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At least 181 records · Page 10Linked to original sources

Optical coherence tomography study of tilted optic disk associated with macular detachment.

PURPOSE: To describe the macular findings by optical coherence tomography in both eyes of a patient with tilted optic disk and visual decrease. METHODS: A 35-year-old woman with bilateral tilted optic disk and serous macular detachment was examined by slit-lamp biomicroscopy, fluorescein angiography, indocyanine green angiography and optical coherence tomography (OCT). RESULTS: Fluorescein angiography demonstrated staining of the temporal rim of the staphyloma adjacent to the optic disk and hyperfluorescence of the diffuse pigmentary changes in the papillomacular area. Leakage points and serous macular detachment were not observed. The existing neurosensory detachment at the fovea became evident only by OCT. CONCLUSIONS: The existence of subretinal fluid, which became evident only by OCT, supports the view that OCT could further contribute to the study of the asymptomatic pigmentary lesions of the macula that are present in 11% of eyes with tilted optic disk. The reason for the localized macular detachment remains unclear. Dysfunction of the retinal pigment epithelium (RPE) or leakage of the optic disk staphyloma rim could possibly explain the cause of fluid accumulation in the macula.

Adult↗

Leber hereditary optic neuropathy: mitochondrial mutations and degeneration of the optic nerve.

The predominant manifestation of Leber hereditary optic neuropathy (LHON) is a sudden and usually severe bilateral loss of central vision, most often in the mid-20s, that is due to a degeneration of the ganglion cell layer and optic nerve. LHON is an inherited form of blindness in which a mutation in the mitochondrial genome (mtDNA) is the primary etiological event. More than 95% of the LHON pedigrees in peoples of Northern European descent harbor one of the three mitochondrial mutations at nucleotides 3460, 11,778 and 14,484, although there are other rare primary mutations. In addition, there may be mtDNA mutations that have a secondary etiological role. The penetrance of the optic neuropathy is incomplete in LHON families, and males are affected much more often then females. The incomplete penetrance indicates that secondary etiological factors are necessary for the development of the optic neuropathy, although they are poorly understood at the present time. Several types of studies suggest that optic nerve function in LHON patients is impaired in the presymptomatic phase, probably as a result of a mitochondrial respiratory chain abnormality, although visual acuity is not compromised. In some family members, the presence of secondary etiological factors triggers a wave of optic nerve dysfunction in which vision is lost (the acute phase). Depending upon the particular primary LHON mutation that the patient carries, a variable proportion of the dysfunctional ganglion cells and optic nerve axons die during the atrophic phase, probably through an apoptotic pathway. In 11,778 LHON patients, retinal ganglion cell degeneration occurs almost without exception, and recovery of vision is extremely rare. In contrast, activation of the cell death pathway is less frequent, or less extensive, in 14,484 LHON patients and there is often a substantial recovery of vision.

DNA, Mitochondrial↗

Combined transconjunctival/intranasal endoscopic approach to the optic canal in traumatic optic neuropathy.

Surgical decompression of the optic canal is indicated in patients with traumatic optic neuropathy who fail to respond to corticosteroids. Traditional surgical approaches to the orbital apex have been effective in achieving optic nerve decompression but require either a craniotomy, provide limited exposure with late identification and protection of the optic nerve, or require external incisions. The combined transconjunctival/intranasal endoscopic approach to the optic canal offers sufficient exposure, allows early identification and protection of the optic nerve, provides space for the use of multiple surgical instruments, obviates a craniotomy and external incisions, and can be performed quickly with minimal morbidity. The technique of combined transconjunctival/intranasal endoscopic optic nerve decompression will be described and the experience with nine cases will be presented.

Adolescent↗

Optical coherence tomography disc assessment in optic nerves with peripapillary atrophy.

BACKGROUND AND OBJECTIVE: Optical coherence tomography (OCT) is able to determine the optic disc margin automatically. The aim of this study was to investigate the accuracy of the automatic OCT optic nerve head measurements in the presence of peripapillary atrophy. PATIENTS AND METHODS: This was a cross-sectional, retrospective study. Thirty-one subjects with peripapillary atrophy underwent optic nerve head scanning with OCT version 3. Nineteen of the eyes were classified clinically as having glaucoma, nine had suspected glaucoma, and three were normal. Automatic OCT results were compared with manual tracing results. RESULTS: Significant differences were found between most OCT optic nerve head automated and manual disc assessment parameters; however, good agreement was found between the two methods for all parameters (intraclass correlation, 0.71 to 0.94). Areas under receiver operator characteristics curves for clinical status were similar for all parameters with both methods. CONCLUSION: Automated OCT optic nerve head analysis may be used in the clinical setting in the presence of peripapillary atrophy; however, caution should be used when comparing individual results with population-derived optic nerve head results.

Cross-Sectional Studies↗

Analysis of optic disc change using the heidelberg retina tomograph in an acquired pit of the optic nerve.

A 51-year-old woman diagnosed as having normal-tension glaucoma developed an acquired pit of the optic nerve. The optic disc was viewed by the Heidelberg Retina Tomograph (HRT; Heidelberg Engineering, Heidelberg, Germany) before and after development of an acquired pit of the optic nerve. HRT parameters and cross-sectional images of the optic disc were compared. Maximum cup depth at the site of the acquired pit of the optic nerve increased after development of the acquired pit of the optic nerve (from 1.200 to 2.432 mm). The neuroretinal rim area and volume in the inferotemporal octant were reduced (rim area from 0.070 to 0.010 mm2, rim volume from 0.009 to 0.001 mm3). The morphologic changes in the optic disc were also detected topographically and reflectively.

Diagnostic Techniques, Ophthalmological↗

Integrating sphere effect in whole-bladder wall photodynamic therapy: III. Fluence multiplication, optical penetration and light distribution with an eccentric source for human bladder optical properties.

Whole-bladder-wall (WBW) photodynamic therapy (PDT) is performed using approximately 630 nm light emitted by an isotropic light source centered in the bladder cavity. The phenomenon of an increased fluence rate in this spherical geometry, due to light scattering, is denoted as the integrating sphere effect. The fluence rate and the optical penetration depth depend on a single tissue optical parameter, namely the reduced albedo. The optical properties of (diseased) human bladder tissue, i.e. absorption coefficient, scattering coefficient, anisotropy factor and refractive index, were determined in vitro in the wavelength range of 450-880 nm. The integrating sphere effect and optical penetration depth were calculated with diffusion theory and compared to Monte Carlo (MC) computer simulations using approximately 630 nm optical properties. With increasing albedo, the integrating sphere effect calculated with diffusion approximation is increasingly larger than that found with MC simulations. Calculated and simulated optical penetration depths are in reasonable agreement. The smaller the integrating sphere effect for a given tissue absorption, the larger the optical penetration depth into the bladder wall, as the effective attenuation coefficient decreases. Optical penetration depths up to approximately 7.5 mm (definition dependent) can be responsible for unintended tissue damage beyond the bladder tissue. MC simulations were also performed with an eccentric light source and the uniformity of the light distribution at the bladder wall was assessed. The simulations show that even for a small eccentricity, the extremes in deviation from the mean fluence rate are large. All these results indicate that WBW PDT should be performed with some kind of in situ light dosimetry.

Cystitis↗

Observation of orbital angular momentum transfer between acoustic and optical vortices in optical fiber.

Acousto-optic interaction in optical fiber is examined from the perspective of copropagating optical and acoustic vortex modes. Calculation of the acousto-optic coupling coefficient between different optical modes leads to independent conservation of spin and orbital angular momentum of the interacting photons and phonons. We show that the orbital angular momentum of the acoustic vortex can be transferred to a circularly polarized fundamental optical mode to form a stable optical vortex in the fiber carrying orbital angular momentum. The technique provides a useful way of generating stable optical vortices in the fiber medium.

Journal Article↗

Optical-CT gel-dosimetry. II: Optical artifacts and geometrical distortion.

There is a clear need for technology that enables accurate, high-resolution, three-dimensional (3D) measurement of intricate dose distributions associated with modern radiation treatments. A potential candidate has emerged in the form of water-equivalent "3D gel dosimetry" utilizing optical-computed-tomography (optical-CT). In a previous paper we presented basic physical characterization of an in-house prototype optical-CT scanning system. The present paper builds on that work by investigating sources of optical artifacts and geometric distortion in optical-CT scanning. Improvements in scanner design are described. Correction strategies were developed to compensate for reflection and refraction, imperfections in the water-bath, signal drift, and other effects. Refraction and reflection were identified as the principal factors causing inaccurate reconstruction of absolute attenuation coefficients. A correction specific to a given flask was developed utilizing prescans of the flask when filled with water-bath fluid, thereby isolating the refractive and reflective components for that flask. Residual artifacts were corrected by fitting a theoretical model to the well-behaved portion of these prescans and extrapolating to regions of lost data, enabling reconstruction of absolute optical-CT attenuation coefficients to within 4% of corresponding spectrophotometer values. Needle phantoms are introduced to quantify geometric distortion under a range of conditions. Radial distortion of reconstructed needle positions was reduced to < 0.3 mm (0.27% of the field of view) through adjustment of the water-bath refractive index. Geometric distortion in polymer gel due to radiation-induced refractive index changes was found to be negligible under the conditions examined. The influence of scattered light on reconstructed attenuation coefficients was investigated by repeat optical-CT scans while varying the aperture of a scatter-rejecting collimator. Significant depression of reconstructed attenuation coefficients was observed, particularly under conditions of poor scatter rejection collimation. The general conclusion is that the first-generation optical-CT technique can be made insensitive to geometrical distortion, but can be susceptible to scatter effects. For accurate reconstruction of absolute attenuation coefficients, correction strategies are essential.

Artifacts↗

Simulated optic flow and extrastriate cortex. I. Optic flow versus texture.

A locomoting observer sees a very different visual scene than an observer at rest: images throughout the visual field accelerate and expand, and they follow approximately radial outward paths from a single origin. This so-called optic flow field is presumably used for visual guidance, and it has been suggested that particular areas of visual cortex are specialized for the analysis of optic flow. In the cat, the lateral suprasylvian visual area (LS) is a likely candidate. To test the hypothesis that LS is specialized for analysis of optic flow fields, we recorded cell responses to optic flow displays. Stimulus movies simulated the experience of a cat trotting slowly across an endless plain covered with small balls. In different simulations we varied the size of balls, their organization (randomly or regularly dispersed), and their color (all one gray level, or multiple shades of gray). For each optic flow movie, a "texture" movie composed of the same elements but lacking optic flow cues was tested. In anesthetized cats, > 500 neurons in LS were studied with a variety of movies. Most (70%) of 454 visually responsive cells responded to optic flow movies. Visually responsive cells generally preferred optic flow to texture movies (69% of those responsive to any movie). The direction in which a movie was shown (forward or reverse) was also an important factor. Most cells (68%) strongly preferred forward motion, which corresponded to visual experience during locomotion.

Animals↗

Optical tweezers and fluid characteristics of an optical rotator with slopes on the surface upon which light is incident and a cylindrical body.

The characteristics of the optical trapping force, optical torque, and viscous drag force for a newly proposed cylindrical optical rotator are analyzed. The optical trapping force and torque are evaluated by use of a ray optics model for both parallel and focused laser beam illumination. The drag force is calculated from computational fluid dynamics to be the sum of the components of both the pressure and the shearing stress on all the surfaces of the rotator. We analyze the rotation rate by balancing the optical torque with the drag force. A cylindrical optical rotator is expected to rotate at a high speed because of its highly efficient generation of optical torque and its small viscous drag force.

Journal Article↗

High- and low-risk profiles for the development of multiple sclerosis within 10 years after optic neuritis: experience of the optic neuritis treatment trial.

OBJECTIVE: To identify factors associated with a high and low risk of developing multiple sclerosis after an initial episode of optic neuritis. METHODS: Three hundred eighty-eight patients who experienced acute optic neuritis between July 1, 1988, and June 30, 1991, were followed up prospectively for the development of multiple sclerosis. Consenting patients were reassessed after 10 to 13 years. RESULTS: The 10-year risk of multiple sclerosis was 38% (95% confidence interval, 33%-43%). Patients (160) who had 1 or more typical lesions on the baseline magnetic resonance imaging (MRI) scan of the brain had a 56% risk; those with no lesions (191) had a 22% risk (P<.001, log rank test). Among the patients who had no lesions on MRI, male gender and optic disc swelling were associated with a lower risk of multiple sclerosis, as was the presence of the following atypical features for optic neuritis: no light perception vision; absence of pain; and ophthalmoscopic findings of severe optic disc edema, peripapillary hemorrhages, or retinal exudates. CONCLUSIONS: The 10-year risk of multiple sclerosis following an initial episode of acute optic neuritis is significantly higher if there is a single brain MRI lesion; higher numbers of lesions do not appreciably increase that risk. However, even when brain lesions are seen on MRI, more than 40% of the patients will not develop clinical multiple sclerosis after 10 years. In the absence of MRI lesions, certain demographic and clinical features seem to predict a very low likelihood of developing multiple sclerosis. This natural history information is a critical input for estimating a patient's 10-year multiple sclerosis risk and for weighing the benefit of initiating prophylactic treatment at the time of optic neuritis or other initial demyelinating events in the central nervous system.

Acute Disease↗

Imaging congenital optic disc pits and associated maculopathy using optical coherence tomography.

OBJECTIVE: To elucidate the anatomy of congenital optic disc pits with and without maculopathy using optical coherence tomography. SETTING: All patient were examined, photographed, and scanned at the New York Eye and Ear Infirmary. PATIENTS: Ten eyes of eight consecutive patients with congenital optic disc pits were studied. Three eyes had associated serous macular detachment (group 1), four had evidence of resolved detachment (group 2), and three had no clinical macular pathologic lesion (group 3). METHODS: Optical coherence tomography, a new, noninvasive, noncontact, imaging technology capable of producing cross-sectional images of the retina in vivo with high resolution ( < 17 microns) was used to obtain multiple cross-sectional images of the pit, peripapillary retina, and macula. Ophthalmologic examination and standard fundus photography were performed on all eyes. Fluorescein angiography was performed in eyes that had associated macular detachment. RESULTS: Communication between a schisis cavity or subretinal space and the optic nerve pit was imaged in all eyes in group 1. No such communication could be identified in groups 2 and 3. Cystic degeneration and schisis were imaged in the peripapillary retina, macula, or both in all eyes of groups 1 and 2 and in one patient in group 3. A direct communication between the subretinal space and vitreous cavity could not be identified in any eye. CONCLUSIONS: Schisis formation plays an integral role in the development of serous retinal detachment in the presence of congenital optic disc pits. Our findings are consistent with the theory that the optic disc pit acts as a conduit for fluid flow between the schisis cavity or subretinal space and the subarachnoid space.

Adult↗

A quantitative study of the reinnervation of the goldfish optic tectum following optic nerve crush.

Stereological and quantitative morphometric methods were used to study changes in the stratum fibrosum et griseum superficialis (SFGS), the major retinal target, in optic tectum of goldfish, during regeneration of the optic nerve. Orthograde transport of HRP by optic axons was used to characterize the retinal projection in SFGS. Profiles of HRP-labeled optic terminals contained rounded vesicles, contacted small dendrites, and were distributed uniformly throughout the area of SFGS sampled; labeling density estimates indicate that at least 37% of the total terminal population in SFGS is retinal in origin. Partial denervation of the tectum by optic nerve crush is accompanied by a loss of 40% of the total terminal population in SFGS and by a marked decrease of SFGS thickness. Entry of massive numbers of regenerating optic axons into SFGS begins about 3 weeks postoperatively, about the time that some visual function recovers and produces a marked increase in SFGS thickness which persists for several months postoperatively. The area occupied by regenerating axons and the number of terminals in the tectum only approach preoperative levels 3 months postoperatively. The recovery of normal synaptic number is therefore delayed several months beyond the time of entry of regenerative axonal sprouts. The results indicate that return of synaptic number to normal is temporally associated with the reduction of the excess number of regenerating optic axons and that both these processes are prolonged.

Animals↗

Intrinsic optical signals in the rat optic nerve: role for K(+) uptake via NKCC1 and swelling of astrocytes.

Measurements of extracellular space volume and imaging of intrinsic optical signals (IOSs) have shown that neuronal activity increases light transmittance by causing cellular swelling. However, the cellular mechanisms underlying these volume changes and the contribution of astrocyte swelling to the changes in tissue volume are unclear. In this study, we have investigated IOSs in optic nerves to analyze the mechanisms contributing to these signals in a system consisting of only axons and glial cells. We examined both intact optic nerves and enucleated optic nerves, which contained no axons and consisted primarily of astrocytes. Electrical stimulation of intact optic nerves evoked an increase in light transmittance, which was graded with increasing stimulation frequency and was mimicked by raising extracellular K(+) concentration ([K(+)](o)). The stimulation-induced IOS grew in amplitude and had a time course similar to extracellular space shrinkage. Tetrodotoxin (TTX) blocked the electrically induced but not the high K(+)-induced IOS. In enucleated nerves, light transmittance progressively increased in higher [K(+)](o). The high [K(+)](o)-induced IOSs were reversibly depressed by furosemide and bumetanide, antagonists for Na-K-2Cl cotransport, but were unaltered by TTX. We also used a monoclonal antibody to the NKCC1 form of the Na-K-2Cl cotransporter to show that NKCC1 is expressed in optic nerves as shown in Western blotting and is colocalized in GFAP immunopositive astrocytes. In summary, these results indicated that KCl uptake into astrocytes via an Na-K-2Cl cotransporter during raised [K(+)](o) contributes to the generation of cellular swelling and the intrinsic optical signals.

Action Potentials↗

Optic disk size in ischemic optic neuropathy.

We measured the horizontal diameter, vertical diameter, and area of the optic disk in fellow eyes of patients with unilateral nonarteritic ischemic optic neuropathy and in control eyes without ocular disease. The fellow eyes of patients with anterior ischemic optic neuropathy had a smaller horizontal than vertical disk diameter (P less than .05), a difference not present in controls. Both the horizontal disk diameter and the disk area were significantly smaller in fellow eyes of patients with anterior ischemic optic neuropathy than in controls (P less than .05). There was no statistical difference in the vertical disk diameters between the two groups. Our findings suggest that a small disk area along with a horizontal shortening of the scleral canal can lead to crowding of optic nerve fibers, predisposing to a circulatory compromise of the optic nerve head in non-arteritic anterior ischemic optic neuropathy.

Adult↗

Leber hereditary optic neuropathy: respiratory chain dysfunction and degeneration of the optic nerve.

Leber hereditary optic neuropathy (LHON) is an inherited form of bilateral optic atrophy in which the primary etiological event is a mutation in the mitochondrial genome. The optic neuropathy involves a loss of central vision due to degeneration of the retinal ganglion cells and optic nerve axons that subserve central vision. The primary mitochondrial mutation is necessary, but not sufficient, for manifestation of the optic neuropathy and secondary genetic and/or epigenetic risk factors are also involved, although they are poorly defined at the present time. There is broad agreement that mutations at nucleotides 3460, 11,778 and 14,484 are primary LHON mutations, but there may also be other rare primary mutations. It appears that the three primary LHON mutations are associated with respiratory chain dysfunction, but the derangement may be relatively subtle. There is also debate on whether there are mitochondrial mutations that have a secondary etiological or pathogenic role in LHON. The specific pattern of neurodegeneration in LHON may arise from a 'chokepoint' in the optic nerve in the region of the nerve head and lamina cribosa and which may be more severe in those LHON family members who become visually affected. It is hypothesized that the respiratory chain dysfunction leads to axoplasmic stasis and swelling, thereby blocking ganglion cell function and causing loss of vision. In some LHON patients, this loss of function is reversible in a substantial number of ganglion cells, but in others, a cell death pathway (probably apoptotic) is activated with subsequent extensive degeneration of the retinal ganglion cell layer and optic nerve.

Cell Death↗

Visual field and optic disc progression in patients with different types of optic disc damage: a longitudinal prospective study.

OBJECTIVE: To evaluate the incidence of visual field and optic disc progression in glaucoma patients with distinct patterns of optic disc damage. DESIGN: Prospective, observational case series. PARTICIPANTS: One hundred five patients with open-angle glaucoma. METHODS: Baseline optic disc photographs of 105 study eyes of 105 patients were reviewed by 2 masked observers and classified according to patterns of disc damage into the following categories: focal, myopic, senile sclerotic, and generalized disc damage. Patients were followed up every 6 months with standard automated perimetry (SAP), high-pass resolution perimetry (HRP), and scanning laser tomography (SLT) with the Heidelberg Retina Tomograph. MAIN OUTCOME MEASURES: Visual field (SAP and HRP) and optic disc (SLT) progression were determined according to predefined criteria. RESULTS: Twenty-four eyes were classified into the focal, 8 into the myopic, 12 into the senile sclerotic, and 28 into the generalized group. Eyes from 33 patients could not be classified by the observers into any of these groups and were excluded from further analysis. Although intraocular pressure during follow-up was similar among the four groups, some differences in frequency of progression were observed. Patients with senile sclerotic discs had the lowest rates of visual field progression (both with SAP and HRP) and optic disc progression, although the differences were significant only for optic disc progression (P = 0.05). CONCLUSIONS: Patients with senile sclerotic discs showed a tendency towards less visual field and optic disc progression when compared with patients with other types of disc damage.

Aged↗

The treatment of traumatic optic neuropathy: the International Optic Nerve Trauma Study.

OBJECTIVE: To compare the visual outcome of traumatic optic neuropathy treated with corticosteroids, treated with optic canal decompression surgery, or observed without treatment. DESIGN: Comparative nonrandomized interventional study with concurrent treatment groups. PARTICIPANTS: A total of 133 patients with traumatic optic neuropathy (127 unilateral and 6 bilateral) who had an initial visual assessment within 3 days of injury. At least 1 month of follow-up was required for inclusion in the primary analysis. INTERVENTIONS: On the basis of treatment received within 7 days of injury, patients with unilateral injuries were categorized as being in one of three treatment groups: untreated (n = 9), corticosteroid (n = 85), or optic canal decompression surgery (n = 33). MAIN OUTCOME MEASURE: Visual acuity. RESULTS: Visual acuity increased by > or = 3 lines in 32% of the surgery group, 57% of the untreated group, and 52% of the steroid group (P = 0.22). The surgery group had more patients whose initial vision was no light perception. After adjustment for the baseline visual acuity, there were no significant differences between any of the treatment groups. There was no indication that the dosage or timing of corticosteroid treatment or the timing of surgery was associated with an increased probability of visual improvement. CONCLUSIONS: No clear benefit was found for either corticosteroid therapy or optic canal decompression surgery. The number of patients studied was sufficient to rule out major effects in the treatment groups, although clinically relevant effects in specific subgroups could have been missed. These results and the existing literature provide sufficient evidence to conclude that neither corticosteroids nor optic canal surgery should be considered the standard of care for patients with traumatic optic neuropathy. It is therefore clinically reasonable to decide to treat or not treat on an individual patient basis.

Adult↗