ABSTRACT
Purpose@#To analyze topographic progression of geographic atrophy with different concentric circles centered on the fovea in correlation with decrease of visual acuity. @*Methods@#We retrospectively analyzed 36 eyes of 26 patients diagnosed with geographic atrophy and followed at least 1 year. One millimeter circular area at the foveal center were defined as zone 1, and doughnut shape areas from between 1 and 2 mm to between 5 and 6 mm were defined as zone 2 to 6. Then, changes of geographic atrophy area in each zone were measured with semi-automatic software. Correlation analysis and regression analysis were performed to determine the relationship between changes in visual acuity and atrophic area in each zone. @*Results@#Mean age was 76.9 years and follow-up period were 3.38 years. The mean atrophic area increased from 8.09 to 16.34 mm2 and visual acuity decreased from 0.39 to 0.69 on logarithm of the minimal angle of resolution. Mean change of total geographic atrophy area was not significantly correlated with visual acuity decrease. While geographic atrophy progression within zone 1, 2, and 3 showed significant causal relationship with decrease of visual acuity (all, p < 0.05). @*Conclusions@#In contrast to the total geographic atrophy area, progression of geographic atrophy in parafoveal area was significantly correlated with decrease of visual acuity.
ABSTRACT
PURPOSE: We evaluated the surgical prognoses of patients with advanced cataract who were unable to be evaluated by fundus imaging and their satisfaction with daily life.METHODS: We retrospectively reviewed 748 eyes of 480 patients who underwent cataract surgery from January 2015 to December 2017. Preoperative factors, surgical technique, degree of cataract, and the best-corrected visual acuity for 1 and 6 months after surgery were analyzed. Among 91 eyes of 78 patients with advanced cataract who were unable to be evaluated by fundus imaging, the degree of discomfort before surgery and postoperative satisfaction were evaluated.RESULTS: Hypertension was positively correlated with visual acuity after cataract surgery (p = 0.004). Low corneal endothelial cell count, primary open-angle glaucoma, a history of trabeculectomy due to glaucoma, corneal dystrophy or corneal opacity, advanced cataract unable to be evaluated by fundus imaging, hypermature cataract, extracapsular cataract extraction, and intracapsular cataract extraction and visual acuity <0.5 after 1 month showed negative correlations with the visual outcomes after 6 months (p = 0.019, p = 0.002, p = 0.037, p = 0.001, p = 0.004, p = 0.012, p = 0.00, and p = 0.00, respectively). The risk of a final visual acuity <0.5 after cataract surgery was 3.18-fold higher in cases of advanced cataract, unable to be evaluated by fundus imaging (p = 0.003). Ten patients with 10 eyes postponed surgery due to poor prognoses, which was expected, and six patients (60%) had a best-corrected visual acuity <0.5 after 6 months. Six patients (60%), expected to have a poor prognosis were satisfied after surgery and the postoperative satisfaction was high when compared with a poor visual outcome.CONCLUSIONS: Poor surgical prognoses were expected in advanced cataract patients unable to be evaluated by fundus imaging. However, advanced cataract patients, who postponed surgery due to an unfavorable visual prognosis, showed a higher subjective satisfaction when compared with the postoperative visual acuity.