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Purpose@#To assess the association between the choroidal vascularity index (CVI) and prelaminar tissue thickness (PTT) in healthy and glaucomatous eyes. @*Methods@#The study included 86 eyes with perimetric glaucoma (PG), 86 with pre‐perimetric glaucoma (PPG), and 43 agematched healthy eyes. Total choroidal area (TCA) and CVI were measured by image binarization of spectral‐domain optical coherence tomography (SD‐OCT) 3.5 mm from the center of Bruch’s membrane opening. The CVI was the percentage of choroidal vasculature to choroidal tissue. The association between CVI and PTT measured on a center‐horizontal scan of enhanced depth imaging SD‐OCT was assessed. @*Results@#The CVI was lowest in PG (61.67% ± 4.11%), followed by PPG (63.36% ± 3.54%), and healthy (64.84% ± 3.13%) eyes (p < 0.001). PG (102.05 ± 44.01 μm) had a significantly thinner PTT than PPG (106.16 ± 38.03 μm) and the healthy (154.98 ± 79.46 μm) eyes (p < 0.001). In a multivariate regression analysis, CVI was associated with PTT and TCA in all subjects, including healthy and glaucomatous eyes (p < 0.05). @*Conclusions@#The CVI and PTT had significantly lower values in glaucomatous eyes than in healthy eyes, and the two parameters were positively associated in all subjects, including healthy and glaucomatous eyes.
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Purpose@#To investigate the use of second AREDS2 formula in patients with intermediate or advanced age-related macular degeneration. @*Methods@#A prospective survey was conducted between December 2019 and July 2020. The questionnaire consisted of 24 questions on demographics, disease perception, and formula intake. @*Results@#The survey included 100 patients (males, 56%; age [>60 years], 89%). We found that 66%, 84%, and 93% of patients had a good understanding of their disease, had stopped smoking, and were aware of the need for antioxidant supplements; 58% of patients were aware of the supplement they were prescribed, and 63.8% (37% of total) were using the AREDS2 formula. Only 8% of patients had knowledge regarding the supplement ingredients, and 91% consumed the supplement daily. Patients with long disease duration used supplements less frequently (p < 0.05). Older patients and those with a low education level had a limited perception of the disease (p < 0.05). @*Conclusions@#In this prospective survey, some patients consumed supplements other than the AREDS2 formula. Further studies are required to determine ways to increase the use of the AREDS2 formula.
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Purpose@#This study compared the contrast sensitivity before and after surgery for intermittent exotropia and consecutive esotropia and examined the correlation between contrast sensitivity and other visual function factors. @*Methods@#The medical records of patients who underwent surgery for consecutive esotropia after surgery for intermittent exotropia were analyzed retrospectively. To analyze changes after each surgery, contrast sensitivity was tested before surgery for exotropia, before surgery for consecutive esotropia, and 3 months after surgery for consecutive esotropia. The changes in contrast sensitivity were analyzed, and correlation analyses between contrast sensitivity and the Titmus test and Worth 4 Dot (W4D) test were performed. @*Results@#The study included 14 patients. In consecutive esotropia, the contrast sensitivity was significantly improved at 7.1 and 10.2 cycles per degree (cpd) under mesopic conditions in the presence of glare and at 10.2 cpd under photopic conditions with and without glare after esotropia surgery (p < 0.05). There was a significant negative correlation between contrast sensitivity and stereopsis at 1.1 cpd under photopic conditions without glare before esotropia surgery (p = 0.011). Comparing the contrast sensitivity according to the W4D results, the fusion group had significantly better contrast sensitivity than the non-fusion group at 10.2 cpd under photopic conditions without glare and 2.9, 4.5, and 7.1 cpd with glare before exotropia surgery (p < 0.05). @*Conclusions@#The contrast sensitivity at high spatial frequencies improved after surgery for consecutive esotropia and there was a significant negative correlation between the contrast sensitivity and stereopsis in consecutive esotropia. This means that in patients with esotropia, the contrast sensitivity test is an indirect indicator of visual function.
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Purpose@#This study compared the contrast sensitivity before and after surgery for intermittent exotropia and consecutive esotropia and examined the correlation between contrast sensitivity and other visual function factors. @*Methods@#The medical records of patients who underwent surgery for consecutive esotropia after surgery for intermittent exotropia were analyzed retrospectively. To analyze changes after each surgery, contrast sensitivity was tested before surgery for exotropia, before surgery for consecutive esotropia, and 3 months after surgery for consecutive esotropia. The changes in contrast sensitivity were analyzed, and correlation analyses between contrast sensitivity and the Titmus test and Worth 4 Dot (W4D) test were performed. @*Results@#The study included 14 patients. In consecutive esotropia, the contrast sensitivity was significantly improved at 7.1 and 10.2 cycles per degree (cpd) under mesopic conditions in the presence of glare and at 10.2 cpd under photopic conditions with and without glare after esotropia surgery (p < 0.05). There was a significant negative correlation between contrast sensitivity and stereopsis at 1.1 cpd under photopic conditions without glare before esotropia surgery (p = 0.011). Comparing the contrast sensitivity according to the W4D results, the fusion group had significantly better contrast sensitivity than the non-fusion group at 10.2 cpd under photopic conditions without glare and 2.9, 4.5, and 7.1 cpd with glare before exotropia surgery (p < 0.05). @*Conclusions@#The contrast sensitivity at high spatial frequencies improved after surgery for consecutive esotropia and there was a significant negative correlation between the contrast sensitivity and stereopsis in consecutive esotropia. This means that in patients with esotropia, the contrast sensitivity test is an indirect indicator of visual function.
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Purpose@#To report a case of carotid-cavernous fistula associated with superior ophthalmic vein thrombosis which was misdiagnosedas orbital cellulitis.Case summary: A 72-year-old female was transferred to our hospital because she had been diagnosed with orbital cellulitis atanother hospital due to pain, swelling, and redness of the left eye, which became increasingly severe 3 days prior to her visit. Thepatient had edema and ptosis of the left eyelid, severe chemosis, and congestion of the conjunctiva. The eye movement testshowed limitations in abduction, adduction, and infraduction of the left eye, and the patient complained of diplopia. Paranasal sinuscomputed tomography showed an edema of the left upper eyelid, enlargement of the extraocular muscles, and dilation andthrombosis of the superior ophthalmic vein. On brain magnetic resonance imaging and magnetic resonance angiography, leftcarotid-cavernous fistula was suspected, so she was transferred to neurosurgery and a cerebral angiography was performed.Cerebral angiography showed an indirect carotid-cavernous fistula on the ipsilateral side and a direct carotid-cavernous fistulaon the opposite side. The patient underwent embolization and stenting. Seven days after surgery, the eyelid and conjunctivalswelling and diplopia disappeared and there was no limitation of eye movement in any direction. @*Conclusions@#An infectious disease such as orbital cellulitis is the most common cause of superior ophthalmic vein thrombosis.However, as in this patient, carotid-cavernous fistula can be the cause, so thorough imaging is important for rapid improvementof symptoms.
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PURPOSE: To report a case of iridocorneal endothelial syndrome, which overlapped with some of the features of posterior polymorphous corneal dystrophy. CASE SUMMARY: A 61-year-old female presented with tearing pain and blurred vision in her left eye, which was aggravated in the morning. The symptom started approximately 1 year prior to her visit. At the initial visit, the visual acuities were 1.0 in both eyes and the intraocular pressures were normal. On slit-lamp examination, a single pair of horizontal parallel lines was observed at the central corneal endothelial layer in the right eye. In contrast, multiple pairs of oblique parallel lines were observed in the left eye. The lines of the lesions were more prominent and wavier in the left eye than those of the right eye. The overlying cornea was clear, and the corneal thicknesses were in the normal range in both eyes. Using a gonioscopic examination, localized peripheral anterior synechiae were observed only in the left eye. The pupil and iris were normal in both eyes. On specular microscopic examination, the corneal endothelial cell size in the right eye increased and the corneal endothelial density decreased to 668 cells/mm². In the left eye, multiple abnormal endothelial cells with dark-light reversal were observed. In conclusion, the patient was subsequently diagnosed with iridocorneal syndrome, rather than posterior polymorphous corneal dystrophy. CONCLUSIONS: Posterior polymorphous corneal dystrophy and iridocorneal endothelial syndrome may present with many similarities. Therefore, in cases of uncertain diagnosis, an understanding of the clinical features is important for proper diagnosis.