Intrasession and Intersession Repeatability of a new PCT-200 Corneal Topographer on Calibrated Steel Surfaces and Healthy Eyes

PURPOSE: To assess intrasession and intersession repeatability of a new tilted-cone, Placido-disc based corneal topographer (PCT-200, Optopol Tech., Poland) on calibrated steel surfaces and healthy human eyes. METHODS: Five repeated measures of surface topography were obtained on a set of four different calibrated steel spherical surfaces and on a sample 30 healthy human eyes in each of two sessions. Variance of apical radius, eccentricity and Fourier Indices was assessed both within and between sessions using analysis of variance (ANOVA), paired samples t-test and intraclass correlation coefficients (ICC). RESULTS: Repeated measurements on calibrated steel surfaces and human eye sample of all parameters were not significantly different within session (ANOVA) nor between sessions (paired samples t-test), p-values exceeded greatly 0.05 in all cases. ICCs were greater than 0.98 and 0.77 for steel surfaces and human eyes, respectively, for all parameters analysed. CONCLUSIONS: The new tilted-cone corneal topographer performs well in both spherical surfaces and healthy human eyes, providing with repeatable measures of corneal topography, comparable to other Placido-based devices currently in the market

Impacto social y económico de la incorporación del óptico-optometrista en Atención Primaria

La incorporación del óptico-optometrista al Sistema Nacional de Salud (SNS), en España, es una reivindicación mayoritaria que viene reclamándose desde hace tiempo. La presencia en nuestro país de profesionales legal y altamente capacitados para determinadas funciones específicas en salud visual, justifica que aspiren legítimamente a integrarse profesionalmente en aquellas tareas concretas para las que han sido formados. Pero además, la incorporación en Atención Primaria para asumir las derivaciones a oftalmología relacionadas con la agudeza visual, supondría una mejora cualitativa de la atención prestada a los ciudadanos e implicaría una reducción del gasto sanitario y una mejora de la eficiencia del sistema. Más aún, ante las consecuencias derivadas de pandemia COVID-19

Pilot Study on Visual Function and Fundus Autofluorescence Assessment in Diabetic Patients

Purpose. Evaluate optimized fundus autofluorescence (FAF) imaging in early stages of diabetic retinopathy (DR) and relate findings with conventional colour fundus imaging and visual function in diabetic patients and control subjects. Materials and Methods. FAF and colour images were obtained using the CR-2 Plus digital nonmydriatic retinal camera in seven diabetic patients and thirteen control subjects. Visual-Functioning Questionnaire-25 (VFQ-25) and Diabetes Self-Management Questionnaire (DSMQ) were used to assess the quality of life and diabetes self-care. Contrast sensitivity function (CSF) was evaluated with the Vistech 6500 chart. Results. FAF and optimized-FAF imaging showed more retinal alterations related to DR than colour imaging. In diabetic patients, compatible signs with microaneurysms, capillary dilations, and haemorrhages were less numerous in colour imaging than optimized-FAF and FAF imaging in areas analysed. Control subjects at risk of developing DM showed more retinal pigment epithelium defects than those without risk in all retinal areas. Significant differences were not found in VFQ-25 and CSF between diabetic patients and control subjects. Conclusions. FAF and optimized-FAF imaging showed significant alterations related to DR not observed in colour imaging. FAF and optimized-FAF images could be a useful complementary tool for detecting early alterations associated with the development and progression of DR

Interaction between diurnal variations of intraocular pressure, pachymetry, and corneal response to an air puff: Preliminary evidence

Diurnal changes in corneal geometry, pachymetry, and intraocular pressure (IOP) in a healthy eye were recorded. The deformation response to an air puff was simulated using 3 levels of corneal stiffness. The response was dependent on IOP and pachymetry and not only on the biomechanical properties of the cornea. Similarly, the maximum variability due to the diurnal changes in pachymetry and IOP in the corneal displacement generated by the air puff was found to reach 5%. Therefore, diurnal changes in IOP and corneal thickness were able to induce some variability in the air puff–based corneal deformation response. This potential variability should be considered when the biomechanical properties of the cornea are analyzed with air-puff devices.Supported by the European Union’s Seventh Framework Program managed by Research Executive Agency under Grant Agreement number FP7-SME-2013 606634 (POPCORN Project) and the Spanish Ministry of Economy and Competitiveness (DPI2011-27939-C02-01)

Influence of angle kappa on visual and refractive outcomes after implantation of a diffractive trifocal intraocular lens

Purpose: To evaluate changes in angle kappa following the implantation of a trifocal intraocular lens (IOL), and to assess the postoperative outcomes of patients with different angle kappa values. Setting: IOA Madrid Innova Ocular, Madrid, Spain Design: Prospective trial Methods: Sixty-three patients due to have bilateral implantation of the diffractive trifocal IOL (POD F, PhysIOL, Belgium) were included. Pupil offset was used as the best estimate of angle kappa and was measured using Pentacam (Oculus, Wetzlar, Germany) preoperatively and at 3-months after surgery. Postoperative refractive outcomes (sphere, cylinder, and MRSE) and visual outcomes at far, intermediate and near distance were assessed and compared between eyes with small pupil offset and eyes with large pupil offset. Quality of vision was assessed using a subjective questionnaire. Results: There was significant decrease in pupil offset post-operatively (mean: 0.197 ± 0.12 mm) compared to preoperatively (mean: 0.239 ± 0.12 mm), with a mean decrease of -0.042 mm (P = 0.0002). The same significant decrease was found for both the right eyes and left eyes, when analysed separately. No statistically significant difference was found in any of the refractive and visual acuity outcomes between eyes with small pupil offset and eyes with large pupil offset. The majority of patients (14 out of 16) complaining of significant halos had eyes with small pupil offset. Conclusion: Large pupil offset did not negatively affect visual and refractive outcomes. The tolerance to larger pupil offset might be due to the IOL optical design, with the first diffractive ring being larger than other commonly used multifocal IOLs. More studies comparing various diffractive IOL models will be useful to confirm such hypothesis

Corneal backscatter in insulin-dependent and non-insulin-dependent diabetes mellitus patients: a pilot study

<div><p>ABSTRACT Purpose: To compare central corneal backscatter obtained from Scheimpflug images between patients with insulin-dependent and non-insulin-dependent diabetes mellitus (IDDM and NIDDM, respectively) and healthy controls. Methods: Seven patients with IDDM (7 eyes), eleven patients with NIDDM (11 eyes), and sixteen healthy subjects (16 eyes) were included in this pilot study. Scheimpflug imaging system (Pentacam, Oculus Inc., Germany) was used to obtain optical sections of the cornea. Seven meridians were analyzed for each eye, oriented from 70° to 110°. Optical density values for the central 3-mm and 5-mm zones of the cornea were obtained by image analysis using external software. Results: Corneal backscatter was significantly higher in the diabetic patients than in the controls for the central 3-mm (p=0.016) and 5-mm (p=0.014) zones. No significant differences in corneal backscatter were found between the IDDM and NIDDM groups for either zone (both p>0.05). In the NIDDM group, significant correlations were observed for both central zones between corneal backscatter and age (3 mm: r=0.604, p=0.025; 5 mm: r=0.614, p=0.022) and central corneal thickness (3 mm: r=0.641, p=0.017; 5 mm: r=0.671, p=0.012); this was not found in the IDDM group (p>0.05). The presence of diabetes showed a significant effect on central corneal backscatter (Kruskal-Wallis test, p<0.001). Conclusions: Diabetic patients showed higher values of corneal light backscatter than healthy subjects. Corneal optical density analysis may be a useful tool for monitoring and assessing the ocular changes caused by diabetes.</p></div