Purpose: To determine age-related changes in choroidal thickness and the volume of choroidal vessels and stroma using automated algorithms based on structural swept source OCT (SS-OCT) scans.Design: Prospective and observational study.Participants: One hundred and forty-four normal subjects with ages ranged from 20 to 88 years.Methods: A previously reported strategy was used to automatically segment the choroid using SS-OCT structural images. Attenuation correction was applied on B-scans to enhance the choroidal contrast and facilitate more accurate automatic segmentation of the 3D choroidal vessel and stroma. The parameters investigated included mean choroid thickness (MCT), choroidal vessel volume (CVV), choroidal stroma volume (CSV), choroid vascularity index (CVI), and the choroidal stroma-to-vessel volume ratio (CSVR). Correlations between MCT and choroidal vessel metrics of CVV, CSV, CVI, and CSVR were studied. Regional distributions of MCT and CVI were analyzed using a grid centered on the fovea. Age-related changes in MCT, CVV, CSV, and CVI were studied in the whole scanning region, as well as in the sub-regions of the grids.Main Outcome Measures: Age-related changes in MCT, CVV, CSV, and CVI using 6×6 mm and 12×12 mm SS-OCT scans. Results:The automated choroid segmentations were validated against manual segmentations, and MCT measurements were shown to be in good agreement (P<0.0001). CVV and CSV showed significant correlations with MCT (all P < 0.0001). Interestingly, CVI and CSVR were constant with little variation among all subjects regardless of age and MCT (61.1±1.8% and 0.64±0.05, respectively). Measurements on 12×12 and 6×6 mm scans showed excellent agreement in all scan *

Swept source optical coherence tomography (SS-OCT) is being used more widely in clinical studies to investigate the choroid due to its deeper penetration under the retinal pigment epithelium and improved image quality compared with spectral domain OCT. However, automatic methods to reliably assess choroidal thickness and vasculature are still limited. This paper reports an approach that applies attenuation correction on SS-OCT structural scans to facilitate accurate automatic segmentation of the choroid and provides visualization of the choroidal vasculature without the necessity of OCT angiography. After attenuation correction, enhanced interlayer contrast at the choroidal-scleral interface was observed (from 0.13 ± 0.05 to 0.29 ± 0.10; P < 0.001). An algorithm that segmented the choroid from attenuation compensated B-scans achieved significantly higher accuracy when compared with an automated segmentation performed on regular OCT scans (91.8 ± 3.7% vs.74.5 ± 8.0%; P < 0.01). After attenuation correction, en face images of choroidal vessels were achieved with fewer artifacts from retinal vessels. Measurements of mean choroidal thickness and vessel density showed high repeatability. The attenuation correction assisted segmentation of the choroid and visualization of the choroidal vasculature will be helpful in studying the quantitative changes that occur in a myriad of diseases involving the choroid such as age-related macular degeneration, polypoidal choroidal vasculopathy, pathologic myopia, central serous chorioretinopathy, and inflammatory eye conditions.

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Transplantation of autologous ILM is an effective addition to the surgical options for large macular holes after failed surgeries with ILM removal.

Summary Background The outbreak of coronavirus disease 2019 (COVID‐19) is a critical challenge for public health. The effect of COVID‐19 on liver injury has not been fully established. Aims To evaluate the dynamic changes in liver function and the relationship between liver damage and prognosis in patients with COVID‐19. Methods Retrospective analysis of clinical data of 675 patients with COVID‐19 in Zhongnan Hospital of Wuhan University from January 3 to March 8, 2020. Patients were classified as having normal or abnormal liver function and liver injury. Results Of 675 patients, 253 (37.5%) had abnormal liver function during hospitalisation, and 52 (7.7%) had liver injury. The dynamic changes of ALT and AST levels were more significant in patients with liver injury and in those who died. AST >3‐fold upper limit of normal (ULN) had the highest risk of death and mechanical ventilation. Compared to patients with normal AST levels, mortality and risk of mechanical ventilation significantly increased 19.27‐fold (95% confidence interval [CI], 4.89‐75.97; P < 0.0001) and 116.72‐fold (95% CI, 31.58‐431.46; P < 0.0001), respectively, in patients with AST above 3‐fold ULN. Increased leucocytes, decreased lymphocytes and female sex were independently associated with liver injury. Conclusions The dynamic changes in liver function may have a significant correlation with the severity and prognosis of COVID‐19. Increased index of liver injury was closely related to mortality and need for mechanical ventilation. Therefore, these indicators should be closely monitored during hospitalisation.

Purpose To investigate the microvascular changes in macular retina and choriocapillaris (CC) in diabetic eyes without retinopathy using swept-source optical coherence tomography angiography (SS-OCTA). Methods A commercial SS-OCTA system was used to collect 6 × 6-mm macular scans from patients. Three depth-resolved retinal slabs and a CC slab were segmented by a validated semiautomated algorithm. Retinal vessel area density, vessel skeleton density, and nonperfusion area were calculated on segmented retinal slabs. Foveal avascular zone was automatically measured based on en face image of the whole retinal layer. For CC quantification, the percentage of flow deficits (FD%) and the flow deficit (FD) sizes were measured. Results Sixteen eyes from 16 diabetic patients without clinically detectable retinopathy and 16 eyes from 16 age-matched nondiabetic controls were included. There was no significant difference between the two groups in all retinal vessel quantitative parameters (all P > 0.05). However, the mean FD% and mean FD sizes were significantly increased in CC in the central 1.0-mm disk ( P = 0.011 and P = 0.017, respectively), the central 1.5-mm rim ( P = 0.003 and P = 0.009, respectively), the central 2.5-mm rim ( P = 0.018 and P = 0.020, respectively), and the entire 5.0-mm disk ( P = 0.009 and P = 0.008, respectively) in diabetic eyes compared with controls. Conclusions CC perfusion in the macula is decreased in diabetic patients without retinopathy as compared to age-matched normal controls. Decreased CC perfusion in the macula may be an early indicator of otherwise clinically undetectable diabetic vasculopathy.

VATS is an alternative surgical approach for pulmonary metastasectomy in patients with resectable pulmonary metastases. Further large prospective studies are needed to identify the indications for VATS in patients with pulmonary metastases.

Weakened diaphragm contraction in the septic rats was associated with reduced mRNA and protein expression of DHPRα1s and RyR1, the isoforms of skeletal muscles.