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RM Vessani, HV Tran, H Ishikawa, C Tello, JM Liebmann, R Ritch; Ultrasound Biomicroscopic (UBM) Assessment of Zonular Appearance in Exfoliation Syndrome (XFS) . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1076.
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Purpose: To assess zonular appearance in XFS using a UBM scoring system. Methods: Normal and XFS eyes were enrolled. Following pupillary dilation, XFS patients were clinically classified into 3 stages (early, moderate, or severe) by a single examiner (RR). Cross-sectional zonular UBM images were obtained circumferentially at 8 evenly spaced locations. Five experienced UBM observers evaluated the images using a standardized scoring system (0: none, 1: early, 2: moderate, 3: severe) based on the zonular appearance. Results: 44 eyes (11 normal, 10 early, 10 moderate, and 13 severe XFS eyes) were enrolled (mean age, 69.4 ± 9.9 (SD) yrs.; range, 50 to 87 yrs.). UBM scores of all observers were significantly different between the normal/early and the moderate/severe group (p<0.001, t-Test). With discriminant analysis, the predicted XFS stage showed moderate agreement with the clinical staging (all kappa≷0.61, area under ROC curve≷0.86). Conclusion: UBM can detect significant zonular involvement in XFS, and may be useful in preoperative planning. This may be important in eyes with posterior synechiae in which a diagnosis of XFS cannot be determined on slit-lamp examination.
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