Nodular Posterior Scleritis: Clinico-Sonographic Characteristics and Proposed Diagnostic Criteria

Purpose: To report the clinical and ultrasound features and outcomes of a series of nodular posterior scleritis. / Methods: Retrospective medical record review of 11 consecutive patients with nodular posterior scleritis. Patient demographics, ocular and systemic findings, ultrasound features, and final anatomical and visual outcomes were recorded. / Results: There were 9 females and 2 males (11 eyes) with mean age at presentation of 57 years (range, 30-84 years). Underlying systemic inflammatory disease was present in 73%. Symptoms included pain in 73% and blurred vision in 45%. A solitary amelanotic mass without the presence of lipofuscin was found in all cases. Associated ocular features included retinal pigment epithelial changes (67%), intraocular inflammation (55%), subretinal fluid (50%), macular edema (50%), and choroidal folds (30%). B-mode ultrasound showed a sclerochoroidal mass with high internal reflectivity (100%) of mean elevation of 4.1 mm. There was nodular thickening of the sclera (100%) and fluid in Tenon space or "T" sign (36%). A complete regression of the nodule after the treatment was observed only in 1 patient (11%) and partial regression in 4 patients (44%). / Conclusion: Nodular posterior scleritis should be considered in the differential diagnosis of a single amelanotic choroidal mass showing high internal reflectivity on ultrasound B-scan. It can produce intraocular inflammation in 50% of the cases and may be painless in 25%. It has a high association with a systemic underlying disease

Malpractice claims related to recurrent laryngeal nerve injury: Forensic remarks regarding 15 cases

Abstract Malpractice claims concerning recurrent laryngeal nerve (RLN) injuries are often related to thyroid surgery, but they can also involve surgeons of different specialties. Our survey was made considering expert opinions on claims for medical malpractice evaluated at Brescia Institute of Forensic Medicine in Italy during the period 1992–2012. Fifteen cases concerned RLN injury. Malpractice was identified in 10 cases, according to the following conditions: low pre and intra-operative risk of nerve injury, no documentation showing that the nerve was isolated and preserved despite the existence of potential risk factors. An accurate, well written and complete surgical report is the main tool for the expert examination in malpractice claims

Repeatability of swept-source optical coherence tomography retinal and choroidal thickness measurements in neovascular age-related macular degeneration

BACKGROUND: The aim was to determine the intrasession repeatability of swept-source optical coherence tomography (SS-OCT)-derived retinal and choroidal thickness measurements in eyes with neovascular age-related macular degeneration (nAMD). METHODS: A prospective study consisting of patients with active nAMD enrolled in the Distance of Choroid Study at Moorfields Eye Hospital, London. Patients underwent three 12×9 mm macular raster scans using the deep range imaging (DRI) OCT-1 SS-OCT (Topcon) device in a single imaging session. Retinal and choroidal thicknesses were calculated for the ETDRS macular subfields. Repeatability was calculated according to methods described by Bland and Altman. RESULTS: 39 eyes of 39 patients with nAMD were included with a mean (±SD) age of 73.9 (±7.2) years. The mean (±SD) retinal thickness of the central macular subfield was 225.7 μm (±12.4 μm). The repeatability this subfield, expressed as a percentage of the mean central macular subfield thickness, was 23.2%. The percentage repeatability of the other macular subfields ranged from 13.2% to 28.7%. The intrasession coefficient of repeatability of choroidal thickness of the central macular subfield was 57.2 μm with a mean choroidal thickness (±SD) of 181 μm (±15.8 μm). CONCLUSIONS: This study suggests that a change >23.2% of retinal thickness and 57.2 μm choroidal thickness in the central macular subfield is required to distinguish true clinical change from measurement variability when using the DRI OCT-1 device to manage patients with nAMD

On the Stereochemistry of the Cations in the Doping Block of Superconducting Copper-Oxides

Metal-oxygen complexes containing Cu,- Tl-, Hg-, Bi- and Pb-cations are electronically active in superconducting copper-oxides by stabilizing single phases with enhanced $T_c$, whereas other metal-oxygen complexes deteriorate copper-oxide superconductivity. Cu, Tl, Hg, Bi, Pb in their actual oxidation states are closed shell $d^{10}$ or inert $s^2$ pair ions. Their electronic configurations have a strong tendency to polarize the oxygen environment. The closed shell $d$ ions with low lying $nd^{10}\leftrightarrow nd^9(n+1)s$ excitations form linear complexes through $d_{z^2}-s$ hybridization polarizing the apical oxygens. Comparatively low $nd^9(n+1)s$ excitation energies distinguish $\rm Cu^{1+,3+}, Tl^{3+}, Hg^{2+}$ from other closed shell $d^{10}$ ions deteriorating copper-oxide superconductivity, {\it e.g.} $\rm Zn^{2+}$.Comment: 5 pages, uses REVTEX. To be published in: J. Superconductivity, Proc. Int. Workshop on "Phase Separation, Electronic Inhomogenities and Related Mechanisms for High T_c Superconductors", Erice (Sicily) 9-15 July 199

Evaluation of iris and iridociliary body lesions with anterior segment optical coherence tomography versus ultrasound B-scan.

To compare anterior segment optical coherence tomography (AS-OCT) with ultrasound B-scan (USB) in evaluating iris and iridociliary body lesions

Detection of extrascleral extension in uveal melanoma with histopathological correlation

PURPOSE: Uveal melanoma is the most common primary intraocular malignancy. Extrascleral extension (ESE) is rare, but associated with an increased rate of orbital recurrence and an overall poor prognosis. Clinical studies show low rates when compared with histological studies. Due to the prognostic importance of ESE, we sought to compare our clinical, intraoperative, and histological detection rates. DESIGN: A retrospective cross-sectional case series. METHODS: A list of eyes enucleated for uveal melanoma was compiled from the admissions records of the London Ocular Oncology Service during the 28-month period, i.e. January 2010-April 2012. The surgical and clinical notes of patients with histopathology proven ESE were reviewed to determine when it was first diagnosed or suspected. The subsequent management of these cases is discussed. RESULTS: A total of 16 out of 174 (9%) eyes had histologically proven ESE. Eight of 16 cases were detected preoperatively at clinical examination, including the use of ocular ultrasound, 3 of 16 were discovered intra-operatively, and 5 of 16 deemed microscopic ESE, were first detected on histological examination. Seven of 7 (100%) of cases with anterior ESE were detected clinically by slit lamp biomicroscopy, while only 1 out of 9 (11%) of cases with posterior ESE was detected preoperatively with ultrasound. CONCLUSIONS: Slit lamp biomicroscopy is sensitive for detecting anterior ESE. Most posterior ESE is microscopic, but macroscopic posterior ESE may also be missed by B-scan ocular ultrasound. Orbital surgeons should be suspicious of clinically undetected posterior ESE, and consider adjuvant orbital radiotherapy in cases with macroscopic ESE

TOI-858 B b: A hot Jupiter on a polar orbit in a loose binary

We report the discovery of a hot Jupiter on a 3.28-day orbit around a 1.08 M$_{Sun}$ G0 star that is the secondary component in a loose binary system. Based on follow-up radial velocity observations of TOI-858 B with CORALIE on the Swiss 1.2 m telescope and CHIRON on the 1.5 m telescope at the Cerro Tololo Inter-American Observatory (CTIO), we measured the planet mass to be $1.10\pm 0.08$ M$_{J}$ . Two transits were further observed with CORALIE to determine the alignment of TOI-858 B b with respect to its host star. Analysis of the Rossiter-McLaughlin signal from the planet shows that the sky-projected obliquity is $\lambda = 99.3\pm 3.8$. Numerical simulations show that the neighbour star TOI-858 A is too distant to have trapped the planet in a Kozai-Lidov resonance, suggesting a different dynamical evolution or a primordial origin to explain this misalignment. The 1.15 Msun primary F9 star of the system (TYC 8501-01597-1, at $\rho$ ~11") was also observed with CORALIE in order to provide upper limits for the presence of a planetary companion orbiting that star.Comment: Accepted for publication in A&