The Structure-function Relationships between Two Different Optical Coherence Tomography in Patients with High Myopic Glaucoma

Purpose@#To evaluate the structure-function relationships between swept-source optical coherence tomography (SS-OCT) and spectral-domain optical coherence tomography (SD-OCT) in glaucoma patients with high myopia. @*Methods@#Forty-three eyes with high-myopia (axial length over 28 mm) and 30 with emmetropia (axial length 21 to 24 mm) of patients with preperimetric glaucoma and primary open-angle glaucoma were retrospectively enrolled. Visual field (VF) sensitivity and mean deviation were evaluated via standard automated perimetry. Peripapillary retinal nerve fiber layer (RNFL) thickness was measured using SD-OCT and SS-OCT. The topographic relationships between structure and function were investigated. @*Results@#In the high myopia group, the average (p 0.05). The emmetropic group exhibited a significant correlation between the average RNFL thickness, and the MS and VF mean deviation (MD) using SS-OCT (both p ≤ 0.001). The average RNFL thickness correlated significantly with the MD using SD-OCT (p = 0.036). In emmetropia patients, the superotemporal, inferotemporal, superonasal, and inferonasal RNFL thicknesses correlated with the corresponding VF sensitivities using both SS-OCT and SD-OCT (all p < 0.05). @*Conclusions@#SS-OCT assessed structure-function relationships more accurately than did SD-OCT in glaucoma patients with high myopia.

The Structure-function Relationships between Two Different Optical Coherence Tomography in Patients with High Myopic Glaucoma

Purpose@#To evaluate the structure-function relationships between swept-source optical coherence tomography (SS-OCT) and spectral-domain optical coherence tomography (SD-OCT) in glaucoma patients with high myopia. @*Methods@#Forty-three eyes with high-myopia (axial length over 28 mm) and 30 with emmetropia (axial length 21 to 24 mm) of patients with preperimetric glaucoma and primary open-angle glaucoma were retrospectively enrolled. Visual field (VF) sensitivity and mean deviation were evaluated via standard automated perimetry. Peripapillary retinal nerve fiber layer (RNFL) thickness was measured using SD-OCT and SS-OCT. The topographic relationships between structure and function were investigated. @*Results@#In the high myopia group, the average (p 0.05). The emmetropic group exhibited a significant correlation between the average RNFL thickness, and the MS and VF mean deviation (MD) using SS-OCT (both p ≤ 0.001). The average RNFL thickness correlated significantly with the MD using SD-OCT (p = 0.036). In emmetropia patients, the superotemporal, inferotemporal, superonasal, and inferonasal RNFL thicknesses correlated with the corresponding VF sensitivities using both SS-OCT and SD-OCT (all p < 0.05). @*Conclusions@#SS-OCT assessed structure-function relationships more accurately than did SD-OCT in glaucoma patients with high myopia.

Bilateral Central Retinal Vein Occlusion in Patient with Disseminated Intravascular Coagulation

PURPOSE: To report a case of bilateral central retinal vein occlusion (CRVO) as one of the initial signs of disseminated intravascular coagulation (DIC). CASE SUMMARY: A 33-year-old woman with a history of pregnancy-induced thrombotic thrombocytopenic purpura presented to our hospital with bilateral visual loss. On her initial visit, visual acuity was counting fingers at 30 cm in both eyes. Based on the findings of a funduscopic examination, the patient was diagnosed with bilateral CRVO. Laboratory tests confirmed the diagnosis of DIC combined with thrombotic thrombocytopenic purpura (TTP). Plasma exchange and transfusion of cryoprecipitate with fresh frozen plasma was performed. The ocular fundus findings did not improve. Despite medical treatment, the patient's systemic condition deteriorated and she died of metabolic acidosis two weeks later. CONCLUSIONS: Bilateral central retinal vein occlusion occurred as a sign of aggravation of preexisting TTP and progression to DIC in the presented case. In patients with severe bilateral retinal venous changes, there should be a very high level of suspicion for presence or progression of systemic disease, with the possibility of effective early systemic evaluation and therapy.

Combined Clear Corneal Phacoemulsification and Vitrectomy Versus Two-Step Surgery in Korean Patients With Idiopathic Epiretinal Membrane

PURPOSE: To evaluate the surgical outcomes on the combined procedures of phacoemulsification, intraocular lens (IOL) implantation, and vitrectomy, and to compare clinical results with sequential surgery results in Korean patients with idiopathic epiretinal membrane. METHODS: The present retrospective study included 20 eyes of 19 patients with idiopathic epiretinal membrane who underwent combined phacoemulsification, IOL implantation, and pars plana vitrectomy (combined surgery), and 18 eyes of 18 patients who underwent phacoemulsification and IOL implantation subsequent to vitrectomy (sequential surgery). Postoperative clinical results and intra- and postoperative complications were compared between the 2 groups. RESULTS: Postoperative best corrected visual acuity (BCVA) (logMAR) was 0.41 +/- 0.42 in the combined group, and 0.35 +/- 0.37 in the sequential group. There was no significant difference in BCVA between the 2 groups (p = 0.675). The mean refractive prediction error was -0.46 +/- 0.88 diopters (D) in the combined group, and -0.06 +/- 0.68 D in the sequential group, showing no statistically significant difference between the 2 groups (p = 0.147). The present study showed no major differences between the 2 groups in complications such as intraoperative mild corneal edema, postoperative ocular hypertension, and lens capsular opacity. CONCLUSIONS: Combined phacoemulsification, IOL implantation, and pars plana vitrectomy as well as the two-step procedure are safe and effective for treating patients with idiopathic epiretinal membrane.

Comparison of Outcomes of Femtosecond Laser-assisted Keratoplasty and Conventional Penetrating Keratoplasty

PURPOSE: To compare the outcomes of IntraLase femtosecond laser-enabled keratoplasty (IEK) versus conventional penetrating keratoplasty (C-PKP). METHODS: This retrospective study included 18 eyes of 17 patients who underwent C-PKP and 26 eyes of 25 patients who underwent IEK. Postoperative clinical results were compared between two groups. RESULTS: The mean logMAR best spectacle-corrected visual acuity (BSCVA) was 0.70, 0.58, and 0.61 in the IEK group, and 1.06, 1.01, and 0.90 in the C-PKP group at postoperative 2, 4, and 6 months respectively. The difference between the two groups was statistically significant at 2 and 4 months postoperatively (p=0.033, 0.011). The mean refractive cylinder was 4.08 diopters (D), 4.01D, and 4.44D in the IEK group, while 5.75D, 5.75D, and 5.21D in the C-PKP group for each month, and the difference between the groups was statistically significant at 2 and 4 months postoperatively (p=0.037, 0.027). The complication rate showed no significant differences up to 6 months of follow-up between the two groups. CONCLUSIONS: The IEK showed better results in BSCVA and refractive astigmatism in the early postoperative period, in comparison with the C-PKP, and can be considered as a valuable method in penetrating keratoplasty.

Clinical Results of Cataract Surgery in Nanophthalmic Eyes

PURPOSE: To evaluate the outcomes in patients with nanophthalmos that had phacoemulsification and intraocular lens (IOL) implantation. METHODS: This retrospective study included 13 eyes of eight patients with nanophthalmos who had phacoemulsification with IOL implantation: Preoperative and postoperative manifest refraction, best-spectacle corrected visual acuity (BSCVA), preoperative axial length, anterior chamber depth, corneal diameter, manual keratometry, intraocular pressure (IOP), and postoperative complications were analyzed. RESULTS: Eight patients (13 eyes) had phacoemulsification with IOL implantation, 11 eyes by posterior chamber IOL implantation, and two eyes by ciliary sulcus fixation. The mean change in visual acuity from preoperative to postoperative was 2.1+/-2.0 lines. IOP was well controlled postoperatively, but one eye required a trabeculectomy. No patients required partial sclerotomy during the operation. Choroidal effusions or choroidal detachment was not observed intraoperatively or postoperatively. The mean endothelial cell loss was 12.6+/-17.7% at two months postoperative. CONCLUSIONS: The results of phacoemulsification and IOL implantation through clear corneal incision in nanophthalmic patients are encouraging. Most patients showed improved visual acuity without severe complications.