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Korkmaz I, Esen Baris M, Guven Yilmaz S, Palamar M. Effect of Cycloplegia on Anterior Segment Structures and Scleral Thickness in Emmetropic Eyes. J Ocul Pharmacol Ther 2023; 39:699-704. [PMID: 37695817 DOI: 10.1089/jop.2023.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023] Open
Abstract
Purpose: To evaluate the effects of topical cyclopentolate hydrochloride-induced cycloplegia on anterior segment biomechanics in emmetropic eyes using anterior segment-optical coherence tomography (AS-OCT). Methods: Twenty-five emmetropic eyes of 25 volunteers were included. All underwent central corneal thickness (CCT) and anterior chamber depth (ACD) measurements. Anterior scleral thickness (AST) was measured at the level of the scleral spur (SS)(AST-0), 1,000 μm posterior of the SS (AST-1), and 2,000 μm posterior of the SS (AST-2) in the nasal and temporal quadrants using AS-OCT. All measurements were repeated after cycloplegia. Results: The mean age was 30.6 ± 12.4 (8-45) years. The mean CCT did not significantly change after cycloplegia (P = 0.7). The mean ACD was significantly increased [3.3 ± 0.2 (2.7-3.9) to 3.7 ± 0.3 (3-4.2) μm; P = 0.001]. In the nasal quadrant, the mean AST-1 and AST-2 were 512.3 ± 34.4 (433-570) and 529.6 ± 34.2 (449-599); decreased to 478 ± 26.8 (423-530) and 486.2 ± 28.3 (422-544) μm, respectively, after cycloplegia (P = 0.00; P = 0.00). In the temporal quadrant, the mean AST-1 and AST-2 were 522.5 ± 24.7 (473-578) and 527.2 ± 39.9 (450-604); decreased to 481.1 ± 33.7 (421-550) and 484.6 ± 26.6 (433-528) μm, respectively (P = 0.00; P = 0.00). There was no significant difference in AST-0 after cycloplegia in both quadrants [from 697.5 ± 46 (605-785) to 709.5 ± 64.7 (565-785) for nasal and from 718.4 ± 40.1 (632-796) to 722.9 ± 60.6 (596-838) for temporal; P = 0.2; P = 0.3, respectively]. Conclusion: After cycloplegia, there was a significant thinning of ASTs posterior to SS and a slight increase in AST in the SS level. ACD deepened after cycloplegia, and there was no significant change in CCT. Cycloplegic agents temporarily inhibit ciliary muscle contraction and may affect anterior segment parameters and sclera. Inhibition of forward-inward movement of the ciliary body by cycloplegia affects ASTs and ACD by causing a change in the mechanical force of the ciliary muscle on the sclera.
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Affiliation(s)
- Ilayda Korkmaz
- Department of Ophthalmology, Ege University Medical Faculty Hospital, Izmir, Turkey
| | - Mine Esen Baris
- Department of Ophthalmology, Ege University Medical Faculty Hospital, Izmir, Turkey
| | - Suzan Guven Yilmaz
- Department of Ophthalmology, Ege University Medical Faculty Hospital, Izmir, Turkey
| | - Melis Palamar
- Department of Ophthalmology, Ege University Medical Faculty Hospital, Izmir, Turkey
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Gessesse GW, Debela AS, Anbesse DH. Ocular Biometry and Their Correlations with Ocular and Anthropometric Measurements Among Ethiopian Adults. Clin Ophthalmol 2020; 14:3363-3369. [PMID: 33116387 PMCID: PMC7575035 DOI: 10.2147/opth.s277359] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 09/23/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To determine the average values of ocular biometry dimensions and investigate their inter-correlations and their association with anthropometric measurements among Ethiopian adults with healthy eyes. Methods A cross-sectional study was undertaken from June 2018 to July 2019. A total of 400 eyes of 200 subjects were included in the study. Univariable and multivariable linear regression were used to determine the association of demographic variables (age and sex) and anthropometric parameters (height, weight and BMI) with ocular biometric indices. Results The mean age was 40.31±11.39 with a range from 18 to 69 years. The mean (SD) of horizontal corneal diameter, average corneal refractive power, anterior chamber depth (ACD), lens thickness (LT) and axial length (AL) were 11.45 (0.89) mm, 43.94 (9.78) diopter, 2.91 (0.43) mm, 4.29 (0.55) mm and 22.96 (0.82) mm, respectively. Age had a negative correlation with ACD (r= -0.196, p= <0.001) and positive correlation with lens thickness (r= 0.324, p<0.001). Height had a positive correlation with ACD (r=0.114, p=0.023) and LT (r= 0.206, p=<0.001) while negative correlation with LT (r=-0.129, p=0.01). In the multivariate linear regression, age (-0.009 (-0.013, -0.05), p-value <0.001) and sex (0.104 (0.01, 0.198), p-value=0.03) had a significant association with ACD and only gender (0.478 (0.302, 0.654), p-value <0.001) had a statistically significant association with lens thickness. Conclusion This study determined the normative values for ocular biometric parameters among Ethiopian adults for the first time. Age, gender and height were associated with biometric indices. AL was significantly positively correlated with ACD and negatively correlated with LT. There was a negative correlation between LT and both AL and ACD.
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Affiliation(s)
- Girum W Gessesse
- Department of Ophthalmology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Asrat Sime Debela
- Department of Ophthalmology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Dereje Hayilu Anbesse
- Department of Ophthalmology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Kamath SJ, Nayak MK. Central Corneal Thickness as Measured by Spectral-Domain Optical Coherence Tomography in Glaucomatous and Non-Glaucomatous Eyes. JOURNAL OF MEDICAL SCIENCES AND HEALTH 2020. [DOI: 10.46347/jmsh.2019.v05i03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Daba KT, Gessesse GW, Sori SB. Proportion of Glaucoma among Voluntary People Coming for Glaucoma Screening Program at Jimma University Department of Ophthalmology, Jimma, Ethiopia. Ethiop J Health Sci 2020; 30:13-22. [PMID: 32116428 PMCID: PMC7036452 DOI: 10.4314/ejhs.v30i1.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Glaucoma is the second leading cause of blindness worldwide. Glaucoma screening has been controversial, and much of the controversy has centered on the value of mass or community screening. Methods The aim of this study was to determine the proportion of glaucoma among volunteer adults who were screened in Jimma University Department of Ophthalmology. A cross-sectional study was conducted among 459 volunteer residents of Jimma town and surrounding areas. The study subjects were aged 40 years and above, who came for community screening program after media announcement during the four consecutive weekends of November 2014. Comprehensive eye examination was done including best corrected visual acuity, intra-ocular pressure measurement, stereoscopic optic nerve evaluation, angle structure evaluation and visual field testing. Three diagnostic criteria for glaucoma were employed for all cases. Results Of all adults who came for screening, 47(10.24%) were diagnosed to have glaucoma, 59(12.85%) were glaucoma suspects, and 8(1.74%) had ocular hypertension. The proportion of glaucoma increased with increasing age, (P value= 0.001 (99%CI)). Primary open angle glaucoma was the most common form (42.55%) of all new cases while 4.4% of all screened adults were followed by normal tension glaucoma (29.79%), pseudoexfoliative glaucoma (19.15%), and primary angle closure glaucoma (6.38%) Around 5.7% of all glaucoma cases were found to be blind. Conclusion The proportion of glaucoma in this community screening program in Southwest Ethiopia was 10.24% with primary open angle glaucoma being the commonest subtype. Glaucoma community screening should be promoted for early diagnosis and intervention to prevent irreversible blindness.
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Affiliation(s)
| | - Girum W Gessesse
- Department of Ophthalmology Saint Paul's Hospital Millennium Medical College
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Thompson AC, Vu DM, Cowan LA, Asrani S. Factors Associated with Interventions after Laser Peripheral Iridotomy for Primary Angle-Closure Spectrum Diagnoses. Ophthalmol Glaucoma 2019; 2:192-200. [PMID: 32672592 DOI: 10.1016/j.ogla.2019.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 03/09/2019] [Accepted: 03/11/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE To assess factors associated with receipt of subsequent medical, laser, or surgical interventions after laser peripheral iridotomy (LPI). DESIGN Retrospective review. PARTICIPANTS A total of 1271 eyes in 692 subjects with narrow angles (NAs) that were treated with LPI. METHODS Demographic and clinical factors associated with primary angle-closure (PAC) or PAC glaucoma (PACG) versus PAC suspect (PACS) diagnosis and use of glaucoma medications at the time of LPI, as well as factors predictive of subsequent addition of glaucoma medications, and receipt of selective laser trabeculoplasty (SLT), cataract surgery, and glaucoma surgery were assessed using logistic regression with generalized estimating equations. Kaplan-Meier curves and Cox proportional-hazards regression analysis were used to assess baseline factors affecting the time to SLT, cataract surgery, or glaucoma surgery. MAIN OUTCOME MEASURES Diagnosis of PAC/PACG and medical, laser, or surgical interventions after LPI. RESULTS African Americans (odds ratio [OR], 2.12; P < 0.001) were significantly more likely than whites to have PAC/PACG than PACS and to already be taking glaucoma medications (OR, 2.25, P < 0.001) at the time of LPI. In multivariable logistic regression analysis, African Americans were significantly more likely to be prescribed additional glaucoma medications after LPI (OR, 1.73; P = 0.025) and receive glaucoma surgery (OR, 2.7; P = 0.007), but were less likely to receive SLT (OR, 0.37; P = 0.009). In multivariate Cox proportional-hazards regression analysis, African Americans had longer time to SLT than whites (hazard ratio [HR], 0.41; P = 0.022), but a shorter time to glaucoma surgery (HR, 2.57; P = 0.004). There was no significant association between race and the likelihood of cataract surgery or time to cataract surgery (P > 0.10). CONCLUSIONS African Americans were more likely than whites to carry a diagnosis of PAC or PACG at the time of LPI and were significantly more likely to be prescribed additional glaucoma medications and require glaucoma surgery after LPI. Improved screening methods that target African Americans with NAs are needed so that preventive interventions such as LPI can be performed earlier to decrease the risk of progression.
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Affiliation(s)
- Atalie C Thompson
- Duke University Medical Center, Department of Ophthalmology, Durham, North Carolina
| | - Daniel M Vu
- Duke University Medical Center, Department of Ophthalmology, Durham, North Carolina
| | - Lisa A Cowan
- Duke University Medical Center, Department of Ophthalmology, Durham, North Carolina; Southern California Permanente Medical Group, Bakersfield, California
| | - Sanjay Asrani
- Duke University Medical Center, Department of Ophthalmology, Durham, North Carolina.
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Özkan Aksoy N, Çakır B, Doğan E, Alagöz G. Evaluation of Anterior Segment Parameters in Pseudoexfoliative Glaucoma, Primary Angle-Closure Glaucoma, and Healthy Eyes. Turk J Ophthalmol 2018; 48:227-231. [PMID: 30405943 PMCID: PMC6216528 DOI: 10.4274/tjo.03271] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 03/30/2018] [Indexed: 12/01/2022] Open
Abstract
Objectives: To evaluate anterior segment parameters measured by dual Scheimpflug corneal topography in pseudoexfoliative glaucoma (PEXG), primary angle-closure glaucoma (PACG), and healthy eyes. Materials and Methods: One hundred forty-three eyes of 86 patients were included in this study. Forty-seven eyes of 38 patients with PEXG, 30 eyes of 15 patients with PACG, and 66 eyes of 33 healthy subjects were evaluated. Patients who underwent previous ophthalmic surgery and contact lens wearers were excluded. After full ophthalmological examination, mean central corneal thickness (CCT), white-to-white horizontal corneal diameter (WTW), pupillary diameter (PD), anterior chamber volume (ACV), anterior chamber depth (ACD), and mean anterior chamber angle were measured by dual Scheimpflug corneal topography and compared between the three groups. Statistical analyses were done using Statistical Package for Social Sciences for Windows 18.0 program. Results: No statistical difference was found in mean age or gender among the study groups (p>0.05). There were also no statistical differences in CCT, WTW, or PD among the groups (p=0.568, p=0.064, p=0.321, respectively). ACV, ACD, and mean anterior chamber angle values were significantly lower in the PACG group compared to the other groups (p=0.000 for all). There was no statistically significant difference in these measurements between the PEXG and normal eyes. Conclusion: ACV and depth and mean anterior chamber angle were statistically different (lower) in PACG when compared with PEXG and healthy eyes. Dual Scheimpflug corneal topography can be used as an objective method for the measurement of anterior segment parameters in glaucoma.
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Affiliation(s)
- Nilgün Özkan Aksoy
- Sakarya University Training and Research Hospital, Department of Ophthalmology, Sakarya, Turkey
| | - Burçin Çakır
- Sakarya University Training and Research Hospital, Department of Ophthalmology, Sakarya, Turkey
| | - Emine Doğan
- Sakarya University Training and Research Hospital, Department of Ophthalmology, Sakarya, Turkey
| | - Gürsoy Alagöz
- Sakarya University Training and Research Hospital, Department of Ophthalmology, Sakarya, Turkey
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Muhsen S, Alkhalaileh F, Hamdan M, AlRyalat SA. Central corneal thickness in a Jordanian population and its association with different types of Glaucoma: cross-sectional study. BMC Ophthalmol 2018; 18:279. [PMID: 30373555 PMCID: PMC6206916 DOI: 10.1186/s12886-018-0944-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 10/16/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Central corneal thickness (CCT) has long been implicated to affect glaucoma predisposition. Several reports have identified that thinner CCT is a risk factor for open-angle glaucoma, and that CCT can be very variable between different ethnic groups. In this study, we aim to identify the relation between CCT and different glaucoma parameters in different types of glaucoma in an Arabian ethnicity. METHODS We classified our participants into four main groups: primary open-angle glaucoma (POAG), primary angle-closure glaucoma (PACG), pseudoexfoliative glaucoma (PXFG), and a control group. We obtained demographics, intraocular pressure (IOP), cup to disc ratio (CDR), visual field mean deviation (MD) and pattern standard deviation (PSD), CCT, and retinal nerve fiber layer (RNFL) thickness for each participant. RESULTS We included A total of 119 eyes with glaucoma, including POAG (54 eyes), PXFG (31 eyes) and PACG (34 eyes), we also included 57 control eyes. We found that PACG eyes have the thinnest CCT. Mean measurements of CCT for our groups were: 538.31 μm (SD = 36.30) in eyes with POAG, 544.45 μm (SD = 28.57) in eyes with PXFG, 506.91 μm (SD = 34.55) in eyes with PACG and 549.63 μm (SD = 42.9) in the control group. We found that CCT is significantly correlated with CDR (p = 0.012, r = - 0.231), MD (p < 0.001, r = 0.327),and RNFL thickness (p = .007, r = .283). CONCLUSION In Arabian ethnicity, PACG patients have the thinnest CCT compared to other types of glaucoma, namely POAG and PXFG. We demonstrated that glaucomatous eyes with thinner corneas will probably have more advanced glaucomatous optic neuropathy. Our results emphasize the importance of taking ethnicity into account upon glaucoma management.
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Affiliation(s)
- Sana' Muhsen
- Ophthalmology, Glaucoma and Anterior Segment Surgeon, University of Jordan Hospital, The University of Jordan, Amman, Jordan
| | | | - Mohammad Hamdan
- School of Medicine, The University of Jordan, Amman, 11942, Jordan
| | - Saif Aldeen AlRyalat
- Department of Ophthalmology, University of Jordan Hospital, The University of Jordan, Amman, 11942, Jordan.
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Ayala M, Karlsson J. No differences in central corneal thickness between open-angle and pseudoexfoliation glaucoma patients. Clin Ophthalmol 2017; 11:733-738. [PMID: 28458512 PMCID: PMC5402997 DOI: 10.2147/opth.s136007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Measurements of intraocular pressure (IOP) with Goldmann applanation tonometry are affected by central corneal thickness (CCT), as thinner corneas underestimate and thicker corneas overestimate the true IOP value. The literature is controversial regarding CCT values in patients with primary open-angle glaucoma (POAG) and exfoliation glaucoma (XFG). The aim of this study was to evaluate CCT in patients with XFG and POAG. Methods CCT was evaluated with optical coherence tomography (OCT). All participants who were previously diagnosed with either POAG or XFG underwent ophthalmological examinations. Contact lens users and patients with corneal diseases were excluded. Results Totally, 145 patients were enrolled in this study. The mean CCT was 535±30.4 µm in patients with POAG and was 536±33.7 µm in patients with XFG. The result was not statistically significant (P=0.98). The mean age for all participants was 73.8±7.7 years. The study included totally 61 women and 84 men. The two groups were similar in their demographic data, and mean deviation was the only parameter that differed statistically when comparing POAG with XFG (P=0.02). Conclusion Our data indicate that patients with XFG do not have thinner corneas than those with POAG, and therefore, CCT can not explain why they progress differently.
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Affiliation(s)
- Marcelo Ayala
- Eye Department, Skaraborg Hospital, Skövde, Sahlgrenska Academy, Gothenburg University and Karolinska Institute
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