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Al-Timimi Z, Campbell A, Keay L, Popovic G, Mulligan N, Thompson C, Game J, Hopley C, Rossiter-Thornton M, Nguyen E, Dunn H. Glaucoma severity at first presentation to an ophthalmologist and risk factors for late presentation in rural Australia: the S1P study. Clin Exp Optom 2025; 108:466-473. [PMID: 38844089 DOI: 10.1080/08164622.2024.2344835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 04/02/2024] [Accepted: 04/10/2024] [Indexed: 05/02/2025] Open
Abstract
CLINICAL RELEVANCE Well-targeted referrals and timely commencement of treatment are essential to limiting vision loss in glaucoma. Optometrists, primary care providers, and public health policymakers can utilise predictors of late to identify and target at-risk populations. BACKGROUND This study, which aimed to evaluate glaucoma severity at first presentation to an ophthalmologist in a rural Australian population, is the first of its kind in an Australian population. METHODS Patient records from a large ophthalmology clinic in Port Macquarie, NSW were retrospectively reviewed using the Fight Glaucoma Blindness registry to identify patients who were first diagnosed with glaucoma at an ophthalmology practice in 2020 or 2021. Associations with glaucoma severity at presentation, measured with visual field index (VFI), were analysed using a beta-regression model. Retinal nerve fibre layer measurements were evaluated as a secondary outcome measure using linear regression. RESULTS From 3548 new patients seen, 110 cases of glaucoma were diagnosed, 95 of whom met inclusion criteria. These comprised 41.8% primary open-angle glaucoma, 32.7% normal-tension glaucoma, 11.8% secondary open-angle glaucoma, 12.7% primary angle closure glaucoma, and 0.9% secondary angle closure glaucoma. The median VFI at presentation was 94.5%, and 71.9% of patients had a VFI ≥ 90%. However, 6.3% of patients presented with a VFI below 50%. Older age, higher intraocular pressure, and worse visual acuity were significantly associated with severity at presentation. No associations were found for remoteness, sex, family history, or glaucoma type. CONCLUSIONS Glaucoma appears to be diagnosed relatively early in this population. Severity at presentation was associated with age, intraocular pressure, and visual acuity, but not influenced by the social determinants assessed. These findings underscore the importance of frequent comprehensive eye examinations in older patients. Replication in other Australian populations is recommended as the generalisability of these findings is limited.
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Affiliation(s)
- Zayn Al-Timimi
- Rural Clinical School, University of New South Wales, Port Macquarie, Autralia
| | - Alexis Campbell
- Rural Clinical School, University of New South Wales, Port Macquarie, Autralia
| | - Lisa Keay
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Gordana Popovic
- Mark Wainwright Analytical Centre, University of New South Wales, Sydney, Australia
| | | | | | - Justin Game
- Port Macquarie Eye Centre, Port Macquarie, Australia
| | | | | | - Ethan Nguyen
- Port Macquarie Eye Centre, Port Macquarie, Australia
| | - Hamish Dunn
- Rural Clinical School, University of New South Wales, Port Macquarie, Autralia
- Port Macquarie Eye Centre, Port Macquarie, Australia
- Department of Ophthalmology, Save Sight Institute, Sydney University, Sydney, Australia
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Yang CN, Chen CP, Hsieh YT. Analysis of macular retinal thickness in polyarteritis nodosa using spectral domain optical coherence tomography. J Ophthalmic Inflamm Infect 2025; 15:6. [PMID: 39808358 PMCID: PMC11732801 DOI: 10.1186/s12348-025-00453-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2024] [Accepted: 01/03/2025] [Indexed: 01/16/2025] Open
Abstract
PURPOSE To identify the macular retinal layer thickness changes in polyarteritis nodosa (PAN) patients without pathological findings appearing in color fundus photography (CFP), and to investigate the correlations with disease durations. METHODS A total of 24 PAN patients who had been for 3 years or more and underwent SD-OCT were recruited from the UK Biobank, with exclusions for diabetes, eye disease, or abnormal CFP findings. Only the right eyes were included, with each PAN patient paired one-to-one with a control matched for age, sex, and ethnicity. Paired t-tests or Wilcoxon Signed-Rank tests were used to assess the differences in thickness of different retinal layers between groups, followed by linear regression analysis to evaluate the correlations with disease durations. RESULTS PAN patients had significantly thinner retinal nerve fiber layer (RNFL) by 12.27% (mean ± standard deviation = 27.39 ± 8.94 μm for PAN patients and 31.22 ± 5.57 μm for controls, p = 0.048) and thinner outer plexiform and outer nuclear layers (OPL-ONL complex) by 10.67% (44.93 ± 6.59 μm for PAN patients and 50.31 ± 7.60 μm for controls, p = 0.032). Visual acuity and the whole macular thickness showed no statistical difference. The RNFL was thinned by 1.22 μm per year of disease progression (95% confidence interval: 0.12, 2.32, p = 0.042). CONCLUSIONS PAN patients without visual impairments or abnormal CFP findings may exhibit significant thinning in RNFL and OPL-ONL complex. SD-OCT may serve as a useful tool for early screening of ophthalmic changes in PAN.
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Affiliation(s)
- Che-Ning Yang
- School of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chia-Ping Chen
- Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Ting Hsieh
- School of Medicine, National Taiwan University, Taipei, Taiwan.
- Department of Ophthalmology, National Taiwan University Hospital, 7 Zhongshan S. Rd., Zhongzheng Dist., Taipei, 10002, Taiwan.
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Joo HJ, Moon Y, Jung JH. Variability of relationship between inner-retinal structural changes and visual dysfunction in optic neuropathy. Sci Rep 2024; 14:12069. [PMID: 38802443 PMCID: PMC11130194 DOI: 10.1038/s41598-024-62704-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 05/20/2024] [Indexed: 05/29/2024] Open
Abstract
Optical coherence tomography (OCT) displays the retinal nerve fiber layer (RNFL) or macular ganglion cell and inner plexiform layer (GCIPL) thickness below 1st percentile in red color. This finding generally indicates severe inner-retinal structural changes and suggests poor visual function. Nevertheless, some individuals show preserved visual function despite these circumstances. This study aimed to identify the correlation between best-corrected visual acuity (BCVA) and inner-retinal thickness based on OCT parameters in various optic neuropathy patients with extremely low RNFL/GCIPL thickness, and determine the limitation of OCT for predicting visual function in these patients. 131 patients were included in the study. The mean BCVA in logMAR was 0.55 ± 0.70 with a broad range from - 0.18 to 3.00. Among the OCT parameters, temporal GCIPL (r = - 0.412) and average GCIPL (r = - 0.366) exhibited the higher correlations with BCVA. Etiological comparisons of optic neuropathies revealed significantly lower BCVA in LHON (all p < 0.05). Idiopathic optic neuritis (ON) and MOGAD exhibited better and narrower BCVA distributions compared to the other optic neuropathies. OCT had limited utility in reflecting BCVA, notwithstanding significant inner-retinal thinning after optic nerve injuries. Caution is needed in interpreting OCT findings, especially as they relate to the etiology of optic neuropathy.
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Affiliation(s)
- Hye Jun Joo
- Department of Ophthalmology, Seoul National University Hospital, Seoul, South Korea
| | - Yeji Moon
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jae Ho Jung
- Department of Ophthalmology, Seoul National University Hospital, Seoul, South Korea.
- Department of Ophthalmology, Seoul National University College of Medicine, 101, Daehak-ro Jongno-gu, Seoul, 03080, South Korea.
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Wu JH, Moghimi S, Nishida T, Mohammadzadeh V, Kamalipour A, Zangwill LM, Weinreb RN. Association of macular OCT and OCTA parameters with visual acuity in glaucoma. Br J Ophthalmol 2023; 107:1652-1657. [PMID: 36126109 PMCID: PMC9995602 DOI: 10.1136/bjo-2022-321460] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 08/08/2022] [Indexed: 12/17/2022]
Abstract
BACKGROUND/AIMS To investigate the association of macular optical coherence tomography (OCT)/OCT angiography (OCTA) parameters with visual acuity (VA) in glaucoma. METHODS 144 pseudophakic primary open-angle glaucoma eyes were included. Foveal (fVD), parafoveal (pf), perifoveal (perifVD) and whole-image vessel densities (wiVD) of superficial and deep layers, and their corresponding ganglion cell complex (GCC) thicknesses were obtained from OCTA 6×6 mm2 macula scans. Foveal avascular zone (FAZ) area, FAZ circumference and foveal density-300 (FD300) were measured. Correlation between OCT/OCTA parameters and Logarithm of the Minimum Angle of Resolution VA (logMAR VA) in early and moderate-advanced glaucoma was evaluated with age and Signal Strength Index-adjusted mixed models. Area under receiver operating characteristic (AUC) was used to evaluate discriminative power of OCT/OCTA for decreased VA (<20/25). RESULTS In early glaucoma (80 eyes), no parameter correlated with VA. In moderate-advanced glaucoma (64 eyes), greater FAZ area (β=0.228) and circumference (β=0.063) correlated with worse VA (p<0.05), but not FD300. fThinner sectoral and global GCC was associated with worse VA (β=0.002-0.003, p<0.05), except for inferior hemifield perifGCC and wiGCC. For VD, lower superior hemifield superficial perifVD and wiVD (β=0.007-0.008) and deep fVD (β=0.004) correlated with worse VA (p<0.05). OCT/OCTA parameters showed modest ability to discriminate decreased VA, with the superior hemifield performing better than the inferior hemifield. In early glaucoma, GCC and VD showed similar discrimination (AUC=0.67-0.77). In moderate-advanced glaucoma, fGCC and pfGCC yielded higher AUC (0.75-0.81) than VD (AUC=0.63-0.72). CONCLUSIONS Some macular OCT/OCTA parameters were associated with VA in moderate-advanced, but not early glaucoma. These structural parameters may help identify glaucoma patients with impaired vision and reduced quality of life. TRIAL REGISTRATION NUMBER NCT00221897.
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Affiliation(s)
- Jo-Hsuan Wu
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California, USA
| | - Sasan Moghimi
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California, USA
| | - Takashi Nishida
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California, USA
| | - Vahid Mohammadzadeh
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California, USA
| | - Alireza Kamalipour
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California, USA
| | - Linda M Zangwill
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California, USA
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California, USA
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Shiga Y, Nishida T, Jeoung JW, Di Polo A, Fortune B. Optical Coherence Tomography and Optical Coherence Tomography Angiography: Essential Tools for Detecting Glaucoma and Disease Progression. FRONTIERS IN OPHTHALMOLOGY 2023; 3:1217125. [PMID: 37982032 PMCID: PMC10655832 DOI: 10.3389/fopht.2023.1217125] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/03/2023] [Indexed: 11/21/2023]
Abstract
Early diagnosis and detection of disease progression are critical to successful therapeutic intervention in glaucoma, the leading cause of irreversible blindness worldwide. Optical coherence tomography (OCT) is a non-invasive imaging technique that allows objective quantification in vivo of key glaucomatous structural changes in the retina and the optic nerve head (ONH). Advances in OCT technology have increased the scan speed and enhanced image quality, contributing to early glaucoma diagnosis and monitoring, as well as the visualization of critically important structures deep within the ONH, such as the lamina cribrosa. OCT angiography (OCTA) is a dye-free technique for noninvasively assessing ocular microvasculature, including capillaries within each plexus serving the macula, peripapillary retina and ONH regions, as well as the deeper vessels of the choroid. This layer-specific assessment of the microvasculature has provided evidence that retinal and choroidal vascular impairments can occur during early stages of glaucoma, suggesting that OCTA-derived measurements could be used as biomarkers for enhancing detection of glaucoma and its progression, as well as to reveal novel insights about pathophysiology. Moreover, these innovations have demonstrated that damage to the macula, a critical region for the vision-related quality of life, can be observed in the early stages of glaucomatous eyes, leading to a paradigm shift in glaucoma monitoring. Other advances in software and hardware, such as artificial intelligence-based algorithms, adaptive optics, and visible-light OCT, may further benefit clinical management of glaucoma in the future. This article reviews the utility of OCT and OCTA for glaucoma diagnosis and disease progression detection, emphasizes the importance of detecting macula damage in glaucoma, and highlights the future perspective of OCT and OCTA. We conclude that the OCT and OCTA are essential glaucoma detection and monitoring tools, leading to clinical and economic benefits for patients and society.
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Affiliation(s)
- Yukihiro Shiga
- Neuroscience Division, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Québec H2X 0A9, Canada
- Department of Neuroscience, Université de Montréal, Montréal, Québec H3C 3J7, Canada
| | - Takashi Nishida
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California 92093, USA
| | - Jin Wook Jeoung
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Adriana Di Polo
- Neuroscience Division, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Québec H2X 0A9, Canada
- Department of Neuroscience, Université de Montréal, Montréal, Québec H3C 3J7, Canada
| | - Brad Fortune
- Discoveries in Sight Research Laboratories, Devers Eye Institute and Legacy Research Institute, Legacy Health, 1225 NE Second Avenue, Portland, Oregon 97232, USA
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Wu JH, Moghimi S, Nishida T, Kamalipour A, Liebmann JM, Fazio M, Girkin CA, Zangwill LM, Weinreb RN. Association Between Longitudinal 10-2 Central Visual Field Change and the Risk of Visual Acuity Loss in Mild-to-Moderate Glaucoma. J Glaucoma 2023; 32:549-555. [PMID: 37171991 PMCID: PMC10330348 DOI: 10.1097/ijg.0000000000002236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 04/16/2023] [Indexed: 05/14/2023]
Abstract
PRCIS Faster worsening of 10-2 visual field (VF) was associated with the development of visual acuity (VA) loss in mild-to-moderate glaucoma, suggesting longitudinal 10-2 VF change is associated with the risk of VA impairment. PURPOSE To examine whether longitudinal 10-2 central VF change is associated with the risk of VA loss in glaucoma. PATIENTS AND METHODS Primary open angle glaucoma and glaucoma suspect eyes with ≥3 years and 5 visits of 10-2 VF examinations were included. Cox proportional hazard modeling with shared frailty was used to evaluate the hazard ratio (HR) of 10-2 VF mean deviation (MD), superior hemifield mean sensitivity (hemi-MS), and inferior hemi-MS worsening rates for developing VA loss, defined as a change in logMAR VA ≥95% test-retest variability. RESULTS Among the 252 eyes (148 participants, mean follow-up = 5.8 y), 30 eyes (21 participants, mean follow-up = 4.9 y) developed VA loss. There was no difference in baseline VF between eyes with and without VA loss ( P > 0.05). Eyes with VA loss showed faster 10-2 VF MD worsening [-0.39 (95% CI: -0.60, -0.18) dB/y] and hemi-MS decrease (range: -0.42~-0.38 dB/y), as compared with no-VA loss eyes [10-2 VF MD change = -0.11 (-0.16, -0.07) dB/y; hemi-MS change: -0.12~-0.07 dB/y; P < 0.05]. In the multivariable model, faster 10-2 VF MD worsening [HR (95% CI) = 4.05 (1.61, 10.22), per 1 dB/y faster], superior hemi-MS decrease [HR (95% CI) = 7.07 (2.48, 20.14), per 1 dB/y faster], and inferior hemi-MS decrease [HR (95% CI) = 8.32 (1.99, 34.91), per 1 dB/y faster] were all associated with increased risk of developing VA loss ( P < 0.05). CONCLUSIONS Faster 10-2 VF MD and hemifield MS worsening are associated with the development of VA loss. Monitoring the longitudinal central 10-degree VF change may suggest that there is impending VA impairment in glaucoma.
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Affiliation(s)
- Jo-Hsuan Wu
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, United States
| | - Sasan Moghimi
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, United States
| | - Takashi Nishida
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, United States
| | - Alireza Kamalipour
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, United States
| | - Jeffrey M Liebmann
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, New York
| | - Massimo Fazio
- Department of Ophthalmology and Vision Sciences, Heersink School of Medicine, University of Alabama-Birmingham, Birmingham
| | - Christopher A Girkin
- Department of Ophthalmology and Vision Sciences, Heersink School of Medicine, University of Alabama-Birmingham, Birmingham
| | - Linda M. Zangwill
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, United States
| | - Robert N. Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, United States
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Arrigo A, Aragona E, Perra C, Saladino A, Amato A, Bianco L, Pina A, Basile G, Bandello F, Battaglia Parodi M. Morphological and functional involvement of the inner retina in retinitis pigmentosa. Eye (Lond) 2023; 37:1424-1431. [PMID: 35768721 PMCID: PMC10169765 DOI: 10.1038/s41433-022-02139-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 05/09/2022] [Accepted: 06/10/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND To investigate the morphological retinal parameters associated with retinal sensitivity status in retinitis pigmentosa (RP) through a quantitative multimodal imaging approach. METHODS The study was designed as an observational, prospective case series, including RP patients and healthy controls. Multimodal imaging included fundus autofluorescence (FAF), structural optical coherence tomography (OCT), OCT angiography (OCTA) and microperimetry (MP). The follow-up lasted 12 months. For each imaging modality, we performed an overall quantitative analysis and a detailed investigation based on the ETDRS-9 sectors grid. Quantitative parameters included the thickness of each retinal and choroidal layer, vessel density (VD), choriocapillaris porosity (CCP), FAF intensity and MP retinal sensitivity. RESULTS We included 40 eyes (40 patients) affected by RP and 40 healthy eyes (40 controls). Mean baseline BCVA was 0.14 ± 0.18 LogMAR, with 0.18 ± 0.24 LogMAR after 1-year of follow-up. RP eyes showed statistically significant alterations of retinal and choroidal layers on the ETDRS-9 sectors grid, significant reduction of VD values and MP retinal sensitivity, and significantly higher CCP than controls. The inner retinal layers proved closely associated with the functional integrity of the posterior pole. In addition, our ROC analysis provided quantitative cutoffs connected significantly with a high probability of observing a partial sparing of MP retinal sensitivity. CONCLUSIONS The inner retinal layers are closely associated with the functional integrity of the posterior pole in RP. FAF intensity reduction may be interpreted as lipofuscin metabolism impairment inducing increased phototoxic distress for retinal structures. Vascular involvement contributes to the morpho-functional deterioration of the macular region in RP.
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Affiliation(s)
- Alessandro Arrigo
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
| | - Emanuela Aragona
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Cristian Perra
- Department of Electrical and Electronic Engineering (DIEE), CNIT Research Unit, University of Cagliari, Cagliari, Italy
| | - Andrea Saladino
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alessia Amato
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lorenzo Bianco
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Adelaide Pina
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giulia Basile
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesco Bandello
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Kim HJ, Sung MS, Park SW. Factors Associated with Visual Acuity in Advanced Glaucoma. J Clin Med 2023; 12:jcm12093076. [PMID: 37176517 PMCID: PMC10179664 DOI: 10.3390/jcm12093076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/19/2023] [Accepted: 04/22/2023] [Indexed: 05/15/2023] Open
Abstract
This study aimed to comprehensively analyze various parameters in advanced glaucoma patients to identify the factors that can affect best-corrected visual acuity (BCVA) in advanced glaucoma. This cross-sectional retrospective study included 113 patients (mean age, 61.66 ± 13.26 years; males, 67) who had advanced glaucomatous damage (113 eyes; mean BCVA, 0.18 ± 0.38 logMAR; mean deviation of 30-2 visual field [VF], -19.08 ± 6.23 dB). Peripapillary retinal nerve fiber layer (RNFL) and total and segmented macular thickness (RNFL, ganglion cell layer (GCL), and inner plexiform layer (GCL)) were measured using Spectralis optical coherence tomography (OCT). Correlations between BCVA and OCT parameters or 30-2 VF parameters were assessed using Pearson correlation analysis. Multivariate regression analysis was performed to determine the factors associated with BCVA in advanced glaucoma patients. Peripapillary RNFL thickness, subfoveal choroidal thickness, and global macular RNFL, GCL, IPL, and total thickness were found to be significantly correlated with BCVA and central visual function. Multivariate analysis showed a significant correlation between subfoveal choroidal thickness and BCVA. In addition, central VF mean sensitivity, especially inferior hemifield, showed a significant relationship with BCVA. In conclusion, subfoveal choroidal thickness and central VF sensitivity, especially the inferior hemifield area, are factors that affect BCVA in advanced glaucoma.
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Affiliation(s)
- Hyun Jee Kim
- Department of Ophthalmology, Research Institute of Medical Sciences, Chonnam National University Medical School and Hospital, Gwangju 61469, Republic of Korea
| | - Mi Sun Sung
- Department of Ophthalmology, Research Institute of Medical Sciences, Chonnam National University Medical School and Hospital, Gwangju 61469, Republic of Korea
| | - Sang Woo Park
- Department of Ophthalmology, Research Institute of Medical Sciences, Chonnam National University Medical School and Hospital, Gwangju 61469, Republic of Korea
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Sun CC, Wu IW, Lee CC, Liu CF, Lin YT, Yeung L. Retinal Neurodegeneration and Visual Acuity Decline in Patients with Chronic Kidney Disease. Ophthalmol Ther 2023; 12:909-923. [PMID: 36571674 PMCID: PMC10011354 DOI: 10.1007/s40123-022-00635-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 12/06/2022] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Chronic kidney disease (CKD) has been associated with accelerated retinal neurodegeneration. The purpose of this study is to evaluate the association between retinal neurodegeneration and the best-corrected visual acuity (BCVA) decline in patients with CKD. METHODS Post hoc analysis of two prospective studies. Patients with CKD stage ≥ 3 were enrolled. Macular thickness, peripapillary retinal nerve fiber layer (pRNFL) thickness, and macular ganglion cell complex (GCC) thickness were measured by optical coherence tomography. Eyes were classified into three groups: Group 1, no GCC defect; Group 2, GCC defect confined to parafoveal area; and Group 3, GCC defects extending beyond the parafoveal area. Each group was matched for age, sex, axial length, lens status, and cataract grading. RESULTS A total of 120 eyes (40 eyes in each group) from 120 patients (age 63.0 ± 10.3 years) were included. The logMAR BCVA was 0.076 ± 0.101, 0.100 ± 0.127, and 0.196 ± 0.191 in Group 1, 2, and 3, respectively. Group 3, but not Group 2, had a significantly worse BCVA than Group 1. In simple linear regression, parafoveal inner retinal thickness, pRNFL thickness, presence of pRNFL defect, GCC thickness, GCC global loss volume, GCC focal loss volume, and GCC defect extending beyond parafoveal area were associated with BCVA. Central subfield retinal thickness (CRT), parafoveal full retinal thickness, and parafoveal outer retinal thickness were not associated with BCVA. In backward stepwise linear regression, age and GCC defects extending beyond the parafoveal area were factors associated with BCVA. Moreover, GCC defect extending beyond parafoveal area was connected with worse BCVA in both phakic and pseudophakic subgroups. CONCLUSIONS GCC defect extending beyond parafoveal area could be an independent biomarker associated with decreased BCVA in patients with CKD. However, macular thinning measured by CRT or parafoveal full retinal thickness might have low discriminative power in determining BCVA.
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Affiliation(s)
- Chi-Chin Sun
- Department of Ophthalmology, Keelung Chang Gung Memorial Hospital, No. 222, Maijin Rd., Anle Dist., Keelung, 20401, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Chinese Medicine, Chang Gung University, Taoyuan, Taiwan
| | - I-Wen Wu
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Nephrology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.,Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Chin-Chan Lee
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Nephrology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Chun-Fu Liu
- Department of Ophthalmology, Keelung Chang Gung Memorial Hospital, No. 222, Maijin Rd., Anle Dist., Keelung, 20401, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Program in Molecular Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yu-Tze Lin
- Department of Ophthalmology, Keelung Chang Gung Memorial Hospital, No. 222, Maijin Rd., Anle Dist., Keelung, 20401, Taiwan.,Retina Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Ling Yeung
- Department of Ophthalmology, Keelung Chang Gung Memorial Hospital, No. 222, Maijin Rd., Anle Dist., Keelung, 20401, Taiwan. .,College of Medicine, Chang Gung University, Taoyuan, Taiwan. .,Retina Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.
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10
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Association of macular structure, function, and vessel density with foveal threshold in advanced glaucoma. Sci Rep 2022; 12:19771. [PMID: 36396716 PMCID: PMC9671888 DOI: 10.1038/s41598-022-24129-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 11/10/2022] [Indexed: 11/18/2022] Open
Abstract
Identifying new biomarkers associated with central visual function impairment is important in advanced glaucoma patients. This retrospective cross-sectional study enrolled 154 eyes from 154 subjects, consisting of 86 patients with advanced open-angle glaucoma (mean deviation of 24-2 visual field [VF] tests < - 15 dB) and 68 healthy controls. Structure, function, and vessel density (VD) parameters were obtained using optical coherence tomography (OCT), 24-2 standard automated perimetry, and OCT angiography, respectively. The relationships of macular thickness, central 5° and 10° VF mean sensitivity (MS), and macular VD parameters with foveal threshold (FT), representing central visual function, were investigated using partial correlation analyses and linear regression analyses, with age adjustment. Superficial and deep layer macular VD, central 5° and 10° VF MS, and best corrected visual acuity (BCVA) correlated significantly with FT after age adjustment (P < 0.05). In multivariate linear regression analyses, FT associated significantly with BCVA (β = - 8.80, P < 0.001), central 5° MS (β = 0.30, P = 0.037), and deep-layer global parafoveal VD (β = 0.37, P = 0.037). Thus, deep-layer parafoveal VD is an independent predictor of FT and may be a potential biomarker for central visual function in advanced glaucoma.
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11
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Dong Y, Guo X, Arsiwala-Scheppach LT, Sharrett AR, Ramulu PY, Mihailovic A, Pan-Doh N, Mosley T, Coresh J, Abraham AG. Association of Optical Coherence Tomography and Optical Coherence Tomography Angiography Retinal Features With Visual Function in Older Adults. JAMA Ophthalmol 2022; 140:809-817. [PMID: 35834267 DOI: 10.1001/jamaophthalmol.2022.2099] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Importance Although there is abundant evidence relating neuronal and vascular optical coherence tomography (OCT) and OCT angiography (OCTA) measures to retinal disease, data on the normative distribution of retinal features and their associations with visual function in a healthy, older, community-based population are sparse. Objectives To characterize the normative OCT and OCTA measures in older adults and describe their associations with visual function. Design, Setting, and Participants This was a cross-sectional, observational study conducted from May 17, 2017, to May 31, 2019. The study included a community-based sample. Participants in the Atherosclerosis Risk in Communities study from Jackson, Mississippi (all self-reported Black participants), and Washington County, Maryland (all self-reported White participants), were recruited in the Eye Determinants of Cognition study (EyeDOC). Data analyses were conducted from June 14, 2020, to May 31, 2021. Main Outcomes and Measures Retinal measurements, including retinal nerve fiber layer (RNFL) thickness, macular ganglion cell complex (GCC) thickness, macular vessel density (VD) in the superficial capillary plexus (SCP) and deep capillary plexus (DCP), and foveal avascular zone (FAZ) area, were captured with spectral-domain OCT and OCTA. Visual function, including presenting distance vision, corrected distance vision, near visual acuity (VA), and contrast sensitivity (CS), was assessed. Results A total of 759 participants (mean [SD] age, 80 [4.2] years; 480 female participants [63%]; 352 Black participants [46%]) were included in the study. Mean (SD) GCC thickness (89.2 [9.3] μm vs 92.3 [8.5] μm) and mean (SD) FAZ (0.36 [0.16] mm2 vs 0.26 [0.12] mm2) differed between Jackson and Washington County participants, respectively. Mean (SD) RNFL thickness and mean (SD) VD in SCP and DCP were greater for participants 80 years or younger than for participants older than 80 years (RNFL: ≤80 years, 93.2 [10.5] μm; >80 years, 91.1 [11.6] μm; VD SCP, ≤80 years, 44.3% [3.5%]; >80 years, 43.5% [3.8%]; VD DCP, ≤80 years, 44.7% [4.9%]; >80 years, 43.7% [4.8%]). Linear regression showed each 10-μm increment in RNFL thickness and GCC thickness was positively associated with 0.016 higher logCS among all participants (RNFL: 95% CI, 0.005-0.027; P = .004; GCC: 95% CI, 0.003-0.029; P = .02), with stronger associations among Jackson participants. The associations of VA and structural measures were found only in Jackson participants, with coefficients per 10-μm increment of 0.012 logMAR VA (RNFL: 95% CI, 0.000-0.023; P = .049) and 0.020 logMAR VA (GCC: 95% CI, 0.004-0.034; P = .04). Conclusions and Relevance In this cross-sectional study, better CS was associated with greater RNFL thickness and GCC thickness, but no visual measures were associated with angiographic features overall. These findings suggest that clinical application of normative references for OCT- and OCTA-based measures should consider demographic and community features.
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Affiliation(s)
- Yanan Dong
- Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Xinxing Guo
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - A Richey Sharrett
- Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Pradeep Y Ramulu
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Aleksandra Mihailovic
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Nathan Pan-Doh
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Thomas Mosley
- The MIND Center, University of Mississippi Medical Center, Jackson
| | - Josef Coresh
- Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Alison G Abraham
- Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Department of Epidemiology, University of Colorado, Anschutz Medical Campus, Denver.,Department of Ophthalmology, University of Colorado, Anschutz Medical Campus, Denver
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12
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Buelens T, Fils JF, Willermain F. Posterior segment spectral domain oct in the differential diagnosis of bilateral temporal optic neuropathy and its correlation with visual acuity. Int Ophthalmol 2022; 42:3877-3889. [PMID: 35809163 DOI: 10.1007/s10792-022-02408-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/13/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE To identify the underlying etiologies and to evaluate the differential diagnostic value of posterior segment spectral domain OCT measurements and their correlation with best-corrected visual acuity (BCVA) in a group of patients with OCT documented bilateral optic neuropathy limited to the temporal quadrants. METHODS Retrospective study. RESULTS We included 61 patients: 35 presented with presumed "classic" acquired mitochondrial optic neuropathy (MON) (18 nutritional, 11 toxic, 6 mixed toxic-nutritional) and 2 with suspected hereditary MON. Nine patients were identified as 'MON mimickers' (especially multiple sclerosis), and 4 were found to have a mixed mechanism, while 11 remained undiagnosed. Across all etiologies, the strongest positive relationship between BCVA and tested OCT parameters was with macular GCL (ganglion cell layer) and GCIPL (combined ganglion cell and inner plexiform layer) volumes rather than peripapillary retinal nerve fiber layer (RNFL) thicknesses (all statistically significant). There was an inverse relationship between BCVA and inner nuclear layer (INL) volumes, with significant differences for BCVA and all tested OCT parameters between eyes with and without INL microcystoid lesions. OCT (absolute values and intereye differences) was not helpful in distinguishing between presumed acquired mitochondrial disease and patients with multiple sclerosis without optic neuritis. However, significantly greater intereye differences in global RNFL and inner plexiform layer and GCIPL volumes were found in patients with a previous history of unilateral optic neuritis. CONCLUSIONS The strongest positive relationship with BCVA was found for macular GCL and GCIPL volumes. OCT could not differentiate between acquired mitochondrial disease and multiple sclerosis without optic neuritis.
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Affiliation(s)
- Tom Buelens
- CHU St Pierre and Brugmann, Department of Ophthalmology, 322 rue Haute, 1000, Brussels, Belgium.
| | | | - François Willermain
- CHU St Pierre and Brugmann, Department of Ophthalmology, 322 rue Haute, 1000, Brussels, Belgium
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13
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Relationship Between Macular Microvasculature and Visual Acuity in Advanced and Severe Glaucoma. Am J Ophthalmol 2022; 236:154-163. [PMID: 34653358 DOI: 10.1016/j.ajo.2021.10.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 10/04/2021] [Accepted: 10/05/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE To evaluate the correlation between structural parameters and visual acuity (VA) in advanced glaucoma. DESIGN Prospective, cross-sectional study. METHODS A total of 238 eyes from 238 patients (82 were men and mean ± SD age was 59.9 ± 13.8 years) from a tertiary center were divided into an advanced (mean deviation of 24-2 visual field tests from -12.01 to -20.0 dB) and severe (< -20 dB) glaucoma group. Structural parameters were obtained by RTVue (Optovue Inc) optical coherence tomography and angiography. Pearson correlation, partial correlation adjusted for age and axial length, and receiver operating characteristic curves to detect decreased VA (<20/25) were performed. RESULTS In the advanced glaucoma group (133 eyes), superficial (Pearson correlation coefficient, r = -0.46, P < .001; partial correlation coefficient, r' = -0.30, P < .001) and deep macular vessel densities (VDs) (r = -0.47, P < .001; r' = -0.30, P < .001) showed highest correlation with VA. The area under the receiver operating characteristic curves of the superficial parafoveal/macular VDs were 0.816 (95% CI, 0.735-0.897) and 0.808 (95% CI, 0.725-0.891), respectively. In the severe glaucoma group (105 eyes), deep nasal grid VD (r = -0.31, P = 0.002; r' = -0.35, P < .001) showed highest correlation with VA. Deep macular VD showed better correlation with VA than other structural parameters. The area under the receiver operating characteristic curves of deep macular VD and deep nasal grid VD were 0.740 (95% CI, 0.632-0.849) and 0.748 (95% CI, 0.640-0.857), respectively. CONCLUSIONS Macular VD showed better correlation with VA in advanced glaucoma. Deep macular VD, especially nasal grid, may be a promising structural parameter in severe glaucoma.
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14
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Etheridge T, Liu Z, Nalbandyan M, Cleland S, Blodi BA, Mares JA, Bailey S, Wallace R, Gehrs K, Tinker LF, Gangnon R, Domalpally A. Association of Macular Thickness With Age and Age-Related Macular Degeneration in the Carotenoids in Age-Related Eye Disease Study 2 (CAREDS2), An Ancillary Study of the Women's Health Initiative. Transl Vis Sci Technol 2021; 10:39. [PMID: 34003924 PMCID: PMC7910637 DOI: 10.1167/tvst.10.2.39] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate the relationship of retinal layer thickness with age and age-related macular degeneration (AMD) in the Carotenoids in Age-Related Eye Disease Study 2. Methods Total retinal thickness within the macular area, and individual layer thickness was determined for CAREDS2 participants (n = 906 eyes, 473 women) from the Women's Health Initiative using Heidelberg optical coherence tomography (OCT). Mean measurements within the OCT grid were compared across age tertiles (69–78, 78–83, and 83–101 years) and AMD outcomes. Results Mean retinal thickness in the central circle, inner ring, and outer ring were 277 ± 34 µm, 326 ± 20 µm, and 282 ± 15 µm, respectively. Thickness did not vary by age in the central circle, but decreased with age in the inner and outer circles (P ≤ 0.004). Specifically, ganglion cell (GCL), inner plexiform, and outer nuclear (ONL) layer thickness decreased with age (P ≤ 0.003). Age-adjusted retinal thickness in all three circles did not vary by AMD outcomes (486 without AMD and 413 with AMD). However, individual layers showed changes with GCL and photoreceptor thinning and retinal pigment epithelial thicknening in eyes with late AMD. After controlling for age and AMD, higher ONL thickness was associated with better visual acuity. Conclusions In this cohort of older women, a decrease in perifoveal thickness was associated with increasing age, particularly in the inner retinal layers. Variabilty in thickness in AMD eyes was primarily due to outer retinal layers. Among all retinal layers, the ONL plays an important role in preserving visual acuity. Translational Relevance The study provides a deeper understanding of age related changes to the retinal layers and their effect on visual loss.
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Affiliation(s)
- Tyler Etheridge
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Zhe Liu
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Marine Nalbandyan
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Spencer Cleland
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Barbara A Blodi
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Julie A Mares
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Steven Bailey
- Oregon Health Sciences University Casey Eye Institute, Portland, OR, USA
| | - Robert Wallace
- University of Iowa, College of Public Health, Department of Epidemiology, Iowa City, IA, USA
| | - Karen Gehrs
- University of Iowa, Department of Ophthalmology, University of Iowa, Iowa City, IA, USA
| | - Lesley F Tinker
- Cancer Research Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Ronald Gangnon
- Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Department of Biostatistics & Medical Informatics, University of Wisconsin-Madison, Madison, WI, USA
| | - Amitha Domalpally
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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15
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Wen Y, Chen Z, Zuo C, Yang Y, Xu J, Kong Y, Cheng H, Yu M. High-Pass Visual Acuity Loss and Macular Structure-Function Relationship in Patients With Primary Open-Angle Glaucoma. Transl Vis Sci Technol 2021; 10:26. [PMID: 34004003 PMCID: PMC8083119 DOI: 10.1167/tvst.10.4.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The Logarithm of the Minimum Angle of Resolution (logMAR) chart is the most common clinical test for assessing central visual function in glaucoma. However, based on the use of these charts, visual acuity (VA) often remains normal even when severe macular damage exists. Here, we aim to investigate the potential advantages of high-pass VA in detecting glaucoma compared with conventional VA. Methods Monocular best-corrected VA measurements were compared for a novel high-pass electronic VA chart (e-chart) and a conventional e-chart in 113 primary open-angle glaucoma (POAG) patients with normal logMAR VA and 65 age-similar healthy controls. One hundred thirty-nine POAG patients underwent spectral-domain optical coherence tomography (SD-OCT) for measurement of macular ganglion cell layer plus inner plexiform layer (GCL+IPL) thickness. Structure-function relationships between OCT measurements and the two VAs were compared. The enrolled eyes were divided into two groups for further analyses according to macular visual field (MVF) defects, specifically two or more adjacent abnormal points within the 12 central sites of 30-2 VF. Results The mean deviation (MD) of 30-2 VF test was -12.77 ± 7.47 dB for glaucoma group and -1.70 ± 1.12 dB for control group. The mean difference of the two VAs was slightly larger in glaucoma group (0.29 logMAR) than in control group (0.22 logMAR). The area under the receiver operating characteristic curve of the high-pass e-chart was larger than that of conventional e-chart (0.917 vs. 0.757, P < 0.001). Significant correlations between high-pass VA and GCL+IPL thickness were found only in the MVF-damaged group. Compared with conventional VA, high-pass VA demonstrates stronger correlations with nasal-side macular GCL+IPL thickness (Fisher's Z-test, two-tailed, P2mmin diameter = 0.033 and P3mmin diameter = 0.005). Conclusions Compared with conventional VA, high-pass VA displays slightly higher sensitivity to visual loss in glaucoma and has a stronger correlation with the nasal-side macular GCL+IPL thickness. Translational Relevance The high-pass acuity test has the potential to be used as an ancillary tool to monitor glaucoma over time.
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Affiliation(s)
- Yun Wen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zidong Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Chengguo Zuo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yangfan Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jiangang Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yang Kong
- School of Electronics and Communication Engineering, Sun Yat-sen University, Shenzhen, China
| | - Hui Cheng
- School of Computer Science and Engineering, Sun Yat-sen University, Guangzhou, China
| | - Minbin Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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16
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Wen Y, Chen Z, Zuo C, Yang Y, Xu J, Kong Y, Cheng H, Yu M. Low-Contrast High-Pass Visual Acuity Might Help to Detect Glaucoma Damage: A Structure-Function Analysis. Front Med (Lausanne) 2021; 8:680823. [PMID: 34055847 PMCID: PMC8160221 DOI: 10.3389/fmed.2021.680823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 04/19/2021] [Indexed: 11/20/2022] Open
Abstract
Purpose: The conventional visual acuity (VA) test is not sensitive enough to detect glaucoma macular damage. We aimed to investigate whether VA measurements using low-contrast high-pass optotypes are more sensitive to macular dysfunction in glaucoma and to find the potential structural basis of this difference. Methods: A total of 147 subjects were recruited, including 118 patients with glaucoma (mean age: 46.08 ± 14.64 years) and 29 healthy controls (mean age: 39.83 ± 9.81 years). For each participant, monocular best-corrected VA was measured using a conventional chart and six high-pass charts at 100, 50, 10, 5, 2.5, and 1.25% contrast levels, respectively. The macular retinal thickness and circumpapillary retinal nerve fiber layer (cpRNFL) thickness of all the glaucoma patients were obtained by spectral-domain optical coherence tomography (SD-OCT). Results: Compared with healthy subjects, glaucoma patients with normal vision demonstrated worse VAs in high-pass acuity measurements (0.22–0.93 vs. 0.28–1.08, p < 0.05). Receiver operating characteristic curve (ROC) showed that 1.25% low-contrast high-pass VA was optimal for discriminating between the controls and glaucoma patients (AUC: 0.918, p < 0.001; sensitivity: 77.33%; specificity: 96.55%). Compared with conventional VA, 1.25% high-pass VA correlated better with nasal-side macular retinal ganglion cell (RGC)-related parameters (r = −0.419 to −0.446 vs. r = −0.538 to −0.582; Fisher's Z transformation, pz < 0.05). There was no difference in the strength of correlations between the VAs measured using different charts and cpRNFL thickness (Fisher's Z transformation; pz > 0.05). Conclusions: VA measurement taken with low-contrast (1.25%) high-pass acuity chart is more sensitive in detecting central visual loss in glaucoma than that taken with the conventional chart. Macular RGC damage appears to be associated with low-contrast (1.25%) high-pass visual loss in glaucomatous eyes.
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Affiliation(s)
- Yun Wen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zidong Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Chengguo Zuo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yangfan Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jiangang Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yang Kong
- School of Electronics and Communication Engineering, Sun Yat-sen University, Shenzhen, China
| | - Hui Cheng
- School of Computer Science and Engineering, Sun Yat-sen University, Guangzhou, China
| | - Minbin Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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17
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Suzuki Y, Kiyosawa M. Visual Acuity in Glaucomatous Eyes Correlates Better with Visual Field Parameters than with OCT Parameters. Curr Eye Res 2021; 46:1717-1723. [PMID: 33910431 DOI: 10.1080/02713683.2021.1924384] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The visual acuity is very important for glaucoma patients in their lives. The purpose of this study was to examine about the correlation of visual acuity and visual field (VF) parameters or optical coherence tomography (OCT) parameters in patients with glaucoma. We evaluated 210 eyes of 210 patients (110 men and 100 women; mean age, 69.6 ± 9.6 years) with open-angle glaucoma and 68 eyes of healthy controls. In glaucomatous eyes including healthy eyes, correlation between visual acuity and each of the VF parameters or each of the OCT parameters was estimated using regression analyses. The average visual acuity of control group was - 0.08, and that of glaucoma group was - 0.06 (early stage), - 0.03 (moderate stage), and 0.08 (severe stage), respectively. Regression analyses including healthy eyes and glaucomatous eyes revealed significant correlations between visual acuity and mean deviation (MD) of 30-2 Humphrey VF (rs = - 0.44), MD of 10-2 VF (rs = - 0.45), total deviation in central 10-2 VF (rs = - 0.42), ganglion cell complex thickness (macula, rs = - 0.33; superior, rs = - 0.33; inferior, rs = - 0.35; and global, rs = - 0.34), and circumpapillary retinal nerve fiber layer (rs = - 0.38). The visual acuity of glaucomatous eyes correlated with VF parameters and OCT parameters. The visual acuity decreased as glaucoma progressed.
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Affiliation(s)
- Yukihisa Suzuki
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan.,Department of Ophthalmology, Japan Community Health Care Organization, Mishima General Hospital, Mishima, Japan.,Research Team for Neuroimaging, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Motohiro Kiyosawa
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan.,Kiyosawa Eye Clinic, Tokyo, Japan
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18
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Mohammadzadeh V, Fatehi N, Yarmohammadi A, Lee JW, Sharifipour F, Daneshvar R, Caprioli J, Nouri-Mahdavi K. Macular imaging with optical coherence tomography in glaucoma. Surv Ophthalmol 2020; 65:597-638. [PMID: 32199939 PMCID: PMC7423773 DOI: 10.1016/j.survophthal.2020.03.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 03/10/2020] [Accepted: 03/12/2020] [Indexed: 02/07/2023]
Abstract
With the advent of spectral-domain optical coherence tomography, imaging of the posterior segment of the eye can be carried out rapidly at multiple anatomical locations, including the optic nerve head, circumpapillary retinal nerve fiber layer, and macula. There is now ample evidence to support the role of spectral-domain optical coherence tomography imaging of the macula for detection of early glaucoma. Macular spectral-domain optical coherence tomography measurements demonstrate high reproducibility, and evidence on its utility for detection of glaucoma progression is accumulating. We present a comprehensive review of macular spectral-domain optical coherence tomography imaging emerging as an essential diagnostic tool in glaucoma.
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Affiliation(s)
- Vahid Mohammadzadeh
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA
| | - Nima Fatehi
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA; Saint Mary Medical Center - Dignity Health, Long Beach, California, USA
| | - Adeleh Yarmohammadi
- Shiley Eye Institute, University of California, San Diego, La Jolla, California, United States
| | - Ji Woong Lee
- Department of Ophthalmology, Pusan National University College of Medicine, Busan, Korea
| | - Farideh Sharifipour
- Department of Ophthalmology, Shahid Beheshti university of Medical Sciences, Tehran, Iran
| | - Ramin Daneshvar
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Joseph Caprioli
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA
| | - Kouros Nouri-Mahdavi
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA.
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19
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Serfozo C, Barta AG, Horvath E, Sumanszki C, Csakany B, Resch M, Nagy ZZ, Reismann P. Altered visual functions, macular ganglion cell and papillary retinal nerve fiber layer thickness in early-treated adult PKU patients. Mol Genet Metab Rep 2020; 25:100649. [PMID: 32995291 PMCID: PMC7516291 DOI: 10.1016/j.ymgmr.2020.100649] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/07/2020] [Accepted: 09/08/2020] [Indexed: 12/12/2022] Open
Abstract
Purpose Retinal changes are poorly described in early treated phenylketonuria (ETPKU). We aimed to investigate possible visual functional and ocular microstructural changes in adult patients with ETPKU. Optical coherence tomography (OCT) and its angiography (OCTA) data from patients with PKU were compared to healthy controls. Methods In this prospective, monocentric, cross-sectional, case-control study 50 patients with ETPKU and 50 healthy subjects were evaluated with OCT and OCTA. Measurements were performed on right eyes. The following visual function parameters were studied: best corrected visual acuity (BCVA), spherical equivalent (SE), contrast sensitivity and near stereoacuity; microstructural parameters: retinal nerve fiber layer thickness (RNFLT), ganglion cell layer (GCC) thickness, focal loss of volume (FLV), global loss of volume (GLV), peripapillary, papillary vessel density (VD), ocular axial length (AL) and intraocular pressure (IOP). Results Among functional tests there were significant differences in contrast sensitivity at 1.5 (p < 0.001), 6 (p < 0.013), 12 (p < 0.001), 18 (p < 0.003) cycles per degree, in near stereoacuity (Titmus Wirt circles, p < 0.001) and in best corrected visual acuity (BCVA, p < 0.001). A statistically significant, moderate positive linear correlation was observed between BCVA and average Phe levels over the last ten years (β = 0.49, p < 0.001). The average (p < 0.001), superior (p < 0.001) inferior GCC (p < 0.001), the FLV (p < 0.003), GLV (p < 0.001) and the average RNFLT (p < 0.004) values of the PKU group were significantly lower than the controls. The serum phenylalanine level (Phe) in the PKU group negatively correlated with inferior (−0.32, p < 0.007), superior (r = −0.26, p < 0.028) and average (−0.29 p < 0.014) RNFL and with AL (−0.32, p < 0.026). In AL we detected a significant difference (p < 0.04) between the good and suboptimal dietary controlled group. There was no significant difference between the ETPKU and control group in the measured vessel density parameters and in IOP. Conclusions Our results suggest that functional and ocular microstructural defects are present in patients with PKU, and some of them may depend on dietary control. The mechanism is unclear, but the correlation indicates the importance of strict dietary control in terms of preservation of retinal functions.
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Key Words
- AAS, aminoacid supplements
- AL, axial length
- BCVA, best corrected visual acuity
- BH4, Tetrahydrobiopterine
- D, diopters
- DA, dopamine
- Dopamine
- ETDRS, early treatment diabetic retinopathy study
- ETPKU, early-treated phenylketonuria
- FLV, focal loss of volume
- GCC, ganglion cell layer thickness
- GLV, global loss of volume
- GMP, Glycomacropeptide
- Ganglion cell layer thickness
- IOP, intraocular pressure
- LogMAR, logarithm of the minimum angle of resolution
- Myopia
- OCT, optical coherence tomography
- OCTA, optical coherence tomography angiography
- Optical coherence tomography angiography
- PD, Parkinson's disease
- PKU, phenylketonuria
- Phe, phenylalanine
- Phenylalanine level
- Phenylketonuria
- RNFL, retinal nerve fiber layer
- RNFLT, retinal nerve fiber layer thickness
- Retinal nerve fiber layer thickness
- SD, spectral domain
- SE, spherical equivalent
- SWCT, sine wave contrast test
- VD, vessel density
- VEPs, Visual evoked potentials
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Affiliation(s)
- Csilla Serfozo
- Department of Ophthalmology, Faculty of Medicine, Semmelweis University, Maria utca 39, Budapest 1085, Hungary
| | - Andras Gellert Barta
- Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis University, Koranyi Sandor utca 2/a, Budapest 1083, Hungary
| | - Endre Horvath
- Independent statistician, H-1171, Alsodabas park 4/2, Budapest, Hungary
| | - Csaba Sumanszki
- Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis University, Koranyi Sandor utca 2/a, Budapest 1083, Hungary
| | - Bela Csakany
- Department of Ophthalmology, Faculty of Medicine, Semmelweis University, Maria utca 39, Budapest 1085, Hungary
| | - Miklos Resch
- Department of Ophthalmology, Faculty of Medicine, Semmelweis University, Maria utca 39, Budapest 1085, Hungary
| | - Zoltan Zsolt Nagy
- Department of Ophthalmology, Faculty of Medicine, Semmelweis University, Maria utca 39, Budapest 1085, Hungary
| | - Peter Reismann
- Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis University, Koranyi Sandor utca 2/a, Budapest 1083, Hungary
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Relationship Between Foveal Threshold and Macular Structure/Function/Vessel Density in Glaucoma. J Glaucoma 2019; 29:104-111. [DOI: 10.1097/ijg.0000000000001410] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Zwierko T, Jedziniak W, Lesiakowski P, Śliwiak M, Kirkiewicz M, Lubiński W. Eye-Hand Coordination Impairment in Glaucoma Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224332. [PMID: 31703245 PMCID: PMC6888341 DOI: 10.3390/ijerph16224332] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 11/03/2019] [Accepted: 11/04/2019] [Indexed: 01/10/2023]
Abstract
This study examined whether patients with glaucoma exhibit differences in eye–hand coordination tasks compared to age-matched normal-sighted control subjects. Twenty-eight patients with moderate-to-advanced stages of glaucoma and 28 subjects with no ocular disease participated in the study. The Motor Performance Series (MLS) of the Vienna Test System including aiming, linear tracking, tremor, and tapping tests were used to assess eye–hand coordination. Monocular Humphrey Visual Field and binocular Humphrey Esterman Visual Field tests were used to estimate visual field (VF) defect severity. Correlation between MLS scores and VF defects, visual acuity, and patient age were assessed. Glaucoma patients performed slower aiming at targets, committed more errors, and took longer to complete linear tracking and tremor tasks compared to the normal-sighted control group. Furthermore, tapping test scores indicated reduced hand movements at maximum frequency. The presence of asymmetrical monocular VF defects were associated with longer error durations in linear tracking tasks. Furthermore, MLS scores decline with advancing age and reduced visual acuity. Glaucoma patients had lower values for most MLS parameters compared to controls. However, monocular and binocular VF defects cannot fully explain the impartments in eye–hand coordination associated with glaucoma.
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Affiliation(s)
- Teresa Zwierko
- Institute of Physical Culture Sciences, Laboratory of Kinesiology in Functional and Structural Human Research Center, University of Szczecin, 70-240 Szczecin, Poland;
- Correspondence:
| | - Wojciech Jedziniak
- Institute of Physical Culture Sciences, Laboratory of Kinesiology in Functional and Structural Human Research Center, University of Szczecin, 70-240 Szczecin, Poland;
| | - Piotr Lesiakowski
- Department of Physical Education and Sport, Pomeranian Medical University, 70-123 Szczecin, Poland;
| | - Marta Śliwiak
- II Department of Ophthalmology, Pomeranian Medical University, 70-111 Szczecin, Poland; (M.Ś.); (M.K.); (W.L.)
| | - Marta Kirkiewicz
- II Department of Ophthalmology, Pomeranian Medical University, 70-111 Szczecin, Poland; (M.Ś.); (M.K.); (W.L.)
| | - Wojciech Lubiński
- II Department of Ophthalmology, Pomeranian Medical University, 70-111 Szczecin, Poland; (M.Ś.); (M.K.); (W.L.)
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Aksoy NÖ, Çakır B, Doğan E, Alagöz G. CORRELATIONS between Functional and Structural Tests Measured by Spectral Domain Optical Coherence Tomography in Severe Glaucoma. Semin Ophthalmol 2019; 34:446-450. [PMID: 31361521 DOI: 10.1080/08820538.2019.1648688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: To evaluate the relationship between visual acuity, visual field and spectral domain optical coherence tomography (OCT) parameters, including retinal nerve fiber layer (RNFL), ganglion cell-internal plexiform layer (GC-IPL) thicknesses, and optic nerve head parameters in patients with severe glaucoma. Material and Methods: Patients with the diagnosis of severe glaucoma were recruited from the data gathered at our glaucoma department. A detailed ophthalmic examination was performed using the Standard Automated Perimetry (the 30-2 SITA standard program was used for VF testing). Cirrus EDI-OCT was used for peripapillary RNFL and GC-IPL thickness measurements. Optic nerve head parameters, including mean cup-to-disc (c/d) ratio, rim area, vertical c/d ratio, cup volume, were also measured by spectral domain OCT. Correlations between these structural parameters and functional parameters (visual acuity, VF parameters) were investigated. Results: Forty-one eyes of 34 patients with severe glaucoma were enrolled in this study. Correlations between BCVA and mean GC-IPL thickness (p = .03), superior GC-IPL thickness (p = .03), inferonasal GC-IPL thickness (p = .01), superonasal GC-IPL thickness (p = .01), superotemporal GC-IPL thickness (p = .04), and rim area (p = .00) were found to be positive statistically significant. There was also a positive statistically significant correlation between MD and inferotemporal GC-IPL thickness (p = .03). Negative statistically significant correlations were found between BCVA and mean c/d ratio (p = .00), vertical c/d ratio (p = .02) and cup volume (p = .00). Discussion: Mean, superior, inferonasal, superonasal, and superotemporal GC-IPL thicknesses and mean c/d ratio, vertical c/d ratio and cup volume were found to be correlated with BCVA in patients with severe glaucoma.
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Affiliation(s)
- Nilgün Özkan Aksoy
- a Department of Ophthalmology, Sakarya University MedicalEducation and Research Hospital , Sakarya , Turkey
| | - Burçin Çakır
- a Department of Ophthalmology, Sakarya University MedicalEducation and Research Hospital , Sakarya , Turkey
| | - Emine Doğan
- a Department of Ophthalmology, Sakarya University MedicalEducation and Research Hospital , Sakarya , Turkey
| | - Gürsoy Alagöz
- a Department of Ophthalmology, Sakarya University MedicalEducation and Research Hospital , Sakarya , Turkey
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Feola AJ, Fu J, Allen R, Yang V, Campbell IC, Ottensmeyer A, Ethier CR, Pardue M. Menopause exacerbates visual dysfunction in experimental glaucoma. Exp Eye Res 2019; 186:107706. [PMID: 31226338 DOI: 10.1016/j.exer.2019.107706] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 06/03/2019] [Accepted: 06/17/2019] [Indexed: 10/26/2022]
Abstract
Glaucoma is the leading cause of irreversible blindness worldwide. Recently, estrogen deficiencies caused by early menopause, alterations in estrogen signaling via mutations in estrogen receptors, and polymorphisms along estrogen metabolic pathways have all been linked to an increased risk of developing glaucoma. Here, we examined how menopause and age impact visual function and retinal structure in an experimental model of glaucoma. Young (3-4 months) and aged (9-10 months) female Brown Norway rats were divided into pre- and post-menopausal cohorts by surgically inducing menopause via ovariectomy (OVX). After six weeks, ocular hypertension (OHT) was induced unilaterally for a period of eight weeks. Four cohorts were successfully followed to eight weeks: young sham (n = 8), young OVX (n = 9), aged sham (n = 10), and aged OVX (n = 11) animals. Intraocular pressure (IOP) was monitored weekly in all groups. Prior to inducing OHT (baseline) and at four and eight weeks after inducing OHT, we assessed visual acuity via the optomotor response (OMR) and retinal structure using optical coherence tomography (OCT). OHT decreased the OMR in all cohorts. We found that spatial frequency thresholds decreased by 54% in OVX animals after OHT compared to sham animals after OHT, regardless of age (p < 0.001). We also found thinning of the retinal nerve fiber layer (RNFL) and loss of total retinal thickness after induction of OHT. Aged animals had more thinning of the RNFL and loss of total retinal thickness compared to young animals (p < 0.001). Overall, OHT caused significant changes in visual function and retinal structure. Observing that OVX in young and aged animals further decreased spatial frequency thresholds after OHT suggests that an estrogen deficiency may intensify visual impairment after OHT.
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Affiliation(s)
- Andrew J Feola
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Healthcare System, Atlanta, GA, United States; Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States.
| | - Jieming Fu
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Healthcare System, Atlanta, GA, United States
| | - Rachael Allen
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Healthcare System, Atlanta, GA, United States; Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
| | - Victoria Yang
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Healthcare System, Atlanta, GA, United States
| | - Ian C Campbell
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Healthcare System, Atlanta, GA, United States; Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
| | | | - C Ross Ethier
- Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
| | - Machelle Pardue
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Healthcare System, Atlanta, GA, United States; Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
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24
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Nutritional supplementation in the treatment of glaucoma: A systematic review. Surv Ophthalmol 2018; 64:195-216. [PMID: 30296451 DOI: 10.1016/j.survophthal.2018.09.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 09/17/2018] [Accepted: 09/17/2018] [Indexed: 01/02/2023]
Abstract
Current treatment strategies for glaucoma are limited to halting disease progression and do not restore lost visual function. Intraocular pressure is the main risk factor for glaucoma, and intraocular pressure-lowering treatment remains the mainstay of glaucoma treatment, but even successful intraocular pressure reduction does not stop the progression of glaucoma in all patients. We review the literature to determine whether nutritional interventions intended to prevent or delay the progression of glaucoma could prove to be a valuable addition to the mainstay of glaucoma therapy. A total of 33 intervention trials were included in this review, including 21 randomized controlled trials. These suggest that flavonoids exert a beneficial effect in glaucoma, particularly in terms of improving ocular blood flow and potentially slowing progression of visual field loss. In addition, supplements containing forskolin have consistently demonstrated the capacity to reduce intraocular pressure beyond the levels achieved with traditional therapy alone; however, despite the strong theoretical rationale and initial clinical evidence for the beneficial effect of dietary supplementation as an adjunct therapy for glaucoma, the evidence is not conclusive. More and better quality research is required to evaluate the role of nutritional supplementation in glaucoma.
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Besada E, Frauens BJ, Makhlouf R, Shechtman D, Rodman J, Demeritt M, Hardigan P. More sensitive correlation of afferent pupillary defect with ganglion cell complex. JOURNAL OF OPTOMETRY 2018; 11:75-85. [PMID: 28676353 PMCID: PMC5904827 DOI: 10.1016/j.optom.2017.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 02/14/2017] [Accepted: 02/21/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE This study investigated the correlation between the relative afferent pupillary defect (RAPD) and retinal nerve fiber layer thickness (RNFLT) in optic neuropathy. METHODS RAPD assessment was performed using a log unit neutral density filter bar. Spectral domain optical coherence tomography RTVue-100 (Optovue) was used to examine the subjects. The optic nerve head pattern (ONH) was subdivided and identified for the purpose of the study into circumpapillary RNFLT (cpRNFLT) and peripheral circumpapillary RNFLT (pcpRNFLT). The cpRNFLT, pcpRNFLT and ganglion cell complex (GCC) parameters were analyzed. RESULTS Eighteen females and twenty three males with asymmetric optic neuropathy and a RAPD participated. Thirty-three subjects had glaucoma and eight had optic neuropathy other than glaucoma. Significant correlations (p<0.02) were obtained for the RAPD and the percentage difference loss of the GCC and RNFLT parameters. The grouped mean percentage difference loss for RNFLT was significantly different from that of the GCC (p<0.001). At a 0.6log unit RAPD, the average mean percentage difference loss was 23% for the CRNFLT, 15% for the GCC, 12% for the global loss volume percentage and 6% for the focal loss volume percentage (FLV%). CONCLUSIONS Significant correlations between RNFLT loss for cpRNFLT, pcpRNFLT and GCC parameters with RAPD were observed. Approximately a 35% higher sensitivity was obtained using GCC compared to CRNFL parameters. The expected change in GCC average for every 0.3log unit increment was approximately 8.49μm. The FLV% corresponded more sensitively to a RAPD but appeared to be influenced by disease severity.
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Affiliation(s)
- Eulogio Besada
- Nova Southeastern University College of Optometry, United States.
| | - Barry J Frauens
- Nova Southeastern University College of Optometry, United States
| | - Rim Makhlouf
- Nova Southeastern University College of Optometry, United States
| | - Diana Shechtman
- Nova Southeastern University College of Optometry, United States
| | - Julie Rodman
- Nova Southeastern University College of Optometry, United States
| | - Marlon Demeritt
- Nova Southeastern University College of Optometry, United States
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Structure-Functional Parameters in Differentiating Between Patients With Different Degrees of Glaucoma. J Glaucoma 2017; 25:e884-e888. [PMID: 27483418 DOI: 10.1097/ijg.0000000000000491] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE We evaluated spectral-domain optical coherence tomography (SD-OCT) parameters and visual field parameters in patients with different degrees of open-angle glaucoma (preperimetric, mild, moderate, and severe glaucoma) to determine which parameter best identifies each glaucomatous group. MATERIALS AND METHODS A total of 131 patients (66 preperimetric, 41 mild, 35 moderate, 40 severe glaucomatous eyes) and 40 normal eyes (control group) were included in this prospective study. The SD-OCT parameters [mean ganglion cell complex (GCC), superior GCC, inferior GCC, global loss volume, focal loss volume, mean circumpapillary retinal nerve fiber layer (RNFL), superior circumpapillary retinal nerve fiber layer [cpRNFL], and inferior cpRNFL] and visual field parameters (mean deviation and pattern SD) were evaluated. The area under the receiver operating characteristic curve (AUROC) was calculated for each parameter to determine which best identified glaucomatous changes. RESULTS Of the SD-OCT parameters, inferior (AUROC, 0.792) and mean GCC thickness (AUROC, 0.741) best discriminated between normal eyes and preperimetric glaucoma eyes. CONCLUSIONS GCC measurements were more efficient than cpRNFL measurements in detecting preperimetric glaucomatous damage. This finding could be an aid to an early diagnosis.
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Fatehi N, Nowroozizadeh S, Henry S, Coleman AL, Caprioli J, Nouri-Mahdavi K. Association of Structural and Functional Measures With Contrast Sensitivity in Glaucoma. Am J Ophthalmol 2017; 178:129-139. [PMID: 28342719 DOI: 10.1016/j.ajo.2017.03.019] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 03/15/2017] [Accepted: 03/15/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE To test the hypothesis that structural and functional measures predict contrast sensitivity (CS) outcomes in glaucomatous eyes. DESIGN Cross-sectional prospective study. METHODS One hundred five eyes of 65 patients who underwent macular spectral-domain optical coherence tomography imaging, 24-2 standard achromatic visual fields (VF), and CS measurement on the same day were enrolled. Association of CS at 4 spatial frequencies (3, 6, 12, and 18 cycles per degree, cpd) with structural and functional outcomes was explored with correlation and regression analyses. RESULTS The median (IQR) 24-2 visual field mean deviation was -7.6 (-11.1 to -3.0). Significant correlations were found between CS at 6 cpd and ganglion cell/inner plexiform layer thickness at inferotemporal and inferonasal macular sectors (ρ = 0.222, P = .023 and ρ = 0.209, P = .032, respectively). CS at 6 cpd demonstrated higher correlations with full macular thickness measurements, the strongest of which was with the central macular thickness in the superior 6 × 3-degree region (ρ = 0.311, P = .001). Contrast sensitivity at 6 cpd also had the strongest correlation with mean deviation of the 4 central VF points (ρ = -0.420; P < .001). There was a significant correlation between logMAR visual acuity and contrast sensitivity at 6, 12, and 18 cpd (ρ = -0.306, ρ = -0.348 and ρ = -0.241, P < .013, respectively). CONCLUSIONS Structural and functional measures showed a fair relationship with contrast sensitivity. This association was most prominent between full-thickness macular measures or central VF parameters and CS at 6 cpd. Contrast sensitivity was not a reliable surrogate for glaucoma severity in this cross-sectional study.
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Liu G, Liu X, Li H, Du Q, Wang F. Optical Coherence Tomographic Analysis of Retina in Retinitis Pigmentosa Patients. Ophthalmic Res 2016; 56:111-22. [DOI: 10.1159/000445063] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 02/27/2016] [Indexed: 11/19/2022]
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Yang JM, Sung MS, Ji YS, Heo H, Park SW. Analysis of Clinical Factors Associated with Retinal Morphological Changes in Patients with Primary Sjögren's Syndrome. PLoS One 2016; 11:e0157995. [PMID: 27327297 PMCID: PMC4915668 DOI: 10.1371/journal.pone.0157995] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 06/08/2016] [Indexed: 11/18/2022] Open
Abstract
Purpose To investigate clinical factors associated with abnormal retinal morphologies in patients with primary Sjögren's syndrome (pSS). Methods One-hundred-thirty patients with pSS who underwent immunoserological tests, minor salivary gland biopsies, and optical coherence tomography examinations were retrospectively analyzed. Risk factors for abnormally reduced peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell–inner plexiform layer (mGCIPL) thicknesses were evaluated, as well as the correlation between clinical factors and pRNFL and mGCIPL thicknesses. Results Anti-Sjögren's syndrome type B (SSB) antibody positivity (P = 0.048) was identified as a risk factor associated with abnormally reduced pRNFL thickness, and anti-SSB positivity (P = 0.005) and erythrocyte sedimentation rate (ESR) level (P = 0.031) were identified as risk factors associated with an abnormally reduced mGCIPL thickness as revealed by multivariate logistic regression analysis. There was a significant negative correlation between anti-SSB antibody levels and the thickness of pRNFL and mGCIPL. The thicknesses of pRNFL and mGCIPL were significantly reduced in anti-SSB–positive eyes when compared to anti-SSB–negative eyes (P < 0.05). However, histopathologic grading was not associated with the pRNFL and mGCIPL thicknesses. Conclusion Anti-SSB antibody positivity and ESR levels may be useful for predicting an abnormally reduced pRNFL or mGCIPL thickness in patients with pSS. Our results may provide clinical evidence to substantiate the association between aberrant autoimmunity and inner retinal changes in patients with pSS.
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Affiliation(s)
- Jee Myung Yang
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
| | - Mi Sun Sung
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Yong Sok Ji
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Hwan Heo
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Sang Woo Park
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
- Center for Creative Biomedical Scientists at Chonnam National University, Gwangju, Republic of Korea
- * E-mail:
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Repeatability of Perimacular Ganglion Cell Complex Analysis with Spectral-Domain Optical Coherence Tomography. J Ophthalmol 2015; 2015:605940. [PMID: 26229687 PMCID: PMC4502302 DOI: 10.1155/2015/605940] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 06/14/2015] [Indexed: 11/17/2022] Open
Abstract
Purpose. To assess the repeatability of spectral-domain optical coherence tomography to measure macular and perimacular ganglion cell complex thicknesses and compare retinal ganglion cell parameters between algorithms. Methods. Ninety-two nonglaucomatous eyes from 92 participants underwent macular and perimacular ganglion cell complex thickness measurement using OCT-HS100 Glaucoma 3D algorithm and these measurements were repeated for 34 subjects. All subjects also had macular ganglion cell-inner plexiform layer thickness measured by Cirrus HD-OCT Ganglion Cell Analysis algorithm. Intraclass correlation coefficient and Pearson's correlation analyses were performed. Results. Subfields of both macular and perimacular ganglion cell complex thicknesses had high intraclass correlation coefficient values between 0.979 (95% confidence interval [CI]: 0.958-0.989) and 0.981 (95% CI: 0.963, 0.991) and between 0.70 (95% CI: 0.481-0.838) and 0.987 (95% CI: 0.956-0.989), respectively. The overall average ganglion cell complex and macular average ganglion cell-inner plexiform layer thicknesses were strongly correlated (r = 0.83, P < 0.001). Conclusions. The assessment of macular and perimacular retinal ganglion cell parameters by OCT-HS100 Glaucoma 3D algorithm is highly repeatable, and strongly correlates to retinal ganglion cell parameters assessed by Ganglion Cell Analysis algorithm. A comprehensive evaluation of retinal ganglion cells may be possible with OCT-HS100.
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Meshi A, Goldenberg D, Armarnik S, Segal O, Geffen N. Systematic review of macular ganglion cell complex analysis using spectral domain optical coherence tomography for glaucoma assessment. World J Ophthalmol 2015; 5:86-98. [DOI: 10.5318/wjo.v5.i2.86] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Revised: 12/12/2014] [Accepted: 04/07/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To review the use of spectral domain optical coherence tomography (SD-OCT) for macular retinal ganglion cells (RGC) and ganglion cell complex (GCC) measurement in glaucoma assessment, specifically for early detection and detection of disease progression.
METHODS: A systematic review was performed by searching PubMed, Medline, and Web of Science for articles published in English through July 2014 describing the various macular SD-OCT scanning strategies developed for glaucoma assessment. The review focused on papers evaluating the use of macular RGC/GCC SD-OCT to detect early glaucoma and its progression. The search included keywords corresponding to the index test (macular ganglion cell/RGC/GCC/Spectral domain OCT), the target condition (glaucoma), and diagnostic performance. The RGC/GCC SD-OCT scanning strategies used to assess glaucoma of most commonly used SD-OCT instruments were described and compared. These included the Cirrus high definition-OCT (Carl Zeiss Meditec, Inc., Dublin, CA, United States), RTVue (Optovue, Inc., Fremont, CA, United States), Spectralis (Heidelberg Engineering, Heidelberg, Germany) and the 3D OCT 2000 (Topcon Corporation, Tokyo, Japan). Studies focusing on the ability of RGC/GCC SD-OCT to detect early glaucomatous damage and on the correlation between glaucomatous progression and RGC/GCC measurement by SD-OCT were reviewed.
RESULTS: According to the literature, macular RGC/GCC SD-OCT has high diagnostic power of preperimetric glaucoma, reliable discrimination ability to differentiate between healthy eyes and glaucomatous eyes, with good correlation with visual filed damage. The current data suggests that it may serve as a sensitive detection tool for glaucomatous structural progression even with mild functional progression as the rate of change of RGC/GCC thickness was found to be significantly higher in progressing than in stable eyes. Glaucoma assessment with RGC/GCC SD-OCT was comparable with and sometimes better than circumpapillary retinal nerve fiber layer thickness measurement.
CONCLUSION: An increasing body of evidence supports using macular RGC/GCC thickness as an indicator for early glaucoma. This might be a useful tool for monitoring disease progression.
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