Indian Journal of Ophthalmology最新文献

Purpose: To evaluate the optical coherence tomography-angiography (OCT-A) findings and choroidal vascularity index (CVI) of patients followed with a diagnosis of obsessive-compulsive disorder (OCD) by comparing them with the healthy control group (HCG).

Methods: This prospective study included 33 patients diagnosed with OCD and 32 HCG patients who followed up for at least 3 months. OCT-A images were obtained to evaluate the microvascular circulation, and enhanced HD line images were obtained for the CVI calculation of all patients.

Results: Statistical analysis results revealed that the rates of superficial vascular density in the fovea region and deep vascular density in the parafovea region decreased in the OCD group compared to the HCG group ( P = 0.003 and P = 0.010, respectively). Subfoveal choroidal thickness values of the OCD group were lower than those of the HCG group ( P = 0.008). While total choroidal area and lumen area values were lower in the OCD group than in the HCG group ( P < 0.001 and P < 0.001, respectively); CVI values were similar in both groups ( P = 0.436).

Conclusion: The use of the OCT-A device, which is a non-invasive method for detecting retinal and choroidal changes in OCD cases, may provide insight into the pathogenesis of the disease.

Purpose: To compare the intraocular pressure (IOP)-lowering efficiency of gonioscopy-assisted transluminal trabeculotomy (GATT) and trabeculectomy (TRAB) with mitomycin C in patients with primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma (PEXG).

Methods: In this retrospective comparative study, consecutive patients with POAG or PEXG who underwent GATT or TRAB by a single surgeon and with a follow-up period of at least 1 year were included. Surgical success rates, change in best-corrected visual acuity, IOP, the need for antiglaucoma medication, surgical complications, and the need for additional glaucoma surgery were compared. Surgical success was defined as an IOP reduction of ≥30% or an IOP of ≤18 mmHg. Complete success was defined as without medication. Qualified success was defined as with or without topical medication.

Results: The mean baseline IOP was 27.4 ± 8.3 and 24.6 ± 7.6 mmHg ( P = 0.13) with the mean number of medications being 3.7 ± 1.0 and 3.7 ± 1.1 ( P = 0.98) in TRAB and GATT, respectively. At 12 months, the mean IOP was 15.3 ± 3.5 and 12.5 ± 4.6 mmHg ( P = 0.24) with the mean number of medications being 0.9 ± 1.2 and 0.8 ± 1.4 ( P = 0.76) after GATT and TRAB, respectively. IOP was lowered from baseline by 52.7% ± 17.5% after TRAB and 45.7% ±18.6% after GATT ( P = 0.12). There was no decrease in best-corrected visual acuity in either group. The qualified surgical success rate was 94.4% in the GATT group and 94.9% in the TRAB group ( P = 0.75). Percentage of complete success was 64.1% and 52.8% ( P = 0.22) after TRAB and GATT, respectively.

Conclusion: In patients with POAG and PEXG, GATT was as effective and safe as TRAB in lowering IOP and reducing the number of antiglaucomatous drugs.

Purpose: To investigate predictors for myopic shift after pediatric cataract surgery after at least 3 years follow-up.

Study design: Cross-sectional and retrospective study.

Methods: This study included patients treated for congenital or infantile cataract operated up to 5 years of age between 2010 and 2017. Patients were recruited for ophthalmologic evaluation. Surgical and medical data were acquired in medical charts.

Statistical analysis: Univariate and multivariate regressions were performed to look for potential risk factors for myopic shift.

Results: This study evaluated 81 eyes of 50 patients, with 62 (77%) being bilateral cases, 48 (59%) with intraocular lens implantation, and 37 (74%) patients being strabismic. Age at surgery was 7.7 (3.7-30.5) months and at evaluation was 93.5 (55.1-113.0) months. Total myopic shift was -4.32 ± 3.25 D, significantly greater in patients operated on up to 6 months of life (-5.73 ± 3.14 D). The distant best-corrected visual acuity (BCVA) was 0.6 (0.3-1.0) log of minimum angle of resolution (logMAR). Regarding myopic shift, in univariate analysis, older age at surgery is a protective factor (+0.08 D for each month older, P = 0.001). The presence of strabismus (-2.52 D, P = 0.014), aphakia (-2.45 D, P = 0.006), distant BCVA (-0.15 D per 0.1 logMAR, P = 0.024), and surgical complications (-3.02 D, P = 0.001) are risk factors. In multivariate analysis, older age at surgery (+0.06 D, P = 0.012) and surgical complications (-2.52 D, P = 0.001) remain significant.

Conclusion: In pediatric cataract surgery, myopic shift is greater when surgery is performed in a younger age and if associated with surgical complications.

Purpose: To evaluate incision-related astigmatism (IRA) on the anterior and total cornea after implantable collamer lens (ICL) implantation through superior and temporal corneal incisions.

Methods: The retrospective study included 141 eyes of 80 consecutive patients who underwent ICL implantation. An ocular examination was performed preoperatively and at 1 and 6 months postoperatively. The magnitude and axis of corneal astigmatism were assessed with keratometry (AstigK) and total corneal refractive power (TCRP, AstigTCRP) using a Scheimpflug camera, while the IRA obtained from keratometry (IRAK) and TCRP (IRATCRP) were evaluated using vector analysis.

Results: At 6 months, AstigK significantly decreased from 1.45 ± 0.72 D to 1.15 ± 0.75 D in the superior incision group, whereas it increased from 1.70 ± 0.74 D to 1.88 ± 0.79 D in the temporal incision group (both P < 0.001). AstigTCRP significantly decreased from 1.32 ± 0.74 D to 1.09 ± 0.80 D in the superior incision group, while it increased from 1.61 ± 0.78 D to 1.83 ± 0.86 D in the temporal incision group (both P < 0.001). IRAK was 0.55 ± 0.30 D and 0.35 ± 0.25 D in the superior and temporal incision groups, respectively, while IRATCRP was 0.50 ± 0.28 D and 0.40 ± 0.26 D in the superior and temporal incision groups, respectively. IRAK was larger in the superior incision group than in the temporal incision group for both low- (P = 0.009) and high-astigmatism (P = 0.017).

Conclusions: Incisions in ICL surgery cause corneal flattening in the meridian of the incision. The superior incision had a greater IRAK compared to the temporal incision.