Purpose: To evaluate relationships between tear meniscus dimensions and parameters of ocular surface disease in a variety of tear dysfunction conditions.Design: Single-institution prospective observational study.Methods: This study from the Baylor College of Medicine included 128 eyes of 64 subjects. Cross-sectional lower tear meniscus height and tear meniscus area were measured using optical coherence tomography and were compared with tear break-up time (TBUT), corneal staining, conjunctival staining, and an irritation symptom questionnaire (Ocular Surface Disease Index). Study groups included meibomian gland disease (MGD), aqueous tear deficiency (ATD), Sjögren syndrome, non–Sjögren syndrome ATD, and control subjects. Statistical analyses were performed using the Pearson correlation and Student’s t test.Results: When compared with mean tear meniscus height in controls (345 μm), mean tear meniscus height was lower in all tear dysfunction (234 μm; P = .0057), ATD (210 μm; P = .0016), and Sjögren syndrome groups (171 μm; P = .0054). For tear meniscus height ≤210 μm, relative risk ratio for developing corneal staining ≥10 was 4.65. Tear meniscus height correlated with corneal staining for all subjects (R = −0.32; P = .0008), MGD (R = +0.40; P = .059), and ATD (R = −0.36; P = .04). Tear meniscus area showed similar trends in MGD (R = +0.55; P = .006) and ATD (R = −0.40; P = .018). Tear meniscus height correlated with TBUT for all subjects (R = +0.39; P < .0001) and ATD (R = +0.37; P = .018).Conclusions: In tear dysfunction conditions, lower tear volume correlates with worse corneal epithelial disease in ATD and Sjögren syndrome, conditions with lacrimal gland dysfunction. In contrast, higher tear volume is associated with corneal epithelial disease in MGD. These findings may improve the ability to identify patients at risk for corneal epithelial disease.
Author: Am J Ophthalmol
Increased Risk of Parkinson Disease Following a Diagnosis of Neovascular Age-Related Macular Degeneration: A Retrospective Cohort Study – Corrected Proof
Purpose: To investigate the risk for Parkinson disease during a 3-year follow-up period after a diagnosis of neovascular age-related macular degeneration (AMD) using a nationwide population-based dataset in Taiwan.Design: A retrospective matched-cohort study.Methods: We identified 877subjects with neovascular AMD as the study cohort and randomly selected 8770 subjects for a comparison cohort. Each subject was individually followed for a 3-year period to identify those who subsequently developed Parkinson disease. Stratified Cox proportional hazard regressions were performed as a means of comparing the 3-year risk of subsequent Parkinson disease between the study and comparison cohorts.Results: The incidence rate of Parkinson disease was 5.32 (95% confidence interval [CI]: 3.03-8.72) per 1000 person-years in patients with neovascular AMD and 2.09 (95% CI: 1.59-2.70) per 1000 person-years in comparison patients. The log-rank test indicated that subjects with neovascular AMD had a significantly lower 3-year Parkinson disease–free survival rate than comparison subjects (P < .001). After censoring cases in which patients died during the follow-up period and adjusting for monthly income, geographic region, hypertension, diabetes, hyperlipidemia, and coronary heart disease, the hazard ratio of Parkinson disease during the 3-year follow-up period for subjects with neovascular AMD was 2.57 (95% CI: 1.42-4.64) that of comparison subjects.Conclusion: In this study, subjects with neovascular AMD were found to be at a significant risk of Parkinson disease during a 3-year follow-up period after their diagnosis among Taiwanese Chinese. Further study is needed to confirm our findings and explore the underlying pathomechanism.
Combination Therapy with Diquafosol Tetrasodium and Sodium Hyaluronate in Patients with Dry Eye after Laser In Situ Keratomileusis – Accepted Manuscript
Abstract: Purpose: To evaluate the possible advantages of combination therapy with diquafosol tetrasodium and sodium hyaluronate for dry eye after laser in situ keratomileusis (LASIK).Design: Prospective, randomized, comparative trialMethods: A total o…
Combination Therapy with Dexamethasone Intravitreal Implant and Macular Grid Laser in Patients with Branch Retinal Vein Occlusion – Accepted Manuscript
Abstract: Purpose: To test a combination of dexamethasone intravitreal implant with macular grid laser for macular edema in patients with branch retinal vein occlusion (BRVO).Design: Prospective interventional, randomized, multi-center studyMethods: Pa…
Myopia Control in Children through Refractive Therapy Gas Permeable Contact Lenses: Is it for Real?
Purpose: To compare the safety and efficacy of orthokeratology as a nonsurgical treatment for myopia in children with alternate methods, such as soft contact lenses, rigid gas permeable lenses, and spectacles, throughout multiple studies.Design: Perspe…
Orthokeratology: Does it Live Up to Expectations?
Overnight orthokeratology is a technique for correcting myopia and is more recently proposed for the prevention of myopic progression. It is potentially an alternative to laser in situ keratomileusis and may be offered to parents whose children are no…
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Thank you very much for your comments concerning our article, Surgical Results of a Muscle Transposition Procedure for Abducens Palsy without Tenotomy and Muscle Splitting. As you pointed out, in Figure 3, the eyes of patient 7 in right gaze seem to…
Posterior Capsule Opacification With the iMics1 NY-60 and AcrySof SN60WF 1-Piece Hydrophobic Acrylic Intraocular Lenses: 3-Year Results of a Randomized Trial
We read with great interest the study by Leydolt and associates investigating the long-term posterior capsular opacification (PCO) severity associated with the use of 2 acrylic hydrophobic intraocular lenses (IOL). They concluded that the differences b…
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We thank the authors for their interest in our recently published article. This study was strictly a microbiological study using data from the microbiology department. These data did not include any clinical information regarding etiology of endophthal…
Endophthalmitis Isolates and Antibiotic Susceptibilities: A 10-Year Review of Culture-Proven Cases
We read with great interest the recent article from Schimel and associates on the important topic of antibiotic susceptibility of pathogens isolated in endophthalmitis cases. In particular, we commend the authors for reporting a significant increase …
Contents
Reporting Visual Acuities
The AJO encourages authors to report the visual acuity in the manuscript using the same nomenclature that was used in gathering the data provided they were recorded in one of the methods listed here. This table of equivalent visual acuities is provided…
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We thank Abramson and associates for their comments regarding our report and welcome the opportunity to clarify our conclusions. In our study, only 1 of 252 patients that had received systemic chemotherapy developed pineoblastoma, while 3 of 156 patien…
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I have been involved at every stage in the development of the Neusidl Corneal Inserter (NCI), from the moment that a talented ophthalmologist and innovative engineer, William Neusidl, showed me his initial drawings, through laboratory testing and revis…
Incidence of Pineal Gland Cyst and Pineoblastoma in Children With Retinoblastoma During the Chemoreduction Era
We carefully read the recent paper by Ramasubramanian and associates on the incidence of pineal gland cyst and pineoblastoma in retinoblastoma patients. Over a 12-year period this busy center saw only 4 pineoblastomas in 408 patients. Despite the small…
Endothelial Keratoplasty: Prospective, Randomized, Masked Clinical Trial Comparing an Injector With Forceps for Tissue Insertion
In regard to the recent paper by Terry and associates, I would like to point out a potential mitigating factor that limits the clinical applicability of the paper. Although the authors state, “All other steps of the surgical procedure were exactly the same,” this is not precisely correct. The authors utilized viscoelastic protection for the Charlie II forceps (Bausch & Lomb Surgical, St. Louis, Missouri, USA) group and did not utilize any viscoelastic for the Neusidl Cornea Inserter (Fischer Surgical, Imperial, Missouri, USA) group, stating that viscoelastic is not part of the standard operating procedure for the Neusidl Cornea Inserter. The authors are confusing standard or typical use with what a manufacturer can list in its labeling. As the authors know, the Charlie forceps did not require any clinical data to support its marketing and, as such, the companies do not supply any use information or suggest the use of a viscoelastic. The procedure used by the authors is their standard of practice for the Charlie forceps and not a manufacture-supplied procedure. The Food and Drug Administration (FDA) required extensive clinical data from Fischer Surgical prior to their marketing of the Neusidl Cornea Inserter. The procedure the authors followed is not typical of the standard practice with the Neusidl Cornea Inserter, in which the majority of surgeons utilize viscoelastic. The original Neusidl Cornea Inserter standard operating procedure included the optional use of viscoelastic protection but that information was removed for the submission. The lack of viscoelastic use in the FDA protocol (personal communication) was based on limiting variables and potentially further data requests from the FDA as well as the belief that cell loss without viscoelastic would still be at an acceptable level. A proper or more comparative study would have used viscoelastic in both arms to better reflect the different insertion devices and techniques and would then have been more clinically meaningful.
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The authors appreciate the questions posed by Drs. Carifi, Zygoura, Deshmuck, and Kopsakilis regarding the issues of capsule-optic overlap and whether intraoperative bleeding, iris trauma, or postoperative inflammation were considered as exclusion crit…
Surgical Results of a Muscle Transposition Procedure for Abducens Palsy Without Tenotomy and Muscle Splitting
Muraki and associates deserve appreciation for describing a new procedure in the article Surgical Results of a Muscle Transposition Procedure for Abducens Palsy Without Tenotomy and Muscle Splitting. However, the success they claim regarding improvemen…
Combined photodynamic therapy with intravitreal bevacizumab injections for polypoidal choroidal vasculopathy: long-term visual outcome – Accepted Manuscript
Abstract: Purpose: To evaluate the long-term visual outcome after combination therapy of photodynamic therapy (PDT) with intravitreal bevacizumab injections for polypoidal choroidal vasculopathy (PCV).Design: Retrospective, observational study.Methods:…
Unilateral Partial Limbal Stem Cell Deficiency: Contralateral versus Ipsilateral Autologous Cultivated Limbal Epithelial Transplantation – Accepted Manuscript
Abstract: Purpose: To report the outcomes of autologous cultivated limbal epithelial transplantation utilizing the healthy part of the affected eye or the fellow eye as a source of limbal stem cells in patients with unilateral, partial limbal stem cell…