Peer reviewed article authored by (Tomomi Higashide, Kazuhisa Sugiyama). Read article or submit your manuscript for publishing.

To identify the factors which significantly contribute to the thickness variabilities in macular retinal layers measured by optical coherence tomography with or without magnification correction of analytical areas in normal subjects. The thickness of retinal layers {retinal nerve fiber layer (RNFL), ganglion cell layer plus inner plexiform layer (GCLIPL), RNFL plus GCLIPL (ganglion cell complex, GCC), total retina, total retina minus GCC (outer retina)} were measured by macular scans (RS-3000, NIDEK) in 202 eyes of 202 normal Asian subjects aged 20 to 60 years. The analytical areas were defined by three concentric circles (1-, 3- and 6-mm nominal diameters) with or without magnification correction. For each layer thickness, a semipartial correlation (sr) was calculated for explanatory variables including age, gender, axial length, corneal curvature, and signal strength index. Outer retinal thickness was significantly thinner in females than in males (sr², 0.07 to 0.13) regardless of analytical areas or magnification correction. Without magnification correction, axial length had a significant positive sr with RNFL (sr², 0.12 to 0.33) and a negative sr with GCLIPL (sr², 0.22 to 0.31), GCC (sr², 0.03 to 0.17), total retina (sr², 0.07 to 0.17) and outer retina (sr², 0.16 to 0.29) in multiple analytical areas. The significant sr in RNFL, GCLIPL and GCC became mostly insignificant following magnification correction. The strong correlation between the thickness of inner retinal layers and axial length appeared to result from magnification effects. Outer retinal thickness may differ by gender and axial length independently of magnification correction.

Purpose: To compare the sectoral structure-function relationships in glaucoma between two structural parameters, vessel density (VD) and thickness, in the peripapillary retinal nerve fiber layer (RNFL). Methods: Optical coherence tomography (OCT) angiography (AngioVue/RTVue-XR) for VD and OCT (RS-3000) for peripapillary RNFL thickness were performed in 129 eyes from 129 subjects (94 glaucoma, 17 glaucoma suspects, and 18 normal eyes). Humphrey visual field (VF) tests were performed using a SITA standard 24-2 program. Sectoral structure-function relationships based on the Garway-Heath map were compared between VD and thickness using a semipartial correlation coefficient (sr) and partial residual plots determined by multiple linear regression models controlling for the effects of sex, age, axial length, disc area, beta- and gamma- parapapillary atrophy (PPA) zones, and signal strength index (SSI). Results: For all VF sectors, the sr² of VD was largest when the VD sector corresponded to the VF sector (sr²: 0.17–0.39). In contrast, in only three sectors was the sr² of thickness largest when the thickness sector corresponded to the VF sector (sr²: 0.02–0.34): the inferior temporal, temporal, and superior temporal sectors. The partial residual plots against VD showed more linear relationships with VF sensitivity than those against thickness in the qualitative evaluation of fitting by locally weighted scatterplot smoothing. Eyes with larger SSI had higher VD, whereas eyes with a larger extension of the PPA zone into the VD measurement area had lower VD. Conclusions: Peripapillary RNFL VD and thickness have different characteristic sectoral structure-function relationships in glaucoma.

To investigate visual field changes after vitrectomy for macular diseases in glaucomatous eyes. A retrospective review of 54 eyes from 54 patients with glaucoma, who underwent vitrectomy for epiretinal membrane (ERM; 42 eyes) or macular hole (MH; 12 eyes). Standard automated perimetry (Humphrey visual field 24–2 program) was performed and analyzed preoperatively and twice postoperatively (1^st and 2nd sessions; 4.7 ± 2.5, 10.3 ± 3.7 months after surgery, respectively). Postoperative visual field sensitivity at each test point was compared with the preoperative value. Longitudinal changes in mean visual field sensitivity (MVFS) of the 12 test points within 10° eccentricity (center) and the remaining test points (periphery), best-corrected visual acuity (BCVA), intraocular pressure (IOP), and ganglion cell complex (GCC) thickness, and the association of factors with changes in central or peripheral MVFS over time were analyzed using linear mixed-effects models. In addition, 45 eyes from 45 patients without glaucoma who underwent vitrectomy for epiretinal membrane (ERM; 34 eyes) or macular hole (MH; 11 eyes) were similarly examined and statistically analyzed (control group). In glaucomatous eyes, visual field test points changed significantly and reproducibly; two points deteriorated only at the center and twelve points improved only at the periphery. Central MVFS decreased (p = 0.03), whereas peripheral MVFS increased postoperatively (p = 0.010). In the control group, no visual field test points showed deterioration, and central MVFS did not change significantly after vitrectomy. BCVA improved, GCC thickness decreased, and IOP did not change postoperatively in both groups. The linear mixed-effects models identified older age, systemic hypertension, longer axial length, and preoperative medication scores of ≥2 as risk factors for central MVFS deterioration in glaucomatous eyes. Visual field sensitivity within 10° eccentricity may deteriorate after vitrectomy for ERM or MH in glaucomatous eyes.

Purpose. To determine whether a scanning laser ophthalmoscope (SLO) is useful for in vivo imaging and counting of rat retinal ganglion cells (RGCs).

To evaluate findings of reverse pupillary block after scleral-fixated sutured posterior chamber intraocular lens (PC IOL) implantation using anterior segment optical coherence tomography (AS-OCT) and report a possible association with postoperative complications. Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan. Anterior segment OCT was used to evaluate eyes with reverse pupillary block (ie, deep anterior chamber, concave iris configuration, contact between pupil and IOL) after IOL explantation or cataract extraction combined with vitrectomy and scleral-fixated sutured PC IOL implantation. The PC IOL was implanted using an ab externo method in all cases. After 2 scleral flaps were created 180 degrees apart, a straight needle attached to a 10-0 polypropylene suture for IOL fixation was passed through the bed of half-thickness scleral flaps 2.0 mm posterior to the limbus in a direction parallel to the iris. Four eyes (3 patients) were evaluated. Anterior segment OCT showed a concave iris configuration with an increase in anterior chamber depth and anterior chamber angle in all cases. Two eyes had intermittent pupil capture. Laser iridotomy prevented recurrence of reverse pupillary block and pupil capture. Widening of the gap between the inner and outer flaps of the scleral tunnel during reverse pupillary block was seen on AS-OCT in 2 eyes; the widening was associated with wound leakage in 1 eye. Anterior segment OCT showed that reverse pupillary block can occur in eyes with scleral-fixated sutured PC IOLs and cause postoperative pupil capture and scleral tunnel insufficiency.