Thermal fatigue and wear of compacted graphite iron brake discs with various thermomechanical properties

The increase in payload capacity of trucks has heightened the demand for cost-effective yet high performance brake discs.In this work,the thermal fatigue and wear of compacted graphite iron brake discs were investigated,aiming to provide an experimental foundation for achieving a balance between their thermal and mechanical properties.Compacted graphite iron brake discs with different tensile strengths,macrohardnesses,specific heat capacities and thermal diffusion coefficients were produced by changing the proportion and strength of ferrite.The peak temperature,pressure load and friction coefficient of compacted graphite iron brake discs were analyzed through inertia friction tests.The morphology of thermal cracks and 3D profiles of the worn surfaces were also discussed.It is found that the thermal fatigue of compacted graphite iron discs is determined by their thermal properties.A compacted graphite iron with the highest specific heat capacity and thermal diffusion coefficient exhibits optimal thermal fatigue resistance.Oxidization of the matrix at low temperatures significantly weakens the function of alloy strengthening in hindering the propagation of thermal cracks.Despite the reduced hardness,increasing the ferrite proportion can mitigate wear loss resulting from low disc temperatures and the absence of abrasive wear.

Automated evaluation of parapapillary choroidal microvasculature in crowded optic discs:a controlled,optical coherence tomography angiography study

AIM:To compare superficial and deep vascular properties of optic discs between crowded discs and controls using optical coherence tomography angiography(OCT-A).METHODS:Thirty patients with crowded discs,and 47 control subjects were enrolled in the study.One eye of each individual was included and OCT-A scans of optic discs were obtained in a 4.5×4.5 mm^(2) rectangular area.Radial peripapillary capillary(RPC)density,peripapillary retinal nerve fiber layer(pRNFL)thickness,cup volume,rim area,disc area,cup-to-disc(c/d)area ratio,and vertical c/d ratio were obtained automatically using device software.Automated parapapillary choroidal microvasculature(PPCMv)density was calculated using MATLAB software.When the vertical c/d ratio of the optic disc was absent or small cup,it was considered as a crowded disc.RESULTS:The mean signal strength index of OCT-A images was similar between the crowded discs and control eyes(P=0.740).There was no difference in pRNFL between the two groups(P=0.102).There were no differences in RPC density in whole image(P=0.826)and peripapillary region(P=0.923),but inside disc RPC density was higher in crowded optic discs(P=0.003).The PPCMv density in the inner-hemisuperior region was also lower in crowded discs(P=0.026).The pRNFL thickness was positively correlated with peripapillary RPC density(r=0.498,P<0.001).The inside disc RPC density was negatively correlated with c/d area ratio(r=-0.341,P=0.002).CONCLUSION:The higher inside disc RPC density and lower inner-hemisuperior PPCMv density are found in eyes with crowded optic discs.

Numerical and Experimental Analysis of the Aerodynamic Torque for Axle-Mounted Train Brake Discs

As the velocity of a train increases,the corresponding air pumping power consumption of the brake discs increases proportionally.In the present experimental study,a standard axle-mounted brake disc with circumferential pillars was analyzed using a 1:1 scale model and a test rig in a wind tunnel.In particular,three upstream velocities were selected on the basis of earlier investigations of trains operating at 160,250,and 400 km/h,respectively.Moreover,3D steady computational fluid dynamics(CFD)simulations of the flow field were conducted to compare with the wind tunnel test outcomes.The results for a 3-car train at 180 km/h demonstrated:(1)good agreement between the air resistance torques obtained from the wind tunnel tests and the related numerical results,with differences ranging from 0.95%to 5.88%;(2)discrepancies ranging from 3.2 to 3.8 N·m;(3)cooling ribs contributing more than 60%of the air resistance torque;(4)the fast rotation of brake discs causing a significantly different flow field near the bogie area,resulting in 25 times more air pumping power loss than that obtained in the stationary brake-disc case.

Nucleus Pulposus Cells from Calcified Discs Promote the Degradation of the Extracellular Matrix through Upregulation of the GATA3 Expression

Objective Disc calcification is strongly associated with disc degeneration;however,the underlying mechanisms driving its pathogenesis are poorly understood.This study aimed to provide a gene expression profile of nucleus pulposus cells(NPCs)from calcified discs,and clarify the potential mechanism in disc degeneration.Methods Primary NPCs were isolated from calcified and control discs(CAL-NPC and CON-NPC),respectively.The proliferation and extracellular matrix(ECM)metabolism capacities of the cells were evaluated using MTT and Western blotting,respectively.RNA sequencing was used to identify differentially expressed genes(DEGs)in the CAL-NPCs.The biological functions of the DEGs were analyzed using the Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)databases.The transcription factor database and Cytoscape software were used to construct the transcription factor-DEGs regulatory network.The role of the verified transcription factor in NPC proliferation and ECM metabolism was also investigated.Results The CAL-NPCs exhibited a lower proliferation rate and higher ECM degradation capacity than the CON-NPCs.In total,375 DEGs were identified in the CAL-NPCs.The GO and KEGG analyses showed that the DEGs were primarily involved in the regulation of ribonuclease activity and NF-kappa B and p53 signaling pathways.GATA-binding protein 3(GATA3)with the highest verified levels was selected for further studies.Overexpression of GATA3 in the CON-NPCs significantly inhibited their proliferation and promoted their ECM degradation function,while the knockdown of GATA3 in the CAL-NPCs resulted in the opposite phenotypes.Conclusion This study provided a comprehensive gene expression profile of the NPCs from the calcified discs and supported that GATA3 could be a potential target for reversing calcification-associated disc degeneration.

基于性格分析DISC理论的临床带教模式对护生核心能力的影响

目的:探讨基于性格分析DISC理论的临床带教模式对护生核心能力的影响。方法:选取2022年1月-12月在江苏省某三级甲等医院全科医学科的96名实习护生为研究对象,根据实习先后顺序分为试验组48人和对照组48人。在临床带教过程中,对照组实施传统带教方法,试验组实施基于性格分析DISC理论的临床带教模式,比较两组的核心能力、理论成绩、护理技能操作成绩、带教管理质量及带教满意度。结果:干预结束后,试验组核心能力、理论成绩、护理技能操作成绩、带教管理质量总分均高于对照组(P<0.05)。结论:将性格分析DISC理论应用于临床实习带教中,有利于培养护生的核心能力和提高其理论成绩、护理技能操作成绩及带教管理质量。

DLGAP5在肝细胞癌中的表达及临床意义

目的:探讨Discs大同源物相关蛋白5(Discs large homolog associated protein 5,DLGAP5)在肝细胞癌(hepatocellular carcinoma,HCC)中的表达及其临床意义。方法:采用免疫组化法检测144对肝细胞癌组织和对应的癌旁组织样本中DLGAP5蛋白的表达,分析其表达与患者临床病理特征的关系,绘制Kaplan-Meier生存曲线分析DLGAP5表达对患者预后的影响。结果:肝细胞癌组织中DLGAP5表达阳性率77.8%,高于癌旁组织的阳性率38.9%,差异有统计学意义(P<0.01)。DLGAP5表达与肿瘤直径、TNM分级、脉管癌栓及肿瘤包膜完整性有关(均P<0.05),而与患者性别、年龄、乙型肝炎表面抗原、肝硬化及远处转移无关(均P>0.05)。Kaplan-Meier生存曲线分析显示,DLGAP5高表达组患者总生存率显著低于DLGAP5低表达组患者,差异具有统计学意义(P<0.05)。结论:DLGAP5蛋白在肝细胞癌中表达增高,其高表达与患者的预后不良有关。

An Improved Deep Learning Framework for Automated Optic Disc Localization and Glaucoma Detection

Glaucoma disease causes irreversible damage to the optical nerve and it has the potential to cause permanent loss of vision.Glaucoma ranks as the second most prevalent cause of permanent blindness.Traditional glaucoma diagnosis requires a highly experienced specialist,costly equipment,and a lengthy wait time.For automatic glaucoma detection,state-of-the-art glaucoma detection methods include a segmentation-based method to calculate the cup-to-disc ratio.Other methods include multi-label segmentation networks and learning-based methods and rely on hand-crafted features.Localizing the optic disc(OD)is one of the key features in retinal images for detecting retinal diseases,especially for glaucoma disease detection.The approach presented in this study is based on deep classifiers for OD segmentation and glaucoma detection.First,the optic disc detection process is based on object detection using a Mask Region-Based Convolutional Neural Network(Mask-RCNN).The OD detection task was validated using the Dice score,intersection over union,and accuracy metrics.The OD region is then fed into the second stage for glaucoma detection.Therefore,considering only the OD area for glaucoma detection will reduce the number of classification artifacts by limiting the assessment to the optic disc area.For this task,VGG-16(Visual Geometry Group),Resnet-18(Residual Network),and Inception-v3 were pre-trained and fine-tuned.We also used the Support Vector Machine Classifier.The feature-based method uses region content features obtained by Histogram of Oriented Gradients(HOG)and Gabor Filters.The final decision is based on weighted fusion.A comparison of the obtained results from all classification approaches is provided.Classification metrics including accuracy and ROC curve are compared for each classification method.The novelty of this research project is the integration of automatic OD detection and glaucoma diagnosis in a global method.Moreover,the fusion-based decision system uses the glaucoma detection result obtained using several convolutional deep neural networks and the support vector machine classifier.These classification methods contribute to producing robust classification results.This method was evaluated using well-known retinal images available for research work and a combined dataset including retinal images with and without pathology.The performance of the models was tested on two public datasets and a combined dataset and was compared to similar research.The research findings show the potential of this methodology in the early detection of glaucoma,which will reduce diagnosis time and increase detection efficiency.The glaucoma assessment achieves about 98%accuracy in the classification rate,which is close to and even higher than that of state-of-the-art methods.The designed detection model may be used in telemedicine,healthcare,and computer-aided diagnosis systems.

Development of high-power microwave mechanical integrated continuous mining device

This article introduces a high-power microwave mechanical integrated continuous mining device,which can achieve synchronous cutting of hard rocks by microwave and machinery.The device includes a cutting system,a rotary translation system,a loading system,a high-power microwave system,and a control and monitoring system.The technology of“master-slave follow-up”disc cutter alternating side cutting of rock was proposed,which could improve the effectiveness of rock breaking.The integrated structure of a microwave-cut system was then proposed,and synchronous motion of the microwave-cut system and adjustment of the loading system could be realized.The automatic adjustment technology of the microwave working distance was developed to dynamically control the optimal microwave working distance.The basic functions of the equipment were verified by tests.By comparing the two types of disk cutters,it is found that the master-slave follow-up disk cutter can improve significantly the dust removal effect and rock breaking efficiency in rock breaking process versus the conventional large disc cutter.Cutting tests of slate with or without microwave were conducted using a master-slave follow-up disk cutter.The results show that the cutting patterns of slates change from intermittent chunks(without microwave irradiation)to persistent debris(with microwave irradiation),and the cutting speed is significantly improved(170%).The development of the device provides a scientific basis for changing the conventional mining technology of metal mines and realizing the mechanical continuous mining in hard metal mines.

Single atom Cu-N-C catalysts for the electro-reduction of CO_(2) to CO assessed by rotating ring-disc electrode

The electrochemical CO_(2) reduction reaction(CO_(2)RR) to controllable chemicals is considered as a promising pathway to store intermittent renewable energy. Herein, a set of catalysts based on copper-nitrogendoped carbon xerogel(Cu-N-C) are successfully developed varying the copper amount and the nature of the copper precursor, for the efficient CO_(2)RR. The electrocatalytic performance of Cu-N-C materials is assessed by a rotating ring-disc electrode(RRDE), technique still rarely explored for CO_(2)RR. For comparison, products are also characterized by online gas chromatography in a H-cell. The as-synthesized Cu-NC catalysts are found to be active and highly CO selective at low overpotentials(from -0.6 to -0.8 V vs.RHE) in 0.1 M KHCO_(3), while H_(2) from the competitive water reduction appears at larger overpotentials(-0.9 V vs. RHE). The optimum copper acetate-derived catalyst containing Cu-N_(4) moieties exhibits a CO_(2)-to-CO turnover frequency of 997 h^(-1) at -0.9 V vs. RHE with a H_(2)/CO ratio of 1.8. These results demonstrate that RRDE configuration can be used as a feasible approach for identifying electrolysis products from CO_(2)RR.

A Dual Closed-Loop Digital Twin Construction Method for Optimizing the Copper Disc Casting Process

The copper disc casting machine is core equipment for producing copper anode plates in the copper metallurgy industry.The copper disc casting machine casting package motion curve(CPMC) is significant for precise casting and efficient production.However,the lack of exact casting modeling and real-time simulation information severely restricts dynamic CPMC optimization.To this end,a liquid copper droplet model describes the casting package copper flow pattern in the casting process.Furthermore,a CPMC optimization model is proposed for the first time.On top of this,a digital twin dual closed-loop self-optimization application framework(DT-DCS) is constructed for optimizing the copper disc casting process to achieve self-optimization of the CPMC and closed-loop feedback of manufacturing information during the casting process.Finally,a case study is carried out based on the proposed methods in the industrial field.

Refined Anam-Net:Lightweight Deep Learning Model for Improved Segmentation Performance of Optic Cup and Disc for Glaucoma Diagnosis

In this work,we aim to introduce some modifications to the Anam-Net deep neural network(DNN)model for segmenting optic cup(OC)and optic disc(OD)in retinal fundus images to estimate the cup-to-disc ratio(CDR).The CDR is a reliable measure for the early diagnosis of Glaucoma.In this study,we developed a lightweight DNN model for OC and OD segmentation in retinal fundus images.Our DNN model is based on modifications to Anam-Net,incorporating an anamorphic depth embedding block.To reduce computational complexity,we employ a fixed filter size for all convolution layers in the encoder and decoder stages as the network deepens.This modification significantly reduces the number of trainable parameters,making the model lightweight and suitable for resource-constrained applications.We evaluate the performance of the developed model using two publicly available retinal image databases,namely RIM-ONE and Drishti-GS.The results demonstrate promising OC segmentation performance across most standard evaluation metrics while achieving analogous results for OD segmentation.We used two retinal fundus image databases named RIM-ONE and Drishti-GS that contained 159 images and 101 retinal images,respectively.For OD segmentation using the RIM-ONE we obtain an f1-score(F1),Jaccard coefficient(JC),and overlapping error(OE)of 0.950,0.9219,and 0.0781,respectively.Similarly,for OC segmentation using the same databases,we achieve scores of 0.8481(F1),0.7428(JC),and 0.2572(OE).Based on these experimental results and the significantly lower number of trainable parameters,we conclude that the developed model is highly suitable for the early diagnosis of glaucoma by accurately estimating the CDR.

Clinical characteristics of peripapillary hyperreflective ovoid mass-like structures in myopic children

AIM:To describe the characteristics of peripapillary hyperreflective ovoid mass-like structure(PHOMS)in myopic children and to investigate factors associated with PHOMS.METHODS:This retrospective observational study included 101 eyes of 101 children(age≤17y)with myopia.All included patients underwent comprehensive clinical examination.Optic nerve canal parameters,including disc diameter,optic nerve head(ONH)tilt angle,and border tissue angle were measured using serial enhanced-depth imaging spectral-domain optical coherence tomography(EDI-OCT).Based on the optic disc drusen consortium’s definition of PHOMS,eyes were classified as PHOMS group and non-PHOMS group.PHOMS was categorized according to height.RESULTS:Sixty-seven(66.3%)eyes were found with PHOMS.Small PHOMS could only be detected by optical coherence tomography(OCT).Medium PHOMS could be seen with blurred optic disc borders corresponding to OCT.The most frequent location of PHOMS was at the nasosuperior(91%,61 of 67 eyes)to ONH disc.The axial length and spherical equivalent were more myopic in the PHOMS group than in the non-PHOMS group(both P<0.001).ONH tilt angle was also significantly greater in PHOMS group than in non-PHOMS group[8.90(7.16-10.54)vs 3.93(3.09-5.25),P<0.001].Border tissue angle was significantly smaller in PHOMS group than in non-PHOMS group[29.70(20.90-43.81)vs 45.62(35.18-60.45),P<0.001].In the multivariable analysis,spherical equivalent(OR=3.246,95%CI=1.209-8.718,P=0.019)and ONH tilt angle(OR=3.275,95%CI=1.422-7.542,P=0.005)were significantly correlated with PHOMS.There was no disc diameter associated with PHOMS.In the linear regression analysis,border tissue angle was negatively associated with PHOMS height(β=-2.227,P<0.001).CONCLUSION:PHOMS is associated with optic disc tilt and optic disc nasal shift in myopia.Disc diameter is not a risk factor for PHOMS.The changes in ONH caused by axial elongation facilitated an understanding of the mechanism of PHOMS.

FINITE RANGE SET WITH TRUNCATED MULTIPLICITY FOR MEROMORPHIC FUNCTIONS ON SOME COMPLEX DISC

In this paper,we consider the truncated multiplicity finite range set problem of meromorphic functions on some complex disc.By using the value distribution theory of meromorphic functions,we establish a second main theorem for meromorphic functions with finite growth index which share meromorphic functions(may not be small functions).As its application,we also extend the result of a finite range set with truncated multiplicity.

Clinical therapeutic effect of self-prescribed Sanhanchushi Tongbi on lumbar disc herniation

BACKGROUND Lumbar disc herniation(LDH)commonly occurs during spinal surgery;LDH is on the increase in younger patients and is classified as"paralysis"and"back pain."Sanhanchushi Tongbi(SPST)is a customized prescription.It disperses cold,relieves pain,removes cold from the meridians and viscera,and treats neuropathic pain.However,few studies have investigated its mechanism of pain relief.AIM To observe the clinical therapeutic effects on LDH treated with self-prescribed SPST.METHODS A total of 211 patients with LDH syndrome were divided into two groups:107 patients in the control group were treated with conventional massage combined with traction,and 104 patients in the observation group were treated with a combination of the control regimen and self-prescribed oral SPST.The patients were treated for 4 wk.Indices of traditional Chinese medicine(TCM)syndrome score and serum inflammatory factor levels were measured.RESULTS After therapy,the TCM syndrome score in the observation group was significantly lower than that in the control group(P<0.05).The main symptoms,clinical signs,daily activities,and Japanese Orthopedic Association scores in the observation group were significantly higher than those in the control group after therapy(P<0.05).The levels of tumor necrosis factor-α,interleukin-6,and C-reactive protein were lower in the observation group than in the control group(P<0.05).In the observation group,superoxide dismutase levels were significantly higher,whereas malondialdehyde levels were significantly lower,compared with the control group(P<0.05).The overall efficacy rate in the observation group was 96.15%,which was substantially higher than that in the control group(88.79%;P<0.05).CONCLUSION Self-prescribed SPST can reduce the levels of inflammatory and pain-causing factors as well as lumbar pain in patients with LDH.

Treatment of lumbar disc herniation with robot combined with unilateral biportal endoscopic technology:A case report

BACKGROUND This reported procedure combines the orthopedic surgical robot with the unilateral biportal endoscopy-lumbar interbody fusion(UBE-LIF),utilizing the UBE's wide viewing field and operating space to perform minimally invasive decompressive fusion of the lesioned segment,and the orthopedic surgical robot's intelligence and precision to perform percutaneous pedicle screw placement.The advancement of this procedure lies in the superposition of advantages and offsetting disadvantages of the two new technologies,and the maximum effect of treatment is achieved with maximum minimization of invasiveness and precision under the monitoring of imaging instruments to maximize the benefit of patients,and this review reports a case of multiple-segment lumbar decompression and fusion surgery for lumbar disc herniation via robot-assisted UBE for reference.CASE SUMMARY A 44-year-old patient presented to our hospital.Combining various clinical data,we diagnosed the patient with lumbar disc herniation with radiculopathy,lumbar spondylolisthesis,and lumbar spinal stenosis.We developed a surgical plan of"UBE decompression+UBE-LIF+orthopedic surgery robot-assisted percutaneous pedicle screw implantation for internal fixation".The results were satisfactory.CONCLUSION We present an extremely rare case of multiple-segment lumbar decompression and fusion surgery for lumbar disc herniation via robot-assisted UBE and achieved good results.Therefore,the technique is worthy of clinical promotion.

A meta-analysis on the clinical efficacy of fire dragon cupping in the treatment of lumbar disc herniation

Background:The incidence of lumbar disc herniation(LDH)is notably high.Consensus among experts highlights non-surgical treatments as the primary therapeutic approach for LDH.Contemporary medicine frequently employs pharmacotherapy and epidural injections in such treatments,which are associated with numerous adverse effects.Prolonged use can severely impair the liver and kidney functions of patients.Hence,the role of safe and effective traditional Chinese medicine techniques becomes pivotal.Among various traditional Chinese medicine approaches for treating LDH,fire dragon cupping,renowned for its remarkable efficacy,cost-effectiveness,and ease of application,is extensively utilised in clinical settings for managing LDH.Nonetheless,there is a scarcity of systematic and standardised evidence from evidence-based medicine studies.Therefore,conducting a meta-analysis is imperative.Methods:A comprehensive computerised search was conducted in databases including China National Knowledge Infrastructure,WanFang Data,VIP,China Biology Medicine disc,PubMed,EMbase,The Cochrane Library,Web of Science,and CINAHL.The search aimed to gather randomised controlled trials on fire dragon cupping therapy for LDH,spanning from the inception of these databases until December 2023.Two researchers independently screened the literature according to inclusion and exclusion criteria,extracted data,and assessed the methodological quality of the studies included,utilising RevMan 5.3 software for meta-analysis.Results:The results show that the fire dragon cupping therapy group had better clinical effectiveness(relative risk=1.23,95%confidence interval(CI)(1.14,1.33),P<0.00001),less pain(standardized mean difference=–1.33,95%CI(–1.49,–1.16),P<0.00001),and some improvement in lumbar function(Japanese Orthopaedic Association scores:mean difference=3.37,95%CI(2.31,4.43),P<0.00001.Conclusion:The fire dragon cupping therapy significantly alleviates LDH,warranting its extensive application.However,considering the limitations in the number and quality of studies included,the aforementioned conclusion necessitates further validation through more high-quality research.

Application Research of PETD Combined with MRI Nerve Root Water Imaging in the Minimally Invasive Treatment of LDH

Objective: This study aims to evaluate the safety and efficacy of PETD combined with nerve root water imaging of MRI for the treatment of lumbar disc herniation. Methods: A retrospective review was performed on 62 patients with lumbar disc herniation from March 2019 to March 2021. The study included an experimental group of 30 patients and a control group of 32 patients. The experimental group underwent PETD combined with nerve root water imaging of MRI, while the control group received traditional PETD treatment. The visual analogue scoring method (VAS score), and JOA lumbar spine function score before and after surgery were compared between the two groups, and efficacy was assessed and compared using the MacNab score. Results: The mean operation time was significantly reduced in the experimental group (56.43 &#177;10.40 minutes) compared to the control group (65.69 &#177;14.12 minutes). The VAS score was compared between the two groups with preoperative (p = 0.624), one month after surgery (p = 0.325), three months after surgery (p = 0.676), one year after surgery (p = 0.341);The JOA score was compared between the two groups with preoperative (p = 0.961), one month after the surgery (p = 0.266), three months after surgery (p = 0.185), one year after surgery (p = 0.870), they were no significant statistical difference;The efficacy evaluation of the last follow-up Macnab showed that all the 30 patients in the experimental group were excellent, 31 of 32 patients in the control group were excellent, 1 case was good;There was no statistical difference in the comparison between the two groups (p > 0.05). Conclusion: The study concludes that the combined approach of PETD with nerve root water imaging of MRI is a safe, effective, and more efficient alternative to conventional PETD for treating lumbar disc herniation.

Morning Glory Syndrome or Bindweed Flower Papilla Syndrome

Introduction: Morning Glory Syndrome (MGS) is a rare anomaly of the optic nerve characterized by a flower-shaped excavation in the optic disc. This anatomical peculiarity is of growing interest due to its impact on vision and the therapeutic challenges it presents. Despite research advances, gaps persist, requiring thorough exploration to better understand this rare condition. We present the case of a young girl. Observation: A 7-year-old girl presented with persistent deterioration of vision in the right eye since birth. Visual acuity was counting fingers at 2 meters in the right eye and 10/10 in the left eye. Biomicroscopy was normal in both eyes, and fundus examination revealed a funnel-shaped excavation at the optic disc of the right eye, associated with central glial proliferation, thin blood vessels in a radial distribution, and atrophy of the neuroretinal rim. Additional tests confirmed the diagnosis of isolated unilateral Morning Glory Syndrome in the right eye. Combined treatment included appropriate optical correction and functional rehabilitation. Regular ophthalmological follow-up over a one-year period was established to monitor visual acuity evolution, optic disc stability, and detect any potential complications. The reserved prognosis was marked by the absence of ocular complications and maintenance of initial visual acuity in the right eye. Conclusion: The positive response to management underscores the importance of an integrated approach, early diagnosis, therapeutic adherence, and personalized strategies.

Late Diagnosis of Congenital Optic Disc Abnormalities

Purpose: To show epidemiological and imaging aspects of congenital optic disc abnormalities diagnosed late. Method: It was a retrospective study, including all patients with congenital optic disc abnormalities diagnosed at a late age between January 2020 and October 2022 at the eye center of Abass Ndao Hospital. Complete ophthalmological examination was performed with eye imaging according to the cases. Results: 09 patients (10 eyes) were diagnosed with congenital optic disc abnormalities. The mean age was 29 years, with a sex ratio of 0.8. Three patients had consulted for unilateral decreased visual acuity since childhood, two for sudden vision loss and in four cases the diagnosis was fortuitous. Visual acuity was ranged from 1/200 to 20/20. Fundus examination showed myelinated retinal nerve fibers in four eyes, optic disc pit in three eyes including two complicated by maculopathy, two cases of morning glory syndrome and a case of pseudoduplication of the optic disc. Optical coherence tomography, ocular ultrasound B and OCT-Angiography were performed according to the cases. Conclusion: Congenital optic disc abnormalities are often diagnosed late. They are potentially amblyogenic and complications are not rare, worsening the visual prognosis. Their screening should be systematic by ophthalmological examination in newborns.

Birth Defects of the Child Optic Disc: Diagnostic Challenges and Prospects for Care

Introduction: Congenital optic disc anomalies in children refer to structural variations of the optic nerve head present from birth. These deformations involve the size, shape, color, and vessels of the optic disc. Although often asymptomatic, these anomalies can impact the visual development of the child, underscoring the importance of a thorough fundus examination for early detection and appropriate medical follow-up. We present two cases of congenital optic disc anomalies in children, illustrating the diagnostic challenges and complexity of their management. Case 1: A 3-year-old girl presented with a white spot in her left eye present since birth. Uncorrected distance visual acuity was 2/10 in the right eye, while she could perceive hand movements at 2 meters with the left eye. Normal examination in the right eye showed leukocoria, microphthalmia, and a white mass at the center of the optic disc on fundus examination in the left eye. Ocular imaging, including ultrasound and optical coherence tomography (OCT), confirmed the diagnosis of persistent hyperplastic primary vitreous (PHPV) in its mixed form in the left eye. Management included prescribing full optical correction and functional rehabilitation, without resorting to surgery. The course was marked by persistent amblyopia leading to a poor prognosis. Case 2: A 7-year-old girl consulted for vision disturbance in her right eye. Visual acuity was finger counting at 2 meters in the right eye and 10/10 in the left eye. Anterior segment examination revealed no abnormalities in both eyes. However, fundus examination highlighted a large funnel-shaped excavation associated with central glial proliferation, wheel spoke vessels, and neuroretinal ring atrophy in the right eye. Optical coherence tomography (OCT) of the right eye confirmed the diagnosis of isolated unilateral Morning Glory syndrome. Management included full optical correction and orthoptic rehabilitation. The course was marked by the absence of ocular complication and maintenance of visual stability in the right eye. The prognosis seemed favorable. Conclusion: Congenital optic disc anomalies in children exhibit great clinical variability and require an individualized diagnostic and therapeutic approach.