Comparison of long-term results of trabeculectomy to treat pseudoexfoliative glaucoma and primary open angle glaucoma.

AIM: To compare the long term outcome of trabeculectomy in patients with pseudoexfoliative glaucoma (PEG) and primary open angle glaucoma (POAG) in terms of surgical success. METHODS: The success of the trabeculectomy was evaluated by three criteria. Criterion A: intraocular pressure (IOP) ≤21 mm Hg and decrease in IOP ≥20%; Criterion B: IOP ≤18 mm Hg and decrease in IOP ≥30%; Criterion C: IOP ≤15 mm Hg and decrease in IOP ≥50%. Patients that met these criteria without medical treatment were considered to be completely successful, while those that met these criteria with medical treatment were considered partially successful. Significance levels of differences between the POAG and PEG groups in the Kaplan-Meier survival curves were calculated with the log-rank test. RESULTS: Sixty-four eyes from 64 patients with PEG and 51 eyes from 51 patients with POAG were evaluated. No significant differences were detected between the PEG and POAG groups according to full or partial success relative to each of the three criteria (A: P=0.73, 0.32; B: P=0.73, 0.31; C:P=0.90, 0.27). CONCLUSION: There is no difference in the long-term success of trabeculectomy between PEG and POAG patients whose clinical characteristics are otherwise the same.

Assessment of anterior chamber depth using Visante optical coherence tomography, slitlamp optical coherence tomography, IOL Master, Pentacam and Orbscan IIz.

AIMS: To assess and compare the anterior chamber depth (ACD) by different anterior segment imaging techniques. METHODS: Eighty healthy eyes of 40 patients were recruited, and 3 consecutive measurements of ACD were determined prospectively utilizing Visante optical coherence tomography (OCT), slitlamp (SL) OCT, IOL Master, Pentacam and Orbscan IIz. The statistical significance of interdevice differences between measurements was evaluated by one-way ANOVA and Bland-Altman analysis. The repeatability of 3 consecutive measurements was analyzed by repeated-measures ANOVA. RESULTS: The mean ACD was 2.98 ± 0.29, 2.85 ± 0.29, 3.33 ± 0.42, 2.93 ± 0.30 and 2.80 ± 0.29 mm with Visante OCT, SL-OCT, IOL Master, Pentacam and Orbscan IIz, respectively. All devices displayed a high intrasession repeatability (repeated-measures ANOVA, p > 0.05). ACD measurements obtained by the IOL Master were significantly greater compared to other devices. ACD values detected by Visante OCT and SL-OCT, Pentacam and Orbscan IIz were not clinically interchangeable, even though no statistically significant difference was detected. CONCLUSION: Although noncontact ACD measurements using all modalities were easy to handle and demonstrated good repeatability, the tested devices were not regarded as compatible. Hence, the clinician should take the different modalities into consideration during ACD assessment using various devices.

In Vivo Confocal Microscopy in Presumed Central Cloudy Dystrophy of François.

A 70-years-old woman with no visual symptoms was incidentally diagnosed with presumed central cloudy dystrophy of François (CCDF) on regular ophthalmic examination. Bilateral polygonal opacities separated by clear spaces were seen in corneal biomicroscopic examination. The opacities were prominent in the central cornea and occupied full-thickness corneal stroma. Confocal microscopy revealed small highly refractile granules and deposits in the anterior and deeper stromal layers. Multiple dark acellular striae among extra-cellular matrices with increased intensities were seen in the posterior stroma. No stromal layer of keratocytes was observed. In the right eye, the corneal endothelial cell density was 3,319 cells/mm(2), polymegathism was 52.9%, and pleomorphism was 34.3%. In the left eye, endothelial cell counts could not be performed because of high stromal reflectance intensity. Full-thickness involvement of the corneal stroma with hyperreflective granules and microstriae and absence of keratocytes may represent a more advanced stage of the dystrophy.

Assessment and comparison of anterior chamber dimensions using various imaging techniques.

BACKGROUND AND OBJECTIVE: To assess and compare the horizontal dimensions of the anterior chamber by different anterior segment imaging techniques. PATIENTS AND METHODS: Eighty eyes of 40 patients without any ocular disease or previous ocular surgery were recruited and three consecutive measurements of internal anterior chamber diameter and white-to-white distance (WTW) parameters were determined. RESULTS: Mean internal anterior chamber diameter was 11.80 +/- 0.39, 11.56 +/- 0.47, and 11.61 +/- 0.58 mm with Visante-OCT, SL-OCT, and Pentacam, respectively. Mean WTW distance was 11.87 +/- 0.35 and 11.65 +/- 0.32 mm by IOLMaster and OrbscanIIz, respectively. There was no significant difference between Visante-OCT and Pentacam, IOLMaster, and OrbscanIIz (P = .125, .918, and .314). However, detection of mean internal anterior chamber diameter was significantly greater by Visante-OCT than SL-OCT (P = .026). All devices displayed a high intrasession repeatability (repeated measured ANOVA, P > .05). CONCLUSION: Internal anterior chamber diameter measurements using Visante-OCT, SL-OCT, and Pentacam, and WTW measurements using IOLMaster and OrbscanIIz were easy to handle and demonstrated good repeatability. Although similar results of horizontal anterior chamber diameter were determined by Visante-OCT, Pentacam, IOLMaster, and OrbscanIIz, the inter-device differences should be considered during clinical practice.

Correlation of retinal sensitivity and retinal thickness in central serous chorioretinopathy.

AIM: To evaluate the correlation of microperimetry (MP) and optical coherence tomography (OCT) in eyes having acute onset of central serous chorioretinopathy (CSCR). METHODS: After a detailed ophthalmological examination, all cases were evaluated by fundus fluorescein angiography, OCT and MP. Mean macular thickness was detected by OCT. Mean macular sensitivity (MS) and mean defect (MD) were determined by MP. The correlation between OCT and MP findings was analyzed by Spearman's correlation test. RESULTS: Fifteen eyes with CSCR of 15 patients with a mean age of 40.5 +/- 6.7 years were recruited. The mean visual acuity was 0.7 +/- 0.2, and the mean macular thickness was 348.9 +/- 75.8 mum. Mean MS and MD were 13.9 +/- 4.6 and -5.2 +/- 4.1 dB, respectively. The mean macular thickness was significantly correlated with both mean MS and MD (p = 0.011 and p = 0.017, respectively). A significant correlation was also found between mean macular thickness, MS and MD in the central 1 mm, superior 3 mm and nasal 3 mm of the macula (p < 0.05). CONCLUSIONS: Our results demonstrated a significant correlation between structural and functional changes in CSCR. MP provides quantitative measurements of central macular function in CSCR that may supplement OCT findings as well as the better understanding of visual functions during the acute stage of the disease.

Quantitative assessment of anterior chamber volume using slit-lamp OCT and Pentacam.

PURPOSE: To quantitatively assess and compare the anterior chamber volume (ACV) by different anterior segment imaging techniques. METHODS: Forty healthy eyes of 40 patients were recruited and three consecutive measurements of ACV were determined prospectively utilizing SL-OCT and Pentacam. Statistical significance of interdevice differences between measurements was evaluated by unpaired t test and Bland-Altman analysis. The repeatability of three consecutive measurements was analyzed by repeated measured analysis of variance. RESULTS: Eighty eyes of 40 patients (18 female, 22 male) with a mean spherical error of -0.55+/-1.4 diopters were included in the study. Mean ACV were detected as 163.34+/-29.76 mm3 by Pentacam and 164.14+/-28.44 mm3 by SL-OCT (unpaired t test, p=0.872). Pentacam and SL-OCT displayed a high intrasession repeatability (repeated measured analysis of variance, p>0.05). ACV values detected by SL-OCT were clinically interchangeable with Pentacam. CONCLUSIONS: Noncontact measurements of ACV using SL-OCT and Pentacam were easy to handle and demonstrated good repeatability. The tested devices were regarded as compatible in measuring ACV.

Arterial distensibility as determined by carotid-femoral pulse wave velocity in patients with Behçet's disease.

Behçet's disease (BD) is a chronic, multisystem disorder characterized by genital and oral aphthae, skin lesions, uveitis, and tendency to thrombosis. Pulse wave velocity (PWV) is an important factor in determining cardiovascular mortality and morbidity. It is an index of arterial wall stiffness and inversely related to the arterial distensibility. In this study we investigated the arterial distensibility in BD by PWV. We studied 14 patients with BD (18-44 years old, 10 men) and 28 healthy subjects (18-39 years old, 21 men) without known cardiovascular disease. Arterial distensibility was assessed by automatic carotid-femoral PWV measurement using the Complior Colson device. PWV is calculated from measurements of pulse transit time and the distance traveled by the pulse between two recording sites, according to the following formula: pulse wave velocity (m/s)=distance (m)/transit time(s). The mean ages, systolic blood pressure, diastolic blood pressure, pulse pressure, heart rate, and PWV of Behçet's disease and control subjects were 32.1+/-7.4 vs 27.9+/-6.1 years, 112.9+/-12.0 vs 108.7+/-10.0 mmHg, 72.1+/-10.7 vs 67.7+/-7.5 mmHg, 40.7+/-12.2 vs 41.0+/-10.7 mmHg, 74.1+/-10.2 vs 77.2+/-10.1 bpm, and 8.4+/-1.4 vs 8.5+/-1.1 m/s, respectively. Differences between all parameters studied were not found to be statistically significant (p>0.05). The carotid-femoral PWV, an index of arterial stiffness and a marker of atherosclerosis, is not increased in patients with BD compared with control subjects.

Two cases of Stenotrophomonas maltophilia endophthalmitis.

Two cases of Stenotrophomonas maltophilia endophthalmitis, a rare cause of postoperative endophthalmitis, are reported in this study. Both of the patients underwent vitreus tap and intravitreal antibiotic injection. The therapy was augmented with systemic and subconjunctival injections. The response to this therapy protocol was excellent and the final visual acuity in both of the patients was 10/10. The results are discussed and the literature, which consists of only 8 reported cases of Stenotrophomonas maltophilia endophthalmitis, is reviewed. Although endophthalmitis caused by this pathogen is a rare but important cataract surgery complication, with appropriate therapy, this clinical presentation can be cured without risk of reoccurrence.