scholarly journals Progression of Subclinical Pachychoroid Neovasculopathy to an Active Neovascularization in the Presence of Acquired Vitelliform Lesions

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Manoj Soman ◽  
Sameer Iqbal ◽  
Jay U. Sheth ◽  
Padmanaban Meleth ◽  
Unnikrishnan Nair

We describe a unique case of bilateral acquired vitelliform lesions in a 67-year-old-female with pachychoroid associated with subretinal fluid in the right eye (OD) and a nonexudative choroidal neovascular membrane (CNVM) in the left eye (OS). Multimodal imaging performed at baseline and over the ensuing two years showed an increase in the OS vitelliform lesions with a concurrent transformation of quiescent CNVM to an exudative form. Further studies are warranted to gain better insight into the etiopathogenesis of these vitelliform lesions in pachychoroid and their potential role in instigating CNVM activation.

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Geun Woo Lee ◽  
Hyeon Cheol Roh ◽  
Se Woong Kang ◽  
A. Young Kim ◽  
Hoon Noh ◽  
...  

AbstractThis study aimed to identify the clinical characteristics and longitudinal changes in exudative pachychoroid neovasculopathy (PNV) and non-exudative PNV. This retrospective cohort study involved 81 eyes of PNV diagnosed by multimodal imaging including optical coherence tomography angiography. At baseline, they were divided into exudative PNV group and non-exudative PNV group depending on the presence of subretinal fluid. The clinical features of both groups and the longitudinal changes were investigated and compared. There were 55 eyes with non-exudative PNV and 26 eyes with exudative PNV. Individuals with non-exudative PNV were older, more frequently asymptomatic and had a higher prevalence of polypoidal choroidal vasculopathy in the opposite eye (all P’s < 0.05). Whereas individuals with exudative PNV showed thicker choroid and more frequent history of central serous chorioretinopathy (all P’s < 0.001). During about 12 months of longitudinal observation, the transformation into polypoidal choroidal vasculopathy was noted in 4 eyes of non-exudative PNV group, whereas in none of the exudative PNV group. Exudative PNV and non-exudative PNV seem to be separate entities with different epidemiological parameters. Non-exudative PNV, which is frequently found without symptoms at an older age, is suspected to be the significant precursor lesion of polypoidal choroidal vasculopathy. In contrast, exudative PNV may share the same pathophysiology as central serous chorioretinopathy.


2020 ◽  
Vol 17 (1) ◽  
pp. 56-69
Author(s):  
Aishath Muneeza ◽  
Zakariya Mustapha

Limitations of action designate extent of time after an event, as set by statutes of limitations, within which legal action can be initiated by a party to a transaction. No event is actionable outside the designated time as same is rendered statute-barred. This study aims to provide an insight into application and significance of Limitations Act 1950 and Limitation Ordinance 1952 to Islamic banking matters in Malaysia as well as Shariah viewpoint on the issue of limitation of action. In conducting the study, a qualitative research methodology is employed where reported Islamic banking cases from 1983 to 2018 in Malaysia were reviewed and analysed to ascertain the application of those statutes of limitations to Islamic banking. Likewise, relevant provisions of the statutes as invoked in the cases were examined to determine possible legislative conflicts between the provisions and the rule of Islamic law in governing the right and limitation of action in Islamic banking cases under the law. The reviewed cases show the extent to which statutes of limitations were invoked in Malaysian courts in determining validity of Islamic banking matters. The limitation provisions so referred to are largely sections 6(1)(a) and 21(1) Limitations Act 1953 and section 19 Limitation Ordinance 1953, which do not conflict with Shariah viewpoint on the matter. This study will prove invaluable to financial institutions and their customers alike in promoting knowledge and creating awareness over actionable event in the course of their transactions.


2015 ◽  
Vol 18 (6) ◽  
pp. 253
Author(s):  
Renyuan Li ◽  
Yiming Ni ◽  
Peng Teng ◽  
Weidong Li

<p>Coronary artery fistula (CAF) is a rare entity. Sometimes it may associate with mild diffuse or segmental coronary ectasia. CAF with giant coronary artery is exceptionally rare. We present a unique case of a 49-year-old female patient with a giant right coronary artery of diffuse ectasia coexisting with a fistula draining into the right ventricle. To our best knowledge, CAF with diffuse coronary ectasia of such giant size has never been reported. The patient was treated successfully by resection of the dilated right coronary artery, fistula closure, and coronary artery bypass grafting.</p>


Author(s):  
Jérémie Gilbert

The issue of sovereignty over natural resources has been a key element in the development of international law, notably leading to the emergence of the principle of States’ permanent sovereignty over their natural resources. However, concomitant to this focus on States’ sovereignty, international human rights law proclaims the right of peoples to self-determination over their natural resources. This has led to a complex and ambivalent relationship between the principle of States’ sovereignty over natural resources and peoples’ rights to natural resources. This chapter analyses this conflicting relationship and examines the emergence of the right of peoples to freely dispose of their natural resources and evaluates its potential role in contemporary advocacy. It notably explores how indigenous peoples have called for the revival of their right to sovereignty over natural resources, and how the global peasants’ movement has pushed for the recognition of the concept of food sovereignty.


Molecules ◽  
2021 ◽  
Vol 26 (3) ◽  
pp. 767
Author(s):  
Kamar Hamade ◽  
Ophélie Fliniaux ◽  
Jean-Xavier Fontaine ◽  
Roland Molinié ◽  
Elvis Otogo Nnang ◽  
...  

Lignans, phenolic plant secondary metabolites, are derived from the phenylpropanoid biosynthetic pathway. Although, being investigated for their health benefits in terms of antioxidant, antitumor, anti-inflammatory and antiviral properties, the role of these molecules in plants remains incompletely elucidated; a potential role in stress response mechanisms has been, however, proposed. In this study, a non-targeted metabolomic analysis of the roots, stems, and leaves of wild-type and PLR1-RNAi transgenic flax, devoid of (+) secoisolariciresinol diglucoside ((+) SDG)—the main flaxseed lignan, was performed using 1H-NMR and LC-MS, in order to obtain further insight into the involvement of lignan in the response of plant to osmotic stress. Results showed that wild-type and lignan-deficient flax plants have different metabolic responses after being exposed to osmotic stress conditions, but they both showed the capacity to induce an adaptive response to osmotic stress. These findings suggest the indirect involvement of lignans in osmotic stress response.


2021 ◽  
pp. 62-67
Author(s):  
Annegret Abaza ◽  
Özlem Dikmetas ◽  
Irmingard Neuhann ◽  
Faik Gelisken

We report a case of posterior uveal effusion (UE) with a long-term follow-up that has occurred following cataract surgery. A 64-year-old woman presented with diminished vision of the right eye (RE) 3 weeks after an uneventful phacoemulsification and intraocular lens implantation. Complete ophthalmic examination including fluorescein angiography (FA), indocyanine green angiography (ICGA), echography and optical coherence tomography (OCT) were performed. Best corrected visual acuity (BCVA) of the RE was 20/50. Anterior segment and intraocular pressure were unremarkable. OCT revealed prominent folds of the choroid and retina, subretinal fluid and darkening of the choroid with reduced visibility of the choroidal vessels and the scleral border. The left eye (LE) was unremarkable. BCVA of the LE was: 20/20. After topical anti-inflammatory and systemic corticosteroid therapy for 5 months, no morphological change of the macula was seen. The patient was observed without any treatment. Forty-three months after the cataract surgery and 38 months after cessation of the corticosteroid therapy, OCT revealed a normal macular morphology and the BCVA improved to 20/25. Even though rare, UE at the posterior pole may occur after modern cataract surgery. OCT examination is a reliable tool in monitoring the macular morphology. Since morphological and functional improvement can be seen in long-term, observation may be considered for some cases of posterior UE with resistance to the therapy.


2021 ◽  
pp. 116-123
Author(s):  
Leonie F. Keidel ◽  
Benedikt Schworm ◽  
Siegfried G. Priglinger ◽  
Jakob Siedlecki

Nonresponse of neovascular age-related macular degeneration (nAMD) to anti-vascular endothelial growth factor (anti-VEGF) therapy can often be attributed to misdiagnosis, and pathologies mimicking AMD might require different therapeutic concepts. In the following, we want to outline a case of presumed nAMD which revealed to be pachychoroid neovasculopathy (PNV) and was successfully treated by the addition of spironolactone. A 67-year-old female patient was referred for nonresponse of nAMD on her left eye after 29 intravitreal injections of aflibercept with no complete resolution of subretinal fluid. On fundoscopy, both maculae presented with pigment epithelium alterations, while the left eye showed subretinal fluid on optical coherence tomography (OCT) with an associated pigment epithelium detachment, which revealed to contain a neovascular network on OCT angiography. There was faint leakage on fluorescence (FAG) and indocyanine green angiography (ICGA) and some focal vascular dilation of the neovascular network on ICGA. Due to the absence of Drusen on any eye, a thick choroid, and the presence of a gravitational tract on blue autofluorescence (BAF), chronic central serous chorioretinopathy with a choroidal neovascularization, defined as PNV in the pachychoroid disease was diagnosed. Upon the addition of spironolactone to anti-VEGF treatment, choroidal thickness significantly decreased, and subretinal fluid resolution was observed and maintained for the first time. In conclusion, PNV should be ruled out in cases of presumed nAMD nonresponding to anti-VEGF. In these cases, a combination therapy of anti-VEGF and mineralocorticoid antagonists can facilitate fluid resorption.


Author(s):  
Deep K. Datta-Ray

The history of Indian diplomacy conceptualises diplomacy racially—as invented by the West—and restrictively—to offence. This is ‘analytic-violence’ and it explains the berating of Indians for mimicking diplomacy incorrectly or unthinkingly, and the deleting, dismissing, or denigrating, of diplomatic practices contradicting history’s conception. To relieve history from these offences, a new method is presented, ‘Producer-Centred Research’ (PCR). Initiating with abduction, an insight into a problem—in this case Indian diplomacy’s compromised historicisation—PCR solves it by converting history’s racist rationality into ‘rationalities’. The plurality renders rationality one of many, permitting PCR’s searching for rationalities not as a function of rationality but robust practices explicable in producer’s terms. Doing so is exegesis. It reveals India’s nuclear diplomacy as unique, for being organised by defence, not offence. Moreover, offence’s premise of security as exceeding opponent’s hostility renders it chimerical for such a security is, paradoxically, reliant on expanding arsenals. Additionally, doing so is a response to opponents. This fragments sovereignty and abdicates control for one is dependent on opponent’s choices. Defence, however, does not instigate opponents and so really delivers security by minimising arsenals since offence is eschewed. Doing so is not a response to opponents and so maintains sovereignty and retains control by denying others the right to offense. The cost of defence is courage, for instance, choosing to live in the shadow of nuclear annihilation. Exegesis discloses Balakot as a shift from defence to offence, so to relieve the Bharatiya Janata Party’s (BJP) leadership of having to be courageous. The intensity of the intention to discard courage is apparent in the price the BJP paid. This included equating India with Pakistan, permitting it to escalate the conflict, and so imperiling all humanity in a manner beyond history.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Andrea Warren ◽  
Edward Frongillo ◽  
Shana Alford ◽  
Erin McDonald ◽  
Jessica Escobar-Alegria

Abstract Objectives The objective of this study was to understand needs among seniors for food and food assistance and to develop a comprehensive taxonomy for these needs. Methods A total of 147 seniors were purposively sampled from 12 food-assistance programs in 9 states. Of the 12 programs, 10 provided unprepared foods and 2 provided pre-cooked meals. Data were semi-structured qualitative interviews. Coding and analysis of transcripts followed an inductive qualitative analysis approach. A series of thematic summaries were prepared to reflect the content of the interviews for discussion and refinement of the analytic approach. Results An emergent taxonomy comprised 3 categories consisting of abilities and ranges or variants of those abilities. The category of physical ability consists of physical strength, the ability to prepare food, the ability to walk or stand, and health status. These relate to an individual's functional abilities to live and act independently and may be considered pre-conditions for program uptake and benefit distinct from dietary and food security-related needs and limitations. The category of consuming food consists of preferences, accessibility, affordability, and dietary needs. This category highlights the relationship between economic constraints and dietary needs that often necessitates meaningful tradeoffs in consuming the right foods for their health. The category of access and use of transportation consists of own means, friends or family, and public or private services. This category highlights challenges in accessing programs and provides insight into seniors’ experiences of poverty, declining functional abilities, social networks and connectedness, geography, and public services. Conclusions The process used to develop the taxonomy and the taxonomy itself provide an exemplar for implementation research when the nature of need is complex and programs integrated across sectors are required to address the need. The taxonomy provides structure to facilitate the identification of key factors in program engagement—and insight into the economic and social environments in which they occur—that translate into needs relevant to the design, targeting, and uptake of food assistance in a diverse population of seniors. Funding Sources Enterprise Rent-a-Car Foundation.


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