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Avi Wallerstein,1,2 Mathieu Gauvin,1,2 Michael Mimouni,3 Louis Racine,4 Ali Salimi,1,2 Mark Cohen2,5 1Department of Ophthalmology and Visual Sciences, McGill University, Montreal, QC, Canada; 2LASIK MD, Montreal, QC, Canada; 3Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada; 4Department of Ophthalmology, University of Montreal, Montreal, QC, Canada; 5Department of Surgery, University of Sherbrooke, Sherbrooke, QC, CanadaCorrespondence: Avi Wallerstein 1250 Rene-Levesque Blvd W, MD Level, Montreal, QC, H3B 4W8, CanadaTel +1 514-908-9888, Ext. 2273Email awallerstein@lasikmd.comPurpose: To assess the potential application of corneal higher-order aberration (HOA) excimer ablation map imaging in identifying reproducible keratoconus (KC) features and to explore if newly derived map metrics correlate to Pentacam KC indices.Methods: Case series of 12 eyes with KC ≥ grade 2. Topolyzer Vario corneal imaging with its resultant HOA ablation map islands were analyzed for their centroid, distance from center, angular position, orientation, sphericity, diameter, area, and maximal ablation depth. Correlations to Pentacam indices were studied.Results: All eyes showed recurrent features with an arrangement of two elliptical paracentral ablation islands, one deep inferotemporal and one shallow superonasal, in direct mirror-like opposition to each other. These were always accompanied by superior peripheral ablation crescents. The two paracentral islands had highly reproducible distance from center (1.2 ± 0.1 mm and 1.3 ± 0. 2 mm) and angular positions (246.8 ± 15.9° and 76.7 ± 7.7°), with greater variation in ablation depth (68.3 ± 33.2 μm and 17.6 ± 12.1 μm). Distance from center of the peripheral superior crescents was highly reproducible (3.3 ± 0.1 mm), with a larger range of depth (74.5 ± 37.2 μm). The deep paracentral inferotemporal island “hot spot” was coincident with the topographical apical cone. Strong correlations were found between the depth of the inferotemporal island and Pentacam indices of posterior radius curvature (PRC: R = − 0.74) and Belin/Ambrosio enhanced ectasia total deviation (BAD-D: R = 0.71).Conclusion: The corneal HOA ablation map revealed a recurring, distinct, easily recognizable pattern in KC eyes. There was a strong correlation between the depth of novel HOA ablation map metrics and validated Pentacam KC indices. Novel information can be extracted from the corneal HOA ablation map giving it the potential to be a new modality to diagnose and grade KC.Keywords: topography, Contoura, keratoconus, ectasia, diagnosis, higher-order aberration

Ori Segal,1 Yinon Shapira,2 Assaf Gershoni,1 Igor Vainer,2 Arie Y Nemet,1 Noa Geffen,1 Michael Mimouni2 1Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel and the Sackler School of Medicine, Tel Aviv University, Tel Aviv, 2Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel Purpose: To examine the relationship between signal strength and macular thickness as measured by Stratus optical coherence tomography (OCT)’s fast macular thickness protocol in healthy subjects.Methods: In this prospective cross-sectional study 79 eyes of 42 healthy subjects were enrolled. The age, gender, and eye (right vs left) of each subject were recorded. The Stratus OCT fast macular thickness scan protocol was used and the macular thickness was measured with retinal thickness map analysis. Each eye was imaged at least six times to acquire images with signal strengths of 4, 5, 6, 7, 8, and 9 out of 10 via adjustment of the focusing knob. The OCT parameters included in the analysis were thickness in the central 1 mm and in the different quadrants in the 3-mm area.Results: Overall 79 eyes of 42 patients with a mean age of 38.4±12.4 were included. There was no significant difference between the signal strength measurements obtained with different signal strengths in the central thickness (P=0.20). In the superior, nasal, inferior, and temporal quadrants, a signal strength of 8 demonstrated up to 3 µm thicker measurements than a signal strength of 5 (P

Ori Segal,1,2 Yael Segal-Trivitz,1,3 Arie Y Nemet,1,2 Noa Geffen,1,2 Ronit Nesher,1,2 Michael Mimouni4 1Department of Ophthalmology, Meir Medical Center, Kfar Saba, 2The Sackler School of Medicine, Tel Aviv University, Tel Aviv, 3Department of Psychiatry, Geha Psychiatric Hospital, Petah Tikva, 4Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel Purpose: The purpose of this study was to describe antivascular endothelial growth factor intravitreal injection techniques of retinal specialists in order to establish a cornerstone for future practice guidelines. Methods: All members of the Israeli Retina Society were contacted by email to complete an anonymous, 19-question, Internet-based survey regarding their intravitreal injection techniques. Results: Overall, 66% (52/79) completed the survey. Most (98%) do not instruct patients to discontinue anticoagulant therapy and 92% prescribe treatment for patients in the waiting room. Three quarters wear sterile gloves and prepare the patient in the supine position. A majority (71%) use sterile surgical draping. All respondents apply topical analgesics and a majority (69%) measure the distance from the limbus to the injection site. A minority (21%) displace the conjunctiva prior to injection. A majority of the survey participants use a 30-gauge needle and the most common quadrant for injection is superotemporal (33%). Less than half routinely assess postinjection optic nerve perfusion (44%). A majority (92%) apply prophylactic antibiotics immediately after the injection. Conclusion: The majority of retina specialists perform intravitreal injections similarly. However, a relatively large minority performs this procedure differently. Due to the extremely low percentage of complications, it seems as though such differences do not increase the risk. However, more evidence-based medicine, a cornerstone for practice guidelines, is required in order to identify the intravitreal injection techniques that combine safety and efficacy while causing as little discomfort to the patients as possible. Keywords: retina, intravitreal, injection, practices, techniques, patterns

Eyal Cohen,1,* Amir Zerach,1,* Michael Mimouni,2 Adiel Barak1 1Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 2Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel *These authors contributed equally to this work Background: Pneumatic retinopexy (PR) remains a popular technique for the treatment of rhegmatogenous retinal detachment (RRD). Objective: To evaluate the single operation and final success rate of PR for primary treatment of RRD and to determine factors associated with anatomical and visual outcomes. Methods: This retrospective case review study analyzed the data of patients who underwent PR for primary treatment of RRD. Patients with a follow-up period of

Agriculture plays an important role in the economy of the Maghreb region. Most of the water needed for irrigation comes from pumping of the aquifers. A controlled pumping of the groundwater resources does not exist yet, thus, estimating the total water consumption for agricultural use only with in situ data is nearly impossible. In order to overcome this lack of information, Copernicus data are used for determining the groundwater withdrawal through agriculture in the Maghreb region. This paper presents an approach for estimating and monitoring crop water requirements in Tunisia based on multitemporal Sentinel-2 data. Using this multitemporal information, a thorough analysis of the different culture types over time is possible, from which a set of additional multitemporal features is deduced for crop type classification. In this paper, the contribution of those features is analyzed, showing a classification accuracy enhanced by 10% with the multitemporal features. Furthermore, relying on existing methods and FAO standards for the estimation of crop water needs, the methodology aims to estimate the specific crop water consumption. The results of the water estimates are validated against delimited areas where estimates of the water consumption are available from the authorities. Finally, as the study is conducted within the framework of an international technical cooperation, the methodology aims to be reproducible and sustainable for local authorities. The particularity of the results presented here is that they are achieved through automatic processing and using exclusively Open Source solutions, deployable on simple workstations. [ABSTRACT FROM AUTHOR]

The concentration of ozone at the Earth's surface is measured at many locations across the globe for the purposes of air quality monitoring and atmospheric chemistry research. We have brought together all publicly available surface ozone observations from online databases from the modern era to build a consistent dataset for the evaluation of chemical transport and chemistry-climate (Earth System) models for projects such as the Chemistry-Climate Model Initiative and Aer-Chem-MIP. From a total dataset of approximately 6600 sites and 500 million hourly observations from 1971-2015, approximately 2200 sites and 200 million hourly observations pass screening as high-quality sites in regional background locations that are appropriate for use in global model evaluation. There is generally good data volume since the start of air quality monitoring networks in 1990 through 2013. Ozone observations are biased heavily toward North America and Europe with sparse coverage over the rest of the globe. This dataset is made available for the purposes of model evaluation as a set of gridded metrics intended to describe the distribution of ozone concentrations on monthly and annual timescales. Metrics include the moments of the distribution, percentiles, maximum daily eight-hour average (MDA8), SOMO35, AOT40, and metrics related to air quality regulatory thresholds. Gridded datasets are stored as netCDF-4 files and are available to download from the British Atmospheric Data Centre (doi:10.5285/08fbe63d-fa6d-4a7a-b952-5932e3ab0452). We provide recommendations to the ozone measurement community regarding improving metadata reporting to simplify ongoing and future efforts in working with ozone data from disparate networks in a consistent manner. [ABSTRACT FROM AUTHOR]

A 12 year old boy and his two sisters with Hashimoto's thyroiditis and renal impairment were studied. Three generations of this family had autoimmune thyroid disease: Graves' disease was diagnosed in the first generation, and the second and third generations had thyroid enlargement with abnormal thyroid function and immunological abnormalities. The disease in this family could not be explained simply by the types of human leucocyte antigens found. Renal disease in autoimmune thyroid disease is uncommon, treatment difficult, and the prognosis unknown. The proteinuria disappeared in all three children during the three and a half years of follow up, which implies that the renal impairment may be transitory in some patients. [ABSTRACT FROM AUTHOR]

A 3-month-old male infant with type I Klein-Waardenburg syndrome with an imperforated anus and a perineal fistula is reported. The possible association of this gastrointestinal malformation with the KW syndrome is discussed. [ABSTRACT FROM PUBLISHER]

Psychogenic cough is croupy and explosive, never occurs during sleep, and is not affected by antitussive drugs. Physical and radiographic examinations of the respiratory tract and microbiological investigations are normal. Bronchial asthma manifested as chronic cough should be excluded in each patient by lung function testing. [ABSTRACT FROM AUTHOR]

A child with Noonan syndrome and multiple cafe au lait spots, compatible in size and number with von Recklinghausen's neurofibromatosis, is presented. These features may represent a distinct genetic entity rather than the coincidence of two diseases. [ABSTRACT FROM AUTHOR]

To study the ultimate growth variables of children with asthma we analysed the military medical records of 54,041 boys and 38,102 girls at the age of 17 years. History of asthma was found in 2252 boys and 1158 girls, who were then categorised according to three grades of severity. Analysis of their growth was made separately for each sex and for each grade of severity of clinical disease. Boys who suffered from mild asthma that subsided before adolescence were significantly taller, heavier, and fatter than their respective controls. There was a slight decrement in all three growth variables in correlation with increased severity. The most severely affected patients had retarded height and weight in comparison with the mildly affected children, but the differences were not significant. The same tendency was found in the girls. Children with asthma will ultimately reach normal height and weight. Those who are mildly affected tend to be even taller and heavier than adolescents without asthma. The severity of the asthma influences final growth. [ABSTRACT FROM AUTHOR]