New Method of Quantitative Analysis of Hard Exudate Using Optical Coherence Tomography: Application in Diabetic Macular Edema

PURPOSE: In the present study, the volume of hard exudates (HEs) was quantitatively measured using optical coherence tomography (OCT) and the agreement and correlation with area of HEs in fundus photography were analyzed. METHODS: The medical records of patients with diabetic macular edema who underwent focal laser treatment and were followed up more than 3 months were retrospectively evaluated. An automated customized program designed for measuring HE volume was used. The HEs in each OCT B-scan binary image were measured using 512 × 128 pixels, 6 mm × 6 mm OCT cube scans. The volume was measured by summing the segmented HEs in each 128 B-scan image. The area was measured in 6 mm x 6 mm fundus photography. The volume and area were measured before and 3 months after the treatment. The agreement of increase and decrease in HEs, and the correlation of volume and area of HEs were analyzed. RESULTS: A total of 35 patients (39 eyes) were included in the study. The volume was significantly reduced from 0.07978 to 0.02565 mm³ at 3 months (p < 0.001). The area was also significantly reduced from 15.35 to 8.60 mm² at 3 months (p < 0.001). The volume was decreased in 34 eyes and increased in 5 eyes. The area was decreased in 37 eyes and increased in 2 eyes. A significant correlation between volume and area was found (p < 0.001) as well as agreement between increase and decrease in volume and area. CONCLUSIONS: In the 3-dimensional quantitative volumetric analysis, the volume and area of HEs were correlated and the direction of increase and decrease was concordant. Considering the distribution of HEs in multiple layers of the retina, volumetric analysis could be considered a substitute for the analysis of HE area.

Case Profile, Volume Analysis, and Dropout Rate of Antirabies Vaccination Regimens among Animal Bite Victims in Gujarat.

Background: Rabies is a preventable neglected public health problem and associated with multiple cultural, religious, and social practices, myths in our country. There is a lack of organized surveillance system to measure the incidence of animal bite and human rabies as well as to evaluate cost‑saving of different routes, regimen, and types of antirabies vaccines (ARV)/immunoglobulin available in India. Objectives: The objective of this study is to know dropout rate in intradermal (i.d.) ARV regimen among animal bite and to analyze the utilized volume of ARV by a different route of vaccine administration. Methods: A total of 250 animal bite victims were followed up at ARV Clinic (ARVC). Volume utilization of i.d. route over intramuscular (i.m.) route was analyzed among the patients who attended ARVC during the past 2 years. Total dropout and delayed compliance rates of ARV regimen among different group were compared by Chi‑square test. Results: The i.d. route was about five times more volume and cost‑saving than i.m. route. The majority of victims belonged to 15–30 years (27.60%) and children <15 years (26.40%) and had wound at their lower limbs (85%) mainly bitten by dogs (98%). Thirty‑four percent total dropout and 31.5% delayed compliance observed particularly during the last dose of i.d. regimen. There was no significant difference in dropout rates among different demographic groups. Half of the victims practiced wound toilet on the same day of bite. Only 68% received the first dose of ARV within 24 h of the exposure. Conclusion: Children and young adults are at higher risk of having dog bite. I.d. ARV regimen is more volume and cost‑saving than i.m. one and proper counseling and follow‑up should be arranged to complete the vaccination schedule.

Three-Dimensional Volume Analysis of Partial Avascular Necrosis after Talar Neck Fracture / 대한족부족관절학회지

PURPOSE: The purpose of this study is to define the geographic patterns of partial avascular necrosis (AVN) of the talar body and to determine whether there were any predictors of both the location and occurrence of partial AVN. MATERIALS AND METHODS: Nineteen patients with fracture of the talar neck treated by open reduction and internal fixation and followed up for more than 1 year were analyzed. The radiographs were examined 6 to 8 weeks after the operation for Hawkins sign and if it was not observed, magnetic resonance scans were performed. The three-dimensional analysis was performed using Mimics 17.0 (Materialise). The incidence of collapse and time to operative intervention was recorded. RESULTS: Partial AVN of the talar body was observed in six out of 19 patients. The avascular segment of the talar body was located predominantly in the anterolateral portion. The average volume of the avascular segment was 289 mm3, and it occupied 1% of total volume of the talus, and 10% of the talar dome. Collapse occurred in one patient in the area of the avascular process. There were no observable trends with regard to Hawkins classification, incidence of collapse, or time to operative intervention to the location of the avascular segment. CONCLUSION: Partial AVN can occur after fracture of the talar neck. The predominant location of the avascular segment was the anterolateral portion of the talar body. This information may be helpful to understanding the process of avascular necrosis of the talar body.