Intravitreal triamcinolone, bevacizumab and pegaptanib for occult choroidal neovascularization.

PURPOSE: To evaluate best-corrected visual acuity (BCVA) and foveal thickness (FT) changes in occult subfoveal choroidal neovascularization (CNV) from age-related macular degeneration (AMD) after intravitreal bevacizumab (IVB, 1.25 mg/0.05 ml), pegaptanib (IVP, 0.3 mg/0.09 ml) and triamcinolone acetonide (IVTA, 4 mg/0.1 ml) injected on an as needed basis. METHODS:   Retrospective, interventional, comparative study. BCVA (Early Treatment Diabetic Retinopathy Study LogMAR) and FT by optical coherence tomography (OCT) were evaluated during 12 months from first treatment. Patients were retreated if signs of neovascular activity were still present on angiography or OCT. RESULTS: Forty-eight eyes received IVB, 43 eyes received IVP, 52 eyes received IVTA. BCVA and FT at baseline were 1.22 ± 0.49 LogMAR and 410.2 ± 41.83 μm in the IVB group, 1.25 ± 0.43 LogMAR and 452.3 ± 44.83 μm in the IVP group and 1.31 ± 0.4 LogMAR and 456.6 ± 48.27 μm in the IVTA group. BCVA and FT improved in the three groups during follow-up. A significantly greater improvement of BCVA was present at month-3, month-6 and at month-12 in the IVB and IVP groups (p = 0.01). Improvement of FT was greater in the IVTA group at month-3 (p = 0.02), while it was greater in the anti-Vascular Endothelial Growth Factor (VEGF) groups at month-6 and month-12 (p = 0.01). A postoperative increase of intraocular pressure was detected in 9/52 (17.3%) eyes treated with IVTA, and in two cases it was resistant to topical therapy. CONCLUSION:   Intravitreal injection of anti-VEGF drugs administered on an as needed basis for AMD-related occult CNVs provided functional and anatomic improvement during 12 months of follow-up

Optical coherence tomography angiography in myopic peripapillary intrachoroidal cavitation complicated by choroidal neovascularization

Purpose: To detect the vessel density (VD) of the radial peripapillary capillary (RPC) in eyes affected by pathological myopia with or without a peripapillary intrachoroidal cavitation (PICC) and in eyes with PICC complicated by choroidal neovascularization (CNV), using optical coherence tomography angiography (OCTA). Methods: We prospectively enrolled highly myopic patients from January 2016 to December 2019 at the Eye Clinic of the University of Naples “Federico II.” We divided included patients into three groups: group 1 including patients with PICC complicated by CNV; group 2 including patients with PICC without complications; group 3 including patients with high myopia without PICC and CNV. One-way analysis of variance (ANOVA) followed by Bonferroni post hoc analysis was used to evaluate differences in VD of radial peripapillary capillary (RPC) in papillary whole, peripapillary regions and its sectors among the three groups. Results: We enrolled 12 highly myopic eyes with PICC complicated by CNV, 21 highly myopic eyes with PICC without CNV and 23 highly myopic eyes without PICC. The myopic eyes with PICC revealed a statistically significant reduction in VD of the RPC comparing to the other groups (p < 0.001), especially in eyes affected by myopic PICC complicated by CNV (p < 0.001). These results were similar analyzing the VD in different sectors of the peripapillary region among the three groups (p < 0.001). Conclusion: OCTA detects the changes in peripapillary vascular density of highly myopic eyes. We demonstrated that the RPC vasculature is significantly influenced by the presence of PICC, especially in myopic eyes developing a CNV

Optical coherence tomography angiography in Tuberous sclerosis complicated with macular choroidal neovascularization

This study describe the optical coherence tomography angiography (OCTA) features of a young patient with Tuberous sclerosis complicated with CNV unilateral macular choroidal neovascularization during the ranibizumab therapy. OCTA scans of macular region of right eye, revealed a dense microvascular network confirming the diagnosis of CNV. After four monthly intravitreal injections, OCTA revealed a decrease of size and activity of CNV. OCTA is a valid, non-invasive, dyeless, and reliable method that could improve the diagnosis and management of CNV in child with Tuberous sclerosis

Functional and anatomic response of the retina and the choroid to intravitreal bevacizumab for macular edema.

Purpose: This study evaluated the rate of change of best corrected visual acuity (BCVA), central retinal sensitivity, and retinal and choroidal thickness in patients with macular edema after intravitreal bevacizumab. Methods: This was a prospective, nonrandomized, interventional study. Thirty-four consecutive eyes (34 patients) with macular edema were included in the study. Choroidal neovascularization was present in 21 cases, stage 1 retinal angiomatous proliferation in 6 cases, branch retinal vein occlusion in 4 cases, and diabetic edema in 3 cases. Evaluation of BCVA (Early Treatment Diabetic Retinopathy Study [ETDRS] logarithm of the minimum angle of resolution [LogMAR]), central retinochoroidal thickness (RCT) at standardized A-scan, combined optical coherence tomography/microperimetric assessment of central retinal thickness (RT), central scotoma, and fixation behavior was performed during 12 months after treatment. Choroidal thickness was considered as the difference between RCT and RT. All patients received two initial intravitreal bevacizumab injections (1.25 mg/0.05 mL) at a 1-month interval. Results: BCVA and RT during follow-up were significantly better than at baseline. BCVA was improved of 0.32 +/- 0.3 LogMAR (P &lt; 0.001) at month 1,0.18 +/- 0.4 LogMAR (P = 0.05) at month 6, and 0.14 +/- 0.2 (P = 0.09) at month 12. RT was reduced by 172.9 +/- 192.8 mu m (P &lt; 0.001) at month 1,157.7 +/- 134.2 mu m (P = 0.003) at month 6, and 164.3 +/- 122.3 (P = 0.002) at month 12. Mean retinal sensitivity significantly increased during the first month; it decreased afterward, but an improvement if compared with baseline was present at each visit during follow-up. In 23.5% of cases, a choroidal thinning was present during follow-up, and in this group visual acuity at baseline and final visual improvement were significantly greater if compared with patients showing a choroidal thickening. Conclusion: Intravitreal bevacizumab for macular edema determines significant functional and anatomic improvement at the 12-month follow-up. Visual acuity at baseline and following treatment could be influenced by the choroidal involvement

Experimentation of a PVA-Borax hydrogel for the removal of Paraloid B72® from artifacts of archaeological interest from the National Archaeological Museum in Naples, Italy

This paper shows the results of an experimentation aimed at the removal of a polymeric film of aged Paraloid B72® originally placed to protect some wooden artifacts belonging to the Egyptian collection of the National Archaeological Museum of Naples (MANN). The study was conducted on two shabtis dated to the 19th Dynasty and a sculpture of Ptah-Sokar-Osiris dating to the late period. Thanks to the collaboration between the National Archaeological Museum of Naples and the Laboratory of Restoration of Wooden Artifacts of the University of Naples Suor Orsola Benincasa, it was possible to conduct an in-depth study of the artifacts, from both an archaeological-historical point of view and from a conservation point of view. This led to the development of the above-mentioned experimentation and to the planning of a proper restoration intervention. The study and experimentation were supported by several diagnostic techniques. In a first stage, non-invasive investigations were carried out to study the execution technique and the state of conservation of the artifacts. This allowed the recognition of the wood species that constituted the three sculptures through optical microscopy, whereas IR reflectography, UV induced fluorescence and X-ray radiation (XRF) were conducted to identify the type and the chemical nature of the pigments. Based on the above analysis, different restoration strategies, based on the removal of Paraloid B72® through a methodology that would act in full respect of the wooden support of the artifacts, were considered. Pros and cons of the different methodologies applied in the recent past for the removal of aged Paraloid from artifact surfaces were analysed. A removal technique based on the use PVA-Borax hydrogel loaded with a solvent mixture was selected. Experiments were conducted to validate the effectiveness of the selected method

A new paradigm of effective communication based on voice shapes

A new relational paradigm is proposed that is based on voice shapes, which represent the speech style used to establish an effective communication. The functional voice shapes are: "rounded", which means that a colloquial and empath communication is established; "triangular", which means transmitting energy, joy and interest; "squared", which highlights competence and solidity. The dysfunctional shapes are: "flat", a monotone style that does not capture the listener attention; "spiky", which is an aggressive style that transmits anger or blame towards the listener. An attempt has been made to match the voice shapes to acoustic features of the vocal signal, starting from parameters extracted from the recordings of 12 actors that have reproduced the voice shapes. Preliminary results allowed a subset of the estimated parameters to be identified that have shown good capabilities in discriminating the voice shapes. These parameters are related to distributions of voicing and silence periods, pitch and Cepstral Peak Prominence Smoothed. A web campaign has been also launched asking untrained subjects to "give their voice to the research". Even though only two voice shapes have been identified in this data set, a comparison with the parameters extracted from the trained subjects has shown a good agreement

Geopolymer composites for potential applications in cultural heritage

A new class of geopolymer composites, as materials alternative to traditional binders, was synthesized and its potentialities as restoration material in Cultural Heritage has been explored. This material has been prepared through a co-reticulation reaction in mild conditions of a metakaolin-based geopolymer inorganic matrix and a commercial epoxy resin. The freshly prepared slurry displays a consistency, workability and thixotropic behavior that make it suitable to be spread on different substrates in restoration, repair and reinforcement actions, even on walls and ceilings. Applicability and compatibility tests on tuff and concrete substrates were carried out and the microstructure of the samples in correspondence of the transition zone was analyzed by means of scanning electron microscope (SEM) observations and energy dispersive spectroscopy (EDS) mapping. Our studies pointed out the formation of a continuous phase between the geopolymer composite and tuff and concrete substrates, highlighting a high compatibility of the geopolymer binder with different kinds of materials. These features indicate a large potential for applications of these materials in Cultural Heritage

Raman Microspectroscopy Analysis in the Treatment of Acanthamoeba Keratitis

Acanthamoeba keratitis is a rare but serious corneal disease, often observed in contact lens wearers. Clinical treatment of infected patients frequently involves the use of polyhexamethylene biguanide (PHMB), a polymer used as a disinfectant and antiseptic, which is toxic also for the epithelial cells of the cornea. Prompt and effective diagnostic tools are hence highly desiderable for both starting early therapy and timely suspension of the treatment. In this work we use Raman microspectroscopy to analyse in vitro a single Acanthamoeba cell in cystic phase. In particular, we investigate the effect of PHMB at the single-cell level, providing useful information on both the underlying biochemical mechanism and the time frame for Acanthamoeba eradication in ocular infections. Furthermore, we demonstrate that Raman spectroscopy, in conjunction with standard multivariate analysis methods, allows discriminating between live and dead Acanthamoebas, which is fundamental to optimizing patients' treatment

Optical coherence tomography angiography findings in Huntington’s disease

Objectives: To evaluate the retinal and choriocapillaris vascular networks in macular region and the central choroidal thickness (CCT) in patients affected by Huntington disease (HD), using optical coherence tomography angiography (OCTA) and enhanced depth imaging spectral-domain OCT (EDI SD-OCT). Methods: We assessed the vessel density (VD) in superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC) using OCTA, while CCT was measured by EDI SD-OCT. Results: Sixteen HD patients (32 eyes) and thirteen healthy controls (26 eyes) were enrolled in this prospective study. No significant difference in retinal and choriocapillaris VD was found between HD patients and controls while CCT turned to be thinner in patients respect to controls. There were no significant relationships between OCTA findings and neurological parameters. Conclusion: The changes in choroidal structure provide useful information regarding the possible neurovascular involvement in the physiopathology of HD. Choroidal vascular network could be a useful parameter to evaluate the vascular impairment that occurs in this neurodegenerative disease