ALTERATIONS OF MACULAR BLOOD FLOW IN SUPERFICIAL AND DEEP CAPILLARY PLEXUSES IN THE FELLOW AND AFFECTED EYES OF PATIENTS WITH UNILATERAL IDIOPATHIC EPIRETINAL MEMBRANE.

PURPOSE: Previous research suggests that proliferation of the idiopathic epiretinal membrane (IERM) is related to microbreaks in the inner limiting membrane, which are caused by posterior vitreous detachment. In this study, we used optical coherence tomography angiography to determine whether a vascular defect in the inner retina is present before the mechanical damage caused by posterior vitreous detachment. METHODS: For patients with unilateral IERM (N = 23), optical coherence tomography angiography with blood flow measurement was performed in both eyes at the superficial capillary plexuses (SCP) and deep capillary plexuses (DCP) with 6 mm × 6-mm scans and ETDRS grids centered on the fixation point. These values were then compared with 45 healthy control eyes (CEs). RESULTS: The optical coherence tomography angiography data showed that blood flow was lower in the fellow eyes of IERM patients than in CEs when the whole enface macula (SCP: P = 0.031, DCP: P = 0.004) and extramacular area (SCP: P = 0.048, DCP: P = 0.026) were compared between groups. The blood flow was also lower in the affected eyes compared with CEs in both whole en face macula (SCP: P < 0.001, DCP: P < 0.001) and extramacular areas (SCP: P = 0.011, DCP: P < 0.001). CONCLUSION: Data from this study revealed that blood flow is significantly reduced in the fellow eyes of patients with unilateral IERM when compared with CEs. Overall, the data suggest that a vascular retinal defect could produce changes in the inner retina, preceding and influencing the formation of microbreaks occurring at the time of posterior vitreous detachment in the inner limiting membrane. Understanding the upstream mechanism of inner limiting membrane microbreaks may provide a therapeutic target aimed to ultimately prevent Mu[Combining Diaeresis]ller cells, astrocyte, and fibroblast migration, which cause IERM proliferation.

As we age: listening to the voice of LGBTQ older adults.

The LGBT+ community is gaining long-overdue public health attention within the rapidly expanding demographic of older adults. As a group, LGBT+ older adults represent a range of diverse biopsychosocial needs and life experiences that may differ markedly from the general population. This has translated into health disparities experienced by this group and the emergence of policies calling for improved services for this community. In response, this qualitative study engaged ten focus groups (a total of 48 participants) throughout one mid-Atlantic state to better understand the experiences and perceptions of LGBT+ older adults regarding their expectations and needs as they age. Themes included (1) an emphasis on the nuance of connection as an aging LGBT+ adult; (2) a rich discussion of experiences with and expectations for quality of services as this group ages; (3) the realities of planning for future living arrangements as a member of this population; and (4) a clearer understanding of the two sides of advocacy for this group, as a personal responsibility and a call for allyship. Based on insights shared by participants, implications are discussed for improved and more visible engagement of this community within our heath and humans service sectors. We also affirm the need for greater attention from researchers and policy makers in respect to the whole health needs of this group. As a society and as professionals, we need to respond to these needs in better support of equity in the aging process for LGBT+ older adults.