[The extent of nasal and temporal papillary pallor of simple optic disk atrophy and the correlation between nasal atrophy and a diminished visual field].
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Measurement of four parameters, namely brightness of the unaffected optic disc, brightness of the optic disc under artificially elevated eye pressure, baseline eye pressure, and systolic blood pressure, gives the possibility of discerning glaucomatous eyes from healthy ones, with an accuracy of about 90%. Measuring eye pressure and systolic blood pressure is very simple. If measurement of the optical density could be simplified, an additional practical test for glaucoma could be developed.
The authors first described the method of fundus color measurement by visual comparison in 1974, and by its use the clinician is able to follow the development of optic disc atrophy or diseases in which hyperemia is seen by using quantitatively defined color coordinates. Color coordinates of the nasal and temporal papillary halves in 100 normal eyes are demonstrated in the x and y plane. The palor range in atrophy is in the upper left part of the scale in comparison to normality. The mathematical relationship between visual acuity and temporal papillary palor is demonstrated in a defined group of 98 eyes. A formula has been derived with which the probable visual acuity can be calculated from the measured color coordinates and its clinical use is described.
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By employing purple colour filters with a large blue and a small red transmission, normal and atrophic optic disks were photographed on colour transparencies. Normal optic disks reflect red light, and atrophic optic disks reflect blue light. The degree of atrophy estimated by colour contrast is quantitated by microdensitometry in the blue (470 nm) and in the red (640 nm) region of the transparencies. The difference between the blue and red density is used as an expression of optic disc colour.
Ten patients (14 eyes) with chronic simple glaucoma are described, each with features atypical for this disease and more suggestive that each had suffered an acute ischaemic optic neuropathy. Diagnosis of an acute ischaemic optic neuropathy in these cases is important, as treatment of ocular hypertension in the contralateral 'normal' eye may prevent a similar attack. Optic nerve disease and visual loss in chronic simple glaucoma probably occur as a result of several different mechanisms. Sudden field loss following an acute ischaemic optic neuropathy may be only one of them.
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