scholarly journals Evaluation of the effectiveness of glaucoma surgeries

2021 ◽  
Vol 20 (2) ◽  
pp. 57-65
Author(s):  
S. I. Anisimov ◽  
S. Yu. Anisimova ◽  
L. L. Arutyunyan ◽  
A. P. Voznyuk
Keyword(s):  
Visual Fields ◽  
Observation Time ◽  
Diagnostic Process ◽  
Glaucomatous Optic Neuropathy ◽  
Correct Treatment ◽  
Functional Changes ◽  
Functional Components ◽  
Significant Disease ◽  
Entire Treatment ◽  
Functional Defects

Glaucoma is a socially significant disease and ranks first among the causes of visual impairment and blindness. Glaucoma is a chronic disease with progressive course, and the entire treatment and diagnostic process is associated with the need for constant monitoring of the structural and functional components of the visual system to assess the progression of glaucomatous optic neuropathy. With adequately chosen treatment tactics, it is possible to stabilize the glaucomatous process and successfully reverse the structural and functional changes thanks to the links between functional defects of the visual fields and topographic damage in the optic nerve with the stage of the disease. This statement emphasizes the need to choose the correct treatment tactics, as well as to closely monitor the structural and functional characteristics of patients with glaucoma. In this regard, the issue of studying the safety and effectiveness of various glaucoma surgeries depending on observation time remains relevant. 

Modern methods for assessing morphometric and functional indicators in primary glaucoma

2021 ◽  
pp. 83-87
Author(s):  
N.R. Sharvadze ◽  
◽  
A.L. Shtilerman ◽  
D.P. Skachkov ◽  
Y.A. Drovnyak ◽  
...  
Keyword(s):  
Open Angle Glaucoma ◽  
Diagnostic Methods ◽  
High Tech ◽  
Glaucomatous Optic Neuropathy ◽  
Static Perimetry ◽  
Functional Changes ◽  
Modern Methods ◽  
Analytical Review ◽  
Primary Glaucoma ◽  
Key Words Glaucoma

In the article are presented analytical review of scientific articles devoted to the study of modern methods of diagnostics of primary glaucoma. On the basis of scientific articles, a review material was collected and systematized on diagnostic methods for studying morphometric and functional changes in primary glaucoma, which are used in modern ophthalmic practice. In recent years, the improvement and implementation of new high-tech modern diagnostic methods open up new opportunities for researchers and clinicians. Optical coherence tomography, OCT angiography, static perimetry make it possible, by comparing morphometric and functional parameters, to give a more complete, comprehensive assessment of pathological changes in the optic nerve head, in the macular region and at the level of the choriocapillaries. Prevention of glaucoma blindness largely depends on its early diagnosis based on the use of modern organizational and medical technologies. Key words: glaucoma, open-angle glaucoma, intraocular pressure, glaucomatous optic neuropathy, diagnostic methods.

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 Bilateral Glaucomatous Optic Neuropathy Caused by Eye Rubbing

2015 ◽  
Vol 6 (3) ◽  
pp. 279-283 ◽  
Author(s):  
Alfonso Savastano ◽  
Maria Cristina Savastano ◽  
Laura Carlomusto ◽  
Silvio Savastano
Keyword(s):  
Intraocular Pressure ◽  
Visual Field ◽  
Optic Disc ◽  
Optic Neuropathy ◽  
Correct Diagnosis ◽  
Visual Fields ◽  
Pattern Electroretinogram ◽  
Glaucomatous Optic Neuropathy ◽  
Fiber Layer ◽  
The Right

In this report, we describe a particular condition of a 52-year-old man who showed advanced bilateral glaucomatous-like optic disc damage, even though the intraocular pressure resulted normal during all examinations performed. Visual field test, steady-state pattern electroretinogram, retinal nerve fiber layer and retinal tomographic evaluations were performed to evaluate the optic disc damage. Over a 4-year observational period, his visual acuity decreased to 12/20 in the right eye and counting fingers in the left eye. Visual fields were severely compromised, and intraocular pressure values were not superior to 14 mm Hg during routine examinations. An accurate anamnesis and the suspicion of this disease represent a crucial aspect to establish the correct diagnosis. In fact, our patient strongly rubbed his eyes for more than 10 h per day. Recurrent and continuous eye rubbing can induce progressive optic neuropathy, causing severe visual field damage similar to the pathology of advanced glaucoma.

scholarly journals Predicting glaucoma prior to its onset using deep learning

2019 ◽  
Author(s):  
Anshul Thakur ◽  
Michael Goldbaum ◽  
Siamak Yousefi
Keyword(s):  
Deep Learning ◽  
Visual Field ◽  
Optic Neuropathy ◽  
Disease Onset ◽  
Visual Fields ◽  
Learning Model ◽  
Glaucomatous Optic Neuropathy ◽  
Learning Models ◽  
Fundus Photographs ◽  
Deep Learning Model

AbstractPurposeTo assess the accuracy of deep learning models to predict glaucoma development from fundus photographs several years prior to disease onset.DesignA deep learning model for prediction of glaucomatous optic neuropathy or visual field abnormality from color fundus photographs.ParticipantsWe retrospectively included 66,721 fundus photographs from 3,272 eyes of 1,636 subjects to develop deep leaning models.MethodFundus photographs and visual fields were carefully examined by two independent readers from the optic disc and visual field reading centers of the ocular hypertension treatment study (OHTS). When an abnormality was detected by the readers, subject was recalled for re-testing to confirm the abnormality and further confirmation by an endpoint committee. Using OHTS data, deep learning models were trained and tested using 85% of the fundus photographs and further validated (re-tested) on the remaining (held-out) 15% of the fundus photographs.Main Outcome MeasuresAccuracy and area under the receiver-operating characteristic curve (AUC).ResultsThe AUC of the deep learning model in predicting glaucoma development 4-7 years prior to disease onset was 0.77 (95% confidence interval 0.75, 0.79). The accuracy of the model in predicting glaucoma development about 1-3 years prior to disease onset was 0.88 (0.86, 0.91). The accuracy of the model in detecting glaucoma after onset was 0.95 (0.94, 0.96).ConclusionsDeep learning models can predict glaucoma development prior to disease onset with reasonable accuracy. Eyes with visual field abnormality but not glaucomatous optic neuropathy had a higher tendency to be missed by deep learning algorithms.

scholarly journals Neuroimaging in Vascular Parkinsonism

2019 ◽  
Vol 19 (12) ◽  
Author(s):  
Karen K. Y. Ma ◽  
Shi Lin ◽  
Vincent C. T. Mok
Keyword(s):  
Dopamine Transporter ◽  
Diffusion Tensor ◽  
Functional Neuroimaging ◽  
Treatment Decision ◽  
Diagnostic Process ◽  
Vascular Parkinsonism ◽  
Ongoing Research ◽  
Dopamine Transporter Imaging ◽  
Functional Changes ◽  
Therapeutic Trials

Abstract Purpose of Review Being a disease with heterogeneous presentations and unclear consensus on its diagnostic criteria, it is difficult to differentiate vascular parkinsonism (VaP) from other neurodegenerative parkinsonism variants. Ongoing research on structural and functional neuroimaging targeting dopaminergic pathway provides us more insight into the pathophysiology of VaP to improve diagnostic accuracy. The aim of this article is to review how the emerging imaging modalities help the diagnostic process and treatment decision in VaP. Recent Findings Dopamine transporter imaging is a promising tool in differentiating presynaptic parkinsonism and VaP. It also predicts the levodopa responders in VaP. Advanced MRI techniques including volumetry, diffusion tensor imaging and sequences visualising substantia nigra are under development, and they are complementary to each other in detecting structural and functional changes in VaP, which is crucial to ensure the quality of future therapeutic trials for VaP. Summary Dopamine transporter imaging is recommended to patients with suspected VaP. Multimodal MRI in VaP would be an important area to be investigated in the near future.

scholarly journals The photopic negative response (PhNR): measurement approaches and utility in glaucoma

2020 ◽  
Vol 40 (12) ◽  
pp. 3565-3576
Author(s):  
Matteo Prencipe ◽  
Tommaso Perossini ◽  
Giampaolo Brancoli ◽  
Mario Perossini
Keyword(s):  
Optic Neuropathy ◽  
Negative Response ◽  
Photopic Negative Response ◽  
Diagnostic Process ◽  
Glaucomatous Optic Neuropathy ◽  
Specific Information ◽  
Automated Perimetry ◽  
Pattern Erg ◽  
Glaucomatous Damage ◽  
Additional Tool

Abstract Purpose Visual electrophysiological testing continues to generate interest among glaucoma experts because of its potential help in clarifying disease pathophysiology and promoting early detection of glaucomatous damage. The photopic negative response (PhNR) is a slow negative component of the full-field electroretinogram that has been shown to provide specific information about retinal ganglion cells (RGCs) activity. The purpose of this article is to review the literature to explore the currently available measurement methods and the utility of PhNR in glaucoma diagnostic process. Methods We gathered publications related to the origins, types of stimuli used, measurements methods and applications of the PhNR of ERG in animal models and humans through a search of the literature cited in PubMed. Search terms were: “PhNR”, “photopic negative response”, “glaucoma”, “glaucomatous optic neuropathy”, “ERG”, “electroretinogram”. Results The most reliable PhNR measurements are obtained using a red stimulus on a blue background, without requiring refractive correction, fixation monitoring, or ocular media transparency. Given its direct correlation with RGCs response, the PhNR measured as baseline-to-trough (BT) represents the most reliable parameter of evaluation. Glaucoma patients with evident perimetric defects show pathologic PhNR values. Even though the PhNR is promising in detecting early RGCs impairment, distinguishing between healthy subjects and suspect patients at risk of developing glaucomatous damage still remains challenging. Conclusion The PhNR is a useful additional tool to explore disorders that affect the innermost retina, including glaucoma and other forms of optic neuropathy. In particular, comparing reports of the standard examinations (optic disc assessment, OCT RNFL measurement, standard automated perimetry) with the results of electrophysiological tests may be helpful in solving clinical diagnostic and management dilemmas. On the one hand, the PhNR of the ERG can examine the parvocellular pathways; on the other hand, the steady-state pattern ERG optimized for glaucoma screening (PERGLA) can explore the magnocellular pathways. This could give ophthalmologists a useful feedback to identify early RGCs alterations suggestive of glaucoma, stratify the risk and potentially monitor disease progression.

scholarly journals Relationship between structural and functional changes in glaucomatous eyes: a multifocal electroretinogram study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hiroki Tanaka ◽  
Kyoko Ishida ◽  
Kenji Ozawa ◽  
Takuma Ishihara ◽  
Akira Sawada ◽  
...  
Keyword(s):  
Functional Assessment ◽  
Multifocal Electroretinogram ◽  
Visual Fields ◽  
Negative Response ◽  
Photopic Negative Response ◽  
Mean Deviation ◽  
Ganglion Cell Complex ◽  
Functional Changes ◽  
The Mean ◽  
Optimal Measure

Abstract Background The nasal to temporal amplitudes ratio (N/T) of multifocal electroretinography (mfERG) scans measured within 5° of the macula can be used to detect glaucomatous change. The photopic negative response (PhNR) of mfERG elicited by a circular stimulus centered on the fovea was significantly reduced in eyes with glaucoma. The PhNR to B-wave ratio (PhNR/B) is the optimal measure of the PhNR. However, clinical superiority for evaluating glaucoma patients has not been determined between N/T and PhNR/B yet. Methods For morphological assessments, ganglion cell complex (GCC) in six regions and the average were measured by optical coherence tomography (OCT). For functional assessment, Humphrey visual fields (VF) with mean sensitivities (MT) and mfERG scans with parameters of N/T and the multifocal photopic negative response to B-wave ratio (mfPhNR/B) were measured. Sixty-nine eyes of 44 glaucoma patients were included and correlations between mfERG parameters and OCT or VF parameters were evaluated. Results The mean age of patients was 59.4 years. The mean deviation for all eyes obtained with the VF 30–2 and VF 10–2 was − 7.00 and − 6.31 dB, respectively. Significant correlations between GCC thickness or VF parameter and the N/T were found, especially in the inferior and inforotemporal retinal areas corresponding to superior and superonasal VF sectors (GCC vs N/T; coefficient = − 7.916 and − 7.857, and MT vs N/T; coefficient = − 4.302 and − 4.437, in the inferior and inforotemporal retinal areas, respectively, all p values < 0.05). However, similar associations were not obtained between mfPhNR/B and OCT or VF parameters. The mfPhNR/B only in the inferotemporal sector was significantly correlated with the average thickness of GCC (coefficient = 4.823, P = 0.012). Conclusions The N/T was correlated with GCC and VF in more numbers of measurement areas than the mfPhNR/B in the current study, however, a future study modifying the stimuli and amplitudes to obtain the spatial correspondence to OCT and VF measurement will be required to evaluate the value of mfERG.

scholarly journals Vascular Endothelial Growth Factor Is Associated with the Morphologic and Functional Parameters in Patients with Hypertrophic Cardiomyopathy

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Radek Pudil ◽  
Martina Vasatova ◽  
Alena Fucikova ◽  
Helena Rehulkova ◽  
Pavel Rehulka ◽  
...  
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Hypertrophic Cardiomyopathy ◽  
Growth Factor ◽  
Vena Cava ◽  
Left Ventricular ◽  
Diagnostic Process ◽  
Vascular Endothelial ◽  
Functional Changes ◽  
Functional Parameters ◽  
Endothelial Growth Factor

Background. Hypertrophic cardiomyopathy (HCM) is mostly autosomal dominant disease of the myocardium, which is characterized by myocardial hypertrophy. Vascular endothelial growth factor (VEGF) is involved in myocyte function, growth, and survival. The aim of study was to analyze the clinical significance of VEGF in structural and functional changes in patient with HCM. Methods. In a group of 21 patients with nonobstructive HCM, we assessed serum VEGF and analyzed its association with morphological and functional parameters. Compared to healthy controls, serum VEGF was increased: 199 (IQR: 120.4–260.8) ng/L versus 20 (IQR: 14.8–37.7) ng/L, P<0.001. VEGF levels were associated with left atrium diameter (r=0.51, P=0.01), left ventricle ejection fraction (r=-0.56, P=0.01), fractional shortening (r=-0.54, P=0.02), left ventricular mass (r=0.61, P=0.03), LV mass index (r=0.46, P=0.04), vena cava inferior diameter (r=0.65, P=0.01), and peak gradient of tricuspid regurgitation (r=0.46, P=0.03). Conclusions. Increased VEGF level is associated with structural and functional parameters in patients with HCM and serves as a potential tool for diagnostic process of these patients.

scholarly journals Aqueous Humor Proteomic Alterations Associated with Visual Field Index Parameters in Glaucoma Patients: A Pilot Study

2021 ◽  
Vol 10 (6) ◽  
pp. 1180
Author(s):  
Sai Karthik Kodeboyina ◽  
Tae Jin Lee ◽  
Kathryn Bollinger ◽  
Lane Ulrich ◽  
David Bogorad ◽  
...  
Keyword(s):  
Visual Field ◽  
Aqueous Humor ◽  
Molecular Mechanisms ◽  
Visual Fields ◽  
Mean Deviation ◽  
Glaucomatous Optic Neuropathy ◽  
Visual Field Index ◽  
Liquid Chromatography Tandem Mass ◽  
Visual Field Indices ◽  
Apolipoprotein D

Purpose: The purpose of this study was to discover the aqueous humor proteomic changes associated with visual field indices in glaucoma patients. Methods: Aqueous humor samples were analyzed using Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS). The visual fields were analyzed with the Humphrey Visual Field analyzer. Statistical analyses were performed to discover the relationship between the aqueous humor proteins and visual field parameters including Pattern Standard Deviation (PSD), Visual Field Index (VFI), Mean Deviation (MD) and Glaucoma Hemifield Test (GHT). Results: In total, 222 proteins were identified in 49 aqueous humor samples. A total of 11, 9, 7, and 6 proteins were significantly correlated with PSD, VFI, MD, and GHT respectively. These proteins include apolipoprotein D, members of complement pathway (C1S, C4A, C4B, C8B, and CD14), and immunoglobulin family (IKHV3-9, IGKV2-28). Conclusion: Several proteins involved in immune responses (immunoglobulins and complement factors) and neurodegeneration (apolipoprotein D) were identified to be associated with abnormal visual field parameters. These findings provide targets for future studies investigating precise molecular mechanisms and new therapies for glaucomatous optic neuropathy.

Sign in / Sign up

Export Citation Format

Share Document