In Vivo Imaging of Rodent Retina in Retinal Disease.

High-quality imaging of the retina is crucial to the diagnosis and monitoring of disease, as well as for evaluating the success of therapeutics in human patients and in preclinical animal models. Here, we describe the basic principles and methods for in vivo retinal imaging in rodents, including fundus imaging, fluorescein angiography, optical coherence tomography, fundus autofluorescence, and infrared imaging. After providing a concise overview of each method and detailing the retinal diseases and conditions that can be visualized through them, we will proceed to discuss the advantages and disadvantages of each approach. These protocols will facilitate the acquisition of optimal images for subsequent quantification and analysis. Additionally, a brief explanation will be given regarding the potential results and the clinical significance of the detected abnormalities.

A feasibility study on the use of an intraoral optical coherence tomography system for scanning the subgingival finish line for the fabrication of zirconia crowns: An evaluation of the marginal and internal fit.

OBJECTIVES: This study aimed to evaluate the marginal and internal fit of zirconia crowns were fabricated using scan data from an intraoral optical coherence tomography (OCT) scanner and an intraoral scanner (IOS) for scanning the subgingival finish line. METHODS: An extracted maxillary left central incisor was prepared for a zirconia crown. The prepared tooth was placed in artificial gingiva, created using silicone with a refractive index similar to that of the tooth, ensuring a subgingival depth of 0.50 to 0.70 mm from the labial finish line. Scanning data were obtained from four types of models as follows. (1) CAD reference model (CRM) excluding the gingiva and scanned using a laboratory scanner. (2) IOS group excluding the gingiva (IOS only, IOSO group). (3) IOS group with scanned attached artificial (IOS with gingiva, IOSG group). (4) OCT post-processed data of the subgingival finish line and IOSG data (OCT group). Zirconia crowns were fabricated based on these data, and their marginal and internal fit were evaluated using the silicone replica technique. Statistical analyses were conducted using one-way and two-way ANOVA (α = 0.05). RESULTS: The OCT group exhibited a significantly smaller marginal gap than the IOSG group (P < 0.05). The marginal fit of the OCT group did not significantly differ from that of the CRM group (P > 0.05). The IOSG group exhibited a significantly larger chamfer gap, while both the IOSG and OCT groups had significantly larger axial gaps. Furthermore, the OCT group showed a significantly larger incisal gap (P < 0.05). CONCLUSIONS: An intraoral OCT system can enhance the fabrication accuracy of zirconia crowns by achieving superior marginal fit for crowns with subgingival finish lines. CLINICAL SIGNIFICANCE: The use of an IOS for subgingival finish lines without gingival displacement cords may result in a suboptimal marginal fit. However, integrating OCT technology can effectively address this issue, leading to improved clinical outcomes.

Harmonizing Unets: Attention Fusion module in cascaded-Unets for low-quality OCT image fluid segmentation.

Optical coherence tomography (OCT) is widely used for its high resolution. Accurate OCT image segmentation can significantly improve the diagnosis and treatment of retinal diseases such as Diabetic Macular Edema (DME). However, in resource-limited regions, portable devices with low-quality output are more frequently used, severely affecting the performance of segmentation. To address this issue, we propose a novel methodology in this paper, including a dedicated pre-processing pipeline and an end-to-end double U-shaped cascaded architecture, H-Unets. In addition, an Adaptive Attention Fusion (AAF) module is elaborately designed to improve the segmentation performance of H-Unets. To demonstrate the effectiveness of our method, we conduct a bunch of ablation and comparative studies on three open-source datasets. The experimental results show the validity of the pre-processing pipeline and H-Unets, achieving the highest Dice score of 90.60%±0.87% among popular methods in a relatively small model size.

Relationship Between High Frequency Component of Heart Rate Variability and Delta EEG Power During Sleep in Women With Irritable Bowel Syndrome Compared to Healthy Women.

OBJECTIVE: To explore the relationship between the high frequency (HF) heart rate variability (HRV) and electroencephalogram (EEG) delta band power in women with irritable bowel syndrome (IBS) versus healthy control women. MATERIALS AND METHODS: Twenty women with IBS and twenty healthy controls were studied over three consecutive nights using polysomnography in a sleep laboratory. To avoid the first night effect, only second-night data were analyzed. Power spectral analysis was applied to HRV and EEG recordings. The linear system coherence/phase analysis assessed the relationship between normalized HF power of HRV and normalized delta band power of EEG during the first four NREM-REM sleep cycles. RESULTS: Women with IBS exhibited a significantly higher percentage of NREM sleep, higher normalized HF, lower normalized low frequency (LF) and decreased LF/HF ratio of HRV in the first four NREM-REM sleep cycles compared to controls. Additionally, their normalized delta band power was significantly lower in these sleep cycles and over the whole night. The phase shift between HF and delta band power was significantly longer in the IBS group. While the coherence between normalized HF and normalized delta band power was lower in the IBS group, the difference was not statistically significant. CONCLUSIONS: The coherence/phase analysis showed a dysregulated interaction between autonomic and central nervous systems in women with IBS, manifested by increased lag time between cardiac and EEG delta band power compared to healthy controls. Whether this dysregulation contributes to the pathophysiology of IBS remains to be determined.

In-line porosity and hardness monitoring of tablets by means of optical coherence tomography.

In-line monitoring of critical quality attributes (CQAs) during a tableting process is an essential step toward a real-time release strategy. Such CQAs can be the tablet mass, the API content, dissolution, hardness and tensile strength. Since dissolution testing is laborious and time-consuming and cannot be performed in-line, it is desirable to replace dissolution testing with predictive models based on other CQAs that affect the dissolution characteristics, such as the tablet porosity and hardness. Traditionally, porosity is determined offline via gas adsorption methods or other techniques, such as Terahertz spectroscopy or gas in scattering media absorption spectroscopy. Tablet hardness is typically established using a hardness tester. While these destructive tests can readily be performed at-line, they have limited applicability in in-line settings for a high-percentage inspection. Optical coherence tomography (OCT) has recently been proposed as a possible tool for determining quality attributes. This work describes the first application of OCT for the prediction of tablet porosity and hardness. OCT measurements of tablets produced in a ConsiGma 25™ tableting line and a Stylcam 200R compaction simulator in several compaction force settings were made and correlated with the porosity and hardness. It was demonstrated that OCT can easily be installed in-line and provide real-time information about critical material attributes. These insights confirm the applicability of OCT as a real-time quality control tool and its potential to replace time-consuming and destructive offline measurements.

Effect of Childhood Atropine Treatment on Adult Choroidal Thickness Using Sequential Deep Learning-Enabled Segmentation.

PURPOSE: To describe choroidal thickness measurements using a sequential deep learning segmentation in adults who received childhood atropine treatment for myopia control. DESIGN: Prospective, observational study. METHODS: Choroidal thickness was measured by swept-source optical coherence tomography in adults who received childhood atropine, segmented using a sequential deep learning approach. RESULTS: Of 422 eyes, 94 (22.3%) had no previous exposure to atropine treatment, while 328 (77.7%) had received topical atropine during childhood. After adjusting for age, sex, and axial length, childhood atropine exposure was associated with a thicker choroid by 32.1 µm (95% CI, 9.2 to 55.0; P = 0.006) in the inner inferior, 23.5 µm (95% CI, 1.9 to 45.1; P = 0.03) in the outer inferior, 21.8 µm (95% CI, 0.76 to 42.9; P = 0.04) in the inner nasal, and 21.8 µm (95% CI, 2.6 to 41.0; P = 0.03) in the outer nasal. Multivariable analysis, adjusted for age, sex, atropine use, and axial length, showed an independent association between central subfield choroidal thickness and the incidence of tessellated fundus (P < 0.001; OR, 0.97; 95% CI, 0.96-0.98). CONCLUSIONS: This study demonstrated that short-term (2-4 years) atropine treatment during childhood was associated with an increase in choroidal thickness of 20-40 µm in adulthood (10-20 years later), after adjusting for age, sex, and axial length. We also observed an independent association between eyes with thicker central choroidal measurements and reduced incidence of tessellated fundus. Our study suggests that childhood exposure to atropine treatment may affect choroidal thickness in adulthood.

Hyperreflective ganglion cell layer band in a large cohort of non-syndromic retinitis pigmentosa: Frequency and clinical correlations.

PURPOSE: Recently, an 'hyperreflective ganglion cell layer band' (HGB) has been described on spectral-domain optical coherence tomography (SD-OCT) in a subset of patients with retinitis pigmentosa (RP). This study aims to validate and describe the frequency of HGB in a large cohort of Portuguese patients with RP. METHODS: This single-centre, cross-sectional cohort study included consecutive patients with a genetic diagnosis of RP. SD-OCT images were reviewed to identify the presence of the HGB and other retinal comorbidities. The HGB was defined as a continuous hyperreflective band within the thickness of the ganglion cell layer (GCL). We built mixed-effects regression models, accounting for inter-eye correlations, to investigate features predictive of visual acuity. Subsequently, a reduced model was fitted. RESULTS: A total of 398 eyes from 201 patients were included. HGB was identified in 69 (17.3%) eyes from 39 (19.4%) patients. Patients presenting with the HGB were significantly younger at diagnosis and at symptom onset. Median BCVA [ETDRS (IQR)] was 65 (29) letters in eyes with the HGB and 70 (21) letters in eyes without HGB (p < 0.001). In both the full and reduced mixed-effects models, the presence of HGB and macular hole (MH) was significantly associated with worse BCVA. CONCLUSIONS: This study validates the recent description of HGB within the GCL in a subset of patients with RP. Eyes with HGB demonstrated significantly worse BCVA compared to those without HGB, suggesting that the presence of HGB may serve as an SD-OCT biomarker of worse visual prognosis in these patients.

Prevalence, Features and Risk Factors of Macular Retinoschisis in High Myopic Population: the Beijing Eye Study 2011: Macular Retinoschisis in High Myopic Population.

PURPOSE: To investigate the prevalence, features and risk factors of macular retinoschisis (MRS) in highly myopic eyes and their morphological features in Chinese population. DESIGN: Population-based, cross-sectional study. PARTICIPANTS: From Beijing Eye Study 2011, a total of 213 highly myopic eyes from 129 participants were included. METHODS: All participants underwent Spectral-domain optical coherence tomography with a macula cube scan of 30°â€¯× 30°centered in the fovea. MAIN OUTCOME MEASURES: High myopia was defined as a refractive error ≤-6 diopters or an axial length ≥ 26.0 mm. MRS presence and its subtypes were assessed based on location and affected retinal layers were evaluated. Prevalence, features and associated factors of MRS and its subtypes in highly myopic population were assessed. RESULTS: Out of 213 highly myopic eyes (129 participants), MRS was observed in 48 eyes, with a prevalence of 22.5% (95%CI: 16.9, 28.6%) per eye, or 36 participants with 27.9% (95% CI: 20.5, 35.7%) per subject. In addition to well-documented factors like older age and higher myopia, the prevalence of MRS was found to be related with a higher intraocular pressure (P=0.013, OR: 1.25; 95%CI: 1.05, 1.48), a thinner subfoveal choroidal thickness (P=0.006 OR: 0.86; 95%CI: 0.77, 0.96), a wider Gamma zone (P=0.003, OR: 1.99; 95%CI: 1.05, 3.11), the presence of glaucoma (P=0.010, OR: 3.37; 95%CI: 1.34, 8.48) and the presence of epiretinal membrane (P=0.023, OR: 3.13; 95%CI: 1.17, 8.36), after multivariate analysis. Eyes with advanced high myopia (P=0.021) and wider gamma zone (P=0.005) were more likely to develop foveal MRS. Eyes with glaucoma tended to have a higher prevalence of outer retinal MRS compared to inner retinal MRS (60.9% versus 36.0%), though the difference was not statistically significant (P=0.06). MRS located in the foveal region or affecting the outer retina was related with a significant worse best corrected visual acuity (BCVA), as compared to MRS that was perifoveally located or affected other regions (P<0.05). CONCLUSIONS: The prevalence of MRS was 27.9% among the elderly highly myopic population. MRS occurring in the foveal region or involving the outer retina demands increased vigilance due to its significant impact on BCVA. The findings contribute to a deeper understanding of MRS, offering insights into its mechanisms and vision prognosis.

A comprehensive evaluation of efficacy of hyperbaric oxygen therapy in non-arteritic central retinal artery occlusion using enhanced depth imaging optical coherence tomography.

This study aimed to assess the efficacy of hyperbaric oxygen therapy (HBOT) in patients with central retinal artery occlusion (CRAO) by analyzing changes in visual acuity (VA) and enhanced depth imaging optical coherence tomography (EDI-OCT) parameters. A comparative retrospective study was conducted by reviewing the medical records of all HBO-treated RAO patients in our department and comparing them with matched RAO patients who did not receive HBO treatment. All patients treated with HBO received treatment within 7 days of the onset of visual symptoms. Baseline characteristics were compared, and VA and OCT parameters were evaluated at baseline and follow-up visits. A total of 50 eyes from 50 patients were included, with 29 eyes in the HBOT group and 21 eyes in the control group. The mean BCVA of the HBOT group at the initial visit was 2.03 logMAR, which improved to 1.55 logMAR at 6 months, with the change being statistically significant (P < 0.01), while the control group's BCVA remained almost unchanged, from 2.1 to 2.11 logMAR (P = 0.762). The central choroidal thickness increased significantly in the HBOT group over the subsequent period. The central fovea, and outer retinal layer thickness in the HBOT group were significantly greater than those in the control group at the 6-month follow-up after treatment. HBOT appears to be effective in improving VA and inducing favorable changes in OCT parameters in patients with CRAO. It helps to preserve retinal layer thickness, especially in the outer retinal layer.

Characteristics of posterior precortical vitreous pockets visualized by swept-source OCT and en face OCT.

To determine the characteristics of posterior precortical vitreous pockets (PPVPs) and to observe vitreous changes in myopic eyes by swept-source optical coherence tomography (SS-OCT) and en face imaging in a cohort of the Chinese Han population. This was a cross-sectional study. Volunteers (235 participants, 374 eyes) received an SS-OCT examination. The heights and widths of the PPVPs were measured by SS-OCT. The area of the PPVPs was measured on en face images. The relationships between PPVP size and sex, age, axial length (AL) and spherical equivalent (SE) were evaluated. The mean width and height were 6711.64 ± 1241.87 µm and 662.47 ± 326.39 µm, respectively. The area of the PPVPs was 30.296 ± 9.114 mm2. Boat-shaped, oval, and hook-shaped PPVPs were observed in 73.26%, 21.12%, and 5.62% of all eyes, respectively; 73.53% of all PPVPs had channels communicating with Cloquet's tubes. There was a significant difference in the PPVP width among the participates over and under 50 years old (t = -2.508, P = 0.031). Age had a positive correlation with the PPVP width (r = 0.53, P = 0.001). The PPVP height showed significant differences among the different myopia groups (F = 3.618, P = 0.013). SE had a negative correlation with the PPVP height (r = -0.176, P = 0.001). However, there were no correlations between the AL and the width, height or area of the PPVPs (P = 0.117; P = 0.334; P = 0.057, respectively). Age and myopia affect the size of PPVPs. SS-OCT greatly facilitates visualization of the complex structure of the vitreous.

EEG synchronization patterns during a Go/No-Go task in individuals with aphasia in subacute and chronic phases of stroke.

Stroke and subsequent neuroregenerative processes cause changes in neural organization of attentional functions. In this study, we attempted to identify differences in neural synchronization patterns during a visual Go/No-Go task in people with post-stroke aphasia in both subacute and chronic stroke phases. To identify neuronal underpinnings of the behavioral differences we investigated pairwise connectivity patterns using corrected imaginary phase locking value and graph-theoretic measures (efficiency, modularity and clustering coefficient) at global and local level in subacute (n = 13) and chronic stroke phases (n = 14) during a Go/No-Go task. We observed significantly lower phase synchronization in the Subacute Group in the alpha band in the connections spanning frontal and central areas of both hemispheres alongside lower local efficiency and clustering coefficient in the left frontal region. Additionally, we observed higher modularity in the beta band in the unaffected right parietal region in the Subacute Group which may denote inhibition of motor and attention functions. Those mechanisms could serve to align cognitive abilities between the damaged and healthy hemispheres, harmonizing the activity of the neuronal networks of both hemispheres disrupted by the effects of the stroke. Our findings have potential implications for rehabilitation therapies, which should take into account the pattern of connectivity changes during different phases of reovery.

Retinal vascular changes after Silicon Oil removal in the Eye with Rhegmatogenous Retinal detachment.

BACKGROUND: This study aims to examine vessel density changes in the optic nerve and macula following silicone oil removal (SOR) surgery in eyes with rhegmatogenous retinal detachment (RRD) at different time points by Optical Coherence Tomography Angiography (OCTA) in compared to the contralateral eye. METHODS: A total of 43 eyes from 43 patients with silicone oil in their eyes for 3-9 months underwent OCT-A using AngioVue and optic disc-associated vessel density (VD) and thickness, macular-associated VD and thickness, Foveal avascular zone (FAZ) area, FAZ perimeter (PERIM), Acircularity index (AI), vessel density within a 300 µm wide region of the FAZ were compared between eyes. OCTA scans were performed one week before SOR and one month and three months after SOR. RESULTS: The mean age of participants was 52.8 years (SD = 15.85) and a median visual acuity was 0.8 (range: 0.5-1.0). Notably, male participants constituted 67.4% of the sample. The preoperative mean value BCVA (logMAR) of patients was 0.73, and 3 months post-oil removal was 0.7727. Regarding optic disc parameters, RNFL thickness and vessel density (VD) measurements Peripapillary, whole disc, inside disc, and Disc Angio (superior, Nasal, inferior, temporal) did not change. In analyzing macular thickness parameters, all of them (Whole and Fovea, parafoveal, and Perifovea) remained unchanged. Examining macular vessel density parameters revealed no significant changes across superficial and deep retinal layers. Finally, the comparison of the foveal avascular zone (FAZ) area and flow density (FD) parameters demonstrated consistent measurements with non-significant alterations observed in FAZ size (p = 0.6) and FD values (p = 0.49) over the monitored duration. CONCLUSION: There was no change in peripapillary VD and macular vessel density of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) after silicone oil removal. FAZ and full retinal thickness  remained stable 3 month after SOR.  Clinical trial number: Not applicable.

Salutogenic mechanisms in nature-based work: fostering sense of coherence for employees with limited capability for work.

Having a job is important for the well-being and inclusion of people with limited capability for work (LCW) due to physical and/or mental disability. This study explores salutogenic mechanisms that contribute to work-related sense of coherence (Work-SoC) of employees with LCW, i.e. perceiving their work in nature as manageable, comprehensible and meaningful. Semi-structured interviews (26 in total) were conducted with employees with LCW, employee supervisors, job coaches and foresters, all working in nature management. Interviews were held at four worksites of a governmental organisation in the Netherlands that provides permanent jobs for people with LCW. Employees with LCW contributed to the design and analysis of the study as co-researchers. Thematic analysis was used and member checks were carried out on preliminary findings. We identified six salutogenic mechanisms that contribute to nature-based Work-SoC of employees with LCW: (i) having constructive working relationships, (ii) experiencing structure and clarity, (iii) receiving practical and emotional support, (iv) support in the creation of meaning, (v) experiencing and learning in practice and (vi) physical activity and (absence of) stimuli. Identified mechanisms can create a positive effect when leveraged, thereby boosting (new) salutogenic mechanisms. Our findings illustrate that nature-based work can provide resources that promote Work-SoC of employees with LCW through the identified mechanisms. However, employees with LCW, colleagues, supervisors and stakeholders must recognize, mobilize and use these resources to leverage identified mechanisms in order to facilitate health-promoting workplaces for people with LCW. This, in turn, can contribute to sustainable inclusion through enablement.

Axial length acquisition success rates and agreement of two swept-source optical biometers in eyes with dense cataracts.

Background: Swept-source optical coherence tomography-based (SS-OCT) biometers have been used in different clinical studies with the aim of assessing the accuracy of the technique, specifically in eyes with dense cataracts. Our objective is to evaluate the axial length acquisition success rates and agreement of two SS-OCT biometers when measuring axial length and biometric parameters in eyes with dense cataracts. Methods: 46 eyes (46 patients) with dense cataracts (LOCS III grade ≥ 4) were measured 3 consecutive times using the Eyestar 900 and Argos SS-OCT biometers. Keratometry (K1, flat and K2, steep), central corneal thickness (CCT), white-to-white (WTW), anterior-chamber-depth (ACD), lens-thickness (LT), and axial length were measured using both biometers. The percentage acquisition success rate and a Bland-Altman analysis to determine the agreement between the biometers were calculated. Corrected and uncorrected distance visual acuity, subjective refraction, and axial length (to assess preoperative axial length accuracy) were measured 1-month post-cataract surgery. Results: The mean LOCS III score was 4.37 ± 0.68. The acquisition success rates for both biometers was 100%. There were statistically significant differences between the two SS-OCT biometers for all parameters evaluated (p < 0.05). The mean differences for K1, K2, CCT, WTW, ACD, LT and axial length were 0.106 D, 0.128 D, -6.347 µm, -0.054 mm, 0.095 mm, 0.110 mm, and -0.036 mm, respectively. The mean pre- and post-surgery axial length difference was -0.036 mm for the Eyestar 900 and -0.020 mm for the Argos. This difference was ≤ 0.1 mm in 97.82% of eyes with the Eyestar 900 and in 100% of eyes with the Argos. Conclusion: SS-OCT biometry successfully measures axial length in dense cataracts. The differences between biometers in some parameters may have a clinically significant impact but should be judged individually. The pre- and post-surgery axial length differences for each biometer can be considered clinically negligible and should not affect the IOL power calculation.

Sensitive optical coherence tomography angiography parameters detecting retinal vascular changes in Behcet's uveitis.

PURPOSE: To compare the retinal parameters in Behcet's uveitis (BU) patients with wide-field swept-source optical coherence tomography angiography (SS-OCTA) and find a sensitive OCTA parameter. METHODS: Fifty-two eyes from 52 quiescent BU patients and 50 healthy eyes were included. All subjects underwent SS-OCTA examinations with 12 × 12 mm region. Vessel density (VD) and flow area (FA) in nerve fiber layer (NFL), superficial vascular plexus (SVP), intermediate capillary plexus (ICP) and deep capillary plexus (DCP) were analyzed and compared in central, parafoveal, and peripheral regions with diameters of 1, 6 and 12 mm. Receiver operating characteristic curves (ROC), area under the curve (AUC), correlation analysis between OCTA metrics and best-corrected visual acuity (BCVA) were respectively evaluated. RESULTS: BU patients showed significantly lower peripheral VD and FA in NFL (P = 0.019 and 0.002), lower central and parafoveal VD-SVP (P = 0.006 and <0.001), and lower VD-ICP, VD-DCP, FA-SVP, FA-ICP and FA-DCP in all regions (all P < 0.05) as compared to healthy controls. The ROC analysis indicated that the parafoveal, peripheral FA-DCP-1, and a combination of the two metrics were sensitive parameters for identifying retinal vessel changes in BU (AUC=0.90, 0.90, 0.91, respectively). The parafoveal and peripheral FA-DCP were negatively associated with logMAR BCVA (r=-0.764, P < 0.0001; r=-0.641, P < 0.0001). CONCLUSION: The deep retinal layers were apt to be affected in BU patients. The parafoveal and peripheral FA values of DCP may be sensitive parameters for detecting retinal vasculature alterations in BU.

Predictive models for cholesterol crystals and plaque vulnerability in acute myocardial infarction: Insights from an optical coherence tomography study.

BACKGROUND: Cholesterol crystals (CCs) are recognized as a risk factor for vulnerable atherosclerotic plaque rupture (PR) and major adverse cardiovascular events. However, their predictive factors and association with plaque vulnerability in patients with acute myocardial infarction (AMI) remain insufficiently explored. Therefore, This study aims to investigate the association between CCs and plaque vulnerability in culprit lesions of AMI patients, identify the factors influencing CCs formation, and develop a predictive model for CCs. METHODS: A total of 431 culprit lesions from AMI patients who underwent pre-intervention optical coherence tomography (OCT) imaging were analyzed. Patients were divided into groups based on the presence or absence of CCs and PR. The relationship between CCs and plaque vulnerability was evaluated. A risk nomogram for predicting CCs was developed using the least absolute shrinkage and selection operator and logistic regression analysis. RESULTS: CCs were identified in 64.5 % of patients with AMI. The presence of CCs was associated with a higher prevalence of vulnerable plaque features, such as thin-cap fibroatheroma (TCFA), PR, macrophage infiltration, neovascularization, calcification, and thrombus, compared to patients without CCs. The CCs model demonstrated an area under the curve (AUC) of 0.676 for predicting PR. Incorporating CCs into the TCFA model (AUC = 0.656) significantly enhanced predictive accuracy, with a net reclassification improvement index of 0.462 (95 % confidence interval [CI]: 0.263-0.661, p < 0.001) and an integrated discrimination improvement index of 0.031 (95 % CI: 0.013-0.048, p = 0.001). Multivariate regression analysis identified the atherogenic index of plasma (odds ratio [OR] = 2.417), TCFA (OR = 1.759), macrophage infiltration (OR = 3.863), neovascularization (OR = 2.697), calcification (OR = 1.860), and thrombus (OR = 2.430) as independent risk factors for CCs formation. The comprehensive model incorporating these factors exhibited reasonable discriminatory ability, with an AUC of 0.766 (95 % CI: 0.717-0.815) in the training set and 0.753 (95 % CI: 0.704-0.802) in the internal validation set, reflecting good calibration. Decision curve analysis suggested that the model has potential clinical utility within a threshold probability range of approximately 18 % to 85 %. CONCLUSIONS: CCs were associated with plaque vulnerability in the culprit lesions of AMI patients. Additionally, this study identified key factors influencing CCs formation and developed a predictive model with potential clinical applicability.

Acute effects of swimming goggle wearing on intraocular pressure, anterior chamber biometrics, and optic nerve head morphology.

Swimming goggles (SG) are widely used in water sports, and this study aimed to evaluate the acute effects of wearing SG on intraocular pressure (IOP), anterior chamber biometrics, axial length (AL), and optic nerve head (ONH) morphology. Twenty-eight healthy young adults participated in this cross-sectional study, with assessed parameters including IOP, central corneal thickness (CCT), anterior chamber depth (ACD), anterior chamber angle (ACA), AL, and optical coherence tomography (OCT) imaging of the ONH, specifically Bruch membrane opening (BMO), Bruch membrane opening-minimum rim width (BMO-MRW), lamina cribrosa depth (LCD), and prelaminar tissue (PLT). Measurements were taken at four time points: before wearing SG, at the 1st and 10th minutes of wearing, and immediately after removal. The results showed a significant increase in IOP at the 1st and 10th minutes of SG wear compared to pre-wear and post-removal values. Additionally, decreases in CCT, ACD, and ACA, along with an increase in AL, were observed while wearing SG. However, these changes reverted to baseline after the goggles were removed. No significant alterations were detected in ONH parameters during the study. The findings suggest that wearing SG induces an acute rise in IOP and changes in anterior segment parameters, likely due to oculopression, but does not appear to affect ONH morphology in the short term. Further studies are needed to investigate any potential long-term effects.

Cardiac coherence and medical hypnosis: a feasibility study of a new combined approach for managing preoperative anxiety in patients with breast or gynaecological cancer.

Background: Non-pharmaceutical approaches can help manage preoperative anxiety, but few studies have evaluated psychoeducational programmes, especially for cancer surgery. We assessed the feasibility of the COHErence Cardiaque (COHEC) programme where cardiac coherence and medical hypnosis are combined to manage preoperative anxiety in patients undergoing breast or gynaecological cancer surgical interventions (BGCSI). Methods: Patients undergoing BGCSI were enrolled and followed a daily home programme with cardiac coherence and medical hypnosis sessions, starting 7 days before the procedure. The primary endpoint was optimal patient adherence (i.e. completion of ≥14 sessions). Secondary endpoints were anxiety levels, measured using the Visual Analogue Scale (VAS) and the Amsterdam Preoperative Anxiety and Information Scale (APAIS), satisfaction (EVAN-G), and quality of postoperative recovery (QoR-15). Results: In total, 53 patients [mean age: 55 (34-82) yr] were included; 83.7% had breast cancer and 15.1% had gynaecological cancer. Optimal adherence was achieved by 64.2% (95% confidence interval: 49.8-76.9%) of the intention-to-treat population. Among the 43 patients who completed at least one session, exploratory analysis showed that anxiety on the day before (P=0.02) and the morning of the intervention (P=0.04) was decreased in patients with severe anxiety at baseline (VAS ≥70). The median VAS satisfaction score for the programme was 10 (4-10). Overall, 94% of patients were willing to include the COHEC programme in their daily routine. Conclusions: The implementation of a psychoeducational programme combining cardiac coherence and medical hypnosis is feasible and might potentially help patients undergoing BGCSI to manage preoperative anxiety. A randomised trial is underway to assess the efficacy of the COHEC programme. Clinical trial registration: NCT03981731.

Intravitreal Dexamethasone Implants for Macular Edema Secondary to Acute Retinal Necrosis.

PURPOSE: To assess the effectiveness and risk of intravitreal injection of dexamethasone implants in treating macular edema (ME) secondary to acute retinal necrosis (ARN). METHODS: In this retrospective, noncomparative case series study, five patients who developed secondary ME after ARN and received an intravitreal dexamethasone implant injection were enrolled. The features of secondary ME on OCT and the outcomes of dexamethasone intravitreal implanting were presented. RESULTS: The mean age of the patients was 59 years (range, 51-61 years). All patients had unilateral involvement, and all 5 eyes showed mild to moderate anterior uveitis, retinal necrosis, and vasculitis. Herpes zoster virus was detected in all eyes using PCR, and timely antiviral and anti-inflammatory treatment was performed. Aqueous humor samples were negative for herpes zoster virus DNA, and resolution of viral retinitis was noted upon the occurrence of ME. Additionally, three eyes received pars plana vitrectomy with silicone oil prior to ME development. All eyes presented with intraretinal fluid, hyper-reflective foci, and impairments of the external limiting membrane/ellipsoid zone at varying degrees on OCT images. Epiretinal membrane was exhibited in 80% of eyes, but no vitreoretinal traction was detected. Subretinal fluid was visible in 60% of eyes. ME was relieved effectively in all eyes after intravitreal dexamethasone implanting. One of these patients experienced three episodes of ME. No recurrence of retinal necrosis or corticosteroid-associated ocular hypertension was observed during the follow-up period. CONCLUSION: Intravitreal injection of dexamethasone implants can effectively alleviate ME secondary to ARN and improve visual acuity with no adverse reactions.

Macular edema secondary to acute retinal necrosis was characterized by the presence of intraretinal fluid, hyper-reflective foci, and external limiting membrane/ellipsoid zone fracture. The intravitreal injection of dexamethasone implants effectively alleviated this type of edema with no adverse reactions.