To evaluate the gender-related differences in demographic and ocular biometric trends in a defined population presenting for consultation within the Italian public health system and to collect data of several ocular parameters at different stages of life, highlighting the differences between females and males. Patients and Methods: In this retrospective study, keratometry, corneal astigmatism, and axial eye length of 729 patients (729 eyes; mean age: 58±21 years; range: 18-96 years) were evaluated using partial coherence interferometry. Statistical evaluation was performed utilizing a paired t-test and R 2 analysis. Results: In females (396 eyes of 396 patients), mean keratometry ranged between 40.59-47.78 D (44.27±1.36 D), corneal astigmatism ranged between 0-3.82 D (1.13±0.74 D), and axial length ranged between 20.5-31.32 mm (24.07±1.74 mm). In males (333 eyes of 333 patients), mean keratometry ranged between 38.5-46.95 D (43.54±1.35 D; p<0.001), corneal astigmatism ranged between 0.1-3.97 D (1.15±0.79; p=0.75), and axial length ranged between 20.41-31.21 mm (24.57±1.78 mm; p<0.001). Both genders presented a shorter axial length in advanced age. Elderly males presented a higher percentage of against-therule astigmatism. Conclusion: Females may have steeper corneas and shorter eyes. A trend toward axial length reduction with age was observed in both genders. This finding is probably due to the difference in growth between generations, as the new ones have an higher size than the old ones.

PurposeTo check if optical biometry can detect eventual corneal power (Km) and axial length (AL) cataract surgery-related changes that could influence the refractive outcome.MethodsPatients scheduled for sequential bilateral cataract surgery between January and September 2017 were included in the present study. One hundred ninety-six eyes of 98 patients (48 males) were selected. Before surgery of the first eye, patients underwent a complete ophthalmic examination, including IOLMaster biometry; the same evaluations were repeated in both eyes the day before the fellow eye cataract surgery, performed at least 2 months after the first one. The differences in Km and AL in the first operated eyes were evaluated, and the fellow eyes were used as controls.ResultsKm differences in the operated eyes ranged from −1.97 to +0.98 diopter (D) (mean = −0.02 ± 0.36 D) (P = 0.89); in the nonoperated eyes they ranged from −0.6 to +0.7 D (mean = 0 ± 0.20 D) (P = 0.91). The AL differences (pseudophakic option) in the operated eyes ranged from −0.35 to +0.15 mm (mean = −0.10 ± 0.08 mm) (P < 0.001); with the aphakic option they ranged from −0.24 to + 0.26 mm (mean = 0.01 ± 0.08 mm) (P= 0.38). In the nonoperated eyes, the AL differences ranged from −0.04 to +0.06 mm (mean= 0 ± 0.02 mm) (P = 0.02).ConclusionsThe modern phaco-technique seems not to induce changes in Km and AL, supporting the hypothesis that the differences in AL are due to an incorrect estimation in pseudophakic eyes.Translational RelevanceThe results of our study may improve the AL measurements in pseudophakic eyes.

In recent years, ultrasonographic measurement of the optic nerve sheath diameter (ONSD) has been widely used to identify the presence of increased intracranial pressure (ICP). Intracranial hypertension is a life-threatening condition that can be caused by various neurological and non-neurological disorders, and it is associated to poor clinical results. Ultrasonography could be used to qualitatively and efficiently detect ICP increases, but to reach this purpose, clear cut-off values are mandatory. The aim of this review is to provide a wide overview of the most important scientific publications on optic nerve ultrasound normal values assessment published in the last 30 years. A total of 42 articles selected from PubMed medical database was included in this review. Our analysis showed that ocular ultrasonography is considered to be a valuable diagnostic tool, especially when intracranial hypertension is suspected, but unfortunately this research provided conflicting results that could be due to the different ultrasound protocols. This is mainly caused by the use of B scan alone, which presents several limitations. The use of B-scan coupled with the standardized A-scan approach could give more accurate, and reliable ultrasound evaluation, assuring higher data objectivity.

In this letter to the Editor, we would like to comment on the article by Betcher et al., concerning the possibility of teaching military trainees to obtain accurate optic nerve sheath diameter measurements, using a brief didactic and a hands-on training session. In particular, this letter notes the importance of the measurement of optic nerve sheath diameter in detecting the eventual elevated intracranial pressure following traumatic brain injury, highlights several limitations in the use of B-scan for such a purpose and suggests a more accurate evaluation with the standardized A-scan.

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