Intelligent-assistant system for scleral spur location.

A system based on the use of two artificial neural networks (ANNs) to determine the location of the scleral spur of the human eye in ocular images generated by an ultrasound biomicroscopy is presented in this paper. The two ANNs establish a relationship between the distance of four manually placed landmarks in an ocular image with the coordinates of the scleral spur. The latter coordinates are generated by the expert knowledge of a subject matter specialist. Trained ANNs that generate good results for scleral spur location are incorporated into a software system. Statistical indicators and results yield an efficiency performance above 95%.

[Coat's disease treated with bevacizumab (Avastin)]. / Enfermedad de coats tratada con bevacizumab (Avastin).

CASE REPORT: We report a case of Coats' disease in a 10-year-old-girl who presented with a profound visual deficit, exudative retinal detachment, vascular telangiectasias and subretinal lipid, who underwent treatment with an intravitreal injection of bevacizumab (AVASTIN(TM)). Serial examinations documented an involutional response with a reduction of the subretinal fluid, exudates and macular thickness. DISCUSSION: The aetiology of Coats' disease remains uncertain, as does its optimal management. Although resolution of a case depends partially on age, and can even occur spontaneously on rare occasions, intravitreal injections of bevacizumab should be considered when planning treatment.

Functional Outcomes 18 Months After Total and Midarm Transplantation: A Case Report.

BACKGROUND: The function reported after arm transplantation is deemed beneficial relative to the marked disability that upper arm amputation causes. OBJECTIVE: We report a 51-year-old man with a Disabilities of the Arm, Shoulder and Hand (DASH) score of 75.83 who underwent bilateral arm transplantation in October 2015. PROCEDURE: The right arm was transplanted at the glenohumeral joint level, including transplantation of the humeral head, joint capsule, and rotator cuff ligaments and tendons. Additionally, neurorrhaphies were performed at the origin of the terminal branches of the brachial plexus, including the axillary and musculocutaneous nerves. Therefore, this was considered a total arm transplantation. The left arm was transplanted at the transhumeral level, with complete transplantation of the biceps and triceps brachii, and terminolateral neurorrhaphy of the donor musculocutaneous nerve to the receptor radial nerve. A maintenance triple immunosuppression scheme was administered, with tacrolimus levels kept at 10 ng/mL. RESULTS: At 18 months post-transplantation, the intrinsic musculature in the left hand showed electrical registry, DASH score was 67.5, Carroll test score was 28 in both extremities, Hand Transplant Score System was 67.5 in the right extremity and 77.5 in the left extremity, and Short Form-36 score was 96.1. The patient was healthy, with restored body integrity. He could lift medium-sized weightless objects, eat and go to the bathroom by himself, drink liquids with bimanual grasp, swim, dress almost independently, and drive. CONCLUSION: The functional evolution of the patient was similar to previously reported transplanted arms, even though the right arm transplant involved the glenohumeral joint and axillary and musculocutaneous nerve repair.

Enfermedad de Coats tratada con bevacizumab (Avastin(R)) / Coat´s disease treated with bevacizumab (Avastin(R))

Caso clínico: Se presenta el caso de una niña de 10 años de edad con enfermedad de Coats que acude por mala agudeza visual y desprendimiento exudativo de retina, telangiectasias y lípido subretiniano, a quien se le aplicó una inyección intravítrea de Bevacizumab (AVASTIN™). Revisiones subsecuentes del fondo de ojo mostraron una reducción del líquido subretiniano, exudados y disminución del grosor macular. Discusión: La etiología de la enfermedad de Coats no es clara. Es difícil predecir la evolución de un caso y depende en parte de la edad, el tratamiento es incierto. La inyección intravítrea de Bevacizumab es una opción que puede considerarse

Case Report: We report a case of Coats' disease in a 10-year-old-girl who presented with a profound visual deficit, exudative retinal detachment, vascular telangiectasias and subretinal lipid, who underwent treatment with an intravitreal injection of bevacizumab (AVASTIN™). Serial examinations documented an involutional response with a reduction of the subretinal fluid, exudates and macular thickness. Discussion: The aetiology of Coats' disease remains uncertain, as does its optimal management. Although resolution of a case depends partially on age, and can even occur spontaneously on rare occasions, intravitreal injections of bevacizumab should be considered when planning treatment (Arch Soc Esp Oftalmol 2008; 83: 329-332)