Cohort profile: a collaborative multicentre study of retinal optical coherence tomography in 539 patients with neuromyelitis optica spectrum disorders (CROCTINO)

PURPOSE: Optical coherence tomography (OCT) captures retinal damage in neuromyelitis optica spectrum disorders (NMOSD). Previous studies investigating OCT in NMOSD have been limited by the rareness and heterogeneity of the disease. The goal of this study was to establish an image repository platform, which will facilitate neuroimaging studies in NMOSD. Here we summarise the profile of the Collaborative OCT in NMOSD repository as the initial effort in establishing this platform. This repository should prove invaluable for studies using OCT to investigate NMOSD. PARTICIPANTS: The current cohort includes data from 539 patients with NMOSD and 114 healthy controls. These were collected at 22 participating centres from North and South America, Asia and Europe. The dataset consists of demographic details, diagnosis, antibody status, clinical disability, visual function, history of optic neuritis and other NMOSD defining attacks, and OCT source data from three different OCT devices. FINDINGS TO DATE: The cohort informs similar demographic and clinical characteristics as those of previously published NMOSD cohorts. The image repository platform and centre network continue to be available for future prospective neuroimaging studies in NMOSD. For the conduct of the study, we have refined OCT image quality criteria and developed a cross-device intraretinal segmentation pipeline. FUTURE PLANS: We are pursuing several scientific projects based on the repository, such as analysing retinal layer thickness measurements, in this cohort in an attempt to identify differences between distinct disease phenotypes, demographics and ethnicities. The dataset will be available for further projects to interested, qualified parties, such as those using specialised image analysis or artificial intelligence applications

Retinal optical coherence tomography in neuromyelitis optica

BACKGROUND AND OBJECTIVES: To determine optic nerve and retinal damage in aquaporin-4 antibody (AQP4-IgG)-seropositive neuromyelitis optica spectrum disorders (NMOSD) in a large international cohort after previous studies have been limited by small and heterogeneous cohorts. METHODS: The cross-sectional Collaborative Retrospective Study on retinal optical coherence tomography (OCT) in neuromyelitis optica collected retrospective data from 22 centers. Of 653 screened participants, we included 283 AQP4-IgG-seropositive patients with NMOSD and 72 healthy controls (HCs). Participants underwent OCT with central reading including quality control and intraretinal segmentation. The primary outcome was thickness of combined ganglion cell and inner plexiform (GCIP) layer; secondary outcomes were thickness of peripapillary retinal nerve fiber layer (pRNFL) and visual acuity (VA). RESULTS: Eyes with ON (NMOSD-ON, N = 260) or without ON (NMOSD-NON, N = 241) were assessed compared with HCs (N = 136). In NMOSD-ON, GCIP layer (57.4 ± 12.2 μm) was reduced compared with HC (GCIP layer: 81.4 ± 5.7 μm, p < 0.001). GCIP layer loss (-22.7 μm) after the first ON was higher than after the next (-3.5 μm) and subsequent episodes. pRNFL observations were similar. NMOSD-NON exhibited reduced GCIP layer but not pRNFL compared with HC. VA was greatly reduced in NMOSD-ON compared with HC eyes, but did not differ between NMOSD-NON and HC. DISCUSSION: Our results emphasize that attack prevention is key to avoid severe neuroaxonal damage and vision loss caused by ON in NMOSD. Therapies ameliorating attack-related damage, especially during a first attack, are an unmet clinical need. Mild signs of neuroaxonal changes without apparent vision loss in ON-unaffected eyes might be solely due to contralateral ON attacks and do not suggest clinically relevant progression but need further investigation

Optimization of Application of Nitrogen Fertilizers for Growth and Yield of Forage Sorghum under Low-Input and Conventional Farming Systems

In order to maintain sustainable agriculture and prevent excessive use of chemical fertilizers, supplying part of the plant needs by organic fertilizers is necessary. In this respect, effects of nitrogen (N) source and rate on yield and yield components of forage sorghum was evaluated as a factorial experiment arranged in randomized complete blocks design with three replications at the Research Farm of Shahrekord University in 2010. Treatments consisted of three N sources (urea fertilizer, cow manure and equal combination of urea fertilizer + cow manure) and three N levels )80, 160 and 240 kg/ha N, equivalent to 174, 348 and 522 kg/ha urea and 26.2, 52.5 and 78.7 Mg/ha of cow manure and equal combination of urea fertilizer + cow manure at each nitrogen level, respectively). The results showed that increase of N utilization, with increase in leaf, stem and panicle weights and stem diameter, caused a linear increase of forage yield in urea fertilizer and cow manure treatments and a quadratic increase in the combined fertilizer. The highest leaf, stem and panicle weight (600, 3789 and 823 g/m2) and also fresh forage yield (44 Mg/ha) were observed in 240 kg/ha N treatment in combined treatment. But, there was no significant difference in forage yield between this treatment and the 160 kg/ha N treatment. Overall, the results indicated that the potential of sorghum production can be increased by conjunctive use of animal manure and chemical fertilizers, even in low levels of these fertilizers, or low-input agriculture

Sensitivity, Specificity and Accuracy of Color Doppler Ultrasonography for Diagnosis of Retinal Detachment

Purpose: This study evaluated the sensitivity, specificity, and diagnostic accuracy of Color Doppler Ultrasonography (CDUS) in patients with suspected retinal detachment (RD) who underwent surgery. Methods: In this prospective, observational clinical study, 65 eyes of 65 consecutive patients with suspected RD with opaque media were included. Following a standardized protocol, CDUS of the retina of the affected eye was performed. The sensitivity, specificity, and diagnostic accuracy of CDUS were determined and compared to the findings during surgery. Results: The mean age of patients (18 men and 47 women) was 52.36 years (range: 8–77 years). The sensitivity, specificity, and overall accuracy of ocular CDUS were 91.3%, 88.1%, and 89.2%, respectively. The false-negative rate (negative CDUS images but presence of RD at operation) was 3.1% (2/65) and the false-positive rate (positive CDUS images but absence of RD at operation) was 7.7% (5/65). Conclusion: CDUS of the retina could be considered as a promising tool in the diagnosis of RD in patients with opaque media

The effect of upper lid blepharoplasty on forehead and glabellar lines

Purpose: To assess the role of upper blepharoplasty on probable reduction of forehead horizontal lines and glabellar frowns in patients who underwent upper eyelid blepharoplasty. Design: This is a prospective study on 32 female patients with aged between 35 and 75 years and underwent standard blepharoplasty. Method: Measurement of mid brow to hairline distance (MBHLD) and inter brow distance (IBD) were performed within 3 days before, 1 and 6 months after the blepharoplasty surgery. The surgeon and patients reported the extent of their satisfaction about the beneficial effect of upper lid blepharoplasty on decreasing forehead and glabellar lines. Results: Compared to MBHLD at baseline time before the surgery, significant increase was observed in MDHLD after 1 and 6 months follow up in both eyes (p-values were less than 0.05). IBD reached the significant increase after 1 and 6 month(s) after upper lid blepharoplasty (p-values were less than 0.05). On the other hand, compared to mean of IBD in 1 month after surgery, IBD decreased significantly. 59.3 of patients reported satisfaction of high level of improvement in lessening of wrinkles. Conclusion: Our observations documented the beneficial effects in reducing the forehead and glabellar line in patients who underwent upper lid blepharoplasty. © 2020 Informa UK Limited, trading as Taylor & Francis Group

Looking beyond the cosmetic tattoo lesion near the eyebrow: Screening the lungs

Cosmetic tattooing has become a risk factor for several adverse reactions related to inks, procedures, and associated clinical conditions. Development of a sarcoid reaction to the inserted tattoo pigment in the skin is not common. We report a 45 year-old patient with history of dyspnea and mild cough since two years who had subsequently developed reddish, scaly lesions in her 15-year old tattoo done near her right eyebrow. Skin biopsy of the tattoo lesion revealed cutaneous sarcoidosis which led to further investigations and a diagnosis of pulmonary sarcoidosis. The present case highlights the fact that cutaneous sarcoidosis can develop in a long-standing tattoo. Also such a patient should be screened for systemic sarcoidosis disease

Photokeratitis induced by ultraviolet radiation in travelers: A major health problem

Ultraviolet (UV) irradiation is one of the several environmental hazards that may cause inflammatory reactions in ocular tissues, especially the cornea. One of the important factors that affect how much ultraviolet radiation (UVR) humans are exposed to is travel. Hence, traveling is considered to include a more acute UVR effect, and ophthalmologists frequently evaluate and manage the ocular manifestations of UV irradiation, including UV-induced keratitis. The purpose of this paper is to provide an evidence-based analysis of the clinical effect of UVR in ocular tissues. An extensive review of English literature was performed to gather all available articles from the National Library of Medicine PubMed database of the National Institute of Health, the Ovid MEDLINE database, Scopus, and ScienceDirect that had studied the effect of UVR on the eye and its complications, between January 1970 and June 2014. The results show that UVR at 300 nm causes apoptosis in all three layers of the cornea and induces keratitis. Apoptosis in all layers of the cornea occurs 5 h after exposure. The effect of UVR intensity on the eye can be linked to numerous factors, including solar elevation, time of day, season, hemisphere, clouds and haze, atmospheric scattering, atmospheric ozone, latitude, altitude, longitudinal changes, climate, ground reflection, and geographic directions. The most important factor affecting UVR reaching the earth's surface is solar elevation. Currently, people do not have great concern over eye protection. The methods of protection against UVR include avoiding direct sunlight exposure, using UVR-blocking eyewear (sunglasses or contact lenses), and wearing hats. Hence, by identifying UVR intensity factors, eye protection factors, and public education, especially in travelers, methods for safe traveling can be identified