An optical coherence tomography-based grading of diabetic maculopathy proposed by an international expert panel: The European School for Advanced Studies in Ophthalmology classification.

AIMS: To present an authoritative, universal, easy-to-use morphologic classification of diabetic maculopathy based on spectral domain optical coherence tomography. METHODS: The first draft of the project was developed based on previously published classifications and a literature search regarding the spectral domain optical coherence tomography quantitative and qualitative features of diabetic maculopathy. This draft was sent to an international panel of retina experts for a first revision. The panel met at the European School for Advanced Studies in Ophthalmology headquarters in Lugano, Switzerland, and elaborated the final document. RESULTS: Seven tomographic qualitative and quantitative features are taken into account and scored according to a grading protocol termed TCED-HFV, which includes foveal thickness (T), corresponding to either central subfoveal thickness or macular volume, intraretinal cysts (C), the ellipsoid zone (EZ) and/or external limiting membrane (ELM) status (E), presence of disorganization of the inner retinal layers (D), number of hyperreflective foci (H), subfoveal fluid (F), and vitreoretinal relationship (V). Four different stages of the disease, that is, early diabetic maculopathy, advanced diabetic maculopathy, severe diabetic maculopathy, and atrophic maculopathy, are based on the first four variables, namely the T, C, E, and D. The different stages reflect progressive severity of the disease. CONCLUSION: A novel grading system of diabetic maculopathy is hereby proposed. The classification is aimed at providing a simple, direct, objective tool to classify diabetic maculopathy (irrespective to the treatment status) even for non-retinal experts and can be used for therapeutic and prognostic purposes, as well as for correct evaluation and reproducibility of clinical investigations.

Nematic order in a degenerate Hubbard model with spin-orbit coupling.

Using Bogoliubov's inequality we rigorously show that the multiorbital Hubbard model with narrow bands, even in the presence of spin-orbit coupling, does not exhibit long-range nematic order, in low dimensions. This result holds at any finite temperature for both repulsive and attractive Coulomb interactions, with and without spin-orbit coupling.

Surgical treatments of central retinal vein occlusion.

Central retinal vein occlusion is a common retinal disease with usually severe complications. At present no safe treatment exists promoting the recovery of lost vision. Several surgical approaches to modify the natural course of the disease have been proposed in recent years. These options include laser-induced chorioretinal venous anastomosis, the injection of tissue plasminogen activator into a retinal vein, optic nerve decompression, and vitrectomy for macular edema. Even though all the proposed treatments have not yet been supported by randomized clinical trials, these techniques can be considered as innovative in an area where no effective treatment is available. Larger clinical trials are required to assess both the effectiveness and complication rate of surgical treatments designed to reverse the natural evolution of central retinal vein occlusion.