Purpose: To conduct an evaluation of juxtapapillary choroidal thickness of patients suspected with glaucoma obtained through spectral domain optical coherence tomography (SD-OCT) and correlate it with perimetry results. Methods: Design: Cross-sectional Study. Population: 175 eyes diagnosed as “glaucoma suspect” had standard automated perimetry (SAP) to document the presence of functional glaucomatous damage using optimal near-point correction using the Humphrey Visual Field Analyzer II, 30-2 or 24-2 SITA-standard program. SD-OCT imaging of the retinal nerve fi ber layer (RNFL) was also done to look for structural glaucomatous damage and in using enhanced depth imaging of the optic nerve and the Cirrus caliper tool, choroidal thickness was measured at fi ve predetermined points temporal and nasal from the optic nerve. The population was classifi ed into two groups: Group 1 are those with structural or functional glaucomatous damage (n=68) and Group 2 were those without (n=107). Results: One-Way Multivariate Analysis of Covariance was used in comparing the mean temporal and nasal choroidal thickness scores of the two groups. There are no statistical differences in terms of the mean temporal choroidal thickness (p=0.856) and mean nasal choroidal thickness (p=0.734) between patients with and without glaucomatous damage. The mean temporal and nasal choroidal thickness scores of the two groups at different juxtapapillary locations: 0 μm, 250 μm, 500 μm, 750 μm and 1000 μm away from the disc were also not statistically different. Conclusion Results show that from this present cohort of glaucoma suspect patients, juxtapapillary choroidal thickness is not correlated with structural and functional glaucomatous damage.
Visual Field Tests ; Tomography, Optical Coherence ; Ocular Hypertension

The aim of the present study was to evaluate visual functions and retinal morphology of Polypoidal Choroidal Vasculopathy (PCV) patients seen in an AMD referral centre of Malaysia and to further explore association between visual functions and optical coherence tomography (OCT) parameters in PCV eyes. In this single centre, cross sectional study, best corrected distance visual acuity (DVA), near vision acuity (NVA), reading speed (RS), and contrast sensitivity (CS) were measured in naïve PCV eyes. Selective parameters such as integrity of external limiting membrane (ELM), inner segment and outer segment junction (IS-OS), retinal pigment epithelium and Bruch’s membrane (RPE-BM) complex, average retinal thickness (ART) and volume (ARV), central retinal thickness (CT), centre maximum (CTmax) and centre minimum (CTmin) thickness were assessed using spectral-domain OCT. Forty-three new PCV eyes of 42 patients were evaluated. Mean (±SD) DVA, NVA, CS, RS were 0.83 ± 0.35 logMAR, 0.77 ± 0.3 logMAR, 0.69 ±.26 log CS and 59.56 ±14 words per minutes respectively. ART and CT showed good correlation with DVA (r=0.571& 0.546) and CS (r= 0.576 & 0.586). ARV and CTmax showed good correlation with CS (r=0.516 &, 0.513). The mean DVA, NVA and CS between three ELM and IS-OS status were significantly different (p=.002 & .000; p=.012 & .029; p=.005 & .001). In conclusion, present study reports visual functions and OCT characteristics of PCV patients in an AMD referral centre of Malaysia. Many of the quantitative and qualitative OCT parameters showed good association with the visual functions in eyes with PCV.
polypoidal choroidal vasculopathy ; visual functions ; ocular coherence tomography

OBJECTIVETo investigate optical coherence tomography (OCT) characteristics of tuberculous serpiginous-like choroiditis (Tb-SLC) and serpiginous choroiditis (SC) and to perform OCT to differentiate between these conditions.

METHODSThis retrospective, case-control study examined consecutively enrolled patients with active Tb-SLC or SC. Patients underwent comprehensive ocular examinations and imaging (OCT, color fundus photography, autofluorescence imaging, fluorescein angiography, and indocyanine green angiography). Findings were examined and compared between eyes with SC and Tb-SLC.

RESULTSNine patients with active Tb-SLC (14 eyes) and 8 with active SC (12 eyes) were included. The following OCT findings were observed significantly more often in the Tb-SLC group than in the SC group: vitreal hyper-reflective spots [5 Tb-SLC eyes (36%), no SC eyes; P = 0.02], intraretinal edema [11 Tb-SLC eyes (79%), 3 SC eyes (25%); P = 0.01], sub-retinal pigment epithelium (RPE) drusenoid deposits [11 Tb-SLC eyes (79%), 2 SC eyes (17%); P < 0.01], and choroidal granulomas [8 Tb-SLC eyes (57%), 2 SC eyes (17%); P = 0.03]. A hyporeflective, wedge-shaped band was observed more often in the SC group [5 Tb-SLC eyes (36%), 9 SC eyes (75%); P = 0.045] than in the Tb-SLC group. The incidence of other OCT signs did not differ between the groups and included outer nuclear layer hyper-reflection, outer retinal tabulation, and choriocapillaris point-like hyper-reflection.

CONCLUSIONVitreal hyper-reflective spots, intraretinal fluid, sub-RPE drusenoid deposits, and choroidal granulomas on OCT images may indicate Tb-SLC. Additionally, a hyporeflective, wedge-shaped band may indicate SC. Therefore, OCT is likely helpful in differentiating between Tb-SLC and SC.

Adult ; Case-Control Studies ; Choroiditis ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tomography, Optical Coherence ; Tuberculosis, Ocular ; diagnostic imaging ; pathology

Autoimmune retinopathy (AIR) is an immune-mediated retinopathy, resulting from an immunologic process caused by the aberrant recognition of retinal antigens as autoantigens. The diagnosis of AIR involves the detection of antiretinal antibodies with concurrent clinical and electrophysiological evidence of retinopathy. A 40-year-old patient presented with progressive loss of bilateral vision over several months. A fundus examination was unremarkable. Spectral domain optical coherence tomography revealed a blurred photoreceptor ellipsoid zone at the subfoveal region in both eyes with more prominent disruption in the left eye. Full-field electroretinography (ERG) showed relatively normal rod and cone responses in the right eye, and decreased photopic bwaves with minimal attenuation of a-waves in the left eye. Multifocal ERG demonstrated slightly reduced amplitude of the inner segment ring in the right eye and decreased amplitudes and delayed latencies of all modalities in the left eye. The patient was suspected to have AIR and it was supported by positive Western blots for 23-kDa protein, enolase (46-kDa), aldolase (40-kDa), 62-kDa and 78-kDa proteins and by immunohistochemical staining of human retinal bipolar and ganglion cells. Despite the immunosuppressive treatment, the destruction of the retinal photoreceptors progressed, and immunosuppressive interventions produced very little visual improvement. We report on what is, to the best of our knowledge, the very first case of serologically confirmed nonparaneoplastic AIR in Korea.
Autoantibodies/*blood/immunology ; Autoantigens ; Autoimmune Diseases/*immunology ; Electroretinography ; Humans ; Immunologic Factors ; Paraneoplastic Syndromes/*immunology ; Paraneoplastic Syndromes, Ocular ; Phosphopyruvate Hydratase ; Recoverin ; Republic of Korea ; Retina/*immunology ; Retinal Diseases/*immunology ; Tomography, Optical Coherence

PURPOSE: To evaluate the influence of biometric variables on refractive outcomes after cataract surgery in angle-closure glaucoma (ACG) patients. METHODS: In this case-control study, 42 ACG patients, 40 open-angle glaucoma (OAG) patients, and 35 controls without glaucoma who had undergone conventional cataract surgery were enrolled consecutively. Electronic medical records, including preoperative biometric variables (keratometric diopter, axial length, anterior chamber depth, and lens thickness), the refractive change (RC), and the absolute value of refractive change (ARC) were reviewed. RESULTS: In the control and OAG patients, the anterior chamber depth was negatively correlated with the ARC (r = -0.344, p = 0.043 and r = -0.431, p = 0.006, respectively), whereas there was no correlation in the ACG patients. Lens thickness was positively correlated with the RC, but not with the ARC, in the control and OAG groups (r = 0.391, p = 0.020 and r = 0.501, p = 0.001, respectively). In contrast, lens thickness in the ACG group was not correlated with the RC but was positively correlated with the ARC (r = 0.331, p = 0.032). CONCLUSIONS: In contrast with the anterior chamber depth, preoperatively measured lens thickness may be a useful predictor of the direction of the RC after cataract surgery in control and OAG patients. However, in ACG patients, a thicker lens was correlated with a larger RC, regardless of the direction of the shift (hyperopic or myopic).
Aged ; Anterior Chamber/*diagnostic imaging ; Biometry/*methods ; Female ; Follow-Up Studies ; Glaucoma, Angle-Closure/*complications/diagnosis/surgery ; Glaucoma, Open-Angle/*complications/diagnosis/surgery ; Humans ; *Intraocular Pressure ; Male ; Middle Aged ; *Phacoemulsification ; Refraction, Ocular/*physiology ; Retrospective Studies ; Tomography, Optical Coherence

PURPOSE: To investigate and compare the progression of medically treated primary open angle glaucoma according to the baseline intraocular pressure (IOP). METHODS: This study included a total of 345 eyes from 345 patients (mean follow-up period, 4.5 years). Eyes were classified into either conventional normal tension glaucoma (cNTG, < or =21 mmHg) or conventional high-tension glaucoma (cHTG, >21 mmHg) groups according to the conventional cut-off value of the IOP. Additionally, the median IOP (15 mmHg) was used to create two other groups (median NTG [mNTG] < or =15 mmHg and median HTG [mHTG] >15 mmHg). Using these values, 306, 39, 153, and 192 eyes were assigned to the cNTG, cHTG, mNTG, and mHTG groups, respectively. Glaucoma progression was determined either by optic disc/retinal nerve fiber layer photographs or serial visual field data. RESULTS: Mean reduction of IOP after medical treatment and of central corneal thickness was lower in the cNTG group, while the prevalence of disc hemorrhage and baseline visual field mean deviation did not differ between the cNTG and cHTG groups. A mean reduction in the IOP was observed after medical treatment, and central corneal thickness was lower in the mNTG group; disc hemorrhage was more frequent in the mNTG than in the mHTG group. Among the 345 analyzed eyes, 100 (29%) showed progression during the follow-up period. In the cHTG group, a higher baseline IOP (hazard ratio, 1.147; p = 0.024) was associated with glaucoma progression. Disc hemorrhage (hazard ratio, 15.533; p < 0.001) was also strongly associated with progression in the mNTG group. CONCLUSIONS: Baseline IOP was a significant risk factor for glaucoma progression in cHTG patients (10% of our total participants), while disc hemorrhage showed the strongest association with progression in the mNTG group, indicating that a cut-off value other than the conventional 21 mmHg is required to define true low-tension glaucoma in populations where NTG predominates among all glaucoma patients.
Aged ; Disease Progression ; Female ; Glaucoma, Open-Angle/*diagnosis ; Gonioscopy ; Humans ; Intraocular Pressure ; Low Tension Glaucoma/*diagnosis ; Male ; Middle Aged ; Nerve Fibers/pathology ; Optic Disk/pathology ; Optic Nerve Diseases/*diagnosis ; Photography/standards ; Retinal Ganglion Cells/pathology ; Retrospective Studies ; Tomography, Optical Coherence ; Tonometry, Ocular ; Vision Disorders/diagnosis ; Visual Field Tests/standards ; Visual Fields

PURPOSE: To analyze the reasons for glaucoma evaluation and distribution of new patients visiting the glaucoma department. METHODS: In a retrospective study, 330 new patients underwent ocular examination using Goldmann applanation tonometry, gonioscopy, optic disc analysis, optical coherence tomography, and Humphrey perimeter under suspicion of glaucoma for the first time in the Glaucoma Department from January 2013 to December 2013. We analyzed the reasons and their diagnostic outcomes. RESULTS: The reasons for glaucoma evaluation were health screening (103 patients, 32.49%), other symptoms (102 patients, 31.55%), known glaucoma (56 patients, 17.67%), pre-refractive surgery evaluation (31 patients, 9.78%), family history (19 patients, 5.99%), and high myopia (6 patients, 1.89%). The diagnostic outcomes were as follows: glaucoma (139 patients, 43.85%), glaucoma suspect (60 patients, 18.93%), ocular hypertension (9 patients, 2.84%), neither glaucoma nor ocular hypertension (79 patients, 24.92%), normal (30 patients, 9.46%). The percentages of confirmed glaucoma according to the reasons for glaucoma evaluation were as follows: health screening, 26.21%; other symptoms, 40.20%; known glaucoma, 85.71%; pre-refractive surgery evaluation, 58.06%; family history, 15.79% and high myopia, 33.33%. CONCLUSIONS: The reasons for glaucoma evaluation were diverse. Glaucoma was confirmed in 43.85% of the patients and the predicted value of positive test for glaucoma including glaucoma suspect and ocular hypertension was 65.62%.
Glaucoma* ; Gonioscopy ; Humans ; Manometry ; Mass Screening ; Myopia ; Ocular Hypertension ; Outpatients* ; Retrospective Studies ; Tomography, Optical Coherence

PURPOSE: To investigate anterior segment parameters in obese patients in comparison to healthy individuals. METHODS: Thirty-four obese subjects and 34 age-sex-matched healthy subjects were enrolled in this prospective cross-sectional study. Ophthalmological examinations including intraocular pressure (IOP), central corneal thickness (CCT), anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), and axial length (AL) measurements were performed on each subject. Height and weight of all subjects were recorded and body mass index (BMI) was calculated. RESULTS: IOP was significantly higher in the obese group (p = 0.003). The mean ACD in obese subjects was significantly lower than that in control subjects (p = 0.036). AL, ACV, ACA and CCT were not significantly different between the groups. There was a positive correlation between BMI and IOP (r = 0.404, p < 0.001). ACD and ACA were negatively correlated with BMI. CONCLUSIONS: IOP was significantly higher and ACD was significantly lower in obese subjects. AL, ACV, ACA and CCT were not significantly different between the groups. The impact of obesity on anterior chamber parameters should be further investigated.
Adult ; Aged ; Anterior Chamber/*pathology/physiopathology ; Cross-Sectional Studies ; Female ; Humans ; Intraocular Pressure/*physiology ; Male ; Middle Aged ; Obesity/*diagnostic imaging ; Prospective Studies ; Tomography, Optical Coherence/*methods ; Tonometry, Ocular

PURPOSE: To evaluate the anatomical difference between the dominant and nondominant eyes in healthy, young adults by measuring macular, peripapillary retinal nerve fiber layer (PRNFL), and macular ganglion cell layer (MGCL) thicknesses. METHODS: Two hundred healthy adults were recruited and assessed for ocular dominance using 'a hole in the card test'. PRNFL, macular and MGCL thicknesses of both eyes were measured using spectral domain optical coherence tomography (OCT). RESULTS: There were no statistically significant differences for average thicknesses of MGCL in each of the six areas between the dominant and nondominant eyes. No difference was observed between temporal, inferior, average PRNFL thickness and macular thickness in dominant and nondominant eyes. CONCLUSIONS: There was no intraocular anatomical difference between the dominant and nondominant eyes in healthy, young adults.
Adult ; Dominance, Ocular ; Ganglion Cysts ; Humans ; Nerve Fibers ; Retinaldehyde ; Tomography, Optical Coherence ; Young Adult

PURPOSE: To compare the thickness of the lamina cribrosa (LC) and vascular factors of early normal-tension glaucoma (NTG) patients with high and low intraocular pressure (IOP) that are expected to be associated with the development of glaucoma. METHODS: Seventy-one Korean NTG patients with low IOP (the highest IOP <15 mmHg, 40 patients) and high IOP (the lowest IOP >15 mmHg, 31 patients) were included in this study. The thickness of LC and vascular factors were compared. The thickness of the LC was measured using the enhanced depth imaging method with spectral domain optical coherence tomography (Heidelberg Spectralis). RESULTS: The mean thickness of the central LC was 190.0 +/- 19.2 microm in the low IOP group and 197.8 +/- 23.6 microm in the high IOP group, but there was no statistical significant difference between the two groups (p > 0.05). The prevalence of self-reported Raynaud phenomenon was significantly higher in the low IOP group (33.0%) than the high IOP group (10.3%, p = 0.04). CONCLUSIONS: The laminar thickness did not significantly differ between the high and low IOP groups. However, the prevalence of Raynaud phenomenon was higher in the low IOP groups. These results suggest that the development of glaucoma with low IOP patients may be more influenced by peripheral vasospasm, such as Raynaud phenomenon, rather than laminar thickness in NTG.
Aged ; Cross-Sectional Studies ; Female ; Humans ; *Intraocular Pressure ; Low Tension Glaucoma/*diagnosis ; Male ; Middle Aged ; Nerve Fibers/pathology ; Optic Disk/*pathology ; Optic Nerve Diseases/*diagnosis ; Raynaud Disease/*diagnosis ; Retinal Ganglion Cells/pathology ; Tomography, Optical Coherence ; Tonometry, Ocular ; Vision Disorders/diagnosis ; Visual Fields