Symmetry of Peripapillary-Optical Coherence Tomography Angiography Parameters between Dominant and Non-dominant Eyes in Normal Eyes

Purpose@#To assess whether optical coherence tomography (OCT) measurements and peripapillary microvascular parameters measured via optical coherence tomography angiography (OCTA) were similar between the dominant and non-dominant eyes of normal subjects. @*Methods@#We retrospectively analyzed spectral domain OCT and OCTA data on healthy Koreans. The “hole-in-the-card” technique was used to determine ocular dominance. The perfusion density (PD) and flux index (FI) of the peripapillary 4.5 × 4.5-mm area were measured via OCTA. Central macular, peripapillary retinal nerve fiber layer, and macular ganglion cell-inner plexiform layer thicknesses were measured with the aid of spectral-domain OCT. The OCT and OCTA data of dominant and non-dominant eyes were compared. @*Results@#A total of 84 eyes of 42 healthy subjects were analyzed. The average age was 27.3 ± 5.63 years. Twenty-eight subjects (66.7%) were right eye-dominant and 14 (33.3%) left eye-dominant. None of the central macular (260.00 ± 14.16 μm, 258.71 ± 15.18 μm, p = 0.183), macular ganglion cell-inner plexiform layer (82.02 ± 5.07 μm, 82.43 ± 5.60 μm, p = 0.460), or peripapillary retinal nerve fiber layer thickness (99.36 ± 9.27 μm, 97.90 ± 9.46 μm, p = 0.091) differed between the eyes; neither did any OCTA-assessed microvascular parameter. @*Conclusions@#No OCT or OCTA parameter differed between dominant and non-dominant eyes. No parameter identified ocular dominance.

Symmetry of Optical Coherence Tomography Angiography Parameters between Dominant and Non-dominant Eyes in Healthy Koreans

Purpose@#To assess the symmetry of microvascular parameters measured via optical coherence tomography angiography (OCTA) between the dominant and non-dominant eyes of normal Korean subjects. @*Methods@#We retrospectively analyzed data on 120 eyes of 60 healthy Koreans. The ‘hole-in-the-card’ technique was used to determine ocular dominance. Central macular, peripapillary retinal nerve fiber layer thickness, and macular ganglion cell-inner plexiform layer thickness, were measured via spectral domain OCT. Vessel and perfusion density and the area of the foveal avascular zone (FAZ) were measured via OCTA. We used the paired t-test to compare all between-eye parameters. We calculated areas under receiver operating characteristic curves to determine diagnostic utility. @*Results@#The average participant age was 27.4 ± 2.01 years. Forty-one subjects (68.3%) were right eye-dominant and 19 (31.7%) left eye-dominant. None of the central macular, macular GC-IPL, or peripapillary RNFL thickness differed between the eyes; neither did any OCTA-assessed microvascular parameter (vessel or perfusion density or the FAZ area). @*Conclusions@#No OCT or OCTA parameter differed between dominant and non-dominant eyes. No parameter identified ocular dominance.

Interocular Symmetry of Optical Coherence Tomography Angiography Parameters in Normal Eyes of Korean Adults

PURPOSE: To evaluate the interocular symmetry of microvascular parameters measured by optical coherence tomography angiography (OCTA) in normal eyes of Korean adults. METHODS: We retrospectively reviewed the retinal microvascular structure of 91 healthy Korean subjects (182 eyes). We used OCTA to measure the area of the foveal avascular zone (FAZ), vessel density (VD), and perfusion density (PD) in both eyes. Intraclass correlation coefficients (ICCs), coefficients of variation (CVs), and Pearson correlation coefficients were calculated to evaluate the extent of agreement and correlations between binocular OCTA measurements. RESULTS: Both eyes had similar microvascular characteristics: FAZ area (right eye: 0.31 ± 0.11 mm², left eye: 0.30 ± 0.10 mm², p = 0.98), FAZ perimeter (right eye: 2.35 ± 0.45 mm, left eye: 2.36 ± 0.39 mm, p = 0.86). VD 1-mm center (right eye: 9.42 ± 2.75, left eye: 9.14 ± 2.96, p = 0.163), full area (right eye: 19.94 ± 1.65, left eye: 19.72 ± 1.76, p = 0.285), and PD 1-mm center (right eye: 0.16 ± 0.05, left eye: 0.16 ± 0.05, p = 0.151), full area (right eye: 0.36 ± 0.03, left eye: 0.36 ± 0.04, p = 0.716). All ICC values were above 0.8 and all CVs below 10%. CONCLUSIONS: The microvascular structure, as represented by the VD, PD, and FAZ area measured via OCTA, was bilaterally symmetric in normal eyes of Korean adults.

Learning Curve for Endoscopic Endonasal Dacryocystorhinostomy

PURPOSE: To elucidate the learning curve for endoscopic endonasal dacryocystorhinostomy (EE-DCR) based on the results of EE-DCR performed by three surgeons at three different tertiary hospitals. METHODS: A retrospective review of the medical records of 386 eyes of 337 patients who had undergone EE-DCR by three surgeons at three tertiary hospitals and who were available for a >6-month postoperative observation period was conducted. The success of a given surgery was determined based on the results of a test performed during the patient's last outpatient visit to the hospital. The learning curve was identified by dividing the patients into four groups (20, 30, 40, and 50 eyes in each respective group) and comparing their success rates. RESULTS: The overall success rate of the entire study population was 86.3%. The success rates for each of three surgeons was 83.3%, 85.6%, and 88.1%, respectively. After dividing the patients into groups of 30 eyes each, all three surgeons showed a significant increase in surgery success rates after their first group of 30 eyes (p 90% (A, 94.4%; B, 90.8%; C, 95.4%). CONCLUSIONS: A surgeon should be required to perform at least 30 EE-DCR procedures to obtain stable surgical skill for this procedure.

Influence of Biometric Variables on Refractive Outcomes after Cataract Surgery in Angle-closure Glaucoma Patients

PURPOSE: To evaluate the influence of biometric variables on refractive outcomes after cataract surgery in angle-closure glaucoma (ACG) patients. METHODS: In this case-control study, 42 ACG patients, 40 open-angle glaucoma (OAG) patients, and 35 controls without glaucoma who had undergone conventional cataract surgery were enrolled consecutively. Electronic medical records, including preoperative biometric variables (keratometric diopter, axial length, anterior chamber depth, and lens thickness), the refractive change (RC), and the absolute value of refractive change (ARC) were reviewed. RESULTS: In the control and OAG patients, the anterior chamber depth was negatively correlated with the ARC (r = -0.344, p = 0.043 and r = -0.431, p = 0.006, respectively), whereas there was no correlation in the ACG patients. Lens thickness was positively correlated with the RC, but not with the ARC, in the control and OAG groups (r = 0.391, p = 0.020 and r = 0.501, p = 0.001, respectively). In contrast, lens thickness in the ACG group was not correlated with the RC but was positively correlated with the ARC (r = 0.331, p = 0.032). CONCLUSIONS: In contrast with the anterior chamber depth, preoperatively measured lens thickness may be a useful predictor of the direction of the RC after cataract surgery in control and OAG patients. However, in ACG patients, a thicker lens was correlated with a larger RC, regardless of the direction of the shift (hyperopic or myopic).

Prognostic Factors for Successful Endonasal Dacryocystorhinostomy

PURPOSE: To evaluate the factors useful for predicting the surgical outcome of endonasal dacryocystorhinostomy. METHODS: This retrospective observational study included 117 eyes of 94 patients with nasolacrimal duct obstruction who underwent endonasal dacryocystorhinostomy and were followed up for more than 6 months. Factors associated with successful surgery were analyzed based on the preoperative and intraoperative factors and postoperative clinical features. Preoperative factors such as age, gender, laterality, presence or absence of hypertension, and diabetes were analyzed. Intraoperative factors such as use of triamcinolone, removal of uncinate process or middle turbinate during surgery, and location of the sac were analyzed. The postoperative clinical features including high tear meniscus, no intranasal silicone tube movement, and no air reflux feeling were each given a score of 1. Based on aggregate score, the patients were divided into 2 groups, the high score and low score groups and analyzed accordingly. RESULTS: The success rate was 91.5%. Patients with diabetes showed a significantly low success rate (73.3%, p = 0.007). In patients with high tear meniscus at 3, 6, and 9 weeks after surgery, the success rate was significantly low (76.9%, 81.8% and 75.0%; p = 0.003, p = 0.029 and p = 0.002, respectively). The low score group at 3 and 6 weeks after surgery showed a significantly high success rate (100% and 95.9%; p < 0.001 and p = 0.023, respectively). CONCLUSIONS: Besides preoperative and intraoperative factors, the early postoperative clinical features are important for predicting the success of the surgery. If tear meniscus is high and there is no intranasal silicone tube movement and air reflux from the punctum in the early stages after surgery, more active management from the initial treatment is needed.

Changes of Higher Order Aberration Analyzed by Continuous Measurement after Phacoemulsification

PURPOSE: To analyze the changes of higher order aberration (HOA) measured serially by KR-1W(R) wavefront at every second for 10 seconds between, before, and after phacoemulsification and to evaluate the relationships between HOA and the ocular surface indicators (Schirmer test, tear break-up time, superficial punctate keratitis). METHODS: Corneal HOA was measured in 47 eyes of 30 patients pre- and postoperatively at 2, 4, 6, and 8 weeks by KR-1W(R) using the continuous measurement mode. The patients were divided into 2 groups according to their Schirmer test (above 10 mm or under 10 mm), tear break-up time (above 5 seconds or less than 5 seconds), and superficial punctate keratitis (any keratitis, none) for analysis of relationships between HOA and ocular surface indicators, and we also analyzed the correlation coefficient. RESULTS: Short-term follow up after phacoemulsification revealed that corneal HOA rapidly increased at 2 weeks and recovered to the preoperative level 8 weeks after surgery. Corneal HOA values showed increasing tendency depending on time at preop and 8 weeks after phacoemulsification, and the differences were statistically significant (preop: p < 0.001, 8 weeks: p = 0.027). There were no significant differences of HOA between the 2 groups divided according to their ocular surface indicators, and there were no significant correlations between HOA and ocular surface indicators at any time point. CONCLUSIONS: The HOA of the cornea was restored to its preoperative values at 8 weeks after surgery. Preoperative ocular surface indicators are not significantly influenced on postoperative corneal HOA. The surgical factors are more significant in postoperative corneal HOA than preoperative ocular surface indicators.

A Case of Apocrine Adenocarcinoma of the Upper Eyelid

PURPOSE: To report a case involving an eyelid mass that was diagnosed as apocrine carcinoma. CASE SUMMARY: A 52-year-old man visited our hospital with a recurrent mass on his right upper eyelid, which had developed 4 years prior. Initially, he received laser therapy at a dermatologic clinic to remove the mass. Two years later, the mass recurred and was excised at another clinic. At the time the patient visited our institution, the lesion had developed into multiple erythematous nodules at the margin of the right upper eyelid. The results of excisional biopsy performed under local anesthesia revealed hidradenoma papilliferum. One month after excision, recurred multiple elevated nodules were found at the margin of the excision, and thus total excision of the mass and reconstruction of the upper eyelid was performed. Biopsy confirmed that the mass was apocrine adenocarcinoma. Five months have passed since the excision and no evidence of recurrence has been observed. CONCLUSIONS: Apocrine adenocarcinoma is a malignant tumor of the sweat gland and is rarely found on the eyelid. Apocrine adenocarcinoma should be considered in the differential diagnosis of recurrent eyelid mass at the eyelid margin.