OBJECTIVE: To compare the agreement of anterior chamber angle examination by ultrasound biomicroscope (UBM), slit lamp optical coherence tomography (SL-OCT), and gonioscopy in angle recession and angle closure. METHODS: The anterior chamber angle was measured with UBM, SL-OCT and gonioscopy in turns for temporal, nasal, superior and inferior quadrant in the same dark room. The results were compared with the agreement of the three methods in angle recession and angle closure by χ2 test and Kappa test. RESULTS: There were no statistically significant differences of the three methods in testing angle closure and angle recession (P>0.05). The consistency of UBM and gonioscopy was better (Kappa value of 0.882) than that of SL-OCT and gonioscopy (Kappa value of 0.624). CONCLUSION When testing angle recession, UBM is better than SL-OCT with gonioscopy as the standard. When testing angle closure, UBM, SL-OCT and gonioscopy have good agreement.
Anterior Chamber ; Glaucoma, Angle-Closure ; Gonioscopy ; Humans ; Intraocular Pressure ; Microscopy, Acoustic ; Slit Lamp ; Tomography, Optical Coherence

INTRODUCTIONThis study aimed to determine the reproducibility and usability of anterior segment images taken from a smartphone stabilised on a slit-lamp with those taken from a custom-mounted slit-lamp camera.

MATERIALS AND METHODSThis was a prospective, single- blind comparative digital imaging validation study. Digital photographs of patients with cataract were taken using a smartphone camera (an iPhone 5) on a telescopic mount and a Canon EOS 10D anterior segment camera. Images were graded and compared according to the Lens Opacification Classification System III (LOCS III).

RESULTSA total of 440 anterior segment images were graded independently by 2 ophthalmologists, 2 residents and 2 medical students. Intraclass correlation (ICC) between the iPhone and anterior segment camera images were fair for nuclear opalescence (NO) and nuclear colour (NC), and excellent for cortical (C) and posterior subcapsular (PSC) (NO: ICC 0.40, 95% CI, 0.16 to 0.57; NC: ICC 0.47, 95% CI, 0.16 to 0.66; C: ICC 0.76, 95% CI, 0.71 to 0.81; PSC: ICC 0.81, 95% CI, 0.76 to 0.85). There was no difference in grader impression of confidence and images usability between both cameras (P = 0.66 and P = 0.58, respectively).

CONCLUSIONAnterior segment images taken from an iPhone have good reproducibility for retro-illuminated images, but fair reproducibility for NO and NC under low light settings. There were no differences in grader confidence and subjective image suitability.

Cataract ; diagnostic imaging ; Humans ; Ophthalmology ; Photography ; methods ; Prospective Studies ; Reproducibility of Results ; Single-Blind Method ; Slit Lamp Microscopy ; methods ; Smartphone

Behcet's disease is a chronic, relapsing, inflammatory multisystem disorder characterized by recurrent oral and genital ulcerations along with eye lesions (anterior uveitis, posterior uveitis, cells in vitreous on slit lamp examination, retinal vasculitis observed by ophthalmologist), skin lesions (erythema nodosum, pseudofolliculitis, papulopustular lesions, acneiform nodules), arthralgia, central nervous system and vascular involvement, and gastrointestinal manifestations. The etiology of Behcet's disease remains unknown. We report a case of a 48-year-old male with a 25-year-history of blindness, recurrent ulcers on mucosal surfaces, and papulopustular lesions on the trunk. Dapsone is an easily available, cheap and relatively safe drug, useful particularly in the management of the mucocutaneous symptoms of Behcet's disease. Dapsone 100 mg was given daily for one month which resulted in improvement of skin and mucosal lesions. Early diagnosis and treatment of this condition is important to prevent irreversible organ damage and mandatory to reduce mortality and morbidity.

Human ; Male ; Middle Aged ; Arthralgia ; Behcet Syndrome ; Blindness ; Dapsone ; Early Diagnosis ; Erythema Nodosum ; Ophthalmologists ; Retinal Vasculitis ; Skin ; Slit Lamp Microscopy ; Ulcer ; Uveitis, Anterior ; Uveitis, Posterior

PURPOSE: We report two cases of corneal edema in patients who presented with bilateral blurry vision due to vaporized amines while working in a polyurethane processing plant. CASE SUMMARY: A 28-year-old male presented with bilateral blurred vision. His work involved solidifying polyurethane liquid and he often found himself exposed to polyurethane heat and gas. On examination, the patient's uncorrected visual acuity (UCVA) was 20/40 (right) and 30/50 (left). A slit lamp examination revealed subepithelial microbullae in both eyes. The central corneal thickness (CCT) was also increased in both eyes, measuring 698 µm (right) and 672 µm (left). After prescribing 0.5% moxifloxacin and, 1% fluorometholone eye drops for 3 days in both eyes, the UCVA recovered to 20/40 (right) and 20/20 (left). The CCT decreased to 644 µm (right) and 651 µm (left), and the microbullae improved significantly in the left eye. The second patient was a 34-year-old female who presented with bilateral decreased visual acuity while at work. She worked in a factory that produced car seat filling. Her UCVA was 20/25 (right) and 20/20 (left). The CCT by specular microscopy was 537 µm (right) and 541 µm (left). On slit lamp examination, both eyes demonstrated bilateral central subepithelial edema. The patient did not attend any follow-up outpatient appointments after the initial presentation. CONCLUSIONS: Exposure to vaporized amines such as polyurethane may causereversible corneal toxicityeven without direct contact. Further consideration should be given to ocular safety and protection from amine compounds in the industrial field.
Adult ; Amines ; Appointments and Schedules ; Corneal Edema ; Edema ; Female ; Fluorometholone ; Follow-Up Studies ; Hot Temperature ; Humans ; Male ; Microscopy ; Ophthalmic Solutions ; Outpatients ; Plants ; Polyurethanes ; Slit Lamp ; Visual Acuity

PURPOSE: The purpose of this multi-institute, single-group clinical trial was to evaluate the effectiveness and safety of toric orthokeratology lenses for the treatment of patients with combined myopia and astigmatism. METHODS: A total of 44 patients were included in this clinical trial. The patients ranged in age from 7 to 49 years, with myopia of -0.75 to -6.0 diopters (D) and astigmatism of 1.25 to 4.0 D. After excluding 21 subjects, 23 subjects (39 eyes) were analyzed after toric orthokeratology lens use. The subjects underwent ophthalmologic examination after 1 day and 1, 2, 3, and 4 weeks of wearing overnight toric orthokeratology lenses. RESULTS: A total of 19 subjects (31 eyes) completed the trial after five subjects (eight eyes) dropped out. In the patients who completed the study by wearing lenses for 4 weeks, the myopic refractive error decreased significantly by 2.60 ± 2.21 D (p < 0.001), from -3.65 ± 1.62 to -1.05 ± 1.64 D. The astigmatic refractive error were also significantly decreased by 0.63 ± 0.98 D (p = 0.001), from 2.07 ± 0.83 to 1.44 ± 0.99 D. The mean uncorrected and corrected visual acuities before wearing the lenses were 2.14 ± 0.80 logarithm of the logMAR (logMAR) and 0.05 ± 0.13 logMAR, respectively, which changed to 0.12 ± 0.30 logarithm of the logMAR (p < 0.001) and 0.01 ± 0.04 logMAR (p = 0.156) after 4 weeks. No serious adverse reactions were reported during the clinical trial. CONCLUSIONS: Our results suggest that toric orthokeratology is an effective and safe treatment for correcting visual acuity in patients with combined myopia and astigmatism.
Adolescent ; Adult ; Astigmatism/complications/diagnosis/*therapy ; Child ; Cornea/*diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Myopia/complications/diagnosis/*therapy ; Orthokeratologic Procedures/*methods ; Slit Lamp Microscopy ; Treatment Outcome ; *Visual Acuity ; Young Adult

PURPOSE: To compare clinical, angiographic, and optical coherence tomographic characteristics between eyes with acute Vogt-Koyanagi-Harada (VKH) disease and eyes with acute bilateral central serous chorioretinopathy (CSC), and to demonstrate distinguishing features between the two diseases in confusing cases. METHODS: The medical records of 35 patients with VKH disease and 25 patients with bilateral CSC were retrospectively reviewed. Characteristics according to slit-lamp biomicroscopy, ophthalmoscopy, fundus photography, fluorescein angiography, indocyanine green angiography, and spectral-domain optical coherence tomography were compared between the two diseases. RESULTS: Five of 35 patients (10 of 70 eyes, 14.3%) with VKH disease were initially misdiagnosed as CSC patients, and six of 25 patients (12 of 50 eyes, 24%) with bilateral CSC were initially misdiagnosed as patients with VKH disease. Pigment epithelial detachment in CSC and optic disc hyperemia in VKH disease show the highest positive predictive values of 100% for each disease. CONCLUSIONS: Optic disc hyperemia in VKH disease and pigment epithelial detachment in bilateral CSC are the most specific clinical manifestations of each disease at initial patient presentation.
Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Central Serous Chorioretinopathy/*diagnostic imaging ; Female ; Fluorescein Angiography ; Humans ; Hyperemia/diagnosis ; Indocyanine Green/administration & dosage ; Male ; Middle Aged ; Multimodal Imaging ; Ophthalmoscopy ; Optic Disk/blood supply ; Photography ; Retinal Detachment/diagnosis ; Retinal Pigment Epithelium/pathology ; Retrospective Studies ; Slit Lamp Microscopy ; Tomography, Optical Coherence ; Uveomeningoencephalitic Syndrome/*diagnostic imaging ; Young Adult