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

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.

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Association between visual field damage and corneal structural parameters

Scientific Reports ◽

10.1038/s41598-021-90298-0 ◽

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.

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Impact of Visual Field Testing on Intraocular Pressure Change Trends in Healthy People and Glaucoma Patients

Journal of Ophthalmology ◽

10.1155/2020/7936205 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Mengwei Li ◽

Bingxin Zheng ◽

Qi Wang ◽

Xinghuai Sun

Keyword(s):

Intraocular Pressure ◽

Visual Field ◽

Repeated Measures ◽

Healthy Subjects ◽

Open Angle Glaucoma ◽

Field Testing ◽

Automated Perimetry ◽

Open Angle ◽

Standard Automated Perimetry ◽

The Impact

Purpose. To compare the impact of visual field (VF) testing on intraocular pressure (IOP) change trends between healthy subjects and glaucoma patients. Methods. We recruited healthy volunteer subjects who did not have previous ocular diseases and open-angle glaucoma patients who were medically controlled well. IOP in both eyes of each participant was measured by using a noncontact tonometer at five time points: before, immediately after (0 minute), and 10, 30, and 60 minutes after the standard automated perimetry. Repeated measures ANOVA was used to analyze the effect of VF testing on IOP change trends in healthy and glaucoma eyes. Results. Forty healthy subjects (80 eyes) and 31 open-angle glaucoma patients (62 eyes) were included for the study. The baseline IOP of healthy and glaucoma eyes was 16.11 ± 3.01 mmHg and 15.78 ± 3.57 mmHg, respectively. After the VF testing, the IOP in healthy eyes was decreased by 1.5% at 0 minute, 6.5% at 10 minutes (P<0.001), 6.6% at 30 minutes (P<0.001), and 7.0% at 1 hour (P<0.001), indicating that this reduction was sustained for at least 1 hour. However, the IOP in glaucoma eyes was increased by 12.7% at 0 minute (P<0.001) and, then, returned towards initial values 1 hour after the VF testing. Conclusions. IOP change trends after VF field testing between healthy subjects and glaucoma patients were quite different. VF testing led to a mild and relatively sustained IOP decrease in healthy subjects, whereas IOP in open-angle glaucoma patients tended to significantly increase immediately after VF testing and, then, returned to pretest values after 1 hour. These findings indicate that the factors of VF testing should be considered in the clinical IOP measurements.

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Prevalence of Glaucoma among High Myopia

QJM ◽

10.1093/qjmed/hcaa058.033 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

O M Abdelfatah ◽

O A Salem ◽

A I Elawamry ◽

Y A Elzanklony

Keyword(s):

Optical Coherence Tomography ◽

Visual Field ◽

High Myopia ◽

Cross Sectional Study ◽

Automated Perimetry ◽

Optical Coherence ◽

Spherical Equivalent ◽

Sectional Study ◽

Cross Sectional ◽

Rnfl Thickness

Abstract Background Glaucoma is an optic neuropathy that is characterized by the selective loss of retinal ganglion cells and their axons, which manifests as the loss of the retinal nerve fiber layer (RNFL). Numerous studies have shown that the extent of RNFL damage correlates with the severity of functional deficit in the visual field (VF), and that RNFL measurement by optical coherence tomography (OCT) has good sensitivity for the detection of glaucoma. Purpose To assess the prevalence of glaucoma among high myopic patients and the association between them using standard automated perimetry (SAP) and optical coherence tomography (OCT). Patients and Methods A prospective observational randomized cross sectional study included a total of 80 eyes with high myopia, in the period from November 2017 to April 2018. This cross sectional study included 44 subjects with 80 eyes regarding high myopia using the outpatient services of the Qlawoon Hospital, Cairo, who satisfied the inclusion and exclusion criteria between November 2017 and April 2018 aiming to determine the prevalence of glaucoma in high myopic patients. Results In our study, we depended on the following highly significant parameters in detection of prevalence of glaucoma among high myopic patients: Spherical equivalent median is -12, Vertical cup/disc ratio mean is 0.55, MD median of visual field is – 5.38, PSD mean of visual field is 3.53, GHT is 64.7% outside normal limits, 17.6% border line and 17.6% general reduction of sensitivity and RNFL thickness mean is; for average thickness is 86.37, for superior thickness is 90.06 and for inferior thickness is 82.68 a highly significant P-value. Conclusion Prevalence of glaucoma among our study group is 42.5% depending on Spherical equivalent median, Vertical cup/disc ratio mean, MD median of visual field, PSD mean of visual field, GHT and RNFL thickness.

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Rate of Progression in Open-angle Glaucoma Estimated From Cross-sectional Prevalence of Visual Field Damage: Author Reply

American Journal of Ophthalmology ◽

10.1016/s0002-9394(14)70155-2 ◽

1997 ◽

Vol 123 (3) ◽

pp. 427-428

Author(s):

Harry A. Quigley ◽

James M. Tielsch ◽

Joanne Katz ◽

ALFRED SOMMER

Keyword(s):

Visual Field ◽

Open Angle Glaucoma ◽

Open Angle ◽

Author Reply ◽

Cross Sectional ◽

Rate Of Progression ◽

Visual Field Damage

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Agreement between the newly developed OCT glaucoma staging system and the standardized visual field glaucoma staging system 2

European Journal of Ophthalmology ◽

10.1177/11206721211014378 ◽

2021 ◽

pp. 112067212110143

Author(s):

Elshimaa A Mateen Mossa ◽

Heba Khallaf ◽

Khulood Muhammad Sayed

Keyword(s):

Visual Field ◽

Open Angle Glaucoma ◽

Staging System ◽

Control Group ◽

Ganglion Cell Complex ◽

Automated Perimetry ◽

Cross Sectional ◽

Stage 4 ◽

Staging Systems ◽

Stage 1

Purpose: The purpose of this research was to assess the agreement between the new optical coherence tomography (OCT) glaucoma staging system (GSS) and the visual field (VF) GSS 2 (GSS2). Methods: This is a cross-sectional study of 161 eyes of 110 patients with controlled primary open-angle glaucoma (POAG). All eyes were subjected to VF examination using standard automated perimetry and Humphrey field analyzer II 750. GSS2 was used for the classification of the VF defects’ severity. OCT of the optic disc and the macular ganglion cell complex (GCC) was performed using RTVue. Patients were classified by OCT GSS into six stages. Results: The study examined 161 eyes of 110 patients with controlled POAG. The staging according to VF GSS2 was as follows: stage 0 (12.42%), border stage (12.42%), stage 1 (13.04%), stage 2 (14.29%), stage 3 (14.28%), stage 4 (14.28%), and stage 5 (19.25%). The staging by OCT GSS was as follows: stage 0 (18.6 %), border stage (17.3%), stage 1 (6.8%), stage 2 (9.31%), stage 3 (6%), stage 4 (11.8%), and stage 5 (30.43%). The sensitivity of the new OCT GSS was different in different stages of glaucoma. In this study, no normal control group was considered; thus, the specificity could not be calculated. There was moderate agreement between the two staging systems. Conclusions: OCT GSS is a reliable and objective method for diagnosing and monitoring glaucoma. Correlations were found between GSS2, inferior and total macular GCC thickness values, and cup-to-disc ratios, so considering these items as additional parameters may make this new classification even more sensitive than VF GSS2.

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Evaluation of contrast sensitivity in patients with advanced glaucoma: comparison of two tests

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2019-315273 ◽

2020 ◽

Vol 104 (10) ◽

pp. 1418-1422 ◽

Cited By ~ 1

Author(s):

Alessandro A Jammal ◽

Bruna G Ferreira ◽

Camila S Zangalli ◽

Jayme R Vianna ◽

Atalie C Thompson ◽

...

Keyword(s):

Visual Acuity ◽

Visual Field ◽

Contrast Sensitivity ◽

Open Angle Glaucoma ◽

Mean Deviation ◽

Cross Sectional ◽

Additional Information ◽

Advanced Glaucoma ◽

Visual Field Damage ◽

Almost All

AimsTo evaluate contrast sensitivity (CS) in patients with advanced glaucomatous visual field damage, and to compare two clinical CS tests.MethodsThis was a cross-sectional test–retest study. Twenty-eight patients with open-angle glaucoma, visual acuity (VA) better than 20/40 and visual field mean deviation (MD) worse than −15 dB were enrolled. Patients underwent VA, visual field and CS testing with the Pelli-Robson (PR) chart and the Freiburg Visual Acuity and Contrast Test (FrACT). Retest measurements were obtained within 1 week to 1 month.ResultsMedian (IQR) age and MD were 61.5 (55.5 to 69.2) years and −27.7 (−29.7 to −22.7) dB, respectively. Median (IQR) VA was 0.08 logarithm minimum angle of resolution (0.02 to 0.16), corresponding to 20/25 (20/20 to 20/30). Median (IQR) CS was 1.35 (1.11 to 1.51) log units with the PR chart and 1.39 (1.24 to 1.64) log units with FrACT. VA explained less than 40% of the variance in CS (adjusted R2=0.36). CS estimates of both tests were closely related (rho=0.88, p=0.001), but CS was 0.09 log units higher with FrACT compared with the PR chart, and the 95% repeatability intervals (Bland-Altman) were 46% tighter with the PR chart.ConclusionsDespite near-normal VA, almost all patients showed moderate to profound deficits in CS. CS measurement provides additional information on central visual function in patients with advanced glaucoma.

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Rate of Progression in Open-angle Glaucoma Estimated From Cross-sectional Prevalence of Visual Field Damage

American Journal of Ophthalmology ◽

10.1016/s0002-9394(14)72062-8 ◽

1996 ◽

Vol 122 (3) ◽

pp. 355-363 ◽

Cited By ~ 80

Author(s):

HARRY A. QUIGLEY ◽

JAMES M. TIELSCH ◽

JOANNE KATZ ◽

ALFRED SOMMER

Keyword(s):

Visual Field ◽

Open Angle Glaucoma ◽

Open Angle ◽

Cross Sectional ◽

Rate Of Progression ◽

Visual Field Damage

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

BMJ Open ◽

10.1136/bmjopen-2020-046124 ◽

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.

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