Gender-differences in age-related changes of corneal astigmatism in Korean cataract patients.

BACKGROUND: This cross-sectional study investigated age-related changes in anterior, posterior, and total corneal astigmatism and evaluated sex differences in corneal astigmatism with increasing age in cataract patients. METHODS: This study evaluated eyes with cataracts from May 2009 and July 2013. All eyes underwent a complete ophthalmological examination and corneal Scheimpflug imaging by a Pentacam camera (Oculus, Wetzlar, Germany). Anterior, posterior, and total corneal astigmatism were determined. Power vector J0 and linear regression analyses were determined and compared with respect to age and sex. RESULTS: Four hundred and fifteen patients (217 men, 198 women) aged 20-89 years were evaluated. For anterior corneal astigmatism, 100% of patients who were 20-39 years old had with-the-rule (WTR) in both sexes. WTR was significantly lower in patients 80-89 years old (25.6% of men and 37.8% of women). For total corneal astigmatism, WTR also tended to decrease with increasing age: 93.3% of men and 100% of women 20-39 years old versus 20.9% of men and 31.1% of women 80-89 years old. The regression coefficient of both the anterior corneal and total corneal J0 vector values analyzed by age were - 0.018 in men and - 0.016 in women (both p < .001). CONCLUSIONS: The against-the-rule shift was faster for total corneal astigmatism than for anterior corneal astigmatism and it occurred earlier in men than in women. TRIAL REGISTRATION: Retrospectively registered. Registration number: KC15RISI0241 . Registered April 20, 2016.

Comparison of keratometric measurements between color light-emitting diode topography and Scheimpflug camera.

BACKGROUND: To determine the agreement of measurements between color light-emitting diode corneal topography (Cassini) and Scheimpflug camera keratometry (Pentacam HR). METHODS: The current retrospective study investigated 117 right eyes of 117 healthy patients before cataract surgery from June 2017 to July 2017. Steep K, flat K, mean K, astigmatism, and axis for both anterior and posterior corneal surface were measured using the two devices. The measured values were converted into J vectors such as J0 and J45. The mean difference for those measurement values were compared between the two instruments, and the agreement was evaluated using the Bland-Altman plot I. RESULTS: There were statistically significant differences in mean K (44.21D [43.34 to 45.34] and 44.30D [43.30 to 45.10] by Cassini and Pentacam [P = 0.004]) and astigmatism (0.90D [0.58 to 1.30] and 0.70D [0.40 to 1.30] by Cassini and Pentacam [P = 0.002]) on the anterior corneal surface and flat K (- 6.21D [- 6.39 to - 6.07] and - 6.30D [- 6.5 to - 6.10] by Cassini and Pentacam [P < 0.001]), mean K (- 6.39D [- 6.54 to - 6.25] and - 6.40D [- 6.60 to - 6.30] by Cassini and Pentacam [P = 0.019]), and astigmatism (0.33D [0.22 to 0.47] and 0.30D [0.15 to 0.40] by Cassini and Pentacam [P = 0.002]) on the posterior corneal surface. The mean difference (= Cassini - Pentacam) with 95% limit of agreement for mean K and astigmatism of the anterior corneal surface were 0.082D (- 0.60 to 0.76) and 0.11D (- 0.73 to 0.95) for measurements obtained by the two instruments, respectively. Regarding keratometric values from the posterior corneal surface, the mean differences for flat K, mean K, and astigmatism were - 0.081D (- 0.42 to 0.26), - 0.030D (- 0.32 to 0.26), and 0.067D (- 0.33 to 0.46), respectively. Intraclass correlation coefficients for steep K, flat K, mean K, and vector J0 were higher than 0.9 in the anterior cornea. Positive correlation in steep K, flat K, mean K, astigmatism, and J0 was found between two devices in both anterior and posterior cornea (P < 0.001). CONCLUSIONS: Corneal refractive power and astigmatism tend to be higher when measured using Cassini than Pentacam HR in both anterior and posterior cornea. The two different devices might not be used interchangeably. TRIAL REGISTRATION: Retrospectively registered. Registration number: KC17RESI0439 .

Accuracy of swept-source optical coherence tomography based biometry for intraocular lens power calculation: a retrospective cross-sectional study.

BACKGROUND: To evaluate the accuracy of biometric measurements by a swept-source optical coherence tomography (SS-OCT) based biometry for intraocular lens (IOL) power calculation. METHODS: This retrospective observational study enrolled 431 patients undergoing cataract surgery. The charts were reviewed to investigate the failure rate of axial length (AL) measurement of the SS-OCT biometer, partial coherence interferometry (PCI), and A-scan ultrasonography (US) according to cataract type and severity. AL and keratometry in 164 eyes with the same IOL inserted were measured using the SS-OCT biometer, PCI, and A-scan US. The SRK/T formula was used to calculate IOL power. The mean absolute error (MAE) and percentage of eyes with a prediction error (PE) of ±0.50 D were compared. RESULTS: The AL measurement failure rate was 0.00% for A-scan US, 2.32% for the SS-OCT biometer, and 15.31% for PCI. The number of eyes measured using three devices (SS-OCT biometer, PCI, and A-scan US) was 128 (Group A) and the number of eyes measured using two devices (SS-OCT biometer and A-scan US) was 36 (Group B). The score of posterior subcapsular opacity was significantly different between two groups (p < .001). The SS-OCT biometer and PCI showed significantly lower MAE compared to A-scan US in Group A (p = 0.027). Using SS-OCT biometer, MAE showed no significant difference between Group A (0.36 ± 0.27) and Group B (0.36 ± 0.31) (p = 0.785). Whereas, MAE of A-scan US was significantly higher than Group A (0.47 ± 0.39) in Group B (0.64 ± 0.36) (p = 0.023). CONCLUSIONS: Using biometry with advanced OCT is useful in clinical practice as it is more effective in obtaining biometric measurements in the eyes with PSC and provides accurate measurements for IOL power calculation regardless of cataract type and severity. TRIAL REGISTRATION: Retrospectively registered. Registration number: KC16RISI1020 . Registered 03 January 2018.

Gender differences in dry eye disease symptoms associated with psychological health indicators among adults using mobile mental health apps.

PURPOSE: We aimed to investigate the association between dry eye disease (DED) symptoms and mental health among Korean adults in the community. METHODS: A cross-sectional study analyzed the data of 152 participants using mobile-phone applications for recording mental health. We defined individuals with DED symptoms as those who experienced a sense of irritation or dryness of the eye (either constantly or often). Mental health (perceived stress, depression, and anxiety) was assessed using the Perceived Stress Scale, Patient Health Questionnaire-9, and General Anxiety Disorder-7, in this order. Multiple logistic regression analysis was conducted to examine the association between DED symptoms and mental health. We also adjusted for possible covariates. We investigated sex differences in mental health status in relation to DED. RESULTS: We found that 41.4% of the participants (48.4% female and 30.5% male) showed DED symptoms, and its prevalence was higher in female than in male. The average perceived stress and anxiety symptoms in the female with DED (24.69±4.73 and 6.56±5.09, respectively) were significantly higher than those without DED (21.38±4.68 and 4.54±4.03) (p = 0.020 and 0.038, respectively). Even after adjusting for possible covariates, female who had DED showed higher risks of perceived stress (OR = 1.28), depression (OR = 2.64), and anxiety (OR = 5.81). CONCLUSIONS: Clinicians and nurses should therefore be aware of the possibility of mental health problems among female with DED.

Sleep disorders, mental health, and dry eye disease in South Korea.

Dry eye disease (DED) is a multifactorial disease of the ocular surface causing severe discomfort, mild ocular irritation, fatigue, pain, visual disturbance, and foreign body sensation. Stress, depression, and sleep disorders are risk factors for DED. We aimed to investigate the association between DED symptoms and composite factors related to mental health (combined sleep duration, psychological stress perception, and history of depressed mood) in Korean adults aged ≥ 20 years in a population-based study using the 2010-2012 Korea National Health and Nutrition Examination Survey data. Symptoms of DED and data on mental health were obtained using questionnaires. Multiple logistic regression analysis was conducted to examine the association between mental health and DED, and adjusted for possible covariates. Subjects with symptoms of DED were more likely to experience short sleep duration, psychological stress perception, and a history of depressed mood [odds ratio (OR) = 1.42, 95% confidence interval (CI) 1.06-1.90; OR = 1.71, 95% CI 1.37-2.14; and OR = 1.37, 95% CI 1.06-1.77, respectively] even after correcting for demographic factors, lifestyle factors, and medical factors. Additionally, participants with symptoms of DED were more likely to experience composite factors related to mental health (OR = 1.91, 95% CI 1.07-3.39). Therefore, ophthalmologists may report difficulties in both sleep and mental health in patients with DED.

The U-shaped association between self-reported sleep duration and visual impairment in Korean adults: a population-based study.

OBJECTIVE: This study aimed to investigate the association between self-reported sleep duration and visual impairment (VI) in Korean adults. METHODS: This population-based, cross-sectional study examined ophthalmologic data of 16,374 Koreans aged 19 years and older from the 2010-2012 Korea National Health and Nutrition Examination Survey (KNHNES V). VI data (best-corrected distance visual acuity worse than 0.5 logMAR in the better-seeing eye) were obtained from direct ophthalmologic examinations, and data on self-reported sleep duration (≤5, 6, 7, 8, or ≥9 h/night) were obtained using questionnaires. Multiple logistic regression analysis was conducted to examine the association between self-reported sleep duration and VI, and we also adjusted for possible covariates. RESULTS: The weighted VI prevalences (95% CIs) were 1.23% (0.70-1.76), 0.40% (0.10-0.70), 0.18% (0.04-0.31), 0.42% (0.26-0.58), and 0.66% (0.25-1.07) for participants who slept ≤5, 6, 7, 8, and ≥9 h/night, respectively. Even after adjusting for demographic factors (age and sex), lifestyle factors (household income, occupation, smoking status, regular exercise, and suicidal thoughts), and medical factors (diabetes, hypertension, stroke, and history of ocular surgery), greater risk of VI was found in the ≤5 h/night (OR = 3.23, 95% CI: 1.43-7.31) and ≥9 h/night (OR = 2.56, 95% CI: 1.03-6.41) groups, compared to the 7 h/night group. CONCLUSIONS: In Korean adults, self-reported sleep duration and VI exhibited a U-shaped association. Both very short (≤5 h/night) and very long (≥9 h/night) sleep durations were significantly associated with increased VI.