scholarly journals Transient Peripapillary Retinoschisis in Glaucomatous Eyes

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Josine van der Schoot ◽  
Koenraad A. Vermeer ◽  
Hans G. Lemij
Keyword(s):  
Imaging Techniques ◽  
Scanning Laser ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Fiber Layer ◽  
Laser Polarimetry ◽  
Laser Tomography ◽  
Healthy Eyes ◽  
Sd Oct

Purpose. To investigate transient focal microcystic retinoschisis in glaucomatous eyes in images obtained with several imaging techniques used in daily glaucoma care.Methods. Images of 117 glaucoma patients and 91 healthy subjects participating in a large prospective follow-up study into glaucoma imaging were reviewed. Participants were measured with spectral domain optical coherence tomography (SD-OCT), scanning laser polarimetry (SLP), scanning laser tomography (SLT), and standard automated perimetry (SAP). The presence of a focal retinoschisis in SD-OCT was observed and correlated to SLP, SLT, and SAP measurements, both cross-sectionally and longitudinally.Results. Seven out of 117 glaucoma patients showed a transient, localised, peripapillary, heterogeneous microcystic schisis of the retinal nerve fiber layer (RNFL) and sometimes other retinal layers as well in SD-OCT. None of the healthy eyes showed this phenomenon nor did any of the other imaging techniques display it as detailed and consistently as did the SD-OCT. SAP showed a temporarily decreased focal retinal sensitivity during the retinoschisis and we found no signs of glaucomatous progression related to the retinoschisis.Conclusions. Transient microcystic retinoschisis appears to be associated with glaucomatous wedge defects in the RNFL. It was best observed with SD-OCT and it was absent in healthy eyes. We found no evidence that the retinoschisis predicted glaucomatous progression.

scholarly journals Diagnostic Accuracy of Glaucoma Tests in Everyday Practice

2017 ◽  
Vol 1 (1) ◽  
pp. oapoc.0000020 ◽  
Author(s):  
Nina M. Lindbohm ◽  
Eija Vesti ◽  
Päivi Puska ◽  
Teemu Mäkitie ◽  
Kalevi Friberg ◽  
...  
Keyword(s):  
Subjective Evaluation ◽  
Automated Perimetry ◽  
Automated Classification ◽  
Test Results ◽  
Scanning Laser Polarimetry ◽  
Standard Automated Perimetry ◽  
Fiber Layer ◽  
Glaucoma Suspect ◽  
Laser Polarimetry ◽  
Primary Diagnostics

Purpose To evaluate the performance of various tests with automated and subjective evaluation for primary diagnostics of glaucoma in a normal clinical setting. Methods Subjects referred because of suspicion of glaucoma were recruited. All subjects had full ophthalmologic evaluation with stereophotography of the optic nerve head (ONH), red-free retinal nerve fiber layer (RNFL) photography, scanning laser polarimetry (SLP), optical coherence tomography (OCT), and standard automated perimetry (SAP). Analysis of all results was made jointly by 5 glaucoma specialists, with a consensus for each eye as healthy, glaucomatous, or glaucoma suspect. Results from each method were evaluated against this consensus, followed by a subjective evaluation of each method by a glaucoma specialist, comparing this with automated classification by the devices. Results Of the 101 subjects and 202 eyes examined, 23 eyes were by consensus glaucomatous, and 23 were glaucoma suspect. Sensitivity was best with ONH photos and worst with SAP, while SLP had a better sensitivity but poorer specificity than did RNFL photographs and OCT. Subjective evaluation of SLP, OCT, and SAP data gave better sensitivity and specificity than did classification by numeric values from the devices only, with OCT performing better in automatic classification than did SLP or SAP. Conclusions None of the current methods is superior to others in diagnosing glaucoma, and the accuracy of automated tests was better when subjectively evaluated by an experienced ophthalmologist. Diagnosis of glaucoma should be based on a combination of test results interpreted by a clinician.

scholarly journals The Assessment of Morphological and Functional Changes in the Detection of the Initial Stage of Primary Glaucoma

2021 ◽  
Vol 18 (4) ◽  
pp. 857-865
Author(s):  
N. I. Kurysheva ◽  
L. V. Lepeshkina
Keyword(s):  
Open Angle Glaucoma ◽  
Angle Closure ◽  
Ganglion Cell Complex ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Fiber Layer ◽  
Glaucoma Progression ◽  
Functional Changes ◽  
Primary Glaucoma ◽  
Sd Oct

Purpose — to study morphological and functional changes in the detection of primary glaucoma progression.Patients and methods. 128 patients (128 eyes, among them — 64 eyes with primary open angle glaucoma (POAG) and 64 with primary angle closure glaucoma (PACG)) with the initial MD of –6.0 dB were examined at the Ophthalmology Center of the FMBA of Russia from May 2016 to November 2019. The values of corneal-compensated IOP were also considered: minimal (IOPmin), peak (IOPmax) and its fluctuations (IOPfluct). The progression was measured using standard automated perimetry (SAP) and spectral-domain OCT (SD-OCT). During the observation period, each patient received the average of 8.42 ± 2.08 SAP and SD-OCT. Progressive thinning of the retinal nerve fiber layer (RNFL) and its ganglion cell complex (GCC) were evaluated using SD-OCT. If RNFL and/or GCC had a trend of significant (p < 0.05) thinning, the eye was classified as having the SD-OCT progression. The correlation between the rate of progression detected by SAP (ROP1) using thinning of RNFL (ROP2) and GCC (ROP3) with other clinical parameters was analyzed.Results and discussion. Glaucoma progression was detected in 73 eyes. While the isolated use of SAP did not allow detecting progression, it was possible to detect it in 39 % cases by SD-OCT. The combination of both methods allowed detecting progression in 57 %. In both forms, ROP1 correlated with IOPmin: in PACG r = 0.41, p = 0.023 and in POAG r = 0.43, p = 0.016. In PACG, ROP2 and ROP3 correlated with the foveal choroid thickness: r = 0.46, p = 0.019 and r = 0.47, p = 0.009, respectively. At the same time, ROP3 was associated with peak IOP (r = –0.402, p = 0.025); the correlation of peak IOP with its fluctuations amounted to 0.7 (p < 0.001).Conclusion. SD-OCT is more informative than SAP in determining the progression of the initial primary glaucoma. The combination of these two methods 1.5 times increases the possibility of detecting progression in comparison with the isolated use of SD-OCT. The choroid thickness, associated with the IOP fluctuations, plays an important role in the progression of PACG.

scholarly journals Optic Nerve Head Hemoglobin Levels in Glaucoma: A Structural and Functional Correlation Study

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Janaina A. G. Rocha ◽  
Diego T. Dias ◽  
Maria Betânia C. Lemos ◽  
Fábio N. Kanadani ◽  
Augusto Paranhos ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Optic Nerve Head ◽  
Correlation Study ◽  
Mean Deviation ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Fiber Layer ◽  
Wide Range ◽  
Disease Stages ◽  
Sd Oct

Purpose. To investigate structural and functional correlations in glaucoma patients using optic nerve head hemoglobin (ONH Hb) measurements as determined by automated colorimetric analysis of conventional retinography. Methods. We prospectively enrolled healthy participants and glaucomatous patients with a wide range of disease stages. All participants underwent visual field (VF) testing (standard automated perimetry, SAP), color fundus imaging (mydriatic retinography), and peripapillary retinal nerve fiber layer (pRNFL) assessment through spectral-domain optical coherence tomography (SD-OCT). Software Laguna ONhE was used to estimate the amount of ONH Hb and to determine the glaucoma discriminant function (GDF) index. Scatter plots were constructed, and regression analysis was used to investigate the correlations between GDF, average pRNFL thickness, and VF mean deviation (VFMD) index values. A secondary analysis was performed to compare each parameter between three different glaucoma groups divided according to VFMD values (mild, >−6 dB; moderate, −6 to −12 dB; and advanced, <−12 dB). Results. One hundred ninety-six eyes from 123 participants (69 with glaucoma and 54 controls) were enrolled. Overall, all parameters evaluated differed significantly between glaucomatous and control eyes ( p ≤ 0.001 ). The comparison of each parameter according to groups of disease stages revealed significant differences between controls and each of the glaucomatous groups ( p < 0.001 ). More pronounced changes in GDF values were observed in early disease stages. We found significant nonlinear correlations between GDF and VFMD values (R2 = 0.295, p < 0.001 ) and between pRNFL thickness and VFMD (R2 = 0.598, p < 0.001 ). A linear correlation was found between GDF and pRNFL thickness values (R2 = 0.195, p < 0.001 ). Conclusion. Our results showed significant associations between ONH Hb values and both structural and functional damage in glaucoma obtained by SD-OCT and SAP, respectively. The nonlinear correlation we found and the GDF behavior along different disease stages suggest that ONH Hb levels’ reduction may precede visual function changes in early glaucoma stages.

scholarly journals Ganglion cell complex scan in the early prediction of glaucoma

2012 ◽  
Vol 4 (2) ◽  
pp. 236-241
Author(s):  
S Ganekal
Keyword(s):  
Ganglion Cell ◽  
Cell Complex ◽  
P Value ◽  
Ganglion Cell Complex ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Fiber Layer ◽  
Color Code ◽  
Rnfl Thickness ◽  
Significant Difference

Objective: To compare the macular ganglion cell complex (GCC) with peripapillary retinal fiber layer (RNFL) thickness map in glaucoma suspects and patients. Subjects and methods: Forty participants (20 glaucoma suspects and 20 glaucoma patients) were enrolled. Macular GCC and RNFL thickness maps were performed in both eyes of each participant in the same visit. The sensitivity and specificity of a color code less than 5% (red or yellow) for glaucoma diagnosis were calculated. Standard Automated Perimetry was performed with the Octopus 3.1.1 Dynamic 24-2 program. Statistics: The statistical analysis was performed with the SPSS 10.1 (SPSS Inc. Chicago, IL, EUA). Results were expressed as mean ± standard deviation and a p value of 0.05 or less was considered significant. Results: Provide absolute numbers of these findings with their units of measurement. There was a statistically significant difference in average RNFL thickness (p=0.004), superior RNFL thickness (p=0.006), inferior RNFL thickness (p=0.0005) and average GCC (p=0.03) between the suspects and glaucoma patients. There was no difference in optic disc area (p=0.35) and vertical cup/disc ratio (p=0.234) in both groups. While 38% eyes had an abnormal GCC and 13% had an abnormal RNFL thickness in the glaucoma suspect group, 98% had an abnormal GCC and 90% had an abnormal RNFL thickness in the glaucoma group.Conclusion: The ability to diagnose glaucoma with macular GCC thickness is comparable to that with peripapillary RNFL thickness. Macular GCC thickness measurements may be a good alternative or a complementary measurement to RNFL thickness assessment in the clinical evaluation of glaucoma.DOI: http://dx.doi.org/10.3126/nepjoph.v4i2.6538 Nepal J Ophthalmol 2012; 4 (2): 236-241 

scholarly journals Does Posterior Capsule Opacification Affect the Results of Diagnostic Technologies to Evaluate the Retina and the Optic Disc?

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Jose Javier Garcia-Medina ◽  
Monica del Rio-Vellosillo ◽  
Vicente Zanon-Moreno ◽  
Enrique Santos-Bueso ◽  
Roberto Gallego-Pinazo ◽  
...  
Keyword(s):  
Visual Outcome ◽  
Scanning Laser ◽  
Posterior Capsular Opacification ◽  
Automated Perimetry ◽  
Scanning Laser Polarimetry ◽  
Laser Polarimetry ◽  
Optic Nerve Diseases ◽  
Nd:Yag Laser Capsulotomy ◽  
Clinically Significant ◽  
Diagnostic Technologies

The visual outcome obtained after cataract removal may progressively decline because of posterior capsular opacification (PCO). This condition can be treated by creating an opening in the posterior lens capsule by Nd:YAG laser capsulotomy. PCO optical imperfections cause several light reflection, refraction, and diffraction phenomena, which may interfere with the functional and structural tests performed in different ocular locations for the diagnosis and follow-up of ocular disease, like macular and optic nerve diseases. Some parameters measured by visual field examinations, scanning laser polarimetry, and optical coherence tomography (OCT) have changed after PCO removal. Imaging quality also changes following capsulotomy. Consequently, the results of ancillary tests in pseudophakic eyes for studying ocular diseases like glaucoma or maculopathies should be correlated with other clinical examinations, for example, slit-lamp biomicroscopy or funduscopy. If PCO is clinically significant, a new baseline should be set for future comparisons following capsulotomy when using automated perimetry and scanning laser polarimetry. To perform OCT in the presence of PCO, reliable examinations (considering signal strength) apparently guarantee that measurements are not influenced by PCO.

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