logMAR Scores Research Articles

Vision in former very low birthweight young adults with and without retinopathy of prematurity compared with term born controls: the NZ 1986 VLBW follow-up study

ObjectiveThere are few data on visual outcomes in adulthood of former very low birthweight (VLBW; <1500 g) infants. We aimed to assess vision at 27–29 years in a national cohort...

Absolute and estimated values of macular pigment optical density in young and aged Asian participants with or without age-related macular degeneration

BackgroundLutein and zeaxanthin are suggested micronutrient supplements to prevent the progression of age-related macular degeneration (AMD), a leading cause of blindness worldwide. To monitor the levels of lutein/zeaxanthin in the macula, macular pigment optical density (MPOD) is measured. A commercially available device (MPSII®, Elektron Technology, Switzerland), using technology based on heterochromatic flicker photometry, can measure both absolute and estimated values of MPOD. However, whether the estimated value is applicable to Asian individuals and/or AMD patients remains to be determined.MethodsThe absolute and estimated values of MPOD were measured using the MPSII® device in 77 participants with a best-corrected visual acuity (BCVA) > 0.099 (logMAR score).ResultsThe studied eyes included 17 young (20–29 years) healthy, 26 aged (>50 years) healthy, 18 aged and AMD-fellow, and 16 aged AMD eyes. The mean BCVA among the groups were not significantly different. Both absolute and estimated values were measurable in all eyes of young healthy group. However, absolute values were measurable in only 57.7%, 66.7%, and 43.8%, of the aged healthy, AMD-fellow, and AMD groups, respectively, and 56.7% of the eyes included in the 3 aged groups. In contrast, the estimated value was measurable in 84.6%, 88.9% and 93.8% of the groups, respectively, and 88.3% of eyes in the pooled aged group. The estimated value was correlated with absolute value in individuals from all groups by Spearman’s correlation coefficient analyses (young healthy: R2 = 0.885, P = 0.0001; aged healthy: R2 = 0.765, P = 0.001; AMD-fellow: R2 = 0.851, P = 0.0001; and AMD: R2 = 0.860, P = 0.013). Using the estimated value, significantly lower MPOD values were found in aged AMD-related eyes, which included both AMD-fellow and AMD eyes, compared with aged healthy eyes by Student’s t-test (P = 0.02).ConclusionsAbsolute, in contrast to estimated, value was measurable in a limited number of aged participants; however, it was correlated with estimated value both in young and aged Asian populations with or without AMD. These results may inform future clinical studies investigating the measurement of MPOD in understanding the role of macular pigments in the pathogenesis of AMD.

Visual Improvement after Intra-Arterial Thrombolysis for Central Retinal Artery Occlusion Does Not Correlate with Time to Treatment

Background: Intra-arterial thrombolysis (IAT) for the treatment of acute central retinal artery occlusion (CRAO) has demonstrated variable results for improving visual acuity and remains controversial. Despite limited evidence, time from symptom onset to thrombolysis is believed to be an important factor in predicting visual improvement after IAT. Methods: A comprehensive review of the literature was conducted and individual subject level data were extracted from relevant studies. From these, a secondary analysis was performed. Initial and final logarithm of the minimum angle of resolution (logMAR) scores were either abstracted directly from relevant studies or converted from provided Snellen chart scores. Change in logMAR scores was used to determine overall treatment efficacy. Results: Data on 118 patients undergoing IAT from five studies were evaluated. Median logMAR improvement in visual acuity was -0.400 (p < 0.001). There was no significant association between logMAR change and time to treatment when time (hours) was described as a continuous variable or described categorically [0-4, 4-8, 8-12, 12+ h; or 0-6, 6-12, 12+ h]. Conclusion: The visual improvement observed in this series had no relationship to the time from symptom onset to treatment with IAT. This suggests that patients may have the possibility for improvement even with delayed presentation to the neurointerventionalist. Other factors, such as completeness of retinal occlusion, may be more important than time to treatment. Additional studies to determine optimal patient selection criteria for the endovascular treatment of acute CRAO are needed.

The Association Between Visual Function And Race Performance In Elite Visually Impaired Swimmers

Vision impairment (VI) is one of the eligible impairments that qualify athletes to participate in Paralympic swimming in one of three classes depending on their level of visual function. The classification aims to minimise the impact of VI on the outcome of competition so that the winner is the best athlete and not the one with the least impairment. However, the current system is based on anecdotal evidence rather than empirical evidence to show that these classes minimise the impact of VI. PURPOSE: To investigate the association between measures of visual function and swimming performance. METHODS: We recorded video footage of all 100m freestyle races in the VI classes (25 females and 19 males) at the 2014 IPC European Championships. Race time was determined for the entire race and for the start, turn, and finish. Visual acuity and visual field were measured according to the IPC classification procedures. Linear regression was used to investigate the association while taking into account potential confounding factors including age and training volume. RESULTS: For both males and females, there is a significant association between visual function and race performance that remains when accounting for age and training volume (see Figure 1). No significant differences in race performance were found between S12 and S13 classes, however, race times were significantly longer in the S11 class compared to S12 and S13 classes combined. CONCLUSIONS: Freestyle swimming performance is affected by vision impairment, however, the results question the validity of the currently used classification for swimmers with VI. Figure 1. Race time associated with visual function. Dotted lines represent cut-off values between current classes. Lower logMAR scores represent better visual acuity. Class S13 has the best acuity, then S12, and S11 has the most severe VI. (NE= not eligible).

The effect of intravitreal adalimumab on the treatment of active noninfectious ocular inflammation: A pilot study

AbstractPurpose To evaluate the short term efficacy of intravitreal adalimumab (IVA) for the treatment of eyes with active noninfectious uveitis.Methods In a prospective noncomparative interventional case series, consecutive eyes with active noninfectious uveitis were injected with IVA at 0, 2 then every 4 weeks for total of 6 months. Change in VA, grade of inflammation (cells, haze, leakage on FA adopted from the angiography scoring for uveitis working group), and central retinal thickness (CRT) were recorded. No systemic or ocular therapies were added to the IVA treatment during the study period.Results Six out of seven patients (12 of 13 eyes) completed 26 weeks of treatment. One patient (1 eye) failed treatment. Median logMar VA at baseline was 0.243 and improved to 0.049 at 26 weeks. Seven out of twelve eyes had improvement of ≥2 ETDRS lines. All three eyes with anterior chamber cells grade ≥1 at baseline had zero cells at 26 weeks. Also, all nine eyes with vitreous haze grade ≥1 at baseline had zero haze on last follow up. Median CRT at baseline was 317 microns and decreased to 277 microns. Five out of eight eyes with macular edema had complete resolution. Median FA score at baseline was 14 and improved to 4. Using Wilcoxon Signed Rank test, the decrease in logMar, CRT and FA score at 26 weeks compared to baseline was significant (n=12 eyes; p=0.003, 0.021, 0.002 respectively). No local or systemic side effects were detected. Stratifying the data to include one eye per patient revealed similar results.Conclusion IVA was safe in this pilot study; was effective in improving the VA in 7/12 eyes, resolving macular edema in 5/8 eyes &amp; decreasing AC cells, vit haze and FA score in 12 eyes while 1 patient (1 eye) failed treatment.

Early surgery for epiretinal membrane preserves more vision for patients

To establish whether early vitrectomy for epiretinal membrane (ERM) is preferable to delayed surgery. We carried out a retrospective study of 120 eyes from 120 patients with pre-operative visual acuity (VA) of 6/60 or better. Pre-operative logMAR score was considered to act as an appropriate proxy measure for time of surgical procedure, with scores of 0.3 or less considered to represent early surgery, scores of 0.4 or 0.5 considered to represent medium surgery, and scores of 0.6 or more considered to represent late surgery for ERM. Patients were either pseudophakic at the time of vitrectomy or underwent combined phaco-vitrectomy for symptomatic ERM. Evaluation of parameter coefficients indicated that controlling for other factors, a delay of the surgical procedure from a state of early to medium corresponded to an increase (ie, disbenefit) of 0.074 units in post-operative logMAR score (95% confidence interval -0.001-0.15). A delay of the surgical procedure from a state of early to late corresponded to an increase (ie, disbenefit) of 0.21 units in post-operative logMAR score (95% confidence interval 0.13-0.29). Mean post-operative VA for early surgery was 0.16, out of which 36.2% of patients had a LogMAR score of 0.1 or better. This is in comparison to 17.2% in late ERM (those with a pre-operative logMAR score of 0.6 or more). We conclude that early surgery is associated with a lower (ie, better) post-operative logMAR score. Vitrectomy for early symptomatic ERM, in carefully selected patients, is beneficial in preserving excellent vision and allows quicker visual rehabilitation.

Long-term follow-up for efficacy and safety of treatment of retinitis pigmentosa with valproic acid

AimsThe purpose of this study was to determine the long-term efficacy and safety of valproic acid (VPA) treatment in patients with pigmentary retinal dystrophies.MethodsA retrospective chart review was conducted on...

Visual Acuity During Direct Laryngoscopy at Different Illuminance Levels

Adequate light is essential for vision during direct laryngoscopy. The ISO 7376:2009 standard specifies the minimal illuminance for laryngoscopes. No studies have objectively examined the relationship between laryngoscope illumination and visual acuity during laryngoscopy. We measured the near visual performance of 50 anesthesiologists during direct laryngoscopy using near vision charts located at the larynx of 4 manikins. A variable voltage supply adjusted the illuminance from the laryngoscope to 50 lux, 200 lux, 700 lux, and 2000 lux. Participants also rated their experience regarding brightness of the laryngoscope, clarity of view, visual performance, and suitability and adequacy of the light, before proceeding to the next manikin with a different light level. The distance visual performance of the participants was also measured using standard letter acuity wall charts at the same light levels. Visual acuity in manikins and on wall charts was associated with an increasing lux level (P<0.0001). Visual acuity was lower at 50 lux and 200 lux compared with 700 lux by significantly more than the clinically discernible 0.1 logMAR. No statistically significant improvement in visual acuity occurred when illuminance was increased to 2000 lux. The mean (standard deviation) logMAR scores at the 4 chosen lux levels on the manikin charts were: 50 lux 0.05 (0.13), 200 lux 0.06 (0.10), 700 lux -0.05 (0.11), and 2000 lux -0.07 (0.11). This result was unaffected by age, seniority, subspecialty, history of difficulty focusing, or use of lenses for laryngoscopy. Subjective rating of laryngoscope brightness favored 2000 lux for clarity of view, suitability of the light for laryngoscopy, and visual performance. The average observation distance for direct laryngoscopy was 32 cm. Visual acuity improves as the laryngoscope illuminance increases up to 700 lux. No statistically significant improvement was measured by increasing the illuminance up to 2000 lux. Subjectively, anesthesiologists favor illuminance of 2000 lux for direct laryngoscopy.

Efficacy and safety of the intravitreal treatment of diabetic macular edema with pegaptanib: a 12-month follow-up.

This observational study was performed to evaluate the efficacy and safety of intra-vitreal injections of pegaptanib during a 12-month follow-up period. Forty eyes (20 patients) affected by diabetic macular edema were monitored. Twenty were subjected to treatment, and 20 were controls. The treatment involved a cycle of three intravitreal injections of pegaptanib (0.3 mg every 6 weeks), at the end of which treated patients were submitted to a monthly follow-up for a period of 12 months. The aim was to evaluate the clinical condition of the eye after therapy and gauge the efficacy of the long-term use of this drug. Specific criteria were used to measure the efficacy and safety of pegaptanib. Regarding efficacy, we considered the following: an average improvement in the power of vision, or visual acuity, of →10 letters (2 lines), equivalent to an average logMAR score of →0.2, and a reduction in the central macular thickness of →250 μm. Regarding safety, we considered the occurrence of undesired eye and systemic side effects correlated to either the drug itself or the injection procedure. The logMAR score for the measurement of visual acuity at T3 (third intra-vitreal injection at week 13) with respect to T0 decreased from 0.7 ± 0.277 to 0.445 ± 0.216, suggesting an improvement, while the mean Early Treatment Diabetic Retinopathy Study (ETDRS) score increased from 25.75 ± 13.046 to 34.300 ± 11.770 letters. The central macular thickness was reduced from the initial value of 746.95 ± 293.601 to 334.050 ± 93.997 μm. In seven controls, we registered a worsening both in terms of visual acuity and macular thickness in some eyes, justifying a continuation of therapy in eight eyes of the control group. Pegaptanib proved to be efficacious and safe for the treatment of diabetic macular edema throughout the 12-month followup. To evaluate its long-term efficacy, further studies are required with larger numbers of patients and longer observational follow-up periods.

Factors predicting recurrence in successfully treated cases of anisometropic amblyopia

Context:Recurrence after successful treatment of amblyopia is known and understanding the risk factors could help effective management.Aim:To measure incidence of recurrence in successfully treated cases of anisometropic amblyopia and evaluate factors predicting it.Settings and Design:Cohort Study at a tertiary level institution.Materials and Methods:Successfully treated anisometropic amblyopes aged 4−12 years were followed up for 1 year after stopping therapy. Best corrected visual acuity (BCVA), refractive error, stereoacuity and contrast sensitivity were evaluated at baseline and follow-up.Statistical Analysis:Intergroup analysis with appropriate tests: Chi-square test, Fisher's exact test, Wilcoxon rank sum test and paired t-test.Results:One hundred and two patients with mean age at diagnosis 7.06 ± 1.81 years were followed-up for a mean duration of 1.0 ± 0.2 years. The mean pre-treatment BCVA (LogMAR score) at diagnosis was 0.73 ± 0.36 units which improved to 0.20 ± 0.00 with treatment and after 1 year of stopping treatment was 0.22 ± 0.07. Thirteen (12.74%) patients showed amblyopia recurrence during follow-up. Risk of recurrence was higher with older age of onset of treatment (6.64 ± 1.77 years without recurrence v/s 8.53 ± 1.39 years with recurrence, P = 0.0014). Greater extent of improvement of VA (P = 0.048) and final VA at stopping occlusion (P = 0.03) were associated with higher recurrence. Binocularity status or stereoacuity changes were not associated with risk of recurrence.Conclusions:Significant numbers of children suffer recurrence of amblyopia after stopping therapy. Older age, better BCVA after stopping therapy and greater magnitude of improvement in BCVA are important risk factors for recurrence. Careful follow-up is essential for early detection and management of recurrence.

Effect of Age and Early Intervention with a Systemic Steroid, Intravenous Immunoglobulin or Amniotic Membrane Transplantation on the Ocular Outcomes of Patients with Stevens-Johnson Syndrome

PurposeThis retrospective observational case series of fifty-one consecutive patients referred to the eye clinic with acute-stage Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) from 1995 to 2011 examines the effect of early treatment with a systemic corticosteroid or intravenous immunoglobulin (IVIG) on the ocular outcomes in patients with SJS or TEN.MethodsAll patients were classified by age (≤18 years vs. >18 years) and analyzed by treatment modality and early intervention with systemic corticosteroids (≤5 days), IVIG (≤6 days), or amniotic membrane graft transplantation (AMT) (≤15 days). The main outcomes were best-corrected visual acuity (BCVA) in logarithm of the minimum angle of resolution (logMAR) and ocular involvement scores (OIS, 0-12), which were calculated based on the presence of superficial punctate keratitis, epithelial defect, conjunctivalization, neovascularization, corneal opacity, keratinization, hyperemia, symblepharon, trichiasis, mucocutaneous junction involvement, meibomian gland involvement, and punctal damage.ResultsThe mean logMAR and OIS scores at the initial visit were not significantly different in the pediatric group (logMAR = 0.44, OIS = 2.76, n = 17) or the adult group (logMAR = 0.60, OIS = 2.21, n = 34). At the final follow-up, the logMAR and OIS had improved significantly in the adult group (p = 0.0002, p = 0.023, respectively), but not in the pediatric group. Early intervention with IVIG or corticosteroids significantly improved the mean BCVA and OIS in the adult group (p = 0.043 and p = 0.024, respectively for IVIG; p = 0.002 and p = 0.034, respectively for corticosteroid). AMT was found to be associated with a significantly improved BCVA or OIS in the late treatment group or the group with a better initial OIS (p = 0.043 and p = 0.043, respectively for BCVA; p = 0.042 and p = 0.041, respectively for OIS).ConclusionsOur findings suggest that patients with SJS or TEN who are aged 18 years or less have poorer ocular outcomes than older patients and that early treatment with steroid or immunoglobulin therapy improves ocular outcomes.

Association between hearing loss and saccular dysfunction in older individuals.

1) Describe the association between hearing loss and dysfunction of each of the 5 vestibular end-organs--the horizontal, superior, and posterior semicircular canals; saccule; and utricle--in older individuals. 2) Evaluate whether hearing loss and vestibular end-organ deficits share any risk factors. Cross-sectional study. Academic medical center. Fifty-one individuals age 70 years or older. Audiometry, head-thrust dynamic visual acuity (htDVA), sound-evoked cervical vestibular-evoked myogenic potential (cVEMP), and tap-evoked ocular VEMP (oVEMP). Audiometric pure-tone averages (PTA), htDVA LogMAR scores as a measure of semicircular canal function in each canal plane, and cVEMP and oVEMP amplitudes as a measure of saccular and utricular function, respectively. We observed a significant correlation between hearing loss at high frequencies and reduced cVEMP amplitudes (or reduced saccular function; r = -0.37, p < 0.0001) in subjects age 70 years or older. In contrast, hearing loss was not associated with oVEMP amplitudes (or utricular function), or htDVA LogMAR scores (or semicircular canal function) in any of the canal planes. Age and noise exposure were significantly associated with measures of both cochlear and saccular dysfunction. The concomitant decline in the cochlear and saccular function associated with aging may reflect their common embryologic origin in the pars inferior of the labyrinth. Noise exposure seems to be related to both saccular and cochlear dysfunction. These findings suggest a potential benefit of screening individuals with presbycusis-particularly those with significant noise exposure history-for saccular dysfunction, which may contribute to fall risk in the elderly.

Validation of a modified ETDRS chart for European-wide use in populations that use the Cyrillic, Latin or Greek alphabet

PurposeTo validate a modified ETDRS visual acuity (VA) chart developed for European-wide use, in populations that use the Cyrillic, Latin or Greek alphabet. MethodsThe charts were validated in three groups: 310 school children in Bulgaria (mean age 13±1 years), 227 school children in Greece (mean age 14±1 years) and 85 patients with no ocular pathology in Belgium (mean age 26±5 years). VA was assessed with the habitual refractive correction, using the standard ETDRS charts and the modified European-wide charts. The intra-class correlation coefficient (ICC) was used to assess the test–retest reliability of the European-wide chart. The Bland–Altman comparison method was used to assess agreement between the two different versions of the new chart, as well as to compare these to the standard ETDRS-charts. Limits of agreement were calculated for differences in VA scores (test–retest variability (TRV)) between measurement sessions for the European-wide charts. ResultsThe TRV of the European-wide charts was found to be ±0.10 logMAR, corresponding to 5 ETDRS letters, for both chart 1 and chart 2. The ICC was estimated to be 0.968 for the RE and 0.961 for the LE. The European-wide charts generated on average slightly higher logMAR scores compared to the standard ETDRS charts in all three groups. ConclusionsThe “European-wide” charts appear to be a valid alternative to the standard ETDRS acuity charts, offering the advantage of containing letters readable by all European citizens.

Disc swelling and mild initial visual acuity loss predict a better short-term visual acuity outcome in bilateral acute optic neuritis

Bilateral acute optic neuritis (AON) is rare in adults in Western countries, but is relatively common in Asian populations. We aimed to document clinical features in Chinese patients with bilateral AON, and to identify factors that are predictive of visual acuity outcome. We reviewed 41 patients (23 males, 18 females; age 18–74years) diagnosed with bilateral AON from three centers between 2003 and 2009. Demographic and clinical data were compared to a group of patients with unilateral AON. Univariate analysis and multivariate linear regression were used to identify prognostic factors. We found that the median visual acuity (expressed as the logarithm of the minimal angle of resolution [LogMAR] scores) in our patients was 1.55 at presentation and 0.72 at discharge (p<0.001). There was a higher proportion of males (56% compared to 34%, p=0.015), a higher percentage with disc swelling (71% compared to 48%, p=0.014), and poorer visual acuity at presentation (median LogMAR scores: 1.55 compared to 1.70, p=0.001) in patients with bilateral AON than in those with unilateral AON. Both disc swelling (p=0.036) and visual acuity at presentation (p=0.023) were significantly associated with visual acuity at discharge. Our study suggests that bilateral AON has some clinical differences to unilateral AON, and that disc swelling and initial visual acuity may predict a short-term visual acuity outcome in bilateral AON.

A New Spin on the Vestibular Test Battery: Dynamic Visual Acuity and Subjective Visual Vertical

A New Spin on the Vestibular Test Battery: Dynamic Visual Acuity and Subjective Visual Vertical

X-linked retinoschisis maculopathy treated with topical dorzolamide, and relationship to genotype

To correlate the response of topical dorzolamide (Trusopt; Merck) in patients with X-linked retinoschisis (XLRS) with genotype. We carried out a retrospective evaluation of four patients (seven eyes) with XLRS, treated with topical dorzolamide. The change in best-corrected visual acuity (VA) and central macular thickness (CMT; central 1 mm subfield thickness) from optical coherence tomography (OCT) was analysed over the follow-up period, using Student's t-test. Each patient also had genetic analysis for mutations in the retinoschisisgene (RS1). The mean age at the start of treatment was 14.7±11 years, and mean follow-up duration was 21.7±7.7 months. Mean CMT at the final follow-up was significantly better than at baseline (291±123 vs 352±119 μm, P=0.007); however, mean VA was worse (0.38±0.25 vs 0.31±0.24 logMAR score, P=0.041). All four patients had a mutation in the RS1gene; there was no apparent association between the type of mutation and the response to topical dorzolamide. Topical dorzolamide may have some effect in reducing central macular thickness in patients with XLRS, but this does not necessarily correlate with improvement in VA. In our case series, genotypic information did not predict the response to this treatment.

Stable refraction and visual acuity in diabetic patients with variable glucose levels under routine care

To investigate how refraction and visual acuity may vary in patients with diabetes under routine care. Fifty-three eyes of 53 patients with various degrees of diabetic retinopathy were examined prospectively on four different occasions within a month. Refraction, best-corrected visual acuity (expressed as logMAR score) and blood glucose were measured on each occasion. Intraindividual variability was calculated as the range between the highest and lowest measurements. Associations between blood glucose levels and each of the other variables were tested by linear regression analysis for each patient. Refraction was completely stable in 43 patients and changed only slightly in 10, in whom the mean intraindividual variability of the spherical equivalent was 0.4 dioptres. Visual acuity test results were also highly reproducible. Mean intraindividual variability in visual acuity was 0.08 logMAR. Mean haemoglobin A1c (HbA1c) was 7.3 ± 1.5% but individual blood glucose levels ranged from 2.8 to > 22.2 mmol/l. Intraindividual variability ranged from 0.5 to 18.1 mmol/l, with a median of 6.0 mmol/l for the entire group. There were no associations between refraction or visual acuity and blood glucose levels or inter- or intraindividual glucose variations. Refraction and visual acuity test results were highly reproducible and stable in patients with reasonably well controlled diabetes but variable blood glucose levels under routine care.

Therapeutic potential of valproic acid for retinitis pigmentosa

Background/aimTo examine the efficacy and safety of valproic acid (VPA) in patients with retinitis pigmentosa (RP).MethodsThirteen eyes were examined before and after brief treatment (average 4 months) with VPA. Visual...

Foveal Structure Defined by Spectral Domain Optical Coherence Tomography Correlates with Visual Function after Macular Hole Surgery

To study the correlation between final visual acuity after successful anatomic macular hole repair and features on spectral domain optical coherence tomography (SD-OCT). Retrospective review of charts of patients who underwent macular hole surgery. Data collection included pre- and postoperative best-corrected visual acuity (BCVA), central subfield foveal thickness (CSFT), and presence or absence of inner segment-outer segment (IS-OS) line changes on SD-OCT. Data collected from SD-OCT were correlated with Snellen BCVA, which was converted to logMAR score. Subjects were divided into 2 groups: group I had improvement in BCVA of 2 lines or more and group II improved less than 2 lines or had worsening of BCVA. A total of 35 eyes of 32 patients had successful anatomic closure, which was documented both clinically and on SD-OCT. Mean age of the patients was 74.1 years and 71.2% (23/32) of patients were female. Overall, the mean BCVA changed from 1.01+/-0.38 preoperatively to 0.89+/-0.48 postoperatively (p=0.33). Based on the postoperative visual outcome, 16 eyes belonged to group I and 19 eyes belonged to group II. On the SD-OCT, the mean CSFT was 252.7+/-69.1 microm. No correlation was found between the mean CSFT and BCVA in either group. All the 16 patients in group I had a continuous IS-OS line on SD-OCT at the fovea in contrast to 26.3 % (5/19) of patients in group II (p=0.03). Establishment of continuity of IS-OS line is an important indicator of visual recovery in eyes with successful anatomic closure of macular hole.

Conductive Keratoplasty for the Treatment of Astigmatism Induced by Corneal Trauma or Incision

To assess the efficacy, safety, and predictability of conductive keratoplasty for the treatment of corneal trauma/incision-induced hyperopic or compound astigmatism. Thirteen eyes with corneal trauma/incision-induced astigmatism underwent conductive keratoplasty in this prospective study. The main outcome measures included distance uncorrected visual acuity (UCVA), near UCVA, best spectacle-corrected visual acuity (BSCVA), manifest refraction cylinder, keratometric astigmatism, manifest refraction spherical equivalent (MRSE), contrast sensitivity, glare sensitivity, intraocular pressure, tear break-up time, endothelial cell count, and pachymetry. Patients were followed 1 week and 1, 3, and 6 months postoperatively. Mean logMAR scores for distance UCVA, near UCVA, and BSCVA significantly improved from 0.87+/-0.31, 1.32+/-0.41, and 0.18+/-0.18, respectively, to 0.32+/-0.21, 0.59+/-0.21, and 0.08+/-0.11 (P<or=.05), respectively, 6 months after conductive keratoplasty. Mean manifest refraction cylinder, keratometric astigmatism, and MRSE significantly reduced from 4.12+/-2.86 diopters (D), 4.15+/-2.40 D, and 0.73+/-2.56 D, respectively, to 1.46+/-1.35 D, 1.66+/-1.44 D, and -0.52+/-0.99 D (P<or=.05), respectively, at 6 months postoperatively. Contrast sensitivity and glare sensitivity showed significant improvement at spatial frequencies of 1, 1.6, 2.5, 4, and 6.3 cycles per degree (P<or=.05). Surgically induced astigmatism calculated by vector analysis highly correlated to target induced astigmatism (P<or=.05). No severe complications occurred postoperatively. This study suggests that conductive keratoplasty is an effective and safe treatment for hyperopic or compound astigmatism after corneal trauma or incision.