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At least 307 records · Page 17Linked to original sources

[Measuring the optic papilla with planimetry and the optic nerve head analyzer in glaucoma and suspected glaucoma. I. Comparison of the 2 measuring methods].

Two-dimensional planimetric measurement of the neuroretinal rim using the method described by Betz has proved to be one of the most objective parameters in evaluating the optic nerve head. Using a three-dimensional stereoscopic measuring procedure (ONHA) described by Cornsweet, the volume of the papillary excavation can be quantified. The two methods were compared in a study involving 67 eyes with confirmed and suspected glaucoma. In agreement with published data, the correlation between the two measuring procedures was good as regards the disk surface (r2 = 0.73), the surface of the excavation (r2 = 0.90), and the cup/disk ratio (r2 = 0.63), although the last-mentioned parameter is calculated differently. While the disk surface as measured by planimetry was significantly greater than with ONHA, the cup surface measurements were almost exactly the same. In contrast to the results of other authors, the measurements of the neuroretinal rim surface correlated poorly (r2 = 0.09). The difference between the two methods in measuring the rim surfaces depends to a great extent on their absolute size and on the cup surface. The different procedures for defining the boundary of the excavation (in planimetry horizontal boundary definition, with the ONHA 150 micrometers below the retinal surface) are considered responsible for this. Advantages and drawbacks of these two clinical measuring methods are discussed. Once the currently excessive variability in the measurements has been reduced, measurement of the excavation volume could prove to be an important parameter for assessing the development of the optic nerve head in confirmed or suspected glaucoma cases.

Adolescent↗

[Lens implantation in glaucoma. Choice of surgery in various glaucoma situations].

Eyes suffering from cataract and glaucoma often present particular situations which require particular surgical approaches. The technique to be chosen mainly depends on the depth of the anterior chamber, on the state of the pupil, and on whether or not a fistulizing operation has already been performed. According to the given situation, different surgical options need to be considered. Five such different situations are presented and relevant surgical procedures are described. Although lens implantation in glaucoma usually proves to be more difficult than in normal cataractous eyes, careful selection of an appropriate surgical technique usually provides a good surgical result.

Anterior Chamber↗

[Intraocular pulse fluctuations in pressure in neovascularization glaucoma in comparison to other forms of glaucoma (results of direct manometric measurements)].

With tonometric and tonographic measurements it is possible to detect and record oscillations which are synchronous with the intraocular pulse. These oscillations decrease with increasing IOP. In contrast, with direct manometric measurement, the amplitude of the intraocular pulse increases with increasing intraocular pressure. Therefore, in order to determine the intraocular pulse amplitude in patients, direct manometric measurements were performed on blind or almost blind eyes. Intraocular pressure was experimentally elevated by injecting fluid through a cannula into the anterior chamber, using a special Guyon syringe. The course of the drop in pressure and the amplitudes of the intraocular pulse were recorded with the Neuhaus apparatus and a light-spot pen. The most striking result was that in neovascular glaucomas there are excessive pulse amplitudes. The question whether the poor prognosis of neovascular glaucoma is associated with these intraocular pulsations is discussed.

Anterior Chamber↗

Fluorescein filling defects of the optic nerve head in normal tension glaucoma, primary open-angle glaucoma, ocular hypertension and healthy controls.

BACKGROUND: To evaluate fluorescein filling defects of the optic nerve head in normal tension glaucoma (NTG), primary open-angle glaucoma (POAG), ocular hypertension (OHT) and controls. METHODS: Forty patients with NTG (mean age 55 +/- 10 years), 40 patients with POAG (mean age 55 +/- 11 years), 40 patients with OHT (mean age 53 +/- 13 years), and 40 age-matched controls (mean age 54 +/- 11 years) were included in a prospective study. Video fluorescein angiograms were performed by means of a scanning laser ophthalmoscope. The extent of absolute filling defects of the optic nerve head was assessed (as a percentage of the disc area) using digital image analysis. Visual fields were tested by automatic static perimetry (Humphrey Field Analyzer, programme 24-2). RESULTS: Absolute filling defects were significantly larger in patients with NTG (12.2 +/- 15.5%) and POAG (12.9 +/- 13.1%) compared to patients with OHT (1.2 +/- 3.6%) and healthy controls (0.1 +/- 0.5%) (p < 0.0001). The area under the receiver operating characteristic (ROC) curve was 0.806 for NTG vs healthy controls, and 0.812 for POAG vs OHT. Absolute filling defects are significantly correlated to the global indices mean deviation (r = -0.63, p < 0.0001), pattern standard deviation (r = 0.61, p < 0.0001), and corrected pattern standard deviation (r = 0.62, p < 0.0001) and significantly correlated to horizontal (r = 0.50, p < 0.0001) and vertical (r = 0.53, p < 0.0001) cup-to-disc-ratios. CONCLUSIONS: Fluorescein filling defects of the optic disc representing capillary dropout are present in NTG and POAG. The extent of these filling defects is correlated to visual field loss and morphological damage. Fluorescein angiography may be useful in the diagnosis and management of NTG and POAG.

Blood Pressure↗

Finger blood flow in patients with low tension glaucoma and primary open-angle glaucoma.

Finger blood flow was studied by means of laser Doppler flowmetry in 12 patients with low tension glaucoma (LTG), 12 patients with primary open-angle glaucoma (POAG) and 12 normal subjects. Baseline flow, flow after immersion of the hand in warm water (+40 degrees C), and flow after exposure of the hand in cold water (+4 degrees C) were measured. Statistically significant differences were not found in each flow between the three groups of the patients (p greater than 0.05). Vasospastic response to warm and cold water was observed in 25% of LTG patients, 17% of POAG patients, and 25% of normal subjects. There was no significant difference between LTG, POAG, and normal subjects in finger blood flow.

Adult↗

Comparison of flow velocity of ophthalmic artery between primary open angle glaucoma and normal tension glaucoma.

AIMS: This study describes an investigation of the relation between the change of intraocular circulatory dynamics and visual field defect between primary open angle glaucoma (POAG) and normal tension glaucoma (NTG). METHODS: The method was to determine the blood flow velocity of the ophthalmic artery using colour Doppler imaging and quantitative peak systolic flow velocity, mean envelope velocity, end diastolic velocity, and Pourcelot resistivity index (RI) were determined. The visual field was examined using program 30-2 of the Humphrey field analyser: the mean deviation (MD) and corrected pattern standard deviation (CPSD) were calculated as indices for visual field defects. There were 25 patients with POAG and 25 patients with NTG. RESULTS: There were no significant differences in all the four indices of the ophthalmic arterial flow and in both of visual field indices between patients with POAG and those with NTG. However, NTG patients alone showed a statistically significant correlation between RI and MD. CONCLUSION: The results suggest the vascular resistance of the ophthalmic artery may be associated with the development of visual field defect in NTG patients.

Blood Flow Velocity↗

Ocular pulse amplitude in patients with open angle glaucoma, normal tension glaucoma, and ocular hypertension.

BACKGROUND/AIM: Intraocular pressure (IOP) is not a fixed constant value but rather has pulsatile components associated with cardiac action. The SmartLens dynamic observing tonometer (odc, Ophthalmic Development Company AG, Zurich, Switzerland) can measure and record simultaneously IOP and ocular pulse amplitude (OPA). It was the aim of this study to evaluate OPA in patients with primary open angle glaucoma (POAG) and high IOP, normal tension glaucoma (NTG), and ocular hypertension (OHT). Furthermore, the authors examined whether there were any correlations with blood pressure. METHODS: 80 subjects were divided into four groups (n=20): 20 patients each with POAG, NTG, and OHT and 20 volunteers without any ocular pathology except for cataract served as a control group. RESULTS: The OPA of the POAG group was not statistically significant different from the control group and from the OHT group. However, OPA was statistically significant lower (p<0.01) in the NTG group compared with all other groups. The OPA of the OHT group was slightly higher compared to the healthy volunteers (p=0.09) and to the POAG patients (p=0.09). No statistically significant correlations with blood pressure could be detected. A logistic regression model was established which identified OPA as an independent risk factor for NTG. CONCLUSIONS: The study demonstrated a decrease in OPA of patients suffering from NTG. Thus, measuring of OPA by the SmartLens dynamic observing tonometer could be helpful in the detection of NTG patients.

Adult↗

Rate of visual field progression in primary open-angle glaucoma and primary angle-closure glaucoma.

To estimate the rate of visual field progression in primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG), we reviewed the medical records of POAG and PACG patients who had a minimum of 5-year longitudinal Goldmann visual field data. I4e and I2e isopters were quantified using grid systems. The rate of change was calculated from the slope of a linear fit to a series of average visual field scores. Twenty-three eyes of POAG patients and 25 of PACG patients were studied. The rate of visual field score change was -2.00 +/- 2.0% per year in the PACG group, and -0.81 +/- 1.0% per year in the POAG group. In these two patient groups, who were on conventional treatment at two referral hospitals, better visual field on initial presentation yielded faster progression in the POAG group, while the higher average of highest intraocular pressure in each year during follow-up was related to faster progression in the PACG group.

Adult↗

Central corneal thickness of normal-tension glaucoma and non-glaucoma populations in ethnic Chinese.

BACKGROUND: The variations in central corneal thickness can influence intraocular pressure measurement. The aim of our study was to determine whether there is a difference in the central corneal thickness between normal-tension glaucoma (NTG) and non-glaucoma populations. METHODS: This prospective study included 33 consecutive patients with NTG and 33 age- and gender-matched healthy subjects as control subjects. The NTG patients were grouped according to the refractive error into group 1 (spherical equivalent +2.5 D approximately -6.0 D) and group 2 (spherical equivalent more than -6.0 D). Central corneal thickness was measured using a ultrasonic pachymeter. The mean central corneal thickness of the NTG and healthy subjects were compared using the student t-test and Nilcoxon Rank Sum test. RESULTS: The mean (+/- SD) central corneal thickness in the healthy subjects and NTG patients was 554.1 (+/- 36.3) and 547.2 (+/- 31.4) microns, respectively. There were no statistical significant differences between these two groups (p=0.411). The median central corneal thickness in the NTG group 1 and group 2 eyes was 545, and 547.5 microns, respectively. The difference was not statistically significant, either (p=0.799). Ten patients (30%) of NTG had high myopia (group 2), and their median age was 38.5 years old, which was significantly younger than that of the group 1 patients (50 years old, p = 0.0003). CONCLUSION: This study indicated that there were no significant differences of central corneal thickness between NTG patients and healthy subjects in our clinic.

Adult↗

[Long-term effects of isopropyl unoprostone monotherapy on intraocular pressure and visual field for normal-tension glaucoma and primary open-angle glaucoma patients].

We retrospectively investigated the long-term effects of isopropyl unoprostone monotherapy on intraocular pressure and visual field for normal-tension glaucoma and primary open-angle glaucoma patients. Among 80 eyes of 49 subjects receiving isopropyl unoprostone monotherapy for 2 years or more, 32 eyes of 32 subjects were analyzed because of the good reliability of their visual acuity and visual field (age, 68.1 +/- 10.1 yrs, follow-up period 47.8 +/- 14.7 months). The mean values of intraocular pressure and visual field indices were compared with baseline data before medication. The visual field changes were also analyzed using the Kaplan-Meier life-table method. The mean intraocular pressure decreased for 4 years from 14.7 +/- 4.3 mmHg (mean +/- SD) at baseline, to 12.7 +/- 4.4mmHg at 4 years. The global index of visual field (mean defect, loss variance) did not change significantly during the 4 years. The accumulative probability of survival was 80.7 +/- 8.0% after 4 years when the endpoint was defined as 3dB progression in mean defect. Isopropyl unoprostone might have the possibility of stabilizing the visual field for a long period of time.

Aged↗

[Influence of refraction on the visual field defects in normal tension glaucoma and primary open angle glaucoma eyes].

The prevalence of normal tension glaucoma (NTG) or primary open angle glaucoma (POAG) is higher in myopic populations and the prevalence of myopia and NTG is relatively high in the Japanese. To evaluate the influence of myopic refractive error on the central visual field defect in NTG eyes, the data obtained from NTG eyes with the Humphrey Visual Field Analyser were analysed in comparison with those from POAG eyes. One hundred and twenty NTG eyes and one hundred and ninety-seven POAG eyes were included. All of them had clear ocular media, but no myopic degeneration in the fundus. Multiple linear regression analysis was performed with a dependent variable of the deviation of the measured threshold value from normal reference value (total deviation, STATPAC) and independent variables of refractive error and mean deviation (STATPAC). Myopic power was found to be positively correlated with the depression in the lower papillo-macular area in both NTG and POAG eyes, and it was negatively correlated with the depression in an upper arcuate area extending just nasal to the fixation only in NTG eyes.

Adult↗

[Visual field defects in normal tension glaucoma and primary open angle glaucoma. Comparison in the late stage of disease].

To compare the visual field defects in the late stage of disease between normal-tension glaucoma (NTG) and primary open angle glaucoma (POAG), measurements taken with the 30-2 and 10-2 threshold program of the Humphrey Visual Field Analyzer were analysed by statistical methods including logistic discriminant analysis. Thirty-four eyes of 34 NTG cases and 63 eyes of 63 POAG cases whose mean deviation (MD) given by STATPAC was equal to or less than -15 dB were included and there was no significant difference in MD, refraction, or age between the two groups. The analyses demonstrated that the upper arcuate area was significantly more depressed in POAG and the inferior Bjerrum area was significantly more depressed in NTG eyes. It was also shown that the lower papillo-macular area was less affected in NTG than in POAG eyes.

Discriminant Analysis↗

Malignant glaucoma induced by miotics postoperatively in open-angle glaucoma.

A case of malignant glaucoma that developed in a patient with primary open-angle glaucoma is described. The malignant course was induced during the immediate postoperative period by the inadvertent use of miotics. The malignant course was successfully managed by osmotic agents, acetazolamide, cycloplegics, mydriatics, and topical steroids.

Female↗

Correlation of asymmetric damage with asymmetric intraocular pressure in normal-tension glaucoma (low-tension glaucoma).

If intraocular pressure plays a role in producing visual field loss in normal-tension glaucoma, there may be a possible benefit from therapeutic efforts to lower the pressure. To see whether pressure plays a role in the production of damage, we studied 14 cases of normal-tension glaucoma with asymmetric intraocular pressure (1- to 6-mm Hg interocular difference in pressure). In 12 of these 14 cases, we found that glaucomatous cupping and field loss (damage) was greater in the eye with higher pressure. This statistically significant correspondence of the higher pressure with the greater visual damage suggests that the level of pressure is a factor in producing optic nerve damage. Other factors also must contribute to account for the few instances in which damage asymmetry did not reflect interocular pressure-difference and for the occurrence of injury at such low levels of pressure in the first place. Although benefit may be expected from therapeutic lowering of pressure in this condition, the degree of benefit, as well as the side effects from treatment required for successful lowering of pressure, remains to be documented by a future clinical trial.

Glaucoma↗

Oculographic automatic perimetry in glaucoma visual field screening: a clinical study--preliminary results in glaucoma patients.

An automatic method for visual field screening using oculographic potentials have been evaluated on 12 eyes of 65 glaucoma patients. The oculographic perimeter records, plotting the central 22 degrees of the visual field, have been compared with Armaly's manual selective perimetry performed by the Goldman Perimeter. In spite of different testing standards of both methods, equivalent pathological field defects were demonstrated in 72% of the eyes following the first examination. Successive plottings with the automatic method improved the results considerably. The method has proved to be a reliable objective automatic test. Further development is suggested through which the procedure might be useful for glaucoma screening in the future.

Adolescent↗

Inter-individual variation in blood supply of the optic nerve head. Its importance in various ischemic disorders of the optic nerve head, and glaucoma, low-tension glaucoma and allied disorders.

There is no one standard pattern of the blood supply of the optic nerve head in all human eyes. There is a marked inter-individual variation in the blood supply of the optic nerve head, and the various factors which produce this include variations in (I) the anatomical pattern of blood supply, (II) the pattern of posterior ciliary artery (PCA) circulation (the main source of blood supply to the optic nerve head), and (III) the blood flow. The variations in the pattern of PCA circulation include the variations in (a) number of PCAs supplying an eye, (b) area of supply to the optic nerve head by each PCA, (c) location of the watershed zones between the various PCAs in relation to the optic nerve head, and (d) blood pressure in various PCAs as well as short PCAs. The variations in the blood flow in the optic nerve head can be produced by changes in (i) the intraocular pressure, (ii) mean blood pressure in the capillaries of the optic nerve head and (iii) peripheral vascular resistance. These variations are discussed in detail. A lack of appreciation of these complexities of the blood supply of the optic nerve head in health and disease is responsible for many of the current problems in the understanding of the role of vascular disturbances in anterior ischemic optic neuropathy, glaucoma, low-tension glaucoma and various ischemic disorders of the optic nerve head.

Adolescent↗