Asian Eyes Research Articles

Does the palpebral morphology influence the tear meniscus height between Caucasian and Asian eyes?

The central lower TMH is used as a clinical measure of tear volume in the assessment of contact lens candidates and patients with dry eyes. Ethnic differences in eyelid morphology may influence the measurement of the TMH. Furthermore, with the advent of larger contact lenses, such as scleral lenses, it would be of clinical value to assess the TMH centrally and peripherally. The purpose of this study was to evaluate and compare the TMH at different positions along the palpebral margin between Caucasian and Asian eyes. This prospective study evaluated the lower TMH in five positions (central, temporal and nasal limbus and temporal and nasal periphery) of the right eye using the Keratograph 5M (Oculus) instrument in Caucasian and Asian participants between 10 am and 12 pm. The TMH at each position was taken three times and averaged and analyzed using a 5 × 2 repeated-measures analysis of variance. Central TMH did not differ significantly (F = 0.02, p=0.88) in Caucasians (n = 20, aged 24.45 [2.30] years, TMH 0.320 [0.052] mm) and Asians (n = 20, aged 22.25 [3.43] years, TMH 0.325 [0.048] mm). A difference was noted with respect to TMH positions along the lid margin (F = 64.17, p<0.001), independent of ethnicity (F = 2.15, p=0.15). A post hoc analysis revealed a significantly higher TMH temporally when compared with centrally or nasally (p<0.001). This study demonstrated the similarity of the central TMH and the differences in the peripheral TMH within Caucasian and Asian eyes. This may be clinically relevant when using the Tear Film & Ocular Surface Society Dry Eye Workshop II diagnostic algorithm for dry eyes and when fitting scleral contact lenses. Future studies need to consider that ethnic differences may exist for certain tests in order to personalize the care and management of each patient.

Comparing Optical Coherence Tomography Angiography Metrics in Healthy Chinese and Caucasian Adults.

The goal of the present study was to identify differences in retinal microvasculature between healthy Caucasians and healthy Asians in order to provide a better understanding of the variability between different ethnic groups. In this cross-sectional study, 191 healthy Chinese and Caucasian participants were enrolled. They underwent optical coherence tomography angiography (OCTA) scans with Zeiss Cirrus HD-5000 Spectral-Domain with AngioPlex. Linear regression models were used to investigate the association of OCTA metrics with potential risk factors. Whereas participants in both groups are comparable in age and sex, Chinese participants had a longer axial length, higher spherical equivalent, higher intraocular pressure (p < 0.001), and a significantly higher perfusion density of large vessels in the superficial capillary plexus (p < 0.001). Regarding the foveolar avascular area (FAZ), Chinese participants had a larger superficial FAZ, a wider superficial FAZ perimeter, and a more circular deep FAZ shape (p < 0.001). There are significant differences in the retinal vasculature between Caucasian and Asian eyes as measured using OCTA. This needs to be considered when developing normative databases. Whether such findings relate to inter-racial differences in the incidence of retinal vascular disease remains to be shown.

Combined Phacoemulsification and Hydrus Microstent Implantation in Asian Eyes With Moderate-to-Severe Normal Tension Glaucoma-12-Month Outcomes.

This study reports 12-month outcomes of combined phacoemulsification and Hydrus Microstent implantation in Asian eyes with moderate-to-severe normal tension glaucoma (NTG), demonstrating a significant reduction in glaucoma medications with an excellent intra and postoperative safety profile. To evaluate the 12-month safety and efficacy outcomes of combined phacoemulsification and Hydrus Microstent (Ivantis Inc.) implantation in Asian eyes with moderate to severe NTG. Retrospective study of consecutive surgeries performed from August 2019 to August 2021 in a single tertiary eye centre in Singapore. Outcome measures included a reduction in intraocular pressure (IOP), number of glaucoma medications, and intra and postoperative complications. Data from 21 eyes of 21 subjects were analyzed. All subjects were ethnic Chinese, and the majority were males (14, 66.7%). At baseline, the mean IOP was 13.3 (2.3) mm Hg, all eyes had a Humphrey visual field mean deviation of ≥-6dB [mean: -13.9 (4.3) dB], and all eyes were on at least one glaucoma medication. There was no statistically significant reduction in IOP at all time points compared with baseline (all P > 0.05). However, the median number of medications was reduced from 2 to 0 at all time points, up to postoperative month (POM) 12 (all P < 0.001). There were no intraoperative complications. No eyes underwent secondary glaucoma procedures nor lost any Snellen line of visual acuity by POM12. One (4.8%) eye experienced numerical hypotony at postoperative day 1, which resolved conservatively. Two (9.5%) eyes underwent laser iridoplasty for stent occlusion by iris. There was no deterioration in Humphrey visual field mean deviation at POM12 compared with baseline (n = 20, P > 0.05). Combined phacoemulsification and Hydrus Microstent implantation were effective in reducing medication burden in Asian eyes with moderate to severe NTG, up to 12 months postoperatively.

Comparison of keratometry and total corneal power, as measured by an SS-OCT-based optical biometer, for intraocular lens power calculation in Asian eyes.

To investigate whether standard keratometry (K) or total corneal power (TCP) leads to more accurate refractive outcomes for intraocular lens (IOL) power calculation. Public hospital. Retrospective evaluation of a diagnostic test instrument. Preoperatively, all patients underwent optical biometry with Anterion, a swept-source optical coherence tomography device providing both K and TCP. The same IOL model was implanted in all cases. The whole sample was divided into a training dataset, used to optimize the formula constants, and a testing dataset, used to investigate the spherical equivalent prediction error (SEQ-PE) of 8 IOL power formulas. Trueness, precision, and accuracy were evaluated by means of the robust 2-sample t test. Cochran Q test was performed to assess whether the percentage of eyes with an SEQ-PE within each threshold was significantly different; in such an event, the McNemar test was then applied. Both the training and testing datasets included 317 eyes. No significant differences were detected for trueness because of constant optimization. Precision and accuracy were better when K was entered, although a statistically significant difference was observed only with the EVO (precision: P = .02 and accuracy: P = .03) and Haigis ( P < .01 for both precision and accuracy) formulas. No significant differences were observed for the percentage of eyes with an absolute SEQ-PE within any threshold. With most formulas, IOL power calculation is not more accurate when TCP is used instead of K.

Medial Epicanthoplasty with the Skin Re-Draping Technique: Technical Refinements for Predictable outcomes.

The epicanthus is a common feature of the Asian eyes. A prominent medial epicanthal fold gives the impression of a blunted affect and the procedure for its removal, the medial epicanthoplasty, is a very commonly requested by Asian patients. This may be performed as an isolated procedure or more commonly in combination with the upper blepharoplasty. Many conventional medial epicanthoplasty techniques are based on skin flaps transposition and excisions, usually variations of the V-Y, W or Z-plasties (1-4). While these have been variably successful at correcting the epicanthal fold, the common problem is significant scarring in the medial canthal and lower eyelid regions (5-8). This is particularly problematic in Asian patients with greater tendencies for hypertrophic scarring and scar hypo or hyper-pigmentation (9). Recently, the skin re-draping method, designed with incisions limited within the margins of the medial canthus and precise and targeted disruption of the underlying fibromuscular tissues, has emerged as the preferred surgical technique for many Asian surgeons because of its effectiveness and superior aesthetic outcomes(6, 10-12). This technique delivers the most inconspicuous incisions and is advantageous because it is effective in eliminating epicanthal folds of various severities. Precise execution of this technique is difficult, given the complex 3-dimensional anatomy of the epicanthus. This paper presents a detailed explanation of surgical concepts of the skin re-draping epicanthoplasty and provide a step-by-step guide to performing this procedure in a safe and effective manner.

Outcomes of iStent inject combined with cataract surgery in Asian eyes: Australian data from the Fight Glaucoma Blindness international registry

PurposeTo analyse real-world outcomes in Asian eyes of iStent inject, a second-generation trabecular micro-bypass stent, combined with phacoemulsification.MethodsThis is a multi-centre, observational study of glaucomatous Asian eyes that have undergone iStent inject implantation combined with cataract surgery. Patient data were extracted from the Fight Glaucoma Blindness! Registry. Outcome measures included those of IOP reduction, glaucoma medication reduction, and adverse events including the need for secondary surgery.Results123 eyes of 86 patients with a mean age of 68.4 ± 9.3 years underwent iStent inject implantation with phacoemulsification. At baseline, the mean ± SD preoperative intraocular pressure (IOP) was 16.0 ± 4.4 mmHg, and the mean preoperative number of topical glaucoma medications was 1.9 ± 1.4. At 12 months 30.8% of eyes demonstrated a reduction in IOP greater than 20%, the mean IOP reduction was 12.5% with an additional reduction of 0.7 glaucoma medications. 40% of eyes were using no medications at 12 months compared to 16.3% preoperatively. 8.2% of eyes required a subsequent procedure within the 12-month follow-up window.ConclusioniStent inject implantation combined with phacoemulsification in Asian eyes showed a reduction of IOP and glaucoma medication use in a real-world clinical setting. The safety profile of the device is good with minimal adverse outcomes, however, a subset of patients required secondary procedures within the 12 month follow up.

Aqueous humour protein dysregulation in Asian eyes with primary open angle glaucoma

The pathophysiology of Primary Open Angle Glaucoma (POAG) remains poorly understood. Through proteomic analysis of aqueous humour (AH) from POAG patients, we aim to identify changes in protein composition of these samples compared to control samples.High resolution mass spectrometry-based TMT6plex quantitative proteomics analysis is performed on AH samples collected from POAG patients, and compared against a control group of patients with cataracts. Data are available via ProteomeXchange with identifier PXD033153.1589 proteins were quantified from the aqueous samples using Proteome Discoverer version 2.2 software. Among these proteins, 210 were identified as unique master proteins. The proteins which were up or down-regulated by ±3 fold-change were considered significant. Human neuroblastoma full-length cDNA clone CS0DD006YL02 was significantly upregulated in patients with severe POAG on >2 medications, while actin, cytoplasmic 1, V2-7 protein (fragment), immunoglobulin-like polypeptide 1 and phosphatidylethanolamine-binding protein 4 were only present in these patients with severe POAG on >2 medications.Beta-crystallin B1 and B2, Gamma-crystallin C, D and S were significantly downregulated in the severe POAG ≤2 glaucoma medications group.Beta-crystallin B2, Gamma-crystallin D and GCT-A9 light chain variable region (fragment) were significantly downregulated in the non-severe POAG group.Actin, cytoplasmic 1 was significantly upregulated in subjects with severe POAG who required more than 2 glaucoma medications. Crystallins (Beta-crystallin B1 and B2, Gamma-crystallin C, D and S) were significantly downregulated in subjects with severe POAG who required less than 2 glaucoma medications.

Biochemical component analysis of human myopic corneal stroma using the Raman spectrum.

This study aimed to measure the Raman spectrum of the human corneal stroma lens obtained from small incision lenticule extraction surgery (SMILE) in Asian myopic eyes using a confocal Raman micro-spectrometer built in the laboratory. Forty-three myopic patients who underwent SMILE with equivalent diopters between - 4.00 and - 6.00 D were selected, and the right eye data were collected. Corneal stroma lenses were obtained during surgery, and the Raman spectra were measured after air drying. The complete Raman spectrum of human myopic corneal stroma lens tissue was obtained within the range of 700-4000cm-1. Thirteen characteristic peaks were found, with the stronger peaks appearing at 937cm-1, corresponding to proline, valine, and the protein skeleton of the human myopic corneal stroma lens; 1243cm-1, corresponding to collagen protein; 1448cm-1, corresponding to the collagen protein and phospholipids; and 2940cm-1, corresponding to the amino acid and lipids, which was the strongest Raman peak. These results demonstrated that Raman spectroscopy has much potential as a fast, cost-effective, and reliable diagnostic tool in the diagnosis and treatment of eye diseases, including myopia, keratoconus, and corneal infection.

Is Kidney Function Associated with Age-Related Macular Degeneration?: Findings from the Asian Eye Epidemiology Consortium

PurposeChronic kidney disease (CKD) may elevate susceptibility to age-related macular degeneration (AMD) due to shared risk factors, pathogenic mechanisms, and genetic polymorphisms. Given the inconclusive findings in prior studies, we investigated this association using extensive datasets in the Asian Eye Epidemiology Consortium. DesignCross-sectional study. Participants51,253 participants from 10 distinct population-based Asian studies. MethodsAMD was defined using the Wisconsin Age-Related Maculopathy Grading System, the international Age-related Maculopathy epidemiological study group classification, or the Beckman clinical classification. CKD was defined as estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73m2. A pooled analysis using individual-level participant data was performed to examine the associations between CKD and eGFR with AMD (early and late), adjusting for age, sex, hypertension, diabetes, body mass index, smoking status, total cholesterol and study groups. Main Outcome Measuresodds ratio (OR) of early and late AMD. ResultsAmong 51,253 participants (mean age: 54.1±14.5 years), 5,079 had CKD (9.9%). The prevalence of early AMD was 9.0%, and late AMD was 0.71%. After adjusting for confounders, individuals with CKD were associated with higher odds of late AMD (OR, 1.46; 95% CI, 1.11-1.93; P=0.008). Similarly, poorer kidney function (per 10-unit eGFR decrease) was associated with late AMD (OR, 1.12; 95% CI, 1.05-1.19; P=0.001). Nevertheless, CKD and eGFR were not significantly associated with early AMD (all P ≥0.149). ConclusionsPooled analysis from 10 distinct Asian population-based studies revealed that CKD and compromised kidney function are significantly associated late AMD. This finding further underscores the importance of ocular examinations in CKD patients.

Focused analysis of RNFL decay in glaucomatous eyes using circular statistics on high-resolution OCT data.

We generated Optical Coherence Tomography (OCT) data of much higher resolution than usual on retinal nerve fiber layer (RNFL) thickness of a given eye. These consist of measurements made at hundreds of angular-points defined on a circular coordinate system. Traditional analysis of OCT RNFL data does not utilize insightful characteristics such as its circularity and granularity for common downstream applications. To address this, we present a new circular statistical framework that defines an Angular Decay function and thereby provides a directionally precise representation of an eye with attention to patterns of focused RNFL loss. By applying to a clinical cohort of Asian Indian eyes, the generated circular data were modeled with a finite mixture of von Mises distributions, which led to an unsupervised identification in different age-groups of recurrent clusters of glaucomatous eyes with distinct directional signatures of RNFL decay. New indices of global and local RNFL loss were computed for comparing the structural differences between these glaucoma clusters across the age-groups and improving classification. Further, we built a catalog of directionally precise statistical distributions of RNFL thickness for the said population of normal eyes as stratified by their age and optic disc size.

Afro-Asian Antagonism and the Long Korean War

American racial politics during the long Korean War formed what this essay terms Afro-Asian antagonism, a racial hate between African Americans and Asians (and Asian Americans). When the Truman administration issued Executive Order 9981 and proclaimed its commitment to military racial integration in 1948, two years before the outbreak of the Korean War, it seemed to signal a significant step of racial progress. Black servicemen who enlisted in the “liberalized” military, however, were strategically deployed to represent American national violence, especially to the eyes of Asians who were internalizing antiblack racism imported from the United States through the military apparatus. In the face of decolonization and an upsurge in civil rights movements, this article argues, the executive order molded Black Korean War veterans into an instrument to abort Afro-Asian connections while promoting racial liberalism to a global audience. The Korean War inaugurated the American Cold War racial formation that endures into the twenty-first century. Contrasting two Korean War novels written by Asian American and African American authors—Nora Okja Keller’s Fox Girl (2002) and Toni Morrison’s Home (2012)—this article traces how Afro-Asian orphans and a Black veteran internalize and challenge the Afro-Asian antagonisms of the long Korean War.

Quantum molecular resonance electrotherapy (Rexon-Eye) for recalcitrant dry eye in an Asian population.

To assess the safety, efficacy, patients' satisfaction and acceptability of Rexon-Eye electrotherapy in treating Asian severe dry eye disease (DED) patients. Prospective parallel-arm pilot study recruiting 40 DED Chinese patients with >moderate recalcitrant DED (Contact Lens Research Unit [CCLRU] > grade 2). Subjects were randomized into 2 groups, undergoing four weekly treatment sessions each: group 1 received full treatment power; group 2 received control treatment (power 1 treatment). Non-invasive tear break-up time (NIBUT), cornea fluorescein staining graded via CCLRU and Schirmer's I test were compared pre- and 2 months post-treatment. The SPEED and QUEST questionnaires that evaluated subjective symptoms and treatment satisfaction, respectively, at baseline and 2 weeks post-treatment were carried out. Tear cytokine levels in both groups were examined at 2 weeks post-treatment. The amount of improvement in post-treatment corneal staining in the inferior corneal zone was significant in Group 1 (p = 0.038) but not in Group 2 (p = 0.832). Group 1 eyes with worse baseline staining (total score >9.8) had a significantly greater reduction of corneal staining than those with better baseline staining (-11.7 ± 1.98 vs. -4.6 ± 2.89, p < 0.001). There were no other significant differences in NIBUT, Schirmer's 1 and cornea fluorescein staining grading within or between the groups.: Group 1 (n = 24) had improved subjective dryness scores compared to Group 2 (n = 16) (SPEED score: 6.38 + 4.16 vs. 10.0 + 6.36, p = 0.04). No significant differences were seen in 11 tear cytokine levels at 2 weeks post-treatment between the 2 groups. In Asian DED patients treated with Rexon-Eye, inferior cornea staining showed significant improvement compared to placebo, and eyes with greater cornea staining at baseline achieved a greater improvement in staining. There were no other significant improvements in NIBUT and Schirmer's 1. Rexon-Eye also improved subjective DED scores in 41.7% of eyes without any adverse effects.

Comparing clinical outcomes of Optiwave Refractive Analysis, Lenstar, and surgeon’s modified method for intraocular lens power calculation in Asian eyes

The study aimed to compare the accuracy of intraocular lens (IOL) calculation to predict postoperative refraction by Optiwave Refractive Analysis (ORA), Lenstar LS 900, and the surgeon’s Modify method in normal Asian eyes. The IOL power of the Lenstar group was calculated according to Lenstar LS 900, whereas the surgeon's Modify group used topography, axial length (AL) of Lenstar, and Barrett Universal II online formula. Intraoperative aphakic measurements and IOL power calculations were obtained with the ORA system. From the results acquired through Lenstar, Modify, and ORA, the surgeon used his judgment to select the actual IOL power. Postoperative manifest refraction spherical equivalent (MRSE) was obtained 2 months after surgery. The prediction error (PE) was calculated as the difference between the postoperative MRSE and the target refraction proposed by three methods. AL, anterior chamber depth (ACD, measured from corneal endothelium to lens), lens thickness (LT), and ACD + 1/2LT were also included in the survey. In 67 eyes, the average real PE was smaller for the Lenstar (0.06 ± 0.44) and Modify (− 0.05 ± 0.40) than for the ORA group (− 0.25 ± 0.60, p < 0.05). The ORA system demonstrated the best results of IOL power selection in eyes with a normal range of ACD + 0.5 LT (5.2–5.6 mm) in Asian eyes.

Long-term trifocal toric intraocular lens outcomes in Asian eyes after cataract surgery.

To determine the visual and refractive outcomes of trifocal toric intraocular lens (IOL) implantation in Asian eyes with cataract and astigmatism. Asian Eye Institute, Makati City, Philippines. Prospective study. 187 eyes were implanted with the FineVision POD FT IOL and followed for 2 years. The measurements included subjective refraction, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), distance-corrected intermediate visual acuity (DCIVA), uncorrected near visual acuity (UNVA), distance-corrected near visual acuity (DCNVA), defocus curve, photopic and mesopic contrast sensitivity, and rotational stability. The mean spherical equivalent and cylinder values were, respectively, -0.07 ± 0.34 diopters (D) and -0.48 ± 0.31 D at the 2-year follow-up. At this same follow-up, 69.4% of patients had monocular CDVA and 79.3% had binocular UDVA ≤0.0 logMAR. For intermediate vision, monocular DCIVA reached 74.1%, while binocular UIVA was 86.2% ≤ 0.1 logMAR. Near vision showed 63% for monocular DCNVA and 70.7% for binocular UNVA ≤0.1 logMAR. The mean values at this follow-up were 0.02 ± 0.08, 0.08 ± 0.10, and 0.10 ± 0.12 logMAR for CDVA, DCIVA, and DCNVA, respectively. At the visual acuity threshold of ≤0.20 logMAR, the binocular defocus curve extended up to -3.75 D. Stable contrast sensitivity values were obtained at the different follow-ups. The mean IOL rotation was ≤2 degrees. The FineVision POD FT IOL yielded good visual outcomes at far, near, and intermediate distances with accurate refractive outcomes and good rotational stability in Asian eyes.

A survey of Asian Eye Institutions on perioperative antibiotic prophylaxis in cataract surgery

PurposeTo determine current institutional practice patterns for the use of perioperative antibiotics and other measures to prevent infection after cataract surgery in Asia.MethodsAn online survey-based study of leading eye institutions in China, Hong Kong, India, Indonesia, Japan, Malaysia, Pakistan, Philippines, Singapore, South Korea, Taiwan, Thailand and Vietnam was conducted. The survey was administered to 26 representative key opinion leaders from prominent tertiary eye institutions that are also national academic teaching institutions in Asia. Survey responses were collated and anonymized during analysis.ResultsAll surveyed institutions used povidone iodine for the preoperative antiseptic preparation of the eye, with notable variations in the concentration of povidone iodine used for conjunctival sac instillation. Preoperative topical antibiotics were prescribed by 61.5% and 69.2% of institutions in low-risk and high-risk cases, respectively. Regarding the use of intra-operative antibiotics, 60.0% and 66.7% of institutions administered intracameral antibiotics in low-risk and high-risk patients, respectively. Postoperative topical antibiotics use patterns were generally very similar in low-risk and high-risk patients. Over half of the institutions (52.2% and 68.0% in low-risk and high-risk patients, respectively) also indicated prolonged postoperative use of topical antibiotics (> 2 weeks). Not all surveyed institutions had established policies/protocols for perioperative antibiotic use in cataract surgery, endophthalmitis surveillance, and/or a monitoring program for emerging antimicrobial resistance.ConclusionThere are variations in antimicrobial prophylaxis approaches to preoperative, intra-operative and postoperative regimens in cataract surgery in Asia. More evidence-based research is needed to support the development of detailed guidelines for perioperative antibiotic prophylaxis to reduce postoperative infections.

Associations between Chronic Kidney Disease and Thinning of Neuroretinal Layers in Multiethnic Asian and White Populations

To evaluate the relationships between chronic kidney disease (CKD) with retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL) thickness profiles of eyes in Asian and White populations. Cross-sectional analysis. A total of 5066 Asian participants (1367 Malays, 1772 Indians, and 1927 Chinese) from the Singapore Epidemiology of Eye Diseases Study (SEED) were included, consisting of 9594 eyes for peripapillary RNFL analysis and 8661 eyes for GCIPL analysis. Additionally, 45 064 White participants (87 649 eyes) from the United Kingdom Biobank (UKBB) were included for both macular RNFL analysis and GCIPL analysis. Nonglaucoma participants aged ≥ 40 years with complete data for estimated glomerular filtration rate (eGFR) were included from both SEED and UKBB. In SEED, peripapillary RNFL and GCIPL thickness were measured by Cirrus HD-OCT 4000. In UKBB, macular RNFL and GCIPL were measured by Topcon 3D-OCT 1000 Mark II. Chronic kidney disease was defined as eGFR < 60 ml/min/1.73 m2 in both data sets. To evaluate the associations between kidney function status with RNFL and GCIPL thickness profiles, multivariable linear regression with generalized estimating equation models were performed in SEED and UKBB data sets separately. Average peripapillary and macular RNFL thickness and macular GCIPL thickness. In SEED, after adjusting for age, gender, ethnicity, systolic blood pressure, antihypertensive medication, diabetes, hyperlipidemia, body mass index, smoking status, and intraocular pressure, presence of CKD (β=-1.31; 95% confidence interval [CI],-2.37 to-0.26; P= 0.015) and reduced eGFR (per10ml/min/1.73 m2; β=-0.32; 95% CI,-0.50 to-0.13; P= 0.001) were associated with thinner average peripapillary RNFL. Presence of CKD (β=-1.63; 95% CI,-2.42 to-0.84) and reduced eGFR (per10 ml/min/1.73 m2; β=-0.30; 95% CI,-0.44 to-0.16) were consistently associated with thinner GCIPL in SEED (all P < 0.001). In UKBB, after adjusting for the above-mentioned covariates (except ethnicity), reduced eGFR (per 10 ml/min/1.73 m2; β=-0.06; 95% CI,-0.10 to-0.01; P= 0.008) was associated with thinner macular RNFL and CKD (β=-0.62; 95% CI,-1.16 to-0.08; P= 0.024) was associated with thinner average GCIPL. We consistently observed associations between CKD and thinning of RNFL and GCIPL across Asian and White populations' eyes. These findings further suggest that compromised kidney function is associated with RNFL and GCIPL thinning. The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Поиски возможностей объективного критерия риска развития острого приступа глаукомы в анатомически коротких глазах

Purpose. To assess the prognostic significance of the LAF coefficient (Lens thickness/ Axial length Factor) as risk factor for acute attack of glaucoma in anatomically short eyes of Europeans. Material and methods. 1st group consisted of 24 patients (48 eyes) with axial hyperopia. 2nd group included 24 patients (48 eyes) with primary closure of the anterior chamber angle. The 3rd group was formed by 17 patients (34 eyes) with initial stage of primary angle-closure glaucoma. The 4th group included 35 patients (35 eyes) with an acute attack of glaucoma. The studied groups did not differ in age (p = 0.97) and gender (p = 0.28). Lens thickness and axial length (AL) were measured using A-scan on biometer IOLMaster 700 (Carl Zeiss®, Germany) with calculation of LAF coefficient. Results. The LAF coefficient in the 4th (acute attack) group was statistically significantly higher than in the first 3 groups. The best separation of the 1st and 4th groups is provided by LAF coefficient compared to lens thickness and AL indexes with sensitivity, specificity and the Area Under the Curve (AUC) of 89 %, 83 % and 0.9, respectively. LAF coefficient values greater than 2.332 in patients with short AL are objectively associated with high risk of acute attack of glaucoma. The average value of the LAF coefficient (2.528) obtained by us in the 4th (acute attack of glaucoma) group significantly exceeds these indexes in works of other authors, which may be due to morphometric features of structure of eyes of Europeans compared to eyes of Asians. Conclusion. The LAF coefficient provides better separation of the 1st and 4th groups, in comparison with the lens thickness indexes, and especially the AL. LAF coefficient values greater than 2.332 in eyes with short AL objectively indicate high risk of acute attack of glaucoma, as evidenced by high sensitivity, specificity, and AUC. Keywords: acute attack of glaucoma, LAF, lens thickness, short axial length, risk factor

Rotational stability of plate-haptic toric intraocular lenses in Asian eyes: risk period for intraocular lens rotation and its influencing factors.

To investigate the rotational stability of plate-haptic toric intraocular lenses (IOLs) during 3-month follow-up. Eye and ENT Hospital of Fudan University, Shanghai, China. Prospective observational study. Patients with cataracts implanted with AT TORBI 709M toric IOLs were enrolled and followed at 1 hour, 1 day, 3 days, 1 week, 2 weeks, 1 month, and 3 months postoperatively. A linear mixed model of repeated measures was applied to investigate the time course of absolute IOL rotation change. The 2-week overall IOL rotation was analyzed in the age, sex, axial length (AL), lens thickness (LT), preexisting astigmatism, and white-to-white subgroups. A total of 328 eyes of 258 patients were included. The rotation from the end of surgery to 1 hour and 1 day to 3 days was significantly smaller compared with the rotation from 1 hour to 1 day but more than that at other time intervals in the overall group. 2 weeks postoperatively, the mean uncorrected distance visual acuity and remaining positive cylinder were 0.19 ± 0.22 logMAR and 0.60 ± 0.44 diopters, respectively. Significant between-group differences in 2-week overall rotation were found in the age, AL, and LT subgroups. Maximum rotation occurred within 1 hour to 1 day postoperatively, and the first 3 days postoperatively was a high-risk period for the plate-haptic toric IOL rotation. Surgeons should make the patients aware of this.

Long Term Clinical Outcomes of Hydrophilic and Hydrophobic Versions of a Trifocal IOL with the Same Optical Design.

To show the visual and refractive outcomes in Asian eyes with cataract when bilaterally implanted with either a hydrophobic FineVision POD F GF or a hydrophilic FineVision POD F intraocular lens (IOL). Forty-six patients were randomized to receive POD F GF or POD F IOLs. Visual and refractive outcomes were assessed up to 24 months post-surgery. Measurements included uncorrected-distance visual acuity, corrected-distance visual acuity (CDVA), distance-corrected intermediate visual acuity (DCIVA), distance-corrected near visual acuity (DCNVA), refraction, defocus curve, photopic and mesopic contrast sensitivity, and patient-reported outcomes. Mean spherical equivalent was close to emmetropia for both groups and stable across postoperative visits. Overall, 97.73% and 100% of eyes in the POD F GF IOL group and 95.65% and 100%, of eyes in the POD F IOL group were within ±1.00D of the target refraction at 12 and 24 months, respectively. All patients showed a CDVA of ≥20/25 at 12- and 24-months post-surgery. In both groups, 24 months post-surgery 91% of patients presented a DCIVA of ≥20/25 and 83.3% of patients had a DCNVA of ≥20/25. Defocus curve showed continuous visual acuity, being 20/32 or better in both groups over a 4.00D range between 1.00D and -3.00/-3.50D. Both groups showed good contrast sensitivity values for photopic and mesopic conditions. Overall, 86.4%, 86.4%, and 72.7% of patients implanted with the POD F GF IOL reported not wearing glasses at all for distance, intermediate, and near vision, respectively. These values were 81.8%, 86.4%, and 90.9% for patients implanted with the POD F IOL. Both groups of patients reported similar satisfaction percentages (100% very satisfied/satisfied) and would recommend the procedure (100% definitively yes/probably yes). This study demonstrates good visual and refractive outcomes for both the FineVision POD F GF and the FineVision POD F IOLs when implanted in Asian eyes.

Evaluation of generated synthetic OCT images in deep‐learning models for glaucoma detection

AbstractPurpose: To evaluate the use of synthetically generated OCT images for the development of deep‐learning models in glaucoma detection.Methods: Progressively Grown Generative Adversarial Network (PGGAN) models for glaucoma and healthy eyes were developed with data from 862 Asian glaucoma eyes and 990 Asian normal eyes to generate synthetic circumpapillary OCT images. Glaucoma detection deep‐learning models were trained using 1200, 10 000, 60 000 or 200 000 of the generated images, equally split between glaucoma and normal. Detection performance was evaluated on real images from an Asian dataset of 140 eyes from 112 subjects and a Caucasian dataset of 300 eyes from 160 subjects, with half of each being glaucoma. Results were compared with a glaucoma detection model trained with real images from 600 glaucoma and 600 healthy eyes, and with global retinal nerve fibre layer (RNFL) measurements using Area Under the Curve (AUC) analysis.Results: Glaucoma detection performance improved with increasing synthetic dataset size, from an AUC of 0.945 [95% CI: 0.917–0.974] and 0.856 [95% CI: 0.819–0.889] on the Asian and Caucasian test data respectively when 1200 synthetic images were used, to AUCs of 0.969 [95% CI: 0.949–0.987] and 0.897 [95% CI: 0.867–0.927] when 200 000 synthetic images were used. The model trained on 200 000 synthetic images was significantly better (p &lt; 0.05) than the model trained on real images on the Caucasian test data (0.838 [95% CI: 0.800–0.874]) but not on the Asian test data (0.962 [95% CI: 0.939–0.985]). Both detection models showed significantly better AUCs than that of global RNFL for both Asian (0.920 [95% CI: 0.884–0.957]) and Caucasian (0.833 [95% CI: 0.793–0.869]) test datasets.Conclusions: Synthetically circumpapillary OCT images used to train deep‐learning glaucoma detection models showed similar performance to a model trained with real data, and could potentially be used to facilitate sharing of imaging data while addressing privacy considerations.