A case of polypoidal choroidal vasculopathy. Periphery is equally important for such patients

Dimitrios A Karagiannis, Vasilios Soublis, Artemios Kandarakis1st Ophthalmology Department of Ophthalmiatrio Eye Hospital of Athens, Athens, GreeceBackground: To report a case of peripheral polypoidal choroidal vasculopathy (PCV) which was treated successfully.Methods: Interventional case report. Best-corrected visual acuity measurements (BCVA), slit-lamp examination, fundus biomicroscopy, fluorescein angiography (FFA), and indocyanine green angiography (ICGA) were performed at baseline examination and during the follow-up period. The patient underwent ICGA-guided argon laser to treat the active polyps. Results: An 82-year-old Caucasian man presented complaining of sudden deterioration of peripheral vision in his left eye (LE). His previous ocular history was associated with advanced age-related macular degeneration (AMD) involving both eyes (BE). Fundus examination revealed macular scars in BE and a large hemorrhagic pigment epithelial detachment (PED) temporal to the macula in the LE. ICGA revealed active polyps at the margins of the PED. The patient underwent ICGA-guided argon laser to treat the active polyps. Six months post-laser, the patient regained his peripheral vision with resolution of the hemorrhagic PED and remains stable until now, one year after treatment.Conclusions: Appropriate treatment and regular follow-up is important in patients with PCV and peripheral lesions even if central vision is lost.Keywords: argon laser, peripheral vision, polypoidal choroidal vasculopath

Photodynamic therapy of choroidal neovascularization with enlargement of the spot size to include the feeding complex

This is a case report of a 83-year-old man with choroidal neovascularization (CNV), due to age-related macular degeneration (AMD) in his right eye. Digital fluorescein (FA) and indocyanine green angiography (ICG) were performed, which disclosed predominantly classic subfoveal CNV and a dilated and tortuous feeding complex. The visual acuity was 20/800. Anti-vascular endothelial growth factor (anti-VEGF) treatment was suggested, however, the patient was not keen to receive an intraocular injection. Modified photodynamic therapy (PDT) with spot size enlarged, to include not only the CNV lesion but the feeding complex as well, was performed. Ten days after one session of PDT, ICG showed absence of leakage from the CNV and complete occlusion of the feeding complex. The visual acuity gradually improved to 20/100 and remained stable during the following 23 months. No evidence of CNV leakage was seen in the FA and ICG during the follow up period. Adjustment of the PDT spot size to include the detectable by ICG feeding complex might be an additional option in order to close the subfoveal CNV and might be considered as an alternative to intravitreal injection of anti-VEGF in selected cases where anti-VEGF treatment is not available

Intestinal Upregulation of Melanin-Concentrating Hormone in TNBS-Induced Enterocolitis in Adult Zebrafish

Background: Melanin-concentrating hormone (MCH), an evolutionarily conserved appetite-regulating neuropeptide, has been recently implicated in the pathogenesis of inflammatory bowel disease (IBD). Expression of MCH is upregulated in inflamed intestinal mucosa in humans with colitis and MCH-deficient mice treated with trinitrobenzene-sulfonic acid (TNBS) develop an attenuated form of colitis compared to wild type animals. Zebrafish have emerged as a new animal model of IBD, although the majority of the reported studies concern zebrafish larvae. Regulation MCH expression in the adult zebrafish intestine remains unknown. Methods: In the present study we induced enterocolitis in adult zebrafish by intrarectal administration of TNBS. Follow-up included survival analysis, histological assessment of changes in intestinal architecture, and assessment of intestinal infiltration by myeloperoxidase positive cells and cytokine transcript levels. Results: Treatment with TNBS dose-dependently reduced fish survival. This response required the presence of an intact microbiome, since fish pre-treated with vancomycin developed less severe enterocolitis. At 6 hours post-challenge, we detected a significant influx of myeloperoxidase positive cells in the intestine and upregulation of both proinflammatory and anti-inflammatory cytokines. Most importantly, and in analogy to human IBD and TNBS-induced mouse experimental colitis, we found increased intestinal expression of MCH and its receptor in TNBS-treated zebrafish. Conclusions: Taken together these findings not only establish a model of chemically-induced experimental enterocolitis in adult zebrafish, but point to effects of MCH in intestinal inflammation that are conserved across species

Thermally Activated Delayed Fluorescence in a Y3N@C80 Endohedral Fullerene: Time-Resolved Luminescence and EPR Studies

The endohedral fullerene Y3N@C80 exhibits luminescence with reasonable quantum yield and extraordinary long lifetime. By variable-temperature steady-state and time-resolved luminescence spectroscopy, it is demonstrated that above 60 K the Y3N@C80 exhibits thermally activated delayed fluorescence with maximum emission at 120 K and a negligible prompt fluorescence. Below 60 K, a phosphorescence with a lifetime of 192±1 ms is observed. Spin distribution and dynamics in the triplet excited state is investigated with X- and W-band EPR and ENDOR spectroscopies and DFT computations. Finally, electroluminescence of the Y3N@C80/PFO film is demonstrated opening the possibility for red-emitting fullerene-based organic light-emitting diodes (OLEDs)

Reduced Intestinal Tumorigenesis in APCmin Mice Lacking Melanin-Concentrating Hormone

Background: Melanin-concentrating hormone (MCH) is an evolutionary conserved hypothalamic neuropeptide that in mammals primarily regulates appetite and energy balance. We have recently identified a novel role for MCH in intestinal inflammation by demonstrating attenuated experimental colitis in MCH deficient mice or wild type mice treated with an anti-MCH antibody. Therefore, targeting MCH has been proposed for the treatment of inflammatory bowel disease. Given the link between chronic intestinal inflammation and colorectal cancer, in the present study we sought to investigate whether blocking MCH might have effects on intestinal tumorigenesis that are independent of inflammation. Methodology Tumor development was evaluated in MCH-deficient mice crossed to the APCmin mice which develop spontaneously intestinal adenomas. A different cohort of MCH−/− and MCH+/+ mice in the APCmin background was treated with dextran sodium sulphate (DSS) to induce inflammation-dependent colorectal tumors. In Caco2 human colorectal adenocarcinoma cells, the role of MCH on cell survival, proliferation and apoptosis was investigated. Results: APCmin mice lacking MCH developed fewer, smaller and less dysplastic tumors in the intestine and colon which at the molecular level are characterized by attenuated activation of the wnt/beta-catenin signaling pathway and increased apoptotic indices. Form a mechanistic point of view, MCH increased the survival of colonic adenocarcinoma Caco2 cells via inhibiting apoptosis, consistent with the mouse studies. Conclusion: In addition to modulating inflammation, MCH was found to promote intestinal tumorigenesis at least in part by inhibiting epithelial cell apoptosis. Thereby, blocking MCH as a therapeutic approach is expected to decrease the risk for colorectal cancer

A case of bilateral self-induced keratoconus in a patient with tourette syndrome associated with compulsive eye rubbing: case report

<p>Abstract</p> <p>Background</p> <p>Tourette syndrome is a neurologic disorder that is characterized by repetitive muscle contractions that produce stereotyped movements or sounds. Approximately 50% of individuals with TS also exhibit obsessive-compulsive behaviors including eye rubbing. We report a case of bilateral self-induced keratoconus in a patient with TS, associated with compulsive eye rubbing.</p> <p>Case presentation</p> <p>A 35-year-old man was first seen in our clinic as an outpatient due to rapid deterioration of vision in his right eye associated with pain and tearing, over a period of one month. Slit lamp biomicroscopy of the right eye showed a central stromal scar due to corneal hydrops. Clinical examination and corneal topography of the left eye were normal. Six months later the patient developed corneal hydrops of his left eye. During the following examinations his vision continued to deteriorate in both eyes, while a central stromal scar was forming in his left cornea. Four years after the initial examination the patient's visual acuity was no light perception in the right eye and counting fingers at 33 cm in the left eye. His right eye was phthisic.</p> <p>Conclusions</p> <p>Our patient developed a rapidly progressing bilateral corneal ectasia and phthisis of his right eye during a time period of 4 years. This unusual pattern suggests that the patient's compulsive behavior compromised both of his corneas and led to bilateral keratoconus.</p

Bayesian variable selection in modelling geographical heterogeneity in malaria transmission from sparse data : an application to Nouna Health and Demographic Surveillance System (HDSS) data, Burkina Faso

Quantification of malaria heterogeneity is very challenging, partly because of the underlying characteristics of mosquitoes and also because malaria is an environmentally driven disease. Furthermore, in order to assess the spatial and seasonal variability in malaria transmission, vector data need to be collected repeatedly over time (at fixed geographical locations). Measurements collected at locations close to each other and over time tend to be correlated because of common exposures such as environmental or climatic conditions. Non- spatial statistical methods, when applied to analyze such data, may lead to biased estimates. We developed rigorous methods for analyzing sparse and spatially correlated data. We applied Bayesian variable selection to identify the most important predictors as well as the elapsing time between climate suitability and changes in entomological indices.; Bayesian geostatistical zero-inflated binomial and negative binomial models including harmonic seasonal terms, temporal trends and climatic remotely sensed proxies were applied to assess spatio-temporal variation of sporozoite rate and mosquito density in the study area. Bayesian variable selection was employed to determine the most important climatic predictors and elapsing (lag) time between climatic suitability and malaria transmission. Bayesian kriging was used to predict mosquito density and sporozoite rate at unsampled locations. These estimates were converted to covariate and season-adjusted maps of entomological inoculation rates. Models were fitted using Markov chain Monte Carlo simulation. The results show that Anophele. gambiae is the most predominant vector (79.29%) and is more rain-dependant than its sibling Anophele. funestus (20.71%). Variable selection suggests that the two species react differently to different climatic conditions. Prediction maps of entomological inoculation rate (EIR) depict a strong spatial and temporal heterogeneity in malaria transmission risk despite the relatively small geographical extend of the study area. CONCLUSION: Malaria transmission is very heterogeneous over the study area. The EIR maps clearly depict a strong spatial and temporal heterogeneity despite the relatively small geographical extend of the study area. Model based estimates of transmission can be used to identify high transmission areas in order to prioritise interventions and support research in malaria epidemiology

ND:YAG laser for preretinal hemorrhage in diabetic retinopathy

Purpose: To present fundus images of a case with severe preretinal hemorrhage in diabetic retinopathy that was treated with posterior hyaloidotomy with an Nd:YAG laser. Observations: A 35-year-old diabetic patient presented with sudden painless loss of vision due to severe preretinal hemorrhage over the macular area and high risk proliferative diabetic retinopathy. Her visual acuity was counting fingers. Posterior hyaloid face was treated with Nd:YAG laser (posterior hyaloidotomy). Panretinal laser photocoagulation was first performed to control the proliferative diabetic retinopathy. Blood drained inferiorly into the vitreous cavity with clearance of the premacular area. Conclusions and importance: Prompt treatment with Panretinal laser photocoagulation followed by posterior hyaloidotomy with the YAG laser is a viable option in order to avoid further proliferative diabetic retinopathy complications and vision loss. The current image clearly depicts treatment efficacy. Keywords: Diabetic retinopathy, Preretinal hemorrhage, YAG laser, Panretinal photocoagulatio