Posterior staphyloma is associated with the microvasculature and microstructure of myopic eyes

Abstract Objective To investigate the microvasculature and structural characteristics of the eyes of myopic patients and their association with posterior staphyloma (PS). Methods This was a retrospective, case-control study comprising of 106 eyes from 72 individuals. Using 1:1 matching of axial length (AL) of their eyes, patients were allocated into a PS group or no posterior staphyloma (NPS) group. All patients were examined using ultra-widefield fundus imaging, optical coherence tomography angiography, and ocular biometry to acquire microvasculature and microstructure parameters. Results The anterior chamber depth (ACD) of the PS group was significantly different from that of the NPS group (3.56 mm vs 3.76 mm, P < 0.001), as was 1ens thickness (3.72 mm vs 3.57 mm, P = 0.005) and spherical equivalent (SE)(-10.11D vs -8.80D, P = 0.014). The PS group had reduced choriocapillaris flow, subfoveal choroidal thickness (SFCT), and a thinner retinal layer compared with the NPS group. No difference in retinal blood flow between the two groups was observed. The PS group exhibited a smaller disc area (15082.89 vs 17,043.32, P = 0.003) and angle α between temporal retinal arterial vascular arcades (113.29°vs 128.39°, P = 0.003), a larger disc tilt ratio (1.41 vs 1.24, P < 0.001) and parapapillary atrophy (PPA) area (13840.98 vs 8753.86, P = 0.020), compared with the NPS group. Multivariate regression analysis indicated that disc tilt ratio (P = 0.031) and SFCT (P = 0.015) were significant predictors of PS. In addition, PS (P = 0.049), AL (P = 0.003), corneal refractive power (P < 0.001), ACD (P = 0.022), relative lens position (P = 0.045), and disc area (P = 0.011) were significant predictors of SE. Conclusions PS was found to be closely linked to a reduction in choriocapillaris perfusion and anatomical abnormalities including posterior and anterior segments. Furthermore, PS exacerbated the progression of myopia.

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Comparison of Retinal Layer Thickness and Capillary Vessel Density in the Patients with Spontaneously Resolved Acute Central Serous Chorioretinopathy

Journal of Clinical Medicine ◽

10.3390/jcm10010045 ◽

2020 ◽

Vol 10 (1) ◽

pp. 45

Author(s):

Kyu Jin Han ◽

Hyeong Ju Kim ◽

Je Moon Woo ◽

Jung Kee Min

Keyword(s):

Visual Acuity ◽

Layer Thickness ◽

Central Serous Chorioretinopathy ◽

Subretinal Fluid ◽

Vessel Density ◽

Foveal Avascular Zone ◽

Retinal Layer ◽

Healthy Controls ◽

Retrospective Case ◽

Capillary Vessel

We investigate retinal layer thickness and capillary vessel density (VD) in the patients with central serous chorioretinopathy (CSC) who recovered spontaneously and evaluate the correlation between the changes in these values and visual outcomes using swept-source optical coherence tomography (SS-OCT) and OCT angiography (OCTA). This retrospective case–control study included 34 eyes of 34 patients with spontaneously resolved acute CSC. The changes in retinal layer thickness and capillary VD were examined using SS-OCT and OCTA after complete resolution of subretinal fluid (SRF). The fellow eyes and 34 healthy eyes were used as controls. In the eyes with CSC, the outer retinal layer was significantly thinner than in the eyes of fellow and healthy controls. The foveal avascular zone area and VDs in the superficial and deep capillary plexus in the eyes with CSC were not significantly different from those in the eyes of fellow and healthy controls. The VD of the choriocapillaris in the eyes with CSC was significantly lower than that in the eyes of fellow and healthy controls. Correlation analyses revealed that the outer retinal layer thickness and initial visual acuity were positively correlated with the final visual acuity. Furthermore, the initial SRF area and height were negatively correlated with the outer retinal layer thickness after SRF resolution. Attenuation of outer retinal layer thickness and decreased VD of the choriocapillaris were observed in the eyes with spontaneously resolved acute CSC. The outer retinal layer thickness could be an important visual predictor of CSC.

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Evaluation of Anterior Chamber Depth in 28,709 Adult Cataract Patients in China using Swept-Source Optical Biometry

10.21203/rs.3.rs-200270/v1 ◽

2021 ◽

Author(s):

Qiong Lei ◽

Haixia Tu ◽

Xi Feng ◽

Yong Wang

Keyword(s):

Cataract Surgery ◽

Anterior Chamber ◽

Axial Length ◽

Corneal Thickness ◽

Anterior Chamber Depth ◽

Multivariate Regression Analysis ◽

Swept Source ◽

Mean Values ◽

The Mean ◽

Cataract Patients

Abstract Background: To create an anterior chamber depth (ACD) regression model for adult cataract surgery candidates from China, and to evaluate the distribution of their ocular biometric parameters.Methods: The ocular biometric records of 28,709 right eyes of cataract surgery candidates who were treated at Aier Eye Hospitals in nine cities from 2018 to 2019 were retrospectively analyzed. All measurements were taken with IOLMaster 700. We included patients who were at least 40 years old and were diagnosed with cataract.Results: The mean age of the patients was 68.6 ± 11.0 years. The mean values recorded were as follows: axial length (AL), 24.17 ± 2.47 mm; mean keratometry (Km) value, 44.09 ± 3.25 D; corneal astigmatism (CA), 1.06 ± 0.98 D; ACD, 3.02 ± 0.45 mm; lens thickness (LT), 4.52 ± 0.45 mm; central corneal thickness (CCT), 0.534 ± 0.04 mm; and white to white (WTW) corneal diameter, 11.64 ± 0.46 mm. The proportion of patients with long axial length (AL >25 mm) decreased with age. ACD, LT, AL, Km, WTW, and age were correlated. In the multivariate regression analysis of ACD, which included LT, AL, WTW, sex, Km, CCT, and age, there was a reasonable prediction with adjusted R2 = 0.629.Conclusions: The results show that high myopes are inclined to schedule cataract surgery at a younger age. LT and AL were found to be important factors that affect ACD. This study provides reference data for cataract patients from China.

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Effect of a Suction Device for Femtosecond Laser on Anterior Chamber Depth and Crystalline Lens Position Measured by OCT

Journal of Refractive Surgery ◽

10.3928/1081597x-20091016-06 ◽

2009 ◽

Vol 25 (11) ◽

pp. 1005-1011 ◽

Cited By ~ 3

Author(s):

Kathleen S. Kunert ◽

Marcus Blum ◽

Matthias Reich ◽

Manfred Dick ◽

Christoph Russmann

Keyword(s):

Femtosecond Laser ◽

Anterior Chamber ◽

Anterior Chamber Depth ◽

Crystalline Lens ◽

Suction Device ◽

Lens Position

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Broad internal limiting membrane peeling with adjunctive plasma–thrombin for repair of large macular holes

European Journal of Ophthalmology ◽

10.1177/1120672120920218 ◽

2020 ◽

pp. 112067212092021

Author(s):

Kyle A Bolo ◽

Stanley Chang

Keyword(s):

Case Series ◽

Internal Limiting Membrane ◽

Adjunctive Treatment ◽

Retinal Layer ◽

Retrospective Case ◽

Closure Rate ◽

Autologous Plasma ◽

Internal Limiting Membrane Peeling ◽

Membrane Peeling ◽

Macular Holes

Purpose To assess the potential efficacy of broad internal limiting membrane peeling with adjunctive plasma–thrombin instillation to treat large macular holes and to make qualitative comparisons to internal limiting membrane peeling without adjunctive treatment and internal limiting membrane peeling with inverted and free internal limiting membrane flaps. Methods A systematic literature review and a retrospective case series. Participants in the case series (N = 39) had idiopathic macular holes larger than 400 µm as measured on spectral-domain optical coherence tomography and underwent pars plana vitrectomy, internal limiting membrane peeling, placement of autologous plasma and bovine thrombin over the hole, and gas tamponade. Repeat imaging and clinical data were collected from 1, 2, 3, 6, and 12 months postoperatively. Results Macular hole closure rate was 97%; 82% had U-type closures. At 12 months, 11% had defects in the external limiting membrane and 22% in the ellipsoid zone. This closure rate is similar to prior studies of internal limiting membrane flaps, while the U-type closure rate and retinal layer restoration compare favorably to those reported for internal limiting membrane peeling alone and internal limiting membrane flaps; 75% experienced a three-line improvement in visual acuity by 6 months, which exceeds results by either method. Conclusion Plasma–thrombin instillation over macular holes may be a less-complicated alternative adjunct to internal limiting membrane flaps that can achieve similar outcomes when combined with internal limiting membrane peeling.

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Effects of Laser Peripheral Iridotomy in Subgroups of Primary Angle Closure Based on Iris Insertion

Journal of Ophthalmology ◽

10.1155/2015/581719 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Sung-Cheol Yun ◽

Ji Wook Hong ◽

Kyung Rim Sung ◽

Jin Young Lee

Keyword(s):

Anterior Segment ◽

Anterior Chamber Depth ◽

Multivariate Regression Analysis ◽

Angle Closure ◽

Laser Peripheral Iridotomy ◽

Factors Affecting ◽

Primary Angle Closure ◽

Before And After ◽

Qualitative Classification ◽

Peripheral Iridotomy

Purpose. To investigate the effect of laser peripheral iridotomy (LPI) in subgroups of primary angle closure based on iris insertion configuration.Methods. Anterior segment optical coherence tomography (AS-OCT) images were obtained before and two weeks after LPI. Qualitative classification of angle closure eyes according to iris insertion (basal insertion group (BG) and nonbasal insertion group (NBG)) was performed. Anterior chamber depth (ACD), lens vault (LV), iris curvature, iris area, iris thickness (IT750), and angle opening distance (AOD750) 750 microns from scleral spur were calculated. Uni- and multivariate regression analysis was carried out to evaluate factors associated with AOD750before and after LPI.Results. Ninety-two eyes of 92 subjects were categorized as NBG (39 eyes) or BG (53 eyes). The mean change after LPI was not significantly different between two groups in all parameters. In both groups, AOD750was affected by ACD (p<0.001,p=0.044) before LPI. AOD750was affected by LV (p=0.012) in NBG, but by ACD (p<0.001) and IT750(p=0.039) in BG after LPI.Conclusions. The outcomes of LPI are not significantly different between angle closure subgroups with different iris insertions. However, factors affecting AOD750show differences between two subgroups after LPI.

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Biometric indicators of Eyes with Occult Lens Subluxation inducing Secondary Acute Angle Closure

10.21203/rs.2.432/v2 ◽

2019 ◽

Author(s):

Xiaoli Xing ◽

Liangyu Huang ◽

Fang Tian ◽

Yan Zhang ◽

Yingjuan Lv ◽

...

Keyword(s):

Axial Length ◽

Corneal Thickness ◽

Anterior Chamber Depth ◽

Acute Angle ◽

Angle Closure ◽

Lens Subluxation ◽

Lens Thickness ◽

Primary Angle Closure ◽

Lens Position ◽

Acute Angle Closure

Abstract Background: To compare the anterior biometry of eyes with secondary acute angle closure induced by occult lens subluxation (LS), misdiagnosed as acute primary angle closure (APAC) at the first visit, APAC, chronic primary angle closure glaucoma (CPACG), cataract. Methods: This retrospective case study included 17 eyes with PAC due to occult LS, who were misdiagnosed as APAC on their first visit, 56 eyes diagnosed as APAC, 54 eyes diagnosed as CPACG, and 56 eyes diagnosed as cataract. Axial length (AL), Central corneal thickness (CCT), anterior chamber depth (ACD) and lens thickness (LT) were recorded. Lens position (LP), relative lens position (RLP), corrected lens position (CLP) were calculated. Quantitative data were subject to one-way analysis of variance and correlation analysis. Categorical data were analyzed using the chi-squared test. Results: The patients in the LS group had a longer ocular axial length than those with acute angle closure and CPACG. Corneal thickness in the LS group was not significantly different from that in the APAC group, but was significantly different from those of the CPACG and cataract group. The APAC group had the smallest ACD, while the LS group had the smallest AD. The LS group exhibited significantly shallower ACD (P<0.01). The LS group had the largest lens thickness. Conclusions: This study revealed that LS secondary PAC patients had a shallower ACD, thicker CCT and lens thickness comparing to those of APAC, CPACG and cataract patients. A short depth (< 1.25 mm) and a thick lens thickness (> 5.13 mm) are crisis of lens subluxation in our data. LP and CLP can be helpful for differential diagnosis. Trial registration: NCT03752710, retrospectively registered.

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Improving the prediction of effective lens position for intraocular lens power calculations

Asian Journal of Ophthalmology ◽

10.35119/asjoo.v17i2.585 ◽

2020 ◽

Vol 17 (2) ◽

pp. 233-242

Author(s):

Juanita Noeline Chui ◽

Keith Ong

Keyword(s):

Cataract Surgery ◽

Intraocular Lens ◽

Sagittal Plane ◽

Anterior Chamber Depth ◽

Posterior Chamber ◽

Power Calculation ◽

Iol Power Calculation ◽

Lens Position ◽

Iol Power ◽

Corneal Apex

Purpose: Achieving the desired post-operative refraction in cataract surgery requires accurate calculations for intraocular lens (IOL) power. Latest-generation formulae use anterior-chamber depth (ACD)—the distance from the corneal apex to the anterior surface of the lens—as one of the parameters to predict the post-operative IOL position within the eye, termed the effective lens position (ELP). Significant discrepancies between predicted and actual ELP result in refractive surprise. This study aims to improve the predictability of ELP. We hypothesise that predictions based on the distance from the corneal apex to the mid-sagittal plane of the cataractous lens would more accurately reflect the position of the principal plane of the non-angulated IOL within the capsular bag. Accordingly, we propose that predictions derived from ACD + ½LT (length thickness) would be superior to those from ACD alone. Design: Retrospective cohort study, comparing ELP predictions derived from ACD to aproposed prediction parameter. Method: This retrospective study includes data from 162 consecutive cataract surgery cases, with posterior-chamber IOL (AlconSN60WF) implantation. Pre- and postoperative biometric measurements were made using the IOLMaster700 (ZEISS, Jena, Germany). The accuracy and reliability of ELP predictions derived from ACD and ACD + ½LT were compared using software-aided analyses. Results: An overall reduction in average ELP prediction error (PEELP) was achieved using the proposed parameter (root-mean-square-error [RMSE] = 0.50 mm), compared to ACD (RMSE = 1.57 mm). The mean percentage PEELP, comparing between eyes of different axial lengths, was 9.88% ± 3.48% and −34.9% ± 4.79% for predictions derived from ACD + ½LT and ACD, respectively. A 44.10% ± 5.22% mean of differences was observed (p < 0.001). Conclusion: ACD + ½LT predicts ELP with greater accuracy and reliability than ACD alone; its use in IOL power calculation formulae may improve refractive outcomes.

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Refining decisions on which primary care patients to screen for glaucoma

Canadian Journal of Optometry ◽

10.15353/cjo.71.645 ◽

2009 ◽

Vol 71 (5) ◽

pp. 26

Author(s):

Bruce Wick ◽

Ronald Gall

Keyword(s):

Optic Disc ◽

Corneal Thickness ◽

Anterior Chamber Depth ◽

Care Patient ◽

Ocular Structure ◽

Significant Difference ◽

Disc Area ◽

Primary Care Patients ◽

Highly Correlated ◽

Optic Discs

Introduction: Glaucoma, which is often accompanied by elevated intraocular pressure (IOP), causes progressive optic nerve atrophy and blindness. Among ocular structure parameters abnormalities in central corneal thickness (CCT), cup-to-disc (C/D) ratio, inter-eye C/D ratio asymmetry, optic disc area, and neuro-retinal rim area (N-RRA) appear to be highly correlated with glaucoma. We compare these specific ocular structures in a group of young normal pre-presbyopic patients and in a group of patients being treated for glaucoma. Methods: After written informed consent, 1433 consecutive normal, and 56 consecutive patients being treated for glaucoma were assessed by including age, race, sex, IOP (NCT), C/D ratio, optic disc area, N-RRA (Optos), central center thickness (CCT), and anterior chamber depth. Results: Combinations of findings in CCT, C/D ratio, C/D ratio asymmetry, disc area, and N-RRA (assessed by Z-score) were present in 65.52% of patients being treated for glaucoma and 22.96% of young normal patients. For young normal patients, overall average CCT was 550.37+/-39.47µm. Overall average C/D ratio was 0.39+/-0.11. Inter-eye C/D asymmetry was 0.02+/-0.06. Overall average disc area was 2.46+/-0.49mm2 (7863.54+/1630.42 pixels). Overall average N-RRA was 1.44+/-0.35mm2 (4785.88+/1161.14 pixels). C/D ratio increased modestly with disc area increase, an increase not associated with thinning N-RRA. Thin N-RRA was associated with small optic discs that had large C/D (t=-8.21, p=0.000, DF=93). There was a significant difference between young normal patients and patients being treated for glaucoma in CCT, C/D ratio, C/D ratio asymmetry, disc area, and N-RRA. Conclusion: More than one in five (22.96%) young normal patients has ocular structure findings similar to those found in patients being treated for glaucoma. These results will help refine decisions on which primary eye care patient to screen for glaucoma.

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Prediction of effective Lens position using anterior segment optical coherence tomography in Chinese subjects with angle closure

BMC Ophthalmology ◽

10.1186/s12886-021-02213-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yuzhou Wu ◽

Shunhua Zhang ◽

Yong Zhong ◽

Ailing Bian ◽

Yang Zhang ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Anterior Segment ◽

Anterior Chamber Depth ◽

Partial Coherence ◽

Angle Closure ◽

Optical Coherence ◽

Training Set ◽

Lens Position ◽

Regression Formula ◽

Validation Set

Abstract Purpose To assess the accuracy of biometric parameters measured by anterior segment optical coherence tomography (AS-OCT) and partial coherence interferometry (PCI) in prediction of effective lens position (ELP) compared with previous formulas in PACG patients. Methods 121 PACG eyes were randomly divided into training set (85 eyes) and validation set (36 eyes) with same procedure including AS-OCT, PCI, phacoemulsification and IOL implantation surgery. Preoperative anterior chamber depth (pre-ACD), scleral spur depth (SSD), scleral spur width (SSW), lens vault (LV) and cornea thickness (CT) were measured from AS-OCT image. Axial length (AL) and corneal power (K) were measured by PCI. All the 7 parameters were analyzed by multiple linear regression in training set and a statistic regression formula was developed. In validation set, one-way ANOVA was applied to compare the new regression formula with Sanders-Retzlaff-Kraff theoretic (SRK/T), Holladay 1, Haigis, and a regression formula developed in previous study. Results The coefficient of determination (R2) of different parameter combinations are 0.19 (pre-ACD, AL), 0.25 (AL, K) and 0.49 (SSD, AL, SSW) in training set. In validation set, the correlation between predicted and measured ELP are: new formula (R2 = 0.50, P = 0.9947) Holladay 1 (R2 = 0.12, P < 0.0001), SRK/T (R2 = 0.11, P < 0.0001) and Haigis (R2 = 0.06, P < 0.0001). Conclusion Among 7 tested parameters, pre-ACD contribute little in ELP prediction. Formula consist of SSD, AL and SSW showed better accuracy than other formulas tested.

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Cervical Myelopathy Caused by Non-Rheumatic Retro-Odontoid Pseudotumor: An Investigation of Underlying Mechanisms and Optimal Surgical Strategy

Global Spine Journal ◽

10.1177/21925682211069542 ◽

2022 ◽

pp. 219256822110695

Author(s):

Masahiko Takahata ◽

Ryota Hyakkan ◽

Shigeki Oshima ◽

Itaru Oda ◽

Masahiro Kanayama ◽

...

Keyword(s):

Risk Factors ◽

Cervical Spine ◽

Surgical Procedures ◽

Cervical Myelopathy ◽

Multivariate Regression Analysis ◽

Surgical Strategy ◽

Control Group ◽

Retrospective Case ◽

Subaxial Cervical Spine ◽

Spine Function

Study Design Retrospective case-control study. Objective This study aimed to identify the underlying pathologies of non-rheumatic retro-odontoid pseudotumors (NRPs), which would help establish an appropriate surgical strategy for myelopathy caused by NRP. Methods We identified 35 patients with myelopathy caused by NRP who underwent surgery between 2006 and 2017. An age- and sex-matched control group of 70 subjects was selected from patients with degenerative cervical myelopathy. Radiographic risk factors for NRP were compared between cases and controls. We also assessed surgical outcomes following occipital-cervical (O-C) fusion, atlantoaxial (C1-2) fusion, or C1 laminectomy. Results Patients with NRP had significantly lower C1 sagittal inner diameter, C2-7 range of motion (ROM), C2-7 Cobb angle, and C7 tilt, as well as significantly higher C1-2 ROM, atlantodental interval (ADI), and C1-2 to O-C7 ROM ratio. Multivariate regression analysis revealed that ADI, C2-7 ROM, and C7 tilt were independent risk factors for NRP. Neurological recovery and pseudotumor size reduction were comparable among surgical procedures, whereas post-operative cervical spine function was significantly lower in the O-C fusion group than in the other groups. Conclusion Non-rheumatic retro-odontoid pseudotumor was associated with an increase in ADI, suggesting that spinal arthrodesis surgery is a reasonable strategy for NRP. C1-2 fusion is preferable over O-C fusion because of the high prevalence of ankylosis in the subaxial cervical spine. Given that 29% of patients with NRP have C1 hypoplasia, such cases can be treated by posterior decompression alone. Our study highlights the need to select appropriate surgical procedures based on the underlying pathology in each case.

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