Anti-VEGF reduces inflammatory features in macular edema secondary to retinal vein occlusion.

AIM: To investigate the anti-inflammatory effect of intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) in patients with macular edema secondary to retinal vein occlusion (RVO-ME). METHODS: Twenty-eight eyes from twenty-eight treatment-naïve patients (14 males and 14 females) with RVO-ME were included in this retrospective study. The retinal vein occlusion (RVO) was comprised of both central retinal vein occlusion (CRVO, n=14) and branch retinal vein occlusion (BRVO, n=14). Intravitreal injection of anti-VEGF reagents were administered monthly for three consecutive months, in which 18 patients were injected with ranibizumab and 10 patients were injected with conbercept. All eyes were imaged with optical coherence tomography angiography (OCTA) at baseline and 1wk after monthly intravitreal anti-VEGF injection. The visual acuity (VA), central macular thickness (CMT), the number of hyperreflective foci (HRF) recognized as an inflammatory sign in OCT images, and non-perfusion area (NPA), were compared before and after anti-VEGF treatments. RESULTS: The mean interval between baseline and follow-up was 29.4±0.79 (range, 27-48)d. Compared with the baseline, the VA improved (logMAR 1.5±0.1 vs 0.8±0.1, P<0.05) and CMT decreased (460±34.0 µm vs 268.8±12.0 µm, P<0.05), significantly, after anti-VEGF treatment. The number of HRF was decreased significantly (76.5±4.8 vs 47.8±4.3, P<0.05) after anti-VEGF treatment. CONCLUSION: Anti-VEGF therapy is effective in treating RVO-ME. The mechanisms for the decreased HRF and the reduction of NPA by anti-VEGF therapy merits further exploration.

A new handheld fundus camera combined with visual artificial intelligence facilitates diabetic retinopathy screening.

AIM: To explore the performance in diabetic retinopathy (DR) screening of artificial intelligence (AI) system by evaluating the image quality of a handheld Optomed Aurora fundus camera in comparison to traditional tabletop fundus cameras and the diagnostic accuracy of DR of the two modalities. METHODS: Overall, 630 eyes were included from three centers and screened by a handheld camera (Aurora, Optomed, Oulu, Finland) and a table-top camera. Image quality was graded by three masked and experienced ophthalmologists. The diagnostic accuracy of the handheld camera and AI system was evaluated in assessing DR lesions and referable DR. RESULTS: Under nonmydriasis status, the handheld fundus camera had better image quality in centration, clarity, and visible range (1.47, 1.48, and 1.40) than conventional tabletop cameras (1.30, 1.28, and 1.18; P<0.001). Detection of retinal hemorrhage, hard exudation, and macular edema were comparable between the two modalities, in principle, with the area under the curve of the handheld fundus camera slightly lower. The sensitivity and specificity for the detection of referable DR with the handheld camera were 82.1% (95%CI: 72.1%-92.2%) and 97.4% (95%CI: 95.4%-99.5%), respectively. The performance of AI detection of DR using the Phoebus Algorithm was satisfactory; however, Phoebus showed a high sensitivity (88.2%, 95%CI: 79.4%-97.1%) and low specificity (40.7%, 95%CI: 34.1%-47.2%) when detecting referable DR. CONCLUSION: The handheld Aurora fundus camera combined with autonomous AI system is well-suited in DR screening without mydriasis because of its high sensitivity of DR detection as well as its image quality, but its specificity needs to be improved with better modeling of the data. Use of this new system is safe and effective in the detection of referable DR in real world practice.

Nonlocal magnon entanglement generation in coupled hybrid cavity systems.

We investigate dynamical generation of macroscopic nonlocal entanglements between two remote massive magnon-superconducting-circuit hybrid systems. Two fiber-coupled microwave cavities are employed to serve as an interaction channel connecting two sets of macroscopic hybrid units, each containing a magnon (hosted by an yttrium-iron-garnet sphere) and a superconducting-circuit qubit. Surprisingly, it is found that stronger coupling does not necessarily mean faster entanglement generation. The proposed hybrid system allows the existence of an optimal fiber coupling strength that requires the shortest amount of time to generate a systematic maximal entanglement. Our theoretical results are shown to be within the scope of specific parameters that can be achieved with current technology. The noise effects on the implementation of systems are also treated in a general environment, suggesting the robustness of entanglement generation. Our discrete-variable qubit-like entanglement theory of magnons may lead to direct applications in various quantum information tasks.

Expedited Holonomic Quantum Computation via Net Zero-Energy-Cost Control in Decoherence-Free Subspace.

Holonomic quantum computation (HQC) may not show its full potential in quantum speedup due to the prerequisite of a long coherent runtime imposed by the adiabatic condition. Here we show that the conventional HQC can be dramatically accelerated by using external control fields, of which the effectiveness is exclusively determined by the integral of the control fields in the time domain. This control scheme can be realized with net zero energy cost and it is fault-tolerant against fluctuation and noise, significantly relaxing the experimental constraints. We demonstrate how to realize the scheme via decoherence-free subspaces. In this way we unify quantum robustness merits of this fault-tolerant control scheme, the conventional HQC and decoherence-free subspace, and propose an expedited holonomic quantum computation protocol.

Phthiriasis palpebrarum misdiagnosed as allergic blepharoconjunctivitis in a 6-year-old girl.

Phthiriasis palpebrarum is an infestation of the eyelashes caused by the louse Pthirus pubis (Linnaeus, 1758). We report a case of phthiriasis palpebrarum in a 6-year-old girl, which was initially misdiagnosed as allergic blepharoconjunctivitis. Parasites and their nits were found adhering to the eyelashes and eyelids of her right eye as well as scalp hairs. No abnormality was found in the left eye. The histopathology exam revealed the presence of adults and eggs of Pthirus pubis. We mechanically removed all the eyelashes of the right eye at their base, with lice and nits. The scalp was shaved and washed with phenothrin shampoo. No recurrence was found during 3 months of follow-up. Removal of the eyelashes, cutting of scalp hairs, and phenothrin shampoo may be effective in treating phthiriasis palpebrarum. In cases of blepharoconjunctivitis, eyelids and eyelashes should be carefully examined by slit lamp to avoid misdiagnosis.

[Detection of macular foveal by optical coherence tomography and its influence on results of measurement of central retina thickness].

OBJECTIVE: To detect macular foveal by Cirrus(TM) HD-OCT using the post acquisition fovea detection and to study its influence on the results of measurement of central retina thickness (CRT). METHODS: In this retrospectively studies, the 512×128 cube scans from 50 eyes of normal subjects and 50 eyes of macular edema patients were analyzed. Three methods for the foveal detection were used, the scan center (SC), the automated detected foveal (AF) and the manually identified foveal (MF). The foveal detected by MF was set as the reference. Radial distances from SC and AF to MF were calculated. Subfields retinal thickness acquired from different groups using different foveal detection methods were compared by paired Student's t test for normal data or Wilcoxon-Mann-Whitney for non-normal data. RESULTS: For normal subjects, it is reliable determining the foveal by special tomography features. The means of the radial distance from the MF was (35.0 ± 23.0) µm in scan center group and was (6.0 ± 9.0) µm in automated center (t = -3.732, P < 0.05). The average CRT difference between the SC and MF groups was (7.4 ± 10.4) µm. The median difference between the AF and MF groups was 0 µm (0 to 3), which is significantly less than that between the SC and MF groups (Z = -2.956, P < 0.05). In subjects with macular edema, the means of the radial offset was (59.0 ± 26.0) µm in SC group and was (34.0 ± 23.0) µm in AF group (t = -4.555, P < 0.05). The average CRT difference between the SC and MF groups was (28.0 ± 36.0) µm, which was not significantly greater than the difference between the AF and MF groups (23.0 ± 31.0) µm in macular edema eyes. CONCLUSIONS: Post acquisition detection of foveal reduces the radial offset to the real fovea, and may improve the reproducibility and reliability of the central retinal thickness quantification using spectral domain OCT in normal subjects.

Effect of blood flow and metabolism on multidimensional heat transfer during cryosurgery.

Cryosurgery has been recently accepted as a treatment option for eradicating undesirable tissues, especially tumor tissues, due to its minimally invasive nature and low hospitalization needs. A multidimensional, finite element analysis (FEA) for the cooling, holding and rewarming processes of biological tissues during cryosurgery is presented. The tissues were treated as non-ideal materials with temperature dependent thermophysical properties. The enthalpy method has been applied to solve the non-linear problem. The influence of heating effect due to blood flow and metabolism was studied, and furthermore, the effect of pre-injecting solutions with particular thermal properties into the target tissues was also numerically studied. It was found that the heat source term due to blood flow and metabolism in the bioheat transfer equation has a significant influence on the thermal and thermal gradient histories of the target tissues, and that the method of injection of solutions with particular thermal properties into the target tissues before cryosurgery may be a possible way to optimize the treatment process. However, in vitro experiments have not fully supported this viewpoint.

Modeling the heat transfer problem for the novel combined cryosurgery and hyperthermia system.

A multidimensional, finite element analysis (FEA) for the freezing, holding, rewarming and heating processes of biological tissues during the cryosurgery process of the new Combined Cryosurgery/Hyperthermia System is presented to theoretically test its validity. The tissues are treated as nonideal materials freezing over a temperature range, and the thermophysical properties of which are temperature dependent. The enthalpy method is applied to solve the highly nonlinear problem. It was found that when the same boundary condition and the same target tissue presented, the novel Cryosurgery/Hyperthermia System could supply the target tissue an approximative cooling rate, a much lower minimal temperature, a much greater warming rate, and a much greater thermal gradients compared with that of the simplified Endocare system. The numerical simulation indicates that the novel combined cryosurgery and hyperthermia system can provide an excellent curative effect in the corresponding cryotherapy. And the most attractive feature of this FEA framework is that it can be easily mastered by the surgeon without in-depth theory of heat transfer to analyze the cryosurgery process beforehand due to the friendly GUI (graphical user interface) of Ansys software.