Macular microvascular changes after intravitreal bevacizumab injection in diabetic macular edema

Objective: To evaluate the changes in retinal capillary plexus and the choriocapillaris after a single intravitreal injection of bevacizumab in eyes with diabetic macular edema using optical coherence tomography angiography (OCTA). Design: Prospective interventional case series. Participants: Patients having diabetes with centre-involving diabetic macular edema. Methods: In this prospective interventional case series, eyes with centre-involving diabetic macular edema were enrolled. Vascular density (VD), vascular diameter index (VDI), vascular length density (VLD), foveal avascular zone (FAZ) area, and foveal density (FD)-300 were measured using en face OCTA images before and 1 month after administration of intravitreal bevacizumab. VD and VDI measurements were performed in the superficial capillary plexus (SCP) and deep retinal capillary plexus (DCP) and in the choriocapillaris. Additionally, capillary nonperfusion area (CNPA) was detected automatically based on vessel distance map in 4 concentric rings around the foveal centre. The segmentation error was manually corrected, and the measurements were performed by 2 expert graders. Results: Twenty-three eyes of 19 patients with a mean age of 62.76 ± 6.88 years were included. There were no significant changes in the FAZ area, FD-300, or in the VD of the foveal and parafoveal SCP and DCP. Also, VLD and VDI of the SCP and DCP remained unchanged. The change in the CNPA was not statistically significant. The VD of choriocapillaris increased significantly after injections (p = 0.005). Conclusions: FAZ area and VD of the retinal capillary plexus remained stable in the short-term period after intravitreal bevacizumab. In addition, the choriocapillaris blood flow improved after bevacizumab injection. © 2020 Canadian Ophthalmological Societ

Review: Carbonate aquifers and future perspectives of karst hydrogeology in India

International audienceAbout 3 % of India's total land surface is occupied by carbonate rocks which are mostly karstified and constitute a significant source of groundwater. The groundwater drawn from these aquifers matches the water demand of -35 million people living in 106 districts of the country and also the water needs of livestock, irrigation and industry. The studies on karst in India carried out so far have mostly addressed geology, hydrology and groundwater contamination. A literature survey suggests that there is a need for detailed research, applying new approaches and techniques for proper carbonate aquifer identification, characterization and management. Such specific approaches will improve modeling, exploitation and protection of karst groundwater. An overview of the research carried out on groundwater resources of karst formations in India is presented, which also throws light on the protection of karst aquifers from existing anthropogenic activities such as mining and groundwater over-exploitation