Comparison of Oculus Pentacam and Stratus optical coherence tomography for measurement of central corneal thickness.

PURPOSE: Measurement of central corneal thickness (CCT) plays an essential role in the diagnosis and treatment of many ocular diseases. In this study, we aimed to compare the CCT measurements obtained using the Scheimpflug system (Pentacam; Oculus, Inc) with a retinal optical coherence tomography device (Stratus OCT; Carl Zeiss Meditec, Inc) to examine healthy corneas. METHODS: CCT measurements of 80 eyes belonging to 40 male patients (mean age: 24.48 ± 6.01 years) were evaluated with the Pentacam and the Stratus OCT. The relationship between the CCT values obtained with these 2 devices was examined with a Pearson correlation analysis, a paired t test, and a Bland-Altman analysis. RESULTS: The average CCT value obtained with Pentacam was 546.11 ± 34.15 µm and that obtained with Stratus OCT was 567.76 ± 35.02 µm. Although the average difference between the devices was 21.65 ± 8.59 µm (P < 0.0001), the measurements obtained with both devices were significantly correlated (r = 0.969, P < 0.0001). In Bland-Altman analysis, there was a high consistency between measurements obtained with either Pentacam or Stratus OCT devices. CONCLUSIONS: Corneal thickness measurements differ depending on the device used. Corneal thicknesses that have been calculated with Pentacam were lower than the values obtained with Stratus OCT. Both devices used for CCT measurement are easily applied, noninvasive, and effective. However, the devices are not interchangeable. Stratus OCT is not optimal for CCT measurement because of the important limitations of using manual measurements, but it can be used if other measurement devices designed for the purpose are not available.

Effect of hormone replacement therapy in women on ocular refractive status and aberrations.

PURPOSE: To evaluate the effects of hormone replacement therapy (HRT) on refractive status, corneal topography, and aberrations of the eye in postmenopausal women. METHODS: Thirty-six healthy postmenopausal women (72 eyes) were included in the study. All patients received HRT that consisted of 0.625 mg/day conjugated estrogen and 5 mg/day medroxyprogesterone acetate in a continuous combined regimen. Schirmer II test and tear film break-up time (BUT) were performed on all patients at the time of enrollment and 6 months after initiation of HRT. Refractive status, corneal topography, and wavefront aberrations were evaluated with the NIDEK Optical Path Difference-Scan before and 6 months after HRT was initiated. RESULTS: Mean patient age was 50.8 +/- 2.6 years (range: 47 to 57 years). The mean duration of menopause was 2.7 +/- 0.8 years (range: 1.4 to 3.5 years). The Schirmer II test and tear film BUT measurements were significantly lower after HRT (P < .05). Before HRT, the mean spherical equivalent refraction was -0.19 +/- 1.79 diopters (D) (range: -4.38 to +3.00 D). After HRT, the mean spherical equivalent refraction was -0.22 +/- 1.81 D (range: -4.63 to +/- 2.63 D). No significant differences were noted between refractive status, corneal topography, and wavefront aberrations of eyes of patients before and 6 months after HRT (P > .05). CONCLUSIONS: Hormone replacement therapy in postmenopausal women does not significantly affect refractive status, corneal topography, and wavefront aberrations of the eye at 6-month follow-up.

Treatment of Mooren's ulcer with topical administration of interferon alfa 2a.

OBJECTIVE: To report an apparently beneficial effect of topical interferon alfa 2a (IFNalpha2a) as a single therapeutic agent in the treatment of Mooren's ulcer. DESIGN: Two case reports. PARTICIPANTS: Two consecutive patients with unilateral Mooren's ulcer diagnosed at the cornea service of Gulhane Military Medical Academy from December 2004 to December 2005 were studied retrospectively. INTERVENTION: Patients with a clinical diagnosis of Mooren's ulcer were treated with topical IFNalpha2a until their lesions resolved. MAIN OUTCOME MEASURES: A review of medical records was performed to assess the duration and response to treatment with topical IFNalpha2a drops, defined by clinical resolution of Mooren's ulcer. RESULTS: Symptoms and signs in 2 eyes improved during the first week of treatment, and reepithelialization was achieved at 7 and 10 days. Visual acuity levels reached 20/25 and 20/30 within 1 month of treatment. No recurrences were observed during 1 year and 6 months of follow up. CONCLUSIONS: Topical IFNalpha2a as a single therapeutic agent was an effective alternative in the treatment of our 2 patients with Mooren's ulcer. It offers the benefits of topical therapy and avoided surgical or other interventions that may lead to stem cell deficiency. Larger controlled studies are necessary to confirm the long-term efficacy and safety of this treatment.

Dry eye in post-menopausal women using hormone replacement therapy.

PURPOSE: To evaluate the effect of hormone replacement therapy (HRT) on dry eye in post-menopausal women. METHODS: Forty post-menopausal women with dry eye (20 patients, group 1) and without dry eye (20 patients, group 2), and planning to receive HRT (estrogen plus progesterone), were recruited as the study groups. Forty age-matched untreated women were enrolled as controls (group 3 with dry eye, 5 patients; group 4 without dry eye, 35 patients). Patients having at least one of the symptoms (dryness, itching, photophobia, foreign body sensation, and tearing) together with two of the tests with positive results for dry eye (tear film break-up time (BUT), fluorescein staining of the cornea, analysis of the meibomian gland, and Schirmer I test) in both eyes were considered dry eye positive. Hormonal assay for follicle stimulating hormone, luteinizing hormone, estradiol, and free testosterone was performed. Dry eye statuses in the groups were evaluated statistically. RESULTS: Four patients with incomplete follow-up data were excluded. HRT use increased estradiol levels in the groups. Mean ages of patients (50.2+/-4.8 and 50.7+/-3.9 years, and 50.0+/-4.6 and 53.0+/-3.9 years) were similar (p=0.67). Duration of menopause in groups 1 and 2 (3.2+/-2.2 and 1.4+/-1.2 years; p=0.01), and in groups 3 and 4 (3.0+/-1.6 and 1.7+/-1.3 years; p=0.014) were different. At the third month examinations, all of the patients in group 1, and 11 patients (61.1%) in group 2 had dry eye (p=0.003). CONCLUSION: Duration of menopause and use of HRT may increase the incidence of dry eye in post-menopausal woman.