Inverted internal limiting membrane flap technique for very large macular hole

AIMTo assess the anatomical and visual outcome of idiopathic macular holes greater than 1000 µm using the inverted internal limiting membrane flap technique.METHODSThis retrospective case series included 5 eyes of 5 patients with idiopathic macular hole with base diameter greater than 1000 µm who underwent inverted internal limiting membrane flap technique along with standard 23G pars plans vitrectomy with posterior hyaloid detachment and fluid gas exchange with 12%-14% perfluoropropane (C3F8). Preoperative and postoperative visual acuity and spectral domain optical coherence tomography images were evaluated. The main outcome measures were visual outcome and macular hole closure.RESULTSMean age was 63.2±8.4y with all 5 subjects being females. Mean duration of symptoms was 11±14mo with a mean postoperative follow up of 13.2±13mo. The mean base diameter of the macular holes was 1420±84.8 µm (1280-1480 µm). Type 1 closure was achieved in four out of five patients, while one patient had type 2 closure using the inverted internal limiting membrane (ILM) flap technique. Median baseline BCVA was 0.79 logMAR (Snellen’s equivalent 20/120) and median final BCVA 0.6 logMAR (Snellen’s equivalent 20/80) with mean visual improvement of approximately three lines improvement. No complications related to surgical procedure were noted.CONCLUSIONThe inverted internal limiting membrane flap technique may be promising for very large macular holes with high rate of macular closure and good visual outcome.

Do natural resources impact economic growth:An investigation of P5+1 countries under sustainable management

Natural resources represent the base of our living and the entire economic activity.Their depletion is a major challenge for the economic development of both developed and developing economies.Their effi-cient use is an indispensable requirement and must be the aim of the public policies designed by the authorities worldwide.In this research,we have investigated the impact of the natural resources rent on the economic growth in some major wealthy economies of the world(P5+1 countries namely:US,UK,France,China,Russia,and Germany).We have applied a quantile-on-quantile regression to analyse this impact on different quantiles and a cross-sectional autoregressive distributed lag(CS-ARDL)approach for the panel of these six countries.The Dumitrescu-Hurlin panel causality test was also used to check the causality between natural resource rents and economic growth in these countries.Results show a negative relationship between natural resources rent and economic growth for the panel but a different impact on quantiles in each country.Only for China and the US,a positive effect can be noticed for both lower and higher quantiles of natural resources and economic growth.The Dumitrescu-Hurlin causality test shows that natural resources can predict economic growth only in China,the U.S.,and the panel.In contrast,no causality was found for the other four countries included in the panel.We suggest that nations invest in wind and solar projects,use biofuels and nuclear energy,introduce a temporary profit tax to protect consumers from escalating energy prices,and increase energy efficiency in buildings and industry.Businesses would benefit from a regulatory framework that is uniform and exhaustive,as well as easier to traverse and more receptive to innovation and creativity.Public-private partnership investments in innovation,innovation incentives,and environmental sector opportunities may foster long-term economic growth。