PurposeTo evaluate the performance of macular ganglion cell-inner plexiform layer (mGCIPL) measurement with Cirrus high-definition (HD) optical coherence tomography (OCT) for early detection of optic chiasmal compression.MethodsForty-six eyes of 46 patients with optic chiasmal compression caused by a pituitary adenoma (PA group), 31 eyes of 31 patients with normal tension glaucoma (NTG group), and 32 eyes of 32 normal participants (control group) were enrolled. The PA group was subdivided into two subgroups, which comprised patients with temporal visual field (VF) defects (perimetric PA group, 34 eyes) and without VF defect (preperimetric PA group, 12 eyes). The mGCIPL thickness and circumpapillary retinal nerve fiber layer (cpRNFL) thickness were measured using Cirrus HD-OCT. We calculated the number of patients who had an abnormal GCA sector map, defined as at least one yellow or red sector.ResultsEyes in the perimetric PA group had significantly decreased mGCIPL thickness in all sectors. Eyes in the preperimetric PA group had significantly thinner mGCIPL in the superior, superonasal, inferonasal, and inferior sectors than eyes in control group, but no changes in cpRNFL parameters were observed. The mGCIPL thickness in inferonasal area showed the greatest AUC value (0.965), followed by the superonasal area (0.958) for discriminating preperimetric PA group from the control group. A higher reduction rate of mGCIPL thickness was noted in the nasal sector compared to other sectors, which was irrespective of temporal visual field defects. The mGCIPL thickness maps showed superonasal (P = 0.003) and inferonasal thinning in the PA group (P = 0.003), while inferotemporal thinning was revealed in the NTG group (P = 0.001).ConclusionsMacular GCIPL thickness parameters obtained with the Cirrus HD-OCT were useful in early detection of chiasmal compression and differentiating from NTG by characteristic nasal mGCIPL thinning.

Fluoroquinolones have activity against normal aerobic flora of the ocular surface. Normal ocular flora, especially gram-positive species, has low resistance to the fourth-generation fluoroquinolones -- gatifloxacin and moxifloxacin.

Purpose The outbreak of coronavirus disease 2019 (COVID-19) has caused many children to stay indoors. Increased near work and insufficient outdoor activities are considered important risk factors for myopic progression. This study aimed to compare the changes in myopic progression before and after COVID-19 in children treated with low-concentration atropine. Methods The records of 103 eyes of 103 children who were treated with low-concentration atropine eye drops were retrospectively reviewed. We classified children according to the concentration of atropine eye drops and children’s age. The beginning of the pre-COVID-19 period was set from January 2019 to May 2019, and the endpoint was set in March 2020. The beginning of the post-COVID-19 period was set in March 2020, and the endpoint was set from January 2021 to March 2021. We evaluated the questionnaires administered to children’s parents. Results A significant myopic progression was observed in the post-COVID-19 period compared to the pre-COVID-19 period in the 0.05% and 0.025% atropine groups (P < 0.001 and P = 0.020, respectively). For children aged 5 to 7 and 8 to 10 years, the axial elongations were significantly faster in the post-COVID-19 period than in the pre-COVID-19 period (P = 0.022 and P = 0.005, respectively). However, the rates of axial elongation and myopic progression were not significantly different between pre- and post-COVID-19 in children aged 11 to 15 years (P = 0.065 and P = 0.792, respectively). The average time spent using computers and smartphones and reading time were significantly increased, and the times of physical and outdoor activity were significantly decreased in the post-COVID-19 period compared to the pre-COVID-19 period. Conclusions The rates of myopic progression have increased substantially after the spread of COVID-19 with an increase in the home confinement of children. Therefore, it is necessary to control the environmental risk factors for myopia, even in children undergoing treatment for the inhibition of myopic progression.

24Amblyopia is defined as the reduction of best-corrected visual acuity of one or both eyes 25 caused by conditions that affect normal visual development. The basic strategy to treat 26 amblyopia is to obtain a clear retinal image in each eye and correct ocular dominance through 27 forced use of the amblyopic eye. Treatment modalities include correcting any underlying 28 organic disease, prescribing appropriate optical correction, and providing 29 occlusion/penalization therapy for the non-amblyopic eye. Given the success of amblyopia 30 treatment declines with increasing age, the detection and management of amblyopia should 31 begin as early as possible during the sensitive period for visual development. Proper 32 management of amblyopia during childhood can reduce the overall prevalence and severity of 33 visual loss. This study aims to provide an update for the management of childhood amblyopia 34 to provide better visual outcomes. 35 36 37 38

PurposeTo investigate the clinical features of Korean patients with congenital aniridia.MethodsThis retrospective study focused on 60 eyes from 31 patients who were diagnosed with congenital aniridia at Kangnam St. Mary's Hospital from 1996 to 2007. Patient age, gender, visual acuity (VA), family history, and previous ocular history were recorded. The presence of keratopathy, glaucoma, cataract, foveal hypoplasia, and other ocular or systemic anomalies were evaluated for each patient.ResultsThe proportion of sporadic cases was 29.0%. Cataract (82.5%), glaucoma (51.6%), keratopathy (71.6%), and foveal hypoplasia (81.8%) commonly accompanied aniridia. Thirty-four (60.7%) eyes had VAs less than 20/200 and 20 eyes (35.7%) had VAs between 20/200 and 20/60. In patients without a past history of ocular surgery, the mean central corneal thickness was 643.05 ± 37.67 µm and the mean endothelial cell count was 3,349.44 ± 408.17 cells/mm2. Ocular surface surgeries were performed in 6 eyes. The clarity of the transplanted corneal graft vanished in 5 eyes with the progression of peripheral neovascularization and subepithelial fibrosis. The mean age of cataract surgery in 8 eyes was 29.8 ± 5.9 years. Postoperative worsening of corneal clouding and glaucomatous damage were observed in 4 eyes. Two infants had bilateral congenital glaucoma. Two children with sporadic aniridia were identified to have Wilm's tumors.ConclusionsCongenital aniridia is a progressive congenital disorder that is commonly accompanied by complications that can lead to impaired vision. Regular, careful examinations for these accompanying complications should be performed in all patients with congenital aniridia.

In addition to common primary LHON-associated mutations, our study identified secondary mtDNA mutations, which should be considered when evaluating patients with optic atrophy.

Background: We examined the effect of surgical repair on the pattern of refractive errors in Korean patients with congenital blepharoptosis. Methods: We reviewed the clinical records of 54 patients with congenital blepharoptosis who attended our hospital from 2006 to 2012 and underwent a detailed refractive examination before and after ptosis repair surgery. Among them, 21 of the patients whose refractive data was available for both before and after the surgery were included in order to observe the effect of ptosis repair surgery on refractive error characteristics. The astigmatism groups were divided into three subgroups: with-the-rule (WTR), against-the-rule (ATR), and oblique astigmatism (OA). We also evaluated the severity of astigmatism. Results: Before surgery, the ptotic eyes had more severe astigmatism and a greater percentage of OA than the fellow eyes. The changes in astigmatism magnitude before and after surgery were not significant, but the proportion of subjects with OA increased significantly. In ptotic eyes, amblyopia was found in 14 eyes (20.9 %). 3 eyes (4.5 %) were from solely occlusive visual stimulus deprivation due to severe ptosis, and 11 eyes were from refractive errors. Among refractive errors, amblyogenic astigmatism made up to the largest proportion of patients (8 patients, 11.9 %). Conclusions: Ptotic eyes had more severe astigmatism and more OA than fellow eyes. Amblyogenic astigmatism was more common in ptotic eyes. A change in astigmatism toward the OA axis was significantly detected after surgery, and that can be possible amblyogenic cause. Therefore, the correction of astigmatism before and after ptosis repair surgery is very important to prevent amblyopia.

Background/Aims: To estimate the amount and nature of pupil centroid shift and cyclotorsion occurring between preoperative wavefront measurement and refractive surgery. Methods: This retrospective study comprised 183 eyes of 92 patients who had wavefront-guided LASIK using iris registration. We analyzed the pupil centroid shift and cyclotorsional displacement occurring between preoperative wavefront measurements and during the laser procedure. The eyes were measured by the WaveScan® Wavefront® system (VISX, Santa Clara, Calif., USA) and refractive surgery was performed with the VISX STAR S4 excimer laser system. Results: The mean magnitude of shifts in the location of pupil center was 0.26 ± 0.16 mm horizontally, 0.20 ± 0.16 mm vertically and 0.37 ± 0.13 mm vectorally. 162 eyes (88.5%) experienced more than 0.2 mm of shift. The mean amount of torsion was 2.58 ± 1.56° for 83 eyes showing incyclotorsion and 2.94 ± 1.87° for 100 eyes showing excyclotorsion. 117 eyes (63.9%) experienced more than 2° of cyclotorsion and 21 eyes (11.5%) experienced more than 5° of cyclotorsion. Conclusions: Pupil centroid shift and cyclotorsion occur in the majority of eyes undergoing laser treatment. The amount of pupil centroid shift and cyclotorsion shown in this study is considerable. Accurate compensation for cyclotorsion and pupil centroid shift may maximize the potential of visual quality of customized ablations.