New techniques: frequency doubling technology perimetry, objective perimetry and flicker and motion perimetry.
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Biomedical subjects
Publications and source records attributed to P Brusini.
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Central corneal thickness was measured by pachometry in 49 patients with primary open-angle glaucoma (POAG), 41 with ocular hypertension (OHT), 14 with normal tension glaucoma (NTG) and 48 normal subjects. The mean corneal thickness of the OHT patients was significantly greater than that of the normal control group. The NTG patients, on the other hand, had a cornea on average thinner than the normals. These differences may cause misclassification of normals with a thick cornea as ocular hypertensive eyes or, contrarywise, cause those normals whose IOP is underestimated because of a thin cornea to be classed as NTG patients.
The sensitivity of a new device, which is able to measure the thickness of the retina at the posterior pole (Retinal Thickness Analyzer), was assessed in a group of 21 glaucomatous patients, and in 24 patients with ocular hypertension. The specificity of RTA was evaluated in a control group of normal eyes. Of the glaucomatous eyes, 57.6% had a significant reduction in retinal thickness, while another 30.3% were borderline. In the ocular hypertension group, 37.5% of eyes were abnormal, and 45.8% were borderline. In the control group, no eye was abnormal, though 42.9% had borderline alterations. In many glaucomatous eyes (81.8%) there was a relationship between retinal thickness loss and visual field defects.
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Frequency-doubling perimetry (FDP) is a new, out-of-the-ordinary, visual field testing method. Its sensitivity and reliability was tested in 16 patients (32 eyes) with ocular hypertension and 21 patients (37 eyes) with early chronic glaucoma. Significant defects were found in almost 10% of hypertensive eyes and in 67.7% of glaucomatous eyes. FDP is an effective and sensitive technique for glaucoma functional loss assessment.
The ability of two methods (the Glaucoma Staging System and the Functional Score index) in estimating anatomical damage from automated visual field data was studied in 100 patients with chronic open-angle glaucoma. The level of association between functional and anatomical loss (classified by cup/disk ratio assessment) was satisfactory in both systems. Both the GSS (Glaucoma Staging System) and the FS (Functional Score) could be useful for estimating and quantifying the glaucomatous anatomical damage, both in the day-to-day clinical practice and in research.
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Continuous circular capsulorhexis is now widely used in cataract surgery. In the case of mature cataract, however, this technique may be difficult due to the poor visibility of the anterior capsule. This problem can be overcome performing capsulorhexis under air. A small amount of a high molecular weight viscoelastic agent is injected near the incision, so as to avoid air escaping from the anterior chamber. Visibility is good and the handling of the anterior capsule is easy and safe.
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A spontaneous unilateral hyphaema in a 75-year-old woman, due to bleeding from iris vessels, a remnant of the pupillary membrane, was observed. Hyphaema was completely resorbed after 24 h. Fluorescein angiography showed the presence of a blood circulation in the anomalous vessels and a diffusion of fluorescein from saccular dilatations on the inferior vessel.
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This new method, based on the use of MD and CPSD (or CLV) visual field indices, can instantly classify not only the stage of glaucomatous visual field damage, but also the type of defect (localized, generalized or mixed). This system was used to study glaucomatous visual field defects in 500 automated tests, performed with either Humphrey 30-2 or Octopus G1 threshold tests. The most common defects found were mixed, and purely local defects were very unusual, especially in advanced glaucoma.