The spectrum of polypoidal choroidal vasculopathy in Caucasians: clinical characteristics and proposal of a classification.

PURPOSE: To describe the clinical characteristics and outcome of polypoidal choroidal vasculopathy (PCV), also known as aneurysmal type 1 (sub-retinal pigment epithelium (RPE)) neovascularization, in Caucasian patients. METHODS: Single-centre study in 66 Caucasian patients with a diagnosis of PCV based on optical coherence tomography scan and indocyanine green angiography. Clinical characteristics and multimodal imaging were collected and assessed by an experienced retina specialist. RESULTS: This study involved 74 eyes of 66 patients with PCV, with a mean age at onset of 73 years and a female preponderance of 66%. The mean number of polypoidal lesions per eye was 1 (range: 1-5 lesions), out of which 75% was located in the macula and 19% in the peripapillary region. Of the 74 eyes, 37 eyes (50%) had PCV associated with a drusenoidal neovascular age-related macular degeneration (AMD) phenotype (PCV-AMD) and 18 eyes (24%) had PCV associated with non-polypoidal type 1 choroidal neovascularization/branching vascular network (PCV-BVN) without signs of drusenoidal AMD, while 19 eyes (26%) had idiopathic, isolated PCV (iPCV). The mean subfoveal choroidal thickness measured in 22 patients was 245 µm (range: 71-420 µm). In 51% of patients, the initially performed therapy showed good anatomical recovery (resolution of intra- and subretinal fluid). CONCLUSIONS: A spectrum of PCV (aneurysmal type 1/sub-RPE neovascularization) can be seen in Caucasian patients. PCV associated with a drusenoidal neovascular AMD phenotype in Caucasians is phenotypically and presumably pathophysiologically more associated with neovascular AMD (PCV-AMD: type A PCV). However, this may not be the case for patients with PCV with non-polypoidal type 1 choroidal neovascularization or BVN and no signs of drusenoidal AMD (PCV-BVN: type B PCV), and for patients with idiopathic PCV without associated drusen or BVN (iPCV; type C PCV). Most patients have a thin choroid, even when drusen are absent. For the entire patient group, a moderate anatomical recovery was observed after treatment.

A Mixture of Full-Fat and Defatted Hermetia illucens Larvae and Poultry By-Products as Sustainable Protein Sources Improved Fillet Quality Traits in Farmed Barramundi, Lates calcarifer.

The physicochemical quality and shelf-life of fillets from barramundi, which were fed for 56 days on a mixture of poultry by-product meal (PBM), full-fat Hermetia illucens (FHI), and defatted HI (DHI), were investigated and compared to a fishmeal (FM) control diet. The proximate and total amino acids compositions of the fillets were unaffected by the test diets, while the mixture of PBM and HI larvae improved the sensory quality. An eight-day shelf-life study showed that PBM-HI-based diets improved the texture profile based upon the chewiness, cohesiveness, gumminess, and hardness, regardless of the storage time. The improved texture was aligned with comparatively less degradation of the microstructure of the muscle tissue in the same diets. An improvement in the quality index (QI) value, an increase in pH, and a decrease in lipid oxidation were also found in the fillets of barramundi fed test diets compared with the control diet during the storage time. The test diets positively influenced flesh lightness and redness, while the color profiles were negatively influenced by the storage time. Overall, the maintenance of compositional attributes; the enhancement of fillet sensory attributes, texture, and brightness; and the improved raw fillet shelf-life support the inclusion of PBM-HI-based diets in aquafeed.

A Combination of Hermetia illucens Reared on Fish Waste and Poultry By-Product Meal Improves Sensory and Physicochemical Quality of Farmed Barramundi Filets.

The proximate composition, sensory attributes, and shelf life of filets from barramundi, Lates calcarifer, were fed a fishmeal (FM) based diet (0PBM-0HI) and three test diets replacing FM protein entirely with 85% poultry by-products meal (PBM) and 15% Hermetia illucens (HI) larvae meal protein (85PBM-15HI), 80% PBM and 20% HI (80PBM-20HI) and 75% PBM and 25% HI (75PBM-25HI) were investigated. After a 56-day feeding trial, the crude protein, moisture, and ash percentage were unchanged while the crude lipid increased in barramundi filet when fed with PBM-HI-based diets. The increase in C12:0 (lauric acid) and C14:0 (myristic acid) resulted in an increase in the total saturated fatty acid while the monounsaturated fatty acid elevated due to an increase in C16:1n7 and C18:1cis + trans in the filet of the barramundi fed with a PBM-HI based diet. While the decrease in the total polyunsaturated fatty acid (PUFA) content in PBM-HI based fed barramundi filet was mainly due to a decrease in essential fatty acids including C20:5n3 [eicosapentaenoic acid (EPA)] and C22:6n3 [docosahexaenoic acid (DHA)] when compared with the 0PBM-0HI fed barramundi filet. The sensory quality was improved by PBM-HI-based diets, manifested by the highest scores given by the panelists. Texture profiles were not affected by diet but cohesiveness, gumminess, and chewiness decreased with increasing storage time. On days 1 and 8, skin brightness decreased in the skin of the barramundi fed with 85PBM-15HI and 80PBM-20HI compared with the skin of the 0PBM-0HI fed barramundi. Skin redness improved in fish-fed PBM-HI-based diets. The flesh brightness and yellowness increased significantly in barramundi when fed with PBM-HI-based diets. On days 1 and 4, the flesh brightness of the barramundi fed with PBM-HI-based diets demonstrated an increase compared with 0PBM-0HI. PBM-HI diets suppress lipid oxidation while lipid oxidation increased over the storage time. In summary, the improvement in sensory quality and color coupled with the suppression of rancidity in barramundi filets underpinned the potentiality of using the mixture of PBM and HI transformed from food waste in the barramundi diet to improve the filet quality and thus support sustainability and circular economy in aquaculture.

Neovascular age-related macular degeneration without drusen in the fellow eye: clinical spectrum and therapeutic outcome.

PURPOSE: To investigate the clinical characteristics and therapeutic outcome of patients with neovascular age-related macular degeneration (nAMD) in 1 eye, without drusen in the fellow eye. PATIENTS AND METHODS: Medical records of 381 patients were analyzed to identify the cases. The main outcomes included Early Treatment Diabetic Retinopathy Study (ETDRS) best-corrected visual acuity (BCVA) and change in central retinal thickness (CRT). These parameters were reviewed at baseline, first follow-up visit, and after 6, 12, and 24 months. RESULTS: Out of 381 patients, 29 cases (8%) were included (of whom 3 had polypoidal choroidal vasculopathy [PCV]) who were treated with anti-vascular endothelial growth factor (anti-VEGF) therapy which was supplemented by photodynamic therapy (PDT) in the PCV patients. Overall, no statistically significant change in mean BCVA was observed during follow-up. BCVA improved or remained stable (defined as a gain in BCVA, a stable BCVA, or a loss of <5 ETDRS letters) in 22 patients (76%), and 7 patients (23%) had lost ≥5 ETDRS letters at final follow-up. A gain of ≥15 ETDRS letters at final follow-up was seen in 5 patients (17%). Mean CRT had decreased significantly with 99 µm (P<0.001) at 24 months after the initial visit. CONCLUSION: There is a clinical spectrum of nAMD that is not associated with drusen in the fellow eye. Patients with nAMD without drusen in the fellow eye respond to anti-VEGF treatment and, in cases of PCV, to supplemental PDT. The pathophysiology of this spectrum of nAMD may be different from drusen-associated age-related macular degeneration.