An objective evaluation of crystalline lens density using Scheimpflug lens densitometry in different uveitis entities

Crystalline lens clarity in patients treated with isotretinoin

CLINICAL RELEVANCE

Isotretinoin has been the best treatment option for moderate and severe acne vulgaris since the 1980s. Some studies have shown evidence of subclinical anterior segment involvement of the eye in patients treated with isotretinoin.

BACKGROUND

This study aimed to evaluate lens clarity with the densitometry software of Scheimpflug tomography in patients treated with isotretinoin and to compare with healthy control subjects.

METHODS

Thirty-seven acnepatients treated with isotretinoin who met the inclusion criteria (24 males and 13 females, mean age 22.94 ± 4.21 years) and 39 healthy control subjects were included in the study. Clinical characteristics of the isotretinoin and control subjects were recorded. Lens density was evaluated with the densitometry software of the Scheimpflug tomography device (PentacamHR, Oculus, Wetzlar, Germany).

RESULTS

There was no statistically significant difference between the groups in age, gender distribution, spherical equivalent, or anterior segment parameters measured by the Pentacam system (p > 0.05 for all). Lens density values in zones 2 and 3 were significantly higher in the isotretinoin group (p = 0.042, p < 0.001) and positively correlated with cumulative isotretinoin dose (zone 2: r = 0.384, p = 0.032; zone 3: r = 0.384, p = 0.005).

CONCLUSION

Zone 2 and zone 3 lens density are higher in patients treated with isotretinoin when compared to healthy controls.

Visual outcomes of surgical and conservative treatment in children with small posterior polar cataracts and posterior lenticonus

AIM

To compare the visual outcomes of children with small (≤3 mm) posterior polar cataracts (PPC) and posterior lenticonus who had cataract extraction surgery with the visual outcomes of those who were managed conservatively.

METHODS

Children who initially had small PPC and posterior lenticonus who were followed up over 1-year period were retrospective reviewed in the study. Patients receiving surgery were compared with those receiving conservative therapy. The axial length, keratometry, refraction, best-corrected visual acuity (BCVA), and strabismus measurements were recorded. Lens morphology, i.e., the location, size, and depth of the cataract lesion, was measured with a Scheimpflug imaging system. To help control for baseline differences in the groups, patients were matched with controls by propensity score methodology.

RESULTS

The study evaluated 60 patients (30 in the surgery group and 30 in the conservative therapy group) after matching by propensity score. Patients who underwent cataract surgery showed greater BCVA improvements (0.36±0.24 logMAR) than patients who were treated without surgery (0.22±0.26 logMAR; P=0.036). Surgery was effective in patients with a rear projection length (RPL) less than 1.0 mm and a pretreatment BCVA worse than 0.52 logMAR.

CONCLUSION

Children with small PPC and posterior lenticonus who undergo cataract surgery experience greater BCVA improvements than those managed conservatively. Certain patients presenting with a RPL less than 1.0 mm and a pretreatment BCVA of 0.52 logMAR or worse may benefit from surgery.