278 Optometry, Vol 81, No 6, June 2010

Conclusion: Optic nerve head drusen appear in approxi-mately 1% of the population. In patients with optic nervehead drusen, studies have suggested that OCT can beused to differentially diagnose optic nerve head drusenfrom true papilledema by assessing the thickness of the per-ipapillary nerve fiber layer. However, in this case study, ourpatient presented with ONHD and increased peripapillarynerve fiber layer thickness. Although no conclusions canbe drawn from the presentation of the nerve fiber layerthickness of only 1 patient, the findings suggest that furtherinvestigation is warranted to verify the commonly held cor-relation between ONHD and nerve fiber layer thickness.Until further studies have been performed, it is recommen-ded that other clinical tests are performed to differentiateONHD from papilledema.

Poster 17

Clinical Management of Retinitis Pigmentosa WithSpectral Domain OCT

Todd Peabody, O.D., and Adam Russ, O.D., IndianaUniversity School of Optometry, Bloomington, Indiana

Background: Retinitis pigmentosa (RP) refers to a group ofhereditary conditions characterized by progressive visualfield loss, night blindness, and abnormal electroretinograms(ERG). RP is a slowly progressive disease that primarily af-fects the photoreceptors and retinal pigment epithelium(RPE). Diagnosis is usually based on characteristic findingsand examination. Cystoid macular edema (CME) is aknown complication in RP, occurring in up to 70% of pa-tients. In the past, CME was monitored exclusively usingfluorescein angiography (FA), but optical coherence tomog-raphy (OCT), and more recently spectral domain OCT (SDOCT), has played a more prominent role in the monitoringof CME. Additionally, high-resolution OCT has beenshown to be useful in monitoring foveal photoreceptor de-generation via thickness measurements termed FOSPET(foveal outer segment/pigment epithelium thickness).FOSPET has been deemed a probable predictor of visualacuity in RP.Case Summary: A 30-year-old Sri Lankan man presentedto Atwater Eye Care Center with a chief complaint ofblurry vision. Unaided visual acuities were 20/20- OD,20/25 OS, and 20/20 OU. Best-corrected visual acuitieswere 20/20 OD, OS, OU. A dilated fundus examinationfound bone-spicule pigmentation in approximately 270�

of the retina. Humphrey Visual Field 30-2 thresholdand Full Field 81 screener showed constriction withinthe central 30� corresponding to the bone-spicule pig-mentation. An ERG was performed, which yielded re-sults consistent with RP. Baseline Spectralis spectraldomain OCT imaging was performed on the maculaeOU and was unremarkable. The patient was carefullycounseled, was referred for low vision services, and isbeing monitored in our clinic with annual examinationsincluding SD OCT.

Conclusion: Although the loss of peripheral vision in reti-nitis pigmentosa is not preventable, some central visionloss, if attributed to CME, can be treated. New studieshave proven the benefit of Spectral Domain OCT in themanagement of RP via the identification and monitoringof CME and foveal photoreceptor degeneration. The pur-pose of this report is to educate the practitioner’s awarenessof the potential benefit of using the SD OCT in the manage-ment of retinitis pigmentosa patients.

Poster 18

Assessment of Macular Pigment Optical Density andDistribution in an International Population: A PilotStudy Utilizing Autofluorescence Imaging Technology

Brandon Lewis, Ph.D., Heather Richardson, Robert Stomp,Kelli Herrlinger, Richard Roberts, Ph.D., andZoraida DeFreitas, Ph.D., Kemin Health, L.C., Des Moines,Iowa

Background: Lutein and zeaxanthin are the primary carot-enoids deposited in the macula where they are thought toact as antioxidants and filter blue wavelengths of light.Their concentration in this area correlates to the macularpigment optical density (MPOD). Interest in MPOD andhow its distribution in the macula affects eye health isgrowing with the development of technologies that can ac-curately quantify and map the distribution of the macularpigment. This study investigated the correlations amongMPOD, MPOD distribution, and demographic variables ina geographically diverse population of subjects.Methods: MPOD and MPOD distributions were measured byautofluorescence imaging, and demographic data were col-lected in an international population (n5102). MPOD mea-surement and distributions were performed and definedaccording to Sharifzadeh et al. J Opt Soc Am A 2006; 23:2373. Correlations were determined between MPOD andage, race, sex, BMI, and MPOD distribution. Univariate anal-ysis of the data was performed, and post-hoc analysis by t-test,1-way ANOVA, or 2-way ANOVA were performed as appro-priate. Statistical significance was defined as p,0.05.Results: MPOD was negatively correlated with age(r520.43, p,0.001). MPOD was 31% lower in subjectswith a BMI .25 compared with subjects with BMI,25(0.22 6 0.12 vs 0.32 6 0.19, respectively, p50.004). Bygender, MPOD was significantly greater in women thanmen (0.33 6 0.17 vs 0.23 6 0.14, respectively,p50.001). Whites and Hispanics had significantly greaterMPOD than Asians; however, 65% of Asians were self-re-ported as Indian. MPOD distribution fell primarily into 3categories: B - central MPOD with lower eccentricMPOD (41%), C - sharp, central MPOD (22%), and D -central MPOD surrounded by lower MPOD as a ring struc-ture (31%). Average MPOD was significantly greater insubjects with an MPOD distribution of C than either B orD (0.44 6 0.15, 0.25 6 0.14, and 0.19 60.11,respectively).

Poster Presentations 279

Conclusions: This pilot study confirmed previous findingsthat MPOD may decrease with age and be affected bysex as well as BMI and race. This study also showed thatMPOD distribution varies within the population and mayhave an impact on MPOD measurement.

Poster 19

The Use of Optical Coherence Tomography in DiagnosingSolar Maculopathy

Christopher L. Suhr, O.D., MPH, and Angela Sellers, O.D.,Department of Veterans Affairs Outpatient Clinic, New PortRichey, Florida

Background: It is known that direct viewing of the sun causesvisual disturbances. Other solar-induced cases have been re-ported in military recruits who hope to be discharged fromservice, schizophrenic patients, sunbathers, those who sungaze during religious rituals, and in persons under the influ-ence of psychogenic drugs such as LSD. With the advent ofoptical coherence tomography (OCT) we have been able tovisualize the resultant cellular damage. The following casereport is of a Vietnam War veteran who gazed at the sun re-peatedly in hopes of being sent home from the war. Hiscase reveals that damage from long-term, daily sun gazingcan cause permanent damage to the retina.Case Summary: A 63-year-old man presented to our clinicfor a comprehensive eye examination with no vision com-plaints, and best-corrected visual acuities were 20/25-2OD and 20/25 OS. Dilated fundus examination found circi-nate changes (faint bull’s eye appearance) in the macula ofboth eyes. OCT imaging (Topcon 3D OCT 1000) of eacheye revealed the obliteration of a portion of the retinal pig-mented epithelium (RPE) giving a pseudocysticlike appear-ance. The patient stated that he looked at the sun throughhis fist, which simulated a pinhole and did so daily duringhis 9-month tour in Vietnam.Conclusion: The damage caused to the retina by sun gazingcan be acute or permanent. As with our patient, prolonged pe-riods of daily sun gazing may cause irreversible damage to themacula. The advent of the OCT has allowed for the visualiza-tion of this retinal damage at a cellular level. The use of OCTcannot only aid in diagnosing solar maculopathy, but may alsobe useful in monitoring the healing process in acute cases.

Poster 20

Doc, There Is a Large Gunk in My Eye! A Case Report ofConjunctival Papilloma

So-Yeon Sharon Lee, O.D., Southern College of Optometry,Memphis, Tennessee

Background: Conjunctival papilloma, a benign epitheliallesion, can occur on the palpebral or bulbar conjuncti-vae. It can be flat or pedunculated, appear in single ormultiple numbers, and is often associated with humanpapillomavirus.

Case Summary: A 55-year-old black male patient presents toclinic for his first eye examination for near blur. Chair skill re-sults were unremarkable, and vision was best corrected to 20/20 at distance and near with a minor spectacle prescription.During slit lamp examination, lower lid eversion of the righteye found a large conjunctival mass that ‘‘spilled out’’ overthe lid. This soft, fleshy mass was approximately 5 mm verti-cal x 12 mm horizontal in size. It had multiple feeder vesselsnear the base and corkscrew vascular loops on the surface. Itwas attached to lower bulbar conjunctiva by a short stalk.Upon questioning the patient reports he first noticed thismass about a year ago and has been pushing it back underhis eyelid when it spills out occasionally. Other anterior-seg-ment ocular health findings include mild corneal guttata OUwith a small corneal scar OD and mild senile cataracts OU.Posterior segment findings were unremarkable in both eyes.We referred the patient to ophthalmology with an initial diag-nosis of conjunctival papilloma to confirm the diagnosis with/without biopsy to rule out melanoma secondary to appear-ance. The ophthalmologist confirmed this mass as large con-junctival papilloma.Conclusion: We frequently see benign conjunctival lesionssuch as pinguecula, pterygiums, and papilloma on conjunctivaof our patients. However, it is important to differentiate thecommon, benign lesions from the rare but more serious lesionssuch as squamous cell carcinoma or malignant melanoma.

Poster 21

Oasys Versus Extreme H2O in Dry Eye Patients

Thomas P. Kislan, O.D., Stroudsburg Eye Specialists,Stroudsburg, Pennsylvania

Purpose: Contact lens wearers commonly develop ocularsurface dryness and decreased surface wetting. Practi-tioners can change lenses or add treatment to improvetear stability. This study compares silicone hydrogel lenses(Oasys) to a hydrogel lens (ExtremeH20 X-tra 59%) in dryeye contact lens patients.Method: Forty-seven patients were selected based on dry eyehistory. Twenty-five patients were fit with the hydrogel (Ex-treme H2O Xtra 59%) OD and silicone hydrogel (Oasys) OS,and 22 patients were fit with the Oasys OD and Extreme OS.Schirmer and TBUT were performed at baseline, 2 weeks,1 and 4 months after various treatments. At the study end, pa-tients were asked about the most comfortable lens, the pre-ferred lens that keeps moisture at the end of the day, andthe preferred lens to be worn full time. These groups were fur-ther divided and randomized to receive a placebo treatment orRestasis as a secondary methodology.Results: The forced choice preference for the most com-fortable lens at the end of the study was the Extreme H20(34 vs. 13 P,0.001). There was a significant number ofsubjects (31) who preferred to wear the Extreme H2059% lens on a full time basis versus 10 who preferredOasys and 6 who preferred neither (P50.001). The subjec-tive responses were confirmed by the objective data from