Attenuation of corneal neovascularization by topical low-molecular-weight heparin-taurocholate 7 without bleeding complication.

AIM: To investigate the antiangiogenic effects and safety of topically administered low-molecular-weight heparin-taurocholate 7 (LHT7) on corneal neovascularization (CoNV). METHODS: Twenty-four Sprague-Dawley rats were randomly distributed into four groups of six rats each. The central corneas were cauterized using a silver/potassium nitrate solution. From 2d after cauterization, 12.5 mg/mL (low LHT7 group) or 25 mg/mL (high LHT7 group) LHT7 was topically administered three times daily; 12.5 mg/mL bevacizumab was topically administered as positive control (bevacizumab) group, with normal saline (NS) administered as negative control (NS group). The corneas were digitally photographed to calculate the CoNV percentage from the neovascularized corneal area at 1 and 2wk. RESULTS: The 4 study groups did not have different CoNV percentages at 1wk after injury (P>0.05). However, the low LHT, high LHT, and bevacizumab groups had significantly lower CoNV percentages than the NS group at 2wk (all P<0.05). No significant differences in CoNV percentage were found among the low LHT, high LHT, and bevacizumab groups (all P>0.05). All groups except the NS group had lower CoNV percentages at 2wk post-injury than the levels observed at 1wk (all P<0.05). CONCLUSION: Topically-administered LHT7 inhibited CoNV without complication after chemical cauterization in the rat.

Factors associated with anterior chamber narrowing with age: an optical coherence tomography study.

PURPOSE: The purpose of our study is to evaluate the effect of age on various anterior segment (AS) parameters in healthy eyes using AS optical coherence tomography (OCT), and to examine their relationship to anterior chamber angle (ACA) narrowing with age. METHODS: A total of 388 consecutive Korean subjects aged 30 to 89 years was imaged by AS OCT. Anterior chamber depth (ACD), iris cross-sectional area (IA), iris thickness at 750 and 1500 µ from the scleral spur (IT(750, 1500)), iris curvature (IC), lens vault (LV), and anterior chamber area (AA) were determined using Image J software (version 1.44). The absolute and normalized slopes of these parameters, adjusted for axial length and sex, were determined by linear mixed-effects modeling. Multivariate regression analysis was performed to evaluate factors associated with ACA narrowing, which was defined as the angle-opening distance (AOD(500)) at the temporal angle. RESULTS: ACD and AA had significantly negative slopes (-0.0119 mm/year, -0.0845 mm(2)/year, P < 0.0001, <0.0001) with age, and LV, IC, IT(750), IT(1500), and IA had significantly positive slopes (0.0084 mm/year, 0.0019 mm/year, 0.0006 mm/year, 0.0008 mm/year, 0.0131 mm(2)/year, all P < 0.05). IC, ACD, LV, and AA underwent the greatest changes when analyzed by normalized slopes. IC, LV, age, and axial length were associated significantly with ACA narrowing (all P < 0.0001). CONCLUSIONS: Increments of LV, IC, IT, and IA with age led to a reduction in the dimensions of the AC and to narrowing of the ACA. This may explain why aging is a significant risk factor for primary angle closure glaucoma.

Comparison between deviation map algorithm and peripapillary retinal nerve fiber layer measurements using Cirrus HD-OCT in the detection of localized glaucomatous visual field defects.

PURPOSE: To compare the capability of the deviation map algorithm and peripapillary retinal nerve fiber layer (pRNFL) thickness measurements, both determined using Cirrus spectral domain optical coherence tomography (Carl Zeiss Meditec Inc., Dublin, CA), in discrimination between healthy and glaucomatous eyes. METHODS: This cross-sectional comparative prospective study included 54 patients with glaucoma with localized visual field (VF) defects confined to 1 hemifield and 54 normal controls. Mean pRNFL thickness corresponding to localized VF defect was calculated. A deviation Score (DS) was assigned by customized Image J software (Http://www.rsb.info.hih.gov/ij/18) calculating the number of abnormal superpixels in the deviation maps corresponding to localized VF defect. Correlations between DS and mean pRNFL thickness, and VF parameters were obtained. The areas under receiver operating characteristic curves of the DS and mean pRNFL thickness used for discriminating between controls and glaucomatous eyes were compared. RESULTS: DS and the average pRNFL thickness measurements showed a strong correlation (R, -0.844, P<0.0001). There were also significant correlations between DS, mean deviation (MD), and pattern standard deviation (R, -0.678, 0.699, respectively). The areas under receiver operating characteristic curves of the mean pRNFL thickness (0.892) and DS (0.958) differed significantly (P=0.0051). The sensitivities at 80%, 90%, and 95% specificities were 94.4%, 90.6%, and 88.6%, respectively, for DS and 74.5%, 58.8%, and 47.3%, for mean pRNFL thickness. CONCLUSIONS: The deviation map algorithm showed a superior capability for detection of localized glaucomatous VF defects when compared with traditional pRNFL thickness measurements. There were statistically significant correlations between the deviation map algorithm and VF indices.

Homeostatic response of intraocular pressure in the early period after sutureless phacoemulsification.

PURPOSE: To determine the homeostatic response of postoperative intraocular pressure (IOP) by analyzing postoperative IOP trends after sutureless phacoemulsification. SETTING: Asan Medical Center, Seoul, South Korea. DESIGN: Comparative case series. METHODS: Normotensive eyes were treated with sutureless phacoemulsification with in-the-bag posterior chamber IOL (PC IOL) implantation. The patients were randomly divided into 3 groups according to the intended immediate postoperative IOP as follows: Group 1, IOP less than 10 mm Hg; Group 2, IOP 10 to 21 mm Hg; Group 3, IOP over 21 mm Hg. The surgeon intentionally attempted supranormal, normal, or subnormal pressurization. The IOP was measured immediately after surgery and 2 hours, 4 hours, 1 day, 1 week, and 1 month postoperatively. RESULTS: Group 1 included 88 eyes (27.8%), Group 2 included 130 eyes (41.2%), and Group 3 included 98 eyes (31.0%). The mean IOP immediately after surgery was 6.4 mm Hg ± 2.0 (SD), 14.5 ± 3.2 mm Hg, and 27.0 ± 4.6 mm Hg, respectively, with significant differences between the 3 groups (P<.05). However, the IOP values were nearly normalized in the 3 groups 2 to 4 hours postoperatively. Twenty-eight eyes (8.9%) had an IOP lower than 5 mm Hg immediately after surgery in the absence of incision leakage. There were no postoperative complications related to hypotony. Thirty-one eyes (9.8%) had an IOP of at least 30 mm Hg immediately after surgery; the IOP normalized by 1 day postoperatively. CONCLUSION: In normal eyes that had uneventful sutureless phacoemulsification with in-the-bag PC IOL implantation, immediate postoperative high or low IOP did not affect the return to baseline levels.

Spectral-domain optical coherence tomography and scanning laser polarimetry in glaucoma diagnosis.

PURPOSE: To evaluate glaucoma diagnostic capability of the retinal nerve fiber layer (RNFL) imaging by spectral-domain optical coherence tomography (Cirrus OCT) and scanning laser polarimetry (GDx VCC). METHODS: We imaged 88 glaucomatous and 77 healthy eyes using both devices. Areas under the receiver-operating characteristic curves (area under the curves, AUCs) and sensitivities at fixed specificities of average, superior, and inferior RNFL thickness were compared. Likelihood ratios (LRs) and diagnostic agreement based on normative classifications yielded by both devices were determined. RESULTS: The best performing parameter was the nerve fiber indicator (NFI) in GDx VCC and inferior RNFL thickness in Cirrus OCT (AUC = 0.912, 0.961, P = 0.045). The AUCs of the Cirrus OCT were significantly higher than those of GDx VCC in all parameters. Most of the parameters in Cirrus OCT were more sensitive than GDx VCC in the detection of glaucoma at fixed specificity values. Cirrus OCT had an infinite LR with abnormal classification results in both average and superior RNFL thickness. There was good agreement between the two instruments with respect to abnormal classifications (kappa, 0.611-0.766) CONCLUSION: Both Cirrus OCT and GDx VCC RNFL measurements showed good glaucoma diagnostic capabilities. Cirrus OCT showed higher sensitivities than GDx VCC.

Effect of age on anterior chamber angle configuration in Asians determined by anterior segment optical coherence tomography; clinic-based study.

PURPOSE: To evaluate the distribution of anterior chamber angle (ACA) parameters and to assess association of these parameters with age in Asian subjects. METHODS: Four hundred and thirty-nine consecutive Korean subjects aged from 30 to 89 were enrolled from a university clinic. All participants were scanned using anterior segment optical coherence tomography (AS-OCT, Visante, version 2.0). We measured ACA parameters such as anterior chamber depth (ACD), angle opening distance at 500 and 750µm (AOD(500,750) ), angle recess area at 500 and 750µm (ARA(500,750) ), trabecular iris space area at 500 and 750µm (TISA(500,750) ), and determined age-related changes in these parameters with use of a linear mixed effect model that adjusted for gender, axial length, intraocular pressure, and keratometry data. Slopes of ACA parameters as a function of age were determined. For various AS-OCT parameters, the normalized slope was calculated by dividing the slope by the mean value. RESULTS: All analysed ACA parameters decreased with age in both nasal and temporal quadrants. Axial length and keratometry data were significant covariates for ACA changes. The slopes of ACD were -0.02396mm/year, AOD(500) , ARA(500) , and TISA(500) measured at the temporal angle were -0.00634mm/year, -0.0019mm(2) /year, and -0.00177mm(2) /year, respectively. There was no age-dependent difference in central corneal thickness (p value; 0.4597) Based on the normalized slopes, the AOD showed the steepest slope at both temporal and nasal sectors. CONCLUSION: All ACA parameters assessed by AS-OCT, which accounted for other ocular biometric parameters, showed significant negative slopes with increasing age. These results should be considered when assessing changes in the anterior chamber over time.