Characteristic Findings of Optical Coherence Tomography in Retinal Angiomatous Proliferation

PURPOSE: To identify the unique pathologic findings of retinal angiomatous proliferation (RAP) in optical coherence tomography (OCT). METHODS: Retrospectively, 29 eyes of 25 patients with age-related macular degeneration and complicated RAP were analyzed. All 29 eyes had choroidal neovascularization (CNV) in the area of pigment epithelial detachment (PED) or adjacent to it, which was visible with fluorescein angiography or indocyanine green angiography. Cross-sectional images were obtained by OCT scanning through the CNV lesions. RESULTS: Six distinctive findings of OCT included drusen (100%), inner retinal cyst (80%), outer retinal cyst (68%), fibrovascular PED (84%), serous retinal detachment (40%), and PED (68%). CONCLUSIONS: Through analysis of OCT findings, we revealed six different types of lesions distinctive of RAP which may provide helpful diagnostic information for subsequent treatment and predicting the prognosis of RAP.

Comparison of Two Doses of IVB and Prognostic Factor on Myopic CNV : 1-Year Outcome

PURPOSE: To compare the efficacy of 3 consecutive monthly intravitreal bevacizumab (IVB) injections (fixed regimen group) with a single IVB injection (PRN group) on patients with myopic choroidal neovascularization (CNV) and to determine the prognostic factors associated with IVB injection outcomes. METHODS: 23 Twenty-three eyes in 21 patients with myopic CNV (14 eyes in the fixed regimen group and 9 eyes in the PRN group) treated with IVB were studied retrospectively. Best corrected visual acuity (BCVA), central macular thickness (CMT), the size of CNV prior to the initial IVB injection, CMT at the completion of treatment, and the number of IVB injections during the study period was measured. RESULTS: IVB resulted in improved BCVA and decreased CMT in both groups, and the differences before and after IVB injections were significantly correlated. Average injection time in the fixed regimen group and PRN group was 3.4 +/- 0.9 and 1.5 +/- 0.7 respectively, and was not statistically significant (p = 0.16). Differences between the groups in BCVA (p = 0.83) and CMT (p = 0.38) were not significantly correlated. Among the variables measured prior to IVB injection that affected final BCVA was age (p = 0.01). CONCLUSIONS: In the present study, a single injection of IVB compared to 3 consecutive IVB injections in patients with myopic CNV resulted in similar outcomes. In the future, these results can be considered as a reference when designing treatments for myopic CNV patients.

Comparison of Two Doses of IVB and Prognostic Factor on Myopic CNV : 1-Year Outcome

PURPOSE: To compare the efficacy of 3 consecutive monthly intravitreal bevacizumab (IVB) injections (fixed regimen group) with a single IVB injection (PRN group) on patients with myopic choroidal neovascularization (CNV) and to determine the prognostic factors associated with IVB injection outcomes. METHODS: 23 Twenty-three eyes in 21 patients with myopic CNV (14 eyes in the fixed regimen group and 9 eyes in the PRN group) treated with IVB were studied retrospectively. Best corrected visual acuity (BCVA), central macular thickness (CMT), the size of CNV prior to the initial IVB injection, CMT at the completion of treatment, and the number of IVB injections during the study period was measured. RESULTS: IVB resulted in improved BCVA and decreased CMT in both groups, and the differences before and after IVB injections were significantly correlated. Average injection time in the fixed regimen group and PRN group was 3.4 +/- 0.9 and 1.5 +/- 0.7 respectively, and was not statistically significant (p = 0.16). Differences between the groups in BCVA (p = 0.83) and CMT (p = 0.38) were not significantly correlated. Among the variables measured prior to IVB injection that affected final BCVA was age (p = 0.01). CONCLUSIONS: In the present study, a single injection of IVB compared to 3 consecutive IVB injections in patients with myopic CNV resulted in similar outcomes. In the future, these results can be considered as a reference when designing treatments for myopic CNV patients.

Frequency and Characteristic Findings of the Common Canaliculus in Koreans

PURPOSE: To investigate the different types of anatomical connection between the lacrimal sac and the canaliculi using digital subtraction dacryocystography (DCG) in Koreans. METHODS: The authors of the present study performed digital subtraction DCG in Korean patients who presented with epiphora from January 2010 until December 2010. The 248 patients (496 eyes) who achieved a satisfactory DCG image were classified as follows: 1) type I: visible common canaliculus (CC), 2) type II: no visible CC and the canaliculi entering the sac at the point where they meet on the sac wall (common opening), 3) type III: no visible CC and common opening, and each canaliculus entering the sac from different points. RESULTS: Out of a total of 496 eyes, CC was observed in 449 eyes (type I: 90.5%). In 41 eyes (8.3%), the CC was absent (type II), but the upper and lower canaliculi joined at the wall of the lacrimal sac. In 6 eyes (1.2%), the upper and lower canaliculi entered the sac separately (type III). Eighteen patients (7.3%) showed different types of lacrimal drainage system between the 2 eyes. CONCLUSIONS: The CC may not exist in all patients, and the type of anatomical connection between the lacrimal sac and the canaliculi may be different between the eyes in the same individuals. Although such patients comprise a minority, anatomical knowledge of the lacrimal drainage system could be helpful to assess and manage patients with lacrimal drainage disorder.

Attempts to Reduce the Progression of Myopia and Spectacle Prescriptions during Childhood: A Survey of Eye Specialists

PURPOSE: To determine methods tried in clinical trials to reduce the progression of myopia in children, and spectacle prescribing patterns of hospital ophthalmologists. METHODS: A multi-sectioned survey composed of Likert items relating to the methods of reducing myopia progression (orthokeratology lenses [O-K lenses], undercorrected glasses, and topical atropine) and the patterns of prescribing spectacles for children (including two cases involving a 5-year-old girl and an 8-year-old boy) were distributed to members of the Korean Ophthalmological Society, and the collected data was statistically analyzed. RESULTS: A total of 78 out of 130 ophthalmologists returned the survey. On a scale of 1 to 5, the mean rates of whether the ophthalmologists think O-K lenses arrest myopia progression, and whether they recommend their patients to wear O-K lenses if indicative, were 3.06 and 2.75, respectively. Moreover, the mean rates of whether they consider that wearing glasses which are undercorrected would slow down the progression of the myopia, or if they think topical atropine helps in arresting myopia progression in children, were 2.34 and 1.27, respectively. In response to the case studies, the majority of practitioners preferred to prescribe the full amount found in cycloplegic refraction to pediatric patients with myopia. CONCLUSIONS: Ophthalmologists in clinical practice encouraged children to wear O-K lenses more than undercorrected glasses as a way to retard myopia progression. However, the application of atropine is rarely tried in clinical trials. In managing pediatric patients with myopia (case specific), the majority of the practitioners chose to prescribe glasses with full cycloplegic correction.