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Orthokeratology Lenses and Myopia Control

Annals of Optometry and Contact Lens.2024;23(4):139-144. doi:10.52725/aocl.2024.23.4.139

Orthokeratology lenses are effective methods for controlling myopia progression. This paper describes the principles and effects of orthokeratology lenses, focusing on randomized controlled trials investigating their ability to prevent myopia progression. While the short-term effects are widely accepted, further well-designed studies are required to assess the persistence of long-term benefits and the possibility of a rebound phenomenon after lens discontinuation. Additionally, both physicians and patients should prioritize safety, particularly in preventing complications such as infectious keratitis.

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Corneal Endothelial Cell Loss in Viral Anterior Uveitis

In Young CHUNG ; Seong-Jae KIM

Annals of Optometry and Contact Lens.2024;23(4):145-150. doi:10.52725/aocl.2024.23.4.145

Viral anterior uveitis is an inflammatory disease caused by pathogens such as herpes simplex virus (HSV), varicella-zoster virus (VZV), and cytomegalovirus (CMV), often leading to corneal endothelial cell damage. Endothelial cell loss progresses due to various factors, including direct viral infection, immune responses, elevated intraocular pressure, and surgical interventions. These processes can result in corneal edema and vision loss. Accurate diagnosis requires aqueous humor polymerase chain reaction and high-resolution imaging, and the treatment typically involves a combination of antiviral and anti-inflammatory therapies.

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Patient Awareness of Wet Age-Related Macular Degeneration and Need for Regular Fundal Examinations

Woosung JEON ; Jeong Hyun LEE ; Jeeyun AHN ; Ho-Kyung CHOUNG ; Joo Young SHIN

Annals of Optometry and Contact Lens.2024;23(4):151-156. doi:10.52725/aocl.2024.23.4.151

Purpose: To evaluate degree of insight, accessibility to medical care, and availability of regular ocular screening examinations before diagnosis for Korean patients with wet age-related macular degeneration. Methods: Data were collected from 95 patients by questionnaire and analyzed at Seoul National University Boramae Medical Center. Results: Although 80.0% of the patients considered themselves old, only 2.1% thought they were susceptible to wet age-related macular degeneration. Of the overall patients, 48.4% thought their disease was serious despite treatment with intravitreal injections. A majority (71.6%) thought that medical care was easily accessible, 67.4% answered that hospitals were located close by, and 90.5% answered that it was easy to make appointments and they had time to visit the hospital. However, only 15.8% answered that they had undergone regular ocular examinations before being diagnosed with wet age-related macular degeneration. Conclusions Although most patients believed that they had easy access to medical care, only 15.8% underwent regular ocular examinations. Therefore, regular ocular examinations, including fundal examinations, are required in national health screening programs. It is also important to raise public awareness of wet age-related macular degeneration by educating the general population.

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Association between Age-Related Macular Degeneration and Arthritis: Data from the Korean National Health and Nutrition Examination Survey for 2017 and 2018

Jun Sung NAH ; Junho MUN ; Kyoung Lae KIM ; Yong-Kyu KIM ; Youn Joo CHOI ; Sung Pyo PARK ; Kyeong Ik NA

Annals of Optometry and Contact Lens.2024;23(4):171-177. doi:10.52725/aocl.2024.23.4.171

Purpose: We examined the association between age-related macular degeneration (AMD) and arthritis. Methods: Using data from the Korea National Health and Nutrition Examination Survey for 2017 and 2018, we conducted a complex sample analysis of 6,993 individuals with recorded information on AMD, as well as the diagnosis and treatment of osteoarthritis (OA) and rheumatoid arthritis (RA). We compared the diagnosis and treatment of arthritis between the AMD and control groups using logistic regression analysis, with a specific focus on the treatment among patients with arthritis. Results: In the AMD group (n = 1,118) and the control group (n = 5,875), univariate logistic regression analysis showed substantial differences in the diagnosis and treatment of OA and RA. However, after adjusting for age, alcohol consumption, diabetes mellitus, and hypertension in multivariate logistic regression analysis, these differences were no longer substantial. Among patients with OA (n = 246 in the AMD group and n = 821 in the control group), there was a significant association between AMD and OA treatments (odds ratio 1.511, 95% confidence interval 1.051-2.172). Conclusions Patients diagnosed with and treated for OA had a higher likelihood of concurrent AMD than those who did not receive treatment. Therefore, ophthalmic examinations and closer monitoring are recommended for these patients.

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Effects of Tisochrysis lutea on Dry Eye Symptoms

Chae Won KIM ; Hoon KIM ; Yu Yeon PARK ; Yuli PARK ; Kyong Jin CHO

Annals of Optometry and Contact Lens.2024;23(4):157-170. doi:10.52725/aocl.2024.23.4.157

Purpose: Tisochrysis lutea is a marine microalga known for its anticancer and antioxidant properties. This study aimed to investigate the efficacy and safety of T. lutea in adults with dry eye symptoms. Methods: One hundred participants with dry eye symptoms were enrolled and divided into two groups: one received T. lutea powder (test group), and the other received control food (placebo, control group) for 12 weeks. Subsequently, the measurements of ocular surface disease index (OSDI), tear secretion (Schirmer’s test), tear break-up time (TBUT), corneoconjunctival staining, and safety assessments were compared between the test and control groups. Results: In terms of the OSDI score, the value for the test group decreased by 6.51 points after 12 weeks of T. lutea powder intake, compared with baseline, whereas that in the control group decreased by 2.88 points, demonstrating a significant difference between the two groups (p = 0.002). The results of Schirmer's test also showed significant improvements: in the test group, the result for the right eye increased by 1.33 ± 3.71 after 12 weeks (p = 0.020), and that for the left eye increased by 1.93 ± 3.33 (p = 0.0003). However, no significant increases in the results were observed in the control group. Additionally, TBUT showed a significant increase from baseline in the right eye of the test group after 6 weeks of T. lutea powder intake (p = 0.043). Conclusions After 12 weeks of consumption in the powdered form, T. lutea improved the symptoms of dry eye and increased tear production. Therefore, T. lutea can be used as an eye supplement for adults with dry eye symptoms.

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Comparison of Physical Properties of Polypropylene Sutures and Knot Method to Prevent the Slippage of Sutured Scleral Fixation

Yeon Hee CHOI ; Min Ho KANG

Annals of Optometry and Contact Lens.2024;23(4):178-183. doi:10.52725/aocl.2024.23.4.178

Purpose: This study compared the physical properties of 9-0 and 10-0 polypropylene sutures used in scleral-sutured posterior chamber intraocular lens (PCIOL) fixation, with a focus on knot security and methods to prevent slippage. Methods: Tensile strength measurements were performed on 10-0 and 9-0 polypropylene sutures (Prolene™) using a material testing machine (Instron 5966 Load Frame, Model 2701-065 controller; Instron Corp., Norwood, MA). Various knotting techniques were evaluated, including a single fisherman’s knot and one, three, and five overhand knots tied around the haptic of a three-piece IOL. Knot thickness and area of the surgeon’s Knot were measured using microscopy and Image J® software, with statistical analysis conducted to compare the differences between the two suture types. Results: The 9-0 polypropylene sutures exhibited a significantly higher maximum tensile strength than the 10-0 sutures, particularly with a single fisherman’s knot (0.47 N vs. 0.52 N, p = 0.007; 0.27 N vs. 0.50 N, p < 0.001). However, when multiple overhand knots were tied around the haptic, the 10-0 sutures showed increased tensile strength with more knots (0.11 N, 0.23 N, 0.33 N, p < 0.05), whereas the 9-0 sutures did not (0.06 N, 0.31 N, 0.19 N). Notably, three overhand knots provided better stability than five knots (p < 0.05). The knot area and thickness of the surgeon’s knot were significantly larger in the 9-0 sutures than in the 10-0 sutures (21,062.4 μm2 vs. 41,188.5 μm2, p < 0.001; 160.1 μm vs. 195.6 μm, p = 0.021). Conclusions Overhand knots increased friction between the suture and IOL haptic, enhancing knot security. However, in the 9-0 sutures, the higher rigidity caused the knots to loosen more easily, decreasing the tensile strength with more knots. This study suggests that three overhand knots are optimal for securing IOL haptics using both 9-0 and 10-0 sutures.

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A Case of Myelin Oligodendrocyte Glycoprotein Antibody-Positive Optic Neuritis

Phil Kyu LEE ; Seung Hoon LEE ; Ho RA

Annals of Optometry and Contact Lens.2024;23(4):184-189. doi:10.52725/aocl.2024.23.4.184

Purpose: To report a case of optic neuritis associated with myelin oligodendrocyte glycoprotein (MOG) antibodies, treated with intravenous methylprednisolone pulse therapy.Case summary: A 40-year-old male patient with no underlying disease presented to clinic with sudden onset of bilateral blurry vision that began three days ago. He experienced severe headache and had history of bilateral refractive surgery. Best-corrected visual acuity measured right 0.06 and left 0.04. Relative afferent pupillary defect test was unremarkable, while Ishihara color vision test revealed inability to read any numbers in both eyes, except control plates. Although there were no limitations in extraocular movements, the patient reported pain in both eyes for all gaze movements. Widefield photograph and retinal nerve fiber layer image confirmed swelling of optic nerve head in both eyes. He was treated with high-dose intravenous methylprednisolone (1 g/day for 3 days). Magnetic resonance imaging demonstrated enhancement of the optic nerve sheaths in both eyes, and serum testing indicated positivity for MOG IgG antibodies. Three weeks later, visual acuity in both eyes improved to 1.0, and the color vision test showed correct identification of all 17 plates. Optic nerve head swelling in both eyes had resolved. However, optic neuritis recurred at 4, 6 weeks, and 3 months after the initial treatment, with each episode managed by high-dose intravenous methylprednisolone. Conclusions This case shows early diagnosis and treatment of MOG antibody-associated optic neuritis can lead to improved visual outcomes. Appropriate serum testing for the diagnosis may be effective in patients with MOG antibody-associated optic neuritis.

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Comparison of Prediction Accuracy of Four Intraocular Lens Power Calculation Formulas for Presbyopia-Correcting Intraocular Lens

Jun Sik KIM ; Sun Woong KIM

Annals of Optometry and Contact Lens.2025;24(1):19-26. doi:10.52725/aocl.2025.24.1.19

Purpose: This study aimed to evaluate the prediction accuracy of four intraocular lens (IOL) power calculation formulas; Barrett Universal II, SRK/T, Hoffer-QST, and Kane, using conventional keratometry (K) and total keratometry (TK) in patients who underwent implantation of a four-haptic hydrophobic multifocal IOL (Artis Symbiose Plus®). Methods: We analyzed 26 patients (32 eyes) who underwent cataract surgery with implantation of the Artis Symbiose Plus®. Preoperative biometric data, including axial length, keratometry, anterior chamber depth, and lens thickness, were measured using IOL Master 700®. Postoperative refractive outcomes were compared with the target refractive errors derived from four formulas with K and TK. The mean error, mean absolute error, and median absolute error were calculated at 1 and 3 months postoperatively. The results were compared between the formulae and K and TK. Results: At 3 months postoperatively, Barrett Universal II and Kane showed significantly lower refractive errors from the target diopter than SRK/T and Hoffer-QST, with Barrett Universal II showing the most hyperopic shift and SRK/T the most myopic than the target refractive error. No significant difference in refractive prediction was found between K and TK across all the formulas. The proportion of eyes with refractive errors within ± 0.50 diopter (D) and ± 1.00 D was highest for Barrett Universal II and Kane, with no statistical significance. Conclusions Barrett Universal II and Kane provided superior refractive accuracy compared to SRK/T and Hoffer-QST for Artis Symbiose Plus®. There was no significant difference between K and TK in predicting refractive outcomes.

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4 Cases of Reactivated Cytomegalovirus Retinitis in Immunocompromised Patients

Seung Ahn YANG ; Su Hwan PARK ; Ji Eun LEE ; Seung Min LEE

Annals of Optometry and Contact Lens.2025;24(1):39-47. doi:10.52725/aocl.2025.24.1.39

Purpose: This study aimed to report a series of cases of cytomegalovirus retinitis reactivation in immunocompromised patients, focusing on the characteristic clinical and laboratory findings associated with reactivation.Case summary: We retrospectively reviewed the medical records of patients diagnosed with cytomegalovirus retinitis at our clinic between January 2012 and November 2023. We analyzed ophthalmologic clinical findings and diagnostic test results, including quantitative cytomegalovirus polymerase chain reaction (CMV PCR). Reactivation was defined as the resolution or stabilization of the overall lesions on fundus examination, followed by the identification of new retinitis or vitreitis findings. The analysis excluded patients with cytomegalovirus retinitis resistant to ganciclovir or foscarnet. Among 24 patients (34 eyes) treated for cytomegalovirus retinitis, four showed reactivation, and the remaining 20 patients showed improvement with initial treatment. Recurrence occurred at an average of 24.8 days (18–35) after discontinuation of ganciclovir maintenance treatment, and in all cases, new lesions were discovered at the border of existing lesions. The CMV PCR test value tended to increase an average of 8 days (4–14) before recurrence was observed on fundus examination, and declined absolute neutrophil count preceded the increase in CMV PCR by an average of 12.8 days (6–26). Conclusions Monitoring quantitative CMV PCR tests in immunocompromised patients with cytomegalovirus retinitis could be helpful in predicting reactivation.

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A Case of Lattice Corneal Dystrophy Type 1 Initially Showing Phenotypic Characteristics of Granular Corneal Dystrophy Type 2 in One Eye and Dot and Map Lesions in the Contralateral Eye

Moonjung CHOI ; Ji Sang MIN ; Eung Kweon KIM

Annals of Optometry and Contact Lens.2025;24(1):34-38. doi:10.52725/aocl.2025.24.1.34

Purpose: Lattice corneal dystrophy type 1 (LCD1) typically presents with linear lesions in the corneal stroma. We report an atypical case of a patient with LCD type 1, who exhibited granules and deep lines resembling granular corneal dystrophy type 2 (GCD2) in one eye and maps and dots resembling epithelial basement membrane dystrophy (EBMD) in the contralateral eye.Case summary: A 22-year-old woman presented with progressive visual disturbances. Slit lamp examination revealed subepithelial granular opacities and linear lines in one eye and maps and dots in the other eye. Peripheral blood was collected, and genomic sequencing of transforming growth factor β-induced protein (TGFBI) was performed to identify any mutations. The sequencing revealed a heterozygous Arg124Cys (R124C) mutation, which is diagnostic for LCD1. Serial examinations over the years indicated a spontaneous reduction in the granular deposits and an increase in the lattice component, illustrating the progression of the phenotypic traits associated with LCD. Conclusions Although the R124C mutation of TGFBI is known to be associated with LCD1, it can manifest clinical characteristics similar to GCD2 or EBMD in the early stages of the disease. Genetic testing is recommended for definitive diagnosis in cases of TGFBI-related corneal dystrophies.

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