Search

Purpose To describe the distribution and determinants of choroidal thickness (CT) in participants in a population study based on spectral-domain (SD)-OCT measurements. Design Population-based, cross-sectional study. Participants Ethnic Chinese, Indian, and Malay adults aged more than 50 years without any retinal diseases (e.g., diabetic retinopathy, macular edema, age-related macular degeneration, central serous chorioretinopathy) that might affect the CT were recruited from the Singapore Epidemiology of Eye Diseases Study. Methods Choroidal imaging was performed by SD-OCT (Spectralis, Heidelberg Engineering, Heidelberg, Germany) in enhanced depth imaging (EDI) mode. Subfoveal choroidal thickness (SFCT) was measured on the foveal line scan by 2 retinal experts independently (YS and KT), and the average was used in the analyses. In Chinese and Indian cohorts in whom macular raster scans were captured, the manufacturer-supplied research software (Heyex SP-X version 6.4.8.116; Heidelberg Engineering) was used to obtain automated segmentation yielding mean choroidal thickness in each of the 9 ETDRS grid sectors. Main Outcome Measures Subfoveal choroidal thickness and regional CT in the 9 ETDRS grid sectors. Results For the SFCT analysis, 2794 eyes of 1619 participants (Chinese, Indian, and Malay ) were included. The mean age was 60.9 years (standard deviation, 7.7), and 797 (49.2%) were male. Mean SFCT was 255.2 μm (standard deviation, 102.6). The normal range of SFCT was 106 to 447 μm (corresponding to 5th and 95th percentile limits of SFCT, respectively). In multivariable models, thinner SFCT was associated with older age, female gender, longer axial length, and Malay (vs. Chinese) ethnicity. In the subset of Chinese and Indian eyes (n = 1842) in whom regional variation was evaluated, the choroid was thickest at the superior and temporal sectors and thinner at the inferior and nasal sectors. Conclusions Subfoveal choroidal thickness is influenced by age, gender, and ethnicity along with regional differences even within individual eyes. Subfoveal choroidal thickness also shows a wide range in physiologic limits. These data may be used as a reference in future studies.

In this study, the camera angle of a UAV (Unmanned Aerial Vehicle) was adjusted to take aerial photographs, and 2D and 3D models were constructed to evaluate the quantitative impact. The study area was Waryong Bridge, located in Dalseong-gun, Daegu Metropolitan City. The camera angles of the UAV were 90°, 75°, and 60°; DSM, orthophoto, and the 3D model were analyzed. As a result of the analysis of DSM and orthophoto, images were 1.05 times in 75° and 1.10 times in 60° compared to 90°, and matching was 1.09 times in 75° and 1.60 times in 60° compared to 90°. The point cloud for building 3D models increased analysis points to 1.17 times for 75° and 1.47 times for 60° compared to 90°. However, the area of an orthophoto of 1 pixel increased by 1.10 times for 75° and 1.34 times for 60° compared to 90°, resulting in a decrease in resolution. As the camera angle of the UAV decreases, the overlapping ratio of aerial photographs increases and the structure of wide areas can be implemented. However, since a large difference occurs in the precision of the 3D model, a shooting plan according to the purpose should be established.

Atropine eye drops prevent the progression of myopia, but their use has not been tested in the Japanese schoolchildren population. Here, we evaluate the efficacy and safety of 0.01% atropine eye drops for myopia control in Japanese children. Multicenter (7 university hospitals), randomized, double-masked, placebo-controlled trial. Participants were 171 Japanese schoolchildren aged 6 to 12 years, with progressive myopia, spherical equivalence (SE) of −1.00 to −6.00 diopters (D), and astigmatism of ≤1.5 D. They were randomized to receive either 0.01% atropine (n=85) or placebo (n=86) eye drops once nightly OU for 24 months. Primary and secondary efficacy endpoints were changes in SE and axial length (AL), respectively, from baseline to month 24. Data from 168 subjects were analyzed. At month 24, compliance was similar in both groups (atropine: 83.3%; placebo: 85.7%). The least squares mean change in SE and AL from baseline were, respectively, −1.26 D (95% confidence interval [CI]: −1.35, −1.17) and 0.63 mm (0.59, 0.67) for atropine and −1.48 D (− 1.57, −1.39) and 0.77 mm (0.73, 0.81) for placebo. Inter-group differences were 0.22 D (95% CI: 0.09, 0.35; P

Purpose We aimed to explore the velocity waveform characteristics of the retinal artery associated with age and the cardio-ankle vascular index (CAVI) as a conventional arterial stiffness marker by applying the Doppler optical coherence tomography (DOCT) flowmeter. Methods In this cross-sectional study, DOCT flowmeter imaging was performed in 66 participants aged 21 to 83 years (17 men, 49 women) with no history of eye diseases and no systemic diseases, except for hypertension. Retinal blood velocity waveform was analyzed where several parameters in time (upstroke time, T1, T2, T3, and T4) and area under the waveform (area elevation, area declination, A1, A2, A3, and A4) were extracted. Systolic blood pressure-adjusted Pearson's coefficients were calculated to determine the correlations of each parameter with age or CAVI. Results Corrected upstroke time (UTc) was the waveform parameter most positively correlated with age (r = 0.497, P < 0.001). Area declination was the waveform parameter most negatively correlated with age (r = -0.682, P < 0.001) and CAVI (r = -0.601, P < 0.001). Conclusions We extracted the waveform parameters associated with the risks of arterial stiffening. The velocity waveform analysis of the retinal artery with DOCT flowmeter potentially could become a new method for arterial stiffness identification. Translational Relevance DOCT flowmeter could evaluate arterial stiffening in a different way from the conventional method of measuring arterial stiffening using pressure waveform. Because the DOCT flowmeter can easily, quickly, and noninvasively provide a retinal blood velocity waveform, this system could be useful as a routine medical examination for arterial stiffening.

To evaluate choroidal volume and thickness changes after photodynamic therapy (PDT) for chronic central serous chorioretinopathy (CSC). Chronic CSC eyes with a history of PDT were selected. Average choroidal volume, average choroidal thickness, the maximum and minimum choroidal thickness of the macula irradiated area and peripheral non-irradiated areas before and after one and three months of treatment were examined. A total of 14 patients with chronic CSC and 9 controls without any eye pathology were enrolled. The mean choroidal volume in CSC before and, and after one and three months of treatment were 2.36 (standard deviation: 0.70), 1.90 (0.69), 1.86 (0.66) mm3 for the central area, 1.25 (0.38), 1.14 (0.35), 1.13 (0.34) mm3 for superior nasal area, 1.47 (0.41), 1.28 (0.43), 1.26 (0.43) mm3 for superior temporal area, 1.07 (0.49), 0.95 (0.38), 0.93 (0.35) mm3 for inferior nasal area, 1.17 (0.38), 1.04 (0.32), 1.03 (0.33) mm3 for inferior temporal area. This study revealed the choroidal volume changes in a short period after PDT and a decrease in unirradiated choroidal volume was also shown after the treatment. The algorithm provided on the ARI Network enables to evaluate the choroidal changes quantitatively and qualitatively.

This study aimed to investigate the influence of educational pressure on myopia. A less-intense school curriculum was introduced nationally in Japan beginning in 2012 based on a pressure-free education policy. In this retrospective observational study, a total of 1025 Japanese medical students of Asahikawa Medical University underwent measurements of the cycloplegic refractive error and axial length (AL), from 2011 to 2020. The spherical equivalent (SE) and AL were correlated significantly with the fiscal year of births (p = 0.004 and p = 0.034, respectively) only during enforcement of the system of high-pressure education. The SE and AL regression rates during the two educational approaches differed significantly (p = 0.004 and p = 0.037, respectively). The prevalence of high myopia was correlated significantly (p &lt, 0.001) only during the system of high-pressure education. The regression of the prevalence rate of high myopia during the two education approaches differed significantly (p = 0.010). The progression rates of myopia and increased prevalence of high myopia were observed only during high-pressure education, suggesting that not only ophthalmologists but also educators and the government should work on together to control the progression of myopia.

The current study aimed to address whether ripasudil, a Rho-associated coiled-coil containing protein kinase (ROCK) inhibitor developed to treat glaucoma and ocular hypertension (OH), improves diabetic macular edema (DME) since it is known that ROCK upregulates vascular endothelial growth factor. We retrospectively investigated the foveal thickness (FT) measured by spectral-domain optical coherence tomography, visual acuity (VA), and intraocular pressure (IOP) in 12 eyes with DME that received ripasudil treatment for primary open-angle glaucoma or OH and compared them with 14 eyes that received no treatment. One month after ripasudil therapy, the mean FT decreased significantly from 439 ± 72 µm to 395 ± 62 µm (P = 0.003); this change was significantly different from that in the controls, in which the mean FT increased by 1 ± 39 µm (P = 0.01). Ripasudil also caused a significant decrease in IOP from 17.3 ± 5.2 mmHg to 14.6 ± 4.0 mmHg (P = 0.02); this change was significantly greater than that in the controls, in which IOP changed by 0.0 ± 1.6 mmHg (P

With the climate change adding to the frequency and intensity of natural disasters, drought has devastated large areas of lands in South Korea. Still, the exact beginning and end of the drought is difficult to identify, and this impedes the development and implementation of disaster predictions. Although the drought phenomenon has been well-documented, predictions thereof are limited due to the non-linear and complex temporal fluctuations of the hydrologic factors. Hence, this study set up some reference points for disaster-prediction rainfall based on South Korea&rsquo, s agricultural drought damage data, to help in drought relief. To set up the proposed reference points for disaster-prediction rainfall, we analyzed rainfall in light of the disaster-prevention relevance to agricultural droughts and the disaster reduction. As an analysis method, rainfall of municipality was calculated through Thiessen&rsquo, s polygonal method, to apply rainfall weighting value for each rainfall observatory. In addition, the linear regression analysis was applied to suggest the calculation formula for setting the annual disaster reduction rainfall. The results of this study, standard of judgment point for disaster prevention of agricultural drought at the time of disaster management, were analyzed for rainfall for local governments and the whole country. Rather than using various drought indices that are currently developed, policy makers or public servant made suggestions based on rainfall that is most accessible and convenient for judging the timing of agricultural drought. As the disaster-prevention rainfall with agricultural droughts is expected to occur, we established the average annual rainfall of &le, 1200 or 100 mm below the preceding year&rsquo, s average annual rainfall. Moreover, as the disaster-reduction rainfall for agricultural droughts to end, we determined the average monthly rainfall of &ge, 150 mm.

Purpose It has been reported that peripapillary loops develop after central retinal artery occlusion (CRAO). Although cilioretinal anastomoses have been shown by fluorescein angiography (FA) and indocyanine green angiography, these examinations cannot confirm the structural continuity between the retinal arteries and the posterior ciliary arteries. In the current report, we followed a patient with iatrogenic CRAO in which circumpapillary collaterals formed and assessed the connection between these two vascular systems using optical coherence tomography angiography (OCTA). Observation Iatrogenic CRAO developed in the left eye of a 30-year-old woman during preoperative embolization of a convexity meningioma. FA and OCTA showed complete impairment of the retinal circulation. Two weeks after this event, OCTA images showed flow in the retinal vessels and the beginning of collateral vessel development on the optic disc margin. Six months later, OCTA images showed that these circumpapillary collaterals connected branches of the retinal arteries with the vessels supplying the optic disc, which originate from the posterior ciliary arteries. Conclusion and importance OCTA aided our understanding of the three-dimensional configuration of the circumpapillary collaterals that developed after iatrogenic CRAO, which included anastomosis of the retinal and posterior ciliary artery systems. OCTA is useful for noninvasively monitoring the status of retinal circulatory dynamics after iatrogenic CRAO.

The flow of driftwood and soil into drainage from agricultural areas accelerates sedimentation and inflicts overflow damage after rainfall events due to insufficient discharge capacity, causing flooding on agricultural land. However, there have been few efforts to develop a driftwood capture trellis for agricultural drainage ditches, except for some suggested design criteria. In this study, we developed a driftwood capture trellis to capture driftwood in agricultural drainage ditches and evaluated its performance based on hydraulic characteristics. The facility was designed considering criteria for drainage and driftwood control barriers, as well as the properties of driftwood found near agricultural drainage ditches. Performance evaluation was conducted through hydraulic experiments. Driftwood capture trellises were installed in 400 mm drainage pipes and a total of 216 experimental runs were conducted: six runs each in six different velocity variations and six water depth variations. The results showed that the driftwood capture efficiency of the facility exceeded 60% at a velocity of 0.144 m&sup3, /s. Limited conditions for hydraulic experiments should be considered. The driftwood capture trellis for agricultural drainage ditches developed in this study could contribute to a reduction in overflow damage caused by driftwood sedimentation.

Background: Doppler optical coherence tomography (DOCT) flowmeter can be used to measure retinal blood flow (RBF) parameters, including vessel diameter, blood velocity, and the absolute value of RBF within 2.0 s. We investigated the RBF parameters in eyes with branch retinal vein occlusion (BRVO) using a DOCT flowmeter. Methods: Seventeen patients with unilateral BRVO were enrolled. All subjects underwent comprehensive ophthalmologic examinations. The RBF parameters were assessed from three veins, i.e., (1) an occluded vein, (2) a non-occluded vein in the BRVO eyes, and (3) an equivalent (superior or inferior) vein in the fellow eye (non-affected vein), using prototype DOCT flowmeter (Topcon, Tokyo, Japan). Moreover, the correlation between RBF parameters and the best corrected visual acuity (BCVA) was examined. We investigated the correlation between (1) the RBF parameters and the time from the initial visit, (2) the RBF parameters and the time from the last injection, and (3) the RBF parameters and the number of anti-vascular endothelial growth factor injections (VEGF). Results: The diameter of the occluded vein (95.9 &plusmn, 24.7 &micro, m) was smaller than that of the non-occluded vein (127.9 &plusmn, 23.7 &micro, m) and that of the healthy veins (116.4 &plusmn, 13.9 &micro, m). The RBF was lower in the occluded veins (4.7 &plusmn, 3.7 &micro, L/min) than that in the non-occluded veins (10.3 &plusmn, 5.1 &micro, L/min, p &lt, 0.01) and in the fellow eyes (8.6 &plusmn, 4.0 &micro, p = 0.013). In contrast, the blood velocity was not significantly different among the three types of veins. BCVA was correlated with the diameter of the occluded vein (&rho, = 0.711, p = 0.001) but not with the RBF and blood velocity. The time from the initial visit, the time from the last injection, and the total number of anti-VEGF injections were not associated with any RBF parameters on the occluded vein. Conclusions: The RBF was significantly lower in the occluded veins than that in the other veins, and the diameter of the occluded vein was significantly smaller than that of the other veins in patients with BRVO. However, neither the time from the initial visit, nor the time from the last injection, nor the number of anti-VEGF injections were correlated with the RBF parameters on the occluded vein.

Inundation damage occurs in urban regions due to short flood reach time and increased surface runoff caused by urbanized impervious areas. Furthermore, heavy rainfall frequency has increased because of climate change, thus exceeding the design frequency and resulting in sewer pipes&rsquo, lack of flood control capacity, with damage expanding from low-lying areas. Despite many urban disaster-mitigation policies, complex causes and uncertainties make reducing urban inundation damage difficult. This study established a rainfall-related disaster-prevention standard by time duration considering rainfall characteristics targeting urban disaster-induced inundation damage. Based on the South Korean urbanization rate and population, seven target regions were selected. Rainfall by time duration was analyzed with respect to disaster length (number of days) from 2010&ndash, 2017. The average rainfall for durations from 1&ndash, 24 hours were analyzed according to disaster length (1&ndash, 13 days). Using the results, an equation was proposed for rainfall estimation by length of disaster resulting in urban inundation damage, through multiple regression analysis. An equation was developed for rainfall-related disaster-prevention in urban areas considering the length of disaster and rainfall duration. This was accomplished by selecting a duration whereby the average rainfall of duration corresponded to 50% of total rainfall during the disaster period.

Purpose We aimed to observe longitudinal changes in retinal blood flow (RBF) and structural transformations in capillaries using Doppler optical coherence tomography (DOCT) and optical coherence tomography angiography (OCTA) in a feline retinal blood occlusion (RVO) model. Methods RVO was induced by argon green laser photocoagulation (PC) in six eyes of six cats. RBF was measured at a first-order retinal artery and vein by a DOCT flowmeter, and structural changes in the capillaries around the occluded vessels (12 × 12 and 3 × 3 mm) were assessed by OCTA before (at baseline); immediately after PC; and on days 1, 4, 7, and 14 thereafter. Systemic and ocular parameters were monitored during the observation period. Results There were no significant differences in any systemic or ocular parameters before and after PC. Arterial RBF increased significantly on day 1 (160.6 ± 8.6% vs. baseline, P < 0.001) and decreased below baseline after day 1 through 14. Venous RBF decreased immediately after PC (17.4 ± 9.6% vs. baseline, P = 0.001) and then gradually increased afterwards, but did not return to baseline. OCTA showed dilatation of retinal venules immediately after PC to day 1. Collateral vessels began to form on day 4, had matured by day 7, and were pruned on day 14, which formed as mature as normal retinal venule diameters. Conclusions With increasing arterial RBF within 1 day after inducing RVO, venules gradually expanded to form collateral vessels, suggesting that collateral vessels originate from existing capillary networks, not neovascularization.

The agricultural drainage in rural area plays important roles in water supply and drainage for crop cultivation. Various kinds of debris near agricultural drainage, however, causes sedimentation in the drainage during rainfall. The debris introduced into the agricultural drainage moves out of the drainage under a high flow rate. This causes a reduction in the flow rate, which may affect the discharge capacity, resulting in crop damage. This study developed a reduction facility to reduce debris entering agricultural drainage and analyzed the performance by measuring the capture efficacy in the hydraulic experiment. A total of 648 runs were performed for 216 experiment conditions where three replications and error ranges were calculated depending on the inflow characteristics of debris. This study also evaluated the performance of the reduction facility and established the design criteria by developing a capture efficacy equation by flow rate and type of reduction facility.

This study aimed to evaluate whether long-term insulin treatment is associated with abnormalities in retinal circulation in type 2 diabetic patients. We evaluated 19 eyes of nondiabetic individuals and 68 eyes of type 2 diabetic patients. The eyes of diabetic patients were classified into two groups according to the presence or absence of long-term insulin therapy. We used a Doppler optical coherence tomography flowmeter to measure diameter, velocity, and blood flow in the major temporal retinal artery. The pulsatility ratio (PR) and resistance index (RI), indices of vascular rigidity, were calculated from the blood velocity profile. PR and RI were significantly elevated in type 2 diabetic patients compared with nondiabetic subjects (P < 0.05). In type 2 diabetes patients, PR and RI were significantly higher in patients receiving long-term insulin treatment than in those without (P < 0.01). There was a significant difference in velocity (P < 0.05), but not diameter and blood flow, between nondiabetic subjects and type 2 diabetes patients. No significant difference in diameter, velocity, or blood flow was observed between the groups with and without long-term insulin treatment. Long-term insulin treatment can affect PR and RI, which might be associated with vascular rigidity of the retinal artery in patients with type 2 diabetes.

AimsTo evaluate the associations between retinal blood flow (RBF) and optical coherence tomography (OCT) structural measurements in normal-tension glaucoma (NTG) eyes with single-hemifield visual field (VF) damage by the Doppler OCT.MethodsThe Doppler OCT was used to measure temporal artery (TA) RBF and temporal vein (TV) RBF. Retinal nerve fibre layer thickness (RNFLT) was measured by spectral-domain OCT.ResultsForty-three consecutive eyes of 43 patients with NTG with VF defect confined to a single hemifield and 24 eyes of 24 age-matched healthy subjects were studied. TA and TV RBF and RNFLT were reduced in the damaged hemisphere compared with the normal hemisphere (mean (SD), 3.61 (1.68) vs 5.86 (2.59) µL/min, pConclusionIn NTG eyes with single-hemifield damage, the RBF was significantly reduced in the damaged hemisphere compared with the normal one. The RBF decreased in the normal and damaged hemispheres of NTG eyes compared with the healthy hemisphere independent from RNFLT.

Damage caused by natural disasters produces the difference of damage size not only according to damage volume or size, but a national economic level. In addition, budgets and aids should be constantly acquired for disaster management since natural disasters sporadically or irregularly occur. This study proposed disaster management methods by countries considering natural disaster damage documents and economic indicators from 1900 to 2017 among 187 countries in the world. It developed a damage prediction formula considering damage documents of previous natural disasters, economic indicators by countries, and basic indicators as disaster management methods by countries. Independent variables of the damage prediction formula include GDP, population, and area. It applied multiple regression analysis and calculated average human losses due to death, human losses affected, and damage costs by countries. Regarding the adjusted R&sup2, of the natural disaster damage prediction formula, the human losses from deaths mean was 0.893, the human losses affected mean was 0.915, and the damage costs mean was 0.946, which had higher explanatory powers. Therefore, results from this study are considered to calculate quantitative damage sizes considering uncertain damage sizes of natural disasters, economic indicators by countries, and are used as indicators for disaster management.

A 64-year-old man first developed ligneous conjunctivitis at the age of 58 years after right pulmonary resection because of suspected cancer; otherwise, he had been healthy. Since then, he began to suffer from various forms of chronic pseudomembranous mucositis. Laboratory tests demonstrated that he had 7.8 % of plasminogen activity and 5.9 % of the normal antigen level. Thus, he was diagnosed as having severe type I plasminogen deficiency, making him the third case in Japan. DNA sequencing and PCR-restriction fragment length polymorphism analyses revealed that this patient was a compound heterozygote of a G-to-A missense mutation (G266E) in exon VIII and a g-to-a mutation at the obligatory splicing acceptor site in intron 12 (IVS12-1g>a). These two mutations were confirmed to be novel. Molecular modeling and splice site strength calculation predicted conformational disorder(s) for the Glu266 mutant and a drastic decrease in splicing efficiency for intron 12, respectively. Western blot analysis demonstrated that the patient contained a small amount of the normal-sized plasminogen protein. Mass spectrometric analysis of the patient's plasminogen revealed a peptide containing the wild-type Gly266 residue and no peptides with mutations at Glu266. However, he had never suffered from thrombosis. Low levels of fibrinogen/fibrin degradation products (FDP), D-dimer, and plasmin-α2-plasmin inhibitor complex clearly indicated a hypo-fibrinolytic condition. However, his plasma concentration of elastase-digested crosslinked FDPs was 4.8 U/mL, suggesting the presence of an on-going plasmin(ogen)-independent "alternative" fibrinolytic system, which may protect the patient from thrombosis. The patient has been free from recurrence of ligneous conjunctivitis for approximately 2.5 years.

Recently, Flood damage in river is mainly occurring in medium and small streams. In case of national river or large scale local rivers, disaster management such as river improvements were established. Whereas, In case of medium and small stream, disaster management for flood damage is insufficient. Among medium and small streams of the streams passing urban areas if flood damage occur, the focus of management is required to large scale damage of human and infrastructure. In this study, it proposed selection criteria of medium and small streams that flood damage is recently increased and medium and small streams that passes through the urban area that classification criteria of urban basin proposes using impervious area.

Recently, the Republic of Korea has experienced natural disasters, such as typhoons and heavy rainfall, as well as social accidents, such as large-scale accidents and infectious diseases, which are continuously occurring. Despite repeated disasters, problems such as inefficient early response and overlapping command systems occur continuously. In this study, we analyzed the characteristics of disaster management systems by foreign countries, and the status of the damages by disasters for the past 10 years in the Republic of Korea, to suggest possible measures to improve the Republic of Korea&rsquo, s integrated disaster management system. When a disaster occurs in the Republic of Korea, the Si/Gun/Gu Disaster Safety Measure Headquarters, under the command of the local governments, become the responsible agencies for disaster response while the central government supervises and controls the overall disaster support and disaster management. To improve the current disaster management system, we propose to incorporate all disaster types rather than dividing them by type into natural disasters and social disasters. To improve the disaster response and disaster management system, we propose to restructure the current administrative organization, revise the disaster-related laws, and overcome problems, such as inter-ministerial interconnectivity and overlapping regulation.

Purpose To evaluate the repeatability and reproducibility of the measurement of retinal arteriole pulse waveforms using a novel fully-automated Doppler optical coherence tomography (DOCT) flowmeter in healthy subjects. Methods Twenty eyes of 20 healthy subjects were included to test the intrasession repeatability of pulse waveform analysis. DOCT measurements were performed based on a newly developed instantaneous Doppler angle measurement method. Upstroke time (UT), which is the time from the minimum to the maximum retinal blood velocity, and the resistance index (RI) of the retinal arteriole pulse waveform were measured. Coefficients of variation (CVs) and intraclass correlation coefficients (ICCs) were calculated. Interdevice reproducibility between two instruments was assessed in five eyes of five subjects. Results The mean UT was 130.3 ms (range, 110.1-152.1 ms), and the mean RI was 0.66 (range, 0.51-0.82). The respective ICCs of UT and the RI for the intrasession repeatability of assessment were 0.87 and 0.78. The respective CVs of UT and the RI were 6.6 ± 3.3% and 4.7 ± 2.1%. Regarding interdevice reproducibility, there were no significant differences between the measurements derived from the instruments (P > 0.05). Conclusions Pulse waveform measurement in retinal arterioles using a fully-automated DOCT flowmeter exhibited good repeatability and interdevice reproducibility. Translational relevance The above-described improved DOCT flowmeter system provides reasonably repeatable measurements of retinal arteriole pulse waveforms, potentially facilitating systemic-circulation abnormality monitoring. The examination of the circulation with the novel device can be potentially useful for evaluating systemic circulation.

PURPOSE: To evaluate the ability of OCT optic nerve head (ONH) and macular parameters to detect disease progression in eyes with advanced structural glaucomatous damage of the circumpapillary retinal nerve fiber layer (cRNFL). DESIGN: Longitudinal study. PARTICIPANTS: Forty-four eyes from 37 subjects with advanced average cRNFL damage (≤60 μm) followed for an average period of 4.0 years. METHODS: All subjects were examined with spectral-domain optical coherence tomography (SD-OCT) and visual field (VF) during at least 4 visits. MAIN OUTCOME MEASUREMENTS: Visual field (VF) mean deviation (MD) and visual field index (VFI). OCT cRNFL (average, superior and inferior quadrants), ganglion cell/inner plexiform layer (GCIPL) (average, superior and inferior), rim area, cup volume, average cup-to-disc (C/D) ratio, vertical C/D ratio. RESULTS: At baseline, subjects had a median VF mean deviation (MD) of −10.18 dB and mean cRNFL of 54.55±3.42 μm. The rate of change for MD and VFI were significant. No significant rate of change was noted for cRNFL, while significant (p

To use a Doppler optical coherence tomography (DOCT) flowmeter to investigate segmental retinal blood flow (RBF) and sum of the segmental RBFs (SRBF) changes after panretinal photocoagulation (PRP) was used to treat type 2 diabetes mellitus with severe diabetic retinopathy (DR). Data from five patients with proliferative DR (PDR) (mean age 51.9 ± 10.5 years) was analyzed. The vessel diameter (D), average velocity (V), and retinal blood flow (RBF) in veins were measured using a DOCT flowmeter before and four weeks after PRP. Segmental RBF from inferotemporal (IT), superotemporal (ST), inferonasal (IN), and superonasal (SN) veins were measured, and SRBF was defined as the sum of these measurements. All data were analyzed by Wilcoxson test. After PRP, there were statistically significant decreases in the every segmental D, V, RBF (P0.05). The DOCT flowmeter has the potential to be a clinically useful tool to noninvasively evaluate the changes in retinal circulation during PRP in patients with PDR.

PURPOSE: Previously we introduced a state based two-dimensional continuous time hidden Markov model (2D CT-HMM) to model the pattern of glaucoma detected changes using structural and functional information simultaneously. The purpose of this study was to evaluate the glaucoma detected change prediction performance of the model in a real clinical setting using a retrospective longitudinal dataset. DESIGN: A longitudinal retrospective study SUBJECTS: One hundred thirty-four eyes from 134 subjects diagnosed as glaucoma or glaucoma suspect (average follow-up period 4.4 ± 1.2 years, average number of visits 7.1 ± 1.8 visits). METHODS: A 2D CT-HMM model was trained using optical coherence tomography (OCT; Cirrus HD-OCT, Zeiss, Dublin, CA) average circumpapillary retinal nerve fiber layer (cRNFL) thickness and visual field index (VFI) or mean deviation (MD) (Humphrey Field Analyzer, Zeiss, Dublin, CA). The model was trained using a subset of the data (107 out of 134 eyes, 80%) including all visits except for the last visit, which was used to test the prediction performance (training set). Additionally, the remaining 27 eyes were used for secondary performance testing as an independent group (validation set). The 2D CT-HMM predicts one out of 4 possible detected state changes based on one input state. MAIN OUTCOME MEASURES: Prediction accuracy was assessed as the percentage of correct prediction against the actual patients’ recorded state. In addition, deviations of the predicted long-term detected change paths from the actual detected change paths were measured. RESULTS: Baseline age was 61.9 ± 11.4 years (mean ± standard deviation), VFI was 90.7 ± 17.4, MD was −3.50 ± 6.04 dB, and cRNFL thickness was 74.9 ± 12.2 µm. The accuracy of glaucoma detected change prediction using the training set was comparable to the validation set (57.0% and 68.0%, respectively). Prediction deviation from the actual detected change path showed stability throughout patient follow-up. CONCLUSIONS: The 2D CT-HMM demonstrated promising glaucoma detected change prediction performance in a simulated clinical setting using an independent cohort. The 2D CT-HMM allows information from just one visit to predict at least 5 subsequent visits with similar performance.

オープンアクセス誌, Trapdoor fractures, or blowout fractures, result from muscle entrapment after orbital floor fractures. The incarcerated muscles may become necrotic because of ischemia; immediate surgery is recommended for symptomatic persistent diplopia or clinical evidence of entrapment. We report a case of spontaneous resolution of diplopia in a patient with a high suspicion of a trapdoor fracture. A 15-year-old girl presented with diplopia after being hit in the eye while playing volleyball. Computed tomography did not show a fractured orbital bone, but the forced duction test was positive when the left eye was pulled forward toward the left. Magnetic resonance imaging was negative for edema and inflammation in the extraocular muscles. With observation only, the diplopia resolved 2 weeks after onset. A negative forced duction test confirmed the resolution. Observation only may be appropriate in cases with posttraumatic limited ocular movement, after imaging has excluded an emergent condition.

Hydraulic Structure are inevitably set up and operated in the river that flow characteristics are complex. When designing the water surface elevation and velocity by using 1-D Hydraulic Model, it will not be able to reflect the characteristics of Lateral Eddy and Superelevation due to centrifugal force. This study compared with result of 1-D Hydraulic Model and Hydraulic Model Experiments, Through the model experiment of Sloping Drop Structure installed on Curved-Channel. Hydraulic Model was constructed to baekseok bridge and Shinchun Bridge about 210 m interval located in Uijeongbu, Gyeonggi-do. Result of Hydraulic Modeling observed data and 1-D Hydraulic Modeling date are compared to design flood 100 year and 20 year. Result of experiments are depth ovserved data 35~48% low then 1-D Hydraulic Modeling date and velocity ovserved data 135~167% large then 1-D Hydraulic Modeling date. Research reaults expect to basic information for Curved-Channel Characteristics on Sloping Drop Structure.

Purpose To characterize the morphology of neovascularization at the disc (NVD) and neovascularization elsewhere (NVE) in treatment-naive or previously treated proliferative diabetic retinopathy (PDR) patients using optical coherence tomography (OCT) angiography. Methods En face OCT angiograms of NVD/NVE in 40 eyes of 33 patients with PDR were acquired using RTVue XR Avanti OCT. The morphology of NVD/NVE on OCT angiograms was evaluated, and the activity was determined by biomicroscopy and fluorescein angiography (FA). In 12 eyes that were treated or treatment-naive, changes in the morphology and vessel area of NVD/NVE before and after panretinal photocoagulation (PRP) were investigated. Results Twenty eyes had treatment-naive PDR, whereas 20 eyes were previously treated with PRP. All treatment-naive NVD/NVE had remarkable (i.e., active) leakage in early-phase FA. Ninety-five percent of treatment-naive NVD/NVE observed by OCT angiography had exuberant vascular proliferation (EVP), identified as irregular proliferation of fine (smaller-caliber) new vessels; whereas, the presence of EVP in previously treated eyes (13/20) was significantly less than in treatment-naive eyes (65% vs. 95%, P = 0.043). The remaining seven treated eyes had pruned NVD/NVE without EVP, observed as fibrotic changes or faint (inactive) leakage in FA. The vessel areas of NVD/NVE significantly decreased following PRP (n = 12, P = 0.019), and NVD/NVE morphology showed pruning and decreased EVP. Conclusions Exuberant vascular proliferation on OCT angiograms should be considered as an active sign of neovascularization; therefore, morphologic evaluation of neovascularization using OCT angiography may be useful to estimate the activity of each neovascularization in eyes with PDR.

PURPOSE The visual outcome after vitrectomy for proliferative diabetic retinopathy (PDR) is often poor. Bilateral vitrectomy has been especially associated with a poor visual prognosis in patients with PDR. The authors investigated the systemic risk factors for PDR requiring bilateral vitrectomy compared with unilateral vitrectomy. METHODS The authors retrospectively reviewed 86 consecutive patients with Type 2 diabetes mellitus with PDR who underwent vitrectomy. These patients were divided into 2 groups: bilateral vitrectomy within 1 year (n = 25) and unilateral vitrectomy (n = 61). The authors compared the systemic risk factors: age, sex, duration of diabetes, hemoglobin A1c, body mass index, estimated glomerular filtration rate, uric albumin, hypertension, dyslipidemia, history of ischemic heart disease, arteriosclerosis obliterans, and smoking. RESULTS There were significantly more cases with severe renal dysfunction in the bilateral vitrectomy group compared with the unilateral one (estimated glomerular filtration rate

PURPOSE: To investigate how glial cells participate in retinal circulation during flicker stimulation in cats. METHODS: Using laser Doppler velocimetry, we measured the vessel diameter and blood velocity simultaneously and calculated the retinal blood flow (RBF) in feline first-order retinal arterioles. Twenty-four hours after intravitreal injections of L-2-aminoadipic acid (LAA), a gliotoxic compound, and the solvent of 0.01 N hydrochloric acid as a control, we examined the changes in RBF in response to 16-Hz flicker stimulation for 3 minutes. We also measured the changes in RBF 2 hours after intravitreal injection of Nω-propyl-L-arginine (L-NPA), a selective neuronal nitric oxide synthase inhibitor, in LAA-treated eyes. To evaluate the effects of LAA on retinal neuronal function, ERGs were monitored. Immunohistochemical examinations were performed. RESULTS: In LAA-treated eyes, histologic changes selectively occurred in retinal glial cells. There were no significant reductions in amplitude or elongation of implicit time in ERG after LAA injections compared with controls. In control eyes, the RBF gradually increased and reached the maximal level (53.5% ± 2.5% increase from baseline) after 2 to 3 minutes of flicker stimulation. In LAA-treated eyes, the increases in RBF during flicker stimulation were attenuated significantly compared with controls. In LAA-treated eyes 2 hours after injection of L-NPA, flicker-evoked increases in RBF decreased significantly compared with LAA-treated eyes. CONCLUSIONS: The current results suggested that increases in RBF in response to flicker stimulation were regulated partly by retinal glial cells.

Purpose To evaluate the repeatability and reproducibility of retinal blood flow (RBF) measurements in humans by using new auto-alignment and measurement software in a commercially available Doppler optical coherence tomography (DOCT) system. Methods The DOCT flowmeter assessed the intrasession repeatability and the intersession and interobserver reproducibility of the RBF measurements. For intrasession repeatability, the coefficients of variation (CVs) of five repeated RBF measurements were calculated at the retinal arteries and veins in 20 normal eyes of 20 healthy volunteers. For intersession reproducibility, two sets of three measurements obtained by one observer on 2 different days were compared. For interobserver reproducibility, two sets of three measurements obtained by two observers on the same day were compared. Intraclass correlation coefficients (ICCs) also were used to evaluate the repeatability and reproducibility. The relevance of the DOCT flowmeter and laser Doppler velocimetry (LDV) also was assessed. Results Regarding intrasession repeatability, the ICC of the RBF exceeded 0.90 in arterioles and venules (ICC: 0.994 and 0.970, respectively). The CVs of the RBF in the arterioles and venules were 6.0% ± 3.4% and 8.8% ± 5.1%, respectively. The intersession and interobserver RBF values had high reproducibility in the arterioles (ICC: 0.980 and 0.993, respectively) and venules (ICC: 0.982 and 0.986, respectively). The RBF measured with the DOCT flowmeter was correlated strongly with LDV in the arterioles (r = 0.76; P < 0.001). Conclusions The DOCT flowmeter had good reproducibility in the arterioles and venules and precisely measured the RBF as compared to the LDV in the arterioles.

Ligneous conjunctivitis is a rare severe conjunctivitis characterised by fibrin-rich, ‘woody’, pseudomembranes on the tarsal conjunctiva complicated by congenital hypoplasminogenaemia. A previous report suggested that ligneous conjunctivitis may result from tranexamic acid (TA)-induced ‘secondary’ hypoplasminogenaemia. However, the serum plasminogen level has not been confirmed in that scenario. We report for the first time a case of TA-induced ligneous conjunctivitis with reversible hypoplasminogenaemia. A 70-year-old woman developed a gastric ulcer that was treated with oral TA. After 5 weeks of treatment, the patient presented with bilateral pale yellow pseudomembranes on the palpebral conjunctivae. Haematological analysis showed hypoplasminogenaemia. We diagnosed ligneous conjunctivitis. TA was discontinued after 14 weeks after the gastric ulcer symptoms resolved. Six weeks after discontinuation of therapy, the pseudomembranes regressed and the serum plasminogen level returned to the normal range. TA should be considered a possible aetiology in the setting of unresolving ligneous conjunctivitis.

We report a case of hypertensive choroidopathy with detailed retinal images obtained using spectral-domain optical coherence tomography (SD-OCT).A 19-year-old pregnant woman with no history of high blood pressure had an eclamptic seizure at the 39th week of pregnancy; the baby was delivered by emergency Caesarean section. Six days later, she presented with bilateral blurred vision (best-corrected visual acuity [VA], 0.5, right eye; 0.3, left eye). Bilateral extensive, punctate, pale-yellow Elschnig's spots were present in the posterior fundus. SD-OCT showed a serous retinal detachment (SRD) and retinal pigment epithelium detachment (PED) representing a waveform retinal pigment epithelium (RPE) layer in each eye. The reflective intensity decreased partly at the waveform RPE. A wavy structure suggestive of fibrin was present in both foveas between the photoreceptor ellipsoid zone and the RPE-outer segment line. Four weeks after delivery and oral antihypertensive treatment, the SRDs, PEDs and wavy structure resolved and the VA recovered.SD-OCT visualized SRDs, PEDs, wavy structures under the photoreceptor ellipsoid zone, and areas of low intensity RPE layer in hypertensive choroidopathy.

Blood banking has a broad public health impact influencing millions of lives daily. It could potentially benefit from emerging biopreservation technologies. However, although vitrification has shown advantages over traditional cryopreservation techniques, it has not been incorporated into transfusion medicine mainly due to throughput challenges. Here, we present a scalable method that can vitrify red blood cells in microdroplets. This approach enables the vitrification of large volumes of blood in a short amount of time, and makes it a viable and scalable biotechnology tool for blood cryopreservation., National Institutes of Health (U.S.) (NIH R21 EB007707), Wallace H. Coulter Foundation, United States. Army Medical Research and Materiel Command (Acquisition Activity Cooperative Agreement RO1 A1081534), Center for Integration of Medicine and Innovative Technology, United States. Army Medical Research and Materiel Command (Acquisition Activity Cooperative Agreement R21 AI087107), United States. Army. Telemedicine & Advanced Technology Research Center