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Purpose: To analyze the short-term (up to 1 month) clinical outcomes in patients undergoing corneal laser refractive surgery and the impact on dry eye disease (DED) metrics and corneal nerves using in vivo confocal microscopy (IVCM)., Methods: The unaided distance visual acuity, corrected distance visual acuity, and spherical equivalent refraction (SEQ) were determined in 16 and 13 patients undergoing FS-LASIK and SMILE, respectively. DED metrics assessed were Ocular Surface Disease Index, Dry Eye Questionnaire 5-items (DEQ-5), tear film osmolarity, tear meniscus height, noninvasive keratograph breakup time (NIKBUT), ocular staining, and meibomian gland atrophy. An automated analysis of corneal nerve fiber density, corneal nerve branch density, corneal nerve fiber length (CNFL), and corneal nerve fiber fractal dimension were obtained from the IVCM scans using ACCMetrics software (University of Manchester)., Results: Both surgical techniques provided good refractive and visual outcomes. DED symptoms were found to be higher after FS-LASIK compared with SMILE (P < 0.05). A decrease in tear meniscus height (∼31%) and NIKBUT (∼40%) was reported after FS-LASIK (P = 0.005 and P = 0.001, respectively) but not after SMILE. Both procedures affected corneal nerve fiber density, corneal nerve branch density, CNFL, and corneal nerve fiber fractal dimension, but the impact was significantly greater with FS-LASIK (P = 0.001). Only CNFL correlated with the reported symptoms (DEQ-5) after FS-LASIK (r = -0.545, P = 0.029)., Conclusions: FS-LASIK and SMILE provided good refractive and visual outcomes. There was an increased impact on DED symptoms after FS-LASIK compared with SMILE, although there were no significant differences between the procedures for most of the other ocular surface metrics assessed. The IVCM findings showed that SMILE had less impact on corneal nerves compared with FS-LASIK.

Objectives: To compare the circumpapillary retinal nerve fiber layer (cpRNFL) and the macular ganglion cell-inner plexiform layer (GCIPL) in glaucoma patients at different disease stages and to evaluate correlations between optical coherence tomography (OCT) parameters with central visual function and visual field (VF) indexes., Patients and Methods: One hundred forty patients were included in this prospective cross-sectional study. Subjects diagnosed with chronic open-angle glaucoma and 20/40 or better vision were recruited and classified as having early, moderate, or severe VF defects based on Hodapp-Parrish-Anderson criteria. cpRNFL and macular GCIPL were measured using Cirrus high-definition OCT. Central retinal sensitivity and visual acuity were recorded., Results: All OCT measurements differed significantly between patients with early and severe VF defects (p < 0.001). Correlations between central vision and VF indexes with OCT measurements were moderate but significant; better-correlated OCT parameters were the inferior cpRNFL quadrant, average cpRNFL thickness, inferior and inferior temporal GCIPL sectors, and minimum GCIPL thickness (r = 0.63-0.71, p < 0.001). Visual acuity was not correlated with either circumpapillary or macular OCT measurements., Conclusions: Inner macular parameters performed as well as cpRNFL in patients with different stages of glaucoma. Inferior macular GCIPL sectors, minimum GCIPL thickness, and the inferior cpRNFL quadrant best differentiate disease severity and correlate with central visual function and VF indexes., (© 2017 S. Karger AG, Basel.)

Purpose: To test the diagnostic ability of spectral domain optical coherence tomography for the detection of Parkinson disease using retinal nerve fiber layer and retinal thickness parameters. Retinal pigment epithelium produces levodopa., Methods: Patients with Parkinson disease (n = 111) and healthy subjects (n = 200) were enrolled. The Spectralis optical coherence tomography was used to obtain retinal nerve fiber layer thickness and retinal measurements. Two linear discriminant functions (LDFs) were developed, one using retinal nerve fiber layer parameters and another using retinal thickness. A validating set was used to test the performance of both LDFs. Receiver operating characteristic curves were plotted and compared with the standard parameters provided by optical coherence tomography for both LDFs. Sensitivity and specificity were used to evaluate diagnostic performance., Results: The Retinal LDF combines only retinal thickness parameters and provided the best performance: 31.173 + 0.026 × temporal outer - 0.267 × superior outer + 0.159 × nasal outer - 0.197 × inferior outer - 0.060 × superior inner + 0.049 × foveal thickness. The largest areas under the receiver operating characteristic curve were 0.902 for Retinal LDF. The Retinal LDF yielded the highest sensitivity values., Conclusion: Measurements of retinal thickness differentiate between subjects who are healthy and those with advanced Parkinson disease.

Purpose: To evaluate the effect of uncomplicated cataract phacoemulsification on macular and retinal nerve fiber layer (RNFL) thickness using two spectral-domain optical coherence tomography (OCT) instruments, Cirrus OCT and Spectralis OCT, in patients having non-insulin-dependent diabetes mellitus (NIDDM) without retinopathy, and to assess the reliability of the OCT measurements before and after cataract surgery., Methods: The study included 35 eyes of 35 patients having NIDDM without retinopathy (20 men and 15 women, mean age 69.8 years, range, 48-80 years) who underwent cataract phacoemulsification. One month before and 1 month after surgery, visual acuity and three repetitions of scans using the RNFL and macular analysis protocols of the Cirrus and Spectralis OCT instruments were performed. The differences between the two visits were analyzed by Student's t-test for paired samples. Repeatability of OCT measurements was evaluated by calculating the coefficients of variation for each of the parameters recorded and for each visit., Results: RNFL thicknesses provided by Cirrus and Spectralis OCT and macular measurements provided by Cirrus OCT differed significantly between the two visits. Macular thicknesses provided by Spectralis OCT before and after surgery were not significantly different. OCT repeatability was better after surgery with lower coefficients of variation for scans performed after surgical removal of the cataract., Conclusions: The presence of cataracts affects RNFL and macular measurements performed with OCT in NIDDM patients without retinopathy. The repeatability of the images significantly improved after cataract phacoemulsification.

Purpose: To evaluate the ability of time-domain and Fourier-domain optical coherence tomographies (OCTs) to detect macular and retinal nerve fiber layer atrophies in retinitis pigmentosa (RP). To test the intrasession reproducibility using three OCT instruments (Stratus, Cirrus, and Spectralis)., Methods: Eighty eyes of 80 subjects (40 RP patients and 40 healthy subjects) underwent a visual field examination, together with 3 macular scans and 3 optic disk evaluations by the same experienced examiner using 3 OCT instruments. Differences between healthy and RP eyes were compared. The relationship between measurements with each OCT instrument was evaluated. Repeatability was studied by intraclass correlation coefficients and coefficients of variation., Results: Macular and retinal nerve fiber layer atrophies were detected in RP patients for all OCT parameters. Macular and retinal nerve fiber layer thicknesses, as determined by the different OCTs, were correlated but significantly different (P < 0.05). Reproducibility was moderately high using Stratus, good using Cirrus and Spectralis, and excellent using the Tru-track technology of Spectralis. In RP eyes, measurements showed higher variability compared with healthy eyes., Conclusion: Differences in thickness measurements existed between OCT instruments, despite there being a high degree of correlation. Fourier-domain OCT can be considered a valid and repeatability technique to detect retinal nerve fiber layer atrophy in RP patients.

Purpose: To compare the performance of Moorfields Regression Analysis (MRA) and optical coherence tomography (OCT) with that of photographic evaluation of the optic nerve head and retinal nerve fiber layer (RNFL) in the application of the Finnish Evidence-Based Guideline for Open-Angle Glaucoma (FEBG-OAG)., Methods: Patients referred for glaucoma evaluation (n=312) and subjects selected from the general population (n=41) were included in the study. All subjects underwent ophthalmic evaluation, optic nerve head stereophotography, monochromatic RNFL photography, Heidelberg retina tomography, OCT, and laser polarimetry evaluation. The subjects were classified based on stereophotographic or MRA and OCT results by applying the FEBG-OAG., Results: The specificity of the FEBG-OAG for detecting normal patients (stereophotography and imaging devices) was 78% (strict criteria) and 100% (liberal criteria). Agreement between the stereophotographic evaluation and evaluation based on MRA and OCT was 70.2%. Classification of subjects with similar management advice based on these evaluations had 70.5% agreement. Central corneal thickness was a confounding factor in glaucoma diagnosis. Large optic disc sizes played a major role in misleading the diagnosis compared to small discs., Conclusions: Central corneal thickness and large optic disc size are confounding factors in glaucoma diagnosis. Moorfields Regression Analysis and OCT allow for objective implementation of the FEBG-OAG compared to conventional stereophotographic evaluation of the neuroretinal structures.

Purpose: To test intrasession, intersession, intervisit and interoperator reproducibility of retinal nerve fibre (RNFL) measurements and retinal thickness in healthy subjects using Cirrus Fourier-domain optical coherence tomography (OCT) (Carl Zeiss Meditec, Inc)., Methods: Seventy-two eyes of 72 healthy subjects were included in the study. All the eyes underwent three 512 × 128 volume cube centred on the fovea and three 360° circular scans centred on the optic disc by one observer. This sequence was redone by another observer on a second visit within a 2-week period. Descriptive statistics, analysis of variance, intraclass correlation coefficients (ICCs) and coefficients of variation (COVs) were calculated for the nine areas corresponding to the Early Treatment Diabetic Retinopathy Study and for quadrants and RNFL clock hr sectors., Results: Retinal thickness and RNFL measurements were highly reproducible. Mean total retinal thickness was 285.2 ± 15.3 μm by observer 1 and 284.2 ± 12.9 μm by observer 2. Mean COV was 1.2%. Mean RNFL average thicknesses were 96.0 ± 7.7 and 95.7 ± 7.9 μm by observer 1 and 2, respectively. Mean COV was 4.4%. The ICCs ranged from 0.823 to 0.992. Mean differences between both operators were lower than 3 μm, and no significant differences were found., Conclusions: Retinal and RNFL thickness measurements obtained using Cirrus OCT show good repeatability for healthy eyes and few differences between intra- and interobserver evaluations. It can be considered a valid device for measuring retinal and optic nerve parameters in normal eyes., (© 2010 The Authors. Acta Ophthalmologica © 2010 Acta Ophthalmologica Scandinavica Foundation.)

Purpose To present two related cases with Duane Radial Ray syndrome, ophthalmologic affectation with Duane syndrome and retinal nerve fiber layer (RNFL) hypoplasia. Methods The first patient (15‐years woman) showed Duane syndrome, reduction of visual acuity and pale optic discs. The other patient (12 years woman) presented Duane malformation. Both patients underwent a complete ophthalmologic evaluation with best corrected visual acuity, visual field examination, optical coherence tomography (OCT), scanning laser polarimetry, visual evoked potentials, pattern electroretinogram, and a genetic study. Results OCT and scanning laser polarimetry showed diffuse decrease of RNFL thickness, mainly left eye, retaining the typical morphology as double hump, in patient 1. Neurophysiology evaluation showed decrease in amplitudes of visual evoked potentials and pattern electroretinogram, and increased latency of P100 component. Neuro‐ophthalmologic exploration in patient 2 showed subclinical reduction of RNFL average thickness provided by OCT and increase of P50 and N95 latency by pattern electroretinogram. RNFL average thickness presents reduced scores in both patients, but without glaucomatous morphology. Conclusion Duane radial ray syndrome, also named Okihiro syndrome, may affect retinal nerve fiber layer development and visual acuity. [ABSTRACT FROM AUTHOR]