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To compare anterior chamber depth (ACD) and lens thickness (LT) measurements by ultrasound biomicroscopy (UBM), A-scan cross vector (CV) overlay with UBM, and immersion A-scan technique in pediatric eyes. This prospective comparative cohort study comprised 43 eyes of 25 pediatric participants (mean age: 2.3±2.2 y). UBM and immersion A-scan biometry were performed prior to dilation and intraocular surgery. ACD and LT were measured by UBM image analysis, A-scan CV UBM overlay, and immersion A-scan technique. ACD and LT measurements obtained using immersion A-scan were significantly greater than with UBM image analysis with mean differences of 0.52 mm and 0.62 mm, respectively (p < 0.001). Immersion A-scan and UBM measurements were moderately correlated (r = 0.70 and 0.64, p < 0.001). ACD and LT measurements obtained using CV overlay were not significantly different than UBM measurements and the values were strongly positively correlated (r = 0.95 and 0.93, p < 0.001). Immersion A-scan may overestimate ACD and LT compared to UBM in pediatric patients due to oblique placement of the A-scan probe relative to the optical axis. Supplemental use of UBM and/or CV overlay is indicated to improve measurement accuracy in pediatric patients who cannot reliably fixate due to the ability to confirm proper alignment of the probe with the pupil by visualizing the anterior segment. [ABSTRACT FROM AUTHOR]

Purpose: To report a rare case of atopic keratoconjunctivitis (AKC) presenting with bilateral corneal panni associated with limbal inclusion cysts in the left eye. Materials & Methods: Retrospective case report. Results: A 19-year-old female with AKC presented with bilateral corneal panni and limbal inclusion cysts in the left eye. Anterior segment swept-source optical coherence tomography showed bilateral hyperreflective epicorneal membrane and a lobulated cystic lesion in the left eye. Ultrasound biomicroscopy demonstrated a dense membrane overriding the cornea in both eyes and hyporeflective spaces separated by medium reflective septa in the cyst. The patient underwent excision of the limbal inclusion cyst and pannus in the left eye. Histopathological examination revealed subepithelial cystic lesion surrounded by non-keratinizing epithelium; areas of acanthosis, hyperkeratosis, parakeratosis, and hyperplasia in the epithelium of the pannus; as well as inflammation, fibrosis, and increase in vascularization in the stroma. Conclusion: To our knowledge, this is the first case of corneal pannus associated with limbal inclusion cysts in AKC. Surgical excision was done to establish the diagnosis as well as to improve vision in our case. [ABSTRACT FROM AUTHOR]

Background: Accurate prediction of postoperative vault in implantable collamer lens (ICL) implantation is crucial; however, current formulas often fail to account for individual anatomical variations, leading to suboptimal visual outcomes and necessitating improved predictive models. We aimed to verify the prediction accuracy of our new predictive model for vaulting based on anterior and posterior chamber structural parameters. Methods: This retrospective observational study included 137 patients (240 eyes) who previously underwent ICL surgery. Patients were randomly divided into the model establishment (192 eyes) or validation (48 eyes) groups. Preoperative measurements of the anterior and posterior chamber structures were obtained using Pentacam, CASIA2 anterior segment optical coherence tomography (AS-OCT), ultrasound biomicroscopy, and other devices. Stepwise multiple linear regression analysis was used to evaluate the relationship between the vault and each variable (WL formula). The Friedman test was performed for the vaulting prediction results of the WL, NK (Ver. 3), and KS formulas (Ver. 4) in CASIA2 AS-OCT, as well as the Zhu formula and vault measurements. The proportions of prediction error within ± 250 μm per formula were compared. Results: The predicted vault values of the WL, NK, KS, and Zhu formulas and vault measurements were 668.74 ± 162.12, 650.85 ± 248.47, 546.56 ± 128.99, 486.56 ± 210.76, and 716.06 ± 233.84 μm, respectively, with a significant difference (χ2 = 69.883, P = 0.000). Significant differences were also found between the measured vault value and Zhu formula, measured vault value and KS formula, WL formula and Zhu formula, WL formula and KS formula, NK formula and KS formula, and NK formula and Zhu formula (P < 0.001) but not between other groups. The proportions of prediction error within ± 250 μm per formula were as follows: WL formula (81.3%) > NK formula (70.8%) > KS formula (66.7%) > Zhu formula (54.2%). Conclusions: The WL formula, which considers the complexity of the anterior and posterior chamber structures, demonstrates greater calculation accuracy, compared with the KS (Ver. 4) and Zhu formulas. The proportion of absolute prediction error ≤ 250 μm is higher with the WL formula than with the NK formula (ver. 3). This enhanced predictive capability can improve ICL sizing decisions, thereby increasing the safety and efficacy of ICL implantation surgeries. [ABSTRACT FROM AUTHOR]

This study aimed to develop and evaluate a deep learning-based model that could automatically measure anterior segment (AS) parameters on preoperative ultrasound biomicroscopy (UBM) images of implantable Collamer lens (ICL) surgery candidates. A total of 1164 panoramic UBM images were preoperatively obtained from 321 patients who received ICL surgery in the Eye Center of Renmin Hospital of Wuhan University (Wuhan, China) to develop an imaging database. First, the UNet++ network was utilized to segment AS tissues automatically, such as corneal lens and iris. In addition, image processing techniques and geometric localization algorithms were developed to automatically identify the anatomical landmarks (ALs) of pupil diameter (PD), anterior chamber depth (ACD), angle-to-angle distance (ATA), and sulcus-to-sulcus distance (STS). Based on the results of the latter two processes, PD, ACD, ATA, and STS can be measured. Meanwhile, an external dataset of 294 images from Huangshi Aier Eye Hospital was employed to further assess the model's performance in other center. Lastly, a subset of 100 random images from the external test set was chosen to compare the performance of the model with senior experts. Whether in the internal test dataset or external test dataset, using manual labeling as the reference standard, the models achieved a mean Dice coefficient exceeding 0.880. Additionally, the intra-class correlation coefficients (ICCs) of ALs' coordinates were all greater than 0.947, and the percentage of Euclidean distance distribution of ALs within 250 μm was over 95.24%.While the ICCs for PD, ACD, ATA, and STS were greater than 0.957, furthermore, the average relative error (ARE) of PD, ACD, ATA, and STS were below 2.41%. In terms of human versus machine performance, the ICCs between the measurements performed by the model and those by senior experts were all greater than 0.931. A deep learning-based model could measure AS parameters using UBM images of ICL candidates, and exhibited a performance similar to that of a senior ophthalmologist. [ABSTRACT FROM AUTHOR]

To define the regular upper eyelid anatomy and their changes during dynamic motion using ultrasonographically depicted structures. A cross-sectional study. High-resolution ultrasound biomicroscopy (50MHz) was performed on 84 upper eyelids of 42 healthy volunteers without evidence of eyelid conditions. The skin-orbicularis oculi complex (SOOC), levator aponeurosis, and Müller's muscle-conjunctival complex were imaged. The thickness of these structures was measured in primary gaze and downgaze positions. SOOC and levator aponeurosis thickness was bigger with eyes open than with eyes closed (p < 0.01). With eyes closed, the thickness of SOOC on the pupillary midline and levator aponeurosis was positively correlated with age (p < 0.05, p < 0.01, respectively), and the thickness of levator aponeurosis and SOOC on the pupil midline was also positively correlated with BMI index (p < 0.05). Similarly, SOOC thickness on the medial and lateral canthus line is also positively correlated with BMI index and age (p < 0.05, p < 0.01, respectively). As for the differences between genders, the mean thickness of SOOC and levator aponeurosis was statistically different (p < 0.05, respectively). The magnitude of levator aponeurosis thickness in men varied more than in women in different ocular positions (p < 0.05). All measurements had an intramethod between 0.624 and 0.792, and inter-rater ICC and intrarater ICC between 0.748 and 0.850. Ultrasound biomicroscopy represents a noninvasive tool for the visualization of upper eyelid morphology. Expanding its application can help to understand the dynamics of upper eyelid physiological movement, aging, and disease research in different populations and evaluate surgical outcomes. [ABSTRACT FROM AUTHOR]

PurposeTo describe examination and imaging characteristics of presumed iris papulosa in a case of ocular syphilis.ObservationsA 60-year-old man who presented with granulomatous anterior uveitis in his left eye was also noted to have an unusual vascularized iris papule associated with posterior synechiae at the nasal pupillary margin. Anterior segment OCT (AS-OCT) of the iris lesion demonstrated a hyperreflective anterior surface with multiple vascular lumen, internal hyperreflectivity, and shadowing. Ultrasound biomicroscopy (UBM) imaging revealed an echodense mass with relative hyperechogenicity in the anterior portion of the lesion. Systemic work-up confirmed a diagnosis of syphilis, and he was treated with topical steroids and parenteral penicillin.Conclusion and importanceWe characterize the rare finding of iris papulosa that may be encountered in syphilitic uveitis and its distinctive features on both UBM and AS-OCT. This report highlights that syphilis should be considered as a possible diagnosis for an undifferentiated vascular iris mass.

AIM: To investigate the effect of scleral-fixated capsular tension ring(SFCTR)combined with phacoemulsification and intraocular lens(IOL)implantation in the treatment of traumatic lens subluxation.METHODS: A total of 14 patients(14 eyes)who underwent SFCTR combined with phacoemulsification and IOL implantation for traumatic lens subluxation from December 2018 to February 2023 were selected. Visual acuity, intraocular pressure, anterior segment photography, and ultrasound biomicroscopy(UBM)were examined during postoperative follow-up. The location of IOL and postoperative complications were recorded.RESULTS: SFCTRs and IOLs were successfully implanted in all patients. The mean postoperative follow-up was 1.92±1.36 a. At the last follow-up, the uncorrected distance visual acuity(UDVA; 0.20±0.18 LogMAR)and corrected distance visual acuity(CDVA; 0.16±0.17 LogMAR)were significantly improved compared with the UDVA(1.13±0.56 LogMAR)preoperatively(P

Purpose: To examine the rate of ciliary body detachment in patients with choroidal detachment following glaucoma surgery and its effect on the clinical course, management, and prognosis. Methods: A prospective observational case-series study. Patients with choroidal detachment following glaucoma surgery in 2018–2019 were included. All underwent complete ophthalmological examination and ultrasound biomicroscopy for evaluation of the presence and extent of ciliary body detachment. Follow-up examinations including ultrasound biomicroscopy scans were performed at 1 week, 1 month, 3 months, and 6 months. Results: Eight patients (8 eyes) were enrolled, 4 male and 4 female, of mean age 72 years (range 60–83). Five patients underwent trabeculectomy with mitomycin C (0.02%), which was combined with phacoemulsification cataract extraction in one; two underwent Ahmed glaucoma valve implantations, and one underwent ab-interno Xen45 gel stent implantation with mitomycin C (0.02%). The mean intraocular pressure was 26.0 ± 7.65 mmHg preoperatively, dropping to 6.9 ± 2.64 mmHg on first postoperative day one. Mean time from surgery to diagnosis of choroidal detachment was 11.6 ± 5.73 days. Ciliary body detachment was identified by ultrasound biomicroscopy in all patients, ranging between one and four quadrants. All patients were treated with topical steroids and cycloplegics; three (37.5%) received oral steroids. No surgical intervention for the choroidal or ciliary body detachments was indicated. Conclusions: In this real-world prospective study, concurrent ciliary body detachment was identified in all patients who presented with choroidal detachment following glaucoma surgery. This observation may deepen our understanding of the mechanism underlying the hypotony that is often seen after glaucoma surgery. [ABSTRACT FROM AUTHOR]

Introduction: This study investigates the relationship between ciliary muscle dynamics, thickness, and the regulation of intraocular pressure (IOP), focusing on the progression of cataracts and changes post-phacoemulsification. It explores how these factors impact canine ocular health, particularly in the context of cataract development and subsequent surgical intervention. Materials and methods: Data was collected using Ultrasound Biomicroscopy (UBM) from dogs at the Veterinary Medical Teaching Hospital of Chungbuk National University, Korea. The study involved 57 eyes from 35 dogs, categorized into five groups: 13 normal eyes, 14 with incipient cataracts, 12 with immature cataracts, 6 with mature cataracts, and 12 post-phacoemulsification. UBM measurements assessed various ciliary muscle parameters including ciliary body axial length (CBAXL), ciliary process-sclera angle (CPSA), longitudinal fibers of ciliary muscle thickness (Lf-CMT), and longitudinal and radial fibers of ciliary muscle thickness (LRf-CMT). Results: Findings indicated a decrease in CBAXL and an increase in Lf-CMT as cataracts progressed in severity. Post-phacoemulsification, there was a notable increase in CBAXL and a decrease in CPSA, Lf-CMT, and LRf-CMT, compared to both cataractous and normal eyes. Regression analysis revealed a significant positive association between CBAXL and IOP, alongside a negative association between Lf-CMT and IOP. These findings suggest that variations in ciliary muscle dynamics and thickness, as influenced by cataract progression and phacoemulsification, have distinct impacts on intraocular pressure. Discussion: The study proposes that phacoemulsification leads to ciliary muscle contraction, causing an inward and anterior movement of the ciliary muscle. This movement results in the narrowing of the ciliary cleft and constriction of the unconventional outflow pathway, potentially causing an increased risk of glaucoma post-surgery. Our research contributes to understanding the anatomical and physiological changes in the canine eye following cataract surgery and underscores the importance of monitoring IOP and ciliary muscle dynamics in these patients. [ABSTRACT FROM AUTHOR]

OBJECTIVE To assess the characteristics of blebs formed after Ahmed glaucoma valve (AGV) surgery in dogs using ultrasound biomicroscopy (UBM) and to analyze their correlation with postoperative intraocular pressure (IOP). ANIMALS 16 eyes (13 dogs) were diagnosed with primary angle-closure glaucoma and were followed up after AGV surgery from June 2021 to September 2023. METHODS In this prospective study, UBM examinations were performed to assess bleb characteristics, including bleb wall thickness and reflectivity. IOP at the time of UBM imaging and the duration from AGV surgery to UBM imaging were recorded. Histological examination of an enucleated eye removed due to uncontrolled IOP leading to blindness was also conducted. RESULTS A significant correlation was observed between IOP and relative reflectivity (Pearson r = 0.60; P = .01), and a negative correlation was observed between bleb wall thickness and relative reflectivity (Pearson r = −0.72; P = .002). No significant correlation was observed between the duration from AGV surgery to UBM imaging and either bleb wall thickness or relative reflectivity, respectively. Histological examination of the enucleated eye revealed collagenrich fibrous encapsulation of the bleb wall, including myofibroblasts that exhibited positive α-smooth muscle actin immunostaining. CLINICAL RELEVANCE In dogs that underwent AGV surgery, less dense, thick-walled blebs on UBM tended to maintain IOP within the normal range. However, denser, thinner-walled blebs showed IOP levels above the normal range despite the use of antiglaucoma medications. UBM is a useful tool for evaluating bleb characteristics and their influence on IOP regulation after AGV surgery in dogs. [ABSTRACT FROM AUTHOR]

Differentiation of iris and ciliary body lesions as benign or malignant and cystic or solid is important. The aim of this study was to compare anterior segment swept-source optical coherence tomography (AS SS-OCT) and ultrasound biomicroscopy (UBM) findings in iris and ciliary body tumors. Forty-two eyes of 38 cases with iris and ciliary body tumors imaged with UBM and AS SS-OCT between September 2018 and September 2023 were evaluated retrospectively. Of 42 eyes, 14 had melanoma, 14 iris pigment epithelial (IPE) cysts, 7 nevi, 3 Lisch nodules, 2 iris stromal cysts, 1 pars plana cysts, and 1 iris mammillations. An equivalent (100%) visualization of the anterior tumor margin was obtained with both techniques. Compared to AS SS-OCT, UBM was superior for posterior margin visualization in melanocytic tumors and IPE cysts. Bland-Altman plots demonstrated good agreement between UBM and AS SS-OCT for melanocytic tumors < 2.5 mm in base diameter and < 2 mm in thickness. Although, UBM is the gold standard for ciliary body and iridociliary tumors. AS SS-OCT should be considered as an excellent alternative to UBM, especially in minimally elevated iris lesions. [ABSTRACT FROM AUTHOR]

Background: Ocular foreign bodies (OFBs) are a relatively common occurrence in ocular injuries, and a severe risk factor for vision disorders. They are notoriously challenging to identify and localize precisely to allow surgical removal, even with the most recent technological advancements. Purpose: To compare the efficiency of different imaging methods in detecting and localizing OFBs. Methods: We conducted a retrospective analysis of the medical records of patients with OFBs, detected by ultrasound biomicroscopy (UBM) and confirmed during surgery. Patients who presented to our medical center between January 2016 and January 2022 and also underwent computed tomography (CT), X ray, and/or ocular B‐scan ultrasonography (B‐scans) were selected. Results: This study included 134 patients with a history of ocular trauma and OFBs (mean age: 47.25 years, range: 8–78). The mean time interval from injury to UBM examination was 36.31 months (range: 0.2–120 months). Most OFBs were metallic (51.82%) or plant‐based (25.37%); 22.39% of them were located in the sclera, 26.87% in the anterior chamber, and 23.88% in the ciliary body and iris. OFBs ranged in size from 0.10 to 6.67 mm (mean: 1.15 ± 1.10 mm). B‐scans identified OFBs in 37 of the 119 patients examined (31.09%); CT in 52 of 84 patients (61.90%); and radiography in 29 of 50 patients (58.00%). Univariate and multivariate analyses determined that both CT and radiography showed low detection rates for plant‐based versus non‐plant‐based OFBs (CT: p < 0.001; radiography: p = 0.007), small particles (<1.00 mm vs. >1.00 mm; CT: p = 0.001, radiography: p = 0.024), and with eyeball wall locations (vs. intraocular; CT: p < 0.001, radiography: p = 0.021). Similarly, B‐scans were less efficient for plant‐based and eyeball wall‐located OFBs (both p = 0.001), whereas the difference based on dimensions was not significant (p = 0.118). Conclusions: CT, radiography, and B‐scans showed lower detection rates for plant‐based, small, and eyeball wall‐located OFBs. Our findings strongly suggest that UBM could be a more adequate imaging modality when such OFBs are suspected. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the anterior segment structures using ultrasound biomicroscopy (UBM) in primary congenital glaucoma (PCG) and explore their correlation with disease severity and surgical outcomes. Methods: Clinical information of PCG patients who underwent UBM prior to their first glaucoma surgeries from September 2014 to March 2021 were reviewed. The study included 214 UBM images of 154 PCG eyes and 60 fellow unaffected eyes. Anterior segment characteristics were analyzed. UBM parameters, including the iris thickness (IT) at variant distances from the pupil edge and iris root, anterior chamber depth (ACD), and pupil diameter (PD), were compared between two groups and their relationship with clinical factors and surgical outcomes were analyzed in PCG eyes. Results: PCG eyes had unclear scleral spur, thin iris, wide anterior chamber angle, deep anterior chamber, rarefied ciliary body, elongated ciliary processes, and abnormal anterior iris insertion. ITs were thinner, ACD was deeper, and PD was larger in PCG eyes than fellow unaffected eyes (all P < 0.001). In PCG eyes, thinner ITs correlated with bilateral involvement and earlier age at presentation, and larger PD correlated with earlier age at presentation (P = 0.030) and higher intraocular pressure (P < 0.001). Thinner IT2 (P = 0.046) and larger PD (P = 0.049) were identified as risk factors for surgical failure. Conclusion: UBM is a powerful technique to exam anterior segment structures in PCG. The anatomical features are associated with disease severity and surgical outcomes, providing essential clinical insights. [ABSTRACT FROM AUTHOR]

An 8-year-old female pre-metamorphic axolotl (Ambystoma mexicanum) was examined for a suspected anterior lens luxation. Slit-lamp biomicroscopy revealed two lens-like structures in the anterior chamber of the right eye (OD), each with cataractous change. Ultrasound biomicroscopy and optical coherence tomography (OCT) were performed without sedation, and revealed small lenticular structures each with distinct nuclei and cortices. Although a distinct connection of the two lenticular structures could not be definitively ruled out, the structures appeared separate. Each of the lenticular structures was closely associated with its respective iris leaflet. This report demonstrates application of advanced imaging for diagnostic use in axolotl ophthalmology, showing that imaging of the lens can be performed without sedation, topical anesthetic, nor contact gel with high diagnostic quality. Although two distinct lenses were diagnosed with no historical evidence of trauma, the small sizes of each lenticular structure, with no detectable connection between them, are suggestive of a possible regenerative abnormality. This report opens discussion for the regenerative capabilities of the pre-metamorphic adult axolotl and possible implementations of their use in regenerative medicine research for the development of future therapies.

To present a modified technique for the reconstruction of a large cyclodialysis cleft with capsular tension ring (CTR) and continuous and cerclage sutures without scleral flaps in 12 cases. The mean visual acuity was 0.75 ± 0.47 logarithm of the minimal angle of resolution (logMAR), and the average intraocular pressure (IOP) was 3.35 ± 0.41 mmHg before surgery. Ultrasound biomicroscopy (UBM) revealed a ciliary cleft of 4.3 ± 3.5 clock hours. We performed the modified technique for the reconstruction of a large cyclodialysis cleft. Postoperative visual acuity improved to 0.48 ± 0.26 logMAR, and the IOP improved to 15.88 ± 3.81 mmHg. Postoperative UBM showed that cyclodialysis disappeared in the whole circumference of 12 eyes. The postoperative complications included 42% (5 eyes) with a temporary elevation of IOP and 16% (2 eyes) with a posterior shift of the ciliary body. No other complications were detected during the follow-up. Based on the results, our modified technique might be useful for most cyclodialysis clefts.

Abstract Background The structural features have an impact on the surgical prognosis for congenital corneal opacity (CCO). The structural classification system of CCO, however, is lacking. Based on data from ultrasound biomicroscopy (UBM) findings in infants and toddlers with CCO, this research proposed a classification system for the anterior segment structure severity. Methods Medical records, preoperative UBM images and slit-lamp photographs of infants and toddlers diagnosed with CCO at University Third Hospital between December 2018 and June 2022 were reviewed. According to the anterior segment structural features observed in UBM images, eyes were classified as follows: U1, opaque cornea only; U2, central anterior synechia; U3, peripheral anterior synechia combined with angle closure; and U4, aniridia or lens anomaly. The opacity appearance and corneal vascularization density observed in slit-lamp photographs were assigned grades according to previous studies. The extent of vascularization was also recorded. The corresponding intraocular anomaly classifications and ocular surface lesion severity were analysed. Results Among 81 eyes (65 patients), 41 (50.6%) were right eyes, and 40 (49.4%) were left eyes. The median age at examination was 6.91 months (n = 81, 1.00, 34.00). Two (2.5%) of the 81 eyes were classified as U1, 20 (24.7%) as U2, 22 (27.2%) as U3a, 11 (13.6%) as U3b and 26 (32.1%) as U4. Bilateral CCO eyes had more severe UBM classifications (P = 0.019), more severe dysgenesis (P = 0.012) and a larger angle closure (P = 0.009). Eyes with more severe UBM classifications had higher opacity grades (P = 0.003) and vascularization grades (P = 0.014) and a larger vascularization extent (P = 0.001). Eyes with dysgenesis had higher haze grades (P = 0.012) and more severe vascularization (P = 0.003 for density; P = 0.008 for extent), while the angle closure range was related to haze grade (P = 0.013) and vascularization extent (P = 0.003). Conclusions This classification method based on UBM and slit-lamp photography findings in the eyes of CCO infants and toddlers can truly reflect the degree of abnormality of the ocular surface and anterior segment and is correlated with the severity of ocular surface anomalies. This method might provide meaningful guidance for surgical procedure design and prognostic determinations for keratoplasty in CCO eyes.

AIM: To investigate the characteristics of anterior segment structure in first-degree relatives of patients with primary angle-closure glaucoma(PACG).METHODS: A total of 48 first-degree relatives of PACG patients aged 40-60 who were treated in the Affiliated Eye Hospital of Nanchang University from September 2020 to October 2022 were selected as the observation group. Additionally, 40 cases(40 eyes)of healthy individuals without glaucoma and family history of glaucoma at the same age group were collected as the control group. They were divided into younger group(40-49 years old)and elder group(50-60 years old). All subjects were examined with ultrasound biomicroscopy(UBM)and were measured using camera measure software. The parameters mainly included anterior chamber depth(ACD), anterior chamber area(ACA), anterior chamber width(ACW), anterior segment depth(ASD), angle open distance(AOD500), trabecular iris angle(TIA), trabecular iris area(TISA500), lens vault(LV), iris curve(IC), iris thickness(IT500), scleral ciliary process angle(SCPA), and iris ciliary process distance(ICPD).RESULTS: ACD, ACA, AOD500, TISA500 and TIA in the observation group were lower than those of the control group, and LV and IC were higher than those of the control group(all P

AIM: To explore a more convenient and accurate method for evaluating the anterior chamber angle width based on the Van Herick method.METHODS:A total of 58 patients(69 eyes)with age-related cataract who visited our hospital between January and December 2021 were included. They were divided into the chamber angle width ≥1/2 corneal thickness(CT)group(44 eyes of 37 cases)and 0.05), while the differences of chamber angle degrees of other quadrants were all statistically significant(P

PurposeTo report a case of congenital ciliary body cysts causing microspherophakia, ectopia lentis, and secondary angle closure glaucoma in an infant.ObservationsA 16-month-old male was found to have bilateral ciliary body cysts associated with zonular laxity or absence causing microspherophakia and ectopia lentis as demonstrated on multimodal imaging. Additionally, the patient had secondary angle closure glaucoma which was likely multi-factorial related to both lens abnormalities and anterior displacement of the iris from the cysts themselves. The patient underwent lensectomy and cyst removal which resulted in intraocular pressure stabilization and visual rehabilitation.Conclusions and importanceCongenital ciliary body cysts are a rare cause of lens abnormalities and secondary angle closure glaucoma in children. Information regarding genetic underpinnings or systemic associations is limited.

Ultrasound biomicroscopy (UBM) is an invaluable investigation for imaging anterior segment structures. Although it is operator‐dependent and time consuming, unlike optical‐based imaging techniques, it is able to image structures posterior to the iris, such as the zonules, ciliary body and part of the pars plana. It is especially useful in advanced cataracts, traumatic cataracts, subluxed lenses, posterior polar cataracts, and congenital and developmental anomalies affecting the anterior segment. It provides diagnostic information in eyes with complex cataracts or intraocular lens (IOL)‐related pathology, and aids in surgical planning in order to minimise complications. In this review, we describe the UBM features of various lenticular pathologies and demonstrate its application in the diagnosis and surgical management of lens and IOL‐related pathologies. [ABSTRACT FROM AUTHOR]

To present a modified technique for the reconstruction of a large cyclodialysis cleft with capsular tension ring (CTR) and continuous and cerclage sutures without scleral flaps in 12 cases. The mean visual acuity was 0.75 ± 0.47 logarithm of the minimal angle of resolution (logMAR), and the average intraocular pressure (IOP) was 3.35 ± 0.41 mmHg before surgery. Ultrasound biomicroscopy (UBM) revealed a ciliary cleft of 4.3 ± 3.5 clock hours. We performed the modified technique for the reconstruction of a large cyclodialysis cleft. Postoperative visual acuity improved to 0.48 ± 0.26 logMAR, and the IOP improved to 15.88 ± 3.81 mmHg. Postoperative UBM showed that cyclodialysis disappeared in the whole circumference of 12 eyes. The postoperative complications included 42% (5 eyes) with a temporary elevation of IOP and 16% (2 eyes) with a posterior shift of the ciliary body. No other complications were detected during the follow-up. Based on the results, our modified technique might be useful for most cyclodialysis clefts. [ABSTRACT FROM AUTHOR]

Background: The structural features have an impact on the surgical prognosis for congenital corneal opacity (CCO). The structural classification system of CCO, however, is lacking. Based on data from ultrasound biomicroscopy (UBM) findings in infants and toddlers with CCO, this research proposed a classification system for the anterior segment structure severity. Methods: Medical records, preoperative UBM images and slit-lamp photographs of infants and toddlers diagnosed with CCO at University Third Hospital between December 2018 and June 2022 were reviewed. According to the anterior segment structural features observed in UBM images, eyes were classified as follows: U1, opaque cornea only; U2, central anterior synechia; U3, peripheral anterior synechia combined with angle closure; and U4, aniridia or lens anomaly. The opacity appearance and corneal vascularization density observed in slit-lamp photographs were assigned grades according to previous studies. The extent of vascularization was also recorded. The corresponding intraocular anomaly classifications and ocular surface lesion severity were analysed. Results: Among 81 eyes (65 patients), 41 (50.6%) were right eyes, and 40 (49.4%) were left eyes. The median age at examination was 6.91 months (n = 81, 1.00, 34.00). Two (2.5%) of the 81 eyes were classified as U1, 20 (24.7%) as U2, 22 (27.2%) as U3a, 11 (13.6%) as U3b and 26 (32.1%) as U4. Bilateral CCO eyes had more severe UBM classifications (P = 0.019), more severe dysgenesis (P = 0.012) and a larger angle closure (P = 0.009). Eyes with more severe UBM classifications had higher opacity grades (P = 0.003) and vascularization grades (P = 0.014) and a larger vascularization extent (P = 0.001). Eyes with dysgenesis had higher haze grades (P = 0.012) and more severe vascularization (P = 0.003 for density; P = 0.008 for extent), while the angle closure range was related to haze grade (P = 0.013) and vascularization extent (P = 0.003). Conclusions: This classification method based on UBM and slit-lamp photography findings in the eyes of CCO infants and toddlers can truly reflect the degree of abnormality of the ocular surface and anterior segment and is correlated with the severity of ocular surface anomalies. This method might provide meaningful guidance for surgical procedure design and prognostic determinations for keratoplasty in CCO eyes. [ABSTRACT FROM AUTHOR]

Abstract Background The spatial position of the lens in patients with cortical age-related cataract (CARC) is unclear. We investigated a basis for the assessment of visual quality after cataract surgery by analysing the ultrasound biomicroscopic characteristics of the biological parameters of the lens in patients with CARC. Methods In this retrospective study, 119 patients (50 males and 69 females, totalling 238 eyes) with CARC who underwent simple cataract surgery were selected. The lens thickness (LT), axial length (AL), anterior chamber depth (ACD), lens vault (LV), trabecular-iris angle (TIA), iris-lens angle (ILA), iris-lens contact distance (ILCD) were measured by A-scan ultrasound and ultrasound biomicroscopy. The corresponding lens position (LP) and relative lens position (RLP) were calculated. Results LP was greater in men than in women (P

Abstract A 10‐year‐old spayed female Maltese dog was presented for hypotony of the right eye (OD) with decreased vision. The dorsomedial region of conjunctiva was partially swollen but the globe remained intact. Slit‐lamp biomicroscopy revealed intraocular haemorrhage, uveitis, and a limbal, corneoconjunctival ulcer near the swollen conjunctiva. During ocular ultrasonography (OUS), the sclera became indented and hypotony occurred, implicating a full‐thickness scleral wound. Ultrasound biomicroscopy (UBM) confirmed a full‐thickness scleral defect, which was surgically apposed. The intraocular pressure normalised and the uveitis subsided post‐operatively. OUS and UBM were helpful in suggesting and definitively diagnosing scleral perforation, leading to accurate treatment and good prognosis.

Abstract Background This study aims to identify the relationship between iris -ciliary angle (ICA) and the vault. Additionally, we also seek to investigate the chain mediating effects of the ICL haptic related factors on this relationship. Methods The participants were categorized into three groups according to the ICA value as follows: low ICA group ( 70°). We compared the preoperative ocular characteristics and postoperative examinations among the three groups. Multiple variable stepwise regression was performed to establish the vault prediction formula. The Process V4.0 in SPSS and Hayes’s PROCESS model 6 was conducted to further elucidate the mediating effects of the final tip point of ICL haptic and the ICL arc-lens arc on the relationship between the ICA and vault. Results There was a significant difference in the positions of the ICL haptic among three ICA groups. The regression vault equation was Vault = 679.42–7.26*TCA + 192.30*ACD-196.37*CLR + 73.21* STS(horizontal).A significant negative correlation was found between the ICA and vault (P

The goal of the work described here was to develop and assess a deep learning-based model that could automatically segment anterior chamber angle (ACA) tissues; classify iris curvature (I-Curv), iris root insertion (IRI), and angle closure (AC); automatically locate scleral spur; and measure ACA parameters in ultrasound biomicroscopy (UBM) images. A total of 11,006 UBM images were obtained from 1538 patients with primary angle-closure glaucoma who were admitted to the Eye Center of Renmin Hospital of Wuhan University (Wuhan, China) to develop an imaging database. The UNet++ network was used to segment ACA tissues automatically. In addition, two support vector machine (SVM) algorithms were developed to classify I-Curv and AC, and a logistic regression (LR) algorithm was developed to classify IRI. Meanwhile, an algorithm was developed to automatically locate the scleral spur and measure ACA parameters. An external data set of 1,658 images from Huangshi Aier Eye Hospital was used to evaluate the performance of the model under different conditions. An additional 439 images were collected to compare the performance of the model with experts. The model achieved accuracies of 95.2%, 88.9% and 85.6% in classification of AC, I-Curv and IRI, respectively. Compared with ophthalmologists, the model achieved an accuracy of 0.765 in classifying AC, I-Curv and IRI, indicating that its high accuracy was as high as that of the ophthalmologists (p > 0.05). The average relative errors (AREs) of ACA parameters were smaller than 15% in the internal data sets. Intraclass correlation coefficients (ICCs) of all the angle-related parameters were greater than 0.911. ICC values of all iris thickness parameters were greater than 0.884. The accurate measurement of ACA parameters partly depended on accurate localization of the scleral spur (p < 0.001). The model could effectively and accurately evaluate the ACA automatically based on fully automated analysis of UBM images, and it can potentially be a promising tool to assist ophthalmologists. The present study suggested that the deep learning model can be extensively applied to the evaluation of ACA and AC-related biometric risk factors, and it may broaden the application of UBM imaging in the clinical research of primary angle-closure glaucoma. [ABSTRACT FROM AUTHOR]

Purpose: To reveal refractive errors, the relationship between refractive errors and optical parameters, and the effect of prematurity and retinopathy of prematurity (ROP) on ocular development in school children with a history of prematurity. Methods: Premature children aged 8–12 years were divided into 3 groups as those without ROP (Group 1), with ROP that did not require treatment (Group 2), and with laser-treated ROP (Group 3). Age-matched full-term healthy children were included in the control group. Demographic features were recorded. A detailed ophthalmologic examination was performed. Anterior chamber depth (ACD), trabecular-iris angle (TIA), iris thickness (IT), lens thickness (LT), vitreous body length (VBL), axial length (AL) were measured by ultrasound biomicroscopy (UBM). The results were compared between groups. Results: Group 3 had the lowest best corrected visual acuity (0.81 ± 0.31 SL), the highest rates of myopia (55.9%) and astigmatism (50.0%). In the premature groups, ACD (p < 0.001), TIA (p < 0.001), IT (p = 0.016), VBL (p < 0.001) and AL (p < 0.001) were lower; LT (p < 0.001) was higher than in the control group. As birth weight (BW) and gestational age (GA) increased, ACD, TIA, VBL and AL increased, and LT decreased (p < 0.001). In the group 3, 35.2% anisometropia, 17.6% of esotropia and 5.9% of exotropia were detected. Conclusions: The frequency of myopia, astigmatism, hyperopia and anisometropia is increasing in premature children, especially in cases with laser-treated ROP. Premature cases are characterized by thicker lens, shallower ACD, narrower TIA and shorter AL. Refractive errors, anisometropia, amblyopia and strabismus are important causes of visual impairment in children with laser-treated ROP. [ABSTRACT FROM AUTHOR]

Background: The spatial position of the lens in patients with cortical age-related cataract (CARC) is unclear. We investigated a basis for the assessment of visual quality after cataract surgery by analysing the ultrasound biomicroscopic characteristics of the biological parameters of the lens in patients with CARC. Methods: In this retrospective study, 119 patients (50 males and 69 females, totalling 238 eyes) with CARC who underwent simple cataract surgery were selected. The lens thickness (LT), axial length (AL), anterior chamber depth (ACD), lens vault (LV), trabecular-iris angle (TIA), iris-lens angle (ILA), iris-lens contact distance (ILCD) were measured by A-scan ultrasound and ultrasound biomicroscopy. The corresponding lens position (LP) and relative lens position (RLP) were calculated. Results: LP was greater in men than in women (P < 0.05), LV was smaller in men than in women (P = 0.002), ILA and ILCD were not statistically significant (P = 0.072 and P = 0.854, respectively). There were significant differences in TIA, ILA, and ILCD in the four quadrants (all P < 0.05), with a trend in the distribution of TIA: superior < inferior < nasal < temporal, ILA: nasal < inferior < temporal < superior, and ILCD: superior < temporal < inferior < nasal. Conclusions: The lens protrudes more obviously in females than in males and the lens tilts to a certain extent with the increase of age and tends to be more upward and temporal in the supine position. Therefore, trends in lens-related parameters in patients with CARC should be taken seriously. [ABSTRACT FROM AUTHOR]

Purpose: To compare the differences in anterior segment parameters between eyes with primary angle closure (PAC) with and without gonioscopically-visualized ciliary body processes (CBP). Study design: Prospective, observational, comparative clinical study. Methods: Detailed ocular examinations and gonioscopy were performed in 89 eyes of 89 patients with PAC to determine the visibility of the CBP. Anterior chamber depth (ACD), anterior chamber width, lens thickness (LT), lens vault (LV) and pupil diameter were determined using ultrasound biomicroscopy. The lens–axial length factor (LAF) and relative lens position (RLP) were calculated. All parameters were compared between eyes with and without gonioscopically visible CBP (PAC+CBP and PAC−CBP groups) after adjusting for age and gender. The association of the parameters with visible CBP was analyzed by univariate logistic regression analysis. Results: PAC+CBP group included 41 eyes and the PAC−CBP group, 48 eyes. The axial length and ACD were statistically significantly smaller (p = 0.009 and p = 0.005, respectively) and LT, LV and LAF were statistically significantly greater (p = 0.03, p = 0.008 and p = 0.004, respectively) in the PAC+CBP group. In the PAC eyes with glaucoma, the LT, LV and LAF were statistically significantly greater in the PAC+CBP group (p = 0.02, p = 0.001 and p = 0.02, respectively). The LAF had the strongest association with visible CBP in the regression analysis (Odds ratio = 141.70, p = 0.002). Conclusion: Gonioscopical visualization of ciliary processes may suggest that anterior segment crowding, especially lens factor is the underlying mechanism in PAC. It may provide a practical gonioscopic examination method for predicting the predominant pathophysiology of PAC. [ABSTRACT FROM AUTHOR]

A 10‐year‐old spayed female Maltese dog was presented for hypotony of the right eye (OD) with decreased vision. The dorsomedial region of conjunctiva was partially swollen but the globe remained intact. Slit‐lamp biomicroscopy revealed intraocular haemorrhage, uveitis, and a limbal, corneoconjunctival ulcer near the swollen conjunctiva. During ocular ultrasonography (OUS), the sclera became indented and hypotony occurred, implicating a full‐thickness scleral wound. Ultrasound biomicroscopy (UBM) confirmed a full‐thickness scleral defect, which was surgically apposed. The intraocular pressure normalised and the uveitis subsided post‐operatively. OUS and UBM were helpful in suggesting and definitively diagnosing scleral perforation, leading to accurate treatment and good prognosis. [ABSTRACT FROM AUTHOR]

Background: This study aims to identify the relationship between iris -ciliary angle (ICA) and the vault. Additionally, we also seek to investigate the chain mediating effects of the ICL haptic related factors on this relationship. Methods: The participants were categorized into three groups according to the ICA value as follows: low ICA group (< 35°); moderate ICA group (35°-70°); high ICA group (> 70°). We compared the preoperative ocular characteristics and postoperative examinations among the three groups. Multiple variable stepwise regression was performed to establish the vault prediction formula. The Process V4.0 in SPSS and Hayes's PROCESS model 6 was conducted to further elucidate the mediating effects of the final tip point of ICL haptic and the ICL arc-lens arc on the relationship between the ICA and vault. Results: There was a significant difference in the positions of the ICL haptic among three ICA groups. The regression vault equation was Vault = 679.42–7.26*TCA + 192.30*ACD-196.37*CLR + 73.21* STS(horizontal).A significant negative correlation was found between the ICA and vault (P < 0.01).The chain mediation model revealed that the final tip point of ICL haptic and the ICL arc-Lens arc were sequential mediators between ICA and vault (effect = -1.63, 95% CI = -2.72–-0.73). Conclusion: The ICA was associated with vault via the mediation effect of the final tip point of the ICL haptic and the ICL arc -lens arc. Assessment of ICL haptic related parameters adds significant information to interpret the vault after surgery. [ABSTRACT FROM AUTHOR]

PURPOSE: To describe three anterior segment dysgenesis disorders with infantile corneal opacities, namely, congenital hereditary endothelial dystrophy (CHED), primary congenital glaucoma (PCG), and Peters anomaly (PA) in terms of clinical characteristics, histopathology, genetic association, and diagnostic imaging profiles using imaging modalities such as ultrasound biomicroscopy (UBM) and microscope-integrated intraoperative optical coherence tomography (i-OCT). MATERIALS AND METHODS: Seventy-four eyes with 22 eyes of CHED, 28 eyes of PA, and 24 eyes of PCG were clinically evaluated and underwent imaging using UBM and i-OCT. Corneal buttons of 16 operated patients underwent histopathological analysis, while genetic analysis was done in 23 patients using whole-exome sequencing. RESULTS: Corneal diameters (CD) and UBM parameters like anterior chamber depth (ACD), iris thickness (IT), and ciliary body (CB) thickness revealed a statistically significant difference between the three categories. In PA, 9 eyes had a third rare phenotype with only a posterior corneal defect with no iris adhesions. Genetic mutations were seen in all tested patients with CHED, in 83.3% of patients with PCG, and in 80% of patients with the third type of PA. i-OCT helped in the characterization of corneal opacity, identification of posterior corneal defects, iridocorneal adhesions, and contour of Descemet's membrane. CONCLUSION: Overlapping phenotypes of the above disorders cause a diagnostic dilemma and parameters like CDs, UBM ACD, IT, and CB thickness help differentiate between them. i-OCT can help in classifying the diseases in a high resolution, non-contact manner, and can better delineate corneal characteristics. The rare third type of PA phenotype may have a genetic association. [ABSTRACT FROM AUTHOR]

Mucopolysaccharidosis are group of inherited metabolic diseases caused by the absence or malfunctioning of lysosomal enzymes resulting in accumulation of glycosaminoglycans. Over time this accumulation damages cells, tissues, and organs. There are seven types of MPS and 13 subtypes that are associated with multiple organ systems, such as the respiratory, liver, spleen, central nervous systems, arteries, skeletons, eyes, joints, ears, skin, and/or teeth. The various types share some common ocular features that differ in terms of the severity of the affection. Visual loss in MPS patients is varied and can be due to corneal clouding, glaucoma, retinopathy, and optic neuropathy. The primary focus of this review is on changes in the cornea and anterior segment in MPS patients, including clinical and novel investigative modalities, current surgical management, effects of systemic therapy like hematopoietic stem cell transplants (HSCT)and enzyme replacement therapy (ERT), as well as significant research developments. [ABSTRACT FROM AUTHOR]

PurposeThis study aims to explore the relationships between lens diameter (LD) measured with ultrasound biomicroscopy (UBM) and ocular biometric parameters.MethodsOcular biometric parameters including axial length (AL), white-to-white distance (WTW), anterior chamber depth (ACD), lens thickness (LT) and anterior segment length (ASL) were measured with IOL-Master 700, and the direct measurement of LD was conducted through UBM (ArcScan Insight 100). Relationships between LD and ocular biometric parameters were then investigated. Eyes with AL ≥ 28 mm were defined as eyes with extreme myopia, and eyes with AL 0.05). Backward stepwise regressions revealed that a larger LD was associated with larger WTW, ASL and AL in eyes without extreme myopia (all p

Objectives:The purpose of this study was to analyze the use of ultrasound biomicroscopy (UBM) in the diagnosis and follow-up anterior segment diseases.Materials and Methods:The records of patients who presented to our clinic for UBM between January 1, 2004, and December 31, 2018 were reviewed retrospectively. Demographic characteristics, indications for UBM imaging and findings of the patients were recorded. Also, the change in clinical indications over the years were analyzed.Results:The study included 1.256 eyes of 917 patients, of whom 723 (57.6%) were female and 533 (42.4%) were male. The mean age was 48.7±14.8 years (range: 12-85 years). Indications for UBM imaging were to evaluate glaucoma pathogenesis and surgical outcomes (n=764, 60.8%), iris and ciliary body masses (n=263, 20.9%), congenital anomalies of the crystalline lens and complications of cataract surgery (n=86, 6.8%), the etiology of hypotony (n=57, 4.5%), corneal diseases (n=46, 3.7%), anterior segment findings after trauma (n=22, 1.8%), conjunctival pathologies (n=11, 0.9%), and scleral pathologies (n=7, 0.6%). In patients with glaucoma, the most common reason for requesting UBM according to years was to investigate the plateau iris configuration.Conclusion:UBM is an important imaging method used in the determination of the pathophysiology of anterior segment diseases, clinical evaluation, planning of surgical treatment and analyzing the outcomes.

Fenglei Wang, Zhiying Yu, Shasha Xue, Yunxiao Wang, Lin Li, Dabo Wang, Ling Wang Department of Ophthalmology, the Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, People’s Republic of ChinaCorrespondence: Ling Wang, Department of Ophthalmology, the Affiliated Hospital of Qingdao University, University, No. 16 Jiangsu Road, Shinan District, Qingdao, 266003, People’s Republic of China, Tel +86 18661806679, Email tsingtaowl@hotmail.comPurpose: To investigate the differences in parameters related to angle configuration and lens position in patients with cortical age-related cataract by ultrasound biomicroscopy (UBM) in different body positions.Methods: Prospective study with 55 patients with cortical age-related cataract proposed for phacoemulsification, examined using a Compact Touch STS UBM (Quantel Medical, France). UBM bag/balloon technology was applied to measure the central anterior chamber depth (ACD) and lens vault (LV) in horizontal and vertical orientation in sitting and supine positions, angle opening distance (AOD500), trabecular iris angle (TIA) and iris lens angle (ILA) in four quadrants: superior, inferior, nasal, and temporal.Results: We found no significant difference in ACD between sitting and supine positions (p = 0.053); LV was significantly greater in the supine position (p < 0.001); AOD500 in superior and inferior quadrants were significantly longer in the sitting position (p = 0.001; p < 0.001); TIA in superior and inferior quadrants was significantly greater in the sitting position (p < 0.001; p < 0.001), and TIAmax-min was significantly smaller in the sitting position (p = 0.001); ILA in temporal quadrant was significantly larger in the sitting position (p = 0.015) and ILAmax-min was significantly smaller in the sitting position (p < 0.001).Conclusion: The anterior chamber angle was narrower and the lens was positioned more anteriorly in the supine than in the sitting position in cortical age-related cataract. Different positions may affect the angle configuration and the relative space of lens through different directions of mechanics and modes of action.Keywords: angle configuration, body position, ultrasound biomicroscopy, cortical age-related cataract

IntroductionGlaucoma is one of the most serious complications that causes irreversible blindness after phacoemulsification in dogs; however, a clear mechanism has not been elucidated. This study aimed to analyse the possible anatomical factors associated with glaucoma after phacoemulsification using parameters that reflect the anatomical characteristics of dogs.Materials and methodsA total of 69 eyes of 48 dogs were included in this study. The patients were divided into three groups: normal eye (n = 18), cataract (n = 39), and post-phacoemulsification for at least 2 months after surgery (post-phaco, n = 12). For further analysis, the dogs were subdivided into two groups according to cataract stage: phacoemulsification non-candidate and candidate groups. Non-cataracts and incipient cataracts were categorized into the non-candidate group, whereas immature and mature cataracts were categorized into the candidate group. Measurements of the ciliary cleft parameters, including the area of the ciliary cleft (CCA), length of the ciliary cleft (CCL), width of the ciliary cleft (CCW), iridocorneal angle, and angle opening distance, were obtained using ultrasound biomicroscopy.ResultsCCA, CCL, and CCW were significantly higher in the candidate group than in the non-candidate group. CCA, CCL, and CCW were significantly reduced in the post-phaco group compared to those in the cataract group. Based on these results, we found that the ciliary cleft expanded in cataract-affected eyes and narrowed after phacoemulsification. This may indicate that the space between the trabecular meshworks became narrower, potentially leading to an increase in the resistance of the aqueous humor.ConclusionA narrowed ciliary cleft after phacoemulsification may be an anatomical factor associated with glaucoma.

Purpose: Ophthalmic diagnosis in many avian species remains hindered by a lack of normative values. This study aimed to establish normal ophthalmic parameters for select diagnostic tests in clinically normal Quaker parrots. Methods: Ninety‐six captive Quaker parrots aged 8–18 years underwent ophthalmic examination to include assessment of neuro‐ophthalmic reflexes, phenol red thread test, rebound tonometry, fluorescein staining, palpebral fissure length measurements, slit lamp biomicroscopy, indirect ophthalmoscopy, and ocular ultrasound biometry. Results: Menace response, dazzle reflex, and direct pupillary light reflex were present for all Quaker parrots. Tear production (mean ± SD) was 13.3 ± 4.0 mm/15 s and intraocular pressure (IOP, mean ± SD) was 10.6 ± 1.4 and 6.0 ± 1.3 mmHg in the D and P rebound tonometer calibration settings, respectively. For IOP measurement, D and P calibration settings were not interchangeable, with the lesser variation of the D setting preferred in the absence of a gold standard. Ultrasound measurement of the anterior chamber depth increased with age and males had longer axial globe and vitreous lengths. Incidental adnexal and ocular lesions, identified in 36/96 (37.5%) of Quaker parrots, did not statistically affect the created reference data. Conclusions: This work provides reference values and clinical findings to assist with monitoring the health of wild populations and maintaining the health of captive Quaker parrots. [ABSTRACT FROM AUTHOR]

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Our aim was to assess the therapeutic efficacy of a modified single-arm suture technique on traumatic cyclodialysis cleft with vitreoretinal injury. The procedure involved fixing a detached ciliary body using a single-armed 10-0 polypropylene suture under the assistance of a 29-gauge needle. Patients with a traumatic cyclodialysis cleft combined with an anterior and posterior segment injury who underwent modified internal cyclopexy together with vitreoretinal surgery were enrolled in this study. Ultrasound biomicroscopy (UBM) was used to diagnose and evaluate the cyclodialysis and anterior segment injury. B-scan ultrasonography was performed to assess the condition of the vitreous, retina and choroid. The surgical time and successful rate for repairing the cyclodialysis cleft were recorded. Preoperative and postoperative best-corrected visual acuity (BCVA), and intraocular pressure (IOP) were documented for assessment. The study included 20 eyes. The extent of the cyclodialysis cleft was from 30° to 360°. Besides a traumatic cyclodialysis cleft, the included cases also combined this with vitreous hemorrhages, retinal detachment, macular holes, choroid avulsion, and suprachoroidal hemorrhage. All the clefts were anatomically closed in one surgery. The average surgical time for fixing the cyclodialysis cleft was 2.68 ± 0.54 min/30° cleft. A significant improvement in LogMAR BCVA was observed from 2.94 ± 0.93 preoperatively to 1.81 ± 1.11 at the 6-month follow-up. IOP was elevated from 10.90 ± 6.18 mmHg preoperatively to 14.45 ± 2.35 mmHg at the 6-month follow-up. The modified single-armed suture technique was proved to be an effective method to fix the traumatic cyclodialysis cleft, which could facilitate the use of the procedure to repair chorioretinal disorders. It improved the BCVA and maintained the IOP with less postoperative complications. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to analyze the use of ultrasound biomicroscopy (UBM) in the diagnosis and follow-up anterior segment diseases Materials and Methods: The records of patients who presented to our clinic for UBM between January 1, 2004, and December 31, 2018 were reviewed retrospectively. Demographic characteristics, indications for UBM imaging and findings of the patients were recorded. Also, the change in clinical indications over the years were analyzed. Results: The study included 1.256 eyes of 917 patients, of whom 723 (57.6%) were female and 533 (42.4%) were male. The mean age was 48.7±14.8 years (range: 12-85 years). Indications for UBM imaging were to evaluate glaucoma pathogenesis and surgical outcomes (n=764, 60.8%), iris and ciliary body masses (n=263, 20.9%), congenital anomalies of the crystalline lens and complications of cataract surgery (n=86, 6.8%), the etiology of hypotony (n=57, 4.5%), corneal diseases (n=46, 3.7%), anterior segment findings after trauma (n=22, 1.8%), conjunctival pathologies (n=11, 0.9%), and scleral pathologies (n=7, 0.6%). In patients with glaucoma, the most common reason for requesting UBM according to years was to investigate the plateau iris configuration. Conclusion: UBM is an important imaging method used in the determination of the pathophysiology of anterior segment diseases, clinical evaluation, planning of surgical treatment and analyzing the outcomes. [ABSTRACT FROM AUTHOR]

Primary angle closure glaucoma(PACG)is the leading type of glaucoma in Asia, especially in China. PACG still has a high proportion of angle closure after laser peripheral iridectomy(LPI). Plateau iris is one of the non-pupillary blockage factors that cause angle closure. With the wide application of ultrasound biomicroscopy(UBM)in ophthalmology, the understanding of plateau iris has been deepened continually. This paper will elaborate the concept, mechanism, prevalence, relationship with angle closure, diagnostic criteria and the treatment of plateau iris, aiming to have a deeper understanding of the relationship between plateau iris and PACG, and to provide references for the treatment and research of PACG in the future.

PURPOSE: To describe three anterior segment dysgenesis disorders with infantile corneal opacities, namely, congenital hereditary endothelial dystrophy (CHED), primary congenital glaucoma (PCG), and Peters anomaly (PA) in terms of clinical characteristics, histopathology, genetic association, and diagnostic imaging profiles using imaging modalities such as ultrasound biomicroscopy (UBM) and microscope-integrated intraoperative optical coherence tomography (i-OCT). MATERIALS AND METHODS: Seventy-four eyes with 22 eyes of CHED, 28 eyes of PA, and 24 eyes of PCG were clinically evaluated and underwent imaging using UBM and i-OCT. Corneal buttons of 16 operated patients underwent histopathological analysis, while genetic analysis was done in 23 patients using whole-exome sequencing. RESULTS: Corneal diameters (CD) and UBM parameters like anterior chamber depth (ACD), iris thickness (IT), and ciliary body (CB) thickness revealed a statistically significant difference between the three categories. In PA, 9 eyes had a third rare phenotype with only a posterior corneal defect with no iris adhesions. Genetic mutations were seen in all tested patients with CHED, in 83.3% of patients with PCG, and in 80% of patients with the third type of PA. i-OCT helped in the characterization of corneal opacity, identification of posterior corneal defects, iridocorneal adhesions, and contour of Descemet's membrane. CONCLUSION: Overlapping phenotypes of the above disorders cause a diagnostic dilemma and parameters like CDs, UBM ACD, IT, and CB thickness help differentiate between them. i-OCT can help in classifying the diseases in a high resolution, non-contact manner, and can better delineate corneal characteristics. The rare third type of PA phenotype may have a genetic association.

Mucopolysaccharidosis are group of inherited metabolic diseases caused by the absence or malfunctioning of lysosomal enzymes resulting in accumulation of glycosaminoglycans. Over time this accumulation damages cells, tissues, and organs. There are seven types of MPS and 13 subtypes that are associated with multiple organ systems, such as the respiratory, liver, spleen, central nervous systems, arteries, skeletons, eyes, joints, ears, skin, and/or teeth. The various types share some common ocular features that differ in terms of the severity of the affection. Visual loss in MPS patients is varied and can be due to corneal clouding, glaucoma, retinopathy, and optic neuropathy. The primary focus of this review is on changes in the cornea and anterior segment in MPS patients, including clinical and novel investigative modalities, current surgical management, effects of systemic therapy like hematopoietic stem cell transplants (HSCT)and enzyme replacement therapy (ERT), as well as significant research developments.

Ultrasound biomicroscopy (UBM) is a non-invasive and high-resolution approach to studying anatomical characteristics and relationships among various anterior segment components. This imaging approach provides real-time cross-sectional images even in opaque corneas. It is especially valuable to assess lesions and document anatomical abnormalities, i.e., irido-cilliary complex, zonular abnormalities, and mass lesions in the anterior segment. This review article gives an overview of the UBM imaging technique and its applications to various types of Glaucoma.

BACKGROUND: The aim of this study was to determine whether anterior scleral thickness (AST) varies significantly between patients with central serous chorioretinopathy (CSCR) versus normal individuals. To validate scleral thickness measurements by ultrasound biomicroscopy (UBM) vis a vis anterior segment optical coherence tomography (ASOCT). METHODS: This case–control study analyzed 50 eyes of 50 patients with CSCR (cases) and compared it with that of 50 eyes of 50 age- and gender-matched controls. In cases, AST was measured at 1 mm and 2 mm temporal to the temporal scleral spur by ASOCT and UBM. In controls, AST was measured only by ASOCT. In all participants, posterior choroidal thickness (CT) was measured subfoveally, 1 mm nasal and 1 mm temporal to fovea by enhanced depth imaging optical coherence tomography. RESULTS: The mean AST, as measured by ASOCT among cases and controls was 703.86 μm and 667.54 μm, respectively (P = 0.006). The mean AST by ASOCT and UBM in cases were 703.86 μm and 657.42 μm, respectively (P = 0.001). AST measurement by ASOCT and UBM showed a positive and statistically significant correlation (r = 0.431, P = 0.000). The mean CT among cases and controls was 443.56 μm and 373.88 μm, respectively (P = 0.000). We found a weak positive correlation (r = 0.11) in cases and weaker positive correlation in controls, between CT and AST measured by ASOCT. CONCLUSIONS: Our findings suggest that AST varies significantly between patients with CSCR versus normal individuals. We found poor agreement of AST when measured by ASOCT and UBM.

Purpose: To describe examination and imaging characteristics of presumed iris papulosa in a case of ocular syphilis. Observations: A 60-year-old man who presented with granulomatous anterior uveitis in his left eye was also noted to have an unusual vascularized iris papule associated with posterior synechiae at the nasal pupillary margin. Anterior segment OCT (AS-OCT) of the iris lesion demonstrated a hyperreflective anterior surface with multiple vascular lumen, internal hyperreflectivity, and shadowing. Ultrasound biomicroscopy (UBM) imaging revealed an echodense mass with relative hyperechogenicity in the anterior portion of the lesion. Systemic work-up confirmed a diagnosis of syphilis, and he was treated with topical steroids and parenteral penicillin. Conclusion and Importance: We characterize the rare finding of iris papulosa that may be encountered in syphilitic uveitis and its distinctive features on both UBM and AS-OCT. This report highlights that syphilis should be considered as a possible diagnosis for an undifferentiated vascular iris mass.

Iris/ciliary body tumors can broadly be classified as benign or malignant, cystic or solid, and melanocytic or non-melanocytic. This study aims to provide a systematic review of anterior segment optical coherence tomography (AS-OCT) findings in iris and ciliary body tumors. We conducted a search of published articles related to the use of AS-OCT in iris/ciliary body tumors as of December 2022. Databases that were searched included PubMed, Scopus, and Web of Science. The following search terms in various combinations were used: 'anterior segment optical coherence tomography,' 'ciliary body melanoma,' 'ciliary body nevus,' 'ciliary body tumor,' 'iris cyst,' 'iris melanoma,' 'iris nevus,' 'iris tumor,' and 'metastasis.' A total of 41 studies (10 original articles and 31 case reports) met the inclusion criteria. AS-OCT data pertaining to 545 iris/ciliary body lesions could be retrieved. AS-OCT has proved to be useful as a noninvasive tool for the diagnosis of solid tumors involving the iris/angle with no marked ciliary body involvement, iris pigment epithelial, and iris stromal cysts. To the best of our knowledge, this is the first systematic review in the literature evaluating the utility of AS-OCT in iris/ciliary body tumors. [ABSTRACT FROM AUTHOR]