Conversion to aflibercept for diabetic macular edema unresponsive to ranibizumab or bevacizumab

Background: The purpose of this study was to determine if eyes with diabetic macular edema (DME) unresponsive to ranibizumab or bevacizumab would benefit from conversion to aflibercept. Methods: This study was conducted as a retrospective chart review of subjects with DME unresponsive to ranibizumab and/or bevacizumab and subsequently converted to aflibercept. Results: In total, 21 eyes from 19 subjects of mean age 62±15 years were included. The majority of subjects were male (63%). The median number of ranibizumab or bevacizumab injections before switching to aflibercept was six, and the median number of aflibercept injections after switching was three. Median follow-up was 5 months after the switch. Mean central foveal thickness (CFT) was 453.52±143.39 mm immediately prior to the switch. Morphologically, intraretinal cysts were present in all cases. Mean CFT after the first injection decreased significantly to 362.57±92.82 mm (Wilcoxon signed-rank test; P<0.001). At the end of follow-up, the mean CFT was 324.17±98.76 mm (P<0.001). Mean visual acuity was 0.42±0.23 logMAR just prior to the switch, 0.39±0.31 logMAR after one aflibercept injection, and 0.37±0.22 log-MAR at the end of follow-up. The final visual acuity was significantly better than visual acuity before the switch (P=0.04). Conclusion: Eyes with DME unresponsive to multiple ranibizumab/bevacizumab injections demonstrate anatomical and visual improvement on conversion to aflibercept

Real-time plasma state monitoring and supervisory control on TCV

In ITER and DEMO, various control objectives related to plasma control must be simultaneously achieved by the plasma control system (PCS), in both normal operation as well as off-normal conditions. The PCS must act on off-normal events and deviations from the target scenario, since certain sequences (chains) of events can precede disruptions. It is important that these decisions are made while maintaining a coherent prioritization between the real-time control tasks to ensure high-performance operation. In this paper, a generic architecture for task-based integrated plasma control is proposed. The architecture is characterized by the separation of state estimation, event detection, decisions and task execution among different algorithms, with standardized signal interfaces. Central to the architecture are a plasma state monitor and supervisory controller. In the plasma state monitor, discrete events in the continuous-valued plasma state are modeled using finite state machines. This provides a high-level representation of the plasma state. The supervisory controller coordinates the execution of multiple plasma control tasks by assigning task priorities, based on the finite states of the plasma and the pulse schedule. These algorithms were implemented on the TCV digital control system and integrated with actuator resource management and existing state estimation algorithms and controllers. The plasma state monitor on TCV can track a multitude of plasma events, related to plasma current, rotating and locked neoclassical tearing modes, and position displacements. In TCV experiments on simultaneous control of plasma pressure, safety factor profile and NTMs using electron cyclotron heating (ECH) and current drive (ECCD), the supervisory controller assigns priorities to the relevant control tasks. The tasks are then executed by feedback controllers and actuator allocation management. This work forms a significant step forward in the ongoing integration of control capabilities in experiments on TCV, in support of tokamak reactor operation

The design of gradient-index lenses using analytical and optimization techniques

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Cystoid Macular Edema in Acute Presentation of Central Retinal Artery Occlusion

A seventy-six-year-old lady with poor vision of the left eye due to previous retinal detachment presented with acute visual loss of her right eye secondary to central retinal artery occlusion. Clinical examination showed a pale right optic disc, macular edema, and a cherry red spot. Optical coherence tomography done four hours after onset showed right acute cystoid macular edema and diffuse inner retinal thickening. Subsequent treatment with intravenous carbonic anhydrase inhibitor resulted in some visual improvement. Central retinal artery occlusion has been known to produce diffuse intraretinal edema instead of cystoids changes. We would like to discuss a case of acute cystoid macular edema in acute central retinal artery occlusion

Generalized from of Telegrapher’s Equations for the Electromagnetic Field Coupling to Buried Wires of Finite Length

In this paper, a generalized form of telegrapher's equations for electromagnetic field coupling to buried wires is derived. The presented approach is based on thin-wire antenna theory. The effect of a dissipative half-space is taken into account via the reflection/transmission coefficient approximation. The conductor losses can be taken into account via the surface impedance per unit length. The derived equations are treated numerically via the Galerkin-Bubnov indirect boundary element method. Numerical results are presented for induced current along the wire, and compared with transmission-line (TL) and modified TL (MTL) approximations, respectively, for the case of perfectly conducting electrode buried in a lossy medium. It is shown that the TL and MTL approximations can result in an inaccurate induced current distribution along the conductor at HFs and for shorter electrode lengths, respectively

Near-field coupling of wireless devices and long communications cables

A comprehensive investigation of the coupling between mobile devices and communication/control cables in several environments is described here. Both experimental and numerical results are shown and compared using a number of different methods in different laboratories. Results indicate a good level of agreement between the different approaches thus giving confidence that predictive studies based on simulation can give a good quantitative assessment of coupling. Moreover, the studies show that varying the configuration of the coupled systems does not significantly affects the maximum coupling thus making it possible to obtain a reasonable worst case estimate of coupling from a small number of generic studies.Electromagnetic compatibility in diffused communications system