Effects of three intravitreal injections of aflibercept on the ocular circulation in eyes with age-related maculopathy

Aims: To investigate changes in ocular perfusion following three consecutive intravitreal injections with aflibercept for treatment of neovascular age-related macular degeneration (nAMD). Methods The study included 20 eyes from 20 Caucasian patients with unilateral nAMD and 20 fellow eyes. All nAMD eyes were treated with standard intravitreal injection of aflibercept (IVA;2 mg). Measurements of ocular perfusion at the optic nerve head (ONH) and the choroid were performed with laser speckle flowgraphy (LSFG). Measurements were conducted at baseline, 1 week after the first injection, at the time point of the second and third injection as well as 1 month after the third injection. Results In treated eyes, mean blur rate (the main output parameter of LSFG) in the ONH microvasculature and in the choroid was significantly reduced 1 week after the first IVA treatment. The effect persisted throughout the entire follow-up period (p<0.001). No change in ocular perfusion was observed in fellow eyes. Conclusions: IVA for treatment of nAMD leads to a reduction in perfusion of the ONH and the choroid in the treated eye with no apparent effect on the fellow eye

Optimizing OCT acquisition parameters for assessments of vitreous haze for application in uveitis

Detection and evaluation of inflammatory activity in uveitis is essential to the management of the condition, and yet continues to be largely dependent on subjective clinical measures. Optical coherence tomography (OCT) measurement of vitreous activity is an alternative to clinical vitreous haze scoring and has passed a number of early validation studies. In this study we aimed to evaluate the impact of ‘operator factors’ on the variability of the technique as part of the validation process, and to help evaluate its suitability for ‘real world’ use. Vitreous haze index was calculated as a ratio between the reflectivity of the vitreous and of the outer retina in each scan. Different scanning conditions were tested and their effect on the measurement is reported. Our results show that the ‘quantitative imaging’ technique of OCT-measured vitreous activity had good reliability in normal subjects under a range of ‘real world’ conditions, such as when the operator changes the averaging value. The technique was however vulnerable to highly inaccurate focussing or abnormal downward displacement of the image. OCT-based quantification of vitreous activity is a promising alternative to current subjective clinical estimates, with sufficient ‘tolerance’ to be used in routine clinical practice as well as clinical trials

Most Powerful Selling Techiques

Company Y Healthcare being a part of Company Y International was formulated as a medical device conglomerate after several big acquisitions of Company V, Company Z, Company X, and Company Q. So far, these independent companies with their different cultures, strategies and philosophy have been merged into one company almost at the same time. The major problem facing all managers was to find a way to integrate these three businesses into one profitable and growing company under new Company Y rule - to maximize the operating profit. The aim of the essay is to show how a short term restructuring and strategic plan focusing on cost reduction only, can determine a consolidation process reflecting in damages of the sales training program affecting the sales and business growth. Based on pro-sales Company X business model with confrontation to the Company Y cost reduction model imposed on a newly acquired companies there is a need to show how important solid salespeople training is, and to find the answer to the question “To what extent has probing lead to increased sales?” With the use of analytical tools such a SWOT analysis, Life Cycle charts, Line & Column charts and manager’s interview’s, this project will prove the importance of high-quality sales training leading by omnipresent probing technique which brings the outstanding selling results providing the continuous business growth