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Paolo Brusini

Publications and source records attributed to Paolo Brusini.

13 recordsLinked to original sources
PubMed2006

Frequency doubling technology perimetry with the Humphrey Matrix 30-2 test.

PURPOSE: To assess the Humphrey Matrix 30-2 test in detecting functional glaucomatous damage. PATIENTS AND METHODS: One eye in each of 60 healthy individuals, 108 patients with ocular hypertension (OHT), and 150 patients with preperimetric (48) or perimetric (102) high-tension primary open-angle glaucoma (POAG) were considered. Visual fields were assessed by the standard automated perimetry (SAP) Humphrey Field Analyzer 30-2, frequency doubling technology (FDT) N-30, and Humphrey Matrix 30-2 tests. Significantly abnormal points in the pattern deviation probability plot, testing time, sensitivity, specificity, and area under the receiver operating characteristic curve of the FDT tests were evaluated. RESULTS: FDT revealed a significantly greater percentage of depressed points than did SAP in OHT and preperimetric POAG eyes. The FDT-N-30 test showed a significantly greater percentage of areas with P < 5% in the OHT, preperimetric POAG, and early POAG groups. The Matrix-30-2 test provided an area under the receiver operating characteristic curve slightly lower than the FDT-N-30 test in the preperimetric POAG group, and significantly greater in the perimetric POAG group. CONCLUSIONS: FDT perimetry appeared more sensitive than SAP in detecting early glaucomatous VF loss. The FDT-N-30 test showed a slightly higher ability to detect early glaucomatous damage in patients at risk for the development of glaucoma, whereas the Matrix-30-2 test provided a more detailed characterization of the glaucomatous VF loss pattern, although it required 30% more time.

Adult↗
PubMed2006

Enhanced Glaucoma Staging System (GSS 2) for classifying functional damage in glaucoma.

PURPOSE: To introduce a new method, derived from the Glaucoma Staging System (GSS), for classifying glaucomatous visual field defects. PATIENTS AND METHODS: Four sample groups composed respectively of 471 (sample #1), 128 (sample #2), 185 (sample #3), and 131 (sample #4) patients with either ocular hypertension or chronic glaucoma were considered. The GSS 2 uses both the MD and CPSD/CLV or PSD/LV perimetric indices to classify visual field defect in 6 stages and in 3 types (generalized, localized, and mixed). The formulas were determined using sample #1. A new borderline stage was created, on the basis of sample #2. The relationship between the PSD/LV and CPSD/CLV values was studied on sample #3 to verify the possibility of using the uncorrected indices instead of the CPSD/CLV. The relationship with other classification methods was studied on sample #4. RESULTS: The GSS 2 showed a strong level of association with the AGIS and the Hodapp-Parrish-Anderson methods in staging defect severity. A good correlation was also found with a classification based on the Bebie curve. CONCLUSIONS: The GSS 2 was able to correctly classify both damage severity and perimetric defect type in the sample studied, using either the corrected or uncorrected visual field indices. It is a quick and easy method, and its formulas can be introduced in any software.

Adult↗
PubMed2006

Comparison of ICare tonometer with Goldmann applanation tonometer in glaucoma patients.

PURPOSE: To compare the intraocular pressure (IOP) readings taken with the new ICare tonometer and with the Goldmann applanation tonometer (GAT) and to evaluate the influence of central corneal thickness (CCT) on the IOP measurements. PATIENTS AND METHODS: One eye of 178 consecutive patients with primary open-angle glaucoma underwent ultrasonic CCT measurement, followed by IOP evaluation with the GAT and with the ICare tonometer. The deviation of ICare readings from GAT values, corrected according to the Doughty and Zaman formula, was calculated and correlated to CCT by a linear regression model. The agreement between the 2 devices was assessed by use of the Bland-Altman method. RESULTS: The average CCT was 552+/-39 mum. The mean IOP and the mean corrected IOP with GAT were 19.4+/-5.4 mm Hg, and 18.5+/-5.7 mm Hg, respectively. The mean ICare IOP reading was 18.4+/-5.2 mm Hg. The deviations of ICare readings from corrected GAT values were highly correlated with CCT values (r=0.63, P<0.01). Linear regression analysis showed that a CCT change of 10 mum resulted in an ICare reading deviation of 0.7 mm Hg. The Bland-Altman scatter-plot showed a reasonable agreement between the 2 tonometers. CONCLUSIONS: The ICare tonometer can be useful in a routine clinical setting. The IOP readings are quite in accordance with those obtained by GAT. The measurements seemed to be influenced by CCT variations, and thus pachymetry should always be taken into consideration.

Adult↗
PubMed2006

Humphrey matrix frequency doubling technology perimetry and optical coherence tomography measurement of the retinal nerve fiber layer thickness in both normal and ocular hypertensive subjects.

PURPOSE: The purpose of this study was to determine by means of the Humphrey Matrix frequency doubling technology (FDT) perimetry and the optical coherence tomography (OCT) retinal nerve fiber layer (RNFL) thickness measurement whether functional and/or structural differences exist between normal and ocular hypertensive (OHT) subjects. PATIENTS AND METHODS: One eye of 60 consecutive normal individuals and 60 OHT subjects was enrolled in this prospective observational comparative case series study. All subjects were examined at either the Ophthalmology Clinic, University of Chieti-Pescara, Chieti, Italy or the Department of Ophthalmology, S. Maria della Misericordia Hospital, Udine, Italy. All subjects underwent a full ophthalmic examination, including visual acuity, slit-lamp biomicroscopy, central corneal thickness ultrasound pachymetry measurement, achromatic automated perimetry, Matrix FDT perimetry, stereoscopic optic nerve head photography, and OCT. Matrix FDT perimetry mean deviation (MD), pattern standard deviation, glaucoma hemifield test, and 12 OCT RNFL thickness parameters were examined. Student t test, Bonferroni correction for multiple comparisons and receiver operator characteristics curve areas (AUROCs) were used to find any discrimination function between healthy and OHT eyes. Sensitivities at 83% and 92% specificities were reported. RESULTS: The FDT MD scores ranged from -1.10 to +3.80 decibels (db) in normal individuals and from -4.75 to +3.20 db in OHT subjects. The comparison between the average MD in the 2 groups showed a statistically significant difference (P=0.024). OCT showed a statistically significant difference between the 2 groups when examining the ratio between the inferior and the superior mean RNFL thickness (P=0.004). For OCT, the parameter with the largest AUROC for discriminating between healthy and hypertensive eyes was the ratio between the mean inferior and superior RNFL thickness (AUROC=0.85, sensitivity=75% at specificity=83%, sensitivity=67% at specificity=92%). For Matrix FDT perimetry, the parameter with the largest AUROC was MD (AUROC=0.78, sensitivity=67% at specificity=83%, sensitivity=58% at specificity=92%). CONCLUSIONS: Our results suggest that OHT eyes having a normal achromatic automated perimetry and a normal clinical disc appearance cannot be differentiated from normal eyes using conventional OCT parameters. When analyzing the ratio between inferior and superior average RNFL thickness, however, a significant difference is evident between healthy and hypertensive eyes. Using Matrix FDT perimetry, a significant difference in MD seems to exist between these 2 groups of eyes. The AUROCs confirm that OCT Iavg/Savg and Matrix FDT MD show the greatest sensitivity and specificity among the examined OCT and Matrix FDT parameters.

Adult↗
PubMed2006

Frequency doubling technology staging system 2.

PURPOSE: To develop and evaluate a new staging system that can specifically be used for the classification of visual field defects with Humphrey Matrix Frequency Doubling 30-2 threshold test. MATERIALS AND METHODS: The new frequency doubling technology staging system version (FDT SS 2) was created on the basis of a total of 200 tests obtained from 34 normal subjects, 67 patients with ocular hypertension (OHT), and 99 with primary open-angle chronic glaucoma (POAG). This system was used to classify defect severity in another group of 54 patients having POAG tested with the Humphrey Matrix 30-2 threshold test. A modified 5-stage classification method of Aulhorn and Karmeyer was taken as the gold standard. The reliability of FDT SS2 in categorizing according to type of defect (generalized, mixed, and localized) was also compared with a clinical classification on the basis of the analysis of probability maps. A control sample of 48 normal subjects was also analyzed. RESULTS: With regards to the glaucomatous patients, 38 of 54 (70.4%) resulted with the same severity classification. All FDT SS2 grades (100%) were within 1 level of the clinical grade. The ability of FDT SS2 to correctly define the type of defect was also quite good (Spearman test: 0.719, P<0.001). In the control group, the FDT SS2 classified 45 of 48 cases as stage 0, giving a specificity of 93.7%. CONCLUSIONS: The new FDT SS2 is able to both stage the severity of functional damage studied with the Humphrey Matrix 30-2 threshold test, and to correctly distinguish between generalized, localized, and mixed defects.

Adult↗
PubMed2006

Visual field testing with the new Humphrey Matrix: a comparison between the FDT N-30 and Matrix N-30-F tests.

PURPOSE: To determine if the N-30-F test with the new Humphrey Matrix instrument is comparable to the traditional frequency-doubling technology (FDT) N-30 test. METHODS: A sample of 47 eyes from 47 patients (five normal subjects, 27 with ocular hypertension and 15 with glaucoma) underwent visual field (VF) testing with standard automated perimetry, and with FDT, using the FDT N-30 program, and the Matrix N-30-F program (using the same 19 tested points, full-threshold strategy, but with an enhanced algorithm to reduce testing time). The plots, mean deviation (MD), pattern standard deviation (PSD), defect locations and test time were compared. RESULTS: The agreement between the two tests was shown to be good, except for subjects with large VF defects, in which greater PSD values were observed with the FDT test, whereas the Matrix test gave a higher MD and number of abnormal test locations in the total deviation plot. A lack of agreement was also found for the number of abnormal test locations on the pattern deviation plot at any VF loss severity level. The test time for the Matrix test was significantly shorter. CONCLUSION: The FDT N-30 and Matrix N-30-F tests proved to be comparable in cases of early to moderate VF defects.

Adult↗
PubMed2006

Comparison between GDx VCC scanning laser polarimetry and Stratus OCT optical coherence tomography in the diagnosis of chronic glaucoma.

PURPOSE: To compare the abilities of scanning laser polarimetry with the variable corneal compensator (GDx VCC) with those of optical coherence tomography (Stratus OCT) in discriminating between healthy and early-to-moderate perimetric glaucomatous eyes. METHODS: A total of 95 glaucomatous patients (mean deviation - 3.7 +/- 3.0 dB, pattern standard deviation 4.5 +/- 2.7 dB) and 62 control subjects underwent imaging by the GDx VCC and Stratus OCT using both optic nerve head (ONH) and retinal nerve fibre layer (RNFL) scan protocols. One eye per patient was considered. Sensitivity at > or = 90% specificity and area under the receiver operating characteristic curve (AROC) were calculated for each GDx VCC and Stratus OCT index. RESULTS: The largest AROCs with Stratus OCT were associated with cup : disc area ratio (0.88) for ONH scan indices, and with average thickness (0.84) for RNFL scan indices. The nerve fibre indicator provided the greatest AROC for the GDx VCC indices (0.85). CONCLUSIONS: Both the GDx VCC and Stratus OCT instruments were shown to be useful in the detection of glaucomatous damage. The best performing indices for the GDx VCC and Stratus OCT with both ONH and RNFL scans gave similar AROCs, showing a moderate sensitivity in early-to-moderate glaucoma patients.

Adult↗
PubMed2003

[Correlation between confocal tomography of the optic nerve (HRT) and the perimetric frequency doubling technology].

PURPOSE AND METHODS: To correlate the five phases of optic nerve (ON) damage staging, as assessed by means of confocal tomography (HRT) with the five stages of visual field, assessed by conventional perimetry (standard automatic perimetry, SAP) and classified in five stages according to the "GLAUCOMA STAGING SYSTEM". The second step was to correlate the same optic nerve staging system with the results of the visual field tested with non-conventional perimetry using the frequency doubling technology (FDT) employing the Humphrey-Zeiss and Welch-Allyn perimeter. The five stages of FDT visual field data evolution were classified according to the new "FDT STAGING SYSTEM". MATERIAL: 58 visual fields of 58 consecutive selected patients with either ocular hypertension or glaucoma with an age-range between 15 and 65 years. METHOD: Visual field examination was performed with conventional (Octopus G2 threshold test) and non-conventional perimetry (FDT N30 threshold test), and the ON was assessed with confocal tomography (Heidelberg Retina Tomograph). RESULTS: In 40 % of the visual fields tested normal with conventional perimetry, non-conventional perimetry (FDT) detected glaucomatous visual field defects corresponding topographically with the optic nerve damage revealed by HRT. CONCLUSIONS: New non-conventional perimetric techniques such as FDT enable the very early detection of visual field defects topographically correlated to optic nerve damage.

Adolescent↗
PubMed2003

Staging of functional damage in glaucoma using frequency doubling technology.

PURPOSE: To evaluate three new approaches for staging severity of glaucomatous visual field defects using frequency doubling technology. PATIENTS AND METHODS: One hundred and four patients with either ocular hypertension or chronic glaucoma were tested with both standard automated perimetry (SAP, 30-2 Humphrey threshold test) and frequency doubling technology (N-30 threshold test). Standard automated perimetry results were classified into four groups (normal tests, early defects, moderate defects, and severe defects) using the Glaucoma Staging System. Frequency doubling technology tests were also classified in four groups using three different approaches: frequency doubling technology probability map analysis, considering the number and location of disturbed points, frequency doubling technology MD and PSD indices, graphed on a two-axis diagram (FDT Staging System), and an abnormality score, based on both the statistical significance and the spatial location of depressed points. A control group of 20 eyes from 20 normal subjects was also tested and classified in the same way. The Cohen Kappa was used to compare the level of agreement between the three frequency doubling technology methods of classification and the glaucoma staging system. RESULTS: Measure of agreement was 0.679 using probability map assessment, 0.793 using the frequency doubling technology staging system, and 0.663 using the abnormality score. The specificity rate was 95% for all three methods. CONCLUSIONS: All the studied approaches were able to correctly stage the glaucomatous functional damage, but the frequency doubling technology staging system was the easiest and quickest method. Moreover, it is the only method that supplies information on the characteristics of the defect, without requiring any other time-consuming procedures.

Chronic Disease↗