Search Results - "International Ophthalmology"

1573-2630

retinal nerve fiber layer ; automated perimetry ; ocular hypertension ; glaucoma ; early diagnosis

Springer Online Journal Archives 1860-2000

Medicine

Abstract Preliminary results of a larger investigation on correlation between Retinal Nerve Fiber Layer Defects (RNFL) and Automated Perimetry (AP) are presented. A group of ocular hypertensive patients was recruited and a cross-section, randomized study was carried out. The group was composed of 54 eyes from 28 patients; 15 men and 13 women, mean age 42.76 year, mean visual acuity 0.95 (Snellen cart) and mean visual defect expressed in diopters was+0.514 (from − 2.5 to+5). A total of 17 (31.48%) refractive fields were pathologic according to our criteria, one from a normal RNFL and the others from nerve fiber defects. We observed 6 no reliable RNFL photographs, 18 normal, 11 slits, 6 wedge, 11 diffuse and 2 mixed defects. Comparing RNFL and AP, 53.33% of eyes with fiber defects had abnormal perimetries. The more evolutioned the defect, the larger percentage of abnormal visual fields were observed: 36.36% in slit defects, 66.66% in wedge, 54.55% in diffuse and 100% in mixed ones. Comparing location of defects with location of cluster of decreased sensibility points in visual field, a higher correlation in inferior than superior defects was found.

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1573-2630

glaucoma ; microcirculation ; reflectometry ; scattering ; spectra deconvolution ; xanthophyll

Springer Online Journal Archives 1860-2000

Medicine

Abstract The approximation of logarithmic difference spectra between the reflectance of the normal fundus and the fundus reflectance in different stages of glaucoma is demonstrated by a model. The influences of fundus pigments like oxihemoglobin, melanin, xanthophyll and rhodopsin as well as the intensity and the exponent of the scattered light are optimized. Glaucomatous alterations in the extinction of these pigments and of the scattering parameters are different in the macula, in the papillo-macular bundle and in the parapapillary region temporal to the optic disc. A lack of oxihemoglobin only in the papillo-macular bundle in first relative losses in the visual field function points to a damaged microcirculation in early POAG. In progressive glaucoma the extinction spectrum of xanthophyll is detectable in the papillo-macular bundle. A decreased intensity of the scattered light and an altered scattering exponent are suggestive of a damage in the nerve fiber layer at early stages of glaucoma.

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1573-2630

atrial fibrillation ; glaucoma ; geriatric ; institutionalization

Springer Online Journal Archives 1860-2000

Medicine

Abstract This study investigates the relationship of atrial fibrillation, systemic blood pressure and nerve fiber loss. 213 institutionalized glaucoma patients (mean age 83.9 years) and 100 control patients (mean age 81.8 years) were examined ophthalmologically and analyzed for blood pressure. A 12-lead electrocardiogram, analyzed according to the Minnesota code, was taken for 212 glaucoma patients and 100 control patients. 17% of the glaucoma patients had atrial fibrillation (AF), which was significantly more than in the control group (8%). Patients with AF had lower systolic blood pressures (mean 146.5mmHg) than the other patients (mean 153.7 mmHg). Visual acuity (VA) of the patients having AF was lower than that of the other patients. Severe visual field defects occurred more frequently in patients having AF (in 70% v.s. 42%). Patients with severe visual field defects and lower VA had lower systolic blood pressures than the patients with better visual fields and VA. 75% of geriatric glaucoma patients with AF and 64% of geriatric glaucoma patients without AF had intraocular pressures 〈18 mmHg. Atrial fibrillation and low systolic blood pressure are connected with impairment of ocular functions of geriatric glaucoma patients.

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1573-2630

anterior chamber depth ; Greenland Eskimos ; limbal chamber depth ; primary angle-closure glaucoma ; risk factors ; screening

Springer Online Journal Archives 1860-2000

Medicine

Abstract A population of 539 persons was examined in 1979, using LCD and ACD estimations acc. to van Herick et al. and by Haag Streit pachymetry, respectively. ACD had been measured already in 1969, due to a remarkable occurrence of primary angle-closure glaucoma (PACG) in the survey population of Greenland Eskimos (District of Uummannaq). The present follow up study in 1989 aimed at persons presently above age 40, who had showneither an LCD value graded as 0 (contact) or 1 (〈 0.25 of corneal thickness=CT),or a value of 2 (=0.25 CT) if an ACD value of 〈=2.70mm (CT included) had also been found. PACG patients or suspects known in 1979 already were excluded from the present analyses. A total of 75 persons was now examined. Five had developed acute (n=2) or intermittent PACG (n=3)during the ten year period.At the survey 3 intermittent and 4 latent PACG cases were detected, yielding in ten years a PACG prevalence of 12/75=16% (sex ratio: M/F=2/10). One male case of severe secondary (partly inflammatory) ACG was also found. Past and present LCD and ACD values are given as well as gonioscopical status. Creeping, synechial angle-closure was frequent. Among probands who could not be examined, mostly due to death before 1989, 5/54 had developed PACG during the ten year period. Non-probands according to above criteria were mostly not examined. Yet their records were scrutinized for any event suspect of PACG. Thus among 258 persons above age 40 no PACG case was found.In conclusion: a fairly simple, anatomical slit lamp screening (of LCD and ACD) was found effectively to select a subgroup which proved to be at risk of PACG-development in the following ten year period.

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1573-2630

intraocular pressure ; Goldmann tonometer ; air-pulsed tonometer ; glaucoma

Springer Online Journal Archives 1860-2000

Medicine

Abstract The air pulsed automatic tonometer X-PERT NCT has been tested in hospitals on glaucomatous patients. This new technique avoids direct contact with the patient's eyes and therefore avoids any risk of contamination. The population studied consisted of 118 eyes of 60 patients whose intraocular pressure (I.O.P.) is measured by applanation with the Goldmann tonometer and then by the air pulsed tonometer. The average I.O.P. obtained by Goldmann tonometer is 17.5±5mmHg while by X-PERT tonometer, the average I.O.P. is 17.4 ±1.5 mmHg. Statistical analysis of these data showed a very good correlation (r=0.969) in the two methods of measurement.

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1573-2630

glaucoma ; fluorophotometry

Springer Online Journal Archives 1860-2000

Medicine

Abstract In this fluorophotometric study, in 25 eyes with middle advanced stages of glaucoma simplex (visual field defects ranged from 500 dB to 800 dB) and treated with topical antiglaucomatous agents, the posterior vitreous penetration ratio (PVPR) was compared with that from normal subjects. Vitreous fluorophotometry (Fluorotron Master, Coherent) was used to measure posterior vitreous fluorescein concentration. Due to additional fixation light in horizontal plane, three scans were taken along the following directions: temporal (t), foveal (f), nasal (n). The angle of deviation from the foveal scan was 15 degrees in each direction. The average values of posterior vitreous penetration ratio in group of patients with glaucoma were higher in comparison with those in healthy subjects. In both groups the PVPR was significantly lower in nasal (n) scan (optic disc area) in comparison with temporal (t) or foveal (f) scans (p 〈 0.05).

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1573-2630

self-tonometry ; non-contact tonometer ; intraocular pressure (IOP) ; glaucoma ; Goldmann tonometer

Springer Online Journal Archives 1860-2000

Medicine

Abstract The authors considered the possibility of using the Pulsair-Keeler non-contact tonometer in self-tonometry. For this reason, 45 patients have been trained to use the instrument and, after a reasonable trial period, were able to self-measure their IOP, The results have been compared to the tonometric values measured with Goldmann tonometer to evaluate statistically the limits and the dependability of this method of measurement. The results shows that self-tonometry with the Pulsair-Keeler tonometer can be used in monitoring glaucomatous patients at home.

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1573-2630

aqueous humor dynamics ; fluorophotometry ; glaucoma

Springer Online Journal Archives 1860-2000

Medicine

Abstract One hundred and ten eyes in 40 normal persons with no ocular pathology, 20 with ocular hypertension and 50 with primary open angle glaucoma were studied. The value of the aqueous humor flow was obtained and then compared with the different samples and with general (age, sex) and ocular factors (intraocular pressure, tonographic outflow facility, campimeter and disk/cup ratio, among others.

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1573-2630

aqueous humor flow ; fluorophotometry ; trabeculoplasty ; Yablonsky's protocol

Springer Online Journal Archives 1860-2000

Medicine

Abstract We have investigated the variations in the aqueous humor flow (F) after argon laser photocoagulation (ALT) in the trabecular meshwork. The research has been done on 60 eyes with primary open angle glaucoma within initial stages. The argon laser trabeculoplasty was made around 360 degrees in anterior trabecular meshwork with 100 burns. The flow (F) has been studied by fluorophotometry using Yablonsky's protocol. Aqueous humor flow has been measured after 24 hours and after 7 days, to determine the immediate effects of laser trabeculoplasty; and also after 6 months for the long term effects. The initial aqueous humor flow was 1.35μl/min. By means of ANOVA we found statistically significant differences on aqueous humor flow after the 7th day (F=1.67μ/min, p〈0.01), which remain six months later (F=1.71μl/min, p〈0.01). This findings suggest that the effects of argon laser trabeculoplasty, either by mechanical or biological changes in the trabecular meshwork do not appear until the 7th day and remain throughout the follow up study.

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1573-2630

automated perimetry ; maleate timolol ; mean sensitivity ; visual field

Springer Online Journal Archives 1860-2000

Medicine

Abstract This single-blind, randomized study investigated the effects of unilateral instillation of 0.5% maleate timolol twice a day for 7 days on visual-field parameters of both eyes. Twelve normal, young subjects (30.6±4.2 years) participated in this study. Using program Gl of the Octopus 500 automated perimeter, the visual fields were measured one week and one day before therapy and a third time one week after beginning therapy. The paired T-test was used for statistical analysis, where a P-value⩽0.05 indicated significance. Whereas nothing statistically significant was found in the treated eyes, the contralateral, untreated eyes showed a statistically significant decrease of mean sensitivity between the first visual fields and the third ones (P〈 0.01) This diminution of mean sensitivity in the untreated contralateral eyes may be due to statistically significant lowering of blood pressure (P〈0.01) and slowing of cardiac frequency, which were not compensated by a local decrease of intraocular pressure. If confirmed, these findings could be of clinical importance in the management of glaucoma patients, since some authors have, in some cases, recommended a unilateral therapy.

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1573-2630

bromocriptine ; dopamine ; haloperidol ; intraocular pressure ; prolactin

Springer Online Journal Archives 1860-2000

Medicine

Abstract In a double-blind randomised, prospective single dose study, we measured intraocular pressure (IOP), pupil diameter, systemic blood pressure and heart rate in 43 ocular normotensive subjects before (baseline) and 2, 4, and 6 hours after topical instillation of the following drugs: dopamine 2% (n=11), a dopamine receptor blocking drug, haloperidol 0.5% (n=11), a dopamine receptor stimulating drug, bromocriptine 0.05% (n=11) and 0.1% (n=10). In the groups receiving dopamine or haloperidol, there were no significant differences in IOP compared with baseline values (p〉0.01). But, a significant decrease in IOP compared with the baseline values was found in both bromocriptine groups (p〈0.001). With the 0.05% and 0.1% concentrations, maximum reductions in intraocular pressure were 22.0%±5.8% and 28.4%±9.8%, respectively. No significant differences in mean pupil diameter, systemic blood pressure and heart rate were detected in all of these groups. In addition, in the group receiving bromocriptine 0.1%, there was no change in serum prolactin levels. These results suggest that topically administered bromocriptine has satisfactory intraocular pressure lowering capacity without serious ocular or systemic side effects. Consequently we conclude that, an ophthalmic formulation of bromocriptine may have substantial clinical potential for the treatment of glaucoma.

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1573-2630

dopamine ; dopaminergic agonists ; dopaminergic antagonists ; IOP ; glaucoma

Springer Online Journal Archives 1860-2000

Medicine

Abstract The study refers to the clinical experiences performed with several D1 and D2 dopaminergic receptors agonists in 20 patients with high tension open angle glaucoma. The substances were administered topically as eye drops as well as an ocular eye bath. The parameter examined was intraocular pressure (IOP). The substances taken in consideration were: Dopamine, Ibopamine (dopamine analog), Fenoldopam and 3B90 (D1-receptor agonists) and Bromocriptine (dopaminergic agonist with higher affinity for D2 than for D1-receptors). It has been shown that all selective D1-receptors agonists induce a significant increase in IOP only in eyes with hydrodynamic disorders (p〈0.001). Such hypertensive effects could not be antagonized either by topically administered dopaminergic antagonists (Sulpiride, D2-receptors antagonist, and Haloperidol, non-selective dopaminergic antagonist) or by the pretreatment with the commonly used topical antiglaucomatous drugs. The only substance which proved able to inhibit the IOP increase induced by the D1-receptors agonists was the D1-selective antagonist SCH-23390, suggesting that IOP increase may be a result of a stimulation of the D1-receptors. The authors hypothesize that dopaminergic system may play a role in the regulation of aqueous humor hydrodynamics.

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1573-2630

glaucoma triple procedure ; phacoemulsification ; poly HEMA intraocular lens ; small-incision cataract surgery ; trabeculectomy

Springer Online Journal Archives 1860-2000

Medicine

Abstract In a prospective study 35 eyes of 25 patients with coexisting cataract and glaucoma underwent trabeculectomy, phacoemulsification and implantation of a folded polyHema intraocular lens through the trabeculectomy opening. Follow-up ranged from 6 to 27 months (mean 13.3). The mean age was 76.4 (68 to 88 years). 22 eyes suffered from primary open angle glaucoma, 10 eyes from a pseudoexfoliation glaucoma and 3 eyes had a chronic angle closure glaucoma. Preoperatively intraocular pressure was controlled in 10 eyes with a mean medication of 2.1 but uncontrolled in 25 eyes (mean medication: 2.5). The preoperative visual acuity ranged from 20/40 to hand motions. Postoperatively intraocular pressure was controlled (〈18 mmHg) in all (100%) eyes and without therapy in 32 (91%) eyes. Three (9%) eyes had to be treated with topical timolol twice a day after surgery. Mean intraocular pressure dropped from 21.2±6.0 mmHg preoperatively to 13.5± 2.1 mmHg postoperatively. Vision improved in all but 4 eyes, 25 (74%) achieving a visual acuity of 20/40 or better. The causes for failed improvement or deterioration of vision were senile macular degeneration in 2 eyes and central retinal vein occlusion and vascular optic nerve atrophy in one eye respectively. Postoperative complications included hyphema in 9 (26%) eyes, fibrin effusion to a various extent into the anterior chamber in 19 (54%) eyes and delayed hypotony (〈5 mmHg) with chorioidal effusion in 1 (3%) eye. Fibrin effusion was frequently observed in eyes with intraocular pressure below 10 mmHg, iris surgery and hyphema. Finally the complications did not effect the results regarding visual acuity or glaucoma control. In summary we conclude that the combination of small-incision cataract surgery and trabeculectomy is an effective surgical approach to obtain visual rehabilitation and glaucoma control with one single surgical intervention.

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1573-2630

glaucoma ; central function ; visual field damage ; mechanisms of glaucomatous damage

Springer Online Journal Archives 1860-2000

Medicine

Abstract 82 eyes of 82 patients with different types of glaucoma were examined with various psychophysical tests assessing central and paracentral function, including foveal temporal contrast sensitivity function, FM 100-Hue test, and foveal and parafoveal blue-on-yellow-sensitivity. For all eyes visual field tests were performed with the Humphrey-Field-Analyzer, program 30-2. Global visual field indices were calculated as follows: Mean Sensitivity MS, Mean Deviation MD, and Corrected Pattern Standard Deviation CPSD. Linear regression analysis and multiple regression analysis correcting for a possible influence of age between the central and paracentral criteria and the global indices was performed. For the entire study population highly significant correlations are present between foveal and parafoveal blue-on-yellow-sensitivity and MS, MD and CPSD. Whereas in the Normal Tension Glaucoma subgroup (19/82 eyes) no significant correlations are found, the subgroup of 35/82 eyes with markedly elevated intraocular pressure (≥30mmHg) shows highly statistically significant correlations between the low- and high-frequency end of the foveal temporal contrast sensitivity function and foveal and parafoveal blue-on-yellow-sensitivity and the global field indices. The results of the present study support the idea that there are two different mechanisms of glaucomatous damage, one which is pressure-dependent and one which may be pressure-independent. The pressuredependent mechanism is responsible for deficits of central or paracentral function which are correlated to overall visual field damage.

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1573-2630

glaucoma ; perimetry ; psychophysics

Springer Online Journal Archives 1860-2000

Medicine

Abstract To calibrate oculokinetic perimetry (OKP) as developed by Damato in terms of conventional perimetric threshold values, 33 eyes with either glaucoma or ocular hypertension were tested with a standard Humphrey Field Analyzer using the Central 30-2 test and twice with a 26-point OKP chart. The frequency of seeing of the OKP test spot was plotted against 30-2 thresholds. This showed a weak relation between the two tests. Subsequently eyes that were considered to have had poor fixation were omitted, but false positive and false negative results still occurred in 19 remaining eyes. To check whether Troxler's effect (local adaptation) might have caused false positives, 6 subjects were tested with OKP, controlling the fixation times. Increasing the fixation time from ‘very short’ to 2 and 5 seconds yielded more ‘not seen’ responses in OKP. False negative data were found to occur preferentially in border areas of visual field defects. The average frequency of seeing curve over all data showed a 50% frequency of seeing for the OKP stimulus at a 14.6 dB equivalent conventional threshold value. The spreading of the curve was 7 dB (95% confidence interval 28 dB).

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1573-2630

color vision tests ; glaucoma ; ocular hypertension

Springer Online Journal Archives 1860-2000

Medicine

Abstract Forty-eight patients aged from 60 to 69 years (58 eyes) with ocular hypertension (OHT) or primary open angle glaucoma (POAG) and a control group of 16 persons (31 eyes) were studied with six color vision tests: Standard Pseudoisochromatic Plates Part 2, Farnsworth Panel D 15, Farnsworth-Munsell 100-hue (FM 100) test, Lanthony Desaturated Panel, Nagel (red-green) anomaloscope, and Besançon (blue) anomalometer. In the color vision tests, the newly diagnosed OHT eyes without treatment differed significantly from the control group in the blue anomalometer. The long-term OHT eyes with treatment had no significant difference from the normals in any of the tests. The newly diagnosed POAG eyes without treatment were significantly different from the normals in the FM 100 test as well as in the boxes I, II, III and IV of the test, in the Lanthony Desaturated Panel and in the blue anomalometer. The long-term POAG eyes with treatment only differed significantly from the normal eyes in the blue anomalometer. The box IV of the FM 100 test and blue anomalometer were observed to be the most useful of these six tests in finding the possible early beginning of the blue color vision defect in the group of newly diagnosed OHT.

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1573-2630

control ; diabetic retinopathy ; glucose ; insulin dependent diabetics ; prevalence of retinopathy ; risk of retinopathy

Springer Online Journal Archives 1860-2000

Medicine

Abstract The authors analyse the data resulting from the first ophthalmological observation of 1,302 insulin dependent diabetics whose age at diagnosis is less than 30 years and who have been observed regularly by the Portuguese Diabetic Association. The prevalence of retinopathy is 41,6%; 34.3% is non-proliferative and 7.3% is proliferative. Retinopathy is more frequent in males (P〈0.001). The prevalence of retinopathy increases with the duration of diabetes and it is equal to or greater than 80% in people who have had diabetes for 10 years or more. ‘Poor’ glucose control, the coexistence of other late complications and arterial hypertension increase the risk of retinopathy (P〈0.001).

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1573-2630

cytomegalovirus ; retinitis ; ganciclovir (DHPG) ; treatment failure ; resistance ; virustatic drug ; AIDS-patients

Springer Online Journal Archives 1860-2000

Medicine

Abstract Between January 1988 and May 1991 intravenous ganciclovir (GCV) treatment was administered to eight male AIDS-patients with unilateral cytomegalovirus(CMV)-retinitis. Despite of continuous therapy with at least the recommended dose of GCV, three patients developed slowly progressive CMV-retinitis in the fellow eye after 4 to 13 months. The progression could not be stopped by GCV and thus bilateral blindness resulted after 12 to 22 months. The number of CD4-lymphocytes in the blood was reduced in all patients, but particularly in patients with progressive disease. Treatment failure was partly related to the duration of CMV-retinitis and partly to the degree of immunodeficiency. Intravenous treatment with GCV alone can not stop the progression of CMV-retinitis in long-term survivors and in those with advanced immunodeficiency.

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1573-2630

Best's vitelliform macular disease ; multifocal lesions

Springer Online Journal Archives 1860-2000

Medicine

Abstract Best's disease with multifocal lesions is rare. The authors describe four cases of multifocal vitelliform disease. The fluorescein angiographic features of macular and extramacular lesions are considered. Different stages of evolution may be present between central and extramacular lesions.

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1573-2630

glaucoma ; non-mydriatic camera ; retinal nerve fiber layer ; screening

Springer Online Journal Archives 1860-2000

Medicine

Abstract In order to evaluate the value of photographic screening in predicting progressive glaucomatous damage, we re-examined 26 subjects 5 years after the initial screening. Of the 26 patients 16 had typical glaucomatous optic disc and visual field abnormalities (n=7), retinal nerve layer damage (n=6), or other risk factors of glaucoma (n=3). In 10 of 26 patients suspected of having glaucoma, no abnormalities were initially confirmed. Of the 16 eyes with initially abnormal findings, 10 (63%) showed progressive changes during the 5-year follow-up period. The 10 initially suspected cases have remained healthy throughout the follow-up, giving a false positive rate of 5.5%. The results of this study indicate that it is possible to identify correctly patients with progressive glaucomatous changes with a non-mydriatic fundus camera.

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