0000000000024903
AUTHOR
Rafael J. Pérez-cambrodí
Reliability and Intersession Agreement of Microperimetric and Fixation Measurements Obtained with a New Microperimeter in Normal Eyes.
Purpose: To evaluate the reliability and intersession agreement of measurements of retinal sensitivity as well as of the fixation pattern obtained in healthy eyes with a microperimeter integrating the mechanism of the scanning laser ophthalmoscope (SLO) with the static perimetry. Methods: This study included a sample of 44 healthy eyes of 44 subjects of a mean age of 27.0 ± 8.5 years. In all cases, microperimetric exams with the MAIA system (Centervue, Padova, Italy) were performed in three different sessions to evaluate the intersession repeatability. The consistency of measurements was analyzed by using the Friedman test and by analyzing the correlation between consecutive measurements. A…
Medium-term visual, refractive, and intraocular stability after implantation of a posterior chamber phakic intraocular lens to correct moderate to high myopia.
To evaluate the medium-term refractive and visual outcomes and the complications after implantation of a silicone posterior chamber phakic intraocular lens (PC pIOL) for moderate to high myopia.Oftalmar, Medimar International Hospital, Alicante, Spain.Retrospective case series.Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, and intraocular pressure were evaluated during a medium-term follow-up. Postoperative complications were also studied.The study enrolled 35 eyes (mean preoperative spherical equivalent [SE] -10.25 diopters [D] ± 3.19 [SD]) of 20 patients with a mean age of 31.83 ± 8.87 years and a mean follow-up of 57.34 ± 9.24 months. The mean UDVA improved…
Decreased Perifoveal Sensitivity Detected by Microperimetry in Patients Using Hydroxychloroquine and without Visual Field and Fundoscopic Anomalies
Purpose. To evaluate the usefulness of microperimetry in the early detection of the ocular anomalies associated with the use of hydroxychloroquine.Methods. Prospective comparative case series study comprising 14 healthy eyes of 7 patients (group A) and 14 eyes of 7 patients under treatment with hydroxychloroquine for the treatment of rheumatologic diseases and without fundoscopic or perimetric anomalies (group B). A comprehensive ophthalmological examination including microperimetry (MP) and spectral-domain optical coherence tomography was performed in both groups.Results. No significant differences were found in mean MP foveal sensitivity between groupsP=0.18. However, mean MP overall sens…
Current Clinical Application of Microperimetry: A Review.
Microperimetry (MP) is a technology that allows the study of retinal sensitivity at different foveal and parafoveal areas as well as eye fixation. It is a technique of functional evaluation, providing a direct correlation between anatomical and functional outcomes. There are a great variety of studies which evaluate the repeatability or reliability of measurements obtained with this technology and also describe and explore different clinical applications. MP has been shown to be useful in the characterization of sensory and motor conditions, such as amblyopia or nystagmus. Concerning ocular pathology, several studies have confirmed the usefulness of MP for evaluating and analyzing different…
Fixed Mydriatic Pupil Associated with an Intraocular Pressure Rise as a Complication of the Implant of a Phakic Refractive Lens (PRL)
We describe a case report of a patient that was implanted with a posterior chamber phakic intraocular lens (Phakic Refractive Lens, PRL) for the correction of moderate myopia and who developed postoperatively a fixed mydriasis compatible with an Urrets-Zavalia Syndrome (UZS). Specifically, a sudden acute increase of IOP in the left eye was observed in the immediate postoperative period. After IOP stabilization, the refractive result was good, but a fixed and mydriatic pupil appeared. This condition led the patient to experience visual discomfort, halos, and glare associated with high levels of higher-order aberrations in spite of the good visual result. A tinted-contact lens was fitted in o…
Ocular autofluorescence in diabetes mellitus. A review
Diabetes mellitus is a metabolic disease with a considerable impact on healthcare owing to its increased prevalence and high mortality rate. Structural, morphological, and physiological changes in each of the ocular components have been described in detail. Autofluorescence has been described as a good indicator of metabolic activity. The aim of the present review is to provide an overview of ocular endogenous fluorophores in the cornea, the crystalline lens, and the retinal pigment epithelium, the effects of diabetes mellitus and therefore the potential of autofluorescence assessment for screening and monitoring changes in diabetic patients.
Quantitative corneal anatomy: evaluation of the effect of diabetes duration on the endothelial cell density and corneal thickness.
Purpose To evaluate the differences in endothelial cell density (ECD) and central corneal thickness (CCT) between type II diabetic patients and age-matched healthy controls, and determine the impact of time from diagnosis. Methods This is a comparative study of 77 eyes of type II diabetic patients (33 males, 44 females) and 80 eyes of healthy subjects (42 males, and 38 females) whose ages ranged from 38 to 56 years. CCT, ECD, HbA1c levels, and Goldmann tonometry were measured. Results The CCT was significantly higher and the ECD significantly lower in long-term diabetic patients (10 years + since diagnosis) when compared with short-term diabetic patients (<1 year since diagnosis) and contro…
Preliminary in vivo positional analysis of a posterior chamber phakic intraocular lens by optical coherence tomography and its correlation with clinical outcomes
Purpose: To analyze by spectral-domain optical coherence tomography the anatomical relationship of a specific type of posterior chamber phakic intraocular lens (pIOL) implanted in cases of high to moderate myopia with the adjacent intraocular structures and to correlate it with clinical outcomes. Methods: Prospective observational case series including 18 eyes with high to moderate myopia (spherical equivalent between −5.88 and −15.75 D) of 9 patients (age range, 29–49 years) undergoing bilateral Phakic Refractive Lens (PRL, Zeiss) implantation. Postoperative visual acuity, refraction, contrast sensitivity (CS), and ocular higher order aberrations (HOA) were evaluated. Furthermore, the in v…
Optical quality of the diabetic eye: a review
Diabetes mellitus is a metabolic disorder characterized by the presence of chronic hyperglycaemia. Several structural, morphological, and physiological changes in each of ocular component have been described in detail during the past decades. Due to these abnormalities, the diabetic patient undergoes a degradation of the retinal image by an increase of higher ocular aberrations and ocular scattering coming from mainly tear film, cornea, and crystalline lens. This review aims to provide an overview of current knowledge about the effects of diabetes mellitus in these optical phenomena and its consequence on the visual quality of the diabetic patient.
Binocular vision alterations after refractive and cataract surgery: a review.
To review binocular and accommodative disorders documented after corneal or intraocular refractive surgery, in normal healthy prepresbyopic patients. A bibliographic revision was performed; it included works published before 1st July 2017 where accommodation and/or binocularity was assessed following any type of refractive surgical procedure. The search in Pubmed yielded 1273 papers, 95 of which fulfilled the inclusion criteria. Few publications reporting binocular vision and/or accommodative changes after refractive surgery in normal subjects were found. The reduction in fusional vergence is the most frequently reported alteration. Anisometropia is an important risk factor for postoperativ…
Retroespalhamento luminoso das córneas de pacientes com diabete melito dependente e não dependente de insulina: estudo piloto
ABSTRACT Purpose: To compare central corneal backscatter obtained from Scheimpflug images between patients with insulin-dependent and non-insulin-dependent diabetes mellitus (IDDM and NIDDM, respectively) and healthy controls. Methods: Seven patients with IDDM (7 eyes), eleven patients with NIDDM (11 eyes), and sixteen healthy subjects (16 eyes) were included in this pilot study. Scheimpflug imaging system (Pentacam, Oculus Inc., Germany) was used to obtain optical sections of the cornea. Seven meridians were analyzed for each eye, oriented from 70° to 110°. Optical density values for the central 3-mm and 5-mm zones of the cornea were obtained by image analysis using external software. Resu…
Confocal scanning laser ophthalmoscopy versus modified conventional fundus camera for fundus autofluorescence.
Fundus autofluorescence (FAF) is a noninvasive imaging method to detect fundus endogenous fluorophores, mainly lipofuscin located in the retinal pigment epithelium (RPE). The FAF provides information about lipofuscin distribution and RPE health, and consequently an increased accumulation of lipofuscin has been correlated with ageing and development of certain retinal conditions. Areas covered: An exhaustive literature search in MEDLINE (via OVID) and PUBMED for articles related to ocular FAF in retinal diseases and different devices used for acquiring FAF imaging was conducted. Expert commentary: This review aims to show an overview about autofluorescence in the RPE and the main devices use…
Visual performance with simultaneous vision multifocal contact lenses.
Purpose: The aim was to assess visual performance after PureVision high addition multifocal contact lens (PM) fitting through contrast sensitivity measured under different illumination levels for both distance and near. Methods: In a cross-over study, 20 presbyopic patients were randomly assigned to PM or spectacles. Near contrast sensitivity was measured with the Vistech VCTS 6500 system. Distance contrast sensitivity and distance visual acuity (VA) were measured with the Functional Vision Analyser under photopic (85 cd/m2) and mesopic (3.0 cd/m2) conditions, the latter also under two levels of induced glare: 1.0 lux and 28 lux. Near VA was measured by logMAR charts under approximately 8…
Normal Values for Microperimetry with the MAIA Microperimeter: Sensitivity and Fixation Analysis in Healthy Adults and Children
Purpose To establish normative values of retinal sensitivity and parameters describing the fixation pattern using macular analyzer integrity assessment (MAIA) microperimetry (Centervue, Padova, Italy) in adults and children. Methods A sample of 237 eyes of 237 healthy subjects aged between 10 and 70 years (mean age 30.63 ± 16.23 years) was evaluated using the MAIA microperimeter. The following parameters provided by the MAIA device were evaluated: average threshold (AT), macular integrity, fixation indexes (P1% and P2%), bivariate contour ellipse area (BCEA) for 95% and 63% of points, and horizontal (H) and vertical (V) axes of the ellipse of fixation. Differences between different age-rela…
Fixation pattern analysis with microperimetry in nystagmus patients
Objective: To assess the usefulness of microperimetry (MP) as an additional objective method for characterizing the fixation pattern in nystagmus. Design: Prospective study. Participants: Fifteen eyes of 8 subjects (age, 12–80 years) with nystagmus from the Lluís Alcanyís Foundation (University of Valencia, Spain) were included. Methods: All patients had a comprehensive ophthalmologic examination including a microperimetric examination (MAIA, CenterVue, Padova, Italy). The following microperimetric parameters were evaluated: average threshold (AT), macular integrity index (MI), fixating points within a circle of 1° (P1) and 2° of radius (P2), bivariate contour ellipse area (BCEA) considerin…
Biometric characterization of the anterior segment in a Sahrawi pediatric population
Purpose: To examine the biometric characteristics of the anterior segment in a group of Sahrawi children. Methods: A total of 66 children (33 male and 33 female, aged between 8 and 13 years) participated in this prospective, observational study. The non-invasive Pentacam Scheimpflug imaging device was used to measure corneal thickness (CT) (at the thinnest corneal point), mean anterior (Km Ant) and posterior (Km Post) corneal radii, corneal volume (CVol), anterior chamber depth (ACD) and anterior chamber volume (ACVol). The contribution of age and gender to the various parameters was investigated. Results: CT values of the present group of Sahrawi children were 521.70 ± 3.92 m. Boys had thi…
The posterior chamber phakic refractive lens (PRL): a review
Implantation of phakic intraocular lenses (pIOLs) is a reversible refractive procedure, preserving the patient’s accommodative function with minimal induction of higher order aberrations compared with corneal photoablative procedures. Despite this, as an intraocular procedure, it has potential risks such as cataracts, chronic uveitis, pupil ovalization, corneal endothelial cell loss, pigmentary dispersion syndrome, pupillary block glaucoma, astigmatism, or endophthalmitis. Currently, only two models of posterior chamber pIOLs are commercially available, the implantable collammer lens (STAAR Surgical Co.) and the phakic refractive lens (PRL; Zeiss Meditec). The number of published reports on…
Clinical Impact of a Spontaneous Decentration of a Phakic Refractive Lens
PURPOSE To evaluate the clinical impact and possible causes of a spontaneous decentration of a phakic refractive lens (PRL) implanted in a highly myopic eye, and analyzing the visual, refractive, and aberrometric outcome as well as the possible causes for this phenomenon. METHODS The description of a case of bilateral high myopia corrected by implantation with the phakic intraocular lens (pIOL) PRL (Carl Zeiss Meditec, Germany) is presented and documented. Both eyes had similar anatomical configuration, and therefore, a pIOL (Model 101) with the same size was implanted without any associated intraoperative complication. Clinical outcomes were evaluated during a 3-month follow-up. RESULTS Im…
Pilot Study on Visual Function and Fundus Autofluorescence Assessment in Diabetic Patients.
Purpose. Evaluate optimized fundus autofluorescence (FAF) imaging in early stages of diabetic retinopathy (DR) and relate findings with conventional colour fundus imaging and visual function in diabetic patients and control subjects.Materials and Methods. FAF and colour images were obtained using the CR-2 Plus digital nonmydriatic retinal camera in seven diabetic patients and thirteen control subjects. Visual-Functioning Questionnaire-25 (VFQ-25) and Diabetes Self-Management Questionnaire (DSMQ) were used to assess the quality of life and diabetes self-care. Contrast sensitivity function (CSF) was evaluated with the Vistech 6500 chart.Results. FAF and optimized-FAF imaging showed more retin…