Cereal bar enriched with ora-pro-nóbis (Pereskia aculeata Miller): physicochemical and sensory characterization.

Ora-pro-nobis (OPN) is an unconventional food plant with high nutritional value, and its nutritional composition can be altered according to cultivation. Cereal bars are a popular nutrient-poor foods, and OPN could be incorporated to improve the nutritional quality. This study aimed to evaluate the physicochemical characteristics and sensory acceptability of cereal bars enriched with OPN flour (OpnF) from different forms of cultivation. OpnF was obtained by dehydrating and grinding OPN leaves collected in rural (ROpnF) and urban (UOpnF) municipalities. Two formulations of cereal bars, peanut flavor (Bpn) and mango flavor (Bmg), each with 10% OpnF, were prepared. The macronutrients and mineral composition, oxalate content, water activity, texture, color profile, and acceptability were evaluated. ROpnF had the highest protein, iron, and manganese content, whereas UOpnF had the highest ash and magnesium content. The oxalic acid/calcium ratio was 1.43 and did not imply calcium bioavailability. In addition to nutritional and protein values, Bpn and Bmg presented a good sensory acceptability index of > 77.5% with market potential. Bmg has the highest mineral content and is a source of iron, manganese, and magnesium. OpnF can be used in cereal bars and potentially improve nutritional attributes and used in other foods in a similar way.

Light conditions affect the growth, chemical composition, antioxidant and antimicrobial activities of the white-rot fungus Lentinus crinitus mycelial biomass.

The mycelial biomass of basidiomycetes is a promising source of compounds and represents an alternative for industrial and biotechnological applications. Fungi use light as information and hold photoresponse mechanisms, in which sensors respond to light wavelengths and regulate various biological processes. Therefore, this study aimed to investigate the effects of blue, green, and red lights on the growth, chemical composition, and antioxidant and antimicrobial activity of Lentinus crinitus mycelial biomass. The chemical composition of the mycelial biomass was determined by chromatographic methods, antioxidant activity was analyzed by in vitro assays, and antimicrobial activity was investigated by the microdilution assay. The highest mycelial biomass yield was observed under blue-light cultivation. Many primordia arose under blue or green light, whereas the stroma was formed under red light. The presence of light altered the primary fungal metabolism, increasing the carbohydrate, tocopherol, fatty acid, and soluble sugar contents, mostly mannitol, and reducing the protein and organic acid concentrations. Cultivation under red light increased the phenol concentration. In contrast, cultivation under blue and green lights decreased phenol concentration. Benzoic and gallic acids were the main phenolic acids in the hydroalcoholic extracts, and the latter acids increased in all cultures under light, especially red light. Mycelial biomass cultivated under red light showed the highest antioxidant activity in the 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay. The ferric reducing antioxidant power (FRAP) method showed that all light wavelengths increased the antioxidant activity of mycelial biomass, with the highest value under red light. Moreover, the ß-carotene/linoleic acid co-oxidation (BCLA) assay demonstrated that the antioxidant activity was affected by light cultivation. Mycelial biomass grown under all conditions exhibited antibacterial and antifungal activities. Thus, mycelial biomass cultivation of L. crinitus under light conditions may be a promising strategy for controlling the mycelial chemical composition and biomass yield.

Factors That Can Prolong Ocular Treatment Duration in Age-Related Macular Degeneration.

Intravitreal injections of anti-vascular endothelial growth factor (VEGF) agents are used to treat wet age-related macular degeneration (wAMD); however, they are associated with a considerable treatment burden and poor real-world outcomes. The molecular size and charge of anti-VEGF agents influence drug pharmacokinetics in the vitreous and peak drug efficacy. This article reviews the established and novel strategies to prolong drug action, in the vitreal cavity, and thus reduce dosing frequency. Increased ocular residency can be attained by increasing drug size as with large molecules, such as KSI-301; adding polyethylene glycol to pegcetacoplan (APL-2) or avacincaptad pegol to increase molecular size; or binding to other targets that increase molecular size, such as vitreal albumin in the case of BI-X. Faricimab is a bispecific antibody in which the fragment crystallizable portion is engineered to prolong ocular residency and reduce systemic exposure. Conversely, small VEGF-binding molecules, such as brolucizumab, can be administered at higher clinical doses, with the potential for prolonged clinical activity versus larger molecules. Other important considerations include sustained drug delivery routes, such as the ranibizumab port delivery system or subconjunctival or suprachoroidal injection. More effective and longer-lasting treatments are needed for wAMD to prolong drug action and reduce dosing frequency. Several strategies are under investigation and the prevention of vision loss in patients with AMD or other retinal diseases may be attainable in the near future.

The Optical Coherence Tomography and Microperimetry Biomarker Evaluation in Patients with Geographic Atrophy (OMEGA) Study: Design and Baseline Characteristics - OMEGA Report 1.

INTRODUCTION: The aim of this study was to describe the design and the participants' baseline characteristics of a prospective natural history study of geographic atrophy (GA) secondary to age-related macular degeneration. METHODS: The optical coherence tomography (OCT) and microperimetry biomarker evaluation in patients with GA (OMEGA) study was conducted at a tertiary referral center (ClinicalTrials.gov identifier: NCT05963646). Participants were followed for 12 months during 4 visits (baseline and follow-up exams at weeks 12, 24, and 48) with best-corrected Early Treatment of Diabetic Retinopathy Study visual acuity, low-luminance visual acuity (LLVA), and quick contrast sensitivity function testing. Further, participants underwent spectral-domain OCT, OCT angiography, fundus autofluorescence imaging, and mesopic microperimetry testing. RESULTS: Thirty participants (median [IQR] age of 79 [77, 84] years) and 37 study eyes were included with a (median [IQR]) GA area of 1.40 mm2 (0.49, 5.24) at baseline. Out of 37 study eyes, six developed macular neovascularizations (16%). The study-eye best-corrected visual acuity was (median [IQR]) 0.18 logarithm of the minimum angle of resolution (logMAR) (0.06, 0.26), LLVA 0.66 logMAR (0.36, 0.88), and the microperimetry mean sensitivity 18.4 dB (9.21, 20.9). The highest correlation between square root GA area and a visual function test was evident for LLVA (R2 of 0.578), followed by area under the log contrast sensitivity function curve (0.519) and microperimetral retinal sensitivity (0.487). CONCLUSION: This report lays out the design and baseline characteristics of the OMEGA study, which aims to contribute to the understanding of the natural history of GA. The OMEGA study will provide estimates of the ability to detect change and retest reliability for a panel of structure and functional assessments.

Biosorption of methylene blue by residue from Lentinus crinitus mushroom cultivation.

Conventional textile effluent treatments cannot remove methylene blue, a mutagenic azo dye, and an endocrine disruptor, that remains in the drinking water after conventional water treatment. However, the spent substrate from Lentinus crinitus mushroom cultivation, a waste, could be an attractive alternative to remove persistent azo dyes in water. The objective of this study was to assess the methylene blue biosorption by spent substrate from L. crinitus mushroom cultivation. The spent substrate obtained after mushroom cultivation had been characterized by the point of zero charge, functional groups, thermogravimetric analysis, Fourier transform infrared spectroscopy, and scanning electron microscopy. Moreover, the spent substrate biosorption capacity was determined in function of pH, time, and temperature. The spent substrate had a point of zero charge value of 4.3 and biosorbed 99% of methylene blue in pH from 3 to 9, with the highest biosorption in the kinetic assay of 15.92 mg g- 1, and in the isothermal assay of 120.31 mg g- 1. Biosorption reached equilibrium at 40 min after mixing and best fitted the pseudo-second-order model. Freundlich model best fitted the isothermal parameters and each 100 g spent substrate biosorbed 12 g dye in an aqueous solution. The spent substrate of L. crinitus cultivation is an effective biosorbent of methylene blue and an alternative to removing this dye from water, adding value to the mushroom production chain, and supporting the circular economy.

Utilization of Agro-Industrial Residues in the Rearing and Nutritional Enrichment of Zophobas atratus Larvae: New Food Raw Materials.

Edible insects are a potential alternative food source of high feed conversion efficiency and protein content. Zophobas atratus is an edible insect that adapts to different diets, enabling sustainable rearing by adding value to by-products and agro-industrial residues. This study aimed to evaluate the performance and nutritional characterization of Zophobas atratus larvae fed with different proportions of grape residue. Physicochemical analysis of the diets and larvae (AOAC procedures), fatty acid profile (chromatographic techniques), metals and non-metals (inductively coupled plasma optical emission spectrometry), larval mass gain, feed conversion efficiency, and mortality rate were assessed. The replacement of 25% of the conventional diet with grape residue increased lipid, ash, and fiber contents and reduced protein, carbohydrates, and energy. It promoted greater mass gain, lower mortality rate, and reduced larval growth time by 51%. Among the replacements, 25% resulted in the second-highest content of calcium, sodium, magnesium, and zinc, and the lowest content of potassium and phosphorus in the larvae. The 100% replacement resulted in the highest amounts of C18:2n6 (27.8%), C18:3n3 (2.2%), and PUFA (30.0%). Replacing 25% of the conventional diet with grape residue is equivalent to the conventional diet in many aspects and improves several larvae performance indices and nutritional values.

Endophytic fungi of Brunfelsia uniflora: isolation, cryopreservation, and determination of enzymatic and antioxidant activity.

Brunfelsia uniflora (Pohl.) D. Don (Solanaceae), commonly known as manacá-de-cheiro, is widely distributed in Brazil and used by local indigenous peoples as an antirheumatic, antisyphilitic, depurative, emetic, vermifuge, and purgative agent. Several studies have examined the biological activities and phytochemical profile of Brunfelsia; however, few have focused on the diversity of endophytic microorganisms that colonize members of the genus. This study aimed to isolate and cryopreserve endophytic fungi from B. uniflora and determine their cellulase, laccase, and antioxidant activities. Endophytic fungi were isolated from B. uniflora stems, cultured on wheat grains, immersed in a 150 g L-1 aqueous sucrose solution, and cryopreserved at - 80 °C for 1 and 6 months. Cellulase activity was determined by a qualitative test using carboxymethylcellulose medium and laccase activity by a quantitative test based on the oxidation of 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonate). Prior to antioxidant activity assays, fungi were grown in malt extract broth for production of mycelial biomass. A methanolic extract was prepared for evaluation of DPPH· scavenging activity, FRAP activity, and total phenolic content. A total of 46 endophytic fungal isolates were obtained from B. uniflora stems and classified into 24 groups according to morphological similarities. B. uniflora was shown to harbor different genera of ascomycete fungi as endophytic organisms. Mycelial viability was observed after 1 and 6 months of cryopreservation at - 80 °C. Fungi exhibited cellulase and laccase activities. Isolate CE23 had the highest laccase activity after 7 days of cultivation. Twelve isolates were found to have low total phenolic contents and DPPH· and FRAP activities.

Basidiocarp structures of Lentinus crinitus: an antimicrobial source against foodborne pathogens and food spoilage microorganisms.

Lentinus crinitus basidiocarps are an alternative to antimicrobials, but the stipe (24% basidiocarp) is discarded even with potential antimicrobial activity. This study evaluated the antimicrobial activity of L. crinitus basidiocarp pileus and stipe extracts against foodborne pathogens and food spoilage microorganisms. Basidiocarps of L. crinitus were grown in sugarcane bagasse and rice husks and the pileus and stipe methanolic extract was analyzed by broth microdilution method for antimicrobial activity against eight bacteria and eight fungi. The minimum bactericidal concentration values for pileus and stipe ranged from 0.40 to 0.50 mg mL- 1, for streptomycin from 0.10 to 0.50 mg mL- 1, and for ampicillin from 0.40 to 1.20 mg mL- 1. The minimum fungicidal concentration values for pileus and stipe ranged from 0.06 to 0.60 mg mL- 1, for bifonazole from 0.20 to 0.25 mg mL- 1, and for ketoconazole from 0.30 to 3.50 mg mL- 1. Extracts had bacteriostatic, bactericidal, fungistatic and fungicidal activity against all microorganisms, but with greater efficiency and specificity for some microorganisms. Both pileus and stipe are promising and sustainable alternatives for use in food, agricultural, and pharmaceutical industries.

The Use of Neuroprotective Agents in Treating Geographic Atrophy.

Geographic atrophy (GA) secondary to age-related macular degeneration accounts for close to one-quarter of cases of legal blindness in the USA and the UK. Despite this notable disease burden, the pathophysiology of GA is complex and not fully understood, and there is currently no approved treatment to prevent or slow its progression. GA is heterogeneous in its appearance and extent, and underlying associated traits such as drusen and complement factor polymorphisms vary between patients and by ethnicity, posing a challenge for treatment development. The root cause of vision loss in GA is photoreceptor death; therefore, protecting photoreceptors from damage and delaying their degeneration are key to successful GA treatment. There are multiple neuroprotective pathways that may contribute to protecting photoreceptors from damage, and compounds that target these pathways include antioxidants, neurotrophic factors, and catalases. However, the efficacy of previously trialled neuroprotective therapies in GA, such as brimonidine, tandospirone, and NT-501, has been inconsistent; this may be due to their target of action, method of delivery, and/or suboptimal duration of action. Neurotrophic factors, or molecules involved in neuroprotective signalling cascades, may be ideal agents for further investigation for the treatment of GA. Future neuroprotective strategies in GA must focus on the development of agents with a long duration of action that can combat the progression of chronic damage in GA to provide clinically meaningful benefits for patients.

Red Tomato Products as an Alternative to Reduce Synthetic Dyes in the Food Industry: A Review.

Most dyes used in the food industry are synthetic and can be a health hazard. Red tomato may serve as a natural alternative dye to replace synthetic colorants. This study aimed to review the literature on the addition of red tomato products (powder tomato, paste, freeze-dried, tomato peel powder, tomato pomace) to reduce the usage of synthetic dyes in the food industry. Red tomato products have been used as coloring in pasta, bologna, sausages, cookies, crackers, macaroons, hamburgers, breads, muffins, cheeses, and nuggets. The trans-cis isomerization of lycopene by oxidative processes directly affects the color of the pigment. The lycopene contained in tomato has antioxidant activity and could reduce or eliminate other oxidants and/or synthetic preservatives in food. Moreover, tomatoes in foods have high sensory scores, nutritional appeal, and marketing potential. However, its use as a food colorant has been not extensively explored. Therefore, further studies are still required, especially on the stability of carotenoids in tomatoes used in processed foods.

COMPARISON BETWEEN SEVERAL OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY DEVICES AND INDOCYANINE GREEN ANGIOGRAPHY OF CHOROIDAL NEOVASCULARIZATION.

PURPOSE: To compare indocyanine green angiography and four different optical coherence tomography angiography (OCTA) devices and to test their reproducibility in the evaluation of choroidal neovascularization (CNV). METHODS: This study was an observational case series of Type 1 and Type 2 CNV presenting at the Eye Clinic, Department of Biomedical and Clinical Sciences, Luigi Sacco Hospital, University of Milan, imaged with indocyanine green angiography and four different OCTA devices: prototype PlexElite (Carl Zeiss Meditec), prototype Spectralis OCTA (Spectralis; Heidelberg Engineering, Heidelberg, Germany), Optovue RTVue XR Avanti (Optovue, Inc, Fremont, CA), and AngioPlex (Cirrus 5000 HD-OCT; Carl Zeiss Meditec, Inc, Dublin, CA). Optical coherence tomography angiography examinations were performed using a 3 × 3-mm or 6 × 6-mm volume scan pattern to capture the full lesion. The mean area of CNV, vessel density, and fractal dimension were compared between the devices. RESULTS: Seventeen eyes of 17 patients with CNV were enrolled. The CNV area was significantly larger in indocyanine green angiography than in the OCTA devices. Moreover, the four different instruments produced measurements with different mean values of CNV area, vessel density, and fractal dimension. The Bland-Altman analysis revealed that the limits of agreement for the comparisons were not acceptable. CONCLUSION: The choroidal neovascularization area is larger when imaged with standard indocyanine green angiography than with different OCTA devices with different algorithms, wavelengths, and scan patterns. The differences between several OCTA devices in the evaluation of quantitative parameters of CNV, such as CNV area, vessel density, and fractal dimension, suggest the necessity to standardize OCTA measurements for research and clinical practice.

Iron Or Zinc Bioaccumulated In Mycelial Biomass Of Edible Basidiomycetes.

Iron and zinc bioaccumulation in mycelial biomass of different medicinal basidiomycetes was evaluated in order to produce metal-enriched mycelial biomass as an alternative functional food from non-animal sources and based on biotechnology processes. Pleurotus ostreatus strain U2-9, U2-11, U6-8, and U6-9, Pleurotus eryngii strain U8-11, Schizophyllum commune strain U6-7, and Lentinula edodes strain U6-11 and U6-12 were grown in malt extract agar with or without addition of 50 mg/L iron or 7.5 mg/L zinc. The mycelial biomass was separated and iron and zinc concentrations were determined in a flame atomic absorption spectrophotometer. Basidiomycete strains presented different growth rates with the presence of iron and zinc; there was no dependence between the metal bioaccumulation and the fungal growth. The fungi presented greater capacity to bioaccumulate iron than zinc. P. ostreatus (U2-9) has greater iron bioaccumulation (3197.7 mg/kg) while P. ostreatus (U6-8) greater zinc bioaccumulation (440.4 mg/kg) in mycelial biomass. P. ostreatus (U2-9), P. ostreatus (U2-11), and S. commune (U6-7) had the highest metal translocation rates from the culture medium to mycelial biomass. The mycelial biomass enriched with iron or zinc is an alternative to a new functional food from non-animal sources.

COMPARISON AMONG DIFFERENT DIAGNOSTIC METHODS IN THE STUDY OF TYPE AND ACTIVITY OF CHOROIDAL NEOVASCULAR MEMBRANES IN AGE-RELATED MACULAR DEGENERATION.

PURPOSE: To determine interobserver and intraobserver agreement in classifying the subtypes of choroidal neovascularization (CNV) and the decision of retreatment in patients affected by exudative age-related macular degeneration. Different imaging techniques were evaluated individually and compared with multiimaging. METHODS: Fifty-two patients with naive CNV in age-related macular degeneration were evaluated after 3 monthly intravitreal injections of ranibizumab. Choroidal neovascularization subtype and activity were evaluated using spectral domain optical coherence tomography, infrared light, fundus autofluorescence, fluorescein angiography (FA), and indocyanine green angiography (ICGA). The evaluation was performed independently by 10 different retina specialists, 2 for each test. Other two operators analyzed all the information available together. RESULTS: The interobserver k regarding the types of CNV was 0.69 for multiimaging, 0.63 for spectral domain optical coherence tomography, 0.43 for FA, and 0.46 for ICGA. The k values for interobserver for retreatment decision were 0.77 for multiimaging, 0.88 for spectral domain optical coherence tomography, 0.61 for infrared, 0.37 for fundus autofluorescence, 0.25 for FA, and 0.23 for ICGA. Fluorescein angiography, spectral domain optical coherence tomography, ICGA, and infrared showed good association with multiimaging on defining CNV activity (P = 0.0003, P < 0.0001, P = 0.01, and P = 0.05, respectively). CONCLUSION: Optical coherence tomography and infrared evaluations of CNV activity were reproducible and strongly associated with multiimaging, whereas FA and ICGA evaluations showed poor reproducibility.

OCRIPLASMIN FOR VITREOMACULAR TRACTION: LOOKING OUTSIDE THE MACULA: A Wide-Field Optical Coherence Tomography Study.

PURPOSE: To evaluate baseline features and morphologic changes of vitreoretinal adhesion and outer retinal layers outside the macula after intravitreal ocriplasmin injection. To study the relation between vitreous detachment and attenuation of retinal outer segments signal. METHODS: Retrospective cases series of 15 eyes. Each eye was scanned with the 55° wide-field optical coherence tomography lens in 6 different locations, three horizontal B-scan (central, temporal, and nasal) and three vertical B-scan (central, superior, and inferior) at baseline, 1 week, 1 month, 3 months, and 6 months after injection. RESULTS: After ocriplasmin injection, vitreomacular traction (VMT) resolved in 12 patients (80%), 3 of them presenting a complete posterior vitreous detachment. Eight patients (53%) showed a panretinal attenuation of photoreceptors outer segment signal, 7 with VMT resolution and 1 with non-posterior vitreous detachment and no VMT resolution. In three patients after VMT resolution the attenuation involved also areas with no posterior vitreous detachment. The attenuation resolved during follow-up in 7/8 eyes (87.5%). CONCLUSION: Intravitreal ocriplasmin injection induced resolution of VMT in most cases and more rarely a release of vitreopapillary adhesion and a complete posterior vitreous detachment. An acute panretinopathy was visible in more than half of the patients and was not related to vitreous detachment.

Long-term follow-up of fellow eye in patients with lamellar macular hole.

BACKGROUND: To evaluate macular changes in fellow eyes of patients diagnosed with lamellar macular hole (LMH) using spectral-domain optical coherence tomography (SD-OCT) and blue fundus autofluorescence (B-FAF). METHODS: Fellow eyes of patients diagnosed with a LMH were retrospectively evaluated on OCT. Best-corrected visual acuity (BCVA) and central foveal thickness (CFT) were recorded. Corresponding B-FAF images, vitreo-macular relations, and type of epiretinal membranes (ERMs) were also examined. RESULTS: Thirty-five patients were included. At baseline, six fellow eyes (17%) showed a normal foveal profile, 26 (74%) had a tractional ERM, and three cases (9%) revealed a bilateral LMH, one of them with a lamellar hole-associated epiretinal proliferation (LHEP). A posterior vitreous detachment (PVD) was present in 29 patients (83%), four (11%) had only a vitreo-papillary adhesion (VPA), and two (6%) had both vitreo-macular adhesion (VMA) and VPA. After a mean follow-up of 4.6 ± 1.9 years, one eye (3%) developed a vitreous detachment from the macula with persistent VPA, and one developed a PVD from a VPA with subsequent ERM formation. BCVA and mean CFT remained stable in 35 eyes (100%). Likewise, no B-FAF signal variations were detected. One patient developed a LMH during the 3rd year of follow-up. CONCLUSIONS: Our data suggest that the presence of a LMH in one eye does not increase significantly the risk of developing the same condition in the fellow eye after 4 years. Bilateral condition is uncommon, and an ERM is often detected in the fellow eye. LHEPs were not observed in fellow eyes with foveal integrity, and all LHEPs observed (in main and fellow eyes) were always associated with LMHs; this supports the hypothesis that LHEP is a consequence and not a causative factor for LMHs. The occurrence of a LMH in one fellow eye after 3 years follow-up may suggest that a higher incidence of bilateral disease could develop in a longer time span.

Dark Atrophy: An Optical Coherence Tomography Angiography Study.

PURPOSE: To assess the status of choriocapillaris in eyes with macular atrophy secondary to age-related macular degeneration (AMD) (geographic atrophy [GA]) and Stargardt disease (STGD) using optical coherence tomography angiography (OCTA). DESIGN: Prospective, observational case series. PARTICIPANTS: A total of 14 patients (20 eyes) affected by GA and 10 patients (20 eyes) affected by STGD. METHODS: Each patient underwent a complete ophthalmological examination including fundus autofluorescence (FAF), dynamic simultaneous fluorescein angiography (FA) and indocyanine green angiography (ICGA), enhanced-depth imaging optical coherence tomography (EDI-OCT) (HRA+OCT Spectralis, Heidelberg Engineering, Heidelberg, Germany), and OCTA using AngioVue technologies (Optovue Inc, Freemont, CA). MAIN OUTCOME MEASURES: An evaluation of the status of choriocapillaris in the 2 groups was performed. RESULTS: Patients' mean age was 75 years for subjects with GA (median, 76 years; range, 63-88 years) and 61 years for STGD (median, 62 years; range, 40-74 years). Atrophy was bilateral in 42% (n = 6) of subjects with GA and 100% (n = 10) of subjects with STGD. In the early frames, FA displayed hyperfluorescence in the atrophic area in 100% (n = 20) of eyes affected by GA and 20% (n = 4) of eyes affected by STGD; dark choroid was present in 0% of GA eyes and 65% of STGD eyes (n = 13). Atrophy in ICGA late frames was hypofluorescent in 20% (n = 4) of GA eyes and 100% (n = 20) of STGD eyes. A ring at atrophy margins was detected in both FA (90%, n = 18) and ICGA (100%, n = 20) in STGD eyes. Mean subfoveal choroidal thickness was 156 µm (147, 42-362 µm) for GA eyes and 168 µm (167, 55-320 µm) for STGD eyes (P = 0.59). At OCTA evaluation, GA eyes showed persisting, rarefied choriocapillaris in correspondence of retinal pigment epithelium (RPE) atrophy in 80% (n = 16) of cases, whereas eyes affected by STGD had disappearance of this tissue in 100% (n = 20; P < 0.0001). CONCLUSIONS: Analysis of macular atrophy by OCTA in patients with STGD revealed an extensive loss of choriocapillaris in the central area with persisting tissue at its margins, whereas in those with GA the area of RPE loss showed persistent but rarefied choriocapillaris.

Interpretation of fundus autofluorescence changes in choriocapillaritis: a multi-modality imaging study.

PURPOSE: We aimed to describe imaging findings in primary inflammatory choriocapillaropathies (PICCPs) after a photobleaching process. METHODS: 2Images from six consecutive cases of patients affected by PICCPs (four with multiple evanescent white dot syndrome and two with multifocal choroiditis) were reviewed. Patients underwent fundus autofluorescence (FAF), fluorescein angiography (FA), indocyanine green angiography (ICGA), and spectral-domain optical coherence tomography (SD-OCT) by means of the Spectralis HRA (Heidelberg Engineering, Heidelberg, Germany). FAF images were acquired at the beginning of the examination in partially dark-adapted conditions followed by light adapted conditions. RESULTS: During the active phase of the diseases, all patients showed areas of increased FAF that became isoautofluorescent after photobleaching. Simultaneously with increased FAF, the ICGA showed typical hypofluorescent dark areas that were more evident in the late phase. SD-OCT showed disruptions in the hyper-reflective band at the ellipsoid zone. CONCLUSIONS: FAF and SD-OCT are complementary imaging techniques that show alterations in the outer retina of patients affected by PICCPs.

RETINAL ANGIOMATOUS PROLIFERATION DIAGNOSIS: A Multiimaging Approach.

PURPOSE: To identify signs occurring more frequently in retinal angiomatous proliferation (RAP) lesions compared with other types of choroidal neovascularization (CNV) in age-related macular degeneration. METHODS: In this cross-sectional retrospective study, 30 patients were evaluated. These signs were correlated with the type of CNV: shunting of blood flow to the lesion by fluorescein angiography, late leakage by indocyanine green angiography, intraretinal cysts and retinal pigmented epithelium interruption along the retinal pigmented epithelium detachment with a hyperreflective oval area by spectral domain optical coherence tomography, and presence of reticular pseudodrusen by infrared light. RESULTS: Shunting of blood flow was found in 56% of RAP, whereas it was absent in 100% of other CNVs. Late leakage in indocyanine green angiography occurred in all RAP cases, while it was found in 7% of other CNVs. Intraretinal cysts were detected in 100% of RAP cases and in 14% of other CNVs. Retinal pigmented epithelium interruption along the retinal pigmented epithelium detachment was evident in 93% of RAP cases and in 15% of other CNVs. Reticular pseudodrusen were present in 87% of RAP cases and in 21% of other CNVs. CONCLUSION: All the signs investigated were strongly associated to RAP lesions. A multimodal imaging approach may help differentiating subtypes of neovascularization.

Predominance of the critical shoulder angle in the pathogenesis of degenerative diseases of the shoulder.

HYPOTHESIS: The critical shoulder angle (CSA) could be responsible for cuff tears and concentric osteoarthritis. We aimed to assess this association when potential confounding factors were excluded and to test the hypothesis that more extreme CSAs are associated with larger tears and more severe osteoarthritis. METHODS: The study cohort was composed of 200 patients with primary concentric osteoarthritis (40 patients), isolated supraspinatus tears (40 patients), cuff tears involving at least the supraspinatus and infraspinatus (40 patients), and no history of shoulder problems (control group, 80 patients). Data pertaining to CSA, age, gender, dominant arm, smoking, hypertension, body mass index, and type of work were collected. RESULTS: The average CSA angle was 34° ± 3° in the control group, 36° ± 3° with supraspinatus tears, 40° ± 3.5° with supraspinatus and infraspinatus tears, and 28° ± 2° with concentric osteoarthritis. Patients with large cuff tears had a significantly greater CSA compared with those with isolated supraspinatus tears (P = .03). The CSA (odds, 1.7; confidence interval [CI], 1.4-2.0) was the most relevant risk factor for cuff tears. The Spearman coefficient between CSA and grade of eccentric osteoarthritis was 0.4 (P = .01). The 2 significant risk factors for concentric osteoarthritis were the CSA (odds, 0.5; CI 0.4-0.6) and age (odds, 1.1; CI, 1.0-1.2). CONCLUSION: Larger CSAs are associated with increased risk of symptomatic cuff tears, larger cuff tears, and the severity of eccentric osteoarthritis. Smaller angles increased the risk and severity of concentric symptomatic osteoarthritis. These associations remained significant even after removal of some of the potentially confounding variables.

Enhanced depth imaging optical coherence tomography features of choroidal osteoma.

PURPOSE: To describe the choroidal findings in eyes affected by choroidal osteoma imaged by enhanced depth imaging optical coherence tomography. METHODS: Retrospective case series. RESULTS: Seven eyes from five patients with choroidal osteoma were included in the study. Patients mean age of presentation was 26 years (median, 34; range, 6-37 years) and mean best-corrected visual acuity was 20/32 (median, 20/20; range, 20/20-20/200). Enhanced depth imaging optical coherence tomography examination revealed normal inner retina in all the cases and normal outer retina in three eyes. Abnormalities included irregularities in external limiting membrane (n = 2), myoid zone (n = 1), ellipsoid junction (n = 4), cone outer segments of photoreceptors (n = 5), and retinal pigment epithelium (n = 3). Choroidal analysis revealed thinned (n = 4) or non visible (n = 2) choriocapillaris, thinned (n = 3) or non visible (n = 4) medium vessels, and thinned large vessels layer (n = 4). The osteoma showed multiple intralesional layers (n = 5), a sponge-like appearance (n = 7), and intralesional vessels (n = 7). The sclero-choroidal junction was visible in all cases. Choroidal neovascularization was found in four eyes. CONCLUSION: Analysis of eyes affected by choroidal osteoma revealed a characteristic sponge-like tumor appearance with the presence of multiple intralesional layers. The lesion showed a typical transparency with visibility of sclero-choroidal junction in all cases.