Stingray injuries responded well to hot water immersion for pain control. Skin and soft tissue infection was diagnosed in 1 of 22 patients (4.55%).

The patients with geographic atrophy have a small significant loss of the GCL. Ganglion cell death may precede axonal loss, and increased macular retinal nerve fiber layer volumes are not indicative of GCL volume. Residual ganglion cell stimulation by interneurons may enable vision in patients with GA.

PurposeWe evaluate patient-reported quality of life outcomes in severely visually impaired (SVI) individuals using the Aira system, an on demand assistive wearable technology.MethodsAira is an on-demand assistive wearable technology designed for the severely visually impaired (visual acuity of better eye <20/200). The user wears glasses with a video camera mounted that, when activated, livestreams to a human agent who assists the user in the specified task. Aira subscribers were recruited consecutively and administered the 28-item Impact of Vision Impairment-Very Low Vision (IVI-VLV) Questionnaire, a previously validated survey for vision-related quality of life specifically for low vision individuals. The questionnaire was administered by phone before starting Aira and at 3-month follow-up. Total score as well as validated subset scores of activities of daily living, mobility and safety (ADLMS) and emotional wellbeing (EWB) were assessed.ResultsA total of 69 participants (mean age, 52.1; 35 female, 34 male) were recruited with a mean of 108 (SD = 19.7) days to follow-up. Mean total minutes used over the interval were 334.1 (SD = 318.5). Initial total score (mean 51.7 ± 18.6) significantly improved at follow-up (mean 62.2 ± 15.0; P < 0.0001) with mean change +10.4 ± 12.5. ADLMS subset score (mean 30.4 ± 10.8) significantly improved at follow-up (mean 36.6 ± 8.8; P < 0.0001) with mean change +6.5 ± 8.7. EWB subset score (mean 21.6 ± 8.8) significantly improved at follow-up (mean 25.6 ± 7.9 respectively; P < 0.0001) with mean change +4.0 ± 5.2. There was no correlation between minutes used and improvement in total (r = −0.205, P = 0.098), ADLMS (r = −0.237, P = 0.055), and EWB (r = −0.242, P = 0.051) scores.ConclusionsIn this exploratory study, regardless of minutes used, the use of Aira significantly improves IVI-VLV total score and ADLMS and EWB subscores for SVI individuals. This improvement is not correlated with total minutes used.Translational RelevanceThe Aira assistive technology system may provide improvement in quality of life for low vision patients and is worthy of further study to assess the use of this technology to assist SVI patients.

BACKGROUND AND OBJECTIVE: To quantify the size and location of nonperfusion associated with posterior segment neovascularization (NV) in proliferative diabetic retinopathy (PDR) using ultra-wide- field fluorescein angiography. PATIENTS AND METHODS: Cross-sectional study of 18 eyes with PDR. The total image area, areas of nonperfusion, buds of posterior segment neovascularization (either neovascularization of the disc or elsewhere), and the distances from each bud to the nearest area of nonperfusion and to the disc were measured. RESULTS: Nonperfused areas with associated neo- vascularization were significantly larger than areas without neovascularization (32.0% ± 5.24% of the retinal image vs. 3.3% ± 0.92%; P < .001) and were more likely to be posteriorly located. Nonperfusion encompassing greater than 23% of the total angiographic image had more associated neovascular buds (9.64 ± 2.16 vs. 0.86 ± 0.29; P < .0001), which were closer to the disc (7.53 mm ± 0.27 mm vs. 9.24 mm ± 0.64 mm; P = .014). CONCLUSION: A threshold size of nonperfusion greater than 23% of the retinal image is associated with posterior segment neovascularization and may serve as an indicator of risk for the development of PDR.

PurposeTo systematically evaluate the needs of low vision individuals through call data obtained through the Aira assistive technology system.Patients and methodsAira (Aira Tech Corporation, La Jolla, CA, USA) is an on-demand assistive wearable technology designed for individuals with low vision. The user wears glasses with an integrated front-facing video camera that connects with a remote human agent who assists the user with the specified task. Call types, temporal characteristics, and duration of call were compared by gender and vision status (low vision, light perception, and blind). Chi-square tests, t-tests, ANOVA, linear regression and Poisson regression analyses were performed.Results878 subscribers placed 10,022 total calls (4759 female, 5263 male) over 3 months. The most common categories were reading (35%), navigation (33%), and home management (16%). The distribution of categories (χ2=49.3, p<0.001), duration (t=−7.59, p<0.0001) and time of call (χ2=37.4, p<0.001) differed by gender. The distribution of categories (χ2=61, p<0.001), duration (F=13.7, p<0.0001), and time of call (χ2=36.9, p<0.001) differed by vision status. Blind [adjusted IRR=1.68 (95% CI: 1.56–1.79)] and light perception users [adjusted IRR=1.43 (95% CI: 1.32–1.53)] had increased usage compared to low vision users. Women had higher usage than men [adjusted IRR=1.09 (95% CI: 1.04–1.13)].ConclusionTo our knowledge, this is the first large-scale needs assessment of 878 low vision individuals over 10,022 calls. The most common categories were reading, navigation, and home management. Distribution of call types, duration, and time of call differed significantly by gender and vision status. Blind and light perception users had higher usage rates than those with low vision. Women had higher usage rates than men. This large-scale needs analysis of low vision individuals provides insight into utilization patterns across varying levels of vision loss and gender, which will guide future evolutions of assistive technology by tailoring future hardware and software upgrades.

F-FDG PET/CT may be helpful with localization of painful abnormalities in the inflamed regions of the joints, which could potentially be used to direct individualized treatment in moderate and severe OA. Furthermore, SUV measurement on F-FDG PET/CT could serve as an inflammation activity index in the knees that may be predictive of outcomes and progression rate of OA.

Virtual reality (VR) systems can offer benefits of improved ergonomics, but their resolution may currently be limited for the detection of small features. For detection of lung nodules, we compared the performance of VR versus standard picture archiving and communication system (PACS) monitor. Four radiologists and 1 novice radiologist reviewed axial computed tomography (CTs) of the thorax using standard PACS monitors (SM) and a VR system (HTC Vive, HTC). In this study, 3 radiologists evaluated axial lung-window CT images of a Lungman phantom. One radiologist and the novice radiologist reviewed axial lung-window patient CT thoracic images (32 patients). This HIPAA-compliant study was approved by the institutional review board. Detection of 227 lung nodules on patient CTs did not result in different sensitivity with SM compared with VR. Detection of 23 simulated Lungman phantom lung nodules on CT with SM resulted in statistically greater sensitivity (78.3%) than with VR (52.2%, P = .041) for 1 of 3 radiologists. The trend was similar but not significant for the other radiologists. There was no significant difference in the time spent by readers reviewing CT images with VR versus SM. These findings indicate that performance of a commercially available VR system for detection of lung nodules may be similar to traditional radiology monitors for assessment of small lung nodules on CTs of the thorax for most radiologists. These results, along with the potential of improving ergonomics for radiologists, are promising for the future development of VR in diagnostic radiology.

Purpose: To assess patient-reported quality of life outcome improvements in severely visually impaired (SVI) individuals using the Aira system over a 1-year follow-up period. Methods:Aira is an on-demand assistive technology designed for SVI. Aira subscribers were recruited and administered the validated 28-item Impact of Vision Impairment-Very Low Vision Questionnaire by phone before starting Aira with follow-ups at 3 months and 1 year. Total score and validated subset scores of activities of daily living, mobility, and safety (ADLMS) and emotional well-being (EWB) were assessed. Pearson correlation analyses and paired t-tests were used to examine the data.Results: Fifty participants (mean, age, 52.5 years; 25 males, 25 females) were recruited with a mean of 401 ± 66.3 days to follow-up. The initial total score (mean, 53.1 ± 18.9) significantly improved at 1 year (mean, 63.1 ± 16.2; P = 0.0002). The initial ADLMS score (mean, 30.7 ± 11.3) significantly improved at 1 year (mean, 37.2 ± 10.7; P = 0.001). The initial EWB score (mean, 22.5 ± 8.5) significantly improved at 1 year (mean, 25.9 ± 8.0; P = 0.0001). There was no significant difference between the 3-month and 1-year total (P = 0.972), ADLMS (P = 0.897), and EWB scores (P = 0.700). There was a significant correlation between minutes used and improvement in total (r = 0.371; P = 0.009), ADLMS (r = 0.302; P = 0.035), and EWB (r = 0.439; P = 0.002) scores. Conclusions:Aira use significantly improves Impact of Vision Impairment-Very Low Vision total, ADLMS, and EWB scores for SVI individuals at 3 months. This improvement is sustained at the 1-year follow-up and correlated with total minutes used.Translational Relevance: Aira technology may provide sustained improvement in quality of life for SVI, and further study to evaluate the usefulness of this technology to assist SVI may be beneficial.