Diagnostic Potential of Anterior Segment Optical Coherence Tomography Scans for Pseudomonas Keratitis.

Purpose: The purpose of this study was to investigate the diagnostic value of anterior segment optical coherence tomography (AS-OCT) scans for Pseudomonas keratitis. Methods: Patients with treatment-naïve keratitis underwent AS-OCT imaging. The following parameters were evaluated: corneal thickness (CT), infiltrate thickness (IT), infiltrate diameter (ID), tissue loss/gain, entropy, and distance of the lesion from the corneal pupillary center. Three different OCT devices were used for the analysis. The relationship between the detected pathogen and the OCT patterns was analyzed. Results: Nineteen eyes of 19 patients were included in the analysis: seven cases in the Pseudomonas group and 12 cases in the Gram-positive group. The mean (SD) values for the Pseudomonas and Gram-positive groups, respectively, were as follows: CT, 834 µm (165 µm) and 760 µm (120 µm); IT, 290 µm (152 µm) and 287 µm (84 µm); ID, 2067 µm (1470 µm) and 1307 µm (745 µm); distance to center, 3.0 mm (1.2 mm) and 3.0 mm (1.6 mm); epithelial defect, 1193 µm (586 µm) and 484 µm (615 µm); tissue gain, +31% (19%) and +10% (12%); and entropy level, 4.0 (0.8) and 3.9 (1.1). Conclusions: This study introduces novel insights by identifying specific OCT parameters that distinguish Pseudomonas keratitis, including a 30% tissue gain. These findings align with earlier research that underscores the potential of OCT in differentiating various pathogens causing keratitis. Translational Relevance: The findings of this study could be used to develop new diagnostic strategies for Pseudomonas keratitis. The OCT findings could be used to develop new biomarkers for the infection.

Evaluation of phakic intraocular lens power calculation using the new Linz-Homburg-Castrop formula and comparison with four conventional methods.

PURPOSE: To evaluate the accuracy of phakic intraocular lens (pIOL) power calculation in a middle European patient cohort. SETTING: EyeLaser Clinic, Linz, Austria. DESIGN: Single-center single-surgeon retrospective consecutive case series. METHODS: Patients were included after uneventful pIOL surgery implanting 91 nontoric and toric Visian implantable collamer lens model V4c. Online Calculation and Ordering System (OCOS) software, JPhakic software, Olsen-Feingold formula, Holladay formula, and Linz-Homburg-Castrop (LHC) formula were compared. When possible, lens constants were optimized for the patient cohort. Data of single eye per patient were included. Outcome measures were mean absolute prediction error, median absolute prediction error, mean prediction error with SD, and median prediction error, as well as the percentage of eyes with an absolute prediction error within limits of 0.25 diopters (D), 0.5 D, 0.75 D, and 1.0 D. RESULTS: 91 eyes of 91 patients were assessed. After application of the Cochran Q test, the Olsen-Feingold formula achieved a significantly lower percentage of eyes within an absolute prediction error of 1.0 D than all other methods. CONCLUSIONS: In the patient cohort, OCOS software, JPhakic software, and Holladay and LHC formulas showed equal results and can be cross-checked. The LHC formula was not published before. A ready-to-use Excel sheet is available as an addendum.

Long-term rotational stability and visual outcomes of a single-piece hydrophilic acrylic toric IOL: a 1.5-year follow-up.

AIM: To evaluate the rotational stability and visual outcomes of a single-piece hydrophilic acrylic toric intraocular lenses (IOL) over a 1.5-year follow-up period. Data from the 6-month follow-up study have been previously reported. METHODS: Forty eyes of 26 cataract patients (mean age: 72.8±7.9y) with pre-existing corneal astigmatism of 1.0 to 2.6 D were enrolled in the study. Mean axial length was 23.17±0.88 mm. Main outcome measures after implantation of the Torica-aA IOL (HumanOptics) were IOL rotational stability, subjective refraction, astigmatism correction, uncorrected and corrected distance visual acuity (UDVA, CDVA). RESULTS: There was no significant change in the parameters evaluated between the 6-month and 1.5-year follow-ups. At last visit, mean absolute IOL rotation (objective method) was 1.81°±1.87° (range 0.00° to 7.20°) with 78.6% of eyes having IOL rotation <3°, 92.9% of eyes <5° and 100% of eyes <8°. No patient required secondary IOL repositioning during the course of the study. Mean residual refractive cylinder was -0.60±0.40 D. There was a significant reduction in the magnitude of the J0 vector postoperatively (P<0.0001) with a mean absolute change of 0.76±0.40 D. The mean J45 vector was close to zero preoperatively and postoperatively and didn't change significantly (P=0.28). Mean monocular UDVA and CDVA was 0.09±0.12 logMAR and -0.01±0.12 logMAR, respectively. No treatment with Nd:YAG laser was required. CONCLUSION: The Torica-aA IOL shows good and stable visual performance and rotational stability over a 1.5-year follow-up period.

Rotational stability and patient satisfaction after implantation of a new toric IOL.

PURPOSE: To evaluate rotational stability, astigmatism correction, visual outcomes, and patient satisfaction after implantation of the toric intraocular lens (IOL) Torica-aA following cataract extraction over a 6-month follow-up period. METHODS: This prospective observational study enrolled 40 eyes of 26 patients presenting with preexisting corneal astigmatism of 1.00 to 2.60 D. The rotational stability of the IOL was evaluated using retroillumination photographs taken within 24 hours after surgery and 1 week and 6 months postoperatively. Other main study outcomes were assessed 6 months postoperatively and included uncorrected and distance-corrected visual acuities, astigmatism correction, and patient satisfaction. RESULTS: Six months postoperatively, mean absolute IOL rotation was 1.99 ± 1.88° (range 0.10-7.40°) and secondary repositioning was not required. The IOL rotation was <3° in 85% of eyes, ≤5° in 94% of eyes, and <8° in 100% of eyes. Mean residual refractive cylinder was -0.57 ± 0.34 D. The magnitude of the J0 vector was significantly decreased postoperatively (p<0.0001). The mean J45 vector was close to zero preoperatively and postoperatively (p = 0.27). Mean monocular uncorrected distance visual acuity (UDVA) was 0.09 ± 0.12 logMAR and 97% of eyes achieved UDVA of 20/40 or better including 66% of eyes having 20/25 or better. The good UDVA resulted in high levels of spectacle independence and patient satisfaction. CONCLUSIONS: Implantation of the Torica-aA IOL was safe and effective in reducing low to moderate preexisting corneal astigmatism and provided good rotational stability and refractive outcomes, which led to a high degree of patient satisfaction.

Reduced forearm blood flow in children and adolescents with type 1 diabetes (measured by near-infrared spectroscopy).

OBJECTIVE: The aim of this study was to measure forearm blood flow (FBF) to detect any possible changes that might indicate vascular disorders in children and adolescents with type 1 diabetes. RESEARCH DESIGN AND METHODS: FBF was measured by near-infrared spectroscopy (NIRS), venous occlusion at rest, and after handgrip exercise. A total of 40 children and adolescents with type 1 diabetes and 40 healthy children and adolescents (6-18 years) were matched for age and sex for comparison. RESULTS: In the diabetic group (age 12.79 +/- 2.9 years, duration of diabetes 51.5 +/- 36 months), FBF at rest was significantly lower (1.39 +/- 0.76 ml x 100 g muscle(-1) x min(-1)) than in control subjects (age 12.66 +/- 2.9 years, FBF at rest 1.90 +/- 1.19 ml x 100 g muscle(-1) x min(-1)). After exercise, FBF increased significantly less in the diabetic group (0.70 +/- 0.82 ml. 100 g muscle(-1) x min(-1)) compared with the control subjects (1.15 +/- 1.05 ml. 100 g muscle(-1) x min(-1)). FBF at rest decreased with increasing age in both groups. The change in FBF after exercise was independent of age in the diabetic group and increased with increasing age in control subjects. FBF is reduced with impaired hyperemic response after exercise in children and adolescents with type 1 diabetes. CONCLUSIONS: These data suggest that vascular disorders in childhood are detectable noninvasively by NIRS.