sheath and the outer diameter of the open-hole well compared with those from open-hole logging. To correctly apply the cased-hole formation density logging data, one must eliminate these influences on the measured values and study the characteristics of how the cased-hole density logging instrument responds to these factors. In this paper, a Monte Carlo numerical simulation technique was used to calculate the responses of the far detector of a cased-hole density logging instrument to in-hole fluid, casing wall thickness, cement sheath density and the formation and thus to obtain influence rules and response coefficients. The obtained response of the detector is a function of in-hole liquid, casing wall thickness, the casing's outer diameter, cement sheath density, open-hole well diameter and formation density. The ratio of the counting rate of the detector in the calibration well to that in the measurement well was used to get a fairly simple detector response equation and the coefficients in the equation are easy to acquire. These provide a new way of calculating cased-hole density through forward modelling methods. (paper)

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; ...

Bilateral Simultaneous Macular Infarction with Spontaneous Visual ...

African Journals Online (AJOL)

2018-01-30

Jan 30, 2018 ... eyes and near acuity was; right eye: N24, left eye: N36. ... Keywords: Macular infarction, macular ischemia, sickle cell, visual loss ... and build upon the work non-commercially, as long as the author is credited and the new.

Frequency of vitreo macular traction in diabetic macular edema on optical coherence tomography

International Nuclear Information System (INIS)

Fatima, N.; Islam, Q.U.; Shafique, M.

2017-01-01

To determine the frequency of vitreo macular traction (VMT) in patients of diabetic macular edema (DME) as detected on spectral domain optical coherence tomography (SD-OCT). Study Design: Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Ophthalmology (AFIO) Rawalpindi, from May 2013 to Jan 2014. Patients and Methods: Diabetic patients of less than 18 years of age with DME and central macular thickness of more than 250 micrometers (micro m) were included. The patients with idiopathic VMT, history of vitreoretinal surgery, and history of other retinal vascular diseases were excluded from the study. Dilated fundus was done in each patient using 90 D lens on a slit lamp biomicroscope and patients with diabetic retinopathy changes and DME were subjected to OCT examination using Topcon 3-D OCT 1000 (Topcon Corporation). Record of each patient including demographic data, ocular findings and OCT data were endorsed on a pre-devised proforma. Results: Seventy one eyes of 68 patients were included, 36 (50.7 percent) were males and 35 (49.29 percent) were females. Mean age was 53.17 +- 8.79 years. Mean central macular thickness (CMT) was 361.8 +- 109 mu m. VMT was detected in 17 (23.9 percent) eyes. Amongst these, 2(12.5 percent) eyes had vitreofoveal traction, epiretinal membrane was found in 4 (25 percent) eyes and 11(62.5 percent) eyes had extra foveal VMT. Conclusion: Detection of VMT in about a quarter of cases reflects that OCT is a viable tool for early detection of vitreomacular interface abnormalities. (author)

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.

Connections Between Jet Formation and Multiwavelength Spectral Evolution in Black Hole Transients

Science.gov (United States)

Kakemci, Emrah; Chun, Yoon-Young; Dincer, Tolga; Buxton, Michelle; Tomsick, John A.; Corbel, Stephane; Kaaret, Philip

2011-01-01

Multiwavelength observations are the key to understand conditions of jet formation in Galactic black hole transient (GBHT) systems. By studying radio and optical-infrared evolution of such systems during outburst decays, the compact jet formation can be traced. Comparing this with X-ray spectral and timing evolution we can obtain physical and geometrical conditions for jet formation, and study the contribution of jets to X-ray emission. In this work, first X-ray evolution - jet relation for XTE J1752-223 will be discussed. This source had very good coverage in X-rays, optical, infrared and radio. A long exposure with INTEGRAL also allowed us to study gamma-ray behavior after the jet turns on. We will also show results from the analysis of data from GX 339-4 in the hard state with SUZAKU at low flux levels. The fits to iron line fluorescence emission show that the inner disk radius increases by a factor of greater than 27 with respect to radii in bright states. This result, along with other disk radius measurements in the hard state will be discussed within the context of conditions for launching and sustaining jets.

Macular Hole

Science.gov (United States)

... NEI Intranet (Employees Only) *PDF files require the free Adobe® Reader® software for viewing. This website is maintained by the NEI Office of Science Communications, Public Liaison, and Education. Technical questions about this website can be addressed ...

Black holes and the multiverse

International Nuclear Information System (INIS)

Garriga, Jaume; Vilenkin, Alexander; Zhang, Jun

2016-01-01

Vacuum bubbles may nucleate and expand during the inflationary epoch in the early universe. After inflation ends, the bubbles quickly dissipate their kinetic energy; they come to rest with respect to the Hubble flow and eventually form black holes. The fate of the bubble itself depends on the resulting black hole mass. If the mass is smaller than a certain critical value, the bubble collapses to a singularity. Otherwise, the bubble interior inflates, forming a baby universe, which is connected to the exterior FRW region by a wormhole. A similar black hole formation mechanism operates for spherical domain walls nucleating during inflation. As an illustrative example, we studied the black hole mass spectrum in the domain wall scenario, assuming that domain walls interact with matter only gravitationally. Our results indicate that, depending on the model parameters, black holes produced in this scenario can have significant astrophysical effects and can even serve as dark matter or as seeds for supermassive black holes. The mechanism of black hole formation described in this paper is very generic and has important implications for the global structure of the universe. Baby universes inside super-critical black holes inflate eternally and nucleate bubbles of all vacua allowed by the underlying particle physics. The resulting multiverse has a very non-trivial spacetime structure, with a multitude of eternally inflating regions connected by wormholes. If a black hole population with the predicted mass spectrum is discovered, it could be regarded as evidence for inflation and for the existence of a multiverse

Black holes and the multiverse

Energy Technology Data Exchange (ETDEWEB)

Garriga, Jaume [Departament de Fisica Fonamental i Institut de Ciencies del Cosmos, Universitat de Barcelona, Marti i Franques, 1, Barcelona, 08028 Spain (Spain); Vilenkin, Alexander; Zhang, Jun, E-mail: jaume.garriga@ub.edu, E-mail: vilenkin@cosmos.phy.tufts.edu, E-mail: jun.zhang@tufts.edu [Institute of Cosmology, Tufts University, 574 Boston Ave, Medford, MA, 02155 (United States)

2016-02-01

Vacuum bubbles may nucleate and expand during the inflationary epoch in the early universe. After inflation ends, the bubbles quickly dissipate their kinetic energy; they come to rest with respect to the Hubble flow and eventually form black holes. The fate of the bubble itself depends on the resulting black hole mass. If the mass is smaller than a certain critical value, the bubble collapses to a singularity. Otherwise, the bubble interior inflates, forming a baby universe, which is connected to the exterior FRW region by a wormhole. A similar black hole formation mechanism operates for spherical domain walls nucleating during inflation. As an illustrative example, we studied the black hole mass spectrum in the domain wall scenario, assuming that domain walls interact with matter only gravitationally. Our results indicate that, depending on the model parameters, black holes produced in this scenario can have significant astrophysical effects and can even serve as dark matter or as seeds for supermassive black holes. The mechanism of black hole formation described in this paper is very generic and has important implications for the global structure of the universe. Baby universes inside super-critical black holes inflate eternally and nucleate bubbles of all vacua allowed by the underlying particle physics. The resulting multiverse has a very non-trivial spacetime structure, with a multitude of eternally inflating regions connected by wormholes. If a black hole population with the predicted mass spectrum is discovered, it could be regarded as evidence for inflation and for the existence of a multiverse.

Black and white holes

International Nuclear Information System (INIS)

Zeldovich, Ya.; Novikov, I.; Starobinskij, A.

1978-01-01

The theory is explained of the origination of white holes as a dual phenomenon with regard to the formation of black holes. Theoretically it is possible to derive the white hole by changing the sign of time in solving the general theory of relativity equation implying the black hole. The white hole represents the amount of particles formed in the vicinity of a singularity. For a distant observer, matter composed of these particles expands and the outer boundaries of this matter approach from the inside the gravitational radius Rsub(r). At t>>Rsub(r)/c all radiation or expulsion of matter terminates. For the outside observer the white hole exists for an unlimited length of time. In fact, however, it acquires the properties of a black hole and all processes in it cease. The qualitative difference between a white hole and a black hole is in that a white hole is formed as the result of an inner quantum explosion from the singularity to the gravitational radius and not as the result of a gravitational collapse, i.e., the shrinkage of diluted matter towards the gravitational radius. (J.B.)

Black and white holes

Energy Technology Data Exchange (ETDEWEB)

Zeldovich, Ya; Novikov, I; Starobinskii, A

1978-07-01

The theory is explained of the origination of white holes as a dual phenomenon with regard to the formation of black holes. Theoretically it is possible to derive the white hole by changing the sign of time in solving the general theory of relativity equation implying the black hole. The white hole represents the amount of particles formed in the vicinity of a singularity. For a distant observer, matter composed of these particles expands and the outer boundaries of this matter approach from the inside the gravitational radius R/sub r/. At t>>R/sub r//c all radiation or expulsion of matter terminates. For the outside observer the white hole exists for an unlimited length of time. In fact, however, it acquires the properties of a black hole and all processes in it cease. The qualitative difference between a white hole and a black hole is in that a white hole is formed as the result of an inner quantum explosion from the singularity to the gravitational radius and not as the result of a gravitational collapse, i.e., the shrinkage of diluted matter towards the gravitational radius.

Comparison of Visual Function in Older Eyes in the Earliest Stages of Age-related Macular Degeneration to Those in Normal Macular Health.

Science.gov (United States)

Owsley, Cynthia; Huisingh, Carrie; Clark, Mark E; Jackson, Gregory R; McGwin, Gerald

2016-01-01

To compare the ability of several visual functional tests in terms of the strength of their associations with the earliest phases of age-related macular degeneration (AMD), which bears on their potential to serve as functional endpoints in evaluating treatments for early AMD and prevention strategies. Eyes from adults ≥60 years old were identified as being in normal macular health or in the earliest stages of AMD (steps 2, 3 or 4) through grading of color stereo-fundus photos by an experienced grader masked to all other study variables who used the 9-step Age-Related Eye Disease Study (AREDS) classification system for AMD severity. Visual function was assessed using the following tests: best-corrected visual acuity, low luminance visual acuity, spatial contrast sensitivity, macular cone-mediated light sensitivity and rod-mediated dark adaptation. A total of 1260 eyes were tested from 640 participants; 1007 eyes were in normal macular health (defined as step 1 in AREDS system) and 253 eyes had early AMD (defined as steps 2, 3 or 4). Adjusting for age and gender, early AMD eyes had two times the odds of having delayed rod-mediated dark adaptation than eyes in normal macular health (p = 0.0019). Visual acuity, low luminance acuity, spatial contrast sensitivity and macular light sensitivity did not differ between normal eyes and early AMD eyes. Eyes in the earliest phases of AMD were two times more likely to have delayed rod-mediated dark adaptation, as assessed by the rod-intercept, as compared to older eyes in normal macular health, whereas there was no difference in early AMD versus normal eyes in tests of visual acuity, low luminance acuity, macular light sensitivity and spatial contrast sensitivity.

USING CENTER HOLE HEAT TRANSFER TO REDUCE FORMATION TIMES FOR CERAMIC WASTE FORMS FROM PYROPROCESSING

International Nuclear Information System (INIS)

Kenneth J. Bateman; Charles W. Solbrig

2006-01-01

The waste produced from processing spent fuel from the EBR II reactor must be processed into a waste form suitable for long term storage in Yucca Mountain. The method chosen produces zeolite granules mixed with glass frit, which must then be converted into a solid. This is accomplished by loading it into a can and heating to 900 C in a furnace regulated at 915 C. During heatup to 900 C, the zeolite and glass frit react and consolidate to produce a sodalite monolith. The resultant ceramic waste form (CWF) is then cooled. The waste is 52 cm in diameter and initially 300 cm long but consolidates to 150 cm long during the heating process. After cooling it is then inserted in a 5-DHLW/DOE SNF Long Canister. Without intervention, the waste takes 82 hours to heat up to 900 C in a furnace designed to geometrically fit the cylindrical waste form. This paper investigates the reduction in heating times possible with four different methods of additional heating through a center hole. The hole size is kept small to maximize the amount of CWF that is processed in a single run. A hole radius of 1.82 cm was selected which removes only 1% of the CWF. A reference computation was done with a specified inner hole surface temperature of 915 C to provide a benchmark for the amount of improvement which can be made. It showed that the heatup time can potentially be reduced to 43 hours with center hole heating. The first method, simply pouring high temperature liquid aluminum into the hole, did not produce any noticeable effect on reducing heat up times. The second method, flowing liquid aluminum through the hole, works well as long as the velocity is high enough (2.5 cm/sec) to prevent solidification of the aluminum during the initial front movement of the aluminum into the center hole. The velocity can be reduced to 1 cm/sec after the initial front has traversed the ceramic. This procedure reduces the formation time to near that of the reference case. The third method, flowing a gas

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....... 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...

Electromagnetic ``black holes'' in hyperbolic metamaterials

Science.gov (United States)

Smolyaninov, Igor

2013-03-01

We demonstrate that spatial variations of the dielectric tensor components in a hyperbolic metamaterial may lead to formation of electromagnetic ``black holes'' inside this metamaterial. Similar to real black holes, horizon area of the electromagnetic ``black holes'' is quantized in units of the effective ``Planck scale'' squared. Potential experimental realizations of such electromagnetic ``black holes'' will be considered. For example, this situation may be realized in a hyperbolic metamaterial in which the dielectric component exhibits critical opalescence.

Management of macular epiretinal membrane by vitrectomy and intravitreal triamcinolone.

Science.gov (United States)

Shukla, Dhananjay

2014-04-01

A patient underwent successful vitrectomy for macular epiretinal membrane with anatomical and functional improvement. 10 weeks later, there was a recurrence of macular edema with corresponding visual decline. An intravitreal injection of triamcinolone acetonide not only restored the macular anatomy but also improved the visual outcome beyond that achieved after surgery.

Will we observe black holes at the LHC?

International Nuclear Information System (INIS)

Cavaglia, Marco; Das, Saurya; Maartens, Roy

2003-01-01

The generalized uncertainty principle, motivated by string theory and non-commutative quantum mechanics, suggests significant modifications to the Hawking temperature and evaporation process of black holes. For extra-dimensional gravity with Planck scale O(TeV), this leads to important changes in the formation and detection of black holes at the large hadron collider. The number of particles produced in Hawking evaporation decreases substantially. The evaporation ends when the black-hole mass is Planck scale, leaving a remnant and a consequent missing energy of order TeV. Furthermore, the minimum energy for black-hole formation in collisions is increased, and could even be increased to such an extent that no black holes are formed at LHC energies. (letter to the editor)

A value-based medicine comparison of interventions for subfoveal neovascular macular degeneration.

Science.gov (United States)

Brown, Gary C; Brown, Melissa M; Brown, Heidi C; Kindermann, Sylvia; Sharma, Sanjay

2007-06-01

To perform a value-based medicine analysis of clinical trials that evaluate the interventions of laser photocoagulation, intravitreal pegaptanib therapy, and photodynamic therapy (PDT) with verteporfin for the treatment of classic subfoveal choroidal neovascularization. Reference case cost-utility analysis using value-based medicine principles, which use patient-based utility values and standardized, input variable criteria. Data from participants in the Macular Photocoagulation Study, Pegaptanib for Neovascular Age-Related Macular Degeneration Study, and the Treatment of Age-Related Macular Degeneration with Photodynamic Therapy Study. Visual data were converted to a value-based format using time tradeoff utility analysis values from patients with macular degeneration. Costs were obtained from 2005 Medicare data. Outcomes (quality-adjusted life-years [QALYs]) and costs were discounted at a 3% annual rate. Interventional QALYs gained, percent improvement in quality of life, and dollars spent per QALY gained. Laser photocoagulation confers a 4.4% (P = 0.03 versus pegaptanib therapy) improvement in quality of life for the reference case, whereas pegaptanib therapy confers a 5.9% improvement and PDT confers an 8.1% (P = 0.0002 versus pegaptanib therapy) improvement. The cost-utility associated with laser photocoagulation is $8179, that for pegaptanib therapy is $66978, and that for PDT is $31544. All sensitivity analyses remain within the conventional standards of cost-effectiveness. Photodynamic therapy confers greater patient value than intravitreal pegaptanib therapy and laser photocoagulation for the treatment of classic subfoveal choroidal neovascularization. Despite the fact that laser photocoagulation is the most cost-effective intervention, both PDT and pegaptanib therapy deliver greater value, and thus are both preferred over laser photocoagulation. Using an economic measure, photodynamic therapy is the preferred treatment among these 3 interventions.

[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

Blister/hole formation on tungsten surface due to low-energy and high-flux deuterium/helium plasma exposures

International Nuclear Information System (INIS)

Nishijima, D.; Iwakiri, H.; Yoshida, N.; Ye, M.Y.; Ohno, N.; Takamura, S.

2005-01-01

Deuterium/helium plasma exposures on tungsten surface bring serious damages such as blister and hole. Blistering occurs by cleaving along layered structure intrinsic to the press-roll manufacturing process. Mechanical polishing and helium pre-exposure on mirror-finished powder metallurgy tungsten drastically suppress blister formation. Small cracks made by a polishing would become paths to the surface for diffusing deuterium atoms in the substrate, resulting in no gas accumulation and no blister formation on the surface. Helium pre-exposure would make a helium-enriched layer near the surface, which becomes a kind of diffusion barrier for incident deuterium atoms. Blister formation and deuterium retention are suppressed on the surface with helium-enriched layer. (author)

Autophagy and exosomes in the aged retinal pigment epithelium: possible relevance to drusen formation and age-related macular degeneration.

Directory of Open Access Journals (Sweden)

Ai Ling Wang

Full Text Available Age-related macular degeneration (AMD is a major cause of loss of central vision in the elderly. The formation of drusen, an extracellular, amorphous deposit of material on Bruch's membrane in the macula of the retina, occurs early in the course of the disease. Although some of the molecular components of drusen are known, there is no understanding of the cell biology that leads to the formation of drusen. We have previously demonstrated increased mitochondrial DNA (mtDNA damage and decreased DNA repair enzyme capabilities in the rodent RPE/choroid with age. In this study, we found that drusen in AMD donor eyes contain markers for autophagy and exosomes. Furthermore, these markers are also found in the region of Bruch's membrane in old mice. By in vitro modeling increased mtDNA damage induced by rotenone, an inhibitor of mitochondrial complex I, in the RPE, we found that the phagocytic activity was not altered but that there were: 1 increased autophagic markers, 2 decreased lysosomal activity, 3 increased exocytotic activity and 4 release of chemoattractants. Exosomes released by the stressed RPE are coated with complement and can bind complement factor H, mutations of which are associated with AMD. We speculate that increased autophagy and the release of intracellular proteins via exosomes by the aged RPE may contribute to the formation of drusen. Molecular and cellular changes in the old RPE may underlie susceptibility to genetic mutations that are found in AMD patients and may be associated with the pathogenesis of AMD in the elderly.

Reconstructing the massive black hole cosmic history through gravitational waves

International Nuclear Information System (INIS)

Sesana, Alberto; Gair, Jonathan; Berti, Emanuele; Volonteri, Marta

2011-01-01

The massive black holes we observe in galaxies today are the natural end-product of a complex evolutionary path, in which black holes seeded in proto-galaxies at high redshift grow through cosmic history via a sequence of mergers and accretion episodes. Electromagnetic observations probe a small subset of the population of massive black holes (namely, those that are active or those that are very close to us), but planned space-based gravitational wave observatories such as the Laser Interferometer Space Antenna (LISA) can measure the parameters of 'electromagnetically invisible' massive black holes out to high redshift. In this paper we introduce a Bayesian framework to analyze the information that can be gathered from a set of such measurements. Our goal is to connect a set of massive black hole binary merger observations to the underlying model of massive black hole formation. In other words, given a set of observed massive black hole coalescences, we assess what information can be extracted about the underlying massive black hole population model. For concreteness we consider ten specific models of massive black hole formation, chosen to probe four important (and largely unconstrained) aspects of the input physics used in structure formation simulations: seed formation, metallicity ''feedback'', accretion efficiency and accretion geometry. For the first time we allow for the possibility of 'model mixing', by drawing the observed population from some combination of the 'pure' models that have been simulated. A Bayesian analysis allows us to recover a posterior probability distribution for the ''mixing parameters'' that characterize the fractions of each model represented in the observed distribution. Our work shows that LISA has enormous potential to probe the underlying physics of structure formation.

Calcium K-line network in coronal holes

Energy Technology Data Exchange (ETDEWEB)

Marsh, K A [Hale Observatories, Pasadena, Calif. (USA)

1977-05-01

Microphotometry of calcium K-line photographs in the regions of polar coronal holes shows that the chromospheric network exterior to a hole has a slightly broader intensity distribution than that inside the hole itself, a fact which can be attributed to a greater number of bright network elements outside the hole. These bright elements presumably represent the enhanced network resulting from the dispersal of magnetic flux from old active regions, a hypothesis which is consistent with current ideas of coronal hole formation.

Intermediate-Mass Black Holes

Science.gov (United States)

Miller, M. Coleman; Colbert, E. J. M.

2004-01-01

The mathematical simplicity of black holes, combined with their links to some of the most energetic events in the universe, means that black holes are key objects for fundamental physics and astrophysics. Until recently, it was generally believed that black holes in nature appear in two broad mass ranges: stellar-mass (M~3 20 M⊙), which are produced by the core collapse of massive stars, and supermassive (M~106 1010 M⊙), which are found in the centers of galaxies and are produced by a still uncertain combination of processes. In the last few years, however, evidence has accumulated for an intermediate-mass class of black holes, with M~102 104 M⊙. If such objects exist they have important implications for the dynamics of stellar clusters, the formation of supermassive black holes, and the production and detection of gravitational waves. We review the evidence for intermediate-mass black holes and discuss future observational and theoretical work that will help clarify numerous outstanding questions about these objects.

Effect of Conbercept injection and macular grid pattern photocoagulation in treating macular edema after non-ischemic branch retinal vein occlusion

Directory of Open Access Journals (Sweden)

Jiang Zhu

2018-06-01

Full Text Available AIM: To investigate the effects and safety of intravitreal injection of Conbercept combined with macular grid pattern photocoagulation for macular edema secondary to non-ischemic branch retinal vein occlusion(BRVO. METHODS: A total of 38 patients(38 eyes with macular edema following non-ischemic BRVO were retrospectively analyzed. All patients were given best corrected visual acuity(BCVA, intraocular pressure, slit lamp with preset lens, optic coherent tomography(OCTand fluorescence fundus angiography(FFAexamination. The BCVA and central macular thickness(CMTwere observed before and 1wk, 1, 2, 3, 6, 9 and 12mo after treatment. The change in pre-treatment and post-treatment were compared, and the related complications were recorded. RESULTS:BCVA before treatment and 1wk, 1, 2, 3, 6, 9 and 12mo after treatment were 0.89±0.62, 0.64±0.59, 0.55±0.62, 0.46±0.43, 0.53±0.67, 0.43±0.38, 0.42±0.29, 0.40±0.30, the difference was statistically significant between that before and after treatment(PP>0.05. CMT were 683.25±236.47, 298.65±116.12, 276.89±107.28, 281.55±99.62, 251.41±119.47, 240.58±88.62, 231.74±75.36, 209.51±84.68μm, the difference was statistically significant between that before and after treatment(PP>0.05. There were 11 eyes received one injection, 18 eyes with two injections, 2 eyes with 3, 3 eyes with 4, and 4 eyes more than 4, the average injection was 2.01±1.42. The CMT decreased after every injection. The intraocular hypertension and other complications were not seen after treatment. CONCLUSION: Intravitreal injection of conbercept combined with macular grid pattern photocoagulation for macular edema to non-ischemic BRVO can reduce the macular edema and improve BCVA, which is effective and safety.

Relationship between macular ganglion cell complex thickness and macular outer retinal thickness: a spectral-domain optical coherence tomography study.

Science.gov (United States)

Kita, Yoshiyuki; Kita, Ritsuko; Takeyama, Asuka; Anraku, Ayako; Tomita, Goji; Goldberg, Ivan

2013-01-01

To assess the relationship between macular ganglion cell complex and macular outer retinal thicknesses. Case-control study. Forty-two normal eyes and 91 eyes with primary open-angle glaucoma were studied. Spectral-domain optical coherence tomography (RTVue-100) was used to measure the macular ganglion cell complex and macular outer retinal thickness. Ganglion cell complex to outer retinal thickness ratio was also calculated. The relationships between the ganglion cell complex and outer retinal thicknesses and between the ganglion cell complex to outer retinal thickness ratio and outer retinal thickness were evaluated. There was a positive correlation between ganglion cell complex and outer retinal thicknesses in the normal group and the glaucoma group (r = 0.53, P variation in the outer retinal thickness. Therefore, when determining the ganglion cell complex, it seems necessary to consider the outer retinal thickness as well. We propose the ratio as a suitable parameter to account for individual variations in outer retinal thickness. © 2013 The Authors. Clinical and Experimental Ophthalmology © 2013 Royal Australian and New Zealand College of Ophthalmologists.

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

Blood-retinal barrier glycerol permeability in diabetic macular edema and healthy eyes: estimations from macular volume changes after peroral glycerol

DEFF Research Database (Denmark)

Thornit, Dorte Nellemann; Vinten, Carl Martin; Sander, Birgit

2010-01-01

PURPOSE: To compare the changes in macular volume (MV) between healthy subjects and patients with diabetic macular edema (DME) after an osmotic load and to determine the glycerol permeability (P(gly)) of the blood-retinal barrier (BRB). METHODS: In this unmasked study, 13 patients with DME and 5...

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.

Black-hole production from ultrarelativistic collisions

International Nuclear Information System (INIS)

Rezzolla, Luciano; Takami, Kentaro

2013-01-01

Determining the conditions under which a black hole can be produced is a long-standing and fundamental problem in general relativity. We use numerical simulations of colliding self-gravitating fluid objects to study the conditions of black-hole formation when the objects are boosted to ultrarelativistic speeds. Expanding on the previous work, we show that the collision is characterized by a type-I critical behaviour, with a black hole being produced for masses above a critical value, M c , and a partially bound object for masses below the critical one. More importantly, we show for the first time that the critical mass varies with the initial effective Lorentz factor 〈γ〉 following a simple scaling of the type M c ∼ K〈γ〉 −1.0 , thus indicating that a black hole of infinitesimal mass is produced in the limit of a diverging Lorentz factor. Furthermore, because a scaling is present also in terms of the initial stellar compactness, we provide a condition for black-hole formation in the spirit of the hoop conjecture. (fast track communication)

Comparison of macular choroidal thickness among patients older than age 65 with early atrophic age-related macular degeneration and normals.

Science.gov (United States)

Sigler, Eric J; Randolph, John C

2013-09-19

To compare macular choroidal thickness between patients older than 65 years with early atrophic age-related macular degeneration (AMD) and normals. This was a consecutive, cross-sectional observational study. Enhanced depth imaging spectral-domain optical coherence tomography using horizontal raster scanning at 12 locations throughout the macula was performed in one eye of consecutive patients presenting with large soft drusen alone, drusen with additional features of early AMD, or a normal fundus. Choroidal thickness was measured at 7 points for each raster scan in the central 3 mm of the macula (total 84 points per eye). In addition, a single subfoveolar measurement was obtained for each eye. One hundred fifty eyes of 150 patients were included. There was no significant difference between mean refractive error for each diagnosis category via one-way ANOVA (P = 0.451). Mean macular choroidal thickness (CT) was 235 ± 49 μm (range, 125-334 μm; median 222 μm) for normals, 161 ± 39 μm (range, 89-260 μm; median = 158 μm) for the drusen group, and 115 ± 40 μm (range, 22-256 μm; median = 112 μm) for patients with AMD. Mean macular CT was significantly different via one-way ANOVA among all diagnosis categories (P < 0.001). The presence of features of early AMD without geographic atrophy and/or soft drusen alone is associated with decreased mean macular CT in vivo compared to that in patients with no chorioretinal pathology. Using enhanced depth imaging, measurement of a single subfoveolar choroidal thickness is highly correlated to mean central macular CT.

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 autofluorescence matching optical coherence tomography angiography showed that the CC nonperfusion area was almost included in the MA area. The mean concordance rate for the MA area inside the CC nonperfusion area was 87.7 ± 13.9%. The MA and CC nonperfusion areas markedly overlapped. The area of CC nonperfusion correlated with the MA area. Choroidal ischemia might be involved in the pathogenesis of MA in treated 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.

Topics in black-hole physics: geometric constraints on noncollapsing, gravitating systems, and tidal distortions of a Schwarzschild black hole

International Nuclear Information System (INIS)

Redmount, I.H.

1984-01-01

This dissertation consists of two studies on the general-relativistic theory of black holes. The first work concerns the fundamental issue of black-hole formation: in it geometric constraints are sought on gravitating matter systems, in the special case of axial symmetry, which determine whether or not those systems undergo gravitational collapse to form black holes. The second project deals with mechanical behavior of a black hole: specifically, the tidal deformation of a static black hole is studied by the gravitational fields of external bodies

Macular xanthophylls, lipoprotein-related genes, and age-related macular degeneration.

Science.gov (United States)

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

2014-07-01

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. © 2014 American Society for Nutrition.

The Distribution of Macular Thickness and Its Determinants in a Healthy Population.

Science.gov (United States)

Hashemi, Hassan; Khabazkhoob, Mehdi; Yekta, AbbasAli; Emamian, Mohammad Hassan; Nabovati, Payam; Fotouhi, Akbar

2017-10-01

To determine the distribution of macular thickness in a healthy Iranian population aged 45-69 years and its association with certain determinants. All participants underwent optometric examinations including measurement of uncorrected and corrected visual acuity, objective refraction by retinoscopy, and subjective refraction. Subsequently, all participants underwent slit-lamp biomicroscopy followed by fundus examination through direct and indirect ophthalmoscopy, and optical coherence tomography (OCT) imaging under pupil dilation. Mean central macular thickness was 255.4 µm (95% confidence interval, CI, 254.5-256.3 µm), average inner macular thickness was 316.5 µm (95% CI 315.9-317.1 µm), average outer macular thickness was 275.3 µm (95% CI 274.8-275.8 µm), and overall average thickness was 278.6 µm (95% CI 278.1-279.1 µm). A linear multiple regression model showed that all indexes were significantly larger in male participants (p < 0.001). Central macular thickness increased with age (coef = 0.25, p < 0.001) while overall, inner and outer macular thickness decreased with age (coef = -0.18, -0.15, -0.19, respectively, all p < 0.001). Central and inner macular thickness had a positive correlation (coef = 3.8, 2.6, respectively, both p < 0.001) and outer macular thickness had a negative correlation (coef = -1.6, p < 0.001) with axial length. Age, sex, refractive error, axial length, and keratometry were found to be associated with macular thickness. These factors should be taken into account when interpreting macular thickness measurements with spectral-domain OCT.

Black hole thermodynamics based on unitary evolutions

International Nuclear Information System (INIS)

Feng, Yu-Lei; Chen, Yi-Xin

2015-01-01

In this paper, we try to construct black hole thermodynamics based on the fact that the formation and evaporation of a black hole can be described by quantum unitary evolutions. First, we show that the Bekenstein–Hawking entropy S BH may not be a Boltzmann or thermal entropy. To confirm this statement, we show that the original black hole's ‘first law’ may not simply be treated as the first law of thermodynamics formally, due to some missing metric perturbations caused by matter. Then, by including those (quantum) metric perturbations, we show that the black hole formation and evaporation can be described effectively in a unitary manner, through a quantum channel between the exterior and interior of the event horizon. In this way, the paradoxes of information loss and firewall can be resolved effectively. Finally, we show that black hole thermodynamics can be constructed in an ordinary way, by constructing statistical mechanics. (paper)

[Current concepts in pathogenesis of age-related macular degeneration].

Science.gov (United States)

Kubicka-Trząska, Agnieszka; Karska-Basta, Izabella; Romanowska-Dixon, Bożena

2014-01-01

Age-related macular degeneration is the leading cause of central blindness in elderly population of the western world. The pathogenesis of this disease, likely multifactorial, is not well known, although a number of theories have been put forward, including oxidative stress, genetic interactions, hemodynamic imbalance, immune and inflammatory processes. The understanding of age-related macular degeneration pathogenesis will give rise to new approaches in prevention and treatment of the early and late stages of both atrophic and neovascular age-related macular degeneration.

PATTERNS OF FUNDUS AUTOFLUORESCENCE DEFECTS IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION SUBTYPES.

Science.gov (United States)

Ozkok, Ahmet; Sigford, Douglas K; Tezel, Tongalp H

2016-11-01

To test define characteristic fundus autofluorescence patterns of different exudative age-related macular degeneration subtypes. Cross-sectional study. Fifty-two patients with choroidal neovascularization because of three different neovascular age-related macular degeneration subtypes were included in the study. Macular and peripheral fundus autofluorescence patterns of study subjects were compared in a masked fashion. Fundus autofluorescence patterns of all three neovascular age-related macular degeneration subtypes revealed similar patterns. However, peripapillary hypo-autofluorescence was more common among patients with polypoidal choroidal vasculopathy (88.2%) compared with patients with retinal angiomatous proliferation (12.5%) and patients without retinal angiomatous proliferation and polypoidal choroidal vasculopathy (21.1%) (P autofluorescence defects in neovascular age-related macular degeneration maybe suggestive of polypoidal choroidal vasculopathy as a variant of neovascular age-related macular degeneration.

Current status in diabetic macular edema treatments

Institute of Scientific and Technical Information of China (English)

Pedro; Romero-Aroca

2013-01-01

Diabetes is a serious chronic condition,which increase the risk of cardiovascular diseases,kidney failure and nerve damage leading to amputation.Furthermore the ocular complications include diabetic macular edema,is the leading cause of blindness among adults in the industrialized countries.Today,blindness from diabetic macular edema is largely preventable with timely detection and appropriate interventional therapy.The treatment should include an optimized control of glycemia,arterial tension,lipids and renal status.The photocoagulation laser is currently restricted to focal macular edema in some countries,but due the high cost of intravitreal drugs,the use of laser treatment for focal and diffuse diabetic macular edema(DME),can be valid as gold standard in many countries.The intravitreal anti vascular endothelial growth factor drugs(ranibizumab and bevacizumab),are indicated in the treatment of all types of DME,but the correct protocol for administration should be defined for the different Retina Scientific Societies.The corticosteroids for diffuse DME,has a place in pseudophakic patients,but its complications restricted the use of these drugs for some patients.Finally the intravitreal interface plays an important role and its exploration is mandatory in all DME patients.

Orbital circularisation of white dwarfs and the formation of gravitational radiation sources in star clusters containing an intermediate mass black hole

OpenAIRE

Ivanov, P. B.; Papaloizou, J. C. B.

2007-01-01

(abbreviated) We consider how tight binaries consisting of a super-massive black hole of mass $M=10^{3}-10^{4}M_{\\odot}$ and a white dwarf can be formed in a globular cluster. We point out that a major fraction of white dwarfs tidally captured by the black hole may be destroyed by tidal inflation during ongoing circularisation, and the formation of tight binaries is inhibited. However, some stars may survive being spun up to high rotation rates. Then the energy loss through gravitational wave...

Probability of primordial black hole formation and its dependence on the radial profile of initial configurations

International Nuclear Information System (INIS)

Hidalgo, J. C.; Polnarev, A. G.

2009-01-01

In this paper we derive the probability of the radial profiles of spherically symmetric inhomogeneities in order to provide an improved estimation of the number density of primordial black holes (PBHs). We demonstrate that the probability of PBH formation depends sensitively on the radial profile of the initial configuration. We do this by characterizing this profile with two parameters chosen heuristically: the amplitude of the inhomogeneity and the second radial derivative, both evaluated at the center of the configuration. We calculate the joint probability of initial cosmological inhomogeneities as a function of these two parameters and then find a correspondence between these parameters and those used in numerical computations of PBH formation. Finally, we extend our heuristic study to evaluate the probability of PBH formation taking into account for the first time the radial profile of curvature inhomogeneities.

EVIDENCE FOR THREE ACCRETING BLACK HOLES IN A GALAXY AT z ∼ 1.35: A SNAPSHOT OF RECENTLY FORMED BLACK HOLE SEEDS?

International Nuclear Information System (INIS)

Schawinski, Kevin; Urry, Meg; Treister, Ezequiel; Simmons, Brooke; Natarajan, Priyamvada; Glikman, Eilat

2011-01-01

One of the key open questions in cosmology today pertains to understanding when, where, and how supermassive black holes form. While it is clear that mergers likely play a significant role in the growth cycles of black holes, the issue of how supermassive black holes form, and how galaxies grow around them, still needs to be addressed. Here, we present Hubble Space Telescope Wide Field Camera 3/IR grism observations of a clumpy galaxy at z = 1.35, with evidence for 10 6 -10 7 M ☉ rapidly growing black holes in separate sub-components of the host galaxy. These black holes could have been brought into close proximity as a consequence of a rare multiple galaxy merger or they could have formed in situ. Such holes would eventually merge into a central black hole as the stellar clumps/components presumably coalesce to form a galaxy bulge. If we are witnessing the in situ formation of multiple black holes, their properties can inform seed formation models and raise the possibility that massive black holes can continue to emerge in star-forming galaxies as late as z = 1.35 (4.8 Gyr after the big bang).

Plasma electron hole kinematics. I. Momentum conservation

Energy Technology Data Exchange (ETDEWEB)

Hutchinson, I. H.; Zhou, C. [Plasma Science and Fusion Center, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139 (United States)

2016-08-15

We analyse the kinematic properties of a plasma electron hole: a non-linear self-sustained localized positive electric potential perturbation, trapping electrons, which behaves as a coherent entity. When a hole accelerates or grows in depth, ion and electron plasma momentum is changed both within the hole and outside, by an energization process we call jetting. We present a comprehensive analytic calculation of the momentum changes of an isolated general one-dimensional hole. The conservation of the total momentum gives the hole's kinematics, determining its velocity evolution. Our results explain many features of the behavior of hole speed observed in numerical simulations, including self-acceleration at formation, and hole pushing and trapping by ion streams.

Experiments on the breakup of drop-impact crowns by Marangoni holes

KAUST Repository

Aljedaani, Abdulrahman Barakat

2018-04-04

We investigate experimentally the breakup of the Edgerton crown due to Marangoni instability when a highly viscous drop impacts on a thin film of lower-viscosity liquid, which also has different surface tension than the drop liquid. The presence of this low-viscosity film modifies the boundary condition, giving effective slip to the drop along the solid substrate. This allows the high-viscosity drop to form a regular bowl-shaped crown, which rises vertically away from the solid and subsequently breaks up through the formation of a multitude of Marangoni holes. Previous experiments have proposed that the breakup of the crown results from a spray of fine droplets ejected from the thin low-viscosity film on the solid, e.g. Thoroddsen et al. (J. Fluid Mech., vol. 557, 2006, pp. 63–72). These droplets can hit the inner side of the crown forming spots with lower surface tension, which drives a thinning patch leading to the hole formation. We test the validity of this assumption with close-up imaging to identify individual spray droplets, to show how they hit the crown and their lower surface tension drive the hole formation. The experiments indicate that every Marangoni-driven patch/hole is promoted by the impact of such a microdroplet. Surprisingly, in experiments with pools of higher surface tension, we also see hole formation. Here the Marangoni stress changes direction and the hole formation looks qualitatively different, with holes and ruptures forming in a repeatable fashion at the centre of each spray droplet impact. Impacts onto films of the same liquid, or onto an immiscible liquid, do not in general form holes. We furthermore characterize the effects of drop viscosity and substrate-film thickness on the overall evolution of the crown. We also measure the three characteristic velocities associated with the hole formation: i.e. the Marangoni-driven growth of the thinning patches, the rupture speed of the resulting thin films inside these patches and finally the

Bilateral Intravitreal Dexamethasone Implant for Retinitis Pigmentosa-Related Macular Edema

Directory of Open Access Journals (Sweden)

Ali Osman Saatci

2013-03-01

Full Text Available Purpose: To report the efficacy of intravitreal dexamethasone implant in a patient with retinitis pigmentosa and bilateral cystoid macular edema unresponsive to topical carbonic anhydrase inhibitors. Case Report: A 36-year-old man with bilateral cystoid macular edema associated with retinitis pigmentosa that was unresponsive to topical carbonic anhydrase inhibitors underwent bilateral 0.7-mg intravitreal dexamethasone implants two weeks apart. Spectral domain optical coherence tomography revealed resolution of macular edema one week following each injection in both eyes and his visual acuity improved. However, macular edema recurred two months later in OS and three months later in OD. Second implant was considered for both eyes. No implant-related complication was experienced during the follow-up of seven months. Conclusion: Inflammatory process seems to play a role in retinitis pigmentosa. Intravitreal dexamethasone implant may offer retina specialists a therapeutic option especially in cases unresponsive to other treatment regimens in eyes with retinitis pigmentosa-related macular edema.

The birth of a supermassive black hole binary

Science.gov (United States)

Pfister, Hugo; Lupi, Alessandro; Capelo, Pedro R.; Volonteri, Marta; Bellovary, Jillian M.; Dotti, Massimo

2017-11-01

We study the dynamical evolution of supermassive black holes, in the late stage of galaxy mergers, from kpc to pc scales. In particular, we capture the formation of the binary, a necessary step before the final coalescence, and trace back the main processes causing the decay of the orbit. We use hydrodynamical simulations of galaxy mergers with different resolutions, from 20 pc down to 1 pc, in order to study the effects of the resolution on our results, remove numerical effects, and assess that resolving the influence radius of the orbiting black hole is a minimum condition to fully capture the formation of the binary. Our simulations include the relevant physical processes, namely star formation, supernova feedback, accretion on to the black holes and the ensuing feedback. We find that, in these mergers, dynamical friction from the smooth stellar component of the nucleus is the main process that drives black holes from kpc to pc scales. Gas does not play a crucial role and even clumps do not induce scattering or perturb the orbits. We compare the time needed for the formation of the binary to analytical predictions and suggest how to apply such analytical formalism to obtain estimates of binary formation times in lower resolution simulations.

String cavitation formation inside fuel injectors

Science.gov (United States)

Reid, B. A.; Gavaises, M.; Mitroglou, N.; Hargrave, G. K.; Garner, C. P.; McDavid, R. M.

2015-12-01

The formation of vortex or ‘string’ cavitation has been visualised at pressures up to 2000 bar in an automotive-sized optical diesel fuel injector nozzle. The multi-hole nozzle geometry studied allowed observation of the hole-to-hole vortex interaction and, in particular, that of a bridging vortex in the sac region between the holes. Above a threshold Reynolds number, their formation and appearance during a 2 ms injection event was repeatable and independent of upstream pressure and cavitation number. In addition, two different hole layouts and threedimensional flow simulations have been employed to describe how, the relative positions of adjacent holes influenced the formation and hole-to-hole interaction of the observed string cavitation vortices, with good agreement between the experimental and simulation results being achieved.

Macular degeneration - age-related

Science.gov (United States)

... AMD occurs when the blood vessels under the macula become thin and brittle. Small yellow deposits, called drusen, form. Almost all people with macular degeneration start with the dry form. Wet AMD occurs ...

Massive Black Hole Binaries: Dynamical Evolution and Observational Signatures

Directory of Open Access Journals (Sweden)

M. Dotti

2012-01-01

Full Text Available The study of the dynamical evolution of massive black hole pairs in mergers is crucial in the context of a hierarchical galaxy formation scenario. The timescales for the formation and the coalescence of black hole binaries are still poorly constrained, resulting in large uncertainties in the expected rate of massive black hole binaries detectable in the electromagnetic and gravitational wave spectra. Here, we review the current theoretical understanding of the black hole pairing in galaxy mergers, with a particular attention to recent developments and open issues. We conclude with a review of the expected observational signatures of massive binaries and of the candidates discussed in literature to date.

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)....

Immunotherapy for choroidal neovascularization in a laser-induced mouse model simulating exudative (wet) macular degeneration

Science.gov (United States)

Bora, Puran S.; Hu, Zhiwei; Tezel, Tongalp H.; Sohn, Jeong-Hyeon; Kang, Shin Goo; Cruz, Jose M. C.; Bora, Nalini S.; Garen, Alan; Kaplan, Henry J.

2003-03-01

Age-related macular degeneration (AMD) is the leading cause of blindness after age 55 in the industrialized world. Severe loss of central vision frequently occurs with the exudative (wet) form of AMD, as a result of the formation of a pathological choroidal neovasculature (CNV) that damages the macular region of the retina. We tested the effect of an immunotherapy procedure, which had been shown to destroy the pathological neovasculature in solid tumors, on the formation of laser-induced CNV in a mouse model simulating exudative AMD in humans. The procedure involves administering an Icon molecule that binds with high affinity and specificity to tissue factor (TF), resulting in the activation of a potent cytolytic immune response against cells expressing TF. The Icon binds selectively to TF on the vascular endothelium of a CNV in the mouse and pig models and also on the CNV of patients with exudative AMD. Here we show that the Icon dramatically reduces the frequency of CNV formation in the mouse model. After laser treatment to induce CNV formation, the mice were injected either with an adenoviral vector encoding the Icon, resulting in synthesis of the Icon by vector-infected mouse cells, or with the Icon protein. The route of injection was i.v. or intraocular. The efficacy of the Icon in preventing formation of laser-induced CNV depends on binding selectively to the CNV. Because the Icon binds selectively to the CNV in exudative AMD as well as to laser-induced CNV, the Icon might also be efficacious for treating patients with exudative AMD.

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...... 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...... center field thickness and in 6 of 8 eyes by an increase in BCVA of 5 or more approxETDRS letters. A mild transient rise in intraocular pressure occurred in 3 out of 8 eyes. CONCLUSION: Diabetic macular edema involving the foveal center that presented during pregnancy responded promptly to intravitreal...

Analysis of laser photocoagulation with cataract surgery for improvement of visual acuity and macular edema in patients with cataract and diabetic macular edema

Directory of Open Access Journals (Sweden)

Chao-Yu Wang

2016-02-01

Full Text Available AIM:To explore laser photocoagulation with cataract surgery for improvement of visual acuity and macular edema in patients with cataract and diabetic macular edema.METHODS:A total of 60 patients(72 eyesfrom January 2014 to July 2015 in our hospital were selected, which all were diagnosed as cataract with diabetic macular edema. According to a random number table method, the patients were divided into observation group and control group, 30 cases(36 eyesin each group. The observation group was treated with combination therapy of laser photocoagulation before cataract surgeries, while the control group with the combination therapy of laser photocoagulation after cataract surgeries. At 2mo after surgeries, some routine examination, such as visual acuity, fundus examination after mydriasis, slit lamp examination, optical coherence tomography(OCTexamination, fluorescence angiography examination(FFAfor retinal blood vessels were applied in all the patients. RESULTS:The visual acuity of the observation group and the control group before treatments was not significantly different(P>0.05. At 2mo after treatments, the visual inspection showed that compared with the visual acuity before treatment, the visual acuity of the two groups were both significantly improved(PPP>0.05. At 2mo after treatments, compared with those before treatments, the macular thickness of two groups were both significantly improved(PPCONCLUSION:The laser photocoagulation before cataract surgery for patients with cataract and diabetic macular edema can significantly improve their visual acuity and macular thickness.

Investigation of Spiral and Sweeping Holes

Science.gov (United States)

Thurman, Douglas; Poinsatte, Philip; Ameri, Ali; Culley, Dennis; Raghu, Surya; Shyam, Vikram

2015-01-01

Surface infrared thermography, hotwire anemometry, and thermocouple surveys were performed on two new film cooling hole geometries: spiral/rifled holes and fluidic sweeping holes. The spiral holes attempt to induce large-scale vorticity to the film cooling jet as it exits the hole to prevent the formation of the kidney shaped vortices commonly associated with film cooling jets. The fluidic sweeping hole uses a passive in-hole geometry to induce jet sweeping at frequencies that scale with blowing ratios. The spiral hole performance is compared to that of round holes with and without compound angles. The fluidic hole is of the diffusion class of holes and is therefore compared to a 777 hole and Square holes. A patent-pending spiral hole design showed the highest potential of the non-diffusion type hole configurations. Velocity contours and flow temperature were acquired at discreet cross-sections of the downstream flow field. The passive fluidic sweeping hole shows the most uniform cooling distribution but suffers from low span-averaged effectiveness levels due to enhanced mixing. The data was taken at a Reynolds number of 11,000 based on hole diameter and freestream velocity. Infrared thermography was taken for blowing rations of 1.0, 1.5, 2.0, and 2.5 at a density ration of 1.05. The flow inside the fluidic sweeping hole was studied using 3D unsteady RANS.

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.

Very early disease manifestations of macular telangiectasia type 2

NARCIS (Netherlands)

Issa, P.C.; Heeren, T.F.C.; Kupitz, E.H.; Holz, F.G.; Berendschot, T.T.J.M.

Background: To report very early morphologic and functional alterations in patients with macular telangiectasia type 2. Methods: Patients with asymmetric disease manifestations, in whom retinal alterations characteristic for macular telangiectasia type 2 were present in one but not in the apparently

Black hole evaporation: a paradigm

International Nuclear Information System (INIS)

Ashtekar, Abhay; Bojowald, Martin

2005-01-01

A paradigm describing black hole evaporation in non-perturbative quantum gravity is developed by combining two sets of detailed results: (i) resolution of the Schwarzschild singularity using quantum geometry methods and (ii) time evolution of black holes in the trapping and dynamical horizon frameworks. Quantum geometry effects introduce a major modification in the traditional spacetime diagram of black hole evaporation, providing a possible mechanism for recovery of information that is classically lost in the process of black hole formation. The paradigm is developed directly in the Lorentzian regime and necessary conditions for its viability are discussed. If these conditions are met, much of the tension between expectations based on spacetime geometry and structure of quantum theory would be resolved

Black hole evaporation in conformal gravity

Energy Technology Data Exchange (ETDEWEB)

Bambi, Cosimo; Rachwał, Lesław [Center for Field Theory and Particle Physics and Department of Physics, Fudan University, 220 Handan Road, 200433 Shanghai (China); Modesto, Leonardo [Department of Physics, Southern University of Science and Technology, 1088 Xueyuan Road, Shenzhen 518055 (China); Porey, Shiladitya, E-mail: bambi@fudan.edu.cn, E-mail: lmodesto@sustc.edu.cn, E-mail: shilp@iitk.ac.in, E-mail: rachwal@fudan.edu.cn [Department of Physics, Indian Institute of Technology, 208016 Kanpur (India)

2017-09-01

We study the formation and the evaporation of a spherically symmetric black hole in conformal gravity. From the collapse of a spherically symmetric thin shell of radiation, we find a singularity-free non-rotating black hole. This black hole has the same Hawking temperature as a Schwarzschild black hole with the same mass, and it completely evaporates either in a finite or in an infinite time, depending on the ensemble. We consider the analysis both in the canonical and in the micro-canonical statistical ensembles. Last, we discuss the corresponding Penrose diagram of this physical process.

Semiclassical Approach to Black Hole Evaporation

OpenAIRE

Lowe, David A.

1992-01-01

Black hole evaporation may lead to massive or massless remnants, or naked singularities. This paper investigates this process in the context of two quite different two dimensional black hole models. The first is the original CGHS model, the second is another two dimensional dilaton-gravity model, but with properties much closer to physics in the real, four dimensional, world. Numerical simulations are performed of the formation and subsequent evaporation of black holes and the results are fou...

Ejection of massive black holes from galaxies

International Nuclear Information System (INIS)

Kapoor, R.C.

1976-01-01

Gravitational recoil of a gigantic black hole (M approximately 10 8-9 M) formed in the nonspherical collapse of the nuclear part of a typical galaxy can take place with an appreciable speed as a consequence of the anisotropic emission of gravitational radiation. Accretion of gaseous matter during its flight through the galaxy results in the formation of a flowing shock front. The accompanying stellar captures can lead to the formation of an accretion disk-star system about the hole. Consequently, the hole can become 'luminous' enough to be observable after it emerges out of the galaxy. The phenomenon seems to have an importance in relation to the observations of quasar-galaxy association in a number of cases. (author)

Accumulation of macular xanthophylls in unsaturated membrane domains.

Science.gov (United States)

Wisniewska, Anna; Subczynski, Witold K

2006-05-15

The distribution of macular xanthophylls, lutein and zeaxanthin, between domains formed in membranes made from an equimolar ternary mixture of dioleoylphosphatidylcholine/sphingomyelin/cholesterol, called a raft-forming mixture, was investigated. In these membranes, two domains are formed: the raft domain enriched in saturated lipids and cholesterol (detergent-resistant membranes, DRM), and the bulk domain enriched in unsaturated lipids (detergent-soluble membranes, DSM). These membrane domains have been separated using cold Triton X-100 extraction from membranes containing 1 mol% of either lutein or zeaxanthin. The results indicated that xanthophylls are substantially excluded from DRM and remain concentrated in DSM. Concentrations of xanthophylls in DRM and DSM calculated as the mole ratio of either xanthophyll to phospholipid were 0.005 and 0.03, respectively, and calculated as the mole ratio of either xanthophyll to total lipid (phospholipid + cholesterol) were 0.003 and 0.025, respectively. Thus, xanthophylls are over eight times more concentrated in DSM than in DRM. No significant difference in the distribution of lutein and zeaxanthin was found. It was also demonstrated using saturation-recovery EPR that at 1 mol%, neither lutein nor zeaxanthin affect the formation of membrane domains. The location of xanthophylls in domains formed from unsaturated lipids is ideal if they are to act as a lipid antioxidant, which is the most accepted mechanism through which lutein and zeaxanthin protect the retina from age-related macular diseases.

Can superconducting cosmic strings piercing seed black holes generate supermassive black holes in the early universe?

Energy Technology Data Exchange (ETDEWEB)

Lake, Matthew J. [The Institute for Fundamental Study, ' ' The Tah Poe Academia Institute' ' , Naresuan University, Phitsanulok (Thailand); Thailand Center of Excellence in Physics, Ministry of Education, Bangkok (Thailand); Harko, Tiberiu [Department of Physics, Babes-Bolyai University, Cluj-Napoca (Romania); Department of Mathematics, University College London (United Kingdom)

2017-10-15

The discovery of a large number of supermassive black holes (SMBH) at redshifts z > 6, when the Universe was only 900 million years old, raises the question of how such massive compact objects could form in a cosmologically short time interval. Each of the standard scenarios proposed, involving rapid accretion of seed black holes or black hole mergers, faces severe theoretical difficulties in explaining the short-time formation of supermassive objects. In this work we propose an alternative scenario for the formation of SMBH in the early Universe, in which energy transfer from superconducting cosmic strings piercing small seed black holes is the main physical process leading to rapid mass increase. As a toy model, the accretion rate of a seed black hole pierced by two antipodal strings carrying constant current is considered. Using an effective action approach, which phenomenologically incorporates a large class of superconducting string models, we estimate the minimum current required to form SMBH with masses of order M = 2 x 10{sup 9} M {sub CircleDot} by z = 7.085. This corresponds to the mass of the central black hole powering the quasar ULAS J112001.48+064124.3 and is taken as a test case scenario for early-epoch SMBH formation. For GUT scale strings, the required fractional increase in the string energy density, due to the presence of the current, is of order 10{sup -7}, so that their existence remains consistent with current observational bounds on the string tension. In addition, we consider an ''exotic'' scenario, in which an SMBH is generated when a small seed black hole is pierced by a higher-dimensional F-string, predicted by string theory. We find that both topological defect strings and fundamental strings are able to carry currents large enough to generate early-epoch SMBH via our proposed mechanism. (copyright 2017 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

FORMATION OF CORONAL HOLES ON THE ASHES OF ACTIVE REGIONS

International Nuclear Information System (INIS)

Karachik, Nina V.; Pevtsov, Alexei A.; Abramenko, Valentyna I.

2010-01-01

We investigate the formation of isolated non-polar coronal holes (CHs) on the remnants of decaying active regions (ARs) at the minimum/early ascending phase of sunspot activity. We follow the evolution of four bipolar ARs and measure several parameters of their magnetic fields including total flux, imbalance, and compactness. As regions decay, their leading and following polarities exhibit different dissipation rates: loose polarity tends to dissipate faster than compact polarity. As a consequence, we see a gradual increase in flux imbalance inside a dissipating bipolar region, and later a formation of a CH in place of more compact magnetic flux. Out of four cases studied in detail, two CHs had formed at the following polarity of the decaying bipolar AR, and two CHs had developed in place of the leading polarity field. All four CHs contain a significant fraction of magnetic field of their corresponding AR. Using potential field extrapolation, we show that the magnetic field lines of these CHs were closed on the polar CH at the North, which at the time of the events was in imbalance with the polar CH at the South. This topology suggests that the observed phenomenon may play an important role in transformation of toroidal magnetic field to poloidal field, which is a key step in transitioning from an old solar cycle to a new one. The timing of this observed transition may indicate the end of solar cycle 23 and the beginning of cycle 24.

What Is Macular Edema?

Medline Plus

Full Text Available ... 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 untreated. Next What ...

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

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.

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

Thermodynamic theory of black holes

Energy Technology Data Exchange (ETDEWEB)

Davies, P C.W. [King' s Coll., London (UK). Dept. of Mathematics

1977-04-21

The thermodynamic theory underlying black hole processes is developed in detail and applied to model systems. It is found that Kerr-Newman black holes undergo a phase transition at a = 0.68M or Q = 0.86M, where the heat capacity has an infinite discontinuity. Above the transition values the specific heat is positive, permitting isothermal equilibrium with a surrounding heat bath. Simple processes and stability criteria for various black hole situations are investigated. The limits for entropically favoured black hole formation are found. The Nernst conditions for the third law of thermodynamics are not satisfied fully for black holes. There is no obvious thermodynamic reason why a black hole may not be cooled down below absolute zero and converted into a naked singularity. Quantum energy-momentum tensor calculations for uncharged black holes are extended to the Reissner-Nordstrom case, and found to be fully consistent with the thermodynamic picture for Q < M. For Q < M the model predicts that 'naked' collapse also produces radiation, with such intensity that the collapsing matter is entirely evaporated away before a naked singularity can form.

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...

Interocular agreement in melanin and macular pigment optical density.

NARCIS (Netherlands)

Kanis, M.J.; Berendschot, T.T.J.M.; van Norren, D.

2007-01-01

Macular pigment (MP) and melanin possibly protect the macular area by absorbing blue light and acting as antioxidants. Because little is known about the interocular correlation of melanin, we determined its optical density (MOD) in both eyes of healthy subjects using fundus reflectometry. The

Decreased Thickness and Integrity of the Macular Elastic Layer of Bruch’s Membrane Correspond to the Distribution of Lesions Associated with Age-Related Macular Degeneration

Science.gov (United States)

Chong, N.H. Victor; Keonin, Jason; Luthert, Phil J.; Frennesson, Christina I.; Weingeist, David M.; Wolf, Rachel L.; Mullins, Robert F.; Hageman, Gregory S.

2005-01-01

Age-related macular degeneration (AMD) is a leading cause of blindness in the elderly. In its severest form, choroidal neovessels breach the macular Bruch’s membrane, an extracellular matrix compartment comprised of elastin and collagen laminae, and grow into the retina. We sought to determine whether structural properties of the elastic lamina (EL) correspond to the region of the macula that is predilected toward degeneration in AMD. Morphometric assessment of the macular and extramacular regions of 121 human donor eyes, with and without AMD, revealed a statistically significant difference in both the integrity (P macula than in the periphery. The integrity of the macular EL was significantly lower in donors with early-stage AMD (P = 0.028), active choroidal neovascularization (P = 0.020), and disciform scars (P = 0.003), as compared to unaffected, age-matched controls. EL thickness was significantly lower only in individuals with disciform scars (P = 0.008). The largest gaps in macular EL integrity were significantly larger in all categories of AMD (each P macula is more susceptible to degenerative events that occur in this disease. PMID:15632016

Self-reported optometric practise patterns in age-related macular degeneration.

Science.gov (United States)

Ly, Angelica; Nivison-Smith, Lisa; Zangerl, Barbara; Assaad, Nagi; Kalloniatis, Michael

2017-11-01

The use of advanced imaging in clinical practice is emerging and the use of this technology by optometrists in assessing patients with age-related macular degeneration is of interest. Therefore, this study explored contemporary, self-reported patterns of practice regarding age-related macular degeneration diagnosis and management using a cross-sectional survey of optometrists in Australia and New Zealand. Practising optometrists were surveyed on four key areas, namely, demographics, clinical skills and experience, assessment and management of age-related macular degeneration. Questions pertaining to self-rated competency, knowledge and attitudes used a five-point Likert scale. Completed responses were received from 127 and 87 practising optometrists in Australia and New Zealand, respectively. Advanced imaging showed greater variation in service delivery than traditional techniques (such as slitlamp funduscopy) and trended toward optical coherence tomography, which was routinely performed in age-related macular degeneration by 49 per cent of respondents. Optical coherence tomography was also associated with higher self-rated competency, knowledge and perceived relevance to practice than other modalities. Most respondents (93 per cent) indicated that they regularly applied patient symptoms, case history, visual function results and signs from traditional testing, when queried about their management of patients with age-related macular degeneration. Over half (63 per cent) also considered advanced imaging, while 31 per cent additionally considered all of these as well as the disease stage and clinical guidelines. Contrary to the evidence base, 68 and 34 per cent rated nutritional supplements as highly relevant or relevant in early age-related macular degeneration and normal aging changes, respectively. These results highlight the emergence of multimodal and advanced imaging (especially optical coherence tomography) in the assessment of age-related macular degeneration

Severe Macular Edema in Patients with Juvenile Idiopathic Arthritis-Related Uveitis

Directory of Open Access Journals (Sweden)

Maria Pia Paroli

2013-01-01

unilateral macular edema. OCT revealed massive macular thickening (range from 550 μm to 1214 μm. Conclusions. Macular edema appeared in female adolescent patients in eyes with long-dating CAU submitted to cataract surgery. In such patients, in presence of age-related microvascular changes due to the enhancer effect of sex hormones, cataract extraction should be a factor triggering the retinal complication.

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.

Correlation of visual acuity and central macular morphology in different types of diabetic macular edema

Directory of Open Access Journals (Sweden)

Qiu-Ju Wu

2016-02-01

Full Text Available AIM:To observe the correlation of visual acuity and central macular morphology in patients with different types of diabetic macular edema(DME. METHODS: Presented study was single-center, uncontrolled retrospective clinical study. Sixty-two patients(103 eyeswith DME were included. Best corrected visual acuity(BCVAwas evaluated using early treatment diabetic retinopathy study(ETDRSvision test chart. All patients were examined by non-contact tonometer, slit lamp, indirect ophthalmoscope, and fundus fluorescein angiography(FFA. Central subfield mean thickness(CSMTin the macular area of diameter 1mm was measured by optical coherence tomography(OCT.And in the same time the integrity of inner segments/ outer segments(IS/OSand external limiting membrane(ELMreflecting light strip of 350μm center horizontal scanning line was investigated by OCT. BCVA and CSMT in different types of DME patients were analyzed using Kruskal- Wallis test. BCVA and CSMT between the two-two groups in different types of DME patients were analyzed using Nemenyi test, and multiple regression analysis was used to analyze the relative factors of BCVA. RESULTS: In the 103 eyes, 47 eyes(45.6%were focal DME, 35 eyes(34.0%were diffuse DME, 6 eyes(5.8%were ischemic DME and 15 eyes(14.6%were proliferative DME. The difference of mean BCVA(H=69.167, PH=57.113, Pχ2=14.982,Pχ2=14.537,Pχ2=15.596,Pχ2=15.393,Pχ2=16.567,Pχ2=15.687,Pχ2=12.974、P=0.008; CSMT:χ2=13.999,Pr=-0.064,-0.207,-0.082 and -0.160, respectively, Pr=-0.885, -2.522, -1.504, and-0.595, respectively, P>0.05. CONCLUSION: There are statistically significant differences on macular morphology and vision function among different types of DME patients.

Filling bore-holes with explosive

Energy Technology Data Exchange (ETDEWEB)

Alfredsson, S H

1965-03-02

In this device for filling boreholes formed in a rock formation with particulate explosive, the explosive is conveyed into the hole by means of a pressure fluid through a tube which has a lesser diameter than the hole. The tube is characterized by a lattice work arranged externally on it, and having a structure adapted to allow passage of a pressure fluid returning between the tube and the wall of the hole, but retaining particles of explosive entrained by the returning pressure fluid. In another arrangement of the device, the lattice work has the form of a brush, including filaments or bristles which are dimensioned to bridge the spacing between the tube and the wall of the hole. (12 claims)

Prevalence of cystic macular lesions in patients with Usher II syndrome.

Science.gov (United States)

Walia, S; Fishman, G A; Hajali, M

2009-05-01

To evaluate the prevalence of cystic macular lesions in patients with Usher II syndrome. All Usher type II patients seen in the inherited eye disease clinic at the University of Illinois at Chicago between January 2002 and December 2007 were included (n=76). Each participating patient underwent a detailed clinical examination, including best-corrected visual acuity, slit-lamp biomicroscopy and dilated fundus examination. The presence of cystoid lesions was determined by optical coherence tomography (OCT), fundus fluorescein angiogram (FFA), fundus photographs and/or clinical examination. A cystic-appearing macular change was observed in at least one eye in 19 out of the 76 patients (25%), 13 on the basis of OCT, five using FFA (two solely with the use of FFA and three based on clinical notes and FFA findings) and one based solely on clinical notes. Of the 18 patients with CME, determined by OCT or FFA, five (27.8%) showed either a funduscopically normal-appearing macula (n=4) or an atrophic appearing macular change (n=1). One-fourth of our total cohort of Usher II patients had cystic macular lesions. Moreover, a funduscopically normal-appearing macula was observed in 22% (n=4) of our 18 patients with cystic-appearing macular lesions on OCT and/or FFA testing. On the basis of the reasonably high prevalence of cystic macular lesions in our cohort, it would seem prudent to evaluate Usher II patients for the presence of cystoid macular oedema.

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)

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

Influence of age-related macular degeneration on macular thickness measurement made with fourier-domain optical coherence tomography.

Science.gov (United States)

Garas, Anita; Papp, András; Holló, Gábor

2013-03-01

To evaluate the influence of age-related macular degeneration (AMD) on macular thickness measurement made with Fourier-domain optical coherence tomography (RTVue-OCT) to detect glaucoma. : One nonglaucomatous eye of 79 white persons was imaged. This comprised 25 healthy eyes, 19 eyes with early/intermediate AMD (geographic atrophy excluded), 16 eyes with subfoveal choroidal neovascularization (CNV), and 19 CNV eyes after intravitreal antiangiogenic treatment [CNV-antivascular endothelial growth factor (VEGF)]. Compared with the age-matched controls, no difference in any nerve fiber layer and optic disc parameter was seen for any AMD group. No macular retinal segmentation error was detected in the control group. Localized inner retinal image segmentation errors topographically related to AMD were detected in 8 eyes with drusen (42.1%), all 16 CNV eyes (100%) and 17 eyes in the CNV-anti-VEGF group (89.5%; χ test, P0.05). In contrast, all pattern-based ganglion cell complex (GCC) parameters were significantly higher (more abnormal) in the CNV and CNV-anti-VEGF group than in the control eyes (Mann-Whitney test, Bonferroni correction, P<0.001). For GCC focal loss volume, the only pattern-based parameter classified by the software, the frequency of "borderline" and "outside normal limits" classifications was significantly greater in each AMD group than in the control group (χ test, Bonferroni correction, P ≤0.03). In nonglaucomatous eyes, AMD significantly influences the pattern-based inner macular thickness parameters of the RTVue optical coherence tomograph and the software-provided classification of GCC focal loss volume, for detection of glaucoma.

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.

Age-Related Macular Degeneration: New Paradigms for Treatment and Management of AMD

OpenAIRE

Hernández-Zimbrón, Luis Fernando; Zamora-Alvarado, Ruben; Ochoa-De la Paz, Lenin; Velez-Montoya, Raul; Zenteno, Edgar; Gulias-Cañizo, Rosario; Quiroz-Mercado, Hugo; Gonzalez-Salinas, Roberto

2018-01-01

Age-related macular degeneration (AMD) is a well-characterized and extensively studied disease. It is currently considered the leading cause of visual disability among patients over 60 years. The hallmark of early AMD is the formation of drusen, pigmentary changes at the macula, and mild to moderate vision loss. There are two forms of AMD: the “dry” and the “wet” form that is less frequent but is responsible for 90% of acute blindness due to AMD. Risk factors have been associated with AMD pro...

Selected Data for Wells and Test Holes Used in Structure-Contour Maps of the Inyan Kara Group, Minnekahta Limestone, Minnelusa Formation, Madison Limestone, and Deadwood Formation in the Black Hills Area, South Dakota

National Research Council Canada - National Science Library

Carter, Janet M

1999-01-01

This report presents selected data on wells and test holes that were used in the construction of structure-contour maps of selected formations that contain major aquifers in the Black Hills area of western South Dakota...

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.

[Fundus autofluorescence. Has it a place in the management of diabetic macular edema?

Science.gov (United States)

Zbiba, W; Baba, A; Bouayed, E; Daldoul, A

2016-11-01

Analyze the characteristics of fundus autofluorescence of diabetic macular edema and study the association between these characteristics and visual function. Our study included 18 patients (28 eyes) with clinically significant diabetic macular edema. All patients had a complete eye examination with a fundus autofluorescence imaging and optical coherence tomography. The central macular thickness and central macular volume were measured. The integrity of the inner segment-outer segment junction and the integrity of the external limiting membrane were also evaluated in the same area. Among the 28 eyes studied, 8 had normal autofluorescence. The remaining 20 eyes had abnormal autofluorescence: a hyper-cystoid autofluorescence in 5 eyes (25%), hyper-spot autofluorescence in 8 eyes (40%), and hypo-irregular autofluorescence in 5 eyes (25%). Best corrected visual acuity was significantly better in patients with normal autofluorescence and those with hyper-cystoid autofluorescence. There was no significant difference in central macular thickness (P=0.186) and central macular volume (P=0.191) between the four groups. The autofluorescence is a simple, fast, and non-invasive technique for the study of diabetic macular edema with good correlation to the visual function as well as to the extent of damage to the retina. It is, therefore, a possible alternative to other invasive imaging techniques in particular in the long term monitoring of diabetic macular edema. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Diabetic Macular Edema: Current Understanding, Pharmacologic Treatment Options, and Developing Therapies.

Science.gov (United States)

Miller, Kevin; Fortun, Jorge A

2018-01-01

Diabetic retinopathy and diabetic macular edema comprise a major source of visual disability throughout the developed world. The etiology and pathogenesis of macular edema is intricate and multifactorial, in which the hyperglycemic state in diabetes induces a microangiopathy. Through several inflammatory and vasogenic mediators, including vascular endothelial growth factor (VEGF) upregulation and inflammatory cytokines and chemokines, pathologic changes are induced in the vascular endothelium triggering breakdown of the blood retinal barrier, causing extravasation of fluid into the extracellular space and manifesting clinically as macular edema, resulting in visual loss. The advent of medications targeting the VEGF pathway has led to great clinical improvements compared with the previous standard of care of laser therapy alone, as shown in studies such as RISE, RIDE, VIVID, VISTA, and DRCR. However, analyses have shown that many patients have inadequate response or are nonresponders to anti-VEGF therapy, demonstrating the need for additional therapies to more comprehensively treat this disease. Although corticosteroid treatments and implants have demonstrated some efficacy in adjunctive and supplemental treatment, the need to more adequately treat macular edema remains. Our knowledge of diabetic macular edema continues to grow, leading to new currently available and emerging pharmacotherapies to further enhance our treatment and restore vision in those affected by diabetic macular edema. This review will discuss the pathogenesis of diabetic macular edema and the pharmacologic therapies available for its treatment, including anti-VEGF, steroids, and newer therapies still in development, such as angiopoietin antagonists, Tie2 agonists, kallikrein inhibitors, interleukin inhibitors, and others. Copyright 2018 Asia-Pacific Academy of Ophthalmology.

Selected stratigraphic data for drill holes located in Frenchman Flat, Nevada Test Site. Rev. 1

International Nuclear Information System (INIS)

Drellack, S.L. Jr.

1997-02-01

Stratigraphic data are presented in tabular form for 72 holes drilled in Frenchman Flat, Nevada Test Site, between 1950 and 1993. Three pairs of data presentations are included for each hole: depth to formation tops, formation thicknesses, and formation elevations are presented in both field (English) and metric units. Also included for each hole, where available, are various construction data (hole depth, hole diameter, surface location coordinates) and certain information of hydrogeologic significance (depth to water level, top of zeolitization). The event name is given for holes associated with a particular nuclear test. An extensive set of footnotes is included, which indicates data sources and provides other information. The body of the report describes the stratigraphic setting of Frenchman Flat, gives drill-hole naming conventions and database terminology, and provides other background and reference material

Black holes by analytic continuation

CERN Document Server

Amati, Daniele

1997-01-01

In the context of a two-dimensional exactly solvable model, the dynamics of quantum black holes is obtained by analytically continuing the description of the regime where no black hole is formed. The resulting spectrum of outgoing radiation departs from the one predicted by the Hawking model in the region where the outgoing modes arise from the horizon with Planck-order frequencies. This occurs early in the evaporation process, and the resulting physical picture is unconventional. The theory predicts that black holes will only radiate out an energy of Planck mass order, stabilizing after a transitory period. The continuation from a regime without black hole formation --accessible in the 1+1 gravity theory considered-- is implicit in an S matrix approach and provides in this way a possible solution to the problem of information loss.

What Is Macular Edema?

Medline Plus

Full Text Available ... for Diabetic Macular Edema Jul 17, 2015 Top 5 Risk Factors for AMD Jan 29, 2014 Is Your Laser Pointer Dangerous Enough to Cause Eye Injury? Dec 20, 2013 Study Finds Tablets Help People with Low Vision Nov 27, 2013 Follow The ...

Unilateral Macular Star in a Case of Hypertension and Retinitis Pigmentosa.

Science.gov (United States)

Chawla, Rohan; Tripathy, Koushik; Chaudhary, Sunil; Phuljhele, Swati; Venkatesh, Pradeep

2017-01-01

To describe a case of hypertension and retinitis pigmentosa presenting with a unilateral macular star. Case report. A 17-year-old female with chronic kidney disease and hypertension presented with a mild blurring of vision in the left eye. There was a history of night blindness. Both eyes had optic disc pallor, arteriolar attenuation, and peripheral bony spicules suggestive of the triad of retinitis pigmentosa. Macular star was seen in the left eye alone. We ascribe the macular star to hypertension as the patient had only a mild decrease in vision, no relative afferent pupillary defect, and similar visual evoked response amplitude and latency in both eyes. Unilateral macular star may be seen in hypertension and may simulate neuroretinitis in the clinical setting.

[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.

Genetic association of apolipoprotein E with age-related macular degeneration

NARCIS (Netherlands)

M. Kliffen (Mike); C.M. van Duijn (Cornelia); M. Cruts (Marc); D.E. Grobbee (Diederick); P.T.V.M. de Jong (Paulus); C.C.W. Klaver (Caroline); C. van Broeckhoven (Christine); A. Hofman (Albert)

1998-01-01

textabstractAge-related macular degeneration (AMD) is the most common geriatric eye disorder leading to blindness and is characterized by degeneration of the neuroepithelium in the macular area of the eye. Apolipoprotein E (apoE), the major apolipoprotein of the CNS and an

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...

Stable micron-scale holes are a general feature of canonical holins.

Science.gov (United States)

Savva, Christos G; Dewey, Jill S; Moussa, Samir H; To, Kam H; Holzenburg, Andreas; Young, Ry

2014-01-01

At a programmed time in phage infection cycles, canonical holins suddenly trigger to cause lethal damage to the cytoplasmic membrane, resulting in the cessation of respiration and the non-specific release of pre-folded, fully active endolysins to the periplasm. For the paradigm holin S105 of lambda, triggering is correlated with the formation of micron-scale membrane holes, visible as interruptions in the bilayer in cryo-electron microscopic images and tomographic reconstructions. Here we report that the size distribution of the holes is stable for long periods after triggering. Moreover, early triggering caused by an early lysis allele of S105 formed approximately the same number of holes, but the lesions were significantly smaller. In contrast, early triggering prematurely induced by energy poisons resulted in many fewer visible holes, consistent with previous sizing studies. Importantly, the unrelated canonical holins P2 Y and T4 T were found to cause the formation of holes of approximately the same size and number as for lambda. In contrast, no such lesions were visible after triggering of the pinholin S(21) 68. These results generalize the hole formation phenomenon for canonical holins. A model is presented suggesting the unprecedentedly large size of these holes is related to the timing mechanism. © 2013 John Wiley & Sons Ltd.

Production of high stellar-mass primordial black holes in trapped inflation

Energy Technology Data Exchange (ETDEWEB)

Cheng, Shu-Lin; Lee, Wolung [Department of Physics, National Taiwan Normal University,Taipei 11677, Taiwan (China); Ng, Kin-Wang [Institute of Physics, Academia Sinica,Taipei 11529, Taiwan (China); Institute of Astronomy and Astrophysics, Academia Sinica,Taipei 11529, Taiwan (China)

2017-02-01

Trapped inflation has been proposed to provide a successful inflation with a steep potential. We discuss the formation of primordial black holes in the trapped inflationary scenario. We show that primordial black holes are naturally produced during inflation with a steep trapping potential. In particular, we have given a recipe for an inflaton potential with which particle production can induce large non-Gaussian curvature perturbation that leads to the formation of high stellar-mass primordial black holes. These primordial black holes could be dark matter observed by the LIGO detectors through a binary black-hole merger. At the end, we have given an attempt to realize the required inflaton potential in the axion monodromy inflation, and discussed the gravitational waves sourced by the particle production.

Treatment Paradigms for Retinal and Macular Diseases Using 3-D Retina Cultures Derived From Human Reporter Pluripotent Stem Cell Lines.

Science.gov (United States)

Kaewkhaw, Rossukon; Swaroop, Manju; Homma, Kohei; Nakamura, Jutaro; Brooks, Matthew; Kaya, Koray Dogan; Chaitankar, Vijender; Michael, Sam; Tawa, Gregory; Zou, Jizhong; Rao, Mahendra; Zheng, Wei; Cogliati, Tiziana; Swaroop, Anand

2016-04-01

We discuss the use of pluripotent stem cell lines carrying fluorescent reporters driven by retinal promoters to derive three-dimensional (3-D) retina in culture and how this system can be exploited for elucidating human retinal biology, creating disease models in a dish, and designing targeted drug screens for retinal and macular degeneration. Furthermore, we realize that stem cell investigations are labor-intensive and require extensive resources. To expedite scientific discovery by sharing of resources and to avoid duplication of efforts, we propose the formation of a Retinal Stem Cell Consortium. In the field of vision, such collaborative approaches have been enormously successful in elucidating genetic susceptibility associated with age-related macular degeneration.

Macular edema might be a rare presentation of hydroxychloroquine-induced retinal toxicity

Directory of Open Access Journals (Sweden)

Chih-Yao Chang

2017-01-01

Full Text Available The aim of this study is to report a rare case of macular edema as a presentation of hydroxychloroquine-related retinal toxicity. We presented a case of a 46-year-old female patient using hydroxychloroquine for underlying rheumatoid arthritis (RA with blurred vision over the left eye. Uveitis and macular edema were found initially. Systemic survey did not reveal any other etiology. Topical corticosteroid was given under the impression of RA-related uveitis. The uveitis resolved 1 week later, but macular edema persisted in spite of treatment. Under the suspicion of drug-related complication, we try to discontinue hydroxychloroquine. Her symptoms improved gradually after cessation of hydroxychloroquine, and further serial image study confirmed subsiding of the macular edema without any further treatment. Except the well-known signs of the retinal toxicity, macular edema might be a rare presentation of hydroxychloroquine-related retinal toxicity.

Brief communication "Stratospheric winds, transport barriers and the 2011 Arctic ozone hole"

Directory of Open Access Journals (Sweden)

M. J. Olascoaga

2012-12-01

Full Text Available The Arctic stratosphere throughout the late winter and early spring of 2011 was characterized by an unusually severe ozone loss, resulting in what has been described as an ozone hole. The 2011 ozone loss was made possible by unusually cold temperatures throughout the Arctic stratosphere. Here we consider the issue of what constitutes suitable environmental conditions for the formation and maintenance of a polar ozone hole. Our discussion focuses on the importance of the stratospheric wind field and, in particular, the importance of a high latitude zonal jet, which serves as a meridional transport barrier both prior to ozone hole formation and during the ozone hole maintenance phase. It is argued that stratospheric conditions in the boreal winter/spring of 2011 were highly unusual inasmuch as in that year Antarctic-like Lagrangian dynamics led to the formation of a boreal ozone hole.

NASA Observatory Confirms Black Hole Limits

Science.gov (United States)

2005-02-01

The very largest black holes reach a certain point and then grow no more, according to the best survey to date of black holes made with NASA's Chandra X-ray Observatory. Scientists have also discovered many previously hidden black holes that are well below their weight limit. These new results corroborate recent theoretical work about how black holes and galaxies grow. The biggest black holes, those with at least 100 million times the mass of the Sun, ate voraciously during the early Universe. Nearly all of them ran out of 'food' billions of years ago and went onto a forced starvation diet. Focus on Black Holes in the Chandra Deep Field North Focus on Black Holes in the Chandra Deep Field North On the other hand, black holes between about 10 and 100 million solar masses followed a more controlled eating plan. Because they took smaller portions of their meals of gas and dust, they continue growing today. "Our data show that some supermassive black holes seem to binge, while others prefer to graze", said Amy Barger of the University of Wisconsin in Madison and the University of Hawaii, lead author of the paper describing the results in the latest issue of The Astronomical Journal (Feb 2005). "We now understand better than ever before how supermassive black holes grow." One revelation is that there is a strong connection between the growth of black holes and the birth of stars. Previously, astronomers had done careful studies of the birthrate of stars in galaxies, but didn't know as much about the black holes at their centers. DSS Optical Image of Lockman Hole DSS Optical Image of Lockman Hole "These galaxies lose material into their central black holes at the same time that they make their stars," said Barger. "So whatever mechanism governs star formation in galaxies also governs black hole growth." Astronomers have made an accurate census of both the biggest, active black holes in the distance, and the relatively smaller, calmer ones closer by. Now, for the first

Formation of primordial black holes from non-Gaussian perturbations produced in a waterfall transition

Science.gov (United States)

Bugaev, Edgar; Klimai, Peter

2012-05-01

We consider the process of primordial black hole (PBH) formation originated from primordial curvature perturbations produced during waterfall transition (with tachyonic instability), at the end of hybrid inflation. It is known that in such inflation models, rather large values of curvature perturbation amplitudes can be reached, which can potentially cause a significant PBH production in the early Universe. The probability distributions of density perturbation amplitudes in this case can be strongly non-Gaussian, which requires a special treatment. We calculated PBH abundances and PBH mass spectra for the model and analyzed their dependence on model parameters. We obtained the constraints on the parameters of the inflationary potential, using the available limits on βPBH.

SCARB1 rs5888 is associated with the risk of age-related macular degeneration susceptibility and an impaired macular area.

Science.gov (United States)

Stanislovaitiene, Daiva; Zaliuniene, Dalia; Krisciukaitis, Algimantas; Petrolis, Robertas; Smalinskiene, Alina; Lesauskaite, Vita; Tamosiunas, Abdonas; Lesauskaite, Vaiva

2017-01-01

Age-related macular degeneration (ARMD), a progressive retinal disease, is responsible for an impaired central vision in about 180 million people worldwide. Current options for ARMD prevention and treatment are limited due to an incomplete understanding of disease etiopathogenesis. We aimed to test the hypothesis that the single nucleotide polymorphism rs5888 of SCARB1 gene reflecting lipid and antioxidant micronutrient metabolism pathways is associated with ARMD susceptibility and to evaluate if there is any relation between SCARB1 rs5888 and the macular lesion area. The prospective case-control study included patients with ARMD (n = 215) and the reference group (n = 238) drawn from a random sample of the Lithuanian population (n = 1436). The genotyping test of SCARB1 rs5888 was carried out using the real-time polymerase chain reaction method. Regression analysis adjusted by gender and age demonstrated that SCARB1 rs5888 TT genotype significantly decreased the odds for ARMD development (OR: 0.61, 95%; CI: 0.380-0.981, p = 0.04). A smoking habit and leading an outdoor life are associated with larger macular lesion areas in ARMD patients (0.54 (0.00-39.06) vs. 3.09 (0.02-19.30) and 0.27 (0.00-34.57) vs. 0.75 (0.00-39.06), respectively). In late stage ARMD subjects with CT genotype, the macular lesion area was larger than in TT carriers (7.64 (0.49-39.06) mm 2 vs. 5.02 (0.03-37.06) mm 2 , p = 0.006). SCARB1 rs5888 and environmental oxidative stress have a prominent role in ARMD susceptibility, early ARMD progression to advanced stage disease and even in the outcome of the disease-an area of macular lesion.

AN ENERGETIC AGN OUTBURST POWERED BY A RAPIDLY SPINNING SUPERMASSIVE BLACK HOLE OR AN ACCRETING ULTRAMASSIVE BLACK HOLE

International Nuclear Information System (INIS)

McNamara, B. R.; Kazemzadeh, F.; Kirkpatrick, C. C.; Rafferty, D. A.; Birzan, L.; Nulsen, P. E. J.; Wise, M. W.

2009-01-01

Powering the 10 62 erg nuclear outburst in the MS0735.6+7421 cluster central galaxy by accretion with a 10% mass-to-energy conversion efficiency implies that its putative supermassive black hole (SMBH) grew by ∼6 x 10 8 M sun over the past 100 Myr. Guided by data at several wavelengths, we place upper limits on the amount of cold gas and star formation near the nucleus of 9 M sun and sun yr -1 , respectively. These limits imply that an implausibly large fraction of the preexisting cold gas in the inner several kpc must have been consumed by its SMBH at the rate of ∼3-5 M sun yr -1 during the past 100 Myr while leaving no trace of star formation. Such a high accretion rate would be difficult to maintain by stellar accretion or the Bondi mechanism, unless the black hole mass approaches 10 11 M sun . Furthermore, its feeble nuclear luminosities in the UV, I, and X-ray bands compared to its enormous mechanical power are inconsistent with rapid accretion onto a ∼5 x 10 9 M sun black hole. We suggest instead that the active galactic nucleus (AGN) outburst is powered by angular momentum released from a rapidly spinning black hole. The rotational energy and power available from a spinning black hole are consistent with the cavity and shock energetics inferred from X-ray observations. A maximally spinning 10 9 M sun black hole contains enough rotational energy, ∼10 62 erg, to quench a cooling flow over its lifetime and to contribute significantly to the excess entropy found in the hot atmospheres of groups and clusters. Two modes of AGN feedback may be quenching star formation in elliptical galaxies centered in cooling halos at late times. An accretion mode that operates in gas-rich systems, and a spin mode operating at modest accretion rates. The spin conjecture may be avoided in MS0735 by appealing to Bondi accretion onto a central black hole whose mass greatly exceeds 10 10 M sun . The host galaxy's unusually large 3.8 kpc stellar core radius (light deficit) may

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

Effect of methazolamide in patients with refractory uveitic macular edema

Directory of Open Access Journals (Sweden)

Yun-Bin Jiang

2017-07-01

Full Text Available AIM:To evaluate the efficacy and safety of methazolamide in treating refractory uveitic macular edema. METHODS: Retrospective self-controlled study was designed. A total of 15 patients(20 eyeswith refractory uveitic macular edema which used methazolamide as adjuvant therapy were enrolled in Shanghai First People's Hospital from January 2015 to June 2016. The changes of central macular thickness(CMTand best corrected visual acuity(BCVAwere observed at baseline and 2, 4, 8wk after treatment. We also focused on the incidence of complications and relapse. RESULTS: The CMT was 445.95±154.10μm, 338.83±138.34μm, 251.50±40.20μm, 244.90±35.68μm at baseline, 2, 4 and 8wk after treatment, respectively. The differences among them were statistically significant(F=15.467, PF=5.208, PCONCLUSION: Methazolamide is beneficial in improving macular edema and vision in 4wk. When the cumulative dose is more than 1400mg, we need pay attention to the complications. After discontinuing methazolamide for 1wk, macular edema relapsed in some patients, and more than half of patients recurred after 3mo. So the patients should be followed closely in 3mo after withdrawal of methazolamide.

Black holes - a way out of the universe

International Nuclear Information System (INIS)

Hartvigsen, Y.

1975-01-01

Following a general discussion of the phenomenon of gravitational collapse and the formation of dwarf stars, neutron stars and black holes, the characteristics of black holes are discussed in more detail. The nature of a black hole in the space-time continuum of the general relativity theory is described and the 'Einstein-Rosen bridge', or 'snake-pit', is presented. The concept that matter drawn into a black hole in our universe may be emitted from a 'white hole' on the 'other side' is also presented. Evidence for the existence of black holes in the universe is discussed and the X-ray source in Cygnus X-1 is cited as a possible example. Finally the interesting possibility is mentioned that our universe itself may be a black hole, having its origin in a white hole, which mathematically could represent the 'big bang' theory. (JIW)

Black holes - a way out of the universe

Energy Technology Data Exchange (ETDEWEB)

Hartvigsen, Y [Oslo Univ. (Norway). Institutt for Teoretisk Fysikk

1975-01-01

Following a general discussion of the phenomenon of gravitational collapse and the formation of dwarf stars, neutron stars and black holes, the characteristics of black holes are discussed in more detail. The nature of a black hole in the space-time continuum of the general relativity theory is described and the 'Einstein-Rosen bridge', or 'snake-pit', is presented. The concept that matter drawn into a black hole in our universe may be emitted from a 'white hole' on the 'other side' is also presented. Evidence for the existence of black holes in the universe is discussed and the X-ray source in Cygnus X-1 is cited as a possible example. Finally the interesting possibility is mentioned that our universe itself may be a black hole, having its origin in a white hole, which mathematically could represent the 'big bang' theory.

Tracking black holes in numerical relativity

International Nuclear Information System (INIS)

Caveny, Scott A.; Anderson, Matthew; Matzner, Richard A.

2003-01-01

This work addresses the problem of generically tracking black hole event horizons in computational simulation of black hole interactions. Solutions of the hyperbolic eikonal equation, solved on a curved spacetime manifold containing black hole sources, are employed in development of a robust tracking method capable of continuously monitoring arbitrary changes of topology in the event horizon as well as arbitrary numbers of gravitational sources. The method makes use of continuous families of level set viscosity solutions of the eikonal equation with identification of the black hole event horizon obtained by the signature feature of discontinuity formation in the eikonal's solution. The method is employed in the analysis of the event horizon for the asymmetric merger in a binary black hole system. In this first such three dimensional analysis, we establish both qualitative and quantitative evidence for our method and its application to the asymmetric problem. We focus attention on (1) the topology of the throat connecting the holes following merger, (2) the time of merger, and (3) continuing to account for the surface of section areas of the black hole sources

New developments in age-related macular degeneration

Directory of Open Access Journals (Sweden)

Lyndon da Cruz

2008-09-01

Full Text Available The World Health Organization (WHO estimates that over 3 million people (9% of global blindness are blinded by age-related macular degeneration (AMD. AMD affects people over the age of 55. There are two main types of AMD, dry and wet. In dry AMD, patients slowly lose vision through progressive atrophy of the macular tissue. Wet, or exudative, AMD, is associated with new blood vessels called subretinal neovascular membranes (or SRNVM and affected patients lose vision more rapidly due to fluid leakage and haemorrhage at the macula.

Correlation of visual recovery with macular height in macula-off retinal detachments.

Science.gov (United States)

Mowatt, L; Tarin, S; Nair, R G; Menon, J; Price, N J

2010-02-01

To determine the relationship between the preoperative macular height of a macular detachment and visual outcome of the post retinal reattachment. Prospective case series of 26 patients who presented to the Wolverhampton Eye Infirmary with a primary rhegmatogenous macula-off retinal detachment. Macular detachment height was assessed by B-scan ultrasound (10 Mhz) in the seated and supine postures before surgery. Age, gender, duration of the detachment, type of surgery, preoperative (pre-op) and postoperative (post-op) visual acuities at 3 and 6 months and status of the fellow eye were noted. A total of 26 eyes of 26 patients (mean age: 61.4 years+/-15.56 SD) were recruited. The mean logMAR pre- and post-op visual acuities at 3 and 6 months were 1.5+/-1.1 SD (range: 0.2-3), 0.38+/-0.23 SD (range: 0-0.84), and at 6 months 0.29+/-0.22 SD (range: 0-1.0). The median period of the macular detachment was 4.5 days (95% CI: 2-8 days). There was no significant difference between the mean macular heights while seated 2.42 mm+/-1.2 or supine 2.39 mm+/-1.0 (t-test, P=0.9). Correlation showed that the pre-op macular height is a statistical predictor of post-op visual acuity in our group of patients with macula-off retinal detachments. The shallower the macular detachment the greater the likelihood of a good visual outcome.

Magnetic holes in the dipolarized magnetotail: ion and electron anisotropies

Science.gov (United States)

Shustov, P.; Artemyev, A.; Zhang, X. J.; Yushkov, E.; Petrukovich, A. A.

2017-12-01

We conduct statistics on magnetic holes observed by THEMIS spacecraft in the near-Earth magnetotail. Groups of holes are detected after dipolarizations in the quiet, equatorial plasma sheet. Magnetic holes are characterized by significant magnetic field depressions (up to 50%) and strong electron currents ( 10-50 nA/m2), with spatial scales much smaller than the ion gyroradius. These magnetic holes are populated by hot (>10 keV), transversely anisotropic electrons supporting the pressure balance. We present statistical properties of these sub-ion scale magnetic holes and discuss possible mechanisms on the hole formation.

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)

Image formation in weak gravitational lensing by tidal charged black holes

International Nuclear Information System (INIS)

Horvath, Zsolt; Gergely, Laszlo Arpad; Hobill, David

2010-01-01

We derive a generic weak lensing equation and apply it for the study of images produced by tidal charged brane black holes. We discuss the similarities and point out the differences with respect to the Schwarzschild black hole weak lensing, to both first- and second-order accuracy, when either the mass or the tidal charge dominates. In the case of mass-dominated weak lensing, we analyze the position of the images, the magnification factors and the flux ratio, as compared to the Schwarzschild lensing. The most striking modification appears in the flux ratio. When the tidal charge represents the dominating lensing effect, the number and orientation of the images with respect to the optical axis resembles the lensing properties of a Schwarzschild geometry, where the sign associated with the mass is opposite to that for the tidal charge. Finally it is found that the ratio of the brightness of the images as a function of image separation in the case of tidal charged black holes obeys a power-law relation significantly different from that of Schwarzschild black holes. This might provide a means for determining the underlying spacetime structure.

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.

What Is Macular Edema?