Category: Peer-reviewed

Treatment Outcomes in Malignant Glaucoma

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Purpose:
To report treatment outcomes in malignant glaucoma.

Design:
Retrospective case series.

Participants:
Twenty-eight eyes of 26 patients who were treated for malignant glaucoma between 1991 and 2009.

Methods:
Malignant glaucoma was diagnosed based on the presence of a shallow or flat central and peripheral anterior chamber in the presence of patent iridotomy, with intraocular pressure (IOP) of 22 mmHg or more after any intraocular surgery. The treatment algorithm included antiglaucoma medications and cycloplegics as first-line methods; the second-line therapy in pseudophakic eyes was laser hyaloidotomy, followed by vitrectomy-hyaloidotomy-iridectomy (VHI) (Read more...)

Fuchs’ Endothelial Corneal Dystrophy: Subjective Grading versus Objective Grading Based on the Central-to-Peripheral Thickness Ratio

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Purpose:
To assess interobserver agreement between 2 corneal specialists grading Fuchs’ dystrophy clinically and to determine if the corneal central-to-peripheral thickness ratio (CPTR) may be an alternative and objective metric of disease severity.

Design:
Cross-sectional study.

Participants:
Forty-five eyes (26 subjects) with mild and moderate Fuchs’ dystrophy, 73 eyes (60 subjects) with advanced Fuchs’ dystrophy, and 267 eyes (142 subjects) with normal corneas.

Methods:
Corneas with Fuchs’ dystrophy were graded by 2 corneal specialists based on the confluence and area of guttae and the presence or absence of edema. Central (Read more...)

Functional Improvement after One- and Two-Eye Cataract Surgery in the Salisbury Eye Evaluation

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Purpose:
To determine the impact that cataract and cataract surgery have on clinical measurements of vision, reading speed, objective mobility performance, and subjective visual functioning.

Design:
Prospective, population-based study.

Participants:
A total of 1739 Salisbury Eye Evaluation (SEE) participants without previous cataract surgery with bilateral baseline best-corrected visual acuity (BCVA) of logarithm of the minimum angle of resolution (logMAR) ≤0.3 (≥20/40) or cataract surgery between rounds 1 and 2.

Methods:
Participants were categorized on the basis of cataract surgery by round 2 into no surgery, unilateral surgery, or bilateral surgery. (Read more...)

Seasonal Changes in Visual Field Sensitivity and Intraocular Pressure in the Ocular Hypertension Treatment Study

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Purpose:
Longitudinal testing plays a key role in glaucoma management. Variability between visits hampers the ability to monitor progression. It has previously been shown that average intraocular pressure (IOP) exhibits seasonal fluctuations. This study examines whether visual field sensitivity also exhibits seasonal fluctuations and seeks to determine whether such fluctuations are correlated to seasonal IOP effects.

Design:
Comparative case series.

Participants:
A total of 33 873 visits by 1636 participants enrolled in the Ocular Hypertension Treatment Study. Participants were split into 6 geographic zones according to the prevailing climate in (Read more...)

Progression of Intermediate Age-related Macular Degeneration with Proliferation and Inner Retinal Migration of Hyperreflective Foci

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Purpose:
Drusen and migrating retinal pigment epithelium have been associated with hyperreflective foci (HF) detected by spectral-domain optical coherence tomography (SD-OCT). This study sought to quantify the change in intraretinal HF distribution and its correlation with age-related macular degeneration (AMD) disease progression.

Design:
Prospective observational study from the multicenter Age-Related Eye Disease Study 2 (AREDS2) Ancillary SD-OCT Study.

Participants:
Patients (n=299) with 1 enrolled eye with intermediate AMD and baseline SD-OCT, followed by SD-OCT imaging at 1-year and 2-year visits.

Methods:
The number and location of HF were scored in (Read more...)

Spectral-Domain Optical Coherence Tomographic Assessment of Schlemm’s Canal in Chinese Subjects with Primary Open-angle Glaucoma

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Purpose:
To evaluate in vivo features of Schlemm’s canal (SC) in patients with primary open-angle glaucoma (POAG) with spectral-domain optical coherence tomography (SD-OCT) and to investigate the relationship of SC size with intraocular pressure (IOP) and glaucoma severity.

Design:
Prospective, comparative study.

Participants:
Fifty Chinese patients with newly diagnosed POAG who had not undergone surgery and 50 normal Chinese subjects from a population-based, cross-sectional study in Shanghai.

Methods:
All participants underwent SD-OCT. The diameter and area of SC were examined in the temporal and nasal sections and measured with customized (Read more...)

Comparison of Clinical Characteristics Between Korean and Western Normal-Tension Glaucoma Patients – Corrected Proof

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Purpose: To detect potential differences in the phenotypes between Western normal-tension glaucoma (NTG) and Korean NTG.Design: A retrospective, cross-sectional study.Methods: One hundred eighty-four NTG eyes of 71 patients of the Jules Stein Eye Institute, University of California, Los Angeles, and 113 patients of the Seoul National University Hospital, Seoul, Korea, were studied after reviewing medical charts retrospectively. All eligible patients from both institutions who were evaluated between July 2007 and June 2008 were included. The groups were matched for stage of glaucoma severity based on the visual field mean deviation value. All patients underwent a complete ophthalmic examination, Humphrey perimetry, Heidelberg Retina (Read more...)

Use of Corneal Power-Specific Constants to Improve the Accuracy of the SRK/T Formula

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Purpose:
To evaluate the effect of average corneal power (K) and axial length (AL) in a data-adjusted A-constant for improving the refractive outcome in the Sanders–Retzlaff–Kraff (SRK)/T formula.

Design:
Retrospective, consecutive, case series.

Participants:
A total of 637 patients (637 eyes) who underwent uncomplicated phacoemulsification with implantation of the Acrysof IQ (IQ; Alcon, Fort Worth, TX; 314 eyes) or Akreos AO (AO; Bausch & Lomb, Rochester, NY; 323 eyes) intraocular lens (IOL) by a single surgeon.

Methods:
The correlation among the K, AL, and predicted refractive error in the SRK/T (Read more...)

Angiographic and Optical Coherence Tomography Characteristics of Recent Myopic Choroidal Neovascularization – Corrected Proof

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Purpose: To analyze the contribution of fluorescein angiography (FA) and spectral-domain optical coherence tomography (SD OCT) to the diagnosis of recent choroidal neovascularization (CNV) associated with high myopia.Design: Retrospective, observational case series.Methods: Ninety eyes of 73 highly myopic patients (refractive error ≥−6 diopters) with CNV in 1 or both eyes were included. Epidemiologic features, refractive error, fundus examination, fluorescein angiography, and SD OCT findings at onset of CNV were analyzed.Results: Mean age at onset of CNV was 54.4 ± 14 years. CNV was bilateral in 17 of 73 cases. Mean refractive error was −13.9 ± 5.2 diopters. Myopic CNV was associated (Read more...)

High-Resolution Imaging of Retinal Nerve Fiber Bundles in Glaucoma Using Adaptive Optics Scanning Laser Ophthalmoscopy – Corrected Proof

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Purpose: To detect pathologic changes in retinal nerve fiber bundles in glaucomatous eyes seen on images obtained by adaptive optics (AO) scanning laser ophthalmoscopy (AO SLO).Design: Prospective cross-sectional study.Methods: Twenty-eight eyes of 28 patients with open-angle glaucoma and 21 normal eyes of 21 volunteer subjects underwent a full ophthalmologic examination, visual field testing using a Humphrey Field Analyzer, fundus photography, red-free SLO imaging, spectral-domain optical coherence tomography, and imaging with an original prototype AO SLO system.Results: The AO SLO images showed many hyperreflective bundles suggesting nerve fiber bundles. In glaucomatous eyes, the nerve fiber bundles were narrower than in normal (Read more...)

Scleral Necrosis after Plaque Radiotherapy of Uveal Melanoma: A Case-Control Study

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Purpose:
To identify risk factors and outcome of scleral necrosis after plaque radiotherapy of uveal melanoma.

Design:
Case-control study.

Participants:
A total of 73 cases with scleral necrosis and 73 controls without necrosis after plaque radiotherapy. Controls were matched for anteroposterior tumor epicenter and follow-up duration.

Intervention:
Plaque radiotherapy with iodine-125, cobalt-60, iridium-192, or ruthenium-106.

Main Outcome Measures:
Scleral necrosis.

Results:
Of 5057 patients treated with plaque radiotherapy for uveal melanoma, 73 (1%) developed radiotherapy-induced scleral necrosis. Scleral necrosis occurred in <1% of patients (3/1140) when plaque radiotherapy was used (Read more...)