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1.
J Glaucoma ; 31(1): 8-14, 2022 01 01.
Article in English | MEDLINE | ID: mdl-34559701

ABSTRACT

PRCIS: Characteristics of the most mentioned glaucoma articles on the internet were analyzed, allowing a better understanding of the dissemination of glaucoma research to the general public. PURPOSE: The aim was to determine the 100 most mentioned articles on the internet in the field of glaucoma and analyze their characteristics. MATERIALS AND METHODS: We identified the top 100 glaucoma articles with the highest Altmetric Attention Score (AAS), an automatically calculated metric for monitoring social media. Each article was evaluated for several characteristics including year of publication, title, journal name, journal impact factor (IF), article topic, article type, affiliation, and online mentions (news, blog, policy, Twitter, Facebook, etc.). Correlation analysis was conducted for AAS with these characteristics. RESULTS: The selected 100 articles came from 44 journals with more than half (56%) published in ophthalmology-specific journals. There was no significant correlation between IF and number of articles in a specific journal or AAS (P>0.1), but the number of articles in the top 100 was higher for ophthalmology journals with a higher IF (P<0.05). Original study was the most common study type (87%), of which clinical observation study was the most common subgroup (40%). Epidemiology/risk factor and basic science were the most common article topics (each 24%), followed by medical treatment (13%). Article topics regarding medical treatment had a significantly greater AAS than other topics (P<0.05). Of the top 5 articles, more than half (60%) were related to "Lifestyle choice" topics. CONCLUSIONS: There was no association between journal IF and AAS, consistent with previous studies. 90% of journals that had articles in the top 100 had a Twitter page. "Lifestyle choice" activities and other modifiable risk factors attracted significant online attention regarding glaucoma studies, with two of the top three most mentioned articles related to dietary intake. The present study thus provides a better understanding of online engagement with glaucoma research and the dissemination of this research to the general public.


Subject(s)
Glaucoma , Social Media , Bibliometrics , Humans , Intraocular Pressure , Journal Impact Factor
2.
Ophthalmic Plast Reconstr Surg ; 37(6): e198-e202, 2021.
Article in English | MEDLINE | ID: mdl-34284421

ABSTRACT

Metastases of solid tumors to the eye and ocular adnexa are rare. Herein, the authors describe the clinical, histologic, and immunohistochemical findings of a patient with a history of adenocarcinoma of the colon and a uterine carcinosarcoma (malignant mixed Müllerian tumor) who presented with proptosis and decreased vision. Positive staining with PAX-8, p16 and negative reaction for CK20 and CDX2 helped to establish the uterine origin of the metastasis. This rare case demonstrates the utility of immunohistochemical probes, especially in patients with a complex oncological history, where multiple primary sources of the metastasis are in the differential diagnosis.


Subject(s)
Carcinosarcoma , Orbital Neoplasms , Uterine Neoplasms , Biomarkers, Tumor , Carcinosarcoma/diagnosis , Female , Humans , Immunohistochemistry , Orbit , Orbital Neoplasms/diagnosis , Uterine Neoplasms/diagnosis
3.
J Glaucoma ; 29(7): 561-566, 2020 07.
Article in English | MEDLINE | ID: mdl-32224804

ABSTRACT

PRéCIS:: Publications in glaucoma have seen an increase in the number of authors and disclosures per article, authors with dual degrees, and international authors, but contributions of women to articles published remains low. PURPOSE: Authorship trends have been studied across many medical specialties and in ophthalmology as a whole, but not specifically in glaucoma. The authors explored the authorship trends of original scientific articles in the Journal of Glaucoma. MATERIALS AND METHODS: The authors recorded the number of authors and disclosures per article, degree type of first and last authors, geographical origin of the corresponding author, and sex of first and last authors of original content from the Journal of Glaucoma published in 1992, 1997, 2002, 2007, 2012, and 2017. RESULTS: A total of 642 articles were analyzed. From 1992 to 2017, annual published articles increased from 38 to 242 (P=0.02), the mean number of authors per article increased from 3.2 to 5.2 (P<0.01), the mean number of disclosures per article increased from 0.3 to 1.0 (P=0.04), the proportion of first and last authors with dual degrees (medical plus advanced degrees) also increased (both P<0.03), whereas the proportion with a sole medical degree decreased (both P<0.05). There was a proportional decrease in articles from North America (P=0.03), and proportional increase from the "Far East" (P=0.04) and "Other" regions (P=0.04). No significant changes in proportions of female first and last authors were found (both P>0.28). CONCLUSIONS: Consistent with authorship trends across various other medical specialties, glaucoma has seen an increase in the number of authors and disclosures per article, authors with dual degrees, and authors from the "Far East" and "Other" regions. However, contributions of women to articles published in Journal of Glaucoma remain low.


Subject(s)
Authorship , Ophthalmology/trends , Periodicals as Topic/trends , Publishing/trends , Bibliometrics , Female , Glaucoma , Humans , Male , Sex Distribution
4.
Ophthalmic Plast Reconstr Surg ; 36(2): 185-190, 2020.
Article in English | MEDLINE | ID: mdl-31743287

ABSTRACT

PURPOSE: To describe the clinicopathologic characteristics and the expression of diagnostic/treatment targets in ocular adnexal Kaposi Sarcoma. METHODS: We conducted a clinical-pathologic retrospective case series. Immunohistochemical staining for cluster of differentiation 31 (CD31), human herpesvirus-8 (HHV8), platelet-derived growth factor receptor alpha (PDGFR-A), vascular endothelial growth factor receptor-1 (VEGF), tyrosine-protein kinase Kit (c-Kit), and programmed cell death protein 1 (PD-1) were performed. Percentage of positive tumor cells was recorded for PD-1; staining intensity and distribution (H-score) were determined for the remaining stains. A Friedman non-parametric ANOVA analysis evaluated the staining. RESULTS: The study cohort included 13 patients (age 25 to 95 years; mean 46): 7 lesions were in the eyelid, 5 in the conjunctiva, and 1 in the cornea. Nine of 11 lesions (82%) were in human immunodeficiency syndrome-positive patients (human immunodeficiency syndrome status was unknown in 2 cases). Staging included 6 plaques and 7 nodules. The mean H-scores of CD31, HHV8, c-Kit, VEGF, and PDGF-A were 8.00, 8.23, 2.77, 11.54, and 10.31, respectively. Mean PD-1 staining was 6.46%. The Friedman non-parametric ANOVA analysis showed VEGF, PDGF-A, CD31, and HHV8 differed significantly, and all differed significantly from c-Kit. Programmed cell death protein 1 staining was not significant with any clinical variable. CONCLUSIONS: Cluster of differentiation 31 and HHV8 are helpful diagnostic adjuncts for ocular adnexal Kaposi Sarcoma. Platelet-derived growth factor receptor alpha and VEGF are promising treatment targets. Programmed cell death protein 1/PD-L1 and c-Kit are targets that are useful in several tumors; their roles in ocular adnexal Kaposi Sarcoma warrant further studies.


Subject(s)
Herpesvirus 8, Human , Sarcoma, Kaposi , Adult , Aged , Aged, 80 and over , Humans , Immunophenotyping , Middle Aged , Retrospective Studies , Sarcoma, Kaposi/diagnosis , Vascular Endothelial Growth Factor A
5.
J Glaucoma ; 27(12): 1073-1078, 2018 12.
Article in English | MEDLINE | ID: mdl-30256278

ABSTRACT

PURPOSE: To compare the effects of laser iridotomy (LI) and pilocarpine on iridocorneal angle and anterior chamber structure in anatomically narrow angles (ANAs). MATERIALS AND METHODS: Temporal LI was performed 90 minutes after 2% pilocarpine administration in patients with occludable ANA. Swept-source optical coherence tomography B-scans of the anterior segment were obtained at baseline, 60 minutes after 2% pilocarpine administration, and 1 week after LI. Angle-opening distance (AOD), trabecular-iris surface area (TISA), and angle recess area (ARA) were measured at the temporal, superior, nasal, and inferior quadrants. Anterior chamber depth (ACD) and lens vault (LV) were also measured. AOD, TISA, ARA, ACD, and LV were compared among 3 time points: at baseline, 60 minutes after 2% pilocarpine administration, and 1 week after LI. RESULTS: Twenty-four eyes (24 patients; mean age, 55 y) were included. In all 4 quadrants and globally, AOD, TISA, and ARA increased from baseline after pilocarpine and after LI (all P<0.010). The increase in AOD, TISA, and ARA was greater after LI than after pilocarpine globally and in the temporal and superior quadrants (all P<0.040). ACD decreased and LV increased from baseline after pilocarpine (both P<0.001). Postpilocarpine anterior chambers were shallower with higher LV than post-LI (both P<0.016). CONCLUSION: LI is more effective than pilocarpine in widening the iridocorneal angle without significant shallowing the anterior chamber in eyes with ANA.


Subject(s)
Anterior Chamber/diagnostic imaging , Cornea/diagnostic imaging , Glaucoma, Angle-Closure/therapy , Iridectomy/methods , Iris/diagnostic imaging , Laser Therapy/methods , Muscarinic Agonists/therapeutic use , Pilocarpine/therapeutic use , Adult , Aged , Female , Glaucoma, Angle-Closure/diagnostic imaging , Glaucoma, Angle-Closure/drug therapy , Glaucoma, Angle-Closure/surgery , Gonioscopy , Humans , Intraocular Pressure/physiology , Male , Middle Aged , Ophthalmic Solutions , Prospective Studies , Tomography, Optical Coherence/methods
7.
PLoS One ; 12(9): e0184230, 2017.
Article in English | MEDLINE | ID: mdl-28949971

ABSTRACT

PURPOSE: To investigate patients' perception of glaucomatous VF loss and its association with glaucoma severity using the Amsler grid test. METHODS: In this prospective cross-sectional study, glaucoma patients with abnormal 10-2 Humphrey Swedish Interactive Threshold Algorithm-standard VF tests were enrolled consecutively. All patients underwent a black-on-white Amsler grid test for each eligible eye. They were asked to outline any perceived scotomas (areas with abnormal grid lines) on the grid and then describe verbally their perception of the scotomas. Examiners asked patients to clarify their descriptions. All descriptions used by patients were recorded in their own words, which were then sorted into descriptor categories according to similar themes. The number of descriptor categories was counted for each eye. 10-2 VF mean deviation (MD) was compared among eyes that reported different number of descriptor categories. The mean 10-2 VF MD values were compared among different descriptor categories. RESULTS: Fifty glaucoma patients (88 eyes) were included. Patients used a total of 44 different descriptors for their scotomas. Patients' descriptors were classified into categories that incorporated similar themes, resulting in 4 overarching descriptor categories: Missing/White, Blurry/Gray, Black, and Not Aware. Fifty-two eyes reported one descriptor category and 19 eyes reported two descriptor categories (mean number of descriptor categories = 1.27±0.45). Eyes that reported two descriptor categories had worse VF MD than those that reported one (-17.86±10.31 dB vs. -12.08±7.53 dB; p = 0.012). When eyes were organized according to its combination of descriptor categories, each eye naturally sorted into one of the following 5 groups, in frequency order: Missing/White (27 eyes; 31%), Blurry/Gray (21 eyes; 24%), combined Missing/White and Blurry/Gray (19 eyes; 21%), Not Aware (17 eyes; 19%), and Black (4 eyes; 5%). The mean 10-2 VF MD severity order was Black (-21.18±10.59 dB), combined Missing/White and Blurry/Gray (-17.86±10.31 dB), Missing/White (-11.92±6.76 dB), Blurry/Gray (-10.55±7.03 dB), and Not Aware (-3.91±4.05 dB) (p<0.001). CONCLUSION: Paracentral vision loss in glaucoma is perceived by patients. As the perception of scotomas and the variety of terms to describe scotomas are related to glaucoma severity, clinicians should pay attention to patients' subjective descriptions of their glaucomatous VF loss. The historical notion that glaucoma patients lose their peripheral vision first and eventually look through a black tunnel needs to be updated to reflect the true perception of glaucoma.


Subject(s)
Glaucoma/physiopathology , Visual Fields , Adult , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Glaucoma/prevention & control , Humans , Male , Middle Aged , Prospective Studies , Severity of Illness Index
8.
J Glaucoma ; 26(7): 626-632, 2017 Jul.
Article in English | MEDLINE | ID: mdl-28486274

ABSTRACT

PURPOSE: The purpose of this study is to investigate the use of anterior segment enhanced depth imaging (EDI) optical coherence tomography (OCT) for ex vivo lamina cribrosa (LC) imaging. MATERIALS AND METHODS: After removing anterior segment and vitreous, the optic nerve head (ONH) tissue of porcine eyes was placed on a customized eye holder for imaging. Serial EDI OCT B-scans (interval, ∼35 µm) of the ONH were obtained using anterior segment module of spectral-domain OCT. Various conditions were tested for better quality LC images. After EDI OCT, serial histologic sections were obtained (distance between sections, ∼5 µm). LC structures in OCT scans were compared with those in histologic sections. Three-dimensional LC reconstructions created using serial OCT scans were compared with LC structures in disc photographs. RESULTS: ONHs of 3 enucleated eyes were examined. The LC was more clearly imaged when the retina and part of the prelaminar tissue were removed (quality score, 39.01±3.30 vs. 26.40±5.85; P<0.001) and when the tissue was kept moist during imaging (quality score, 38.70±2.11 vs. 36.18±5.98; P<0.001). LC image quality was similar before and after fixation (quality score, 38.84±6.57 vs. 39.21±9.69; P=0.79). LC beams and part of retrolaminar glial columns identified in OCT scans matched those in histologic sections. LC beams and pores in 3-dimensional reconstructions matched those in disc photographs. CONCLUSIONS: High-resolution cross-sectional images of the LC, comparable to histologic sections, can be obtained using anterior segment EDI OCT in ex vivo eyes with proper tissue preparation.


Subject(s)
Axons , Optic Disk/anatomy & histology , Retinal Ganglion Cells/cytology , Retinal Vessels/anatomy & histology , Tomography, Optical Coherence/methods , Animals , Image Processing, Computer-Assisted , Imaging, Three-Dimensional , Pilot Projects , Swine
9.
Asia Pac J Ophthalmol (Phila) ; 6(3): 273-282, 2017.
Article in English | MEDLINE | ID: mdl-28558180

ABSTRACT

Primary neural tumors of the orbit account for approximately 10% of all orbital tumors. Different tumor entities include meningiomas, optic nerve gliomas, neurofibromas, schwannomas, malignant peripheral nerve sheath tumors, and granular cell tumors. This review summarizes current concepts regarding epidemiology, clinical presentation, diagnosis, pathology, immunohistochemistry, prognosis, and treatment for neural tumors of the orbit based on the available literature.


Subject(s)
Nerve Sheath Neoplasms , Neuroimaging/methods , Orbit/diagnostic imaging , Orbital Neoplasms , Combined Modality Therapy , Global Health , Humans , Morbidity/trends , Nerve Sheath Neoplasms/diagnosis , Nerve Sheath Neoplasms/epidemiology , Nerve Sheath Neoplasms/therapy , Orbital Neoplasms/diagnosis , Orbital Neoplasms/epidemiology , Orbital Neoplasms/therapy
10.
J Glaucoma ; 26(4): 335-342, 2017 Apr.
Article in English | MEDLINE | ID: mdl-28355173

ABSTRACT

PURPOSE: To compare varying circumpapillary optical coherence tomographic (OCT) scan diameters for glaucoma diagnosis. MATERIALS AND METHODS: Prospective, cross-sectional, observational study. Circumpapillary retinal nerve fiber layer thickness (RNFLT) was measured using spectral-domain OCT in 1 randomly selected eye. Scans with diameters of 3.5, 4.1, and 4.7 mm were obtained, each with 7 parameters: mean global (G) RNFLT and mean RNFLT for the temporal-inferior (TI), nasal-inferior (NI), temporal-superior (TS), nasal-superior (NS), nasal (N), and temporal (T) sectors. Areas under the receiver operating characteristic curve (AUCs) were calculated. RESULTS: Mean age was 55±18 years in 68 healthy eyes and 59±15 years in 95 glaucomatous eyes (P=0.12). Visual field mean deviation was -7.55±6.61 dB in glaucomatous eyes. In all 3 circle scans, mean TI RNFLT had the greatest AUC (0.974 to 0.983), followed by mean G RNFLT (0.949 to 0.956). The AUC of mean TI RNFLT in the 4.1-mm scan (0.983) was greater than the AUCs of mean TI RNFLTs in the 4.7- (0.978; P=0.128) and 3.5-mm (0.974; P=0.049) scans. The AUC of mean TI RNFLT in the 4.1-mm scan (0.983) was greater than the AUCs of mean G RNFLTs in the 3.5- (0.954; P=0.011), 4.1- (0.956; P=0.016), and 4.7-mm (0.949; P=0.011) scans. In 2 eyes with large parapapillary atrophy, RNFL segmentation error was noted only in the 3.5-mm scan in the area of parapapillary atrophy. CONCLUSIONS: Further investigations to find the spectral-domain OCT circle scan diameter with the best diagnostic capability and the least artifacts are warranted, especially focusing on larger-than-conventional circle scans.


Subject(s)
Glaucoma/diagnosis , Nerve Fibers/pathology , Retina/pathology , Tomography, Optical Coherence/methods , Adult , Aged , Area Under Curve , Cross-Sectional Studies , Female , Glaucoma/diagnostic imaging , Humans , Intraocular Pressure/physiology , Male , Middle Aged , Prospective Studies , ROC Curve , Visual Fields/physiology
11.
J Glaucoma ; 26(4): 361-366, 2017 Apr.
Article in English | MEDLINE | ID: mdl-28079655

ABSTRACT

PURPOSE: To characterize the in vivo effect of selective laser trabeculoplasty (SLT) on the Schlemm canal (SC) in eyes with primary open-angle glaucoma (POAG). MATERIALS AND METHODS: Eighty-one serial horizontal enhanced depth imaging optical coherence tomograph B-scans (interval between B-scans, ∼35 µm) of the nasal corneoscleral limbus were obtained before and 4 weeks after SLT. Fifty B-scans in the overlapping regions before and after SLT were selected for analysis based on the structures of aqueous and blood vessels as landmarks. The SC cross-sectional area (CSA) was measured in each selected B-scan and averaged to generate the mean SC CSA of the eye. SC volume in the overlapping region was calculated using commercially available 3-dimensional reconstruction software. The mean SC CSA and SC volume were compared between pre-SLT and post-SLT B-scans. Correlation analysis was performed between SC CSA changes and intraocular pressure (IOP) changes. RESULTS: Thirteen POAG eyes (13 patients) were included for analysis (mean age, 68.2±9.2 y). After SLT, the mean IOP was reduced from 19.8±7.6 to 14.4±3.8 mm Hg (P=0.003); the mean SC CSA increased by 8%, from 2478±550 to 2682±598 µm (P=0.029); and the mean SC volume increased from 4,304,592±954,777 to 4,658,250±1,039,956 µm (P=0.029). Increase in SC CSA had a significant positive correlation with IOP reduction after SLT (P=0.023, R=0.622). CONCLUSIONS: SLT expands SC in POAG patients and even more so with greater IOP reduction after SLT. Post-SLT expansion of SC may be due to increased trabecular aqueous outflow, IOP decrease, or structural changes in trabecular meshwork resulting from SLT.


Subject(s)
Glaucoma, Open-Angle/surgery , Laser Therapy/methods , Limbus Corneae/pathology , Trabeculectomy/methods , Aged , Aged, 80 and over , Female , Humans , Intraocular Pressure , Limbus Corneae/diagnostic imaging , Male , Middle Aged , Ocular Hypotension/pathology , Ocular Hypotension/surgery , Sclera/diagnostic imaging , Tomography, Optical Coherence/methods , Trabecular Meshwork/diagnostic imaging
12.
Am J Ophthalmol ; 176: 134-140, 2017 Apr.
Article in English | MEDLINE | ID: mdl-27993591

ABSTRACT

PURPOSE: To characterize the expression of vascular endothelial growth factor (VEGF) in a patient with retinopathy of prematurity (ROP) treated with ranibizumab (Case 1) and compare it with a case of ROP without treatment (Case 2), a case of a premature baby without ROP (Case 3), and a case of a baby without history of ROP or prematurity (Case 4). DESIGN: Observational case series. METHODS: The eyes of the deceased babies were removed postmortem and were sent to the Florida Lions Ocular Pathology Laboratory, where they were processed. The specimens were immunostained using an antibody against VEGF. RESULTS: All eyes except for the eyes in Case 4 disclosed positive VEGF staining. Positive staining was present within the nerve fiber layer, inner plexiform layer, and inner and outer nuclear layers and within the spindle-shaped cell population in the vanguard in Case 1. In the posterior pole, positive staining was only observed at the level of the nerve fiber layer. This case also demonstrated less positive staining when compared with Case 2, where positive staining was found within all layers of the retina. CONCLUSION: Less VEGF staining was observed within the retina of the eyes treated with ranibizumab when compared with the VEGF staining in Case 2. This supports the idea that anti-VEGF agents are effective in reducing the amount of VEGF present in the retina. Furthermore, the fact that some expression of VEGF remains in the immature retina after injection supports the idea that anti-VEGF agents can suppress uncontrolled neovascularization without completely blocking the vascular drive for the vascularization of the immature retina.


Subject(s)
Infant, Premature , Ranibizumab/administration & dosage , Retina/pathology , Retinopathy of Prematurity/diagnosis , Vascular Endothelial Growth Factor A/biosynthesis , Angiogenesis Inhibitors/administration & dosage , Dose-Response Relationship, Drug , Female , Humans , Infant , Infant, Newborn , Male , Retina/metabolism , Retinopathy of Prematurity/drug therapy , Retinopathy of Prematurity/metabolism
13.
J Glaucoma ; 26(2): 133-137, 2017 Feb.
Article in English | MEDLINE | ID: mdl-27906812

ABSTRACT

PURPOSE: To characterize the in vivo effect of cyclopentolate on the microstructure of Schlemm canal (SC) in healthy eyes. METHODS: For healthy subjects, 81 serial horizontal enhanced depth imaging optical coherence tomography B-scans (interval between scans, ∼35 µm) of the nasal corneoscleral limbal area were obtained before and 1 hour after cyclopentolate 1% administration in 1 eye. The structures of aqueous and blood vessels in each scan were used as landmarks to select 50 overlapping scans between the 2 sets of 81 serial scans (before and after cyclopentolate administration). The SC cross-sectional area was measured in each of the 50 selected scans. After 3-dimensional reconstruction, SC volume was determined. RESULTS: Twelve eyes (12 healthy subjects) were imaged successfully before and after cyclopentolate administration. Mean age was 27.8±4.9 years (range, 25 to 38 y). Following cyclopentolate administration, mean intraocular pressure did not change significantly (13.9±1.5 to 14.2±1.5 mm Hg; P=0.19). Mean SC cross-sectional area decreased by 17%, from 3563±706 to 2959±460 µm (P<0.001). Mean SC volume in the overlapping area (approximately 1.7 mm of circumferential length of SC) decreased from 6,164,061±1,220,787 to 5,119,462±794,763 µm (P<0.001). The decrease in the mean SC cross-sectional area after cyclopentolate administration was greater in eyes with larger baseline SC cross-sectional area (P<0.001, R=0.873). CONCLUSIONS: Cyclopentolate causes a reduction in SC dimensions in healthy eyes. Future studies are warranted to determine the exact mechanism(s) of this change.


Subject(s)
Cyclopentolate/pharmacology , Limbus Corneae/anatomy & histology , Limbus Corneae/drug effects , Mydriatics/pharmacology , Adult , Female , Healthy Volunteers , Humans , Intraocular Pressure , Male , Prospective Studies , Tomography, Optical Coherence/methods , Tonometry, Ocular
14.
Ophthalmology ; 124(3): 320-325, 2017 03.
Article in English | MEDLINE | ID: mdl-27914831

ABSTRACT

OBJECTIVE: To investigate the prevalence of optic nerve head drusen (ONHD) in clinically normal subjects using enhanced depth imaging (EDI) optical coherence tomography (OCT) and to evaluate associated factors. DESIGN: Prospective, cross-sectional, observational study. PARTICIPANTS: Total of 130 clinically normal subjects. METHODS: Serial horizontal and vertical EDI OCT B-scans (interval between scans, ∼30 µm) of the optic nerve head (ONH) were obtained in both eyes of clinically normal subjects. Signs of ONHD were defined as horizontal hyperreflective bands perpendicular to the OCT beam with or without a signal-poor core. The minimum length of isolated hyperreflective bands was determined based on analysis of 34 eyes with clinically definite ONHD. Age, gender, ONH diameter, and axial length were obtained from participants. MAIN OUTCOME MEASURES: Prevalence of ONHD in clinically normal subjects and its association with age, gender, ONH diameter, and axial length. RESULTS: Based on the measurements of 94 isolated hyperreflective bands in the 34 eyes with clinically definite ONHD, the minimum length of isolated hyperreflective ONHD bands in clinically normal subjects was set as 45 µm (mean minus 2 standard deviations). Among 260 clinically normal eyes (130 subjects; 68 women; mean age, 40±17 years), EDI OCT was positive for horizontal hyperreflective ONHD bands in 28 eyes (10.8%) of 19 subjects (14.6%). Of these 28 eyes, 25 eyes (9.6% of total 260 eyes) of 16 subjects (12.3% of total 130 subjects) showed isolated hyperreflective bands with no signal-poor core, and 3 eyes (1.2% of total 260 eyes) of 3 subjects (2.3% of total 130 subjects) showed a signal-poor core surrounded by hyperreflective bands. No significant differences were found in mean age (44 vs. 39 years; P = 0.121) or gender distribution (56% vs. 52% female; P = 0.766) between clinically normal subjects with hyperreflective ONHD bands and those without. Logistic regression analysis showed that a decrease in ONH diameter by 100 µm and axial length by 1 mm increased the odds of ONHD presence by 1.5-fold (odds ratio [OR] = 1.56 [confidence interval (CI), 1.22-2.00]; P < 0.001) and 2-fold (OR = 2.00 [CI, 1.15-3.49]; P = 0.015), respectively. CONCLUSIONS: Subclinical ONHD may be more prevalent than previously believed. Significant associations of subclinical ONHD with smaller ONH and shorter axial length were found.


Subject(s)
Optic Disk Drusen/epidemiology , Tomography, Optical Coherence , Adult , Age Factors , Axial Length, Eye/pathology , Cross-Sectional Studies , Female , Healthy Volunteers , Humans , Male , Middle Aged , Optic Disk/pathology , Optic Disk Drusen/diagnosis , Prevalence , Prospective Studies , Risk Factors , Sex Factors , Visual Acuity/physiology , Visual Field Tests , Visual Fields/physiology , Young Adult
15.
Br J Ophthalmol ; 101(6): 808-813, 2017 06.
Article in English | MEDLINE | ID: mdl-27688593

ABSTRACT

BACKGROUND/AIMS: To characterise in vivo Schlemm's canal (SC) and collector channels (CC) microstructures using enhanced-depth imaging (EDI) optical coherence tomography (OCT). METHODS: Serial horizontal EDI OCT B-scans (81 scans, 15×5° rectangle) were prospectively obtained in the nasal and temporal limbus. SC cross-sectional area (CSA) was measured by delineating its lumen in each B-scan. CCs connected to SC were counted. SC CSA and the number of CCs were compared between the nasal and temporal areas. RESULTS: Eleven eyes (11 normal subjects) were included (mean age, 28±5 years). SC and CCs were clearly demarcated in EDI OCT B-scans with excellent repeatability and reproducibility (intraclass correlation coefficients, 0.830-0.886 and 0.793, respectively; all p<0.001). SC CSA varied considerably among subjects, ranging from 1664 to 6007 µm2 (average, 3514±1235 µm2), and among different regions of the same eye with coefficient of variation in each eye ranging from 23% to 46% (average, 32±7%). The number of CCs in the analysed area also varied considerably among subjects, ranging from 5 to 11 (average, 8.73±1.85). The mean SC CSA (3839±1402 µm2 vs 3189±1209 µm2; p=0.033) and number of CCs (5.5±1.4 vs 3.3±1.1; p=0.001) were significantly greater nasally than temporally. The mean SC CSA was significantly correlated with the number of CCs (r=0.635, p=0.036). CONCLUSIONS: High-quality images of the aqueous outflow pathway can be obtained with a clinical device, avoiding postacquisition processing. In vivo SC and CC microstructures vary considerably among individuals and regions. SC tends to be larger in regions with more CCs.


Subject(s)
Aqueous Humor/metabolism , Imaging, Three-Dimensional/methods , Intraocular Pressure/physiology , Tomography, Optical Coherence/methods , Trabecular Meshwork/cytology , Adult , Cross-Sectional Studies , Female , Healthy Volunteers , Humans , Limbus Corneae/cytology , Limbus Corneae/metabolism , Male , Prospective Studies , Reproducibility of Results , Trabecular Meshwork/metabolism , Young Adult
16.
J Glaucoma ; 26(3): 208-215, 2017 Mar.
Article in English | MEDLINE | ID: mdl-27811573

ABSTRACT

PURPOSE: To compare glaucoma diagnostic capability of global/regional macular layer parameters in different-sized grids. MATERIALS AND METHODS: Serial horizontal spectral-domain optical coherence tomography scans of macula were obtained. Automated macular grids with diameters of 3, 3.45, and 6 mm were used. For each grid, 10 parameters (total volume; average thicknesses in 9 regions) were obtained for 5 layers: macular retinal nerve fiber layer (mRNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), ganglion cell-inner plexiform layer (GCIPL; GCL+IPL), and ganglion cell complex (GCC; mRNFL+GCL+IPL). RESULTS: Sixty-nine normal eyes (69 subjects) and 87 glaucomatous eyes (87 patients) were included. For the total volume parameter, the area under the receiver operating characteristic curves (AUCs) in 6-mm grid were larger than the AUCs in 3- and 3.45-mm grids for GCL, GCC, GCIPL, and mRNFL (all P<0.020). For the average thickness parameters, the best AUC in 6-mm grid (T2 region for GCL, IPL, and GCIPL; I2 region for mRNFL and GCC) was greater than the best AUC in 3-mm grid for GCL, GCC, and mRNFL (P<0.045). The AUC of GCL volume (0.920) was similar to those of GCC (0.920) and GCIPL (0.909) volume. The AUC of GCL T2 region thickness (0.942) was similar to those of GCC I2 region (0.942) and GCIPL T2 region (0.934) thickness. CONCLUSIONS: Isolated macular GCL appears to be as good as GCC and GCIPL in glaucoma diagnosis, while IPL does not. Larger macular grids may be better at detecting glaucoma. Each layer has a characteristic region with the best glaucoma diagnostic capability.


Subject(s)
Glaucoma/diagnosis , Macula Lutea/pathology , Retinal Ganglion Cells/pathology , Retinal Neurons/pathology , Aged , Area Under Curve , Case-Control Studies , Cross-Sectional Studies , Female , Glaucoma/pathology , Humans , Intraocular Pressure , Macula Lutea/diagnostic imaging , Middle Aged , Prospective Studies , ROC Curve , Tomography, Optical Coherence/methods
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