Search

Background: Peripheral hypertrophic subepithelial corneal opacification (PHSCO) is a corneal disease that may severely affect vision. The major goal of this study was to test the hypothesis that tear secretion, medication and systemic diseases are associated with PHSCO. Methods: This is a retrospective, case–control study conducted at the Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz. We analysed medical records of patients diagnosed with PHSCO. Sex, age, Schirmer's test II, general medication and medical history were assessed and compared to an age‐ and sex‐matched control group from the Gutenberg Health Study (GHS). Results: One hundred ninety‐five eyes of 112 patients with PHSCO were included. Eighty‐eight patients were female with a mean age of 55.3 ± 14.7 years (23–89 years) and 24 patients were male with a mean age of 59.3 ± 12.6 years (38–84 years). In 83 patients (74.1%) both eyes were involved. The Schirmer's test II was significantly reduced in patients with PHSCO compared to the GHS control group (p < 0.001). Patients with PHSCO were more frequently administered artificial tears and steroid eye drops (p < 0.001) and were more hyperopic than healthy controls (p = 0.01). Systemic diseases or medication did not differ markedly between PHSCO and healthy controls. Conclusion: Reduced tear secretion and more frequent use of artificial tears in patients with PHSCO suggest a link between PHSCO and dry eye disease. The results of the study do not support our hypothesis that PHSCO is associated with systemic diseases. Interestingly, patients with PHSCO were less frequently on β‐blockers than control subjects. [ABSTRACT FROM AUTHOR]

Purpose: Intrauterine growth restriction leading to a birth weight (BW) which is too low for gestational age (GA) is a known risk factor for various altered organ morphologies and dysfunction in later life. This study aimed to determine for the first time the effects of being small (SGA) or large for gestational age (LGA) on the ocular geometry of adults born at term. Methods: All participants were examined with optical biometry (LenStar 900, Haag Streit) to compare the corneal curvature, white‐to‐white distance, anterior chamber depth, lens thickness and axial length between former moderate (BW percentile 3rd to <10th) and severe (BW <3rd percentile) SGA, controls (BW 10th‐90th percentile) and former moderate (BW >90th to 97th percentile) and severe (BW >97th percentile) LGA. Multivariable linear regression was used to analyse associations with GA, BW percentile categories, placental insufficiency, preeclampsia and breastfeeding after adjustment for age and sex. Results: In total, 589 eyes of 296 individuals born at term (aged 30.0 ± 9.4 years, 156 females) were examined, including 40 severe SGA, 38 moderate SGA, 140 with normal BW, 38 moderate LGA and 40 severe LGA. There was an association between a steeper corneal curvature with moderate (B = −0.201; p < 0.001) and severe SGA (B = −0.199; p < 0.001), with extreme SGA associated with smaller white‐to‐white (B = −0.263; p = 0.001) and a shorter axial length (B = −0.524; p = 0.031). Conclusions: Severe and moderate prenatal growth restriction in adults born at term leads to an altered ocular geometry, namely a steepening of the cornea and a smaller corneal diameter. [ABSTRACT FROM AUTHOR]

This article discusses a study on the postnatal environmental factors associated with corneal shaping in individuals born preterm and full-term. The study found that a longer stay in the incubator and increased time in the intensive care unit were linked to steeper corneal morphology, while postnatal temperature did not have a significant impact. The findings suggest that factors related to prematurity during incubator and ICU stays may affect corneal development. However, the study has limitations, such as being a single-center study and taking place several decades after birth. [Extracted from the article]

This article discusses the potential impact of low birthweight on macular morphology in individuals born at term. Previous studies have shown that low birthweight is associated with increased foveal thickness in individuals born preterm. However, it is unclear whether this effect is solely due to preterm birth or if it is also influenced by perinatal hypotrophy in individuals born small-for-gestational age (SGA). This study aimed to explore the association between fetal growth restriction in individuals born at term and various macular parameters. The results showed no significant differences in macular morphology between different birthweight groups, suggesting that macular developmental alterations are more likely a consequence of prematurity rather than perinatal growth indicated by birthweight. [Extracted from the article]

Copyright of Acta Ophthalmologica (1755375X) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: Changes in peripheral corneal thickness are described in various corneal diseases such as corneal ectasia. However, few data exist describing the increase in corneal thickness from central to peripheral and reporting the normal distribution of corneal thickness in rings around the corneal centre. The aim of this study was to report these cornea characteristics and investigate associated factors in a population‐based setting. Methods: The Gutenberg Health Study is a prospective, population‐based study examining participants in a 5‐year follow‐up (age range 40–80 years) using Scheimpflug imaging. Corneal thickness was assessed in each participant at the apex, as well as in the corneal centre (thinnest corneal thickness) and in rings with 2, 4, 6, 8 and 10 mm diameter around the corneal centre, and the increase in corneal thickness towards the periphery. The relationship between corneal thickness at these locations and possible associated factors was determined using linear regression models. For this purpose, general and ocular parameters were included. Results: A total of 9729 participants were included in the present analysis (4874 women, age 59.2 ± 10.8 years). Multivariable analysis showed a correlation between the increase in corneal thickness in the circles from 0 to 10 mm (diameter) and the following parameters: age (B = −0.24 µm per year, p < 0.001); body height (B = −0.04 µm, p = 0.005); smoking (B = −0.72 µm, p < 0.001); spherical equivalent (B = −0.70 µm per dioptre, p < 0.001); white‐to‐white distance (B = −0.75 µm/mm, p < 0.001); mean corneal radius (B = −3.61 µm/mm, p < 0.001); intraocular pressure (B = −0.12 µm/mmHg, p < 0.001); glaucoma (B = −1.94 µm, p < 0.001); and pseudophakia (B = 0.89 µm, p < 0.001). Conclusion: The results of the present study suggest that several general and ocular parameters are associated with peripheral corneal thickness. In the context of diagnosing glaucoma, a smaller increase in corneal thickness towards the periphery might be a new additional marker. [ABSTRACT FROM AUTHOR]

Purpose: To assess surgical success and the post‐operative development of intraocular pressure between XEN45® gelstent, Preserflo® MicroShunt and trabeculectomy with mitomycin C. Methods: Data from 105 eyes from 105 patients of matched cases with refractory open‐angle glaucoma, who underwent surgery between January 2019, and August 2020, were evaluated. Patients underwent either stand‐alone XEN gelstent insertion with Mitomycin C, stand‐alone Preserflo with Mitomycin C or trabeculectomy with Mitomycin C. The primary outcome was the proportion of complete surgical success at 6 months post‐operatively (i.e. intraocular pressure between 5mmHg and 18mmHg, no revision surgery, no loss of light perception and no post‐operative pharmaceutical antiglaucomatous treatment). The reduction of intraocular pressure after 6 months, the classes of antiglaucomatous medication used post‐operatively, best‐corrected visual acuity, spherical refractive errors and astigmatism were assessed as secondary outcomes. Results: We included 35 eyes in each group. After 6‐month follow‐up, complete success was 73.5% [95%‐CI: 57.9%–89.2%] in the trabeculectomy group, 51.4% [95%‐CI: 34.0%–68.8%] in the XEN group and 74.2% [95%‐CI: 57.9%–90.5%] in the Preserflo group (p = 0.08). Regarding secondary outcomes, the reduction of intraocular pressure was 12.1 ± 7.9 mmHg in the trabeculectomy group and was thereby 5.8 [95%‐CI: 2.2–9.6] mmHg greater compared with the XEN group (p < 0.001) and 4.8 [95%‐CI: 0.9–8.7] mmHg higher than the Preserflo group (p = 0.01). Conclusions: No statistically significant differences were found between trabeculectomy, XEN45® gelstent implantation and Preserflo® MicroShunt implantation regarding surgical success after 6 months. Yet reduction in intraocular pressure was significantly higher in the trabeculectomy group. However, all three interventions resulted in sufficiently low post‐operative intraocular pressure and may therefore be considered individually for glaucoma treatment. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate long‐term results of glaucoma surgery in newborn and infants with glaucoma. Methods: Seventy‐nine eyes of 52 children (age: 3 weeks–15.3 years) with primary congenital or secondary glaucoma treated between 2015 and 2017 were included. The median follow‐up time was 3.9 years. Conventional probe trabeculotomy, 360° catheter‐assisted trabeculotomy, filtering and cyclodestructive surgery were compared. Strict criteria for surgical success were applied: Complete surgical success (IOP below target IOP, no further surgery) and incomplete surgical success (additional surgery allowed) were analyzed, and IOP at baseline and last follow‐up was compared. Results: Intraocular pressure (IOP) was significantly reduced in primary congenital (preoperative IOP: 27.8 ± 7.5 mmHg vs. postoperative IOP: 14.2 ± 4.5 mmHg) and secondary glaucoma (preoperative IOP: 29.2 ± 9.1 mmHg vs. postoperative IOP: 16.6 ± 4.7 mmHg). 90% of all eyes reached target IOP with or without medication allowing for additional surgeries. As first surgery, 360° catheter‐assisted trabeculotomy had a tendency to higher surgical success than other surgical approaches, while cyclodestructive procedures had lowest. Conclusions: We found very promising surgical results in our childhood glaucoma patient group. Surgical success in both congenital and secondary glaucoma was high. [ABSTRACT FROM AUTHOR]

Purpose: Using a bleb‐grading system clinically facilitates long‐term follow‐up of patients with previous glaucoma surgery. Clinical evaluation of these patients can be challenging for untrained ophthalmologists. Morphological bleb configuration might influence planning of follow‐up visits in glaucoma patients due to different and individual prognosis after trabeculectomy. In this study, we compared the MaBAGS (Mainz Bleb Appearance Grading System), a classification system for filtering blebs with other classification systems (MBGS/Moorfields Bleb Grading System, IBAGS/Indiana Bleb Appearance Grading Scale) in reference to usability and reliability and compare it to grading by bleb photographs. Methods: Forty‐two eyes of 31 patients after trabeculectomy were included. Three observers, two senior and one junior observer, graded all blebs using MaBAGS, MBGS and IBAGS during slit‐lamp examination. Bleb photographs were reviewed at least 4 weeks after clinical examination. Statistical analysis was performed to determine agreement between the observers using intraclass correlation coefficients. Results: With MaBAGS, excellent and good levels of agreement were found for vascularity indices, Seidel test and transparency. Parameters for area and height yielded moderate agreement, while indices for conjunctival mobility and microcysts failed to show satisfying levels of agreement. Using MBGS resulted in excellent and good interobserver consistency for parameters regarding subconjunctival blood, Seidel test, and central and peripheral vascularity. Height and nonbleb vascularity reached moderate levels of agreement. Agreement for area parameters was low. With IBAGS, good levels of agreement were found for height and vascularity, and moderate for extent. In all grading systems, consistency was considerably better between the two experienced observers compared to the inexperienced grader. Conclusions: MaBAGS shows good reproducibility. Using such a grading system improves precision of the description of a highly variable clinical finding. The reliability of grading by slit‐lamp examination exceeds that of grading on photographs. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study was to investigate the relationship between visual acuity, peripapillary retinal nerve fibre layer (pRNFL), retinal thickness at the fovea and other factors with the neurologic status of former preterm children. Methods: In this cross‐sectional hospital based study in a maximum care tertiary centre, detailed anthropometric and ophthalmological data of former preterm children ranging from 4 to 10 years of age with a gestational age (GA) ≤32 weeks were assessed. Analyses of the correlation between pRNFL and foveal thickness, as well as visual acuity (VA) parameters at 4–10 years of age, with neurological development were evaluated at 2 years of age by Bayley Scales II of Infant Development, including Psychomotor Developmental Index (PDI) and Mental Developmental Index (MDI). Results: Data were available for 106 former preterm children. Univariate analysis revealed a correlation between PDI with pRNFL thickness (B = 0.43; p = 0.013), VA (B = −29.2; p < 0.001), GA (B = 2.7; p = 0.002), retinopathy of prematurity (ROP; B = −16.3; p < 0.001) and intraventricular haemorrhages (IVH; B = −22.9; p < 0.001) but not with strabismus or foveal thickness. In the multivariable analysis, the association remained for visual acuity and IVH, but not for pRNFL thickness or ROP. Mental Developmental Index (MDI) was associated with visual acuity (B = −34.3; p = 0.001), GA (B = 2.53; p = 0.02) and IVH (B = −15.4; p = 0.02), the latter also in the multivariable analysis. Conclusion: This study revealed an association between PDI at 2 years of age and lower visual acuity later in childhood. However, there was no correlation between retinal morphology and neurologic outcome in former preterm children after adjusting for several potential confounders. [ABSTRACT FROM AUTHOR]

GA and BW percentiles were also not associated with CRAE in a multivariable model with adjustment for age, sex, mean arterial blood pressure and arterial hypertension. Preterm birth and associated factors are linked with an increased risk for cardiovascular disease and arterial hypertension in later life (Barker 2004; Barker & Bagby 2005). Associations were assessed with linear regression analyses between GA, BW and BW percentile, ROP occurrence, ROP treatment, placental insufficiency, preeclampsia, breastfeeding, maternal smoking during pregnancy, mean arterial blood pressure (mmHg) and arterial hypertension with retinal vessel characteristics. [Extracted from the article]

Purpose Optical coherence tomography ( OCT) of the anterior segment allows quantitative analysis of the geometry of the iris. We performed spectral domain OCT examinations in healthy emmetropic, hyperopic and myopic subjects to investigate iris curvature and its associations. Methods In a cross-sectional study, out of 4617 eyes (2309 subjects) those with refractive errors of <−4 or >+3 dioptres were identified by objective refraction. The iris was examined using the anterior segment mode of a spectral domain 3D OCT-2000 (Topcon Inc., Japan) in the temporal meridian, and OCT scans were investigated with respect to presence and amount of convex and concave iris configuration. Ninety-three eyes of 50 subjects served as emmetropic group (−0.5 ≤ x ≤+0.5 dioptres). Previous ocular surgery was exclusion criterion. Results Six hundred and sixty-eight eyes of 398 persons [292 male (76%); age range; 18-66 years] were included in the study. In the myopic group, 105 eyes had a concave iris configuration (26%), while in the hyperopic group, no eye had this configuration (0%) and in the emmetropic group five eyes (5%). Convex iris configuration was found in 96% of hyperopic, in 85% of the emmetropic and in 67% of the myopic eyes. There was an association between concave iris configuration and myopia, younger age and male gender, and with anterior chamber angle width. Conclusion Spectral domain OCT images can be used for analysis of the iris structure and geometry. Our results are limited to the properties of the study population having an age range from 18 to 66 years and consisting mainly of men. [ABSTRACT FROM AUTHOR]

Pterygium is a benign, slowly progressing disease of bulbar conjunctival tissue growing onto the cornea. Hundred participants (1.0 %; 95% CI: 0.8-1.2%) had pterygium in only one eye while 20 participants (0.2 %; 95% CI 0.1-0.3%) had pterygium in both eyes. In summary, we report data on the prevalence of pterygium in Germany. [Extracted from the article]

Retinal artery occlusion (RAO) is a rare and severe disease potentially causing blindness. Data from the health insurance AOK Baden-Württemberg in Germany in 2016. gl Using health claims data comes with several limitations including misclassification and under/over-reporting. In summary, we report incidence of RAO in Germany for the first time using health claims data and found it to be slightly higher than the data for the US (Leavitt et al.). [Extracted from the article]