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Biomedical subjects

A Tuulonen

Publications and source records attributed to A Tuulonen.

53 records · Page 3Linked to original sources
PubMed1990

Screening for glaucoma with a non-mydriatic fundus camera.

183 first-degree relatives of glaucoma patients were photographed by a technician with non-mydriatic fundus camera in order to study the suitability of wide angle black-and-white fundus photographs in screening for glaucoma. The success rate of photography was 92%. The optic disc and retinal nerve fiber layer abnormalities were evaluated from the photographs by an ophthalmologist. 31 subjects (17%) were referred to further ophthalmological examinations. We found 6 (3%) new glaucomas. In addition, in 6 patients (3%) retinal nerve fiber layer defect was the only abnormality, 5 subjects (3%) showed a hemorrhage and 2 eyes had collateral vessels as a sign of asymptomatic venous stasis change at the optic disc. Only 1 of the 6 (17%) patients with glaucoma would have been found with tonometry alone. The results of this study indicate that non-mydriatic retinal camera is a useful tool in screening for glaucoma.

Adult↗
PubMed1990

Retinal nerve fiber layer abnormalities and high-pass resolution perimetry.

The purpose of this study was to compare high-pass resolution perimetry (HRP) test results with clinical optic disc measurements and semi-quantitative retinal nerve fiber layer (RNFL) estimates. HRP reflects the separation of functional ganglion cells in the retina, and estimates a 'Functional Channel Fraction (FCF)' index that expresses the number of functional ganglion cells relative to average normal. FCF was statistically highly significantly correlated both with the overall and diffuse RNFL score (r = -0.63, P less than 0.0001) and with the neuroretinal rim area (r = 0.44; P less than 0.001). This suggests that HRP is a useful psychophysical test to assess optic nerve integrity in glaucoma.

Adult↗
PubMed1990

Molteno implant surgery in uncontrolled glaucoma.

Molteno implant surgery was performed on 33 eyes of 29 patients with complicated and uncontrolled glaucoma. Average preoperative IOP was 34.0 +/- 8.8 mmHg. After a mean postoperative follow-up period of 18.3 months the IOP was 15.8 +/- 8.3 mmHg. Three patients had an IOP over 22 mmHg. Overall, success rate was 73% with IOP and medication as criteria. In 75% of eyes visual acuity improved or remained within two lines of the preoperative value. The highest success rate was 83% (10 of 12 eyes) in congenital and uveitic glaucoma when both IOP, medication and visual acuity were taken into account. At the end of the study 52% of eyes were controlled without medication. Complications included transient hyphema (21%), flat anterior chamber with hypotony, with or without choroidal detachment (12%), tube touch to lens or cornea (9%), and tube block with vitreous (3%).

Adolescent↗
PubMed1989

Asymptomatic miniocclusions of the optic disc veins in glaucoma.

This study was done to document photographically the evolution of asymptomatic venous stasis changes of the optic disc in glaucoma, estimate their prevalence, and report the clinical findings. Asymptomatic venous miniocclusions were found to develop and occasionally disappear in the optic disc stereophotographs of nine patients with early to moderate glaucoma or ocular hypertension during a mean follow-up of 9 years. In the 1664 photographs examined, a prevalence of 3% was found. None of the patients had a history of retinal vein occlusion or venous stasis retinopathy. Progression of glaucomatous optic disc changes occurred in eight of nine patients. It is possible that asymptomatic miniocclusions are secondary to the changes at the bottom of the optic cup. The miniocclusions, which are easily missed if not looked for, may be an early indicator of glaucomatous progression of the optic disc cupping.

Adult↗
PubMed1989

Laser trabeculoplasty versus medication treatment as primary therapy for glaucoma.

The first-year results of a 5-year prospective randomized follow-up study on 39 glaucoma patients, of whom 19 patients received laser trabeculoplasty and 20 patients medication therapy as primary treatment of their newly detected open-angle glaucoma, are presented. The optic disc changes were recorded by measuring the magnification corrected neuroretinal rim area from stereoscopic optic disc photographs and the visual field changes with an automated perimeter. There were no statistically significant differences in success rate, intraocular pressure reduction, and optic disc or visual field changes between the two groups during the first year of follow-up. In half of the laser treated patients the intraocular pressure was below 22 mmHg without medication treatment. Many patients in the medication group required frequent modifications of their therapy. Laser trabeculoplasty has an important role as primary therapy in glaucoma.

Acetazolamide↗
PubMed1987

A controlled five-year follow-up study of laser trabeculoplasty as primary therapy for open-angle glaucoma.

We followed up 32 eyes of 32 patients with early glaucoma (22 with capsular glaucoma and ten with simple glaucoma) who received laser trabeculoplasty as a primary therapy. These eyes were compared with a matched control group of 32 eyes treated with medication initially. The success rate (intraocular pressure below 22 mm Hg with laser alone or medication alone) at five years was 50% (16 of 32 eyes) in the laser-treated group and 22% (seven of 32 eyes) in the control group (P less than .02). The control group required more modifications of their therapy to control intraocular pressure. The neuroretinal rim area in the control eyes decreased 2.5 times as much as in the laser group (P = .017). Changes in the Friedmann visual fields did not differ significantly between the two groups.

Aged↗
PubMed1987

Optic disk cupping and pallor measurements of patients with a disk hemorrhage.

We evaluated whether the rate of occurrence of glaucomatous disk damage in eyes with an optic disk hemorrhage differed from the rate of occurrence in control eyes. We compared 24 patients with a disk hemorrhage to 24 control patients, who had been matched for diagnosis, disk appearance, and visual fields. Cup volume and cup-to-disk area ratio of the optic disk were measured using the stereophotogrammetric technique, and area of pallor was measured using computerized image analysis. We found that diabetes increased the probability that a patient would have a disk hemorrhage, and that a hemorrhage was associated with progression of glaucomatous disk changes in half of the cases during the mean 3.1-year follow-up period. However, the mean rate of glaucomatous disk damage in patients with a hemorrhage was not different from matched control patients. A disk hemorrhage is a sign of later disk damage, but it does not alter the rate of glaucomatous disk progression.

Eye Hemorrhage↗
PubMed1987

Increase of pallor and fluorescein-filling defects of the optic disc in the follow-up of ocular hypertensives measured by computerized image analysis.

In 24 ocular hypertensive patients, two optic disc fluorescein angiograms were obtained a mean of 3.9 years apart. Using computerized image analysis, we measured the area of pallor and the fluorescein-filling defect area within the disc and the fluorescein circulation parameters representing the filling rates of optic disc, choroid, and retinal vessels. The results indicated that increase in pallor and fluorescein-filling defect areas, as well as a slowed filling rate of the retinal veins, correlated with glaucomatous progression.

Aged↗
PubMed1985

Factors influencing the outcome of laser trabeculoplasty.

We applied multiple stepwise logistic regression analysis to the preoperative data for 153 glaucomatous patients to determine the predictive value of different variables in the outcome of laser trabeculoplasty. One hundred patients had capsular glaucoma and 53 patients had simple glaucoma. Of the 14 preoperative variables included in the analysis, the following best predicted successful outcome of the laser treatment: laser trabeculoplasty performed as primary therapy, low maximum pretreatment intraocular pressure, a diagnosis of capsular glaucoma, no preoperative treatment with pilocarpine, and the operator's experience with the procedure. Age, sex, pigmentation of the angle, the energy level used, the number of burns, the use of preoperative medication other than pilocarpine, and the occurrence of an immediate postoperative increase in intraocular pressure could not be shown to have predictive value as to the outcome of the treatment. Inclusion of postoperative follow-up period did not improve the model.

Adult↗
PubMed1985

The effect of topical indomethacin on acute pressure elevation of laser trabeculoplasty in capsular glaucoma.

In this controlled study 24 phakic patients with capsular glaucoma received a 5-drop loading dose of topical 1.0% indomethacin on the eye to be treated and the fellow eye prior to argon laser trabeculoplasty and post-operatively every 3 h to the end of the day. A control group consisted of 25 phakic eyes with capsular glaucoma which were lasered without indomethacin drops. There were no statistically significant differences between the groups in the post-operative mean intraocular pressures (IOP) and mean corrected changes in IOP immediately and one month after laser treatment. However, no eyes in the indomethacin treated group showed a true pressure rise greater than or equal to 10 mmHg whereas 4 eyes in the control group did (P = 0.1).

Aged↗
PubMed1984

Laser trabeculoplasty as primary therapy in chronic open angle glaucoma.

Sixty-three phakic eyes of 54 patients with early simple (21 eyes) or capsular (42 eyes) glaucoma treated with laser trabeculoplasty (LTP) as the primary therapy were followed retrospectively 12 to 18 months after LTP. In 59 of 63 eyes followed up for 12 months and 46 of 52 eyes followed up for 18 months the intraocular pressure (IOP) was constantly maintained below 22 mmHg with no medication. After a good initial response for 6 to 12 months, 6 eyes required medical therapy because of uncontrolled pressure or progression in the damage of the optic disc or visual fields. The mean pressure reduction of all eyes 18 months after LTP was 28% in simple and 37% in capsular glaucoma. No severe complications were seen. LTP seems to be an effective and safe procedure as the primary therapy for open angle glaucoma.

Adult↗
PubMed1984

Early glaucoma changes in patients with and without an optic disc haemorrhage.

Previous reports have shown that retinal nerve fibre layer (RNFL) observation is useful for detection of early glaucoma changes in patients with optic disc haemorrhage. Since disc haemorrhages are not a factor in all glaucoma patients this study was carried out in order to estimate the value of RNFL observation in patients whose first glaucoma damage developed without a haemorrhage. Evaluation of the retrospective data showed that RNFL defects were the first and only detectable glaucoma changes in 46% of haemorrhagic eyes and 26% of non-haemorrhagic eyes. RNFL observation is useful in the follow-up of ocular hypertensive patients for detection of very early glaucoma changes, regardless of whether the changes develop with or without an optic disc haemorrhage.

Adolescent↗
PubMed1983

Laser trabeculoplasty I in simple and capsular glaucoma.

One hundred and thirty-one phakic eyes of 109 patients with simple (52 eyes) and capsular (79 eyes) glaucoma were retrospectively followed at least for 12 months after laser trabeculoplasty (LTP). LTP was as effective in both groups with a success rate of 65% in simple glaucoma and 68% in capsular glaucoma. In half of the successful responders medication could be tapered. The mean intraocular pressure (IOP) reduction was greater in capsular glaucoma (37%) than in simple glaucoma (22%). The average pressure reduction in successfully treated eyes obtained at one month was essentially the same throughout the entire time of observation with 27 patients followed for 18 months. In 2 eyes IOP increased 32 and 51 mmHg above the base line after LTP; no other severe complications were observed.

Adult↗
PubMed1983

Laser trabeculoplasty II in secondary glaucoma and after failed trabeculectomy in primary open angle glaucoma.

Thirteen eyes of 12 patients with secondary glaucoma and 18 eyes of 18 patients with failed trabeculectomy were retrospectively followed at least for 12 months. The success rate in secondary glaucoma was 23% (3 of 13 eyes). Six eyes were operated, and 2 eyes were re-lasered without success. In the eyes with failed trabeculectomy the success rate was 83% (15 of 18 eyes) with a 37% reduction of the mean intraocular pressure at one year. Medication could be tapered in 9 eyes and no eyes had to be re-operated. Laser trabeculoplasty (LTP) seems to be highly effective in eyes with failed trabeculectomy while eyes with secondary glaucoma have a poor response.

Adolescent↗
PubMedDate not supplied

Intraocular pressure and prevalence of glaucoma in elderly people in Finland: a population-based study.

The distribution of intraocular pressure (IOP) and the prevalence of glaucoma and their correlates were studied in a population-based study of inhabitants aged 70 years or older of three communities in the county of Oulu, Finland. 500 of the 560 eligible subjects (89%) were examined. IOP was measured using applanation tonometry. The diagnosis of glaucoma (or suspected glaucoma) was based on previous history and/or characteristic optic disc changes assessed first by ophthalmoscopy and later by photographic evaluation. No correlation existed between IOP level and age, but IOP was higher in women than in men. Glaucoma occurred in 12% of the participants (60 of 500 persons). In 42 of the 60 persons (8% of the participants) glaucoma had been diagnosed before this survey: non-exfoliative open-angle glaucoma in 15 persons (3.0%), bilateral or unilateral exfoliative open-angle glaucoma in 19 persons (3.8%), and congestive glaucoma in 8 persons (1.6%). In another 18 persons (4% of the participants) new open-angle glaucoma was detected, one third of these were exfoliative. In addition, 6% of the study population had suspected glaucomatous disc changes. In all new glaucoma cases and in all suspected cases the IOP was lower than 25 mmHg. Ocular hypertension (> or = 25 mmHg) without disc changes was found in 2%.

Aged↗
PubMedDate not supplied

Ocular findings in arthrogryposis multiplex congenita.

Close ophthalmological follow-up of a case of arthrogryposis multiplex congenita disclosed a progressing paresis of the lateral recti, a gradual decrease in the corneal blinking reflex by the age of eight weeks and a clear deterioration of the visual evoked responses by the first 16 weeks of life along with preservation of normal ERG responses. These observations are believed to represent the gradual affection of the motor and sensorial cranial nerves occurring post-natally in this case of AMC.

Adult↗