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Purpose: To describe a new algorithm to measure corneal densitometry based on images obtained by swept source anterior segment ocular coherence tomography (SS-AS-OCT) and establish standard densitometry values in a group of normal eyes., Methods: A total of 111 healthy participants (195 eyes) were enrolled in this study. Using a MATLAB designed algorithm, the cornea was segmented into three layers: anterior, posterior and mid-stroma, and it was divided into two concentric areas, 0-2 and 2-4 mm, resulting in nine areas for the analysis. The mean corneal densitometry values were calculated and expressed as grayscale units (GSU)., Results: The mean age was 57 years (range 22-87), with 100 (51.3%) right eyes and 95 (48.7%) left eyes. The total corneal densitometry was 86.9 ± 12.1 GSU. The mid-stroma layer had the highest densitometry values, 87.4 ± 12.1 GSU, and the anterior layer had the lowest values, 81.9 ± 14.2 GSU. Densitometry differences between the anterior layer and the mid-stroma layer (P < 0.001), as well as the anterior layer and the posterior layer (P < 0.05) were statistically significant. The 0-2 mm concentric area had higher mean densitometry values, 97.8 ± 12.7 GSU, and the differences were significant compared to the 2-4 mm concentric area (P < 0.001). No correlation was found between the corneal densitometry values and gender or age., Conclusions: The new MATLAB segmentation algorithm for the analysis of corneal SS-AS-OCT images is capable to objectively assess corneal densitometry. We provide standard and normal data for better clinical and research approach., (© 2021. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.)

Purpose: To describe paediatric keratoconus (KC) patients by tomographic and aberrometric characteristics at first diagnosis, in a multicentre study., Methods: We included 278 eyes from 139 paediatric patients, with a first tomographic diagnosis (Pentacam ® ) of KC prior to 18 years old. KC classification was based on the KC Index (≥ 1.07) and Topographic Keratoconus Classification (TKC ≥ 1). Patients were divided based on age ranges (14 and under and over 14 years) and gender. Statistical analysis was performed with SPSS statistics 25.0. ANOVA factor was carried out comparing to compare groups., Results: 278 eyes were screened, and 230 eyes were diagnosed with paediatric KC. Mean age was 15.48 ± 2.33 (6 to 18) years. We found differences in terms of TKC (2.08 ± 0.89 and 2.38 ± 0.82, p < 0.05) and spherical aberration (-0.71 ± 0.97 and -1.07 ± 1.36, p < 0.05) among the 14 years old or under and above 14 years old groups, respectively. Overall, female paediatric KC patients presented a more severe TKC, Belin Ambrosio Display, maximum keratometry, asphericity and primary and secondary coma aberrations compared to male KC patients. We observed a correlation between CDVA and asphericity (r = 0.71, p < 0.01), as well as between CDVA and spherical aberration (r = 0.69, p < 0.01)., Conclusion: Our findings revealed that the debut of KC is usually in a moderate to advanced stage in the paediatric population at first diagnosis, particularly in female patients. Corneal tomography should be systematically performed in children with recent onset of corneal astigmatism., (© 2020 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

Competing Interests: None

Purpose: To determine corneal topographic, anatomic, and biomechanical properties in patients newly diagnosed with severe obstructive sleep apnea-hypopnea syndrome (OSAHS)., Methods: This is a cross-sectional study including 25 patients recently diagnosed with severe OSAHS (apnea-hypopnea index above 30) and a paired control group of 25 healthy subjects. All patients underwent a complete eye examination with an elevation topography Pentacam Scheimpflug study and a study with Reichert Ocular Response Analyzer, collecting several topographic, anatomic, and biomechanical variables., Results: Fifty eyes of 25 patients (23 of them were men) diagnosed with OSAHS by somnography and the same number of healthy subjects (23 of them were men) were included, with an average age of 64 ± 11 years (range 45-78 years) for cases and an average age of 64 ± 11 years (range 45-81 years) for the controls. No differences were found in keratometry, cylinder, refractive indexes, Bad-D, or pachymetry. The mean corneal volume for cases was 58.64 ± 3.05 mm and for the controls 60.48 ± 3.33 mm (P = 0.005). The mean minimum radius for cases was 7.49 ± 0.31 and for the controls 7.36 ± 0.30 (P = 0.035). The mean elevation in apex for cases was 8.46 ± 5.18 and for the controls 2.38 ± 2.36 (P ≤ 0.001). Two eyes with a topographic diagnosis of keratoconus (KC) and another 6 with subclinical KC were detected using the Pentacam in the OSAHS group., Conclusions: Many of the corneal topographic and biomechanical variables in patients with severe OSAHS present different values from the general population with a trend toward KC values, such as keratoconus index or paired keratoconus index. Compared with the control group, significant differences were found in corneal volume, corneal elevation, and minimum radius.

To describe the effectiveness and safety of nicergoline in patients with epithelial corneal defect or corneal ulcer due to neurotrophic keratitis (NK). A prospective case series review was performed in 14 patients with NK who started treatment with nicergoline as an off-label prescription from January to November 2020. Patients with a epithelial defect or corneal ulcer due to NK were treated with oral nicergoline. Complete corneal healing was observed in 10 (71.4%) of the 14 patients after 25.6 ± 26.60 days (range 7–90) with nicergoline. In three (21.5%) patients wound healing was not achieved, and one patient (7.1%) was lost to follow-up. The mean time between diagnosis and the starting of nicergoline was 10.92 ± 8.85 days (0–28). No adverse effects of nicergoline were observed. Nicergoline as an adjunctive treatment for NK showed a potential use in the healing of epithelial defect in real-life clinical practice. [ABSTRACT FROM AUTHOR]