Influence of Myopia on Size of Optic Nerve Head and Retinal Nerve Fiber Layer Thickness Measured by Spectral Domain Optical Coherence Tomography

PURPOSE: To investigate optic nerve head size and retinal nerve fiber layer (RNFL) thickness according to refractive status and axial length. METHODS: In a cross-sectional study, 252 eyes of 252 healthy volunteers underwent ocular biometry measurement as well as optic nerve head and RNFL imaging by spectral-domain optical coherence tomography. Correlation and linear regression analyses were performed for all subjects. The magnification effect was adjusted by the modified axial length method. RESULTS: Disc area and spherical equivalent were positively correlated (r = 0.225, r² = 0.051, p = 0.000). RNFL thickness showed significant correlations with spherical equivalent (r = 0.359, r² = 0.129, p = 0.000), axial length (r = -0.262, r² = 0.069, p = 0.000), disc radius (r = 0.359, r² = 0.129, p = 0.000), and radius of the scan circle (r = -0.262, r² = 0.069, p = 0.000). After adjustment for the magnification effect, those relationships were reversed; RNFL thickness showed negative correlation with spherical equivalent and disc radius, and positive correlation with axial length and radius of the scan circle. The distance between the disc margin and the scan circle was closely correlated with RNFL thickness (r = -0.359, r² = 0.129, p = 0.000), which showed a negative correlation with axial length (r = -0.262, r² = 0.069, p = 0.000). CONCLUSIONS: Optic disc radius and RNFL thickness decreased in more severely myopic eyes, but they increased after adjustment for magnification effect. The error due to the magnification effect and optic nerve head size difference might be factors that should be considered when interpreting optical coherence tomography results.

Research on the Quality of Life of Glaucoma Patients

PURPOSE: To compare subjective quality of life (QOL) of a glaucoma group with a control group. METHODS: The Korean version of the National Eye Institute Visual Function Questionnaire 25 (NEI-VFQ-25) was completed by 105 glaucoma clinic patients including 54 glaucoma group and 56 control group. We compared questionnaire scores and previous performed visual field parameters between a glaucoma group and a control group. RESULTS: The glaucoma group results were: Mean age: 55.73 +/- 15.17 years; mean best corrected visual acuity (BCVA; log MAR) 0.05 +/- 0.09 in better eyes and 0.06 +/- 0.09 in worse eyes; and mean intraocular pressure (IOP) 15.94 +/- 2.93 mm Hg in better eyes and 15.49 +/- 3.18 mm Hg in worse eyes. Control group scores were: Mean age: 51.85 +/- 11.36 years; mean BCVA (log MAR) 0.04 +/- 0.07 in better eyes and 0.06 +/- 0.08 in worse eyes; and mean IOP 16.40 +/- 2.50 mm Hg in better eyes and 16.13 +/- 2.16 mm Hg in worse eyes. Age, BCVA, and IOP were not significantly different between groups, but visual field index (VFI) score and visual function questionnaire (NEI-VFQ-25) total score were significantly lower in the glaucoma group (p < 0.01). Additionally, visual field parameters and QOL had a significant relationship in the glaucoma group, especially in better eyes. CONCLUSIONS: The QOL of glaucoma patients was lower than that of normal controls regardless of visual acuity. The degree of visual field loss in the better eye may affect QOL more significantly.

Research on the Quality of Life of Glaucoma Patients

PURPOSE: To compare subjective quality of life (QOL) of a glaucoma group with a control group. METHODS: The Korean version of the National Eye Institute Visual Function Questionnaire 25 (NEI-VFQ-25) was completed by 105 glaucoma clinic patients including 54 glaucoma group and 56 control group. We compared questionnaire scores and previous performed visual field parameters between a glaucoma group and a control group. RESULTS: The glaucoma group results were: Mean age: 55.73 +/- 15.17 years; mean best corrected visual acuity (BCVA; log MAR) 0.05 +/- 0.09 in better eyes and 0.06 +/- 0.09 in worse eyes; and mean intraocular pressure (IOP) 15.94 +/- 2.93 mm Hg in better eyes and 15.49 +/- 3.18 mm Hg in worse eyes. Control group scores were: Mean age: 51.85 +/- 11.36 years; mean BCVA (log MAR) 0.04 +/- 0.07 in better eyes and 0.06 +/- 0.08 in worse eyes; and mean IOP 16.40 +/- 2.50 mm Hg in better eyes and 16.13 +/- 2.16 mm Hg in worse eyes. Age, BCVA, and IOP were not significantly different between groups, but visual field index (VFI) score and visual function questionnaire (NEI-VFQ-25) total score were significantly lower in the glaucoma group (p < 0.01). Additionally, visual field parameters and QOL had a significant relationship in the glaucoma group, especially in better eyes. CONCLUSIONS: The QOL of glaucoma patients was lower than that of normal controls regardless of visual acuity. The degree of visual field loss in the better eye may affect QOL more significantly.

A Case of Retained Descemet's Membrane after Penetrating Keratoplasty

PURPOSE: To report a case of retained Descemet's membrane after penetrating keratoplasty (PKP). CASE SUMMARY: A 64-year-old man visited our clinic, complaining of visual disturbance and corneal opacity in his right eye 40 years in duration. On the first visit, his best corrected visual acuity was hand movement on the right eye, and he underwent an uneventful PKP. On the postoperative first day, the patient's visual acuity was 20/200 and slit lamp examination showed a retained Descemet's membrane and pseudo-chamber behind the corneal graft. The corneal graft was edematous, but no intraocular inflammation was observed. The retained Descemet's membrane was surgically removed a quarter at a time. Sutures in one quadrant were removed; the retained Descemet's membrane was lifted with forceps, removed with scissors and knife, and then sutured again. Two months after PKP, the corneal graft remained clear and no intraocular inflammation was observed. An extracapsular cataract extraction (ECCE) was then successfully performed with posterior chamber lens implantation for the senile cataract in his right eye. After the 1-year follow-up, the status of the corneal graft remained clear with a single anterior chamber and best corrected visual acuity improved to 20/100. CONCLUSIONS: Careful post-operative slit-lamp examination is considered important for diagnosis of retained Descemet's membrane after undergoing PKP, and surgical removal can be helpful for maintaining the corneal graft clear.

Clinical Course of Submacular Hemorrhage Due to Various Chorioretinal Diseases According to Pneumatic Displacement

PURPOSE: To assess the clinical course of submacular hemorrhage (SMH) due to various chorioretinal diseases with or without pneumatic displacement and the factors related with the final visual outcome. METHODS: The authors of the present study retrospectively reviewed the charts of 12 eyes (group 1) which underwent pneumatic displacement for SMH and the charts of 14 eyes (group 2) which did not receive pneumatic displacement. Best-corrected visual acuity (BCVA) at baseline was compared with the BCVA at 1, 3, and 6 months and on the final visit. Association between final BCVA and other clinical features was analyzed including age, baseline BCVA, duration of symptoms, and size of SMH. RESULTS: In group 1, log MAR BCVA was 1.22 +/- 0.66 at baseline and there was a significant BCVA improvement of 0.77 +/- 0.57 at 6 months compared with baseline (p = 0.045). On the final visit, 6 eyes (50%) had gained 2 Snellen lines or more. In group 2, BCVA was significantly improved from 1.29 +/- 0.70 at baseline to 1.06 +/- 0.84 at 1 month (p = 0.045). Ten eyes (71.4%) had gained 2 Snellen lines or more on the final visit. In group 1, there were no factors correlated with final BCVA (p > 0.05), while the final BCVA was significantly correlated with age and baseline BCVA in group 2. CONCLUSIONS: Clinicians may expect conservative treatment to lead to significant improvement of BCVA in patients with SMH due to various chorioretinal diseases who did not undergo any procedures to displace the hemorrhage.