Author: Am J Ophthalmol

In Vivo 3-Dimensional Corneal Epithelial Thickness Mapping as an Indicator of Dry Eye: Preliminary Clinical Assessment – Corrected Proof

Purpose: To evaluate in vivo epithelial thickness in dry eye by anterior segment optical coherence tomography.Design: Observational, retrospective case-control study.Methods: Two age-matched groups of female subjects, 70 eyes each, age ≈ 55 years, were studied in clinical practice setting: a control (unoperated, no ocular pathology) and a dry eye group (clinically confirmed dry eye, unoperated and no other ocular pathology). Corneal epithelium over the entire cornea was topographically imaged via a novel anterior segment optical coherence tomography (AS-OCT) system. Average, central, and peripheral epithelial thickness as well as topographic epithelial thickness variability were measured.Results: For the control group, central epithelial thickness was 53.0 ± 2.7 μm (45-59 μm). Average epithelium thickness was 53.3 ± 2.7 μm (46.7-59.6 μm). Topographic thickness variability was 1.9 ± 1.1 μm (0.7-6.1 μm). For the dry eye group, central epithelial thickness was 59.5 ± 4.2 μm (50-72 μm) and average thickness was 59.3 ± 3.4 μm (51.4-70.5 μm). Topographic thickness variability was 2.5 ± 1.5 μm (0.9-6.9 μm). All pair tests of respective epithelium thickness metrics between the control and dry eye group show statistically significant difference (P < .05).Conclusions: This study, based on very user-friendly, novel AS-OCT imaging, indicates increased epithelial thickness in dry eyes. The ease of use and the improved predictability offered by AS-OCT epithelial imaging may be a significant clinical advantage. Augmented epithelial thickness in the suspect cases may be employed as an objective clinical indicator of dry eye.

Correlation of the Corneal Collagen Cross-Linking Demarcation Line Using Confocal Microscopy and Anterior Segment Optical Coherence Tomography in Keratoconic Patients – Corrected Proof

Purpose: To evaluate and compare the depth of the corneal stromal demarcation line after corneal collagen cross-linking (CXL) using 2 different methods: confocal microscopy and anterior segment optical coherence tomography (AS OCT).Design: Prospective,…

Performance of the Visual Field Index in Glaucoma Patients With Moderately Advanced Visual Field Loss – Corrected Proof

Purpose: To explore the relationship between the visual field index (VFI) and the visual field mean deviation (MD) in glaucoma patients with moderately advanced perimetric damage and to identify the magnitude of the boundary effect of VFI that occurred when the VFI estimation strategy changed from pattern deviation probability value to total deviation probability value as the MD crossed −20 dB in longitudinal visual field (VF) series.Design: A retrospective cohort study of longitudinal data analysis.Methods: The MD and VFI values obtained from VF tests conducted on 148 eyes of 148 glaucoma patients having an MD around −20 dB were studied. A total of 1286 VFs with MD values within the range of −16 dB to −24 dB were included. The eyes were divided into 2 groups, with the first having serial MDs all better than or all worse than −20 dB and the second with serial MDs crossing the −20 dB value. Change in MD (ΔMD) was defined as the absolute difference between the MD values of 2 consecutive VFs. Based on the 2 VFI values of the same VFs, the absolute value of change in VFI (ΔVFI) was calculated.Results: The means (± standard deviation) for the ΔVFI were 4.17% (± 3.3%) in the group of eyes with MDs on either side of −20 dB, and were 15.8% (± 8.4%) in the group with MDs crossing −20 dB (P < .0001). For ΔVFI/ΔMD, these values were 6.8%/dB (± 10.5%) when the range of MD falls on either side of −20 dB, and 7.9%/dB (± 6.2%) when the range of MD crosses the −20 dB values (P = .042).Conclusions: The values of the VFI become highly variable in serial VFs of eyes with MDs crossing −20 dB, in comparison to those VFIs associated with MDs on either side of −20 dB. The likelihood for this effect is the change from use of pattern deviation probability value to total deviation probability value in the points included in the calculation of VFI at −20 dB of MD. The development of indices to measure VF rates that are free from this boundary effect in moderately advanced glaucoma is desirable.

Dry Eye Disease and Work Productivity Loss in Visual Display Users: The Osaka Study – Accepted Manuscript

Abstract: Purpose: To estimate the impact of dry eye disease (DED) on work performance and productivity in office workers using visual display terminals (VDTs).Design: Cross-sectional study.Methods: Six hundred and seventy-two Japanese young and middle-aged office workers using VDTs completed questionnaire which was designed to measured at-work performance deficits and productivity losses using the Japanese version of the Work Limitations Questionnaire, completed by e-mail. Using the Japanese dry eye diagnostic criteria, respondents were classified into three groups: definite DED, probable DED, and non-DED.Results: Of the 672 office workers, 553 subjects (82.3%) including 366 men and 187 women completed the questionnaire and underwent clinical evaluation. As for the total workplace productivity loss, the non-DED group demonstrated a loss of 3.56%, those with probable DED, a loss of 4.06%, and those with definite DED, a loss of 4.82%, indicating significantly worse performance and productivity (trend test p=0.014). For the four subscales, DED was associated with significantly lower on-the-job time management (trend test p=0.009) and mental performance/interpersonal functioning (trend test p=0.011). After controlling for age, gender, VDT working hours, and diagnosis of DED, time management, physical demands, and mental/interpersonal functioning, showed a significant relationship to DED (each p>0.05). Annual DED productivity losses were estimated to be $6,160 per employee when measured by total production and $ 1,178 per employee calculated by wage.Conclusions: This study indicates that there is a significant impact of DED on the total productivity of Japanese visual display terminal users.

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We thank Dr Coroneo for the comments and interest in our article. We agree that if the posterior capsule is stained with trypan blue, completion of the surgery, although more difficult, can still be performed successfully, and we believe it is importan…

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…