Structural changes of macula and optic disk of the fellow eye in patients with nonarteritic anterior ischemic optic neuropathy

PURPOSE

The aim was to assess the ganglion cell complex (GCC) thickness, retinal nerve fiber layer (RNFL) thickness and optic disk features in the affected eyes (AE) and unaffected fellow eyes (FE) of subjects with unilateral nonarteritic anterior ischemic optic neuropathy (NAION) and to compare with healthy control eyes (CE) using spectral domain-optical coherence tomography (SD-OCT).

METHODS

This study included 28 patients and age, sex and refraction-matched 28 control subjects. Mean GCC thickness and peripapillary RNFL thickness in four quadrants measured by cirrus SD-OCT were evaluated in both AE and FE of patients and CE. In addition, optic disk measurements obtained with OCT were evaluated.

RESULTS

Mean GCC thickness was significantly lower in AE compared with both FE and CE (P < 0.001), and mean GCC thickness in FE was significantly lower than CE (P = 0.022). In addition, mean RNFL thickness in superior and nasal quadrants significantly decreased in FE compared with CE (P = 0.020 and 0.010, respectively). Furthermore, AE had significantly greater optic disk cupping compared with both FE and CE (P < 0.001).

CONCLUSIONS

GCC and RNFL thickness decreased significantly at late stages of NAION, in both AE and FE compared with CE, suggesting that some subclinical structural changes may occur in FE despite lack of obvious visual symptoms. In addition, there was no significant difference in optic disk features between the CE and FE. And significantly greater optic disk cupping in the AE compared with both FE and CE supports the acquired enlargement of cupping after the onset of NAION.

A new visual field test in empty sella syndrome: rarebit perimetry

PURPOSE

Several visual field defects can be seen in empty sella syndrome (ESS). In this study, the authors aimed to evaluate the visual field defects in patients with ESS by rarebit perimetry and to compare the results with Humphrey perimetry.

METHODS

Left eyes of 13 patients with ESS and left eyes of 15 age-matched normal subjects were included in the study. Visual field testing was performed by Humphrey Visual Field Analyzer II (Fastpack 30-2 strategy) and rarebit perimetry (regular test). Statistical analysis was performed by independent-samples t-test, Mann-Whitney U test, receiver operating characteristic (ROC) curves, and Pearson correlation test.

RESULTS

Humphrey perimetry mean deviation was -3.67 dB in control group and -6.06 dB in patients with ESS (p=0.12). Mean hit rate calculated by rarebit test was 91.8% in control group and 75.9% in cases with ESS (p=0.005). Area under ROC curve was 0.756 for Humphrey visual field test and 0.827 for rarebit hit rate (p=0.59). There was a significant correlation between rarebit hit rate and Humphrey visual field test mean deviation (r=0.755, p<0.001).

CONCLUSIONS

Rarebit perimetry correlates significantly with Humphrey perimeter in detecting visual field defects related with ESS and has a higher sensitivity and specificity.

Evaluation of the change in accommodation amplitude in subjects with pseudoexfoliation

PURPOSE

To evaluate the changes in accommodation amplitude in cases with pseudoexfoliation.

MATERIALS AND METHODS

Twenty-nine eyes having pseudoexfoliation and 37 normal eyes aged between 40-60 years were included in the study. After ophthalmic examination, accommodation amplitude was measured using Powerrefractor II. Besides, axial length, anterior chamber depth, and lens thickness was measured by A-scan ultrasonography. The results obtained were evaluated by independent samples' t-test.

RESULTS

There was no difference in mean age between cases with pseudoexfoliation and normal cases (P=0.131). Mean accommodation amplitude was significantly lower in cases with pseudoexfoliation (P=0.002). Axial length, anterior chamber depth, and lens thickness measurements did not show significant change between groups (P=0.55, P=0.66, P=0.36, respectively).

CONCLUSION

In the presence of pseudoexfoliation, ciliary apparatus can be affected and accommodation amplitude can be decreased in earlier ages.

The effect of levodopa and dopamine agonists on optic nerve head in Parkinson disease

PURPOSE

To evaluate the effects of levodopa and dopamine agonists on retinal nerve fiber layer using scanning laser ophthalmoscope.

METHODS

Forty-four patients with the diagnosis of Parkinson disease and receiving levodopa or dopamine agonist monotherapy were included in this prospective study. The control group consisted of 21 normal cases. The optic nerve head images were taken with Heidelberg Retina Tomograph; rim area, rim volume, mean retinal nerve fiber layer thickness, and the results of Moorfields regression analysis were calculated. The measurement results were evaluated with Kruskal Wallis test and Mann-Whitney U-test.

RESULTS

There was no significant difference in mean age among groups (p=0.093). Retinal nerve fiber layer was measured to be significantly decreased in cases with Parkinson disease (p=0.004) while rim area and rim volume did not show a significant change (p=0.224, p=0.804 respectively). Rim area, rim volume, and retinal nerve fiber layer were significantly greater in the group treated with levodopa while it was the thinnest in the group receiving dopamine agonists.

CONCLUSIONS

Levodopa can have a protective affect to retinal nerve fiber layer in Parkinson disease compared to dopamine agonists.