Abstract W P26: Itemized NIHSS Subsets Predict MRI Positive Strokes In Patients With Mild Deficits

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Shadi Yaghi ◽  
Charlotte Herber ◽  
Joshua Z Willey ◽  
Howard Andrews ◽  
Randolph S Marshall ◽  
...  
Keyword(s):  
Visual Field ◽  
Infarct Volume ◽  
Final Diagnosis ◽  
Motor Deficits ◽  
Lesion Volume ◽  
Nihss Score ◽  
Visual Deficits ◽  
Multivariable Regression ◽  
The Mean ◽  
Attending Physician

Background: While imaging is useful in confirming the diagnosis of ischemic stroke, negative diffusion weighted imaging (DWI) is reported in up to 10% of patients. We aim to (1) identify predictors of MRI-positive stroke from the itemized NIHSS, and (2) to correlate subsets with infarct volume. Methods: Data were derived from the Stroke Warning Information and Faster Treatment study from 2006 to 2009 among patients with mild deficits (NIHSS 0-5) and attending physician final diagnosis of stroke. Using Medical Image Processing, Analysis, and Visualization (MIPAV, NIH) (Version 7.1.1), we calculated lesion volume (cm3) from DWI sequence. Univariate models studied the association between itemized NIHSS subsets, including cortical deficits (visual field cut, aphasia, or neglect), and presence of DWI hyperintensity and lesion volume. Multivariable regression assessed factors predicting DWI-positive strokes; p<0.05 was considered significant. Results: Of 611 patients with a discharge diagnosis of stroke, 498 underwent MRI and 29.5% were DWI negative. On multivariate analysis, predictors of a positive DWI were NIHSS score of 3-5 (OR= 2.5, 95%CI:1.1-5.5), motor deficits (OR= 1.9, 95%CI:1.1-3.4), and ataxia (OR=3.0, CI:1.5-6.1). All patients with neglect and visual deficits were DWI positive (table). The mean lesion volume in cm3 was larger in patients with NIHSS 3-5 vs. NHSS 0-2 (49.0 vs. 17.3, p=0.002), cortical deficits (112.6 vs. 22.9, p<0.001), neglect (236.6 vs. 29.7, p<0.001), and visual deficits (245.7 vs. 26.4, p<0.001). Other subsets showed no differences. Conclusion: NIHSS score subsets predict DWI positivity and lesion volume in mild strokes. The presence of neglect or visual field deficit on the NIHSS subsets is highly likely to have an MRI correlate even in patients with low NIHSS.

Abstract WP44: NIHSS Score Components Predict Infarct Volume in Minor Ischemic Stroke Patients

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Shadi Yaghi ◽  
Charlotte Herber ◽  
Amelia K Boehme ◽  
Howard Andrews ◽  
Joshua Z Willey ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Language Disorder ◽  
Infarct Volume ◽  
Final Diagnosis ◽  
Minor Stroke ◽  
Lesion Volume ◽  
Nihss Score ◽  
Therapeutic Implications ◽  
Significant Relationships ◽  
Minor Ischemic Stroke

Background: Prior studies have shown a correlation between the National Institutes of Health Stroke Scale (NIHSS) score and infarct volume on diffusion weighted imaging (DWI); however data are limited in patients with minor stroke whose treatment is controversial. Our aim is to determine the association between DWI lesion(s) volume and the (1) total NIHSS score and (2) NIHSS components in a population of patients with minor ischemic stroke. Methods: We included all patients with minor stroke (NIHSS 0-5) who were enrolled in the prospective Stroke Warning Information and Faster Treatment (SWIFT) study. All patients were admitted to the hospital with a final diagnosis of stroke. We calculated lesion(s) volume (cm 3 ) on DWI sequence using Medical Image Processing, Analysis, and Visualization (MIPAV, NIH, Version 7.1.1). Based on the distribution of lesion volume, we summarized the explanatory value into median cm 3 . We used non-parametric tests to study the association between the primary outcome, DWI lesion(s) volume, and the predictors (NIHSS score and its components). Results: 894 patients had a discharge diagnosis of ischemic stroke; 709 underwent MRI and 510 were DWI positive. There was a weak graded relationship between NIHSS score and median DWI lesion volume in cm 3 : (NIHSS 0: 7.1, NIHSS 1: 8.0, NIHSS 2: 17.1, NIHSS 3: 11.6, NIHSS 4: 19.0, NIHSS 5: 23.6). We also noted highly significant relationships between lesion volume and certain NIHSS components. Compared to patients without the deficit, the median lesion volume was significantly higher in patients with neglect (105.6 vs. 12.5,p=0.025), language disorder (34.6 vs. 11.9,p<0.001), and visual field deficits (185.6 vs. 11.6,p<0.001). Other components of the NIHSS were not associated with lesion volume. Conclusion: In patients with minor stroke, the nature of the neurological deficit improves prediction of infarct volume when added to the total NIHSS score. This may lead to clinical and therapeutic implications.

Abstract 145: Outcome in Patients with Minor Stroke: The Effect of Itemized NIHSS Score Subsets

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Shadi Yaghi ◽  
Joshua Z Willey ◽  
Howard Andrews ◽  
Amelia K Boehme ◽  
Leigh Quarles ◽  
...  
Keyword(s):  
Intravenous Thrombolysis ◽  
Minor Stroke ◽  
Motor Deficits ◽  
Stroke Severity ◽  
Nihss Score ◽  
Discharge Disposition ◽  
Discharge Home ◽  
Dichotomous Variable ◽  
Secondary Analyses ◽  
Multivariable Regression

Background: The use of the National Insitutes of Health Stroke Scale (NIHSS) to assess stroke severity in minor stroke is controversial. We hypothesized that patients with cortical signs on the itemized NIHSS subsets (neglect, visual, or language) will have a worse outcome than those without. Methods: Data was retrieved from the Columbia SPOTRIAS dataset. All patients with NIHSS between 0 and 5 within 12 hours from symptom onset who were not treated with intravenous thrombolysis were included. Patients were followed prospectively as part of the “Stroke Warning Information and Faster Treatment” Study. Poor outcome was defined as not being discharged home and analyzed using multivariable logistic regression. The primary predictor was cortical features on the itemized NIHSS. Individual components of the NIHSS score, treated as a dichotomous variable, as well as the admission NIHSS score were assessed in secondary analyses. Results: The sample included 894 patients, of which 162 (18%) were not discharged home. In multivariable regression analysis of baseline demographics, risk factors, median NIHSS, and cortical signs, only mean age (OR = 1.02, P<0.001) and NIHSS score (OR = 1.59, p<0.001) were associated with non-discharge home. In secondary analyses having any score on the following items predicted non-discharge home: Motor (OR = 2.40, p<0.001), LOC (OR = 6.67, p=0.004), and Ataxia (OR = 3.21, p<0.001). Other items from the NIHSS were not associated with discharge disposition. Motor deficits (AUC 0.623) appeared to be more predictive of discharge outcome than ataxia (AUC 0.569) and LOC deficits (AUC 0.517). In addition, the admission NIHSS had a fair correlation with discharge outcome (AUC 0.683). Conclusion: Deficits in LOC, motor weakness, and ataxia predict discharge outcome in patients with mild stroke, with the motor score being the most influential component. This may potentially alter treatment decisions in this population. The fair correlation between NIHSS score and discharge outcome suggests that certain factors not captured by the NIHSS score may contribute to discharge outcome in this patient population.

Abstract TP59: Clinical Course and Radiological Outcome of Mild Stroke Patients Treated and not Treated with Thrombolysis

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Xabier Urra ◽  
Helena Ariño ◽  
Sergi Amaro ◽  
Víctor Obach ◽  
Alvaro Cervera ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Clinical Course ◽  
Past History ◽  
Infarct Volume ◽  
Clinical Severity ◽  
Lesion Volume ◽  
Radiological Outcome ◽  
Nihss Score ◽  
Neurological Improvement ◽  
Mild Stroke

Background: Around 30% of patients with acute stroke are excluded from thrombolysis because of mild or improving symptoms, but some of these patients don’t achieve a good recovery. We compared the clinical and radiological course in a cohort of 239 patients with mild stroke treated and not treated with thrombolysis in the same institution. Methods: We studied all patients with ischemic stroke admitted within 6 hours of symptom-onset with previous mRS≤1 and mild symptoms (NIHSS≤5) at arrival or during initial evaluation. We compared the baseline characteristics, clinical course (NIHSS), radiological outcome (final DWI lesion volume), incidence of symptomatic intracranial hemorrhage (sICH) and favourable 3-month outcome (mRS≤1) of patients treated with thrombolysis (123 tPA only and 9 endovascular interventions) or not treated (n=107). Results: Treated patients had greater clinical severity at presentation and after imaging and arrived to the hospital faster than not treated patients. In a general linear model of repeated measures, their course was significantly different (p=0.03) and thrombolised patients improved more during hospitalization. Patients with significant neurological improvement (NIHSS score>1) had more severe strokes at presentation but similar outcome, and were more often treated with tPA (p<0.001). Infarct volume was significantly correlated with NIHSS score especially at day 1. Despite the differences in the initial clinical severity, final infarct volume was similar in treated and not treated patients. The rate of sICH was similar in both groups. Outcome at 3-months was associated to past history of stroke, glucose levels and deterioration during hospital stay. On multivariate analysis, thrombolysis remained associated to neurological improvement (OR 4.34;p<0.001) and was non-significantly associated to greater chances of good functional outcome at 3-months (OR 2.38;p=0.099). Conclusions: In patients with mild stroke thrombolysis was safe and was associated to better neurological course. Overall, these results suggest that patients presenting with mild symptoms do benefit from thrombolysis.

scholarly journals The Itemized NIHSS Scores Are Associated With Discharge Disposition in Patients With Minor Stroke

2016 ◽  
Vol 6 (3) ◽  
pp. 102-106 ◽  
Author(s):  
Shadi Yaghi ◽  
Joshua Z. Willey ◽  
Howard Andrews ◽  
Amelia K. Boehme ◽  
Randolph S. Marshall ◽  
...  
Keyword(s):  
Area Under The Curve ◽  
Final Diagnosis ◽  
Minor Stroke ◽  
Stroke Severity ◽  
Nihss Score ◽  
Discharge Disposition ◽  
Poor Outcome ◽  
Level Of Consciousness ◽  
Unit Increase ◽  
Multivariable Regression

Background and purpose: The ability of the National Institutes of Health Stroke Scale (NIHSS) score to predict functional outcome in minor stroke is controversial. In this study, we examined the association of itemized NIHSS score with discharge outcome. Methods: We included all patients with final diagnosis of stroke with an NIHSS score of 0 to 5 untreated with thrombolysis enrolled in the “Stroke Warning Information and Faster Treatment” trial. Individual components of the NIHSS score were the primary predictors. Poor outcome was defined as not being discharged home. Logistic regression was used to identify predictors of outcome. Results: A total of 861 patients met the inclusion criteria; 162 (19%) were not discharged home. In multivariable regression, predictors of discharge other than home were age (odds ratio [OR] = 1.02 per year increase, P < .001) and total NIHSS score (OR per unit increase in the NIHSS = 1.51, P < .001). Motor (OR = 2.32, P < .001), level of consciousness (LOC; OR = 6.62, P = .004), and ataxia (OR = 3.10, P < .001) were also associated with not being discharged home. Motor (area under the curve [AUC] 0.623) appeared to be more predictive of poor outcome than ataxia (AUC 0.569) and LOC (AUC 0.517). The total NIHSS had a fair correlation with discharge outcome (AUC 0.683). Conclusion: Total and itemized NIHSS components have a fair correlation with outcome in minor stroke highlighting the importance of other measures of stroke severity for clinical trials.

scholarly journals RTHP-13. EFFICACY OF FRACTIONATED GAMMA KNIFE RADIOSURGERY FOR ORBITAL CAVERNOUS HEMANGIOMA: 10-YEAR EXPERIENCE AT A SINGLE INSTITUTION

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi212-vi213
Author(s):  
Kyung Hwan Kim ◽  
Seon-Hwan Kim ◽  
Jung-Il Lee ◽  
Doo-Sik Kong ◽  
Ho Jun Seol ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Gamma Knife ◽  
Cavernous Hemangioma ◽  
Tumor Volume ◽  
Gamma Knife Radiosurgery ◽  
Reduction Rate ◽  
Visual Field Defects ◽  
Lesion Volume ◽  
The Mean

Abstract This study aimed to evaluate the efficacy and safety of fractionated gamma knife radiosurgery (GKS) for the treatment of orbital cavernous hemangioma (OCH). METHODS From January 2007 to June 2018, 34 patients who underwent fractionated GKS (median 20 Gy in 4 fractions) for OCH at a single tertiary institution were reviewed. Ophthalmic evaluations including exophthalmometry, best corrected visual acuity with the Snellen chart and Humphrey visual field were investigated. Changes in lesion volume were also analyzed. RESULTS The median age was 43 years (range, 10–67 years) and 18 patients were male (53%). The median clinical follow-up time was 42 months (range, 12–132 months). The most common presenting symptom was proptosis followed by visual impairment. Proptosis improved in all 27 patients. The mean value of proptosis was reduced from 2.9 mm to 1.1 mm (P < 0.001). Of 15 patients who showed decreased visual acuity preoperatively, 12 patients (80%) had improved in vision. Preoperative visual field defects were evident in 17 patients and resolved in 15 patients (88%) after treatment. The median tumor volume at the time of GKS was 2.2 cm3 (range, 0.2–8.5 cm3). Tumor shrinkage was observed in all patients and the mean volume reduction rate was 64%. No patient experienced GKS-related ocular morbidity, though two transient GKS-related adverse events (6%) were observed. CONCLUSION Fractionated GKS is an effective and safe option for the treatment of OCH, with significant reduction in tumor volume and improvement of ophthalmic outcomes.

Comparison of Fluorine(18)-fluorodeoxyglucose and Gallium(68)-citrate PET/CT in patients with tuberculosis

2019 ◽  
Vol 58 (05) ◽  
pp. 371-378
Author(s):  
Alfred O. Ankrah ◽  
Ismaheel O. Lawal ◽  
Tebatso M.G. Boshomane ◽  
Hans C. Klein ◽  
Thomas Ebenhan ◽  
...  
Keyword(s):  
Tracer Uptake ◽  
Pet Ct ◽  
The Mean ◽  
18F Fdg ◽  
Definition Of ◽  
Gallium 68 ◽  
Attending Physician ◽  
Pet Scans ◽  
The Brain

Abstract 18F-FDG and 68Ga-citrate PET/CT have both been shown to be useful in the management of tuberculosis (TB). We compared the abnormal PET findings of 18F-FDG- and 68Ga-citrate-PET/CT in patients with TB. Methods Patients with TB on anti-TB therapy were included. Patients had a set of PET scans consisting of both 18F-FDG and 68Ga-citrate. Abnormal lesions were identified, and the two sets of scans were compared. The scan findings were correlated to the clinical data as provided by the attending physician. Results 46 PET/CT scans were performed in 18 patients, 11 (61 %) were female, and the mean age was 35.7 ± 13.5 years. Five patients also had both studies for follow-up reasons during the use of anti-TB therapy. Thirteen patients were co-infected with HIV. 18F-FDG detected more lesions than 68Ga-citrate (261 vs. 166, p < 0.0001). 68Ga-citrate showed a better definition of intracerebral lesions due to the absence of tracer uptake in the brain. The mean SUVmax was higher for 18F-FDG compared to 68Ga-citrate (5.73 vs. 3.01, p < 0.0001). We found a significant correlation between the SUVmax of lesions that were determined by both tracers (r = 0.4968, p < 0.0001). Conclusion Preliminary data shows 18F-FDG-PET detects more abnormal lesions in TB compared to 68Ga-citrate. However, 68Ga-citrate has better lesion definition in the brain and is therefore especially useful when intracranial TB is suspected.

Prolonged survival in a subgroup of patients with brain metastases treated by gamma knife surgery

2005 ◽  
Vol 102 (Special_Supplement) ◽  
pp. 262-265
Author(s):  
C. P. Yu ◽  
Joel Y. C. Cheung ◽  
Josie F. K. Chan ◽  
Samuel C. L. Leung ◽  
Robert T. K. Ho
Keyword(s):  
Brain Metastases ◽  
Gamma Knife ◽  
Patient Survival ◽  
Gamma Knife Surgery ◽  
Prolonged Survival ◽  
Organ Involvement ◽  
Lesion Volume ◽  
Content Type ◽  
The Mean ◽  
Fine Print

Object. The authors analyzed the factors involved in determining prolonged survival (≥ 24 months) in patients with brain metastases treated by gamma knife surgery (GKS). Methods. Between 1995 and 2003, a total of 116 patients underwent 167 GKS procedures for brain metastases. There was no special case selection. Smaller and larger lesions were treated with different protocols. The mean patient age was 56.9 years, the mean number of initial lesions was 3.15, and the mean lesion volume was 10.45 cm.3 The mean follow-up time was 9.2 months. The median patient survival was 8.68 months. One-, 2-, 3-, 4-, and 5-year actuarial survival rates were 31.8%, 19.8%, 14.6%, 7.7%, and 6.9%, respectively. Patient age, number of lesions at presentation, and lesion volume had no influence on patient survival. Twenty-three (19.8%) patients survived for 24 months or more. Certain factors were associated with increased survival time. These were stable primary disease (21 of 23 patients), a long latency between diagnosis of the primary tumor and the occurrence of brain metastases (mean 28.4 months, median 16 months), absence of third-organ involvement, and repeated local procedures. Ten patients underwent repeated GKS (mean 3.4 per patient). Seven patients required open surgery for local treatment failures (recurrence or radiation necrosis). Two patients had both. Fifteen patients underwent repeated procedures. Conclusions. Aggressive local therapy with GKS, repeated GKS, and GKS plus surgery can achieve increased survival in a subgroup of patients with stable primary disease, no third-organ involvement, and long primary-brain secondary intervals.

scholarly journals Acute Zonal Occult Outer Retinopathy: Vision Loss in an Active Duty Soldier

2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Courtney M. Crawford ◽  
Bruce A. Rivers ◽  
Mark Nelson
Keyword(s):  
Visual Field ◽  
Visual Field Defect ◽  
Vision Loss ◽  
Fundus Autofluorescence ◽  
Final Diagnosis ◽  
Active Duty ◽  
Visual Field Defects ◽  
Fundus Photographs ◽  
Optical Coherence Tomograph ◽  
Field Defect

Objective. To describe a case of acute zonal occult outer retinopathy (AZOOR) in an active duty patient.Methods. In this paper we studied fundus photographs, optical coherence tomograph, Humphrey visual field 30-2, fundus autofluorescence images, fluorescein angiograms, and electroretinography.Results. Exam findings on presentation: a 34-year-old American Indian female presented with bilateral photopsias, early RPE irregularity, and an early temporal visual field defect. Progression RPE damage and visual field defect along with ERG findings support final diagnosis of AZOOR.Conclusion. AZOOR may initially be identified as a broader category of disease called the “AZOOR complex of disorders”. Specific visual field defects, ERG results, and clinical exam findings will help distinguish AZOOR from other similar disorders.

scholarly journals POS1435 CLINICAL CHARACTERIZATION AND PREDICTIVE FACTORS FOR PROGRESSION IN A COHORT OF ILD PATIENTS WITH FEATURES OF AUTOIMMUNITY: ARE IPAF CRITERIA SUFFICIENT?

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1002.1-1002
Author(s):  
F. Bozzao ◽  
P. Tomietto ◽  
E. Baratella ◽  
F. Giudici ◽  
M. Kodric ◽  
...  
Keyword(s):  
Interstitial Pneumonia ◽  
Predictive Factors ◽  
Usual Interstitial Pneumonia ◽  
Final Diagnosis ◽  
Classification Criteria ◽  
Radiological Progression ◽  
Nonspecific Interstitial Pneumonia ◽  
The Mean ◽  
Functional Deterioration ◽  
Worse Prognosis

Background:It is unknown whether patients with interstitial lung disease (ILD) and only some features of autoimmunity have a different natural history from those with a defined connective tissue disease (CTD-ILD). The classification criteria for “ILD with autoimmune features” (IPAF) may not be able to characterize all these patients, especially those with a usual interstitial pneumonia (UIP) pattern [1].Objectives:To determine clinical characteristics and predictive factors for progression in a cohort of ILD patients with features of autoimmunity, through the application of classification criteria for IPAF and specific CTD, whenever possible.Methods:We retrospectively selected a cohort of consecutive patients with ILD as onset manifestation and features of autoimmunity (at least 1 autoantibody and/or 1 clinical sign/symptom), evaluated by our multidisciplinary unit from March 2009 to March 2020. All the final diagnoses were revised according to the latest CTD and IPAF criteria. Patients were followed up for 33 (16.5-69.5) months.Results:Of the 101 patients enrolled (67.4±10.9 yrs, F/M ratio 65/36), 53 (52.5%) and 37 (36.6%) respectively satisfied the CTD and IPAF criteria. Eleven patients (10.9%) did not satisfy IPAF criteria because of only 1 item (clinical or serologic) within the IPAF domains and a UIP pattern; we defined this group as “autoimmune” UIP (AI-UIP). All the 8 patients initially classified as undifferentiated CTD had sufficient IPAF criteria. Among the IPAF patients (68.2±10.1 years, F/M ratio 20/17), the most common findings were: Nonspecific interstitial pneumonia pattern (56.8%), antinuclear antibodies positivity (43.2%) and arthritis (24.3%). The combination of a positive morphologic and serologic domain was the most common to reach the diagnosis (48.6%). Some IPAF patients had features not included in IPAF criteria, such as non-anti-synthetase myositis-specific antibodies (21.6%), objective sicca syndrome (13.5%) and anti-myeloperoxidase antibodies (2.7%). Over a median of 17 months, 2 IPAF patients (5.4%) developed a definite UIP pattern, while 4 (10.8%) a specific CTD. Comparing the IPAF, CTD-ILD and AI-UIP groups, no statistically significant differences were found in the mean age, sex distribution, smoking habits and mean duration of the disease. However, IPAF patients had a significantly higher prevalence of arterial hypertension and left-sided heart failure and a lower predominance of UIP pattern as expected (10.8% vs. 32.1% vs. 100%, p<0.01). Although no differences were found at the diagnosis, at 1 year the proportion of IPAF patients with radiological progression of the fibrosis and/or functional deterioration (defined by a decline in FVC of ≥ 10% and/or DLCO of ≥ 15% predicted) was lower to that of CTD-ILD and AI-UIP (17.1% vs. 31.4% vs. 63.6%, p 0.01). Fewer IPAF patients needed oxygen support (8.6% vs. 31.4% vs. 36.4, p 0.02). Considering the overall 101 patients, having an IPAF and a UIP pattern respectively predicted a slower (OR: 0.37, p 0.04) and a faster (OR: 3.56, p 0.01) ILD progression at the multivariate analysis.Conclusion:In our cohort, IPAF criteria were useful to identify a subset of patients with a slower ILD progression and a possible evolution to CTD (10-15% of cases) [2]. These criteria do not characterize all the patients with a UIP pattern and limited features of autoimmunity, which seem to have a worse prognosis, independently from the final diagnosis. Further studies are needed to clarify if the prognosis of AI-UIP is different from that of idiopathic pulmonary fibrosis.References:[1]Graney, et al. Ann Am Thorac Soc 2019;16(5):525-33.[2]Sebastiani, et al. Biomedicines 2021,9,17.Disclosure of Interests:None declared

scholarly journals Correlation between fundus autofluorescence and visual function in patients with cone-rod dystrophy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Satoru Kanda ◽  
Takumi Hara ◽  
Ryosuke Fujino ◽  
Keiko Azuma ◽  
Hirotsugu Soga ◽  
...  
Keyword(s):  
Visual Field ◽  
Significant Relationship ◽  
Fundus Autofluorescence ◽  
Univariate Analysis ◽  
Retrospective Chart Review ◽  
Mean Deviation ◽  
Wide Field ◽  
The Mean ◽  
The Relationship ◽  
Field Imaging

AbstractThis study aimed to investigate the relationship between autofluorescence (AF) signal measured with ultra-wide field imaging and visual functions in patients with cone-rod dystrophy (CORD). A retrospective chart review was performed for CORD patients. We performed the visual field test and fundus autofluorescence (FAF) measurement and visualized retinal structures with optical coherence tomography (OCT) on the same day. Using binarised FAF images, we identified a low FAF area ratio (LFAR: low FAF/30°). Relationships between age and logMAR visual acuity (VA), central retinal thickness (CRT), central choroidal thickness (CCT), mean deviation (MD) value, and LFAR were investigated. Thirty-seven eyes of 21 CORD patients (8 men and 13 women) were enrolled. The mean patient age was 49.8 years. LogMAR VA and MD were 0.52 ± 0.47 and − 17.91 ± 10.59 dB, respectively. There was a significant relationship between logMAR VA and MD (p = 0.001). LogMAR VA significantly correlated with CRT (p = 0.006) but not with other parameters. Conversely, univariate analysis suggested a significant relationship between MD and LFAR (p = 0.001). In the multivariate analysis, LFAR was significantly associated with MD (p = 0.002). In conclusion, it is useful to measure the low FAF area in patients with CORD. The AF measurement reflects the visual field deterioration but not VA in CORD.

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