Table of Contents - WOC 2012

WOC2012 Abstract Book
PO-GLA-64
Neurotrophic Ulcers: A Complication of Transscleral Diode Laser
Cyclophotocoagulation
de la Paz Maria Fideliz (1,2) , Carcamo Ana Lilia (1) , Torrico Mauricio (1) , Canut
Maria Isabel (1,2)
1. Centro de Oftalmologia Barraquer
2. Institut Universitari Barraquer
Objective: To describe 4 cases of neurotrophic ulcers produced after diode
laser cyclophotocoagulation and review the different contributory clinical
factors associated in each case.
Methods: Retrospective case series on 4 eyes of 4 patients who developed
neurotrophic keratopathy after diode laser trans-scleral cyclophotocoagulation.
Results: All patients were diagnosed to have glaucoma and have been on
prolonged use of beta-blockers (not preservative free). One case had
keratoconus, two cases had congenital cataracts and one had pseudophakic
bullous keratopathy. All four cases had previous multiple ocular surgeries
such as cataract extraction, trabeculectomy , glaucoma valve implantation
or penetrating keratoplasty. Transscleral diode laser cyclophotocoagulation
power was between 2800 to 3000 milliwatts with 3000 millisecond exposure
time, and between 9 -30 impacts. Neurotrophic ulcers appeared between 10
-30 days after treatment. Treatment success was achieved with autologous
serum and therapeutic bandage contact lens in three cases. One eye ended
up in phthisis bulbi.
Conclusion: To our knowledge, there are no reported cases of neurotrophic
keratitis as a complication of diode laser transscleral cyclophotocoagulation.
The four cases presented demonstrate that the use of high power and long
exposure time on clinically predisposed eyes with corneal hypoesthesia may
cause sight-threatening complications like neurotrophic keratitis.
PO-GLA-65
Optic Nerve and Retinal Nerve Fiber Layer Measurements of Filipino
Volunteers at the Ospital ng Makati Taken Using the Cirrus HD-OCT
Bonzon Neil Paulo (1) , Reyes Manolito (1,2)
1. Ospital ng Makati
2. Far Eastern University
PURPOSE: Measure the optic nerve and retinal nerve fiber layer parameters
of healthy Filipinos aged 19 to 66 using the HD-OCT machine.
Methods: 261 eyes of 142 screened healthy Filipinos were involved. Visual
acuity, refraction, tonometry, and axial length measurements were noted. Optic
nerve parameters and retinal nerve fiber layer thickness were measured using
the Cirrus HD-OCT. Statistical analyses were applied.
Results: Descriptive statistics for optic nerve and retinal nerve fiber layer
parameters are illustrated. Average RNFL thickness parameters were found
to decrease with age. Among the optic nerve parameters, only the rim area
demonstrated a substantial decrease with age while the cup volume was
almost maintained even when the age progressed. The rest of the optic nerve
parameters considerably increased with advanced age.
Conclusion: As evident with the findings, average RNFL thickness and optic
nerve parameters vary with age. When the HD-OCT machine is used in
evaluating the optic nerve and RNFL thickness, the different segments and
age-related differences must be considered. This research may provide
valuable information regarding the local parameters of optic nerve and retinal
nerve fiber layer thickness among Filipinos which in turn may aid in their future
essential assessment and diagnosis.
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PO-GLA-66
Evaluation of Morphologic Changes in Optic Nerve and Visual
Pathway in Glaucoma using 3T MRI
A Rahman Fadzlina (1) , Sidek Sabrilhakim (2) , Ramli Norlisah (2) , Ramli Norlina
(1) (1)
, Zahari Mimiwati
1. Department of Ophthalmology, University Malaya Medical Centre
2. Department of Radiology, University Malaya Medical Centre
PURPOSE: To create mean diffusion (MD) and fractional anisotropy (FA) maps
where MD and FA values were calculated for each optic nerve and visual
pathway of severe glaucoma and normal subject for comparison. METHOD:
A healthy normal subject and a severe glaucoma with MD > -12.0dB (age
matched) were selected for 3TMRI.MD and FA values which reflect fiber
density, axonal diameter, and myelination in white matter were compared. Optic
nerve was manually outlined and the optic nerve volumetric was processed by
using GE DTI software.
Results: FA values were markedly lower in severe glaucoma than in the healthy
subject (RE= -3.60%:optic nerve ,-44.5%:optic tract, -5.89%:optic radiation;
LE= -28.9%:optic nerve , -4.24%:optic tract, -11.30%:optic radiation). MD
values were markedly higher in severe glaucoma than in the healthy subject
(RE=11.59% :optic nerve, 43.0% :optic tract, 0.1% :optic radiation; LE=40.9%
:optic nerve, 0.57% :optic tract, 1.89% :optic radiation).
Conclusion: DT MR imaging-derived MD and FA in the optic nerves, optic tract
and optic radiation could serve as complementary indicators of glaucoma
disease severity. The parameters could be useful for diagnosis of glaucoma by
evaluating the morphological changes in the optic nerve and visual pathway.
PO-GLA-67
Angle closure mechanisms of primary angle closure glaucoma
based on ultrasound biomicroscopy.
Dzumatayeva Zaure (1) , Botabekova Tursungul (1) , Begimbayeva Gulnar (1) ,
Chuikeyeva Elmira (1)
1. Kazakh Scientific Research Institute of Eye Diseases
Objective/Purpose. : to study angle closure mechanisms of primary angle
closure glaucoma based on ultrasound biomicroscopy. Methods. 53 patients
(72 eyes) with primary angle closure glaucoma were examined on ultrasound
biomicroscopy. Mean age of patients was 65,4 (±10,4) ranged 43 - 87 . 24 of
them are males and, 29 females. Ultrasound biomicroscopy was performed
with probe frequency of 50 MHz, VuMax II. Examination was made by
one operator with same meridian evaluation. Results. Based on obtained
topography of angle structures all patients were divided on three groups.
The groups were formed based on prevailing mechanism of angle closure as
different mechanisms can be combined in one eye. First group was formed
by 22 patients (26 eyes) with pupilary block. Second group was formed by
25 patients (35 eyes) with plateau iris. Third group consisted of 6 patients
(11eyes) with ciliary - lens block glaucoma. Conclusion. Thus, three different
angle closure mechanisms were noted in patients with primary angle closure
glaucoma. The main causes of angle closure were plateau iris (47%) and
pupillary block (42%), and the least is ciliary - lens block (11%).
PO-GLA-68
Racial features of central corneal thickness based on Visante OCT
Dzhumatayeva Zaure (1) , Botabekova Tursungul (1) , Khudzhatova Madina (1)
1. Kazakh Scientific Research Institute of Eye Diseases
Objective/Purpose.To study racial features of central corneal thickness.
Material and methods. Central corneal thickness was measured in 133 healthy
subjects. Patients were divided into 2 group based on their race. There were
74 subjects (148 eyes) in Mongoloid race group, mean age was 47, 5±5,3
(ranged 20-75), 28 (37, 8%) of them were male and 46 (62,2%) female. In
group with European race there were 59 subjects (118 eyes), 22 (37,3%) of
them were male and 37 (62,7%) female. CCT was measured on Visante OCT
with wave length 1310nm, 2000 scans/sec, with axial resolution of 8-60 mcm.
CCT was classified in five groups (Balashevich L.I., 2004):”ultrathin”(less than
480mcm), “thin” (481-520mcm),”thick” (561-600 mcm) and “utltrathick” (more
than 60 mcm). Results. Mean CCT had no statistically significant difference
in different age groups of both races. Comparison of CCT in Mongoloid and
European race showed statistically significant difference. In Mongoloid race
of all age groups the cornea was “thin”, and CCT was on 3,38% less than
in European race group. Conclusion. Thin central corneal thickness leads
to underestimation of IOP measurements and thus undercorrection of IOP.
Patients with thin corneas need special attention for glaucoma estimation and
monitoring.