Open Ophthalmology Journal最新文献

Purpose: To report visual acuity, contrast sensitivity and color vision prior to, 1 year after, 2 years after and 3 years after iodine-125 brachytherapy for choroidal and ciliary body melanoma (CCM).

Design: Prospective interventional case series.

Participants: Thirty-seven patients (37 eyes) with CCM.

Methods: Patients had best-corrected Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity, Pelli-Robson contrast sensitivity and Hardy-Rand-Rittler color vision measurement; comprehensive ophthalmology examination; optical coherence tomography; and ultrasonography at baseline prior to, 1 year after, 2 years after and 3 years after I-125 brachytherapy.

Main outcome measures: Visual acuity, contrast sensitivity and color vision prior to, 1 year after, 2 years after and 3 years after brachytherapy.

Results: Nineteen (19) men and 18 women with mean age of 58 years (SD 13, range 30-78) prior to, 1 year after, 2 years after and 3 years after brachytherapy had mean best-corrected visual acuity of 77 letters (20/32), 65 letters (20/50), 56 letters (20/80) and 47 letters (20/125); contrast sensitivity of 30, 26, 22 and 19 letters; color vision of 26, 20, 17 and 14 test figures, respectively. Decrease in visual acuity, contrast sensitivity and color vision was statistically significant from baseline at 1 year, 2 years, and 3 years after brachytherapy. Decreased acuity at 3 years was associated with mid-choroid and macula melanoma location, ≥ 4.1 mm melanoma height, radiation maculopathy and radiation optic neuropathy.

Conclusion: 1, 2 and 3 years after brachytherapy, eyes with CCM had significantly decreased visual acuity, contrast sensitivity and color vision.

Purpose: To evaluate visual field progression with trend and event analysis in open angle glaucoma patients under treatment.

Materials and methods: Fifteen year follow-up results of 408 eyes of 217 glaucoma patients who were followed at Adnan Menderes University, Department of Ophthalmology between 1998 and 2013 were analyzed retrospectively. Visual field data were collected for Mean Deviation (MD), Visual Field Index (VFI), and event occurrence.

Results: There were 146 primary open-angle glaucoma (POAG), 123 pseudoexfoliative glaucoma (XFG) and 139 normal tension glaucoma (NTG) eyes. MD showed significant change in all diagnostic groups (p<0.001). The difference of VFI between first and last examinations were significantly different in POAG (p<0.001), and XFG (p<0.003) but not in NTG. VFI progression rates were -0.3, -0.43, and -0.2 % loss/year in treated POAG, XFG, and NTG, respectively. The number of empty triangles were statistically different between POAG-NTG (p=0.001), and XFG-NTG (p=0.002) groups. The number of half-filled (p=0.002), and full-filled (p=0.010) triangles were significantly different between XFG-NTG groups.

Conclusion: Functional long-term follow-up of glaucoma patients can be monitored with visual field indices. We herein report our fifteen year follow-up results in open angle glaucoma.

Purpose: To describe a surgical method for corneal pocket creation for KeraKlear keratoprosthesis implantation by PocketMaker microkeratome.

Methods: We implanted keratoprosthesis KeraKlear in 3 patients. In all cases, we used a microkeratome PocketMaker to create a corneal pocket, where the incision was made at a depth of 300 µm with a vibrating diamond blade.

Results: Although corneas have been extensively opaque and vascularized, in all three cases we successfully performed suction of the microkeratome system and created a corneal pocket without any difficulties. Subsequent keratoprosthesis implantations were performed without any problems.

Conclusion: The technique is simple, relatively cheap, and the creation of the corneal pocket is possible even in patients with vascularized and opaque cornea.

Purpose: To evaluate the normal distribution of exophthalmometric values in Turkish adult population and the effect of age, gender, refractive status and axial length on globe position.

Methods: One hundred and twenty-two males and 114 healthy females with age ranging from 18 to 87 years were included in the study. The study population was recruited from patients presenting to our institution for routine refractive examination. Hertel exophthalmometer was used to measure the degree of ocular protrusion. Effect of age, refractive error, interpupillary distance, and axial length on globe position was detected with linear regression analyses.

Results: The mean Hertel exophthalmometric size was 15.7+2.6 mm (range; 11 to 21 mm). The mean value for males was 16.1±2.6 mm (range; 11 to 21 mm), and for females 15.5±2.6 mm (range; 11 to 20 mm). The mean distance between the lateral rims of the orbit was 102 + 5.1 mm (range; 88 to 111mm). The mean exophthalmometric values were not statistically different in males and females. Age and mean spherical equivalents were negatively correlated with exophthalmometric measurements. Axial length was positively correlated with exophthalmometric measurements.

Conclusion: The exophthalmometric measurement of the eye is affected by the age, spherical equivalent and the axial length. Standard normative values of the Hertel exophthalmometric measurements should be reevaluated with larger samples.

Sight is one of the most important senses that human beings possess. The ocular system is a complex structure equipped with mechanisms that prevent or limit damage caused by physical, chemical, infectious and environmental factors. These mechanisms include a series of anatomical, cellular and humoral factors that have been a matter of study. The cornea is not only the most powerful and important lens of the optical system, but also, it has been involved in many other physiological and pathological processes apart from its refractive nature; the morphological and histological properties of the cornea have been thoroughly studied for the last fifty years; drawing attention in its molecular characteristics of immune response. This paper will review the anatomical and physiological aspects of the cornea, conjunctiva and lacrimal apparatus, as well as the innate immunity at the ocular surface.

Glaucoma is a neurodegenerative disease characterized by retinal ganglion cell (RGC) death and axonal loss. It remains a major cause of blindness worldwide. All current modalities of treatment are focused on lowering intraocular pressure (IOP), and it is evident that increased IOP is an important risk factor for progression of the disease. However, it is clear that a significant number of glaucoma patients show disease progression despite of pressure lowering treatments. Much attention has been given to the development of neuroprotective treatment strategies, but the identification of such has been hampered by lack of understanding of the etiology of glaucoma. Hence, in spite of many attempts no neuroprotective drug has yet been clinically approved. Even though neuroprotection is without doubt an important treatment strategy, many glaucoma subjects are diagnosed after substantial loss of RGCs. In this matter, recent approaches aim to rescue RGCs and regenerate axons in order to restore visual function in glaucoma. The present review seeks to provide an overview of the present and new treatment strategies in the management of glaucoma. The treatment strategies are divided into current available glaucoma medications, new pressure lowering targets, prospective neuroprotective interventions, and finally possible neuroregenrative strategies.

Glaucoma in children differs from adult-onset disease and typically requires surgical intervention. However, affected children exhibit a spectrum of disease severity and prospective data guiding the choice of operation are lacking. This article reviews common procedures and a surgical approach to pediatric glaucoma.

Confocal scanning laser ophthalmoscopy through the Heidelberg Retina Tomograph (HRT) provides a rapid, safe, noncontact, and noninvasive imaging of the optic disc in three-dimensions, and provides precise detailed information about the optic disc beyond that which the clinical exam can measure. The HRT I was developed for research purposes only and was not used clinically. The HRT II was developed to be user-friendly, more rapid, and was used as an adjunct to clinical examination in the detection and progression of glaucoma. One of the main pitfalls of the HRT II was that it was operator-dependent. The HRT III was developed to be operator-independent. Initially the Moorsfield Regression Analysis provided the analysis of the stereometric optic disc parameters. The Glaucoma Probability Score, given its ease of use, operator-independence, and rapidity of use, soon gained popularity. Numerous studies have compared these two methods of analysis, with the conclusion that the Glaucoma Probability Score provides a higher sensitivity and a lower specificity than the Moorsfield Regression Analysis, which may indicate that it has potential as a screening test for glaucoma. However, there is no consensus on the use of the Glaucoma Probability Score as a screening test for glaucoma. While HRT data may be useful as a clinical adjunct in the screening and diagnosis of glaucoma, it should ultimately only be used to support clinical examination.

Detection of progression and measurement of rates of change is at the core of glaucoma management, and the use of Spectral Domain Optical Coherence Tomography (SD-OCT) has significantly improved our ability to evaluate change in the disease. In this review, we critically assess the existing literature on the use of SD-OCT for detecting glaucoma progression and estimating rates of change. We discuss aspects related to the reproducibility of measurements, their accuracy to detect longitudinal change over time, and the effect of aging on the ability to detect progression. In addition, we discuss recent studies evaluating the use of combined structure and function approaches to improve detection of glaucoma progression.