Intra-Examiner Repeatability and Agreement of Corneal Pachymetry Map Measurement by Time-Domain and Fourier-Domain Optical Coherence Tomography

To assess the intra-examiner repeatability and agreement of corneal pachymetry maps measured by time-domain (Visante OCT ) and Fourier-domain optical coherence tomography (RTVue OCT ). This observational cross- sectional study enrolled 72 eyes from 72 volunteers. Only one eye of each patient was chosen randomly to receive repeated scanning with both devices by the same examiner, in order to test the intra-observer repeatability. The first scan by each device from all enrolled eyes was used to analyze the difference and agreement between the two devices. The agreement between the two devices was analyzed by the Bland-Altman method. Intra- observer repeatability of each OCT device was analyzed by intra-class correlation (ICC). The mean corneal thickness of the central 2 mm zone was 524.3 +/- 35.7 A mu m and 525.4 A +/- 35.3 A mu m by the Visante OCT and the RTVue OCT respectively (p = 0.089). The intra-observer repeatability of the RTVue OCT (ICC = 0.994) was superior to that of the Visante OCT ( ICC = 0.989) in the central 2 mm zone. However, the intra-observer repeatability of the RTVue OCT in the pericentral 2 to 5 mm zone was not superior to that of the Visante OCT. Both OCT devices had similar repeatability in the pericentral 2 to 5 mm zone [ICC of the Visante OCT = 0. 991; 95% confidence interval (CI) 0.986-0.995), ICC of the RTVue OCT = 0.991; 95% CI 0.985-0.994)). The difference in CCT measurement by the Visante OCT and the RTVue OCT is probably too small to influence clinical decision making for refractive surgery and glaucoma management. The RTVue OCT demonstrated better intra-observer repeatability in the central 2 mm zone, which probably was related to its rapid image acquisition capability

Intraocular Formation of Heavy Oil in the Subretinal Space

Background: Heavy oil formation was found in the subretinal space in three patients with repeated vitreoretinal surgery. Cases: These patients had received perfluorocarbon liquid ( PFL) and silicone oil injection for retinal detachment in a previous surgery. Observations: A transparent " heavy density" oil bubble was found in the subretinal space in these patients. The heavy oil bubble was eventually removed by manual aspiration with a blunt-tipped 21-gauge needle. The retinas were reattached in all three cases. Conclusions: Silicone oil may mix with incompletely removed PFL to form heavy oil. During reoperation for persistent retinal detachment, these substances should be specifically sought and removed. (C ) Japanese Ophthalmological Society 2004

Influence of Myopia on the Humphrey Matrix Frequency Doubling Perimetry

台灣高度近視者比例之高是世界上其他國家少有的，因此高度近視引起的問題對身處台灣的眼科醫師是一項特殊的挑戰。由於高度近視者的眼軸拉長、視網膜遭受拉扯特別顯著，常被認為視覺功能與正視眼或低度近視者有所差別。為了確定高度近視者即使在確定無青光眼的狀態下，是否其視野檢查的表現仍較低、中度近視者差。關於這方面的研究並不多，尤其是第二代的Humphrey Matrix倍頻視野檢查計從未被評估過。因此，本研究的目的乃為了解不同近視程度是否會對第二代倍頻視野檢查的影響。而近視程度的劃分，係依據球面當量及眼軸長度兩種方式定義之。 本研究樣本共有91位、18至40歲之健康志願者參與。所有參與者需先接受眼壓測量、電腦驗光、最佳矯正視力檢驗、細隙燈檢查、眼底照相、中心角膜厚度及眼軸長度測量、及青光眼家族史、糖尿病病史詢問。如果有眼壓高於21毫米汞柱、視神經盤凹陷與視神經盤直徑比大於0.5、兩側視神經盤凹陷與視神經盤直徑比相差大於0.2、視網膜神經纖維層具有楔形或廣泛性缺損、患有糖尿病，則該名受測者的兩眼資料均排除。如果有最佳矯正視力未達1.0、散光超過2屈光度、曾接受眼科手術、白內障、角膜病變、視網膜病變，則該眼資料排除。通過篩檢者，繼續完成對比敏感度檢查及Humphrey Matrix倍頻視野C-30-2程式的檢查。我們依據球面當量及眼軸長度兩種定義，將受測眼分為低度近視組、中度近視組、高度近視組。由於同時將同一位受測者的雙眼資料均納入分析，所以我們利用線性混合模型之隨機效用（random effect）處理同一位受測者左右眼相關性的問題。利用線性混合模型（linear mixed model）檢驗三種近視程度組間視野指標（平均偏差值與型態標準偏差值）的差異及近視指標（球面當量與眼軸長度）與視野指標（平均偏差值與型態標準偏差值）的關係。最後，共有80位、151隻眼睛的資料納入分析。 受測者之平均年齡為29.6Purpose: Because the optic disc morphology of myopia is frequently similar to the glaucomatous disc, it is a challenge for ophthalmologists to differentiate myopia form glaucoma. Myopia-related visual dysfunction, which is considered as results of eyeball elongation or optic quality deterioration, may mimic other diseases such as glaucoma. This study is to evaluate whether high myopia patients may demonstrate poorer visual field results obtained from the Humphrey Matrix frequency doubling perimetry (FDP). Method: Ninety-one healthy volunteers between the ages of 18 to 40 were participated in this study. All subjects first received a whole panel of ophthalmic examinations including slit lamp exam, autorefraction, intraocular pressure, central corneal thickness, axial length measurement, and fundus photography. The subjects with diabetes, cataract, corneal opacity, retinal and neuro-ophthalmic pathology, cup-to-disc ratio greater than 0.5, bilateral cup-to-disc ratio asymmetry greater than 0.2, wedge or diffuse retinal nerve fibers defect, intraocular pressure greater than 21 mmHg, astigmatism greater than 2 diopters, and best corrected visual acuity less than 1.0 were excluded from the study. Eighty qualified subjects were further examined on contrast sensitivity and the Humphrey Matrix FDP full-threshold C30-2 program. Finally, onne hundred and fifty-one eyes from 80 subjects were included in data analysis. According to spherical equivalent and axial length parameters, we classified the subjects into low, intermediate and high myopia groups. Due to the correlation of right and left eye from the same subject, we used the randome effect of linear mixed model to capture the correlation. The mean deviation (MD), pattern standard deviation (PSD), and other variables obtained from the three groups were compared using linear mixed model. The association between the myopia indices (i.e. spherical equivalent and axial length) and the visual field indices (i.e. MD and PSD) were also analyzed by linear mixed model. Results: The average age of participated patients is 29.6目 錄 口試委員會審定書…………………………………………………………i 中文摘要………………………………………………………………… ii 英文摘要………………………………………………………………… iv 第一章 背景與研究動機……………………………………………… 1 第二章 文獻回顧……………………………………………………… 5 2.1. 倍頻視野檢查………………………………………………… 5 2.1.1. 倍頻幻象………………………………………………… 5 2.1.2.使用倍頻幻象的理由…………………………………… 6 2.1.3. 倍頻視野檢查對於青光眼診斷之幫助---早期診斷… 6 2.2. 影響倍頻視野檢查結果的因素……………………………… 7 2.2.1. 失焦……………………………………………………… 7 2.2.2. 學習效果……………………………………………… 10 2.2.3. 瞳孔大小…………………………………………………12 2.2.4. 白內障……………………………………………………12 2.2.5. 糖尿病……………………………………………………14 2.3. 近視對眼球特徵之影響………………………………………14 2.3.1. 瞳孔………………………………………………………14 2.3.2. 中心角膜厚度……………………………………………14 2.4. 近視對視覺功能之影響………………………………………15 2.4.1. 對視力的影響……………………………………………15 2.4.2. 對對比敏感度之影響……………………………………16 2.4.3. 近視對視野檢查之影響…………………………………19 2.4.3.1. 近視對傳統電腦視野檢查的影響………………19 2.4.3.2. 近視對倍頻視野檢查的影響…………………… 21 2.5. 名詞解釋…………………………………………………22 第三章 材料與方法……………………………………………………25 3.1. 研究設計………………………………………………………25 3.2. 研究對象………………………………………………………27 3.3. 樣本數估計……………………………………………………27 3.4. 篩選研究對象…………………………………………………27 3.5. 分組……………………………………………………………28 3.5.1. 依球面當量分組…………………………………………28 3.5.2. 依眼軸長度分組…………………………………………28 3.6. 檢查步驟………………………………………………………29 3.6.1. 基本檢查…………………………………………………29 3.6.2. 倍頻視野檢查進行方式…………………………………29 3.7. 變項之測量與紀錄……………………………………………30 3.7.1. 依變項之測量與紀錄……………………………………30 3.7.2. 自變項之測量與紀錄……………………………………30 3.8. 統計分析………………………………………………………33 第四章 結果……………………………………………………………34 4.1. 依球面當量分組之比較………………………………………36 4.1.1. 人口學與基本特徵之差異………………………………36 4.1.2. 對比敏感度之比較………………………………………38 4.1.3. 倍頻視野檢查結果相關資料之差異……………………38 4.1.4. 球面當量與視野指標（平均偏差值與型態標準偏差值） 之相關性分析……………………………………………43 4.1.4.1. 球面當量與視野平均偏差值之相關性分析……43 4.1.4.2. 球面當量與視野型態標準偏差值之相關性分析… …………………………………………………………50 4.2. 依眼軸長度分組之比較………………………………………57 4.2.1. 人口學與基本特徵之差異………………………………57 4.2.2. 對比敏感度之比較………………………………………57 4.2.3. 倍頻視野檢查結果相關資料之差異……………………60 4.2.4. 眼軸長度與視野指標（平均偏差值與型態標準偏差值） 之相關性分析…………………………………………………64 4.2.4.1. 眼軸長度與視野平均偏差值之相關性分析……64 4.2.4.2. 眼軸長度與視野型態標準偏差值之相關性分析………………………………………………………71 第五章 結論與討論……………………………………………………77 5.1. 主要之發現……………………………………………………78 5.2. 本研究的優點…………………………………………………80 5.3. 本研究的限制…………………………………………………81 參考資料…………………………………………………………………82 表目錄 表一、失焦對倍頻視野檢查之影響………………………………………9 表二、學習效果對倍頻視野檢查之影響………………………………11 表三、白內障對倍頻視野檢查之影響…………………………………13 表四、近視對對比敏感度之影響………………………………………17 表五、近視對傳統靜態電腦視野檢查之影響………………………… 20 表六、各空間頻率對比敏感度之對數單位轉換表……………………32 表七、低度、中度、及高度近視三組基本特質之差異（依球面當量分組）………………………………………………………………37 表八、低度、中度、及高度近視三組之對比敏感度之差異（依球面當量分組）……………………………………………………39 表九、低度、中度、及高度近視三組倍頻視野檢查結果相關資料之差異（依球面當分組）……………………………………………40 表十、球面當量與視野平均偏差值相關性之單變項分析（依球面當分 組）………………………………………………………………45 表十一（一）、影響視野平均偏差值因素之多變項分析（全部）…46 表十一（二）、影響視野平均偏差值因素之多變項分析（依球面當量分組，低度近視組）……………………………………………47 表十一（三）、影響視野平均偏差值因素之多變項分析（依球面當量分組，中度近視組）……………………………………………48 表十一（四）、影響視野平均偏差值因素之多變項分析（依球面當量分組，高度近視組）……………………………………………49 表十二、球面當量與視野型態標準偏差值相關性之單變項分析（依球面當量分組）……………………………………………………52 表十三（一）、影響視野型態標準偏差值因素之多變項分析（全部）………………………………………………………………53 表十三（二）、影響視野型態標準偏差值因素之多變項分析（依球面當量分組， 低度近視組）………………………………………54 表十三（三）、影響視野型態標準偏差值因素之多變項分析（依球面當量分組， 中度近視組）………………………………………55 表十三（四）、影響視野型態標準偏差值因素之多變項分析（依球面當量分組， 高度近視組）………………………………………56 表十四、低度、中度、及高度近視三組基本特質之差異（依眼軸長度分組）……………………………………………………………58 表十五、低度、中度、及高度近視三組之對比敏感度之差異（依眼軸長度分組）………………………………………………………59 表十六、低度、中度、及高度近視三組倍頻視野檢查結果相關資料之差異（依眼軸長度分組）………………………………………61 表十七、眼軸長度與視野平均偏差值相關性之單變項分析（依眼軸長度分組）…………………………………………………………66 表十八（一）、影響視野平均偏差值因素之多變項分析（全部）…67 表十八（二）、影響視野平均偏差值因素之多變項分析（依眼軸長度分組，低度近視組）……………………………………………68 表十八（三）、影響視野平均偏差值因素之多變項分析（依眼軸長度分組，中度近視組）……………………………………………69 表十八（四）、影響視野平均偏差值因素之多變項分析（依眼軸長度分組，高度近視組）……………………………………………70 表十九、眼軸長度與視野型態標準偏差值相關性之單變項分析（依眼軸長度分組）……………………………………………………72 表二十（一）、影響視野型態標準偏差值因素之多變項分析（全部）………………………………………………………………73 表二十（二）、影響視野型態標準偏差值因素之多變項分析（依眼軸長度分組， 低度近視組）………………………………………74 表二十（三）、影響視野型態標準偏差值因素之多變項分析（依眼軸長度分組， 中度近視組）………………………………………75 表二十（四）、影響視野型態標準偏差值因素之多變項分析（依眼軸長度分組， 高度近視組）………………………………………76 圖目錄 圖一、倍頻幻覺……………………………………………………………5 圖二、研究進行之流程圖………………………………………………26 圖三、球面當量與眼軸長度與之相關分布圖（全部）………………35 圖四、各組視野平均偏差值之盒狀圖（依球面當量分組）…………41 圖五、各組視野型態標準偏差值之盒狀圖（依球面當量分組）……42 圖六、視野平均偏差值與球面當量之相關分布圖（全部）…………44 圖七、視野型態標準偏差值與球面當量之相關分布圖（全部）……51 圖八、各組視野平均偏差值之盒狀圖（依眼軸長度分組）…………62 圖九、各組視野型態標準偏差值之盒狀圖（依眼軸長度分組）……63 圖十、視野平均偏差與眼軸長度之相關分布圖（全部）……………65 圖十一、視野型態標準偏差值與眼軸長度之相關分布圖（全部）…7

A newly recorded insect pest, pink pineapple mealybug (Dysmicoccus brevipes (Cockerell)) (Homoptera : Pseudococcidae), infesting on the roots of peanut in Taiwan

鳳梨嫡粉介殼蟲（Dysmicoccus brevipes (Cockerell)）（pink pineapple mealybug）， 一般稱為鳳梨粉介殼蟲（ pineapple mealybug ）， 屬於同翅目（Homoptera）、介殼蟲總科（Coccoidea）、粉介殼蟲科（Pseudococcidae）。此蟲主要行孤雌生殖為主。蟲體粉紅色、橢圓形，體上披覆白色粉臘，蟲體周圍附有白色之長絲繸狀物。體長約2.0-3.0 mm，寬約1.8-2.0 mm。觸角7-8 節。背、腹面具各種大小之篩狀孔。體毛在體背短小，但肛環前有成叢長毛，體腹面毛較長。蠟孔17 對，均具顯著三角形分泌孔群及3-4 根圓錐形刺毛與3-5 根副刺毛。本種與夏威夷種D. neobrevipes（gray pineapple mealybug）外部型態相近，其區別在於夏威夷種肛環前無成叢背毛、尾瓣腹面硬化區呈長方形，且行兩性生殖。 The pink pineapple mealybug, Dysmicoccus brevipes (Cockerell), had been known as an important insect pest of pineapple and banana in Taiwan. Recently, it was firstly discovered to infest on the basal part and roots of some regarded peanuts in a field nearby a pineapple plantation. The infested plants showed leaves yellowing, wilting, and the growth was retarded remarkably. The synonym, morphological characteristic and its difference from allied species, and the host plants of the pest were reviewed in this paper