Lesion area progression in eyes with neovascular age-related macular degeneration treated using a proactive or a reactive regimen.

BACKGROUND: To compare the change in lesion area over 4 years of follow-up in eyes with neovascular age-related macular degeneration (nAMD) treated with anti-vascular endothelial growth factor (VEGF) agents using either a proactive or a reactive regimen in routine clinical practice. METHODS: This was a multicentre, retrospective comparative study. Totally, 202 treatment-naïve nAMD eyes (183 patients) received anti-VEGF therapy according to a proactive (n = 105) or reactive (n = 97) regimen. Eyes were included if they had received anti-VEGF injections for a period of at least 4 years and had baseline fluorescein angiography and annual optical coherence tomography (OCT) imaging. Two masked graders independently delineated the lesion's margins from serial OCT images and growth rates were calculated. RESULTS: At baseline, the mean [SD] lesion area was 7.24 [5.6] mm2 in the proactive group and 6.33 [4.8] mm2 in the reactive group respectively (p = 0.22). After four years of treatment, the mean [SD] lesion area in the proactive group was 5.16 [4.5] mm2 showing a significant reduction compared to the baseline (p < 0.001). By contrast, the mean [SD] lesion area kept expanding in the reactive group during the follow-up and was 9.24 [6.0] mm2 at four years (p < 0.001). The lesion area at 4 years was significantly influenced by treatment regimen, baseline lesion area, and proportion of visits with active lesions. CONCLUSIONS: Eyes treated using a reactive strategy had an increased lesion area and worse visual outcomes at 4 years. By contrast, the proactive regimen was associated with fewer recurrences of active disease, shrinkage of the lesion area, and better vision at four years.

Multimodal imaging of retinitis pigmentosa associated with Mainzer-Saldino syndrome.

Background: Syndromic ciliopathies have been variably linked to different retinal dystrophies. However, to date, few reports have characterized by means of multimodal imaging the retinal degeneration occurring in Mainzer-Saldino syndrome (MSS).Methods: Two siblings with history of kidney disease and other systemic abnormalities presented at our eye clinic in October 2017 complaining of night blindness and visual loss. They underwent a complete ophthalmologic examination including visual acuity (VA) assessment, optical coherence tomography (OCT) and blue-light autofluorescence (BAF). A screen for inherited retinal dystrophies was performed in this occasion.Results: At baseline, the youngest sister had slightly worse VA (20/30 vs. 20/20-25 Snellen equivalents). On fundoscopy, both siblings had severe thinning of the peripheral retina, attenuation of retinal vessels and widespread accumulation of pigmented deposits. Significant outer retinal atrophy with apparent foveal sparing was appreciable on OCT.During the 3 years of follow-up, vision remained overall stable in both patients whereas minimal progression of outer retinal atrophy was observed by means of OCT. Genetic analysis revealed compound heterozygosity in the IFT172 gene. Based on these findings, a diagnosis of retinitis pigmentosa (RP) associated with MSS was formulated.Conclusions: Our report describes the cases of two siblings affected by retinitis pigmentosa associated with MSS. Although both carrying the same mutations and a severe RP phenotype, the youngest sister had slightly more advanced retinal degeneration highlighting the remarkable variability related to the IFT172 retinopathy.

Foot Inertial Sensing for Combined Cognitive-Motor Exercise of the Sustained Attention Domain.

OBJECTIVE: In the past decade, cognitive training tools have been used to improve brain functioning, and some have been applied to cognitive decline in dementia. Recently, research studies have demonstrated that aerobic exercise could play an important restorative role toward cognitive impairments. Therefore, the main objective of this paper is to present the innovative use of the SmartWalk tool, which combines aerobic exercise and cognitive protocols traditionally used to stimulate cognitive function. METHODS: The primary goal of this study to demonstrate if our tool is correlated with traditional computerized test in stimulating the cognitive system similarly, despite the fact that SmartWalk adds a supplementary physical load on the task. The SmartWalk tool was tested with a total of 49 subjects-29 healthy subjects and 20 subjects with Mild Cognitive Impairments. The participants were asked to perform both the tests to fulfil the proposed goal. RESULTS: The results obtained considering the overall population show a good and significant (p < 0.05) correlation for the "correct," "error," and "omitted" scores (r = 0.54, r = 0.34, and r = 0.39, respectively). CONCLUSION: The results suggest a good correlation between the two approaches with the advantage of adding aerobic exercise to the traditional cognitive task. SIGNIFICANCE: The results of this study may be useful in designing ecological and combined cognitive-physical tool to personalize interventions and delay the onset of cognitive disorders like dementia.

Can physical and cognitive training based on episodic memory be combined in a new protocol for daily training?

BACKGROUND: Cognitive training (CT) is defined as guided practice on a set of standard tasks designed to stimulate particular cognitive functions. Recent studies have shown that physical exercise is beneficial for cognitive activity in older adults and patients with degenerative diseases. AIMS: The main objective of the present study is to create a new cognitive tool able to provide training for cognitive functions that take advantage of the physical activity involved in the execution of the task. A study concerning the application of a new CT tool for episodic memory is presented and divided in two parts. The first one aims at developing a new sensorized device, called SmartTapestry, for physical and cognitive training. The second part aims at understanding its technical viability and level of sensitivity in stimulating the same cognitive domain covered by the standardized tests, despite the introduction of the physical activity variable. METHODS: The SmartTapestry device was tested with a total of 53 subjects, 29 healthy subjects and 24 subjects suffering from mild cognitive impairment. RESULTS AND DISCUSSIONS: The results show a good correlation between the two approaches (p < 0.005), suggesting that SmartTapestry can stimulate the same cognitive functions of traditional cognitive tasks, with the addition of physical exercise. CONCLUSIONS: The results of this study may be useful in designing ecological and combined cognitive-physical tools, which can be used daily at home, reducing the presence of clinical staff, to train at the same time the brain and the body so as to improve the cognitive treatments efficacy.

Robotic Services Acceptance in Smart Environments With Older Adults: User Satisfaction and Acceptability Study.

BACKGROUND: In Europe, the population of older people is increasing rapidly. Many older people prefer to remain in their homes but living alone could be a risk for their safety. In this context, robotics and other emerging technologies are increasingly proposed as potential solutions to this societal concern. However, one-third of all assistive technologies are abandoned within one year of use because the end users do not accept them. OBJECTIVE: The aim of this study is to investigate the acceptance of the Robot-Era system, which provides robotic services to permit older people to remain in their homes. METHODS: Six robotic services were tested by 35 older users. The experiments were conducted in three different environments: private home, condominium, and outdoor sites. The appearance questionnaire was developed to collect the users' first impressions about the Robot-Era system, whereas the acceptance was evaluated through a questionnaire developed ad hoc for Robot-Era. RESULTS: A total of 45 older users were recruited. The people were grouped in two samples of 35 participants, according to their availability. Participants had a positive impression of Robot-Era robots, as reflected by the mean score of 73.04 (SD 11.80) for DORO's (domestic robot) appearance, 76.85 (SD 12.01) for CORO (condominium robot), and 75.93 (SD 11.67) for ORO (outdoor robot). Men gave ORO's appearance an overall score higher than women (P=.02). Moreover, participants younger than 75 years understood more readily the functionalities of Robot-Era robots compared to older people (P=.007 for DORO, P=.001 for CORO, and P=.046 for ORO). For the ad hoc questionnaire, the mean overall score was higher than 80 out of 100 points for all Robot-Era services. Older persons with a high educational level gave Robot-Era services a higher score than those with a low level of education (shopping: P=.04; garbage: P=.047; reminding: P=.04; indoor walking support: P=.006; outdoor walking support: P=.03). A higher score was given by male older adults for shopping (P=.02), indoor walking support (P=.02), and outdoor walking support (P=.03). CONCLUSIONS: Based on the feedback given by the end users, the Robot-Era system has the potential to be developed as a socially acceptable and believable provider of robotic services to facilitate older people to live independently in their homes.

Ultrabiomicroscopy Anterior Segment Evaluation of Ocular Contusive Trauma Caused by Pressurized Bottled Drink Caps: A Case Report.

We report the case of a patient presented to the emergency department because of a contusive trauma from a pressurized bottled drink cap. During the visit, the patient indicated that he had been hit in his left eye by a cork while he was opening a sparkling wine bottle. He underwent a total ophthalmology examination. He had an important reduction of visual acuity, corneal swelling, Descemet's folds, and hyphema. Therefore, we decided to perform ultrabiomicroscopy (UBM) of the anterior segment to study the endothelial damage and Descemet's membrane. UBM images confirmed the direct biomicroscopy, highlighting the damaged location.

Ocriplasmin in the Treatment of Vitreomacular Traction in a Patient with Central Retinal Vein Occlusion: A Case Report.

AIM: To investigate the efficacy of intravitreal injection of ocriplasmin (JETREA®) in the treatment of vitreomacular traction (VMT). MATERIALS AND METHODS: An 81-year-old man with VMT associated with central retinal vein occlusion in his left eye, was treated with a single intravitreal injection of ocriplasmin (25 µg). Best corrected visual acuity (BCVA), ocular fundus, and optical coherence tomography were examined before and after treatment. RESULTS: Complete release of VMT produced a reduction of central macular thickness, ranging from 459 to 141 µm. BCVA remained stable. DISCUSSION AND CONCLUSIONS: The use of ocriplasmin was effective in the treatment of VMT. Ocriplasmin represents a valid alternative to conventional pars plana vitrectomy.

Ambient Assisted Living and ageing: preliminary results of RITA project.

The ageing of population is a social phenomenon that most of worldwide countries are facing. They are, and will be even more in the future, indeed trying to find solutions for improving quality of life of their elderly citizens. The project RITA wants to demonstrate that an update of the current socio-medical services with an Ambient Assisted Living (AAL) approach could improve the service efficiency and the quality of life of both elderly and caregiver. This paper presents the preliminary results obtained in RITA.

Hydrodynamics of binary fluid phase segregation.

Starting with the Vlasov-Boltzmann equation for a binary fluid mixture, we derive an equation for the velocity field u when the system is segregated into two phases (at low temperatures) with a sharp interface between them. u satisfies the incompressible Navier-Stokes equations together with a jump boundary condition for the pressure across the interface which, in turn, moves with a velocity given by the normal component of u. Numerical simulations of the Vlasov-Boltzmann equations for shear flows parallel and perpendicular to the interface in a phase segregated mixture support this analysis. We expect similar behavior in real fluid mixtures.