Is the Blind Spot Enlarged in Early Glaucoma?

1998 ◽  
Vol 8 (1) ◽  
pp. 28-32 ◽  
Author(s):  
J.H. Meyer ◽  
M. Guhlmann ◽  
J. Funk
Keyword(s):  
Optic Disc ◽  
Visual Fields ◽  
Stimulus Presentation ◽  
Light Sensitivity ◽  
Blind Spot ◽  
Control Group ◽  
Horizontal Meridian ◽  
Early Glaucoma ◽  
Disc Center ◽  
Optic Discs

Purpose We investigated whether the blind spot is larger in early “preperimetric” glaucoma with already deeply excavated optic discs than in normal persons. Methods We examined eight eyes of five patients with definite glaucomatous optic disc cupping but normal visual fields. Ten eyes of five normal healthy volunteers, with normal central excavation, served as controls. With SLO-perimetry we measured the differential light sensitivity 0.5-1.0° outside the disc margins, “within” the center (Goldmann V stimulus) and along the horizontal meridian of the optic discs. Optic disc topography was documented with the Heidelberg Retina Tomograph (HRT). Results Differential light sensitivities adjacent to the optic discs did not differ in the two groups (normal 8.3dB, early glaucoma 8.4dB). Goldmann IV stimuli presented on the horizontal meridian of optic discs with glaucomatous cupping were seen up to 0.7° centrally (i.e., towards the center) of the disc margin. In the control group this distance was significantly greater (1.3°). The light differential thresholds with stimulus presentation in the disc center (Goldmann V) were significantly higher in the glaucoma group (0±2.8dB) than in the normal controls (6.6±1.3dB), though disc size was the same in both groups. Conclusions Blind spots of normal discs seem to be smaller than those of deeply excavated discs in eyes with early glaucoma, possibly because there is more light scattering by the normal disc surface towards the adjacent functioning retina.

Is a virtual clinic model a safe and effective way for assessing patients referred with suspiciously blurred optic discs? The blurred disc clinic

2020 ◽  
pp. 112067212097604
Author(s):  
Joanna M Jefferis ◽  
Nigel Griffith ◽  
Daniel Blackwell ◽  
Ruth Batty ◽  
Simon J Hickman ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Optic Disc ◽  
Direct Contact ◽  
Visual Fields ◽  
Referral Letter ◽  
Face To Face ◽  
The Face ◽  
Optic Discs ◽  
Eye Clinic ◽  
Virtual Clinic

Background: There are increasing numbers of referrals to ophthalmology departments due to blurred optic disc margins. In light of this and the COVID-19 pandemic we aimed to assess whether these patients could be safely assessed without direct contact between the clinician and patient. Methods: We retrospectively reviewed the records of consecutive patients seen in our ‘blurred disc clinic’ between August 2018 and October 2019. We then presented anonymous information from their referral letter, their visual fields and optic nerve images to two consultant neuro-ophthalmologists blinded to the outcome of the face-to-face consultation. In the simulated virtual clinic, the two consultants were asked to choose an outcome for each patient from discharge, investigate or bring in for a face-to-face assessment. Results: Out of 133 patients seen in the blurred disc clinic, six (4.5%) were found to have papilloedema. All six were identified by both neuro-ophthalmologists as needing a face-to-face clinic consultation from the simulated virtual clinic. One hundred and twenty (90%) patients were discharged from the face-to-face clinic at the first consultation. The two neuro-ophthalmologists chose to discharge 114 (95%) and 99 (83%) of these respectively from the simulated virtual clinic. The virtual clinic would have potentially missed serious pathology in only one patient who had normal optic discs but reported diplopia at the previous face-to-face consultation. Conclusions: A virtual clinic model is an effective way of screening for papilloedema in patients referred to the eye clinic with suspicious optic discs. Unrelated or incidental pathology may be missed in a virtual clinic.

Inherited or Congenital Optic Nerve Diseases

Visual Fields ◽  
2010 ◽  
Author(s):  
Peter A. Quiros ◽  
Alfredo A. Sadun
Keyword(s):  
Optic Nerve ◽  
Optic Disc ◽  
Case Reports ◽  
Visual Fields ◽  
Maternal Diabetes ◽  
Disc Center ◽  
Double Ring ◽  
Optic Nerve Diseases ◽  
Disc Size ◽  
Optic Disc Anomaly

In this chapter, we discuss inherited/congenital optic nerve diseases and their related visual fields defects. It is important for the ophthalmologist to establish, on the basis of the visual fields defect whether the optic nerve is involved and, if so, whether this is at the level of the optic disc or further back. In addition, the visual fields defect can help establish whether the etiology is acquired or congenital. If the former is the case, then the visual fields defect may reveal an insult that is rapidly progressive and hence requires immediate and aggressive management. The diseases are divided into the categories of congenital optic disc anomalies and heredodegenerative optic atrophies. Congenital optic disc anomalies include aplasias, dysplasias (hyperplasia and hypoplasia), optic nerve colobomas and pits, anomalous disc elevations: pseudopapilledema with or without hyaline bodies (drusen), and tilted disc and crescents. Absence of the optic disc (aplasia) is extremely rare and only a few case reports have been published in the literature. Optic disc size varies and may be larger (hyperplasia) or smaller (hypoplasia) than normal. Hyperplasia is much less common than hypoplasia and is usually related to ametropias. Optic nerve hypoplasia (ONH) may be unilateral or bilateral and isolated or associated with different syndromes. It may be associated with good or poor visual prognosis. It is the most common congenital optic disc anomaly encountered in pediatric ophthalmic practice. When the nerve head is slightly or segmentally reduced, especially in the presence of normal visual acuity, the diagnosis is based on comparison of disc photographs or calculation of the ratio of the disc center-to-fovea distance to disc diameter. Usually this ratio is increased in hypoplasia and, if higher than 3.0, is almost diagnostic. Sometimes the hypoplastic disc is surrounded by a ring of sclera and a ring of hyperpigmentation, described as “double-ring sign”. Maternal diabetes and use of teratogenic agents such as phenytoin, alcohol, quinine, and cocaine may be associated with ONH.

scholarly journals Features of the Retina Light Sensitivity in Patients with Chronic Cerebral Ischemia, Depending on the Stage of Discirculatory Encephalopathy with the Use of a Neuropeptide

2020 ◽  
Vol 17 (4) ◽  
pp. 784-788
Author(s):  
M. A. Frolov ◽  
A. M. Gasankhanova
Keyword(s):  
Cerebral Ischemia ◽  
Visual Fields ◽  
Light Sensitivity ◽  
Cellular Structures ◽  
Visual Field Defects ◽  
Control Group ◽  
Chronic Cerebral Ischemia ◽  
Partial Restoration ◽  
Before And After ◽  
Transfer Of Information

Objective. Our study was to examine the degree of the light sensitivity impairment of the retina in patients with chronic cerebral ischemia, as well as to reveal the dynamics of these disorders on the background of the neuropeptide, depending on the stage of vascular encephalopathy.Patients and methods. Comparative analysis of visual function was conducted in 70 persons (140 eyes). Patients were divided into 2 groups, each group is divided into two subgroups. To study the light sensitivity of the retina used automatic computer perimeter Hamphrey Field Analyzer HFA II — I Series (model 610, ZEISS, Germany).Results. As a result of quantifying visual field defects in patients with chronic cerebral ischemia at 2 and 3 tbsp. vascular encephalopathy before treatment received preferential reduction of the light sensitivity of the retina in the temporal halves When comparing manual data with chronic cerebral ischemia patients 2 and 3 stadies vascular encephalopathy control group no significant differences before and after treatment have been identified. However, it is important to note that after 6 months treatment in the same group showed a slight increase in absolute numbers of cattle. In the control group using Cortexin observed reduction in the amount of absolute cattle.Conclusions. The light sensitivity of the retina in patients with chronic cerebral ischemia decreases as the disease progresses, with a primary lesion of the temporal halves of the visual fields. The improvement in the computer perimetry during the treatment, especially in combination with cortexin can be attributed to the normalization of the retina cellular structures, improving the transfer of information and the partial restoration of the disturbed functions, which indicates the relative ischemia is reversible processes, which is effective in patients with stage 2 or 3 vascular encephalopathy. 

Results of Applying the Method of Visual Fatigue Prevention Using Low-Intensity Laser Radiation

2020 ◽  
pp. 56-59
Author(s):  
NYu Mal’kova ◽  
MD Petrova
Keyword(s):  
Laser Radiation ◽  
Work Experience ◽  
Study Groups ◽  
Light Sensitivity ◽  
Control Group ◽  
Sensitivity Threshold ◽  
Visual Fatigue ◽  
Strain Relief ◽  
Visual Stress ◽  
Stress At Work

Summary. Introduction: Visual fatigue is caused by changes in the muscular apparatus and retina of the eye and is characterized by deterioration in their functional activity. Along with an increase in work experience and age, workplace visual stress promotes the loss of performance. Known methods of visual fatigue prevention and eye strain relief are ineffective. In this regard, a technique of relieving visual fatigue using scattered low-level red laser radiation was developed and patented. The purpose of our study was a retrospective evaluation of effectiveness of the visual fatigue reduction technique. Materials and methods: We examined two groups of women (PC operators and jewellers) aged 43–57 years experiencing visual stress at work and practicing the method under study over the previous 20 years. The state of daylight vision was assessed by adaptation time. Results: A five-day testing of the method of visual fatigue relief showed stabilization of the light sensitivity threshold throughout the work shift. Over the 20-year period, the female workers had had no complaints of eye strain, burning or lacrimation. Objective studies of the functional state of the organ of sight showed that the light sensitivity threshold during the working day in two study groups was significantly lower than that in the control group with no preventive measures taken. Conclusions: We established that using the technique of eye strain relief based on a two-minute binocular exposure to red laser radiation with the power density of 2×10–7 W/cm2, a 5-day course every six months over the period of 20 years, helped retain retinal activity in terms of light sensitivity, thus preventing visual fatigue.

Visual Field Damage and Progression in Glaucomatous Myopic Eyes

2007 ◽  
Vol 17 (4) ◽  
pp. 534-537 ◽  
Author(s):  
A. Perdicchi ◽  
M. Iester ◽  
G. Scuderi ◽  
S. Amodeo ◽  
E.M. Medori ◽  
...  
Keyword(s):  
Visual Field ◽  
Open Angle Glaucoma ◽  
Linear Regression Analysis ◽  
Visual Fields ◽  
Light Sensitivity ◽  
Progressive Increase ◽  
Central Visual Field ◽  
Trend Function ◽  
Visual Field Damage ◽  
Loss Variance

Purpose To make a visual field retrospective analysis on a group of patients with primary open angle glaucoma (POAG) and to evaluate whether different refractive errors could have different progression of the 30° central sensitivity. Methods A total of 110 patients with POAG (52 men and 58 women) were included in the study. All the patients were divided into four subgroups based on the refractive error. The visual field of all the included patients was assessed by an Octopus 30° central visual field every 6 months, for a total of 837 visual fields examined. The resulting data were analyzed by PERIDATA for Windows 1.7 TREND function. Mean defect (MD) and loss variance (LV) were considered for the analysis. Results At the first examination, 82% of eyes showed a global decrease of differential light sensitivity (MD >2 dB) and in 67% the distribution of the defect was nonhomogeneous (LV >6 dB). The analysis of variance for subgroups showed a more significant decrease of MD in highly myopic patients. A linear regression analysis highlighted a statistically significant change in time of MD in 36% and of LV in 34% of the eyes studied. Highly myopic patients had the highest (p<0.01) percentage of change of MD and LV (46% and 42%, respectively). Among the four subgroups, there was no difference in progression of MD decrease in time. Conclusions These results showed that after 5 years of glaucoma, the visual field was altered in most of the eyes examined (82%) and that in 67% of cases, its defect was nonhomogeneous and worsened with the increase of myopia. The regression linear analysis of visual field changes in time showed a progressive increase of MD and LV in approximately one third of all the eyes examined.

Comparison of the parameters of retinal sensitivity after vitrectomy due to rhegmatogenous retinal detachment

2021 ◽  
pp. 349-354
Author(s):  
R.R. Fayzrakhmanov ◽  
◽  
A.V. Sukhanova ◽  
O.A. Pavlovsky ◽  
E.D. Bosov ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Light Sensitivity ◽  
Control Group ◽  
Strong Positive Correlation ◽  
Gas Tamponade ◽  
Group I ◽  
Silicone Oil Tamponade ◽  
Group Ii

Purpose. To compare the parameters of a light sensitivity (LS) of the central zone of a retina after vitrectomy due to reghmatogenous retinal detachment (RRD) with a silicone oil tamponade (SOT) and gas tamponade (GT). Material and methods. The study included 20 eyes after pars plana vitrectomy due to macula-off rhegmatogenous retinal detachment (RRD) by 25G. All patients were divided in 2 groups depending on the choice of the tamponade. The group I (10 eyes) included cases with the silicone oil tamponade (SOT) (1300 cSt), in the group II (10 eyes) – the gas tamponade (GT) (C2F6). The control group included contralateral eyes without ophthalmic pathology. All patients underwent standard ophthalmological examination and fundus- microperimetry (FMP) on the 30th day after removal of the SOT for the group I, or on the 30th day after the C2F6 tamponade for the group II. Results. According to FMP data, the parameter of average light sensitivity (LS) in the group I was significantly reduced, both in comparison with the group II (p=0.007) and the control group (p=0.003). Differentiation by zones in the group I revealed a decrease in each analyzed parameter in comparison with the control group (p<0.05) and a decrease in the 2nd zone (p=0.031) and the 4th zone (p=0.038) in comparison with the group II. In the 1st zone of the group I the formation of a relative scotoma was revealed in 4 cases out of 10 (40%). The parameters of light sensitivity (LS) in comparison with the control in the group II were significantly reduced when analyzed in each zone (p<0.05). A strong positive correlation was found between the Best Corrected Visual Acuity (BCVA) and the average LS in the group II (r=0.87). Conclusion. There is a decrease in the functional parameters of the retina with SOT compared with GT in the form of a decrease in the LS parameter in the 10° zone according to FMP data. Key words: retinal detachment, photosensitivity, microperimetry, silicone tamponade.

Optic Disc Drusen: Longitudinal Aspects, with Emphasis on Visual Field Constriction and Enlarged Blind Spot: A Retrospective Hospital-Based Clinical Series

2016 ◽  
Vol 27 (3) ◽  
pp. 372-378 ◽  
Author(s):  
Hans C. Fledelius
Keyword(s):  
Visual Field ◽  
Optic Disc ◽  
Blind Spot ◽  
Observation Time ◽  
Main Trend ◽  
Visual Field Defects ◽  
Optic Disc Drusen ◽  
Clinical Series ◽  
Field Defects ◽  
Visual Field Constriction

Purpose To examine long-term data on optic disc drusen (ODD) from an outpatient hospital series that indicated more cases with advanced visual field constriction than is apparent from other clinical reports. The underlying pathophysiology is discussed, also with regard to enlarged blind spot, which, in view of the small disc at risk, may seem a paradox. Methods This is an observational retrospective study on an eye clinic series (n = 49), focusing on visual acuity, kinetic/static perimetry, and longitudinal trends, to include the question of eventual visual incapacity. Results Forty-nine patients (32 female and 17 male; bilateral ODD in 45) aged 5-76 years (median age 29 years for both sexes) were included in the study. Observation time was 1-54 years, with serial data recorded over at least 3 years in 25 patients. Visual field defects were found in 32 patients, with ODD considered responsible for the visual field defects demonstrated. Advanced unilateral concentric constriction (for the largest Goldmann object) was recorded in 10 patients, and bilaterally in 2. With regard to nonexplanatory side diagnoses, 2 patients had pituitary adenoma, 1 had a cavernous sinus meningioma, and 1 had neurosurgery for an arachnoid cyst. Conclusions We found more cases of marked visual field constriction than reported in other clinical series. A few such cases appeared acute and vascular, but the main trend was clinically quiet over time. All 49 patients could manage visually in daily life.

Association between glaucomatous optic disc and depressive symptoms independent of light exposure profiles: a cross-sectional study of the HEIJO-KYO cohort

2018 ◽  
Vol 103 (8) ◽  
pp. 1119-1122 ◽  
Author(s):  
Tadanobu Yoshikawa ◽  
Kenji Obayashi ◽  
Kimie Miyata ◽  
Tetsuo Ueda ◽  
Norio Kurumatani ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Optic Disc ◽  
Light Exposure ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Confounding Factors ◽  
Sectional Study ◽  
Night Time ◽  
Cross Sectional ◽  
Optic Discs

BackgroundGlaucoma may cause physiological and behavioural circadian misalignment because of the loss of intrinsically photosensitive retinal ganglion cells, the primary receptors of environmental light. Although studies have suggested a high prevalence of depression in patients with glaucoma, it is unclear whether the association is independent of the light exposure profiles as an important confounding factor.MethodsIn this cross-sectional study of a community-based cohort of 770 elderly individuals (mean age, 70.9 years), glaucomatous optic discs were assessed using fundus photographs and depressive symptoms were assessed using the short version of the Geriatric Depression Scale (GDS). Daytime and night-time ambient light exposures were objectively measured for 2 days.ResultsDepressive symptoms (GDS score ≥6) were observed in 114 participants (prevalence, 14.8%) and glaucomatous optic discs were detected in 40 participants (prevalence, 5.2%). The prevalence of depressive symptoms was significantly higher in the group with glaucomatous optic disc than in the group without it (30.0% vs 14.0%, respectively; p=0.005). Multivariable logistic regression analysis adjusted for potential confounding factors, including daytime and night-time light exposures, revealed that the OR for depressive symptoms was significantly higher in the group with glaucomatous optic disc than in the group without it (OR 2.45, 95% CI 1.18 to 5.08; p=0.016).ConclusionsIn this general elderly population, glaucomatous optic disc was significantly associated with higher prevalence of depressive symptoms independent of a number of potential confounding factors, including daily light exposure profiles.

scholarly journals Pattern ERG as a predictor in ocular hypertensive

2016 ◽  
Vol 15 (2) ◽  
Author(s):  
Paaraj Dave ◽  
Jitendra Jethani
Keyword(s):  
Amplitude Ratio ◽  
Corneal Thickness ◽  
Visual Fields ◽  
Cross Sectional Study ◽  
Control Group ◽  
Study Group ◽  
Pattern Erg ◽  
Check Size ◽  
Cross Sectional ◽  
The Mean

Purpose: To report the repeatability of Pattern Electrotretinogram (PERG) and its findings in ocular hypertension (OHT) and normal eyes.Methods: A cross-sectional study where PERG responses were compared between the study group comprising of 80 eyes of 80 patients with intraocular pressure (IOP)>21 mmHg and the control group with 80 eyes of 80 normal individuals (IOP≤21mmHg). The optic disc and the visual fields were normal with a visual acuity of ≥ 0.8 in both groups. PERG was recorded twice for each individual in the control group by a single operator on 2 consecutive days to assess the repeatability.Results: The mean age in the study and control groups was 50.05±10.03 and 54.8±7.66 years(p=0.44) respectively. The mean IOP was 26.55±3.9 mmHg for the study group as opposed to 14.45±2.9 mmHg for the controls (p<0.001). The central corneal thickness and the cup-disc ratio was similar between the groups (p>.05). The P50-N95 amplitude (p=0.01) and the P50 latency (p<0.001) was statistically significantly different between both the groups. The intra-class correlation coefficient (ICC) showed poor agreement for all parameters except for N35-P50 0.8 to 16 degree check size amplitude ratio (PERG ratio).Conclusion:  Increase in P50 latency emerges as a new candidate for early glaucoma indicator in addition to reduction in P50-N95 amplitude. PERG parameters suffer from high test-retest variability. Deterioration in PERG recordings should be interpreted with caution. The variability is lesser for the PERG ratio which maybe more meaningful while monitoring for change over time.

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