Peripapillary retinal nerve fiber layer and optic nerve head characteristics in eyes with situs inversus of the optic disc.

PURPOSE: This study was performed to investigate the peripapillary retinal nerve fiber layer (RNFL) and optic nerve head (ONH) characteristics, as determined using a spectral-domain optical coherence tomography (OCT), in eyes with situs inversus of the optic disc. METHODS: The peripapillary RNFL and the ONH were assessed in 12 eyes belonging to 6 subjects with situs inversus of the optic disc (situs inversus group) and 24 eyes in 12 age-matched, sex-matched, and refractive error-matched healthy subjects (control group) by using OCT. The average, quadrant, and clock-hour RNFL thicknesses (clock-hour 9 on the scan represented the temporal side of the optic disc in both eyes), the superior/inferior RNFL peak locations, and ONH characteristics such as disc area, rim area, cup-to-disc ratio, vertical cup-to-disc ratio, and cup volume were obtained. The differences in RNFL and ONH characteristics between the 2 groups were analyzed. RESULTS: The situs inversus group had a thicker RNFL in the clock-hour sectors 3 and 4, a thinner RNFL in the clock-hour sectors 7, 8, and 11, and more nasally located superior and inferior RNFL peak locations than the control group (P≤0.001). The situs inversus group had a smaller cup-to-disc area ratio, smaller vertical cup-to-disc ratio, and a lesser cup volume than the control group (P<0.01). CONCLUSIONS: Eyes with situs inversus of the optic disc showed different peripapillary RNFL and ONH characteristics from those without this abnormality. These findings should be considered when assessing eyes with situs inversus of the optic disc.

Long-term reproducibility of cirrus HD optical coherence tomography deviation map in clinically stable glaucomatous eyes.

OBJECTIVE: To determine the long-term reproducibility of the retinal nerve fiber layer (RNFL) thickness deviation map in glaucoma patients. DESIGN: Retrospective, longitudinal study. PARTICIPANTS: One hundred two eyes of 102 glaucoma patients. METHODS: From a total of 318 screened glaucoma patients who had undergone at least 3 serial Cirrus HD optical coherence tomography sessions during an 18-month or longer follow-up period, 102 eyes with localized RNFL defects on red-free photographs that did not progress during this period based on stereoscopic disc photography, red-free photography, and standard automated perimetry (SAP) were included. The angular widths from the RNFL thickness deviation maps and average, clock-hour, and quadrant-map thicknesses of the RNFL defects were measured serially to assess intersession variability. MAIN OUTCOME MEASURES: Intraclass correlation coefficient (ICC), coefficient of variation (CV), test-retest standard deviation (TRT SD), and tolerance limit. RESULTS: The ICC, CV, and TRT SD were 0.994, 4.2%, and 1.46°, respectively, for the angular widths; 0.944, 3.1%, and 2.35 µm, respectively, for the average thicknesses; and 0.840 and 0.934, 7.8% and 6.4%, and 7.21 and 5.58 µm, respectively, for the superior and inferior quadrant positions of the RNFL defects. The severity of glaucoma based on the mean deviation of SAP did not affect the reproducibility of the angular widths (TRT SD, 1.3° and 1.84°, respectively; P = 0.905). CONCLUSIONS: Both the angular widths of RNFL defects in the RNFL thickness deviation map and conventional peripapillary thickness parameters exhibit excellent long-term reproducibility. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Anorexiant-induced transient myopia after myopic laser in situ keratomileusis.

We report a case of acute transient myopia associated with ciliochoroidal effusion induced by anorexiants. The patient had had myopic laser in situ keratomileusis 7 years earlier. Acute bilateral myopia associated with anterior chamber shallowing, intraocular pressure elevation, diffuse ciliochoroidal effusion, and perimacular retinal folds was relieved 14 days after discontinuation of anorexiant medications. Tropicamide and atropine were used to deepen the anterior chamber. Sympathomimetic drugs such as phendimetrazine and ephedrine are used as anorexiants and may induce transient myopia associated with ciliochoroidal effusion, shallow anterior chamber, and acute angle-closure glaucoma.