Age related macular degeneration (AMD) is the most frequent cause of blindness among the elderly. Several studies have suggested, but not proved, that obesity may be one of the risk factors of AMD. In this case-control study, Iranian investigators assessed the relation between body mass index (BMI) and the incidence of AMD.

The study included 50 patients with AMD and 80 other subjects who were adjusted for age, sex, cigarette smoking, blood pressure and diabetes. Data analysis was performed by SPSS V9.0 using Student's t and chi(2) tests.

Forty-two percent of the subjects in the case group and 35 percent of those in the control group were men. Mean age of subjects in the case and control groups was 69.9 years (62 to 77 years) and 64.08 years (56 to 71 years), respectively. Mean BMI measured 25.38 (range 21 to 29) and 30.24 (26 to 34) in the case and control groups, respectively. Twelve percent of subjects in the case group were obese, 42 percent were overweight and 14 percent were lean. A total of 22.5 percent of subjects in the control group were obese, 45 percent were overweight and 7.5 percent were lean.

Results showed no significant difference in BMI between the case and control groups. Recent studies indicate that obesity is a probable risk factor for progression of AMD, but there is no significant relation with the presence of AMD. With multifactorial analysis, the authors were unable to identify any significant relation between the presence of AMD and the studied risk factors.

Investigators at the Medical University of South Carolina sought to report interocular axial length difference (IALD) between the operated eye and fellow eye at the time of pediatric cataract surgery. They conducted a retrospective analysis of 171 cataractous (operated) eyes (mean patient age at surgery, 56.9 months; range, 0.2 to 230.0), using descriptive statistics, analysis of covariance, and regression analysis.

The mean IALD was 0.05 +/- 1.15 mm. If absolute values were used, mean IALD was 0.76 +/- 0.86. Nearly half of the subjects (48 percent) showed an IALD of 0.5 mm or greater; 41 patients (24 percent) had operated (cataractous) eyes that were 0.5 mm or more shorter than the fellow eye, and 41 patients (24 percent) had operated eyes that were 0.5 mm or more longer than the fellow eye. The mean IALD in unilateral and bilateral cases was 0.10 +/- 1.33 and -0.03 +/- 0.76, respectively. If absolute values were used, it was 0.98 +/- 0.90 and 0.40 +/- 0.65 in unilateral and bilateral cases, respectively. IALD was more predictable in unilateral than in bilateral cases. In unilateral cases, age at surgery and AL of the operated eye correlated with IALD. IALD did not correlate with gender, ethnicity or type of cataract in either unilateral or bilateral cases.

Researchers at Johns Hopkins’ Wilmer Ophthalmological Institute conducted a study aimed at identifying the clinical characteristics of the dragged-fovea diplopia syndrome, introducing a simple diagnostic test that aids in the evaluation of such patients and providing a simple treatment option to improve the diplopia in some of these patients.

The retrospective, observational case series included 95 affected eyes in 83 consecutive patients seen between January 1, 1993, and August 9, 2004, who were diagnosed with the dragged-fovea diplopia syndrome at one institution. Researchers reviewed the records of 222 patients who had been seen in the Krieger Children's Eye Center at the Wilmer Institute since 1993 with a diagnosis of maculopathy, internal limiting membrane, or dragged fovea. They collected ocular findings and history for those patients who reported binocular diplopia that was not amenable to prism therapy and not secondary to acquired strabismus.

They recorded the presence of metamorphopsia on Amsler grid testing or other clinical evidence of macular wrinkling, response to prism trial, response to the small-field central fusion test (lights on-off test), and response to partial occlusion with Scotch Satin tape (3M Co., St. Paul, MN). The 69 patients who were tested with the lights on-off test responded positively, demonstrating rapid central fusion with room lights off, and recurrence of central diplopia with peripheral fusion with room lights on. Forty-six patients (of 64 tested) were receptive to monocular occlusion with Scotch Satin tape.

The authors of the study concluded that dragged-fovea diplopia syndrome consists of central diplopia in the presence of peripheral fusion, secondary to dragging of the fovea in one or both eyes by retinal disease. They maintain that central diplopia cannot be eliminated by prism therapy or eye muscle surgery. They also state that the lights on-off test has proved pathognomonic for this syndrome, and many patients have benefited from partial monocular occlusion with Scotch Satin tape.

The rate of postoperative retinal detachment in eyes with intraocular lens (IOL) and no intraoperative posterior capsule rupture seems to be low, according to results of a study by Tokyo’s Keio University School of Medicine. The investigators believe that IOL implantation with capsular bag fixation may reduce the incidence of postoperative retinal detachment triggered by lens surgery for atopic cataract.

In a retrospective review, the investigators followed 169 eyes of 126 patients who underwent cataract surgery for atopic cataract for more than one year. None of the eyes previously had a retinal detachment or retinal detachment surgery. The eyes were divided into 132 eyes of 95 patients with an IOL implantation (IOL group) and 37 eyes of 31 patients without an IOL implantation (aphakia group). The postoperative visual acuity and incidence of postoperative retinal detachment were compared between the two groups. The effects of the location of the causative retinal breaks, intraoperative posterior capsule rupture, and postoperative posterior capsulotomy on the incidence of retinal detachments were evaluated.

Results showed that final visual acuity was better than or equal to 20/20 in 128 eyes (97.0 percent) of the IOL group and in 29 eyes (78.4 percent) of the aphakia group. Retinal detachment after an uncomplicated cataract surgery occurred in three eyes (2.3 percent) of the IOL group and in 8 eyes (25.8 percent) of the aphakia group. Two of three eyes (66.7 percent) in the IOL group and one of eight eyes (16.7 percent) in the aphakia group that later developed a retinal detachment had an intraoperative posterior capsule rupture. Posterior capsulotomy by YAG laser did not seem to alter the incidence of postoperative retinal detachment in either the IOL (2.0 percent) or the aphakia group (25.0 percent).

The purpose of this study by Spanish researchers was to analyze refractive, visual and contrast sensitivity outcomes of LASIK performed under thin flaps (less than 100 microns), and compare them with those of conventional thicker flaps.

In the retrospective study, 280 consecutive eyes that had LASIK for myopia using the Moria LSK-One microkeratome and the Technolas 217C excimer laser were included. Investigators compared efficacy, predictability and contrast sensitivity indicators among three groups of flap thicknesses: thin (less than 100 microns, 105 patients), medium (100 to 129 microns, 122 patients), and thick (greater than 130 microns, 53 patients).

Refractive results were excellent and comparable among the three groups; however, visual outcomes--measured as efficacy, postoperative evaluation of uncorrected visual acuity and contrast-sensitivity test--were significantly better in the thin flap group. Efficacy results were 92.9 percent, 91.0 percent, and 81.0 percent in the thin, medium and thick flap groups, respectively, and the rate of enhancements was 0 percent, 2.3 percent, and 5.6 percent, respectively. With contrast sensitivity changes between preoperative and postoperative values at month three of follow-up, the thin flap group achieved the preoperative levels at three spatial frequencies (3, 6, and 18 cycles per degree), while the thicker flap groups maintained lower than preoperative levels at more than two spatial frequencies. When comparing contrast sensitivity values among the three groups, the thin flap group also obtained the best results at lower spatial frequencies.

Investigators concluded that thin flap LASIK is a safe technique to correct myopic defects, since it blends the advantages of surface and lamellar procedures (minimal debilitation of corneal biomechanical architecture with the rapid and comfortable visual recovery of lamellar approaches). Moreover, it achieves excellent refractive outcomes, a lower rate of enhancements and a good visual performance with better contrast sensitivity test results.