scholarly journals Functional Monitoring after Trabeculectomy or XEN Microstent Implantation Using Spectral Domain Optical Coherence Tomography and Visual Field Indices—A Retrospective Comparative Cohort Study

Biology ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 273
Author(s):  
Marc Schargus ◽  
Catharina Busch ◽  
Matus Rehak ◽  
Jie Meng ◽  
Manuela Schmidt ◽  
...  

The aim of this study was to compare the efficacy of trabeculectomy (TE), single XEN microstent implantation (solo XEN) or combined XEN implantation and cataract surgery (combined XEN) in primary open-angle glaucoma cases, naïve to prior surgical treatment, using a monocentric retrospective comparative cohort study. Intraocular pressure (IOP) and the number of IOP-lowering drugs (Meds) were monitored during the first 24 months after surgery. Further disease progression was monitored using peripapillary retinal nerve fiber layer (RNFL) thickness examinations using spectral domain optical coherence tomography (OCT) as well as visual acuity (VA) and visual field (VF) tests. In the TE group (52 eyes), the mean IOP decreased from 24.9 ± 5.9 to 13.9 ± 4.2 mmHg (p < 0.001) and Meds decreased from 3.2 ± 1.2 to 0.5 ± 1.1 (p < 0.001). In the solo XEN (38 eyes) and the combined XEN groups, the mean IOP decreased from 24.1 ± 4.7 to 15.7 ± 3.0 mmHg (p < 0.001) and 25.4 ± 5.6 to 14.7 ± 3.2 mmHg (p < 0.001), while Meds decreased from 3.3 ± 0.8 to 0.8 ± 1.2 (p < 0.001) and 2.7 ± 1.2 to 0.4 ± 1.0 (p < 0.001), respectively. The VF and VA indices showed no sign of further deterioration, the RNFL thickness further decreased in all treatment groups after surgery. TE and XEN led to comparable reductions in IOP and Meds. Although the VA and VF indices remained unaltered, the RNFL thickness continuously decreased in all treatment groups during the 24-month follow-up.

2014 ◽  
Vol 6 (2) ◽  
pp. 131-139 ◽  
Author(s):  
Madhu Thapa ◽  
Safal Khanal ◽  
Gulsan B Shrestha ◽  
Ananda K Sharma

Objective: To determine the normal values for peripapillary retinal nerve fibre layer thickness (RNFL) measured by spectral domain optical coherence tomography (SD- OCT) in a healthy Nepalese population and to compare the RNFL thicknesses between the genders and among the various age groups.Material and methods: One hundred and fifty six eyes of 156 healthy Nepalese subjects (66 males and 88 females) of various age groups were enrolled in this observational, cross-sectional, hospital-based study. The peripapillary RNFL of the randomly chosen eye of each subject was imaged with a high resolution SD-OCT (Spectralis HRA+OCT, Heidelberg Engineering). The RNFL thickness was measured around the optic nerve head using 16 automatically averaged, consecutive, circular B scans with a 3.4 mm diameter and compared between the genders and among the various age groups.Results: The mean age of the subjects was 38.94 ± 17.00 years (range - 14 to 76 years). The average peripapillary RNFL was found to be 102.64 ± 9.56 μm (95 % CI 97.01 - 101.93). The mean ± SD peripapillary RNFL measurements at the superior, nasal, inferior and temporal sectors in the study population were 129.51 ± 15.09 μm, 76.55 ± 12.02 μm, 134.53 ± 17.19 μm and 70.74 ± 15.53 μm respectively. The average RNFL thickness was 99.47 ± 10.18 μm in the male whereas it was 105.09 ± 8.31 μm in the female participants. The RNFL decreased by 2.26 μm per age per decade.  Conclusion: The Average RNFL thickness is 102.64 ± 9.56 μm in the Nepalese population. Gender and age related variation in the RNFL could serve as a useful guideline in the diagnosis of glaucoma in our population.DOI: http://dx.doi.org/10.3126/nepjoph.v6i2.11709Nepal J Ophthalmol 2014; 6(12): 131-139 


2015 ◽  
Vol 08 (04) ◽  
pp. 1550012 ◽  
Author(s):  
Qinqin Zhang ◽  
Maureen Neitz ◽  
Jay Neitz ◽  
Ruikang K. Wang

Purpose: To provide a geographical map of choroidal thickness (CT) around the macular region among subjects with low, moderate and high myopia. Methods: 20 myopic subjects (n = 40 eyes) without other identified pathologies participated in this study: 20 eyes of ≤ 3 diopters (D) (low myopic), 10 eyes between -3 and -6D (moderate myopic), and 10 eyes of ≥ 6D (high myopic). The mean age of subjects was 30.2 years (± 7.6 years; range, 24 to 46 years). A 1050 nm spectral-domain optical coherence tomography (SD-OCT) system, operating at 120 kHz imaging rate, was used in this study to simultaneously capture 3D anatomical images of the choroid and measure intraocular length (IOL) in the subject. The 3D OCT images of the choroid were segmented into superior, inferior, nasal and temporal quadrants, from which the CT was measured, representing radial distance between the outer retinal pigment epithelium (RPE) layer and inner scleral border. Measurements were made within concentric regions centered at fovea centralis, extended to 5 mm away from fovea at 1 mm intervals in the nasal and temporal directions. The measured IOL was the distance from the anterior cornea surface to the RPE in alignment along the optical axis of the eye. Statistical analysis was performed to evaluate CT at each geographic region and observe the relationship between CT and the degree of myopia. Results: For low myopic eyes, the IOL was measured at 24.619 ± 0.016 mm. The CT (273.85 ± 49.01 μm) was greatest under fovea as is in the case of healthy eyes. Peripheral to the fovea, the mean CT decreased rapidly along the nasal direction, reaching a minimum of 180.65 ± 58.25μm at 5 mm away from the fovea. There was less of a change in thickness from the fovea in the temporal direction reaching a minimum of 234.25 ± 42.27 μm. In contrast to the low myopic eyes, for moderate and high myopic eyes, CTs were thickest in temporal region (where CT = 194.94 ± 27.28 and 163 ± 34.89 μm, respectively). Like the low myopic eyes, moderate and high myopic eyes had thinnest CTs in the nasal region (where CT = 100.84 ± 16.75 and 86.64 ± 42.6μm, respectively). High myopic eyes had the longest mean IOL (25.983 ± 0.021mm), while the IOL of moderate myopia was 25.413 ± 0.022 mm (**p < 0.001). The CT reduction rate was calculated at 31.28 μm/D (diopter) from low to moderate myopia, whilst it is 13.49 μm/D from moderate to high myopia. The similar tendency was found for the IOL reduction rate in our study: 0.265 mm/D from low to moderate myopia, and 0.137 mm/D from moderate to high myopia. Conclusion: The CT decreases and the IOL increases gradually with the increase of myopic condition. The current results support the theory that choroidal abnormality may play an important role in the pathogenesis of myopic degeneration.


2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Ozen Ayrancı Osmanbasoglu ◽  
Zeynep Alkin ◽  
Abdullah Ozkaya ◽  
Yavuz Ozpınar ◽  
Ahmet Taylan Yazici ◽  
...  

Purpose. To analyse the diurnal variation of central choroidal thickness (CCT) in healthy emetropic patients during working hours.Methods. Fifty healthy young emmetrpic volunteers were included in this study. CCT was measured at 9 AM and 4 PM with spectral domain optical coherence tomography (Spectralis, Heidelberg Engineering) with enhanced depth imaging. Diurnal variation of CCT, the correlation between rigth and left eyes and the demographic factors affecting this variation were assessed.Findings. The mean CCT at 9 AM and 4 PM was 308.7 ± 64.5 μm and 308.7 ± 62 μm, respectively, with a mean diurnal amplitude of −0.03 ± 14.7 μm, ranging between −55 μm and 47 μm, the difference was statistically insignificant (P: 0.9). There were positive correlations between right and left eyes among CCT measurements at 9 AM, 4 PM and the mean amplitude of diurnal change (r: 0.65,P<0.01;r: 0.60,P<0.01;r: 0.45,P: 0.00, resp.). There was a statistically significant negative correlation between the magnitude of diurnal change and age (r: −0.27,P: 0.01).Conclusion. Although the mean CCT in the all group does not show significant variation during working hours, the pattern of diurnal variation may vary from person to person according to age, and there is a great harmony between the two eyes.


2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Timm Oberwahrenbrock ◽  
Sven Schippling ◽  
Marius Ringelstein ◽  
Falko Kaufhold ◽  
Hanna Zimmermann ◽  
...  

Background.Optical coherence tomography (OCT) has facilitated characterisation of retinal alterations in MS patients. Only scarce and in part conflicting data exists on different MS subtypes.Objective.To analyse patterns of retinal changes in different subtypes of MS with latest spectral-domain technology.Methods.In a three-centre cross-sectional study 414 MS patients and 94 healthy controls underwent spectral-domain OCT examination.Results.Eyes of MS patients without a previous optic neuritis showed a significant reduction of both retinal nerve fibre layer (RNFL) thickness and total macular volume (TMV) compared to healthy controls independent of the MS subtype (P<0.001for all subtypes). RNFL thickness was lower in secondary progressive MS (SPMS) eyes compared to relapsing-remitting MS (RRMS) eyes (P=0.007), and TMV was reduced in SPMS and primary progressive MS (PPMS) eyes compared to RRMS eyes (SPMS:P=0.039, PPMS:P=0.005). Independent of the subtype a more pronounced RNFL thinning and TMV reduction were found in eyes with a previous optic neuritis compared to unaffected eyes.Conclusion.Analysis of this large-scale cross-sectional dataset of MS patients studied with spectral-domain OCT confirmed and allows to generalize previous findings. Furthermore it carves out distinct patterns in different MS subtypes.


2011 ◽  
Vol 04 (01) ◽  
pp. 12 ◽  
Author(s):  
Elaine To ◽  
Dennis Lam ◽  
Christopher Kai-shun Leung ◽  
◽  
◽  
...  

High-speed, high-resolution imaging of the retinal nerve fiber layer (RNFL) with spectral-domain optical coherence tomography (OCT) has become an essential tool for evaluation of glaucoma. The Cirrus HD-OCT (Carl Zeiss Meditec, Inc. Dublin, CA) is a spectral-domain OCT that provides visualization of the distribution pattern and measurement of RNFL abnormalities in a 6x6mm2optic disc region. Analysis of the RNFL thickness deviation map—a color-coded map displaying areas of RNFL abnormalities—detects glaucoma with high sensitivity and specificity. Trend analysis of average and sectorial RNFL thicknesses, and event analysis of the RNFL thickness maps and the RNFL thickness profiles can be used to detect and follow diffuse and focal RNFL progression. RNFL measurement with spectral-domain OCT could provide important information for use in formulating treatment plans and evaluating disease prognosis in the management of glaucoma.


Author(s):  
Pasha Anvari ◽  
Amin Najafi ◽  
Reza Mirshahi ◽  
Mahsa Sardarinia ◽  
Maryam Ashrafkhorasani ◽  
...  

Purpose: To compare the area of the foveal avascular zone (FAZ) in the superficial and deep retinal layers using two different spectral-domain optical coherence tomography angiography (OCTA) devices. Methods: A cross-sectional comparative study was conducted to obtain macular OCTA images from healthy subjects using Optovue RTVue XR Avanti (Optovue, Inc, Fremont, CA) and Spectralis HRA+OCTA (Heidelberg Engineering, Heidelberg, Germany). Two independent trained graders measured the FAZ area using automated slab segmentation. The FAZ area in the superficial and deep retinal layers were compared. Results: Twenty-three eyes of 23 subjects were included. The graders agreement was excellent (>0.86) for all measurements. The mean FAZ area was significantly larger at the superficial retinal layer as compared to the deep retinal layer on both devices (0.31 ± 0.08 mm2 vs 0.26 ± 0.08 mm2 in Optovue and 0.55 ± 0.16 mm2 vs 0.36 ± 0.13 mm2 in Spectralis, both P < 0.001). The mean FAZ area was significantly greater in the superficial and deep retinal layers using Spectralis as compared to Optovue measurements (P < 0.001 for both comparisons). Conclusion: In contrast to previous reports, the FAZ area was larger in the superficial retina as compared to deep retinal layers using updated software versions. Measurements from different devices cannot be used interchangeably.


QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
O M Abdelfatah ◽  
O A Salem ◽  
A I Elawamry ◽  
Y A Elzanklony

Abstract Background Glaucoma is an optic neuropathy that is characterized by the selective loss of retinal ganglion cells and their axons, which manifests as the loss of the retinal nerve fiber layer (RNFL). Numerous studies have shown that the extent of RNFL damage correlates with the severity of functional deficit in the visual field (VF), and that RNFL measurement by optical coherence tomography (OCT) has good sensitivity for the detection of glaucoma. Purpose To assess the prevalence of glaucoma among high myopic patients and the association between them using standard automated perimetry (SAP) and optical coherence tomography (OCT). Patients and Methods A prospective observational randomized cross sectional study included a total of 80 eyes with high myopia, in the period from November 2017 to April 2018. This cross sectional study included 44 subjects with 80 eyes regarding high myopia using the outpatient services of the Qlawoon Hospital, Cairo, who satisfied the inclusion and exclusion criteria between November 2017 and April 2018 aiming to determine the prevalence of glaucoma in high myopic patients. Results In our study, we depended on the following highly significant parameters in detection of prevalence of glaucoma among high myopic patients: Spherical equivalent median is -12, Vertical cup/disc ratio mean is 0.55, MD median of visual field is – 5.38, PSD mean of visual field is 3.53, GHT is 64.7% outside normal limits, 17.6% border line and 17.6% general reduction of sensitivity and RNFL thickness mean is; for average thickness is 86.37, for superior thickness is 90.06 and for inferior thickness is 82.68 a highly significant P-value. Conclusion Prevalence of glaucoma among our study group is 42.5% depending on Spherical equivalent median, Vertical cup/disc ratio mean, MD median of visual field, PSD mean of visual field, GHT and RNFL thickness.


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