Biomedical subjects

M A Motolko

Publications and source records attributed to M A Motolko.

4 recordsLinked to original sources

PubMed1999

Central corneal thickness in low-tension glaucoma.

BACKGROUND: It is possible that the intraocular pressure (IOP) is underestimated in eyes whose central cornea is thinner than normal. The objective of this study was to determine and establish the significance of central corneal thickness in patients with low-tension (normal-tension) glaucoma compared with those with chronic open-angle glaucoma (COAG) or ocular hypertension and healthy eyes. METHODS: The study was carried out from February 1998 to May 1999. Central corneal thickness was measured by ultrasonic pachymetry and IOP was measured by Goldmann applanation tonometry in 25 patients with low-tension glaucoma (untreated IOP less than 21 mm Hg with evidence of optic nerve head damage and corresponding visual field loss on automated perimetry), 80 patients with COAG (untreated IOP 21 mm Hg or greater with evidence of optic nerve head damage and corresponding visual field loss on automated perimetry), 16 patients with ocular hypertension (untreated IOP 21 mm Hg or greater, with normal optic nerve head and no history of glaucoma or elevated IOP, and normal visual field on automated perimetry) and 50 control subjects (untreated IOP less than 21 mm Hg with normal optic nerve head and no history of glaucoma or elevated IOP). Analysis with Pearson's product-moment correlation was performed to determine the correlation of IOP and central corneal thickness, and one-way analysis of variance was used to compare corneal thickness between groups. RESULTS: The central cornea was significantly thinner in the low-tension glaucoma group (mean 513.2 mu [standard deviation (SD) 26.1 mu]) than in the COAG group (mean 548.2 mu [SD 35.0 mu]) and the control group (mean 556.7 mu [SD 35.9 mu]) (p < 0.001). No significant difference in corneal thickness was found between the COAG and control groups. The ocular hypertension group had significantly thicker corneas (mean 597.5 mu [SD 23.6 mu]) than the three other groups (p < 0.001). INTERPRETATION: Patients with low-tension glaucoma may have thinner corneas than patients with COAG and healthy subjects. This results in underestimation of their IOP. Corneal thickness should be taken into account when managing these patients to avoid undertreatment.

Chronic Disease↗

PubMed1984

Contrast sensitivity in asymmetric glaucoma.

We measured central contrast sensitivity in both eyes of 27 patients with asymmetric glaucomatous visual field loss or optic disc cupping. In 15 patients contrast sensitivity was less in the eye that by perimetry or ophthalmoscopy was the more severely damaged. In 10 patients contrast sensitivity was the same in the two eyes. In two patients, it was impaired more in the eye with the normal visual field. However, the latter two patients had ophthalmoscopic evidence of optic nerve damage (disc hemorrhage or large cup) in the eye with the lower contrast sensitivity, even though the visual field was normal. Asymmetry of contrast sensitivity was not found in normal control subjects. These results suggest that glaucoma does alter central vision, even when visual acuity remains normal and visual field defects are far from fixation. Contrast sensitivity may be impaired by a different mechanism than that which leads to visual dield loss. Although the two types of visual dysfunction often occur together, some patients may have more severe impairment of central vision (as measured by contrast sensitivity testing) in one eye and more severe loss of peripheral vision (as measured by perimetry) in the other eye.

Glaucoma↗

PubMed1983

Baring of a circumlinear vessel in glaucoma.

We independently examined 144 optic disc stereophotographs. Despite a preliminary learning trial, we were able to agree about the presence of a circumlinear vessel in only 73% of eyes and about baring of a vessel, if present, in only 71% of eyes. Bared vessels were present in 73% of 22 glaucomatous eyes, 41% of 71 ocular hypertensive eyes, and 14% of 51 normal eyes. During several years of follow-up of 44 ocular hypertensive eyes with bared circumlinear vessels, visual field defects developed in only three. We conclude that baring of a circumlinear vessel is a difficult sign for trained observers to detect with certainty and, although present frequently in glaucoma, is of low specificity as a sign or predictor of glaucomatous damage.

Glaucoma↗

PubMed1982

Sources of variability in the results of applanation tonometry.

Sources of variability in measurements of intraocular pressure (IOP) by applanation tonometry were examined with a repeated 3 X 3 Latin square design that allowed independent extraction of variation attributable to nine patients, three observers and the order in which the observers performed the measurements. The observers, who were experienced, did not differ significantly in the general level of the IOP readings they obtained or in the variability of the readings. The effect of order was significant; there was an approximately linear decrease in IOP with successive measurements, though the difference between the first and second readings was the largest. The intrinsic variability of the IOP readings gave approximate 90% tolerance intervals of +/- 4.5 mm Hg for a single reading and +/- 3 mm Hg for the average of two readings. The mean decrement between the first and second IOP readings, 1.0 mm Hg, implies the need for a consistent protocol for successive sessions of applanation tonometry.

Adult↗