Choroidal Thickness in Advanced Glaucoma Patients

Purpose: We investigated choroidal thickness according to the classification of glaucoma and related factors in patients with advanced glaucoma.Methods: The present study included 133 eyes of 133 advanced glaucoma patients with a mean deviation of <-12 dB. Patients were classified into primary open angle glaucoma (POAG) and normal-tension glaucoma (NTG) groups. Factors related to the subfoveal and peripapillary choroidal thickness were analyzed using linear regression analysis.Results: The mean peripapillary choroid thickness was 99.20 ± 46.85 µm in the NTG group, which was significantly thinner than in the POAG group (121.85 ± 45.39 µm, p = 0.006). Additionally, in the sectoral comparison, the NTG group had thinner choroids than the POAG group in all areas (p < 0.05 for all). In the linear regression analysis, glaucoma class (p = 0.007), age (p = 0.005), and intraocular pressure (IOP) (p = 0.024) significantly affected the peripapillary choroid thickness. Moreover, age (p = 0.029) and macular thickness (p = 0.002) were significantly associated with subfoveal choroid thickness.Conclusions: In advanced glaucoma, low baseline IOP, NTG, and old age were significantly associated with a thin peripapillary choroid, suggesting an association between thin peripapillary choroid and the etiology of NTG. Further studies are needed to clarify the significance of a thin choroid in the pathogenesis of glaucoma.

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Involvement of Inner Choroidal Layer in Choroidal Thinning during Regression of Multiple Evanescent White Dot Syndrome

Journal of Ophthalmology ◽

10.1155/2019/6816925 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Yuki Hashimoto ◽

Wataru Saito ◽

Yuka Hasegawa ◽

Kousuke Noda ◽

Susumu Ishida

Keyword(s):

Regression Analysis ◽

Linear Regression ◽

Choroidal Thickness ◽

Linear Regression Analysis ◽

Case Series ◽

Enhanced Depth Imaging ◽

Initial Visit ◽

White Dot Syndrome ◽

The Mean ◽

Fellow Eyes

Purpose. To investigate relationships between total thickness and the thickness of inner and outer layers in the choroid during regression in patients with multiple evanescent white dot syndrome (MEWDS). Methods. This retrospective observational case series included 15 unilaterally affected eyes and 13 unaffected fellow eyes from 15 MEWDS patients (4 men and 11 women; mean age, 37.6 ± 17.6 years). Using enhanced depth imaging optical coherence tomography, whole, inner, and outer choroidal layer thicknesses at the fovea and perifovea were manually measured at the initial visit and at 1 and 3 months after the initial visit. The mean thickness values of the layers were compared at each stage. Results. With regression of MEWDS, the mean subfoveal whole and inner choroidal layer thicknesses significantly decreased at 1 and 3 months compared to baseline values in MEWDS eyes (P=0.01 and P<0.0001, respectively), but not in fellow eyes. The outer layer in MEWDS eyes tended to thin. Changes in the inner and outer layers at the perifovea in MEWDS eyes also showed the same trends. Simple linear regression analysis revealed significant positive correlations in choroidal thickness changes between the whole and inner layers (R = 0.53, P=0.04) and between the whole and outer layers (R = 0.91, P<0.0001) from baseline to 3 months. Multiple linear regression analysis revealed that choroidal thickness changes in the whole layer were significantly correlated with those in the inner (β = 0.51, P<0.0001) and outer (β = 0.73, P<0.0001) layers. Conclusion. The inner choroidal layer significantly thinned with regression of MEWDS, correlating with the thinning of total choroidal thickness. These results suggest that MEWDS lesions in the choroid are likely to lie mainly in the inner layer.

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Comparison of central visual sensitivity between monocular and binocular testing in advanced glaucoma patients using imo perimetry

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2019-315251 ◽

2020 ◽

pp. bjophthalmol-2019-315251 ◽

Cited By ~ 1

Author(s):

Tomoyuki Kumagai ◽

Takuhei Shoji ◽

Yuji Yoshikawa ◽

Izumi Mine ◽

Junji Kanno ◽

...

Keyword(s):

Open Angle Glaucoma ◽

Cross Sectional Study ◽

Visual Sensitivity ◽

Mean Deviation ◽

Clinical Settings ◽

Clinical Tool ◽

Cross Sectional ◽

Advanced Glaucoma ◽

The Mean

Background/AimThis study aimed to compare central visual sensitivity under monocular and binocular conditions in patients with glaucoma using the new imo static perimetry.MethodsFifty-one consecutive eyes of 51 patients with open-angle glaucoma who were affected with at least one significant point in the central 10° were examined in this cross-sectional study. Monocular and binocular random single-eye tests were performed using the imo perimeter and the Humphrey field analyser (HFA) 24-2 and 10-2 tests. The eyes were assigned to ‘better’ and ‘worse’ categories based on the visual acuity and central visual thresholding. Central visual sensitivity results obtained by monocular, binocular random single-eye tests and binocular simultaneous both eye test were compared.ResultsThe average mean deviation with the HFA 24-2 was −5.5 (–1.5, –14.6) dB (median, (IQR)) in the better eyes and −18.0 (–12.9, –23.8) dB in the worse eyes. The mean sensitivity in the central 4 points of the visual field (VF) of the worse eyes was lower when measured under the binocular eye condition than under the monocular condition. Conversely, this value of the better eyes was greater when measured under the binocular eye condition than under the monocular condition.ConclusionsThe central sensitivity of the better eyes was better and that of the worse eyes poorer with binocular testing than with monocular testing in patients with glaucoma. Although monocular VF testing is still the most straightforward means to monocularly monitor glaucoma at clinical settings, binocular testing, such as provided with imo perimetry, may be a useful clinical tool to predict the effect of VF impairments on a patient’s quality of visual life.

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Plasma GDF-15 concentration is not elevated in open-angle glaucoma

PLoS ONE ◽

10.1371/journal.pone.0252630 ◽

2021 ◽

Vol 16 (5) ◽

pp. e0252630

Author(s):

Wouter H. G. Hubens ◽

Mariëlle T. Kievit ◽

Tos T. J. M. Berendschot ◽

Irenaeus F. M. de Coo ◽

Hubert J. M. Smeets ◽

...

Keyword(s):

Linear Regression ◽

Mitochondrial Dysfunction ◽

Open Angle Glaucoma ◽

Linear Regression Analysis ◽

Nonparametric Test ◽

Normal Tension Glaucoma ◽

Systemic Hypertension ◽

Open Angle ◽

Linear Regression Models ◽

Median Plasma

Aim Recently, the level of growth differentiation factor 15 (GDF-15) in blood, was proposed as biomarker to detect mitochondrial dysfunction. In the current study, we evaluate this biomarker in open-angle glaucoma (OAG), as there is increasing evidence that mitochondrial dysfunction plays a role in the pathophysiology of this disease. Methods Plasma GDF-15 concentrations were measured with ELISA in 200 OAG patients and 61 age-matched controls (cataract without glaucoma). The OAG patient group consisted of high tension glaucoma (HTG; n = 162) and normal tension glaucoma (NTG; n = 38). Groups were compared using the Kruskal-Wallis nonparametric test with Dunn’s multiple comparison post-hoc correction. GDF-15 concentration was corrected for confounders identified with forward linear regression models. Results Before correcting for confounders, median plasma GDF-15 levels was significantly lower in the combined OAG group (p = 0.04), but not when analysing HTG and NTG patients separately. Forward linear regression analysis showed that age, gender, smoking and systemic hypertension were significant confounders affecting GDF-15 levels. After correction for these confounders, GDF-15 levels in OAG patients were no longer significantly different from controls. Subgroup analysis of the glaucoma patients did not show a correlation between disease severity and plasma GDF-15, but did reveal that for NTG patients, intake of dietary supplements, which potentially improve mitochondrial function, correlated with lower plasma GDF-15. Conclusion The present study suggests that plasma GDF-15 is not suited as biomarker of mitochondrial dysfunction in OAG patients.

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Outcome of a single XEN microstent implant for glaucoma patients with different types of glaucoma

10.21203/rs.3.rs-38738/v3 ◽

2020 ◽

Author(s):

Marc Schargus ◽

Therese Teilig ◽

Matus Rehak ◽

Catharina Busch ◽

Caroline Bormann ◽

...

Keyword(s):

Open Angle Glaucoma ◽

Normal Tension Glaucoma ◽

Secondary Glaucoma ◽

Mean Deviation ◽

Open Angle ◽

Treatment Groups ◽

Different Types ◽

Registration Number ◽

The Mean

Abstract Background The aim of this retrospective study was to compare the efficacy and safety profile of a single XEN-microstent in different types of primary and secondary open angle glaucoma. Methods A single XEN microstent was implanted in patients with primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG), pseudoexfoliation glaucoma (PEX) and secondary glaucoma (Sec.Gl). The intraocular pressure (IOP), the active substances of the applied IOP-lowering drugs, the best corrected visual acuity (BCVA) and the mean deviation (MD) of the perimetry were measured at baseline and at regular follow-ups, scheduled at 2 days and 1, 3, 6 and 12 months after surgery. Results 153 eyes were included in this analysis. 113 eyes were affected by POAG (74%), 5 eyes by NTG (3%), 22 eyes by PEX (14%) and 13 eyes by Sec.Gl (9%). Mean IOP decreased in all treatment groups during the 12 months of follow-up (complete group: 23.9±7.4 to 15.4±5.1 mmHg (p<0.01); POAG: 22.8±6.5 to 15.1±4.6 mmHg (p<0.01); NTG: 16.6±3.4 to 11.6±2.2 mmHg (p<0.05); PEX: 28.0±7.9 to 17.1±6.6 mmHg (p<0.01); Sec.Gl: 28.9±13.9 to 15.5±6.9 mmHg (p<0.05)). In the 153 eyes the average number of IOP-lowering drugs applied decreased from 2.6±1.2 to 0.8±1.3 12 months after surgery (p<0.01). BCVA and mean deviation of automated standard perimetry remained stable in all groups during follow-up. Conclusion As in eyes suffering from POAG, IOP and number of IOP-lowering drugs applied can be effectively reduced by XEN implantation in eyes suffering from NTG, PEX and secondary glaucoma while leaving BCVA and visual field unchanged. Trial registration Trial was registered at DRKS (registration number: DRKS00020800, Registered 25.February 2020 - Retrospectively registered, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00020800)

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Changes in Peripapillary and Macular Vessel Densities and Their Relationship with Visual Field Progression after Trabeculectomy

Journal of Clinical Medicine ◽

10.3390/jcm10245862 ◽

2021 ◽

Vol 10 (24) ◽

pp. 5862

Author(s):

Jooyoung Yoon ◽

Kyung Rim Sung ◽

Joong Won Shin

Keyword(s):

Visual Field ◽

Linear Regression ◽

Open Angle Glaucoma ◽

Linear Regression Analysis ◽

Reduction Rate ◽

Vessel Density ◽

Mean Deviation ◽

Factors Associated ◽

Significant Difference

The aim of this study was to determine the factors associated with visual field (VF) deterioration after trabeculectomy, including the peripapillary vessel density (pVD) and macular vessel density (mVD) changes assessed by optical coherence tomography angiography (OCT-A). Primary open-angle glaucoma patients with more than two years of follow-up after trabeculectomy were included. pVD was calculated in a region defined as a 750 μm-wide elliptical annulus extending from the optic disc boundary. mVD was calculated in the parafoveal (1–3 mm) and perifoveal (3–6 mm) regions. VF deterioration was defined as the rate of mean deviation (MD) worse than −1.5 dB/year. The change rates of pVD and mVD were compared between the deteriorated VF and non-deteriorated VF groups. The factors associated with the rate of MD were determined by linear regression analyses. VF deterioration was noted in 14 (21.5%) of the 65 eyes that underwent trabeculectomy. The pVD (−2.26 ± 2.67 vs. −0.02 ± 1.74%/year, p ≤ 0.001) reduction rate was significantly greater in the deteriorated VF group than in the non-deteriorated VF group, while that of parafoveal (p = 0.267) and perifoveal (p = 0.350) VD did not show a significant difference. The linear regression analysis showed that the postoperative MD reduction rate was significantly associated with the rate of pVD reduction (p = 0.016), while other clinical parameters and preoperative vascular parameters did not show any association. Eyes with greater loss of peripapillary retinal circulation after trabeculectomy tended to exhibit VF deterioration. The assessment of peripapillary vascular status can be an adjunctive strategy to predict visual function after trabeculectomy.

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Comparison of the effectiveness of the XEN microstent in the treatment of different types of glaucoma

10.21203/rs.3.rs-38738/v1 ◽

2020 ◽

Author(s):

Marc Schargus ◽

Therese Teilig ◽

Matus Rehak ◽

Catharina Busch ◽

Caroline Bormann ◽

...

Keyword(s):

Open Angle Glaucoma ◽

Normal Tension Glaucoma ◽

Secondary Glaucoma ◽

Mean Deviation ◽

Open Angle ◽

Treatment Groups ◽

Different Types ◽

Registration Number ◽

The Mean

Abstract PurposeThe aim of this study was to compare the efficacy and safety profile of the XEN-microstent in different types of primary and secondary open angle glaucoma. MethodsThe XEN microstent was implanted in patients with primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG), pseudoexfoliation glaucoma (PEX) and secondary glaucoma (Sec.Gl). The intraocular pressure (IOP), the active substances of the applied IOP-lowering drugs, the best corrected visual acuity (BCVA) and the mean deviation (MD) of the perimetry were measured at baseline and at regular follow-ups, scheduled at 2 days and 1, 3, 6 and 12 months after surgery. Results153 eyes were included in this analysis. 113 eyes were affected by POAG (74%), 5 eyes by NTG (3%), 22 eyes by PEX (14%) and 13 eyes by Sec.Gl (9%). Mean IOP decreased in all treatment groups during the 12 months of follow-up (complete group: 23.9±7.4 to 15.4±5.1 mmHg (p<0.01); POAG: 22.8±6.5 to 15.1±4.6 mmHg (p<0.01); NTG: 16.6±3.4 to 11.6±2.2 mmHg (p<0.05); PEX: 28.0±7.9 to 17.1±6.6 mmHg (p<0.01); Sec.Gl: 28.9±13.9 to 15.5±6.9 mmHg (p<0.05)). In the 153 eyes the average number of IOP-lowering drugs applied decreased from 2.6±1.2 to 0.8±1.3 12 months after surgery (p<0.01). BCVA and mean deviation of automated standard perimetry remained stable in all groups during follow-up. ConclusionAs in eyes suffering from POAG, IOP and number of IOP-lowering drugs applied can be effectively reduced by XEN implantation in eyes suffering from NTG, PEX and secondary glaucoma while leaving BCVA and visual field unchanged. Trial registrationTrial was registered at DRKS (registration number: DRKS00020800, Registered 25.February 2020 - Retrospectively registered, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00020800)

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Outcome of a single XEN microstent implant for glaucoma patients with different types of glaucoma

BMC Ophthalmology ◽

10.1186/s12886-020-01764-8 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Marc Schargus ◽

Theresa Theilig ◽

Matus Rehak ◽

Catharina Busch ◽

Caroline Bormann ◽

...

Keyword(s):

Open Angle Glaucoma ◽

Normal Tension Glaucoma ◽

Secondary Glaucoma ◽

Mean Deviation ◽

Open Angle ◽

Treatment Groups ◽

Different Types ◽

Registration Number ◽

The Mean

Abstract Background The aim of this retrospective study was to compare the efficacy and safety profile of a single XEN-microstent in different types of primary and secondary open angle glaucoma. Methods A single XEN microstent was implanted in patients with primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG), pseudoexfoliation glaucoma (PEX) and secondary glaucoma (Sec.Gl). The intraocular pressure (IOP), the active substances of the applied IOP-lowering drugs, the best corrected visual acuity (BCVA) and the mean deviation (MD) of the perimetry were measured at baseline and at regular follow-ups, scheduled at 2 days and 1, 3, 6 and 12 months after surgery. Results 153 eyes were included in this analysis. 113 eyes were affected by POAG (74%), 5 eyes by NTG (3%), 22 eyes by PEX (14%) and 13 eyes by Sec. Gl (9%). Mean IOP decreased in all treatment groups during the 12 months of follow-up (complete group: 23.9 ± 7.4 to 15.4 ± 5.1 mmHg (p < 0.01); POAG: 22.8 ± 6.5 to 15.1 ± 4.6 mmHg (p < 0.01); NTG: 16.6 ± 3.4 to 11.6 ± 2.2 mmHg (p < 0.05); PEX: 28.0 ± 7.9 to 17.1 ± 6.6 mmHg (p < 0.01); Sec.Gl: 28.9 ± 13.9 to 15.5 ± 6.9 mmHg (p < 0.05)). In the 153 eyes the average number of IOP-lowering drugs applied decreased from 2.6 ± 1.2 to 0.8 ± 1.3 12 months after surgery (p < 0.01). BCVA and mean deviation of automated standard perimetry remained stable in all groups during follow-up. Conclusion As in eyes suffering from POAG, IOP and number of IOP-lowering drugs applied can be effectively reduced by XEN implantation in eyes suffering from NTG, PEX and secondary glaucoma while leaving BCVA and visual field unchanged. Trial registration Trial was registered at DRKS (registration number: DRKS00020800, Registered 25.February 2020 - Retrospectively registered).

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Outcome of a single XEN microstent implant for glaucoma patients with different types of glaucoma

10.21203/rs.3.rs-38738/v2 ◽

2020 ◽

Author(s):

Marc Schargus ◽

Therese Teilig ◽

Matus Rehak ◽

Catharina Busch ◽

Caroline Bormann ◽

...

Keyword(s):

Open Angle Glaucoma ◽

Normal Tension Glaucoma ◽

Secondary Glaucoma ◽

Mean Deviation ◽

Open Angle ◽

Treatment Groups ◽

Different Types ◽

The Mean ◽

Active Substances

Abstract Background: The aim of this retrospective study was to compare the efficacy and safety profile of the XEN-microstent in different types of primary and secondary open angle glaucoma. Methods: The XEN microstent was implanted in patients with primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG), pseudoexfoliation glaucoma (PEX) and secondary glaucoma (Sec.Gl). The intraocular pressure (IOP), the active substances of the applied IOP-lowering drugs, the best corrected visual acuity (BCVA) and the mean deviation (MD) of the perimetry were measured at baseline and at regular follow-ups, scheduled at 2 days and 1, 3, 6 and 12 months after surgery. Results: 153 eyes were included in this analysis. 113 eyes were affected by POAG (74%), 5 eyes by NTG (3%), 22 eyes by PEX (14%) and 13 eyes by Sec.Gl (9%). Mean IOP decreased in all treatment groups during the 12 months of follow-up (complete group: 23.9±7.4 to 15.4±5.1 mmHg (p<0.01); POAG: 22.8±6.5 to 15.1±4.6 mmHg (p<0.01); NTG: 16.6±3.4 to 11.6±2.2 mmHg (p<0.05); PEX: 28.0±7.9 to 17.1±6.6 mmHg (p<0.01); Sec.Gl: 28.9±13.9 to 15.5±6.9 mmHg (p<0.05)). In the 153 eyes the average number of IOP-lowering drugs applied decreased from 2.6±1.2 to 0.8±1.3 12 months after surgery (p<0.01). BCVA and mean deviation of automated standard perimetry remained stable in all groups during follow-up. Conclusion: As in eyes suffering from POAG, IOP and number of IOP-lowering drugs applied can be effectively reduced by XEN implantation in eyes suffering from NTG, PEX and secondary glaucoma while leaving BCVA and visual field unchanged.

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Characteristics of Visual Field Defects in Korean Advanced Glaucoma

Journal of the Korean Ophthalmological Society ◽

10.3341/jkos.2021.62.8.1105 ◽

2021 ◽

Vol 62 (8) ◽

pp. 1105-1115

Author(s):

Hyung Nam Jin ◽

Yeon Soo Kang ◽

Mi Sun Sung ◽

Sang Woo Park

Keyword(s):

Visual Field ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Central Area ◽

Normal Tension Glaucoma ◽

Visual Field Defects ◽

Mean Deviation ◽

Glaucoma Diagnosis ◽

Significant Difference ◽

Advanced Glaucoma

Purpose: We investigated the clinical characteristics of visual field (VF) defects in Korean advanced glaucoma patients.Methods: The present study included 109 eyes of 109 advanced glaucoma patients whose mean deviation (MD) is under -12 dB. The subjects were classified into primary open angle glaucoma (POAG) and normal tension glaucoma (NTG) group. Average numeric decibel in each VF points were visualized with color topographic image and dot graph image using python 3.5. VF was divided into four quadrants or two half fields, and the differences in the degree of VF defects in each locations were assessed with raw decibel data. Additionally, mean sensitivity of central 12 points were compared between the two groups.Results: Generally the features of VF defects were severely depressed VF sensitivity at the superonasal quadrant and relatively preserved central area and inferotemporal quadrant in both of the glaucoma groups. But we found the extent of deflection for VF defect in the NTG eyes was higher than that of the POAG eyes (p < 0.05). The POAG eyes tended to show more diffuse and evenly distributed VF defect, whereas NTG eyes tended to have more severely depressed VF at the superonasal quadrant and relatively preserved VF at the inferotemporal quadrant. There was no significant difference in the degree of central VF defects between the two groups.Conclusions: The characteristics of VF defect in Korean advanced glaucoma revealed different features based on the glaucoma diagnosis. The POAG eyes tended to show diffuse VF defects, whereas NTG eyes tended to have more severely depressed VF sensitivity at the superonasal quadrant and relatively preserved VF at the inferotemporal quadrant.

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Outcome of a single XEN microstent implant for glaucoma patients with different types of glaucoma

10.21203/rs.3.rs-38738/v4 ◽

2020 ◽

Author(s):

Marc Schargus ◽

Therese Teilig ◽

Matus Rehak ◽

Catharina Busch ◽

Caroline Bormann ◽

...

Keyword(s):

Open Angle Glaucoma ◽

Normal Tension Glaucoma ◽

Secondary Glaucoma ◽

Mean Deviation ◽

Open Angle ◽

Treatment Groups ◽

Different Types ◽

Registration Number ◽

The Mean

Abstract Background The aim of this retrospective study was to compare the efficacy and safety profile of a single XEN-microstent in different types of primary and secondary open angle glaucoma.Methods A single XEN microstent was implanted in patients with primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG), pseudoexfoliation glaucoma (PEX) and secondary glaucoma (Sec.Gl). The intraocular pressure (IOP), the active substances of the applied IOP-lowering drugs, the best corrected visual acuity (BCVA) and the mean deviation (MD) of the perimetry were measured at baseline and at regular follow-ups, scheduled at 2 days and 1, 3, 6 and 12 months after surgery.Results 153 eyes were included in this analysis. 113 eyes were affected by POAG (74%), 5 eyes by NTG (3%), 22 eyes by PEX (14%) and 13 eyes by Sec.Gl (9%). Mean IOP decreased in all treatment groups during the 12 months of follow-up (complete group: 23.9±7.4 to 15.4±5.1 mmHg (p<0.01); POAG: 22.8±6.5 to 15.1±4.6 mmHg (p<0.01); NTG: 16.6±3.4 to 11.6±2.2 mmHg (p<0.05); PEX: 28.0±7.9 to 17.1±6.6 mmHg (p<0.01); Sec.Gl: 28.9±13.9 to 15.5±6.9 mmHg (p<0.05)). In the 153 eyes the average number of IOP-lowering drugs applied decreased from 2.6±1.2 to 0.8±1.3 12 months after surgery (p<0.01). BCVA and mean deviation of automated standard perimetry remained stable in all groups during follow-up.Conclusion As in eyes suffering from POAG, IOP and number of IOP-lowering drugs applied can be effectively reduced by XEN implantation in eyes suffering from NTG, PEX and secondary glaucoma while leaving BCVA and visual field unchanged. Trial registration Trial was registered at DRKS (registration number: DRKS00020800, Registered 25.February 2020 - Retrospectively registered, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00020800)

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