Korean journal of ophthalmology : KJO最新文献

Purpose: To introduce subepithelial pterygium pedicle (SPP) and to investigate the effect of SPP length on the anterior corneal curvature including keratometry and aberrations.

Methods: In this single-center retrospective cohort, 72 eyes of 72 patients with primary nasal pterygium were analyzed using anterior segment swept-source optical coherence tomography (AS SS-OCT, Anterion®). We evaluated SPP length, horizontal invasion length (HIL), and corneal profiles including keratometry, root mean square values for lower- and higher-order aberrations, and 1st-to-4th order wavefront aberrations. Correlations between SPP length and these parameters were assessed after adjusting for HIL. The SPP cutoff for significant anterior horizontal tilt deterioration was determined using receiver operating characteristic (ROC) analysis and validated by analysis of covariance controlling for HIL.

Results: SPP was detected in 79.2% (57 of 72) of eyes, with a mean length of 842.3 ± 408.1 µm. A significant positive correlation was found between SPP length and HIL (r = 0.376 and P = 0.001). After adjusting for HIL, SPP length remained significantly associated with anterior corneal horizontal tilt (P = 0.026), whereas no significant correlations were observed with other refractive or aberration parameters. ROC curve analysis identified an SPP length of approximately 850 μm as the threshold for predicting anterior horizontal tilt ≥ 3.65 µm. Consequently, this cutoff significantly differentiated subgroups after adjusting for HIL, showing a marked increase in horizontal tilt in eyes with SPP ≥ 850 µm (P = 0.016), indicating mechanical distortion.

Conclusion: SPP length, a subepithelial microstructural parameter visualized by AS SS-OCT, independently correlates with anterior horizontal tilt after adjustment for HIL. This finding suggests that SPP length serves as a microstructural indicator of horizontal mechanical corneal distortion in eyes with pterygium.

Myopia, particularly high myopia, is a significant risk factor for several ocular pathologies including cataract, glaucoma, and retinal detachment. Excessive axial elongation associated with high myopia can induce biomechanical stretching, increasing the risk of serious complications like posterior staphyloma and myopic maculopathy. Global meta-analyses estimate that approximately 10 million people were visually impaired due to myopic maculopathy in 2015, with 3 million being blind. Recent nationwide surveys in Korea revealed a prevalence of 65.4% for myopia and 6.9% for high myopia in children and adolescents, highlighting the urgent need for effective management. Delaying the onset and slowing the progression of myopia during childhood and adolescence is crucial for reducing the potential lifetime risk of these complications. This consensus statement, prepared by the Korean Myopia Society for KAPOS (Korean Association for Pediatric Ophthalmology and Strabismus), reviews the current evidence for myopia control interventions and provides management strategies applicable to the Korean clinical setting. Key interventions covered include lifestyle modifications (outdoor time, near work adjustment), optical methods (myopia-control spectacle lenses, dual-focus soft contact lenses, orthokeratology), and pharmacologic treatment (low-concentration atropine), as well as combination therapies. The statement also addresses patient selection, treatment outcome evaluation using spherical equivalent (SE) and axial length (AL) changes, and the crucial aspects related to treatment cessation and the rebound effect.

Purpose: To characterize perioperative changes in posterior corneal curvature (PCC) following pterygium excision using anterior segment swept-source optical coherence tomography (AS SS-OCT), and to identify the critical threshold of horizontal invasion length (HIL) predicting significant PCC alterations.

Methods: This retrospective cohort study included 85 eyes of 77 patients with primary nasal pterygium. PCC parameters, including posterior K average, posterior steep K, posterior flat K and posterior corneal astigmatism, were measured preoperatively and postoperatively using AS SS-OCT (Anterion®, Heidelberg Engineering, Heidelberg, Germany). Perioperative PCC changes were analyzed in relation to HIL and postoperative duration. Subgroup analyses were performed to identify the HIL cutoff value associated with statistically significant changes in posterior K average.

Results: Significant postoperative flattening was observed in both posterior K average (from -6.27 ± 0.24 D to -6.23 ± 0.23 D, P < 0.001) and posterior flat K (from -6.14 ± 0.23 D to -6.09 ± 0.23 D, P < 0.001), accompanied by a significant increase in posterior corneal astigmatism (from -0.25 ± 0.12 D to -0.29 ± 0.17 D, P = 0.003). The magnitude of posterior flattening showed a significant positive correlation with HIL (r = 0.384, P < 0.001) but was not correlated with postoperative duration (P = 0.428). In subgroup analysis, eyes with HIL ≥ 3.5 mm exhibited a significant change in posterior K average (P < 0.001), whereas those with HIL < 3.0 mm and HIL < 3.5 mm showed no significant change (P = 0.065 and P = 0.443, respectively).

Conclusion: Pterygium excision leads to significant posterior corneal flattening proportional to HIL, with 3.5 mm identified as a clinically relevant cutoff. Although the refractive impact may be subtle, surgeons should be aware of these posterior corneal changes as a consistent morphological response, especially in eyes with HIL ≥ 3.5 mm.

Purpose: To evaluate functional and anatomical outcomes, including vessel morphology parameters on swept-source optical coherence tomography angiography (SS-OCTA), in eyes with neovascular age-related macular degeneration (nAMD) switched to brolucizumab.

Methods: This retrospective study included 37 eyes with nAMD that were switched from other anti-vascular endothelial growth factor (VEGF) agents to intravitreal brolucizumab. Best-corrected visual acuity (BCVA), injection intervals, central subfield thickness (CST), pigment epithelial detachment (PED) and presence of retinal fluid were compared between baseline and 12 months post-switch. SS-OCTA images were analyzed to quantify macular neovascularization (MNV) area, vessel density, fractal dimension (FD), and lacunarity.

Results: Switching to brolucizumab significantly extended injection intervals and reduced CST, PED height and retinal fluid, while maintaining BCVA at 12 months. Quantitative OCTA analysis showed reductions in MNV area and FD following the switch. When compared with the preceding 12 months of other anti-VEGF therapy, FD still showed a significant reduction after brolucizumab treatment (p = 0.019). Intraocular inflammation occurred in 1 eye and resolved with topical corticosteroids.

Conclusions: Intravitreal brolucizumab demonstrated favorable anatomical improvements and maintained visual outcomes over 12 months. Quantitative OCTA biomarkers, particularly FD, may serve as imaging indicators of disease activity and treatment response in eyes with nAMD undergoing a therapy switch.

Purpose: We sought to investigate the association between allergen-specific immunoglobulin E (IgE) sensitization and open-angle glaucoma (OAG) using a nationally representative Korean population.

Methods: This cross-sectional study used data from the 2010 Korea National Health and Nutrition Examination Survey (KNHANES). Among 8,958 participants, 1,334 subjects with complete ophthalmologic and allergen-specific IgE test results were included. Sensitization to indoor allergens (house dust mites, cockroaches, and dog dander) was assessed using ImmunoCAP assays. Multivariate logistic regression models were used to evaluate the association between allergen sensitization and OAG, adjusting for demographic, metabolic, and lifestyle factors.

Results: Among the 1,334 participants analyzed, 62 were diagnosed with OAG. Sensitization to cockroach allergens was associated with increased odds of OAG (adjusted OR = 1.19; 95% CI: 1.02-1.38), whereas sensitization to house dust mites was associated with lower odds (adjusted OR = 0.56; 95% CI: 0.31-1.00). No significant associations were found for total IgE levels or sensitization to dog allergens.

Conclusions: Allergen sensitization is differentially associated with OAG, depending on the allergen type. Cockroach sensitization was associated with greater odds of glaucoma, while house dust mite sensitization demonstrated an inverse association. These findings provide epidemiological evidence for a differential association between specific allergen sensitizations and OAG. Also, it support the hypothesis of immune-mediated mechanisms in glaucoma pathogenesis and justify further investigation into these inflammatory pathways.