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Dit proefschrift heeft betrekking op de implantatie van de iris-gefixeerde Artisan lens voor correctie van een (hoge) brilsterkte bij volwassenen. Een lange follow-up van deze patiënten in de afgelopen decennia heeft ons waardevolle kennis opgeleverd rondom het proces vanaf implantatie tot aan het verwijderen van de Artisan lens. Gezien bijziendheid een wereldwijd groeiend probleem is, is de verwachting dat deze behandeling vaker toegepast zal worden en dat elke oogarts een dergelijke patiënt vaker in zijn/haar praktijk zal treffen. Zo blijkt uit dit proefschrift dat deze behandeling veilig en effectief is, maar levenslange follow-up essentieel blijft. Andere interessante inzichten zijn bijvoorbeeld de toename in aslengte over tijd van ogen die bijziend zijn, op volwassen leeftijd; dat de bepaling van de positie van de iris-gefixeerde lens per apparaat wat kan verschillen en dat een combinatie-procedure van het verwijderen van de lens en een staaroperatie veilig kan.

Dit proefschrift heeft betrekking op de implantatie van de iris-gefixeerde Artisan lens voor correctie van een (hoge) brilsterkte bij volwassenen. Een lange follow-up van deze patiënten in de afgelopen decennia heeft ons waardevolle kennis opgeleverd rondom het proces vanaf implantatie tot aan het verwijderen van de Artisan lens. Gezien bijziendheid een wereldwijd groeiend probleem is, is de verwachting dat deze behandeling vaker toegepast zal worden en dat elke oogarts een dergelijke patiënt vaker in zijn/haar praktijk zal treffen. Zo blijkt uit dit proefschrift dat deze behandeling veilig en effectief is, maar levenslange follow-up essentieel blijft. Andere interessante inzichten zijn bijvoorbeeld de toename in aslengte over tijd van ogen die bijziend zijn, op volwassen leeftijd; dat de bepaling van de positie van de iris-gefixeerde lens per apparaat wat kan verschillen en dat een combinatie-procedure van het verwijderen van de lens en een staaroperatie veilig kan.

Background This study investigated the characteristics of corneal higher-order aberrations (HOAs) of the anterior surface, posterior surface, and total cornea in adolescents with mild to moderate myopia. Methods A total of 183 patients with myopia (183 eyes) aged 8 to 18 years were enrolled in this study. The axial length (AL) of the eyes was measured by an IOL-Master, and corneal curvatures (K-values) and HOAs were measured by a Pentacam anterior segment diagnostic analyzer. Results Results of this study showed that the anterior, posterior and total corneal horizontal coma Z31 were − 0.1249 ± 0.105 μm, 0.0009 ± 0.001 μm, and − 0.1331 ± 0.116 μm, respectively; the anterior, posterior and total corneal vertical coma Z3− 1 were − 0.0212 ± 0.164 μm, 0.0003 ± 0.043 μm, and − 0.0216 ± 0.168 μm, respectively; and spherical aberration (SA) Z40 values were 0.2244 ± 0.091 μm, 0.1437 ± 0.029 um, and 0.1889 ± 0.090 μm, respectively. Total corneal Z31 was statistically correlated with posterior corneal astigmatism (K2b − K1b) (p = 0.038). Total corneal Z3− 1 was correlated with anterior corneal astigmatism (K2f − K1f) (p = 0.027). Anterior, posterior, and total corneal Z40 were correlated with anterior and posterior corneal curvature (K1f, K2f, K1b, K2b) (p = 0.001). Posterior corneal Z40b was also significantly correlated with AL. Conclusions In adolescents with mild to moderate myopia, the posterior corneal surface shape may play a compensatory role in the balance of corneal aberrations, and the posterior corneal SA tended to become less negative as the AL increased. The corneal coma may also play a compensatory role in posterior corneal surface astigmatism, which was valuable for the treatment for improving visual quality. This conclusion still needs to be verified.

Background Axial myopia is the most common type of myopia. However, due to the high incidence of myopia in Chinese children, few studies estimating the physiological elongation of the ocular axial length (AL), which does not cause myopia progression and differs from the non-physiological elongation of AL, have been conducted. The purpose of our study was to construct a machine learning (ML)-based model for estimating the physiological elongation of AL in a sample of Chinese school-aged myopic children. Methods In total, 1011 myopic children aged 6 to 18 years participated in this study. Cross-sectional datasets were used to optimize the ML algorithms. The input variables included age, sex, central corneal thickness (CCT), spherical equivalent refractive error (SER), mean K reading (K-mean), and white-to-white corneal diameter (WTW). The output variable was AL. A 5-fold cross-validation scheme was used to randomly divide all data into 5 groups, including 4 groups used as training data and one group used as validation data. Six types of ML algorithms were implemented in our models. The best-performing algorithm was applied to predict AL, and estimates of the physiological elongation of AL were obtained as the partial derivatives of ALpredicted-age curves based on an unchanged SER value with increasing age. Results Among the six algorithms, the robust linear regression model was the best model for predicting AL, with a R2 value of 0.87 and relatively minimal averaged errors between the predicted AL and true AL. Based on the partial derivatives of the ALpredicted-age curves, the estimated physiological AL elongation varied from 0.010 to 0.116 mm/year in male subjects and 0.003 to 0.110 mm/year in female subjects and was influenced by age, SER and K-mean. According to the model, the physiological elongation of AL linearly decreased with increasing age and was negatively correlated with the SER and the K-mean. Conclusions The physiological elongation of the AL is rarely recorded in clinical data in China. In cases of unavailable clinical data, an ML algorithm could provide practitioners a reasonable model that can be used to estimate the physiological elongation of AL, which is especially useful when monitoring myopia progression in orthokeratology lens wearers.

Contains fulltext : 249579.pdf (Publisher’s version ) (Open Access) In pediatric ophthalmology it is often necessary to obtain axial length in young children. For children older than 3 years, noncontact biometry can be used. For younger children this is usually not an option, and the clinician needs to rely on other imaging modalities. Depicted data curves in textbooks elaborate on few studies and limited number of subjects. The existing literature regarding normal axial length for preterm infants and term newborns is summarized and critically appraised for number of subjects, relevance, measurement method and error, gender and retinopathy of prematurity. We obtained axial length measurements for a total number of 6,575 eyes in 27 papers published from 1964 to 2018 (9 papers with 2,272 eyes for preterm children, 24 papers with 4,303 eyes for term children). Initially, axial length increases rapidly: from a mean 5.1-16.2 mm in week 12 to week 37 gestational age. From 38 weeks, growth rate decreases from 16.2 mm to a mean of 21.8 mm at 3 years old. Male infants have a larger average axial length than females at birth; the difference is 0.24 mm (95%CI: 0.15-0.33, P < 0.001). We present a useful growth curve and formula that may serve as a reference for diagnosing abnormal growth.

Objective The purpose of this study is to analyze axial length, body height, hand length, and foot length to find new factors that predict myopia and to identify gender differences as one of the factors of high myopia. A cross-sectional study was conducted as a single observation. Body height, hand length, and foot length were measured according to standard anthropometric methods. Axial length, retinal thickness, and choroidal thickness were measured using the IOL Master 700 and the Heidelberg Spectralis-OCT. To account for body height differences among participants, foot length/body height and hand length/body height were analyzed using a mixed-effects model. Results A total of 80 eyes (men, n = 20, 40 eyes; women, n = 20, 40 eyes) were analyzed. The mean age was 33.5 years (range 21–59 years, SD: 9.6). For choroidal thickness, there was a significant association with axial length in men (p

Aim: To determine the socio demographic distribution of ocular axial length (AL) for use in estimating intraocular lens power, detect abnormal values and possibly associate them with pathological conditions. Methods: This is a community based descriptive study carried out in Port Harcourt City LGA, Nigeria of subjects 18 years of age or older and with Visual Acuity > 6/18. The major ethnic/linguistic groups in Rivers state are Ikwerre, Ogoni, Ekpeye Kalabari, Okrika, Ogba, Igbani, Obolo and Etche. Socio demographic data was obtained through a proforma. Ocular examinations done included visual acuity, applanation tonometry, and ophthalmoscopy. Axial length (AL) was measured using Amplitude (A) scan ultrasonography (SONOMED PACSCAN 300AP). Data analysis was by SPSS (Version 17), and p value was set at ≤ 0.05. Results: Four hundred and sixty six (466) subjects participated in the study made up of two hundred and twelve (212) males (45.5%) and two hundred and fifty four (254) females (54.5%) with M: F ratio of 1:1.2. The age range was 18-92 years and mean age of the subjects studied 43.0±14.2 years. Findings revealed mean AL to be 23.2±1.0 mm which was greater in males than females. The longest mean AL in males was seen among age group 51 and 60 years and that for females was seen in age group 41 and 50 years after which in both gender there was noticed to be a decline in mean axial lengths. There was no statistically significant relationship between age and axial length. Axial length was found to be longer in subjects with higher level of education and this pattern was statistically significant. Conclusion: AL was significantly longer in males and has a positive relationship with the level of education of the study population. The longest mean AL in males was seen among age group 51 and 60 years and that for females was seen in age group 41 and 50 years after which in both gender there was noticed to be a decline in mean axial lengths.

Aim: To determine the anthropometric parameters affecting ocular axial length in Niger Delta region of Nigeria. Methods: This was a community based descriptive study carried out in Port Harcourt City LGA, Nigeria using a multistage random sampling technique. Inclusion criteria were Visual Acuity > 6/18, age greater than 18 years and no history of past ocular surgeries or trauma. Socio demographic data was obtained through an interviewer based proforma and included age, sex and tribe. Anthropometric parameters were measured using a standard height and weight automated scale (SECA 769,220). Ocular examinations done included visual acuity, applanation tonometry, and ophthalmoscopy. Axial length (AL) was measured using Amplitude (A) scan ultrasonography (SONOMED PACSCAN 300AP). Data obtained from one eye of the subjects were analyzed using SPSS (Version 17), and P value was set at ≤ .05. Results: The study was made up of two hundred and twelve (212) males (45.5%) and two hundred and fifty four (254) females (54.5%) with M: F ratio of 1:1.2 giving a total of four hundred and sixty six (466) subjects. The age range was 18-92 years and mean age of the subjects studied 43.0±14.2 years. Findings revealed mean AL, Height and Weight to be (23.2±1.0 mm), (162.5±9 cm) and (70.5±14.8 kg) respectively. The mean AL was greater in males than females. There was a statistically significant relationship between height and AL in both gender with AL increasing by 0.035mm (p=0.001, r=0.261) with one centimeter change in height in males and 0.025 mm (p=0.001, r=0.2680) in females. There was also a statistically significant (0.009 mm) increase in AL per one kilogram change in weight in females (p=0.0001, r=0.188). Conclusion: This study noted that there are significant relationships between AL and height and weight respectively. This could add to the data bank for AL in the country and form a basis for identifying deviations from the normal, for further research.

Aim: To determine the correlation between Ocular axial length (AL) and body mass index (BMI) in a black population. Methods: This was a descriptive cross sectional study carried out in Port Harcourt City LGA, Nigeria. Subjects were selected using multistage random sampling with inclusion criteria of Visual Acuity > 6/18, age greater than 18 years with no history of past ocular surgeries or trauma. Socio demographic data was obtained through an interviewer based structured proforma. Data obtained included age, sex, tribe, occupation and level of education. Weight, height and Body Mass Index (BMI) were measured using a standard height and weight automated scale (SECA 769,220). Ocular examinations done included visual acuity, applanation tonometry and ophthalmoscopy. Axial length (AL) was measured using Amplitude (A) scan ultrasonography (SONOMED PACSCAN 300AP). Data obtained from one eye of the subjects were analyzed using SPSS (Version 17), and p value was set at ≤ 0.05. Results: Four hundred and sixty six (466) subjects participated in the study made up of two hundred and twelve (212) males (45.5%) and two hundred and fifty four (254) females (54.5%) with M: F ratio of 1:1.2. The age range was 18-92 years and mean age of the subjects studied 43.0±14.2 years. Findings revealed mean AL, Body Mass Index, Height and Weight to be (23.2±1.0 mm), (26.9±6.2 kg/m2), (162.5±9 cm) and (70.5±14.8 kg) respectively. The mean AL was greater in males than females. There was no statistically significant relationship between age and axial length. There was a statistically significant relationship between height and AL in both gender with AL increasing by 0.035 mm (p=0.001, r=0.261) with one centimeter change in height in males and 0.025 mm (p=0.001, r=0.2680) in females and between AL and level of education (p=0.001). There was also a statistically significant (0.009 mm) increase in AL per one kilogramme change in weight in females (p=0.0001, r=0.188). Males had longer AL than females in all the BMI groups with a statistically significant difference found between the different BMI classes. Conclusion: This study noted that although there is no statistically significant relationship between AL and BMI, there are significant relationships between AL and height and weight respectively. Estimated AL in mm= 16.91 + 0.039 (height in cm).

Background: This study aimed to compare the presence of blepharitis with corneal thickness, refractive values and ocular axial length changes in premenopausal and postmenopausal women. Methods: Thyroid-stimulating hormone (TSH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), oestradiol (E2), refractive values with prolactin, refractions in horizontal and vertical meridians, ocular tension (OT) values, ocular axial length, central corneal thickness and the presence of blepharitis were evaluated in 142 premenopausal patients and 153 postmenopausal patients. Results: Statistically significant differences were found for the values for right eye OT (P < 0.001), left eye OT (P < 0.001) and presence of blepharitis in the premenopausal group (pConclusions: Woman in postmenopausal period should be examined by ophthalmologist because of significant increase in blepharitis and OT.

Introduction: Studies are being conducted to correlate second (2D) to fourth digit (4D) length ratio as an anthropometric marker of prenatal sex steroid exposure with human body. As 2nd digit: 4th digit(2D:4D)ratio is an anthropometric window into the interplay of sex hormones in-utero, this tool may be tested to note if there is any correlation between the sexual dimorphism of axial length and the Digit length ratio. Aim: To find a correlation between digit length ratio (2D:4D) with physical parameters like height, BMI and axial length of eyeball in the adult population of South Bengal presenting in a tertiary care hospital, in Burdwan, West Bengal, India. Materials and Methods: A cross-sectional study with simple random sampling was conducted on 500 patients (age ≥20 years) from March 2016 to February 2017 in the Departments of Anatomy and Ophthalmology Out Patients Department (OPD) of a tertiary care Hospital and Medical College in West Bengal, India. Height, weight, axial length of eyeball were measured and the BMI was computed for the study population. Statistical analysis was done with Statistical Package for Social Sciences(SPSS) version 16.0. Unpaired t-test was used for determining possible group differences in 2D:4D length ratios. Pearson’s correlation coefficients were used to find a correlation between second and fourth digit length ratio (2D:4D) with height, BMI and axial length of eyeball in the study population. The p-value 0.05) Conclusion: In this study, we have tried to establish that 2D:4D ratio (which is significantly higher in females) can be used as a putative non-invasive anthropometric marker to differentiate between males and females, which presumably is prenatally determined by in-utero sex steroid hormone exposure. By correlation studies, we have also tried to prove that this parameter correlates well with other anthropometric measurements like height, BMI and ocular axial length which are already known to be significantly different in males and females

Myopia is a worldwide major public concern, aside from the visual disturbance needing optical correction, myopia may be associated with open angle glaucoma, retinal detachment and myopic maculopathy. The higher the myopia the higher the risk for retinal associated comorbidities, and the axial length is the more important measure to estimate risk of visual impairment. Recently a formula to predict axial length using spherical equivalent and keratometry was proposed, with the intention of categorizing the risk of visual impairment with Tideman et al. classification. Purpose To evaluate the accuracy of an axial length prediction formula in a Colombian population 8–17 years old. Methods Children from MIOPUR study with optical biometer axial length measure (AL), manifest refraction and keratometry were included in the analysis. Predicted axial length (PAL) was calculated with the prediction formula. A Bland-Altman assessment was conducted, and the concordance correlation coefficient was measured. Proposed classification of AL to establish risk of visual loss was used with measured AL and with PAL. The percentage of eyes misclassified was then established. Results A total of 2129 eyes were included in the analysis. Mean difference of axial length (actual AL minus PAL) was −0.516 mm (−1.559 mm – 0.528 mm). Concordance correlation coefficient (CCC) of 0.656 (IC95 0.636-0.675) was found between the real AL and PAL. PAL differed from measured AL by 1 mm or more in 16.58 %, and by 2 mm or more, in 0.61 % of the eyes. In myopic eyes, PAL was in average 0.426 mm longer than the AL actually measured with CCC of 0.714 (IC95 0.666−0.761). PAL differed from measured AL by 1 mm or more in 21.92 %, and by 2 mm or more, in 0.45 % of the myopic eyes. The study revealed that 15.03 % of all eyes, and 29.81 % of myopic eyes, were misclassified when PAL was used. Conclusions The proposed axial length prediction formula was not accurate, and it did not adequately classify risk of visual impairment in myopic eyes in a group of Colombian children. We consider that it is not possible to predict the axial length based only on optometric data, such as the corneal radius of curvature and the spherical equivalent. This is very possibly related to the variability of crystalline lens power within a population.

IMPORTANCE Visual outcome after intraocular lens (IOL) implantation in long eyes is considerably affected by IOL power calculation. Various formulas have been designed to achieve an accurate IOL power prediction. However, controversy about the accuracy remains. BACKGROUND To evaluate the accuracy of IOL power calculation formulas in long eyes. DESIGN Meta-analysis. PARTICIPANTS Patients with ocular axial length (AL) over 24.5 mm. METHODS A comprehensive search in PubMed, EMBASE, Cochrane Data Base of Systematic Reviews and the Cochrane Central Register of Controlled Trials were conducted by September, 2017. The weighted mean differences of mean absolute errors (MAE) and the odds ratio of percentage of eyes within ±0.50D of prediction error among formulas were analysed. MAIN OUTCOMES MEASURES Between-group differences of MAE among formulas. RESULTS Eleven observational studies, involving 4047 eyes, were enrolled. Six formulas for IOL power calculation were compared: Barrett Universal II, Haigis, Holladay 2, SRK/T, Hoffer Q and Holladay 1. The MAE of Barrett Universal II was statistically lower than that of Holladay 2 (mean difference, MD = -0.04D, P = 0.0002), SRK/T (MD = -0.05D, P

Objective To assess a new method to measure the distance of the needle passage from the ciliary sulcus to the corneal limbus anterior border (CTC) in eyes with ectopia lentis directly in vivo via endoscopy and to further evaluate the correlations among the CTC, age, automated horizontal white-to-white distance (WTW), and ocular axial length (AL). Methods The WTW and AL were measured using an optical biometer. An intraocular endoscope was used during transscleral suture fixation of posterior chamber intraocular lenses to identify the true location of the ciliary sulcus. Linear regression analysis was used to assess the correlation between the CTC and other ocular biological parameters, including age, WTW, and AL. Results Thirty eyes of 30 children with ectopia lentis were evaluated. A statistically significant correlation was found between age and the CTC. The CTC could be predicted by the equation CTC = 0.1313 × Age + 0.9666. No statistically significant correlations were found between CTC and WTW, CTC and AL, WTW and AL, or WTW and age. Conclusion Endoscopy is useful for precisely suturing intraocular lens haptics in the real ciliary sulcus. Age can be used as an equivalent parameter for prediction of the true ciliary sulcus location.

Supplemental Digital Content is available in the text, Objectives: To examine factors influencing retinal vasculature in two environmentally contrasted, cross-sectional studies of adult participants of European descent and to estimate the extent and specificity of genetic contributions to each retinal vasculature feature. Methods: Retinal images from 1088 participants in the Orkney Complex Disease Study and 387 in the CROATIA-Korčula study, taken using the same nonmydriatic camera system and graded by the same person, were evaluated. Using general linear models, we estimated the influence of an extensive range of systemic risk factors, calculated retinal traits heritabilities and genetic correlations. Main results: Systemic covariates explained little (10%, up to 31.7%) of the variation in vessel width and monofractal dimension. Suggestive not well trodden associations of biological interest included that of urate, tissue plasminogen activator and cardiac PR interval with arteriolar narrowing, that of carotid intima–media thickness with less-tortuous arterioles and of cardiac QT interval with more tortuous venules. The genetic underpinning of tortuosity is largely distinct from that of the other retinal vascular features, whereas that of fractal dimension and vessel width greatly overlaps. The previously recognized influence of ocular axial length on vessel widths was high and can be expected to lead to artefactual genetic associations [genetic correlation with central retinal arteriolar equivalent: −0.53 (standard error 0.11)]. The significant genetic correlation between SBP and central retinal arteriolar equivalent, −0.53 (standard error 0.22) (after adjusting for age, sex and axial length of the eye), augurs more favourably for the discovery of genetic variants relevant to vascular physiology.

BACKGROUND The aim of the present study was to establish the normal-range orbital parameters and to explore the relationships between ocular protrusion and various orbital morphological factors. MATERIAL AND METHODS A retrospective, non-comparative case series was conducted from January 2014 to December 2015. We recruited 56 subjects (112 orbits), including 27 males (21 to 87 years of age) and 29 females (22 to 88 years of age) in this study. Nine length measurements, 2 angle measurements, and 2 volume measurements of various aspects of the orbit were obtained using Mimics v18.0 software. The data were collected manually using a 3D measurement technique. Statistical analyses using t tests and Pearson's correlation analyses were performed to evaluate the differences and relationships between the parameters, respectively. RESULTS Ocular protrusion in both sexes was closely related to the following values: orbital soft tissue volume (OSTV) (males: r=0.61, p

Background/Aim. Preterm birth and retinopathy of prematurity (ROP) could affect optical and biometric features of eyes and cause refractive errors. The aim of this study was to compare the ocular axial length, anterior chamber depth and lens thickness changes during the first year in preterm born babies with and without ROP. Methods. This prospective longitudinal study included 87 preterm born babies. The examinations were performed at 3 and 12 months after birth and included fundus examination and measurements of the ocular axial length, anterior chamber depth and lens thickness. Based on the results of fundus examination at 3 months, the subjects were divided into two groups and the measurements of those with and without ROP were compared. Results. At 3 months 60.92% of infants had ROP. The mean values in the ROP group were: axial length 16.56 mm and 16.53 mm, chamber depth 2.34 mm and 2.38 mm and lens thickness 4.04 mm and 3.96 mm, in the right and the left eye, respectively. In the no ROP group these values were: axial length 17.06 mm and 17.08 mm, chamber depth 2.31mm and 2.39 mm and lens thickness 4.16 mm and 4.14 mm in the right and the left eye, respectively. At 12 months 28.74% of the children had a change in the ocular fundus as a result of the ROP therapy. In the ROP group the axial length was 19.94 mm in both eyes, chamber depth 3.01 mm and 2.99 mm and lens thickness 4.28 mm and 4.29 mm, in the right and the left eye, respectively. In the no ROP group the axial length was 20.64 mm and 20.29 mm, lens thickness 4.37 mm and 4.36 mm, in the right and the left eye, respectively and chamber depth 3.10 mm in both eyes. Conclusion. In the group of children with ROP axial length of the eye at 3 and 12 months was statistically significantly smaller in comparison to the group without ROP. Statistically significant difference was not found between these groups in the anterior chamber depth and lens thickness.

The use of Information and Communication Technology devices (ICT) has spread globally; therefore, increasing exposure to these display devices is an important health issue in the workplace. The association between ocular axial length (AL) elongation and ICT use was investigated among 7334 middle-aged Japanese male workers. Detailed ICT use information was obtained using a self-administered questionnaire. The high AL group was defined as the group with AL above the 75th percentile for each 5-year age interval. Logistic analysis showed that the odds ratio (OR) for the high AL group of >8 hours/day, adjusted for potent confounding factors, was significantly elevated relative to

Purpose Straylight refers to an optical phenomenon that takes places in the eye and leads to a deterioration of the retinal image. Past clinical findings suggest an increase of straylight with the eye's axial length, but the aetiology of the phenomenon was unclear. The purpose of this work is to demonstrate, through raytracing, simple geometrical optics, and the well-established inverse-angle square law for the angular distribution of straylight, why straylight increases when a myopic eye is corrected with spectacles. Methods The angular dependence of straylight is investigated using geometrical optics. An expression relating the eye's 2(nd) nodal point, the ocular axial length and the eye's straylight parameter S is found. Subsequently, using a model of the human eye, the location of the 2(nd) nodal point is computed using ray tracing for different axial lengths and refractive corrections. Finally, the results are compared against psychophysical data for the straylight parameter, corrected for the subject's age. Results When correcting axial myopia using spectacles, the eye's 2(nd) nodal point shifts towards the retina and away from the scattering plane, leading to an increase in straylight. Meanwhile, straylight should theoretically decrease in hyperopic eyes. Contact lenses keep the 2(nd) nodal point relative stable, leading to a very minor change in straylight with axial length. Our model has shown good agreement with previously taken straylight measurements in real eyes, explaining the observed change of straylight with ocular axial length. Conclusion We proposed an explanation for the underlying optical mechanism for the clinically observed increase of straylight with axial myopia, when corrected with glasses. Our model predicts that the increase can be as high as 0.12 log units for a myopic eye with 10 dioptres, which agrees with prior observations.

Aims: To determine the reliability of transpalpebral ultrasound in B-mode (B-TUS) with a high-resolution linear probe (18 MHz) in estimating both the ocular anterior chamber depth (ACD) and axial length (AL), as well as its agreement with the IOL Master 500 optical biometer. Material and methods : Cross-sectional study on 82 eyes of 41 volunteers with no history of eye disease. ACD and AL were determined using B-TUS and the IOL Master 500. The agreement between the two tech - niques and the variability of B-TUS (inter- and intra-observer) were analyzed with the Bland-Altman method. To this end, the mean difference between measures±1.96 SD was calculated to determine the limits of agreement (LoA). Results: The mean difference±1.96SD between B-TUS and the IOL Master 500 was -0.41±0.25mm for ACD (p

Introduction: To report the case of a high hyperopic refractive shift associated with significant shortening of the ocular axial length following glaucoma filtering surgery. Methods: Case report. Patient’s records were consulted retrospectively. Results: A 57-year-old woman, highly myopic, with a history of bilateral intraocular refractive surgery in 1998 (phakic lens ZB5M) and bilensectomy in 2011 (phakic intraocular lens extraction plus cataract surgery with pseudophakic intraocular lens implantation), presented with consistently high intraocular pressure. Despite the treatment with different topical antiglaucomatous medications and good compliance, her intraocular pressure values remained consistently above 20 mmHg. In 2016, the patient was submitted for glaucoma filtering surgery and the mini shunt Ex-Press was implanted in both the eyes (3 months between surgeries). On the first postoperative day, the eyes were hypotonic (intraocular pressure of 5 mmHg) and bilateral macular edema was observed. Three days later, the intraocular pressure in both the eyes reached values higher than 6 mmHg (between 6 and 14 mmHg). Five months after the surgery the macular edema resolved and a significant shortening of the axial length and an important hyperopic refractive shift was observed. When comparing the preoperative and postoperative (18 months) measurements, the variation of the axial length was 2.49 mm in the right eye and 2.19 mm in the left eye; the patient refraction (spherical equivalent) shifted 2.50 diopters in the right eye and 1.75 diopters in the left eye. Conclusion: To the best of our knowledge, we report herein the first documented case of an axial length change of this magnitude after glaucoma filtering surgery.

Aims: A previous genome-wide association study of high myopia identified five genome-wide loci for ocular axial length (C3orf26, ZC3H11B, RSPO1, GJD2, and ZNRF3). The aim of our study was to investigate the association between high myopia and genetic variants in the five loci in Han Chinese subjects. Methods: Five single nucleotide polymorphisms were genotyped in 296 unrelated high-myopia subjects and 300 matched emmetropic controls by the SNaPshot method. The distribution of genotypes in the cases and controls was compared in codominant, dominant, and recessive genetic models by using SNPStats online software. Results: Significant associations between rs994767 near ZC3H11B (p = 0.001), rs4074961 in RSPO1 (p < 0.001), and rs11073058 in GJD2 (p = 0.029) and high myopia were observed. Odds ratios (95% confidence intervals) were 1.532 (1.200-1.955), 1.603 (1.267-2.029), and 1.290 (1.027-1.621) for the rs994767 T allele, rs4074961 T allele, and rs11073058 T allele, respectively. But rs9811920 in C3orf26 and rs12321 in ZNRF3 were not associated with high myopia. Conclusion: Our findings suggested that genetic variants in ZC3H11B, RSPO1, and GJD2 are associated with susceptibility to the development of high myopia in a Han Chinese population. Functional roles of ZC3H11B, RSPO1, and GJD2 in the pathology of high myopia need to be further investigated.

Objective The aim of this article is to study the effect of unilateral congenital cataract surgery on ocular growth and corneal flattening. Methods This is a cross-sectional study of 59 patients operated on due to a unilateral congenital cataract. The median age of the patients at the time of diagnosis was 17 months (interquartile range, 5–39 months). The median age at cataract the time of surgery was 28 months (interquartile range, 8–52 months), and the mean follow-up between cataract surgery and assessments was 149.7 ± 69.9 months (range, 30–319 months). Axial length and corneal curvature were measured in both operated and non-operated eyes, comparing the results between them. Results There were no statistically significant differences for axial length growth or corneal flattening between operated and non-operated eyes: axial length ( P = .327, Student t test) and corneal curvature ( P = .078, Student t test). A sub-analysis was performed using the visual acuity and the age of the patient at the time of surgery. The only statistically significant data ( P = .007, Student t test) was a lower axial length in operated eyes compared to non-operated eyes, in the non-deep-amblyopia group. Conclusions No significant axial length growth modifications were observed between operated and non-operated eyes. Only the non-deep-amblyopia group presented with a lower axial length in the operated eyes compared to non-operated eyes. No significant differences in corneal flattening were found between groups after unilateral congenital cataract surgery.

Objective: To evaluate the effect of intravitreal anti-vascularendothelial growth factor (anti-VEGF) injection onintraocular pressure (IOP) and ocular axial length (AL).Methods: A prospective series of consecutive patientsundergoing injection of intravitreal bevacizumab or ranibizumabin our clinic was investigated. IOP was measuredwith Tono-Pen and ocular AL with ultrasound biometrybefore (IOP0, AL0) and about 1 min (IOP1, AL1) and 24hours (IOP2, AL2) after intravitreal injection. Logistic regressionanalysis was used to investigate factors (lensstatus, presence of glaucoma and previous intravitrealinjection) associated with increased IOP and AL.Results: We recruited 96 patients with a mean age of66.7±12 years, 53 (55%) men and 43 (45%) women.One minute after the injection (IOP1), mean IOP increasedfrom 15.2±3.5 mmHg (IOP0) to 22.2±8.6 mmHg(p

Background and objective: Assessment of optic disc morphology is essential in diagnosis and management of visual impairment. The aim of this study was to evaluate associations between optic disc morphometric parameters, i.e., size and shape, and age, gender, and ocular axial length in normal and glaucomatous eyes based on time-domain optical coherence tomography image analysis.Materials and methods: It was a case–control study of 998 normal and 394 eyes with primary open angle glaucoma that underwent an ophthalmological examination and time-domain optical coherence topography scanning. Areas and shapes of the disc, cup, and neuroretinal rim were analyzed.Results: The shape of the optic disc did not differ between the study groups, i.e., normal and glaucomatous case groups, but the disc area of the primary open angle glaucoma group was significantly larger. The shape of the small disc was significantly different, but the shape of the medium and the large disc did not differ between the study groups. The central area of the disc, i.e., cup area was significantly larger in the case group and its shape was significantly different between the study groups. No significant differences in the area of the cup and its shape, nerve fibers on the edge of the disc, i.e., neuroretinal rim area, were found between the study groups of the small discs. There were significant associations between age, gender, and ocular axial length and morphometric parameters of the optic disc.Conclusions: Informative results with regard to the size and shape due to various ocular characteristics between the healthy control group and patients suffering with primary open angle glaucoma were obtained. Both study groups were significant in size, which makes the findings interesting and important contribution in the field.