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

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.

Comparing the usefulness of a new algorithm to measure visual field using the variational Bayes linear regression in glaucoma patients, in comparison to the Swedish interactive thresholding algorithm

2021 ◽  
pp. bjophthalmol-2020-318304
Author(s):  
Hiroshi Murata ◽  
Ryo Asaoka ◽  
Yuri Fujino ◽  
Masato Matsuura ◽  
Kazunori Hirasawa ◽  
...  
Keyword(s):  
Visual Field ◽  
Linear Regression ◽  
Open Angle Glaucoma ◽  
Variational Bayes ◽  
Mean Deviation ◽  
Test Duration ◽  
Field Analyser ◽  
Measurement Duration ◽  
Measurement Algorithm ◽  
Thresholding Algorithm

Background/aimsWe previously reported that the visual field (VF) prediction model using the variational Bayes linear regression (VBLR) is useful for accurately predicting VF progression in glaucoma (Invest Ophthalmol Vis Sci. 2014, 2018). We constructed a VF measurement algorithm using VBLR, and the purpose of this study was to investigate its usefulness.Method122 eyes of 73 patients with open-angle glaucoma were included in the current study. VF measurement was performed using the currently proposed VBLR programme with AP-7700 perimetry (KOWA). VF measurements were also conducted using the Swedish interactive thresholding algorithm (SITA) standard programme with Humphrey field analyser. VF measurements were performed using the 24–2 test grid. Visual sensitivities, test–retest reproducibility and measurement duration were compared between the two algorithms.ResultMean mean deviation (MD) values with SITA standard were −7.9 and −8.7 dB (first and second measurements), whereas those with VBLR-VF were −8.2 and −8.0 dB, respectively. There were no significant differences across these values. The correlation coefficient of MD values between the 2 algorithms was 0.97 or 0.98. Test–retest reproducibility did not differ between the two algorithms. Mean measurement duration with SITA standard was 6 min and 02 s or 6 min and 00 s (first or second measurement), whereas a significantly shorter duration was associated with VBLR-VF (5 min and 23 s or 5 min and 30 s).ConclusionVBLR-VF reduced test duration while maintaining the same accuracy as the SITA-standard.

Validating the usefulness of sectorwise regression of visual field in the central 10°

2021 ◽  
pp. bjophthalmol-2020-317391
Author(s):  
Takashi Omoto ◽  
Hiroshi Murata ◽  
Yuri Fujino ◽  
Masato Matsuura ◽  
Takehiro Yamashita ◽  
...  
Keyword(s):  
Visual Field ◽  
Mean Absolute Error ◽  
Open Angle Glaucoma ◽  
Absolute Error ◽  
Open Angle ◽  
Clustering Method ◽  
Significant Difference ◽  
The Mean ◽  
Test Points

AimTo evaluate the usefulness of the application of the clustering method to the trend analysis (sectorwise regression) in comparison with the pointwise linear regression (PLR).MethodsThis study included 153 eyes of 101 patients with open-angle glaucoma. With PLR, the total deviation (TD) values of the 10th visual field (VF) were predicted using the shorter VF sequences (from first 3 to 9) by extrapolating TD values against time in a pointwise manner. Then, 68 test points were stratified into 29 sectors. In each sector, the mean of TD values was calculated and allocated to all test points belonging to the sector. Subsequently, the TD values of the 10th VF were predicted by extrapolating the allocated TD value against time in a pointwise manner. Similar analyses were conducted to predict the 11th–16th VFs using the first 10 VFs.ResultsWhen predicting the 10th VF using the shorter sequences, the mean absolute error (MAE) values were significantly smaller in the sectorwise regression than in PLR. When predicting from the 11th and 16th VFs using the first 10 VFs, the MAE values were significantly larger in the sectorwise regression than in PLR when predicting the 11th VF; however, no significant difference was observed with other VF predictions.ConclusionAccurate prediction was achieved using the sectorwise regression, in particular when a small number of VFs were used in the prediction. The accuracy of the sectorwise regression was not hampered in longer follow-up compared with PLR.

scholarly journals Classification and Statistical Trend Analysis in Detecting Glaucomatous Visual Field Progression

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Cristiana Valente ◽  
Elisa D’Alessandro ◽  
Michele Iester
Keyword(s):  
Statistical Analysis ◽  
Standard Deviation ◽  
Visual Field ◽  
Trend Analysis ◽  
Open Angle Glaucoma ◽  
Mean Deviation ◽  
Threshold Strategy ◽  
Visual Field Progression ◽  
The Mean

Aim. To evaluate the agreement between different methods in detection of glaucomatous visual field progression using two classification-based methods and four statistical approaches based on trend analysis. Methods. This is a retrospective and longitudinal study. Twenty Caucasian patients (mean age 73.8 ± 13.43 years) with open-angle glaucoma were recruited in the study. Each visual field was assessed by Humphrey Field Analyzer, program SITA standard 30-2 or 24-2 (Carl Zeiss Meditec, Inc., Dublin, CA). Full threshold strategy was also accepted for baseline tests. Progression was analyzed by using Hodapp–Parrish–Anderson classification and the Advanced Glaucoma Intervention Study visual field defect score. For the statistical analysis, linear regression (r2) was calculated for mean deviation (MD), pattern standard deviation (PSD), and visual field index (VFI), and when it was significant, each series of visual field was considered progressive. We also used Progressor to look for a significant progression of each visual field series. The agreement between methods, based on statistical analysis and classification, was evaluated using a weighted kappa statistic. Results. Thirty-eight visual field series were analyzed. The mean follow-up time was 6.2 ± 1.53 years (mean ± standard deviation). At baseline, the mean MD was −7.34 ± 7.18 dB; at the end of the follow-up, the mean MD was −9.25 ± 8.65 dB; this difference was statistically significant (p<0.001). The agreement to detect progression was fair between all methods based on statistical analysis and classification except for PSD r2. A substantial agreement (κ = 0.698 ± 0.126) was found between MD r2 and VFI r2. With the use of all the statistical analysis, there was a better time-saving. Conclusions. The best agreement to detect progression was found between MD r2 and VFI r2. VFI r2 showed the best agreement with all the other methods. GPA2 can help ophthalmologists to detect glaucoma progression and to help in treatment decisions. PSD r2 was the worse method to detect progression.

Low-cost, smartphone-based frequency doubling technology visual field testing using a head-mounted display

2019 ◽  
pp. bjophthalmol-2019-314031 ◽  
Author(s):  
Karam AlRahman Alawa ◽  
Ryan P Nolan ◽  
Elaine Han ◽  
Alejandro Arboleda ◽  
Heather Durkee ◽  
...  
Keyword(s):  
Visual Field ◽  
Linear Regression ◽  
Open Angle Glaucoma ◽  
Low Cost ◽  
Frequency Doubling ◽  
Regression Analyses ◽  
Field Screening ◽  
Head Mounted Display ◽  
Frequency Doubling Technology ◽  
Significant Difference

BackgroundCurrent visual field screening machines are bulky and expensive, limiting their accessibility, affordability and use. We report the design and evaluation of a novel, portable, cost-effective system for glaucoma screening using smartphone-based visual field screening using frequency doubling technology (FDT) and a head-mounted display.MethodsNineteen eyes of 10 subjects with new-onset or chronic primary open angle glaucoma were tested and compared with the Humphrey Zeiss FDT and the newly developed Mobile Virtual Perimetry (MVP) FDT with the C-20 testing pattern. Mann-Whitney, Bland-Altman and linear regression analyses were performed to assess statistical difference, agreement and correlation, respectively, between the two devices.ResultsThe average age of the participants was 58±15 years. No statistically significant difference was found between the MVP FDT and the Humphrey Zeiss FDT (p>0.05). Bland-Altman and linear regression analyses demonstrated good agreement and correlation between the two devices.ConclusionThe MVP FDT is a low-cost, portable visual field screening device that produces comparable results to the Humphrey Zeiss FDT and may be used as an easily accessible screening tool for glaucoma.

scholarly journals Influence of automated visual field testing on intraocular pressure

2020 ◽  
Author(s):  
Samuel Bertaud ◽  
Elisabeth Skarbek Borowski ◽  
Rachid Abbas ◽  
Christophe Baudouin ◽  
Antoine Labbé
Keyword(s):  
Intraocular Pressure ◽  
Visual Field ◽  
Open Angle Glaucoma ◽  
Corneal Thickness ◽  
Angle Closure ◽  
Mean Deviation ◽  
Test Duration ◽  
Automated Perimetry ◽  
Significant Difference ◽  
The Impact

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.

scholarly journals Change of Retinal Vessel Density After Lowering Intraocular Pressure in Ocular Hypertension

2021 ◽  
Vol 8 ◽  
Author(s):  
Xuhao Chen ◽  
Ying Hong ◽  
Haohao Di ◽  
Qianru Wu ◽  
Di Zhang ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Intraocular Pressure ◽  
Linear Regression ◽  
Ocular Hypertension ◽  
Linear Regression Analysis ◽  
Vessel Density ◽  
Factors Associated ◽  
Rnfl Thickness ◽  
Deep Layers ◽  
The Mean

Purpose: To investigate the relationship between retinal microvasculature changes and intraocular pressure (IOP) for ocular hypertension (OHT) patients and further assess the factors associated with retinal microcirculation changes.Methods: This was a single-center prospective study designed for OHT patients, which consisted of two visits. After collecting baseline data of those who met the eligibility criteria, these patients were treated with latanoprost 0.005% ophthalmic solution for 4 weeks. Peripapillary vessel density (VD) of radial peripapillary capillaries (RPC) layer, macular VD in both superficial and deep layers, and foveal avascular zone (FAZ) area were measured by optical coherence tomography angiography (OCTA) before and after the treatment. We compared the changes in IOP and VD among the two visits by paired-sample t-test. Bonferroni correction was applied. Factors associated with VD changes were analyzed by linear regression analysis.Results: Thirty-four eyes of thirty-four patients were included. The mean IOP decreased by 6.5 ± 2.2 mmHg (p &lt; 0.001). The peripapillary RPC VD increased significantly from 51.8 ± 2.5 to 53.0 ± 3.1% (Adjusted-p = 0.012). We found no significant difference in detailed sectors of the peripapillary region after correction. In the macular area, both the superficial and deep layers in foveal (superficial: 0.2 ± 1.9%, p = 0.523; deep: 0.0 ± 2.3%, p = 0.969) and parafoveal (superficial: 0.3 ± 3.0%, p = 0.565; deep: 0.5 ± 3.1%, p = 0.423) VD remained unchanged. The decrease of the mean FAZ area was insignificant (p = 0.295). The percentage of IOP reduction (β = 0.330, p = 0.031) and the baseline RNFL thickness (β = 0.450, p = 0.004) significantly correlated with the percentage of peripapillary RPC VD improvement in the multivariate linear regression analysis.Conclusion: The peripapillary VD in OHT patients increased after the reduction of IOP. The mild change of IOP did not alter the microcirculation in the macula. In addition, the percentage of IOP change and the baseline RNFL thickness were independent factors for the peripapillary RPC VD improvement.

scholarly journals Investigation of progression pattern and associated risk factors in glaucoma patients with initial paracentral scotomas using Humphrey 10-2

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Eun Kyoung Kim ◽  
Hae-Young Lopilly Park ◽  
Kyung Euy Hong ◽  
Da Young Shin ◽  
Chan Kee Park
Keyword(s):  
Risk Factors ◽  
Visual Field ◽  
Open Angle Glaucoma ◽  
Linear Regression Analysis ◽  
Test Point ◽  
Mean Deviation ◽  
Central Visual Field ◽  
Total Deviation ◽  
Paracentral Scotoma ◽  
Associated Risk Factors

AbstractCentral visual field (VF) progression could directly threaten patientss visual function compared to glaucomatous damage. This study was designed to investigate visual field (VF) progression pattern and associated risk factors including optical coherence topography angiographic (OCT-A) findings in glaucoma patients with initial paracentral scotoma. This prospective, observational study included 122 eyes presenting as initial paracentral scotomas with serial 24-2 and 10-2 VF tests at the glaucoma clinic of Seoul St Mary's Hospital between November 2017 and August 2020. The participants underwent at least 5 serial VF exams and OCT-A at baseline. Numerical values of the initial and final 10-2 VF tests were averaged for each VF test point using the total deviation map. Innermost 10-2 VF progression was defined as three or more new contiguous points at the central 12 points on 10-2 VF. Other clinical characteristics were collected including history of disc hemorrhage and vessel density (VD) was measured from OCT-A images. Linear regression analysis was performed to obtain the change of mean deviation and a cut-off for progression was defined for both 24-2 and 10-2 VFs. The average total deviation maps of the initial 10-2 VF tests shows initial paracentral scotoma located in the superior region in an arcuate pattern that was deep in the 4°–6° region above fixation. This arcuate pattern was more broadly located in the 4°–10° region in the primary open-angle glaucoma (POAG) group, while it was closer to fixation in 0°–4° region in the normal-tension glaucoma (NTG) group. The final average map shows deepening of scotomas in the 4°–10° region in POAG, which deepened closer to the region of fixation in NTG. The diagnosis of NTG (β 1.892; 95% CI 1.225–2.516; P = 0.035) and lower choroidal VD in the peripapillary atrophy (PPA) region (β 0.985; 95% CI 0.975 to 0.995; P = 0.022) were significantly related to innermost 10-2 VF progression. Initial paracentral scotomas in NTG tended to progress closer to the region of fixation, which should be monitored closely. Important progression risk factors related to paracentral scotoma near the fixation were the diagnosis of NTG and reduced choroidal VD in the β-zone PPA region using OCT-A. We should consider vascular risk factors in NTG patients presenting with initial paracentral scotoma to avoid vision threatening progression of glaucoma.

scholarly journals Corneal biomechanics and biomechanically corrected intraocular pressure in primary open-angle glaucoma, ocular hypertension and controls

2019 ◽  
Vol 104 (1) ◽  
pp. 121-126 ◽  
Author(s):  
Riccardo Vinciguerra ◽  
Salwah Rehman ◽  
Neeru A Vallabh ◽  
Mark Batterbury ◽  
Gabriela Czanner ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Visual Field ◽  
Ocular Hypertension ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Corneal Biomechanics ◽  
Mean Deviation ◽  
Open Angle ◽  
Corvis St ◽  
Significant Difference

AimsTo compare the biomechanically corrected intraocular pressure (IOP) estimate (bIOP) provided by the Corvis-ST with Goldmann applanation tonometry (GAT-IOP) in patients with high-tension and normal-tension primary open-angle glaucoma (POAG; HTG and NTG), ocular hypertension (OHT) and controls. Moreover, we compared dynamic corneal response parameters (DCRs) of the Corvis-ST in POAG, OHT and controls, evaluated the correlation between global visual field parameters mean deviation and pattern SD (MD and PSD) and DCRs in the POAG group.Methods156 eyes of 156 patients were included in this prospective, single-centre, observational study, namely 41 HTG and 33 NTG, 45 OHT cases and 37 controls. Central corneal thickness (CCT), GAT-IOP and bIOP were measured, GAT-IOP was also adjusted for CCT (GATAdj). DCRs provided by Corvis-ST were evaluated, MD and PSD were recorded by 24–2 full-threshold visual field. To evaluate the difference in DCRs between OHT, HTG and NTG, a general linear model was used with sex, medications and group as fixed factors and bIOP and age as covariates.ResultsThere was a significant difference between GAT-IOP, GATAdj and bIOP in NTG and HTG, OHT and controls. NTG corneas were significantly softer and more deformable compared with controls, OHT and HTG as demonstrated by significantly lower values of stiffness parameters A1 and highest concavity and higher values of inverse concave radius (all p<0.05). There was a significant correlation (p<0.05) between MD, PSD and many DCRs with POAG patients with softer or more compliant corneas more likely to show visual field defects.ConclusionsCorneal biomechanics might be a significant confounding factor for IOP measurement that should be considered in clinical decision-making. The abnormality of corneal biomechanics in NTG and the significant correlation with visual field parameters might suggest a new risk factor for the development or progression of NTG.

scholarly journals Glaucoma Progression after Delivery in Patients with Open-Angle Glaucoma Who Discontinued Glaucoma Medication during Pregnancy

2021 ◽  
Vol 10 (10) ◽  
pp. 2190
Author(s):  
Duri Seo ◽  
Taekjune Lee ◽  
Joo Yeon Kim ◽  
Gong Je Seong ◽  
Wungrak Choi ◽  
...  
Keyword(s):  
Visual Field ◽  
Open Angle Glaucoma ◽  
Linear Regression Analysis ◽  
Univariate Analysis ◽  
Field Tests ◽  
Mean Deviation ◽  
Close Monitoring ◽  
Open Angle ◽  
Fiber Layer ◽  
Glaucoma Progression

In this retrospective study, clinical characteristics and glaucoma progression of open-angle glaucoma (OAG) patients who discontinued intraocular pressure (IOP)-lowering medication during pregnancy were investigated. Glaucoma progression was determined using either serial visual field tests or optic disc/retinal nerve fiber layer (RNFL) photographs. Age, number of previous pregnancies, diagnosis, average IOP, IOP fluctuation, visual field mean deviation, pattern standard deviation, and RNFL thickness were examined, and their association with glaucoma progression was determined using linear regression analysis. Among 67 eyes (37 patients), 19 eyes (28.4%) exhibited glaucoma progression 13.95 ± 2.42 months after delivery. The progression group showed significantly higher mean IOP than the nonprogression group in the first, second, and third trimesters (p = 0.02, 0.001, and 0.04, respectively). The average IOP in the second, and third trimesters and IOP fluctuation during the entire pregnancy were significantly associated with glaucoma progression according to a univariate analysis (p = 0.04, 0.031, and 0.026, respectively). In conclusion, IOP elevation during pregnancy is associated with glaucoma progression after delivery in patients who had discontinued medication during pregnancy. Therefore, close monitoring of glaucoma is necessary, particularly if patients discontinue medication during pregnancy, and appropriate intervention should be considered in case of increased IOP.

scholarly journals Spino cranial angle as a predictor of loss of cervical lordosis after laminoplasty in patients with cervical myelopathy

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zheng Wang ◽  
Jia-Xin Xu ◽  
Zhen Liu ◽  
Ruo-Yu Li ◽  
Zhi-Wei Wang ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Linear Regression ◽  
Cervical Myelopathy ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Cervical Lordosis ◽  
Significant Difference ◽  
Cervical Sagittal Alignment ◽  
Sagittal Parameters

Abstract Background To explore the relationship between spino cranial angle (SCA) and loss of cervical lordosis (LOCL), and to determine whether SCA has the ability to predict LOCL for patients with cervical myelopathy. Methods A total of 68 consecutive patients with cervical myelopathy who received laminoplasty (LAMP) were selected to the current study. C2–C7 lordosis was defined as a representation of the cervical alignment. Alignment change > 0° was considered LOCL. Multiple linear regression analysis was applied to evaluate the association between LOCL and various sagittal parameters at preoperative, such as SCA, CL, T1s and cSVA. Linear regression analysis was applied to evaluate the relationships between LOCL and preoperative SCA in each subgroup. Results Patients were assigned to three groups depending on the quartile of preoperative SCA. The first quarter of patients were defined as the low SCA group, the last quarter were defined as the high SCA group and the middle half were defined as the middle SCA group. There was no statistically significant difference in age, sex and the type of OPLL among the three groups. Patients in the low SCA group showed more cervical lordosis before surgery and more LOCL after LAMP (p < 0.001). After linear regression analysis for SCA and LOCL, preoperative SCA was negatively correlated with LOCL in the low SCA group (r = − 0.857, p < 0.001) and high SCA group (r = − 0.515, p = 0.034). However, there was no significant correlation between preoperative SCA and LOCL in the middle SCA group (r = 0.027, p = 0.881). Conclusions Patients with lower SCA had more lordosis preoperatively and performed more LOCL after LAMP at 2 years of follow-up. Both too high or low preoperative SCA were negatively correlated with the degree of LOCL, while when the SCA fluctuates in a suitable range, it is easier to compensate for the changes of cervical sagittal alignment.

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