Surgical Approaches to Serous Retinal Detachment With Retina-Lens Touch in Eyes With Nanophthalmos.

Purpose:To describe the visual outcomes and problems that resulted from surgical treatment of nanophthalmic complete retinal detachment (RD) with retina-lens contact. Methods: A multicenter retrospective case series with deep sclerectomy as a treatment was performed. Results: Five cases had extensive deep sclerectomies, 3 with intended drainage of subretinal fluid (SRF). The RD resolved 1 week postoperatively in 4 cases and within 1 month in 1 case. The visual acuity improved from light perception to a median of 20/100. Three cases had longstanding lens touch beyond 1 year and improved VA to 20/100, 20/150, and hand motions, respectively. Complications included focal lens dialysis in 2 cases (passive drainage of SRF) and lens or intraocular lens dislocation in 1 case each (active drainage of SRF). Ultrasound biomicroscopy and anterior optical coherence tomography showed a very narrow angle and short zonules. Conclusions: Deep sclerectomy results in good anatomic and functional improvements in advanced cases of nanophthalmos exudative detachment, which is often considered to be incurable.

Prepapillary vascular loop-a new classification.

BACKGROUND/OBJECTIVES: To analyze the ophthalmic characteristics of congenital prepapillary vascular loop (PVL) and to propose a new morphologic classification dividing the loops into six types. SUBJECTS/METHODS: Collaborative multinational multicentre retrospective study of PVL cases. RESULTS: There was a total of 49 cases (61 eyes), 37 unilateral (75.5%) and 12 bilateral (24.5%), 32 arterial type (65.3%) and 18 venous type (36.7%) (one patient had either kind in each eye). The mean number of loops per eye was 2.7 (range, 1-7). The loops were asymptomatic in 42 cases (85.7%). Other findings included: the presence of cilioretinal artery (14 cases), retinal vascular tortuosity (26 cases), amaurosis fugax (1 case), branch retinal artery occlusion (1 case) and vitreous haemorrhage (3 cases). Six morphologic loop types could be discerned based on elevation (flat vs. elevated), shape (figure of 8 or corkscrew with hyaline sheath), number (multiple or single), location (central or peripheral), lumen size (arterial vs. arteriolar) and presence of vascular tortuosity or vitreous traction. CONCLUSIONS: PVL are usually asymptomatic and can be divided into six morphologic types with different pathogenesis during early embryogenesis.

A Pathogenetic Classification of Diabetic Macular Edema.

PURPOSE: The aim of this study was to define a new pathogenetic classification of diabetic macular edema (DME) and to present the results of its application in common clinical practice. METHODS: One hundred and seventy-seven consecutive patients with center-involving DME, central retinal thickness (CRT) ≥250 µm, were prospectively enrolled. A complete ophthalmological examination included best-corrected visual acuity (BCVA) assessment, fundus photography, and spectral-domain optical coherence tomography (OCT). The DME classification was broken down into 4 categories, combining the presence of retinal thickening with the presence/absence of visible vascular dilations and OCT-detectable macular traction. The OCT parameters included were as follows: CRT, subretinal fluid, intraretinal cysts, and hyper- reflective foci (HF). RESULTS: Four subtypes of DME were identified: vasogenic (131 eyes, DME with vascular dilation), nonvasogenic (46 eyes, DME without vascular dilation), tractional (11 eyes), and mixed DME (13 eyes). Vasogenic DME was the pattern mainly represented in each subclass of CRT (< 300, 300-400, and > 400 µm), with tractional DME observed especially with CRT > 400 µm. Internal and external cysts and a greater presence of hard exudates were predominantly found in vasogenic DME, whereas HF was equally distributed in the 4 DME subgroups. CONCLUSION: The study offers a new pathogenetic classification able to detect significant differences among DME subtypes. A tailored therapeutic approach could take into consideration specific changes associated with the different DME subtypes.

Magma transfer at Campi Flegrei caldera (Italy) before the 1538 AD eruption.

Calderas are collapse structures related to the emptying of magmatic reservoirs, often associated with large eruptions from long-lived magmatic systems. Understanding how magma is transferred from a magma reservoir to the surface before eruptions is a major challenge. Here we exploit the historical, archaeological and geological record of Campi Flegrei caldera to estimate the surface deformation preceding the Monte Nuovo eruption and investigate the shallow magma transfer. Our data suggest a progressive magma accumulation from ~1251 to 1536 in a 4.6 ± 0.9 km deep source below the caldera centre, and its transfer, between 1536 and 1538, to a 3.8 ± 0.6 km deep magmatic source ~4 km NW of the caldera centre, below Monte Nuovo; this peripheral source fed the eruption through a shallower source, 0.4 ± 0.3 km deep. This is the first reconstruction of pre-eruptive magma transfer at Campi Flegrei and corroborates the existence of a stationary oblate source, below the caldera centre, that has been feeding lateral eruptions for the last ~5 ka. Our results suggest: 1) repeated emplacement of magma through intrusions below the caldera centre; 2) occasional lateral transfer of magma feeding non-central eruptions within the caldera. Comparison with historical unrest at calderas worldwide suggests that this behavior is common.

Shifts in the eruptive styles at Stromboli in 2010-2014 revealed by ground-based InSAR data.

Ground-Based Interferometric Synthetic Aperture Radar (GBInSAR) is an efficient technique for capturing short, subtle episodes of conduit pressurization in open vent volcanoes like Stromboli (Italy), because it can detect very shallow magma storage, which is difficult to identify using other methods. This technique allows the user to choose the optimal radar location for measuring the most significant deformation signal, provides an exceptional geometrical resolution, and allows for continuous monitoring of the deformation. Here, we present and model ground displacements collected at Stromboli by GBInSAR from January 2010 to August 2014. During this period, the volcano experienced several episodes of intense volcanic activity, culminated in the effusive flank eruption of August 2014. Modelling of the deformation allowed us to estimate a source depth of 482 ± 46 m a.s.l. The cumulative volume change was 4.7 ± 2.6 × 10(5) m(3). The strain energy of the source was evaluated 3-5 times higher than the surface energy needed to open the 6-7 August eruptive fissure. The analysis proposed here can help forecast shifts in the eruptive style and especially the onset of flank eruptions at Stromboli and at similar volcanic systems (e.g. Etna, Piton de La Fournaise, Kilauea).