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Long-term results of photorefractive keratectomy for hyperopia and hyperopic astigmatism.

PURPOSE: This study was conducted to determine the safety and efficacy of using the Nidek EC-5000 excimer laser for photorefractive keratectomy to correct hyperopia and hyperopic astigmatism. METHODS: We treated 67 eyes of 44 patients for hyperopia and hyperopic astigmatism with the Nidek EC-5000 excimer laser. The algorithm provided an ablation zone of 5.5 mm diameter with the addition of a tapered transition zone of 3.5 mm diameter, for a total ablation of 9 mm diameter. RESULTS: Uncorrected visual acuity (geometrical mean) changed from 0.16 to 0.37 at 12 months; corrected visual acuity (geometrical mean) changed from 0.8 to 0.89; mean sphere decreased by 2.08 D from 3.76 to 1.40 D (range, 1.70 to 1.68 D) and cylinder by 1.40 D from 2.20 to 1.00 D. Refractive results for < or = 3.00 D were reasonably accurate and stable, but for > +3.00 D, undercorrection and regression over l year were the rule. CONCLUSION: Hyperopic PRK proved to be a safe technique in regard to the risk of loss of visual acuity with no central corneal opacities and with a generally rapid recovery of baseline spectacle-corrected visual acuity, but the predictability of correction greater than +3.00 needs improvement.

Adult↗

Photorefractive keratectomy for hyperopia using an erodible disc and axicon lens: 2-year results.

BACKGROUND: This paper presents the results over a 2-year follow-up of the first human trial of photorefractive keratectomy (PRK) for correction of hyperopia using an erodible disc excimer laser delivery system (Summit) coupled to an axicon lens. METHODS: We treated 25 eyes of 21 patients for a mean correction of +3.38 +/- 0.97 D (range, +1.00 to +4.00 D). The hyperopic correction was made using an erodible disc inserted on the laser optical pathway; an axicon lens was then used to create a blend transition zone. Eyes were evaluated at 1, 3, 6, and 12 months after surgery. For a smaller series of 11 eyes, we also present 24-month results. RESULTS: Mean refractive error 1 month after treatment (25 eyes) was -2.35 +/- 1.55 D (range, +1.00 to -6.50 D). Eight eyes (32%) had a spectacle-corrected visual acuity loss greater than 1 line. Twelve months after treatment, mean spherical equivalent refraction was -0.47 +/- 0.80 D (range, +1.25 to -2.25 D). Nineteen eyes showed an improvement (range, 3 to 8 lines) in uncorrected distance visual acuity and 23 showed improvement in uncorrected vision at reading distance (1 to 7 lines). CONCLUSION: This technique proved effective in reducing hyperopia, but predictability must be demonstrated in a larger treatment group. Safety was confirmed by the absence of delayed reepithelialization and the absence of spectacle-corrected visual acuity loss greater than 1 line at 1 year after surgery.

Adult↗

Treatment of hyperopia with contact Ho:YAG laser thermal keratoplasty.

PURPOSE: To evaluate the effectiveness, safety, and stability of contact Ho:YAG laser thermal keratoplasty for low to moderate hyperopia. METHODS: Fifty-five hyperopic eyes of 39 patients were treated with a Technomed contact Ho:YAG laser; 23 eyes were treated a second time. Treatment parameters were 1 octagonal ring of 8 spots with a treatment diameter of 6 mm, 7 mm, or 8 mm. Efficacy of the Ho:YAG laser treatment was evaluated after 6 months, comparing 3 treatment zone diameters. Stability and efficacy after 12 months was evaluated comparing 7-mm and 8-mm treatment zone diameters. RESULTS: Mean reduction of spherical equivalent refraction after 6 months was not statistically significantly different between the 6-mm or 7-mm diameter zones: 1.42 (+/- 1.30) D versus 2.22 (+/- 0.44) D. An 8-mm diameter treatment zone was significantly less effective, 1.12 (+/- 0.47) D. Longer follow-up did not show stability: mean reduction of spherical equivalent manifest refraction was 1.58 (+/- 0.45) D for the 7-mm diameter treatment zone and 0.82 (+/- 0.61) D for the 8-mm diameter treatment zone after approximately 12 months. Retreatment had a limited additive effect. No clinically significant loss of spectacle-corrected visual acuity was reported. No eyes lost more than 1 line of visual acuity. CONCLUSION: Contact Ho:YAG laser thermal keratoplasty corrected hyperopia up to 2.50 D, but predictability was poor and a regression of initial effect occurred. Instability of refraction persisted to 1 year after surgery.

Adult↗

Laser in situ keratomileusis for hyperopia.

OBJECTIVE: To evaluate laser in situ keratomileusis (LASIK) ablation zone size and its relationship to refractive and visual outcomes in the treatment of hyperopia. METHODS: We evaluated retrospectively 40 eyes of 20 patients who had LASIK: 20 eyes had a refractive ablation zone ranging from 5.5 to 9.0 mm (Group 1); Group 2 consisted of 20 eyes with a refractive ablation zone from 5.5 to 8.25 mm. We used the Nidek EC-5000 excimer laser and the Hansatome microkeratome. Mean spherical equivalent refraction was +2.72 D in Group 1 and +2.75 D in Group 2. Objective refraction and visual acuity were evaluated over 6 months in both groups. RESULTS: Six months after LASIK, mean spherical equivalent refraction in Group 1 was +1.00 +/- 0.84 D and in Group 2 it was +0.75 +/- 0.42 D. One patient in Group 1 lost 1 line of spectacle-corrected visual acuity; none in Group 2 lost lines. Six patients gained 1 to 3 lines from their preoperative spectacle-corrected visual acuity. CONCLUSIONS: LASIK provides good results for mild and moderate hyperopia. LASIK with an ablation zone from 5.5 to 8.25 mm showed better predictability and more stable results. However, corneal diameter and the thickness and width of the flap appear to be important factors in the feasibility of LASIK in hyperopic eyes.

Adult↗

Laser in situ keratomileusis for recurrent hyperopia following laser thermal keratoplasty.

PURPOSE: Laser thermal keratoplasty (LTK) has its main indication in the correction of hyperopia. However, regression of refractive effect following LTK is a limitation. Laser in situ keratomileusis (LASIK) may provide a good alternative to correct residual refractive errors. METHODS: Fifty hyperopic eyes with varying amounts of regression after LTK underwent LASIK. The Chiron Automated Corneal Shaper microkeratome was used to make a flap of 160 microm and laser ablation was performed with the Technolas 217 Planoscan excimer laser. Postoperative follow-up was 6 months. RESULTS: Mean spherical equivalent refraction improved from +2.92+/-1.60 D to +0.36+/-1.48 D. Mean best spectacle-corrected visual acuity changed from 0.78+/-0.14 before LASIK to 0.76+/-0.16 D 6 months after LASIK. Mean uncorrected visual acuity changed from 0.37+/-0.16 to 0.66+/-0.24. Forty-two percent (21 eyes) were within +/-0.50 D of intended correction, 60% (30 eyes) were within +/-1.00 D, and 76% (38 eyes) were within +/-2.00 D. After LASIK, confluent haze between previous LTK spots was observed in most eyes, as LASIK ablation took place at the sites of the LTK spots. CONCLUSIONS: LASIK after LTK is a good alternative for hyperopic regression. Predictability and efficacy are less than with primary LASIK for hyperopia, but the procedure is equally safe.

Adult↗

Holmium laser thermal keratoplasty for hyperopia and astigmatism after photorefractive keratectomy.

PURPOSE: To report results of holmium laser thermal keratoplasty used to treat induced hyperopia and induced, as well as pre-existing astigmatism after photorefractive keratectomy. METHODS: Sixteen eyes of 16 patients were included in this study. Contact holmium laser (Technomed Holmium 25) was used in 7 patients to correct hyperopia (8 spots at 8 or 9 mm) and in 9 patients to correct astigmatism (4 spots at 7, 8, or 9 mm). Follow-up evaluation was done after at least 6 months. The effectiveness, stability, and safety of the procedure were investigated. RESULTS: Spherical correction was ineffective (1.00 D or less) when applied at the 9-mm diameter treatment zone. Spherical correction applied at the 8-mm diameter treatment zone was ineffective in 1 eye. Three eyes achieved 1.00 to 2.00 D change, but 2 of these eyes showed an induced astigmatic change as well. Correction of astigmatism at the 7-mm diameter treatment zone resulted in a 0 to 4.00 D cylinder component change. Treatment at the 8-mm diameter treatment zone showed a 0 to 1.50 D effect and at the 9-mm treatment zone, 0.25 to 1.50 D. All eyes that achieved significant improvement (1.00 D or more change in cylinder component) showed significant overcorrection in the first postoperative phase. There were no sight threatening complications. CONCLUSION: Holmium laser thermal keratoplasty can be useful for the treatment of overcorrection and induced as well as pre-existing astigmatism after photorefractive keratectomy. However, predictability is low and astigmatism can be induced with the attempted spherical correction.

Adult↗

Anterior corneal optical aberrations induced by photorefractive keratectomy for hyperopia.

PURPOSE: Photorefractive keratectomy (PRK) for hyperopia requires both a steepening of the central cornea and a flattening of the mid-periphery to achieve its effect and is likely to affect the optical aberrations of the eye. METHODS: Nine patients underwent PRK to correct between +2.00 and +4.00 D of hyperopia (first eye treated for each patient) using the Summit Technology Apex Plus excimer laser. Anterior corneal aberrations for pupil diameters of 3, 5.5 and 7 mm were estimated from corneal topography data (TMS-1), assuming a uni-index, single surface cornea. Refractive error was assessed using retinoscopy and standard subjective tests. RESULTS: Apart from the intended change in refraction (mean spherical equivalent manifest refraction, +4.60 +/- 1.60 D before surgery and +0.70 +/- 1.60 D at 1 year after surgery), the most significant change was in spherical aberration. Anterior corneal spherical aberration was positive (+1.60 +/- 0.60 D for a 5.5-mm pupil) before surgery and became negative after surgery (-1.80 +/- 1.20 D at 1 year). The change in spherical aberration was related to the achieved change in refractive error. CONCLUSIONS: The large change (approximately 3.00 D) in spherical aberration (from positive to negative aberration) has implications for the optical performance of the whole eye, where the effects of lenticular aberration must also be considered.

Cornea↗

Reduction of hyperopia associated with manual excision of Salzmann's nodular degeneration.

PURPOSE: Removing central corneal pathology often leads to a hyperopic shift secondary to corneal flattening. A myopic shift, or reduction in hyperopia, would be expected after removal of peripheral corneal pathology with central corneal steepening. This case illustrates the refractive changes induced by Salzmann's nodular degeneration and the myopic shift associated with their excision. METHODS: A 53-year-old female presented with a slowly progressive increase in hyperopia. Vision in the right eye was 20/40 with a refraction of +10.00 -4.00 x 90 degrees. Vision in the left eye was 20/30 with a refraction of +5.75 -2.00 x 105 degrees. Both corneas exhibited nodular subepithelial opacities in the mid-periphery. A superficial keratectomy was performed on each eye, 1 year apart. RESULTS: Twelve days postoperatively, uncorrected visual acuity in the right eye was 20/25, and 20/20 with a refraction of -0.75 -0.50 x 31 degrees, 6 months later. Six days postoperatively, uncorrected visual acuity in the left eye was 20/40, and 20/30 with a refraction of -1.25 D, 1 month later. CONCLUSION: Superficial keratectomy provides a means of restoring the original corneal contour, especially when the pathology is easily dissected from Bowman's layer. The surgeon should investigate the refractive status prior to the development of the nodules and be aware of the possible refractive change upon removal of the pathology.

Corneal Dystrophies, Hereditary↗

Laser in situ keratomileusis for hyperopia and hyperopic and mixed astigmatism with LADARVision using 7 to 10-mm ablation diameters.

PURPOSE: To evaluate the results of laser in situ keratomileusis (LASIK) performed to correct hyperopia, and hyperopic and mixed astigmatism using wider ablation diameters (optical zone diameter and overall ablation diameter) than those commonly used with the same and other lasers. METHODS: After flap creation using an Alcon SKBM microkeratome set for a 10-mm flap diameter, 53 eyes (33 patients) with a mean spheroequivalent attempted correction of +2.34 +/- 2.09 D underwent LASIK (Alcon LADARVision 4000) using a 7-mm optical zone diameter and a 3-mm transition zone for an overall 10-mm total ablation diameter. The nasal hinge was prevented from undesired ablation by the use of proprietary hinge protector software. Eyes were followed for 6 months after surgery. RESULTS: Six months after surgery, mean spheical equivalent refractive error was -0.22 +/- 0.41 D. There were 79.2% of eyes within +/- 0.50 D, and 98.1% within +/- 1.00 D of intended correction. Uncorrected visual acuity of 20/20 or better was achieved by 28 eyes (53%) and 20/40 or better by 50 eyes (94.3%). No meaningful visual complaints during nighttime hours, such as haloes or glare, were subjectively reported by patients. CONCLUSION: The use of larger ablation diameters in LASIK for hyperopia, and hyperopic and mixed astigmatism produced accurate results, early refractive stability, and good visual performance.

Adult↗

Ablation centration in laser in situ keratomileusis for hyperopia: comparison of VISX S3 ActiveTrak and VISX S2.

PURPOSE: To compare ablation centration and outcome measurements in laser in situ keratomileusis (LASIK) for hyperopia using the pupil-tracking VISX S3 ActiveTrak or the nontracking VISX S2 excimer laser. METHODS: In a retrospective study, 49 consecutively treated hyperopic eyes (32 patients) that had LASIK by the VISX StarS3 ActiveTrak were compared to 49 control-matched eyes treated with the VISX StarS2 without pupil-tracking. Primary outcome variables including ablation centration, uncorrected visual acuity, best spectacle-corrected visual acuity, manifest refraction, complications, and induced cylinder analyzed by vector analysis were evaluated 3 months postoperatively. RESULTS: Hyperopic sphere ranged between plano and +5.50 D and cylinder between 0 and +2.75 D. Ninety-five of 98 eyes (96.9%) were available for analysis at 3 months. Of these 95, 52 eyes could be used for analysis of ablation centration. Mean decentration of the ablation zone from the entrance pupil was 0.30 +/- 0.20 mm in tracked eyes (n=31) and 0.41 +/- 0.39 mm in nontracked eyes (n=21), P=.17. Two eyes (6.5%) in the tracked group were significantly decentered between 0.5 and 1 mm from the pupil center. In the nontracked group, decentration was between 0.5 and 1 mm in one eye (4.8%) and greater than 1 mm in two eyes (9.5%). CONCLUSIONS: Comparable ablation centration in LASIK for hyperopia was achieved between actively-tracked and nontracked eyes. Decentrations (greater than 1 mm) were not seen with a tracking system in this study. Visual and refractive results were similar between the VISX StarS3 ActiveTrak and VISX StarS2 laser systems.

Cornea↗

Non-contact holmium:YAG laser thermal keratoplasty for hyperopia: two-year follow-up.

PURPOSE: We evaluated the safety and efficacy of the non-contact holmium:YAG laser thermal keratoplasty (LTK) for the treatment of mild to moderate hyperopia without astigmatism. METHODS: A prospective, non-comparative case series included 50 eyes of 28 patients (aged > or =40 years) who had stable refraction and an astigmatic component < +0.50 diopters (D). We applied the non-contact pulsed holmium:YAG laser to treat the hyperopic spherical component using the Hyperion LTK System. All patients had minimum 12-month follow-up and 64% (18 patients) had 24-month follow-up. RESULTS: The mean age of patients was 48.4 +/- 8.23 years (range: 40 to 62 years). The preoperative hyperopic mean spherical equivalent refraction was +2.32 +/- 0.975 D (range: +1.00 to +4.75 D). Postoperatively, the subjective manifest refraction decreased from the preoperative mean value of +2.32 D to a mean -0.09 D at 1 month after surgery and regressed to +0.315 D at the last follow-up examination, resulting in a mean correction of +2.005 +/- 0.81 D at 24 months after surgery. Preoperatively, mean uncorrected visual acuity in LogMAR units was 0.798 +/- 0.353 and at 12 months after surgery, it was a mean 0.108 +/- 0.136. Keratometric power increased from 42.595 +/- 1.949 D before surgery to 44.605 +/- 1.626 D at 24 months after surgery. CONCLUSIONS: Holmium:YAG LTK was an acceptable alternative for the correction of mild to moderate hyperopia in this middle-aged population.

Adult↗

Hyperopia and loss of accommodation following ciliary muscle disinsertion in the cynomolgus monkey: physiologic and scanning electron microscopic studies.

Twenty-three cynomolgus monkeys underwent 360-degree disinsertion and retrodisplacement of the ciliary muscle in one eye. Ten to 12 weeks after unilateral disinsertion, resting refraction in the "disinserted" eyes was more hyperopic than in the opposite eyes by 1.12 +/- 0.21 (mean +/- S.E.M.) diopters (p less than 0.001). Accomodative responses to intramuscular pilocarpine (2 or 3 mg/kg) were 0.90 +/- 0.14 (mean +/- S.E.M.) diopters in the disinserted eyes and 13.88 +/- 0.79 diopters in the opposite eyes. The induced hyperopia and loss of accommodation in the disinserted eyes seemed permanent, persisting for at least 14 months in one monkey and 29 months in three monkeys tested periodically after disinsertion. By light microscopy, the ciliary muscle in the disinserted eyes appeared normal and was contracted by pilocarpine. Scanning electron microscopy of the accommodative apparatus revealed retrodisplacement of the ciliary muscle, ciliary processes, and zonular plexus in the disinserted eyes. Structural alterations in the zonular apparatus seemed insufficient to account for the physiological findings. Hyperopia and loss of accommodation following ciliary muscle retrodisplacement are consistent with a new theory of zonular action during accommodation.

Accommodation, Ocular↗

Clear lens extraction to correct hyperopia in presbyopic eyes with or without arcuate keratotomy for pre-existing astigmatism.

This retrospective study evaluates visual (functional) and refractive outcome of correcting hyperopia (i.e. 2.5 D or more) by means of a cataract procedure and simultaneously the pre-existing clinical significant astigmatism (1.5 D or more with the rule; 1 D or more against the rule), if present, by means of an arcuate keratotomy. Nine eyes undergoing clear lens extractions with intraocular lensimplantation (IOL) in combination with arcuate keratotomy (group one) and 29 eyes without arcuate kertotomy (group two) are included in the study. The mean age at the time of surgery was 62.89 years (range, 50 to 83) in group one and 68.17 years (range, 53 to 86) in group two. For calculation of the lens power a modified SRK II program, aiming at emmetropia was used. In only one highly hyperopic patient the Holladay I formula was used to calculate two piggyback lenses. A modified Istre nomogram was used to determine the surgical parameters of the arcuate keratotomy. The Cravy formula and the Holladay, Cravy, Koch vector analysis were used to determine the change in refractive cylinder results. Patients were followed postoperatively for a mean of 2.8 months in group one and 7.5 months in group two. In group one, 6 out of 9 eyes achieved a postoperative refraction within +/- 0.5 D of intended refraction and 8 out of 9 were within +/- 1 D of intended refraction. In group two, it was 15/29 and 24/29 respectively. Postoperatively, the uncorrected visual acuity was 20/40 or better in all eyes of group one (9/9) and in 27/29 eyes of group two. None of the eyes in both groups lost two or more lines of the best corrected visual acuity. Clear lens extraction with IOL is an effective and safe procedure for the correction of hyperopia in a presbyopic age group. In combination with an arcuate keratotomy, pre-existing astigmatism can be corrected simultaneously.

Aged↗

[LASIK for high and moderate hyperopia].

OBJECTIVE: To evaluate safety and efficacy of excimer laser in situ keratomileusis (LASIK) for high and moderate hyperopia. METHODS: LASIK was performed on 17 eyes of 9 patients using the SCHWIND KERATOM-F excimer laser. The range of preoperative spherical equivalent was + 5.50 to + 9.00 D, and its mean value, (+ 7.18 +/- 1.00) D. All the cases were followed up for 12 months or longer. RESULTS: There was no serious complication during the operation. No eye lost more than 1 line of the best corrected visual acuity after surgery. At 12 months, the mean postoperative spherical equivalent was (+ 1.77 +/- 1.56) D. 52.9% of eyes reached 0 to + 1.00 diopter. 88.2% of eyes achieved an uncorrected far vision of >or= 0.5. 100.0% and 76.5% eyes got uncorrected near visual acuities of >or= 0.5 and >or= 1.0 respectively. CONCLUSION: It is demonstrated the LASIK is a safe and effective technique for the treatment of high and moderate hyperopia. Further algorithm calibration must be made to avoid undercorrection.

Adult↗

Surgical correction of hyperopia following radial keratotomy.

BACKGROUND: No effective treatment for hyperopia following radial keratotomy has been described. A new surgical technique of two purse-string intrastromal sutures was investigated for correction of this hyperopia. METHODS: Eighteen radial keratotomy patients who were unhappy with uncorrected vision and who were unsatisfied with contact lens or spectacle correction, after informed consent, underwent corneal suturing. The 19 hyperopic eyes included 5 original overcorrections, 5 overcorrections after reoperation, and 9 progressive hyperopes. The refractive error ranged from +1.25 to +5.75 diopters spherical equivalent (mean +3.47 D). Presuturing uncorrected visual acuity ranged from 20/50 to 20/400 with 11 eyes (58%) 20/100 or worse. RESULTS: The follow up after double purse-string suturing averaged 24 months (range, 12 to 47 months). All patients had follow up of at least 1 year; 14 patients (74%) had follow up of 2 years or more. The change in refractive spherical equivalent following surgery averaged -3.30 D (range, -1.00 to -7.50 D). The steepening in average keratometry was 4.10 D (range, 1.00 to 8.00 D). The refraction after suturing averaged -1.12 D (range, +2.50 to -3.50 D). Uncorrected visual acuity after suturing was 20/40 or better in 14 eyes (74%), and 20/50 to 20/80 in 5 eyes (36%). There were no significant intraoperative, early or late postoperative complications. Seventeen eyes were either the same or gained 1 line of acuity; 2 eyes gained 2 lines of acuity; no eyes lost any lines of refractive Snellen acuity. CONCLUSIONS: The placement of two purse-string intrastromal sutures appears to provide significant steepening of the central cornea following excessive flattening after radial keratotomy. The steepening effect appears to remain stable with greater than 1-year follow up. This surgical technique offers an alternative to symptomatic hyperopic postradial keratotomy patients who cannot be corrected with spectacles or contact lenses.

Adult↗

[Changes of axial dimensions of the eye during growth in emmetropia, myopia and hyperopia].

PURPOSE: The aim ot this study was to evaluate changes ot axial dimensions ot the eye during growth in emmetropia, myopia and hyperopia. MATERIAL AND METHODS: We examined 183 children (363 eyes) aged 4 to 19 with emmetropia, myopia and hyperopia. All measurements were performed after cycloplegia with 1% tropicamidum (Polfa Warszawa). Total and corneal refraction was examined with autokeratorefractometer (Nikon NRK-8000). Then we used ultrasound biometer Ocuscan (Alcon, USA), to measure axial length of the eye, axial length of the vitreous cavity, axial dimension of the lens and axial depth of the anterior chamber. RESULTS AND CONCLUSIONS: 1. Growth of the axial length of the emmetropic eyes is finished at the age of 12, in hyperopic eyes in the age of 11 and in myopic eyes growth is proportional until the age of 14 and then significantly accelerates. 2. Growth of the axial length is mainly caused by increasing axial length of vitreous cavity. A little role in human eye growth is also played by increasing depth of the anterior chamber. 3. Between 4 and 19 years old, mean cycloplegic axial dimension of the lens is slightly decreasing in emmetropic and hyperopic eyes, whereas in myopic eyes is constant.

Adolescent↗

Radial thermokeratoplasty for the correction of hyperopia.

Hyperopic thermokeratoplasty involves making controlled thermal burns in the corneal stroma in a radial pattern up to a premarked clear zone. It steepens the central cornea and reduces the hyperopia. A series of 117 radial thermokeratoplasty eyes done in the Soviet Union were analyzed. Mean preoperative hyperopia of +5.27 diopters (range = +0.50 to +17.00 D) was reduced at 12 months after surgery by a mean of -3.48 D, resulting in a mean postoperative spherical equivalent of +1.84 D. Average correction was 70.8%. Forty percent of eyes were corrected to less than 1.00 D residual refractive error; however, 58% were undercorrected by 1.00 D or more. The proportion of eyes seeing 20/40 or better unaided increased from 10% preoperatively to 52% by 3 months after surgery and remained at 53% at 12 months after surgery. Overall refractive stability was demonstrated during the 1st postoperative year. Stepwise regression showed that none of the preoperative or surgical factors significantly predicted outcome when all eyes were evaluated.

Adolescent↗

CT of acquired hyperopia with choroidal folds.

Seven patients with an ophthalmologic diagnosis of acquired hyperopia with choroidal folds were evaluated by high-resolution axial CT of the orbits. Coronal, oblique coronal, and parasagittal reformations were obtained and the thickness of the optic nerve and morphologic appearance of the globes were assessed by measurement and subjective appearance. Flattening of the globe, which caused the globe to assume an ellipsoid shape, was seen in all 11 affected eyes. Mild to moderate optic nerve enlargement was also demonstrated in most patients. In six of 11 affected eyes a visible space was noted between the optic nerve and its sheath, implying expansion of the subarachnoid perineural compartment. These findings were not demonstrated in a control group of five patients scanned in a similar manner. Scans of a phantom revealed no evidence of CT-generated distortion. These findings may help to identify hyperopia with choroidal folds as a benign disease and eventually help to establish its cause.

Choroid↗