Journal of Ophthalmology The latest articles from Hindawi Publishing Corporation © 2016 , Hindawi Publishing Corporation . All rights reserved. Response to: Comment on “The Effects of Hemodialysis on Tear Osmolarity” Tue, 23 Aug 2016 14:13:00 +0000 Muhittin Taskapili, Kubra Serefoglu Cabuk, Rukiye Aydin, Kursat Atalay, Ahmet Kirgiz, Dede Sit, and Hasan Kayabasi Copyright © 2016 Muhittin Taskapili et al. All rights reserved. Lacrimal Gland, Ocular Surface, and Dry Eye Tue, 23 Aug 2016 09:06:59 +0000 Chuanqing Ding, Edit Tóth-Molnár, Ningli Wang, and Lei Zhou Copyright © 2016 Chuanqing Ding et al. All rights reserved. Effects of Target Size and Test Distance on Stereoacuity Sun, 21 Aug 2016 12:24:48 +0000 Target size and test distance effects on stereoacuity were investigated in 24 subjects using a three-dimensional monitor. Examination 1: Target Size Effects. The test distance was 2.5 m for 0.1°, 0.2°, 0.5°, and 0.9° target sizes; crossed parallax was presented in 22-second units. Average stereoacuity values for 0.1°, 0.2°, 0.5°, and 0.9° target sizes were , , , and seconds, respectively. Stereoacuity was significantly worse with a 0.1° target than with 0.2°, 0.5°, and 0.9° target sizes (, , and , resp.). Examination 2: Test Distance Effects. Test distances of 2.5, 5.0, and 7.5 m were investigated for a 0.5° target size; crossed parallax was presented in 22-second units. Average stereoacuity values at 2.5 m, 5.0 m, and 7.5 m test distances were , , and seconds, respectively. Stereoacuity at a 7.5 m distance was significantly better than at distances of 2.5 m and 5.0 m ( and , resp.). Stereoacuity at a 5.0 m distance was significantly better than at 2.5 m (). Stereoacuity should be estimated by both parallax and other elements, including test distance and target size. Yo Iwata, Fusako Fujimura, Tomoya Handa, Nobuyuki Shoji, and Hitoshi Ishikawa Copyright © 2016 Yo Iwata et al. All rights reserved. Visual Rehabilitation in Combined Surgical Procedures: Bridging Two Eye Poles for Better Vision Thu, 18 Aug 2016 09:28:26 +0000 M. J. Koss, C. Y. Choi, R. R. Krueger, M. Maia, and H. B. Fam Copyright © 2016 M. J. Koss et al. All rights reserved. Corrigendum to “Expression of HGF and c-Met Proteins in Human Keratoconus Corneas” Wed, 17 Aug 2016 12:43:59 +0000 Jingjing You, Li Wen, Athena Roufas, Chris Hodge, Gerard Sutton, and Michele C. Madigan Copyright © 2016 Jingjing You et al. All rights reserved. Intrastromal Injection of Bevacizumab in the Management of Corneal Neovascularization: About 25 Eyes Wed, 17 Aug 2016 09:18:40 +0000 Introduction. Corneal neovessels are a major risk factor for corneal graft rejection, due to the loss of the immune privilege. The purpose of this study is to evaluate the effectiveness of intrastromal injection of bevacizumab in the treatment of corneal neovascularization. Material and Methods. This is a prospective study that included 25 eyes of 22 patients with deep corneal neovessels, treated with intrastromal injections of bevacizumab. Results. The average age of patients was 31 years ranging from 16 to 44 years. The causes of neovascularization were dominated by herpetic keratitis (10 cases). The evolution was marked by complete regress of neovessels in 16 patients, partial regress in 6 cases, and reduced opacity and improved visual acuity in 5 patients. No side effects were noted. Discussion. Short-term results demonstrated the effectiveness of intrastromal injection of bevacizumab in the treatment of corneal neovessels. It may be an option or a complement to other useful treatments in stabilizing or improving vision. Conclusion. Bevacizumab is an effective additional treatment for the improvement of corneal transplants prognosis with preoperative corneal neovascularization. Belghmaidi Sarah, Hajji Ibtissam, Baali Mohammed, Soummane Hasna, and Moutaouakil Abdeljalil Copyright © 2016 Belghmaidi Sarah et al. All rights reserved. Novel Technique of Transepithelial Corneal Cross-Linking Using Iontophoresis in Progressive Keratoconus Mon, 15 Aug 2016 09:05:24 +0000 In this work, the authors presented the techniques and the preliminary results at 6 months of a randomized controlled trial (NCT02117999) comparing a novel transepithelial corneal cross-linking protocol using iontophoresis with the Dresden protocol for the treatment of progressive keratoconus. At 6 months, there was a significant average improvement with an average flattening of the maximum simulated keratometry reading of  D (); in addition, corrected distance visual acuity improved significantly () and spherical equivalent refraction was significantly less myopic () 6 months after transepithelial corneal cross-linking with iontophoresis. The novel protocol using iontophoresis showed comparable results with standard corneal cross-linking to halt progression of keratoconus during 6-month follow-up. Investigation of the long-term RCT outcomes are ongoing to verify the efficacy of this transepithelial corneal cross-linking protocol and to determine if it may be comparable with standard corneal cross-linking in the management of progressive keratoconus. Marco Lombardo, Sebastiano Serrao, Paolo Raffa, Marianna Rosati, and Giuseppe Lombardo Copyright © 2016 Marco Lombardo et al. All rights reserved. Low-Fluence Photodynamic Therapy versus Subthreshold Micropulse Yellow Wavelength Laser in the Treatment of Chronic Central Serous Chorioretinopathy Mon, 15 Aug 2016 07:48:01 +0000 Purpose. To compare the efficacy and safety of subthreshold micropulse yellow wavelength laser (SMYL) and low-fluence photodynamic therapy (PDT) in the treatment of chronic central serous chorioretinopathy (CSC). Methods. Thirty-three eyes of 30 patients with chronic CSC received either PDT (18 eyes) or SMYL (15 eyes) therapy. Best corrected visual acuity (BCVA), subretinal fluid (SRF) height, and central macular thickness (CMT) were evaluated at the baseline visit and one, three, six, nine, and 12 months after the therapy. Results. After 12 months, mean BCVA improved from to ETDRS letters in SMYL group and from to ETDRS letters in PDT group ( and , resp.). Mean CMT decreased from  μm to  μm in the PDT group and from  μm to  μm in the SMYL group ( and , resp.). SRF resolved completely in 72.2% and 80.0% of the eyes in the PDT and SMYL groups, respectively. Mean SRF height decreased from  μm to  μm in the PDT group and from  μm to  μm in the SMYL group ( and , resp.). Conclusions. Subthreshold micropulse yellow wavelength laser seems to be effective in the treatment of chronic CSC without any side effect and results in the resorption of SRF without causing visible retinal scarring. Emin Özmert, Sibel Demirel, Özge Yanık, and Figen Batıoğlu Copyright © 2016 Emin Özmert et al. All rights reserved. How Important Is the Etiology in the Treatment of Epiphora? Wed, 10 Aug 2016 13:14:06 +0000 Purpose. There are several etiological factors that cause epiphora, and treatment differs according to the cause. We aimed to evaluate the etiology of epiphora and the treatment modalities of the affected patients. Materials and Methods. Data of patients who were referred to ophthalmology clinics for epiphora were retrospectively analyzed. All patients were evaluated for epiphora etiology, treatment modalities, and duration of complaints, after complete ophthalmologic examination. Results. This study consisted of 163 patients with a mean age of 64.61 ± 16.52 years (range 1–92 years). Lacrimal system disease (48.4% [79/163]) was the most common cause, followed by ocular surface disease (dry eye/blepharitis) (38.7% [63/163]). Among the patients included in this study, 69% (113/163) did not receive any treatment, whereas only 1.8% (3/163) were treated surgically. About 4.3% of the patients (7/163) had a complaint for more than 5 years () and six of these had chronic dacryocystitis and one had ectropion. Conclusion. Epiphora not only has a negative impact on patients’ comfort, but also puts them at risk for probable intraocular operations in the future. Therefore, the wide range of its etiology must be taken into consideration and adequate etiology-specific treatment options must be applied. Mahmut Oğuz Ulusoy, Sertaç Argun Kıvanç, Mehmet Atakan, and Berna Akova-Budak Copyright © 2016 Mahmut Oğuz Ulusoy et al. All rights reserved. Endoscopic-Assisted Scleral Fixated IOL in the Management of Secondary Aphakia in Children Wed, 10 Aug 2016 11:05:40 +0000 Purpose. To evaluate the short-term postoperative outcomes in endoscopic-assisted sclera fixation intraocular lens (IOL) for the management of secondary aphakia in children. Methods. This is a prospective study, whereas 40 aphakic eyes with absence of a good capsular support were implanted by endoscopy-assisted sclera fixation technique. Results. No major intraoperative complications were recorded. All cases were followed up for 6 months. Only transient ocular hypertension occurred in 10 (25%) eyes. Lens decentration and/or tilting were clinically detected in 2 eyes (5%). Ultrasonic biomicroscopic (UBM) examination revealed lens tilting in 2 (5%) of the operated eyes, despite the proper haptics positioning in the ciliary sulcus. Postoperative vitreous hemorrhage was reported in 5 eyes (12.5%) in the early postoperative period and retinal detachment in one eye. A postoperative refractive astigmatism ranging from 0.75 D to 3.75 D (mean 1.7 D ± 0.79) was recorded, as compared to mean preoperative values of 2.00 D, with no statistically significant differences being recorded (). An improvement of BCVA, 1-2 lines on Snellen chart at the end of the follow-up period, was detected in 23 eyes (57.5%) with a mean of  SD, as compared to a preoperative mean values of  SD (). Conclusion. Using an endoscope for transscleral suturing of intraocular lenses in aphakic pediatric eyes might be considered as being an effective technique that can reduce surgical complications, especially postoperative lens decentration. Heba A. El Gendy, Hossam Eldin Khalil, Hazem Effat Haroun, and Mohamed Wagieh El Deeb Copyright © 2016 Heba A. El Gendy et al. All rights reserved. Multimodal Imaging in Ophthalmology Wed, 10 Aug 2016 08:34:39 +0000 Lisa Toto, Roberto dell’Omo, Gian Marco Tosi, Giuseppe Querques, Sandrine A. Zweifel, and Antoine Labbé Copyright © 2016 Lisa Toto et al. All rights reserved. Prognostic Factors for Visual Outcome in Traumatic Cataract Patients Tue, 09 Aug 2016 15:35:26 +0000 Purpose. To investigate the prognostic factors for visual outcome in traumatic cataract patients. Methods. The demographic features of traumatic cataract patients in Central China were studied. The factors that might influence the visual outcome were analyzed. The sensitivity and specificity of OTS (ocular trauma score) in predicting VA were calculated. Results. The study enrolled 480 cases. 65.5% of patients achieved VA at >20/60. The factors associated with the final VA were initial VA, injury type, wound location, the way of cataract removal, and IOL implantation. The sensitivities of OTS in predicting the VA at NLP (nonlight perception), LP/HM (light perception/hand motion), and ≥20/40 were 100%. The specificity of OTS to predict the final VA at 1/200-19/200 and 20/200-20/50 was 100%. Conclusion. The prognostic factors were initial VA, injury type, wound location, cataract removal procedure, and the way of IOL implantation. The OTS has good sensitivity and specificity in predicting visual outcome in traumatic cataract patients in long follow-up. Ying Qi, Yan F. Zhang, Yu Zhu, Ming G. Wan, Shan S. Du, and Zhen Z. Yue Copyright © 2016 Ying Qi et al. All rights reserved. Subfoveal Choroidal Thickness after Panretinal Photocoagulation with Red and Green Laser in Bilateral Proliferative Diabetic Retinopathy Patients: Short Term Results Tue, 09 Aug 2016 13:30:08 +0000 Purpose. To compare subfoveal choroidal, central retinal, and peripapillary nerve fiber layer (RNFL) thickness after panretinal photocoagulation (PRP) with red and green laser in diabetic patients. Study Design. Randomized clinical trial. Methods. A total of 50 patients with bilateral proliferative diabetic retinopathy and no diabetic macular edema underwent PRP. One eye was randomly assigned to red or green laser. Subfoveal choroidal, central retinal, and RNFL thicknesses were evaluated at baseline and 6 weeks after treatment. Results. The mean subfoveal choroidal, central retinal, and peripapillary nerve fiber layer (RNFL) thickness increased significantly in each eye 6 weeks after PRP ( values in red laser group: <0.01, 0.03, and <0.01, resp., and in green laser group <0.01, <0.01, and <0.01). There was no difference between red and green laser considering subfoveal choroidal, central retinal, and peripapillary nerve fiber layer (RNFL) thickness increase after PRP ( values: 0.184, 0.404, and 0.726, resp.). Conclusion. Both red and green lasers increased mean subfoveal choroidal, central retinal, and peripapillary nerve fiber layer (RNFL) thickness significantly 6 weeks after PRP, but there is no difference between these two modalities in this regard. Ramak Roohipoor, Sina Dantism, Aliasghar Ahmadraji, Reza Karkhaneh, Mohammad Zarei, and Fariba Ghasemi Copyright © 2016 Ramak Roohipoor et al. All rights reserved. Rotating Scheimpflug Imaging Indices in Different Grades of Keratoconus Mon, 08 Aug 2016 11:56:57 +0000 Purpose. To evaluate accuracy of various Keratoconus (KC) screening indices, in relation to Topographic Keratoconus (TKC) grading. Setting. Al Watany Eye Hospital, Cairo, Egypt. Methods. Data of 103 normal (group 1) and 73 KC eyes (group 2), imaged by Pentacam (branded as Allegro Oculyzer), were analysed. Group 2 was divided into 2a: 14 eyes (TKC = 1, early KC), 2b: 25 eyes (TKC = 1 to 2 or 2, moderate KC), and 2c: 34 eyes (TKC = 2 to 3 up to 4, severe KC). Participants were followed up for six years to confirm diagnosis. Area under the receiver operating characteristic curve (AUROC) was calculated for evaluated curvature, elevation, and pachymetry indices with various reference shapes at different diameters. Results. When comparing normal to KC eyes, ten indices had significantly higher AUROC. Only five of them had significantly higher AUROC in early KC compared to normal corneas: Pachymetry Progression Index- (PPI-) Maximum (Max), Ambrósio’s Relational Thickness- (ART-) Max, PPI-Max minus PPI-Minimum (Min), central corneal thickness (CCT), and diagonal decentration of thinnest point from the apex (AUROC = 0.690, 0.690, 0.687, 0.683, and 0.674, resp.). Conclusion. Generally, ten pachymetry and elevation-based indices had significantly higher AUROC. Five indices had statistically significant high AUROC when comparing early KC to normal corneas. Sherine S. Wahba, Maged M. Roshdy, Rania S. Elkitkat, and Karim M. Naguib Copyright © 2016 Sherine S. Wahba et al. All rights reserved. Evaluation of Retinal and Choroidal Thickness in Fuchs’ Uveitis Syndrome Mon, 08 Aug 2016 11:13:50 +0000 Purpose. We aimed to investigate retinal and choroidal thickness in the eyes of patients with Fuchs’ uveitis syndrome (FUS). Methods. Fifteen patients with unilateral FUS and 20 healthy control subjects were enrolled. Spectral domain optical coherence tomography (Spectralis HRA+OCT, 870 nm; Heidelberg Engineering, Heidelberg, Germany) was used to obtain retinal and choroidal thickness measurements. The retinal nerve fiber layer (RNFL) thickness, macular thickness, and choroidal thickness of the eyes with FUS were compared with the unaffected eye and the eyes of healthy control subjects. Results. The mean choroidal thickness at fovea and at each point within the horizontal nasal and temporal quadrants at 500 μm intervals to a distance of 1500 µm from the foveal center was significantly thinner in the affected eye of FUS patients compared with the unaffected eye of FUS patients or the eyes of healthy control subjects. However, there were no significant differences in RNFL or macular thickness between groups. Conclusions. Affected eyes in patients with FUS tend to have thinner choroids as compared to eyes of unaffected fellow eyes and healthy individuals, which might be a result of the chronic inflammation associated with the disease. Ozlem Balci and Mustafa Ozsutcu Copyright © 2016 Ozlem Balci and Mustafa Ozsutcu. All rights reserved. Prognostic Factor Analysis of Intraocular Pressure with Neovascular Glaucoma Sun, 07 Aug 2016 14:30:18 +0000 Purpose. To perform multivariate analysis for identifying independent predictors of elevated intraocular pressure (IOP) with neovascular glaucoma (NVG), including antivascular endothelial growth factor (VEGF) intravitreal injections. Methods. We retrospectively reviewed 142 NVG patients (181 eyes) with ischemic retinal diseases [proliferative diabetic retinopathy (PDR) in 134 eyes, retinal vein occlusion (RVO) in 29, and ocular ischemic syndrome in 18]. We analyzed age, gender, initial/final LogMAR VA, initial/final IOP, extent of iris and/or angle neovascularization, treatments, preexisting complications, concurrent medications, and follow-up duration. Results. The mean follow-up duration was 23.8 ± 18.8 months. At the final follow-up, 125 (72.3%) eyes had IOP ≤ 21 mmHg. NVG patients with RVO had a higher degree of angle closure and higher IOP. NVG with PDR had better IOP and LogMAR VA. Angle closure had the greatest impact on final IOP. Greater than 90% of patients treated with trabeculectomy with mitomycin C (LEC) had persistent declines in IOP (≤21 mmHg). Stand-alone and combination anti-VEGF therapies were not associated with improved long-term prognosis of IOP. Conclusions. Angle closure was found to have the greatest effect on NVG-IOP prognosis. When target IOP values are not obtained after adequate PRP with or without anti-VEGF, early LEC may improve the prognosis of IOP. Satoko Nakano, Takako Nakamuro, Katsuhiko Yokoyama, Kunihiro Kiyosaki, and Toshiaki Kubota Copyright © 2016 Satoko Nakano et al. All rights reserved. Multivendor Spectral-Domain Optical Coherence Tomography Dataset, Observer Annotation Performance Evaluation, and Standardized Evaluation Framework for Intraretinal Cystoid Fluid Segmentation Thu, 04 Aug 2016 12:47:30 +0000 Development of image analysis and machine learning methods for segmentation of clinically significant pathology in retinal spectral-domain optical coherence tomography (SD-OCT), used in disease detection and prediction, is limited due to the availability of expertly annotated reference data. Retinal segmentation methods use datasets that either are not publicly available, come from only one device, or use different evaluation methodologies making them difficult to compare. Thus we present and evaluate a multiple expert annotated reference dataset for the problem of intraretinal cystoid fluid (IRF) segmentation, a key indicator in exudative macular disease. In addition, a standardized framework for segmentation accuracy evaluation, applicable to other pathological structures, is presented. Integral to this work is the dataset used which must be fit for purpose for IRF segmentation algorithm training and testing. We describe here a multivendor dataset comprised of 30 scans. Each OCT scan for system training has been annotated by multiple graders using a proprietary system. Evaluation of the intergrader annotations shows a good correlation, thus making the reproducibly annotated scans suitable for the training and validation of image processing and machine learning based segmentation methods. The dataset will be made publicly available in the form of a segmentation Grand Challenge. Jing Wu, Ana-Maria Philip, Dominika Podkowinski, Bianca S. Gerendas, Georg Langs, Christian Simader, Sebastian M. Waldstein, and Ursula M. Schmidt-Erfurth Copyright © 2016 Jing Wu et al. All rights reserved. Visual Performance after Bilateral Implantation of a Four-Haptic Diffractive Toric Multifocal Intraocular Lens in High Myopes Tue, 02 Aug 2016 09:16:45 +0000 Background. The vision with diffractive toric multifocal intraocular lenses after cataract surgery in long eyes has not been studied previously. Objectives. To report visual performance after bilateral implantation of a diffractive toric multifocal intraocular lens in high myopes. Methods. Prospective, observational case series to include patients with axial length of ≥26 mm and corneal astigmatism of >1 dioptre who underwent bilateral AT LISA 909M implantation. Postoperative examinations included photopic and mesopic distance, intermediate, and near visual acuity; photopic contrast sensitivity; visual symptoms (0–5); satisfaction (1–5); and spectacle independence rate. Results. Twenty-eight eyes (14 patients) were included. Postoperatively, mean photopic monocular uncorrected distance, intermediate, and near visual acuities (logMAR) were (standard deviation), , and , respectively. Corresponding binocular values were , , and , respectively. One eye (4%) had one-line loss in vision. Under mesopic condition, intermediate vision and near vision decreased significantly (all ). Contrast sensitivity at all spatial frequencies did not improve significantly under binocular condition (all ). Median scores for halos, night glare, starbursts, and satisfaction were 0.50, 0.00, 0.00, and 4.25, respectively. Ten patients (71%) reported complete spectacle independence. Conclusions. Bilateral implantation of the intraocular lens in high myopes appeared to be safe and achieved good visual performance and high satisfaction. John S. M. Chang, Vincent K. C. Chan, Jack C. M. Ng, and Antony K. P. Law Copyright © 2016 John S. M. Chang et al. All rights reserved. Cellular and Molecular Pathology of Age-Related Macular Degeneration: Potential Role for Proteoglycans Mon, 01 Aug 2016 10:53:09 +0000 Age-related macular degeneration (AMD) is a retinal disease evident after the age of 50 that damages the macula in the centre of retina. It leads to a loss of central vision with retained peripheral vision but eventual blindness occurs in many cases. The initiation site of AMD development is Bruch’s membrane (BM) where multiple changes occur including the deposition of plasma derived lipids, accumulation of extracellular debris, changes in cell morphology, and viability and the formation of drusen. AMD manifests as early and late stage; the latter involves cell proliferation and neovascularization in wet AMD. Current therapies target the later hyperproliferative and invasive wet stage whilst none target early developmental stages of AMD. In the lipid deposition disease atherosclerosis modified proteoglycans bind and retain apolipoproteins in the artery wall. Chemically modified trapped lipids are immunogenic and can initiate a chronic inflammatory process manifesting as atherosclerotic plaques and subsequent artery blockages, heart attacks, or strokes. As plasma derived lipoprotein deposits are found in BM in early AMD, it is possible that they arise by a similar process within the macula. In this review we consider aspects of the pathological processes underlying AMD with a focus on the potential role of modifications to secreted proteoglycans being a cause and therefore a target for the treatment of early AMD. Othman Al Gwairi, Lyna Thach, Wenhua Zheng, Narin Osman, and Peter J. Little Copyright © 2016 Othman Al Gwairi et al. All rights reserved. The Blockade of IL6 Counterparts the Osmolar Stress-Induced Apoptosis in Human Conjunctival Epithelial Cells Sun, 31 Jul 2016 10:08:48 +0000 To determine the effect of hyperosmolarity on cell survival/apoptosis of conjunctival epithelial cells and evaluate the possible role of IL6, Wong-Kilbourne derivative of Chang conjunctival cell line (WKD) was used in this study. Confluent cells were incubated under different osmolarity (290 mOsm and 500 mOsm) with or without neutralizing IL6 antibody (50 ng/mL). The expression of IL6 level was measured in the supernatant of each conditioned medium. Cell viability/apoptosis assay was performed using Annexin V/Propidium Iodide (PI) and Cell Counting Kit-8 (CCK-8). Western blot was conducted to measure the abundance of apoptotic markers and IL6 related downstream signaling pathway. The concentration of IL6 showed time-dependent increase in cells treated with 500 mOsm. Although apoptosis of WKD cell is increased in treated 500 mOsm for 24 h, apoptosis reduced in WKD cell treated 500 mOsm with anti-IL6 for 24 h. Anti-IL6 inhibited the activation of JAK-STAT signaling pathway, which was induced by hyperosmolarity. Hyperosmolar condition induced apoptosis in conjunctival epithelial cells, along with increase of IL6 production. IL6 neutralizing antibody inhibited apoptosis and JAK-STAT signaling in hyperosmolar condition. These findings suggested that IL6 may be involved in apoptotic change and in hyperosmolarity. Hee-Jung Ju, Yong-Soo Byun, Jee-Won Mok, and Choun-Ki Joo Copyright © 2016 Hee-Jung Ju et al. All rights reserved. Serial Diffusion Tensor Imaging of the Optic Radiations after Acute Optic Neuritis Sun, 31 Jul 2016 08:30:40 +0000 Previous studies have reported diffusion tensor imaging (DTI) changes within the optic radiations of patients after optic neuritis (ON). We aimed to study optic radiation DTI changes over 12 months following acute ON and to study correlations between DTI parameters and damage to the optic nerve and primary visual cortex (V1). We measured DTI parameters [fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD)] from the optic radiations of 38 acute ON patients at presentation and 6 and 12 months after acute ON. In addition, we measured retinal nerve fibre layer thickness, visual evoked potential amplitude, optic radiation lesion load, and V1 thickness. At baseline, FA was reduced and RD and MD were increased compared to control. Over 12 months, FA reduced in patients at an average rate of −2.6% per annum (control = −0.51%; ). Change in FA, RD, and MD correlated with V1 thinning over 12 months (FA: , ; RD: , ; MD: , ). In patients with no optic radiation lesions, AD significantly correlated with RNFL thinning at 12 months (, ). In conclusion, DTI can detect optic radiation changes over 12 months following acute ON that correlate with optic nerve and V1 damage. Scott C. Kolbe, Anneke van der Walt, Helmut Butzkueven, Alexander Klistorner, Gary F. Egan, and Trevor J. Kilpatrick Copyright © 2016 Scott C. Kolbe et al. All rights reserved. Classification of SD-OCT Volumes Using Local Binary Patterns: Experimental Validation for DME Detection Sun, 31 Jul 2016 06:03:04 +0000 This paper addresses the problem of automatic classification of Spectral Domain OCT (SD-OCT) data for automatic identification of patients with DME versus normal subjects. Optical Coherence Tomography (OCT) has been a valuable diagnostic tool for DME, which is among the most common causes of irreversible vision loss in individuals with diabetes. Here, a classification framework with five distinctive steps is proposed and we present an extensive study of each step. Our method considers combination of various preprocessing steps in conjunction with Local Binary Patterns (LBP) features and different mapping strategies. Using linear and nonlinear classifiers, we tested the developed framework on a balanced cohort of 32 patients. Experimental results show that the proposed method outperforms the previous studies by achieving a Sensitivity (SE) and a Specificity (SP) of 81.2% and 93.7%, respectively. Our study concludes that the 3D features and high-level representation of 2D features using patches achieve the best results. However, the effects of preprocessing are inconsistent with different classifiers and feature configurations. Guillaume Lemaître, Mojdeh Rastgoo, Joan Massich, Carol Y. Cheung, Tien Y. Wong, Ecosse Lamoureux, Dan Milea, Fabrice Mériaudeau, and Désiré Sidibé Copyright © 2016 Guillaume Lemaître et al. All rights reserved. Intraocular Pressure-Lowering Potential of Subthreshold Selective Laser Trabeculoplasty in Patients with Primary Open-Angle Glaucoma Wed, 27 Jul 2016 11:29:30 +0000 Purpose. To compare the efficacy of subthreshold and conventional selective laser trabeculoplasty (SLT) in lowering intraocular pressure (IOP) in the patients with primary open-angle glaucoma (POAG). Methods. Fifty-two eyes from fifty-two POAG patients were randomized into two groups, one group treated with subthreshold SLT using two-thirds of the conventional energy and the other one treated with the conventional energy. IOP was measured with the Goldmann tonometer and the anterior chamber inflammation was determined using laser flare meter. Results. The initial energy dosage used in subthreshold SLT group was significantly lower than the amount of the energy used in conventional SLT group ( mJ versus  mJ, ). The total energy dosage was also significantly lower in subthreshold SLT group compared to the other group ( mJ versus  mJ, ). However, the level of inflammation in aqueous humor, amount of reduction in IOP, and the success rate in controlling IOP was the same in both groups. Conclusion. The efficacy of subthreshold SLT group in reducing IOP in POAG patients is comparable to the efficacy of conventional SLT group. Hong Yang Zhang, Yong Jie Qin, Yang Fan Yang, Jian Gang Xu, and Min Bin Yu Copyright © 2016 Hong Yang Zhang et al. All rights reserved. Comment on “Exotropia Is the Main Pattern of Childhood Strabismus Surgery in the South of China: A Six-Year Clinical Review” Mon, 25 Jul 2016 14:13:19 +0000 Onder Ayyildiz, Osman Melih Ceylan, and Fatih Mehmet Mutlu Copyright © 2016 Onder Ayyildiz et al. All rights reserved. The Application of a Contact Lens Sensor in Detecting 24-Hour Intraocular Pressure-Related Patterns Mon, 25 Jul 2016 07:30:06 +0000 Glaucoma is one of the leading causes of blindness worldwide. Recent studies suggest that intraocular pressure (IOP) fluctuations, peaks, and rhythm are important factors in disease advancement. Yet, current glaucoma management remains hinged on single IOP measurements during clinic hours. To overcome this limitation, 24-hour IOP monitoring devices have been employed and include self-tonometry, permanent IOP, and temporary IOP monitoring. This review discusses each IOP measuring strategy and focuses on the recently FDA-approved contact lens sensor (CLS). The CLS records IOP-related ocular patterns for 24 hours continuously. Using the CLS, IOP-related parameters have been found to be associated with the rate of visual field progression in primary open-angle glaucoma, disease progression in primary angle-closure glaucoma, and various clinical variables in ocular hypertension. The CLS has been used to quantify blink rate and limbal strain and measure the circadian rhythm in a variety of disease states including normal-tension glaucoma and thyroid eye disease. The effects of various IOP-lowering interventions were also characterized using the CLS. CLS provides a unique, safe, and well-tolerated way to study IOP-related patterns in a wide range of disease states. IOP-related patterns may help identify patients most at risk for disease progression and assist with the development of tailored treatments. Sarah C. Xu, Angela C. Gauthier, and Ji Liu Copyright © 2016 Sarah C. Xu et al. All rights reserved. Corneal Biomechanics Determination in Healthy Myopic Subjects Thu, 21 Jul 2016 14:33:20 +0000 Purpose. To determine the corneal biomechanical properties by using the Ocular Response Analyzer™ and to investigate potential factors associated with the corneal biomechanics in healthy myopic subjects. Methods. 135 eyes from 135 healthy myopic subjects were included in this cross-sectional observational study. Cornea hysteresis (CH), corneal resistance factor (CRF), cornea-compensated intraocular pressure (IOPcc), and Goldmann-correlated intraocular pressure (IOPg) were determined with the Reichert Ocular Response Analyzer (ORA). Univariate and multivariate regression analyses were performed to investigate factors associated with corneal biomechanics. Results. The mean CH and CRF were  mmHg and  mmHg, respectively. In univariate regression analysis, CH was significantly correlated with axial length, refraction, central corneal thickness (CCT), and IOPg (, 0.23, 0.45, and 0.21, resp.; all with ), but not with corneal curvature or age; CRF was significantly correlated with CCT and IOPg ( and 0.70, resp.; all with ), but not with axial length/refraction, corneal curvature, or age. In multivariate regression analysis, axial length, IOPcc, and CCT were found to be independently associated with CH, while CCT and IOPg were associated with CRF. Conclusions. Both CH and CRF were positively correlated with CCT. Lower CH but not CRF was associated with increasing degree of myopia. Evaluation of corneal biomechanical properties should take CCT and myopic status into consideration. Kunliang Qiu, Xuehui Lu, Riping Zhang, Geng Wang, and Mingzhi Zhang Copyright © 2016 Kunliang Qiu et al. All rights reserved. Innovations in Glaucoma Surgery: Improving the Results Thu, 21 Jul 2016 09:08:50 +0000 Michele Figus, Shlomo Melamed, Antonio Ferreras, Giorgio Marchini, and Vital P. Costa Copyright © 2016 Michele Figus et al. All rights reserved. Convergence Insufficiency, Accommodative Insufficiency, Visual Symptoms, and Astigmatism in Tohono O’odham Students Wed, 20 Jul 2016 07:53:51 +0000 Purpose. To determine rate of convergence insufficiency (CI) and accommodative insufficiency (AI) and assess the relation between CI, AI, visual symptoms, and astigmatism in school-age children. Methods. 3rd–8th-grade students completed the Convergence Insufficiency Symptom Survey (CISS) and binocular vision testing with correction if prescribed. Students were categorized by astigmatism magnitude (no/low: <1.00 D, moderate: 1.00 D to <3.00 D, and high: ≥3.00 D), presence/absence of clinical signs of CI and AI, and presence of symptoms. Analyses determine rate of clinical CI and AI and symptomatic CI and AI and assessed the relation between CI, AI, visual symptoms, and astigmatism. Results. In the sample of 484 students (11.67 ± 1.81 years of age), rate of symptomatic CI was 6.2% and symptomatic AI 18.2%. AI was more common in students with CI than without CI. Students with AI only () and with CI and AI () had higher symptom scores than students with neither CI nor AI. Moderate and high astigmats were not at increased risk for CI or AI. Conclusions. With-the-rule astigmats are not at increased risk for CI or AI. High comorbidity rates of CI and AI and higher symptoms scores with AI suggest that research is needed to determine symptomatology specific to CI. Amy L. Davis, Erin M. Harvey, J. Daniel Twelker, Joseph M. Miller, Tina Leonard-Green, and Irene Campus Copyright © 2016 Amy L. Davis et al. All rights reserved. Evaluation of Outflow Structures In Vivo after the Phacocanaloplasty Tue, 19 Jul 2016 12:57:47 +0000 Purpose. To evaluate the in vivo changes in Schlemm’s canal (SC) and the trabecular meshwork (TM) in patients with primary open-angle glaucoma (POAG) after phacocanaloplasty using anterior segment optical coherence tomography (AS-OCT). Methods. Ten eyes of nine patients with POAG (6 men and 3 women) who underwent phacocanaloplasty. Preoperative and postoperative visual acuity (VA), intraocular pressure (IOP), and use of glaucoma medications were evaluated. The main outcome measures were the area of SC and TM thickness assessed using AS-OCT before and 12 months after surgery. Results. We found statistically significant reduction in IOP (from 26.4 (8.6) mmHg to 12.9 (2.5) () mmHg), increase in VA from 0.7 (0.4) to 0.9 (0.2), and decrease in glaucoma medication from 2.6 (1.2) to 1.1 (1.3) at 12 months postoperatively. There was a significant increase in the SC area (3081.7 (842.8) μm2 versus 5098.8 (1190.5) μm2, ) and a decrease in mean TM thickness (91.2 (18.6) μm versus 81.3 (15.1) μm, ) after surgery. We found negative correlations between SC area and IOP before surgery (, ) and also between SC area before and IOP reduction 12 months after the phacocanaloplasty (, ). Conclusions. Our results showed statistically significant dilation of SC area and reduction of TM thickness after phacocanaloplasty in POAG patients. The degree of SC expansion was related to the IOP decrease. Daiva Paulaviciute-Baikstiene, Renata Vaiciuliene, Vytautas Jasinskas, and Ingrida Januleviciene Copyright © 2016 Daiva Paulaviciute-Baikstiene et al. All rights reserved. The Predictability of Preoperative Pilocarpine-Induced Lens Shift on the Outcomes of Accommodating Intraocular Lenses Implanted in Senile Cataract Patients Tue, 19 Jul 2016 07:08:22 +0000 Purpose. To evaluate the predictability of lens shift induced by pilocarpine () on the outcomes of accommodating intraocular lens (Acc-IOL) implantation. Methods. Twenty-four eyes of 24 senile cataract patients who underwent phacoemulsification and Acc-IOL implantation were enrolled. was evaluated with anterior segment optical coherence tomography (AS-OCT). At 3 months postoperatively, the best corrected distance visual acuities (BCDVA), distance-corrected near visual acuities (DCNVA), and subjective and objective accommodations were measured. IOL shifts under accommodation stimulus () were evaluated with AS-OCT. Results. The mean was 112.29 ± 30.72 µm. was not associated with any preoperative parameters. The mean was 130.46 ± 42.71 µm. The mean subjective and objective accommodation were 1.54 ± 0.39 D and 1.27 ± 0.41 D, respectively. The mean postoperative BCDVA and DCNVA (log MAR value) were 0.22 ± 0.11 and 0.24 ± 0.12, respectively. positively correlated with (; ), subjective accommodation (; ), and objective accommodation (; ), respectively. Conclusion. is an independent preoperative parameter associated with the postoperative Acc-IOL mobility and pseudophakic accommodation. It may offer valuable information for ophthalmologists in determining the suitable candidates for Acc-IOL implantation. Jin Li, Qi Chen, Zhibo Lin, Lin Leng, Fang Huang, and Ding Chen Copyright © 2016 Jin Li et al. All rights reserved.