scholarly journals Global assessment of arteriolar, venular and capillary changes in normal tension glaucoma

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Timothy P. H. Lin ◽  
Yu Meng Wang ◽  
Kevin Ho ◽  
Cherie Y. K. Wong ◽  
Poemen P. Chan ◽  
...  
Keyword(s):  
Normal Tension Glaucoma ◽  
Mean Deviation ◽  
Computer Assisted ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Cross Sectional ◽  
Retinal Microvasculature ◽  
Branching Angle ◽  
Retinal Photographs ◽  
Retinal Arteriolar

Abstract Microcirculatory insufficiency has been hypothesized in glaucoma pathogenesis. There is a scarcity of data to comprehensively examine the changes in retinal microvasculature and its role in normal tension glaucoma (NTG). We conducted a cross-sectional case–control study and included 168 eyes from 100 NTG patients and 68 healthy subjects. Quantitative retinal arteriolar and venular metrics were measured from retinal photographs using a computer-assisted program. Radial peripapillary capillary network was imaged with OCT-A and quantitative capillary metrics (circumpapillary vessel density (cpVD) and circumpapillary fractal dimension (cpFD)) were measured with a customized MATLAB program. We found that NTG was associated with decreased arteriolar and venular tortuosity, arteriolar branching angle, cpVD and cpFD. Decreased venular caliber, arteriolar and venular branching angles, cpVD and cpFD were associated with thinner average RNFL thickness. Decreased arteriolar and venular branching angles, cpVD and cpFD were also associated with worse standard automated perimetry measurements (mean deviation and visual field index). Compared with retinal arteriolar and venular metrics, regression models based on OCT-A capillary metrics consistently showed stronger associations with NTG and structural and functional measurements in NTG. We concluded that NTG eyes showed generalized microvascular attenuations, in which OCT-A capillary metrics attenuations were more prominent and strongly associated with NTG.

scholarly journals Retinal microvasculature: population epidemiology and concordance in Australian children aged 11–12 years and their parents

BMJ Open ◽  
2019 ◽  
Vol 9 (Suppl 3) ◽  
pp. 44-52 ◽  
Author(s):  
Julian Dascalu ◽  
Mengjiao Liu ◽  
Kate Lycett ◽  
Anneke C Grobler ◽  
Mingguang He ◽  
...  
Keyword(s):  
Correlation Coefficients ◽  
Population Based ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Complex Sampling ◽  
Retinal Microvasculature ◽  
Automated Software ◽  
Retinal Photographs ◽  
Retinal Arteriolar ◽  
Parent Child

ObjectivesTo describe distributions and concordance of retinal microvasculature measurements in a population-based sample of Australian parent–child dyads at child age 11–12 years.DesignCross-sectional Child Health CheckPoint study, between waves 6 and 7 of the national population-based Longitudinal Study of Australian Children (LSAC).SettingAssessment centres in seven Australian cities, February 2015–March 2016.ParticipantsOf the 1874 participating families, 1288 children (51% girls) and 1264 parents (87% mothers, mean age 43.7) were analysed. Diabetic participants and non-biological pairs were excluded from concordance analyses.Outcome measuresRetinal photographs were taken by non-mydriatic fundus camera. Trained graders scored vascular calibre using semi-automated software, yielding estimates of central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) and arteriolar–venular ratio (AVR). Pearson’s correlation coefficients and multivariable linear regression models assessed parent–child concordance. Survey weights and methods accounted for LSAC’s complex sampling, stratification and clustering within postcodes.ResultsMean (SD) of CRAE and CRVE were larger in children (159.5 (11.8) and 231.1 (16.5) μm, respectively) than parents (151.5 (14.0) and 220.6 (19.0) μm), yielding similar AVR (children 0.69 (0.05), parents 0.69 (0.06)). Correlation coefficients for parent–child pairs were 0.22 (95% CI 0.16 to 0.27) for CRAE, 0.23 (95% CI 0.17 to 0.28) for CRVE and 0.18 (95% CI 0.13 to 0.24) for AVR. Mother–child and father–child values were similar (0.20 and 0.32 for CRAE, 0.22 and 0.29 for CRVE, respectively). Relationships attenuated slightly on adjustment for age, sex, blood pressure, diabetes and body mass index. Percentiles and concordance are presented for the whole sample and by sex.ConclusionsArteriolar and venular calibre were similar to previously documented measures in midlife adult and late childhood populations. Population parent–child concordance values align with moderate polygenic heritability reported in smaller studies.

scholarly journals Standard automated perimetry using size III and size V stimuli in advanced stage glaucoma: an observational cross-sectional comparative study

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e046124
Author(s):  
Devindra Sood ◽  
Gabriela Czanner ◽  
Tobi Somerville ◽  
Ishaana Sood ◽  
Fiona J Rowe
Keyword(s):  
Visual Field ◽  
Mean Deviation ◽  
Test Duration ◽  
Automated Perimetry ◽  
Advanced Stage ◽  
Standard Automated Perimetry ◽  
Cross Sectional ◽  
Dynamic Strategy ◽  
Mean Sensitivity ◽  
Loss Variance

ObjectivesIn this study, we sought to evaluate the extent of further visual field that could be assessed when using stimulus size V in standard automated perimetry compared with size III in advanced stage glaucoma and whether cut-off values could be determined for when to switch from size III to size V.DesignProspective cross-sectional study.SettingSingle-centre outpatient eye clinic in India (New Delhi).ParticipantsAdvanced stage glaucoma defined as stages 3–4.InterventionCentral static perimetry with Octopus 900 G programme (size III stimulus dynamic strategy) and low vision central programme (size V stimulus dynamic strategy).Primary and secondary outcome measuresVisual field assessment for right and left eyes with both sizes III and V were undertaken within one clinic visit.ResultsWe recruited 126 patients (170 eyes). Mean patient age at assessment was 55.86 years (SD 15.15). Means (SD) for size III versus size V, respectively, were 6.94 dB (5.58) and 12.98 dB (7.77) for mean sensitivity, 20.02 dB (5.67) and 19.22 dB (7.74) for mean deviation, 5.89 dB (2.29) and 7.69 dB (2.78) for standard loss variance and 3.32 min (1.07) and 6.40 min (1.43) for test duration. All except mean deviation were significantly different between size III and V tests.ConclusionUseful visual field information was obtained with size V stimuli which allowed continued monitoring of these patients that was not possible with size III. Increased test duration, standard loss variance and mean sensitivity were found with size V, as expected, given that more visual responses were obtained with the increased target size. A switch from size III to V may be considered when mean sensitivity reaches 10 dB and/or mean deviation reaches 18 dB.

scholarly journals Association between Combined Structure Function Index and Glaucoma Severity

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Shumpei Ogawa ◽  
Yoshimasa Tanabe ◽  
Yoshinori Itoh ◽  
Takahiko Noro ◽  
Hisato Gunji ◽  
...  
Keyword(s):  
Structure Function ◽  
Open Angle Glaucoma ◽  
Normal Tension Glaucoma ◽  
Mean Deviation ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Function Index ◽  
Combined Structure ◽  
Three Stages ◽  
The Relationship

The aim of this study was to investigate the relationship between combined structure function index (CSFI) and standard automated perimetry (SAP) parameters such as mean deviation (MD) and visual field index (VFI) in open-angle glaucoma (OAG). We retrospectively reviewed medical records from September 2009 to July 2015, which included 195 eyes of 195 patients with OAG or normal-tension glaucoma who underwent SAP and optical coherence tomography on the same day (male: female, 128 : 67; mean age, 61.4 ± 11.3 years; mean spherical equivalent, −2.39 ± 2.3 D). We divided participants into three stages based on MD value: early, MD > −6 dB; middle, −6 dB ≥ MD ≥ −12 dB; and advanced, MD < 12 dB. We then evaluated correlations between CSFI and SAP parameters in each stage using Pearson’s correlation coefficient. Mean CSFI (%), mean MD (dB), and VFI (%) in each stage were early (22.4, −2.13, and 94.0); middle (47.9, −8.78, and 75.4); and advanced (68.3, −17.32, and 49.0), respectively. Correlations between CSFI and whole, early, middle, and advanced MD were −0.88 (p<0.001), −0.68, −0.24, and −0.76, respectively. Correlations between CSFI and whole, early, middle, and advanced VFI were −0.86 (p<0.001), −0.59, −0.20, and −0.83, respectively. Consistency between CSFI and SAP indices in middle-stage glaucoma was low.

scholarly journals Association between visual field damage and corneal structural parameters

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alexandru Lavric ◽  
Valentin Popa ◽  
Hidenori Takahashi ◽  
Rossen M. Hazarbassanov ◽  
Siamak Yousefi
Keyword(s):  
Machine Learning ◽  
Visual Field ◽  
Structural Parameters ◽  
Corneal Thickness ◽  
Anterior Segment ◽  
Mean Deviation ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Visual Field Damage ◽  
Corneal Shape

AbstractThe main goal of this study is to identify the association between corneal shape, elevation, and thickness parameters and visual field damage using machine learning. A total of 676 eyes from 568 patients from the Jichi Medical University in Japan were included in this study. Corneal topography, pachymetry, and elevation images were obtained using anterior segment optical coherence tomography (OCT) and visual field tests were collected using standard automated perimetry with 24-2 Swedish Interactive Threshold Algorithm. The association between corneal structural parameters and visual field damage was investigated using machine learning and evaluated through tenfold cross-validation of the area under the receiver operating characteristic curves (AUC). The average mean deviation was − 8.0 dB and the average central corneal thickness (CCT) was 513.1 µm. Using ensemble machine learning bagged trees classifiers, we detected visual field abnormality from corneal parameters with an AUC of 0.83. Using a tree-based machine learning classifier, we detected four visual field severity levels from corneal parameters with an AUC of 0.74. Although CCT and corneal hysteresis have long been accepted as predictors of glaucoma development and future visual field loss, corneal shape and elevation parameters may also predict glaucoma-induced visual functional loss.

scholarly journals Associations between cardiac function and retinal microvascular geometry among Chinese adults

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Lihua Huang ◽  
Wei-Qing Chen ◽  
Izzuddin M. Aris ◽  
Louis L. Y. Teo ◽  
Tien Yin Wong ◽  
...  
Keyword(s):  
Cardiac Function ◽  
Cross Sectional Study ◽  
Chinese Adults ◽  
Cross Sectional ◽  
Atrial Contraction ◽  
Retinal Microvasculature ◽  
Velocity Flow ◽  
Retinal Vascular Caliber ◽  
Unit Increase ◽  
Branching Angle

Abstract Abnormal retinal microvascular geometry has been associated with cardiac remodeling and heart failure. However, its relation to cardiac function, prior to clinical disease has not been explored. In this cross-sectional study, 50 participants (mean age 62.5 ± 11.7 years) without cardiovascular disease (CVD) were recruited from the Cardiac Ageing Study. Transthoracic echocardiography imaging was performed to measure cardiac function indices, and retinal imaging was used to measure retinal vascular caliber and retinal vascular geometric indices. Multiple linear regressions were applied to examine associations between indices of cardiac function and retinal microvasculature, adjusting for age, sex, body mass index, mean blood pressure and comorbidity (i.e. hypertension, diabetes and dyslipidemia). After adjusting for confounders, each unit decrease in peak systolic septal mitral annular velocity (Septal S′) indicating poorer left function was associated with smaller retinal venular branching angle (β: − 2.69°; 95% CI − 4.92, − 0.46). Furthermore, each unit increase in peak velocity flow in late diastole by atrial contraction (MV A Peak) indicating poorer left atrial function was associated with lower retinal venular fractal dimension (− 0.13Df; − 0.25, − 0.004). Our findings suggested a relationship between poorer cardiac function and suboptimal retinal microvascular geometry, among Chinese without CVD.

scholarly journals Estimating Rates of Progression and Predicting Future Visual Fields in Glaucoma Using a Deep Variational Autoencoder

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Samuel I. Berchuck ◽  
Sayan Mukherjee ◽  
Felipe A. Medeiros
Keyword(s):  
Visual Field ◽  
Learning Algorithm ◽  
Visual Fields ◽  
Visual Field Loss ◽  
Absolute Error ◽  
Rate Of Change ◽  
Mean Deviation ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Deep Learning Algorithm

AbstractIn this manuscript we develop a deep learning algorithm to improve estimation of rates of progression and prediction of future patterns of visual field loss in glaucoma. A generalized variational auto-encoder (VAE) was trained to learn a low-dimensional representation of standard automated perimetry (SAP) visual fields using 29,161 fields from 3,832 patients. The VAE was trained on a 90% sample of the data, with randomization at the patient level. Using the remaining 10%, rates of progression and predictions were generated, with comparisons to SAP mean deviation (MD) rates and point-wise (PW) regression predictions, respectively. The longitudinal rate of change through the VAE latent space (e.g., with eight dimensions) detected a significantly higher proportion of progression than MD at two (25% vs. 9%) and four (35% vs 15%) years from baseline. Early on, VAE improved prediction over PW, with significantly smaller mean absolute error in predicting the 4th, 6th and 8th visits from the first three (e.g., visit eight: VAE8: 5.14 dB vs. PW: 8.07 dB; P < 0.001). A deep VAE can be used for assessing both rates and trajectories of progression in glaucoma, with the additional benefit of being a generative technique capable of predicting future patterns of visual field damage.

scholarly journals Comparing isolated-check visual evoked potential, pattern visual evoked potential, and standard automated perimetry in dysthyroid optic neuropathy eyes

Eye ◽  
2020 ◽  
Author(s):  
Xin Qi ◽  
Boding Tong ◽  
Weikun Hu ◽  
Ban Luo
Keyword(s):  
Optic Neuropathy ◽  
Visual Evoked Potential ◽  
Evoked Potential ◽  
Mean Deviation ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Dysthyroid Optic Neuropathy ◽  
Pattern Visual Evoked Potential ◽  
Diagnostic Capabilities ◽  
Visual Evoked

Abstract Objective To determine the diagnostic ability of isolated-check visual evoked potential (icVEP), pattern visual evoked potential (pVEP), and standard automated perimetry (SAP) between dysthyroid optic neuropathy (DON) and thyroid-associated ophthalmopathy (TAO) without DON (non-DON). Methods This is a case-control study, 49 bilateral patients (26 DON and 23 non-DON) were included. icVEP, pVEP, and SAP were conducted in all the subjects, icVEP parameters compared were signal-to-noise ratios (SNRs) under 8, 16, and 32% depth of modulation (DOM). pVEP parameters compared were amplitude and latency. SAP parameters were mean deviation (MD) and pattern standard deviation (PSD). The area under the receiver operating characteristic (ROC) curve (AUC), net reclassification index (NRI), integrated discrimination index (IDI), and decision curve analysis (DCA) were applied for analysis. Results In icVEP, values of SNR in DON were significantly smaller than non-DON (p < 0.05). In pVEP, P100 latent time in DON was significantly larger than non-DON (p = 0.0026). In SAP, value of PSD in DON was larger than non-DON (p = 0.0006), and value of MD in DON was smaller (p = 0.0007). AUC, NRI, and IDI among the three tests were not significantly different. DCA showed that SNR of icVEP under 8% DOM was the farthest from the two extreme curves. Conclusions icVEP, pVEP, and SAP have equal diagnostic capabilities to discern between DON and non-DON. In addition, icVEP may represent a significant ancillary diagnostic approach to DON detection, with more clinical benefit.

scholarly journals CLINICAL PROFILES OF GLAUCOMATOUS PATIENTS WITH HIGH- AND LOW-TENSION OPTIC DISC HEMORRHAGES: A COMPARATIVE STUDY

2020 ◽  
Author(s):  
Izabela Almeida ◽  
Diego Torres Dias ◽  
Paula Azevedo Alhadeff ◽  
Flavio Siqueira Santos Lopes ◽  
Carolina P B Gracitelli ◽  
...  
Keyword(s):  
Optic Disc ◽  
Normal Tension Glaucoma ◽  
Cross Sectional Study ◽  
Mean Deviation ◽  
Cross Sectional ◽  
Disc Hemorrhage ◽  
Vascular Dysregulation ◽  
Median Split ◽  
Clinical Profiles ◽  
Low Tension

Background/Aims: Optic disc hemorrhage (DH) is an important glaucoma risk factor, and occurs in a wide intraocular pressure (IOP) range. We sought to characterize distinct clinical subtypes of patients with high- (HTDH) and low-tension DHs (LTDH). Methods: In this cross-sectional study, treated glaucomatous patients with DHs from two Glaucoma Services were consecutively enrolled. Disc photographs were evaluated for the presence of DH by two glaucoma specialists. After inclusion, patients were classified on HTDH (IOP≥16mmHg) and LTDH (IOP<16mmHg; median split). Clinical and ocular data from the time of DH detection were compared between groups. Results: One hundred thirty-three DH patients were included (LTDH=66 eyes; HTDH=67 eyes). Patients with LTDH were more often women than those with HTDH (77% vs 42%; p=0.030). There was also a trend for a higher prevalence of Asian descendants (24% vs 9%; p=0.058) and symptoms suggestive of vascular dysregulation (34% vs 14%; p=0.057) in LTDH patients. Eyes with LTDH also had worse visual field (VF) mean deviation index (p=0.037), higher prevalence of normal-tension glaucoma (NTG) diagnosis (46% vs 17%; p<0.001) and tended to have thinner central corneas (p=0.066). Conclusion: Patients developing DHs with treated IOPs in the low teens seem to more frequently fit in a profile represented by women, NTG diagnosis and greater VF loss. The presence of symptoms suggestive of vascular dysregulation and race also seem to differ between these two clinical subtypes. A closer optic disc surveillance is recommended for patients with the LTDH subtype, as they may develop DHs despite seemingly well-controlled IOP.

Comparison of vascular–function and structure–function correlations in glaucomatous eyes with high myopia

2019 ◽  
Vol 104 (6) ◽  
pp. 807-812
Author(s):  
Seung Hyen Lee ◽  
Eun Ji Lee ◽  
Tae-Woo Kim
Keyword(s):  
Visual Field ◽  
Vascular Function ◽  
High Myopia ◽  
Open Angle Glaucoma ◽  
Retinal Vessel ◽  
Retinal Nerve Fibre Layer ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Cross Sectional ◽  
Visual Field Damage

Background/aimsTo determine the usefulness of peripapillary retinal vessel density (VD) measured using optical coherence tomography (OCT) angiography (OCTA) in the evaluation of glaucomatous visual field damage in highly myopic eyes with primary open-angle glaucoma (POAG).MethodsThis cross-sectional observational study enrolled a total of 124 myopic POAG eyes consisting of 40 eyes showing a segmentation error (SE) in OCT scans and 84 eyes without an SE. The peripapillary retinal VD, circumpapillary retinal nerve fibre layer thickness (RNFLT) and visual field sensitivity loss (VFSL) were assessed using OCTA, spectral-domain OCT and standard automated perimetry, respectively. The topographical correlations between the VD and VFSL, and between the RNFLT and VFSL were determined in subgroups divided according to the presence of an SE.ResultsThe peripapillary retinal VD showed significant topographical correlation with VFSL both in the highly myopic POAG eyes without an SE globally (R=0.527, p<0.001), and in temporal (R=0.593), temporal-superior (R=0.543), nasal-inferior (R=0.422) and temporal-inferior sectors (R=0.600, all p<0.001), and in those with an SE globally (R=0.343, p=0.030), and in temporal (R=0.494, p=0.001), temporal-superior (R=0.598, p<0.001), and temporal-inferior sectors (R=0.424, p=0.006). The correlation with VFSL did not differ between the VD and RNFLT in the eyes without an SEConclusionPeripapillary VD as measured with OCTA showed a topographical correlation with VFSL in highly myopic POAG eyes regardless of the presence of an OCT SE OCTA may be a useful adjunct for evaluating glaucomatous visual field damage in high myopia, where the OCT results are frequently confounding.

scholarly journals Comparison of multifocal visual evoked potential, standard automated perimetry and optical coherence tomography in assessing visual pathway in multiple sclerosis patients

2010 ◽  
Vol 16 (4) ◽  
pp. 412-426 ◽  
Author(s):  
Michal Laron ◽  
Han Cheng ◽  
Bin Zhang ◽  
Jade S Schiffman ◽  
Rosa A Tang ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Optical Coherence Tomography ◽  
Mean Deviation ◽  
Automated Perimetry ◽  
Optical Coherence ◽  
Standard Automated Perimetry ◽  
Fiber Layer ◽  
Field Of Vision ◽  
Multiple Sclerosis Patients ◽  
Visual Evoked

Background: Multifocal visual evoked potentials (mfVEP) measure local response amplitude and latency in the field of vision. Objective: To compare the sensitivity of mfVEP, Humphrey visual field (HVF) and optical coherence tomography (OCT) in detecting visual abnormality in multiple sclerosis (MS) patients. Methods: mfVEP, HVF, and OCT (retinal nerve fiber layer [RNFL]) were performed in 47 MS-ON eyes (last optic neuritis [ON] attack ≥6 months prior) and 65 MS-no-ON eyes without ON history. Criteria to define an eye as abnormal were: (1) mfVEP amplitude/latency — either amplitude or latency probability plots meeting cluster criteria with 95% specificity; (2) mfVEP amplitude or latency alone (specificity: 97% and 98%, respectively); and (3) HVF and OCT, mean deviation and RNFL thickness meeting p < 0.05, respectively. Results: MfVEP (amplitude/latency) identified more abnormality in MS-ON eyes (89%) than HVF (72%), OCT (62%), mfVEP amplitude (66%) or latency (67%) alone. Eighteen percent of MS-no-ON eyes were abnormal for both mfVEP (amplitude/latency) and HVF compared with 8% with OCT. Agreement between tests ranged from 60% to 79%. mfVEP (amplitude/latency) categorized an additional 15% of MS-ON eyes as abnormal compared with HVF and OCT combined. Conclusions: mfVEP, which detects both demyelination (increased latency) and neural degeneration (reduced amplitude), revealed more abnormality than HVF or OCT in MS patients.

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