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At least 307 records · Page 17Linked to original sources

Fourteen novel OPA1 mutations in autosomal dominant optic atrophy including two de novo mutations in sporadic optic atrophy.

The OPA1 gene, encoding a dynamin-related GTPase that plays a role in mitochondrial biogenesis, is implicated in most cases of autosomal dominant optic atrophy (ADOA). Sixty-nine pathogenic OPA1 mutations have been reported so far. Most of these are truncating mutations located in the GTPase domain coding region (exons 8-16) and at the 3'-end (exons 27-28). We screened 44 patients with typical ADOA using PCR-sequencing. We also tested 20 sporadic cases of bilateral optic atrophy compatible with ADOA. Of the 18 OPA1 mutations found, 14 have never been previously reported. The novel mutations include one nonsense mutation, 3 missense mutations, 6 deletions, one insertion and 3 exon-skipping mutations. Two of these are de novo mutations, which were found in 2 patients with sporadic optic atrophy. The recurrent c.2708_2711delTTAG mutation was found in 2 patients with a severe congenital presentation of the disease. These results suggest that screening for OPA1 gene mutations may be useful for patients with optic atrophy who have no affected relatives, or when the presentation of the disease is atypical as in the case of early onset optic atrophy.

Alternative Splicing↗

Long echo time STIR sequence MRI of optic nerves in optic neuritis.

MRI of the optic nerves was obtained in 13 patients with acute optic neuritis and 13 with a previous optic neuritis (ON), assessed by clinical features, visual fields and visual evoked potentials. Results of the conventional short tau inversion recovery (STIR) sequence obtained with a short echo time (STE-STIR; 22 ms) were compared with those of a long echo time (LTE-STIR: 80 ms) sequence. The conventional STE-STIR sequence revealed lesions in the optic nerves in 78.5% of acute and 58.8% of previous ON. The LTE-STIR sequence showed abnormalities in 92.8% of acutely symptomatic nerves and 94.1% of nerves with previous ON. The optic nerve lesions appeared significantly longer with the LTE-STIR sequence than with the conventional STE-STIR sequences, in both acute and previous ON.

Adult↗

[Optical coherence tomography in optic pit and associated maculopathy].

BACKGROUND: Of patients with an optic pit 30% develop an associated maculopathy of unknown origin. We report on 8 patients with an optic pit and associated maculopathy evaluated by optical coherence tomography (OCT) for detection of structural retinal changes and indications for the pathogenesis. PATIENTS AND METHODS: A total of 8 patients (mean age 25 years) suffering from an optic pit and associated maculopathy were evaluated by biomicroscopy, fluorescein angiography (FLA) and OCT and the results were compared. RESULTS: Visual acuity was on average 0.5 (0.05-0.8). Funduscopy revealed a macular elevation. In clinically suspected 'pseudo' macular hole, OCT revealed foveal schisis. OCT demonstrated a retinal detachment with a typical convex schisis of the outer retinal layer (n=6), and three patients showed a neurosensory detachment with (n=2) and without (n=1) intraretinal cystoid formation. CONCLUSION: The typical macular schisis pattern in OCT in optic pit with serous maculopathy helps to differentiate this condition from other macular elevations.

Adolescent↗

STRATUS optical coherence tomography in unilateral colobomatous excavation of the optic disc and secondary retinoschisis.

PURPOSE: To report the STRATUS optical coherence tomography (STRATUSOCT) findings in a patient with unilateral coloboma-like excavation of the optic disc without pit but secondary retinoschisis, as well as to discuss the possible involved pathophysiologic mechanisms. METHODS: Observational case report. STRATUSOCT findings in a 66-year-old woman with a coloboma-like excavation of the optic disc without pit but secondary retinoschisis encompassing the macular region, along with evidence of a mild epiretinal membrane superonasal to the disc were evaluated. RESULTS: STRATUSOCT showed signs of a connection between the perineural space and the inner retinal layers on the temporal optic disc border, as well as schisis-like changes extending from the disc to the macula, with cystoid degeneration and two lamellar holes in their nasal portion. CONCLUSION: The use of third generation OCT afforded an enhanced visualization of retinal structures, revealing signs of fluid at several distinct levels, as well as deep and superficial inner breaks apart from the schisis cavity. We are unaware of such previous reports, and could find no reference to them in a computerized search using MEDLINE. In addition, our study supports a common pathomechanism for the development of macular complications in optic pits and colobomas.

Aged↗

Fluorescein leakage of the optic disc in glaucomatous optic neuropathy.

PURPOSE: To identify and quantify the role of capillary leakage of the optic nerve head in digital fluorescein angiography in normal subjects and patients with open-angle glaucoma. METHODS: We conducted a prospective cross-sectional study in the Department of Ophthalmology of the Technical University of Aachen. Thirty patients with primary open-angle glaucoma (POAG) and 30 healthy age-matched subjects were included. Fluorescein angiograms were performed using the scanning laser ophthalmoscope. The fluorescence of the optic nerve head and the surrounding retina (ratio of leakage) was measured using digital imaging analysis in the late phases of the angiogram (9-10 min). RESULTS: The ratio of optic nerve head fluorescence to retinal reference loci was significantly increased (p=0.01) in patients with glaucoma (POAG, 1.38+/-0.34) compared with normal subjects (1.20+/-0.19). Intraocular pressure (p=0.0001), visual field indices (mean deviation, p<0.0001; pattern standard deviation, p<0.0001; corrected pattern standard deviation, p<0.0001), and cup to disc ratios (p=0.02) differed significantly between the groups. Age and systolic and diastolic blood pressure showed no significant differences between groups. CONCLUSION: Fluorescein angiography revealed significantly increased vascular leakage of glaucomatous optic nerve heads. An endothelial disruption and fluorescein leakage might be the result of mechanical stress at the level of the lamina cribrosa and/or a sign of ischemic damage. This measurement approach might enable us to judge the severity of optic nerve head leakage, and it is a potential way to evaluate therapeutic regimens.

Blood-Retinal Barrier↗

Use of pattern electroretinography to differentiate acute optic neuritis from acute anterior ischemic optic neuropathy.

The transient pattern electroretinogram (PERG) was recorded from 16 patients with acute optic neuritis and from 13 patients with acute non-arteritic anterior ischemic optic neuropathy (AION). All patients were tested within 35 days from the the onset of visual symptoms and all had significant central visual field abnormalities in their affected eyes as quantified by automated perimetry. Analysis of the PERGs showed that the amplitude of the N95 peak was abnormally reduced for each eye affected with AION while it remained normal in optic neuritis. No significant alteration in P50 amplitude was observed in either condition. The loss of N95 amplitude in AION was highly correlated with the average depth of visual field loss (in decibels) within a radius of 10 degrees of fixation. These results suggest that PERG could be used early in the course of optic neuropathy to distinguish optic neuritis from AION in those cases for which the diagnosis is still uncertain after the clinical examination.

Adult↗

Segregation of optic axons based on central target: the medial optic tract in Rana pipiens.

The retinofugal projection to the nucleus of Bellonci (nB) was examined in Rana pipiens using both anterograde and retrograde transport of horseradish peroxidase (HRP). Following HRP injection into the nB, retrogradely labeled optic axons formed a discrete fascicle that crossed the lateral margin of the anterior diencephalon. We have designated this branch of the retinofugal pathway as the "medial optic tract." HRP-positive, medial optic tract axons projecting to nB occupied the rostral and most dorsal portion of the optic chiasm. The present findings indicate that within the optic chiasm, retinal axons are sorted according to their final destinations.

Animals↗

Long time echo stir sequence magnetic resonance imaging of optic nerves in optic neuritis.

Magnetic resonance imaging of optic nerves was obtained in 13 patients with acute optic neuritis and in 13 patients with a previous history of optic neuritis (ON), assessed by clinical, visual fields and visual evoked potentials evaluations. Results of the conventional short tau inversion recovery (STIR) sequence obtained with short time echo (STE-STIR: 22 ms) were compared with long time echo (LTE-STIR: 80 ms) sequence. The conventional STE-STIR sequence revealed lesions in 78.5% of acute ON and in 58.8% of optic nerves affected by previous ON. The LTE-STIR sequence was diagnostic in 92.8% of acutely symptomatic nerves, in 94.1% of nerves with previous ON. The calculated length of optic nerve lesions was significantly longer in imaging obtained with the LTE-STIR sequence than with the conventional STE-STIR sequences, both in acute and previous ON.

Adult↗

Evaluation of macular thickness measurements for detection of band atrophy of the optic nerve using optical coherence tomography.

PURPOSE: To evaluate the ability of optical coherence tomography (OCT) macular thickness parameters to differentiate between eyes with band atrophy (BA) of the optic nerve and healthy eyes. DESIGN: Cross-sectional study. PARTICIPANTS: The study included 1 eye of each of 40 consecutive patients with BA of the optic nerve and permanent temporal hemianopic visual field (VF) defects owing to chiasmal compression and 31 age- and gender-matched healthy subjects. METHODS: All patients underwent VF assessment with kinetic Goldmann perimetry and Humphrey 24-2 full-threshold standard automated perimetry (SAP). Macular and retinal nerve fiber layer (RNFL) thickness scans were obtained using the commercially available Stratus OCT. The severity of VF defect in patients with BA was evaluated by the temporal mean defect (TMD), calculated as the average of the 22 values of the temporal total deviation plot of the SAP 24-2 test, excluding the 2 points immediately above and below the blind spot. MAIN OUTCOME MEASURES: Receiver operating characteristic (ROC) curves and sensitivities at fixed specificities were calculated for each parameter. Spearman's rank correlation coefficients were used to evaluate the relationship between RNFL and macular thickness parameters and severity of VF loss as measured by the TMD. RESULTS: The macular thickness parameters related to the nasal hemiretina had the best performance to detect damage in BA eyes. No statistically significant difference (P = 0.19) was found between the ROC curve areas (AUCs) for the best macular thickness parameter (temporal/nasal macular thickness, AUC = 0.96) and the best RNFL parameter (average thickness, AUC = 0.99). Lower values of TMD, indicating more severe VF loss, were associated with lower macular thickness measurements. The highest correlation was observed for the parameter nasal average macular thickness (rho = 0.693, R2 = 48%, P<0.001). CONCLUSION: Eyes with BA of the optic nerve show significant thinning of the retinal thickness on the nasal macular area, which is associated with the severity of VF damage in these eyes. Macular thickness measurements could potentially be used to evaluate the amount of ganglion cell loss in patients with BA of the optic nerve and could prove clinically useful for detection of damage and for monitoring these patients.

Adolescent↗

Comparison of optic nerve head measurements obtained by optical coherence tomography and confocal scanning laser ophthalmoscopy.

PURPOSE: To evaluate the relationship between optic nerve head (ONH) measurements generated by optical coherence tomography (OCT; versions 2 and 3) and confocal scanning laser ophthalmoscopy (CSLO) and to compare the association between OCT and CSLO ONH measurements with glaucoma disease status, as determined by clinical evaluation and perimetry. DESIGN: Cross-sectional study. METHODS: In a prospective study in the glaucoma service of an academic department of ophthalmology, 159 eyes (97 subjects) and 77 eyes (44 subjects) were recruited in two separate periods. All subjects were scanned with a CSLO device. Subjects tested within the first period of recruitment were scanned with OCT version 2 and in the second period with OCT version 3. The main outcome measure was the correlation between automatic and manually defined OCT ONH measurements and the correlation of CSLO and OCT ONH measurements between devices and with glaucoma disease status. RESULTS: A high correlation was found between ONH measurements obtained by the automatic determination of ONH margin and those obtained by manual tracing of the disk margin (r =.93 to.98). Optical coherence tomography and CSLO ONH measurements were highly correlated. Optical coherence tomography-measured mean disk area was significantly larger than that measured by CSLO, as were all other disk size-related parameters. The areas under the receiver operator characteristic (AROC) curves for the associations between CSLO and OCT ONH measurements and clinical diagnosis were found to be similar and in the range of 0.47 to 0.79 for both devices. CONCLUSIONS: Automated OCT ONH measurements correlate highly with those obtained by manual tracing of disk margin. Optical coherence tomography and CSLO ONH analyses are highly correlated and have similar associations with glaucoma disease status.

Cross-Sectional Studies↗

Visual function more than 10 years after optic neuritis: experience of the optic neuritis treatment trial.

PURPOSE: To assess visual function more than 10 years after an episode of optic neuritis in patients enrolled in the Optic Neuritis Treatment Trial. DESIGN: Longitudinal follow-up of a randomized clinical trial. METHODS: Vision testing included measures of visual acuity, contrast sensitivity, and visual field. Quality of life was assessed with the National Eye Institute Visual Function Questionnaire. RESULTS: Examinations were completed on 319 patients. In most patients, visual function test results in the eyes that experienced optic neuritis at study entry ("affected eyes") were normal or only slightly abnormal after 9.9 to 13.7 years. Visual acuity in the affected eyes was >or=20/20 in 74%, 20/25 to 20/40 in 18%, <20/40 to 20/200 in 5%, and <20/200 in 3%. On average, visual function was worse in patients with multiple sclerosis (MS) than in those without MS. Recurrent optic neuritis in either eye occurred in 35% of patients. Such attacks were more frequent in patients with MS (P <.001). The National Eye Institute Visual Function Questionnaire scores were lower when visual acuity was abnormal and when MS was present. CONCLUSIONS: Most patients retained good to excellent vision more than 10 years after an attack of optic neuritis. Recurrences were more frequent in patients with MS.

Adolescent↗

Optical recording system based on a fiber optic image conduit: assessment of microscopic activation patterns in cardiac tissue.

Optical recording of transmembrane voltage changes with the use of potentiometric dyes has opened the possibility of determining spatial patterns of electrical activity in excitable tissues. To follow such activation patterns on the cellular/subcellular level in heart cell cultures, a recording system was developed that features both high spatial resolution (4-200 microm) and high temporal resolution (uncertainty in the determination of delays between fast rising signals of +/-1 micros). Central to the system is a fiber optic image conduit consisting of 379 individual optical fibers. At one end the fibers are fused to form an input window that matches the size of the field of view of the microscope. At the other end, the fibers are loose, permitting a selectable subset to be connected to 80 discrete photodetectors. This design allows the sensitive area of the imager to be adapted to regions of interest in a given preparation, thus making optimal use of the limited number of detectors. Furthermore, by using a second fiber optic imager, individual photodetectors can be assigned to different optical ports, thus providing the means for fast and simultaneous dual-emission wavelength measurements. This feature permitted the elimination of motion artifacts arising from the myocytes without the use of contraction-suppressing drugs.

Action Potentials↗

Baseline features of idiopathic optic neuritis as determined by a multicenter treatment trial in Japan. Optic Neuritis Treatment Trial Multicenter Cooperative Research Group (ONMRG).

BACKGROUND: An optic neuritis treatment trial was conducted at 30 clinical centers in Japan using the same protocol. Patient participation was based on: age range of 14-55 years; acute symptoms indicative of unilateral optic neuritis of unknown or demyelinating origin; visual symptoms of 14-day duration or less; relative afferent pupillary defect in affected eye; and normal or swollen optic disc of affected eye. CASES: Initially, 102 patients qualified for participation; baseline data were obtained for analysis from 70 of these patients. Demographic characteristics of Japanese patients with optic neuritis were clarified and compared with those in a US study. OBSERVATIONS: The incidence of ocular or periocular pain and the presence of periventricular plaques were noted to be lower, and the incidence of disc swelling higher, in the Japanese patients, suggesting racial differences in the characteristics of the disease. Such differences may possibly be related to the lower incidence of multiple sclerosis in Japanese patients. The results of visual function tests were virtually the same in both studies. The nonaffected eyes of more than half the patients showed abnormal mean deviation in Humphrey field analysis, as also noted in the US study. CONCLUSIONS: The baseline clinical features of optic neuritis in the Japanese patients have been defined. Some racial differences in the characteristics of the disease may exist.

Adolescent↗

Reproducibility of evaluation of optic disc change for glaucoma with stereo optic disc photographs.

PURPOSE: To determine the reproducibility of the assessment for glaucomatous change in serial optic disc stereo-slides. DESIGN: Masked interobserver variability study. PARTICIPANTS: Serial optic disc stereo-slides from 40 patients. METHODS: Three independent ophthalmologists evaluated for change a set of two serial 20 degrees optic disc color stereo-slides of 40 patients. This test set was not from European Glaucoma Prevention Study (EGPS) patients. Each observer performed two evaluations at least 30 days apart and was masked from the temporal sequence of the slides and his or her previous evaluation. Each patient was graded as changed or stable by two-out-of-three agreement. A kappa statistic was used to calculate the intra- and interobserver reproducibility as well as the assignment reproducibility (first consensus versus second consensus). The same procedure was followed to test the reproducibility when another experienced ophthalmologist was added to one of the three reading centers. MAIN OUTCOME MEASURES: Reproducibility in evaluating glaucomatous optic disc change. RESULTS: The intraobserver reproducibility (95% confidence interval [CI]) in the evaluation of change ranged between 0.79 (0.45-1.14) and 1.00 (0.69-1.31). The interobserver reproducibility (95% CI) in the evaluation of change ranged between 0.45 (0.15-0.75) and 0.75 (0.44-1.06). The assignment reproducibility (first consensus versus second consensus in the evaluation of change) between the senior EGPS readers was 0.94 (0.63-1.25). The assignment reproducibility when another experienced ophthalmologist replaced one of the readers was 0.94 (0.63-1.25). CONCLUSIONS: The assignment reproducibility of three expert readers looking for glaucomatous change in serial optic disc stereo-slides was excellent. It remained so when one of the three experts was replaced by another experienced reader.

Double-Blind Method↗

VIP fibers in rat optic chiasm and optic nerve arising from the hypothalamus.

This is the first report showing VIP fibers in the optic chiasm and the optic nerves of intact rats. These fibers form a fan-shaped dorso-medial bundle in the optic nerves. After colchicine injection into the vitreous body VIP fibers could be followed farther in the optic nerve toward the eye when compared to intact rats. After removal of eyes (enucleation) the VIP fiber-bundle became more prominent and VIP immunoreactive perikarya appeared in the supraoptic and para ventricular nuclei. When five-nine months after the enucleation Phaseolus vulgaris leucoagglutinin was administered to the paraventricular or supraoptic area, the anterogradely transported tracer was demonstrated in the optic nerve. These observations suggest the existence of a hypothalamic projection to the eye, which is, at least in part, VIP immunoreactive.

Animals↗

Influence of antioxidant enzymes in reduction of optic disc edema in experimental optic neuritis.

Acute experimental allergic optic neuritis was induced in 18 adult strain-13 guinea pigs. The animals were divided into three groups. The first group of six animals received intraperitoneal injections of saline, the second group received superoxide dismutase (SOD), and the third group received catalase, given daily, starting 1 week after encephalogenic myelin sensitization. Morphometric analysis of longitudinal histopathologic sections of the optic nerve head revealed that the animals treated with the antioxidant enzyme catalase had a statistically significant reduction of optic disc edema when compared to the saline-treated group. Although animals treated with SOD had less optic disc swelling than the saline-treated controls, the differences were not statistically significant. These results indicate that detoxification of hydrogen peroxide, released by invading inflammatory cells, can reduce the severity of axonal swelling within the optic nerve head.

Animals↗

Effect of different illumination conditions and ionic environment on the guanylate cyclase activity in retina, optic nerve and optic chiasm of the rat.

Guanylate cyclase is sensitive to changes of light and dark periods in incubated extracts obtained from soluble fractions of the retina, optic nerve and optic chiasm. The changes in guanylate cyclase activity found, about 100-fold between dark and light periods in those tissues, indicate a key role for this enzyme. The results showed that light inhibits strongly the retinal guanylate cyclase activity, while it increases the activity of this enzyme in the optic nerve. A generalized photo-inhibited response of guanylate cyclase was observed in all studied tissues in animals adapted to the dark. This suggests that light could act as a double stimulus gating the central circuit which promotes the hydrolysis of cGMP via cGMP phosphodiesterase-rhodopsin-transducin cascade, and by direct inhibition of the retinal guanylate cyclase activity. Finally, different responses have been observed in the guanylate cyclase activity in relation with the ion exposure depending on the studied tissue. In summary, all indicate an important role for the soluble guanylate cyclase activity in retina, and other tissues involved in the visual process such as optic nerve and optic chiasm, which have not been examined until now.

Adaptation, Physiological↗

Macular thickness reduction in eyes with unilateral optic atrophy detected with optical coherence tomography.

AIMS: To assess the changes in macular and peripapillary retinal nerve fibre layer (RNFL) thickness in eyes with unilateral optic atrophy and to evaluate the relationship between retinal thickness and visual function. METHODS: Enrolled were 22 patients with unilateral optic atrophy. Macular thickness at the divided nine areas and peripapillary RNFL thickness in quadrantic sections were measured by optical coherence tomography. Thickness values in the affected eyes were compared with those in the contralateral unaffected eyes. The correlation of foveal thickness with best-corrected visual acuity (BCVA) was evaluated. The correlation between retinal thickness and the remaining visual field area circumscribed with I-4-e isopter in superior and inferior hemifield was assessed. RESULTS: Macular thinning was observed in all areas (P < 0.001 in each area) other than the fovea (P = 0.068). Peripapillary RNFL thickness decreased in all quadrantic sections (P < 0.001 in each section). The affected to unaffected eye ratio of retinal thickness was more than 0.6 in each area. BCVA did not correlate with foveal thickness (correlation coefficient = 0.094, P = 0.668). Although not statistically significant (P = 0.281, superior hemifield; P = 0.053, inferior hemifield), there was a tendency that eyes with severe visual field loss show more marked retinal thinning. CONCLUSIONS: Macular thinning with the preserved foveal thickness is a hallmark of eyes with optic atrophy. Together with no correlation between foveal thickness and BCVA, this finding would help in differential diagnosis of macular and optic nerve diseases.

Adult↗