Swept-source OCT reduces the risk of axial length measurement errors in eyes with cataract and epiretinal membranes

Aims: To compare the biometric data from partial coherence interferometry (PCI) and swept-source OCT (SS-OCT) in patients with age-related cataract and epiretinal membrane (ERM): ERM, ERM with foveoschisis and macular pseudohole. Methods: 49 eyes of 49 subjects including 36 ERM, 9 ERM foveoschisis and 4 macular pseudohole were analysed to evaluate the axial length (AL) measurements and the presence of AL measurement errors, defined basing on the shape of the biometric output graphs and on the concordance of AL values between instruments. Eyes with ERM were divided in four stages according to OCT features (i.e. presence/absence of the foveal pit, presence of ectopic inner foveal layers, disrupted retinal layers). Results: The devices provided similar mean AL measurements in all subgroups, with differences <0.1 mm in 41/49 cases (83.6%). AL measurement errors were observed in ERM stages 3 and 4, characterized by ectopic inner foveal layers, and were significantly more frequent with the PCI (8/17, 47%) as compared with the SS-OCT device (2/17, 12%), p = 0.02. The refractive prediction error in cases with AL measurement errors was significantly greater using the PCI compared to the SS-OCT device (p<0.05). Conclusion: Both devices provide reliable biometric data in the majority of patients and can be used in the preoperative assessment of patients with age-related cataract and ERM. In eyes with ectopic inner foveal layers, attention should be paid as AL measurement and refractive prediction errors may occur, more frequently with the PCI device

The subjective symptoms experience in eating disorders patients

In the last years, many limits about the clinical utility of ED (Eating disorders) diagnostic cathegories are pointed out: they don’t take consider the clinical variability in the same diagnostic cathegory, the turning from one cathegory to another and between subtypes, and the resources of patients (Anderluh et al., 2009; Eddy et al., 2002; Keel et al., 2005). Personality features evidenced a powerful capacity to capture the ED complexity (Westen, Harnden-Fisher, 2001; Thompson-Brenner et al., 2005, 2008). In the light of these considerations, in the same way of personality, we hypothized that the focus on subjective symptoms experience in ED patients had a major clinical and therapeutic utility. We developed ESSE (Eating Symptoms Subjective Experience, Nassisi, Speranza, 2012), a clinician report composed by 34 items on a five point Likert scale. 101 clinicians assessed their ED female patients (mean age 27.8; ds 10.8; 18 to 57) on clinical variables, Global Assessment of Functioning (GAF), personality (SWAP-200, Westen, Shedler, 1999a,b) and attachment (AAQ, Westen, Nakash, 2005). The 69.3% of patients were anorexic, the 20.8% were bulimic and 9.9% EDNOS. A factor analysis with a varimax rotation pointed out three factors (46,6% of the overall variance): Omnipotent control (21.9%; 15 items), Negative affective regulation (16.9%; 12 items), Relational meaning (7.8%; 7 items). The Omnipotent control correlated with dismissing attachment (r=.34; p=.000) and with preoccupied too (r=.22; p=.026). For the Negative affective regulation no results were found. The Relational meaning correlated with the GAF (r=-.27; p=.007) and preoccupied attachment (r=.34; p=.000); it also predicted a lower general functioning (β=-.191; p=.05), the presence of personality disorders (β=.233; p=.024) and sexual abuse (β=.238; p=.018). This study highlights the importance of considering subjective experience in managing ED patients for identifying prognostic and therapeutic features

Eating Disorders and Therapist Emotional Responses

The aims of this study were to identify (a) patterns of clinicians' emotional responses to patients with eating disorders (ED); (b) patient, clinician, and treatment variables associated with therapist emotional responses; and (c) the influence of patient personality on therapist emotional responses. A random national sample of psychodynamic and cognitive-behavioral psychotherapists (N = 149) was asked to examine one patient (>18 years old) with an ED. Clinicians completed the SWAP-200, the Therapist Response Questionnaire, and the Clinical Questionnaire-Eating Disorder Form to provide general information about themselves, patients, and therapies. Results suggested a therapist pattern of emotional response in relation to different ED diagnosis and indicated meaningful influence of therapist experience and patient variables (such as sexual abuse, dissociative symptoms, and self-harm) on therapist emotional reactions. Finally, regression analysis suggested that therapist responses are more related to patient personality than ED symptoms. This study confirms the importance of patient personality in evoking specific therapists' reactions