To investigate the clinical significance of corneal biomechanical properties assessed using an ocular response analyser in patients with progressing normal-tension glaucoma (NTG).
Methods
In this retrospective study, we included 82 eyes of 82 NTG patients who had been receiving topical anti-glaucoma medications. Patients were allocated to two groups based on the mean value of corneal hysteresis (CH) and the status of progression. The assessment of progression was based on the trend analysis using mean deviation slope. Uni- and multivariable logistic analyses were constructed to identify factors associated with increased odds of progression, including CH, central corneal thickness (CCT), and retinal nerve fibre layer (RNFL) thickness.
Results
Forty-six eyes (56.1%) reached the progression criteria. Eyes with progression had lower CCT (530.2±38.6 vs 549.4±38.3 μm, p=0.03), thinner average RNFL thickness (70.6±16.1 vs 82.8±17.4 μm, p<0.01), lower CH (9.4±1.3 vs 10.8±1.4 mm Hg, p<0.01), and lower corneal resistance factor (9.3±1.3 vs 10.4±1.8 mm Hg, p<0.01) than eyes without progression. CH and CCT were significantly correlated (r=0.44, p<0.01). Upon multivariable analysis, CH (β (B)=0.32 per mm Hg lower, p<0.01) and average RNFL thickness (β=0.96 per μm lower, p=0.04) remained statistically significant.
Conclusions
Corneal biomechanical properties are correlated and associated with the progression of visual field damage in NTG patients. These findings suggest that CH can be used as one of the prognostic factors for progression, independent of corneal thickness or intraocular pressure.
Purpose: To compare the measurements of central corneal thickness (CCT) obtained using two kinds of spectral domain optical coherence tomography (OCT), Pentacam ® , and ultrasound pachymetry (USP).Methods: CCT was measured by Cirrus OCT ® , Spectralis OCT ® , Pentacam ® , and USP in 32 eyes from 32 subjects without ocular disease of the anterior segment.Results: The average CCT measurements using Cirrus OCT ® , Spectralis OCT ® , Pentacam ® , and USP were 549.2 ± 28.7 µm, 545.2 ± 25.4 µm, 554.0 ± 27.8 µm, and 548.4 ± 27.9 µm respectively.The measurements were significantly highly correlated with each other (Pearson's correlation coefficient r > 0.9, all p-values < 0.001), but were significantly different (p < 0.001).The CCT 95% limits of agreement between Cirrus OCT ® and Spectralis OCT ® , Cirrus OCT ® and Pentacam ® , Cirrus OCT ® and USP, Spectralis OCT ® and Pentacam ® , and Spectralis OCT ® and USP were 27.70 µm, 26.1 µm, 26.97 µm, 22.91 µm, 35.59 µm, and 32.15 µm, respectively. Conclusions:The CCT values measured using the four devices were highly correlated with each other, but the measurement using Pentacam ® was significantly thicker than that using USP.The measurements of the two kinds of spectral domain OCT were similar to those using USP.Therefore, these differences should be considered in clinical use, and measurements cannot be considered interchangeable.
Purpose: To evaluate the morphological changes of meibomian glands and dry eye syndrome in patients with type II diabetes.Methods: The medical records of 72 diabetic patients referred to the ophthalmology clinic for the evaluation of diabetic retinopathy, who had dry eye symptoms, were retrospectively reviewed.Results: A total of 72 patients, with an age of 56.3 ± 13.3 years, were analyzed.The group with diabetic retinopathy (52 patients) had a significantly lower tear film break-up time (p = 0.046), lower Schirmer's test value (p = 0.005), and higher percentage of upper (p = 0.036) and lower (p = 0.017) meibomian gland area losses than the group without diabetic retinopathy (20 patients).According to multilinear regression analyses considering sex, age, and diabetes-related characteristics, the Schirmer's test value was significantly lower with increasing stage of diabetic retinopathy (β = -1.180,p = 0.016).The percentage of upper meibomian gland area loss was significantly increased with increasing age (β = 0.605, p < 0.001), glycosylated hemoglobin (β = 1.881, p = 0.011), and stage of diabetic retinopathy (β = 4.458, p = 0.001).The percentage of lower meibomian gland loss area was significantly increased with increasing age (β = 0.443, p = 0.001) and stage of diabetic retinopathy (β = 4.879, p = 0.001).Conclusions: In patients with type 2 diabetes, the more severe the diabetic retinopathy, the more likely the meibomian gland loss will occur, so careful and appropriate treatment should be conducted.
Purpose To investigate the toxicity of repeated simultaneous intrastromal and intracameral injections of voriconazole in corneal endothelial cells in a rabbit model.Methods Thirty-six eyes of 18 New Zealand white rabbits (six eyes per group) were divided into 6 groups according to the concentration of voriconazole (Group A, 0%; Group B, 0.05%; Group C, 0.1%; Group D, 0.25%; Group E, 0.5%; Group F, 1%). A combination of intrastromal and intracameral voriconazole injections were administrated to the eyes of each group three times on days 0, 3, and 7. Corneal clouding grades and central corneal thickness (CCT) were examined on days 0, 3, 7, 10, and 14. The endothelial cell counts (ECC) were measured on days 0 and 14. Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) were performed on day 14.Results Group F (1%) showed more severe corneal clouding than the other groups (Groups A–E) from day 7 (p < 0.05, respectively). There were no significant differences in CCT and ECC among the six groups at any time point (p > 0.05, respectively). SEM revealed blurring of the cell border and loss of microvilli at concentrations ≥0.25% (Groups D–F). TEM revealed microstructural changes in endothelial cells at concentrations ≥0.1% (Groups C–F), and multiple vacuoles were observed at a concentration of 1% voriconazole (Group F).Conclusions Repeated simultaneous intrastromal and intracameral voriconazole injections at a concentration of 0.1% or higher induced microstructural endothelial damage in rabbit corneal endothelial cells.
Purpose: To investigate the accuracy of biometry and intraocular lens (IOL) power calculation using partial coherence interferometry (IOL Master®) in highly myopic patients with axial lengths of 26 mm or greater. Methods: Patients with axial lengths equal to or greater than 26 mm who had undergone cataract surgery were enrolled. IOL power was calculated using IOL Master and/or applanation ultrasonography with the SRK/T formula. Twenty-seven eyes using both IOL Master and applanation ultrasonography were included in a paired group, and forty-eight eyes using the IOL Master only and twenty-five eyes using applanation ultrasonography only were included in unpaired groups. The differences between the predicted refraction and the actual refraction were compared and analyzed. Results: In the paired study, the axial lengths in patients using IOL Master (29.14±2.32 mm) were significantly longer than those of patients using applanation ultrasonography (28.57±2.23 mm) (p0.05). In the unpaired study, the MAEs of the IOL Master and applanation ultrasonography groups were 0.61±0.61D and 0.65±0.63D, respectively. Conclusions: In eyes with axial lengths of 26.0 mm or greater, the accuracy of IOL power calculation with IOL Master using the SRK/T formula was comparable to that with applanation ultrasonography.
ABSTRACT PURPOSE: To investigate the incidence of epithelial ingrowth after laser in situ keratomileusis (LASIK) using the VISX 20/20B and VISX Star S3 laser systems. METHODS: A chart review of patients who had undergone LASIK between April 1999 and December 2001 was performed. Patients having known risk factors for epithelial ingrowth were excluded from the study. Both eyes of patients who were operated with both laser systems were included in a paired analysis. The first operated eyes of the remaining patients were included in an unpaired analysis. The outcomes studied were epithelial ingrowth (a region of epithelial growth under the flap that was contiguous with the flap edge and extended at least 0.7 mm in the radial direction) and epithelial ingrowth requiring treatment (extending into the pupillary zone, causing reduced vision, causing nighttime glare, or inducing any melting of the flap edge). RESULTS: In the paired study, 11 (61.1%) of 18 eyes treated with the VISX 20/20B had epithelial ingrowth, and 7 (38.9%) eyes required treatment. None of the eyes treated with the VISX Star S3 had epithelial ingrowth. In the unpaired study, 39 (37.1%) of 105 eyes treated with the VISX 20/20B were noted to have epithelial ingrowth and 14 (13.3%) eyes required treatment. None of the eyes treated with the VISX Star S3 had epithelial ingrowth. The incidence of epithelial ingrowth was significantly different for the VISX 20/20B and the VISX Star S3 in both analyses (paired: P<.001, McNemar's test; unpaired: P<.001, Fisher's exact test). CONCLUSIONS: The laser system used in LASIK is a risk factor for the development of epithelial ingrowth. [J Refract Surg, 2005;21:276-280.]
Purpose: This study reports a case of meibomian gland dysfunction associated with bortezomib, which is a treatment of choice for multiple myeloma.Case summary: A 59‐year‐old female patient presented to our hospital with a complaint of dryness that had worsened for 2 months and eye discharges that were difficult to remove even after washing her face. The patient had been diagnosed with multiple myeloma 5 months prior and had undergone four cycles of bortezomib therapy. Slit‐lamp microscopy revealed a number of pouting of the meibomian gland (MG) orifices in both eyes. Meibography revealed that more than one‐third and less than twothirds of the total MG area of both upper lids were lost and more than two‐thirds of the total MG area of both lower lids were lost. No clinically significant improvements were noted at 8 months despite thorough eyelid hygiene therapy, including warm compresses, topical antibiotics, steroids, and artificial tears. However, when the patient revisited our clinic 2 months after completing bortezomib treatment, the subjective symptoms had improved and all of the pouting of MG orifices had disappeared. There was no significant difference in the MG dropout area for either eye compared with the observations from a previous visit during bortezomib treatment.Conclusions: Clinicians should be aware that MG dysfunction may occur or worsen in patients receiving bortezomib treatment and should consider this when establishing a treatment plan for meibomian dysfunction or when educating patients.
To evaluate the compatibility of corneal curvature and astigmatism, and higher-order aberrations (HOAs) measured by the Scheimpflug camera Pentacam HR and the swept-source optical coherence tomography ANTERION.This prospective study included normal subjects with no ophthalmic history. Steep keratometry (K), flat K, astigmatism and its axis of the anterior and posterior surfaces, total corneal power, and HOAs using the two instruments were compared. To compare the mean values of the measurements, a paired t-test was used. Bland-Altman analysis was applied to assess the agreement between the two devices.Fifty-three eyes of 53 subjects were evaluated. There were statistically significant differences for steep K, astigmatism, and vector J0, J45 in the anterior surface and total corneal power between the two devices (p < 0.05). There were also significant differences in the most of the keratometric values of the posterior corneal surface (p < 0.05) except J0 (p = 0.410). Both devices showed strong positive correlations in steep K, flat K, astigmatism (r > 0.81, p < 0.001) with wide ranges of a 95% limit of agreement. Vectoral components were significantly correlated (r > 0.78, p < 0.001) with narrow 95% limit of agreement, except J45 of the posterior surface (r = 0.39, p = 0.004). In the corneal HOAs, there were statistically significant differences in the vertical coma, horizontal trefoil, spherical aberration, and root mean square of each fifth- and sixth-order Zernike coefficient (p = 0.043, p = 0.041, p < 0.001, p < 0.001, and p < 0.001, respectively). Other HOAs showed moderate to strong positive correlations (r > 0.37, p < 0.05). Most HOAs, except for the horizontal trefoil, showed clinically acceptable agreements. The total root mean square of HOAs was not significantly different between the two devices (p = 0.122).Most of the keratometric values cannot be used interchangeably. However, the vectoral component of astigmatism showed clinically good agreement. Several HOAs have statistically significant differences; however, almost all HOAs showed acceptable agreements, except for the horizontal trefoil.
'%3e%3cg id='b'%3e%3cpath id='a' stroke='%23000' stroke-width='2' d='M-6-25H6m-12 3H6m-12 3H6'/%3e%3cuse xlink:href='%23a' y='44'/%3e%3c/g%3e%3cpath stroke='%23fff' d='M0 17v10'/%3e%3ccircle r='12' fill='%23cd2e3a'/%3e%3cpath fill='%230047a0' d='M0-12A6 6 0 0 0 0 0a6 6 0 0 1 0 12 12 12 0 0 1 0-24z'/%3e%3c/g%3e%3cg transform='rotate(-123.69)'%3e%3cuse xlink:href='%23b'/%3e%3cpath stroke='%23fff' d='M0-23.5v3M0 17v3.5m0 3v3'/%3e%3c/g%3e%3c/svg%3e)