The Effect of Yellow Filter Use on Standard Automated Perimetry and Contrast Sensitivity in Healthy Individuals.

Purpose The purpose of this study is to investigate the effect of two yellow filters (category 1: visible light transmission {VLT} from 80% to 43%) of Essilor (Kiros® and Lumior®) on standard automated perimetry (SAP) indices and Pelli-Robson (PR) contrast sensitivity (CS) testing in healthy individuals. Materials and methods This study is a prospective comparative study of 31 eyes of 31 healthy individuals aged 32.14 (8.13) years (14 males and 17 females). All participants underwent a series of three visual field (VF) examinations (24-2, Swedish Interactive Thresholding Algorithm {SITA} standard) with the Humphrey field analyzer (HFA II 740, Carl Zeiss Meditec, Jena, Germany) and three CS examinations with the PR chart (Precision Vision, Inc., Woodstock, IL). VF and CS examinations were carried out as follows: (a) no filter (NF), (b) with the yellow filter Kiros® (KIROS), and (c) with the yellow-orange filter Lumior® (LUMIOR). The effect of the two yellow filters on global VF indices (glaucoma hemifield test {GHT}, mean deviation {MD}, pattern standard deviation {PSD}, and visual field index {VFI}) and on CS score was evaluated and compared. Results When comparing the three pairs NF-KIROS, NF-LUMIOR, and KIROS-LUMIOR, no difference was presented on the global VF indices. However, a statistically significant difference was detected in the CS scores for all three pairs, favoring KIROS. It is important to note that while this difference was statistically significant, it did not reach clinical significance. Conclusions The use of yellow filters (category 1: VLT of 75% and 65%) does not affect the global VF indices and the CS of healthy individuals but significantly improves their CS score. Further studies are required to explore the clinical significance of these findings.

Early Postoperative Changes in Macular Choroidal Thickness After Uncomplicated Phacoemulsification in Patients With and Without Glaucoma: A Swept-Source Optical Coherence Tomography Study.

Purpose The objective of this study was to examine the impact of uncomplicated phacoemulsification on macular choroidal thickness (CT) within the first three postoperative months and to investigate its relationship with postoperative cystoid macular edema (CME) in both glaucomatous and healthy subjects, utilizing swept-source optical coherence tomography (SS-OCT). Methods The non-randomized prospective study involved 82 patients, selected via convenience sampling from the First Department of Ophthalmology, Medical School of Athens, "G. Gennimatas" Hospital, Athens, Greece, between May 2018 and May 2022, undergoing phacoemulsification and intraocular lens (IOL) implantation. The inclusion criteria encompassed patients aged 50 years or above, with or without glaucoma. Patients with ocular pathologies that could influence macula or CT measurements were excluded. Data collection focused on retinal and CT variables of the macular area, measured using SS-OCT. Baseline measurements were established preoperatively, with follow-up assessments at one week, one month, and three months postoperatively to monitor CT and macular edema onset. Results A total of 82 eyes from 82 patients with a mean age of 79.1±8.3 years were included. The study population was divided into a glaucoma group (n=28 eyes) and a control group (n=54 eyes). Our findings indicate a consistently significant increase in macular CT measurements one month after cataract surgery, observed in both glaucomatous and non-glaucomatous eyes. In the first postoperative week, statistically significant changes in CT were observed only in patients with CME. Subsequently, at one-month interval, both patient groups, those with and without CME, exhibited statistically significant changes in CT across all macular sectors. CME was detected in 10 out of 28 eyes in the glaucoma group and in 16 out of 54 eyes in the control group. When evaluating the impact of postoperative CME on groups of glaucomatous and non-glaucomatous eyes, it was observed that glaucomatous eyes exhibited a significantly larger magnitude of change in subfoveal CT (SFCT) (p=0.03) at one month (relative to baseline) compared to non-glaucomatous eyes. There was also a 31% increase in the odds of developing CME for glaucoma patients; this result was not statistically significant (odds ratio {OR}, 1.31; 95% confidence interval {CI}, 0.50-3.47; p=0.57). Conclusions During the early postoperative period, the study revealed a significant increase in CT at one month after phacoemulsification in both glaucomatous and non-glaucomatous eyes. When CME was present, a significantly more pronounced magnitude of change in SFCT was observed at one month in glaucomatous eyes, as opposed to non-glaucomatous eyes. This observation suggests a possible selective susceptibility of glaucomatous eyes in the early postoperative period that requires further research.

Changes in Subfoveal Choroidal Thickness Following Uncomplicated Cataract Surgery: A Scoping Review.

This scoping review investigates the relationship between subfoveal choroidal thickness (SFCT) and cataract surgery. We synthesized existing research to clarify SFCT changes following surgery and identify contributing factors. Our aim was to enhance understanding of the ocular changes associated with cataract surgery. A comprehensive database search identified studies on SFCT changes after uncomplicated cataract surgery, categorized as "SFCT changes after cataract surgery," "Factors influencing SFCT," "Macular thickness changes," and "Long-term changes." Quantitative data and findings were extracted from a total of 13 research articles. Studies on SFCT changes after cataract surgery provided valuable insights for the subject under review. Factors influencing SFCT changes included age, axial length, and cataract surgery. Macular thickness increased at various time points. Long-term SFCT changes varied among studies. The present research provides valuable insights into SFCT changes after cataract surgery. Factors including age, axial length, and cataract surgery consistently influence SFCT. The clinical relevance of macular thickness changes remains uncertain, and the influence of age, ocular pathologies, and patient populations is highlighted. Long-term changes in SFCT vary, suggesting a need for further research. Standardized measurement techniques and larger cohort studies are recommended to enhance comparability and generalizability. This review enhances understanding of ocular changes associated with cataract surgery and informs future research.

Blind spot enlargement: A differential diagnosis challenge.

A 39-year-old woman, without any systemic or ocular history, presented with a paracentral scotoma in her right eye with normal visual acuity. Humphrey's visual fields showed a reversible enlargement of the right blind spot. The final diagnosis was acute idiopathic blind spot enlargement which was successfully treated with intravenous steroids. Although differential diagnosis of blind spot enlargement can be challenging, multimodal imaging with combination of visual field's assessment can help us make the right diagnosis.

Comparison of Diagnostic Ability Between Wide-Field Swept-Source Optical Coherence Tomography Imaging Maps and Heidelberg Retina Tomograph 3 Optic Nerve Head Assessment to Discriminate Glaucomatous and Non-glaucomatous Eyes.

Background In this study, we aimed to determine the diagnostic performance of optic nerve head (ONH), macular, and circumpapillary retinal nerve fiber layer (cpRNFL) thickness measurements of wide-field maps (12 × 9 mm) using swept-source optical coherence tomography (SS-OCT) compared to measurements of the ONH and RNFL parameters measured by Heidelberg Retina Tomograph (HRT3). Methodology This case-control study included 39 eyes of 39 glaucoma patients and 36 eyes of 36 normal subjects (control group). All participants underwent standard automated perimetry (SAP) as well as structural measurements by SS-OCT (DRI-OCT, Triton; Topcon Inc., Tokyo, Japan) and HRT3 (Heidelberg Engineering, Heidelberg, Germany). The abilities of the continuous parameters to discriminate between glaucoma and control groups were assessed using areas under the receiver operating characteristic curves (AUCs). To assess the glaucoma diagnostic abilities of each of the categorical variables, sensitivity, specificity, positive predictive value, and negative predictive value were tested. Results The highest sensitivities were achieved by the DRI-OCT categorical parameters of Superpixel-200 map and cpRNFL (12 sectors) thickness analysis. The best performing HRT3 continuous parameter was rim volume (AUC = 0.829, 95% confidence interval (CI) = 0.735-0.922), and the best continuous parameter for DRI-OCT wide-field was vertical cdr (AUC = 0.883, 95% CI = 0.805-0.951), followed by total cpRNFL thickness (AUC = 0.862, 95% CI = 0.774-0.951). AUCs for disc area, rim area, linear cdr, and RNFL thickness were not significantly different between the two technologies. Using either the most or the least specific criteria, SuperPixel-200 map always showed the highest sensitivity among the categorical parameters of both technologies (82.1% and 89.7%, respectively). The highest sensitivity among HRT3 classification parameters was shown by MRA and GPS classification algorithms. Conclusions Both wide-field DRI-OCT maps and HRT3 showed good diagnostic performance in discriminating glaucoma. Although DRI-OCT thickness values and normative diagnostic classification showed the best performance, more studies are required to determine the clinical role of wide-field DRI-OCT scan in glaucoma diagnosis.

Ocular stem cells: a narrative review of current clinical trials.

Stem cells are undifferentiated cells showcasing a remarkable capacity of self-replenishing and differentiating into mature cells. Their ability to proliferate connotes that a designated stem cell source is capable of generating an unrestricted number of mature cells. The ever-increasing comprehension of position, activity, and function of ocular stem cells has led to rapid progress and incessant improvement of possible procedures and therapies. A narrative review was conducted to summarize the current evidence on clinical trials and respective literature, regarding current evolution in the field of ocular regenerative medicine. We tried to ascertain the safety of experimental and clinical procedures, their effectiveness, and the ethical repercussion of their use.

Chronic Central Serous Chorioretinopathy in a Patient with Pigment Dispersion Syndrome: A Possible Correlation.

Chronic central serous chorioretinopathy (CSCR) is a progressive chorioretinopathy with widespread atrophic RPE abnormalities and serous retinal detachments (SRDs) present for 6 months or longer. We report a case of CSCR in a 38-year-old patient with Pigment Dispersion Syndrome (PDS). In the presented case of CSCR, the chronic course of the disease may in part be associated with an underlying generalized degenerative dysfunction of the pigmented cells of the eye on grounds of PDS. We suggest that a chronic course of disease may be suspected in the setting of CSCR with concurrent RPE pathology, such as what is found in PDS.

New nonlinear multivariable model shows the relationship between central corneal thickness and HRTII topographic parameters in glaucoma patients.

PURPOSE: In this paper a new nonlinear multivariable regression method is presented in order to investigate the relationship between the central corneal thickness (CCT) and the Heidelberg Retina Tomograph (HRTII) optic nerve head (ONH) topographic measurements, in patients with established glaucoma. METHODS: Forty nine eyes of 49 patients with glaucoma were included in this study. Inclusion criteria were patients with (a) HRT II ONH imaging of good quality (SD < 30 mum), (b) reliable Humphrey visual field tests (30-2 program), and (c) bilateral CCT measurements with ultrasonic contact pachymetry. Patients were classified as glaucomatous based on visual field and/or ONH damage. The relationship between CCT and topographic parameters was analyzed by using the new nonlinear multivariable regression model. RESULTS: In the entire group, CCT was 549.78 +/- 33.08 mum (range: 484-636 mum); intraocular pressure (IOP) was 16.4 +/- 2.67 mmHg (range: 11-23 mmHg); MD was -3.80 +/- 4.97 dB (range: 4.04 - [-20.4] dB); refraction was -0.78 +/- 2.46 D (range: -6.0 D to +3.0 D). The new nonlinear multivariable regression model we used indicated that CCT was significantly related (R(2) = 0.227, p < 0.01) with rim volume nasally and type of diagnosis. CONCLUSIONS: By using the new nonlinear multivariable regression model, in patients with established glaucoma, our data showed that there is a statistically significant correlation between CCT and HRTII ONH structural measurements, in glaucoma patients.

Surgical technique for small-incision intraocular lens exchange.

We present a simple, effective technique to remove an intraocular lens (IOL) via a very small incision (2.2 mm). After the IOL is carefully removed from the capsular bag, into the anterior chamber, 2 radial incisions, 35 degrees to 50 degrees apart, are made with a Vannas scissors. This results in 2 IOL pieces (maximum width of 2.70 mm) that can be easily explanted through the unenlarged small clear corneal incisions (2.2 mm) in use today.

Trachoma in late Greek antiquity and the early Byzantine periods.

Trachoma is an ancient disease that has survived until the present day and represents the most common cause of infectious blindness globally. This study reviews the main Greek medical sources of the period from the 1st to 7th century AD and presents the medical knowledge relating to trachoma, including its definition, clinical features, diagnosis, complications, and treatment. It was widely accepted that trachoma was a disease of the palpebral conjunctiva, and the different stages of trachoma were described in detail. However, it is unclear whether the stages of trichiasis and pannus were identified as trachoma complications. The extensive references to the treatment of trachoma during the Byzantine period provide a strong argument for the case that trachoma was one of the most serious and common eye diseases. Both surgical and pharmaceutical treatments were often applied at the same time. Occasionally, surgical treatment could be rather dramatic, involving the use of stiff fig leaves or a chisel. Nevertheless, the prognosis was always poor, and the disease developed over the years until it threatened the cornea.

Greek mythology: the eye, ophthalmology, eye disease, and blindness.

BACKGROUND: In distant eras, mythology was a form of expression used by many peoples. A study of the Greek myths reveals concealed medical knowledge, in many cases relating to the eye. METHODS: An analysis was made of the ancient Greek texts for mythological references relating to an understanding of vision, visual abilities, the eye, its congenital and acquired abnormalities, blindness, and eye injuries and their treatment. RESULTS: The Homeric epics contain anatomical descriptions of the eyes and the orbits, and an elementary knowledge of physiology is also apparent. The concept of the visual field can be seen in the myth of Argos Panoptes. Many myths describe external eye disease ("knyzosis"), visual disorders (amaurosis), and cases of blinding that, depending on the story, are ascribed to various causes. In addition, ocular motility abnormalities, congenital anomalies (cyclopia), injuries, and special treatments, such as the "licking" method, are mentioned. INTERPRETATION: The study of mythological references to the eye reveals reliable medical observations of the ancient Greeks, which are concealed within the myths.

Comparison of glaucoma progression evaluated with Heidelberg retina tomograph II versus optic nerve head stereophotographs.

BACKGROUND: To compare disease progression in glaucoma evaluated by means of the Heidelberg retina tomograph (HRT II) or by expert clinical assessment of colour stereophotographs of the optic nerve head (ONH). METHODS: One eye each of 54 subjects with glaucoma was reviewed using the HRT II and ONH stereophotographs. The ONH stereophotographs were assessed twice each for glaucomatous progression by 2 expert observers (Drs. Buys and Trope). They were considered to be in agreement if their results were the same in 3 of 4 assessments. Progression on the HRT II was defined by using the topographic change analysis (TCA). The clinical assessments were the reference standard used to determine sensitivity and specificity of the HRT II TCA. RESULTS: The expert observers were in agreement in 50 subjects (92%). Concordance between the HRT II and ONH stereophotographs assessments was obtained in 35 patients (65%); 16 patients (30%) showed progression on HRT II only, while 3 patients (6%) showed progression on stereophotographs only. When these results were used to perform a post hoc analysis, HRT II sensitivity increased from 70% to 78% and specificity increased from 63.6% to 70%. The positive predictive value of the HRT II rose from 30.4% to 47.8%, while the negative predictive value remained at 90.3%. INTERPRETATION: Our results demonstrate only fair agreement between HRT II and clinical judgment of ONH stereophotographs for progression in glaucomatous eyes. At present, HRT II progression alone should not indicate a treatment change. HRT II change must be evaluated in conjunction with other clinical features of deterioration before altering therapy.