Purpose: To compare the effects on axial elongation and associated factors between orthokeratology lenses and 0.025% low-concentration atropine eye drops. Methods: A retrospective analysis was conducted on the medical records of children matched by sex and age, with a spherical equivalent difference within 0.125 diopters, who were followed for more than 2 years after starting treatment with orthokeratology lenses or 0.025% low-concentration atropine eye drops. The results of refractive error and axial length were analyzed using an independent t-test, paired t-test, Pearson correlation test, and multiple regression analysis. Results: Seventy-four patients (92 eyes) were included in this study. Before treatment, the axial length was 24.44 ± 0.91 mm in the orthokeratology lenses group and 24.67 ± 0.80 mm in the low-concentration atropine eye drops group. There were no statistically significant differences between the two groups in age at the start of treatment, sex, spherical equivalent, and axial length before treatment. At the 2-year follow-up, the mean axial length change was 0.53 ± 0.30 mm in the orthokeratology lenses group and 0.49 ± 0.26 mm in the low-concentration atropine eye drops group, respectively. There were no statistically significant differences between the two groups in the mean axial length change. Additionally, the age at the start of treatment showed a significant negative correlation with the axial length change in both the orthokeratology lenses group and the low-concentration atropine eye drops group (p = 0.001, p = 0.011, respectively). Conclusions There was no significant difference in axial elongation for 2 years between orthokeratology lenses and 0.025% low-concentration atropine eye drops treatment groups. Since younger age was associated with faster eye growth, it is important to actively consider treatment in cases of early onset myopia.

Purpose: To compare axial length (AL), keratometry (K), and refractive measurements using Myopia Master, Lenstar, and KR-1 autorefractor. Methods: The study involved 44 eyes of 44 children who visited our clinic. We compared AL, flat K, steep K, mean K, and spherical equivalent (SE) measured by Myopia Master, Lenstar, and KR-1. We utilized a paired t-test and RM-ANOVA to compare mean differences and used Bland–Altman plots, intraclass correlation coefficients (ICCs), and Pearson correlation tests for agreement analysis. Results: The mean ALs (mm) measured with Myopia Master and Lenstar were 24.59 ± 0.91 mm and 24.60 ± 0.91 mm, respectively, with no statistical differences (p = 0.085). Both the ICC and Pearson correlation coefficient were 0.999. The mean SEs (D) measured with Myopia Master and KR-1 were -3.32 ± 1.75 D and -3.18 ± 1.68 D, respectively, with significant differences (p < 0.001). The ICC was 0.996 and the Pearson correlation coefficient was 0.995. The mean K (D) values measured by Myopia Master, KR-1, and Lenstar were 43.15 ± 1.59 D, 43.38 ± 1.58 D, and 43.32 ± 1.63 D, respectively, and differed significantly (p < 0.001). Conclusions While statistical differences emerged in SEs between Myopia Master and KR-1, the differences were not clinically significant and the tools may be used interchangeably due to their good agreement. However, measured K values differed among Myopia Master, KR-1, and Lenstar, so these tools are not interchangeable. Based on the results from paired t-tests, ICCs, and Pearson correlations, AL measurements were in good agreement between Myopia Master and Lenstar but caution should be exercised due to the wider range of measured values.

Purpose: To compare axial length (AL), keratometry (K), and refractive measurements using Myopia Master, Lenstar, and KR-1 autorefractor. Methods: The study involved 44 eyes of 44 children who visited our clinic. We compared AL, flat K, steep K, mean K, and spherical equivalent (SE) measured by Myopia Master, Lenstar, and KR-1. We utilized a paired t-test and RM-ANOVA to compare mean differences and used Bland–Altman plots, intraclass correlation coefficients (ICCs), and Pearson correlation tests for agreement analysis. Results: The mean ALs (mm) measured with Myopia Master and Lenstar were 24.59 ± 0.91 mm and 24.60 ± 0.91 mm, respectively, with no statistical differences (p = 0.085). Both the ICC and Pearson correlation coefficient were 0.999. The mean SEs (D) measured with Myopia Master and KR-1 were -3.32 ± 1.75 D and -3.18 ± 1.68 D, respectively, with significant differences (p < 0.001). The ICC was 0.996 and the Pearson correlation coefficient was 0.995. The mean K (D) values measured by Myopia Master, KR-1, and Lenstar were 43.15 ± 1.59 D, 43.38 ± 1.58 D, and 43.32 ± 1.63 D, respectively, and differed significantly (p < 0.001). Conclusions While statistical differences emerged in SEs between Myopia Master and KR-1, the differences were not clinically significant and the tools may be used interchangeably due to their good agreement. However, measured K values differed among Myopia Master, KR-1, and Lenstar, so these tools are not interchangeable. Based on the results from paired t-tests, ICCs, and Pearson correlations, AL measurements were in good agreement between Myopia Master and Lenstar but caution should be exercised due to the wider range of measured values.

Purpose: To compare axial length (AL), keratometry (K), and refractive measurements using Myopia Master, Lenstar, and KR-1 autorefractor. Methods: The study involved 44 eyes of 44 children who visited our clinic. We compared AL, flat K, steep K, mean K, and spherical equivalent (SE) measured by Myopia Master, Lenstar, and KR-1. We utilized a paired t-test and RM-ANOVA to compare mean differences and used Bland–Altman plots, intraclass correlation coefficients (ICCs), and Pearson correlation tests for agreement analysis. Results: The mean ALs (mm) measured with Myopia Master and Lenstar were 24.59 ± 0.91 mm and 24.60 ± 0.91 mm, respectively, with no statistical differences (p = 0.085). Both the ICC and Pearson correlation coefficient were 0.999. The mean SEs (D) measured with Myopia Master and KR-1 were -3.32 ± 1.75 D and -3.18 ± 1.68 D, respectively, with significant differences (p < 0.001). The ICC was 0.996 and the Pearson correlation coefficient was 0.995. The mean K (D) values measured by Myopia Master, KR-1, and Lenstar were 43.15 ± 1.59 D, 43.38 ± 1.58 D, and 43.32 ± 1.63 D, respectively, and differed significantly (p < 0.001). Conclusions While statistical differences emerged in SEs between Myopia Master and KR-1, the differences were not clinically significant and the tools may be used interchangeably due to their good agreement. However, measured K values differed among Myopia Master, KR-1, and Lenstar, so these tools are not interchangeable. Based on the results from paired t-tests, ICCs, and Pearson correlations, AL measurements were in good agreement between Myopia Master and Lenstar but caution should be exercised due to the wider range of measured values.

Purpose: We present a case of alitretinoin-induced pseudotumor cerebri.Case summary: A 28-year-old woman presented with a 1-month history of bilateral papilledema and intermittent blurred vision in the left eye. She had been taking alitretinoin (9-cis-retinoic acid, AlitocⓇ; GlaxoSmithKline) for atopic dermatitis and hand eczema. Although visual acuity remained intact in both eyes, mild central scotoma was detected bilaterally. Optical coherence tomography revealed increased retinal nerve fiber layer thickness in both eyes. Enhanced magnetic resonance imaging revealed no abnormalities except for bilateral flattening of the posterior sclera. Cerebrospinal fluid exhibited an elevated opening pressure (220 mmH2O) and a normal composition. Following the discontinuation of alitretinoin, the intermittent blurred vision, papilledema, and central scotoma improved significantly within 2 months. Conclusions Alitretinoin use should be monitored carefully for a potential development of pseudotumor cerebri, particularly in patients with pre-existing risk factors.mmH2O) and a normal composition. Following

PURPOSE: To compare the surgical outcomes between modified bilateral lateral rectus muscle (BLR) recession and augmented unilateral recession-resection (R&R) for the convergence insufficiency intermittent exotropia (IXT). METHODS: 37 patients with convergence insufficiency IXT were divided into two groups: 13 patients (underwent BLR recession) and 24 patients (underwent unilateral R&R). Success was defined as within 10 prism diopters (PD) at distance and near, and within 10 PD of the difference between them at postoperative 12 months. RESULTS: After the patch test, the preoperative distance deviation angle in the BLR group was 29.9 ± 8.4 PD, and the near deviation angle was 42.3 ± 9.7 PD; the difference between them was 12.5 ± 3.2 PD. In the R&R group, the preoperative distance deviation angle was 26.7 ± 5.8 PD, and the near deviation angle was 41.5 ± 7.4 PD; the difference between them was 14.8 ± 4.3 PD (p = 0.235, p = 0.987, and p = 0.123). At the 12-month follow-up in the BLR group, the distance angle was 3.8 ± 5.1 PD, and the near deviation angle was 4.9 ± 6.1 PD; the difference between them was 2.9 ± 5.9 PD. In the R&R group, the postoperative distance deviation angle was 4.7 ± 6.1 PD, and the near deviation angle was 7.9 ± 6.6 PD; the difference between them was 3.65 ± 5.1 PD (p = 0.708, p = 0.162, and p = 0.632, respectively). The surgical success rate did not differ significantly between groups at 12 months postoperatively (76.9%: BLR group and 70.8%: R&R group; p = 0.690). CONCLUSIONS: Modified BLR recession showed a similar surgical success rate to augmented unilateral R&R, and was effective in reducing both distance and near exodeviation, and in decreasing the difference between distance and near deviation in convergence insufficiency IXT.
Exotropia ; Follow-Up Studies ; Humans ; Ocular Motility Disorders ; Patch Tests

PURPOSE: The purpose of our study was to evaluate the cause of acquired third, fourth, and sixth nerve palsy while also establishing recovery rates and important factors for recovery. METHODS: A retrospective chart review was performed for 92 patients who visited the ophthalmologic department of Konyang University Hospital with acquired third, fourth, and sixth nerve palsy from March 2015 to February 2016. Recovery rates and factors for recovery were evaluated in only 66 patients who received first ocular exam within 2 weeks of onset and who were followed up for at least 6 months. Complete recovery was defined as both complete recovery of the angle of deviation and the restoration of eye movement in all directions. For the degree of ocular motor restriction, −4 was defined as not crossing the midline and −2 was defined as 50% eye movement. The degree of ocular motor restriction was analyzed from −1/2 to 4. RESULTS: The fourth nerve was affected most frequently (n = 37, 40.2%), followed by the sixth cranial nerve (n = 33, 35.9%), the third cranial nerve (n = 18, 19.6%), and a combination of 2 or more cranial nerves (n = 4, 4.3%). Vasculopathy (n = 44, 47.8%) was the most common etiology, followed by trauma (n = 14, 15.2%), idiopathic (n = 13, 14.1%), inflammation(n = 10, 10.9%), neoplasm (n = 9, 9.8%), and aneurysm (n = 2, 2.2%). Complete recovery rate occurred for 66.7% (n = 44) of patients, and the overall recovery rate (i.e., at least partial recovery) was 86.3% (n = 57). Significant factors for complete recovery were the initial deviation angle and the limitation of extraocular movement (p < 0.001, p = 0.005, respectively, according to univariate analysis). CONCLUSIONS: In this study, paralytic strabismus due to vasculopathy was the most common etiology, and a lower degree of initial deviation resulted in an improved complete recovery rate. In addition, a high overall recovery rate was possible through quick diagnosis and early treatment of cranial nerve palsy.
Abducens Nerve ; Abducens Nerve Diseases ; Aneurysm ; Cranial Nerve Diseases ; Cranial Nerves ; Diagnosis ; Eye Movements ; Humans ; Oculomotor Nerve ; Retrospective Studies ; Strabismus*

PURPOSE: To evaluate diagnostic the usefulness of blind spot mapping in measuring ocular torsion changes and to investigate the correlations of inferior oblique muscle overaction (IOOA) and excyclotorsion measurements using fundus photographs and blind spot mapping in patients with secondary IOOA. METHODS: Eleven patients (12 eyes; IOOA group) diagnosed with secondary IOOA were evaluated for ocular movement, fundus photograph and Humphrey standard automated perimetry, and 10 patients (20 eyes; control group) were subjected to the same tests. An ocular movement examination was performed to evaluate IOOA, and fundus photograph and Humphrey standard automated perimetry were used to measure the ocular torsion. Inferior oblique myectomy or recession was performed along with horizontal strabismus surgery, and preoperative and postoperative IOOA and ocular torsion measurements were compared between the groups. RESULTS: In the IOOA group after surgery, the IOOA decreased from +2.42 ± 0.63 to +0.50 ± 0.52, the ocular torsion decreased from +14.15 ± 3.60° to +7.47 ± 1.65° (p < 0.001) on fundus photographs, and from +12.19 ± 1.62° to +9.69 ± 1.75° (p = 0.061) in Humphrey standard automated perimetry. The control group showed a mean ocular torsion of 7.44 ± 1.62° on fundus photographs and +7.24 ± 1.28° on Humphrey standard automated perimetry. CONCLUSIONS: The usefulness of blind spot mapping when the ocular torsion was measured in IOOA patients was considered low, due to the weak correlation between IOOA and extorsion; preoperative and postoperative ocular torsion amount values were not significantly different.
Humans ; Optic Disk* ; Strabismus ; Visual Field Tests

No abstract available.
Child ; Eye Movements/*physiology ; Humans ; Male ; Oculomotor Muscles/physiopathology/*surgery ; Ophthalmologic Surgical Procedures/*methods ; Strabismus/physiopathology/*surgery ; Syndrome

No abstract available.
Child, Preschool ; DNA Mutational Analysis ; Diseases in Twins/*genetics/metabolism ; Ectopia Lentis/*genetics/metabolism ; Extracellular Matrix Proteins ; Humans ; Male ; Microfilament Proteins/*genetics/metabolism ; *Mutation ; *Twins, Monozygotic