Purpose.: To investigate the diagnostic ability of posterior pole asymmetry analysis (PPAA) with spectral domain optical coherence tomography (SD-OCT) for detecting localized retinal nerve fiber layer defects (RNFLD). Methods.: Eighty-four open-angle glaucoma subjects (84 eyes) with localized, wedge-shape RNFLDs by red-free RNFL photography and 122 eyes of healthy subjects were enrolled. The subjects were examined by SD-OCT to obtain circumpapillary RNFL (cpRNFL) thickness as well as PPAA. The PPAA provides a corresponding cell to cell comparison between hemispheres within the central 20° and presents the difference using gray scale. Area under the receiver operating characteristic curve (AUROC) was calculated. The sensitivity and specificity of PPAA to detect glaucoma with the localized defects were also examined using various criteria; two consecutive black cells (criterion A), three consecutive black cells (criterion B), and four consecutive black cells (criterion C). Results.: An AUROC of PPAA based on the number of black cells was 0.958 ± 0.013. The sensitivity and specificity of PPAA were 95.2% and 81.1% for criterion A, 83.3% and 92.6% for criterion B, and 69.0% and 98.4% for criterion C, respectively. The sensitivity and specificity of the cpRNFL thickness were 85.7% and 95.1%, respectively. Conclusions.: SD-OCT PPAA detects localized RNFLDs with high sensitivity and specificity, which are comparable to the cpRNFL thickness profile of OCT. These findings suggest that the PPAA can be complementary to other tests for diagnosing glaucoma in patients with localized RNFLDs.

Purpose. To investigate the characteristics of the lamina cribrosa (LC) depth in healthy eyes using enhanced depth imaging (EDI) spectral-domain optical coherence tomography (SD-OCT). Methods. Serial horizontal B-scans of the optic nerve head were obtained using EDI SD-OCT for both eyes of 150 healthy subjects. Anterior LC surface (ALCS) depths were measured with B-scan images from equidistant planes in each eye and defined as the distance from the Bruch's membrane opening plane to the anterior LC surface. The ALCS depths were compared between eyes within each subject. A linear mixed model was used to identify factors associated with the ALCS depth. Results. The average ALCS depth was 402.06 ± 101.46 μm (range, 193.08–826.81). The ALCS depth was not significantly different between the right and left eyes (Ps > 0.05 at all planes). There was a strong intereye correlation within subjects (Rs ≥ 0.808 at all planes, Ps < 0.0001 at all planes). The ALCS depth was largest in the superior periphery and smallest in the central inferior plane. ALCS depth was larger in males (P < 0.05) and also larger in eyes with shorter axial length (P = 0.029). Conclusions. This study reports the range of ALCS depth in healthy subjects. These data suggest that ALCS depth is related to sex and axial length.

Background: Adequate physical activity (PA) is essential for preventing sarcopenia in older adults. However, there are insufficient epidemiological data on the intensity of PA needed to prevent age-related sarcopenia. The purpose of this study was to investigate the association of PA intensity with skeletal muscle mass and muscle strength. Methods: This was a population-based study with a cross-sectional design that was conducted using data from the 2008 − 2011 and 2014 − 2018 Korea National Health and Nutrition Examination Surveys, which included a total of 11,162 participants aged ≥ 60 years. PA was assessed using the results of a questionnaire and organized by intensity, frequency, and duration. The study population was divided into the following groups based on PA intensity: no exercise, walking only, moderate PA, and vigorous PA. To assess sarcopenia, skeletal muscle index (SMI) and hand grip strength (HGS) were measured as indicators of muscle mass and strength, respectively. Logistic regression analysis was used to explore the relationship between PA intensity and sarcopenia. Results: SMI and HGS were significantly higher in men and women engaged in moderate to vigorous PA than in those who did not exercise. The odds ratios (ORs) for sarcopenia defined based on SMI and HGS were lowest in men engaged in vigorous PA (0.444, 95% confidence interval [CI]: 0.242 − 0.818 and 0.450, 95% CI: 0.228 − 0.890, respectively). In women, the OR for sarcopenia defined based on HGS was the lowest in the group engaged in vigorous PA (0.441, 95% CI: 0.199 − 0.975), while there was no risk reduction for sarcopenia defined based on SMI. Conclusions: Moderate to vigorous PA was highly correlated with SMI and HGS in men and women. Intensive PA was positively correlated with sarcopenia prevention, which can be monitored using HGS.

To compare the features of localized retinal nerve fiber layer (RNFL) defects between a low-teen intraocular pressure (IOP) group and a high-teen IOP group in normal-tension glaucoma (NTG) patients. Seventy-seven eyes of 77 NTG patients showing localized RNFL defects on RNFL photographs and corresponding visual filed defects at the initial visit to a glaucoma specialist were selected for this study. Patients with range of diurnal IOP within low-teen or high-teen in both eyes were included. All participants completed refraction, diurnal IOP measurement, central corneal thickness (CCT) measurement, stereoscopic disc photography, RNFL photography, and automated perimetry. On RNFL photograph, approximation of the defect to the macula (angle alpha) and width of the defects (angle beta) were measured to represent RNFL defects. The patients were divided into 2 groups according to the level of IOP. A low-teen group had highest IOP of 15 mm Hg (group B). Age at diagnosis, percentage of male patients, systemic disease, refraction, CCT, highest IOP, angle alpha, angle beta, and mean deviation and pattern standard deviation of visual field were compared between the 2 groups. Age at diagnosis of NTG, age distribution, percentage of male patients, systemic disease, spherical equivalent of refraction, CCT, mean deviation, and pattern standard deviation were not different between the 2 groups. Highest IOP was 13.8+/-1.2 mm Hg in group A and 19.2+/-1.4 mm Hg in group B (P<0.001). Angle alpha was significantly smaller in group A than in group B (37.0+/-14.0 vs. 56.5+/-21.2 degrees, P<0.001), whereas angle beta was not different between the 2 groups (39.9+/-17.9 vs. 37.5+/-15.9 degrees, P=0.54). There were no significant correlations between spherical equivalent and angle alpha (r=-0.03, P=0.82), between spherical equivalent and angle beta (r=-0.04, P=0.74), and between angle alpha and angle beta (r=-0.21, P=0.07). Localized RNFL defect was closer to the center of the macula in group A than in group B, whereas width of defects was not different between the 2 groups. These findings provide indirect evidence to suggest that more than one pathogenic mechanism may exist in the development of RNFL defects in NTG.