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Our previous studies showed that in patients with brain diseases, neurotrophic factors in lacrimal fluid (LF) may change more prominently than in blood serum (BS). Since glial cell line-derived neurotrophic factor (GDNF) is involved in the control of neuronal networks in an epileptic brain, we aimed to assess the GDNF levels in LF and BS as well as the BDNF and the hypothalamic-pituitary-adrenocortical and inflammation indices in BS of patients with focal epilepsy (FE) and epilepsy and comorbid depression (FE + MDD) and to compare them with those of patients with major depressive disorder (MDD) and healthy controls (HC). GDNF levels in BS were similar in patients and HC and higher in FE taking valproates. GDNF levels in LF were significantly lower in all patient groups compared to controls, and independent of drugs used. GDNF concentrations in LF and BS positively correlated in HC, but not in patient groups. BDNF level was lower in BS of patients compared with HC and higher in FE + MDD taking valproates. A reduction in the GDNF level in LF might be an important biomarker of FE. Logistic regression models demonstrated that the probability of FE can be evaluated using GDNF in LF and BDNF in BS; that of MDD using GDNF in LF and cortisol and TNF-α in BS; and that of epilepsy with MDD using GDNF in LF and TNF-α and BDNF in BS.

Background: Many studies indicate a significant role of GDNF in the pathogenesis of the mood disorders, including bipolar disorder (BD) and major depressive disorder (MDD). Potentially, neurotrophic factors in lacrimal fluid (LF) could become biomarkers of various specific disorders. The aim of this study was to assess GDNF levels in LF and blood serum (BS) of patients with a current depressive episode (cDE)., Methods: We studied the glial cell line-derived neurotrophic factor (GDNF) concentration in the LF and BS of 39 healthy controls and 137 patients with a current depressive episode (cDE) (both subgroups members were 20-49 years): BD - 46 patients, MDD - 91 patients., Results: GDNF concentration in BS of women with MDD was significantly lower than in men. In BD patients, univariate linear regression analysis revealed significant correlations between GDNF concentration in the LF and the use of anxiolytics or antidepressants. These correlations were confirmed by the multivariate linear regression analysis. A significant correlation between GDNF concentrations in the LF and BS was found in controls., Limitations: The unequal proportion of men in the BD group did not permit adjusting GDNF concentrations for sex. The collected LF was stimulated, which could influence GDNF levels. It should also be noted that the patients included in the study were not treatment- naïve., Conclusions: Our findings suggest that GDNF concentration in LF could be a biomarker of the cDE (both unipolar and bipolar), though the sensitivity of this potential biomarker may be lower in depressive patients with anxiety symptoms., Competing Interests: Conflict of interest Authors declare they have no conflict of interest with respect to this study., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Purpose: To study glial cell line-derived neurotrophic factor (GDNF) concentrations in aqueous humor (AH), lacrimal fluid (LF), and blood serum (BS) in patients with age-related cataract and primary open-angle glaucoma (POAG)., Methods: GDNF was studied in AH, LF, and BS in 47 patients with age-related cataract, and 30 patients with POAG combined with cataract (one eye in each person). AH was sampled during cataract surgery., Results: GDNF concentration (pg/ml) in patients with POAG and cataract was lower than in cataract-only patients (p<0.001), both in AH (46.3±31.1 versus 88.9±46.9) and in LF (222±101 versus 344±134). The difference was not significant for the GDNF concentration in BS (194±56 versus 201±45). In the earlier (early and moderate) stages of POAG, compared to later (advanced and severe) stages, GDNF concentration was significantly lower in LF (176±99 versus 258±91; p = 0.027) and in BS (165±42 versus 217±55; p = 0.017), while GDNF concentration in AH showed an insignificant difference (40.0±25.7 versus 51.1±34.7). In patients with POAG, GDNF concentration in LF and BS was inversely correlated with the Humphrey visual field index: Pearson's correlation coefficient r = -0.465 (p = 0.01) for LF and r = -0.399 (p = 0.029) for BS. When compared to the cataract group, patients in the earlier stages of POAG showed significantly lower GDNF concentrations in all studied biologic fluids., Conclusions: Compared to patients with cataract only, GDNF levels are lower in the AH and LF of patients with POAG and cataract, especially at earlier stages of the disease (at these stages, the GDNF level in BS is also lower). At earlier stages of POAG, compared to later stages, GDNF content is lower in LF and BS. These data could serve as a reason for the therapeutic use of GDNF in patients with POAG., (Copyright © 2022 Molecular Vision.)

Purpose: To investigate the dependence of the area of the foveal avascular zone (FAZ) on axial eye length (AL) and to develop a feasible method for correcting this dependence., Material and Methods: The study involved 209 patients over the age of 18 years (209 eyes), of them 52 patients with AL of 20-22 mm (hyperopia group), 60 patients with AL of 25.5-28.5 mm (myopia group) and 97 patients with AL of 22.5-24.5 mm (emmetropia group). Optical coherence tomography angiography (OCTA) examination was performed on Cirrus HD-OCT 5000 with AngioPlex («Carl Zeiss Meditec», Germany)., Results: FAZ area was corrected using the Littmann-Bennett formula modified by A.A. Shpak and M.V. Korobkova. FAZ area values both in emmetropic patients and in patients with refractive errors varied over a very wide range. Before correction, AL had a significant influence on the FAZ area (mm 2 ), which compared to the emmetropia group (0.27±0.09) was significantly reduced in the myopia group (0.21±0.07; p <0.000) and increased in the hyperopia group (0.31±0.11; p =0.015). The corrected FAZ area values did not differ in the compared groups. After correction the FAZ area decreased on average by 19% in the hyperopia group and increased by 25% in the myopia group. A chart and an Excel (Microsoft)/LibreOffice Calc program have been developed for correction of the FAZ area depending on the AL., Conclusion: Refractive errors, especially high-degree ones, have a significant effect on the FAZ area. This study proposes an original chart and a calculation program for correct interpretation of FAZ area measurements in patients with refractive errors, providing an accessible and quick way to assess the obtained results.

Significance: Optical coherence tomography (OCT) measurements of peripapillary retinal nerve fiber layer (pRNFL) play an important role in the diagnosis of glaucoma and optic atrophy. However, the interpretation of these measurements in patients with refractive errors, especially of a high degree, presents great difficulties. Optical coherence tomography instruments from most manufacturers do not take into account the effect of refractive errors, especially of a high degree, on quantitative measurements of pRNFL., Purpose: The aim of this study was to develop a simple and easy method for evaluation of average pRNFL in eyes with refractive errors., Methods: Average pRNFL was measured by Cirrus HD-OCT (Carl Zeiss Meditec Inc., Dublin, CA) in 183 healthy White subjects (183 eyes) older than 40 years, with an axial length of the eye from 22.5 to 24.5 mm and spherical equivalent of refraction from -1.63 to 2.0 D., Results: For an average pRNFL, normative database of eyes with refraction close to emmetropia was constructed. The calculated first and fifth percentiles for age groups 41 to 50, 51 to 60, 61 to 70, and 71 to 85 years were 81 and 83, 79 and 81, 78 and 80, and 76 and 79 μm, respectively. Littmann-Bennett formula was modified to calculate a table containing first and fifth percentiles for eyes with axial lengths of 19 to 30 mm in the same age groups., Conclusions: For the correct interpretation of the measurements of pRNFL in patients with refractive errors, an original table was proposed, which provides a quick assessment of the results obtained on the Cirrus HD-OCT device. The proposed new formulas make it easy to calculate a similar table for any optical coherence tomography device using existing databases or after collecting a normative database of eyes with refraction close to emmetropia., Competing Interests: Conflict of Interest Disclosure: None of the authors have reported a financial conflict of interest., (Copyright © 2021 American Academy of Optometry.)

Objective: To evaluate brain-derived neurotrophic factor (BDNF) level in blood serum (BS) and lacrimal fluid (LF) of people with epilepsy (PWE)., Methods: It was a case-control study of 72 consecutive patients with focal epilepsy (cases, Epilepsy group) and 60 age- and gender-matched healthy volunteers (controls). Based on comorbid depression, two subgroups of PWE were formed. BDNF level was measured by enzyme-linked immunosorbent assay (ELISA) in BS and LF., Results: Compared to controls, BDNF level (pg/mL) in PWE was lower both in BS (22,520 ± 3810 vs. 26,360 ± 3090, P < 0.000) and in LF (100.8 ± 23.3 vs. 113.4 ± 19.3, P = 0.001). However, no significant correlation was found between BDNF level in BS and LF either in the Epilepsy group or in controls. No impact of comorbid depression on BDNF level was found either in BS or LF of PWE. We revealed a higher BDNF level in LF of men as compared to women in controls and a similar non-significant trend in PWE. Higher BDNF level in BS of PWE receiving valproates versus other AEDs was found, however, a relatively small number of observations and use of polytherapy in most cases should be taken into account., Significance: In patients with focal epilepsy, BDNF level is decreased both in BS and LF, though with no correlation between them. No association of BDNF levels with age and epilepsy characteristics, as well as the occurrence of depression, was found. Low BDNF level in LF could be considered as a non-invasive biomarker of focal epilepsy., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Purpose: To compare the results of treatment of idiopathic full-thickness macular holes (MHs) with and without the use of autologous platelet-rich plasma (APRP)., Methods: This partially retrospective study included 152 patients (152 eyes) with MHs operated in the years 2010-2014 using conventional technology with internal limiting membrane peeling (control group) and 62 patients (62 eyes), operated by the same surgeons in 2015-2017 with additional application of APRP on MH (platelet group). Pre and postoperative best-corrected visual acuities (BCVA) were recorded, and retinal microstructure was studied using optical coherence tomography. Thirty-seven patients in the platelet group and 80 controls were followed for at least 12 months (for visual outcomes 15 controls were followed for 15-24 months). The data of 72 controls (72 eyes) were analyzed retrospectively., Results: The minimum diameter of the MH in the platelet group was larger than in controls: 454 ± 186 vsersus 381 ± 148 μm (P = 0.003). Despite this, all MHs in the platelet group were closed, while in the control group 11 holes (7.2%) remained open (P = 0.036). The final mean BCVA, standardized by the minimum diameter of the macular hole, was higher in the platelet group by 3.9 ETDRS letters (P = 0.012). After surgery with APRP, foveal hyperreflective lesion (presumably glial proliferation) was found, which persisted in most large MHs, but gradually disappeared in small and most medium MHs., Conclusion: The use of APRP significantly improves the anatomical and functional results of treatment of idiopathic MHs. In very large MHs, APRP presumably enhances glial proliferation, which ensures their closure.

Purpose: The purpose of this study was to analyze the natural history and phenotypic overlap of patients with microcephaly and a chorioretinopathy or familial exudative vitreoretinopathy (FEVR) ocular phenotype caused by mutations in KIF11, TUBGCP4, or TUBGCP6., Methods: Patients diagnosed with congenital microcephaly and chorioretinopathy or FEVR were included. Molecular investigations consisted of targeted genetic sequencing. Data from medical records, ophthalmologic examination and imaging, electroretinography, and visual fields were analyzed for systemic and ophthalmic features and evidence of posterior segment disease progression., Results: Twelve patients from 9 families were included and had a median of 8 years of follow-up. Nine patients had KIF11 variants, two had heterozygous TUBGCP6 variants, and one had heterozygous variants in TUBGCP4. All patients had reduced visual function and multiple individuals and families showed features of both chorioretinopathy and FEVR. Progression of posterior segment disease was highly variable, with some degree of increased atrophy of the macula or peripheral retina or increased vitreoretinal traction observed in 9 of 12 patients., Conclusions: Microcephaly due to mutations in KIF11, TUBGCP4, or TUBGCP6 can be associated with retinal disease on a spectrum from chorioretinal atrophy to FEVR-like posterior segment changes. Visually significant disease progression can occur and patients should be monitored closely by a team experienced in ophthalmic genetics.

The issue of indications for surgical treatment of lamellar macular holes (LMH) remains debatable, especially considering the different opinions about the possibility of their progression., Purpose: To study natural course of LMH and to develop criteria of their progression., Material and Methods: The study analyses retrospective data of patients with LMH observed in S. Fyodorov Eye Microsurgery Federal State Institution from 2013 to 2018 who were examined by optical coherence tomography (OCT) at least 2 times with an interval between the initial and last examinations of at least 6 months. The examinations were carried out to evaluate the types of LMH and epiretinal membrane, the ellipsoid zone of photoreceptors and vitreoretinal interface, as well as calculate the changes in the quantitative parameters of the LMH., Results: One hundred and three patients with LMH were identified; data of 65 patients (65 eyes) was studied in detail. The follow-up lasted 20.5±12.9 months on average. Statistically substantiated criteria for the progression of tractional and degenerative LMH were developed, taking into account the OCT changes most significant for each type of LMH. According to the proposed criteria, signs of marked progression were found in 2 (5.3%) of 38 patients with tractional and 4 (14.8%) of 27 patients with degenerative LMH. Moderate progression was detected in 2 (5.3%) patients with tractional and 2 (7.4%) patients with degenerative LMH. In two patients who were not included in the groups for calculating the criteria for progression, the formation of a full-thickness macular hole has occurred., Conclusion: One of the variants of the natural course of LMH can be its progression up to transition into a full-thickness macular hole. The proposed statistically substantiated criteria allows identifying dangerous progression of LMH, which should be taken into account when determining the treatment tactics.

Purpose: The present study aimed to determine the main cause of ganglion cell-inner plexiform layer (GCIPL) thinning in long myopic eyes., Methods: Optical coherence tomography was performed in 53 subjects with moderate or high myopia (53 eyes; myopia group) and 20 emmetropic subjects (20 eyes; control group). All subjects were over the age of 40 years., Results: Compared groups did not differ in age, sex, and radius of corneal curvature. Spherical equivalent in the myopia group was - 8.2 ± 3.3 D (from - 4.0 to - 22.6 D). A specialized computer program was created to study the effect of the ocular magnification on the average GCIPL thickness. Based on the data of control subjects, a mathematical model was constructed, which showed a very little effect of ocular magnification on GCIPL thickness. It was confirmed by real measurements. After correction by the program, GCIPL thickness in myopes increased only slightly (from 73.9 ± 5.2 to 75.0 ± 5.2 μm, P < 0.000) remaining much lower than in controls (79.7 ± 6.3 μm, P < 0.000). Modeling myopic eye as an ellipsoid showed a significant increase in its surface area compared with emmetropia. Retinal stretching associated with an increase in the surface area of the eyeball explained most of the thinning of GCIPL in myopia., Conclusions: Ocular magnification is responsible for only a minor part of GCIPL thinning in myopia. Stretching of the retina in a long eye is the main cause of the GCIPL thinning. Myopic normative databases should be created to account for the GCIPL thinning in highly myopic eyes.

Introduction: One important question for patients with both myopia and glaucoma is comparability of optical coherence tomography (OCT) data obtained before and after a significant change in eye refraction following cataract extraction surgery with implantation of intraocular lens (IOL)., Purpose: To assess the impact of correcting moderate and high myopia during cataract phacoemulsification with IOL implantation (Phaco/IOL) on the parameters measured by OCT., Material and Methods: OCT was performed in 31 patients (31 eyes) with axial eye length of more than 25.5 mm before and the day after Phaco/IOL. Changes in 17 parameters of the retina, retinal ganglion cells-inner plexiform layer (GCIPL), peripapillary retinal nerve fiber layer (RNFL) and optic nerve head (ONH) were analyzed., Results: Axial eye length was 26.94±1.09 mm in average (25.57-29.39 mm). The average refractive effect of the intervention was 8.44±4.16 D (3.75-19.0 Diopters). Signal strength in all OCT protocols was no lower than 5. Changes in the average values of OCT parameters after surgery were insignificant. They exceeded 1% of the pre-operation values only in 7 cases, including all 5 parameters of the ONH, and were significant only in 5 out of 17 parameters. For GCIPL and RNFL thickness, the changes on average did not exceed 0.9 μm, for retinal thickness in the macular area - 2.1 μm. In relative terms, the largest decrease (an average of -0.03 mm 2 ; -2.5%) was in the optic disc area., Conclusion: In patients with high and moderate myopia, the parameters of the retina, RNFL, GCIPL, and ONH, as measured by OCT, changed insignificantly on the first day after Phaco/IOL (considering the signal strength of Cirrus HD-OCT device was not lower than 5).

Purpose: To study brain-derived neurotrophic factor (BDNF) content in aqueous humor (AH), lacrimal fluid (LF), and blood serum (BS) in patients with age-related cataract and primary open-angle glaucoma (POAG)., Methods: BDNF was studied in 57 patients with age-related cataract, 55 patients with POAG combined with cataract, and 29 healthy controls (one eye in each person). AH was sampled during cataract surgery., Results: The levels of BDNF in LF and BS did not differ in cataract patients and controls. The concentration of BDNF (pg/mL) in patients with POAG and cataract was lower than in cataract patients in AH (35.2 ± 14.2 vs. 54.6 ± 29.6, P < 0.001), LF (78.0 ± 25.1 vs. 116.2 ± 43.1, P < 0.001), and BS (19230 ± 5960 vs. 22440 ± 7580, P < 0.02), while the AH/LF ratio was similar (0.46 ± 0.18 vs. 0.48 ± 0.19). The AH level of BDNF declined in early POAG and relatively increased in the next stages of the disease, inversely correlating with visual field index (Pearson's correlation coefficient r = -0.404, P = 0.002) and average retinal nerve fiber layer thickness (r = -0.322, P = 0.018). BDNF contents in LF and BS were also the lowest in early POAG. BDNF in AH strongly correlated with its content in LF (r = 0.66, P < 0.000). A formula was suggested to calculate the AH concentration of BDNF basing on its content in LF., Conclusions: BDNF contents are decreased in AH, LF, and BS of patients with POAG demonstrating a significant decrease in the early POAG and relative increase in the next stages of the disease. A strong correlation exists between BDNF contents in AH and LF.

The effect of significant changes in corneal power after refractive surgery on the parameters of optical coherence tomography (OCT) has not been sufficiently studied., Purpose: To study effects of corneal refractive surgery on optical coherence tomography (OCT) measurements in patients with moderate and high myopia., Material and Methods: OCT was performed in 62 patients (62 eyes) with myopia over 4 D before and one month after LASIK. The changes in 14 parameters of the thickness of the retina, ganglion cell-inner plexiform layer (GCIPL) and peripapillary retinal nerve fiber layer (pRNFL) were analyzed., Results: The mean refractive effect was 7.07±2.02 D (4.0 to 11.75 D). Postoperative changes in the parameters analyzed were insignificant, averaging not more than 1.3% of the baseline value with the exception of pRNFL thickness in the temporal quadrant (2.2%). Only six of the 14 parameters were statistically significant - retinal thickness in the central subfield and the inner nasal quadrant, average and minimum thickness of GCIPL, and pRNFL thickness (mean and in the temporal quadrant). Individual changes of the parameters in most patients did not exceed the error of method., Conclusion: In patients with moderate to high myopia, LASIK operation has only a slight effect on the OCT parameters of the retina and pRNFL. Only in patients with very high myopia, the decrease over 10 D in corneal refractive power creates an optical effect of increasing the average thickness of pRNFL and GCIPL by 2-3 μm. This should be taken into account when examining such patients for glaucoma.

Purpose: To study the ciliary neurotrophic factor (CNTF) concentration in the aqueous humor (AH), lacrimal fluid (LF), and blood serum (BS) in patients with age-related cataract and primary open-angle glaucoma (POAG)., Methods: CNTF concentrations were studied in 61 patients with age-related cataract, 55 patients with POAG combined with cataract, and 29 healthy controls (one eye in each person). Preliminary experiments permitted us to extend the minimum quantifiable value of the CNTF Quantikine enzyme-linked immunosorbent assay (ELISA) kit to 2.5 pg/ml., Results: The levels of CNTF in LF and BS did not differ in patients with cataract and controls. The CNTF concentration (pg/ml) in patients with POAG and cataract was lower than in patients with cataract (p<0.001) in AH (39.9±26.2 versus 57.2±25.6) and in LF (25.7±14.9 versus 39.9±18.0). The differences were not statistically significant for the CNTF level in BS (5.45±4.72 versus 5.96±4.92) and the AH/LF ratio (1.69±1.05 versus 1.58±0.70). In the patients with POAG, the AH level of CNTF correlated with the visual field index (Pearson's correlation coefficient r = 0.35, p = 0.01). A statistically significant decrease in the AH and LF concentrations of CNTF was observed in patients in all stages of POAG compared with the cataract group. This decrease was particularly prominent in patients with severe glaucoma. Compared to patients with combined early and moderate stages of disease patients with advanced glaucoma showed an insignificant reduction in the median CNTF concentration in AH and LF. The serum CNTF concentration did not show any dependence on the glaucoma stage. The CNTF concentration in the AH strongly correlated with the CNTF concentration in the LF (r=0.71, p<0.000). A formula was suggested to calculate the concentration of CNTF in AH based on the CNTF concentration in LF., Conclusions: The CNTF concentration is reduced in the AH and LF of patients with POAG, especially in those with severe visual field loss. The CNTF concentration in AH and LF showed a strong correlation, and this phenomenon opens up new options for a noninvasive estimation of the CNTF concentration in AH. The CNTF concentration established in the AH, LF, and BS of patients with age-related cataract can serve as normative data for persons older than 50 years old.

Aim: To study the dynamics of visual status and its correlation with morphological changes in patients operated for idiopathic macular hole (IMH)., Material and Methods: The study enrolled 78 patients (82 eyes) whose ocular media remained transparent throughout the whole follow-up period that started 1 month after a successful IMH surgery and lasted for no less than a year. Two equivalent subgroups, 29 patients (30 eyes) each, were then formed and designated as «transparent media» (pseudophakic patients or those who remained free of cataract over the follow-up period) and «comparison»., Results: Only patients from the «transparent media» subgroup have consistently improved their visual functions by the end of the first year after surgery. Positive correlation has been found between an increase in best corrected visual acuity (BCVA) and a decrease in the size of the hyporeflective defect within the so called ellipsoid zone (correlation coefficient r=-0.50, p<0.01). The correlation was the strongest at months 3 and 12 (r=-0.57, p<0.01). It was also noticed that the lower BCVA at baseline the greater the treatment effect (ETDRS chart; r=-0.93, p<0.000). As a result, at the end of the follow-up period, BCVA varied little, reaching 0.5--1.0 in 76 cases and 0.3--0.4 in the remaining 6 cases., Conclusion: Modern IMH surgery ensures restoration of the outer retinal structure and high visual functions in most patients over a long term (more than a year of follow-up) on the only condition of transparent ocular media. Thus, the prediction of postoperative VA is of low significance in these patients.

Aim: To determine the parameters most informative in predicting the anatomical results of surgical treatment of idiopathic full-thickness macular hole (IMH)., Methods: One hundred and sixty-two consecutive patients (170 eyes) after primary operation for IMH were enrolled. Outcomes were classified as anatomical success when both IMH closure and restoration of the outer retinal structure were achieved. "Prospective" group included 108 patients (115 eyes) followed with optical coherence tomography (OCT) and microperimetry for 1y after surgery. Potential prognostic criteria, except microperimetry data, were tested in "retrospective" group (54 patients, 55 eyes). Prognostic value of each parameter was determined using receiver operating characteristic (ROC) analysis. Combined predictive power of the best prognostic parameters was tested with the use of linear discriminant analysis., Results: IMH closure was achieved in 106 eyes (92%) in the prospective group and 49 eyes (89%) in the retrospective group. Despite anatomical closure, the outer retinal structure was not restored in two eyes in the first group and in one eye in the second group. Preoperative central subfield retinal thickness demonstrated the best discriminatory capability between eyes with anatomical success and failure: area under the ROC-curve (AUC) 0.938 (95% CI: 0.881-0.995), sensitivity 64% at fixed specificity 95% (cut-off value 300 µm) in the prospective group; sensitivity 57% and specificity 90% in the retrospective group. Other continuous parameters except tractional hole index (AUC: 0.796, 95% CI: 0.591-1.000) had significantly lower AUCs (P<0.05). The best combination of the parameters, established by discriminant analysis in the prospective group, could not confirm its predictive value in the retrospective group., Conclusion: Preoperative central subfield retinal thickness is a strong and probably the best predictor of anatomical results of IMH surgical treatment.

Purpose: To use anterior segment optical coherence tomography (AS-OCT) to evaluate the clinical effectiveness of Implantable Collamer Lens posterior chamber phakic intraocular lens (PC pIOL) sizing based on measurement of the distance from the iris pigment end to the iris pigment end., Setting: S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia., Design: Evaluation of diagnostic test or technology., Methods: Stage 1 was a prospective study. The sulcus-to-sulcus (STS) distance was measured using ultrasound biomicroscopy (UBM) (Vumax 2), and the distance from iris pigment end to iris pigment end was assessed using a proposed AS-OCT algorithm. Part 2 used retrospective data from patients after implantation of a PC pIOL with the size selected according to AS-OCT (Visante) measurements of the distance from iris pigment end to iris pigment end. The PC pIOL vault was measured by AS-OCT, and adverse events were assessed., Results: Stage 1 comprised 32 eyes of 32 myopic patients (mean age 28.4 years ± 6.3 [SD]; mean spherical equivalent [SE] -13.11 ± 4.28 diopters [D]). Stage 2 comprised 29 eyes of 16 patients (mean age 27.7 ± 4.7 years; mean SE -16.55 ± 3.65 D). The mean STS distance (12.35 ± 0.47 mm) was similar to the mean distance from iris pigment end to iris pigment end distance (examiner 1: 12.36 ± 0.51 mm; examiner 2: 12.37 ± 0.53 mm). The PC pIOL sized using the new AS-OCT algorithm had a mean vault of 0.53 ± 0.18 mm and did not produce adverse events during the 12-month follow-up. In 16 of 29 eyes, the PC pIOL vault was within an optimum interval (0.35 to 0.70 mm)., Conclusion: The new measurement algorithm can be effectively used for PC pIOL sizing., Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned., (Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)

A total of 92 patients (92 eyes), including 52 patients with early-stage primary open-angle glaucoma and 40 glaucoma suspects, were enrolled in the study and followed up during 25.5 +/- 3.3 months on the average by means of computer perimetry, optical coherence tomography and Heidelberg retinal tomography. The prognoses for POAG progression made on the basis of these tests using both conventional (conservative) and extended (liberal) evaluation criteria demonstrated poor correspondence. It is suggested to consider glaucoma progression confirmed if characteristic changes are registered by at least two of the three methods.

The new Cirrus HD-OCT software was used to measure the thickness of ganglion cell and inner plexiform layers (GCIPL) in macular region in 56 patients (56 eyes) with early-stage primary open-angle glaucoma (POAG) and 53 healthy controls (53 eyes). The diagnostic value of the best parameters of GCIPL for POAG detection was insignificantly lower as compared to the best parameters of the peripapillary retinal nerve fiber layer and optic nerve head.

Purpose: To study the accommodative changes in the central anterior chamber depth (ACD) in patients with high myopia using anterior segment optical coherence tomography (AS-OCT)., Setting: Cataract Surgery Department and Clinical & Functional Diagnostics Department, S. Fyodorov Eye Microsurgery Complex-Federal State Institution, Moscow, Russian Federation., Design: Prospective case-control study., Methods: The ACD measurements were obtained in the nonaccommodative state (baseline) and during accommodation using the Visante AS-OCT device., Results: Thirty-six myopic eyes (36 patients; mean age 27 years; mean spherical equivalent (SE) -12.52 diopters [D]) and 31 emmetropic eyes (31 subjects; mean age 26 years; mean SE -0.39 D) were examined. At baseline, the mean ACD in both groups was similar. During accommodation, the mean maximum changes in the ACD were significantly less pronounced in the myopia group (-0.14 mm ± 0.07 [SD]; range -0.03 to -0.29 mm) than in the emmetropia group (-0.22 ± 0.08 mm; range -0.04 to -0.35 mm) (P<.0001). Ten patients in the myopia group had a critically shallow anterior chamber (ACD <2.8 mm) in the state of accommodation., Conclusions: Accommodative changes in the ACD were significantly less pronounced in eyes with high myopia than in emmetropic eyes. Still, the anterior chamber might become critically shallow during accommodation in some myopic eyes, and this should be taken into account when planning phakic intraocular lens implantation to correct high myopia., Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned., (Copyright © 2012 ASCRS and ESCRS. All rights reserved.)

Macula changes diagnosed with optical coherence tomography (OCT) within a year after cataract phacoemulsification (PE) with intraocular lens implantation with and without yellow filter are presented. 32 patients (36 eyes) with early stages of age macular degeneration (AMD) were included into the experimental group and 35 patients (36 eyes) served as controls. IOLs with yellow filter were implanted in 21 eyes, and in 15 cases IOLs without filter were used in each group. According to OCT data thickening of fovea and increasing of macula volume developed within 6 months after cataract PE. Implantation of yellow filter IOLs reduced the intensity of these changes after surgery in patients with AMD. The progression of early AMD into advanced stages within a year after PE was not observed.

Two clinical cases of children with foveal hypoplasia and high visual acuity examined using optical coherence tomography are presented. Genetic examination found oculocutaneous albinism type 1 in one patient. Potential causes and functional value of foveal hypoplasia are discussed.

Background: To compare the measurement error of Cirrus HD-OCT and Heidelberg Retina Tomograph 3 (HRT3) in patients with early glaucomatous visual field defect., Methods: Thirty-nine consecutive patients (39 eyes) with early glaucomatous visual field defect were included. One eye of a patient was examined with Cirrus HD-OCT and HRT3 in one session. Each instrument was used by two operators, each taking two measurements in turn. We performed measurements of average retinal nerve fiber layer (RNFL) thickness and RNFL thickness in four quadrants with Cirrus HD-OCT and 13 stereometric parameters of the optic nerve head and RNFL with HRT3., Results: Cirrus HD-OCT parameters performed much better than HRT3 stereometric parameters. Mean (for both operators) intraoperator within-subject coefficient of variation of the best Cirrus HD-OCT parameter (average RNFL thickness) was 2.6-2.7 times lower than the best HRT3 parameters [mean cup depth and rim area (P < 0.001)]. Mean intraoperator variability of RNFL thickness in quadrants (except nasal quadrant) was also significantly lower with OCT than with HRT. The interoperator within-subject coefficients of variation for both average RNFL thickness and RNFL thickness in all quadrants were significantly lower than the interoperator variability of best HRT3 parameter [mean cup depth (P < 0.001)]. The within-subject coefficient of variation of the average/mean RNFL thickness assessed by both instruments was 5.4-7.3 times lower for Cirrus HD-OCT. Among HRT3 parameters, mean cup depth, rim area and linear cup/disk ratio were the least variable, while cup volume, cup area and cup/disc area ratio were the most variable parameters., Conclusions: Cirrus HD-OCT provides excellent intrasession intra- and interoperator repeatability of the RNFL measurements, especially of the average RNFL thickness in primary open-angle glaucoma (POAG) patients and POAG suspects with early glaucomatous visual field defect. The measurement error (expressed as within-subject coefficient of variation) of RNFL measurements by Cirrus HD-OCT is much lower than the error of HRT3 measurements of stereometric parameters of the optic nerve head and RNFL.

29 patients with initial primary open angle glaucoma were examined using Heidelberg retinal tomograph III (HRT III), factors influencing measurements reproducibility and variability were studied. The following factors were found to cause outliers in stereometric parameters of the optic nerve head and retinal nerve fiber layer: standard reference height showing large difference of measurements or very high values, significant difference of scan depth, small optic disc, astigmatism, old age, interobserver variability of disc area (contour line position). Considering these factors one can determine indications for control examination thus improving method accuracy.

29 patients with initial primary open angle glaucoma were examined using Heidelberg retinal tomograph III (HRT III). In one visit 2 observers took 2 measurements. Intra- and interobserver errors (reproducibility and intraobserver variability coefficient) were calculated for 13 stereometric parameters of optic disc and retinal nerve fiber layer (RNFL). Rim area, cup depth (mean, maximum) and linear cup/disc ratios showed to be minimally variable. Cup area and volume, disc/cup area ratio were found to have greater variability. When performed by different observers (each entering his own contour) reproducibility was 1,4 fold lower compared with intraobserver reproducibility.

The aim was to study reproducibility and variability of measurements of retinal nerve fiber layer (RNFL) using spectral-domain optical coherence tomography (SOCT) and to compare with error of Heidelberg retinal tomograph (HRT). 29 patients with initial primary open-angle glaucoma were examined using Heidelberg retinal tomograph III (HRT III) and SOCT (Cirrus HD-OCT). Intra- and interobserver errors (reproducibility and intraobserver variability coefficient) for mean RNFL thickness and its thickness in temporal, upper, nasal and inferior quadrants. Mean RNFL thickness measured with SD-OCT showed the highest intra- and interobserver reproducibility and minimal variability. Intraobserver variability coefficient was 3 times lower as compared with the best parameter measured with HRT (rim area) and it was 7 fold lower as compared with mean RNFL thickness measured with HRT. Thus study of RNFL using SD-OCT showed high reproducibility and low variability particularly for mean RNFL thickness. The measurement error of SOCT is lower as compared with HRT and provides the most accurate study of RNFL.

Two similar groups of healthy individuals were examined by optical coherence tomography (OCT) on a Stratus OCT 3000 (Carl Zeiss Meditec, Inc. USA) (n = 26) and by spectral OCT on a 3D OCT-1000 (Topcon, Japan) (n = 25). Each of two operators made two peripapillary retinal nerve fiber layer measurements during a session. The measurement error indicators (intraindividual standard deviation and repeatability rate) were determined for each of the operators and in the comparison of the latter. Spectral OCT ensured a reduction in the measurement error indicators as compared with classical OCT, which was significant when the measurement was made by a rather skilled operator.

Thirteen healthy individuals and 27 patients with diabetic retinopathy were examined (23 patients (23 eyes) with diabetic retinopathy being selected for analysis). The proposed indicator of optic nerve head (ONH) edema from the data of optical coherence tomography could more frequently diagnose asymptomatic ONH edema due to the detection of its early forms on 5 of the 23 eyes versus 3 eyes, as evidenced by biomicroophthalmoscopy (slit-lamp ophthalmoscopy). The patients were found to have a drastic reduction in the level of brain-derived neutrotrophic factor (BDNF) in plasma and lacrimal fluid. The most marked decrease in plasma BDNF was observed in patients with asymptomatic ONH edema. The tear content of BDNF was particularly low in patients with increased neuroretinal rim volume.

Optical coherence tomography (OCT) was used to examine 33 patients (33 eyes) with choroidal melanoma and 39 patients (39 eyes) with choroidal nevus. The magnitude of changes in the retina and its pigment epithelium above the pigmented choroidal neoplasms was found to be largely in proportion to their sizes. When primarily detected, choroidal melanomas had larger sizes and were significantly more frequently attended by neuroepithelial detachment, retinal edema, and evident impairments in the normal architectonics of the retina and its pigment epithelium above the tumor, neuroepithelial detachment in the foveal area, and these tumors tended to show a higher rate of pigment epithelial detachments above the tumor and foveal edema. However, in the presence of small neoplasm sizes (from 1 mm, but less than 2 mm), the patients with choroidal melanomas were observed to have more frequently neuroepithelial detachment and to tend to have a higher rate of retinal edema above the tumor.