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PURPOSE: To assess the usefulness of spectral-domain optical coherence tomography (SD-OCT) peripapillary retinal nerve fiber layer (RNFL) thickness measurement in discriminating early phase optic disc edema (ODE) from pseudoedema (PODE). METHODS: Hospital-based, multicenter, cross-sectional study involving external patients referred for recent identification of presumed ODE. Patients underwent SD-OCT optic nerve head (ONH) RNFL thickness measurement at their first evaluation. In 155 of these, the causative etiology was subsequently ascertained and the respective eyes (one per patient) were assigned to the ODE (95 eyes) or PODE (60 eyes) group. Admission SD-OCT data were retrieved and used for the analysis. ROC curve analysis was used to calculate specificity, sensitivity and predictive value (PV) of the RNFL values. RESULTS: The PODE group was significantly younger than the ODE group (p = 0.007). The average and any single-quadrant RNFL thickness was significantly higher in the ODE group compared with the PODE and control groups. The average and the inferior quadrant thicknesses tested the most powerful parameters to differentiate ODE from PODE. A cutoff value of ≥ 110 μm for the average area, or of ≥ 150 μm for the inferior quadrant was associated with maximal sensitivity and specificity with positive PV greater than 80%. CONCLUSIONS: The SD-OCT evaluation of the peripapillary RNFL achieved good specificity, sensitivity and positive PV in discriminating between ODE and PODE. Despite the correct differential diagnosis between these categories still relies on a careful medical history taking and other ancillary testing, we proved the usefulness of SD-OCT RNFL measurement in supporting the diagnostic process.

The aim of this article is to review the potentiality and reliability of the integrated usage of global positioning system (GPS), terrestrial laser scanner (TLS), and total station survey measurements in the geomorphologic studies. Test surveys based on these techniques were done in the area of 'Tana della Volpe' blind valley and in the adjacent 'Monticino' quarry, near Brisighella, Ravenna, Northern Apennines, Italy. Such sites are characterized by peculiar geomorphologic attributes such as the presence of slope, karst, and anthropic forms. We surveyed about 18,000 GPS points and about 42,200,000 TLS points in a total of 22 scans. The processing of the survey's whole data set produced three distinct arrays of three-dimensional (3D) coordinates complemented by orthometric heights. Moreover, an integrated multistep procedure was implemented based on the following premises: (1) the removal of points not referred to the bare earth surface; (2) the combination of three coordinate sets into a single one referred to the whole study; (3) the generation of a bare earth digital model; and (4) the elaboration of a unified contour map. The resulting high correspondence between the observed forms and the 3D models was used to realize a detailed thematic geomorphologic map by means of which it is now possible to locate and highlight the forms observed in the field. In particular by means of TLS measurements we found a maximum difference in the spatial attitude of the observed discontinuities of 5.6[degrees] and some interesting coincidences in the evaluation of the joint roughness of several centimeters. DOI: 10.1061/(ASCE)SU.1943-5428.0000022 CE Database subject headings: Global positioning; Digital techniques; Surveys; Morphology; Case studies; Italy. Author keywords: GPS; TLS; DEM; Digital 3D modeling; Geomorphological survey.

Purpose: We aimed to describe the global and localized correlations among visual field (VF) sensitivity, optic nerve head (ONH) perfusion measured by laser speckle flowgraphy (LSFG) and neural structure measured by optical coherence tomography (OCT) in open‐angle glaucoma (OAG) and to compare the floor effect for LSFG and OCT. Methods: Cross‐sectional, multicenter study including one eye each from fifty OAG patients (mean age 69.3 years; average VF mean deviation, MD, −8.5 dB, range −25.17 to 0.85 dB) and fifty‐one controls. Patients underwent SITA standard 24‐2 automated perimetry and measurement of ONH perfusion, peripapillary retinal nerve fibre layer thickness (RNFLT) and macular ganglion cell‐inner plexiform layer thickness (GCIPLT). We tested the presence of a significant change (breakpoint) in the correlation slope with VF sensitivity to assess floor effect. Results: The correlation between the LSFG parameter Mean All (MA) of the global disc area and MD (r = 0.56, p < 0.001) did not show a breakpoint, in contrast to the correlations between MD and OCT global parameters, which showed breakpoints at −8.53 and −4.05 dB for RNFLT and GCIPLT, respectively. Global and localized correlations with VF sensitivity were stronger for LSFG compared to OCT. In particular, LSFG outperformed OCT in the correlation with the central VF sector (r = 0.50, p < 0.001 and r = 0.06, p = 0.67 for MA and RNFLT, respectively). Conclusion: The global and sectoral correlations with VF sensitivity and the favourable floor effect compared to OCT indicate LSFG as a promising tool to monitor progression particularly in late‐stage glaucoma. Further longitudinal studies are warranted. [ABSTRACT FROM AUTHOR]

The diffusion of Distributed Generation (DG) based on Renewable Energy Sources (RES) requires new strategies to ensure reliable and economic operation of the distribution networks and to support the diffusion of DG itself. An advanced algorithm (DISCoVER – DIStribution Company VoltagE Regulator) is being developed to optimize the operation of active network by means of an advanced voltage control based on several regulations. Starting from forecasted load and generation, real on-field measurements, technical constraints and costs for each resource, the algorithm generates for each time period a set of commands for controllable resources that guarantees achievement of technical goals minimizing the overall cost. Before integrating the controller into the telecontrol system of the real networks, and in order to validate the proper behaviour of the algorithm and to identify possible critical conditions, a complete simulation phase has started. The first step is concerning the definition of a wide range of “case studies”, that are the combination of network topology, technical constraints and targets, load and generation profiles and “costs” of resources that define a valid context to test the algorithm, with particular focus on battery and RES management. First results achieved from simulation activity on test networks (based on real MV grids) and actual battery characteristics are given, together with prospective performance on real case applications.

Abstract Neuro-Behçet’s disease (NBD) involves the central nervous system; peripheral nervous system involvement is not often reported. NBD is quite common in adult patients and occurs rarely during childhood and adolescence. Young patients may share symptoms and signs of NBD with other neuro-ophthalmological disorders (e.g. idiopathic intracranial hypertension); thus, making the differential diagnosis difficult. Neuroimaging is mandatory and necessary for a correct NBD diagnosis but in children radiological examinations are often difficult to perform without sedation. From 1971 to 2011, 130 patients aged ≤16 years have been reported with NBD, according to retrospective surveys, case series, and case reports. The origin of the reported cases met the well-known geographical distribution of Behçet’s disease (BD); the mean age at presentation of neurological findings was 11.8 years, with male gender prevalence (ratio, 2.9:1). We considered in detail the neuro-ophthalmological features of the 53 cases whose neuroimaging alterations were described with an assigned radiological pattern of the disease (parenchymal: 14 cases, non-parechymal: 35 cases, and mixed: 4 cases). In 19/53 patients (36%), neuro-ophthalmological symptoms anticipated any pathognomonic sign for a BD diagnosis, or only occasional aphtae were recalled by the patients. Family history was positive in 17% of subjects. Headache was reported in 75% of the patients; in those presenting with cerebral vascular involvement, headache was combined to other symptoms of intracranial hypertension. Papilledema was the most frequently reported ophthalmological finding, followed by posterior uveitis. Treatment consisted of systemic steroids in 93% of patients, often combined with other immunosuppressive drugs (especially colchicine and azathioprine). Clinical recovery or improvement was documented in the large majority of patients. Nine subjects had definitive alterations, and one died. Based on our review and personal experience, a delayed diagnosis, and the consequently delayed immunosuppressive treatment, may favour permanent sequelae, in particular, optic atrophy.

Abstract Background Rituximab is a monoclonal antibody inducing depletion of B lymphocytes and presently approved for the treatment of non-Hodgkin's lymphoma and rheumatoid arthritis. Here is the first report of the use of this drug in a case of Cogan's syndrome (CS). Case Presentation a 25-year-old Italian woman was referred with conjunctival hyperaemia, interstitial keratitis, moderate bilateral sensorineural hearing loss accompanied by tinnitus, dizziness, nausea and vertigo, poorly responsive to oral and topical steroidal therapy. Diagnosis of typical CS was made. The administration of a combined immunosuppressive treatment resolved ocular inflammation, dizziness, nausea, and vertigo but gave little results in controlling progressive hearing loss. A noticeable improvement in hearing function was documented by pure tone audiometry after infusion of Rituximab. Discussion in CS, hearing function is often the most difficult parameter to control with therapy. A positive effect of Rituximab on was observed in our case. The drug also allowed to significantly reduce the number of adjuvant immunosuppressive medications.

Abstract The role of infectious agents in autoimmune diseases has been the subject of several studies and is still under investigation. Here a paediatric case series of autoimmune uveitis is reported. An exacerbation of the ocular inflammation occurred in concomitance with nasal colonisation by Staphylococcus aureus.

ONH MA but not PR MA correlated with pRNFLT throughout the follow-up, likely because PR MA gathers some choroidal perfusion information unrelated to RGCs blood supply. Non-arteritic anterior ischaemic optic neuropathy (NAION) is the most common acute optic neuropathy in patients older than 50 years, characterized by severe, painless visual loss, associated with axonal ischaemia and death of the retinal ganglion cells (RGCs). Optic nerve head and peripapillary perfusion as assessed with laser speckle flowgraphy in non-arteritic anterior ischaemic optic neuropathy. [Extracted from the article]