No abstract

Purpose. To compare the efficacy and safety of suprachoroidal and intravitreal injection of triamcinolone acetonide in pseudophakic patients with refractory diabetic macular edema (DME) due to epiretinal membrane (ERM). Study Design. This study is a randomized clinical trial (RCT). Participants. Twenty-three nonvitrectomized pseudophakic eyes of 23 subjects (9 M and 14 F with mean age: 54.8 years) with refractory DME due to ERM. Methods. The eyes were randomized to suprachoroidal triamcinolone acetonide injection 4 mg/0.1 ml (SCTA) (n = 13 eyes) or intravitreal triamcinolone acetonide 4 mg/0.1 ml (IVTA) (n = 10 eyes) and were evaluated at baseline and 1 and 3 months after injection to assess outcome measures. Main Outcome Measures. Changes in best-corrected visual acuity (BCVA) (primary outcome), central foveal thickness (CFT) by optical coherence tomography (OCT), and intraocular pressure (IOP) measurement (secondary). Results. Baseline median BCVA (logMAR) was 1.0 (range 0.8–1.0) in both groups, improved within the SCTA group to 0.8 on the 1st and 3rd months, while in the IVTA group, median BCVA changed to 0.8 and 0.9 on the 1st and 3rd months, respectively. No significant differences were noted between groups regarding BCVA at baseline ( P = 0.927 ), and 1st ( P = 0.605 ) and 3rd months ( P = 0.313 ). Regarding mean CFT, no significant differences were observed at baseline ( P = 0.353 ) and at the first month ( P = 0.214 ) between both groups, while at the third month, CFT was significantly higher in the IVTA group (385 um) than in the SCTA group (323 um) ( P = 0.028 ). Mean IOP was significantly higher in the IVTA group (15 mmHg) on 1st month than in the SCTA group (12 mmHg) ( P = 0.011 ); after 3rd month, IOP was significantly higher within the IVTA group (18 mmHg) than SCTA (14 mmHg) ( P = 0.028 ). No significant difference was noted between both groups at baseline IOP ( P = 0.435 ). Conclusions. Both SCTA and IVTA are effective in reduction of CFT and improvement of patients’ visual acuity, but with a higher recurrence rate and rise in IOP after IVTA when compared to SCTA. Both treatments have temporary effects with the possibility of recurrence of DME and the need for retreatment.

HighlightsShedding light on the aggressive nature and rare incidence of Melanotic Neuroectodermal Tumour of Infancy (MNTI).Detailing different clinical and radiographic features of MNTI.Outlining the management of MNTI and postoperative follow-up regimen.Emphasising the importance of early diagnosis and surgical intervention in Melanotic Neuroectodermal Tumour of Infancy.

BACKGROUND AND PURPOSE: No MR imaging measurement criteria are available for the diagnosis of optic nerve atrophy. We determined a threshold optic nerve area on MR imaging that predicts a clinical diagnosis of optic nerve atrophy and assessed the relationship between optic nerve area and retinal nerve fiber layer thickness measured by optical coherence tomography, an ancillary test used to evaluate optic nerve disorders. MATERIALS AND METHODS: We evaluated 26 patients with suspected optic nerve atrophy (8 with unilateral, 13 with bilateral and 5 with suspected but not demonstrable optic nerve atrophy) who had both orbital MR imaging and optical coherence tomography examinations. Forty-five patients without optic nerve atrophy served as controls. Coronal inversion recovery images were used to measure optic nerve area on MR imaging. Retinal nerve fiber layer thickness was determined by optical coherence tomography. Individual eyes were treated separately; however, bootstrapping was used to account for clustering when appropriate. Correlation coefficients were used to evaluate relationships; receiver operating characteristic curves, to investigate predictive accuracy. RESULTS: There was a significant difference in optic nerve area between patients' affected eyes with optic nerve atrophy (mean, 3.09 Ϯ 1.09 mm 2), patients' unaffected eyes (mean, 5.27 Ϯ 1.39 mm 2 ; P ϭ .008), and control eyes (mean, 6.27 Ϯ 2.64 mm 2 ; P Ͻ .001). Optic nerve area Յ 4.0 mm 2 had a sensitivity of 0.85 and a specificity of 0.83 in predicting the diagnosis of optic nerve atrophy. A significant relationship was found between optic nerve area and retinal nerve fiber layer thickness (r ϭ 0.68, P Ͻ .001). CONCLUSIONS: MR imaging-measured optic nerve area Յ 4.0 mm 2 has moderately high sensitivity and specificity for predicting optic nerve atrophy, making it a potential diagnostic tool for radiologists. ABBREVIATIONS: OCT ϭ optical coherence tomography; ONA ϭ optic nerve atrophy; ON area ϭ optic nerve area; RNFL ϭ retinal nerve fiber layer; ROC ϭ receiver operating characteristic

Purpose To assess the efficacy and safety of Suprachoroidal triamcinolone acetonide injection [SCTA] as an adjunctive therapy in management of Vogt-Koyanagi Harada [VKH] serous retinal detachment. Design Prospective parallel group study. Participants 12 eyes of 6 patients with bilateral multiple serous retinal detachment of VKH in acute phase on systemic steroids. Methods Each patient was received single SCTA injection (SCTA group, n = 6 eyes) and the other non-injected eye (Standard treatment group, n = 6 eyes), patients were followed for 1, 3, and 6 months to assess changes in best corrected visual acuity [BCVA], central foveal thickness [CFT] and intraocular pressure [IOP] between both groups. Main outcome measures The primary end point was changes in BCVA from baseline till 6th months follow-up. Secondary end points were changes in CFT and IOP from baseline to 6 months of follow-up. Results BCVA at one and three months was significantly better in eyes received SCTA than in non-injected eyes (p-value = 0.026 for each). CFT at one and three months was significantly higher in non-injected eyes than in eyes received SCTA (p-value = 0.028 for each). IOP showed no significant differences between both groups. Conclusions SCTA is an effective adjuvant treatment for VKH serous retinal detachment, without any serious ocular adverse effects or increase in IOP and causing significant reduction in CFT and rapid improvement in BCVA when combined with oral steroids.

This paper introduces an algorithm for researching the achievement stability set for parametric rough linear goal programming (PRLGP) issues with parameters in the achievement function and roughness in goal and system constraints. The proposed goal programing model has two types of uncertainty. We transform the PRLGP into an upper approximation model and a lower approximation model. Then, the Lexicographical goal programing method is utilized to solve such upper and lower approximation models iteratively to avoid the complexity of the attainment issue. This model has been applied as it enables the decision-maker to articulate the weights for goals however, for the sub-goals it shall be complicated as they possess the same measure. Finally, to clarify how to investigate the achievement stability set for the PRLGP, an algorithm and a numerical illustration was given.

Endometriosis is a heterogeneous sickness with run of the mill and atypical sores that range from peritoneal inserts to ovarian endometrioma and profound invading endometriotic (DIE) knobs, with or without cul-de-sac obliteration. The point of the current investigation was to approve the presentation of preoperative Ultrasound-based Endometriosis Scoring System (UBESS) for foreseeing the right degree of laparoscopic aptitudes needed for endometriosis surgery.This was a forthcoming, observational examination was directed including (100) ladies giving persistent pelvic torment and additionally endometriosis. The span of the investigation was gone from 6 to 12 months.Results: there is high huge connection between UBESS score and RANZCOG/AGES score with practically ideal arrangement between the two scores. Utilizing ROC bend, affectability of UBESS score I was 94.2%, particularity was 95.8%, PPV 96.1%, NPV 93.9%, exactness 95%, affectability of UBESS score II was 83.3%, explicitness was 93.9%, PPV 75%, NPV 96.3%, precision 92% and %, affectability of UBESS score III was 93.3%, particularity was 98.6%, PPV 96.6%, NPV 97.2%, exactness 97%.Conclusion: UBESS could be used to foresee the degree of multifaceted nature of laparoscopic medical procedure for endometriosis. It can possibly encourage the emergency of ladies with suspected endometriosis to the most fitting careful ability needed for laparoscopic endometriosis medical procedure. UBESS should be approved remotely in different focuses to survey its overall appropriateness.

No abstract