PURPOSE To evaluate anterior chamber biometric factors associated with the degree of angle widening and intraocular pressure (IOP) reduction after phacoemulsification. SETTING University of California, San Francisco, California, USA. DESIGN Case series. METHODS Anterior chamber parameters obtained by anterior segment coherence tomography were compared preoperatively and 3 months postoperatively. Measurements included the angle opening distance 500 μm anterior to the scleral spur (AOD500), trabecular–iris space area 500 μm from the scleral spur (TISA500), iris curvature (I-Curv), anterior chamber angle (ACA), trabecular–iris space area, anterior chamber volume, anterior chamber width, and lens vault (LV). RESULTS The study enrolled 73 eyes. The mean patient age was 77.45 years ± 7.84 (SD); 65.75% of patients were women. From preoperatively to 3 months postoperatively, the mean AOD500 increased significantly (0.254 ± 0.105 to 0.433 ± 0.108 mm) and the mean IOP decreased significantly (14.97 ± 3.35 to 12.62 ± 3.37 mm Hg) (P < .001). The reduction in IOP was correlated with the increase in AOD500 (r = 0.240, P = .041) and preoperative LV (r = 0.235, P = .045). After adjusting for related factors, AOD500 widening was positively correlated with LV (β = 0.458, P = .044) and I-Curv (β = 0.235, P = .043) and negatively correlated with preoperative TISA500 (β = −0.269, P = .025) and ACA (β = −0.919, P = .027). CONCLUSIONS Surgically induced AOD widening was significantly correlated with anterior chamber biometric factors. Preoperative LV appears to be a significant factor in angle widening and IOP reduction after phacoemulsification.

To assess the effect of fluid status at baseline (BL) and at the end of the loading phase (LP) of three different ranibizumab regimens: treat-and-extend (T&E), fixed bimonthly (FBM) injections and pro re nata (PRN), in patients with neovascular age-related macular degeneration (nAMD).Design: Post hoc analysis of the In-Eye study (phase IV clinical trial). Methods: Patients were randomized 1:1:1 to the three study arms and were treated accordingly. The presence and type of fluid, intraretinal fluid (IRF) or subretinal fluid (SRF) and the anatomical and visual outcomes were analysed.Main outcome measures: Best-corrected visual acuity (BCVA), the mean change from baseline BCVA (BL BCVA), and the proportion of eyes gaining more than 15 letters or losing more than five letters were analysed. Morphological characteristics including the subtype of choroidal neovascular membrane and the development of atrophy and fibrosis were also evaluated. Results:Patients with SRF at LP had better visual outcomes than patients with IRF. The persistence of SRF did not affect the mean change from BL BCVA among the three treatment regimens. However, in patients with IRF mean change from BL BCVA was significantly lower in the FBM group. The presence of IRF at BL and at the end of the loading phase was associated with the development of fibrosis at the end of the study; this result was contrary to that observed for patients with SRF.Conclusions: While SRF is compatible with good visual and anatomical outcomes, IRF leads to worse results in patients with nAMD; our results suggest that patients with IRF have better outcomes when individualized treatment regimens are used (PRN or T&E) in contrast with a FBM regimen.

In this hospital-based study on the results of LPI for narrow angle subjects, statistically significant independent predictors of anterior chamber angle widening after LPI were older age, smaller iris area, and steeper iris.

To assess the noninferiority of the treat-and-extend (T&E) and fixed bimonthly regimens of 0.5 mg intravitreal ranibizumab as compared with the pro re nata (PRN) in na€ ıve patients with neovascular age-related macular degeneration (nAMD). Methods: Phase IV, randomized, 12-month, multicentre trial. Patients aged ≥50 years with nAMD and visual impairment [best-corrected visual acuity (BCVA) between 23 and 78 Early Treatment Diabetic Retinopathy Study (ETDRS) letters] were eligible. Patients (one eye per patient) were randomized to bimonthly, n = 103, T&E, n = 99 or PRN, n = 104. Noninferiority was established at five letters ETDRS. Results: The mean (95% CI) difference in BCVA at 12 months was 7.2 (4.2-10.2), 6.4 (2.9-9.8), and 8.0 (51.1-11.0) in the bimonthly, T&E and PRN, respectively. The bimonthly or T&E regimens were not inferior to the PRN scheme. All regimens were associated with a significant reduction of central subfield thickness and volume. The mean (95% CI) number of injections in the bimonthly regimen (7.6, 7.5-7.7) was similar as compared with the PRN regimen (7.4, 6.7-8.0) (p = 0.159) but lower than in the T&E regimen (9.3, 8.9-9.7) (p < 0.001). Conclusion: At 12 months, bimonthly and T&E ranibizumab were noninferior to PRN in na€ ıve nAMD. Key words: best-corrected visual acuity-fixed bimonthly-intravitreal anti-VEGF-neovascular age-related macular degeneration-pro re nata-ranibizumab-treat-and-extend † The In-Eye Study Group members are listed in Appendix 1.

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In this study, interdisciplinary approaches are considered to characterize the coastal zone aquifer of the Elbe-Weser region in the North of Lower Saxony, Germany. Geological, hydrogeological, geochemical and geophysical information have been considered to analyze the current status of the aquifers. All the information collectively states that the salinity distribution in the subsurface is heterogeneous both horizontally and vertically. Early age flooding also contributed to this heterogeneity. No general classification of groundwater quality (according to some piper diagrams) could be identified. Helicopter-borne electro-magnetic data clearly show the presence of freshwater reserves below the sea near the west coast. Groundwater recharge largely happens in the moraine ridges (west side of the area) where both the surface elevation and the groundwater level are high. Consequently, submarine groundwater discharge occurs from the same place. All these information will facilitate to develop the planned density driven groundwater flow and transport model for the study area.

ZusammenfassungDie Bundesanstalt für Geowissenschaften und Rohstoffe (BGR) führte in den Jahren 2000–2014 umfangreiche (etwa 5900 km2) aerogeophysikalische Erkundungen an der niedersächsischen Nordseeküste durch. Die Aeroelektromagnetik liefert Informationen über die elektrisch leitfähigen Strukturen im Erduntergrund und ermöglicht die Unterscheidung von Süß- und Salzwasser wie auch von Tonen und Sanden. Im Landesamt für Bergbau, Energie und Geologie (LBEG) sowie am Leibniz Institut für Angewandte Geophysik (LIAG) wurden diese Daten zur Kartierung der Tiefenlage der Süß‑/Salzwassergrenze genutzt. Dadurch ist unter anderem eine detaillierte Karte der Grundwasserversalzung innerhalb der küstennahen Aquifere entlang der niedersächsischen Nordseeküste im Maßstab 1:50.000 entstanden. Diese zeigt den aktuellen Stand der Grundwasserversalzung, abgeleitet aus den gewonnenen Elektromagnetik-Modellen. Die Modelle waren auch Grundlage für eine hydraulische Modellierung der Süßwasserlinse der Nordseeinsel Borkum. Darauf aufbauende Simulationen zeigen die Entwicklung der Grundwassersituation für den Zeitraum bis 2100.