Analysis of Changes in High-order Aberration and Contrast Sensitivity After Epiblepharon Surgery.

PURPOSE: To investigate changes in corneal anterior high-order aberration (HOA) and contrast sensitivity (CS) before and after epiblepharon surgery. METHODS: A retrospective observational analysis of the degree of corneal erosion, HOAs and CS was conducted in the OD and OS, respectively, before and after epiblepharon surgery. The correlations between corneal erosion, HOAs, and CS were analyzed. RESULTS: Forty-nine patients were included in the study. Among the anterior HOAs, total HOA, coma, and trefoil showed significant improvement after surgery ( P = 0.003, P = 0.009, and P = 0.018, respectively). In the CS test, there was a significant improvement in CS after surgery at 1.1 cycles per degree (cpd) under photopic conditions, regardless of glare. Preoperative correlation analysis between HOAs and corneal erosion showed a significant positive correlation with total HOA ( P = 0.001) and coma ( P = 0.001). Preoperative correlation analysis between CS and corneal erosion showed a significant negative correlation at 1.1 cpd with glare under photopic conditions ( P = 0.049). A negative correlation was also observed between CS under mesopic and photopic conditions and total HOA both before and after surgery. CONCLUSION: Significant improvement in corneal anterior HOAs and CS at 1.1 cpd under photopic conditions was observed after epiblepharon surgery. Total HOA of anterior cornea showed a negative correlation with CS. A decrease in HOAs and recovery of corneal erosion after epiblepharon surgery will help improve CS.

Interocular differences in subfoveal choroidal thickness in monocular intermittent exotropia.

PURPOSE: To determine whether subfoveal choroidal thickness and central foveal thickness differ according to the presence of fixation preference in patients with intermittent exotropia without anisometropia or amblyopia. METHODS: Children ≥4 years of age with either monocular (fixation preference) or alternating intermittent exotropia on three consecutive visits who had no anisometropia, no amblyopia, and spherical equivalent of ± 1.25 D or less in both eyes were recruited for this study. Subfoveal choroidal thickness and central foveal thickness, measured using spectral domain optical coherence tomography, in the monocular group and the alternating group were compared. RESULTS: A total of 81 patients were enrolled: 46 in the monocular exotropia group and 35 in the alternating exotropia group. The interocular difference in subfoveal choroidal thickness was -11.0 ± 18.0 µm in the monocular group (dominant eye - nondominant eye) and 1.9 ± 22.2 µm in the alternating group (right eye - left eye). The difference between groups was statistically significant (P = 0.005). The interocular difference in central foveal thickness was 1.1 ± 5.7 µm in the monocular group (dominant eye - nondominant eye) and 0.9 ± 5.0 µm in the alternating group (right eye - left eye). The difference between groups was not significant. CONCLUSIONS: In patients with intermittent exotropia without amblyopia, the difference in subfoveal choroidal thickness between the eyes in the monocular group was significantly greater than that between eyes in the alternating group. These findings suggest the presence or absence of fixation preference may affect subfoveal choroidal thickness.

Deep-layer Microvasculature Dropout in Preperimetric Glaucoma Patients.

PURPOSE: To compare disease severity between preperimetric primary open-angle glaucoma (POAG) patients with and without deep-layer microvasculature dropout. MATERIALS AND METHODS: Ninety-four eyes of 94 preperimetric POAG patients with ß-zone parapapillary atrophy (ßPPA) were categorized according to the presence of deep-layer microvasculature dropout defined as a complete loss of microvasculature within the choroid or scleral flange on optical coherence tomography angiography. Parameters representing disease severity, that is, visual field (VF) mean deviation (MD), global and sectoral (6-sector) retinal nerve fiber layer (RNFL) thickness, and other factors including age, focal lamina cribrosa (LC) defect, width of ßPPA with and without Bruch membrane (BM) (ßPPA+BM and ßPPA-BM), and optic disc hemorrhage were compared between eyes with and without dropout. RESULTS: Deep-layer microvasculature dropout was observed in 33 preperimetric POAG eyes (35.1%). Eyes with dropout had significantly thinner RNFL in all areas except the inferonasal sector, worse VF MD, and higher prevalence of focal LC defect, and larger ßPPA-BM (P<0.05), whereas the 2 groups did not differ in age, disc hemorrhage, or ßPPA+BM width (P>0.05). In the multivariable logistic regression, worse VF MD [odds ratio (OR), 1.485; P=0.045], thinner RNFL (OR, 1.141; P<0.001), and higher prevalence of focal LC defect (OR, 6.673; P<0.001) were significantly associated with dropout. CONCLUSIONS: Deep-layer microvasculature dropout was observed in a considerable number of preperimetric POAG eyes, and worse disease severity was associated with dropout. Future studies elucidating the pathogenic role of deep-layer microvasculature dropout in the development and progression of glaucoma are warranted.