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Henrik Faatz,1 Kai Rothaus,1 Martin Ziegler,1 Marius Book,1 Claudia Lommatzsch,1,2 Georg Spital,1 Matthias Gutfleisch,1 Daniel Pauleikhoff,1,3,4 Albrecht Lommatzsch1,3,4 1Department of Ophthalmology, St. Franziskus Hospital, Münster, Germany; 2Department of Ophthalmology, University of Lübeck, Lübeck, Germany; 3Department of Ophthalmology, University of Essen–Duisburg, Essen, Germany; 4Achim Wessing Institute for Imaging in Ophthalmology, University Hospital Essen, Essen, GermanyCorrespondence: Henrik Faatz Tel +49 251 935 2711Fax +49 251 935 2749Email henrik.faatz@augen-franziskus.dePurpose: The aim of this study was to ascertain and quantify the differences between swept-source (SS) and spectral-domain (SD) optical coherence tomography angiography (OCTA) imaging of macular neovascularizations (MNV) in neovascular age-related macular degeneration (nAMD).Patients and Methods: SD-OCTA (RTVue Avanti) and SS-OCTA (PLEX® Elite 9000) were performed in 37 patients with MNV in nAMD. The MNV was delineated and the data were processed via ImageJ. The parameters MNV area, nodes per area, fractal dimension (FD), and flow density were analyzed using MatLab.Results: There was close agreement between the two devices regarding MNV area (ICCc 0.977, ICCa 0.977, R2 0.977), but only slight agreement regarding nodes per area (ICCa 0.008, ICCc 0.548, R2 0.51), FD (ICCa 0.425, ICCc 0.846, R2 0.96), and flow density (ICCa 0.451, ICCc 0.656, R2 0.65). The difference between the two devices was insignificant for MNV area (type 1: p=0.328; type 2: p=0.426; type 3: p=0.615), but significant for nodes per area (type 1: p=0.002; type 2: p=0.00001; type 3: p=0.003), FD (type 1: p< 0.00001; type 2: p< 0.00001; type 3: p=0.015) and flow density (type 1: p=0.0004; type 2: p=0.004; type 3: p=0.052).Conclusion: MNV area is closely comparable between devices using SS-OCTA and SD-OCTA imaging. However, the two methods differ significantly in their precise assessment of the vascular morphology (FD, flow density, nodes per area). Therefore, results obtained using different devices are not comparable and should not be amalgamated in clinical trials.Keywords: choroidal neovascularization, neovascular age-related macular degeneration, optical coherence tomography angiography

Attualmente il disturbo di panico è uno dei disturbi d’ansia più diffusi nei Paesi occidentali. Il più recente panorama scientifico descrive l’attacco di panico come un fenomeno principalmente connesso ad una paura intensa e incontrollata. Gli autori, psicologi e psicoterapeuti della Gestalt, hanno osservato nei propri setting psicoterapeutici alcune tendenze ricorrenti nelle persone che riferiscono sintomi di attacco di panico. Nelle narrazioni di queste ultime spesso si presenta una mancata assunzione di posizioni chiare e definite all’interno della propria vita affettiva, relazionale e professionale. Oltre che una manifestazione dell’ansia e della paura, gli autori ipotizzano che nel disturbo di panico sia presente un disagio esistenziale e relazionale connesso ad un’inadeguata gestione della rabbia. Il vissuto frequentemente riferito riguarda l’incapacità di opporre un rifiuto a fare qualcosa che non si desidera e il conseguente senso di frustrazione e ansia. Secondo una visione della psicoterapia della Gestalt una persona prova rabbia quando non ottiene ciò che vuole, oppure quando si trova in un conflitto territoriale. Da qui derivano i diversi agiti relativi alla manifestazione della rabbia stessa. Il presente articolo intende favorire una discussione sul ruolo che l’emozione rabbia ha nella genesi e nel mantenimento degli attacchi di panico.

Being the primary site of degeneration, the optic nerve has always been the focus of structural glaucoma assessment. The technical advancements, mainly of optical coherence tomography (OCT), now allow for a very precise quantification of the optic nerve head and peripapillary retina morphology. By far the most commonly used structural optic nerve parameter is the thickness of the parapapillary retinal nerve fiber, which has great clinical utility but also suffers from significant limitations, mainly in advanced glaucoma. Emerging novel imaging technologies, such as OCT angiography, polarization-sensitive or visible-light OCT and adaptive optics, offer new biomarkers that have the potential to significantly improve structural glaucoma diagnostics. Another great potential lies in the processing of the data already available. Artificial intelligence does not only help increase the reliability of current biomarkers but can also integrate data from various imaging modalities and other clinical measures to increase diagnostic accuracy. And it can, in a more efficient way, draw information from available datasets, such as an OCT scan, compared to the current concept of biomarkers, which only use a fraction of the whole dataset.

Abstract The purpose of this study was to ascertain whether a correlation exists between glaucoma-associated alteration of ocular vascular haemodynamics and endothelin-1 (ET-1) levels exist. Eyes of patients with cataract (n = 30) or glaucoma (n = 68) were examined with optical coherence tomography (OCT) and OCT-angiography (OCT-A; AngioVue™-RTVue-XR; Optovue, Fremont, California, USA). The peripapillary and the macular vessel density (VD) values were measured. Inferior and superior retinal nerve fibre layer (RNFL) thickness loss was used for further OCT staging. Aqueous humour of the examined eye and plasma were sampled during cataract or glaucoma surgery and analysed by means of ELISA to determine their ET-1 level. Glaucoma eyes are characterised by reductions in RNFL thickness and VD that correlate significantly with the OCT GSS score. Peripheral and ocular ET-1 level were significantly elevated in patients with glaucoma and correlate positively with the OCT-GSS score of the entire study population. Peripapillary and macula VD of glaucoma patients correlates negatively with plasma ET-1 levels. Multivariable analysis showed a subordinate role of intraocular pressure predictive factor for impaired retinal blood flow compared with plasma ET-1 level in glaucoma. Peripheral ET-1 level serves as risk factor for detection of ocular blood flow changes in the optic nerve head region of glaucomatous eyes.