The rotation of retinal vascular arcades using a first-order approximation technique is no substitute to DFA when assessing torsion in fundus photographs. Of the methods tested, MRA correlated most closely, but DFA remains the gold standard for cycloposition. The rotation of vascular arcades provides a qualitative assessment, particularly in uncertain macular location.
Recibido: 8/6/05. Aceptado: 20/2/06. Centro Oftalmológico Gómez de Liaño. Madrid. España. 1 Doctor en Medicina. 2 Diplomado en Óptica y Optometría. Comunicación presentada parcialmente en el LXXVIII Congreso de la S.E.O. (Murcia 2002). Los autores no tienen interés comercial ni han recibido apoyo económico en la investigación en la que se basa este artículo.Correspondencia: Rosario Gómez de Liaño C/. Fortuny, 51, 4.º C 28010 Madrid España E-mail: rgomezdeliano@med.ucm.es RESUMENObjetivo: Analizar si existen modificaciones de la visión binocular y motilidad ocular en pacientes hipermétropes operados de cirugía refractiva. Métodos: Estudio prospectivo de 31 pacientes consecutivos operados de cirugía refractiva bilateral de hipermetropía entre mayo de 1999 y febrero de 2002. El protocolo de exploración incluyó la agudeza visual corregida, el error refractivo bajo cicloplejía, la motilidad ocular, la fusión en visión lejana, la estereopsis y el grado de amplitud de fusión, realizándose de nuevo al mes, 3 meses, 6 meses, un año y en sucesivas revisiones anuales. Resultados: Tras la cirugía refractiva se han encontrado alteraciones de la agudeza visual, defectos hipermetrópicos residuales, así como cambios de anisometropía, que han influido en la situación oculomotora. El tipo de alteración sensorial más frecuentemente modificado ha sido la supresión de lejos, alterándose la estereopsis en mucho menor grado. Desde el punto de vista de motilidad ocular, en los pacientes estrábicos se ha encontrado una tendencia significativa en el sentido endotrópico (p=0,003). En los sujetos no estrábicos, aunque se han hallado modificaciones sensoriomotoras, han ARTÍCULO ORIGINAL ABSTRACT Purpose: To evaluate the changes in binocular vision and ocular motility in hyperopic patients undergoing refractive surgery. Methods: Prospective study of 31 consecutive patients who underwent bilateral refractive surgery for hyperopia between May 1999 and February 2002. The examination included best-corrected visual acuity, cycloplegic refraction, ocular motility, fusion at distance, stereopsis and fusional amplitudes, before and at one month, 3 months, 6 months, one year after surgery and annually thereafter. Results: After refractive surgery, there were changes in visual acuity, residual hyperopic refractive errors, and anisometropic changes that influenced the oculomotor status. The most frequent sensory modifications were suppression at distance, with much less change in stereopsis. From the point of view of ocular motility, we found a significant tendency to esotropia in strabismic patients (p=0.003). In non-strabismic patients, we also found sensorimotor modifications, but of less intensity and with fewer consequences than in strabismic patients. Sensorial and/or motor decompensation appeared in
Purpose The disc‐fovea angle (DFA) is used as a relevant indicator of ocular torsion change in cyclovertical strabismus. However, interpretation of the variation in time must differentiate whether a real change has occurred or if the disparity is due to random measurement error. The aim of the study was to obtain the minimal detectable change (MDC) of the DFA. It represents the minimal variation between two measurements that may be considered a real ocular torsion change. Methods A prospective cross‐sectional study was conducted in San Carlos Clinical Hospital of Madrid, Spain. Sixty healthy right eyes from 60 patients (31 men and 29 women) were recruited. Three digital fundus photographs were obtained, and between measurements, the patient moved their head away from the head support and then returned. Two observers quantified the DFA with software designed with MATLAB. Test‐retest and interrater reliability were calculated. Results Mean participant age was 56.1 years (SD 16.6, range 25–85). Mean DFA was 8.1° (SD 3.5, range 1.3–18.5). Test‐retest reliability for Observer 1 (Ob1), Observer 2 (Ob2) and interrater reliability were excellent (ICC 0.80, 0.83 and 0.95, respectively). Precision was 2.9° (Ob1) and 3.0° (Ob2), and the MDC95 was 4.1° (Ob1) and 4.2° (Ob2). Bland‐Altman analysis revealed an absence of bias and a homoscedastic distribution of the differences. Conclusions The MDC of the DFA in fundus photography was 4°, which represents the minimal change that may be considered a real change in ocular torsion. This result may improve the interpretation of ocular torsion changes in surgery and clinical scenarios.
IntroductionWhile optical coherence tomography (OCT) measurements of the lower tear meniscus height (LTMH) have been reported in adults, here we obtained LTMH measurements through Fourier Domain OCT in healthy children and compared these with values obtained in healthy adults.MethodsParticipants were children 7–17 years of age and a control group of adults 20–40 years of age. Inclusion criteria were no abnormal eye conditions or the use of contact lenses. Candidates who fulfilled the TFOS DEWS II criteria for dry eye disease (DED) were excluded. All subjects underwent LTMH measurement (OCT Spectralis) and tests for non‐invasive tear break‐up time and ocular surface staining. Participants also completed the ocular surface disease index questionnaire.ResultsA total of 86 children and 27 adults were included. Mean LTMH values in the children and adult groups were 217.40 ± 71.40 μm and 225.0 ± 54.86 μm, respectively; p = 0.53. However, 59.3% of the children had an LTMH ≤210 μm suggestive of DED, compared with only 33.3% of adults (p = 0.02). For the children, no significant differences in LTMH were observed with sex or for those more or less than 12 years of age.ConclusionsOptical coherence tomography‐derived LTMH measurements were obtained in healthy children. While values were similar in children and adults, a greater proportion of children had an LTMH compatible with a diagnosis of DED. More studies in different paediatric populations are required to establish a complete set of normative LTMH measurements.
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