The Patterns of Morphological Change During Intracerebral Hemorrhage Expansion: A Multicenter Retrospective Cohort Study

Objectives: Hemorrhage expansion (HE) is a common and serious condition in patients with intracerebral hemorrhage (ICH). In contrast to the volume changes, little is known about the morphological changes that occur during HE. We developed a novel method to explore the patterns of morphological change and investigate the clinical significance of this change in ICH patients.Methods: The morphological changes in the hematomas of ICH patients with available paired non-contrast CT data were described in quantitative terms, including the diameters of each hematoma in three dimensions, the longitudinal axis type, the surface regularity (SR) index, the length and direction changes of the diameters, and the distance and direction of movement of the center of the hematoma. The patterns were explored by descriptive analysis and difference analysis in subgroups. We also established a prognostic nomogram model for poor outcomes in ICH patients using both morphological changes and clinical parameters.Results: A total of 1,094 eligible patients from four medical centers met the inclusion criteria. In 266 (24.3%) cases, the hematomas enlarged; the median absolute increase in volume was 14.0 [interquartile range (IQR), 17.9] mL. The initial hematomas tended to have a more irregular shape, reflected by a larger surface regularity index, than the developed hematomas. In subtentorial and deep supratentorial hematomas, the center moved in the direction of gravity. The distance of center movement and the length changes of the diameters were small, with median values of less than 4 mm. The most common longitudinal axis type was anterior–posterior (64.7%), and the axis type did not change between initial and repeat imaging in most patients (95.2%). A prognostic nomogram model including lateral expansion, a parameter of morphological change, showed good performance in predicting poor clinical outcomes in ICH patients.Conclusions: The present study provides a morphological perspective on HE using a novel automatic approach. We identified certain patterns of morphological change in HE, and we believe that some morphological change parameters could help physicians predict the prognosis of ICH patients.

Comparison of penetrating keratoplasty outcomes with or without microwave thermokeratoplasty

Microwave thermokeratoplasty (MTK) is a surgical procedure for the correction of pathologic corneal steepening. The purpose of this study was to examine the postoperative outcomes of eyes with advanced keratoconus that underwent femtosecond-laser zig-zag penetrating keratoplasty (z-PK) following MTK for reshaping of the central cornea. This study involved 32 eyes of 32 consecutive advanced keratoconus patients; i.e., 25 eyes of 25 patients who underwent MTK prior to z-PK (MTK + z-PK group), and 7 eyes of 7 patients who underwent z-PK alone (z-PK group). In all treated eyes, visual acuity (VA) and corneal topography were measured before surgery and at 6-months postoperative. At 6-months postoperative, the mean uncorrected distance VA (logarithm of the minimum angle of resolution) and surface regularity index (SRI) of the MTK + z-PK group was 0.62 ± 0.39 (mean ± standard deviation) and 1.26 ± 0.45, respectively, while that in the z-PK group was 1.02 ± 0.18 and 7.64 ± 3.22, respectively. Both variables were significantly better in the MTK + z-PK group than in the z-PK group (P < 0.05). The findings in this study reveal that MTK prior to z-PKP is effective for improving UDVA and reducing the irregularity of corneal topography in patients with advanced keratoconus.

Visualization and assessment of the anterior surface of the cornea by corneal topography (Part II)

Goal. To introduce ophthalmologists and optometrists to the basics of corneal topography. Corneal topography is the main method for assessing corneal surface regularity, the violation of which leads to a deterioration in its refractive properties and a decrease in the quality of vision. The first part of the workshop (The EYE GLAZ. 2020 (22), № 2) presented the main types of topography maps and keratometry data. In the second part, considerations are made regarding mastering the skills of capturing high-quality images and choice of color maps for analysis. Topography patterns as well as topographic signs of keratoconus are also discussed. Conclusion. Placido-based corneal topographers are a useful tool for evaluating the anterior corneal surface, fitting contact lenses and diagnosing keratoconus. Slit-scanning topographers, additionally, are capable of corneal pachymetry and analyzing the posterior surface of the cornea, which allows for carrying out a more detailed assessment and diagnosing keratoconus at preclinical stage.

Changes of wavefront aberrations and corneal surface regularity in dry eye patients measured with OPD Scan III

Background To evaluate changes of wavefront aberrations and corneal surface regularity in dry eye (DE) patients with OPD Scan-III (NIDEK, JPN). Methods Twenty-seven right eyes of 27 DE patients and 23 right eyes of normal subjects were included. The examinations for ocular surface including the Ocular Surface Disease Index (OSDI), tear film breakup time (TBUT) and corneal fluorescein staining (CFS). OPD Scan-III was used to measure anterior corneal aberrations including total corneal aberrations, high order aberration (HOA), spherical aberration (SA), coma and trefoil aberration, standard deviation of corneal power (SDP), surface regularity index (SRI) and surface asymmetry index (SAI). Statistical analysis were assessed with one sample t-test. Correlations between those parameters were also analyzed. Results Wavefront aberrations parameters including total corneal aberrations, HOA, SA, coma and trefoil in DE group were significantly higher than in normal group (P < 0.05). Corneal surface regularity parameters including SRI and SAI in DE group were significantly higher than in normal group (P < 0.05). TBUT had negative correlations with total corneal aberrations and coma (P < 0.05). Both CFS scores and central CFS scores had no correlations with wavefront aberrations parameters and had positive correlations with SDP and SRI (P༜0.05). Central CFS scores also positively correlated with SAI ( P < 0.05). Conclusions Wavefront aberrations and corneal surface irregularity are increased in DE patients. OPD Scan III was have potential to be a new instrument to evaluate the severity of DE and monitor the treatment of DE.

Effectiveness, Safety, and Satisfaction of Silicone Pro Gel in Prophylaxis and Management of Post-Operative Scar: A Randomized, Double-Blinded, Placebo-Controlled Study

Objective: To assess the effectiveness and side effects of Silicone Pro Gel to alleviate scar development among the pregnant women with the first cesarean section, and their satisfaction. Materials and Methods: The present study was a randomized, double-blinded, placebo-controlled study among the women with transverse abdominal wound of the first cesarean section. The formation and improvement of scar was assessed by interventionblinded investigators and patients in terms of redness, height, surface regularity, and attribute of the scar. Ninety women were enrolled into either the study drug or placebo groups by computerized randomization (C0). Women in both groups applied the allocated drugs within 7 to 10 days after cesarean section and had to apply the allocated drugs twice a day. The re-assessment was done at 28±4 days (C1), at 56±4 days (C2) and at 84±4 days (C3). Results: About 76% of women completed the study. The present study product performed better than the placebo in terms of formation of the wound, including height, surface regularity, and attribute of the scar. Neither side effects nor serious complications caused by the study drug were reported. Most women reported high satisfaction and there was no difference of participants’ perception toward the wound between groups. Conclusion: Silicone Pro Gel performed better in terms of alleviation of scar development post cesarean section with high participants’ satisfaction. Keywords: Scar, Photograph assessment, Investigator, Participant

Structure and magnetic properties of PP+Fe3O4 nanocomposites depending on manufacturing techniques

The structures and magnetic properties of the PP[Formula: see text]+[Formula: see text]Fe3O4 nanocomposites manufactured by different technological techniques were studied in this work. Polymeric nanocomposite materials based on PP[Formula: see text]+[Formula: see text]Fe3O4 were obtained by two technological methods: hot pressing and extrusion. Scanning electron microscopy (SEM) and AFM investigations of nanocomposites were carried out for structure analysis. It was found that the distribution of Fe3O4 nanoparticles in the polymer matrix for nanocomposites obtained by the hot pressing method is uniform and monodisperse. Compared to this, the heterogeneous and inhomogeneous distribution of nanoparticles in the polymer matrix for the samples that were produced through extrusion method was observed. Furthermore, the nanocomposite samples produced via the extraction method have a lower surface regularity rather than those obtained by hot pressing. M(H) and M(T) studies of polymer nanocomposite samples synthesized through both technological methods were performed. Studies have shown that for relatively low concentrated samples — PP[Formula: see text]+[Formula: see text]10% Fe3O4, the values of the saturation magnetization were close, but the magnetization of nanocomposites obtained by heat pressing was slightly higher than the other samples. This is because the samples obtained by hot pressing method are characterized by higher uniformity and structure that is called “flat packaging”.

Obstructive sleep apnea-hypopnea syndrome patients prone to developing anisometropia

Objective: This study aims to investigate anisometropia in obstructive sleep apnea-hypopnea syndrome patients. Methods: The obstructive sleep apnea-hypopnea syndrome cohort was divided into groups according to sleeping position: positional obstructive sleep apnea-hypopnea syndrome group (OSA-S group) (n=32), subjects who slept on their sides, and non-positional obstructive sleep apnea-hypopnea syndrome group (OSA-NS group) (n =29), subjects who did not sleep on their sides. The incidence of anisometropia, values of corneal topography, and ocular axial length were compared between groups, and the incidence of anisometropia at different degrees of obstructive sleep apnea-hypopnea syndrome severity was analyzed. Results: The obstructive sleep apnea-hypopnea syndrome groups had a significantly higher incidence of anisometropia than the control group. The OSA-S group had a significantly higher incidence of anisometropia compared with the other groups. There was a significant difference in the incidence of anisometropia between the two obstructive sleep apnea-hypopnea syndrome subgroups with different degrees of severity. The obstructive sleep apnea-hypopnea syndrome groups had significantly higher surface regularity index, surface asymmetry index and cylinder values than the control group. In the OSA-S group, the surface regularity index, surface asymmetry index and cylinder of the eye on the preferred sleeping side were significantly higher than those in the contralateral eye. The ocular axial length of the eye was significantly greater on the preferred sleeping side than in the contralateral eye in the 22 patients with anisometropia in the OSA-S group (P<0.05). Conclusions: obstructive sleep apnea-hypopnea syndrome patients who usually sleep on one side are prone to developing anisometropia, and the incidence of anisometropia is associated with the severity of obstructive sleep apnea-hypopnea syndrome.