Morphometric parameters of the optic disc in normal and glaucomatous eyes based on time-domain optical coherence tomography image analysis.

BACKGROUND AND OBJECTIVE: Assessment of optic disc morphology is essential in diagnosis and management of visual impairment. The aim of this study was to evaluate associations between optic disc morphometric parameters, i.e., size and shape, and age, gender, and ocular axial length in normal and glaucomatous eyes based on time-domain optical coherence tomography image analysis. MATERIALS AND METHODS: It was a case-control study of 998 normal and 394 eyes with primary open angle glaucoma that underwent an ophthalmological examination and time-domain optical coherence topography scanning. Areas and shapes of the disc, cup, and neuroretinal rim were analyzed. RESULTS: The shape of the optic disc did not differ between the study groups, i.e., normal and glaucomatous case groups, but the disc area of the primary open angle glaucoma group was significantly larger. The shape of the small disc was significantly different, but the shape of the medium and the large disc did not differ between the study groups. The central area of the disc, i.e., cup area was significantly larger in the case group and its shape was significantly different between the study groups. No significant differences in the area of the cup and its shape, nerve fibers on the edge of the disc, i.e., neuroretinal rim area, were found between the study groups of the small discs. There were significant associations between age, gender, and ocular axial length and morphometric parameters of the optic disc. CONCLUSIONS: Informative results with regard to the size and shape due to various ocular characteristics between the healthy control group and patients suffering with primary open angle glaucoma were obtained. Both study groups were significant in size, which makes the findings interesting and important contribution in the field.

Bilateral endogenous bacterial panophthalmitis.

We present a case of meningitis with bilateral endogenous bacterial panophthalmitis in a previously healthy individual. The management of this ocular condition is unclear, and the prognosis is poor. The patient was admitted to the Clinic of Eye Diseases after a 9-day treatment with systemic antibiotics with a complete systemic recovery but impaired vision of both eyes. Functional vision was restored in the better eye with intravitreal vancomycin and pars plana vitrectomy. Nevertheless, after the removal of silicone oil, phthisis bulbi began to develop. Better outcomes could be expected if bacteremic patients were examined routinely by an ophthalmologist and, in case of endogenous bacterial endophthalmitis, treated with intravitreal antibiotics.

Correlations between digital planimetry and optical coherence tomography, confocal scanning laser ophthalmoscopy in assessment of optic disc parameters.

OBJECTIVE AND AIM: In routine clinical practice, laser methods for the evaluation of optic disc parameters are expensive and not accessible for all ophthalmologists; therefore, there is a need for less expensive technique. The aim of this study was to assess correlations between the parameters of the optic disc measured by digital planimetry (DP), optical coherence tomography (OCT), and confocal scanning laser ophthalmoscopy (CSLO) in healthy and glaucoma patients with the normal biometric parameters of the eye. MATERIAL AND METHODS: This case-control study enrolled 40 patients with glaucoma and 32 healthy patients with the normal biometric parameters of the eye. All subjects underwent full ophthalmologic examination, digital color optic disc photography, OCT, and CSLO at the same visit. The optic disc was morphometrically analyzed by DP, OCT, and CSLO. Seven optic disc parameters were evaluated. RESULTS: In the glaucoma group, the optic disc and cup areas (r=0.7-0.8, P<0.001) and cup-to-optic disc and rim-to-optic disc area ratios (r=0.7, P<0.001) measured by DP were strongly correlated with those measured by OCT and CSLO, while the horizontal and vertical cup-to-optic disc diameter ratios were found to be moderately correlated (r=0.6-0.7, P<0.001). In healthy patients, the optic disc and cup areas were strongly correlated (r=0.7-8.0, P<0.001). Significant differences in all optic disc parameters, except for the optic disc area, measured by DP, OCT, and CSLO were found between glaucoma and healthy patients. CONCLUSIONS: Strong correlations between the parameters of the optic disc measured by DP, OCT, and CSLO were found. There were significant differences in the parameters between healthy and glaucoma eyes measured using DP; therefore, this technique may be used for diagnosis, management, and screening of glaucoma.

The use of information technologies for diagnosis in ophthalmology.

In 2003, a health IT programme for clinical decision support started in Lithuania. An initial goal was to create databases for ophthalmology images and to develop processing algorithms to extract diagnostically valuable information from images. We have investigated how vectors, consisting of the parameters derived from fundus images, are distributed and whether they form specific groups. When analysing the multidimensional patient data vectors, comprising all the 27 image parameters, it was impossible to separate the healthy eyes from the diseased ones. However, it was possible to simplify the system by eliminating redundant parameters and introducing new ones that represent a subset of parameters from the initial group. Thus it may prove possible to identify glaucoma using this system of parameters.

Prevention of posterior capsule opacification using different intraocular lenses (results of one-year clinical study).

AIM: To evaluate and to compare the preventive effect of different intraocular lenses from different material with a round or sharp optic edge design on posterior capsule opacification. METHODS: Our clinical study included 165 patients. Mean follow-up was 12.4+/-0.9 months, mean patient age was 67.5+/-7.8 years. Patients in the group 1 (n=46) were implanted acrylic three-piece hydrophobic intraocular lenses, sharp optic edge (AcrySof, MA3OBA, Alcon), in the group 2 (n=38)--acrylic hydrophobic single piece intraocular lenses, sharp optic edge (AcrySof, SA3OAL, Alcon), in the group 3 (n=39)--silicone three-piece intraocular lenses, sharp optic edge (CeeOn 911A, Pharmacia), and in the group 4 (n=42)--polymethyl methacrylate single piece intraocular lenses, round optic edge (Crystal, 5T, Alcon). The posterior capsule opacification was evaluated for the entire optic and in the central 3-mm zone using EPCO 2000 Software. RESULTS: Posterior capsule opacification values of the entire optic were 0.002+/-0.001 in the AcrySof MA3OBA group, 0.007+/-0.002 in the AcrySof SA3OAL group, 0.002+/-0.001 in the CeeOn 911A group, 0.029+/-0.008 in the polymethyl methacrylate intraocular lens group 6 months after surgery. The values were 0.011+/-0.005, 0.025+/-0.006, 0.014+/-0.005 and 0.122+/-0.021, respectively, one year after surgery. The intraocular lenses types with sharp-edge design (acrylic and silicone) showed significantly lower posterior capsule opacification values than round-edge optic design polymethyl methacrylate lenses (p<0.05). Posterior capsule opacification values of the central 3-mm zone were 0.000+/-0.000 in the AcrySof MA3OBA group, 0.001+/-0.001 in the AcrySof SA3OAL group, 0.000+/-0.000 in the CeeOn 911A group, 0.002+/-0.001 in the polymethyl methacrylate intraocular lens group 6 months after surgery. The values were 0.0001+/-0.0001, 0.018+/-0.007, 0.004+/-0.002 and 0.028+/-0.009, respectively, one year after surgery. Posterior capsule opacification values differences between AcrySof MA3OBA and polymethyl methacrylate intraocular lenses' groups and between CeeOn 911A and polymethyl methacrylate intraocular lenses' groups one year after cataract surgery were established (p<0.05). CONCLUSIONS: The sharp-edge foldable intraocular lenses types (AcrySof MA3OBA, AcrySof SA3OAL, CeeOn 911A) showed statistically significant difference in posterior capsule opacification values in one-year follow-up time. The effect of these foldable lenses for prevention of posterior capsule opacification is mainly a result of rectangular, sharp-edged optic design, which creates a sharp capsular bend. A role of material of intraocular lenses (hydrophobic acrylate and silicone) in prevention of posterior capsule opacification during one-year follow-up was not established.