PURPOSE:To evaluate the morphological characteristics of posterior corneal regions including keratic precipitates in eyes with cytomegalovirus (CMV) corneal endotheliitis using anterior segment ...spectral domain optical coherence tomography (SD-OCT).
METHODS:Thirteen eyes of 13 patients with polymerase chain reaction–proven CMV corneal endotheliitis were included in this study. Slit-lamp images and anterior segment SD-OCT images of the posterior cornea were obtained to analyze the clinical characteristics of corneal structures and keratic precipitates. Morphological changes in the posterior cornea throughout the course of an antiviral treatment were also investigated.
RESULTS:Anterior SD-OCT images showed protruding structures at the posterior cornea. These protruding structures exhibited dendritic, dome-shaped, quadrangular, or saw-tooth appearance, and reflectivity of these structures was high. Reflectivity of posterior corneal images including the endothelium and deep stromal corneal regions were also high (76.9%). Because corneal inflammation and corneal edema improved, the protruding structures and high-intensity regions of posterior corneal images were resolved after a course of antiviral treatment.
CONCLUSIONS:The anterior segment SD-OCT examination represents a useful noninvasive alternative to diagnose and monitor CMV corneal endotheliitis.
PURPOSE:To evaluate the correlation between anterior chamber parameters and central corneal thickness (CCT) or peripheral corneal thickness (PCT) in patients with Fuchs endothelial corneal dystrophy ...(FECD) using anterior segment optical coherence tomography.
METHODS:This case–control study included 20 eyes from 20 patients with FECD and 31 eyes from 31 patients with healthy corneas. CCT was measured as an indicator of FECD severity. Anterior chamber angle parameters, including trabecular–iris angle (TIA500) and angle opening distance (AOD500), were measured as an indicator of peripheral anterior chamber morphology. We also analyzed PCT and lens vault (LV). The relationships between CCT or PCT and anterior chamber parameters were also analyzed in patients with FECD.
RESULTS:Patients with FECD had a larger CCT (593.9 ± 54.6 μm vs. 533.0 ± 25.4 μm, P < 0.001), smaller TIA500 (21.8 ± 9.9 vs. 32.5 ± 11.2 degrees, P = 0.002), smaller AOD500 (0.21 ± 0.11 vs. 0.34 ± 0.18 mm, P = 0.002), and greater LV (0.60 ± 0.27 vs. 0.40 ± 0.29 mm, P = 0.02) than control subjects. In patients with FECD, CCT was negatively correlated with the angle parameters TIA500 (R = 0.29, P = 0.009) and AOD500 (R = 0.19, P = 0.03). There were no significant correlations between PCT and TIA500 (R = 0.008, P = 0.29) or AOD500 (R = 0.007, P = 0.29). There were also no significant correlations between CCT and LV (R = 0.02, P = 0.55).
CONCLUSIONS:Larger CCT was significantly associated with narrower anterior chamber angle width, but not with LV. We showed that the severity of FECD is associated with angle chamber morphology.
Visual field (VF) data were retrospectively obtained from 491 eyes in 317 patients with open angle glaucoma who had undergone ten VF tests (Humphrey Field Analyzer, 24-2, SITA standard). First, mean ...of total deviation values (mTD) in the tenth VF was predicted using standard linear regression of the first five VFs (VF1-5) through to using all nine preceding VFs (VF1-9). Then an 'intraocular pressure (IOP)-integrated VF trend analysis' was carried out by simply using time multiplied by IOP as the independent term in the linear regression model. Prediction errors (absolute prediction error or root mean squared error: RMSE) for predicting mTD and also point wise TD values of the tenth VF were obtained from both approaches. The mTD absolute prediction errors associated with the IOP-integrated VF trend analysis were significantly smaller than those from the standard trend analysis when VF1-6 through to VF1-8 were used (p < 0.05). The point wise RMSEs from the IOP-integrated trend analysis were significantly smaller than those from the standard trend analysis when VF1-5 through to VF1-9 were used (p < 0.05). This was especially the case when IOP was measured more frequently. Thus a significantly more accurate prediction of VF progression is possible using a simple trend analysis that incorporates IOP measurements.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Purpose To evaluate racial differences in the development of visual field (VF) damage in glaucoma suspects. Design Prospective, observational cohort study. Methods Six hundred thirty-six eyes from ...357 glaucoma suspects with normal VF at baseline were included from the multicenter African Descent and Glaucoma Evaluation Study (ADAGES). Racial differences in the development of VF damage were examined using multivariable Cox proportional hazard models. Results Thirty one of 122 African-descent participants (25.4%) and 47 of 235 European-descent participants (20.0%) developed VF damage ( P = .078). In multivariable analysis, worse baseline VF mean deviation, higher mean arterial pressure during follow-up, and a race ∗ mean intraocular pressure (IOP) interaction term were significantly associated with the development of VF damage, suggesting that racial differences in the risk of VF damage varied by IOP. At higher mean IOP levels, race was predictive of the development of VF damage even after adjusting for potentially confounding factors. At mean IOPs during follow-up of 22, 24, and 26 mm Hg, multivariable hazard ratios (95% confidence intervals) for the development of VF damage in African-descent compared to European-descent subjects were 2.03 (1.15–3.57), 2.71 (1.39–5.29), and 3.61 (1.61–8.08), respectively. However, at lower mean IOP levels (below 22 mm Hg) during follow-up, African descent was not predictive of the development of VF damage. Conclusion In this cohort of glaucoma suspects with similar access to treatment, multivariate analysis revealed that at higher mean IOP during follow-up, individuals of African descent were more likely to develop VF damage than individuals of European descent.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
PurposeIntrachoroidal cavitations (ICCs) are peripapillary pathological lesions generally associated with high myopia that can cause visual field (VF) defects. The current study aimed to evaluate a ...three-dimensional (3D) volume parameter of ICCs segmented from volumetric swept-source optical coherence tomography (SS-OCT) images processed using deep learning (DL)-based noise reduction and to investigate its correlation with VF sensitivity. MethodsThirteen eyes of 12 consecutive patients with peripapillary ICCs were enrolled. DL-based denoising and further analyses were applied to parapapillary 6 × 6-mm volumetric SS-OCT scans. Then, 3D ICC volume and two-dimensional depth and length measurements of the ICCs were calculated. The correlations between ICC parameters and VF sensitivity were investigated. ResultsThe ICCs were located in the inferior hemiretina in all eyes. ICC volume (P = 0.02; regression coefficient RC, -0.007) and ICC length (P = 0.04; RC, -4.51) were negatively correlated with the VF mean deviation, whereas ICC depth (P = 0.15) was not. All of the parameters, including ICC volume (P = 0.01; RC, -0.004), ICC depth (P = 0.02; RC, -0.008), and ICC length (P = 0.045; RC, -2.11), were negatively correlated with the superior mean total deviation. ConclusionsWe established the volume of ICCs as a new 3D parameter, and it reflected their influence on visual function. The automatic delineation and 3D rendering may lead to improved detection and pathological understanding of ICCs. Translational RelevanceThis study demonstrated the correlation between the 3D volume of ICCs and VF sensitivity.
To present a novel microscope-integrated optical coherence tomography (iOCT)-guided surgical technique wherein Descemet's membrane detachment (DMD), occurring during vitrectomy, was treated ...intraoperatively in a patient who had previously undergone Descemet's stripping automated endothelial keratoplasty (DSAEK).
The surgical technique was performed on a 75-year-old man with a history of DSAEK to intraoperatively treat DMD, which occurred during vitrectomy in the left eye. A fine needle mounted on a syringe was inserted into the supra-Descemet's space under iOCT guidance. The location of the needle was easily identified by its high reflection. The interface fluid was safely aspirated under excellent visualization of the needle tip and the interface. Successful aspiration of the interface fluid was confirmed via iOCT imaging at the end of the surgery. The graft has remained well attached to the cornea throughout the one-year postoperative follow-up.
iOCT-guided surgical interventions provide a safe and accurate approach for treating intraoperative complications in eyes with a history of DSAEK.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
To investigate the effects of ocular and systemic risk factors for glaucomatous progression in different sectors of the visual field (VF).
409 eyes from 268 patients with 10 reliable VFs from the ...Japanese Archive of Multicentral Databases in Glaucoma (JAMDIG) were investigated. VFs were divided into six sectors (mean total deviation (mTD)
, mTD
and mTD
, >20°, 10-20° and <10° in the superior hemifield, respectively; and mTD
, mTD
and mTD
, >20°, 10-20° and <10° in the inferior hemifield, respectively). The relationship between sectorial progression rate and eight variables (age, mTD at baseline VF, average intraocular pressure (IOP), SD of IOP, systemic hypertension, migraine, family history of glaucoma and smoking status) was investigated.
The mTD progression rate was -0.21 dB/year. Older age was related to progression of mTD
, mTD
, mTD
and mTD
. Mean IOP was not related to progression in any VF sector; however, a larger SD of IOP was related to progression of mTD
, mTD
, mTD
and mTD
. Smoking status was related to progression in all inferior VF sectors (mTD
, mTD
and mTD
).
Smoking status is related to glaucomatous VF progression in all sectors of the inferior hemifield.
Introduction
The aim of this study was to report a technique for the removal of dislocated polymethyl methacrylate (PMMA) intraocular lenses (IOLs) in glaucomatous eyes.
Methods
Dislocated PMMA IOLs ...were removed from the inferior sclerocorneal incision, and sutureless intrascleral fixation of each IOL was performed to preserve the intact superior conjunctiva and sclera for future trabeculectomy or to maintain a functional filtering bleb of trabeculectomy.
Results
In two cases, the condition of the bleb did not change, while the intraocular pressure improved or did not change after the procedures. IOL fixation was stable with no complications, such as tilt, decentration, or extrication of the IOL haptics.
Conclusion
This procedure of preserving the superior conjunctiva and sclera can maintain the function of the bleb, superior cornea and sclera and may contribute to the success of future trabeculectomy.
Purpose
To measure retinal nerve fiber layer thickness (RNFLT) and ganglion cell complex thickness (GCCT) in eyes with no light perception due to nonglaucomatous optic neuropathy using ...spectral-domain optical coherence tomography.
Methods
Fourteen eyes of 14 patients (9 women, 5 men; mean age 56.0 ± 16.6 (standard deviation) years with no light perception due to optic neuropathy were recruited to this retrospective study. Only clinically stable eyes were included. Eyes were imaged at least 6 months after the onset of the disease. Five patients lost light perception due to traumatic optic neuropathy, four patients had ischemic optic neuropathy, two patients had optic neuritis, two patients had compressive optic neuropathy, and one patient had optic nerve atrophy. Global and quadrant RNFLTs were measured with the Cirrus HD-optical coherence tomography (OCT) system; global and hemisphere GCCTs were measured by spectral-domain OCT (RTVue OCT system). Only reliable OCT images were used for further analysis.
Results
Reliable RNFL images were obtained in 12 eyes, and reliable GCC images were obtained in 11 eyes. Global, superior, temporal, inferior, and nasal RNFLT were 57.5 ± 6.7, 60.6 ± 7.6, 54.1 ± 11.2, 59.7 ± 9.5, and 55.6 ± 7.4 µm, respectively. Global, superior, and inferior GCC thicknesses were 68.8 ± 9.6, 70.7 ± 12.2, and 67.8 ± 8.8 µm, respectively.
Conclusions
A considerable proportion of RNFL and GCC remained in eyes with no light perception vision. Clinicians should take this into account when evaluating the severity of optic neuropathy from OCT-measured RNFLT and GCCT.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
To compare early-stage intrableb structural changes after Ex-PRESS surgery using anterior-segment optical coherence tomography between primary open-angle glaucoma (POAG) and exfoliation glaucoma ...(XFG).
Twenty-five POAG eyes and 15 XFG eyes that underwent Ex-PRESS surgery were evaluated. Intrableb images were classified into four categories based on previously reported scattering intensity: high-, medium-, and low-scattering walls and fluid-filled spaces. Bleb measurements were evaluated in both groups throughout 6 postoperative months. The 3-year surgical success was defined by the criteria intraocular pressure (IOP) < 18 mmHg and IOP < 15 mmHg with or without medications.
The fluid-filled space volume at 3 and 6 months (P = 0.005 and P = 0.022, respectively) and the volume ratio of the low-scattering wall to the bleb wall (P = 0.028) at 6 months were significantly smaller in XFG than POAG postoperatively. The volume ratio of the high-scattering wall to the bleb wall was correlated positively (P = 0.007) with the IOP, and that of the low-scattering wall to the bleb wall was correlated negatively (P = 0.002) with the IOP in XFG. The 3-year surgical success rates for both criteria were significantly lower in XFG than POAG.
Fluid-filled spaces were smaller in XFG than in POAG after Ex-PRESS surgery. The proportion of the high-scattering wall tended to increase and the low-scattering wall tended to decrease in XFG eyes with high IOP. Early-stage intrableb structural changes differed between POAG and XFG and may affect the prognosis.
Our cutting-edge observation of intrableb fibrosis can be an important predictor of the surgical outcome.
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