Axial Length Of Eye Research Articles

Rotational Stability, Decentration, and Tilt of a New Hydrophobic Acrylic Intraocular Lens Platform

To evaluate rotational stability, decentration and tilt of the monofocal intraocular lens (IOL) Nanex (NC1-SP; HOYA Surgical Optics). Prospective interventional case series. The study was performed at the Department of Ophthalmology, Medical University of Vienna. The study population comprised 130 eyes of 68 patients with age-related cataract who underwent cataract surgery with implantation of a Nanex IOL. Baseline image for rotational stability evaluation was obtained at the end of surgery (EoS) and compared to retroillumination images taken at 1 hour, 1 week, 1 month, and 6 months after surgery. Axis alignment was assessed using nonmovable landmarks on the sclera and the optic-haptic junctions of the IOL. Anterior segment OCT images were performed to evaluate decentration and tilt. The main outcome measure was absolute rotation from EoS to 6 months postoperatively. Median IOL rotation of all eyes from EoS to 6 months was 1.9° (interquartile range 0.1°-37.5°). Ten eyes (9.71%) rotated more than 5° and 2 eyes (1.94%), more than 10°. IOL rotation did not correlate with axial eye length (Spearman r=-0.042, P=.46), crystalline lens thickness (Spearman r=0.134, P=.19), and crystalline lens equatorial diameter (Spearman r=0.101, P=.325). IOL rotation positively correlated with anterior fibrosis severity (Spearman r=0.321, P=.002). Preoperative decentration (0.2 ± 0.12 mm) and tilt (5.7 ± 1.6°) did not change significantly after surgery (0.22 ± 0.12 mm and 5.62 ± 1.49°, respectively). The investigated IOL presented good rotational stability and low decentration and tilt values. Nevertheless, anterior capsule fibrosis development led to a higher tendency of IOL rotation after 1 week.

Macular Vascularity and Ganglion Cell Complex Parameters in the Young Adults with Myopia and Progressive Myopia.

The purpose of this study is to determine the relationships between foveal avascular zone (FAZ), foveal vascular density (FD) and GCC (ganglion cell complex) parameters in a healthy myopic population using optical coherence tomography angiography (angio-OCT). Three hundred and eighty-one eyes of 381 healthy participants were included into this study and assigned to three groups according to their spherical equivalent (SE) values and an additional progressive myopia group. One randomly chosen eye from each patient was analyzed. GCC mean thickness, focal loss of volume (FLV), global loss of volume (GLV), FAZ area, FAZ perimeter, and FD parameters were obtained with the RTVue AngioOCT device. FAZ area and its perimeter were strongly correlated with the belonging spherical equivalent group (p = 0.0001, p = 0.0008 accordingly), being the largest in progressive myopia subgroup (mean size 0.42mm2). Other factors that were significantly higher in myopic eyes were FLV (p = 0.0023), GLV (p = 0.0020). There were no differences in FD between groups. In the myopic and progressive myopia groups, there was a significant relationship between FAZ area and FLV, GLV, and GCC thickness. We found that in myopic eyes with AXL exceeding 26.6 mm, FAZ becomes negatively correlated to mean GCC thickness. In myopia, compared to non-myopic groups, there is a greater loss of neural tissue represented by a thinner GCC layer, greater FLV and GLV parameters, and worse blood supply represented by a larger FAZ area. Eye axial length of 26.6 mm is a breaking point, where the negative FAZ area to GCC thickness relationship curve is getting significantly steeper.

Comparison of ocular morphological measurement by wide-angle echography and magnetic resonance imaging.

To compare the eye axial length (AL), equatorial horizontal diameter (HD), and equatorial vertical diameter (VD) of normal eyes using a novel wide-angle, arc-scanning, ultrasound diagnostic device for wide-angle B-mode echography. In this cross-sectional study, wide-angle B-mode echography and magnetic resonance imaging (MRI) were conducted on 22 normal eyes; the AL, HD, and VD were measured. The mean ALs were as follows: wide-angle B-mode echography, 25.22±1.47mm and MRI, 25.24±1.46mm; a significant correlation was observed between the two measurements (β=0.995 [0.976, 1.013]; p<0.001; 95% R2=1.00). The mean HDs were as follows: wide-angle B-mode echography, 22.33±0.84mm and MRI, 22.55±0.90mm; a significant correlation was observed between the two measurements (β=0.902 [0.750, 1.179]; p<0.001; 95% R2=0.81). The mean VDs were as follows: wide-angle B-mode echography, 22.77±0.91mm; and MRI, 22.88±0.92mm; a significant correlation was observed between the two measurements (β=0.966 [0.853, 1.097]; p<0.001; 95% R2=0.93). There were no significant differences in the measurements for each parameter by wide-angle B-mode echography and MRI. Therefore, wide-angle B-mode echography permits accurate visualization of ocular morphology.

Deep Optic Nerve Head Structures Associated With Increasing Axial Length in Healthy Myopic Eyes of Moderate Axial Length

To elucidate which swept-source optical coherence tomography (OCT)-derived optic nerve head (ONH) parameters are associated with longer axial length (AXL) in healthy myopic eyes. Prospective cross-sectional observational study. Two hundred eleven healthy eyes of 140 participants (96 emmetropic-mild myopic [AXL: 22.2-24.5 mm], 83 moderately myopic [24.5-26.0 mm], and 32 highly myopic [26.0-27.4 mm] eyes) were enrolled. Bruch membrane opening (BMO), anterior scleral canal opening (ASCO) area and ovality, minimum rim width, parameters defining misalignment between the BMO and ASCO planes, OCT-defined region of perineural canal retinal epithelium atrophy and externally oblique choroidal border tissue, circumpapillary retinal nerve fiber layer thickness (cpRNFLT), circumpapillary choroidal thickness (cpChT), lamina cribrosa parameters, and peripapillary scleral (PPS) angle were calculated from BMO-centered radial scans reconstructed from 3D raster scans. Multivariate linear mixed models were used to elucidate ONH parameters that are independently associated with AXL. Longer AXL was associated with a greater misalignment between ASCO and BMO planes, larger region of externally oblique choroidal border tissue, thinner cpChT, larger PPS angle, larger ASCO area, and thicker cpRNFLT (all P < .040 after Bonferroni's correction for number of included explanatory variables). A greater misalignment between BMO and ASCO planes, thinner choroid, a more posteriorly bowed PPS, an enlargement of ASCO, and thicker cpRNFLT were each associated with longer AXL. An enhanced understanding of these AXL-associated configurations should provide essential information to improve our ability to detect glaucoma-induced ONH morphology in myopic eyes.

The Relationship between Axis Length Difference and Refractive Error in Unilateral Myopic Anisometropic Children Treated with Orthokeratology.

To explore the correlation between the axial length (AL) difference (myopic and nonmyopic eye) and the refractive error in children with unilateral myopia anisometropia (UMA) and to elucidate its clinical application in the process of Ortho-K lenses review following nonstop wearing. This study retrospectively analyzed the data of 70 children with UMA (age, 8-15 years) whose myopic eyes were treated with Ortho-K lenses. The spherical equivalent refractive errors (SERE) of the myopic eye ranged from -0.75 D to -4.25 D, and astigmatism was no less than -1.50 D. In addition, SERE of nonmyopic eyes were no less than -0.50 D. AL, and the refractive data of both eyes were measured at baseline. A multivariate linear regression was used to analyze the relationship between the AL difference and refractive error, and paired t-test was used to analyze the changes in AL in both eyes. Every 1 mm axial length change corresponds to -1.627 D (95% CI: -1.921 D, -1.333 D; P < 0.001) change in refractive error in children. The association between the AL change and the degree of myopia did not change with age (P=0.751). Among the 70 subjects, 51 (72.86%) had myopia in the right eye, and the 95% confidence interval (CI) for myopia occurring in the right eye was 62.4%-83.3%. The paired t-test showed that the average AL growth was significantly slower in myopic eyes treated with Ortho-K lenses than in nonmyopic eyes (t = 9.805, P < 0.001). Every 1 mm AL change would cause an average refractive error increase. Age did not influence the association between AL changes and the degree of myopia. The right eye is more likely to be affected in children with UMA. The Ortho-K lens treatment slowed down the growth of AL in the myopic eye in children with UMA.

Repeatability of new optical biometer and agreement with 2 validated optical biometers, all based on SS-OCT.

To evaluate the repeatability of the measurements provided by a new optical biometer (EyeStar 900) based on swept-source optical coherence tomography (SS-OCT) and their agreement with the measurements given by 2 validated biometers based on the same technology, the IOLMaster 700 and Argos. IRCCS G.B. Bietti Foundation, Rome, Italy. Prospective evaluation of diagnostic test. In a series of unoperated eyes, 3 consecutive scans were acquired with the EyeStar 900, and 1 with the IOLMaster 700 and the Argos. The following biometry parameters were analyzed: axial length (AL), keratometry (K), corneal astigmatism, central corneal thickness, corneal diameter (CD), anterior chamber depth (ACD), lens thickness (LT), and lens tilting. Repeatability was assessed using test-retest variability, the coefficient of variation (CoV), and the intraclass correlation coefficient (ICC); agreement was based on the 95% limits of agreement. 56 eyes of 56 patients were analyzed. High repeatability was achieved for all measured parameters, as the CoV was <1% in most cases and ICC was >0.95 for all parameters. Good to high agreement was found among the measurements of the 3 optical biometers, although some statistically significant differences were detected between the EyeStar 900 and Argos (mean K, ACD, LT, and CD were higher with the Argos). The Argos measured a shorter AL in eyes >25 mm. The new generation SS-OCT EyeStar 900 optical biometer produces highly repeatable measurements that are in good agreement with those provided by 2 previously validated instruments.

Evaluation of Macular Pigment Optical Density in Eyes with Hyperopic Anisometropic Amblyopia Using Fundus Reflectometry.

This study aimed to evaluate the macular pigment optical density (MPOD) scores in eyes with hyperopic anisometropic amblyopia and compare those with their fellow and control eyes using one-wavelength fundus reflectometry. This cross-sectional study enrolled 33 patients diagnosed with hyperopic anisometropic amblyopia aged 12-40 years. The control group consisted of 36 hyperopic and 42 emmetropic children, age-matched to the patients. Central macular thickness (CMT), MPOD, axial length (AL), best-corrected visual acuity, and refraction errors were measured between the study group and the control group. Eyes with the diagnosis of hyperopic anisometropic amblyopia had significantly higher mean and maximum (max) MPOD scores compared with their fellow eyes as well as hyperopic and emmetropic eyes (p<0.001 for all). The mean AL in eyes with hyperopic anisometropic amblyopia was statistically shorter than that in hyperopic and emmetropic controls (p=0.027, p<0.001, respectively). The mean CMT was found to be thicker in eyes with hyperopic anisometropic amblyopia when compared to their fellow eyes, as well as hyperopic and emmetropic controls, eventhough there was no significant difference was found among the four groups (p=0.052). The mean MPOD levels were significantly correlated with the difference in CMT (r=-0.21, p=0.032), and logMAR visual acuity scores (r=-0.44, p<0.001) in the hyperopic anisometropic amblyopia group. The present study indicates that the MPOD is reduced in eyes with hyperopic anisometropic amblyopia. This reduction may be due to less visual stimulus-induced deterioration of foveal development and microarchitecture in anisometropic amblyopic eyes.

The effect of sustained eye rotation upon eye length in healthy myopic adults.

The aim of the study was to determine whether ocular movement can affect the shape of the globe and lead to measurable change in axial and peripheral eye length. Ten subjects aged 18-30 years (6 M/4 F) participated with informed consent. The mean spherical equivalent refractive error was ≤-1.00 DS with cylindrical refraction <-1.25 DC. One drop of tropicamide hydrochloride 1% was instilled 20 min before measurement to induce mydriasis and mild cycloplegia. Using IOLMaster, eye length was measured centrally and temporally (25° off-axis) in four different positions. Subjects then rotated their eyes 25° in the temporal direction to fixate on a target for 10 min. After that, the same measurements were repeated. Before rotation, the group mean peripheral eye length was significantly shorter than the central eye length (P < 0.05). There was no significant variation in central or peripheral eye length due to off-axis fixation, either after the initial eye rotation or after fixation for 10 min at the off-axis point. The difference between central and peripheral eye lengths was maintained after 10 min of temporal fixation (P < 0.05). Peripheral eye length was shorter than central eye length showing the prolate shape associated with myopia. The action of the extraocular muscles on the globe has no significant effect upon the retinal shape assessed by off-axis eye length measurement in myopic subjects.

Assessing the efficacy of myopia control in monocular orthokeratology treated unilateral myopic children

PurposeTo investigate the efficacy of myopia control by comparing the orthokeratology (Ortho-K) treated eyes and the emmetropic contralateral eyes in unilateral myopic children, and to identify the inter-individual influence factors.MethodIn this retrospective study, 1566 medical records of children wearing Ortho-K lens were reviewed, and 62 children who received monocular Ortho-K lens for more than 1 year were analyzed. The change in axial length (AL) of the Ortho-K eyes and the emmetropic contralateral eyes was recorded. To evaluate the absolute and relative efficacy of myopia control, the intra-bilateral absolute reduction in AL growth (ibARAL) and the intra-bilateral relative reduction in AL growth (ibRRAL) were calculated as main outcomes. Association of the AL elongation, ibARAL and ibRRAL with age, sex and ocular parameters was analyzed by correlation analysis and generalized estimating equation (GEE) analysis.ResultThe average initial wearing age was 10.76 ± 1.45 (ranged 8.5 to 15.8). The average baseline SER was − 2.15 ± 1.03 (ranged − 5.25 to -1.00) D in the Ortho-K eyes and − 0.01 ± 0.40 (ranged − 0.75 to 0.75) D in the contralateral eyes. At the 1-year follow-up, the average increased AL was significantly less in the Ortho-K eyes (0.07 ± 0.18 mm) than in the fellow eyes (0.48 ± 0.24 mm) (p < 0.001). The mean ibARAL was 0.41 ± 0.30 mm, and the mean ibRRAL was 83.4%±56.3%. In the GEE model, the AL change in Ortho-K eyes (β = 0.051, p = 0.009, 95%CI: 0.012 to 0.090), the ibARAL (β= -0.153, p = 0.000, 95%CI: -0.228 to -0.078) and the ibRRAL (β= -0.196, p = 0.020, 95%CI: -0.361 to -0.030) were independently associated with the spherical equivalent refraction (SER) of the Ortho-K eyes, after adjusting for age, sex, and keratometry.ConclusionIn our study, the Ortho-K treatment was efficacious in controlling axial length growth in the monocular orthokeratology treated unilateral myopic eyes. The efficacy increased when the myopia was more severe. In the children from 8 to 16 years old, the effectiveness was independent of age and sex.

Photoreceptor density in relation to axial length and retinal location in human eyes

The purpose of the study was to examine the density of retinal photoreceptors and retinal pigment epithelium (RPE) cells in relation to myopic axial elongation in human eyes. Using light microscopy, we assessed the density of photoreceptors and RPE cells at the ora serrata, equator, and midperiphery (equator/posterior pole midpoint), and the RPE cell density additionally at the posterior pole, in enucleated human globes. The study included 78 eyes (mean age: 59.2 ± 15.6years; range: 32-85years) with a mean axial length of 27.3 ± 3.6mm (range: 21.5-37.0mm). Close to the ora serrata, at the equator and midperiphery, photoreceptor and RPE cell density was 246 ± 183, 605 ± 299 and 1089 ± 441 photoreceptors/mm and 56.1 ± 13.7, 45.2 ± 15.1, and 48.8 ± 15.6 RPE cells/mm, respectively. Densities of both cell types in all three regions were positively correlated with each other (all P < 0.001) and decreased with longer axial length (all P < 0.001) and longer distance between the ora serrata and the posterior pole (all P < 0.001), most marked at the midperiphery and least marked close to the ora serrata. The PRE cell density at the posterior pole was not significantly (P = 0.35) related to axial length. The photoreceptor density at the ora serrata (beta:- 0.33) and equator (beta: - 0.27) and RPE cell density at the ora serrata (beta: - 0.27) decreased additionally with the presence of glaucoma. The findings suggest that the axial elongation-related decrease in photoreceptor and RPE cell density is most marked at the midperiphery, followed by the equator and finally the ora serrata region. It suggests that the axial elongation-related enlargement of the eye wall predominantly takes place in the retro-equatorial region, followed by the equatorial region.

Influence of scan direction on subfoveal choroidal vascularity index using optical coherence tomography

AbstractPurpose: To investigate the influence of scan direction on subfoveal choroidal vascularity index (CVI) measurements using spectral‐domain optical coherence tomography (SD‐OCT) in young healthy subjects.Methods: Seventy‐eight eyes of 41 healthy volunteers were included. Choroidal structures were obtained using SD‐OCT with enhanced depth imaging (EDI) through radial scans at the center of the macula at 30° × 30°. The subfoveal choroidal images in the horizontal (0°), 45°, vertical (90°) and −45° directions were recorded and CVIs were analysed according to their respective directions, using image binarization. Additionally, subfoveal choroidal thickness (SFCT) and axial eye length were measured.Results: The SFCT and subfoveal CVI showed a negative correlation but were only significant for the 45° scan (Pearson's r = −0.262, p = 0.021). The axial eye length and subfoveal CVI had no significant correlation in any direction (all p &gt; 0.05). In the Bland–Altman plot, the subfoveal CVI measurement showed high agreement among the four scan directions. When the SFCT was ≥300 μm, there was no difference in the measured values of the subfoveal CVI among the four scan directions; however, when the SFCT was &lt;300 μm, there was a significant difference in subfoveal CVI among the scan directions (one‐way analysis of variance, F = 4.685, p = 0.004).Conclusions: In subfoveal CVI measurement, it is considered that the horizontal (0°) scan can represent the vertical (90°) or oblique (45°, −45°) scans. However, when the SFCT is thinner, the subfoveal CVI in each direction of radial scan may vary significantly. Hence, caution is required in the interpretation.

Myopic maculopathy and posterior staphyloma. Correlation with ATN classification and severe pathological myopia

AbstractPurpose: The aims of this study were: (1) to correlate posterior staphyloma with the ATN classification; (2) identify differences in clinical characteristics in terms of axial length (AL), age and best corrected visual acuity (BCVA) in eyes with the presence and absence of posterior staphyloma; (3) correlate the presence of posterior staphyloma with severe pathological myopia.Methods: This was a cross‐sectional and observational study developed in consecutive patients with high myopia. A complete ophthalmological examination, classification of myopic maculopathy according to the ATN grading system, staphyloma classification according to Curtin, and multimodal imaging tests (retinography, swept‐source OCT, autofluorescence and OCT‐angiography) were performed.Results: 336 eyes of 178 patients with high myopia were included. 71.4% of the sample were woman. The mean AL was 29.7 ± 2.6 mm (26–36.7). The mean age was 62.7 ± 13.1 years (27–92). The BCVA was 0.5 ± 0.3 (0–1). 238 eyes (70.8%) presented staphyloma; classifying 73.5% (n = 175/238) as simple and 26.5% as compound (n = 63/238). The most frequent types of staphylomas were type 2 and type 3, both present in 18.1% of the total (n = 43/238). Eyes with staphyloma had higher AL, worse BCVA and older age (p &lt; 0.01), with no differences between sexes (p &gt; 0.05). When differentiating between eyes with simple staphyloma and compound staphyloma, statistically significant differences were observed with respect to AL (p &lt; 0.01), being higher in compound staphylomas. The severe pathological myopia subgroup (LA &gt; 29.5 mm) presented a higher incidence of posterior staphyloma, with statistically significant differences (p &lt; 0.01). Regarding the ATN classification, when analysing the eyes with the presence and absence of staphyloma, statistically significant differences (p &lt; 0.01) were observed in the three components (atrophic [A], tractional [T] and neovascular [N]); having more advanced stages of A, T and N the eyes with staphyloma.Conclusions: Posterior staphyloma in highly myopic patients is a crucial finding in the progression of myopic maculopathy, being related to worse visual acuity, greater AL, older age and more advanced stages of the ATN classification. There is a higher prevalence of posterior staphyloma in eyes with severe pathological myopia.

Photoreceptor density in dependence of axial length and retinal location in human eyes

AbstractPurpose: To examine the density of retinal photoreceptors and retinal pigment epithelium (RPE) cells in relation to myopic axial elongation in human eyes.Methods: Using light microscopy, we counted the density of photoreceptors and RPE cells at the ora serrata, the equator, and at the midpoint between the equator and the posterior pole (MEPP) in enucleated human globes .Results: The study included 78 eyes (mean age: 59.2 ± 15.6 years; range: 32–85 years) with a mean axial length of 27.3 ± 3.6 mm (range: 21.5–37.0 mm). Close to the ora serrata, at the equator and at the MEPP, the photoreceptor and RPE cell density was 11.8 ± 8.8, 29.0 ± 14.3 and 52.3 ± 21.1 cells/48 μm and 27.0 ± 6.6, 21.7 ± 7.2 and 23.4 ± 7.5 cells/480 μm, respectively. Densities of both cell types in all regions measured were positively correlated with each other (all p &lt; 0.001), and decreased with longer axial length (all p &lt; 0.001) and retinal length (all p &lt; 0.001), most marked at the MEPP and least marked close to the ora serrata. Close to the ora serrata, at the equator and at the MEPP, differences between both globe sides in photoreceptor and RPE cell density were 3.98 ± 3.91, 8.93 ± 8.03 and 11.8 ± 11.1 cells/48 μm and 4.67 ± 4.37, 4.27 ± 3.13 and 5.30 ± 4.65 cells/480 μm, respectively. They were not significantly (all p &gt; 0.05) related with axial length and did not differ (all P &gt; 0.05) between both globe sides.Conclusions: The axial elongation‐associated decrease in photoreceptor and RPE cell density is most marked at the MEPP, followed by the equator and finally the ora serrata region. It suggests that the axial elongation‐associated enlargement of the eye wall predominantly takes place in the retro‐equatorial region, followed by the equatorial region. Side differences in cell densities suggest different elongation rates between both sides of the globe.

Types of reaction to pilocarpine in patients with low-tension glaucoma

PURPOSE. To determine the types of reaction to pilocarpine in patients with low-tension glaucoma (LTG) and study the nature of fluid outflow along the main pathways in different types of reaction to pilocarpine.METHODS. The observation group included 21 people (42 eyes) with LTG aged 51 to 80 years (average age 68±9.8 years). The criteria for inclusion in the study were emmetropic refraction and no previous laser and surgical interventions on the examined eye. The anterior chamber angle corresponded to medium–wide or wide according to the classification by A.P. Nesterov. The initial stage of LTG was established in 16 eyes, developed stage — 12 eyes, advanced stage — 14 eyes.The examination was carried out both in patients with newly diagnosed glaucoma and in patients with previously established diagnosis who received hypotensive drug therapy; in the latter case the patients were recommended to cease instillations of hypotensive drugs 10–14 days prior to the examination.RESULTS. Among the studied LTG patients, positive pilocarpine test was registered in 5 eyes (12%), negative — in 6 eyes (14%), and paradoxical — in 31 eyes (74%).The obtained data revealed no statistically significant differences in the initial values of anterior chamber depth, lens thickness and axial eye length between patients with paradoxical and positive reactions to pilocarpine. Therefore, there are no anatomical prerequisites for the development of a particular type of reaction to the pilocarpine test in the studied eyes.The ease of outflow coefficient (EOC) for the drainage pathway is significantly reduced in patients with positive reaction to pilocarpine, which in absolute numbers approaches normal values. In these patients the drainage outflow reserves are preserved.In persons with paradoxical reaction to pilocarpine, EOC for the drainage pathway is significantly reduced and is low in absolute numbers. Deterioration of the outflow along the uveoscleral pathway in pilocarpine instillations leads to elevated intraocular pressure.CONCLUSION. The majority of patients with low-tension glaucoma have a paradoxical reaction to the pilocarpine test. The sufficiently high sensitivity of the sample allows recommending it as a diagnostic test for this type of glaucoma.Different types of reaction to pilocarpine in patients with low-tension glaucoma are associated with the intensity of intraocular fluid outflow over the drainage and uveoscleral pathways.

Analysis of macular structure in age-related cataract patients with different antibody levels of severe acute respiratory syndrome coronavirus-2 vaccine

To analyze the macular structure of age-related cataract (ARC) patients with different antibody levels after COVID-19 vaccine injection, in order to obtain the effect of COVID-19 vaccine on the macular structure, and speculate whether the COVID-19 vaccine has adverse effects on the macular structure. This retrospective study is conducted to analysis on the status of COVID-19 vaccine and the thickness of different layers at different positions in the macular area of ARC patients. In the age, sex and eye axial length matched population, in the un-injection, no-antibody, IgM and IgG positive groups after vaccination, the choroid, ganglion cell complex, nerve fiber layer and retinal thickness at different positions of ETDRS zoning in the macular area were discussed. A total of 164 patients (164 eyes) were included in the analysis. There were 63 males and 101 females. The average age was 65.99 ± 8.43 years. There was no significant difference in age and sex among the groups (p>0.05). The average axial length of 164 eyes was 23.56 ± 1.46mm, and no significant difference between the groups (p>0.05). Non parametric test and ANOVA test for the thickness of choroid, retina, ganglion cell complex and retinal nerve fiber layer in each division of ETDRS showed no significant difference in the four groups of un-injection, no-antibody, IgM and IgG (p>0.05). There was no correlation between the antibody concentration and the thickness of macular structure (p>0.05). There was no significant difference in the thickness of choroid, retina, ganglion cell complex and retinal fiber layer in different macular areas after COVID-19 vaccine injection. There was no linear correlation between the thickness of choroid, retina, ganglion cell complex and retinal fiber layer and the antibody concentration produced after COVID-19 vaccine injection. It suggests that the injection of COVID-19 vaccine might have no significant effect on the macular structure of eye.

Post-SMILE-What myopes know about their secondary emmetropic eyes

Small incision lenticule extraction (SMILE) is popular among young myopic adults for long-term correction of myopia; however, the excessive axial lengths of myopic eyes and the associated risks for more serious eye diseases later on remain with surgical correction of the refractive error. These risks are greater the higher the myopia is. Are patients well informed about this and to what extent does further eye growth occur even after SMILE? Myopic young adults who underwent binocular SMILE before 2019 were given the opportunity to have their eyes examined at afollow-up visit (biometry using IOL-Master 700 [Zeiss, Oberkochen, Germany], subjective refraction, examination of the anterior and posterior segments of the eye using the slit lamp) and to participate in asurvey. Patients with a preoperative axial length ≥ 25.5 mm and a preoperative axial length < 25.5 mm (high myopia) were statistically evaluated separately. A total of 44patients (age 30.39 ± 2.39years) appeared at the visit and the SMILE was 3.18 ± 0.82years ago: The spherical equivalent at the follow-up visit was -0.05 ± 0.21 dpt in the weaker myopes and -0.18 ± 0.23 dpt in the high myopes. Of the respondents 27% estimated that SMILE would reduce the risk of retinal detachment and cataract, with 80% of high myopes underestimating the individual risk of retinal detachment. Also, 57% said they would not see an ophthalmologist until within 1week if they had symptoms consistent with acute retinal detachment, and only 27% would go to an emergency room immediately. In general, 59% reported having normal health awareness and 41% reported going for annual ophthalmological check-ups. The collected axial lengths and refractions show no relevant change in the eyes regarding progression of myopia; however, the patients' statements in the survey point out that most patients are not aware of the risk of serious eye diseases (retinal detachment, cataract). Therefore, repeated risk education and close postoperative care are needed, especially in preoperatively highly myopic patients.

Morphometric Characteristics of Axial Length of Eye in Population of the Southern Urals (according to “Ural Very Old Study” and “Ural Eye and Medical Study” Research)

INTRODUCTION: Currently, ametropias are the most important medical and social problem, which occupies one of the leading places in modern ophthalmology. Determination of the length of the anteroposterior eyeball axis (APEA) in myopia ― a type of ametropia directly associated with increase in the axial length of the eyeball ― is an objective method of its diagnosis and identification of progression. Due to the fact that myopia is a multifactorial disease, the study of correlation relationships of the length of the eyeball seems to be extremely relevant.&#x0D; AIM: To give a statistical assessment of the peculiarities of the axial length of the eyeball in the population of the Southern Urals, depending on age, gender and the respondents' settlement sites, and to determine the correlation relationships of this parameter.&#x0D; MATERIALS AND METHODS: The analysis was conducted on the base of Ufa Research Institute of Ophthalmology within large clinical and population studies Ural Eye and Medical Study (UEMS) and Ural Very Old Study (UVOS). Inclusion criteria: signing of voluntary consent to participation in the project, permanent residence in the territory of study; for inclusion in UEMS ― age from 40 to 85 years, in UVOS ― age above 85. UEMS study involved 5899 respondents, UVOS ― 1526. The study protocol suggested evaluation of 683 criteria, 293 of which were answers of respondents to questions of the questionnaire and the results of the general somatic examination, 355 criteria concerned the results of the ophthalmologic examination, 35 ― of laboratory tests. Axial length of the eyeball was measured by the method of ultrasound echo-biometry (A-scanning) (Ultra-compact A/B/P ultrasound system, Quantel Medical, France).&#x0D; RESULTS: The mean length of the APEA in the UEMS population was 23.31 1.08 mm, in the UVOS population ― 23.11 1.08 mm (p 0.001). The length of the eyeball axis was 23.31 1.08 mm in the age group 40-84 years and 23.11 1.08 mm in patients in the age category 85 years and older. The multivariate linear regression analysis in UEMS study showed the highest statistically significant association of APEA length with such factors as age (p 0.001), height (p 0.001), presence of arterial hypertension (p = 0.02), education level (p 0.001 ), intraocular pressure (IOP) (p 0.001), spherical refractive error (p0.001), depth of anterior chamber (p 0.001) and angle of anterior chamber (p 0.001), mosaicism of the eye fundus in the macular region (p 0.001), presence of myopic maculopathy (p 0.001), refractive power of the cornea (p 0.001), corneal volume (p 0.001), macular pigment density (p 0.001), thickness of peripapillary layer of nerve fibers (p 0.001), presence of the epiretinal membrane (p = 0.01). The multivariate linear regression analysis in UVOS study showed statistically significant association of the APEA length with such factors as height (p 0.001), education level (p = 0.002), corneal refractive power (p 0.001), spherical refraction error (p 0.001).&#x0D; CONCLUSION: In the population of the Southern Urals, statistically significant association of the length of the eyeball axis with such factors as height, education level, refractive power of the cornea and spherical refractive error, was demonstrated. Besides, in the population of UEMC study, there was also noted association with age, the presence of arterial hypertension, intraocular pressure, the depth of the anterior chamber and the angle of the anterior chamber, mosaicism of the eye fundus in the macular region, the presence of myopic maculopathy, corneal volume, density of macular pigment, thickness of the peripapillary layer of nerve fibers, presence of the epiretinal membrane.

Influence of scan direction on subfoveal choroidal vascularity index using optical coherence tomography

We investigated the influence of scan direction on subfoveal choroidal vascularity index (CVI) measurements using spectral-domain optical coherence tomography (SD-OCT) in young healthy subjects. Seventy-eight eyes of 41 healthy volunteers were included. Choroidal structures were obtained using SD-OCT with enhanced depth imaging (EDI) through radial scans at the center of the macula. The subfoveal choroidal images in the horizontal (0°), 45°, vertical (90°) and − 45° directions were recorded and CVIs were analyzed according to their respective directions using image binarization. Additionally, subfoveal choroidal thickness (SFCT), and axial eye length were measured. The SFCT and subfoveal CVI showed a negative correlation but were only significant for the 45° scan (Pearson’s r = − 0.262, P = 0.021). The axial eye length and subfoveal CVI had no significant correlation in any direction (all P > 0.05). In the Bland–Altman plot, the subfoveal CVI measurement showed high agreement among the four scan directions. When the SFCT was ≥ 300 µm, there was no difference in the measured values of the subfoveal CVI among the four scan directions; however, when the SFCT was < 300 µm, there was a significant difference in subfoveal CVI among the scan directions (one-way analysis of variance, F = 4.685, P = 0.004). In subfoveal CVI measurement, it is considered that the horizontal (0°) scan can represent the vertical (90°) or oblique (45°, − 45°) scans. However, when the SFCT is thinner, the subfoveal CVI in each direction of radial scan may vary significantly. Hence, caution is required in the interpretation.

The range of clinical manifestations of congenital glaucoma found in people seeking consultation at the Helmholtz National Medical Research Center of Eye Diseases

Purpose: to analyze clinical and functional manifestations and the course of different stages of primary congenital glaucoma (CG) at different times of the disease onset, using the data of admissions to the Department of Eye Pathology in Children of the Helmholtz Research Center of Eye Diseases.Material and methods. 191 patients (320 eyes) with CG, of which 113 were children (191) eyes with primary congenital glaucoma (PCG) aged 1 month to 16 years, underwent standard ophthalmological examination (autorefractometry, visometry, biomicroscopy, ophthalmoscopy), electrophysiological examination (flash VEP, ganzfeld and flicker ERG) and echobiometry (axial eye length measurement).Results. A detailed clinical and functional characteristic of PCG, including structural and functional changes occurring at different stages. Most children with PСG showed advanced stages of the glaucomatous process: in cases where PСG was detected by 1 month of life, the advanced stages claimed 71.1 %, whilst the children diagnosed with PCG between 1 and 12 months of age, the advanced stages were found in 91.2 %. clinical manifestations were found to have variability, not always corresponding to the stages of the disease. In particular, we detected a correlation between disease progression and decreased VEP amplitude (p &lt; 0.05), while no such correlation was found with respet to ERG parameters and VEP latency.Conclusion. Despite the fact that PCG is detected comparative early, the destructive glaucomatous eye damage leads to severe and often irreversible consequences. The timing of CG manifestation is determined by the degree of congenital abnormalities in the eye drainage system that, together with secondary structural changes of eyes (cornea, axial length, retina and ONH) entail a more severe prognosis of PCG in case of an early disease onset. New objective criteria are needed to assess the severity and prognosis of PCG, which is important for the preservation of visual functions, prevention of low vision and blindness.

Regression-Based Strategies to Reduce Refractive Error-Associated Glaucoma Diagnostic Bias When Using OCT and OCT Angiography.

PurposeThe purpose of this study was to correct refractive error-associated bias in optical coherence tomography (OCT) and OCT angiography (OCTA) glaucoma diagnostic parameters.MethodsOCT and OCTA imaging were obtained from participants in the Hong Kong FAMILY cohort. The Avanti/AngioVue OCT/OCTA system was used to measure the peripapillary nerve fiber layer thickness (NFLT), peripapillary nerve fiber layer plexus capillary density (NFLP-CD), macular ganglion cell complex thickness (GCCT), and macular superficial vascular complex vascular density (SVC-VD). Healthy eyes, including ones with axial ametropia, were enrolled for analysis.ResultsA total of 1346 eyes from 792 participants were divided into 4 subgroups: high myopia (<−6D), low myopia (−6D to −1D), emmetropia (−1D to 1D), and hyperopia (>1D). After accounting for age, sex, and signal strength, multivariable regression showed strong dependence in most models for NFLT, GCCT, and NFLP-CD on axial eye length (AL), spherical equivalent (SE) refraction, and apparent optic disc diameter (DD). Optical analysis indicated that AL-related transverse optical magnification variations predominated over anatomic variations and were responsible for these trends. Compared to the emmetropic group, the false positive rates were significantly (Chi-square test P < 0.003) elevated in both myopia groups for NFLT, NFLP-CD, and GCCT. Regression-based adjustment of these diagnostic parameters with AL or SE significantly (McNemar test P < 0.03) reduced the elevated false positive rates.ConclusionsMyopic eyes are biased to have lower NFLT, GCCT, and NFLP-CD measurements. AL- and SE-based adjustments were effective in mitigating this bias.Translational RelevanceAdoption of these adjustments into commercial OCT systems may reduce false positive rates related to refractive error.