scholarly journals Fractal Phototherapy in Neuroprotection of Glaucoma

2019 ◽  
Vol 16 (3) ◽  
pp. 317-328
Author(s):  
M. V. Zueva ◽  
M. A. Kovalevskaya ◽  
O. V. Donkareva ◽  
A. I. Karankevich ◽  
I. V. Tsapenko ◽  
...  
Keyword(s):  
Visual Field ◽  
Ganglion Cells ◽  
Open Angle Glaucoma ◽  
Neuroprotective Effect ◽  
Optical Signal ◽  
Control Group ◽  
Functional Changes ◽  
Low Intensity ◽  
Neuroprotective Therapy ◽  
Before And After

Purpose: to study the effect of low-intensity fractal light stimulation on the sensitivity in the visual field in patients with suspected glaucoma (SG) and primary open-angle glaucoma (POAG). Material and Methods. The study involved 146 people, including 98 patients of the main group (No. 1) and 49 people from the control group “placebo”-therapy (No. 2). Standard automatic perimetry was performed (SITA-Standard, Humphrey, CarlZeissMeditec, 24-2). The dynamics of the perimetry indices MD and PSD were evaluated before and after the course of a ten 10-minute session of fractal phototherapy or after a 10-day course of relaxation consisting in watching a particular training video twice a day. The maximum brightness of the flashes on the cornea during phototherapy was 10–12 lux, the fractal dimension of the optical signal was D = 1.4. Results. A two-week course of low-intensity stimulation with fractal optical signals reliably improved the MD reflected the common defect in the visual field, in all patients with SG and POAG. The expositions to videos with a relaxation program did not have a statistically significant effect on MD and PSD indices. The pronounced effect of fractal stimulation revealed in eyes with POAG III (a reduction of MD on average by 4.39 dB) suggests that even in advanced stages of glaucoma in the general population of retinal ganglion cells there is a significant percentage of cells that are still at the plastic stage of reversible functional changes and can respond positively to therapy. The results substantiate the feasibility of application neuroprotective therapy to patients with any stage of glaucoma, including the advanced stage. Conclusion. In this study, we first used the technology of fractal optical stimulation for the treatment of glaucoma. The first evidence of the neuroprotective effect of fractal phototherapy for POAG at different stages has been obtained. Fractal stimulation can be considered as a new non-pharmacological (physiotherapeutic) approach to neuroprotective therapy, whose potential and mechanisms need to be studied in future studies.

scholarly journals Comparison of Latanoprost/Timolol with Carbonic Anhydrase Inhibitor and Dorzolamide/Timolol with Prostaglandin Analog in the Treatment of Glaucoma

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Kenji Inoue ◽  
Shoichi Soeda ◽  
Goji Tomita
Keyword(s):  
Visual Field ◽  
Fixed Combination ◽  
Open Angle Glaucoma ◽  
Field Testing ◽  
Mean Deviation ◽  
Single Action ◽  
Before And After ◽  
Group 2 ◽  
Concomitant Medications ◽  
Medication Changes

Purpose.We retrospectively reviewed medical records of glaucoma patients to investigate how switching medications may affect intraocular pressure (IOP) management. Three concomitant medications were changed to two medications: one combination drop and one single-action drop. Associated adverse effects were also examined.Subjects and Methods.A total of 112 patients with primary open-angle glaucoma or ocular hypertension were examined. All patients were concomitantly using a prostaglandin (PG) analog, aβ-blocker, and a carbonic anhydrate inhibitor (CAI). Fifty-five patients began using latanoprost (PG analog)/timolol (β-blocker) fixed-combination (LTFC) drops and a CAI (group 1), and 57 patients began using dorzolamide (CAI)/timolol fixed-combination (DTFC) drops and a PG analog (group 2). The IOP was measured every 6 months for 2 years following medication changes. Changes in visual field mean deviation (MD) and medication discontinuations were also examined.Results.There were no significant differences in IOP or MD values before and after medication changes in either group. The proportion of medication discontinuations, uncontrolled IOP, and adverse reactions was similar in both groups.Conclusion.Switching patients from multiple single-action medications to combination medications was not associated with changes in IOP, visual field testing results, or adverse event frequency.

scholarly journals Electrophysiological markers of preclinical diagnosis of glaucomatous optic neuropathy

2021 ◽  
Vol 14 (1) ◽  
pp. 35-41
Author(s):  
M. O. Kirillova ◽  
M. V. Zueva ◽  
I. V. Tsapenko ◽  
A. N. Zhuravleva
Keyword(s):  
Optic Neuropathy ◽  
Ganglion Cells ◽  
Open Angle Glaucoma ◽  
Statistical Significance ◽  
Photopic Negative Response ◽  
Glaucomatous Optic Neuropathy ◽  
Functional Changes ◽  
Bright Flash ◽  
Pattern Size ◽  
Group 2

Purpose: to evaluate the changes in electrophysiological indicators reflecting various aspects of the function of retinal ganglion cells (RGC) and their axons in the early diagnosis of glaucomatous optic neuropathy (GON).Material and methods. Two clinical groups, (1) 35 patients (60 eyes) aged 49 to 70 with suspected glaucoma and (2) 16 patients (30 eyes) aged 43–68 with initial primary open-angle glaucoma (POAG), and a comparison group of 38 relatively healthy subjects (45 eyes) aged 42–70 were tested for pattern-reversed visual evoked potentials (PVEP), transient and stationary pattern-ERGs (PERG) according to ISCEV, and photopic negative response (PhNR).Results. The P100 amplitudes in both clinical groups differed significantly from the norm in PVEP on small and large patterns. The elongation of peak latency (T) of P100 compared with norm was significant for the stimulus 1° in group 2. In both groups of patients, increased variability of the temporal parameters of PERG and PVEP for small patterns was found. In groups 1 and 2, a decrease in the amplitude of P50 and N95 peaks of transient PERG for all stimuli was revealed, which was the most significant for the 0.3° pattern. In group 1, the N95 peak was significantly delayed in PERG for large patterns. A statistically significant reduction in the steady-state PERG's amplitude was found in the groups of suspected glaucoma and initial POAG. The sharpest changes were found for small (0.8° and 0.3°) patterns. The elongation of T compared to the norm was most pronounced for PERG at 0.3°, but due to the high variability of temporary indicators within the group, it had no statistical significance. The amplitude of PhNR was significantly different from the norm in the ERG for a flash of 3.0 cd·sec/m2.Conclusion. In patients with suspected glaucoma, a decrease in the P100 VEP amplitude with the simultaneous elongation of T may be considered as a criteria for the plastic stage at the level of lateral geniculate nucleus. Markers of functional changes in RGCs are the decrease in the amplitude of PhNR in response to bright flash, and P50 and N95 of PERG for pattern size 0.3°. The results indicate a greater vulnerability of the parvocellular system to early events in the development of GON.

scholarly journals Differential Change in Retina Structure and Function in Children and Adolescents with Drusens of the Optic Nerve Disk

2018 ◽  
Vol 15 (2S) ◽  
pp. 73-81
Author(s):  
A. G. Shchuko ◽  
D. Yu. Samsonov ◽  
S. I. Zhukova ◽  
T. N. Iureva ◽  
I. M. Mikhalevich ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Visual System ◽  
Children And Adolescents ◽  
Ganglion Cells ◽  
Control Group ◽  
Clinical Group ◽  
Ophthalmological Examination ◽  
Functional Changes ◽  
The Third ◽  
And Function

The first histological and clinical description of the optic nerve drusens was given in the 19th century. Then authors considered drusens as congenital pathologies, and a study of 1999 showed that drusen is not the primary pathology, but the dysplasia of the optic nerve disk and its circulation predisposes to the formation of drusen. Central vision in patients with drusens of the optic nerve disc is reduced rarely, and their diagnosis is reduced to ascertaining of the fact of having drusen without taking into account the structural and functional changes in the visual system.Purpose of the work: to identify the pattern of changes in visual functions in children and adolescents with druses of the optic nerve disk, the development and addition of classification criteria.Patients and methods. 45 children with drusens were examined, a comprehensive analysis of the visual system included a standard ophthalmological examination, a comprehensive study of visual system with ultrasound scanning, OCT and OCTA, standard automated and pulsarperimetry.Based on the results of the cluster analysis, a graph of the distribution of patients into three groups (control group and two clinical groups) was constructed, and the structural and functional state of the visual system was analyzed. Drusens in children in the second group we marked as “peripheral”, and in the third — “central”. The carried out researches have shown, that the revealed disturbances are more expressed in the third clinical group. All this determines the need to complement the clinical classification of drusens and their separation depending on the location relative to the vessels of the optic nerve disk to the central and peripheral. The compression effect of drusen is accompanied with changes in the volume of the optic nerve disc, a violation of retinal hemodynamics, damage to the neuroglia and ganglion cells, which allows treating this pathology as a progressive neuroopticopathy, and the revealed dependence of changes on the localization of druses requires supplementing the existing classification. 

scholarly journals Cytidine 5′-Diphosphocholine (Citicoline): Evidence for a Neuroprotective Role in Glaucoma

Nutrients ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 793 ◽  
Author(s):  
Stefano Gandolfi ◽  
Giorgio Marchini ◽  
Aldo Caporossi ◽  
Gianluca Scuderi ◽  
Livia Tomasso ◽  
...  
Keyword(s):  
Visual Field ◽  
Therapeutic Agent ◽  
Primary Open Angle Glaucoma ◽  
Ganglion Cells ◽  
Open Angle Glaucoma ◽  
Brain Structures ◽  
Current Evidence ◽  
Retinal Ganglion ◽  
Naturally Occurring ◽  
Endogenous Compound

Glaucoma, a heterogeneous set of progressively degenerative optic neuropathies characterized by a loss of retinal ganglion cells (RGCs) and typical visual field deficits that can progress to blindness, is a neurodegenerative disease involving both ocular and visual brain structures. Although elevated intraocular pressure (IOP) remains the most important modifiable risk factor of primary open-angle glaucoma (POAG) and is the main therapeutic target in treating glaucoma, other factors that influence the disease course are involved and reaching the optimal IOP target does not stop the progression of glaucoma, as the visual field continues to narrow. In addition to a managed IOP, neuroprotection may be beneficial by slowing the progression of glaucoma and improving the visual defects. Citicoline (cytidine 5′-diphosphocholine) is a naturally occurring endogenous compound that has been investigated as a novel therapeutic agent for the management of glaucoma. Citicoline has demonstrated activity in a range of central neurodegenerative diseases, and experimental evidence suggests a it performs a neuromodulator and neuroprotective role on neuronal cells, including RGCs, associated with improvement in visual function, extension of the visual field and central benefits for the patient. This review aims to critically summarize the current evidence for the neuroprotective properties of citicoline in glaucoma.

scholarly journals Effect of Low Intensity Pulsed Ultrasound (LIPUS) on Tooth Movement and Root Resorption: A Prospective Multi-Center Randomized Controlled Trial

2020 ◽  
Vol 9 (3) ◽  
pp. 804 ◽  
Author(s):  
Tarek El-Bialy ◽  
Khaled Farouk ◽  
Terry D. Carlyle ◽  
William Wiltshire ◽  
Robert Drummond ◽  
...  
Keyword(s):  
Tooth Movement ◽  
Root Resorption ◽  
Controlled Trial ◽  
Control Group ◽  
Pulsed Ultrasound ◽  
Low Intensity Pulsed Ultrasound ◽  
Low Intensity ◽  
Control Side ◽  
Before And After ◽  
Group 1

The aim of this study was to evaluate the possible effect of low intensity pulsed ultrasound (LIPUS) on tooth movement and root resorption in orthodontic patients. Twenty-one patients were included in a split-mouth study design (group 1). Ten additional patients were included with no LIPUS device being used and this group was used as the negative control group (group 2). Group 1 patients were given LIPUS devices that were randomly assigned to right or left side on upper or lower arches. LIPUS was applied to the assigned side that was obtained by randomization, using transducers that produce ultrasound with a pulse frequency of 1.5 MHz, a pulse repetition rate of 1 kHz, and average output intensity of 30 mW/cm2. Cone-beam computed tomography (CBCT) images were taken before and after treatment. The extraction space dimensions were measured every four weeks and root lengths of canines were measured before and after treatment. The data were analyzed using paired t-test. The study outcome showed that the mean rate of tooth movement in LIPUS side was 0.266 ± 0.092 mm/week and on the control side was 0.232 ± 0.085 mm/week and the difference was statistically significant. LIPUS increased the rate of tooth movement by an average of 29%. For orthodontic root resorption, the LIPUS side (0.0092 ± 0.022 mm/week) showed a statistically significant decrease as compared to control side (0.0223 ± 0.022 mm/week). The LIPUS application accelerated tooth movement and minimized orthodontically induced tooth root resorption at the same time.

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

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.

Rate of visual field decay in glaucomatous eyes with acquired pits of the optic nerve

2020 ◽  
pp. bjophthalmol-2020-315980
Author(s):  
Golnoush Mahmoudinezhad ◽  
Mark Lin ◽  
Alessandro Rabiolo ◽  
Esteban Morales ◽  
Pradtana Hirunpatravong ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Visual Field ◽  
Open Angle Glaucoma ◽  
Rate Of Change ◽  
Control Group ◽  
Mean Deviation ◽  
Global Rate ◽  
Field Decay ◽  
Event Based ◽  
The Relationship

BackgroundTo evaluate the relationship between the presence of an acquired pit of the optic nerve (APON) and the rate of visual field (VF) decay in primary open-angle glaucoma (POAG).MethodsConsecutive patients with POAG were screened for APON by three glaucoma specialists. A control group of POAG eyes without APON were matched with the APON group for factors such as age, gender, baseline intraocular pressure and baseline mean deviation (MD). The pointwise rate of change (PRC) was used for pointwise comparisons between the two groups. MD rate, Visual Field Index (VFI) rate and Glaucoma Rate Index (GRI) were used for global rate comparisons. We compared the proportions of eyes progressing in the groups with event-based guided progression analysis (GPA), MD, VFI and GRI criteria.ResultsMean (SD) PRC was faster in the APON group −1.00 (±2.57) %/year compared with the control group −0.25 (±2.19) %/year; p<0.001. MD rate (−0.22 (±0.27) dB/year vs 0.03 (±0.41) dB/year; p=0.009), VFI rate (−0.81 (±0.86) %/year vs −0.05 (±1.0) %/year; p=0.04) and GRI (−12.27 (±16.27) vs -3.75 (±10.6); p=0.052) were all faster in the APON group compared with controls. The proportion of progressing eyes with GPA, MD, VFI and GRI was not significantly different between the two groups (p>0.1).ConclusionsThe presence of APON in patients with POAG is associated with focal, fast rates of VF decay. Identification of patients with APON should alert clinicians to the possibility of a fast rate of functional progression and to consider appropriately aggressive treatment of their glaucoma.

scholarly journals The Effect of Contact Lens–spectacle Reversed Galilean Telescope on the Visual Field of Patients with Open-angle Glaucoma

2020 ◽  
Author(s):  
Mohammadreza Moniritilaki ◽  
Maryam Badakhsh ◽  
Asieh Ehsaei ◽  
Ramin Daneshvar
Keyword(s):  
Visual Field ◽  
Contact Lens ◽  
Open Angle Glaucoma ◽  
Field Measurements ◽  
Visual Field Defects ◽  
Mean Deviation ◽  
Open Angle ◽  
A Value ◽  
Before And After ◽  
The Mean

Purpose: Glaucoma causes irreversible visual field defects. This study aims to evaluate the effect of a reversed Galilean telescope on the visual field of patients with open-angle glaucoma. Methods: Fifty-two glaucoma patients with a restricted visual field were recruited for this study. Central 30° visual field measurements were performed using a Humphrey visual field analyzer before and after applying the reversed Galilean telescope. To be more cosmetically acceptable, a combination of contact lens–spectacle was used as the reversed Galilean telescope. Results: Our data analysis showed that the reversed Galilean telescope had a significant effect on all measured perimetric indices. Visual field index (VFI) improved from a basic value of 44.38 ± 26.96 percent to 49.30 ± 29.83 percent by using the reversed telescope (P < 0.001). Moreover, the mean deviation (MD) was significantly improved from the initial value of –19.91 ± 7.19 dB to a value of –18.69 ± 7.73 dB (P < 0.001). However, our results showed a significant reduction in the pattern standard deviation (PSD) comparing before (9.83 ± 2.82) and after (8.51 ± 3.30) values using the reversed Galilean telescope (P < 0.001). Conclusion: The contact lens–spectacle combination reversed Galilean telescope significantly improved the central 30° visual field of glaucoma patients with the restricted visual field.

scholarly journals Evaluation of the New Compression-Perimeter Test Effectiveness in the Early Diagnosis of Glaucoma

2020 ◽  
Vol 17 (2) ◽  
pp. 229-237
Author(s):  
V. V. Volkov ◽  
I. L. Simakova ◽  
I. A. Tikhonovskaya
Keyword(s):  
Visual Field ◽  
Early Diagnosis ◽  
Early Stage ◽  
Open Angle Glaucoma ◽  
Standard Stimulus ◽  
International Standards ◽  
Control Group ◽  
Ophthalmological Examination ◽  
Stress Tests ◽  
Central Visual Field

Purpose: To evaluate the effectiveness of a new modification of the vacuum-perimeter test (VPT) by V.V. Volkov in the early diagnosis of glaucoma in comparison with the results of the original test and its known modification — vacuum-compression automated test (VCAT) in an open comparative clinical research. Patients and Methods. The study involved 26 patients (47 eyes) (average age 52.9 ± 8.5 years) with suspected open-angle glaucoma (OAG). Patients were divided into three groups: 1-st — 19 eyes with preglaucoma, 2-nd — 18 eyes with the early stage of OAG, 3-rd — 10 eyes of five patients with unconfirmed glaucoma. The control group (4-th) included 20 eyes of 10 healthy people (average age 56.4 ± 4.4 years). Along with the standard ophthalmological examination, all patients underwent perimetry on Humphrey Visual Field Analyzer II 745i (Germany-USA), our modification of Frequency Doubling Technology (FDT) perimetry, evaluation of the optic nerve head (ONH) on Heidelberg Retina Tomograph (HRT 3, Germany) and three stress tests: VPT, VCAT and our modification — vacuum-contrast-frequency test (VCFT). VCFT was created on the base of FDT perimetry with the aim of increasing the sensitivity of the original test (VPT) for detection of preglaucoma through the use of non-standard stimulus and increasing the number of investigated points of central visual field.  Results. According to the National classification (1975) the diagnosis of preglaucoma was determined on the basis of a positive result of at least one of three stress tests, taking into account the risk factors for the development of glaucoma in patients. The early stage of OAG was established on the base of International standards for structural and functional assessment of the ONH (2003). The specificity of all three compared stress tests was 100 %, which confirmed their negative results in all patients (10 eyes) from the 3-rd group. However, the sensitivity of VCFT (75 %) was significantly higher than VPT (21.05 %) and VCAT (21.05 %), which is due, we believe, to the specific nature of VCFT stimulus. Conclusion. According to the obtained data, the developed new modification of VPT — VCFT on the specificity of the results was not worse, and the sensitivity was better than the original VPT and VCAT in the diagnosis of preglaucoma. VCFT is quickly performed and comfortable for patients.

Abstract WP61: Pre-hospital Remote Ischemic Perconditioning - A Promising Neuroprotective Therapy.

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Kristina D Hougaard ◽  
Niels Hjort ◽  
Hans-Erik Bø ◽  
Leif H Søen ◽  
Anne Nørd ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Neuroprotective Effect ◽  
Randomized Study ◽  
Intervention Group ◽  
Patient Specific ◽  
Control Group ◽  
Ratio Test ◽  
Remote Ischemic Perconditioning ◽  
Neuroprotective Therapy

Pre-hospital remote ischemic perconditioning (rPerC) is a potential neuroprotective therapy to patients with suspected acute stroke. We tested the effect of pre-hospital rPerC as an adjunct treatment to intravenous alteplase (rtPA) in patients suspected of acute stroke. The study was conducted as a single-blinded randomized study of rPerC in a 1:1 ratio in 298 consecutive patients with acute ischemic stroke or TIA of whom 184 were subsequently treated with rtPA and 149 had a 1 month MRI follow-up (81 rPerC, 68 controls). TIA was more frequent (p=0.006) in the intervention group (n=42) than in the control group (n=16). NIHSS on admission was significantly lower (p=0.016) in the intervention group (median 4, IQR 2-7) than in the control group (5, IQR 3-11). Accordingly there was a trend towards smaller volumes of tissue hypoperfusion (PWI 17.35 (1.01-87.18) vs. 16.55 (1.71-170.16), p=0.26) at the time of the initial MRI. Tissue voxels in the volume difference between PWI and DWI at baseline which did not proceed to infarction on follow-up T2-FLAIR MRI were identified and adjusted for baseline values of PWI and DWI. This voxel based logistic regression analysis takes any imbalance in baseline severity of DWI and PWI and any patient-specific effects into account to determine tissue-level infarct risks. The results were analysed according to baseline vessel status and recanalisation at 24 h. The likelihood ratio test for effect of rPerC in the whole group was p=0.0003. In the subgroups not changing vessel status (occlusion without recanalization and the group without observed occlusion) the tests for effect of rPerC yielded p<0.0001. For the recanalizer subgroup p=0.0002. . The neuroprotective effect of rPerC may have worked already prior to admission.

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