ABSTRACT
Purpose@#To assess the impact of cataract on optic nerve head (ONH) parameters (disc area, rim area, average cup/disc ratio, vertical cup/disc ratio, cup volume), peripapillary retinal nerve fiber layer (pRNFL) thickness, and macular ganglion cell-inner plexiform layer (mGC-IPL) thickness in patients with glaucoma and in a control group. @*Methods@#A retrospective analysis was conducted on medical records from January to December 2021 for individuals undergoing cataract surgery. This group included normal, glaucoma suspects, and glaucoma patients, totaling 44 individuals and 63 eyes. Measurements of ONH parameters, pRNFL thickness, and mGC-IPL thickness were taken using spectral-domain optical coherence tomography before and after surgery. We analyzed postoperative changes in these parameters and related factors to preoperative segmentation errors. @*Results@#In glaucoma patients, a significant increase in the average thickness of the pRNFL (p = 0.002) was observed after surgery, while no significant changes were seen in ONH parameters and the average thickness of the mGC-IPL (all p > 0.05). Conversely, the control group showed an increase in some areas of mGC-IPL thickness after surgery (p < 0.05). Multivariate regression analysis indicated that in glaucoma patients, thinner preoperative pRNFL and mGC-IPL thickness were predictors of increased average thickness after surgery (p < 0.001 and p = 0.008, respectively). @*Conclusions@#Cataract significantly impacts the pRNFL and mGC-IPL thickness in glaucoma patients, with less effect on ONH parameters. These findings suggest that ONH parameters can be more reliable for monitoring patients undergoing cataract surgery and assessing glaucoma progression simultaneously.
ABSTRACT
Purpose@#This study investigated the causative microorganisms, antibiotic susceptibility, and risk factors of infectious keratitis over the past 10 years. @*Methods@#Data from patients with infectious keratitis who underwent microbial culture tests from 2012 to 2021, obtained from anonymized data systems, were analyzed. Microbial culture results and antibiotic susceptibility profiles were examined. A retrospective analysis of the medical records of patients with infectious keratitis during the same period was conducted to investigate the clinical characteristics and risk factors. @*Results@#Data from 1,837 cases of infectious keratitis were extracted from anonymized records. The culture positive rate among patients was 46.0% (1,137/2,474), with coagulase-negative Staphylococcus (CoNS) being the most common causative organism (27.8%). Increased resistance to cefazolin and cefotaxime was observed in gram-negative bacteria, while there were no significant temporal changes in quinolone resistance in gram-positive or negative bacteria. A retrospective medical record analysis of 288 cases revealed that older patients, as well as those with an initial corrected visual acuity < 0.1, a history of ocular surgery, pre-existing ocular conditions, prior steroid eye drops, or glaucoma eye drops, had significantly higher rates of culture positivity. Multivariate analysis identified risk factors for severe keratitis requiring surgical intervention as a symptom-to-presentation period of 7 days or longer (p = 0.048) and pre-existing ocular conditions (p = 0.040). @*Conclusions@#CoNS was the most common microorganism causing infectious keratitis over the past decade. There has been an increase in resistance to cephalosporin antibiotics among gram-negative bacteria. Patients with pre-existing ocular conditions may require surgical intervention, so infectious keratitis in these patients requires greater attention.
ABSTRACT
Purpose@#In the present study, we introduce human lacrimal gland imaging using an ultrasound biomicroscopy (UBM) with a soft cover and show their findings @*Methods@#The representative UBM findings of palpebral lobes in seven subjects (four with non-Sjögren dry eye syndrome, one with Sjögren syndrome, and two healthy subjects) were described in this study. To prolapse the palpebral lobe, the examiner pulled the temporal part of the upper eyelid in the superotemporal direction and directed the subject to look in the inferonasal direction. We scanned the palpebral lobes longitudinally and transversely using UBM. We used an Aviso UBM with a 50 MHz linear probe and ClearScan. @*Results@#In UBM of two healthy subjects, the echogenicity of the lacrimal gland was lower than that of the sclera and homogeneous. But the parenchyma of a patient with Sjögren dry eye syndrome was quite inhomogeneous compared to the healthy subjects. In two patients with dry eye syndrome, we were able to observe some lobules in the parenchyma. We could find excretory ducts running parallel at the surface of the longitudinal section in some subjects. In the longitudinal UBM scan of a subject, we observed a tubular structure at a depth of 1,500 μm that was considered a blood vessel. It ran from the superonasal to the inferotemporal direction. In a subject, we observed a large cyst beneath the conjunctiva. @*Conclusions@#Lacrimal gland imaging using UBM has both advantages of optical coherence tomography and sonography, and could be useful for evaluating dry eye syndrome.