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Nonlinear optical spectroscopy of chiral molecules.

We review nonlinear optical processes that are specific to chiral molecules in solution and on surfaces. In contrast to conventional natural optical activity phenomena, which depend linearly on the electric field strength of the optical field, we discuss how optical processes that are nonlinear (quadratic, cubic, and quartic) functions of the electromagnetic field strength may probe optically active centers and chiral vibrations. We show that nonlinear techniques open entirely new ways of exploring chirality in chemical and biological systems: The cubic processes give rise to nonlinear circular dichroism and nonlinear optical rotation and make it possible to observe dynamic chiral processes at ultrafast time scales. The quadratic second-harmonic and sum-frequency-generation phenomena and the quartic processes may arise entirely in the electric-dipole approximation and do not require the use of circularly polarized light to detect chirality. They provide surface selectivity and their observables can be relatively much larger than in linear optical activity. These processes also give rise to the generation of light at a new color, and in liquids this frequency conversion only occurs if the solution is optically active. We survey recent chiral nonlinear optical experiments and give examples of their application to problems of biophysical interest.

Circular Dichroism↗

Flow cytometers using optical waveguides in place of lenses for specimen illumination and light collection.

Optical waveguides represent alternatives to lenses for delivery of light to, and collection of light from, small regions of space such as the observation point(s) of a flow cytometer. The flow chamber and directly associated illumination and collection optics of a flow cytometer can be built using fiber optic waveguides in fixed positions or as an integrated optical assembly incorporating deposited or implanted waveguides, providing illumination and collection geometries and efficiencies comparable to conventional designs, with the advantage that the optical waveguide design, once assembled, never again requires alignment of the optics. A prototype apparatus in which fiber optics were used to illuminate and collect light from a point inside a thin-walled, round quartz capillary was observed to measure fluorescence of polystyrene spheres with precision close to that obtained from a conventional flow cytometer using the same laser source. The design of the fiber optic system is readily adaptable to construction of multiple illumination beam instruments; other optical waveguide flow cytometer designs that dispense with the capillary share this advantage and can also provide orifices for electronic volume sensing and for jetting prior to droplet sorting.

Fiber Optic Technology↗

Ischemic optic neuropathy.

Ischemic optic neuropathy (ION), based on vascular anatomy of the optic nerve, pathogenesis and clinical picture, consists of two distinct entities: anterior (AION) and posterior (PION) ischemic optic neuropathies. AION is due to interference with posterior ciliary artery supply to the optic nerve head and retrolaminar part of the optic nerve; it initially presents with visual loss and optic disc edema which progresses to optic atrophy in a month or two. PION is due to occlusion of nutrient arteries to the posterior part of the optic nerve; in this condition during the initial stages the optic disc is normal in spite of marked visual loss, but the atrophy develops later on. Their pathogeneses, causes, clinical pictures, diagnosis and management are discussed briefly.

Adrenal Cortex Hormones↗

AIDS-related optic neuropathy: a histological, virological and ultrastructural study.

BACKGROUND: Clinical and histopathological evidence of optic nerve axonal loss has been reported in AIDS patients without retinitis. The study was carried out to investigate the possible involvement of HIV-infected cells in the development of optic nerve degeneration. METHODS: Optic nerves were obtained from eight AIDS patients and four normal controls. These nerves were morphologically and immunohistochemically analyzed. Additionally, using PCR amplification techniques, the retina and optic nerve samples obtained from three HIV-seropositive patients and one control were examined for the presence of HIV and cytomegalovirus antigens. RESULTS: We noted various stages of axonal degeneration in the optic nerves obtained from AIDS patients in whom there was an absence of retinal findings. Characteristic glial changes involving hypertrophic astrocytes, vacuolated oligodendrocytes, and mononuclear phagocyte series cells were also seen in the AIDS optic nerves. HIV DNA was present in at least four of five optic nerves but in only one of five retinas. Control specimens were each negative for all cytomegalovirus and HIV antigens. CONCLUSIONS: Degeneration in the optic nerve may be mediated by HIV-infected macrophages rather than by direct viral infection of neurons. Axonal degeneration due to AIDS at the level of the optic nerve can occur independently of retinal infection.

Acquired Immunodeficiency Syndrome↗

Course of the optic nerve fibers through the lamina cibrosa in human eyes.

BACKGROUND: This study investigated whether regional variations in the course of the optic nerve fibers through the lamina cribrosa may be one of the reasons why the local susceptibility for glaucomatous optic nerve fiber loss differs among the various regions of the optic disc. METHODS: The study included 34 human eyes enucleated because of a malignant melanoma of the peripheral choroid without involvement of the anterior chamber angle or the optic nerve. Anterior-posterior sections through the pupil and the optic disc were histomorphometrically evaluated. In the central region and the peripheral part of the optic disc, we measured the thickness of the lamina cribrosa and the length of the lamina cribrosa "channels" through which the nerve fibers pass. RESULTS: In the peripheral parts of the disc, compared with its central region, the lamina cribrosa was significantly thicker (P < 0.0001, Wilcoxon test), the lamina cribrosa "channels" with the nerve fibers passing through were significantly longer (P < 0.0001), and the ratio of length of the fiber "channels" to the thickness of the lamina cibrosa was significantly higher (P = 0.0001). CONCLUSION: The lamina cribrosa is thicker and the course of the optic nerve fibers through the lamina cribrosa is more curvilinear in the disc pheriphery than in the disc center. These variations in the anatomy of the lamina cribrosa may be one of several factors influencing the regional susceptibility for glaucomatous optic nerve fiber loss within the optic nerve head.

Adult↗

Microglia in tadpoles of Xenopus laevis: normal distribution and the response to optic nerve injury.

We have studied the distribution of microglia in normal Xenopus tadpoles and after an optic nerve lesion, using a monoclonal antibody (5F4) raised against Xenopus retinas of which the optic nerves had been cut 10 days previously. The antibody 5F4 selectively recognizes macrophages and microglia in Xenopus. In normal animals microglia are sparsely but widely distributed throughout the retina, optic nerve, diencephalon and mesencephalon (other regions were not examined). After crush or cut of an optic nerve, or eye removal, there occurs an extensive microglial response along the affected optic pathway. Within 18 h an increase in the number of microglial cells in the optic tract and tectum can be detected. This response increases to peak at around 5 days after the lesion. At this time the nerve distal to the lesion contains many microglial cells; the entire optic tract is outlined by microglia, extended along the degenerating fibres; and the affected tectum shows a heavy concentration of microglia. This microglial response thereafter decreases and has mostly gone by 34 days. We conclude that the microglial response to optic nerve injury in Xenopus tadpoles starts early, peaks just before the regenerating optic nerve axons enter the brain, and is much diminished by the time the retinotectal projection is re-established. The timing is such that the microglial response could play a major role in facilitating regeneration.

Animals↗

Optic disk appearance in advanced age-related macular degeneration.

PURPOSE: To describe and quantify the appearance of the optic disk in patients with advanced age-related macular degeneration (ARMD). DESIGN: Retrospective comparative study. METHODS: A total of 316 charts were reviewed. From these, 45 subjects with advanced ARMD (defined as geographic atrophy or disciform scar) in at least one eye were enrolled. Patients with glaucoma or glaucoma visual field defects were excluded. The probability of glaucomatous optic nerve damage was scored by evaluation of stereoscopic optic disk photographs in a masked fashion, according to a predefined evaluation scale and measured with confocal ophthalmoscopy (Heidelberg Retinal Tomograph; HRT). The area of macular involvement was measured in units of disk area. The optic disk evaluation scores and HRT measurements of a group of eyes with a large area of ARMD were compared with their fellow eyes with smaller areas of ARMD. The correlations between the area of macular involvement with the optic disk evaluation scores and HRT measurements were analyzed. MAIN OUTCOME MEASURES: The optic disk evaluation scores and the HRT measurements between study groups. RESULTS: Eyes with larger areas of ARMD had optic disks that were more likely to be classified as glaucomatous by clinical evaluation (3.45 +/- 0.23 vs 3.05 +/- 0.18, P =.015) and by HRT imaging analysis (-0.995 +/- 0.423 vs -0.376 +/- 0.249, P =.030) than the fellow eyes with smaller areas of ARMD. For eyes with six or more disk areas of ARMD, larger areas of ARMD correlated with a higher cup/disk ratio (P =.022), smaller neuroretinal rim area (P =.022), and glaucomatous classification (P =.040) with HRT discriminant function analysis. CONCLUSIONS: Eyes with large areas of geographic or diskiform ARMD have optic disk structural alterations that resemble glaucomatous optic neuropathy. This should be taken into consideration when evaluating patients with ARMD for glaucomatous damage.

Aged↗

Intravitreal injection of endothelin-1 caused optic nerve damage following to ocular hypoperfusion in rabbits.

The purpose of this study was to investigate the time course of the ocular hypoperfusion, retinal damage, and optic nerve damage induced by intravitreal injection of endothelin-1 (ET-1) in rabbits. ET-1, at 5 pmol (20 microL, twice a week for 2 or 4 weeks), was injected from the pars plana into the posterior vitreous of the right eye. Optic nerve head (ONH) blood flow and retinal artery diameter, together with the neurofilament light chain (NF-L) content, retinal morphology, and axon density of the optic nerve, were evaluated at 2, 4, and 8 weeks after the first injection of ET-1 (n=7 or 8). Tissue blood velocity in ONH was measured using a laser speckle method, and the diameter of major retinal arteries on the rim of the ONH was calculated from fundus photographs by a masked observer. Histological analysis and immunoblot evaluation of NF-L in the optic nerve were performed to evaluate optic nerve damage. At 2 weeks after the first ET-1 injection, tissue blood velocity was decreased by approximately 20% (versus the contralateral eye), and the diameter of retinal arteries had decreased by approximately 40%. These changes were sustained at the same level until 8 weeks after the first ET-1 injection. At 4 and 8 weeks after the first ET-1 injection, the amount of NF-L in the optic nerve was significantly less in the ET-1 treated eyes than in the contralateral eyes. At 8 weeks after the first ET-1 injection, a loss of myelinated axons and increases in gliosis and connective tissue were noted in the optic nerve of the treated eye, and the optic nerve-axon number had decreased significantly (each, versus the untreated eye). Retinal ganglion cells in the retina were not observed any damage at 2, 4, and 8 weeks after ET-1 injection. In conclusion, intravitreal injection of ET-1 induced chronic hypoperfusion in the ONH and retina, which presumably caused decreases in NF-L content and axon number in the optic nerve noted in the later part of the observation period.

Animals↗

Discrimination of glaucomatous optic neuropathy by digital stereoscopic analysis.

PURPOSE: To evaluate the diagnostic power of a novel digital stereoscopic imaging system in the diagnosis of glaucomatous optic neuropathy. DESIGN: Prospective cross-sectional analysis of the diagnostic accuracy of digital stereoscopic optic disc analysis in the diagnosis of glaucomatous optic neuropathy exhibiting mild to moderate field loss. PARTICIPANTS: Fifty-two patients with open-angle glaucoma and 54 normal individuals were recruited. The presence of a reproducible visual field loss characteristic of glaucoma was used as the reference standard for the presence of glaucoma independent of the optic nerve head appearance. Patients were excluded if the optic disc, fundus, or visual field indicated other disease. One eye from each patient and individual was included in the study, the eye with the least field loss and a randomly designated normal eye, respectively. METHODS: Simultaneous stereoscopic optic disc photography was performed on each specified eye. Three experienced observers viewed the resultant stereoscopic image of each nerve head using a Z screen, recorded a subjective clinical diagnosis, and undertook digital stereoscopic planimetry. Separate linear regression analysis was performed, post hoc, from the planimetric results for each observer of the logarithm of neuroretinal rim (NRR) against optic disc area derived from each normal eye. Eyes with NRR areas below the 95th prediction interval of the normal cohort were then classified as glaucomatous. MAIN OUTCOME MEASURES: Sensitivity and specificity for the detection of glaucomatous optic neuropathy. RESULTS: With subjective stereoscopic analysis, sensitivity for glaucoma detection among the 3 observers was 80.8%, 76.9%, and 90.4%, with respective specificities of 94.4%, 79.6%, and 79.6%. Regression analysis of the NRR in 30 degrees segments gave sensitivities between 69.2% and 80.8% and specificities between 83.3% and 90.7%. A combination of the subjective and quantitative analysis did not significantly improve discrimination. CONCLUSIONS: The subjective analysis of digital stereoscopic images provides a useful method for the discrimination of normal and glaucomatous optic nerves. Planimetric analysis does not significantly improve the diagnostic precision of this technique.

Adult↗

Changes in the optic disc after acute primary angle closure.

PURPOSE: To evaluate the changes in optic disc morphology in the first 4 months after an episode of acute primary angle closure (APAC) using stereoscopic optic disc photography and computer-assisted planimetry. DESIGN: Prospective observational case series. PARTICIPANTS: Forty-seven Asian subjects with unilateral APAC who were successfully treated with laser peripheral iridotomy (LPI). MAIN OUTCOME MEASURES: Cup-to-disc ratio (CDR) and optic cup and neuroretinal rim areas. METHODS: Stereoscopic optic disc photographs were taken 2 and 16 weeks after LPI, and the images were analyzed by computer-assisted planimetry. The overall, quadrantic, and 30 degrees sector areas of the optic disc, CDR, and neuroretinal rim area were analyzed by 2 independent masked graders, and the mean of the readings was used to calculate changes in optic disc parameters. RESULTS: The majority of the subjects were female (66%) and Chinese (90%), and the mean age was 67.6+/-11.2 years (range, 40-94). In APAC eyes from week 2 to week 16, the mean CDR increased from 0.56+/-0.05 to 0.59+/-0.03 (P<0.001), and the mean neuroretinal rim area decreased from 1.74+/-0.31 mm2 to 1.59+/-0.27 mm2 (P<0.001). Quadrantic and sector analysis showed preferential loss of neuroretinal rim area at the superotemporal and inferotemporal areas. There was no significant change in optic disc parameters in the fellow eyes over the study period. CONCLUSIONS: This study demonstrated changes in optic disc morphology from week 2 to week 16 after an episode of APAC. The pattern of optic nerve damage demonstrated in our study was comparable with that seen in primary open-angle glaucoma and experimental glaucoma models.

Acute Disease↗

Acquired pit of the optic nerve: a risk factor for progression of glaucoma.

PURPOSE: To examine acquired pit of the optic nerve as a risk factor for progression of glaucoma. METHODS: In a retrospective longitudinal study, 25 open-angle glaucoma patients with acquired pit of the optic nerve were compared with a group of 24 open-angle glaucoma patients without acquired pit of the optic nerve. The patients were matched for age, mean intraocular pressure, baseline ratio of neuroretinal rim area to disk area, visual field damage, and duration of follow-up. Serial optic disk photographs and visual fields of both groups were evaluated by three independent observers for glaucomatous progression. RESULTS: Of 46 acquired pits of the optic nerve in 37 eyes of 25 patients, 36 pits were located inferiorly (76%) and 11 superiorly (24%; P < .001). Progression of optic disk damage occurred in 16 patients (64%) in the group with acquired pit and in three patients (12.5%) in the group without acquired pit (P < .001). Progression of visual field loss occurred in 14 patients (56%) in the group with acquired pit and in six (25%) in the group without pit (P=.04). Bilateral acquired pit of the optic nerve was present in 12 patients (48%). Disk hemorrhages were observed more frequently in the group with acquired pit (10 eyes, 40%) compared with the group without pit (two eyes, 8%; P=.02). CONCLUSION: Among patients with glaucoma, patients with acquired pit of the optic nerve represent a subgroup who are at increased risk for progressive optic disk damage and visual field loss.

Adult↗

Computerized stereochronoscopy and alternation flicker to detect optic nerve head contour change.

PURPOSE/BACKGROUND: Stereochronoscopy, a technique previously explored but abandoned for glaucoma diagnosis, viewed optic nerve images acquired at separate points in time as if a stereo pair. Prior efforts to exploit this technique were impaired by a lack of superimposability for sequential optic nerve images. We investigated computerized registration techniques for aligning sequential, monoscopic optic disc images to facilitate sensitive detection of optic nerve head contour changes in glaucoma. DESIGN: Algorithm and software development. Comparisons with standard techniques. MATERIALS: Existing patient records from the Glaucoma Service, Scheie Eye Institute, University of Pennsylvania. METHODS: Two sets of optic disc photographs, separated in time by 1 to 18 years, of 25 eyes with and without glaucomatous optic disc progression were digitized. We developed custom software for accurate image alignment. Change in disc morphology was then judged by digital stereochronoscopy and user-controlled alternation flicker of superimposed, time-separated images on a computer monitor. Comparisons were made with standard stereoscopic comparison. MAIN OUTCOME MEASURE: Identification of change or no change in optic nerve head contour for images acquired at separate points in time. RESULTS: Image processing and registration permits accurate alignment of optic disc photographs. Alternation flicker of superimposed, sequential images facilitates image comparison and detection of change as indicated by change in vessel position, color, and other cues for contour change. A high concordance was found between standard stereoscopic comparison and alternation flicker. In several cases, reinspection of stereo comparison led to a revised judgment on the basis of disc changes rendered more obvious with alternation flicker. Digital stereochronoscopy was less concordant with standard techniques. CONCLUSIONS: Digital image processing techniques and alternation flicker provide a simple, sensitive, software-based method for detecting glaucomatous optic disc change.

Algorithms↗

Laser in situ keratomileusis-induced optic neuropathy.

OBJECTIVE: To report a case of bilateral optic neuropathy after bilateral laser-assisted in situ keratomileusis (LASIK) surgery. DESIGN: Observational case report. METHODS: Complete eye examination with detailed evaluation of the optic nerve, detailed medical history, stereo disc photographs, GDx Nerve Fiber Analyzer testing, Humphrey 24-2 SITA visual field testing, diurnal intraocular pressure measurement, serologic evaluation, and magnetic resonance imaging of the brain and orbits. MAIN OUTCOME MEASURES: Optic nerve status, visual field status, and visual acuity. RESULTS: A subject with previously healthy optic nerves had bilateral optic neuropathy develop after LASIK surgery. This neuropathy manifested with a subjective decrease in visual field, normal visual acuity, normal color vision, relative afferent pupillary defect, increased cupping of the optic nerve with focal neuroretinal rim defects, decreased nerve fiber layer thickness, and nerve fiber bundle-type visual field defects. The subject had no other risk factors for optic neuropathy. No other cause of neuropathy was identified. CONCLUSIONS: Optic neuropathy is a potential vision-threatening complication of LASIK surgery. This complication may be due to barotrauma or ischemia related to extreme elevation of intraocular pressure by the suction ring. Careful examination of the optic nerve before and after LASIK surgery is warranted.

Adult↗

Optic nerve atrophy in propionic acidemia.

OBJECTIVE: Propionic acidemia is a rare metabolic disorder that is diagnosed in the early neonatal period. The disorder is characterized by life-threatening ketoacidosis, lethargy, failure to thrive, and developmental delay. Herein we report the ocular findings in a prospective series of six patients with propionic acidemia. DESIGN: Prospective case series. PARTICIPANTS: Six children (three male and three female) between the ages of 2 and 10 years with propionic acidemia who were examined at Children's Hospital Los Angeles. METHODS: A complete ophthalmic examination was performed on each of the six children. The examination included visual acuity testing, ocular motility, anterior segment examination, and funduscopic evaluation. Emphasis was placed on the function of the optic nerve and on the appearance of the optic disc, looking for possible atrophic changes. MAIN OUTCOME MEASURES: The clinical appearance of the optic disc and evidence of optic neuropathy. RESULTS: Optic nerve atrophy was present exclusively in all of the male patients in the series; none of the female patients demonstrated any detectable impairment of optic nerve function. The optic nerve atrophy was symmetric and age dependent and varied from moderate to severe. There were no other anterior or posterior segment abnormalities, other than one case of unilateral morning glory syndrome, diagnosed at birth. There was no correlation between metabolic control and the development and progression of optic nerve atrophy. CONCLUSIONS: Males with propionic acidemia have moderate to severe bilateral optic atrophy.

Amino Acid Metabolism, Inborn Errors↗

The histology of human glaucoma cupping and optic nerve damage: clinicopathologic correlation in 21 eyes.

We have examined by light and electron microscopy the retina, optic nervehead, and optic nerves of 21 human eyes from glaucoma patients in whom clinical information was available for comparison. In several cases it was possible to correlate the degree and distribution of optic nerve damage with the clinical appearance of the optic disc and visual field studies. There was no selective loss of astrocytes of the optic nervehead in early glaucoma cupping. Acquired increases in optic disc cup size prior to detectable visual field loss probably represent loss of ganglion cell axonal fibers which is not yet significant enough to produce field defects. It is unlikely that the mechanism of axonal damage in chronic human glaucoma involves early loss of astrocytic glial cells at the optic nervehead. At the level of the retrobulbar optic nerve, the ganglion cell axonal fibers of the superior and inferior quadrants seem to be lost earlier than the fibers of the nasal and temporal nerve periphery. Since the superior and inferior poles of the optic nerve may contain the fibers of arcuate area ganglion cells, these data confirm the presumption from visual field testing that arcuate area ganglion cell fibers are selectively more susceptible to damage in chronic glaucoma.

Adult↗

Fundus lesions in malignant hypertension. V. Hypertensive optic neuropathy.

We produced experimental renovascular arterial hypertension in 57 rhesus monkeys by modified Goldblatt's procedures. Hypertensive fundus changes were studied in detail by serial ophthalmoscopy and fluorescein fundus angiography in all animals on a long-term follow-up, and pathologically in 23 eyes. Initial evidence of hypertensive optic neuropathy was optic disc edema which developed at the median blood pressure (BP) of 190 mmHg (normal BP, 120 mmHg). On follow-up, mild to marked pallor of the optic disc developed. The optic disc changes were correlated with BP and other fundus changes. Pathogenesis of hypertensive optic neuropathy, which has been highly controversial so far, is discussed at length in the light of the findings of the present study and other recent evidence. All the available clinical and pathologic findings in the present study indicate that hypertensive optic neuropathy represents a form of anterior ischemic optic neuropathy, and that hypertensive optic neuropathy is a distinct entity. A caution is given against a precipitous reduction of BP in patients with hypertensive optic neuropathy because that may cause complete, permanent blindness.

Animals↗

Optic disc hemorrhages and progression of glaucoma.

PURPOSE: To assess progressive changes of the optic nerve head and visual fields in patients with glaucoma and ocular hypertension after optic disc hemorrhage. METHODS: The authors reviewed the charts of 91 patients with 121 disc hemorrhages who had a mean follow-up of 41.9 +/- 3.6 months. The frequency of visual field and optic nerve head changes in these patients was studied. RESULTS: The mean intraocular pressure at the examination when the disc hemorrhage was noted was 18.9 +/- 0.5 mmHg. Overall, 64 (63%) of 101 eyes showed progressive changes of visual fields after disc hemorrhage, compared with 24 (24%) of 101 control eyes (P < 0.0005). Similarly, 56 (79%) of 71 eyes showed progressive changes of optic nerve head contour by masked evaluation of stereophotographs, compared with 16 (22%) of 71 control eyes (P < 0.0005). Eyes with disc hemorrhage showed significantly greater progression of visual field defects in patients with open-angle glaucoma (P < 0.001), low-tension glaucoma (P < 0.05), and ocular hypertension (P = 0.0067) compared with control eyes matched by age, follow-up time, and diagnosis. Similarly, progressive changes of optic nerve head contour were observed more often in eyes after disc hemorrhage in patients with open-angle glaucoma (P < 0.0005), low-tension glaucoma (P < 0.025), and ocular hypertension (P < 0.005), compared with controls. The mean time interval to progression after disc hemorrhage was observed was 16.8 +/- 2.0 months for visual field changes and 23.8 +/- 2.9 months for optic nerve head changes. In eyes with disc hemorrhage, 27 (22%) of 121 had recurrent hemorrhages at a mean interval of 21.5 +/- 2.9 months after previous hemorrhage. The most common site of disc hemorrhage was the inferotemporal quadrant. Eyes with disc hemorrhage that occurred on the temporal side of the optic nerve head had a significantly lower intraocular pressure (P < 0.02) and greater progressive changes of the optic discs (P < 0.001) compared with eyes with hemorrhage on the nasal side. CONCLUSION: The authors' results indicate that disc hemorrhages in eyes with glaucoma or ocular hypertension often are associated with progressive changes of the optic nerve head and visual fields.

Adult↗

Correlation between the orbital and intraocular portions of the optic nerve in glaucomatous and ocular hypertensive eyes.

BACKGROUND/PURPOSE: It has recently been reported that the retrobulbar optic nerve diameter (OND) and cross-sectional area (ONCSA) are reduced in glaucoma. This study was performed to investigate the correlation between the orbital and intraocular portions of the optic nerve. METHODS: One eye of 20 volunteers (16 glaucoma subjects, 4 ocular hypertension subjects) underwent optic disc analysis using Heidelberg retinal tomography, and echographic measurements of the retrobulbar optic nerve. RESULTS: The male-to-female ratio was 6.5:3.5, and the mean age of our sample (+/- SD) was 62.25 +/- 13.7 years. Orbital optic nerve diameter and cross-sectional area correlated significantly and positively with the neuroretinal rim area (Spearman's rank correlation coefficient; OND: rs = 0.488, p = 0.0336; ONCSA: rs = 0.619, p = 0.0079), but not with any other topographical disc data. The retrobulbar optic nerve cross-sectional area-to-disc area ratio (ONCSA/D) was found to have a significant negative correlation with the cup area/disc area ratio (simple regression analysis; r = -3.948, p = 0.046), and a statistically demonstrable positive correlation with the neuroretinal rim area/disc area ratio (r = 0.451, p = 0.046). CONCLUSION: The results of this study indicate that orbital optic nerve dimensions are a reflection of the neuroretinal rim area of the optic disc. Echographic measurements of the retrobulbar nerve may be additive to the traditional triad of raised intraocular pressure, field defects and glaucomatous optic neuropathy that suggests a diagnosis of glaucoma.

Adult↗