Purpose: To quantify and compare the severity of metamorphopsia in patients undergoing vitrectomy for vitreoretinal disorders. Methods: Data were collected evaluated from 319 patients with ...vitreoretinal disorders, including epiretinal membrane (ERM), macular hole (MH), cystoid macular edema with branch retinal vein occlusion (BRVO-CME), CME with central retinal vein occlusion (CRVO), diabetic macular edema (DME), macula-off rhegmatogenous retinal detachment (M-off RD), and macula-on RD (M-on RD). Metamorphopsia was recorded with the M-CHARTS preoperatively and at 3 and 6 months postoperatively. Results: Preoperative and 6-month postoperative metamorphopsia scores were 0.69 ± 0.50 and 0.50 ± 0.52, respectively. Before surgery, 94% of patients presented with metamorphopsia (score ≥0.2). Preoperative metamorphopsia scores were significantly correlated with postoperative metamorphopsia scores (r = 0.378, p < 0.0001). Preoperative metamorphopsia score was significantly higher for ERM (0.89) than for DME (0.51). Vitrectomy significantly improved metamorphopsia in ERM and MH but not in the other disorders. In contrast, treatment improved visual acuity for all disorders except CRVO-CME and M-on RD. Conclusion: This quantitative study indicated that metamorphopsia is present in most patients undergoing surgery for vitreoretinal diseases and is most severe in ERM. In these patients, vitrectomy improved visual acuity but not metamorphopsia.
Our prospective study was conducted to compare axial length elongation in myopic children receiving long-term overnight orthokeratology (OK) treatment to those wearing spectacles as controls.
There ...were 59 subjects enrolled in this study. The OK group comprised 29 subjects who matched the inclusion criteria for OK. The control group comprised 30 subjects who also matched the inclusion criteria for OK, but preferred spectacles for myopia correction. Axial length was measured periodically for 5 years using an IOLMaster device, and the time course of changes was evaluated and compared between the groups.
A total of 43 subjects (22 and 21 in the OK and control groups, respectively) completed the 5-year follow-up examinations. At baseline, the mean age ± SD was 10.04 ± 1.43 and 9.95 ± 1.59 years, the spherical equivalent refractive error was -1.89 ± 0.82 and -1.83 ± 1.06 diopters (D), and the axial length was 24.09 ± 0.77 and 24.22 ± 0.71 mm in the OK and control groups, respectively, with no significant differences between the groups. The increase in axial length during the 5-year study period was 0.99 ± 0.47 and 1.41 ± 0.68 mm for the OK and control groups, respectively, and the difference was statistically significant (P = 0.0236, unpaired t-test). The annual increases in axial length were significantly different between the groups for the first (P = 0.0002), second (P = 0.0476), and third years (P = 0.0385), but not for the fourth (P = 0.0938) and fifth (P = 0.8633) years. There were no severe complications throughout the study period.
The current 5-year follow-up study indicated that OK can suppress axial length elongation in childhood myopia.
Abstract This study aimed to evaluate visual function and perform multimodal imaging on patients with focal choroidal excavation without any chorioretinal disease (idiopathic focal choroidal ...excavation iFCE). Seventeen eyes of 15 patients with iFCE (8 men, 7 women; mean ± standard deviation age, 56.0 ± 10.8 years) were assessed for visual function including visual acuity, metamorphopsia, aniseikonia, and retinal sensitivity. Multimodal imaging included optical coherence tomography (OCT), fundus autofluorescence (FAF), and OCT angiography. This study found that the maximum width and depth of the excavation were 597 ± 330 (238–1809) µm and 123 ± 45 (66–231) µm, respectively, and that FAF showed normal or hypoautofluorescence corresponding to iFCE. The fundus examination findings were stable during the follow-up period (96 ± 48 months). None of the eyes showed any abnormalities in central retinal sensitivity or aniseikonia. Metamorphopsia was detected using Amsler grid testing and M-CHARTS in two eyes. Therefore, this study is the first to quantitatively and qualitatively study metamorphopsia of patients with iFCE. Our results showed that most patients with iFCE did not have visual impairments, despite the presence of morphological changes in the outer retina and choroid.
To compare stereopsis and foveal microstructure after internal limiting membrane peeling and inverted internal limiting membrane flap technique in patients with macular hole.
Retrospective ...observational study.
Sixty-six patients with macular hole were included, of whom 41 underwent 25-gauge pars-plana vitrectomy with complete internal limiting membrane peeling (Peeling group) and 25 with the inverted flap technique (Inverted group). We evaluated stereopsis using the Titmus Stereo Test and the TNO stereo test, best-corrected visual acuity, macular hole closure rate, and foveal microstructure with optical coherence tomography before and at 3, 6, and 12 months after surgery.
Stereopsis and foveal microstructure.
Preoperatively, no difference was observed in the base and minimum diameters of macular hole, Titmus Stereo Test score, TNO stereo test score, and best-corrected visual acuity between the Peeling and Inverted groups. The macular hole closure rate in the Peeling and Inverted groups were 97.6% and 100%, respectively, with no significant difference between groups. At 12 months postoperatively, Titmus Stereo Test score (2.1 ± 0.4 in the peeling and 2.2 ± 0.4 in the inverted groups), TNO stereo test score (2.3 ± 0.4 and 2.2± 0.5), and best-corrected visual acuity (0.20 ± 0.18 and 0.24 ± 0.25) were not significantly different between groups (p = 0.596, 0.332, respectively). The defect of the external limiting membrane was more common in the Inverted group than in the Peeling group at 6 months after surgery (5.4 vs. 28.0%; p < 0.05). No statistically significant inter-group differences were noted in the ellipsoid zone defect ratio throughout the follow-up period.
There was no difference in postoperative stereopsis nor foveal microstructure between the internal limiting membrane peeling group and the inverted group in patients with macular hole.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
To determine ocular optical parameters that affect axial length elongation in myopic children undergoing overnight orthokeratology.
Prospective, noncomparative study.
Fifty-nine subjects who met the ...inclusion criteria were enrolled in this study.
Axial length and ocular wavefront aberration were assessed before and 1 year after the start of orthokeratology. Corneal topography was performed, and then corneal multifocality was calculated for a 4-mm pupil. After evaluating simple correlations between axial elongation and optical parameters, multiple linear regression analysis was performed to identify explanatory variables with a statistically significant contribution to axial elongation.
Axial length and ocular wavefront aberration before and 1 year after the start of orthokeratology.
Fifty-five subjects completed the 1-year follow-up examinations. At baseline, their age ranged from 7.2 to 12.0 years. The manifest spherical equivalent refractive error ranged from -3.50 to -0.75 diopters. The mean axial length significantly increased from 24.20 mm at baseline to 24.43 mm 1 year after treatment. The axial elongation showed significant simple correlations with the change in C2(0), change in second-order aberration, change in coma-like aberration, change in spherical-like aberration, change in total higher-order aberrations, change in corneal multifocality, baseline age, and baseline spherical equivalent refractive error, but not C4(0). Multiple linear regression analysis showed that the change in coma-like aberration was the most relevant variable.
Asymmetric corneal shapes, rather than concentric and radially symmetric shapes, have a considerable effect on retardation of axial elongation, suggesting that the inhibitory effect of orthokeratology on myopia progression is caused by mechanisms other than the reduction in peripheral hyperopic defocus.
Purpose
To compare laser photocoagulation and intravitreal injection of bevacizumab (IVB) treatment for retinopathy of prematurity (ROP).
Methods
The study included 52 eyes of 26 patients after ROP ...treatment who were observed up to 5 years of age. Twenty-eight eyes received laser photocoagulation as the initial treatment (laser group), and twenty-four eyes underwent IVB (IVB group). We collected data on gestational age, birth weight, 1- and 5-min Apgar scores, zone and stage at the time of treatment, recurrence of ROP and best-corrected visual acuity (BCVA) (logMAR), equivalent spherical value (SE), ocular complications, and developmental delay at the age of 5.
Results
More zone I low-stage eyes were treated with IVB than laser. There was no difference in BCVA (
p
= 0.836). Although the mean SE was not different between the groups (
p
= 0.280), the prevalence of myopia was significantly higher in the laser group (
p
= 0.020). Developmental delay was observed in 3 of 14 and 3 of 12 cases in the laser and IVB groups, respectively (
p
= 0.596). Retinal holes were observed in 2 eyes in the IVB group, with 1 developing localized retinal detachment. There were no significant differences between the groups in the other factors.
Conclusions
Compared to laser for ROP, IVB was not inferior in neurodevelopment or visual outcome and was superior in refractive error. As cases in the IVB group showed retinal holes, long-term follow-up with fundus examination is recommended after IVB.
Purpose
To compare rates of myopia progression and adverse events between orthokeratology (OK) and soft contact lens (SCL) wearers over a 10‐year period in schoolchildren.
Methods
Medical records of ...consecutive patients (≤16 years of age at baseline) who started OK for myopia correction and continued the treatment for 10 years were retrospectively reviewed. For the control group, patients who started using soft contact lenses (SCLs) for myopia correction and continued to use them for 10 years were also reviewed. Clinical data, including sex, age, manifest refraction, visual acuity, prescription lens power, and adverse events during the 10‐year period, were recorded. Estimated myopia progression was calculated as the sum of ‘changes in prescription lens power during 10 years’ and ‘residual refractive errors at the 10‐year visit,’ and was compared between groups. We also compared the incidence of adverse events between groups over the 10‐year study period.
Results
A total of 104 eyes of 53 patients who underwent OK treatment and 78 eyes of 39 patients who wore SCLs fulfilled the criteria. The estimated myopia progression over the 10‐year period found in the OK and SCL groups were −1.26 ± 0.98 and −1.79 ± 1.24 days, respectively; this difference was statistically significant (p = 0.001). Additionally, lower myopia progression was found in the OK in comparison to the SCL group at all baseline ages (p = 0.003 to p = 0.049) except at 16 years old (p = 0.41). No significant difference was found in the number of adverse events found between the OK (119) and SCL (103) groups (p = 0.72).
Conclusions
The results of this study supports the long‐term efficacy and safety of OK lens wear in reducing myopia progression in schoolchildren.
The current method of controlling the focus of an accommodating intraocular lens is based on ciliary muscle contraction and cannot be used in older patients with presbyopia. We aimed to develop a ...dynamically accommodating intraocular lens powered by a membrane-shaped ion polymer metal composite actuator that is thin enough to be inserted in the eye. This study addresses two key problems identified in our previous accommodating intraocular lens prototype: the lack of repeatability due to the use of swine lenses instead of artificial lenses and the occurrence of a sixth order aberration. Thus, we present a new accommodating intraocular lens design and a method to transfer energy to actuators. To accommodate lens deformation and depth of focus, we used a membrane-shaped ion polymer metal composite actuator, thin enough to be inserted in the eye, and used an artificial silicone lens. To prevent the sixth order aberration, we included a ring between the ion polymer metal composite actuator and the lens. Different voltage patterns were applied to the IPMC actuator and changes in focus were observed. We were able to obtain repeatability and prevent the sixth order aberration. The dioptric power changed to ±0.23 D when ±1.5 V was used; however, at >1.5 V, a large accommodating range occurred, in addition to astigmatic vision. Thus, we have developed a novel prototype that is completely artificial, allowing reproducible and repeatable results. Visual accommodative demands were successfully met; however, although astigmatic vision was lessened, it was not completely eradicated.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
To quantify aniseikonia in patients undergoing vitrectomy for epiretinal membrane (ERM) and to investigate the relationship between the aniseikonia and the foveal microstructure by spectral-domain ...(SD) optical coherence tomography (OCT).
Prospective, consecutive, interventional case series.
This study included 44 eyes of 44 patients undergoing vitrectomy for idiopathic ERM.
We examined visual acuity and aniseikonia using the New Aniseikonia Test and SD-OCT before and 3 and 6 months after surgery. On the basis of the obtained OCT image, we divided the 1.0 × 1.0-mm area centered on the fovea into 9 sections at 0.25-mm intervals and quantified the following parameters using an image-processing program: central foveal thickness and mean thickness of the ganglion cell layer, inner nuclear layer (INL), and outer retinal layer (outer nuclear layer + outer plexiform layer). The status of the photoreceptor inner segment/outer segment junction, external limiting membrane, and cone outer segment tips also was evaluated.
Amount of aniseikonia 6 months after surgery.
Of 44 patients, 39 (89%) had macropsia, 1 (2%) had micropsia, and 4 (9%) had no aniseikonia preoperatively. Mean preoperative aniseikonia was 6.2% ± 4.5%. Vitrectomy significantly improved visual acuity in patients with ERM but did not change the amount of aniseikonia. Multiple regression analysis revealed that preoperative aniseikonia at 6 months was significantly related to preoperative INL thickness, whereas postoperative aniseikonia at 6 months was associated with postoperative INL thickness at 6 months. Preoperative INL thickness was found to be of significant prognostic value for postoperative aniseikonia at 6 months.
Most of the patients with ERM had macropsia. Aniseikonia was not reduced after surgery. The amount of aniseikonia was associated with INL thickness.
We non-invasively evaluated macular non-perfused areas (m-NPAs) of branch retinal vein occlusion (BRVO) using optical coherence tomography (OCT) angiography and the Humphrey visual field analyser ...10-2 programme (HFA 10-2). We enrolled 30 patients (30 eyes) with macular oedema secondary to BRVO. OCT angiography was used to photograph the macula at 6 × 6-mm; sizes of m-NPAs in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were measured in four areas. For HFA 10-2, we divided the actual measurement threshold of 68 points into four areas and calculated the mean central visual field sensitivity (CVFS). The correlation between the mean m-NPA and mean CVFS (dB) in each area was examined. There was a strong correlation between the m-NPA of each region detected in SCP and DCP, and the mean CVFS of each corresponding area (SCP: r = - 0.83, r = - 0.64, r = - 0.73, and r = - 0.79; DCP: r = - 0.82, r = - 0.71, r = - 0.71, and r = - 0.70), p values were < 0.001 for all. m-NPAs were associated with decreased visual field sensitivity in BRVO. Non-invasive m-NPA evaluation was possible using OCT angiography and HFA 10-2.
PDF