Author: Am J Ophthalmol

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We thank Galvis and associates for their interest in our article and their thoughtful comments. They suggested that the amount of change in corneal higher-order aberrations with age is less than that in total ocular higher-order aberrations, and cornea…

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Effect of Timolol on Refractive Outcomes in Eyes With Myopic Regression After Laser In Situ Keratomileusis: A Prospective Randomized Clinical Trial

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We perused with great interest the randomized controlled trial by Shojaei and associates, which studied the effect of timolol eye drops in refractive outcomes in eyes with myopic regression after laser in situ keratomileusis (LASIK). In this trial, the authors compared the outcomes of treating patients presenting with myopic regression following LASIK with timolol eye drops instilled twice a day to treatment by instilling artificial tear drops in an identical regime as placebo. The spherical equivalent was significantly better in the timolol (treatment) arm 6 months after treatment, and also 6 months after discontinuation of treatment (P < .001 for both comparisons). Based on these results, the authors concluded that instillation of timolol eye drops is effective for the treatment of myopic regression after LASIK and its effect seems to last for at least 6 months after discontinuation. The study design and statistical analysis were appropriate, but we do have the following observations to make.

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We would like to thank Dr Sharma and his associates for their interest in our paper. We also appreciate them for noticing the typographical errors in our paper. They noted that the logMAR values reported in Table 5 should have been written as positive…

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We thank Chhablani and associates for their interest in our article and their comments, which mainly concern the methodology of our study. They expressed concern that some of our patients with intermittent exotropia may have a normal range of ocular to…

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Measurement of the Optic Disc Vertical Tilt Angle With Spectral-Domain Optical Coherence Tomography and Influencing Factors – Corrected Proof

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Purpose: To report a novel method for measuring the vertical tilt angle of the optic nerve (ON) head and to investigate the associated factors.Design: Cross-sectional diagnostic study.Methods: One hundred and twelve normal, glaucomatous, and glaucoma suspect eyes (99 patients) were enrolled in this study. Subjects underwent a full eye examination, biometry, and spectral-domain optical coherence tomography (SDOCT). The vertical tilt angle was measured on high-resolution cross-sectional SDOCT images passing through the ON head and foveal centers using the inner edges of the Bruch membrane opening as the reference plane. The correlation between the vertical tilt angle with the ovality index and the potential associated factors was estimated with univariate and multivariate linear regression analyses.Results: The median (interquartile range, [IQR]) axial length and visual field mean deviation were 24.5 (23.8-25.3) mm and −0.9 (−2.76 to 0.26) dB. The median (IQR) tilt angle was 3.5 (1.2-11.2) degrees. There was a moderate correlation between the ovality index and tilt angle (Spearman ρ = 0.351; P < .001). In univariate analyses, axial length, spherical equivalent, and mean deviation were correlated with the tilt angle (P = .002, P = .011, and P = .013, respectively). Axial length, mean deviation, and their interaction showed a statistically significant correlation with the tilt angle in multivariate analyses (P = .044 for axial length, P = .039 for mean deviation, and P = .028 for their interaction).Conclusions: We describe a new method for measuring the ON head vertical tilt angle with high-resolution SDOCT imaging. The ovality index demonstrated only a moderate correlation with the tilt angle measurements and hence is not a good proxy measure for the vertical ON head tilt angle. Axial length and visual field mean deviation are the main factors associated with the ON head vertical tilt angle. The underlying basis for the relationship of vertical tilt angle and glaucoma severity should be further explored.

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Prevalence of Dry Eye Disease and its Risk Factors in Visual Display Terminal Users: The Osaka Study – Corrected Proof

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Purpose: To investigate tear function and prevalence of dry eye disease (DED) in visual display terminal (VDT) users.Design: Cross-sectional study.Methods: Six hundred and seventy-two young and middle-aged Japanese office workers who used VDT completed questionnaires and underwent dry eye testing. We estimated the prevalence of DED using logistic regression analysis to examine associations between DED and possible risk factors. The ocular surface feature, prevalence of DED, and risk factors were evaluated.Results: Of the 672 workers, 561 (83.5%, mean age: 43.3 ± 9.1 years) completed the questionnaire. The percentage of women with a composite outcome of definite DED or probable DED was 76.5%, which was higher than that among men (60.2%; odds ratio [OR] = 2.00; 95% confidence interval [CI], 1.29-3.10, P = .002). Workers over 30 years of age had a higher risk of DED (OR = 2.22; 95% CI, 1.06-4.66), as did workers using a VDT >8 hours per day (OR = 1.94; 95% CI, 1.22-3.09). Average Schirmer value was 18.7 ± 11.7 mm and tear break-up time (TBUT) was 4.0 ± 2.5 seconds (78.6% of study participants had TBUT ≤5 seconds).Conclusions: DED is prevalent among young to middle-aged Japanese VDT users. Ophthalmic findings revealed short TBUT and corneal staining accompanied by normal Schirmer test values. Increased risk for DED was noted for women aged over 30 years and prolonged VDT use. Measures to modify the adverse impact of VDT use on the ocular surface may provide a positive impact on public health and quality of life for office workers using VDTs.

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Comparison of the Effect of Ranibizumab and Verteporfin for Polypoidal Choroidal Vasculopathy: 12-Month LAPTOP Study Results – Corrected Proof

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Purpose: To compare the effect of photodynamic therapy (PDT) and intravitreal ranibizumab in patients with polypoidal choroidal vasculopathy (PCV).Design: Randomized clinical trial.Methods: setting: Multicenter. study population: Total of 93 patients with treatment-naïve PCV. intervention: Patients were randomized to 2 arms. Patients in the PDT arm underwent a single session of PDT with verteporfin, and patients in the ranibizumab arm received 3 monthly ranibizumab injections at baseline. Additional treatment was performed as needed in each arm. main outcome measures: Primary outcome measurement was the proportion of patients gaining or losing more than 0.2 logarithm of minimal angle of resolution (logMAR) units from baseline. Mean change of logMAR and central retinal thickness (CRT) were also evaluated.Results: In the PDT arm (n = 47), 17.0% achieved visual acuity gain, 55.3% had no change, and 27.7% experienced visual acuity loss. The results were 30.4%, 60.9%, and 8.7%, respectively, in the ranibizumab arm (n = 46), significantly better than the PDT arm (P = .039). In the PDT arm, mean CRT improved (366.8 ± 113.6 μm to 289.1 ± 202.3 μm, P < .001), but logMAR was unchanged (0.57 ± 0.31 to 0.62 ± 0.40). The ranibizumab arm demonstrated improvement in both CRT (418.9 ± 168.6 μm to 311.2 ± 146.9 μm, P < .001) and logMAR (0.48 ± 0.27 to 0.39 ± 0.26, P = .003). Mean change of logMAR was also greater in the ranibizumab arm (P = .011).Conclusion: Intravitreal injection of ranibizumab is more effective than PDT for treatment-naïve PCV.

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