Management of retinal vascular diseases: a patient-centric approach

Retinal vascular diseases are a leading cause of blindness in the Western world. Advancement in the clinical management of these diseases has been fast-paced, with new treatments becoming available as well as license extensions of existing treatments. Vascular endothelial growth factor (VEGF) has been implicated in certain retinal vascular diseases, including wet age-related macular degeneration (AMD), diabetic macular oedema (DMO), and retinal vein occlusion (RVO). Treatment of wet AMD and visual impairment due to either DMO or macular oedema secondary to RVO with an anti-VEGF on an as needed basis, rather than a fixed schedule, allows an individualised treatment approach; providing treatment when patients are most likely to benefit from it, while minimising the number of unnecessary intravitreal injections. Thus, an individualised treatment regimen reduces the chances of over-treatment and under-treatment, optimising both the risk/benefit profile of the treatment and the efficient use of NHS resource. Streamlining of treatment for patients with wet AMD and visual impairment due to either DMO or macular oedema secondary to RVO, by using one treatment with similar posology across all three diseases, may help to minimise burden of clinic capacity and complexity and hence optimise patient outcomes. Informed treatment decisions and efficient clinic throughput are important for optimal patient outcomes in the fast-changing field of retinal vascular diseases

Edaphic constraints on seed germination and emergence of three Acacia species for dryland restoration in Saudi Arabia

In situ edaphic factors affecting seed germination and seedling emergence of three framework species of Acacia were investigated with the intent of developing fundamental and scalable restoration capacity for Arabian dryland restoration. Direct seeding represents the most efficient means to restore vegetation at the landscape scale and this study provides insight into edaphic and ecological limitations, as well as effective protocols governing the use of native seeds for restoration in hyper-arid environments. The study was conducted in extant Acacia woodland habitat on conserved land (Thumamah Nature Park) in close proximity to Riyadh, Saudi Arabia. Broad-scale direct seeding using un- and pretreated Acacia gerrardii, A. tortilis, and A. ehrenbergiana seed, and two seed burial depths were implemented across three sites with distinct soil surface characteristics. Eight weeks post-sowing, random samples for each species × seed treatment × burial depth combination were excavated, sieved, and categorized as follows: failed to germinate, germinated but died prior to emerging, or successfully emerged. We show that germination and emergence of Acacia gerrardii, A. tortilis, and A. ehrenbergiana were driven by a three-way interaction among species, site, and seed burial depth. Treating seed with the signaling compound Moddus did not have a definitive effect, positive or negative, on any of the species investigated. Acacia gerrardii was the only species that exhibited widespread emergence, though emergence was not consistent across sites or burial depths. Germination was highest in disturbed soil (up to 69% for A. gerrardii), but very few (<2%) successfully emerged; a greater proportion of germinants in sandy soil emerged (up to 44% for A. gerrardii) even though the overall germination was less. Though species-dependent, a 2-cm sowing depth was most effective in sand; while in disturbed soil, sowing depths of 1 and 2 cm were comparable; and no germination was observed in gravelly clay soil. Sandy soil exhibited rapid water infiltration (107.6 mm min-1), and post-sowing surface crusting was a non-factor (0.44 kg cm-2). Disturbed soil exhibited moderate water infiltration (1.46 mm min-1) and post-sowing surface crusting was double that of sand (0.88 kg cm-2) and restrictive on seedling emergence. Gravelly clay exhibited extremely poor water infiltration (0.12 mm min-1), and surface crusting was severe (4.49 kg cm-2) and an order of magnitude greater than sand. The medium-coarse sand fraction, a key driver of the observed soil surface processes, was greatest in sand (55%) and significantly less and uniform in the disturbed (22%) and gravelly clay (22%) soils. Our findings demonstrate that soil surface characteristics and associated processes can dictate ecological processes at depths as shallow as 1–2 cm, and that soil crusts that slow water infiltration and impede seedling emergence rapidly reconstitute after disturbance; both are important considerations for restoring dryland vegetation