Retinal structural and microvascular deterioration independent of optic neuritis in aquaporin-4 antibody-positive neuromyelitis optica spectrum disorders: An optical coherence tomography angiography study.

PURPOSE: To assess the retinal structural and microvascular change in aquaporin-4 antibody (AQP4) positive neuromyelitis optica spectrum disorder (NMOSD) patients and the correlation with clinical features. METHODS: A cross-sectional study was performed with optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) to measure retinal structure and microvascular parameters in AQP4 positive NMOSD patients. RESULTS: Sixty-two NMOSD patients (44 eyes with ON, NMOSD+ON; 77 eyes without ON, NMOSD-ON) and 62 healthy controls (HC, 124 eyes) were included. BCVA was worse in NMOSD patients compared to HC (p<0.001). Peripapillary retinal nerve fiber layer (pRNFL, p<0.001) and ganglion cell complex (GCC, p<0.001) was thinner in NMOSD+ON eyes compared to NMOSD-ON eyes and HC. Compared to HC, pRNFL (p = 0.002) and GCC (p = 0.001) was thinner in NMOSD-ON eyes. The vessel density (VD) in superficial capillary plexus (SCP, NMOSD+ON vs HC p<0.001, NMOSD-ON vs HC p = 0.002) and radial peripapillary capillary (RPC, NMOSD+ON vs HC p<0.001, NMOSD-ON vs HC p = 0.001) were also lower in NMOSD patients than HC independent of the history of ON. ON frequency and BCVA were correlated with the thickness of pRNFL and GCC, and VD in SCP and RPC (all p<0.001). EDSS was correlated with thickness of GCC (p = 0.008), and VD in SCP (p = 0.013), DCP (p<0.001) and RPC (p = 0.009). CONCLUSIONS: Subclinical degradation of retinal structure and microvasculature was found in NMOSD patients before the occurrence of ON, and was correlated with clinical disability. Retinal parameter might be a tool to estimate the disease progression and investigate the pathogenesis of NMOSD.

Using the inherent elements in yeast biomass to produce Ni2P/N-doped biocarbon composites for efficient hexavalent chromium reduction.

The heterogeneous catalytic reduction of Cr(VI) to Cr(III) is an effective strategy for aqueous Cr(VI) contamination abatement, which requires the development of highly efficient, low-cost, and recyclable catalysts. Herein, Ni2P/N-doped biocarbon composites (Ni2P/N-BC) were fabricated through an anoxic pyrolysis process using NaCl and KCl as activators. A precursor of yeast biomass provided the essential C, N, and P elements for Ni2P/N-BC formation. When adopted for Cr(VI) reduction in the presence of oxalic acid as a reductant, the fabricated Ni2P/N-BC performed superior catalytic activity with a 100% Cr(VI) reduction efficiency within 10 min (Ni2P/N-BC-5 = 0.2 g L-1, oxalic acid = 0.4 g L-1, Cr(VI) = 20 mg L-1). Typical affecting parameters, e.g., catalyst dosage, oxalic acid loading, reaction temperature, initial solution pH, and water matrix, were investigated. Ni2P/N-BC exhibited good applicability in a broad pH range from 3.0 to 9.0 and in actual aquatic systems. Cr(VI) reduction efficiency remained 92.7% after five recycle runs. Such promising catalytic activity may originate from the well-crystallized Ni2P, N-doped biocarbon framework and high specific surface area of the materials. Preliminary reaction mechanism analysis indicated that the favorable charge state of Ni2P, fast hydrogen transfer, affinity of oxalic acid to Cr(VI), and inherent electron transfer in the biocarbon matrix contributed to effective Cr(VI) reduction. This work not only provides a facile and low-cost strategy to construct Ni2P/N-doped biocarbon nanosheet composite using environmentally benign biomass but also brings new insights for the remediation of Cr(VI) contamination.

New retinal findings in NLRP3-associated autoinflammatory disease.

PURPOSE: To determine whether the rare NLRP3-Associated Autoinflammatory Disease (NLRP3-AID) is associated with retinal changes and to assess the ocular involvement. METHODS: A retrospective cohort study of 20 patients(40 eyes) diagnosed with rare NLRP3-AID at Peking Union Medical College Hospital, from April 2015 to August 2022. Patients underwent a comprehensive ophthalmological examination, including visual acuity, intraocular pressure examination, slit-lamp examination, fundus photography, optical coherence tomography(OCT), and fluorescence angiography (FA). Some patients also underwent optical coherence tomography angiography (OCTA). RESULTS: This study analyzed 40 eyes of 20 patients (11 [55.0%] male; median age, 25.0 years [range, 12-52 years]) and 13 patients (26 eyes, 65%) demonstrated ocular involvement. The most common ophthalmologic manifestation was conjunctivitis (22 eyes, 84.6%), followed by papilledema (14 eyes, 53.8%), retinopathy (10 eyes, 38.5%), optic atrophy (6 eyes, 23.1%), uveitis (4 eyes, 15.4%), reduced pupil light reflex (3 eyes, 11.5%) and cataracts (2 eyes, 7.7%). Ocular involvement was bilateral in 11 patients (55.0%). Five kinds of retinal lesions were seen in 5 patients (10 eyes, 25%) with NLRP3-AID, including peripheral retinal vascular leakage, microaneurysms, macular ischemia, macular epiretinal membrane formation and drusen. CONCLUSIONS: Peripheral retinal vascular leakage, macular ischemia, microaneurysms and drusen are newly identified retinal findings in patients with NLRP3-AID, which suggests the importance of detailed retinal examination in these patients.

Significant retinal microvascular impairments in multiple sclerosis assessed through optical coherence tomography angiography.

PURPOSE: Multiple sclerosis (MS) is associated with different ocular disorders. This study aimed to investigate the retinal microvascular changes detected by optical coherence tomography angiography (OCTA) in eyes with MS with or without a history of optic neuritis (ON). METHODS: A comprehensive literature search was conducted in the Web of Science, Embase, PubMed, and Cochrane Library databases on September 26, 2021 for articles focused on OCTA manifestations in the eyes of MS patients compared with healthy controls. RevMan Manager (v.5.4) and Stata (v.14.1) were used to analyze the main differences and publication risks. Weighted mean differences and 95% confidence intervals were calculated for continuous estimates. This study also included subgroup analysis between three groups: eyes with multiple sclerosis and with optic neuritis (MSON); eyes with multiple sclerosis and without optic neuritis (MSNON); and healthy controls. RESULTS: Thirteen studies with a total of 1803 eyes were identified, including 957 eyes with MS and 846 eyes of healthy controls. The vessel density of the MS eyes decreased significantly in most areas of the radial peripapillary capillary. A marked reduction in the macular superficial capillary plexus of MS eyes regardless of ON history was also confirmed. CONCLUSION: The results suggest that MS patients demonstrated significant retinal microvasculature impairment regardless of ON history, compared to healthy controls. Retinal vessel density attenuation detected by OCTA may serve as a reliable early marker of MS.

An FeP/carbon composite derived from a phytic acid-Fe3+ complex for sulfathiazole degradation through peroxymonosulfate activation.

Peroxymonosulfate (PMS) activation-based advanced oxidation technology possesses great potential for antibiotic-containing wastewater treatment. Herein, we developed an iron phosphide/carbon composite and verified its capability and superiority towards a model antibiotic pollutant (sulfathiazole, STZ) degradation through PMS activation. Benefiting from the chelating ability of phytic acid (PA) with metal ions and its abundance on phosphorous element, a PA-Fe3+ complex was firstly formed and then served as sole precursor for iron phosphide formation by anoxic pyrolysis. Well crystalized FeP particle were found loading on the simultaneously formed thin layer carbon structure. Catalytic activity evaluation showed that FeP/carbon composite could remove over 99% of STZ (20 mg L-1) in 20 min adsorption and 30 min catalysis process under the reaction conditions of catalyst dosage 0.2 g L-1, PMS loading 0.15 g L-1. A pseudo-first-order reaction rate constant of 0.2193 min-1 was obtained, which was among the highest compared with reported studies. Further investigations indicated that the developed FeP/carbon composite worked well in a wide solution pH range of 3-9. Reaction mechanism study showed that reactive species of SO4-• and 1O2 generated from PMS activation played major roles for STZ degradation. Based on liquid chromatography-mass spectroscopy (LC-MS) analysis, a few STZ degradation intermediate products were identified, which facilitated the proposal of STZ degradation pathways. The possible ecological risk of STZ and related degradation intermediates were also considered by toxicity assessment using the Ecological Structure Activity Relationships (ECOSAR) Class Program. The obtained acute and chronic toxicity values implied the relatively low ecological risk of FeP/carbon-PMS reaction system for STZ treatment.

Early Retinal Microcirculation in Nonfunctioning Pituitary Adenomas Without Visual Field Defects Using Optical Coherence Tomography Angiography.

BACKGROUND: For patients with nonfunctioning pituitary adenoma (NFPA) without manifesting visual acuity impairment or visual field defect (VFD), more sensitive and objective assessment methods will allow earlier detection before irreversible damage to the visual system. This study aimed to evaluate retinal vessel densities (VDs) alterations in these patients using optical coherence tomography angiography and to determine its diagnostic abilities. METHODS: Between patients with NFPA without VFDs and age-matched, sex-matched healthy control individuals, comparisons of visual field metrics, retinal structural thickness, and microcirculation were conducted after adjusting for axial length (AL) and signal index of scans. Receiver operating characteristic (ROC) curves were further depicted to assess the diagnostic performance of significant parameters. To explore the impact of symptom duration, tumor size, and axial length on the significant parameters, multivariate regression analysis was conducted. RESULTS: This cross-sectional study reviewed 107 patients with NFPA. Twenty-seven eyes of patients with NFPA without VFDs and 27 eyes of healthy controls were enrolled. Compared with healthy controls, patients with NFPA without VFDs had similar foveal avascular zone areas and perimeters, macular ganglion cell complex (mGCC) and peripapillary retinal nerve fiber layer thicknesses, and macular VDs. Only the VD in the radial peripapillary capillary (RPC) segment of the inferior temporal (IT) sector was much lower in the patient group. The 2 largest area under the ROC curves were the focal loss volume (FLV) of the mGCC and the VD in the RPC of the IT sector, both of which were significantly related to symptom duration and tumor size. CONCLUSIONS: At the early stage of NFPA before VFD and retinal thickness thinning, fundus microcirculation impairments may occur initially in the microvascular density of the RPC segment of the IT sector. The FLV and the VD of RPC at the IT sector may provide a basis for the early diagnosis of NFPA without VFD in clinical practice.

Tributyl phosphate degradation and phosphorus immobilization by MnO2: Reaction condition optimization and mechanism exploration.

The treatment of tributyl phosphate (TBP) extractant waste from specific industry, eg., nuclear industry, is a great challenge due to its stability and high environmental risk of phosphorus-containing species releasing. Inspired by chemical looping combustion (CLC) technology, a MnO2-assisted thermal oxidation strategy is proposed for TBP degradation and simultaneously P immobilization. Under recommended reaction conditions of 220 °C, 10 g MnO2 mL-1 TBP and 3 h reaction duration, a high P immobilization efficiency of 93.99% is achieved. Material characterization results indicate that P is mainly immobilized in the form of Mn2P2O7, which greatly reduces the environmental risk of P-containing species. TBP degradation intermediates are further identified by thermogravimetric-gas chromatography-mass spectrometry (TG-GC-MS), liquid chromatography-mass spectrometry (LC-MS) and gas chromatography-mass spectrometry (GC-MS), which facilitates understanding of reaction mechanisms as well as proposing possible pathways of TBP degradation. It is suggested that MnO2 provides essential oxygen as oxygen carrier for flameless combustion. Meantime, MnO2 reduction leads to the generation of Mn(III) species. The existence of oxygen vacancy in MnO2 also facilitates •O2- radical generation. Under flameless combustion and attacks of Mn(III) and •O2-, TBP is firstly degraded into intermediates and finally mineralized into CO2 and H2O, while P is mainly immobilized as pyrophosphate.

Retinal Microvascular Alterations Detected by Optical Coherence Tomography Angiography in Nonfunctioning Pituitary Adenomas.

Purpose: Visual impairment assessment plays a significant role in diagnosis and clinical decisions in nonfunctioning pituitary adenoma (NFPA). Retinal microvascular alterations may potentially reflect the visual impairment. The purpose of this study was to evaluate fundus microvascular alterations in patients with NFPA. Methods: Comparisons of visual field, retinal structure, and microcirculation were conducted between patients with NFPA and age- and sex-matched healthy controls. Multivariate regression modeling was used to assess the relationship between symptom duration, sellar mass size, and fundus vessel density (VD) of patients. Receiver operating characteristic (ROC) curves were depicted to determine the diagnostic performance of significant parameters to discriminate eyes with NFPA from healthy eyes. Results: Forty eyes of patients and 40 eyes of healthy individuals were enrolled. Compared to healthy controls, patients with NFPA had a larger foveal avascular zone area and thinner ganglion cell complex thickness. The VDs of patients presented an obvious decrease in radial peripapillary capillary (RPC) and an increase in the deep capillary plexus segment of the perifoveal area. The peripapillary VDs of patients were significantly related to sellar mass size. The area under the ROC curve of VD in the RPC segment of the temporo-inferior sector was the largest (0.801; 95% confidence interval, 0.70-0.90; P < 0.001). Conclusions: The fundus of patients with NFPA demonstrated significant and characteristic microvascular impairments. The VDs were also significantly associated with sellar mass size. Translational Relevance: Retinal microvascular alterations detected by optical coherence tomography angiography are characteristic and related to sellar mass size, which may provide information that facilitates the diagnosis of NFPA.

Mechanism of efficient remediation of U(VI) using biogenic CMC-FeS complex produced by sulfate-reducing bacteria.

Uranium in groundwater during uranium mining activities urgently needs to be remediated through effective and environmental-friendly approaches. The reduction and immobilization of soluble U(VI) using biogenic carboxymethyl cellulose modified iron sulfide complex (biogenic CMC-FeS complex) is one of the emerging and innovative methods. However, its removal mechanism is largely unknown. Here, biogenic CMC-FeS complex with extracellular polymeric substances (EPS) and CMC was successfully synthesized by sulfate-reducing bacteria (SRB) and showed highly dispersible capacity. The tryptophan and tyrosine, which were the main components in EPS produced by SRB on CMC-FeS surface, significantly increased the U(VI) removal capacity of the biogenic CMC-FeS complex compared with chemically synthesized CMC-FeS. U(VI) removal was attributed to the adsorption of soluble U(VI) by ≡FeO+, CMC, tryptophan, and tyrosine on the biogenic CMC-FeS complex, following its reduction by S2-, S22- and Fe2+. Moreover, biogenic CMC-FeS complex with CMC-to-FeS molar ratio of 0.0005 performed well in the presence of bicarbonate (5 mM), humic acid (10 mg/L), or co-existing cations such as Pb2+, Ni2+, Cd2+, Mn2+, and Cu2+ (200 ug/L) at pH 7.0, and displayed relatively high oxidation resistance and stability ability. This work provides an in-depth understanding of the biogenic CMC-FeS complex for the U(VI) removal and contributes to the development of cost-effective U(VI) remediation technologies.

Observation of fundus and optical coherence tomography angiography manifestations in carotid cavernous fistula patients.

PURPOSE: This study aimed to investigate fundus and optical coherence tomography angiography (angio-OCT) manifestations in carotid cavernous fistula (CCF) patients. METHODS: Nine eyes of 7 CCF patients diagnosed with digital subtraction angiography (DSA) were included in this study. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), slit lamp, fundus, spectral-domain optical coherence tomography (SD-OCT), and optical coherence tomography angiography (angio-OCT) examination in the CCF patients and 10 normal controls were conducted. Subfoveal choroidal thickness (SFCT) and macular vascular density (VD) were measured and compared with the control group. SFCT and VD were also compared before and after embolization therapy. RESULTS: Two male and 5 female CCF patients were included. The average age was 59.7 ±10.0 (years). Embolization therapy was conducted in 3 patients. Fundus manifestations included disc oedema and exudation, retinal venular dilation, and retinal haemorrhage. B-scan OCT examination revealed retinal and choroidal undulations, retinal-choroidal thickness, retinal cystoid oedema, and subretinal fluid. The SFCT of the affected eyes was thicker than that of the control group (412.3 ± 123.7 µm vs. 272.9 ± 62.9 µm; P = 0.006). Macular superficial capillary plexus (SCP) VD in affected eyes was lower than that in the control eyes (50.1 ±2.3 % vs. 52.7 ± 1.7 % ; P = 0.014). The SFCT was reduced, and the vessel density in the SCP was increased after embolization therapy. CONCLUSION: We demonstrated decreased VD in CCF patients with specific fundus and OCT manifestations. The pathological changes were immediately reduced after embolization therapy. This preliminary observation provides a supplemental method for the diagnosis and pathophysiological examination of CCF patients.

Clinical and pathological features of 124 patients with indistinguishable sellar lesions and central diabetes insipidus.

BACKGROUND: Sellar lesions with central diabetes insipidus have a wide range of causes, and diagnosis is relatively difficult. The indication and clinical value of biopsy are still controversial. OBJECTIVE: To describe the etiology, demographic characteristics, manifestations, laboratory tests and imaging findings of this disease and to explore the clinical value and safety of endoscopic transsphenoidal biopsy. METHODS: Retrospective analysis of 124 patients with sellar lesions and central diabetes insipidus who underwent endoscopic transsphenoidal biopsy at the Neurosurgery Department, Peking Union Medical College Hospital, from 2011 to 2019. RESULTS: The main etiology includes congenital diseases, inflammatory/infectious diseases and tumor diseases. The most common diseases were germ cell tumors, Langerhans cell histiocytosis, lymphocytic hypophysitis, and Rathke's cleft cysts. Except for the age at the time of biopsy of patients with tumor diseases, which was significantly lower than that of the other two, the other clinical manifestations of the three types of diseases were not significantly different. Among the 124 patients, biopsy was performed via an endoscopic transsphenoidal approach for 101 with intrasellarly available lesions or via an endoscopic extended transsphenoidal approach for 23 with intrasellarly unavailable lesions. 6 patients had central nervous system infections after surgery, and 3 had cerebrospinal fluid rhinorrhea, of which 2 were surgically repaired. These incidences were basically the same as those of classic surgery. 2 patients had worse visual acuity, 2 had worse visual field, and 2 had worse eye movement. Excepting one patient, all of whom have recovered after treatment. CONCLUSIONS: Noninvasive examination is difficult for identifying the common causes of this type of disease. Endoscopic transsphenoidal biopsy is relatively safe and effective, helps doctors to select the best treatment for patients, and is worth promoting.

Prevalence and risk factors of myopia in Han and Yugur older adults in Gansu, China: a cross-sectional study.

Few studies have investigated the prevalence of myopia in Northwest China. This cross-sectional study aimed to investigate the prevalence and associated factors of myopia and high myopia in adults aged 40-80 years in the Han and Yugur populations living in Gansu Province, Northwest China. A total of 3,845 participants were included. The overall age- and sex-adjusted prevalence of myopia (spherical equivalent (SE) < -0.5 D), high myopia (SE < -6.0 D) and hyperopia (SE > + 0.5 D) were 16.4%, 0.7% and 26.2% in Yugur participants, respectively, and 34.3%, 5.0% and 19.2% in Han participants, respectively. The prevalence of myopia and high myopia in Han participants was significantly higher than that in Yugur participants (both P < 0.001). Yugur population, birth in rural areas, smoking history and outdoor work were found to be negatively associated with myopia. Higher education level and a family history of myopia were found to be positively associated with myopia in the study population. High myopia was negatively associated with Yugur population, aging, birth in rural areas and was positively associated with a family history of myopia. This study provided valuable information regarding the environmental risk factors of myopia and revealed an ethnic disparity in the prevalence of myopia in Gansu Province, Northwest China.

Molten salt induced nitrogen-doped biochar nanosheets as highly efficient peroxymonosulfate catalyst for organic pollutant degradation.

Advanced oxidation processes based on carbon catalysis is a promising strategy possessing great potential for environmental pollution degradation. Herein, nitrogen-doped biochar nanosheets (NCS-x) were synthesized using a nitrogen-rich biomass (Candida utilis) as sole precursor. The involvement of environmental-friendly molten salt (NaCl and KCl) in pyrolysis process not only facilitated the exfoliation of biochar, but also favored the retention of N element in biochar. When applying as catalyst for peroxymonosulfate activation, the as-obtained NCS-6 exhibited outstanding performance in catalytic degradation of bisphenol A (BPA). A 100% removal efficiency was observed in 6 min with fast reaction kinetic (k = 1.36 min-1). Based on quenching test and in-situ electron paramagnetic resonance analysis, both radical pathway and non-radical pathway were suggested to be involved in BPA degradation, while singlet oxygen was identified as the dominant reactive oxygen species. Furthermore, the ecotoxicity evaluation using Chlorella vulgaris as ecological indicator indicated that BPA solution after degradation was less toxic than the original solution. It is expected that this green and facile strategy holds great promise for value-added conversion of nitrogen-rich biomass to highly efficient biochar nanosheets for environment remediation.

Enhanced Cr(VI) removal by waste biomass derived nitrogen/oxygen co-doped microporous biocarbon.

Herein, kitchen waste hydrolysis residue (KWHR) was utilized as the precursor to fabricate nitrogen/oxygen co-doped microporous biocarbons (NOMBs) with ultrahigh specific surface area via KOH activation. Activation temperature was found to be crucial for heteroatom doping and pore structure construction. Attractively, the obtained NOMB with high surface area (2417 m2/g) and microporosity (~ 90%) displayed an outstanding capacity of Cr(VI) removal (526.1 mg/g at pH 2). The kinetics and isotherm studies showed that the adsorption of Cr(VI) onto NOMB was well described by the pseudo-second-order kinetics and Langmuir isotherm. Moreover, it was found that Cr(VI) was partly reduced to Cr(III) during the removal process as the nitrogen/oxygen functionalities and unsaturated carbon bond played crucial roles of electron-donors, which revealed the fact that the removal of Cr(VI) by NOMB was attributed to the coupling of adsorption and reduction reaction. Overall, this study has demonstrated the possibility of preparing microporous biocarbons using KWHR as a renewable material and the resultant NOMB is of great potential to detoxify Cr(VI).

Hydrothermal route-enabled synthesis of sludge-derived carbon with oxygen functional groups for bisphenol A degradation through activation of peroxymonosulfate.

A considerable amount of sewage sludge (SS) is generated from wastewater treatment process, which is hazardous to the environment and in urge to be disposed. In this study, for the first time, we prepared carbocatalyst with abundant surface oxygen functional groups using the hazardous waste of SS as precursor via a facile hydrothermal coupled pyrolysis process. The hydrothermal treatment was found to be crucial for enhancing the oxygen content of sludge carbon (SC), most of which existed as ketonic groups. Catalytic performances of the developed SCs were examined by activating peroxymonosulfate (PMS) to degrade bisphenol A (BPA). Sample with more ketonic group performed better for BPA degradation. Under optimal reaction conditions, 100 % of BPA and 69.53 % of TOC could be removed in 20 min. Singlet oxygen (1O2) was suggested to be the main reactive oxygen species for degrading BPA and a BPA degradation pathway was proposed. The BPA solution showed decreased bio-toxicity after the oxidation process according to the acute ecotoxicity test. This study demonstrated the importance of surface functional groups on carbocatalyst for advanced oxidation process, which could be induced by a facile hydrothermal treatment. The feasibility of utilizing hazardous SS for advanced carbocatalyst fabrication was also revealed.

Inverted Internal Limiting Membrane Flap Technique for Repair of Large Macular Holes: A Short-term Follow-up of Anatomical and Functional Outcomes.

BACKGROUND: Inverted internal limiting membrane (ILM) flap technique has recently been reported in a limited number of studies as an effective surgical technique for the management of large macular holes (MHs) with fair MH closure rates as well as gains in visual acuity. In the current study, longitudinal changes in multi-focal electroretinogram (mfERG) responses, best-corrected visual acuity (BCVA) and spectral-domain optical coherence tomography (SD-OCT) were evaluated in eyes with large MHs managed by this technique. METHODS: A prospective noncontrolled interventional study of eight patients (eight eyes) with large MHs (minimum diameter >400 µm) was conducted. All MHs were treated with pars plana vitrectomy and indocyanine green-assisted inverted ILM flap technique. SD-OCT images were used to assess the anatomical outcomes of surgery while BCVA and mfERG were used to evaluate the functional outcomes during a 3-month follow-up. RESULTS: All patients underwent successful intended manipulation and translocation of the ILM flap without flap dislocation and achieved complete anatomical closure. Partial microstructural reconstruction, demonstrated on SD-OCT as restoration of the external limiting membrane and the ellipsoid zone, was observed in all cases as early as 1 month after surgery. Functionally, as compared to baseline, all patients showed improvements in BCVA and all but one in mfERG response during follow-up. However, Pearson's test revealed no significant correlations between BCVA and mfERG responses of the fovea and of the macular area at each evaluation time point. CONCLUSIONS: Inverted ILM flap technique appears to be a safe and effective approach for the management of large idiopathic MHs with favorable short-term anatomical and functional results. Postoperative reconstruction of the microstructure generally shows good consistency with improvements in both BCVA and mfERG response, of which the latter might be a supplement for the former in postoperative functional follow-up.

Spectral domain optical coherence tomography of Vogt-Koyanagi-Harada disease: novel findings and new insights into the pathogenesis.

OBJECTIVE: To provide novel spectral domain optical coherence tomography (SD OCT) findings of Vogt-Koyanagi-Harada (VKH) disease as well as new insights into the pathogenesis of this disease. METHODS: Detailed SD OCT and fluorescein angiography (FA) findings of 18 consecutive VKH patients (11 women and 7 men) from December 2007 to April 2009 who were in acute uveitic stage at presentation were reviewed. All the patients had been followed up for at least 6 months with reevaluation(s) of SD OCT performed in 10 patients. RESULTS: Intraretinal cysts were found to be located in various layers of the outer retina. In addition to the photoreceptor layer, they could also be found between the outer plexiform layer and the outer nuclear layer, or spanning the external limiting membrane. On FA, intraretinal cysts could be hypofluorescent, normofluorescent, or hyperfluorescent. Some intraretinal cysts had a characteristic FA pattern, in which a small round hypofluorescent area was surrounded by a ring of hyperfluorescence (donut-shaped dye pooling). Subretinal fibrinoid deposit appeared in acute uveitic stage in two severe VKH patients and seemed to develop from subretinal exudates and evolved into typical subretinal fibrosis. Gradual transfiguration/migration and progressive proliferation/pigmentation of the subretinal fibrinoid deposit/subretinal fibrosis was observed in one patient. CONCLUSIONS: Intraretinal cysts could form in various layers of the outer retina and may result from extension of choroidal inflammation. Subretinal fibrosis may develop from subretinal exudates in VKH patients and may cause substantial visual impairment.

Biocompatibility of subretinal parylene-based Ti/Pt microelectrode array in rabbit for further artificial vision studies.

To evaluate the biocompatibility of subretinal implanted parylene-based Ti/Pt microelectrode arrays (MEA). Eyes were enucleated 3 months after MEAs were implanted into the subretinal space of rabbits. Morphological changes of the retinas were investigated by H&E staining. Immunohistochemical staining for glial fibrillary acidic protein and opsin were performed to evaluate changes in Muller cells and photoreceptors in the retinas. Retina tissue around the array remained intact. Photoreceptor degeneration and glial cell activation were observed in the retina overlaying the MEA implant. However, the cells in the inner retinal layers were preserved. Photoreceptor degeneration and glial cell activation at the MEA-retina interface are expected to be a normal reaction to implantation. Material used in this experiment has good biocompatibility within the subretinal environment and is expected to be promising in the further retinal prosthesis studies.