PURPOSE: Recently, the introduction of spectral-domain optical coherence tomography (SD-OCT) has enabled measurement of retinal thickness in the posterior pole in 64 sectors. SD-OCT was used to evaluate the diagnostic effectiveness in detecting glaucomatous abnormality of visual field sensitivity. A normal value for retinal thickness was determined and then compared in corresponding local sectors. METHODS: Thirty healthy controls and 30 glaucoma subjects were evaluated. Macular thickness values from the 4 adjacent square cells in an 8 x 8 posterior pole retinal thickness map were averaged for a mean retinal thickness (MRT) value. A normative database was prepared using the data from the healthy eyes of this study to determine the diagnostic criteria for MRT. If the MRT value was <5% (Criteria A) or <1% (Criteria B) of the normative database, it was considered to be abnormal. The abnormalities of the MRT value for each diagnostic criteria were compared with the visual field sensitivity results in the corresponding positions. RESULTS: The concordance of abnormalities between MRT and visual field sensitivity at 16 measured points was low in both criteria A (Kappa value; -0.418~0.429) and B (Kappa value; -0.363~0.444). Based on the results of the visual field at each focal point, the sensitivities and specificities of MRT values using the 2 criteria ranged from 0% to 100%. CONCLUSIONS: In this study, MRT values showed low correlation and diagnostic ability to detect decreased sensitivity of the visual field in corresponding points, when customized criteria derived from a normative database were applied.
Glaucoma ; Reference Values ; Retinaldehyde* ; Tomography, Optical Coherence* ; Visual Fields

PURPOSE: To compare dorzolamide-timolol fixed combination (DTFC) and latanoprost with regard to their effects on intraocular pressure (IOP) and ocular pulse amplitude (OPA). METHODS: Sixty eyes of 60 patients with open angle glaucoma or glaucoma suspect were included in the present study. Patients were divided into 2 groups, DTFC-treated (n = 30) and latanoprost-treated (n = 30). IOP and OPA were measured with dynamic contour tonometer (DCT) and Goldmann applanation tonometer (GAT), before and at least 1 month after treatment. RESULTS: GAT IOP, DCT IOP and OPA decreased by 2.25 +/- 2.23 mm Hg, 1.97 +/- 2.06 mm Hg, and 0.14 +/- 0.88 mm Hg, respectively in the DTFC-treated group. In the latanoprost-treated group, GAT IOP, DCT IOP and OPA was reduced by 2.74 +/- 2.96 mm Hg, 2.06 +/- 3.50 mm Hg, and 0.69 +/- 1.07 mm Hg, respectively. There was no significant difference (p = 0.311) in the decline of IOP between the 2 groups, but OPA of the DTFC-treated group decreased less than the latanoprost-treated group (p = 0.032). CONCLUSIONS: No significant differences were observed in the short-term decline of IOP between the 2 medications. However, the influence of DTFC on OPA appeared negligible in the latanoprost-treated group.
Glaucoma ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure*

PURPOSE: This study was designed to compare the outcomes in idiopathic epiretinal membrane (ERM) surgery according to solvents of indocyanine green (ICG) for internal limiting membrane (ILM) peeling. METHODS: The medical records of 27 patients (27 eyes) with idiopathic ERM who had undergone pars plana vitrectomy with ICG staining for ILM peeling were retrospectively reviewed. The patients were divided into two groups according to solvents of 0.25% ICG solutions. Solvents used were balanced salt solution (BSS) in group I (15 eyes) and 5% glucose in group II (12 eyes). The severity of ERM, the duration of symptoms, the preoperative and postoperative best corrected visual acuity (BCVA) values, the visibility of the stained ILM (Good, Fair, Poor), and the postoperative complications were compared in the two groups. RESULTS: There was no statistically significant difference in the severity of ERM, the duration of symptoms and the preoperative BCVA in the two groups. The postoperative BCVA was significantly improved in both groups, and the difference was not statistically significant (p = 0.675). There was a significantly smaller number of eyes with poor ILM staining in group II than in group I (p = 0.014). No complications such as recurrence of ERM, atrophy of the retinal pigment epithelium (RPE) or retinal detachment were observed in the two groups. CONCLUSIONS: The higher specific gravity of 5% glucose compared with that of BSS as ICG solvents allows for improved ILM visualization. Therefore using the 5% glucose-ICG solution for staining ILM improved the visibility of ILM compared BSS-ICG solution and led to comparable visual recovery.
Atrophy ; Epiretinal Membrane* ; Glucose ; Humans ; Indocyanine Green ; Medical Records ; Membranes* ; Postoperative Complications ; Recurrence ; Retinal Detachment ; Retinal Pigment Epithelium ; Retrospective Studies ; Solvents ; Specific Gravity ; Visual Acuity ; Vitrectomy

PURPOSE: To evaluate changes in subfoveal choroidal thickness in patients with malignant hypertension. METHODS: A total of 12 eyes of six malignant hypertension patients were included in the present study. Intraocular pressure, blood pressure (systolic and diastolic), and choroidal thickness were measured before and after blood pressure control. Choroidal thickness was measured using enhanced depth imaging optical coherence tomography (EDI-OCT). The changes in choroidal extravascular density of the EDI-OCT image after blood pressure control were evaluated by comparing brightness values obtained with Adobe Photoshop software. RESULTS: The subfoveal choroidal thickness (SFCT) of malignant hypertension patients was 412.63 +/- 66.55 microm (mean +/- SD), which was thicker than in normal patients. After blood pressure control, SFCT decreased significantly to 356.96 +/- 59.08 microm (mean +/- SD) (p = 0.002). The choroidal extravascular density of the EDI-OCT image decreased after blood pressure control (p = 0.002), and the mean change was 17.21 +/- 7.56. CONCLUSIONS: The choroid is thickened in patients with malignant hypertension, and its thickness decreases after blood pressure control. This suggests that changes in blood pressure may affect choroidal thickness.
Blood Pressure ; Choroid* ; Humans ; Hypertension, Malignant* ; Hypertensive Retinopathy ; Intraocular Pressure ; Tomography, Optical Coherence

PURPOSE: To investigate the shape of normal fovea in Korean subjects in their 20's using spectral domain optical coherence tomography (SD-OCT). METHODS: One hundred-twelve emmetropic eyes of 60 subjects and 100 myopic eyes of 58 subjects between 20 and 29 years of age were included in this study. Central foveal thickness (CFT), regional maximal retinal thickness (MRT), pit diameter, pit depth, and slope were obtained using Spectralis OCT and analyzed according to spherical equivalent and gender. RESULTS: In emmetropic and myopic eyes, MRT was significantly thinner temporally (p < 0.001) than in other regions and pit diameter was wider horizontally than vertically (p < 0.001). The CFT was significantly thicker and all regional MRT was thinner in myopic eyes than in emmetropic eyes (p < 0.001). Foveal pits were narrower and shallower in myopic eyes (p < 0.001). In both groups, CFT and all regional MRT in males were significantly thicker than in females (p < 0.05); however, no difference between the genders in horizontal pit diameter, pit depth, and slope were found. CONCLUSIONS: In normal subjects, statistically significant differences were found in foveal shapes between subjects with different spherical equivalent and gender. These differences should be considered when interpreting a foveal shape. Knowledge of the normal foveal morphology is important when conducting further macular studies.
Emmetropia* ; Female ; Humans ; Male ; Myopia* ; Retinaldehyde ; Tomography, Optical Coherence*

PURPOSE: To evaluate the accuracy of intraocular lens (IOL) power calculations between Hoffer Q and other formulas according to corneal curvature by comparing the results of cataract surgery and calculation of chosen formulas in short axial lengths. METHODS: We performed a retrospective analysis of patients who underwent cataract surgery from January 1st, 2012 to June 12th, 2012. The patients were selected if their axial length was below 23.00 mm and 77 patients (90 eyes) were included in the present study. The patients were divided into 2 groups according to mean corneal curvature below 44.0 D and over 45.0 D. IOL power was calculated using the Hoffer Q and SRK II, SRK-T and Holladay I formulas and the error between the calculations and refractive outcome of cataract surgery were measured. The accuracy of each formula was evaluated by comparing the error between the 2 groups. RESULTS: Hoffer Q formula showed a higher predictive accuracy than other formulas regardless of corneal curvature in eyes with short axial lengths (p < 0.001, p = 0.023). Particularly, SRK II, SRK-T and Holladay I showed a lower predictive accuracy in eyes with flat corneal curvature than Hoffer Q (p < 0.001, p = 0.215). CONCLUSIONS: In eyes with short axial lengths, preoperative predicted IOL power calculations showed better accuracy with Hoffer Q formula than SRK II, SRK-T and Holladay I formulas. SRK II, SRK-T and Holladay I formulas showed a lower predictive accuracy in flat corneal curvature eyes than steep corneal curvature eyes with short axial lengths. We hypothesize that SRK II, SRK-T and Holladay I tend to underestimate effective lens position in eyes with short axial lengths indicating Hoffer Q formula is more accurate.
Cataract ; Humans ; Lenses, Intraocular* ; Retrospective Studies

PURPOSE: To evaluate the target refraction of patients with binocular myopia and monocular cataract after intraocular lens (IOL) implantation. METHODS: This study comprised 199 patients with binocular myopia (axial length >25 mm) and monocular cataract after IOL implantation for the removal of the monocular cataract. The research was conducted using a questionnaire method and by performing statistical analysis of the refractive outcomes. RESULTS: The patients are grouped into 3 domains (< or =-3 D group, -3~-6 D group, >-6 D group). There were no statistically significant differences among the 3 groups; whereas the satisfaction of the present corrected state was statistically low in the >-6 D group (p < 0.05). The satisfaction of the corrected state was statistically high in the group of postoperative anisometropia under 3 D (p < 0.05). There was no statistical difference between the groups on the satisfaction of target diopter (-2~-3 D or emmetropia). In terms of correction method, glasses were worn in 119 patients (60%), contact lenses were worn in 26 patients (13%), and monovision was used in 14 patients (7%) were used respectively. Forty patients (20%) with implanted IOL in both eyes did not use any of the correction methods above. Except for the contact lens group, the general satisfaction and the satisfaction of the present corrected state were statistically lower than the other group (p < 0.05). There was no statistically significant difference among the 3 groups in the percentage of cataract surgery in the fellow eye. CONCLUSIONS: There was no statistical difference between the groups in satisfaction of target diopter (-2~-3 D or emmetropia). Setting the target refraction difference between both eyes less than 3 D leads to more satisfactory outcomes.
Anisometropia ; Cataract* ; Contact Lenses ; Eyeglasses ; Glass ; Humans ; Lenses, Intraocular ; Myopia* ; Surveys and Questionnaires ; Telescopes*

PURPOSE: To evaluate preoperative and postoperative spherical aberrations after cataract surgery based on selecting spherical or aspheric intraocular lens (IOL) according to preoperative corneal aberration. METHODS: The medical records of patients who underwent phacoemulsification and IOL implantation in the posterior chamber by a surgeon (H.J.C) were reviewed (68 patients, 97 eyes). IOL was selected based on preoperative corneal spherical aberration measured by corneal topography (ATLAS 9000, Carl Zeiss). The target postoperative total ocular spherical aberration was set to zero (0) and one of the following lenses was chosen: Acrysof SA60AT (n = 25), Acrysof IQ (n = 36) or Tecnis(R) ZCB00 (n = 36). The Wavescan aberrometer and the corneal topography were obtained postoperatively. Absolute prediction errors of postoperative total ocular spherical aberration were analyzed. RESULTS: Preoperative corneal spherical aberration was 0.241 microm; total postoperative ocular spherical aberration was 0.0509 microm (Acrysof SA60AT: 0.0954 microm, Tecnis(R) ZCB00: 0.0374 microm, Acrysof IQ: 0.0335 microm). Postoperative corneal spherical aberration was 0.232 microm, which was not significantly different from the preoperative value (p = 0.199). Postoperative ocular spherical aberration was 0.051 microm; 0.095 microm (Acrysof SA60AT), 0.034 microm (Acrysof IQ), and 0.037 microm (ZCB00). The reducing amounts of spherical aberration were 0.185 microm (Acrysof IQ) and 0.311 microm (ZCB00). The overall absolute prediction error was 0.068 microm. The absolute prediction error of the Acrysof SA60AT group was 0.092 microm, Tecnis(R) ZCB00 group was 0.067 microm and Acrysof IQ group was 0.054 microm. There was no significant difference among the 3 groups (p = 0.089). CONCLUSIONS: Aspheric IOLs can efficiently reduce total ocular spherical aberrations according to preoperative corneal spherical aberrations.
Cataract* ; Corneal Topography ; Humans ; Lenses, Intraocular ; Medical Records ; Phacoemulsification

PURPOSE: To investigate the clinical availability of AL-Scan(R) (Nidek, GAMAGORI, Japan) by comparing anterior segment parameters measured with AL-Scan(R) and Pentacam(R) (Oculus, Wetzlar, Germany). METHODS: Seventy-three patients (117 eyes) who received refractive surgery at our hospital were tested with AL-Scan(R) and Pentacam(R). We compared measurements including anterior chamber depth, central corneal thickness, white-to-white, and corneal curvature. RESULTS: When comparing measurements obtained with AL-Scan(R) and Pentacam(R), the anterior chamber depth (p < 0.001), central corneal thickness (p < 0.001) and 2.4 mm zone K value (p = 0.038) showed significant differences; the white-to-white (p = 0.348) and 3.3 mm zone K value (p = 0.429) showed no significant differences. All AL-Scan(R) and Pentacam(R) parameters had a strong positive linear correlation (p < 0.001). The Bland-Altman plots showed a high degree of agreement between AL-Scan(R) and Pentacam(R) in all parameters except for anterior chamber depth. CONCLUSIONS: AL-Scan(R) is convenient to use clinically because simultaneous measurements of ocular biometry including axial length, intraocular lens power, and topography are possible. However, because differences in some anterior segment parameters exist when compared with Pentacam(R), measurements with AL-Scan(R) may require comparisons with other instruments.
Anterior Chamber ; Biometry ; Humans ; Lenses, Intraocular ; Refractive Surgical Procedures

PURPOSE: To analyze the clinical and radiologic findings and to evaluate the treatment and prognosis of epithelial tumor patients. METHODS: We retrospectively reviewed clinical and radiologic findings of 36 patients who had been histopathologically diagnosed with epithelial tumors of the lacrimal gland after biopsy and surgery at Seoul St. Mary's Hospital from May 2005 to October 2012. RESULTS: Among the patients with epithelial tumors of the lacrimal gland based on histopathological findings, there were 21 cases of pleomorphic adenoma, seven cases of dacryops, four cases of adenoid cystic carcinoma, two cases of adenocarcinoma, one case of benign oncocytoma, and one case of mucoepidermoid carcinoma. The characteristic clinical finding of epithelial tumors of the lacrimal gland was proptosis (52.7%). In contrast with benign epithelial tumors of the lacrimal gland, the characteristic clinical findings of malignant epithelial tumors of the lacrimal gland were limitation of motion (57.1%), diplopia (57.1%), ocular pain (42.9%), and decreased visual acuity (42.9%). The mean duration of the symptoms of malignant epithelial tumors (5.0 +/- 4.2 months) was shorter than that of benign epithelial tumors (11.2 +/- 11.1 months) (t-test, p = 0.034). In radiologic CT and MRI findings, there was minimal bony destruction in two cases of pleomorphic adenoma and calcification in one case of pleomorphic adenoma. Malignant epithelial tumors of the lacrimal gland, in contrast to benign tumors, showed characteristic bony destruction (57.1%), poorly marginated tumor outline (42.9%) and calcification (14.3%). The 57.1% of patients in this study with malignant tumors were treated with chemotherapy and radiotherapy after surgical treatment, and there was one case (14.3%) of recurrence after treatment. CONCLUSIONS: Careful analysis of clinical and radiologic findings can lead to early diagnosis of malignant tumors.
Adenocarcinoma ; Adenoma, Oxyphilic ; Adenoma, Pleomorphic ; Biopsy ; Carcinoma ; Carcinoma, Adenoid Cystic ; Carcinoma, Mucoepidermoid ; Diplopia ; Drug Therapy ; Early Diagnosis ; Exophthalmos ; Humans ; Lacrimal Apparatus* ; Magnetic Resonance Imaging ; Prognosis ; Radiotherapy ; Recurrence ; Retrospective Studies ; Seoul ; Visual Acuity