Multimodal imaging diagnosis and analysis of prognostic factors in patients with adult-onset Coats disease

AIM:To describe the multimodal imaging features,treatment,and outcomes of patients diagnosed with adultonset Coats disease.METHODS:This retrospective study included patients first diagnosed with Coats disease at≥18 years of age between September 2017 and September 2021.Some patients received anti-vascular endothelial growth factor(VEGF)therapy(conbercept,0.5 mg)as the initial treatment,which was combined with laser photocoagulation as needed.All the patients underwent best corrected visual acuity(BCVA)and intraocular pressure examinations,fundus color photography,spontaneous fluorescence tests,fundus fluorescein angiography,optical coherence tomography(OCT),OCT angiography,and other examinations.BCVA alterations and multimodal image findings in the affected eyes following treatment were compared and the prognostic factors were analyzed.RESULTS:The study included 15 patients who were aged 24-72(57.33±12.61)y at presentation.Systemic hypertension was the most common associated systemic condition,occurring in 13(86.7%)patients.Baseline BCVA ranged from 2.0 to 5.0(4.0±1.1),which showed improvement following treatment(4.2±1.0).Multimodal imaging revealed retinal telangiectasis in 13 patients(86.7%),patchy hemorrhage in 5 patients(33.3%),and stage 2B disease(Shield’s staging criteria)in 11 patients(73.3%).OCT revealed that the baseline central macular thickness(CMT)ranged from 129 to 964μm(473.0±230.1μm),with 13 patients(86.7%)exhibiting a baseline CMT exceeding 250μm.Furthermore,8 patients(53.3%)presented with an epiretinal membrane at baseline or during follow-up.Hyper-reflective scars were observed on OCT in five patients(33.3%)with poor visual prognosis.Vision deteriorated in one patient who did not receive treatment.Final vision was stable in three patients who received laser treatment,whereas improvement was observed in one of two patients who received anti-VEGF therapy alone.In addition,8 of 9 patients(88.9%)who received laser treatment and conbercept exhibited stable or improved BCVA.CONCLUSION:Multimodal imaging can help diagnose adult-onset Coats disease.Anti-VEGF treatment combined with laser therapy can be an option for improving or maintaining BCVA and resolving macular edema.The final visual outcome depends on macular involvement and the disease stage.

Tailoring electron transfer with Ce integration in ultrathin Co(OH)_(2) nanosheets by fast microwave for oxygen evolution reaction

The intrinsic activity of Co(OH)_(2) for oxygen evolution reaction(OER)may be elaborately improved through the suitable valence adjustment.Ce modification at electronic level is proved to be an efficient strategy owing to the flexible transformation of Ce^(3+)/Ce4+.Herein,Ce0.21@Co(OH)_(2) with the optimized Ce doping have been fabricated to tailor the fast electron transfer for the enhanced activity and stability for OER.Firstly,the obtained core-shell structure composed of vertical loose Co(OH)_(2) sheets not only exposes a large number of active sites,but also provides channels for Ce doping.Secondly,the high pressure microwave with instantaneous heating can fast introduce Ce into Co(OH)_(2),obtaining Cex@Co(OH)_(2) with well dispersion and close integration.The intimated interaction between Ce and Co species may provide the"d-f electronic ladders"for accelerating electron transfer of the catalytic surface.Meanwhile,Ce promotes the formation of Co-superoxide intermediate and/or the release of oxygen,which is considered to be the rate-determining step for OER.The electrochemical measurements confirmed the low overpotential of 300 m V at 10 m A cm^(-2) and great stability of Ce0.21@Co(OH)_(2) for OER.This work demonstrates a meaningful approach to realize the tuned electronic structure through metal doping.

Controlled high-density interface engineering of Fe_(3)O_(4)-FeS nanoarray for efficient hydrogen evolution

The rational design of double active sites system is vital for constructing high-efficiency iron sulfides electrocatalysts towards hydrogen evolution reaction(HER) in alkaline media. However, it remains a challenge to controllably create the high-density interface of double sites for optimal synergistic effect.Herein, we reported a simple chemical oxidation-induced surface reconfiguration strategy to obtain the interface-rich Fe_(3)O_(4)-FeS nanoarray supported on iron foam(Fe_(3)O_(4)-FeS/IF) using FeS nanosheets as precursors. The abundant Fe_(3)O_(4)-FeS interfaces could improve the dispersion of active sites and facilitate the electron transfer, leading to enhanced hydrogen evolution efficiency. And meanwhile, by altering the oxidation temperature, the content of S and O could be effectively controlled, further achieving the ratio optimization of Fe_(3)O_(4)to FeS. Synchrotron-based X-ray absorption near-edge structure, X-ray photoelectron spectroscopy and ultraviolet photoemission spectroscopy consistently confirm the changes of electronic structure and d-band center of Fe_(3)O_(4)-FeS after chemical oxidation. Consequently, Fe_(3)O_(4)-FeS/IF exhibits excellent alkaline HER activity with a low overpotential of 120.8 mV to reach 20 mA cm^(-2),and remains stable ranging from 10, 20 to 50 mA cm^(-2) for each 20 h, respectively. Therefore, the facile and controllable chemical oxidation may be an effective strategy for designing high-density interfaces of transition metal-based sulfides towards alkaline HER.