Panhandle Eye Group

To assess the 12-month outcomes in subjects developing macular neovascularization (MNV) during intravitreal avacincaptad pegol (IVA) treatment for geographic atrophy (GA) secondary to age-related macular degeneration (AMD). This research was conducted as a case-controlled, retrospective study of AMD subjects undergoing IVA treatment for GA from two private practice institutions. Subjects were divided into 1) a Study Group of patients who developed MNV and then underwent anti-vascular endothelial growth factor (VEGF) therapy during the study period, and 2) a Control Group of patients who were complication-free during the study period. Both cohorts had a baseline Snellen visual acuity of ≥ 20/200, a baseline GA total area of ≥ 1 mm2and ≤ 17.5 mm2, and 12 months of follow-up after initiation of IVA for GA. There were 56 patients analyzed. There were no significant differences in baseline features between cohorts. The Study Group had a greater decrease in visual acuity [-0.22 logMAR (-0.27 to -0.17) versus -0.06 logMAR (-0.12 to 0.00); p=<0.0001], and greater GA total lesion growth [1.78 mm2 (1.53-2.03) versus 0.78 mm2 (0.54-1.02); p=<0.0001] during the 12-month study period compared to the Control Group. Patients developing MNV while undergoing IVA treatment for GA secondary to AMD have worse clinical outcomes despite undergoing anti-VEGF therapy compared to patients who were complication-free at 12-months. This highlights the seriousness of MNV in this patient population and may help specialists counsel patients when considering treatment for GA secondary to AMD.

To evaluate the outcomes of delay in care secondary to the coronavirus pandemic in patients requiring intravitreal anti-vascular endothelial growth factor therapy. A retrospective review was performed, and subjects were divided into two groups: 1) a study group of patients who experienced a treatment delay of ≥6 weeks from the intended follow-up during the coronavirus pandemic and resumed treatment with ≥2 anti-vascular endothelial growth factor injections over 6 months following treatment delay, and 2) a control group of patients who received regular care throughout the coronavirus pandemic. Totally, 234 subjects were analyzed. The mean treatment delay from the intended follow-up in the study group was 11.8 (±4.0) weeks. Visual acuity and central macular thickness worsened from baseline to 6 months after resuming anti-vascular endothelial growth factor therapy in the study group (P < 0.0001 and P = 0.001, respectively). Visual acuity and central macular thickness were better in the control group compared with the study group at the end of the 6-month study period (P < 0.0001 for both). Treatment delay in subjects undergoing anti-vascular endothelial growth factor therapy for retina disease during the coronavirus pandemic had worse visual and anatomical outcomes despite reinitiating treatment over 6 months compared with a control group, suggesting irreversibility and permanence of outcomes.

To evaluate the benefits of internal limiting membrane peeling in proliferative diabetic retinopathy subjects undergoing pars plana vitrectomy for the treatment of vitreous hemorrhage. Two hundred and fifty-eight proliferative diabetic retinopathy subjects undergoing pars plana vitrectomy for vitreous hemorrhage were enrolled into the trial. Patients were randomized into one of two cohorts: Group A patients underwent internal limiting membrane peeling, whereas Group B patients did not undergo internal limiting membrane peeling. The main outcome was best-corrected visual acuity at 6 months. Secondary outcomes were optical coherence tomography central macular thickness at 6 months, incidence of diabetic macular edema treatment during the postoperative trial period, and incidence of epiretinal membrane at 6 months. Two hundred and seven patients were randomized and completed 6 months follow-up. Group A had better best-corrected visual acuity at 6 months than Group B (P < 0.01). Group A had a lower incidence of diabetic macular edema treatment during the postoperative trial period and a lower incidence of epiretinal membrane at 6 months than Group B (P = 0.02 and P < 0.001, respectively). There was a trend toward lower central macular thickness on optical coherence tomography in Group A than Group B (P = 0.09). There were no significant differences in baseline details or complications intraoperatively or postoperatively between cohorts. This trial demonstrated better vision, fewer postoperative diabetic macular edema treatments, and a lower incidence of epiretinal membrane at 6 months when internal limiting membrane peeling was performed. Internal limiting membrane peeling may be considered a vital maneuver to perform in proliferative diabetic retinopathy subjects undergoing pars plana vitrectomy for vitreous hemorrhage.

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A 3-year prospective study was initiated to evaluate torsional resistance of modern football cleat designs and the incidence of surgically documented anterior cruciate ligament tears in high school football players wearing different cleat types. We compared four styles of football shoes and evaluated the incidence of anterior cruciate ligament tears among 3119 high school football players during the 1989 to 1991 competitive seasons. The four cleat designs were 1) Edge, longer irregular cleats placed at the peripheral margin of the sole with a number of smaller pointed cleats positioned interiorly (number of players wearing this shoe, 2231); 2) Flat, cleats on the forefoot are the same height, shape, and diameter, such as found on the soccer-style shoe (N = 832); 3) Screw-in, seven screw-in cleats of 0.5 inch height and 0.5 inch diameter (N = 46); and 4) Pivot disk, a 10-cm circular edge is on the sole of the forefoot, with one 0.5-inch cleat in the center (N = 10). The results showed that the Edge design produced significantly higher torsional resistance than the other designs (P < 0.05) and was associated with a significantly higher anterior cruciate ligament injury rate (0.017%) than the other three designs combined (0.005%).

American Institute of Mining, Metallurgical, and Petroleum Engineers, Inc. Abstract It is possible to history-match an existing gas pipeline network to obtain flow efficiencies that account for abnormal pressure losses resulting from liquids entrained in the gaseous flow stream. An actual gas gathering network which was known to produce relatively large volumes of condensate was successfully history-matched. The network was studied with a simulator which uses the single-phase Panhandle Equations to calculate the pressure losses in the pipeline. The observed pressures were matched in the calculations by lowering the pipeline efficiencies to account for liquids in pipeline efficiencies to account for liquids in the flow stream. Data was gathered which supported the theory that the low pipeline efficiencies resulting from the calculations were in fact due to liquids in the pipeline. Summaries and graphs of the data and calculated results are presented. Introduction The capability exists to completely simulate a gas gathering network with the modern digital computer. The simulator which has been used in this study employs single-phase flow equations to calculate the pressure drops through the pipeline segments. Satisfactory results have been achieved for all dry gas systems which have been studied using the simulator. One gathering system was known to produce relatively large amounts of natural gas liquids, i.e. condensate. The single-phase simulator yielded rather wide pressure discrepancies when applied to this particular network. The purpose of this study was to determine if it is possible to apply a single-phase simulator to an actual operational flow network having abnormal pressure losses caused by the inclusion of liquids pressure losses caused by the inclusion of liquids in the gaseous stream. The simulator calculates the pressure loss in a pipeline segment with an equation which incorporates a flow efficiency term. Normal line efficiencies for dry gas systems range from 70% to 90%. The nature of work performed was to duplicate the observed pressure losses by adjusting the line efficiencies of each individual pipeline segment. The study was accomplished by concentrating on two different time periods; one during the winter when liquid production was high, and one during the spring when liquid production was low. The result was that two efficiencies were derived for each pipeline segment.