Membrane-tube-type glaucoma shunt device for refractory glaucoma surgery.

PURPOSE: To evaluate the safety and efficacy of a novel membrane-tube (MT)-type glaucoma shunt device for refractory glaucoma surgery. The device consists of an expanded polytetrafluoroethylene membranous reservoir, as well as a silicone tube (300-µm external and 200-µm internal diameter) with an intraluminal stent. We named the device "Finetube MT". METHODS: The Finetube MT was implanted into 44 glaucomatous eyes that had insufficient intraocular pressure (IOP) control despite medical treatment or previous trabeculectomy. The membranous reservoir was placed underneath the Tenon's capsule, with each end located below the recti muscles; the tube was placed in the anterior chamber through a partial-thickness scleral track. We investigated the baseline and post-operative IOP values, the number of IOP-lowering medications used, and complications. RESULTS: The mean age of the subjects was 51.6 ± 17.2 years, and the mean follow-up duration was 22.5 ± 12.0 months. One year after the surgery, the mean IOP had decreased from 32.8 ± 12.2 mmHg to 16.9 ± 6.4 mmHg (48.5 % reduction; p < 0.01), and the mean number of IOP-lowering medications used had decreased from 2.5 ± 0.8 to 1.1 ± 0.9 (p < 0.01). We considered the surgery as a success when the IOP was between 6 and 21 mmHg, and had been reduced by ≥ 20 % from baseline; by this standard, the success rate was 92.4 % after 1 year, and 85.0 % after 3 years. Neither postoperative ocular hypotony-related complications nor tube exposure occurred in any case. CONCLUSIONS: The Finetube MT showed promising surgical outcomes as a treatment for refractory glaucoma, with minimal risk of postoperative ocular hypotony or tube-related complications.

Segmentation Errors in Macular Ganglion Cell Analysis as Determined by Optical Coherence Tomography.

PURPOSE: To investigate the prevalence, features, associated factors, and reproducibility of segmentation errors in macular ganglion cell inner plexiform layer (GCIPL) thickness measurement as determined by optical coherence tomography (OCT). DESIGN: Cross-sectional study. PARTICIPANTS: Five hundred thirty-eight glaucomatous and healthy eyes from 290 subjects with OCT-measured macular GCIPL thickness were enrolled. Eyes with macular disorders, including epiretinal membrane, macular degeneration, macular hole, and myopic maculopathy, were excluded. METHODS: By inspecting 128 cross-sectional OCT B-scan images per eye, the presence (yes vs. no), layer (anterior vs. posterior border), location (quadrants), and area (diffuse vs. focal) of macular GCIPL segmentation error were investigated. The effects of age, refractive error, mean deviation of visual field test, circumpapillary retinal nerve fiber layer thickness obtained by OCT, and signal strength of OCT scan on the presence of macular GCIPL segmentation errors were evaluated. In eyes with segmentation errors, repeated OCT examinations were performed to investigate the reproducibility of the segmentation errors. MAIN OUTCOME MEASURES: The prevalence, features, associated factors, and reproducibility of macular GCIPL segmentation errors were assessed. RESULTS: Among the 538 eyes, 52 eyes (9.7%) showed segmentation errors in macular GCIPL thickness measurement. The most common features of segmentation errors were that they affected both the anterior and posterior borders, were located at the nasal quadrant (centered to the fovea), and were diffuse. In univariate analysis, the presence of segmentation error was associated significantly with younger age (P < 0.001), higher degree of myopia (P < 0.001), and lower signal strength of OCT scan (P = 0.038). In multivariate analysis, only higher degree of myopia was associated significantly with the presence of segmentation error (P < 0.001). In repeated examinations, segmentation errors were reproducible in 24 eyes (46.2%). In other cases, the features of segmentation errors changed or disappeared. CONCLUSIONS: Although the OCT segmentation algorithm accurately detected macular GCIPL thickness in most eyes without macular disorders, in some cases, segmentation errors were found, especially in myopic eyes. In repeated examinations, approximately half of the errors were nonreproducible. These findings should be considered when assessing macular GCIPL thickness using OCT.

Novel membrane-tube type glaucoma shunt device for glaucoma surgery.

BACKGROUND: The background of this study is to introduce the surgical technique and outcomes of a novel membrane-tube (MT) type glaucoma shunt device (MicroMT), which was developed to achieve safer and more predictable intraocular pressure (IOP) control compared with conventional trabeculectomy. DESIGN: This is a retrospective, non-comparative, interventional case series study. PARTICIPANTS: The MicroMT was implanted in 43 glaucomatous eyes with insufficient IOP control despite medical treatment. METHODS: The MicroMT consists of an expanded polytetrafluoroethylene membrane and a silicone tube with an intraluminal stent, which allows aqueous drainage from the anterior chamber to the lamellar scleral flap. The intraluminal stent prevents excessive aqueous drainage and allows additional IOP reduction through retraction or removal of the stent. MAIN OUTCOME MEASURES: The main outcome measures of this study are IOP changes and complications. RESULTS: The mean (SD) IOP decreased from a preoperative value of 22.5 (6.9) mmHg to 11.1 (3.6) mmHg 3 years after the operation (50.7% reduction from baseline; P < 0.01). Intraluminal stent removal 4 weeks after the operation induced an additional 40.2% IOP reduction (P < 0.01). When success was defined as an IOP between 6 and 21 mmHg, and an IOP reduction of ≥20% from baseline, the success rate was 89.5% at 3 years after the operation. No postoperative ocular hypotony (IOP <6 mmHg) or tube-related complications occurred. CONCLUSIONS: MicroMT implantation is a novel therapy that may reduce IOP safely and effectively, with no apparent risk of postoperative ocular hypotony. Glaucoma surgery using this device may be a good alternative to conventional glaucoma surgery.

Characteristics of eyes with inner retinal cleavage.

PURPOSE: Inner retinal cleavage can be misdiagnosed as a glaucomatous retinal nerve fiber layer (RNFL) defect. This study was performed to characterize eyes with inner retinal cleavage. METHODS: Inner retinal cleavage is defined as the appearance of a dark spindle-shaped space between the nerve fibers. Patients who presented at our institution with inner retinal cleavage were enrolled in the study. All participants were evaluated by fundus examination, visual field testing with standard automated perimetry, and optical coherence tomography (OCT) imaging. RESULTS: A total of 15 eyes of 11 subjects with inner retinal cleavage were included in the study. The median age of the subjects was 57 years (age range, 30-67 years). In each case, inner retinal cleavage was located adjacent to retinal blood vessels. Tissue bridging the cleavage area was observed in ten eyes. Six eyes had epiretinal membranes (ERMs), two eyes had glaucoma, and one eye had ERM in addition to glaucoma. Six eyes with inner retinal cleavage without combined ocular abnormalities had highly myopic refractive error (-6.50 to -8.50 diopters). Cross-sectional OCT images of the areas of inner retinal cleavage demonstrated defects with irregular margins and empty spaces in the inner layers of the retina. During the follow-up period, no eye showed changes in inner retinal layer cleavage or visual field sensitivity. CONCLUSIONS: Inner retinal cleavage was found in eyes with high myopia or ERMs. Inner retinal cleavage was associated with structural changes distinct from those associated with glaucomatous RNFL defects.

Diagnostic ability of macular ganglion cell asymmetry for glaucoma.

BACKGROUND: Using spectral-domain optical coherence tomography (OCT), this study aims to investigate the glaucoma diagnostic ability of macular ganglion cell asymmetry analysis. DESIGN: A cross-sectional study was conducted. This study was performed to investigate glaucoma diagnostic ability of macular ganglion cell asymmetry analysis in eyes with various degrees of glaucoma. PARTICIPANTS: We enrolled 181 healthy eyes and 265 glaucomatous eyes. METHODS: Glaucomatous eyes were subdivided into pre-perimetric, early, moderate and advanced-to-severe glaucoma based on visual field test results. For each eye, macular ganglion cell-inner plexiform layer (GCIPL) thickness was measured using OCT. Average GCIPL thickness, GCIPL thicknesses in superior and inferior hemispheres, absolute difference in GCIPL thickness between superior and inferior hemispheres and GCIPL asymmetry index calculated as the absolute value of log10 (inferior hemisphere thickness/superior hemisphere thickness) were analysed. MAIN OUTCOME MEASURES: Areas under the receiver operating characteristics curves (AUCs) of GCIPL parameter were calculated and compared. RESULTS: All of the GCIPL parameters showed good glaucoma diagnostic ability (AUCs ≥ 0.817, P < 0.01). AUCs of average, superior and inferior GCIPL thickness increased as the severity of glaucoma increased. GCIPL thickness difference and asymmetry index showed the highest AUCs in early and moderate glaucoma and lower AUCs in pre-perimetric and advanced-to-severe glaucoma. GCIPL thickness difference and asymmetry index showed better glaucoma diagnostic ability than other GCIPL parameters only in early stage of glaucoma (P < 0.05); in other stages, these parameters had similar to or worse glaucoma diagnostic ability than other GCIPL parameters. CONCLUSIONS: Macular ganglion cell asymmetry analysis showed good glaucoma diagnostic ability, especially in early-stage glaucoma. However, it has limited usefulness in other stages of glaucoma.

Macular ganglion cell analysis for early detection of glaucoma.

PURPOSE: To investigate the ability of Cirrus high-definition optical coherence tomography (Cirrus HD-OCT; Carl Zeiss Meditec, Dublin, CA) macular ganglion cell analysis (GCA) sector, deviation, and thickness maps to detect early glaucoma. DESIGN: Cross-sectional study. PARTICIPANTS: We enrolled 131 eyes with early glaucoma (mean deviation >-6.0 dB) and 132 age- and refractive error-matched healthy eyes. METHODS: Macular GCA maps were obtained using Cirrus HD-OCT. The location, angular distance, and width of circumpapillary retinal nerve fiber layer (RNFL) defects were investigated by using red-free fundus photographs. The presence of a structural abnormality in the GCA map was defined as (1) yellow/red color codes in the sector map, (2) yellow/red pixels (>10) in the deviation map, and (3) blue areas in the thickness map. MAIN OUTCOME MEASURES: The prevalence of and factors associated with the presence or absence of abnormal GCA findings were assessed. RESULTS: Among the 131 glaucomatous eyes, 105 (80.2%), 115 (87.8%), and 104 (79.4%) showed structural abnormalities in the GCA sector, deviation, and thickness maps, respectively. The absence of abnormal findings in the GCA maps of glaucomatous eyes was associated with the presence of RNFL defects in the superior hemisphere, a greater angular distance between the fovea and the RNFL defect, a narrower width of the RNFL defect, less severe visual field defects, or an isolated peripheral nasal step (outside 10 degrees of fixation) (P<0.05). A greater angular distance of the RNFL defect remained significant in multivariate analyses (P<0.05). Among the 132 healthy eyes, 28 (21.2%), 37 (28.0%), and 20 (15.2%) had abnormal findings in the GCA sector, deviation, and thickness maps, respectively. The presence of abnormal GCA findings in healthy eyes was associated with a higher degree of myopic refractive error (P<0.05). CONCLUSIONS: Cirrus HD-OCT GCA maps showed a good ability to detect early glaucoma. However, GCA maps did not show abnormal findings in glaucomatous eyes when the angular distance between fovea and RNFL defect was great. These findings should be considered when diagnosing early glaucoma using GCA maps.

Ability of cirrus high-definition spectral-domain optical coherence tomography clock-hour, deviation, and thickness maps in detecting photographic retinal nerve fiber layer abnormalities.

PURPOSE: To investigate the ability of clock-hour, deviation, and thickness maps of Cirrus high-definition spectral-domain optical coherence tomography (HD-OCT) in detecting retinal nerve fiber layer (RNFL) defects identified in red-free fundus photographs in eyes with early glaucoma (mean deviation >-6.0 dB). DESIGN: Cross-sectional study. PARTICIPANTS: Two hundred ninety-five eyes with glaucomatous RNFL defects with clear margins observed in red-free fundus photographs and 200 age-, sex-, and refractive error-matched healthy eyes were enrolled. METHODS: The width and location of RNFL defects were evaluated by using the red-free fundus photograph. When a RNFL defect detected by red-free fundus photograph did not present as (1) yellow/red codes in the clock-hour map, (2) yellow/red pixels in the deviation map, or (3) blue/black areas in the thickness map, the event was classified as a misidentification of a photographic RNFL defect by Cirrus HD-OCT. In healthy eyes, the presence of false-positive RNFL color codes of Cirrus HD-OCT maps was investigated. MAIN OUTCOME MEASURES: The prevalence of and factors associated with the (1) misidentification of photographic RNFL defects by Cirrus HD-OCT in eyes with glaucoma and (2) false-positive RNFL color codes of Cirrus HD-OCT maps in healthy eyes were assessed. RESULTS: Among the 295 red-free fundus photographic RNFL defects from 295 eyes with glaucoma, 83 (28.1%), 27 (9.2%), and 0 (0%) defects were misidentified in the clock-hour, deviation, and thickness maps of Cirrus HD-OCT, respectively. Fifty-six defects (19.0%) were misidentified only in the clock-hour map and 27 (9.2%) in both the clock-hour and deviation maps. The misidentification of photographic RNFL defects by Cirrus HD-OCT was associated with a narrower width and a temporal location of RNFL defects (P<0.05). Among the 200 healthy eyes, 25 (12.5%), 30 (15.0%), and 12 (6.0%) eyes had false-positive RNFL color codes in clock-hour, deviation, and thickness maps of Cirrus HD-OCT, respectively. CONCLUSIONS: Among the clock-hour, deviation, and thickness maps obtained with Cirrus HD-OCT, the thickness map showed the best diagnostic ability in detecting photographic RNFL defects. The RNFL thickness map may be a useful tool for the detection of RNFL defects in eyes with early glaucoma.

Utility of Central 10 Degrees Visual Field Test With Size V Stimulus in End-Stage Glaucoma.

PRCIS: In end-stage glaucoma, the central 10-degree visual field test with a size V stimulus provided useful information, including the number of points with detectable retinal sensitivity threshold values and retinal sensitivity threshold values. PURPOSE: The purpose of this study was to evaluate the clinical utility of the central 10-degree visual field test with a size V stimulus in end-stage glaucoma. MATERIALS AND METHODS: A total of 73 eyes with end-stage glaucoma (visual field limited to a radius of <10 degrees from fixation) were included. Central 10 degrees visual field tests were performed using both size III and V stimuli. Reliability indices, test duration, number of points with detectable retinal sensitivity threshold values, and retinal sensitivity threshold values at 4 central points, 4 quadrants, and 3 clusters (papillomacular area, superior half, and inferior half) were compared between the test results using size III and V stimuli. RESULTS: When the size V stimulus was used, the mean test duration increased from 7.8 to 13.3 minutes ( P < 0.001), the mean number of test points with detectable retinal sensitivity threshold values in total area increased from 19.0 to 37.3 ( P < 0.001), and the mean retinal sensitivity threshold values in total area increased from 3.9 to 9.3 dB ( P < 0.001) compared with the test results with the size III stimulus. Significant increase in the visual field parameters was found in all quadrants and clusters ( P < 0.001), and a greater increase was associated with better visual acuity and greater mean deviation of the visual field ( P < 0.05). CONCLUSIONS: The central 10-degree visual field test with a size V stimulus provided more information than the test with a size III stimulus in end-stage glaucoma.

COVID-19 Vaccination in Korea.

Since December 2020, various coronavirus disease 2019 (COVID-19) vaccines have been developed and approved. As of February 2023, mRNA vaccines including bivalent vaccines (Pfizer/BioNTech, Moderna), recombinant protein vaccines (Novavax, SK Bioscience), and viral vector vaccines (AstraZeneca, Janssen) have been approved in Korea. COVID-19 vaccination can effectively reduce hospitalization and deaths due to symptomatic COVID-19, especially severe and critical COVID-19. The primary series vaccination against COVID-19 is recommended for all adults aged ≥18 years in Korea. Booster vaccination with the bivalent mRNA vaccine is available for those ≥12 years who have completed the primary series vaccination, regardless of the type of vaccine previously received, and is recommended for all adults. Booster vaccination can be administered since 90 days after the last dose. Localized and systemic adverse events following COVID-19 vaccination are relatively common and more frequently documented in younger age groups. Rare but potentially serious specialized adverse reactions include anaphylaxis, thrombosis with thrombocytopenia syndrome, myocarditis, and Guillain-Barré syndrome. Previous severe allergic reactions, such as anaphylaxis, to any COVID19 vaccine or vaccine component are considered a contraindication for vaccination. The indications and schedule for COVID-19 vaccination are subject to change based on further research results and the COVID-19 pandemic.

Correlation between Interocular Asymmetry of Corneal Hysteresis and Visual Field Defect in Glaucoma.

PURPOSE: To evaluate the relationship between interocular asymmetries of corneal hysteresis (CH) and visual field defects in Korean patients with glaucoma. METHODS: A total of 444 eyes from 222 participants with glaucoma in at least one eye were enrolled. CH was measured using an ocular response analyzer (Reichert Technologies Inc). Eyes of each participant were classified into "better eye" and "worse eye" based on the mean deviation (MD) value of visual field test. The correlation between interocular differences in intraocular pressure, axial length, central corneal thickness, CH, and MD values was evaluated using Spearman correlation analysis. To exclude the possible effect of antiglaucoma medication on corneal properties, additional analyses were performed on eyes without any glaucoma treatment at the time of CH measurement (treatment-naive group). RESULTS: Median (interquartile range) MD value was -3.71 dB (-6.87 to -1.30 dB) in the better eye and -10.20 dB (-16.32 to -5.62 dB) in the worse eye. When the correlation between the asymmetry of the MD value and asymmetry of intraocular pressure, axial length, central corneal thickness, and CH were evaluated, only interocular differences in CH were significantly associated with interocular differences in MD values (rho = 0.214, p = 0.001). Among the 222 participants, 60 (27.0%) were treatment-naive group. In these eyes, interocular differences in CH were also significantly associated with interocular differences in the MD values (rho = 0.285, p = 0.029). CONCLUSIONS: The interocular asymmetry of CH was significantly correlated with the interocular asymmetry of visual field defects in glaucoma.

Comparison of posterior vitreous detachment-related and glaucomatous optic disc hemorrhage.

This study compared the characteristics of posterior vitreous detachment (PVD)-related and glaucomatous optic disc hemorrhage (DH). Fundus photographs of eyes with PVD-related DH (PVD group) and glaucomatous DH (glaucoma group) were reviewed. The shape, type, layer, location (clock-hour sector), and DH/disc area (DH/DA) ratio of DH were investigated. In the PVD group, DH presented as a flame (60.9%), splinter (34.8%), and dot or blot (4.3%) shape. However, most of the glaucomatous DH revealed a splinter shape (92.3%), followed by a flame shape (7.7%, p < 0.001). In the PVD group, the most common type of DH was cup margin type (52.2%), whereas, in the glaucoma group it was disc rim type (53.8%, p = 0.003). Both PVD-related and glaucomatous DH were most commonly observed in the 7 o'clock sector. In the PVD group, DH was also found in the 2 and 5 o'clock sectors (p = 0.010). Mean DH/DA ratio in PVD group (0.15 ± 0.19) was greater than in glaucoma group (0.04 ± 0.04, p < 0.001). PVD-related DH showed a higher frequency of flame shape, cup margin type, nasal location, and greater area compared to the glaucomatous DH.

Astigmatism and optical coherence tomography measurements.

BACKGROUND: To evaluate the effect of astigmatism change on measurement of retinal nerve fiber layer (RNFL) and macular thickness by Cirrus HD spectral-domain optical coherence tomography (Cirrus HD OCT; Carl Zeiss Meditec, Dublin, CA, USA). METHODS: A total of 30 right eyes from 30 healthy young subjects underwent RNFL and macular thickness measurements using Cirrus HD OCT. Measurements were performed at the baseline state and induced with-the-rule (WTR) and against-the-rule (ATR) astigmatism states by wearing toric soft contact lenses (+1.50 -3.25 diopter × 90° and +1.50 -3.25 diopter × 180° respectively). Differences in RNFL and macular thickness between the baseline state and induced astigmatism states were analyzed. RESULTS: Wearing toric soft contact lenses induced a mean 2.92 diopter WTR and 3.18 diopter ATR astigmatism respectively. After signal strength change adjustment, RNFL thicknesses of average, superior quadrant, 12 and 6 o'clock hour sectors decreased after induction of a WTR astigmatism (mean difference range, 1.58 to 6.88 µm); RNFL thicknesses of average, nasal, temporal quadrants, 2, 3, and 9 o'clock hour sectors decreased after induction of an ATR astigmatism (mean difference range, 0.75 to 5.11 µm) (all P values <0.05). Macular thickness was not significantly affected by astigmatism changes (all P values ≥ 0.250). CONCLUSION: Although the amount of change was not substantial, RNFL thickness measured by Cirrus HD OCT was affected by astigmatism changes induced by contact lenses. It may be warranted to consider the effect of astigmatism on RNFL thickness measured by OCT in eyes with higher degrees of astigmatism.

Interocular symmetry of optical coherence tomography parameters in healthy children and adolescents.

Evaluation of interocular asymmetry of optical coherence tomography (OCT) parameters is important for the glaucoma and optic neuropathies. This study was performed to evaluate the interocular asymmetry of OCT parameters in healthy children and adolescents. The circumpapillary retinal nerve fiber layer (RNFL) thickness, optic nerve head (ONH) parameters, and macular ganglion cell-inner plexiform layer (GCIPL) thickness were measured in 620 eyes of 310 healthy children and adolescents using Cirrus HD-OCT. The interocular asymmetry (right eye-left eye) in the OCT parameters was analyzed. The mean ± standard deviation age was 10.3 ± 3.7 years (range 5-17). The right eyes showed thinner superior quadrant RNFL, thicker nasal and temporal quadrant RNFL, lesser rim and disc areas, and thinner average, superior, and superonasal GCIPL than the left eyes (P < 0.05). The 2.5th and 97.5th percentile interocular difference tolerance limits were - 9.0 µm and 11.0 µm for average RNFL thickness, - 0.21 and 0.18 for average cup-to-disc ratio, and - 4.0 µm and 4.0 µm for average GCIPL thickness, respectively. Interocular differences were found in RNFL thickness, ONH parameters, and GCIPL thickness in healthy children and adolescents. These findings should be considered when comparing OCT parameters between the right and left eyes.

Effect of Inconsistent Optical Coherence Tomography Scan Location on Glaucoma Progression Analysis.

PRCIS: Circumpapillary retinal nerve fiber layer (RNFL) thickness change induced by optical coherence tomography (OCT) scan circle location displacement was not completely compensated despite the use of Guided Progression Analysis (GPA), especially when the "R1" registration method was applied. PURPOSE: The purpose of this study was to evaluate the effect of inconsistent OCT scan location on glaucoma progression detection using GPA. METHODS: Eighty-four glaucomatous eyes with at least 4 serial OCT tests were included. To evaluate the ability of OCT GPA to adjust the OCT scan location, an analysis was performed without manipulation (control set), and after the OCT scan of the latest test was intentionally moved inferotemporally (test set). The eyes were classified into the adjustment and nonadjustment groups based on the superior or inferior quadrant RNFL thickness agreement between the control and test sets. RESULTS: When the OCT GPA parameters between the control and test sets were compared, the test set showed a greater superior RNFL thickness and lesser inferior RNFL thickness compared with the control set (P<0.05). The eyes in the nonadjustment group (n=21, 25%) had a lower chance of applying the eye-tracking function (P=0.003) and a higher frequency of the "R1" registration method of OCT GPA (P<0.001) than the adjustment group (n=63, 75%); all eyes with the "R1" method were in the nonadjustment group and all eyes with the "R2" method were in the adjustment group. CONCLUSIONS: Inconsistent OCT scan location induced changes in RNFL thickness that were not completely compensated despite the use of OCT GPA, especially when the "R1" registration method was applied. These findings indicates a potential for misidentified glaucoma progression.

Dynamic Ranges of Retinal Nerve Fiber and Optic Nerve Head Parameters Measured Using Optical Coherence Tomography in Glaucoma: A Longitudinal Study.

PURPOSE: To evaluate the dynamic range of retinal nerve fiber layer (RNFL) and optic nerve head (ONH) parameters measured using optical coherence tomography (OCT) in conditions ranging from nonglaucomatous status to advanced glaucoma by longitudinal observation. METHODS: A total of 15 eyes from 12 participants with glaucoma progression from a nonglaucomatous status to advanced glaucoma were included. The RNFL and ONH parameters were compared between the nonglaucomatous and advanced stages within the same eye. The absolute and relative changes in OCT parameters were analyzed. RESULTS: The median highest intraocular pressure was 42.5 mmHg (interquartile range, 37.5 to 54.5 mmHg), and the final mean deviation of the visual field test was -24.68 dB (interquartile range, -23.93 to -31.13 dB). The median relative changes in RNFL thickness were -40.6% in the overall area, and -51.9%, -21.4%, -51.1%, and -41.8% in the superior, nasal, inferior, and temporal quadrants, respectively (all p < 0.05). Relative changes in the rim area, disc area, average cup to disc ratio, vertical cup to disc ratio, and cup volume were -56.64%, 0.59%, 62.10%, 66.0%, and 337.90%, respectively (all p < 0.05, except for disc area with a p-value of 0.753). CONCLUSIONS: The dynamic range of the RNFL thickness ranged from 40.6% to 51.9%, and the dynamic range of the ONH parameters ranged from 56.64% to 337.90%. During the course of glaucoma progression, the cup volume showed the widest dynamic range. However, the disc area did not show significant changes.

Changes in circumpapillary retinal nerve fiber layer thickness after vitrectomy for rhegmatogenous retinal detachment.

The study aimed to evaluate the long-term changes in circumpapillary retinal nerve fiber layer (RNFL) thickness after vitrectomy for rhegmatogenous retinal detachment (RRD) repair. A total of 33 eyes of 33 patients were enrolled. By using optical coherence tomography, the circumpapillary RNFL thickness was measured before surgery and 1, 3, 6 months and 1, 2, 3 years after surgery and compared with the preoperative value. The effect of duration, location, and extent of RRD on RNFL thickness change was evaluated. There was a significant increase of circumpapillary RNFL thickness at the 1-month, 3-month [except in the nasal superior sector (P = 0.627)], and only in the nasal inferior sector at 6-month (P = 0.010) follow-up compared with the baseline value (all Ps < 0.05). No significant differences were observed 1, 2, and 3 years after the surgery (P > 0.05). The duration, location, and extent of detachment did not reveal significant correlations with RNFL parameters (P > 0.05). Circumpapillary RNFL thickness in eyes with RRD after vitrectomy demonstrated a transient increase during the early postoperative period. This increase was not associated with duration, location, and extent of RRD. At 3 years following surgery, no RNFL thinning or thickening was observed.

Effect of Weiss ring on peripapillary retinal nerve fiber layer thickness measurements using SD-OCT.

Spectral-domain optical coherence tomography (SD-OCT) must accurately identify and measure the peripapillary retinal nerve fiber layer (pRNFL) thickness to improve the repeatability and reproducibility, and reduce measurement errors. Because Weiss ring can be located in front of the optic disc, we hypothesized that it may affect pRNFL thickness measurements obtained using SD-OCT. We retrospectively reviewed the medical records of patients with (group W) and without (group N) Weiss ring, observed on OCT fundus image and an RNFL map devised using SD-OCT. Optic disc cube scans (200 × 200) were obtained to measure pRNFL thicknesses (superior, temporal, inferior, nasal, and average) at two consecutive visits. Pearson's correlation coefficient (r), intraclass correlation coefficient (ICC), and coefficient of variation (CV) were calculated. The r and ICC values for the pRNFL thickness measurements at the two visits were lower for group W compared to group N, but statistical significance was reached only for inferior pRNFL thickness. In addition, CV values were greater for group W compared to group N, but the differences were significant only for inferior and average pRNFL thickness measurements (p < 0.001 and p = 0.004, respectively). Weiss ring located near the optic disc can affect pRNFL thickness measurements and repeatability thereof, especially the inferior quadrant and average values. Therefore, it is important to identify the presence of Weiss ring when analyzing pRNFL thickness values.

Clinical application of the Panbio™ COVID-19 Ag rapid test device and SSf-COVID19 kit for the detection of SARS-CoV-2 infection.

OBJECTIVE: We evaluated the sensitivity and specificity of the Panbio™ COVID-19 Ag rapid test device using nasal swabs and those of the SSf-COVID19 kit, one of RT-PCR tests, using saliva specimens. These tests were compared with RT-PCR tests using nasopharyngeal swabs for the diagnosis of SARS-CoV-2 infection. The three diagnostic tests were simultaneously conducted for patients aged ≥ 18 years, who were about to be hospitalized or had been admitted for COVID-19 confirmed by RT-PCR in two research hospitals from August 20 to October 29, 2021. Nasal swabs were tested using the Panbio™ COVID-19 Ag rapid test device. More than 1 mL of saliva was self-collected and tested using the SSf-COVID19 kit. RESULTS: In total, 157 patients were investigated; 124 patients who were about to be hospitalized and 33 patients already admitted for COVID-19. The overall sensitivity and specificity of the Panbio™ COVID-19 Ag rapid test device with nasal swabs were 64.7% (95% confidence interval [CI] 47.9-78.5%) and 100.0% (95% CI 97.0-100.0%), respectively. The median time to confirm a positive result was 180 s (interquartile range 60-255 s). The overall sensitivity and specificity of the SSf-COVID19 kit with saliva specimens were 94.1% (95% CI 80.9-98.4%) and 100.0% (95% CI 97.0-100.0%), respectively.

Effect of baseline test selection on glaucoma progression detection by optical coherence tomography-guided progression analysis.

PURPOSE: To evaluate the effect of baseline test selection on progression detection of circumpapillary retinal nerve fibre layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) in glaucomatous eyes by optical coherence tomography (OCT)-guided progression analysis (GPA). METHODS: A total of 53 eyes with either RNFL or GCIPL progression determined using OCT-GPA were included. Three different baseline conditions were created by dividing eight serial OCT tests from each eye into three sets. Specifically, these sets presented baseline tests at exams 1-2 (1st set), 2-3 (2nd set) and 3-4 (3rd set), respectively. Agreement on progression detection was defined as the presence of 'Possible Loss' or 'Likely Loss' in the 2nd or 3rd sets at the same location in the 1st set. RESULTS: The proportion of eyes with agreement on progression detection was 47.1%, 20.0% and 31.0% for RNFL 'thickness map progression', 'thickness profiles progression' and 'average thickness progression', respectively. In GCIPL 'thickness map progression' and 'average thickness progression', 53.8% and 62.8% of eyes showed agreement, respectively. Eyes with disagreement showed a greater change in thickness (slope of change in the 3rd set-1st set) compared to the eyes with agreement (p<0.05), with the exception of RNFL 'thickness profiles progression' (p=0.064). CONCLUSION: Glaucoma progression detection by OCT-GPA was affected by baseline test selection, especially in eyes with a greater reduction in progression. GCIPL thickness was less influenced by baseline test selection compared to RNFL thickness.