PURPOSE: To compare the anterior segment parameters including precorneal tear film thickness (PTFT) using Pentacam(R) (Oculus, Wetzlar, Germany) between normal control and dry eye groups and to examine the relationships between the PTFT and other parameters for dry eye. METHODS: The present study included 23 normal controls (31 eyes) and 25 patients with dry eyes (31 eyes). We compared measurements including PTFT, corneal thickness and astigmatism using Pentacam(R) and analyzed the correlations among the PTFT and fluorescein tear break-up time (FBUT), Schirmer I test (without anesthesia), and ocular surface disease index (OSDI). RESULTS: The mean PTFT in dry eyes (21.1 +/- 2.0 microm) was significantly thinner than in normal eyes (37.6 +/- 2.0 microm; p < 0.01). In the dry eye group, the corneal thickness was thicker than in the normal eye group but there were no clinically significant differences. The dry eye group experienced more frequent and severe corneal astigmatism compared with the normal group. OSDI scores showed a weak negative correlation with objective clinical measures of dry eye (FBUT, Schirmer I test) but was not statistically significant. However, OSDI was statistically significantly negatively correlated with PTFT (r = -0.46, p < 0.01). The PTFT showed a weak positive correlation with FBUT and Schirmer I test without statistical significance. CONCLUSIONS: The mean PTFT using Pentacam(R) in the dry eye group was thinner than in the normal group. Additionally, the PTFT was correlated with subjective symptoms. Therefore, the PTFT measurement using Pentacam(R) could be considered a useful method for diagnosis and treatment of dry eye.
Astigmatism ; Diagnosis ; Fluorescein ; Humans ; Tears*

PURPOSE: To evaluate the usefulness of the retinal nerve fiber layer thickness and peripapillary atrophy in discrimination between normal and glaucoma patients with small optic discs which can be potentially misleading by cup-to-disc ratio. METHODS: Eyes with average disc diameter 1.617 mm or less which is 33 percentile by topographic scanning system (TopSST M, version 2.2, LDT, Inc., U.S.A) in our normal population study were enrolled. 82 eyes of 82normal subjects, 30 eyes of 30 patients with primary open-angle glaucoma (POAG), 16 eyes of 16 patientswith normal tension glaucoma (NTG) were studied. Program 30-2 of the Humphrey Field and scanning laser polarimetry (Nerve Fiber Analyzer II : NFAII, version 2.1., LDT, Inc., U.S.A.) were performed and color optic disc photographs had been taken. The differences in NFA parameters and peripapillary atrophy (zone alpha and zone beta) between normal subjects and glaucoma patients were examined. RESULTS: Considering all the NFA parameters, superonasal ratio of POAG and NTG group was significantly lower than normal group (p=0.002, p=0.043, respectively) and inferonasal ratio of POAG group was significantly lower than normal group (p=0.020). Zone beta atrophy was detected more frequently in POAG and NTG group than normal group (p=0.015, 0.007, respectively). No significant correlation was found between superonasal, inferonsal ratio and visual field indices and the presence of zone beta was not associated with progression of visual field. CONCLUSIONS: In small optic discs which had been presented diagnostic difficulties with optic disc status, retinal nerve fiber layer thickness (superonasal or inferonasal ratio) and/or peripapillary atrophy (zone beta) analysis can be helpful in identifying glaucoma.
Atrophy* ; Discrimination (Psychology) ; Glaucoma* ; Glaucoma, Open-Angle ; Humans ; Low Tension Glaucoma ; Nerve Fibers* ; Retinaldehyde* ; Scanning Laser Polarimetry ; Visual Fields

PURPOSE: An optimal concentration of hEGF to enhance epithelial healing was determined in the rabbit eyes after alkali wounds. METHODS: Alkali-injured corneas (=5.5 mm, 1N NaOH, 60s) were treated with 0 (control), 2, 5, 10, and 50microgram/ml hEGF 3 times per day. The measurement of epithelial healing rate, transmission electron microscopy and immunohistochemical observation were performed after 7 days treatment. RESULTS: No significant difference was observed in the rates of epithelial healing between control and each hEGF-treated group. Among the tested concentrations, 5microgram/ml hEGF induced the most active proliferation of basal cells and 50microgram/ml hEGF remarkably produced a vascular ingrowth to the central wound area. The number of epithelial layers was increased by hEGF in a concentration-dependent manner. CONCLUSIONS: A low concentration of hEGF may selectively enhance epithelial healing without inducing corneal neovascularization. The optimal concentration of hEGF for the stimulation of basal cell proliferation appears to be 5 microgram/ml in rabbit corneal alkali wounds.
Alkalies* ; Cell Proliferation ; Cornea ; Corneal Neovascularization ; Microscopy, Electron, Transmission ; Wounds and Injuries*

PURPOSE: Only a few cases of keratoconjunctivitis caused by Chlamydophila psittaci have been reported worldwide, and no case reported in Korea. We report an atypical case of keratoconjunctivitis caused by Chlamydophila psittaci. CASE SUMMARY: A 34-year-old male patient who had raised a parrot at home presented with three weeks of conjunctival injection and a week of ocular pain in his left eye. There were papillae on the left upper and lower tarsal conjunctiva and punctuate epithelial erosion of the entire cornea. He also complained of dizziness, fever, and dyspnea. Upon chest X-ray, consolidation on the right middle lobe was apparent. The Chlamydophila IgM antibody test was positive, and the pneumonia improved quickly. Nevertheless, signs of keratoconjunctivitis persisted despite 3-week treatment with oral doxycycline. As a result, the patient received an additional 10-day treatment with oral azithromycin. Four weeks after the first visit, symptoms were improving gradually, and, after six weeks, no signs of keratoconjunctivitis remained except minimal erosion. CONCLUSIONS: When patients show keratoconjunctivitis after contact with a bird, prolonged ketatoconjunctivitis by Chlamydophila psittaci should be considered.
Adult ; Azithromycin ; Birds ; Chlamydophila ; Chlamydophila psittaci ; Conjunctiva ; Cornea ; Dizziness ; Doxycycline ; Dyspnea ; Eye ; Fever ; Humans ; Immunoglobulin M ; Keratoconjunctivitis ; Korea ; Male ; Parrots ; Pneumonia ; Thorax

PURPOSE: To compare the corneal first surface higher-order aberrations (HOAs) of normal subjects and patients with dry eye using KR-1W(R) (Topcon Corp., Tokyo, Japan) and Pentacam(R) HR (Oculus Inc., Dutenhofen, Germany). We analyzed the relationship between the aberrations and the diagnostic parameters of dry eye. METHODS: We evaluated anterior corneal HOAs in 71 normal eyes and 71 dry eyes using KR-1W(R) and Pentacam(R). Dry eye patients were examined for fluorescein staining, tear break-up time (TBUT), and Schirmer I test. Ocular Surface Disease Index (OSDI) was used for assessment of subjective symptoms in dry eye patients. RESULTS: HOAs measured by both instruments were greater in the dry eye group than in the control group, although HOAs using KR-1W(R) only achieved statistical significance. The anterior corneal HOAs measured by the 2 instruments were significantly correlated with superficial punctate keratitis. Moreover, TBUT and the Shirmer I test negatively correlated, and OSDI positively correlated, with anterior corneal HOAs. CONCLUSIONS: The HOAs in patients with dry eye were significantly different from controls and tended to increase with disease severity. KR-1W(R) might be more useful than Pentacam(R) to detect tear film instabilities.
Fluorescein ; Humans ; Keratitis ; Tears

PURPOSE: To investigate the accuracy of biometry and intraocular lens (IOL) power calculation using partial coherence interferometry (IOL Master(R)) in highly myopic patients with axial lengths of 26 mm or greater. METHODS: Patients with axial lengths equal to or greater than 26 mm who had undergone cataract surgery were enrolled. IOL power was calculated using IOL Master and/or applanation ultrasonography with the SRK/T formula. Twenty-seven eyes using both IOL Master and applanation ultrasonography were included in a paired group, and forty-eight eyes using the IOL Master only and twenty-five eyes using applanation ultrasonography only were included in unpaired groups. The differences between the predicted refraction and the actual refraction were compared and analyzed. RESULTS: In the paired study, the axial lengths in patients using IOL Master (29.14+/-2.32 mm) were significantly longer than those of patients using applanation ultrasonography (28.57+/-2.23 mm) (p<0.05). The mean absolute error (MAE) of the IOL Master and applanation ultrasonography groups were 0.62+/-0.58D and 0.87+/-0.49D, respectively (p>0.05). In the unpaired study, the MAEs of the IOL Master and applanation ultrasonography groups were 0.61+/-0.61D and 0.65+/-0.63D, respectively. CONCLUSIONS: In eyes with axial lengths of 26.0 mm or greater, the accuracy of IOL power calculation with IOL Master using the SRK/T formula was comparable to that with applanation ultrasonography.
Biometry ; Cataract ; Eye ; Humans ; Interferometry ; Lenses, Intraocular ; Myopia

PURPOSE: To compare the corneal higher-order aberrations (HOAs) of normal young subjects using Galilei(TM) G4 (Zeimer, Port, Switzerland) and Pentacam(R) (Oculus Inc., Wetzlar, Germany). METHODS: Corneal HOAs were measured using Galilei(TM) G4 and Pentacam(R) in 41 healthy individuals (41 eyes). Intraclass correlation coefficients (ICCs) were obtained to evaluate the repeatability of the 2 devices. Differences in HOAs between the 2 instruments were analyzed with a paired t-test and correlations evaluated. RESULTS: All ICCs measured using Galilei(TM) G4 and Pentacam(R) showed more than moderate repeatability (>0.81) except trefoil, tetrafoil, 4th and 5th HOAs. When comparing the measurements obtained with Galilei(TM) G4 and Pentacam(R), total HOAs, spherical aberration (SA), secondary astigmatism and 5th total HOAs were statistically significantly different between the 2 device (all p < or = 0.001). In addition, Galilei(TM) G4 and Pentacam(R) showed discrepancy among all corneal HOAs items. Although the total corneal HOAs and the SA were significantly correlated, other HOA measurements generally exhibited a low correlation. CONCLUSIONS: Corneal HOAs obtained by the 2 instruments cannot be used interchangeably due to their differences and discrepancy although corneal HOAs measured using Galilei(TM) G4 and Pentacam(R) showed relatively high repeatability.
Astigmatism ; Lotus

PURPOSE: To reconstruct a cultured conjunctival equivalent that closely resembles normal conjunctival epithelium in three-dimensional culture systems. METHODS: Human conjunctival epithelial cells were cultured on dead de-epidermized dermis in the air-exposed state. After 2 weeks of culture, the sections were stained with hematoxylin and eosin. Immunohistochemical and electron microscopic studies were performed. The results were compared with those of normal conjunctiva and cultured eyelid skin equivalent. RESULTS: In the cultured conjunctival equivalent, nonkeratinizing stratified epithelium was formed similarly to normal conjunctival epithelium. Keratin 13 was expressed, but not keratin 10, in the cultured conjunctival equivalent, similarly to normal conjunctival epithelium. However, in the cultured eyelid skin equivalent, keratinizing stratified epithelium was formed. In addition, keratin 10 was expressed, but not keratin 13, contrary to those of the cultured conjunctival equivalent. In the cultured conjunctival equivalent, ultrastructurally, keratin intermediate filaments and desmosomes were found. In addition, microvilli were seen in the uppermost epithelial cells. CONCLUSIONS: These findings demonstrate that the cultured conjunctival equivalent resembles normal conjunctival epithelium morphologically, biochemically and ultrastructurally, thereby suggesting that the cultured conjunctival equivalent may have a great potential in the study of conjunctival epithelium.
Conjunctiva ; Dermis ; Desmosomes ; Eosine Yellowish-(YS) ; Epithelial Cells ; Epithelium* ; Eyelids ; Hematoxylin ; Humans ; Intermediate Filaments ; Keratin-10 ; Keratin-13 ; Microvilli ; Skin

PURPOSE: To evaluate the in vivo corneal endothelial changes after intravitreal bevacizumab (Avastin(R); Genentech Inc., San Francisco, California, USA) injection. METHODS: A total of 30 eyes of 28 patients who received intravitreal bevacizumab injections were included in the present study. Before injection and one and three months after injection, specular microscopy was performed to analyze the corneal endothelial cell changes. In order to compare the differences in the changes of corneal endothelial cells, the eyes were divided into two groups, a single injection group and a multiple injection group. RESULTS: The mean endothelial cell count decreased from 2,497.4 +/- 427.8 at baseline to 2,421.2 +/- 430.5 at one month and to 2,362.7 +/- 366.2 at three months after the injection in all patients. However, the change in endothelial cell count was not statistically significant. In addition, the postoperative change in endothelial cell count was more prominent in the multiple injection group than in the single injection group, although the difference was again not significant. No significant changes in preoperative or postoperative coefficients of variation for cell area or hexagonalities were observed in either patient group or within each group. CONCLUSIONS: There was no significant change in corneal endothelial cells after intravitreal bevacizumab injection. In addition, there was no significant difference in the changes in corneal endothelial cells according to the number of bevacizumab injections.
Antibodies, Monoclonal, Humanized ; California ; Cornea ; Endothelial Cells ; Endothelium ; Eye ; Humans ; Microscopy ; San Francisco ; Bevacizumab

PURPOSE: To study the clinical course of herpes zoster ophthalmicus (HZO) and to compare the demographics, treatments, and outcomes in patients under 50 years of age versus patients 50 years of age or older at the time of diagnosis. METHODS: A retrospective chart review was performed of 102 patients who were diagnosed with HZO between January 1, 2008 and December 31, 2010. Baseline demographics and clinical characteristics between patients with an onset of HZO under the age of 50 years and patients with an onset of HZO at the age of 50 years or older were compared. RESULTS: Similar numbers of patients were affected with HZO in the younger and older age groups (n = 44, 43.1%, vs. n = 58, 56.9%). The mean +/- SD of age was 50.6 +/- 21.8 years (range, 3-89 years) and the most common decade of HZO onset was between 50 and 59 years. Gender and disease laterality were not statistically different between the 2 groups. No significant difference was found regarding the presence of any ocular manifestation between the groups; however, anterior uveitis was more frequent in the younger patients (p = 0.04). The number of patients with immunosuppressive therapy was higher in the younger age group (p = 0.01). CONCLUSIONS: HZO-affected patients under the age of 50 years and older than 50 years were equally distributed, with the most common decade of onset between the age of 50 and 59 years. Younger patients had a higher incidence of anterior uveitis and immunosuppressive therapy due to underlying systemic diseases.
Demography ; Diagnosis ; Herpes Zoster Ophthalmicus* ; Humans ; Incidence ; Retrospective Studies ; Uveitis, Anterior