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Ueda Y, Suda K, Kameda T, Ikeda HO, Miyake M, Hasegawa T, Numa S, Tsujikawa A. Risk Factors for Progression of Primary Open-Angle Glaucoma with Lower Normal Intraocular Pressure. Ophthalmic Res 2024; 67:184-191. [PMID: 38228107 DOI: 10.1159/000536314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 01/14/2024] [Indexed: 01/18/2024]
Abstract
INTRODUCTION This study aimed to investigate intraocular pressure (IOP)-independent factors associated with the progression of primary open-angle glaucoma (POAG) with IOP ≤15 mm Hg. METHODS POAG patients with maximum IOP ≤15 mm Hg at the Kyoto University Hospital between January 2011 and August 2021 were retrospectively enrolled. We evaluated effects of various factors on the rate of mean deviation (MD) changes in the visual field (VF) examinations using a linear mixed model. These factors included hypertension, diabetes mellitus (DM), hyperlipidemia (HL), cardiovascular disease, arrhythmia, disc hemorrhage, sleep apnea syndrome, orthopedic diseases, and malignant tumors. RESULTS In total, 98 eyes from 68 patients were included. The baseline MD was -9.74 ± 7.85 dB. The mean rate of MD change and IOP during the observation period were -0.28 ± 0.04 dB/year and 11.8 ± 1.0 mm Hg, respectively. Comorbidity of DM or HL showed a significant positive association with the rate of MD change (β = 0.35, p = 0.0006 and β = 0.18, p = 0.036, respectively) in the model adjusted for age, sex, axial length, mean IOP, and standard deviation of IOP during the observation period. However, no significant association of DM or HL was found after adjusting for central corneal thickness. CONCLUSION This study suggests that DM or HL is associated with VF deterioration in glaucoma with lower IOP, but the association may be due to differences in IOP characteristics.
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Affiliation(s)
- Yuta Ueda
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kenji Suda
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takanori Kameda
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hanako Ohashi Ikeda
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masahiro Miyake
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tomoko Hasegawa
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shogo Numa
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akitaka Tsujikawa
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Saadat P, Abbasi Golmaee M, Rasoulinejad SA, Bijani A. Determination of the effect of repetitive Transcranial Magnetic Stimulation (rTMS) on the primary visual cortex on improving the visual status of patients with subcortical stroke in the area of the posterior cerebral artery. Heliyon 2023; 9:e14830. [PMID: 37095974 PMCID: PMC10121628 DOI: 10.1016/j.heliyon.2023.e14830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 01/23/2023] [Accepted: 03/17/2023] [Indexed: 04/26/2023] Open
Abstract
Background and objective Repetitive Transcranial Magnetic Stimulation (rTMS)-induced neuroplasticity to induce trans-synaptic transmission at a site away from the stimulus site is one of the recent possible strategies for brain rehabilitation in patients with stroke. This study aimed to determine the effect of rTMS on the primary visual cortex of the lesion side of the brain on improving the visual status of patients with subcortical stroke in the posterior cerebral artery. Methods After obtaining written consent, this non-randomized clinical trial study was performed on ten eligible patients. The National Eye Institute 25-items Visual Function Questionnaire (NEI-VFQ) and 30-degree automated Perimetry (visual field test) were used to assess patients' vision status before and after ten rTMS sessions. Paired T-test and Student T-test were used to analyze the data using SPSS software. Findings A comparison of the mean and standard deviation of the total score of the VFQ-25 for each question did not show a significant difference between pre-test and post-test. In perimetry values based on the Visual Field Index (VFI), the correlation of mean deviation (MD) and the pattern standard deviation (PSD) did not differ significantly before and after the intervention. Conclusion According to the results of this study, the rTMS method cannot be reliable as an effective method in the treatment of visual impairment caused by stroke. Therefore, our study does not definitively support rTMS as the first-choice method by physicians for stroke rehabilitation with visual impairment.
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Affiliation(s)
- Payam Saadat
- Associated Professor of Neurology, Clinical Research Development Unite of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
- Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Corresponding author.Clinical Research Development Unite of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran.
| | | | - Seyed Ahmad Rasoulinejad
- Associate Professor of vitreo retina, Department of Ophthalmology, Ayatollah Rouhani Hospital, Health Research Institute, Babol University of Medical Sciences, Iran
| | - Ali Bijani
- Assistant Professor of Epidemiology (Research-Based), Research Center for Social Factors Affecting Health, Health Research Institute, Babol University of Medical Sciences, Iran
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Behera G, Waghmare SV, Ramasamy A. Comparison of the visual field test of Glaufield Lite with Humphrey Field Analyser. Int Ophthalmol 2023; 43:557-565. [PMID: 35947251 DOI: 10.1007/s10792-022-02457-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 07/31/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE To compare visual field test results of Glaufield Lite AP901 CTS 133 (Appasamy Associates, Mannadipet Commune, Thirubhuvanai, Puducherry, India, hereafter Glaufield Lite) with Humphrey Field Analyser (HFA, Carl Zeiss Meditec, Dublin, California, USA, hereafter HFA). METHODS A pilot study at a tertiary eye centre involving 23 normal and 24 glaucoma patients who underwent two consecutive visual field tests on (i) HFA 24-2 SITA Fast and (ii) Glaufield Lite Quick Central program. RESULTS The mean testing time on HFA was significantly shorter than Glaufield Lite (normals: HFA: 2.75 ± 0.49 min, Glaufield Lite: 6.85 ± 0.86 min, p < 0.001; glaucoma patients: HFA: 3.45 ± 1.08 min, Glaufield Lite: 6.95 ± 0.54 min, p < 0.001). Reliability criteria were similar, but false-positivity was lower with Glaufield Lite. Bland-Altman analysis showed poor agreement for mean deviation (MD), [~ 2.69 units less for HFA], and acceptable agreement for pattern standard deviation (PSD) [~ 0.426 units more for HFA] between the two devices. CONCLUSION Both perimetric techniques showed reliable test results though test duration was longer with Glaufield Lite perimetry. The MD showed poor agreement, likely due to different scales and principles used for perimetry. The PSD showed acceptable agreement, making it valid for use in glaucoma, though a direct comparison of fields from the two devices is not possible. We recommend using the same perimetry device for follow-up evaluation.
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Affiliation(s)
- Geeta Behera
- Department of Ophthalmology, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, 605006, India.
| | - Shradha Vijay Waghmare
- Department of Ophthalmology, Indira Gandhi Government General Hospital and Post Graduate Institute (IGGGH&PGI), Puducherry, India
| | - Amala Ramasamy
- Department of Biostatistics, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India
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Daneshvar R, Ehsaei A, Moghadas Sharif N, Pato Z. Comparison of Visual Field Measurements in Glaucomatous Eyes using Oculus and Metrovision Perimeters. J Curr Ophthalmol 2023; 35:17-22. [PMID: 37680285 PMCID: PMC10481978 DOI: 10.4103/joco.joco_197_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 09/09/2023] Open
Abstract
Purpose To investigate the agreement between the Oculus and Metrovision perimeters in the visual field evaluation of glaucoma patients. Methods In this cross-sectional study, 41 consecutive glaucoma patients were enrolled. After detailed clinical examinations, visual field testing was performed for all patients using the Oculus and Metrovision perimeters. The interval time between the two visual field examinations was 30 min. Results A total of 22 participants were male (53.7%) and the mean ± standard deviation (SD) age was 58.6 ± 9.1 years. The absolute average of the mean deviation (MD) in the oculus perimeter (8.24 ± 4.92 dB) was higher compared to the Metrovision perimeter (4.02 ± 4.62; P < 0.001). This difference was also evident in the Bland-Altman graph. The loss variance (pattern SD) values of Oculus perimeter (28.58 ± 16.40) and Metrovision perimeter (28.10 ± 28.45) were not significantly different; although based on the Bland-Altman plots in the lower MDs, the agreement is better and the data dispersion is lower, and in the higher MDs, the agreement is lower. The parameters of four visual field quadrants were also compared and showed poor correlations (P < 0.001). Conclusion The Oculus and Metrovision perimeter devices have good agreement in lower MDs; however, they cannot be used interchangeably.
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Affiliation(s)
- Ramin Daneshvar
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Asieh Ehsaei
- Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Optometry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nasrin Moghadas Sharif
- Department of Optometry, Mashhad University of Medical Sciences, Mashhad, Iran
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Pato
- Department of Optometry, Mashhad University of Medical Sciences, Mashhad, Iran
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Narang P, Agarwal A, Agarwal A, Narang R, Sundaramoorthy L. Comparative Analysis of 10-2 Test on Advanced Vision Analyzer and Humphrey Perimeter in Glaucoma. Ophthalmol Sci 2022; 3:100264. [PMID: 36846107 PMCID: PMC9944553 DOI: 10.1016/j.xops.2022.100264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 12/08/2022] [Accepted: 12/19/2022] [Indexed: 12/27/2022]
Abstract
Purpose To evaluate diagnostic precision and prove equivalence of 2 devices, Advanced vision analyzer (AVA, Elisar Vision Technology) and Humphrey field analyzer (HFA, Zeiss) for the detection of glaucoma on 10-2 program. Design Prospective, cross-sectional, observational study. Participants Threshold estimates of 1 eye each of 66 patients with glaucoma, 36 control participants, and 10 glaucoma suspects were analyzed on 10-2 test with AVA and HFA. Methods Mean sensitivity (MS) values of 68 points and central 16 test points were calculated and compared. Intraclass correlation (ICC), Bland-Altman (BA) plots, linear regression of MS, mean deviation (MD), and pattern standard deviation (PSD) were computed to assess the 10-2 threshold estimate of the devices. Receiver operating characteristic curves were generated for MS and MD values, and the area under the curve (AUC) was compared with assessing diagnostic precision. Main Outcome Measures Mean sensitivity values of 68 points and central 16 points, AUC for MS and MD values, ICC values, BA plots, and linear-regression analysis. Results Bland-Altman plot showed significant correlation for MS, MD, and PSD values for both devices. For MS, the overall ICC value was 0.96 (P < 0.001) with a mean bias of 0.0 dB and limits of agreement range of 7.59. The difference in MS values between both devices was -0.4760 ± 1.95 (P > 0.05). The AUC for MS values for AVA was 0.89 and for HFA was 0.92 (P = 0.188); whereas it was similar at 0.88 for MD values (P = 0.799). Advanced vision analyzer and HFA identically discriminated between healthy and patients with glaucoma (P < 0.001), although HFA denoted marginally greater ability (P > 0.05). Conclusions Statistical results denote adequate equivalence between AVA and HFA because threshold estimates of AVA strongly correlate with HFA for 10-2 program. Financial Disclosures Proprietary or commercial disclosure may be found after the references.
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Key Words
- AUC, area under the curve
- AVA
- AVA, Advanced vision analyzer
- Advanced vision analyzer
- BA, Bland–Altman
- HFA
- HFA, Humphrey field analyzer
- ICC, intraclass correlation
- LOA, limits of agreement
- Lb, background luminance
- Ls, stimulus luminance
- MB, mean bias
- MD, mean deviation
- MS, mean sensitivity
- PSD, pattern standard deviation
- ROC, receiver operating characteristic
- VR perimeter
- VR, virtual reality
- Visual field test
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Affiliation(s)
- Priya Narang
- Narang Eye Care & Laser Centre, Ahmedabad, Gujarat, India,Correspondence: Priya Narang, MS, Narang Eye Care & Laser Centre, AEON Complex, 2 nd Floor, Vijay cross roads, Ahmedabad 380009, India.
| | - Amar Agarwal
- Dr. Agarwal’s Eye Hospital & Research Centre, Chennai, Tamil Nadu, India
| | - Ashvin Agarwal
- Dr. Agarwal’s Eye Hospital & Research Centre, Chennai, Tamil Nadu, India
| | - Rhea Narang
- Narang Eye Care & Laser Centre, Ahmedabad, Gujarat, India,SMT. NHL Medical College, Ahmedabad, Gujarat, India
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Hsia Y, Wang TH, Huang JY, Su CC. Evaluation of the association between macular damage and disability glare in patients with advanced glaucoma. Graefes Arch Clin Exp Ophthalmol 2022. [PMID: 35192030 DOI: 10.1007/s00417-022-05593-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 02/01/2022] [Accepted: 02/10/2022] [Indexed: 11/04/2022] Open
Abstract
PURPOSE This study aimed to investigate the factors associated with disability glare in patients with advanced glaucoma and evaluate the impact of disability glare on the vision-related quality of life. METHODS We prospectively studied 225 eyes (225 patients) with advanced glaucoma. The visual function was evaluated using the 10-2 and 24-2 Humphrey visual field (VF) (Dublin, California) and contrast sensitivity test. Structural parameters were obtained using RTVue optical coherence tomography and angiography (Fremont, California). Significant loss of macular vessel density (mVD) was defined as VD < 30%. Each participant completed the National Eye Institute Visual Function Questionnaire 25 (NEI-VFQ-25) and questions regarding subjective symptoms of glare. RESULTS Fifty-six patients (24.9%) experienced glare and had a lower NEI-VFQ-25 composite score (P = 0.017). The average retinal nerve fiber layer and ganglion cell complex thickness and mean deviation (MD) in the 24-2 VF test were not associated with glare. Significant superior or inferior mVD loss (P < 0.001; odds ratio [OR], 3.45; and 95% confidence interval [CI], 1.83-6.55), lower logarithmic contrast sensitivity at 0.75 cycles/degree (P < 0.001; OR, 0.27; and 95% CI, 0.13-0.56), and worse MD in the 10-2 VF test (P < 0.001; OR, 0.93; and 95% CI, 0.89-0.97) showed an association with glare. CONCLUSION In advanced glaucoma, central VF defect and mVD loss are associated with disability glare, which negatively impacts vision-related quality of life.
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Bae SH, Yi K. Comparison of clinical usefulness of central 30-2 and 24-2 threshold tests using SITA strategy. Int Ophthalmol 2021. [PMID: 34628542 DOI: 10.1007/s10792-021-02034-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 09/22/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To compare the clinical utilities of the SITA-based central 24-2 and 30-2 threshold tests. METHODS Three hundred sixty-five (365) eyes of 183 glaucoma and glaucoma suspect patients who had undergone both central 30-2 and 24-2 threshold testing using the Swedish interactive threshold algorithm (SITA) standard strategy were retrospectively reviewed. The tests were performed in patients with a minimum visual acuity of LogMAR best-corrected visual acuity (BCVA) 0.3. We compared test time, fixation loss (%), false-positive error rate (%), and false-negative error rate (%), all of which are indices of reliability. We additionally compared the mean deviation (MD), pattern standard deviation (PSD), and visual field index (VFI), all of which are indices of the visual field test. RESULTS The mean age was 54.67 ± 14.95. MD, VFI, and fixation loss showed no significant difference between the 30-2 and 24-2 tests. As expected, 24-2 was shorter in duration: 5.64 ± 1.09 min versus 7.51 ± 1.38 min (p < .001), a 24.51 ± 9.45% difference. The false-positive error rate was significantly higher, but the false-negative error rate was lower, with the 24-2 threshold test (p = .009, p < .001). The PSD also was lower with 24-2 than with 30-2 (p < .001). CONCLUSION The two tests' VFI and MD are comparable. The 24-2 test may be a more efficient examination for most patients in terms of test time. In the other relevant aspects, the two tests are not identical. Therefore, it would be advisable to tailor visual field testing to the individual patient.
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Hsia Y, Lai TT, Su CC, Wang TH, Huang JY. Long-term structural and functional outcomes of primary congenital glaucoma. Graefes Arch Clin Exp Ophthalmol 2021; 259:2317-2326. [PMID: 33885985 DOI: 10.1007/s00417-021-05185-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 03/22/2021] [Accepted: 04/07/2021] [Indexed: 10/21/2022] Open
Abstract
PURPOSE To investigate the clinical characteristics and long-term outcomes of primary congenital glaucoma (PCG) patients. METHODS In this retrospective, longitudinal, cohort study, PCG patients with reliable visual field (VF) tests and optical coherence tomography (OCT) were included. Disease progression was detected using guided progression analysis with OCT and the change analysis of mean deviation (MD) slope with VF tests. Factors associated with the disease progression and visual prognosis were analyzed. RESULTS Twenty-nine eyes from 11 bilateral and 7 unilateral PCG patients were enrolled. LogMAR visual acuity declined (0.15 vs. 0.40, P < 0.001). The change rate of the average retinal nerve fiber layer thickness was - 0.83 ± 1.45 µm/year, and 28% of eyes showed glaucoma progression on OCT. The median of the MD slope was 0.16 (- 1.19 to 1.07) dB/year, and 14% of eyes showed glaucoma progression on the VF test. Higher average intraocular pressure (IOP) (P = 0.046) and IOP fluctuation (P = 0.031) predicted disease progression. None of the fellow eyes of unilateral PCG patients developed glaucoma during the follow-up. At last, 59% of eyes had visual acuity > 20/70, and 31% had MD > - 6 dB. Patients with worse baseline visual acuity (P = 0.027), worse baseline MD (P < 0.001), and smaller neuroretinal rim area (P < 0.001) showed worse final MD values. CONCLUSIONS Aggressive IOP control is necessary to prevent structural and functional decline in PCG patients. Their fellow eyes are not at risk of glaucoma. Baseline neuroretinal rim area can predict the functional outcome.
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Affiliation(s)
- Yun Hsia
- Department of Ophthalmology, National Taiwan University Hospital, No 7, Chung-Shan S. Rd., Taipei, 100, Taiwan.,National Taiwan University Hospital Jin-Shan Branch, New Taipei City, Taiwan
| | - Tso-Ting Lai
- Department of Ophthalmology, National Taiwan University Hospital, No 7, Chung-Shan S. Rd., Taipei, 100, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chien-Chia Su
- Department of Ophthalmology, National Taiwan University Hospital, No 7, Chung-Shan S. Rd., Taipei, 100, Taiwan
| | - Tsing-Hong Wang
- Department of Ophthalmology, National Taiwan University Hospital, No 7, Chung-Shan S. Rd., Taipei, 100, Taiwan
| | - Jehn-Yu Huang
- Department of Ophthalmology, National Taiwan University Hospital, No 7, Chung-Shan S. Rd., Taipei, 100, Taiwan.
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Muranyi DS, Kramer FH, Herbik A, Hoffmann MB. Scotopic multifocal visual evoked potentials. Clin Neurophysiol 2019; 130:379-387. [PMID: 30677707 DOI: 10.1016/j.clinph.2018.11.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 11/24/2018] [Accepted: 11/27/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To investigate the scope of scotopic multifocal visual evoked potentials (mfVEPS) for the assessment of scotopic visual fields. METHODS Pattern-reversal mfVEP for photopic (mfVEPP) and scotopic conditions (mfVEPS; 0.003 cd/m2) were recorded from 36 visual field locations of a circular checkerboard pattern (25° radius) in 9 participants with normal vision. MfVEPP were recorded with a conventional central fixation cross, mfVEPS were recorded (i) with (mfVEPS+) and (ii) without (mfVEPS-) an additional fixation aid. Latency shifts were determined using cross-correlations, mfVEP magnitudes were analysed in an eccentricity dependent manner using signal-to-noise ratios (SNRs). RESULTS In comparison to mfVEPP, mfVEPS- and mfVEPS+ were delayed by 101 ms and 97 ms, respectively, and had smaller signal-to-noise-ratios. Both mfVEPS were reduced down to noise level in the center and also severely reduced for the most peripheral stimulus eccentricity used. The visual-field-coverage for the paracentral eccentricities of mfVEPS+ and mfVEPS- was 76% and 65% [4°-9°], respectively, and 79% and 66% [9°-16°]. CONCLUSIONS MfVEPS were delayed compared to mfVEPP and demonstrated the expected central response drop-out typical for scotopic vision. SIGNIFICANCE MfVEPS may hold promise of an objective, spatially resolved visual field test which motivates testing it in patients with diseases affecting scotopic vision.
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Affiliation(s)
- D S Muranyi
- Department of Ophthalmology, Otto-von-Guericke University Magdeburg, Germany; Department of Ophthalmology, Martin-Luther University Halle, Germany
| | - F H Kramer
- Department of Ophthalmology, Otto-von-Guericke University Magdeburg, Germany; Beuth University of Applied Sciences, Berlin, Germany
| | - A Herbik
- Department of Ophthalmology, Otto-von-Guericke University Magdeburg, Germany
| | - M B Hoffmann
- Department of Ophthalmology, Otto-von-Guericke University Magdeburg, Germany; Center for Behavioral Brain Sciences, Magdeburg, Germany.
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Blanch RJ, Micieli JA, Oyesiku NM, Newman NJ, Biousse V. Optical coherence tomography retinal ganglion cell complex analysis for the detection of early chiasmal compression. Pituitary 2018; 21:515-523. [PMID: 30097827 DOI: 10.1007/s11102-018-0906-2] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE To report patients with sellar tumors and chiasmal compression with normal visual fields, who demonstrate damage to the retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) on optical coherence tomography (OCT). METHODS Seven patients with sellar tumors causing mass effect on the optic chiasm without definite visual field defect, but abnormal GCC are described. GCC/RNFL analyses using Cirrus-OCT were classified into centiles based on the manufacturer's reference range. RESULTS In seven patients with radiologic compression of the chiasm by a sellar tumor, OCT-GCC thickness detected compressive chiasmopathy before visual defects became apparent on standard automated visual field testing. Without OCT, our patients would have been labelled as having normal visual function and no evidence of compressive chiasmopathy. With only OCT-RNFL analysis, 3/7 patients would still have been labelled as having no compression of the anterior visual pathways. CONCLUSIONS These patients show that OCT-GCC analysis is more sensitive than visual field testing with standard automated perimetry in the detection of compressive chiasmopathy or optic neuropathy. These cases and previous studies suggest that OCT-GCC analysis may be used in addition to visual field testing to evaluate patients with lesions compressing the chiasm.
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Affiliation(s)
- Richard J Blanch
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK
| | - Jonathan A Micieli
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA
| | - Nelson M Oyesiku
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA, USA
| | - Nancy J Newman
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Valérie Biousse
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA.
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
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