Periocular Asymmetry Index in Caucasian Populations Using Three-dimensional Photogrammetry Assessment.

OBJECTIVE: To quantitatively assess the periocular asymmetry and investigate its sex and age-related differences in a Caucasian population using three-dimensional (3D) stereophotogrammetry. METHOD: Standardized 3D photos of the periocular region of 301 Caucasians were taken using the VECTRA M3 3D Imaging System. Standardized landmarks were positioned, and data measurements in the periocular region were obtained from these images using VAM software and assessed using intraclass correlation coefficients (ICC) for reliability. Absolute differences and asymmetry index between the right and the left periocular region were calculated with a focus on gender and age-related differences. RESULT: Fissure height asymmetry was positively correlated with age (p < 0.01). Furthermore, reflex distance asymmetry was positively correlated with age in the elderly group (p < 0.05). Absolute differences of upper eyelid crease were 0.65 ± 0.79 mm for females and 0.90 ± 0.94 mm for males (p < 0.05). In the elderly group, the absolute differences of reflex distance were 0.664 ± 0.471 mm for males and 0.470 ± 0.408 mm for females (p < 0.05), while the absolute differences of fissure height were 0.619 ± 0.469 mm and 0.436 ± 0.372 mm, respectively (p < 0.05). All measurements had an inter-rater ICC and intra-rater ICC between 0.761 and 0.957. CONCLUSION: Periocular asymmetry is more prominent in older and male people. 3D photogrammetry is a reliable tool to detect periocular asymmetry and might provide an accurate and effective reference for periocular cosmetic, plastic, and reconstructive surgery in the clinical routine. LEVEL OF EVIDENCE I: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors. www.springer.com/00266 .

FACE-Q eye module for measuring patient-reported outcomes in blepharoplasty surgery: A validation study.

This study aimed to conduct a linguistic validation of all FACE-Q eye module scales in German, and to evaluate the reliability and validity of the scales in patients with blepharoplasty. According to international recommendations, all FACE-Q scales and checklists were translated from English to German. Psychometric testing of blepharoplasty surgery-related scales of translated versions were administered to patients with blepharochalasis or dermatochalasis and a history of blepharoplasty surgery (n = 64; 11 scales) or no history of blepharoplasty surgery (n = 65; seven scales), and to a group of control subjects (n = 64; seven scales). Most of the subscales showed acceptable internal consistency, with Cronbach's alphas ranging from 0.75 to 0.97. Intraclass correlation coefficients were high (0.70-0.92), indicating good reliability, with total values of 0.63 (95% CI 0.46-0.76) and 0.68 (95% CI 0.53-0.80) for the upper eyelid and social function scores, respectively. There was good discriminability between pre- and post-blepharoplasty patients and normal subjects (p < 0.05). The German-language version of the FACE-Q eye module is a successfully validated and helpful tool for assessing outcomes after blepharoplasty surgery, especially with respect to 'satisfaction with overall facial appearance', 'psychological well-being, social function', 'decision satisfaction, outcome satisfaction', and 'early-life impact recovery'.

Relationship between peripapillary choroidal thickness and retinal nerve fiber layer in young people with myopia.

AIM: To study the characteristics and relationship between peripapillary retinal nerve fiber layer (RNFL) and choroidal thickness in young people with myopia. METHODS: We retrospectively analyzed 92 cases (52 myopia, 40 emmetropia) regarding age, sex, refractive power, axial length (AL), and intraocular pressure. Peripapillary RNFL and choroidal thicknesses were measured by optical coherence tomography (OCT) in six sectors. Differences in thicknesses between the two groups were compared by single-factor analysis. RESULTS: RNFL was thickest in the inferotemporal sector (157.3 ± 19.66 µm) and thinnest in the nasal sector (58.78 ± 18.41 µm). Peripapillary choroid was thickest in the superonasal sector (176.37 ± 33.92 µm) and thinnest in the inferotemporal sector (131.79 ± 25.22 µm). The RNFL was thinner in the myopia group (99.04 ± 8.23 µm) vs the emmetropia group (103.25 ± 8.32 µm); significantly different in the superotemporal and inferonasal sectors. Peripapillary choroid thickness in the myopia group (148.65 ± 26.64 µm) was lower vs the emmetropia group (160.88 ± 29.06 µm); significantly different in the nasal, inferonasal, and inferotemporal sectors. RNFL thickness was negatively correlated with choroidal thickness in the nasal sector (r = -0.288). CONCLUSION: Peripapillary RNFL and choroidal thicknesses showed regional distributions. RNFL was negatively correlated with PCT in the nasal sector, possibly related to eye axis growth and choroidal compensation.

Secondary angle-closure glaucoma as an ocular presentation of systemic lupus erythematosus: a case report.

Systemic lupus erythematosus (SLE) is a chronic idiopathic autoimmune disease. SLE can involve almost any part of the eyes. However, bilateral angle-closure glaucoma due to lupus choroidopathy that is accompanied by polyserositis and nephropathy is rare. We report a 21-year-old woman whose clinical manifestations were diagnosed as bilateral angle-closure glaucoma caused by ciliochoroidal effusion. Subsequently, SLE and lupus nephritis were diagnosed on the basis of malar rash, photosensitivity, proteinuria, positive anti-Smith and anti-DNA antibodies, and a renal histopathological biopsy. After 1 month of treatment with steroids and immunosuppressive drugs, the patient's intraocular pressure returned to normal, visual acuity improved, and lupus nephritis was effectively controlled. Bilateral secondary acute angle closure caused by SLE choroidal disease can be an ocular manifestation of SLE, and is usually accompanied by polyserositis and nephropathy. High-dose steroids and immunosuppressive therapy should be immediately and actively provided for this condition.