PURPOSE: To compare the keratometry obtained from optical low-coherence reflectometry (Lenstar LS900®), autokeratometer (KR-8100®), and topography (Medmont E300®) in children. METHODS: A retrospective study was performed in 316 eyes of 160 subjects. Subjects were divided into 3 groups according to age. Group 1 was younger than 10 years, group 2 was older than 10 years and younger than 18 years, and group 3 was older than 18 years. Subjects were tested using the Lenstar LS900®, KR-8100®, and Medmont E300®. Comparisons were made for steep K, flat K, mean K, and astigmatism among three groups. Agreement among the 3 devices was examined using the Bland-Altman method. RESULTS: The keratometry measured by Medmont E300® was highest, followed by that of Lenstar LS900® and KR-8100® in all 3 groups. Almost all keratometry was significantly different among the 3 devices except for the flat K measured by LS900® and KR-8100® in all 3 groups and flat K measured by KR-8100® and Medmont E300® in Group 3 (p < 0.05). With regard to mean K, the agreement between Lenstar LS900® and KR-8100® was better than that between the other two pairs in both Groups 1 and 2, while agreement between Lenstar LS900® and Medmont E300® was better in Group 3. The agreement between KR-8100® and Medmont E300® was worse than that between the other two pairs in Groups 1 and 3, while the agreement between Lenstar LS900® and Medmont E300® was worse in Group 2. CONCLUSIONS: There were significant differences in keratometry among the 3 devices in all 3 groups. In children, Medmont E300® showed relatively less agreement compared with the other two devices. In adults, however, the agreement between 2 devices showed variable results. Consideration of the keratometry measurement from Lenstar LS900®, KR-8100®, and Medmont E300® might be helpful to estimate accurate corneal keratometry in children.
Adult ; Astigmatism ; Child* ; Humans ; Methods ; Retrospective Studies

Purpose: We compared optical biometric measurements made using new swept-source optical-coherence tomography, low-coherence reflectometry, autokeratometry, and A-scan biometry. Methods: In total, 86 eyes of 47 patients were included. Axial length, lens thickness, central corneal thickness, anterior chamber depth, and corneal curvature were measured using the Anterion® (Heidelberg Engineering, inc., Heidelberg, Germany) and Lenstar LS 900® (Haag-Streit AG, Koeniz, Switzerland) platforms. Corneal curvature and axial length were measured using the Essilor AKR 750® (Essilor instruments, France, Charenton-le-Pont) and PacScan 300A® (Sonomed Inc., Chicago, IL, USA) platforms, respectively. The evaluated biometric parameters were compared and verified; intraclass correlation coefficients and Bland-Altman plots were used to analyze statistical agreement. Results: The differences between the Anterion® and Lenstar LS 900® platforms in terms of axial length, lens thickness, central corneal thickness, anterior chamber depth, and white-to-white diameter were -0.02 ± 0.08, 0.08 ± 0.13, -2.66 ± 11.12, 0.05 ± 0.12, and 0.08 ± 0.26, respectively. All values were statistically significant. The mean corneal curvature between Anterion® and Lenstar LS 900® had a statistically significant difference of -0.08 ± 0.47, while the difference between the Anterion® and AKR 750® platforms was not significant. Biometric parameters measured using an Anterion® and other devices showed a strong positive correlation when assessed using Pearson’s correlation analysis; there was good agreement between the results when analyzed using intraclass correlation coefficients and Bland-Altman plots. Conclusions Optical biometric measurements made using the Anterion® platform were not significantly different from those obtained using other devices, but there were significant differences compared to the Lenstar LS 900® platform. Since these significant differences could influence decision making during intraocular lens selection for cataract surgery, the values are clinically useful for reference.

PURPOSE: To analyze the optical coherence tomographic patterns and clinical courses of patients with diabetic macular edema (DME) after treatment. METHODS: The charts of 65 patients with DME were retrospectively reviewed. Baseline optical coherence tomographic patterns of DME were categorized into the 4 groups: group 1 (9 eyes, 13.8%) showed diffuse retinal thickening, group 2 (21 eyes, 32.3%) had cystoid macular edema (CME), group 3 (13 eyes, 20.0%) demonstrated serous retinal detachment (SRD) and group 4 (22 eyes, 33.9%) had combined CME and SRD. Treatments for DME included intravitreal bevacizumab/triamcinolone injection, focal laser photocoagulation and vitrectomy. During 12 months of follow-up, changes in the patterns of DME were assessed. Additionally, the central retinal thickness (CRT) and best-corrected visual acuity (BCVA) were measured at baseline, 6 and 12 months. RESULTS: During 12 months of follow-up, 21 eyes (32.3%) showed changes in the DME pattern: 2 eyes (22.2%) in group 1, 3 (14.3%) in group 2, 4 (30.8%) in group 3 and 12 (54.5%) in group 4. A significantly greater proportion of eyes with changes in DME pattern underwent vitrectomy compared with those without changes in DME pattern (p = 0.012). There was a significant difference in CRT among the 4 groups; group 4 demonstrated the largest CRT at baseline, 6 and 12 months (p < 0.001, 0.002 and 0.029, respectively). However, there were no significant differences in BCVA among the 4 groups at baseline, 6 or 12 months (p = 0.879, 0.375 and 0.246, respectively). CONCLUSIONS: Clinical courses varied according to the tomographic patterns of DME after treatment, and the poorest anatomic outcome was found in group 4. Change in tomographic pattern of DME was correlated with the treatment of DME, which might suggest a poorer outcome in those patients than in the patients who maintained their DME patterns.
Follow-Up Studies ; Humans ; Light Coagulation ; Macular Edema* ; Prognosis ; Retinal Detachment ; Retinaldehyde ; Retrospective Studies ; Tomography, Optical Coherence ; Visual Acuity ; Vitrectomy

PURPOSE: To compare the refractive measurements obtained using a photorefractor (PlusoptiX S09, PlusoptiX GmbH, Germany) with those obtained using cycloplegic refraction in children. METHODS: We assessed the refractive status of 268 eyes in 134 children. The values acquired via photorefraction with a PlusoptiX S09 device were compared with those obtained by cycloplegic retinoscopy. Hyperopia (> or =+3.5 D), myopia (> or =-3.0 D), with the rule or against the rule astigmatism (> or =-1.5 D), and oblique astigmatism (> or =-1.0 D) were set as diagnostic criteria for refractive amblyopia risk factors (RARFs). The difference in the detection of RARFs by the two methods was the main outcome measure. RESULTS: The average spherical refractive power was -0.81 +/- 1.68 D for PlusoptiX S09 versus -0.26 +/- 2.00 D for cycloplegic retinoscopy (average difference -0.54 +/- 0.61 D; p < 0.001). The average spherical equivalent was -1.20 +/- 1.62 D for PlusoptiX S09 versus -0.64 +/- 1.94 D for cycloplegic retinoscopy (average difference -0.56 +/- 0.62 D; p < 0.001). The average cylinder power was -0.79 +/- 0.93 D for PlusoptiX S09 versus -0.76 +/- 0.94 D for cycloplegic retinoscopy (average difference -0.03 +/- 0.33 D; p = 0.135). Even though cycloplegic retinoscopy is considered the gold standard, the sensitivity and specificity for detecting RARFs with the PlusoptiX S09 were 88.0% and 96.3%, respectively. CONCLUSIONS: PlusoptiX S09 is a relatively useful method for detecting RARFs, but the device tends toward myopic shift compared to cycloplegic refraction, and hyperopia is underestimated.
Amblyopia ; Astigmatism ; Child* ; Humans ; Hyperopia ; Myopia ; Outcome Assessment (Health Care) ; Retinoscopy ; Risk Factors ; Sensitivity and Specificity

PURPOSE: To compare ocular biometry and refractive results measured using conventional applanation ultrasonography and 3 different optical interferometries, Lenstar LS900(R), AL-Scan(R) and OA-2000(R). METHODS: The biometries of 31 cataractous eyes were measured using ultrasonography, Lenstar LS900(R), AL-Scan(R) or OA-2000(R). The axial length, anterior chamber depth and keratometry were measured. The SRK/T formula was used to calculate intraocular lens power. Two months after cataract surgery, the refractive outcome was determined and results from the 4 different biometry methods were compared. RESULTS: Axial lengths were 23.39 +/- 0.95 mm, 23.42 +/- 0.98 mm, 23.43 +/- 0.98 mm and 23.44 +/- 0.98 mm measured using ultrasonography, Lenstar LS900(R), AL-Scan(R) and OA-2000(R), respectively with no statistically significant differences observed (p = 0.996). The anterior chamber depth and keratometry were 3.14 +/- 0.41 mm, 3.10 +/- 0.38 mm and 3.13 +/- 0.39 mm (p = 0.936) and 44.41 +/- 1.52 D, 44.54 +/- 1.57 D and 44.44 +/- 1.52 D (p = 0.937) for Lenstar LS900(R), AL-Scan(R) and OA-2000(R) respectively. There were no statistically significant differences between the 3 optical devices. The mean absolute error of the 4 different devices were not statistically significant (p = 0.722). CONCLUSIONS: The ocular biometric measurements and prediction of postoperative refraction using ultrasonography, Lenstar LS900(R), AL-Scan(R) or OA-2000(R) showed no significant differences.
Anterior Chamber ; Biometry ; Cataract ; Interferometry* ; Lenses, Intraocular ; Optical Devices ; Refractive Errors ; Ultrasonography*

Chronic sublethal hypoxia induces brain adaptations associated with changes in neurovascular behavior. Changes to the neurovasculature also influence the formation of the brain-blood barrier (BBB). In this study, I investigated the influence of chronic sublethal hypoxia on astrocytes, using the coculture transwell model of primary cultured astrocytes and RBE4 (brain endothelial) cells. Using a 3D collagen gel model, cytoplasmic processes of astrocytes extended to clumps of endothelial cells. The numbers of astrocytes increased in cocultured and chronic hypoxic environments in the transwell model. Western blotting showed increased production of glial fibrillar acidic protein (GFAP) and proliferating cellular nuclear antigen (PCNA) in chronic hypoxia. I also confirmed the influence of hypoxia on the behavior of astrocytes in this model, using confocal microscopy. The numbers of cytoplasmic processes of astrocytes within the membrane increased in z sections. These data support the idea that chronic hypoxia might induce alterations in the formation of the BBB as part of the adaptation of the brain to chronic hypoxia. These transwell and 3D collagen gel models will probably be useful for functional as well as morphological experiments.
Anoxia* ; Astrocytes* ; Blood-Brain Barrier ; Blotting, Western ; Brain ; Coculture Techniques* ; Collagen ; Cytoplasm ; Endothelial Cells ; Membranes ; Microscopy, Confocal

No abstract available.
Nasal Surgical Procedures*

PURPOSE: To compare the myopic progression before and after wearing an orthokeratology lens (OK). METHODS: Twenty-six patients (49 eyes) with at least 6 months of myopia prior to OK treatment were evaluated. Changes in the spherical equivalent (SE) refractive error and axial length were compared before and after OK use. Changes in the SE and axial length were also compared between two groups according to the myopic progression before baseline: Group 1 with myopic progression < 1 D/year and Group 2 with myopic progression > 1 D/year. RESULTS: The myopic progression rate decreased from −1.1 to −0.3 D/year after OK treatment (p < 0.001). Greater increases in axial length were observed in patients who were younger and had less myopia at baseline, a higher rate of myopia progression before baseline, and a shorter axial length at baseline (p < 0.001, p < 0.004, p < 0.007, and p < 0.001, respectively). The increase in axial length was significantly greater in the group with greater myopic progression before baseline (0.2 mm/year) than in the group with less myopic progression (0.1 mm/year) (p = 0.001). CONCLUSIONS: Myopic progression was reduced significantly after OK treatment.
Humans ; Myopia ; Refractive Errors

Objectives: . The aim of this study was to investigate whether preserved vestibular function in the high-frequency range influences the prognosis of patients with bilateral vestibulopathy (BVP) after vestibular rehabilitation. Methods: . Twenty-four patients followed up with vestibular rehabilitation were recruited. The enrolled patients were divided into two groups according to the preservation of the high-frequency vestibulo-ocular reflex (VOR) based on the video head impulse test (vHIT). The results of computerized dynamic posturography and the Dizziness Handicap Inventory (DHI) survey collected at baseline and at the 6-month follow-up after vestibular rehabilitation therapy were analyzed. Results: . Both groups showed significantly increased composite and DHI scores after follow-up with vestibular rehabilitation. The group with preserved high-frequency VOR showed a better composite score (p=0.064) and vestibular score (p= 0.008) than the group with lost high-frequency VOR at the 6-month follow up. The DHI score significantly decreased only in the group with lost high-frequency VOR (p=0.047). Among the three vestibular function tests (caloric test, rotary chair test, and vHIT) used to diagnose BVP, only vHIT showed a significant correlation (p=0.015) with a favorable prognosis (composite score ≥70). Conclusion . Better treatment outcomes are likely in patients with BVP with preserved vestibular function in response to high-frequency stimulation, as measured by the vHIT.

Objectives: . The aim of this study was to investigate whether preserved vestibular function in the high-frequency range influences the prognosis of patients with bilateral vestibulopathy (BVP) after vestibular rehabilitation. Methods: . Twenty-four patients followed up with vestibular rehabilitation were recruited. The enrolled patients were divided into two groups according to the preservation of the high-frequency vestibulo-ocular reflex (VOR) based on the video head impulse test (vHIT). The results of computerized dynamic posturography and the Dizziness Handicap Inventory (DHI) survey collected at baseline and at the 6-month follow-up after vestibular rehabilitation therapy were analyzed. Results: . Both groups showed significantly increased composite and DHI scores after follow-up with vestibular rehabilitation. The group with preserved high-frequency VOR showed a better composite score (p=0.064) and vestibular score (p= 0.008) than the group with lost high-frequency VOR at the 6-month follow up. The DHI score significantly decreased only in the group with lost high-frequency VOR (p=0.047). Among the three vestibular function tests (caloric test, rotary chair test, and vHIT) used to diagnose BVP, only vHIT showed a significant correlation (p=0.015) with a favorable prognosis (composite score ≥70). Conclusion . Better treatment outcomes are likely in patients with BVP with preserved vestibular function in response to high-frequency stimulation, as measured by the vHIT.