Sanae Asonuma

Reading ability after macular translocation surgery with 360-degree retinotomy☆

PURPOSE To report reading ability using a standardized reading chart after macular translocation with 360-degree retinotomy in eyes with age-related macular degeneration (AMD) or with myopic choroidal neovascularization (mCNV). DESIGN Interventional case series. METHODS In 34 eyes of 34 patients with subfoveal choroidal neovascular membrane (AMD, 23; mCNV, 11), macular translocation surgery with 360-degree retinotomy and simultaneous extraocular muscle surgery were performed. The average age was 67.4 +/- 7.9 years, and the average follow-up period was 7.6 +/- 3.3 months. The best-corrected far visual acuity (FVA) was measured with a standardized visual acuity chart using Landolt Cs, and the critical print size (CPS) was determined with the Japanese version of the Minnesota reading chart (MNREAD-J Chart) preoperatively and postoperatively. Preoperative and postoperative change in the CPS was compared with the subjective visual improvement as assessed by a questionnaire. RESULTS The postoperative improvement of FVA was statistically significant in eyes with mCNV (P =.010) but not significant in eyes with AMD (P =.495). The postoperative improvement of CPS was statistically significant both in eyes with AMD (P =.027) and in eyes with mCNV (P =.004). The subjective visual improvement was significantly correlated with the change of CPS in patients after a second better eye surgery. CONCLUSIONS After macular translocation with 360-degree retinotomy, the improvement of reading ability was significant in eyes with both AMD and mCNV. We conclude that this surgical method is well suited to improve reading ability of patients with AMD or mCNV.

Ocular forward light scattering and corneal backward light scattering in patients with dry eye.

PURPOSE To evaluate ocular forward light scattering and corneal backward light scattering in patients with dry eye. METHODS Thirty-five eyes in 35 patients with dry eye and 20 eyes of 20 healthy control subjects were enrolled. The 35 dry eyes were classified into two groups according to whether superficial punctate keratopathy in the central 6-mm corneal zone (cSPK) was present or not. Ocular forward light scattering was quantified with a straylight meter. Corneal backward light scattering from the anterior, middle, and posterior corneal parts was assessed with a corneal densitometry program using the Scheimpflug imaging system. RESULTS Both dry eye groups had significantly higher intraocular forward light scattering than the control group (both P<0.05). The dry eye group with cSPK had significantly higher values in anterior and total corneal backward light scattering than the other two groups. Moderate positive correlations were observed between the cSPK score and corneal backward light scattering from the anterior cornea (R=0.60, P<0.001) and corneal backward light scattering from the total cornea (R=0.54, P<0.001); however, no correlation was found between cSPK score and ocular forward light scattering (R=0.01, P=0.932). CONCLUSIONS Ocular forward light scattering and corneal backward light scattering from the anterior cornea were greater in dry eyes than in normal eyes. Increased corneal backward light scattering in dry eye at least partially results from cSPK overlying the optical zone.

Use of Dynamic and Colored Stereogram to Measure Stereopsis in Strabismic Patients

The effectiveness of movement or color has not been well studied in assessing stereopsis in patients with strabismus. We developed a new stereotest equipped with both a monochromatic dynamic random dot stereogram (DRDS) and a static-colored stereogram (SCS) and examined the stereopsis of patients with strabismus. Three-dimensional (3D) images were displayed on a liquid crystal display equipped with a parallax barrier system, allowing 3D images to be seen independently by each eye without glasses. A DRDS with maximum disparity of 3200 seconds of arc was displayed having front-rear movement. An SCS displaying cartoon characters with disparities of 400 seconds of arc was also tested and compared with the Titmus stereotest. A total of 52 strabismic patients were tested. The DRDS showed a significantly higher (P = 0.02) detection rate of stereopsis (39/52, 75%) as compared with the Titmus fly test (28/52, 54%). The SCS did not show any difference in the stereopsis detection rate (24/521, 46%) when compared with the Titmus animal test (20/52, 38%). Thus, the DRDS was useful in detecting stereopsis in patients without stereopsis on the conventional Titmus fly test, while the SCS did not show any difference when compared with the Titmus animal test. The DRDS may examine a different aspect of stereopsis from the static stereopsis measured by the Titmus stereotest or SCS.

Age-related changes of phoria myopia in patients with intermittent exotropia

PurposeTo investigate the age-related changes in a myopic shift under binocular conditions (phoria myopia) in patients with intermittent exotropia (IXT).MethodsForty-five patients with IXT were studied: 21 were ≤9 years old (children), 11 were between 10 and 19 years (adolescents), and 13 were between 20 and 43 years (adults). The angle of strabismus was determined by the alternating prism cover test. The spherical refractive error was measured at 1 m using infrared video retinoscopy under monocular and binocular viewing conditions.ResultsThe change in the spherical refractive error (ΔR) between binocular and monocular conditions was significantly larger in adults (ΔR = −1.11 ± 1.01 diopters (D), average ± standard deviation) than in children (ΔR = −0.34 ± 0.34 D; P < 0.05, analysis of variance). ΔR was significantly correlated with the angle of exotropia only in adults (r = 0.55, P = 0.04). After strabismus surgery, ΔR decreased in adults (n = 3).ConclusionsBecause a significant myopic shift under binocular conditions was detected in IXT patients older than 20 years, phoria myopia can occur after age 20 even if functional disturbances are not observed in children or adolescent IXT patients, a fact that specialists need to bear in mind when treating younger patients.

The Effect of Ocular Surface Regularity on Contrast Sensitivity and Straylight in Dry Eye

Purpose To investigate the association between visual function and ocular surface regularity in dry eye. Methods We enrolled 52 eyes of 52 dry eye patients (34 dry eyes with superficial punctate keratopathy [SPK] in the central corneal region [central SPK] and 18 dry eyes without central SPK) and 20 eyes of 20 normal control subjects. All eyes had a best-corrected distance visual acuity better than 20/20. We measured two indices of contrast sensitivity function under photopic conditions: contrast sensitivity and letter contrast sensitivity. The area under the log contrast sensitivity function (AULCSF) was calculated from the obtained contrast sensitivity data. Straylight was quantified using a straylight meter. Results Dry eyes with central SPK had significantly decreased contrast sensitivity function, including AULCSF and letter contrast sensitivity than those without central SPK and normal eyes (P < 0.05 for each). While the straylight values in both dry eye groups did not differ, straylight values were greater than those in normal eyes (P < 0.05 for both). In dry eye, the AULCSF and letter contrast sensitivity negatively correlated with the central SPK score (R = -0.485, P < 0.001, and R = -0.541, P < 0.001, respectively). Conclusions In dry eye, reduced contrast sensitivity in part results from central SPK overlying the optical zone and the increased straylight results from tear film instability rather than central SPK.