The aim of this paper is to assess and highlight the significance of cultural landscapes in protected areas, considering both biodiversity and the delivery of provisioning ecosystem services. In order to do that, we analyzed 26 protected areas in Andalusia (Spain), all of them Natural or National Parks, regarding some of their ecosystem services (agriculture, livestock grazing, microclimate regulation, environmental education and tourism) and diversity of the four terrestrial vertebrate classes: amphibians, reptiles, mammals, and birds. A cluster analysis was also run in order to group the 26 protected areas according to their dominant landscape. The results show that protected areas dominated by dehesa (a heterogeneous system containing different states of ecological maturity), or having strong presence of olive groves, present a larger area of delivery of provisioning ecosystem services, on average. These cultural landscapes play an essential role not only for biodiversity conservation but also as providers of provisioning ecosystem services.

Purpose: To assess in a sample of normal, keratoconic, and keratoconus (KC) suspect eyes the performance of a set of new topographic indices computed directly from the digitized images of the Placido rings. Methods: This comparative study was composed of a total of 124 eyes of 106 patients from the ophthalmic clinics Vissum Alicante and Vissum Almería (Spain) divided into three groups: control group (50 eyes), KC group (50 eyes), and KC suspect group (24 eyes). In all cases, a comprehensive examination was performed, including the corneal topography with a Placido‐based CSO topography system. Clinical outcomes were compared among groups, along with the discriminating performance of the proposed irregularity indices. Results: Significant differences at level 0.05 were found on the values of the indices among groups by means of Mann‐Whitney‐Wilcoxon nonparametric test and Fisher exact test. Additional statistical methods, such as receiver operating characteristic analysis and K‐fold cross validation, confirmed the capability of the indices to discriminate between the three groups. Conclusions: Direct analysis of the digitized images of the Placido mires projected on the cornea is a valid and effective tool for detection of corneal irregularities. Although based only on the data from the anterior surface of the cornea, the new indices performed well even when applied to the KC suspect eyes. They have the advantage of simplicity of calculation combined with high sensitivity in corneal irregularity detection and thus can be used as supplementary criteria for diagnosing and grading KC that can be added to the current keratometric classifications.

Purpose.: To introduce an iterative, multiscale procedure that allows for better reconstruction of the shape of the anterior surface of the cornea from altimetric data collected by a corneal topographer. Methods.: The report describes, first, an adaptive, multiscale mathematical algorithm for the parsimonious fit of the corneal surface data that adapts the number of functions used in the reconstruction to the conditions of each cornea. The method also implements a dynamic selection of the parameters and the management of noise. Then, several numerical experiments are performed, comparing it with the results obtained by the standard Zernike-based procedure. Results.: The numerical experiments showed that the algorithm exhibits steady exponential error decay, independent of the level of aberration of the cornea. The complexity of each anisotropic Gaussian-basis function in the functional representation is the same, but the parameters vary to fit the current scale. This scale is determined only by the residual errors and not by the number of the iteration. Finally, the position and clustering of the centers, as well as the size of the shape parameters, provides additional spatial information about the regions of higher irregularity. Conclusions.: The methodology can be used for the real-time reconstruction of both altimetric data and corneal power maps from the data collected by keratoscopes, such as the Placido ring–based topographers, that will be decisive in early detection of corneal diseases such as keratoconus.

Purpose.: To construct a set of indices that measure the irregularity of the anterior corneal surface, computed directly from the image of the Placido disks reflected on the cornea. Besides the high sensitivity and specificity, this approach allows bypassing the surface or curvature reconstruction step that is currently performed by the software of any commercial Placido topographer. Methods.: Several basic indices are proposed to detect irregularities on the anterior surface of the cornea, via analyzing some geometric and mathematical properties of the mires. These individual primary indices are built directly from the displacement of the digitized images of the rings reflected on the cornea. In addition, compound metrics are proposed (such as the generalized linear model or the classification trees) by combining some of the primary indices to improve their efficiency. The computed metrics were developed and tested for the CSO topography system (CSO, Firenze, Italy), but the methodology proposed here extends easily to any other commercial Placido disks topographer. Results.: The primary indices allow discriminating, with excellent accuracy, between normal eyes and eyes with keratoconic corneas. Sensitivity and specificity of the primary indices is analyzed by using the receiver operating characteristic (ROC) curve methodology. Some combined indices are presented, which raise the efficiency to optimal. Conclusions.: All the primary indices proposed in this work exhibit very good performance in discriminating between normal and irregular corneas. The accuracy of the combined indices is optimal within the test group (perfect classification), allowing their use in clinical practice as corneal markers of a disease. All these indices are fast to compute and can be easily implemented in any corneal topography system.

Purpose The aim of this study was to evaluate the long-term efficacy and safety of the Artiflex® lens implant and to follow the evolution of the number of corneal endothelial cells over time. Design It was a retrospective study of an observational case series of patients who underwent surgery at “The INVISION Ophthalmic Hospital” (Almería, Spain) in 2007 and who were followed for 10 years. Methods Setting: Clinical practice. Study population included 53 eyes of 30 patients who underwent an Artiflex® lens implant for the correction of myopia from −4 to −14 D. Each patient included in this study had stable myopia for at least 2 years and a contraindication for corneal refractive surgery. The efficacy index was defined as the quotient between uncorrected distance visual acuity postoperative and best-corrected distance visual acuity (BCDVA) preoperative. The safety index was calculated as the quotient between BCDVA postop and BCDVA preop. Results The average efficacy and safety indices of the lenses implanted were 1.1 (SD 0.30) and 1.06 (SD 0.2) at 10 years of follow-up. In this period of time there has been a loss of 12% of the corneal endothelial cells. The postoperative complications were pigment dispersion in four eyes (7%) of four patients and decentration of phakic intraocular lens in two eyes (4%) of another two patients. Conclusions The Artiflex® foldable phakic lens could be a safe and effective long-term alternative for myopic patients in whom laser surgery was contraindicated.