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Purpose To determine the diagnostic value of the ganglion cell-inner plexiform layer (GCIPL) thickness in glaucomatous eyes with superior or inferior visual hemifield defects. Patients and methods Eighty-five patients with glaucoma (42 isolated superior hemifield defects and 43 isolated inferior hemifield defects) and 46 normal subjects were enrolled. All patients underwent Cirrus high-definition optical coherence tomography and standard automated perimetry. The area under the receiver operating characteristic curve (AUC) was calculated to determine the diagnostic ability of the GCIPL and peripapillary retinal nerve fiber layer (pRNFL). Results In the superior hemifield defect glaucoma group, the best parameters for discriminating normal eyes from glaucomatous eyes were the inferotemporal GCIPL thickness (0.942), inferior quadrant RNFL thickness (0.974), and 7 o'clock sector RNFL thickness (0.999). For diagnosing inferior hemifield defect glaucoma, the AUCs of all GCIPL parameters (0.331 to 0.702) were significantly lower than that of the superior quadrant RNFL thickness (0.866, P Conclusions The diagnostic ability of GCIPL parameters was similar to that of the pRNFL parameters in superior hemifield defect glaucoma. However, the diagnostic performance of the GCIPL parameters was significantly inferior to those of the pRNFL parameters in eyes with inferior hemifield defect glaucoma.

To compare the topographic characteristics of myopic and nonmyopic disc hemorrhage (DH) in primary open-angle glaucoma. Patients were assigned to the myopic DH group (spherical equivalent of −1.0 diopters or less) or to the nonmyopic DH group (emmetropia and hyperopia). DH was classified as lamina cribrosa-, cup margin-, disc rim-, or peripapillary-type DH according to its proximal location. The DH types of the two groups were compared using Fisher's exact test. Multivariate logistic regression was used to evaluate the factors associated with myopia. Thirty-four eyes were assigned to the myopic DH group and 42 eyes to the nonmyopic DH group. A significantly higher proportion (32.4 %) of lamina cribrosa-type DH was found in the myopic DH group than in the nonmyopic DH group (4.8 %; P = 0.008). Eyes with lamina cribrosa-type DH were 12.59 times more likely to be myopic than were eyes with peripapillary-type DH (95 % CI: 1.22–129.53; P = 0.033). Lamina cribrosa-type DH was significantly more common in myopic eyes than in nonmyopic eyes. This result suggests that the pathogenesis of DH may differ between myopic DH and nonmyopic DH.

Purpose: To evaluate the amount of intraocular pressure (IOP) change in the eye against the pillow in the lateral decubitus position (LDP). Methods: Thirty eyes from 15 healthy volunteers (12 men and three women) aged 29 ± 3 (range 25–37) years participated in this study. Using the rebound tonometer (Icare PRO, Icare Finland Oy, Helsinki, Finland), the IOP of both eyes was checked in sitting, supine, right and left LDPs. In the LDP, the additional IOP measurements were taken with the lower eyeball against the latex pillow. Results: Baseline IOP in the sitting position was 12.7 ± 1.9 mmHg in the right eye and 12.8 ± 2.2 mmHg in the left eye. Ten minutes after shifting from the sitting to the supine position, IOP increased significantly (right eye: +1.4 ± 1.4 mmHg, p = 0.006; left eye: +1.8 ± 1.5 mmHg, p = 0.001). Changing from the supine to the right and left LDP increased significantly the IOP of dependent eye (right eye: +2.3 ± 1.8 mmHg, p = 0.001; left eye: +1.5 ± 1.8 mmHg, p = 0.011). When the dependent eye was compressed against the pillow in the LDP, the IOP of the dependent eyes increased significantly after 10 min (right eye in the right LDP: +4.1 ± 4.9 mmHg, p = 0.011; left eye in the left LDP: +3.4 ± 3.7 mmHg, p = 0.006). Conclusion: The IOP was significantly elevated when the eyeball was against the pillow in the LDP.

Purpose: To evaluate the change of iris-trabecular contact index (ITC index) after cataract surgery in acute angle closure glaucoma. Methods: Twelve patients (17 eyes) who had a history of acute angle closure glaucoma underwent swept source optical coherence tomography before and after cataract surgery. Correlations between lens vault (LV), ITC index and intraocular pressure (IOP), anterior chamber depth (ACD), anterior chamber volume (ACV), and angle parameters were analyzed before and after cataract surgery. Results: IOP (p = 0.007), ACD (p < 0.001), ACV (p < 0.001), angle parameters (p = 0.001), and ITC index (p = 0.012) were improved after cataract surgery. ITC index decreased from 88.42 ± 23.59% to 48.91 ± 35.13% after cataract surgery (p = 0.012). There was no correlation between LV and ACD (p = 0.075), ACV (p = 0.864), angle parameter (p = 0.112-0.707), or ITC index (p = 0.288) before cataract surgery. The correlations between ITC index and IOP (p = 0.021), ACD (p = 0.002), ACV (p < 0.001), and angle parameter (p = 0.001-0.030) were statistically significant before surgery but not statistically significant (p = 0.223/0.206/0.761/ 0.096-0.819) after surgery. Conclusions: ITC index significantly improved after cataract surgery, but part of angle closure was not resolved in some cases of acute angle closure glaucoma. J Korean Ophthalmol Soc 2016;57(9):1400-1406

Purpose: To report a single case of tsutsugamushi disease with anterior uveitis and eschars on the upper eyelid. Case summary: A 56-year-old female patient complained of ocular pain and gradually decreasing visual acuity in her right eye. On physical examination, lymphadenopathy was palpable on the right side of the neck, and eschars were observed on the forehead and upper eyelid. On slit lamp examination, conjunctival injection, episcleral vessel dilations and severe intraocular inflammatory reaction were observed. Fundus examination showed no abnormal findings. A blood test was submitted for analysis, and tsutsugamushi disease was diagnosed. The patient's ocular manifestations responded well to treatment with steroids. After three weeks, the patient showed improvement on ocular examination, and no problems were observed at the six-month follow-up. Conclusions: Although ocular manifestation of tsutusgamushi disease with conjunctivitis and limbitis has previously been reported, ocular manifestation of tsutusgamushi disease with anterior uveitis has not been reported. Anterior uveitis may respond satisfactorily to steroid treatment, along with improvement in systemic conditions.

Purpose: We compared intra-individual visual outcomes and patient satisfaction after implantable contact lens (ICL) and Toric ICL implantation. Methods: Twenty-eight eyes of 14 patients were enrolled in this retrospective study. One eye of each patient was assigned to ICL (ICL Group), and the contralateral eye was allocated to Toric ICL (Toric ICL Group). All patients were examined for visual acuity, refraction, intraocular pressure, slit lamp measurements, and satisfaction one week, one month, two months, and six months postoperatively. Results: Mean spherical equivalents of the two groups were corrected from -7.83D (ICL Group) and -5.55D (Toric ICL Group) to 0.13D and 0.20D, respectively, and the mean refractive cylinders were corrected from 0.92D and 2.60D to 0.42D and 0.27D, respectively, at six months postoperatively. The myopias of these two groups and the astigmatism of the Toric ICL group were effectively corrected. The uncorrected visual acuity (UCVA) of the two groups were 1.02 and 1.05, respectively, at six months postoperatively. The safety index, efficacy index, predictability, and stability were favorable. There were no significant differences between the two groups in terms of postoperative UCVA, intraocular pressure(IOP), vaulting, noticeable complications, or patient satisfaction. Conclusions: The results show ICL implantation is effective treatment for high myopia, and Toric ICL implantation is a viable surgical option for the treatment of compound myopia astigmatism. Selection of proper phakic intraocular lens(IOL) is recommended for correcting astigmatism.

Purpose: To evaluate the clinical features of subretinal hemorrhage after photodynamic therapy in eyes with exudative age-related macular degeneration. Methods: We retrospectively reviewed data for 267 eyes of 243 patients who had undergone PDT for the treatment of ARMD between January 2005 and December 2006. Best corrected visual acuity, fundus photography, fluorescein angiography, and ICG angiography were performed before and after treatment. We followed up the patients at 1 week, 1 month, and 3 months after treatment and at 3-month intervals thereafter. Results: Postoperative subretinal hemorrhage was seen in 36 (13.4%) of 267 eyes. The pretreatment and post-treatment mean visual acuities were logMAR 0.80 and logMAR 1.05 respectively, representing a decrease of 2.05 lines. On FAG, two eyes were predominantly classic, four eyes were minimally classic, and 30 eyes were occult. The laser irradiation spot size was under 3,000 µm in one case and from 3,000 µm to 5,000 µm in 19 cases and over 5,000 µm in 16 eyes. Conclusions: Subretinal hemorrhage after PDT for ARMD can be a common complication in patients who have been treated for larger irradiation spot sizes and for pigment epithelial detachment (PED), so doctors should be aware of the risk of serious hemorrhagic complications in such situations.