scholarly journals Assessing glaucoma deterioration using Spaeth/Richman contrast sensitivity test

2020 ◽  
Vol 12 ◽  
pp. 251584142097741
Author(s):  
Parul Ichhpujani ◽  
Tanu Singh ◽  
Sahil Thakur ◽  
Rohan Bir Singh ◽  
Suresh Kumar

Purpose: To assess changes in the central and peripheral contrast sensitivity in severe primary open-angle glaucoma (POAG) patients using a computer-based Spaeth/Richman contrast sensitivity test (SPARCS) over a period of 24 months. Methods: Our pilot, observational study included 15 patients (30 eyes) with severe POAG. Visual acuity, intraocular pressure, number of anti-glaucoma drugs, visual fields, and SPARCS score were recorded at first visit and at 12 and 24 months. Results: We observed changes in mean deviation (MD) from −19.37 ± 5.04 to −20.63 ± 4.07, mean pattern standard deviation (PSD) from 11.49 ± 2.61 to 11.35 ± 2.01, and mean SPARCS score from 54.97 ± 15.66 to 53.50 ± 16.42. We found no statistically significant difference between visual field parameters and SPARCS scores associated with the number or type of prescribed anti-glaucoma drugs. Spearman’s correlation coefficient of SPARCS at baseline (SPARCS1) versus MD at baseline (MD1) was 0.274 ( p = 0.142) and SPARCS1 versus PSD at baseline (PSD1) was −0.163 ( p = 0.389). The correlation coefficient between SPARCS at 12 months (SPARCS2) versus MD (MD2) at the same time point was computed to be 0.391 ( p = 0.03), whereas SPARCS2 versus PSD at 12 months was −0.212 ( p = 0.262). Similarly, we found the coefficient to be 0.336 ( p = 0.069) for SPARCS3 (SPARCS at 24 months) versus MD3 (MD at 24 months) and −0.242 ( p = 0.197) for SPARCS3 versus PSD3 (PSD at 24 months). Correlation coefficients between SPARCS1/2, SPARCS1/3, MD1/2, MD1/3 PSD1/2, and PSD1/3 were 0.856, 0.865, 0.748, 0.722, 0.497, and 0.562, respectively ( p < 0.001). MD changed by 9.46% ± 12.73%, PSD by 0.64% ± 14.03%, and average SPARCS by 3.31% ± 12.73% over 24 months. Conclusion: The data from our study indicate the utilitarian application of SPARCS, an inexpensive and readily available tool for monitoring functional deterioration in cases with advanced glaucomatous damage, especially in resource-poor settings. Furthermore, it is a useful and reliable alternative to the imaging modalities where retinal nerve fiber layer measurement can be erroneous in advanced cases secondary to the floor effect.

2019 ◽  
Vol 43 (1) ◽  
pp. 28
Author(s):  
Astriviani Widyakusuma ◽  
Widya Artini ◽  
Virna Dwi Oktariana ◽  
Joedo Prihartono

Objective: To evaluate the effect of Mirtogenol towards the changes in retinal nerve fiber layer (RNFL) thickness and visual field in patients with primary open angle glaucoma (POAG) with controlled IOP. Methods: This is a prospective, double blind, randomized study. Forty one POAG patients with IOP ≤ 18 mmHg were randomly assigned to receive either Mirtogenol or placebo. Changes in RNFL thickness and mean deviation of visual fields were evaluated before the treatment, as well as 4 weeks and 8 weeks after the treatment. Patients were asked for any side effects during the treatment period. Result: The average RNFL thickness in the Mirtogenol group decreased -0.70±1.63 μm from 87.29±19.39 μm before the treatment to 86.58±19.43 μm after 8 weeks of treatment, however the change was not significant (p=0.121). The average RNFL thickness in the placebo group decreased -1.74±1.79 μm from 97.14±17.19 μm before the treatment to 95.40±18.56 μm after 8 weeks of treatment, the change was statistically significant (p< 0.001). The average MD of visual field in the Mirtogenol group increased 0.542±1.93 dB after 8 weeks of treatment while the MD of visual field in the placebo group decreased -0.083±1.36 dB after 8 weeks of treatment. Hoewever the changes in MD of visual field was not significant (p>0.05). No side effect was found throughout the study. Conclusion: Mirtogenol seemed to maintain retinal nerve fiber layer thickness and increased mean deviation of visual fields.


2021 ◽  
Vol 7 (3) ◽  
pp. 562-567
Author(s):  
Sowmya Shree B V ◽  
Bharathi N ◽  
Shwetha Kumari C ◽  
Ranjitha C Sadananda ◽  
Madhura M Khanapur

The study is conducted to determine the functional and structural differences between NTG and POAG, to assess the rate of conversion of NTG into POAG and its early intervention. It is a hospital based prospective, cross-sectional study of 56 NTG and 56 POAG patients. History was taken and comprehensive ophthalmic examination with glaucoma work up was done.Majority of the patients belonged to the age group between 51 and 60 years i.e. 48.2% in NTG and 62.5% in POAG. Majority of the NTG patients i.e. 33 (58.9%) were females while 41(73.2%) were males in POAG. 40% of NTG patients had systemic association like bronchial asthma, diabetes, hypertension, ischemic heart disease and migraine. There was no significant difference in CDR between two groups. Inferior & temporal neuroretinal rim thinning was more common in NTG. While bipolar thinning & superior rim thinning was more common in POAG. There is significantly more thinning of RNFL in POAG than NTG. The mean deviation (MD) & pattern standard deviation (PSD) in visual fields between NTG & POAG showed no significant difference. Whereas the field loss was near centre of fixation in NTG group compared to POAG which was diffuse. These differences between NTG and POAG suggest that the pathogenesis of NTG includes IOP and IOP independent risk factors, while IOP is the main risk factor in POAG. The parameters assessed determine the risk and progression of NTG to POAG.


F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 762 ◽  
Author(s):  
Yalong Dang ◽  
Pritha Roy ◽  
Igor I. Bussel ◽  
Ralitsa T. Loewen ◽  
Hardik Parikh ◽  
...  

Prior glaucoma severity staging systems were mostly concerned with visual field function and retinal nerve fiber layer, but did not include intraocular pressure or medications to capture resistance to treatment. We recently introduced a simple index that combines pressure, medications, and visual field damage and applied it to stratify outcomes of trabectome surgery. In the analysis presented here, we combined data of trabectome alone and trabectome with same session cataract surgery to increase testing power and chances of effect discovery. This microincisional glaucoma surgery removes the primary resistance to outflow in glaucoma, the trabecular meshwork, and has been mostly used in mild glaucoma. Traditional glaucoma surgeries have a relatively high complication rate and have been reserved for more advanced disease stages. In the analysis presented here we include our data of trabectome combined with cataract surgery. This is a common practice pattern as both occur in the same age group with increasing frequency. For patients in higher glaucoma index (GI) groups, the intraocular pressure (IOP) reduction was 2.34+/-0.19 mmHg more than those in a GI group one level lower while holding everything else constant. Those who had undergone trabectome combined with phacoemulsification had an IOP reduction that was 1.29+/-0.39 mmHg less compared to those with trabectome alone. No statistically significant difference was found between genders and age groups while holding everything else constant. Hispanics had a 3.81+/-1.08 mmHg greater IOP reduction. Pseudoexfoliation and steroid glaucoma patients had an IOP reduction that was greater by 2.91+/-0.56 and 3.86+/-0.81 mmHg, respectively, than those with primary open angle glaucoma. These results suggest a role for trabectome-mediated ab interno trabeculectomy beyond mild forms of glaucoma. Additionally, the multifactorial glaucoma index demonstrates a role in staging patients when comparing glaucoma surgical modalities.


2007 ◽  
Vol 17 (4) ◽  
pp. 545-549 ◽  
Author(s):  
H. Shah ◽  
C. Kniestedt ◽  
A. Bostrom ◽  
R. Stamper ◽  
S. Lin

Purpose To evaluate the relationship of central corneal thickness (CCT) to baseline visual field parameters and visual field progression in patients with primary open-angle glaucoma (POAG). Methods Charts of consecutive patients with POAG were reviewed to obtain visual field data. Visual field was measured by standard threshold static perimetry. Variables analyzed included mean deviation (MD) and pattern standard deviation (PSD). Results A total of 121 eyes examined over 4 years were evaluated. A significant negative relationship between CCT and PSD (correlation coefficient: −0.02, p<0.05) was found. Analyses comparing CCT to change in PSD and MD (visual field progression) were statistically not significant. Conclusions Patients with thinner corneas initially present with a greater visual field defect, indicating that thin corneas may contribute to advanced glaucomatous damage at the time of diagnosis. However, CCT does not seem to be a significant risk factor for progression of the disease.


2021 ◽  
Vol 13 ◽  
Author(s):  
Vincenzo Parisi ◽  
Lucia Ziccardi ◽  
Lucia Tanga ◽  
Gloria Roberti ◽  
Lucilla Barbano ◽  
...  

Purpose: This study was conducted in order to evaluate retinal ganglion cell (RCG) function and the neural conduction along the postretinal large and small axons and its correlation with retinal nerve fiber layer thickness (RNFL-T) in open-angle glaucoma (OAG) eyes.Methods: Thirty-seven OAG patients (mean age: 51.68 ± 9.83 years) with 24–2 Humphrey mean deviation (MD) between −2.5 and −20 dB and IOP &lt;21 mmHg on pharmacological treatment (OAG group) and 20 age-matched controls (control group) were enrolled. In both groups, simultaneous pattern electroretinograms (PERG) and visual evoked potentials (VEP), in response to checks stimulating macular or extramacular areas (the check edge subtended 15′ and 60′ of visual arc, respectively), and RNFL-T (measured in superior, inferior, nasal, and temporal quadrants) were assessed.Results: In the OAG group, a significant (ANOVA, p &lt; 0.01) reduction of 60′ and 15′ PERG P50-N95 and VEP N75-P100 amplitudes and of RNFL-T [overall (average of all quadrants) or temporal] with respect to controls was found; the values of 60′ and 15′ PERG P50 and VEP P100 implicit times and of retinocortical time (RCT; difference between VEP P100 and PERG P50 implicit times) were significantly (p &lt; 0.01) increased with respect to control ones. The observed increased RCTs were significantly linearly correlated (Pearson’s test, p &lt; 0.01) with the reduced PERG amplitude and MD values, whereas no significant linear correlation (p &lt; 0.01) with RNFL-T (overall or temporal) values was detected.Conclusions: In OAG, there is an impaired postretinal neural conduction along both large and small axons (increased 60′ and 15′ RCTs) that is related to RGC dysfunction, but independent from the RNFL morphology. This implies that, in OAG, the impairment of postretinal neural structures can be electrophysiologically identified and may contribute to the visual field defects, as suggested by the linear correlation between the increase of RCT and MD reduction.


2021 ◽  
pp. bjophthalmol-2021-320137
Author(s):  
Golnoush Mahmoudinezhad ◽  
Diana Salazar ◽  
Esteban Morales ◽  
Peter Tran ◽  
Janet Lee ◽  
...  

Background/aimsTo identify clinical characteristics and factors associated with microcystic macular edema (MME) in patients with primary open-angle glaucoma (POAG).MethodsWe included 315 POAG eyes between 2010 and 2019 with good-quality macular volume scans that had reliable visual fields (VF) available within 6 months in this observational retrospective cohort study. Eyes with retinal pathologies except for epiretinal membrane (ERM) were excluded. The inner nuclear layer was qualitatively assessed for the presence of MME. Global mean deviation (MD) and Visual Field Index (VFI) decay rates, superior and inferior MD rates and pointwise total deviation rates of change were estimated with linear regression. Logistic regression was performed to identify baseline factors associated with the presence of MME and to determine whether MME is associated with progressive VF loss.Results25 out of 315 eyes (7.9%) demonstrated MME. The average (±SD) age and MD in eyes with and without MME was 57.2 (±8.7) versus 62.0 (±9.9) years (p=0.02) and −9.8 (±5.7) versus −4.9 (±5.3) dB (p<0.001), respectively. Worse global MD at baseline (p=0.001) and younger age (p=0.02) were associated with presence of MME. ERM was not associated with the presence of MME (p=0.84) in this cohort. MME was not associated with MD and VFI decay rates (p>0.49).ConclusionsMore severe glaucoma and younger age were associated with MME. MME was not associated with faster global VF decay in this cohort. MME may confound monitoring of glaucoma with full macular thickness.


2015 ◽  
Vol 235 (1) ◽  
pp. 10-17 ◽  
Author(s):  
Chryssanthi Koutsandrea ◽  
Menelaos Kanakis ◽  
Dimitrios Papaconstantinou ◽  
Dimitrios Brouzas ◽  
Ioannis Ladas ◽  
...  

Purpose: To compare visual field loss and retinal nerve fiber layer (RNFL) defects in cases of rhegmatogenous retinal detachment (RRD) treated with scleral buckle (SB) versus pars plana vitrectomy (PPV) and C3F8 injection. Methods: This was a prospective, comparative interventional study of 50 eyes with primary RRD, treated with PPV (25 eyes) or SB (25 eyes). All measurements took place at least 9 months following successful and uncomplicated surgical treatment. The visual field total deviation (TD) values for preoperative attached and detached areas were calculated and compared separately. The optic nerve head morphology was studied with Heidelberg retinal tomography (HRT), and the RNFL using spectral-domain optical coherence tomography. Results: The preoperative detached areas demonstrated more affected TD values (in dB) compared to the preoperative attached areas (-6.9 ± 5.2 vs. -4.3 ± 3.3 for the SB group and -9.6 ± 5.2 vs. -7.8 ± 5.1 for the PPV group; p = 0.001) in both groups. The preoperative attached areas of the SB group showed better TD values (calculated mean values) compared to the preoperative attached areas of the PPV group (-4.3 ± 3.3 vs. -7.8 ± 5.1, p = 0.007). The RNFL and HRT values showed no statistically significant difference between the two groups. Conclusions: It seems that the preoperative detached retina, despite successful reattachment, suffers permanent damage as a result of the detachment, irrespective of the method of treatment. In the PPV group, the postoperative functionality of the preoperative attached areas was detected to be worse compared to the postoperative functionality of the preoperative attached areas of the SB group. We postulate that this fact could be attributed to an additional traumatizing factor (possibly fluid-air exchange or gas injection) in patients with RRD treated with PPV.


2020 ◽  
Author(s):  
Samuel Bertaud ◽  
Elisabeth Skarbek Borowski ◽  
Rachid Abbas ◽  
Christophe Baudouin ◽  
Antoine Labbé

Abstract Background To evaluate the influence of automated visual field (VF) testing on intraocular pressure (IOP) in patients with ocular hypertension (OHT) or glaucoma. Methods We conducted a prospective observational study from October 2015 to July 2016 at Quinze-Vingts National Ophthalmology Hospital in Paris. Ninety-five right eyes of 95 patients followed for glaucoma or OHT with reliable standard automated perimetry (SAP) were included. IOP was measured three times using a Nidek NT-510 non-contact tonometer within a maximum of 5 minutes before and after VF testing. Subanalyses using logistic regression analysis were performed to evaluate the impact of gender, age, central corneal thickness (CCT), mean deviation (MD) of the VF, VF test duration and filtration surgery on IOP fluctuations. Results There was no significant change in IOP after VF testing, with IOP’s 15.14 ± 4.00 mmHg before and 14.98 ± 3.33 mmHg after the VF (P = 0.4). The average change in IOP was 0.15 ± 1.82 mmHg. Using multivariate analysis, no effect of the VF test on IOP was found (global model fit R²=0.12), whether based on duration of the VF test (P = 0.18) or the MD (P = 0.7) after adjustment for age, gender, CCT and history of glaucoma surgery. Similarly, there was no significant difference within different types of glaucoma, including open-angle glaucoma (p = 0.36), chronic angle closure glaucoma (P = 0.85) and OHT (P = 0.42). The subgroup of patients with an IOP elevation > 2 mmHg had a significantly higher SAP test duration (P = 0.002). Conclusion VF testing by SAP does not influence IOP as measured with a non-contact tonometer.


2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Binghong Gao ◽  
Yue Zhang ◽  
Huan Gao

Objective 12 female rowing athletes of Shanghai as research object of this study. 7 weeks of hypoxic experiment will be carried out on the study subjects. Monitoring of HRV and functional indexes of athletes during this period. To explore the effect of 3 weeks of Living High Training High Training Low(HiHiLo) training of female rowers ANS and functional status, and discussion on the relationship between ANS and functional status of athletes in HiHiLo. Methods 12 Shanghai elite female rowers for 3 weeks HiHiLo training. Simulated altitude from 2500m to 3200m, A total of seven weeks of HRV and biochemical function indexes were tested before and after hypoxia training. In addition, the HRV test of the athletes in a hypoxic exposure. According to the change characteristics of each index, analysis of the change of the athletes ANS in acute hypoxic exposure, and the evaluation of the effects of HiHiLo on ANS and functional status. Results 1. The results of HRV test showed that there was no significant difference in time domain and frequency domain between normal condition and low oxygen environment, But SDNN in hypoxia environment in higher than normal environment, RMSSD slightly lower than the normal environment, indicate that hypoxic environment for athletes of cardiovascular ANS regulation will change and PSNS tension decreased; TP decreased and LF/HF increased, but the change was not significant. 2. The detection of the three stages of the athletes found that there were no significant changes in the indicators of HRV. However, the SDNN、RMSSD and PNN50 indexes showed a certain change trend, that settled low oxygen, time domain index increased, and in hypoxia exposure within three weeks are maintained at high levels and hypoxia after the end of each indicator of the level of decline, as well as the domain indexes, the frequency domain indexes HF、LF and LF/HF also showed obvious change tendency. 3. After the beginning of the experiment, Hb、RBC continued to rise, and after three weeks of hypoxia reached the highest value, compared with before the experiment was increased by 7.7%, 5%, RBC and the experiment was significantly different (p<0.05), Hct increased 5.3% after 3 weeks of hypoxia. Hypoxia after the end of the experiment, RBC, Hb and Hct showed a downward trend, at the end of experiment were decreased by 5%, 3.4%, 3.5%(p>0.05); In this experiment, the BU, CK of the Shanghai women`s rowing athletes at each stage in the normal range, there was no significant difference, but there is a clear trend of change; There was no significant difference in the T of the athletes in the seven week test, but the change trend is obvious. The C was significantly decreased (p<0.05) in the second week after hypoxia exposure, and the follow-up period was significantly lower than that before the experiment(p<0.05) at second weeks. T/C value was significantly increased in the second week of hypoxia (p<0.05), the trend of change is roughly the same as T. The correlation analysis between biochemical function index and HRV was found that the correlation coefficient between PNN50 and T/C was 0.672(p<0.05), before hypoxia, LF/HF and T/C were negatively correlated with -0.825(p<0.01), LF/HF and T correlation coefficient -0.789(p<0.01); During the 3 week HiHiLo training, CK was significantly correlated with SDNN, HF and LF, respectively, and the correlation coefficients were -0.425(p<0.05), -0.43(p<0.05), -0.496(p<0.01), LF/HF and T were negatively correlated with -0.42(p<0.05); The tracking period athletes T were significantly positively correlated with SDNN, RMSSD, PNN50, HF in HRV index, correlation coefficients were 0.378(p<0.05), 0.443(p<0.01), 0.341(p<0.05), 0.371(p<0.05). In addition, the correlation coefficient between PNN50 and C was 0.411(p<0.05). Conclusions 1. The ANS of Shanghai female rowers will change in acute hypoxic exposure, SNS would be enhanced. 2. Three weeks of longer periods of hypoxia training will enable the athletes to enhance the PSNS activity of the ANS, and may make the ability of the regulating equilibrium state from SNS and PSNS, the changes of the ANS regulation of the athletes to the PSNS activity were enhanced, this may be the result of long time hypoxia stimulation and training, to a certain extent, it shows that the level of athletes` performance has been enhanced. 3. Functional status index of Shanghai women`s rowing athletes was well in 3 week HiHiLo training, Part of the improvement of the functional status indicators shows that the effect of the hypoxic training is obvious, The functional status of athletes showed a rising trend.   4. In the different stages of the experiment, there was a significant correlation between the HRV partial indexes and some biochemical indexes. This shows that there is a certain relationship between the ANS and functional status in the hypoxic training. Detection and evaluation of autonomic nervous function in hypoxic training can reflect the functional level of the body to a certain extent. This suggests that it is necessary to strengthen the research and application of ANS function evaluation in hypoxic training.


F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 762 ◽  
Author(s):  
Yalong Dang ◽  
Pritha Roy ◽  
Igor I. Bussel ◽  
Ralitsa T. Loewen ◽  
Hardik Parikh ◽  
...  

Prior glaucoma severity staging systems were mostly concerned with visual field function and retinal nerve fiber layer, but did not include intraocular pressure or medications to capture resistance to treatment. We recently introduced a simple index that combines pressure, medications, and visual field damage and applied it to stratify outcomes of trabectome surgery. This microincisional glaucoma surgery removes the primary resistance to outflow in glaucoma, the trabecular meshwork, and has been mostly used in mild glaucoma. Traditional glaucoma surgeries have a relatively high complication rate and have been reserved for more advanced disease stages. In the analysis presented here we include our data of trabectome combined with cataract surgery. This is a common practice pattern as both occur in the same age group with increasing frequency. For patients in higher glaucoma index (GI) groups, the intraocular pressure (IOP) reduction was 2.34+/-0.19 mmHg more than those in a GI group one level lower while holding everything else constant. Those who had undergone trabectome combined with phacoemulsification had an IOP reduction that was 1.29+/-0.39 mmHg less compared to those with trabectome alone. No statistically significant difference was found between genders and age groups while holding everything else constant. Hispanics had a 3.81+/-1.08 mmHg greater IOP reduction. Pseudoexfoliation and steroid glaucoma patients had an IOP reduction that was greater by 2.91+/-0.56 and 3.86+/-0.81 mmHg, respectively, than those with primary open angle glaucoma. These results suggest a role for trabectome-mediated ab interno trabeculectomy beyond mild forms of glaucoma. Additionally, the multifactorial glaucoma index demonstrates a role in staging patients when comparing glaucoma surgical modalities.


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