Medical Hypothesis, Discovery & Innovation (MEHDI) Ophthalmology Journal
Not a member yet
503 research outputs found
Sort by
Visual outcomes of monocular idiopathic epiretinal membrane removal: a prospective follow-up study
Full text linkBackground: Surgical intervention for an idiopathic epiretinal membrane (iERM) could alleviate metamorphopsia or improve vision. We evaluated changes in vision in patients undergoing treatment for monocular iERMs during a 6-month period. We investigated the rate of posterior vitreous detachment (PVD) using optical coherence tomography (OCT) imaging in eyes with iERM and in normal fellow eyes. We also examined the intraoperative rate of PVD in iERM eyes following the administration of triamcinolone acetonide (TA).
Methods: This prospective interventional case series recruited all eligible individuals with treatment-naive monocular iERM who were scheduled for pars plana vitrectomy (PPV) due to reduced best-corrected distance visual acuity (BCDVA) or metamorphopsia. OCT at baseline was used to determine the presence and stage of PVD in the eyes with iERM and the normal fellow eyes. Intraoperative TA-based PVD staging was performed for affected eyes.
Results: Participants comprised 32 cases, with 32 eyes with iERM and 32 normal fellow eyes. The mean (standard deviation [SD]) age was 60.9 (9.7) years, and the majority were men (n = 18, 56.2%). The baseline mean (SD) of BCDVA in affected eyes was 0.50 (0.21) logarithm of the minimum angle of resolution (logMAR), which improved to 0.34 (0.20) logMAR at the 1-month visit, representing a significant mean difference of 0.15 (0.20) logMAR (P < 0.001). At the 6-months visit, the mean (SD) BCDVA had further improved to 0.26 (0.19) logMAR, representing a significant mean difference of 0.23 (0.26) logMAR (P < 0.001) from the baseline value. The mean (SD) visual improvement between the 1- and 6-months follow-ups was 0.07 (0.14) logMAR, which was statistically significantly (P < 0.05). The mean changes in BCDVA were more pronounced in patients aged < 60 years than in those aged ? 60 years. The proportion of eyes at each stage of PVD detected by preoperative OCT in eyes with iERM differed from that detected by intraoperative TA staining. By both methods, the stages advanced significantly with increasing age (both P < 0.001). Similarly, the proportion of eyes at each stage of PVD detected by preoperative OCT in the normal fellow eyes was also higher and advanced significantly with increasing age (P < 0.001).
Conclusions: Continuous visual improvement is anticipated up to 6 months after surgery in eyes with iERM, and this improvement is likely to be more significant in younger individuals. The incidences of each PVD stage varies depending on the use of preoperative OCT or intraoperative TA in these cases. A higher rate of PVD observed in fellow eyes may suggest that PVD progresses through its stages simultaneously and without complications in normal eyes. Further studies are needed to validate our preliminary results and confirm these conclusions
A comparative study and review of visual outcomes with enhanced versus standard monofocal intraocular lenses following cataract surgery
Full text linkBackground: Recent innovations in intraocular lens (IOL) design have introduced extended depth of focus lenses, which has shown promise in improving visual acuity at multiple distances while preserving the distance vision provided by a standard monofocal IOL. This study aimed to evaluate the visual outcomes of TECNIS Eyhance, a monofocal IOL with enhanced intermediate function, and a standard TECNIS monofocal 1-piece IOL, and to review published studies comparing the clinical performance between the TECNIS Eyhance and standard IOLs.
Methods: A retrospective analysis was conducted on patients who underwent cataract extraction with bilateral implantation of either TECNIS Eyhance IOLs or TECNIS Monofocal 1-Piece IOLs. Primary outcomes included monocular and binocular uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), and corrected distance visual acuity (CDVA), and manifest refraction. Outcomes such as glare, halos, and dry eye were also assessed. A literature review was performed to identify studies evaluating the clinical outcomes of TECNIS Eyhance and standard TECNIS monofocal IOLs.
Results: In total 108 patients (216 eyes) underwent bilateral implantation with either TECNIS Eyhance (104 eyes) or TECNIS Monofocal 1-Piece (112 eyes) IOLs. The mean (standard deviation [SD]) binocular UNVA was better in the Eyhance group at 1 month (0.18 [0.13] logMAR) compared to the standard monofocal group (0.24 [0.14] logMAR; P < 0.05). A greater proportion of Eyhance patients achieved binocular UNVA of 20/25 or better (46.9% vs 21.8%; P < 0.01), and 20/32 or better (65.3% vs 45.5%; P < 0.05). However, there was no significant difference for 20/20 visual acuity (20.4% vs 18.2%; P > 0.05). No significant differences were observed in postoperative UDVA or CDVA between groups (both P > 0.05). The mean (SD) monocular UNVA showed a slight, but non-significant, advantage in the Eyhance group (0.26 [0.15] logMAR vs 0.29 [0.15] logMAR; P > 0.05). Eyhance eyes demonstrated less residual refractive cylinder at 1 month (P < 0.01), which may be attributed to a higher rate of toric IOL use (P < 0.01). Patient-reported visual symptoms did not differ between groups. Thirteen studies were identified that compared the Eyhance and standard monofocal IOLs. Across the studies analyzed, the Eyhance group showed better monocular and binocular UNVA with mean (SD) differences of - 0.10 (0.20) logMAR and - 0.10 (0.21) logMAR, respectively (both P < 0.01), as well as improved binocular uncorrected intermediate visual acuity (UIVA) (mean difference [SD]: -0.10 [0.18] logMAR; P < 0.01). These studies also showed low rates of glare and halos for both IOLs.
Conclusions: Patients receiving the TECNIS Eyhance IOL had better binocular UNVA compared to those with a standard monofocal IOL, consistent with published literature. The Eyhance IOL also showed better binocular UIVA and monocular UNVA across the studies reviewed. Both enhanced and standard monofocal IOLs demonstrate excellent distance vision and have similar levels of photic phenomena. Nevertheless, the Eyhance IOL shows promising potential for improving intermediate and near vision
Normative retinal thickness values in children, measured by swept source optical coherence tomography
Full text linkBackground: Although optical coherence tomography (OCT) has become essential in pediatric ophthalmology, normative data for children are lacking in most device databases. Due to ongoing ocular growth and developmental changes that occur during childhood and adolescence, adult reference values are not appropriate for pediatric use. Additionally, OCT measurements vary across devices, indicating the need for device-specific norms. In this study, we aimed to establish normative values for total macular retinal thickness, macular ganglion cell layer (GCL+) thickness, and circumpapillary retinal nerve fiber layer (cpRNFL) thickness in children aged 5–17 years relevant to the Topcon DRI Triton Plus swept-source OCT device.
Methods: We recruited children aged 5–17 years with normal ocular health, adequate visual acuity, and refractive errors within ±3.00 diopters (D) spherical and –1.00 D or less cylindrical under cycloplegia. Each child underwent comprehensive eye examinations and four OCT scans (two macular and two optic disc scans) using the Topcon DRI Triton Plus. Retinal thickness measurements were obtained from the eye with better visual acuity, or from a randomly selected eye in cases where both eyes had similar acuity. Scans were included if image quality was 40 and were free from artifacts or segmentation errors. Measurements were compared between age groups (5–7 and 8–17 years). Intra-visit repeatability was assessed using test–retest correlations based on repeated measurements obtained by the same examiner during a single visit.
Results: Sixty-nine children (n = 33, 48% girls), with a median age of 7 years (5–7-year age group) and 13 years (8–17-year age group), were included. The total macular thickness was 287.5 µm (11.1) and 290.5 µm (13.8), GCL+ thickness was 75.7 µm (4.2) and 74.9 µm (5.2), and cpRNFL thickness was 111.5 µm (10.2) and 108.3 µm (7.9) for the 5–7-year and 8–17-year age groups, respectively (mean [standard deviation]). Mean retinal thickness measures did not differ significantly by age or sex (all P > 0.05). Correlation between repeated measurements showed excellent repeatability: 0.991 for both total macular and GCL+ thickness, and 0.954 for cpRNFL (all P < 0.001). Spherical equivalent did not correlate significantly with retinal thickness measures (all P > 0.05).
Conclusions: This study provided normative values for macular total retinal thickness, macular GCL+ thickness, and cpRNFL thickness in children aged 5–17 years, measured using the Topcon DRI Triton Plus OCT device. We observed no significant age- or sex-based differences in these values, and measurement repeatability was excellent. Given the variability in retinal thickness across populations and devices, region- and device-specific pediatric norms are essential. These findings fill a critical gap in pediatric OCT normative databases and contribute to the development of reliable pediatric reference standards for swept-source OCT imaging. This may enhance diagnostic accuracy and clinical decision-making in pediatric ophthalmology
Bilateral superior oblique suture extension in pediatric A-pattern esotropia
Full text linkBackground: A-pattern esotropia is defined as an increase of more than 10 prism diopters (PD) divergence in down-gaze than in up-gaze. The long-term outcomes of bilateral superior oblique tendon suture extension (SOSE), a hardware-free technique, were evaluated in pediatric A-pattern esotropia with bilateral superior oblique overaction (bi-SOOA), addressing complications associated with traditional silicone spacers and tenotomy.
Methods: In this retrospective cohort study, all participants with A-pattern esotropia and bi-SOOA underwent bilateral SOSE using nonabsorbable polypropylene sutures combined with medial rectus recession. Preoperative and postoperative assessments included prism cover testing in nine gazes, fundus photography for objective torsion quantification, and grading of superior oblique overaction (SOOA).
Results: This study included 64 eyes from 32 children with a mean (SD) age of 7.0 (3.1) years and a mean (SD) postoperative follow-up of 35.2 (15.6) months (range: 8–55). The mean (SD) A-pattern esodeviation collapsed from 23.4 (7.7) PD preoperatively to 2.4 (2.3) PD postoperatively (P < 0.001), representing an 88.3% reduction. The mean (SD) horizontal esodeviation improved from 37.5 (10.9) PD to 1.7 (1.8) PD in primary gaze (P < 0.001). The mean (SD) objective fundus torsion decreased from 10.9 (2.5) degrees to 1.1 (1.4) degrees (P < 0.001), with no cases of torsional diplopia or vertical deviation. SOOA grades normalized from 2.8 (0.7) to 0.2 (0.4) (P < 0.001). No suture-related complications were observed, and alignment stability was maintained through to the final follow-up visit.
Conclusions: In pediatric A-pattern esodeviation surgery, SOSE provided biomechanical precision, anatomical preservation, and elimination of hardware-related risks. Its effectiveness in collapsing A-pattern esotropia, normalizing torsion, and achieving durable outcomes establishes it as a first-line surgical intervention for bi-SOOA. This study addresses a significant gap in pediatric ophthalmology, offering extended follow-up data and highlighting the value of minimally invasive, growth-compatible techniques in protecting visual development. Larger randomized trials with extended follow-up are needed to confirm the efficacy and safety of this procedure for A-pattern esotropia
Finite element analysis of asymmetrical retinal hemorrhages in shaken baby syndrome
Full text linkBackground: Despite the common association between bilateral retinal hemorrhage and shaken baby syndrome (SBS), unilateral retinal hemorrhage does not necessarily exclude this diagnosis. This study used computational simulations to elucidate the biomechanical phenomena within the eye under asymmetrical shaking forces.
Methods: Finite element analysis (FEA) incorporating the vitreous, vitreoretinal interface, retinal layers, and retinal vessels was performed under asymmetrical shaking conditions. To assess the stress-strain response at the preretinal, intraretinal, and subretinal locations, we divided the retinal mesh into three equally spaced layers with an element height of 0.083 mm. The remaining space within the retina was filled with the vitreous humor and attached to it via the main retinal vessels extracted from a standard fundus image. The resulting changes in shear stress and intraocular pressure (IOP) were quantified.
Results: The FEA model demonstrated that increasing the rotational radius from 10 cm to 14 cm or 17 cm led to a significant increase in shear stress and IOP across the vitreoretinal interface and within the retinal layers. Specifically, shear stress in the preretinal layer increased by 70.2% (8.0 kPa vs. 4.7 kPa), in the intraretinal layer by 20.0% (5.4 kPa vs. 4.5 kPa), and in the subretinal layer by 6.1% (3.5 kPa vs. 3.3 kPa). Simultaneously, IOP in the central region increased by 157.5% (39.4 mmHg vs. 15.3 mmHg) and in the posterior region by 162.3% (41.7 mmHg vs. 15.9 mmHg) when the rotational radius was increased to 17 cm from 10 cm. Increasing the rotational radius to 17 cm led to more pronounced changes in peak IOPs, with the central region showing a change of 39.4 mmHg and the posterior region a change of 41.7 mmHg. These results indicate a direct correlation between the rotational radius and the magnitude of IOP changes in the vitreous.
Conclusions: These findings highlight the critical impact of rotational radius on the biomechanical forces exerted within the eye during asymmetrical shaking events, leading to variations in shear stress and IOP that could contribute to unilateral retinal hemorrhage in SBS. These insights reveal the complexity of diagnosing SBS and emphasize the need for careful consideration of the biomechanical evidence in patients presenting with asymmetrical or unilateral retinal hemorrhage
Strip meniscometry in dry eye disease: correlations with standard diagnostic tests
Full text linkBackground: Dry eye disease (DED) is a multifactorial condition with a globally rising prevalence. Diagnosis relies on both symptoms and clinical tests, but these methods demonstrate variability. Strip meniscometry (SMTube) represents a rapid, non-invasive alternative method, but its diagnostic value remains uncertain. We evaluated the correlation of its findings with those of established DED evaluations.
Methods: In this cross-sectional study, we recruited 100 individuals with and without DED (n = 50 each) who visited a tertiary ophthalmology clinic. Diagnosis of DED was based on symptomatology and standard criteria, including a tear break-up time (TBUT) < 5 s or Schirmer test I result < 5 mm, along with an Ocular Surface Disease Index (OSDI) score > 12 and corneal fluorescein staining grade > 1. The exclusion criteria included ocular surgery, allergy, or contact lens use. All participants underwent comprehensive ophthalmic examination and standardized DED assessments (OSDI, tear meniscus height [TMH], SMTube, TBUT, corneal fluorescein staining, and Schirmer test I), conducted in a controlled setting by a single examiner during 9–11 AM to ensure consistency.
Results: The DED group was significantly older (P < 0.05). No significant sex difference was observed between groups (P > 0.05). The OSDI, TMH, SMTube, TBUT, corneal fluorescein staining, and Schirmer test I findings differed significantly (all P < 0.001), while SMTube application discomfort rates were similar between groups (P > 0.05). In the DED group, SMTube correlated moderately with TBUT (r = + 0.41, P < 0.05) and OSDI (r = + 0.43, P < 0.05), while the Schirmer test I correlated weakly with TBUT (r = + 0.34, P < 0.05) and moderately with TMH (r = + 0.52, P < 0.05). In the controls, no significant correlations were observed between tear metrics and SMTube or Schirmer test I findings (all P > 0.05), except for corneal fluorescein staining, which showed a weak negative correlation with SMTube (r = - 0.28, P < 0.05) and a moderate positive correlation with Schirmer test I findings (r = + 0.51, P < 0.05).
Conclusions: SMTube findings differed significantly between the DED and control groups and correlated moderately with those of established diagnostic assessments, particularly the TBUT and OSDI. Unlike Schirmer testing, SMTube results are closely associated with symptom severity, suggesting its utility in reflecting patient-reported discomfort. Given its simplicity, non-invasiveness, and correlation with key clinical indicators, SMTube may serve as a valuable adjunct in the multimodal assessment of DED. However, further studies are needed to establish its diagnostic accuracy and to confirm its clinical utility
Effect of adjunctive scleral buckling on the outcomes of pars plana vitrectomy in retinal detachment repair
Full text linkBackground: Rhegmatogenous retinal detachment (RRD) is a sight-threatening condition requiring prompt surgical repair. Pars plana vitrectomy (PPV) and scleral buckling (SB) are standard surgical interventions for RRD, but the added value of combining these treatments is debated. While PPV offers enhanced visualization and safety in complex RRD cases, SB may provide additional support in selected scenarios. However, the impact on functional outcomes, particularly contrast sensitivity (CS), remains unclear. In this study, we compared the anatomical success and visual function, including best-corrected distance visual acuity (BCDVA) and CS, between patients with primary RRD who were treated with PPV alone and those who were treated with combined PPV+SB.
Methods: This comparative cross-sectional study included consecutive patients with primary RRD who were treated at Madinah Teaching Hospital, Faisalabad, Pakistan, from October 2020 to July 2021. Participants underwent either 25-gauge PPV or 25-gauge PPV combined with SB, based on their clinical indications. BCDVA and CS were measured monocularly under standardized photopic conditions using the logarithm of the minimum angle of resolution (logMAR) visual acuity chart and the Pelli–Robson chart, respectively. Anatomical reattachment status was assessed by dilated fundus examination. Postoperative evaluations of BCDVA, CS, and anatomical reattachment rate were conducted at 1 day, 1 month, and 3 months after treatment.
Results: Ninety eyes of 90 patients with primary RRD were included (PPV: n = 45 eyes; PPV+SB: n = 45 eyes). The PPV group was approximately a decade younger (45.2 vs. 55.4 years, P < 0.05), while sex distribution was similar in both groups (P > 0.05). Anatomical success rates improved over 3 months, reaching 74.0% (n = 33) for PPV versus 62.2% (n = 28) for PPV+SB. PPV achieved significantly better final BCDVA (2.71 vs. 2.84 logMAR, P < 0.05). CS increased significantly over time in the PPV group (P < 0.05) but remained stable in the PPV+SB group (P > 0.05). Although the final CS was significantly higher in the PPV+SB group compared to the PPV group (P < 0.05), this difference reflected the higher baseline values in the former group. Overall, PPV alone provided greater anatomical and functional improvement over 3 months than did the combined surgery.
Conclusions: Standalone PPV achieved higher anatomical success rates and greater visual acuity improvement over 3 months than did combined PPV+SB, while CS gains favored PPV+SB, but largely reflected higher baseline values. Despite mixed evidence in the literature, our findings suggested that PPV alone may suffice for treating selected uncomplicated RRD cases. Further large, randomized studies are needed to clarify the optimal surgical approach across different patient and RRD profiles
Sutureless-dehydrated amniotic membrane (Omnigen®) mounted on contact lens (OmniLenz®) in the treatment of small corneal perforations secondary to exposure keratitis in ICU patients
Full text linkBackground: Exposure keratopathy is a common ocular complication in patients admitted to the intensive care unit (ICU) and may progress from superficial epithelial breakdown to corneal perforation, a vision-threatening emergency requiring timely management. Conventional treatments often necessitate urgent surgery, which is challenging in critically ill individuals who are unsuitable for surgical intervention. OmniLenz®, a customized bandage contact lens pre-lined with vacuum-dried Omnigen® amniotic membrane, offers a practical, non-surgical, bedside alternative for managing small corneal perforations. This study evaluates its clinical outcomes in ICU patients with a small corneal perforation secondary to exposure keratitis.
Methods: This prospective interventional case series included ICU patients with <1 mm corneal perforations secondary to exposure keratitis, recruited over a two-year interval. All patients underwent corneal scraping with culture and sensitivity testing, followed by targeted antimicrobial therapy. A dehydrated amniotic membrane (Omnigen®) was applied beneath a customized bandage contact lens (OmniLenz®) at the bedside under sterile conditions. Patients were examined daily using a portable slit-lamp and followed for one month. The primary outcome was perforation closure, defined by a negative Seidel test and anterior chamber reformation. Secondary outcomes included improvement in epithelial integrity, corneal infiltration, and ciliary injection.
Results: Five ICU patients, aged 18 to 70 years, with < 1 mm corneal perforations secondary to exposure keratitis were included. All eyes demonstrated rapid tectonic recovery following Omnigen®/OmniLenz® device application. Anterior chamber reformation and a negative Seidel test were achieved by day 7 in four patients and by day 10 in one patient. Complete perforation closure occurred in all cases. Marked improvement in keratitis was observed, with full epithelial defect healing and resolution of corneal infiltrates in every patient, followed by stable grade-3 stromal scarring. No neovascularization, device-related adverse events, or treatment complications occurred during the one-month follow-up.
Conclusions: Omnigen®/OmniLenz® device provides a safe, effective, and non-invasive bedside treatment for small corneal perforations secondary to exposure keratitis in critically ill ICU patients. Its use enabled consistent tectonic restoration, rapid perforation closure, and resolution of infection-associated corneal pathology without procedure-related complications. This approach offers a practical alternative to urgent surgical intervention in patients unsuitable for operative care and may serve as a valuable addition to corneal perforation management protocols. Further studies with larger cohorts are needed to evaluate its safety and efficacy in larger perforations and to determine long-term outcomes, including corneal scarring and visual acuity
Structural and microvascular retinal changes in keratoconus: an OCT and OCT angiography study
Full text linkBackground: Keratoconus is increasingly recognized as a condition that may affect not only corneal structure but also posterior segment parameters. This study aimed to evaluate alterations in central macular, choroidal, and peripapillary retinal nerve fiber layer thicknesses, as well as peripapillary vessel densities (VDs), in eyes with keratoconus using optical coherence tomography (OCT) and OCT angiography (OCTA).
Methods: This cross-sectional study included eyes with keratoconus and healthy control eyes. Participants underwent Scheimpflug corneal tomography (Pentacam HR) to assess central corneal thickness (CCT) and keratometry; spectral-domain OCT (SD-OCT) for central macular thickness (CMT), choroidal thickness, and peripapillary retinal nerve fiber layer thickness (RNFLT) measurements; and swept-source OCT angiography (SS-OCTA) to quantify peripapillary VD centrally and across four quadrants at the superficial and deep capillary plexuses (pSCP, pDCP), the peripapillary choriocapillaris (pCC), and the global radial peripapillary capillary plexus (nRPCP).
Results: Eighty-six eyes with keratoconus and 86 age-, sex-, axial-length-, and laterality-matched healthy controls (all P > 0.05) were analyzed. The keratoconus group showed significantly higher spherical equivalent, higher keratometry parameters, higher astigmatism, and lower CCT, along with worse best-corrected distance visual acuity (all P < 0.001). Mean choroidal thickness was significantly greater in eyes with keratoconus (P < 0.001), whereas CMT, global RNFLT, and most quadrant RNFLT measures were comparable (all P > 0.05), except for a thinner inferonasal RNFLT (P < 0.05). Central VD in the pSCP, pDCP, pCC, and global nRPCP were significantly reduced (all P < 0.05). Eyes with keratoconus additionally demonstrated a non-significant (all P > 0.05) but characteristic pattern of regional VD alterations across peripapillary sectors.
Conclusions: Keratoconus was associated with significant microvascular and structural alterations extending beyond the cornea, including reduced VDs in central peripapillary plexuses, localized thinning of inferonasal RNFL, and increased choroidal thickness. These findings support a broader pathophysiologic framework in which keratoconus involves not only anterior corneal remodeling but also measurable changes in blood supply within the macular and lamina cribrosa regions. The characteristic, though nonsignificant, regional VD patterns further underscore potential sectoral vulnerability. Future longitudinal and multimodal imaging studies are warranted to clarify the temporal evolution, clinical relevance, and prognostic utility of these microvascular changes in keratoconus
Evaluating the predictive value of optical coherence tomography angiography metrics and central corneal thickness among glaucoma suspect patients: a comparative cross-sectional study
Full text linkBackground: Glaucoma suspects (GS) exhibit risk factors such as elevated intraocular pressure (IOP), suspicious optic disc or retinal nerve fiber layer (RNFL) findings, or a positive family history, yet their risk of progression varies widely. Optical coherence tomography angiography (OCTA) and central corneal thickness (CCT) have emerged as important markers for detecting early structural and microvascular changes in GS patients. We aimed to estimate the predictive value of OCTA-derived metrics and CCT, and to assess their correlations in GS individuals.
Methods: This comparative cross-sectional study included eyes from GS patients and eyes from age- and sex-matched healthy individuals as a comparison group. All participants underwent a detailed medical history and comprehensive ophthalmologic examination. Investigations included visual field perimetry; optical coherence tomography (OCT) to assess structural optic nerve head parameters, RNFL thickness, and ganglion cell layer (GCL) thickness; OCTA to measure papillary vascular density (PVD) and radial peripapillary capillary density (RPC); and non-contact specular microscopy to determine CCT.
Results: The GS group had a mean age of 36.9 years, with 52.4% male (n = 11). GS eyes showed significantly larger CDR values, reduced rim area, thinner RNFL and GCL, and lower CCT compared with healthy eyes (all P < 0.05). Mean RPC, quadrant-specific RPC values, and mean PVD were significantly reduced in GS individuals (all P < 0.05). CCT showed significant correlations with all vascular metrics and structural parameters (all P < 0.05), except disc area (P > 0.05). In univariate logistic regression all variables were associated with GS status. After multivariate adjustment, only CCT less than or equal to 506 µm remained an independent predictor. Receiver operating characteristic curve analysis showed good diagnostic performance for CCT (area under the curve [AUC] = 0.757) and mean RPC (AUC = 0.820) in identifying GS eyes.
Conclusions: Patients with GS revealed significantly lower structural parameters and vascular metrics compared with the healthy group, and only thin CCT remained an independent predictor of GS status. Both CCT and mean RPC demonstrated good diagnostic performance for identifying GS eyes