This is Glaucoma, but before we get to Glaucoma, we have the pleasure of going back to Lisbon and here again we see the Dr. Zeus Castle here in Lisbon. And it's a very interesting mixture of Dr. Zeus, maybe a little Gadi in there and the Moors and you name it. So that's the castle. Well, the pointer works. All right. We'll just go this way. All right. So this is the main dining room. As you can see, it kind of looks like the dining room in my house. Very similar. A bit, I mean, you know, as expected, you would expect the dining room to be kind of ornate and so very ornate dining room. This was the part of the chapel and again the theme is, but interesting, but again kind of Moorish tiles around it. So very interesting mixture of different influences, you know, in Portugal for through the centuries. And then you just go through the living quarters and this is just one of the handmade closets and the vases, excuse me, if you want to sign it, tell you to say vases, the vases, some of the vases that are in there. And again, this is Jade, by the way, a very ornate Jade. You've got this Jade lion over here. So again, very, very ornate fixtures as you wander through, except this was put in in the turn of the century, a telephone. So they did bring it up to speed. You've got a telephone right here. It's just a little bit different than the cell phones that you guys carry. But imagine answering pages on this call, this phone. Okay, so we're going to talk about the glaucoma and we can't talk about glaucoma without talking about the pathology of the anterior chamber angle. So I'm going to, I always go randomly here because you guys won't know where to sit. So Teresa, you are sitting here. What are we looking at right here? All right, we're looking at the trabecular mesh work and the structures of the anterior chamber angle. So when you are looking at the angle through a goniomere, you put a goniomere on there and you're looking into the angle. What's the first thing you see here as the cornea ends? Shwabbi's line. Shwabbi's line. And then as you go down here, you'll see a little more whitish line, a little bit lighter colored line. Well, this is where it's membrane is where Shwabbi's line, that's where it ends. So we're looking here at the mesh work. So they've divided it into non-pigmented and pigmented mesh work. And so when you look with your goniomere, the part that's closest to the cornea will be lighter colored. The part that's further posteriorly closer to the IRS will be darker colored. So there's Shwabbi's line, the non-pigmented trabecular mesh work, the pigmented trabecular mesh work. Becca, what is this structure right here? If you look in, that will look like a little white. That's the scleral spur. So if you think about it, the trabecular mesh work is shaped like a triangle. So the apex is here, the base is down here and the scleral spur sticks out and makes a little shelf for it. So if it goes around 360 degrees, the trabecular mesh works like a triangle sitting on that shelf. So here's the scleral spur right here. And then we've kind of cut it off here, but what is deep to the scleral spur? Chris? So, well, first before the scleral body, if you look into the angle, you may see part of the iris root. Exactly. So the iris root and then scleral body, and so that's what you'll see when you look in there.  All those little lines don't really define themselves easily like it does in the textbook. So it makes it a little bit more difficult. So you've got to really look inside because you need to know, is that angle open? Is it closed? You know, is it recessed?  Okay, so one more structure we're looking at right here. Fellows get pinned too here. So Josh, what is this structure right here? Is that Schlem's canal? Schlem's canal. So, you know, and for those of you who have followed the old movie, Schlem was the fifth stooge. You know, there was molary, curly, shamp and then Schlem, no. So Schlem's canal, interesting name. So this is Schlem's canal and then what is this structure right here? That's actually right here. Okay, just an aqueous vein. It's an aqueous vein, exactly. So let's go to a little bit of a higher power here. All right, so Nathan, we're zooming in here and Josh mentioned a tissue. Exactly. And so what's important about the juxtacanalicular tissue here? Exactly. So you need to remember that when aqueous flows through the trabecular mesh work, it's not just passive. There's even some active transport and it's interesting that glaucoma is probably the second most common disease that we treat, yet we don't understand it fully, you know, open-angle glaucoma. So the bars of trabecular mesh work have collagen in them. They've got elastin in them. They do have endothelial cells around them, but this area right here, the juxtacanalicular tissue, there is more than just free flow. So there's some obstruction there and so people are really coning in on this area because we really think that when you have open-angle glaucoma, this may be where the pathology is. So slums canal, if you think about it, it's like a flattened, like an inner tube that goes all the way around. Again, it goes around 360 degrees. It's this flat tube and again, here's an aqueous vein that we're looking at. There's a close-up. There you see the endothelial cells in the juxtacanalicular tissue that line slums canal. It's almost like an emphatic channel. It's not got a complete endothelial lining around it. All right. So, Rhys, what we're going to do is we're going to trace the path of aqueous. Where is aqueous made? All right. So it's made in the ciliary body and then where does it go? Okay. So then it goes through the angle, the juxtacanalicular tissue, slums canal. And then what are these right here? Aqueous veins. So, aqueous literally drains out through the veins, through the sclera and then there's some areas, some little veins that are right on the surface of the episcleral tissue here.  But every once in a while, look at the area just behind the limbus with your slit lamp and focus deep and you'll see little vessels there and then you'll see some boxcar. And so you'll see a little bit of clear fluid squirting through there and then you'll see some RBCs in it. So you'll actually be able to see the aqueous veins if you look carefully. So I mean, this is one reason why you can get a secondary glaucoma from increased venous pressure. So see, you've got a disease, you've got an AV malformation, you've got something going on. You can get glaucoma from increased venous pressure which causes a backup of that aqueous flow out of there and causes increased pressure. All right. So we're talking about open-angle glaucoma here and what the point I wanted to stress here is that if you look at the trabecular mesh work in a patient with open-angle glaucoma, you cannot tell any difference with light microscopy from glaucoma to an age match control. Now, trabecular mesh work changes from 20 to 70, but if you take a 70-year-old with glaucoma, 70-year-old without glaucoma, they look the same. Now with EM you can find some subtle differences, but with light microscopy they really look the same. So you don't really see any differences there. All right, Tina, what are we looking at right here? All right, so you see these radial spokes here with transillumination, so there's being pigments scraped off the posterior iris and it's in this radial pattern. Why do you think there's that radial pattern to it when you see pigment dispersion? Exactly. So it's where the zonules rub. So what we want to do when we're starting to look at glaucoma, we want to characterize it. And the first thing we do is you say, is it open-angle? Is it closed-angle or whatever? So when we look at open-angle glaucoma, we first look at primary open-angle glaucoma, where it's open-angle glaucoma with nothing else going on, but there are secondary open-angle glaucomas. And one of the secondary glaucomas is pigment dispersion syndrome, pigment dispersion glaucoma. So what is thought to happen in this entity is that, for some reason, the iris bows backwards. And we're looking at the posterior surface of the iris here, cylinder body here. And if you look right where the zonules run, those zonular bundles scrape on that posterior iris that's going posteriorly. And so you get pigment liberated there. And then, of course, it floats through the pupil and deposits into the trabecular mesh where it's causing pigment dispersion glaucoma. So it's an interesting entity. It occurs in younger males who are moderately myopic, not high myopes, moderate myopes. And for some reason, their iris pushes posteriorly. And before we had OCTs, it was really hard to judge that. Now you put an OCT on. You can see it in a second. And the treatment is you actually do a laser iridotomy. And the iris will actually come forward a little bit. And you can help decrease the pigment dispersion with that. So I have to show path pictures to path fellows. And so what am I illustrating here? There's three things right here I want to show in this one picture. So pigment in the stroma. And look, what's happening here? Actually, so pigment scraping off here. What's the second thing we see? Pretty much you can say all through the mesh work. I mean, there's pigment on there. So if you put a goniomere on there and look, you would just see dark, really be dark with pigment. There's a third thing on here. Hard to tell thickness, but if you look closely, you even see pigment dusting on the corneal endothelium. And so it's interesting, because of the patterns of the way the aqueous flows, you get a deposition in a certain pattern.  That's so exfoliation. Kuchenberg spindle, exactly. So Kuchenberg is just the guy who described it. And if you look, the pigment will deposit kind of in the lower third of the iris in a little triangle, almost. So it's called the Kuchenberg spindle. So you see the pigment on there when you look with your slip beam. You'll see little pigment deposits all over. That's, again, a sign of pigment dispersion. And then eventually, you can get pigment glaucoma. All right, now, Becca, this is another potential cause of secondary open-angle glaucoma, which we're showing here. It's actually kind of stretched out there. What's going on right here? Believe it or not, those are pigmented cells in there. So what could cause a picture like this? We've got a whole bunch of pigmented cells in the ciliary body moving into the angle. Believe it or not, this is a melanoma. And so you can get a secondary open-angle glaucoma from a tumor invading the anterior chamber angle from behind. So here's the iris. Here's the cornea, trabecular mesh work here. And you've got a large, ciliary body, heavily pigmented tumor invading the angle. So this is a secondary open-angle glaucoma due to a tumor invading it. So don't forget, you can get a tumor invading it. And here's just another view. Here's the iris back here, cornea up here. Look at the space in between these. You've got this tumor in the ciliary body invading forward into the mesh work and into the anterior chamber angle. So secondary open-angle glaucoma from a malignant melanoma of the chloride. Chris, what are we seeing right here? Pollution. Why do you have that particular pattern where there's some in the periphery and some in the center and clear in between? You've got the windshield liper effect of the iris contracting and invading. Exactly. So that's why you see this. The iris, every time it goes in and out, looks like a windshield liper. It sweeps the exfoliated material more toward the center to the periphery, but there's a relative clear spot that's right there. And here you can see. We call this the scalloped edge look. You look in the periphery. You see the scalloped edge of this exfoliative material that's deposited on the anterior lens capsule. Why would I be showing you pictures of exfoliation on the lens capsule again in this lecture? Exactly. And so you can get a secondary open-angle glaucoma from exfoliation syndrome. And the thing about exfoliation syndrome, you guys need to remember, when you see these people in clinic, you've got to watch them really close, because they can go downhill very rapidly. So you can watch them, and the pressure's OK, pressure's OK, and then suddenly the pressure will shoot up, and it's pretty rapid. So you've got to keep a close eye on people with dense exfoliation. And so again, here's the classic, what do we call this, pattern again, Chris? The iron filings. And so here you see lens capsule. Which capsule is this? The anterior capsule. And how can we tell that? Exactly. You see, you were awake for that lecture. This is a good sign. So here's the anterior capsule, lens epithelial cells under it, and the iron filing pattern exfoliation. What are we looking at right here, Josh? Exactly. So you see exfoliative material here actually clogging up the angle. So there's a couple different mechanisms that you can get glaucoma from sort of exfoliation. One is it just physically clogs the angle. But you also get, you can even get little exfoliative material even into the trabecular meshwork, into the bars of the meshwork, even into Schlem's canal. And now this stuff is all over. So when you're on board exam and they're asking you about exfoliation in the eye, it's not just on the lens capsule. It gets into corneal endothelial cells. So you have more chance of corneal edema. It gets into the iris cells. It even gets into the iris sphincter and dilator muscles. So this stuff gets everywhere when you look at it. But the one thing that you want to be concerned about is the fact that it can cause pretty significant opening of glaucoma. And this is one of the glaucomas that has really helped by doing cataract surgery. Because when you remove that whole scaffolding of anterior lens capsule that's got exfoliative material on it, that helps to decrease the burden. But also when you take out the crystalline lens from behind, it opens the angle wider. So you can get a 3 to 5 millimeter drop in pressure just by doing cataract surgery in a patient with exfoliation syndrome. So you can literally help the glaucoma by taking out the cataract. All right, Nathan, what are we looking at right here? All right, so what's the lenticular cause of glaucoma? This guy complains of severe pain, hasn't seen through that eye for a while. It's been blurry a long time. My wife drags him in. Exactly. So this is, again, a case of a secondary open angle glaucoma from protein leaking out of an intact lens capsule. It's a hyper-mature cataract. And then what kind of cells are these that gobble up the protein? Macrophages. Macrophages. And so you get these big, juicy macrophages clogging up the meshwork. You even get just the protein itself in between the macrophages clog it up. So this is, again, a glaucoma that is curative by removing that hyper-mature lens.  But, again, these people can show up with a pressure of 50. And their eye really painful and red, and the cornea demidas. And so this can be a pretty acute glaucoma, but it's due to a hyper-mature cataract with leakage of the protein outside the closed capsule. And this is just a little aspiration that was done just to confirm it. And these are macrophages that were just aspirated from the anterior chamber. All right, so I wanted to go over, again, just in this crude drawing a little bit about the angle. Because when you've got open angle, normal angle that will look like this, when you've got a closed angle, you look in with your goniomere. You may not be able to see any structures in the anterior chamber angle. And then, lastly, you get an angle recession, which is deeper than normal. And you look in with your goniomere. You may actually see a big band of ciliary body underneath there, because the iris is pushed way back. OK, Reese, what are we looking at here? And it's painful. All right, so this patient was on the GI ward and had some procedure. And then had this severe pain. And, of course, first thing they do is they give them maybe Tobardex and Tylenol for treatment of this. What would your concern be? An angle closure. Exactly, so when you see a mid-position, usually fixed iris, it's not dilating, it's not constricting. The eye's very red, it's injected. Pressure's really high.  Iris Bombay. So here's the iris bowing forward. Iris Bombay, B-O-M-B-E, with an exxon, a goo, going up. The iris Bombay. But look at the beam on the cornea. And look at the beam on the iris. You can literally see that coming forward. So what do we think the mechanism is for a primary narrow angle glaucoma? So you get what call it a relative pupillary block. So it's interesting, when you have someone with an angle of risk, so they've got a narrow angle to begin with, maybe they're hyper-opical, they've got kind of a big lens in there. It's not when you dilate them that they're widest that they go into angle closure.  That's the point where you have maximum contact between the anterior lens and the iris. And it doesn't take much to get a relative pupillary block. Aqueous builds up behind the iris. Then it blocks off the angle. So you get angle closure glaucoma secondary to that. Tina, we talked about now kind of a primary angle closure glaucoma. Now we want to look at areas that can cause secondary angle closure. What do we see in here? So here's the angle back here. It's pretty much scarred down here. What do you think could cause that? More specific. Exactly. So what we abbreviate as PAS, peripheral anterior synechia.  And so that can be secondary to an acute angle closure or even like a chronic low grade angle closure. Now we don't see that much angle closure here. In Singapore and in Hong Kong, we have a lot of ethnic Chinese. Up to 40% of their glaucomas are chronic angle closure. So just a different patient population, different configuration to their eyes. And so we just don't see it much here.  And here you see a broader one blocking off the angle. And I'm going to show you a close up here. What do you think is going on here that could cause this angle to close off? So we actually call this neovascular glaucoma. So when you have a disease that causes neovascularization of the iris, then you can get abnormal blood vessels growing along the surface of the iris and then actually into the angle and then closing it off. And so, I don't know, extra bonus points. What are entities that can cause neovascular glaucoma? Actually, that's probably not a fair question. Exactly, and so what are, name me, three good causes of chronic ischemia that could lead to neovascularization. Diabetes is the first one. Central vein occlusion, second. Usually, but just ischemia in general. So I mean, people can have severe carotid artery disease and they can just get ocular ischemia in general. But what's interesting is it's not really something focal to the iris that causes this. It's ischemia elsewhere in the eye that creates humors that circulate forward and cause abnormal blood vessels to grow. And so the key thing is as you treat the retinal ischemia or the ocular ischemia before you get permanent changes in the anterior chamber angle from the neovascularization. Yes, we get anything that decreases the ischemia. We can now use anti-veg F injections, we can do laser treatments, and we try to get it before it closes off. Yes, usually not. No, in fact, usually not. It would have to be a significant diffuse ischemia more of the retina than anything else. And here you see a close-up of an iris again and there's those fine vessels on the anterior surface. So iris neovascularization leading to a secondary angle closure. All right, boy, don't worry, I'll come back to Chris Josh. So what are we looking at here? It kind of looks like a dinosaur, you know, he's going, ah, he's coming in and. Yeah, it's stuck right there, so you think that's not an artifact? So was there posterior synechia before? Exactly, so you can get angle closure from posterior synechia. So say you've got chronic inflammation especially and you get the iris stuck to the lens capsule. Again, you get build-up posteriorly of aqueous and you get a secondary angle closure. So this is a posterior synechia, meaning posterior to the iris and it's right at the pupillary border. And this is an extreme example. This is where you've got a completely occluded pupil. So you've got this little inflammatory membrane going all the way across the pupillary space and just closing it down and then you get a secondary angle closure with that. So one of the first things we do when we have someone with an acute iris, especially if it's a bad one, we give them a dilating drop. First of all, to help stop the ciliary spasm so they feel better, but secondly so that that iris doesn't get stuck. Close so that we can open it up a little bit and make it so it doesn't get stuck. All right, Nathan, what are we looking at right here? Exactly, so kind of the opposite. Look, here's the mesh work up here and there's the iris root and so it's clear down there. So what's the most common cause of angle recession? Trauma. And so usually it's a blunt trauma, not a penetrating trauma. So blunt trauma, common cause of angle recession, blunt trauma, there's a couple of causes of the two dudes. So whenever you're assaulted, it's never one guy, it's two and you never started it.  So the two dudes can cause this.  It's interesting, it's actually a tear in the face of the ciliary body. So it's as if, you know, the iris, it's uncommon, surprisingly, for you to get an aero dialysis, you know, where the iris just tears off at the root. It's more common for it to tear into the face of the ciliary body. And the problem with this is you can, and I'm just showing you normal angle below, recessed angle here. Look, there's the mesh work. Look at tear right into the ciliary body. So for extra bonus points, if you were to get glaucoma from an angle recession, from a blunt trauma, what time does it normally occur? How far after the trauma? Yeah, seven to 10 years. And so that's really important.   And so you gotta tell them, you have to come in every year and I see these, you know, not uncommonly every year or so, someone will come in and their claim will be blurred vision. And so what's the matter? Oh man, my vision's really blurring. You'll look, their pressure will be 45, 50. But it's been going up a couple of points a year for several years, so they don't even notice it. And the visual field from glaucoma starts in the periphery where you don't notice it. So by the time it comes down to where they've got just tunnel vision you'll notice that it's too late. So you gotta put fear of God in these guys and tell them you have to come back every year or you could go blind. So again, this is one of the times I use the B word, the blind word. You know, if you don't come back every year you could get glaucoma and you could go blind. So it'll maybe work for a year or two, but do your best, try to get them to come back. And what happens for some reason is when you've got a recessed angle, for some reason that mesh work over time becomes sclerotic. And I'm not sure what exactly the etiology that is, but it almost becomes sclerotic and closes off. All right, Reese, what are we looking at right here?  Kind of? Significantly cut. And then what are we looking at in the front? So you got a little bit of a summering or in cataract here. Whoa, that's bizarre, okay. Again, $60 million building, $200 computer system. So what's happening here in the angle? There's Slim's Canal. No, there's actually just severe angle recession here. And so this was actually someone who completely lost their vision and the eye was intractively painful and lost their vision, so it became a nucleated. And this again was like 12 years after the trauma. So recessed angles, severe glaucomodus cupping. All right, so we're talking about that. Tina, what are we seeing here? Yeah, you look right there, certainly 0.6, maybe even bigger. Look, where's that rim there? Hard to tell right there, but definitely an increased size and you can't see 3D on these flat pictures. So you really wanna look with your 90 diopter looking 3D, but that is definitely cut. So it's an enlarged cut and that's one of the signs of glaucoma. Now, I mean there's an entire literature on what exactly causes glaucomodus cupping. And one argument is that there's focal ischemia in that area and then it causes the nerve fiber layer to the cells to drop out from the nerve fiber layer, the ganglion cell layer that's putting their axons there drop out. The other thing that people have looked at is disruption of axoplasmic flow and it may be both because what happens is if you look at the trabecular, if you look at, I'm sorry, the area where the laminar crebrose is where the fibers leave the eye. Laminar crebrose is an interesting area. You know, you don't wanna just make a hole in the back of the sclera for the nerve to go out because that wouldn't have any strength. So how the body is designed is you have again, almost like a mesh work where these axons go through the laminar crebrose and somewhere in there, there's either ischemia or there's disruption of axoplasmic flow and you'll get posterior bowing and it'll push against those axons. But in any event, you lose those axons and eventually you get cupping and eventually you get the changes that cause opening glaucoma. This one's probably a little bit more prominent. This is one even a pathologist would recognize so you can see enlarged cupping. Are there still a decent rim around there? You can see a decent rim around there. You do, and in fact, you get, the vessels will move a little bit nasally and they'll kind of arc around that so they'll be pushed nasally.  This is one. I mean, this is an eye that is severe end stage glaucoma. There are no intact fibers right here. And so when we look right here, we've got an eye here, look at that, severe cupping. And in fact, sometimes the cup will actually excavate underneath it so it's almost like it's more than one.  And so it'll excavate it. Now for extra bonus points, what happened to this patient that caused this end stage glaucoma? I'll point to it. What's going on up there? That sure looks weird. All right, so that you're half correct. That's a summer injury. It's not then Gorge boat vessels. That's just the cortex that's there. And in fact, that's a severe, that's actually an area where you've got fibrosis coming through actually adherent from behind the iris to the cornea. So this patient has had a severe penetrating trauma. It ruptured their lens. So you've got a summer injury and you've got this adherent white connective tissue. So they call it an adherent glaucoma. Glaucoma means white band. From which language? From the Greek, of course, glaucoma, so white band. So you've got this adherent glaucoma. So this patient had a penetrating trauma, ruptured their lens, caused scarring and then eventually led to this end stage glaucoma. All right, so what do we show in here? Back to, what do we show in here? So I like this picture because oftentimes when you look at these totally cupped out discs, you'll see a little blood vessel coming up to the edge of the disc and then it just disappears because it literally dives around the corner and this bean pod excavates even more so that you can't even see it. So it'll look like that nasal. So it's pushed nasally. This is nasal. This is temporal where it's always flatter and more sloping and that blood vessel dips around and then here is the laminar corbrosa back here. And so you'll get this posterior bowing of the laminar corbrosa also when you get this severe end stage glaucoma effect on the optic nerve there. And here you've got, look at the excavation there and now you've totally killed off all of the fibers here. Look at the atrophy of the optic nerve. Here's the optic nerve sheath. Here's the optic nerve fibers. Look at that space right there. So this is a severe end stage glaucoma.  There again, you can see the, just the severe excavation that's there. All right, guess this one's gonna be yours Becca. First of all, what kind of tissue are we looking at right here? Okay, so it's optic nerve kind of in a cross section on longitudinal section. Now you're seeing some areas here where it's kind of pale and white focally here. So it's kind of a trophic, but it's interesting it's in a focal area here. So you've got some good fibers here. You've got some areas here where it's almost got this little focal degeneration. And I don't know if I put the stain on here or not. Ah, I did, okay. So this is a special stain. Special stain in that area where you've got this focal disrupted nerve. What could that stuff be? Mucin, exactly. So this is a mucin stain. So in what entity do you get a focal degeneration of the optic nerve with kind of mucin material pushed in there? Exactly. So these are usually secondary to a really high pressure. So you get some with an acute glaucoma. Pressure may shoot up to 50 from 20. And this has got kind of a cool name to it. So again, named by the guy who described it. Extra points. Schnobbles. Again, schnobbles, cavernous, optic atrophy. So again, schnobbles.  So it's due to an acute rising pressure. A sudden acute one. It could be angle closure. It could be an acute glaucoma. And you get this mucin stuff. I like to think of it as the pressure's so high it almost pushes vitreous into the nerve. I don't know if that's what happens, but that's the way you can remember it. Now it does some other things. I'm Chris. Boy, this is your day for this. What kind of tissue are we looking at right here? And through your lens capsule again. Why am I showing you this? So you get these little focal vaculated areas right under the lens capsule due to high pressure. And again, bonus points for what you call them. Let's see, I'm skipping the T now. German name. Glaucomflecken, all right, so glaucomflecken. So again, cool-sounding word. And so basically it's little flecks under the anterior lens cap. So the little focal areas where they think the high pressure disrupts those lens epithelial cells. Then they get these little swollen focal areas. These will go away when you treat the pressure. But you'll see these little focal areas are called glaucomflecken. So you know, literally, flecks not from the Greek, by the way. You can see them. Yep, yep, they look like little kind of vaculated areas, little white vaculated areas right under the capsule. All right, back to Joshua. Why am I showing you this picture? What are we looking at here? Picture of the retina. Retina, what's wrong with this retina? So you're looking in here, what cellular layer should there be right here? Ganglion cell, and if you look at it, it's really markedly atrophied. So does that tell you anything? No, probably. Glaucoma, very good, okay. So when glaucoma causes damage, it damages the axons from the ganglion cells. And so you get loss of these axons, and eventually you get the ganglion cells dying off. And so when you look at it in a person with glaucoma, the retina externally is totally intact, but it's this inner neurofiber layer and ganglion cell layer that's affected. So that's what glaucoma does. And if you're looking here, here's a top and a bottom, what? Nathan, what part of the retina are we looking at now? Normal on top, severe glaucoma on the bottom. Josh said the ganglion cell layer. So where, what part of the retina are we in? The macula. So if you look at the top one, you see the ganglion cell layers, multiple cell layers thick, we're in the macula. You come down here, the macula, some of the severe glaucoma. The last thing to go is the macula. That's the last thing, but once the glaucoma gets severe enough, you even start to lose cells in the macula. Got it, all right. So we're gonna switch gears a little bit here. So, Rhys, we're gonna talk about some specific types of glaucoma. So looking at this angle, this angle just looks funny. Tell me what you're seeing here. And this is really disturbing. Yeah, it almost looks like there's kind of some little fine bands of fibrous tissue coming across. You really don't see that much of a develop mesh work behind there. How old is this patient? This could be a kiddo. It's a kiddo. So this is what we call a congenital glaucoma. And so I hate to keep making you guys memorize these names, but again, there's a guy who described this when you look in with a goniomere. It's called Barkhans memory. Now, it's weird because people at one time thought that the mesh work was normal and you treat congenital glaucoma, you put a lens on the eye, you're going with this big blade and you just slice it all the way across 180 degrees and you would slice this Barkhans membrane and then the iris would drop back, the angle would open up and the glaucoma would be magically cured. It's a lot more complex than that because what we're finding is, is that the angle in congenital glaucoma is just misforn. And you do get this little fibrous tissue over here. And if you open that up a little bit, it helps a little, but unfortunately, the mesh work underneath it in congenital glaucoma is often not normal. So even though they used to do this goniotomy, they'd go in with a blade and slice it open. That's not really that successful because you, this Barkhans membrane, it's not really a membrane, it's an area of just not well-developed trabecular mesh work. Here's a close-up. Here's that Barkhans membrane and here's supposedly where the mesh work is and I don't know if my eyes are bad or not, but I just don't see well-developed mesh work on these kids with the congenital glaucoma. All right, Tina, what are we looking at right here? So we call this polychorea, literally, multiple pupils, polychorea. What entity would you think about when you see an iris that looks like this? What does ice stand for? Exactly, so people who are lumpers like to put categories all together, people who are split or split them up, but there's an entity called ice syndrome, irritable corneal endothelial syndrome, and the ice has kind of three different ways of presenting, but they all have the same final pathology and so this is called essential iris atrophy. So the first part of the ice syndrome, it's called essential iris atrophy.  Now there is a second part of it. Again, I don't know if you've even heard, have you ever heard of these in altruistic? So we'll swing over, three so the younger here, yes. All right, so hazy cornea, but what do we see with the iris here? That's kind of thinned, kind of moth eaten here, some holes here, but there's corneal edema, so what's kind of entity two under the ice umbrella? Chandler syndrome. Chandler syndrome and so Chandlers, again you have the iris atrophy and the polychorea, but you have corneal edema. So Chandlers, you have more corneal effect. Becca, what's the third thing you got to know under this umbrella? Iris Neva syndrome, or again two more names, Kogan Reese syndrome, there you go, Reese and Kogan, so Kogan Reese syndrome. And so you see these multiple little knobs on the iris. It's kind of cool looking when you see it, it's kind of velvety in, there's multiple little knobs on there and we see them on there. And the problem is is that these entities are all caused by kind of the same disease process. So Chris, what's the common unifying theme in all these ice syndromes? Well, yeah, that's really a vague term, but what specifically happens here? Different group, different group. That's the next group, okay? This is where you get endothelial growth on the uval tissue and desalination. Exactly, so the whole common theme to these is you get endothelialization of the anterior chamber.  And so what you're looking at here, what kind of stain are we looking at right here? PAS. PAS, so here's decimage membrane a lot thicker than normal and it's coming around the corner and the mesh works clear the heck down here. So you get this decimage membrane growing onto the surface of the iris and it literally closes off the angle. So that's kind of the common theme to all three of these different entities is desmetization of the anterior chamber angle. And if you look, look at decimage membrane, it's like quadruple thick in there. And then it comes around the anterior, the inner surface of the iris where the angle would be and then on the surface of the iris. So you see decimage membrane growing along here and then closing off the angle growing on the surface of the iris. So all three of these entities, it's a desmetization of the anterior chamber and that's what causes the three of these. Now what's kind of cool is when you look at a PI from a patient with the iris nevis with Kogan re-syndrome. And so this is a little peripheral erudectomy in this patient, this is cool because this is my only archive cover. We got, what's the archives called? JAMA ophthalmology, so this was our only cover on JAMA ophthalmology. We had this cool patient with Kogan re-syndrome. If you look at it, you can see here again is decimage membrane on the anterior surface of the iris but you have these little pigmented cells popping through. So the reason it looks velvety is because you've got decimage membrane on the surface of the iris. But in between here, you get these little mushrooms popping out and they're these little benign melanocytes. And so this iris nevis syndrome, you get these little mushroom outpouchings of melanocytes through decimage membrane on the anterior surface of the iris. So again, pretty cool entity, pretty cool entity there. There you see a close-up again, anterior surface of the iris, little iris nevis there. Okay, Nathan, what the heck are we seeing right here? What's that? More specific, which base of membrane? Decimage, exactly, so you see decimage here decimage is thickened and there's almost a little fold and not only that, it's coming out from the irregular measure would be over here and so you've got decimage membrane thickened and even a little fold. And so when you looked in there, you would actually see decimage more toward the center than you would toward the periphery. So what do we call this? Exactly, so there's a second big umbrella that you have to memorize called the anterior chamber cleavage syndromes. Now it's a misnomer again because we used to think that this mesoderm would come into the anterior chamber and then form the anterior chamber and cleave and then you'd get the trabecular mesh work. We know now it's not mesoderm, what kind of tissue is it that forms kind of the, it's neural crest. So kind of what you thought of as mesodermal cells is actually neural crest and instead of this massive tissue coming in and then cleaving, what happens is they think there's successive waves of migration of these neural crest cells. So it's kind of different but the way to remember it is very easy and George Waring, who sadly just passed away last Christmas, came up with what's called the stepladder classification of these anterior chamber cleavage syndromes and he wrote it 40 years ago. But it's still a good way to memorize it. So the first thing you see in these anterior chamber cleavage syndromes is you see a prominent Schwabbe's line, they call this posterior embryotoxin because people would theorize there was something toxic going on. So posterior embryotoxin. Now you see a close up. Okay, going down the stepladder here, Reese, what's the next thing you can see? Here's posterior embryotoxin, what's going on here? You actually see little bands kind of coming down from this posterior embryotoxin to toward the iris but more in the periphery. So what is the next one? Yeah, almost like, but like a longer, broader anterior synechia. So what is the next entity in the stepladder? So it's called axonfels. How do axonfels ride? Axonfels reiger. And so they used to separate them but now they're lumping them a little bit more to get to the axonfels reiger anomaly. Basically, you see posterior embryotoxin but you start to see little bands of connective tissue kind of coming down from that onto the iris. So you'll see some funny iris abnormalities. Now this isn't just an eye abnormality. These kids can sometimes even have funny teeth and funny bones but axonfels, axonfels slash reigers anomaly and you see these changes and then there is a third one, Tina going further down. This is Peter's anomaly. So as you come down, you've got posterior embryotoxin and then you've got axonfels reigers with bands coming to that and then you go to Peter's anomaly and what's interesting about Peter's anomaly is Peter's anomaly is in addition to the other things that you have, you get this central area where decimates membrane and endothelium just don't form. And so you get this little central area where you just have this internal kind of ulcer in the cornea and you get corneal edema. Now sometimes with this Peter's anomaly you can get a focal anterior subcapsular cataract associated with it. So again, the way I remember it is is when it's trying to form and that lens is coming off, it kind of grabs the posterior cornea and pulls it down with it and you get a little focal cataract underneath here and then you get this central ulcer that causes corneal edema. So again, people call this a step ladder because it was these successive waves of mesoderm. That's not what it is, but this is a good way to memorize them because these are all very rare entities. You may see one or two of these in your career depending on where you end up. So Peter's anomaly, you get this central ulcer. Central ulcer of Von Hippel, another nice Greek boy. Come on, wake up guys. Come on, it's not that early. So as a result, you look here, you get corneal edema, there's the boli. You have this central area where there's no decimase, no endothelial cells. So these kids get severe glaucoma, but you still have the other, I mean severe corneal edema, but you still have the other things. You still have the little bands coming down. In fact, if you look at the peripheral part where this central ulcers, you'll even have bands coming down from the cornea to the iris. And so you'll get all three. It kind of goes in a step ladder from milder to worser. Milder to worser. Okay, and we say goodbye to the, see it's up on a hill looking out onto the ocean eventually out there. Sir. Where does scleropordia fit in with Peter's anomaly? People will often throw that in with Peter's anomaly because the cornea kind of loses its normal architecture and it becomes a lot more fluid in it. It turns white like sclera and it even looks like sclera. So people will chuck in sclera corneal in there somewhere too. So it's kind of a, it's an offshoot. Yeah, that is actually a true Peter's. Well, you get eventually peripheral sclerilization of these. You do, exactly. So they often will run together. All right, so I believe next week is retina. I'm pretty sure so please be on time because retina is really tough to cover in an hour. There's a lot there. So please be on time next week. All right, thanks for your attention. As usual.


Nice, higher one. This is Chichou. Welcome to my channel and welcome to another live stream. Today today is July 6, 2023, and we're doing our global mapping of world conflicts again. This is part six, I believe. It must be part six. It is part six. And we built this up slowly. I guess 10 hours of streaming we've done in front of this video. Actually probably longer because we've gone over time for sure. And we've talked a lot about what's going on in the world, and things have continued to shift since we started these global mapping, our global conflicts streams, and we have to pay this map a visit again because things are shifting. Cockpit. How are you doing, amen? Have a great day. You as well. Thank you very much for popping in. Birdie here. How are you doing? We live. We are indeed. We live, we live. Amazing stuff taking place. This is the planet we live on, right? Wow. Wow. On every front, economically, politically, socially, environmentally. In terms of understanding how the world functions, so much has been revealed in the last two decades, and it's accelerating, right? So we're going to pay this thing a visit and take a look at what shifts have taken place since the last time we did it. And I think last time we did it was probably probably, I would like to say about a month and a half ago, two months ago, within the last two months anyway, and already things are shifting. And we'll talk about that. Cockpit, what is your favorite land based, land based on economics? What is your favorite land based on economics? You mean which country is the richest in terms of resources? I'm not sure what that question is referring to. Random moose brain. Good afternoon. How are you doing? Good afternoon. G. Chauvin, chat, indeed. Yeah. Resource wise, Russia huge, Iran huge, Canada huge, United States huge, Brazil huge. I mean, you can take a look at the land masses and pretty much the bigger they are, usually they control more resources. Central Africa, huge, right? Huge, huge, huge. Not resource rich China, right? India to a certain degree, which is really weird because I mean, nothing close to Russia or Canada, right? And these two countries combined have what, almost 3 billion people, right? At least the third planet of the population of the earth is in this region. Throw in Bangladesh and Indonesia, Malaysia. It's crazy. Luxembourg, they're also quite rich for their population. For their population per capita, that would be a different story, right? I'm just talking in terms of raw resources, those of the countries, but in terms of per capita, Sweden would be extremely rich. So would Norway. Norway and Sweden per capita would be huge, right? And Canada was, Canada and Russia would be the top. For sure. For sure. Canada more so than Russia, I think. Russia's population is about 130 million, right? I know it's largest land mass, 11 time zones and stuff like this, but Canada's population is only like 38 million. So and second largest land mass in the world, right? So per capita, it would be a different game. It'd be a different game. I finished it fully, fully. You stream it a lot on your vacation. Yeah, yeah, yeah, yeah. Yeah. I was aching to stream multiple streams in a row, right? I finished with my students on Friday. So I decided to hit up four in a row. Next week, we're going to take it easy. I'm just going to get caught up with other things, but then probably in about eight days or so, we're going to eight, nine days or so, we're going to hit it up again, right? Ronnie Salutations, what you're doing well. But Light Pimp and Australia, of course, right? Any country with natural resources are being slowly controlled by China. Well, it's, it's the resource wars. So I wouldn't say all countries like Canada, where Canada slowly was trying to be controlled by China, but geopolitics started playing a game in this and some big money from China is pulling out of Canada, as they should, right?  It just wouldn't make sense. I mean, look at what the, what the Western world's done with Russia, completely illegal, seizing assets, now closing accounts, taking over corporations, like it's looting, it's stealing and they're digging their own grave in the Western world because what's going on is other countries are looking at this and saying, why the world will have assets in the Western countries? I mean, they didn't start this with Russia, by the way. They just picked, Russia was the straw that broke the camel's back, right? They did this with Venezuela, right? The UK seized Venezuelan gold. What the F, right? So if you're any country outside of the Western world, why in the world would you have assets in the UK? You wouldn't. You'd be crazy to keep assets in the UK. Absolutely insane, right? So an Iran, I mean, look at what they did. This stuff really huge began with Iran in 1978, 1979, 1980 and stuff, right? It's crazy. Just digging their own grave. Look at Iraq, what they did with Iraq. Oh, North Korea, Iraq, Iran, Libya come out and said they're going to start trading oil outside of the US dollar. Oops. What happened? Libya annihilated Iraq, occupied North Korea, locked down sanctions and we know what's going on with Iran, right? Now, Bertie here, should you all move to Canada? No, if you're willing to fight tyranny, for sure.  We don't need any more extra World Economic Forum Puppets in Canada. We've got plenty of those clowns, right? Yeah, exactly. It's getting crazy. It's getting crazy. But China has like amazing spy technology, I think. Here's the thing. Countries when they try to play the tech advantage, that only works for a short period of time, right? And because technology is evolving more as law, faster and faster and faster and faster and faster and faster, then the time span that a certain country has a technological advantage over someone else becomes shorter and shorter and shorter. So tech advantage only goes so far now, right? It used to go a lot further in the past, right? Look at the United States when they developed nuclear weapons, right? That kept them the supreme power on Earth, right? For two to three decades, right? But then Russia started developing nuclear weapons faster and faster and faster and faster and faster, right? From what we understand, in Korea, the Korean War, the United States, the West was losing the Korean War. And the only reason we have North and South Korea right now is because the United States said that they would play the Nuke card, right? They turned to Russia and China and North Korea and said, look, if you guys don't cut a deal right now and we freeze the conflict, we're going to use nukes. And Russia and China at the time didn't have nearly the nuclear power as the United States.  US can't do that anymore. They can't come to Russia in Ukraine and say, hey, listen, we need to freeze the conflict right now or we're going to use nukes.  We've got more nukes than you do, right? So that technological advantage is gone, right? Gone, right? So that's the thing. How long is that going to last? And in my personal opinion, the two top countries in the world, actually three top countries in the world with huge tech supremacy, supremacy right now, right? China is there, but it's not the top three. Russia, Israel and the United States. In my personal opinion, I think United States, Israel and Russia are technologically the superior, the top three players in the game right now.  They do have the supercomputers here, but it's very focused. It's limited right now. They'll catch up super fast in the next less than five years. Less than five years. I swear you should be in my history. I don't know. Don't take everything I say with a grain of salt. Don't take everything I say to heart. Sometimes I get my dates wrong. I get my dates wrong. I get my names wrong. I get the players wrong. I go for more events, the movement of society, right? But like Pimp, China loves to steal intellectual property. That's a fallacy. China was not stealing intellectual intellectual property. The western countries were handing over intellectual property to China. They've been doing that for the last 30, 40 years. Cheaper to build here. You don't need to pay people living wage or the living wage as China was a lot less than the living wage in the United States or Europe or anywhere else. They willingly decided to build their factories in China. China was like, okay, sure, thanks. We'll do it. Then they said, oh, you have to sign these contracts saying you're going to abide by our intellectual rights. China was like, right? Yeah, okay. Sure. We'll just bring in our people, take a look at how you do things and copy it. It wasn't stealing.  If the people in that country hand over that technology, that's not stealing. That's thank you very much, right? Plutorino. Oh my, the map is back. The map is back. Did we talk about Norway phosphate yet? No, no, I don't know Norway phosphate yet. I'm not in the loop on that one. Plutorino. Ronnie, what do you think of Chinese building military base in Cuba? The United States has what 800 military bases around the world, military bases surrounding China, right? What's good for the goose is good for the gander. What's good for this is good for that. Tick for tat, right? That's the whole thing. The technological certain threats that the West has been making for a number of decades against other countries is coming back to bite them in the ass, right? I personally don't want anyone building military bases outside of their own countries.  That's my take, right? Birdie here. Yeah, these countries still largely rely on China at some point in supply chain. Yeah, China don't steal intellectual property. If they want something, they just buy the company these days. Yeah, yeah, 100% 100% micro twist. Yo, how are you doing? Gang, I'm going to do my little quick intro. We're on Patreon, substock, subscribe. Sorry, definitely welcome to follow us there. See what we're doing. We are live streaming on twitch. Okay, if you want to participate in these live streams, you can definitely join us on twitch. We will most likely this summer get into live streaming on rumble and kick as well and we'll see what other platforms we can live stream simultaneously, because we definitely want to start decentralizing more than we have already. For those of you who are supporting this work on twitch, Patreon, sub stack, as well as supporting us on censor tube. Thank you very much for the support, including the support we're getting through other means. Again, thank you very much for the support including cryptos and PayPal and coffee and whatever it is. Just sharing liking being here and participating in discussion, joining our gilded server, sharing information. Gang, thank you very much for your support. It is in large part because of your support that we're able to do what it is that we are doing. Baby night. Hello. And yeah, that's such a weird concept. Building military bases in other countries. Yeah, it's just weird. Like, why not just build a company? Say, welcome, we're going to build a company and it's going to be economic. And that's going on right now, right? The difference between what China has been doing in Africa relative to what Europe and the United States, the Western world was doing in Africa and is continues to do in Africa for the last, for so long now, hundreds of years now, right? Crazy. Politorino Norway found the most immense natural phosphate rock rocks, phosphate is used in batteries and fertilizer. Other than Morocco, there was no natural phosphate. At best, we get cheaper batteries at worse, more expensive fertilizer. Really? Is this is a new discovery? The phosphate deposit? I didn't it didn't hit my radar at all. And I used to follow like the geophysics. I know, I know about Canada and a lot of deposits and stuff like this. I've been down the deepest mine in Sudbury, Ontario, right? Back in the 90s. This was a meteor crater and meteor crater impact hits and just creates a lot of mineral deposits, right? Either through the meteor, meteor bringing in the minerals or as well with the impact, right? That generates sort of stratify some of the deposits and stuff like this puts them together. It's an interesting process to heat the pressure and all that jazz, right? So mineral deposits really intrigued me and a process of a ton of data on doing geophysics, especially the Kimberlite pipes in Northwest Territories. The diamond were extracted diamond. It didn't hit my radar at all. Yes, yes. New like the past couple of days. Wow. Super cool. Super cool. Mainstream talking about it now. I work with some insurance companies working with mining companies. They started talking about this on Sunday. Very cool. Which is really good actually. Which is really good because Norway does have very difficult to do when you're pointing it like this. Norway has Oops and the wrong way. Norway has certain environmental regulations, pays living wage from what I know anyway. I know Canada doesn't more enlarge part for mining and stuff like this. And like you said, higher cost. Higher cost for sure. And expensive fertilizer indeed. That'll put pressure. Which company? Norway nationalized oil but has Norway nationalized other minerals as well? Pluto. I'm going to say Pluto. Pluto Reno. Pluto Reno. I'm going to be able to say that fast. As far as I know, Norway has only nationalized the oil and they've taken that money from oil wealth accumulated. I think in the 1970s they did it. Norway, by the way, has the biggest fund. It's the biggest fund in the world. They have, I forget what it is, like a ridiculous amount of stocks. And every Norwegian citizen gets a certain allowance every year because of the riches of the North Sea oil. Pluto Reno. I'm not sure if it is nationalized but the mining company is Norwegian. The mining company is Norwegian. Okay, cool, cool, cool, cool. Very cool. Might be a good time to get into less investing personal finance maybe. And again, just to finish off this quick intro. We're doing this on Twitter, Minds, VK, Gap, Getter and Substack Notes. About half an hour to an hour before we'll go live. And I do announce other things as well. But more, way more on Gilded. I'm very active on our Gilded server so you're definitely welcome to join us there to see what's going on. And we do have a SoundCloud page where we upload some of the audio of these live streams as podcasts and these podcasts should be available in your favorite podcasting platform, including Spotify, Google Play, Apple, Amazon and all the other ones. Hopefully anyway. I don't think we're censored or anything yet. Aside from that gang, welcome to our live stream and we're going to upload this full live stream onto SensorTube. I don't think we're going to get into a discussion that's going to be censored on SensorTube. So let me take these guys down. I'm going to pour myself a drink. It's hot here so I need to, not need to but I'd like to when it's hot, have spirits on the rocks. SkyPilotX. Yeah, but in Norway we won't allow more pollution of the seabed. Even the salmon farming here is a nasty toilet. Yeah, yeah, yeah. I love salmon but whiskey on the rocks. I love salmon but I don't eat farmed salmon not if I can help it. So any farm fish fishing is very nasty. Very nasty. It creates tons of pollutants. It's lots of parasites in the fish. It's extremely nasty. I believe someone fish farms. There's lots of fish farming. By the way, as SkyPilot says in Norway there's lots of fish farming in Chile and lots of fish farming in Canada. I don't know where else they're doing a lot of fish farming. Those are the three that I know of. And Chile's been doing it for a long time. So is Canada and so is Norway. But it's nasty. It's very nasty. Salute gang. I hope you're on a fantastic Thursday.  Gives you a nice kick which is pretty sweet. Gang, there's a couple of things that I wanted to point out. I guess people fish farm because it's easier to fish. Because they give them hormones. So basically the size difference is insane. So if you have, for example, salmon here's like a wild salmon you can get. Where's my fish tail? Let's say this is your wild salmon. That's your wild salmon. Farm salmon looks like this. Gigantic compared to wild salmon. So you get way more meat and stuff like this. But parasites, diseases, cancer, polluting the environment and it doesn't taste as good. And fattier. Like go to a sushi restaurant and order sashimi. If you want to do an experiment, I don't recommend eating the farm salmon. Just order sashimi. Salmon sashimi. One, just get a six piece or something. Wild salmon, get another one of farm salmon. The wild salmon is pink and beautiful. So nice. The farm salmon is pale and fatty. And not the same. Not the same. Not the same. But light pimped by the way. Have you been following the chaos in France? Yeah, indeed.  France was actively participating. Actually, all of Western Europe was actively participating in war. But two months ago, our last map stream, I don't know if it was two months or three months ago, whatever it was, we said that France was a civil war. Now, people are talking about, oh, France is a civil war. Yeah. So we're trying to, with this mapping stuff, we're sort of trying to stay ahead at a game. Because when it comes to personal finance, safety of our family, ourselves, or finance and stuff like this, we need to know what's going on before corporate media starts talking about it. Because when corporate media starts talking about it, it's too late, really, to do anything about it. Especially in terms of personal finance and stuff. Yeah, so France, yellow, civil war. Okay, civil war for sure. Eight pelos, eight pelos, but also preserves the stock in the ocean. Well, no, not necessarily. Salmon farming or farming fish is actually creating certain diseases that are filtering out to the wild stock in the ocean and killing them. So preserving the stocks in the ocean is not. It's actually damaging the fish stock in the oceans because they're releasing parasites, there's fungus, there's cancer.  So it's having the opposite effect of that, actually. Baby night that we marked the war in France, we did civil war. We did it on the last stream. So it's a civil war. We're ahead of the game there. Padre, Padre, Padre, Padre, how are you doing? Hi, I eat a lot of sardines, delicious. I think the cans I get are from the Black Sea. I'll go check. Okay, okay. We buy sardines every now and then. Sardines are fantastic, by the way. But if you can't get sardines in jars, cans, you know, they might be leaching some toxins, but it's very difficult to find in jars. Skypilot antibiotics are fed to the fish, yeah, and 30% will die from sickness and other factors, yeah. The antibiotics used in fish farming is through the roof, through the roof. Leodent, leodent. We figured out a few years ago how to just increase the natural population. I don't get why we don't do it. It's cheaper to farm salmon, do farming. Give them shitload of antibiotics, right? Give them hormones up the yin and make them all fat, right? Disease-ridden, cut them up and sell them, right? You get more weight, right? It's money, economics. How do they feed the fish with antibiotics? Pellets. The pellets contain everything. They give them pellets and the fish eat the pellets. It's like what the world economic forum wants to do to humans, right? Eat the bugs and be happy. What's in that thing, the pellet that you're going to feed the humans? Soil and green or what, right? Pink QB World War 3 map is back indeed. The purple, the blue, the blue is safe haven. The red is actively war and we need to change the stuff up a little bit. Okay, we need to change Thailand. We did Thailand as a safe haven. It's no longer a safe haven, right? Thailand, that better be Thailand. I'm going to take this down. I'm going to take this down, right? Thailand just had elections, right? And a pro-western party just won the elections in Thailand. Immediately they're starting to put sanctions on China. They're starting to supply weapons to Myanmar. And they're already implementing western style of economics and politics, neoconservative. So in my personal opinion, since we started talking about this, I think Thailand is about to go into a civil war. We're at the beginning stages of it. It's no longer a safe haven. So I think before I do anything to it, I'm going to wait until you guys tell me what you think Thailand is. But that's my take. And some of the news we're following, okay? I saw a video today about Britain and America still in Iraq helping fight ISIS with the Iraqi army. They're not helping fight ISIS. They funded ISIS, right? The best thing Iraq can do is get rid of the UK all foreign forces in Iraq, right? And check this out Saudi Arabia and Yemen, they haven't signed a peace deal yet, right? Saudi Arabia and Yemen, right? With Iran, with the help of China, and Russia, they might be going into peace mode, right? I wouldn't mark them as blue yet but it might not be red anymore here. Fingers crossed it happens, right? Oh Padre, looked it up and Google says nobody farms sardines. Nice, sardines for the wind. They don't. My brain got it. And civil war mixed up, yeah. Oh yeah, sure. Oh, okay. I'm not a surprise baby knights. They feed all animals with antibiotics and hormones. Yeah, unless you're buying locally raised supply, right? Pluto, I don't want to change this fish conversation as I find it exciting, but India also came out recently saying they support the Philippines claim in the South China Sea. Whoa, they do. I need to read more into the situation and see what others reactions are but not many people are talking about this. Oh, okay. That's serious conflict with China, right? Philippines, because China's claiming, you know, South China Sea is Chinese territory, claiming some islands there Japans contesting some of them, Philippines contesting some of them. So if India is coming along and saying taking the side of the Philippines very unstable region, looks stable but could be quite unstable this area. Okay, we've got it marked off as blue, but that could flip on a dime, right? I see a red and purple marker near Chicago. Is that right? Chicago? Yeah, the United States. United States is actively participating in war. United States is at war and actively supporting war right? So and come the next few months, we might have to put a yellow on the United States that it's a civil war as well. Okay, I don't think we're there yet. I think United States depending on what happens in the elections next year will could possibly go into a full out civil war. I hope not. I don't think it'll happen next year but depending how things play out in the elections for 2024 the odds are by the end of this decade United States will be in a civil war and that's what Martin Armstrong has been mentioning as well. The United States is the main actor behind the majority wars on the planet. NATO, yeah, pretty much. And the United States, yeah. Got to love it, baby knight says. Cops on the entire world, yeah. We started out on the right foot with the right idea but history tells us that eventually all good things come to an end. Indeed, indeed. Mr. Brainfreeze will Iran join BRICS? I think Iran just joined the CSO Shanghai Corp. Organization and yes, Iran almost guaranteed is going to be in the BRICS if it's not already in the BRICS. I don't think it's already in it. Did it just get admitted into the BRICS or Shanghai Corp. Organization? I think Shanghai Corp. Organization but it will definitely get into the BRICS as well. It's a line up. Huge line up if people wanted to get into the BRICS, right? Birdie here. Is Iceland a safe haven? Yeah. For now it's a safe haven. However, some of the highest percentage of injected in the world are in Iceland. So that's problematic. Okay. I could only imagine Iceland as a safe haven. Yeah. Right now there aren't too many countries as a safe haven. And any comments about Thailand? Salutations. Good to see you. Good to see you as well. Pimp. But late pimp. I don't understand. I understand it is called the South China Sea but is there not a general consensus that so many miles off a country is considered international waters? Yeah. But what's been happening is there are islands in here and different countries have claims on certain islands. So as soon as you have an island there somewhere, then a certain mile from that island becomes your seaway, I guess, your territory, right? And if there's a whole bunch of islands scattered all along here and if you say mine, mine, mine, mine, mine, mine, mine, then that whole area is yours. Aside from that, China has been building islands on reefs. So all of a sudden they build an island. It's like a gigantic military base with landing planes and whatnot. All of a sudden that becomes a man-made island. And how does that play out? If you make a land-made island that's, if you made it, that's probably, you know, it's legitimate to say it's yours, but you also get the rights to the area of the sea that surrounds you. So that's what's been going on as well, right? Skypilot, are we seeing strategic positioning for water resources in Nicaragua? Yeah. Yeah, I think there's a lot.  I think there's already water wars happening, but the biggest one is here. Huge, huge, huge, right? Cheryl, salutations. Hope you have a good Thursday. Shame socks. Depends on the level of fortifications in 2024. Greetings, fellow bipedal land mammals and quadrupedal contrarians. See death 420 salutations. Hope you're doing well. Baby nice. Should Switzerland be a safe haven? No, I don't think so. Not anymore. They are always neutral. No, they're not anymore. No. But I have no idea if they're taking a part in the NATO Russia war they are. They're supporting Ukraine. Switzerland is no longer a neutral country. Switzerland is actively participating in war. Okay. Mr. Brainphrase, Switzerland is not neutral anymore. Yeah, it's not neutral anymore. What a disaster for Switzerland. What a disaster for Switzerland. Very nice. Really. How so? They're helping Ukraine. Yeah. Yeah. They froze assets. And they came out and said they support Ukraine. They've done some other crazy stuff too. Peeps the sheep. You mean supporting Nazis? Well, they did in the past too, right? Plutorino, neo-imperialism. Make the new land and land the taken. Yeah, basically. Make the new land and take it. Yeah. With China. With building the islands. Just imagine, there's got to be reefs and stuff here. Right?  Let's say, which country should we be? Let's say you're Tanzania.  I'm going to join the imperialistic march. Let's say they come over here and take a reef and build an island. And say, mine. All of a sudden, they have the sea, all the sea area. That's Tanzanian land. What do you think the United States would do about that? Right? Mine. I want an island. Right? They freeze Russian assets and post-sanctions. Yeah. And they post-sanctions. Yeah. Yeah. Very nice. Damn. Didn't know. I love you more. Salutations. What are we going to wipe out? I hope no one wipes them out. I got my vest in and AK-47 ready. Oh, it's going to be enough, man. I don't think you want anything to go down that road. Doesn't matter if one has remembered or done research on the world. No? What if I was born tomorrow? What would matter? If you're born tomorrow, it really just like anything else. It really matters where you're born. Right? Matters who your parents are, how wealthy they are, how much resources your country has, how healthy your parents were, what they did, what your mother did consume while you were pregnant, what types of food you had access to, if you had access, if they had access to clean water. Yeah. Lot of things. Lot of things. Baby Knight, you got to chill, my guy. Yeah, agreed. I love you more. These political streams that we do, especially the map one, we participate in longer discussions. People need to give a reason why they're thinking something or they ask a question. So just pop in comments left and right. Speed of Gonzales style. Just random. It's not the best thing to do and what's going to happen is I'm basically going to start skipping your comments. Right?  Okay? What you like Sleepy Joe? No. No. Those gas and food prices, garb and Go Trump. I love you more. Maybe you need to chill. I know you're pretty recent into our live streams in our community, right? Take a look at what we do. Take a look at what we do. Right? Sometimes it's best to chill and listen. Right? Cheryl Kapow. I think Cheryl did a kapow. Deep's Wishy. Sleepy Joe is just an empty vessel that is a puppet who has his strings pulled by Obama and his mates. Possibly. I don't know. I don't know that 100%. He could be just a very excitable little young kid. But he's definitely if he's for real, he's just excited. Oh, he's maybe discovering stuff, information coming in. Maybe he's on his phone swiping too much. You know, just getting images, memes. Memes could be fantastic by the way. Little words and stuff like this. And that's the way and that's what our education system has done. It hasn't allowed people to have, be able to do calculus and participate in a longer discussion. Right? He could be just someone like that that needs to grow up. Right? He could also be a show. Right? He could also just be in sort of a certain degree agent provocateur or someone that's just a shit-disturber and is just trying to troll. Right? Or a paid agent of the state. Could be that. Either way, I'm going to start skipping his comments after this one. Too many, too elevens. You're right.  You know me. I don't know. I don't know. How come there's no marker on Kazakhstan? Kazakhstan we talked about. Right? We weren't sure if it was a safe haven. We couldn't decide. We didn't know if it was a civil war. It's not actively participating in war. We know that. So we know it's not red. Well, there's no war. We know it's not red. It's not actively participating in war. So we know it's not orange. The question is, is it a safe haven or a civil war brewing? It was a civil war brewing. Russia stepped in. Stable now. But I wouldn't consider it a safe haven because it's a dictatorship. And it could flip on a dime. Right? So that's my take on it. What's the significance of Orange Marker in Canada? Orange Marker, Canada's actively participating in war. Actively participating in war. Canada has sent billions of dollars to Ukraine, military, funding. Canada is actively participating in war. And Canada has the ground in Ukraine. Advisors in Ukraine. So Canada is involved in war. Right? What do the colors mean? The colors are these. Blue, safe haven, red, active war, orange, actively participating in war, supporting war, yellow, civil war. So hot war, supporting war, civil war, safe haven. Okay. I'm curious about Thailand again. I don't think it's a safe haven anymore. It might be a safe haven for about a year. But if I was in Thailand right now, like literally to me a safe haven is this. If I was living in that country, I would assume my finances are cool. I don't think they are. If I was living in Thailand right now, I'd be very concerned. Very concerned. Especially if I was a foreigner living there. Right? Ex-pat living there. I'd be looking into getting some of my finances out of Thailand and putting it in a blue zone. And making sure my passport is valid just in case I get the hell out. Right? So I'm going to take Thailand off. I don't think it's a safe haven. I really don't. I'm definitely, definitely willing to listen to the counter of that. But Eric Berletik. Berletik lives in Thailand, I believe. And he's very concerned. Very concerned. Right? It seems like countries would be damned if they support war and damned if they don't. I don't know damned if they don't. I think neutrality is the way to go right now. Even though there was a global war, World War I and World War II, there were countries that were neutral. They didn't participate in insanity. I think there is a means not to participate in war. Right? Fisted monkey for salutations. Welcome to our last stream. Thank you for the follow. Pink QB. It might be a good idea to put a key screen for the cause. We had a key screen here. There was a key screen. I was going to put it together. Allergot said it was going to put it together. There was someone who had it. But I don't know the command for it. I don't know the command for it. Yeah. Maybe I should put it here. Hold on. Let's do this. Let's do this. Because one of the reasons is we do have people drop in. You're right. So let's do this. We're going to go safe. We're going to go civil war. We're going to go supporting war. War zone. Let's do this. Let me grab my... Let's do this. What have we got? We can do this. All I got is pink. So we're going to do this. We lost that one. So we're just going to do this. I'm going to put this here. Can you guys read that? It's not big enough maybe. Let me do the scissors. Sorry gang. I'm just going to keep on losing it. I'll set something up for next time. Better. Supporting war. Supporting war. Orange. Do I have an orange? I got a yellow. I got a yellow. I don't think I have an orange one of these. Oh, I do have an orange. No, no. That's yellow. Civil war. Do I have a blue? Do I have a blue? Oh, I do have a blue. Nice. Here's a blue. And what do we need? What do we need? Orange. Orange. Let's do this. Couple of oranges. The yellow. Do I have a yellow? Orange is going to be hard. Here's orange. There we go. Apologies I'm not reading the chat. I just want to take care of this for now. The picture is going to be how do we put it on there. I hope these have stickies on them. Let's do this. Let's put a tape on this. That's the best we can do right now. That's the best we can do right now. Let's do this. Safe civil war. Supporting war. Haha. It's good enough. Okay, awesome. Good. Welcome to... Thailand pushed the corona jab big time. Which makes them owned by Pfizer and Big Pharma. Yes, indeed. However, one of the royal families women, girls, got injured. Right? And the royal family came out and started to say they were going to do an investigation into this thing. And lo and behold, as soon as they said that lots of money started going in there and the government flipped. Right? So my take is a civil war. Really. We're at the beginning stage of the civil war in Thailand and most likely Thailand will go orange and it will be actively supporting war. Unfortunately. Patre patre patre. My Vietnamese co-worker told me Thailand was hot a few months ago. I can't remember all that she said though. Yeah, it's maybe pen, pen of common. What do we call it? Brian Valedic? I can't remember something. Brian Valedic? He lives in Thailand and he's been, he covered that. Initially when it flipped over, I watched him on the Doran and I watched some of his videos on what he was saying about what's happening in Thailand. It didn't look good. It did not look good. It did not look good. Patre. Some Asian countries are real tight with China.  I've been lurking a few streams now. So hi everyone. Salutations Fisted Monkey. Thank you for doing the follow and participate in the discussion. Salut. I'm assuming you're enjoying our live streams. Fisted Monkey, thank you for the salutations. So my pleasure. My pleasure. Thank you. It the police. Being Canadian, if it bothers me that a small country such as Ukraine is left alone to defend itself from a giant like Putin. Are you saying countries should not support and then allow Putin to do what he likes? See, here's a kicker. All of Russia, the biggest country in the world is not just Putin. That's a talking point. So there's 130 million people living in Russia. So you can't say Russia is Putin. It's like calling the United States Biden. Is the United States Biden? You never call the United States Biden. You can't allow Biden to build 800 military bases around the world. That doesn't make sense. You can't allow Biden to control NATO.  So saying Putin for Russia is disingenuous. It's not. Really, it's crazy. Ukraine is not small. Ukraine is pretty damn big. Ukraine is huge. Oh, Elder God's in the house and he posted the thing. Nice. Elder God, you weren't here. So we made a hoogie-loogie little thing of a jiggy. Oh, Elder God, you rock. Pin the thing. Nice. Nice. So Ukraine is pretty huge. It had a population of 40 million people before this whole thing happened. Before the 2014 coup. Ukraine has been arming Ukraine for 8 years.  Ukraine had the best army in all of Europe. Really, best train, best equip, best army in all of Europe. So Ukraine was a little kid and Putin, a giant, was stepping on it. Ukraine was threatening Russia. Stupid. Stupid. Stupid. Stupid. Personally for me as a Canadian, I don't want to participate in a fight. If I see fights on the street, depending on what's going on, if there's knives involved, I'm stepping back. Because if there's knives involved and bats involved and weapons involved, you step in, you're part of the conflict. You get hit accidentally. But in my time, I've stopped a lot of fights in the public. Multiple times. There's a couple of times I got hurt. There's a couple of times that I got hit. I can take a punch. I wouldn't do it now. Well, no, I would do it now. But there's certain fights that I stopped that I wouldn't do now. Because we were too dangerous and at the time it was a little tougher. So, no. Neutrality is the way to go. You should be a peacemaker, not participating in more. That's my opinion. We demand a digital map next time. Controllers in. Rendo. I'm also lurking. Rendo. Lurk away. Lurk away. Awesome. Awesome. Love the pig, by the way. I guess it should be a thing. I guess it's in there now. Oh my god. Share all the controllers then. Oh boy, Needy, aren't you? Digital map. Maybe we can pin the comment in chat for now. Like Sho said, yeah, Eldegos on it. He popped on it right on. Thank god, Curry Knight slowed down enough for Eldegos just to pop in for a bit. It's what you are. Six million lives. Salutations, welcome to our live stream. First time chat. Salut, salut. I'm way behind the chat. I'm scrolling down again. I'm going to try to get caught up. Andromeda, 856. Do you think that the war will end soon? Ukraine in victory? Or is Russia more like the... Russia has already won the war. Is the war going to end soon? I sure as hell hope so.  I watched a video of... I shouldn't have watched it. I followed war too much and I told myself I wasn't going to watch the death and carnage of... I stopped... I put out a post in 2011, 2012 saying that I was going to stop following geopolitics because World War 3 was coming. I was not going to slow down. It was going to continue to escalate. I wasn't going to... I didn't want to follow the death and destruction, give the day. Here, I'll read you what I wrote in the paragraph. I'll read you what I wrote because I really want to emphasize this.  Yeah, we could have seen this coming.  You followed geopolitics.  This is political, economic warfare that is absolutely insane. It's disgusting and it could be stopped. This is the most unnecessary war that I know of in history. This is what I said. I'll link it up in the chat. I'm going to read you just one... two paragraphs. Two paragraphs. I called this... This is the title of this post. I called it synopsis of your document, what the future holds, a final note. I treated this as my introduction to geopolitics on my website and this was a previous website that I had that got knocked out so I transferred everything over here. These are the last three paragraphs. These are two of the last three paragraphs I'm going to read. Why George Carlin's words bring me comfort is because they imply that the problem has a solution, education. Hence my work on mathematics. The alternative that we are aware of our history and are indifferent to it is unthinkable and this was a comment that above regarding George Carlin's quote saying think of how stupid the average person is and realize half of them are stupider than that, right? And then the paragraph what I wrote continues saying this via quote. Since I have no desire to document the play-by-play symphony of carnage that is being unleashed and is to come and since I have said what needed to be said or as Aaron Dottie Roy would say quote I feel that I don't have anything direct to say without repeating myself end quote will consider this post to be the introduction to politics on Chico and it will be the the last strictly geopolitical discussion we have on this site for quite some time at least until Russia, China, Iran or another formidable enemy of our choosing or making is directly confronting NATO or until the next major false flag sends the world into frenzy. I think I edited this once but I wrote this back in 2014 I think I actually wrote it in 2012. This is my take on it. I'm not sure what I was even replying to but I thought I would share that just because Ukraine, by the way, it was about Ukraine winning it or Russia winning it. Ukraine has lost the war. Ukrainians have lost their country not because of the war with Russia or the military operation according to what Russia says or war with Russia according to the Ukrainian western perspective but because the Ukrainians allowed puppets of NATO and neocons to be put in place to rule over them they promised peace, they delivered war.    Andromeda, and how does that bode for the Ukraine, right? The Russians gonna take over Kiev?       Sinai, maybe a nitpick but don't you think Civil War flag should be a bit more north that you place in India, around the Kashmir region yeah, and maybe not in the mid, yeah, I agree well, wait a second, is that the register of Kashmir? We're up here, so okay, sure let's throw it up there, let's throw it up there, but then again the, let's put it up there, India I agree, it's not, oops it's, India is really like multiple countries in one right? But it is the country that it's well, I guess we've got India's safe haven down here so India has two things, Civil War, safe haven could possibly be actively participating in war right? I'm gonna scroll down again, I know my rant, I'm gonna read stuff that's directed towards me, Chico swagboyflex, Civil War, US Civil War, we're getting there, I don't think it's there yet it's oligarchic civil war, there's no doubt about it, right? the oligarchs are going at it, but it hasn't filtered into the rest of the population yet peepsbycheapchico, have you seen the movie Ukraine on fire made in 2016, it is very true, that's Oliver Stone yeah, yeah, yeah, yeah, I knew about Ukraine in 2014, I wrote an article on it, right? if you go to my site, go to Ukraine, you'll see, I wrote like three different articles on it, on the left hand column, if you hit, I wrote four articles on it, right? if you hit the Ukraine section, there's four articles on it, right? so I knew what was going on in Ukraine before that, it was pretty important, right? oligarchicchico I watch one where a soldier goes through an underground tunnel shooting enemies like it's call of duty, yeah I don't want to watch any of that shit, lonely piggy, Chico I can't, I canceled and rescheduled my flights, not once, twice over the course of the night, so now I'm departing Montreal tomorrow and landing in Vancouver before heading to Regina, wow, wow, wow, you're going to, oh you got to go to Vancouver and then, so just for you guys, you guys to know Montreal, right? Regina is over here where is Regina?  I heard it's expanding but I wouldn't say yet that it's already done patre patre patre, oh, a control mechanism stream would be cool there's a bunch out there, yeah, yeah control, just control your population man, if we had independent, if every country was just full of independent schools all these wars that we see they'd fucking drop by 90% really, not only because some airlines do Montreal Regina but RCMP uses Air Canada go figure, it initially had me do Montreal Saskatoon, this Saskatoon Regina but yeah, Vancouver it is now, oh well I hope we get a little layover in Vancouver shame socks, the age is set at 21 because that is when the prefrontal cortex is developing to a point that alcohol won't inhibit it I don't think that's the reason, not me personally, right?  Who was it? can you tell me who it was?  Braga, I love your map I studied Geography at the State University of Sao Paulo, Brazil salutations to Brazil we got two people here from Brazil probably more, salut salut Randall, no offense taken Randall's in Sweden Sweden also had that COVID response, I didn't understand on that front they did well right, maybe nice I'm going to make a prediction after France, I think Germany or Belgium will be the next up for civil war if, Belgium I agree with Belgium I agree with, Germany I don't agree with yet I have relatives in Germany, they're pretty sleepy they're pretty sleepy it's going to take a lot to get Germany to wake up or Germans to wake up, majority of them anyway peeps be sheep, I live in Germany and it is very possible you think it's going to happen soon? my prediction is not anytime soon soon meaning next few weeks, next few months Belgium, next few months possibly, next few weeks possibly and Ramallah, does anyone in here think Trump will win in 2024 he should win if, Biden is running if RFK is allowed to run maybe not but according to Martin Armstrong he's not going to win, the elections are going to be same thing as they were before by the way, Brazil Brazil, Braga we mark Brazil as a civil war I think we need to pull that back now I think it's transitioning to become safe again what do you think safe?


Hello, and welcome to this presentation of the STM32WL5 Extended Interrupts and Events Controller, or EXTI. The Extended Interrupt and Event Controller, or EXTI, provides 47 independent events, split into two categories, configurable events, and direct events. Applications benefit through smarter use of low power modes, taking advantage of the STM32WL5's capability to wake up each CPU independently via external communication or requests. This is the block diagram of the Extended Interrupt and Event Controller. Configurable events are generated by peripherals without interrupt capability, but which are able to issue a pulse. The EXTI Controller provides interrupt detection, masking, and software trigger. Direct events are generated by peripherals supporting interrupt requests. In this case, the EXTI Controller is used to generate events to the CPU and to request system wakeups. The Extended Interrupt and Event Controller provides a single interrupt per configurable event to both CPUs. The individual CPU wakeups are provided to allow independent wakeup of both processors. The Extended Interrupt and Event Controller can generate interrupts and events as well as wake up the processors from stop modes. Configurable events are linked with external interrupts from GPIOs, PVD, PVM, Comparators Comp, CPU Sant event, and sub-gigahertz radio busy. Direct events are linked with RTC, TAMP, I2C, USARTS, LPUART, LP-TIM, sub-gigahertz radio, IPCC, HSEM, FLASH, and DEBUG. With WFE, the first instruction executed after a wakeup event is the next sequential one, INSTR N plus 1 in the sequence on the left. By implementing WFI, the processor jumps to the interrupt service routine when an enabled interrupt request is received. Note that an interrupt request is a WFI exit condition, but an event received on RxEV is not a WFI exit condition. For the STM32 WL5 series, the event generation is only available from the listed peripherals. This figure aims to explain the various stages enabling the conversion of a configurable event active edge into an interrupt request. The first stage is the asynchronous edge detection circuit configured by two registers, EXTI-RTSR1 and EXTI-FTSR1. Any edge, possibly both, can be chosen. The software can emulate a configurable event by setting the corresponding bit in the EXTI SWIER register. The bit is auto-cleared by hardware. An AND gate is used to mask or enable the generation of the interrupt to the CPU and VIC. Finally, a flag is set in the EXTI-PR1 register when the interrupt is generated to the CPU and VIC. This flag enables the software to determine the cause of the interrupt. This flag is expected to be cleared by the interrupt service routine. This figure aims to explain the various stages enabling the conversion of a configurable event active edge into a processor event. Both configurable and direct events can be configured to issue events to the CPU, steered to its RxEV input. Unlike interrupt requests, the CPU has a unique event input, so all event requests are OR'd together before entering the event pulse generator. The registers used to mask the generation of events are different from the ones used to mask the generation of interrupts. EXTI-EMR instead of EXTI-IMR. The dual-core STM32WL5 microcontroller has an independent event generation logic for each CPU. The CPU's wake-up signals generated by the EXTI block are connected to the PWR block and are used to wake up the system and CPU subsystem's bus clocks. Both configurable and direct events are able to request a wake-up. A wake-up occurs when an asynchronous edge detection circuit has detected an active edge. Consequently, software is expected to clear the flag in the EXTI-PR1 register to disable the wake-up request when the source of the wake-up is a configurable event. For direct events, the flag is located in the peripheral unit. These flags enable the software to find the cause of the wake-up. The wake-up indication is asserted when either the wake-up or the event generation is enabled. See the OR gate combining EXTI-IMR and EXTI-EMR registers. All CPU wake-up signals are OR'd together and then OR'd with the event requests. CIS wake-up is asynchronous and wakes up the clocks. Once HCLK is running, the synchronous C1 wake-up and or C2 wake-up is generated to wake up the respective CPU. A direct event is able through the EXTI controller to generate a CPU event and trigger a system wake-up. The active edge of direct events is the rising edge. Direct events do not rely on the EXTI controller to assert interrupt requests because they have their dedicated lines to the NVIC. Otherwise, the same circuit as the one described in the previous slides are implemented. Direct events can be independently masked for event generation and interrupt generation. The interrupt mask in the EXTI controller is only used as a wake-up mask. The extended interrupt and event controller is linked with the nested vector interrupt controller of the Cortex-M4 CPU and Cortex-M0 Plus CPU. Please refer to the related presentations. For detailed information, please refer to the programming manual for the STM32 F3, F4, L4 and L4 Plus series and the reference manual of the STM32 WL5 series.