PURPOSE: Color Doppler imaging (CDI) is a relatively new technique that allows quantification of blood flow velocity in orbital and ocular vasculature. Despite the numerous clinical studies that have used CDI, repeatability of this technique and agreement between observers have not been documented. METHODS: The authors performed a prospective investigation of the repeatability and agreement between observers on ophthalmic artery blood flow velocity measurements in 35 patients (35 eyes). RESULTS: Results on the estimated error of measurement (variability between repeated readings on the same subject) indicate good repeatability of the measurements; in fact, the measurement variances were only 5.6% for the peak systolic velocity, 11.4% for the end diastolic velocity, and 6.2% for the mean envelope velocity. The statistical analysis of repeatability showed a very narrow 95% confidence interval for both observers. The measurement of agreement between the two observers demonstrated the existence of a good concordance of the measurements taken by each observer on each subject. CONCLUSIONS: Results suggest that CDI is a reliable tool for quantitative assessment of ophthalmic artery blood flow velocity.

Aged↗

PubMed1996

The glaucomas in pseudophakia.

The glaucomas in pseudophakia are not uncommon. Because they can be related to different mechanisms, each case should be evaluated individually. Once glaucoma has been established and medication fails to maintain the intraocular pressure at a safe level, several options are available. As a group, the glaucomas are considered both difficult to manage with medications and also at high risk for failure of filtration surgery. Trabeculectomy adjuvated with anti-metabolites, draining implants, and cyclodestructive procedures are all effective procedures. Although complications and loss of vision as a consequence of glaucoma surgery are not frequent, they were reported by several authors. The likelihood of any given treatment to preserve the quality of life should be discussed with each patient and should be part of the decision-making process. This article reviews studies on the glaucomas in pseudophakia published from October 1994 to September 1995.

Antimetabolites↗

PubMed1992

Photoablative filtration surgery with the excimer laser for primary open-angle glaucoma: a pilot study.

We have performed ab-externo photoablative filtration surgery on 19 patients affected by uncontrolled primary open-angle glaucoma. All cases had wide open angles, were previously treated with argon laser trabeculoplasty and were considered good candidates for trabeculectomy. After topical and peribulbar anesthesia, a limbus-based conjunctival flap was dissected. Photoablation of a rectangular area at the limbus was performed with an argon fluoride excimer laser (193 nm), at 180 mJ x sq cm fluence. The beam was shaped in the appropriate fashion using a custom-made metal mask. Photoablation was continued until aqueous appeared percolating through the juxtacanalicular tissue at the bottom of the crater; a water-tight closure of conjunctiva was then performed. Postoperatively, the anterior chamber reaction was minimal; in no case a flat chamber or choroidal detachment was observed. In 18 of the 19 cases the IOP was significantly lowered, and a filtering bleb developed. Mean preoperative IOP was 26.4 (+/- 7) mmHg. At a median follow-up of 9 months (range 4-15) the IOP is < or = 18 mmHg on no medications in 16 (84%) of the eyes, with a mean value of 13.3 (+/- 6) mmHg. Our short-term results support excimer laser photoablative filtration as a relatively safe and effective procedure for primary open-angle glaucoma.

Aged↗

PubMed1990

Contribution of manual and computerized perimetry to the differential diagnosis of optic neuropathies.

The contribution given by manual perimetry to differential diagnosis of optic neuropathies is described. The advantages and the disadvantages of automated perimetry in respect to manual perimetry are examined. The programs to use for a more precise diagnosis and according to different pathology are also examined. The problems connected to perimetric interpretation are discussed. The value of global indices in evaluating the visual field as well as the importance of statistical program in comparing more than one test performed are reported. The review stresses the usefulness of automated perimetry in early diagnosis and in the follow up of optic nerve diseases.

Diagnosis, Computer-Assisted↗

PubMed1987

Electrophysiological detection of "silent" plaques in the optic pathways.

The incidence of a delayed P100 component of the VEP after checkerboard stimulation in probable or possible multiple sclerosis (MS) without history, signs or symptoms of optic neuritis is not significantly different from that found in other neurological disorders in which the visual system is unaffected. This reduces the diagnostic validity of a delayed P100 as evidence of "silent" plaques in the optic pathway, at least in suspected MS. The use of grating increases the VEP sensitivity in the MS group, but it still leaves more than a 30% chance of error in attributing a delayed P100 to a demyelinating disorder. In this respect the discordant behaviour of checkerboard and grating responses may represent a useful clue.

Adult↗

PubMed1979

The nasal step in normal and glaucomatous visual fields.

We used an original method of kinetic and static analysis to examine the nasal visual field. When the nasal step is less than 4 degrees wide and its depth is less than 0.5 log units it may be merely a physiological sign of the anatomic and functional asymmetry of the retina. Sometimes it is an artifact. The nasal step can also be a glaucomatous defect. In this case it is often an early sign and it is wider than 4 degrees and its depth is greater than 0.5 log units. Because of its typical shape and invariable location it is easy to discover by kinetic perimetry and easy to check by static perimetry. If it is an early glaucomatous defect, it can be reversed. In practice the nasal step is an early and characteristic glaucomatous field defect like the isolated scotomas in the Bjerrum area, and it is easily detected and can be used as a sensitive marker in the follow up of glaucomatous damage.

Glaucoma↗

PubMed1966

[Facial reconstruction].

Explore the source record for details and available documents.

Facial Injuries↗

PubMed1966

[Further observations on the treatment of malignant tumors of the testicle: the dysembryomas].

Explore the source record for details and available documents.

Humans↗

PubMedDate not supplied

Ocular hypotensive effect of sublingual administration of timolol.

PURPOSE: A randomized clinical, trial to assess ocular hypotensive effect of sublingual administration of timolol was performed. PATIENTS AND METHODS: Seventeen (9 male, 8 female; age range 45 to 68 years) with bilateral ocular hypertension were selected for the study. Each patient was evaluated with regard to IOP, arterial blood pressure and heart rate before and after each of the following experimental treatment: unilateral ocular administration of 20 microliters of 0.5% timolol solution; sublingual administration of 20 microliters of 0.5% timolol solution; unilateral ocular administration of 20 microliters of saline solution (placebo); sublingual administration of 20 microliters of saline solution (placebo). The sequence of the treatments and the eye topically treated were randomly chosen. At least four weeks wash-out elapsed between each experimental treatment. RESULTS: Our results showed that sublingual administration of timolol was able to induce a bilateral significant reduction of the IOP. This reduction was not statistically different from that obtained in the eye treated with timolol. A significantly greater reduction of the IOP was obtained by sublingual timolol than in the contralateral eye after unilateral topical administration of timolol solution. No significant modification of arterial blood pressure and heart rate were evidenced after the treatment. CONCLUSIONS: Sublingual administration seems to be a new interesting way for reducing the IOP. Long term studies are required in order to test efficacy and safety of this new treatment.

Administration, Sublingual↗

PubMedDate not supplied

Decreased corneal complications after no-reflux, low-dose 5 fluorouracil subconjunctival injection following trabeculectomy.

In order to reduce corneal complications in 27 glaucomatous eyes that underwent trabeculectomy and postoperative subconjunctival injection of 5-fluorouracil we tried 1) a low-dose administration of 5-fluorouracil and 2) a modified subconjunctival injection technique. The mean total 5-fluorouracil dose was 18.0 +/- 6 mg. A life-table analysis showed a success rate, at 15 months, of 78% (+/- 7 S.E.). Four of the 27 eyes (13%) had corneal complications, limited to punctate keratopathy, with no corneal epithelial defects and/or abrasions. Our study shows that corneal complications decreased when the contact between 5-fluorouracil and the ocular surface was reduced.

Adolescent↗

PubMedDate not supplied

A method for detecting progression in glaucoma patients with deep, localized perimetric defects.

PURPOSE: To define a method for early detection of progressive visual field loss, based on monitoring the "healthy" component of the visual field, in glaucoma patients whose perimetric findings show the co-existence of deep scotomata and normal sensitivity areas. METHODS: We reviewed all the "central 30-2 threshold tests" stored in the oldest of our Humphrey perimeters (a 640 VFA model, in use at the Glaucoma Service of the University Eye Clinic of Genoa since 1986). Only the perimetric findings of glaucoma patients with pure, deep, localized defects were collected for this study. In accordance with several inclusion criteria, we could select only 12 series of consecutive examinations (12 eyes of 12 patients). Each series included 12 to 20 examinations and the observation period ranged from 6 years 2 months to 9 years 4 months. Some pre-defined criteria made it possible to separate the defective component of the visual field from the "healthy" one. Then two independent "mean deviations" were calculated, one related to the "healthy" area and one to the defective one. RESULTS: The mean deviation related to the "healthy" component of the visual field showed very little variation (0.6 to -1.3 dB) in the four series that had no increase in defects, even at the end of the observation period. However, in 7 of the 8 series with a tendency to worsen there was a small inter-test increase (-2.2 to -2.6 dB). This finding anticipated the enlargement of the scotomata, confirmed by subsequent examinations. Only in one series did the increase of the mean deviation related to the "healthy" area coincide in time with the real deterioration of the visual field, rather than anticipating it, but the inter-test interval had by chance been much longer than in the other series. The mean deviation related to the defective areas always showed very large changes in all the series, caused by the high variability of thresholds inside scotomata. This was the explanation for the large variations revealed by the "global" mean deviation too. CONCLUSIONS: Detecting progression is still one of the major problems in evaluating perimetric results. It might be easier to achieve this goal with a method for selectively monitoring light sensitivity inside the "healthy" areas of the visual field.

Disease Progression↗

PubMedDate not supplied

Computerized system for static and kinetic automatic perimetry.

A new automatic perimeter has recently been developed under the supervision of the Perimetry Study Group of the Genoa University Eye Clinic. The main characteristics of this instrument are the following: projected targets; accurate calibration of stimulus size and shape; preliminary measurement of visual acuity and pupillary diameter; automated fixation control based on an optimized television system; static, kinetic, and mixed procedures; screening and diagnostic threshold and suprathreshold strategies; standard and non-standard parameters for stimuli, background, and procedures; user-friendly software; large disk memory for data storage and analysis.

Diagnosis, Computer-Assisted↗

PubMedDate not supplied

Evaluation of amblyopic scotoma by electrophysiological examinations and computerized perimetry.

To evaluate amblyopic scotoma and the most affected neural cells in suppressive phenomena, eight patients with deep amblyopia from strabismus (visual acuity of the amblyopic eye between 4/50 and 2/10) underwent a pattern electroretinogram (PERG), pattern visual evoked potential (VEP), and event-related potential (ERP) from visual stimuli, and computerized perimetry. The results of stimulation of the amblyopic eye, the leading eye and the leading eye penalized by Ryser filters were compared statistically. Computerized perimetry was used to quantify the depth and amplitude of the amblyopic scotoma. All electrophysiological potentials were reduced in amplitude and the implicit times of VEP and ERP were longer when stimulating the amblyopic eye compared to the leading eye. Only in PERG the penalization induced major changes. Our data suggest that the important suppressive phenomena present in the squint amblyopic eye involve not only the occipital cortex, but also the cognitive areas.

Adolescent↗