Effectiveness of Mp-3 Microperimetric Biofeedback Fixation Training For Low Vision Rehabilitation in Patients Treated With Corticosteroid Ivt in Retinal Vein Occlusions

Mariaelena Malvasi,1 Sabrina Compagno,1 Alessandro Segnalini,1 Vito Maurizio Malvasi,2 Fernanda Pacella,3 Paolo Turchetti,4 Elena Pacella1 1Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy; 2Department of Odontostomatological and Maxillo-Facial Sciences, Sapienza University of Rome, Rome, Italy; 3Department of Ophthalmology, Carlo Poma Hospital, Mantua, Italy; 4National Institute for Health, Migration and Poverty (INMP/NIHMP), Rome, ItalyCorrespondence: Elena Pacella, Department of Sense Organs, University Sapienza, Rome, Policlinico Umberto I, Viale, del Policlinico 155, Rome, 00161, Italy, Email [email protected]: The success of fixation training using microperimetric biofeedback (MP-3 MBFT) in the realm of visual rehabilitation for patients with central vision loss caused by macular pathologies is well established. This study aimed to assess the effectiveness and safety of visual rehabilitation with microperimetric biofeedback in consolidating the benefits obtained, with the goal of reducing the need for repeated intravitreal injections (IVT). Specifically, the focus is on the eyes of patients with central vision loss treated with slow-release corticosteroid IVT following retinal venous thrombosis (RVO), aiming to enhance and maintain postoperative efficacy.Methods: This retrospective review involved the examination of 44 eyes affected by macular edema due to RVO associated with central vision loss. Patients were divided into two groups, with only one undergoing ten sessions of 10-minute visual rehabilitation with a microperimeter (MP-3 MBFT) after IVT over a period of 20 weeks.Results: All the treated patients demonstrated good tolerance to the procedure, with no reported complications. A comparison of best-corrected visual acuity (BCVA), retinal sensitivity recorded with a microperimeter, and pre-IVT fixation stability revealed statistically significant improvements at the end of the first month after IVT. However, the treatment group continued to exhibit superior and more enduring results at four months post-IV.Conclusion: The synergistic use of MP-3 MBFT rehabilitation after IVT with slow-release corticosteroids has proven particularly effective in improving BCVA and long-term fixation stability. This led to a significant reduction in the number of required IVTs, with no related adverse events. The authors argue that biofeedback utilization represents a noninvasive therapeutic option devoid of contraindications and easy to implement and that it positively contributes to the overall patient experience regarding quality of life in advanced stages of macular diseases.Keywords: microperimetric biofeedback, visual rehabilitation, macular edema, intravitreal corticosteroid, retinal vein occlusio

Persistent vertical diplopia after cataract surgery: a case report.

Diplopia is an event that can occur following cataract surgery, although its rate of occurrence is limited and ranges from 0.67% to 0.85%. The authors present a case of vertical diplopia arising after peribulbar anaesthesia for cataract surgery in a 78-year-old woman. Diplopia appeared at distance in primary position, while at near there was binocular single vision. Stereopsis was present at the Lang I - II Test, but the Wirth Test was incomplete. Although in the literature the frequency of these "accidents" is very limited, we think it is relevant to emphasize the need to perform pre-operative routine using a careful orthoptic examination along with a thorough medical, especially strabological, history

Temperature humidity index scenarios in the Mediterranean basin

The study was undertaken to describe the temperature humidity index (THI) dynamics over the Mediterranean basin for the period 1971-2050. The THI combines temperature and humidity into a single value, and has been widely used to predict the effects of environmental warmth in farm animals. The analysis was based on daily outputs of the temperature and relative humidity from the Max Planck Institute data using the Intergovernmental Panel on Climate Change Special Report Emission Scenario A1B. Data revealed a gradual increase of both annual and seasonal THI during the period under investigation and a strong heterogeneity of the Mediterranean area. In particular, the analysis indicated that Spain, southern France and Italy should be expected to undergo the highest THI increase, which in the last decade under study (2041-2050) will range between 3 and 4 units. However, only during summer months the area presents characteristics indicating risk of thermal (heat) stress for farm animals. In this regard, scenario maps relative to the summer season suggested an enlargement of the areas in the basin where summer THI values will likely cause thermal discomfort in farm animals. In conclusion, the study indicated that the Mediterranean basin is likely to undergo THI changes, which may aggravate the consequences of hot weather on animal welfare, performances, health and survival and may help farmers, nutritionists, veterinarians, and policy-makers to develop appropriate adaptation strategies to limit consequences of climate change for the livestock sector in the Mediterranean countries. © 2012 ISB

The climatic, eustatic and tectonic controls on the Mid Carboniferous (Visean and Namurian) strata of Northumbria, England

The Mid Caiboniferous (Viséan and Namurian) Yoredale cycles of Northumbria were deposited as a result of glacio-eustatic fluctuations, arising from waxing aid waning of Gondwanan ice sheets in the southern hemisphere. Each cycle contains a variety of Uthofacies, generally comprising carbonate platform lithofacies deposited during the transgressive systems ttact, followed by deltaic or marine shoreline lithofocies, deposited during the highstand, lowstand and falling stage systems tract. There may or may not be a transgressive shoreline lithofacies present at the top of each cycle. Although there is a general pattern to the composition of each Yoredale cycle, carbonate platform lithofacies are more dominant in the south of the area due to a close proximity to the main marine source to the south-west. Likewise, deltaic and marine shoreline lithofacies are more common in the north of the area due to a close proximity to the main sedimentary source to the north-east The duration of each cycle has been calculated as approximately 200,000 years resulting in their classification as fourth-order cycles. Within each Yoredale cycle, the components of a sea-level curve have been identified indicating their formation was directly influenced by fluctuations in relative sea- level. By using Fischer plots, third-order cycles have also been identified and it is inferred that composite eustasy was տ operation, resulting from Gondwanan glaciation. Evidence for climate change is abundant throughout the Mid Carboniferom. By using palaeosoils and lithological evidence for climate change has been recognised. A major arid phase at the Asbian I Brigantian boundary has been identified by the presence of calcretes, red flmial sediments, a decrease both the amount of coal the amount of fine siliciclastic material within each cycle. This change in climate can be correlated with other areas of similar palaeolatitude indicating that this change was global. Stable isotope analysis reveals little or no information regarding Mid Carboniferous palaeoclimate and I or palaeoceanogiaphy. It has been possible to identify major post-depositional influences on the Mid Caiboniferous strata of Northumbria. Both the Weardale Granite and the Whin Sill Complex appear to have generated large amounts of hydrothermal fluids, both during their emplacement and in the case of the Weardale Granite, after еmplacement. This has led to the obliteration of the original isotopic composition of the marine limestones. Tectonic activity associated with the Variscan orogeny began in the Late Devonian, but was still active in Northumbria during the Viséan. The resulting extensional tectonics had a profound affect on sedimentation. During the Viséan, active extension was still ongoing, with the syn-rift phase lasting until the end of the Asbian period. The result of this was a series of E-w trending sedimentary basins with wedge-shaped geometry of sediments. The intervening blocks subsided at a slower rate due to underlying buoyant granite masses compared to the Caledonian basement rock of the basinal areas. Differential subsidence ended in the Namurian and the post rift-phase gradually took over from the start of the Brigantian period onwards. This resulted in uniform deposition, with localised intrabasinal faulting. The initial objectives for this thesis were to assess not only the effects of climate, eustasy and tectonics on the Mid Caibontferous strata of Northmnbria, but also to look at the clastic and carbonate interactions within the classic Yoredale cycles. The vast amount of previously unpublished information that has been obtained from the rocks especially with regards to climate change has meant that the clastic-carbonate interaction study was abandoned. In an area that has been studied for over two centuries due to it mineral wealth it is perhaps surprisng to find that there is still much work to be gleaned from such a classic area of British geology.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Correlation between specratl-domain optical coherence tomography findings and visual outcome after primary rhegmatogenous retinal detachment repair.

Purpose: To correlate the postoperative visual outcome with the spectral-domain optical coherence tomography (SD-OCT) findings in the fovea after successful rhegmatogenous retinal detachment repair. Cross-sectional, observational study. Methods: Thirty-five patients with preoperative macula-on rhegmatogenous retinal detachment (12 eyes) and macula-off rhegmatogenous retinal detachment (23 eyes) who underwent scleral buckling surgery for primary rhegmatogenous retinal detachment were recruited. Early Treatment Diabetic Retinopathy Study best-corrected visual acuity measurement, microperimetry, and SD-OCT examination were performed on the same day. Foveal center retinal thickness, central 1-mm subfield thickness, and outer nuclear layer thickness were measured using SD-OCT. The presence or absence of epiretinal membrane, intraretinal fluid, and subretinal fluid was assessed. The status of the external limiting membrane, inner/outer segment junction, and intermediate line was also evaluated and judged as disrupted or complete. The correlations between SD-OCT findings and either postoperative best-corrected visual acuity or retinal sensitivities for central 12 degrees were analyzed. Results: The outer nuclear layer thickness was the only significant SD-OCT retinal measurement strongly correlated with both postoperative best-corrected visual acuity (r = 0.61; P < 0.001) and retinal sensitivities for central 12 degrees (r = 0.53; P = 0.001). Among the SD-OCT imaging findings, status of the external limiting membrane, inner/outer segment junction, and intermediate line and the presence of intraretinal fluid showed a significantly high correlation either with best-corrected visual acuity outcome (r = -0.60; P < 0.001, r = -0.63; P < 0.001, r = -0.66; P < 0.001, and r = -0.50; P = 0.002, respectively) or with postoperative retinal sensitivities (r = -0.59; P < 0.001, r = -0.61; P < 0.001, r = -0.66; P < 0.001, r = -0.50; P = 0.002, respectively). Multivariate analysis showed that the outer nuclear layer thickness and the status of the intermediate line were the most important predictors of visual outcome (P, 0.001 and P, 0.001, respectively). Conclusion: This study showed that not only the status of the external limiting membrane and the inner/outer segment junction but also the integrity of the intermediate line and the outer nuclear layer thickness changes may be important predictors of postoperative visual outcome after anatomically successful rhegmatogenous retinal detachment repair. RETINA 32:43-53, 201