ABSTRACT
PURPOSE: To determine the effect of the axial length on the supernormal and false-positive sectors of the peripapillary retinal nerve fibre layer (RNFL) in healthy eyes using the normative database embedded in a spectral domain optical coherence tomographic (SD-OCT) instrument. METHODS: This was a prospective, observational cross -sectional study. The right eyes of 126 healthy young volunteers were studied. The RNFL thickness was measured by SD-OCT in twelve 30-degree sectors (clock hours) around the optic disc. The sectors whose RNFL thickness was <5% probability level were labelled as false-positive sectors. The sectors >95% probability level were labelled as supernormal sectors. The relationships between the axial length and rates of supernormal and false-positive sectors were investigated. RESULTS: A longer axial length was significantly associated with an increase in the rates of supernormal thickness in sector 8 (odds ratio, [OR], 1.494; p = 0.010) and sector 10 (OR, 1.529; p = 0.008). The supernormal sectors were mainly located in the temporal region. A longer axial length was significantly associated with a higher rates of false positives in sector 5 (OR, 1.789; p = 0.017), sector 6 (OR, 2.305; p < 0.001) and sector 12 (OR, 2.277; p = 0.035). CONCLUSIONS: The axial length was significantly related to the rates of supernormal and false-positive sectors even in healthy eyes. These findings indicate that the specificity and sensitivity of SD-OCT will be affected especially in eyes with longer axial lengths.
Subject(s)
Axial Length, Eye/anatomy & histology , Nerve Fibers , Optic Disk/anatomy & histology , Retinal Ganglion Cells/cytology , Adult , Aged , Axial Length, Eye/pathology , Cross-Sectional Studies , False Positive Reactions , Female , Healthy Volunteers , Humans , Intraocular Pressure , Low Tension Glaucoma/diagnosis , Male , Myopia/complications , Optic Disk/pathology , Predictive Value of Tests , Prospective Studies , Reproducibility of Results , Retinal Ganglion Cells/pathology , Sensitivity and Specificity , Tomography, Optical Coherence , Young AdultABSTRACT
BACKGROUND: Cytomegalovirus (CMV) retinitis usually affects severely immunosuppressed individuals. We report two immunocompetent patients who developed CMV retinitis. CASES: Case 1 was a 65-year-old man who was referred to us with blurred vision and floaters of 2 weeks duration in his left eye. Slit-lamp biomicroscopy showed keratic precipitates, aqueous cells, and vitreous opacity in his left eye. Funduscopic examination revealed yellow-white retinal lesions with arterial sheathing in the superotemporal midperiphery. Case 2 was a 63-year-old man who presented with a 2-week history of blurred vision in his left eye. Ophthalmologic examination of the left eye showed keratic precipitates, aqueous cells, vitreous opacity, and yellow-white lesions in the superotemporal peripheral retina. In both cases, CMV DNA was detected in the aqueous humor and therefore the diagnosis was CMV retinitis. CMV retinitis in both cases was indolent and was resolved in one month without treatment with antiviral drugs. Although both patients had diabetes mellitus, the results of their laboratory examinations were unremarkable and they were immunocompetent. CONCLUSIONS: Unlike CMV retinitis in immunocompromised patients, CMV retinitis in immunocompetent patients had significant anterior and vitreous inflammation but did not require antiviral treatment. A possible association between CMV retinitis and diabetes mellitus was suggested.
