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At least 253 records · Page 14Linked to original sources
PubMed2001

Scanning laser ophthalmoscopy of the optic nerve head in exfoliation glaucoma and ocular hypertension with exfoliation syndrome.

AIMS: To study the relation between optic nerve head topography (Heidelberg retina tomograph, HRT) and disc area, visual field index mean defect (MD), and intraocular pressure (IOP), and to see whether change in HRT parameters is associated with change in MD in a prospective follow up. METHODS: 80 consecutive patients (69 patients with exfoliation glaucoma and 11 with ocular hypertension combined with exfoliation syndrome) were examined before IOP reducing intervention and prospectively followed every 6 months for 2 years. RESULTS: At the entry point, multiple regression analysis showed significant linear association between MD and all HRT parameters, when controlling for disc area. Disc area showed significant association with cup area, cup/disc area ratio, rim area, cup volume, and mean RNFL thickness. Six months after intervention IOP had decreased significantly. Reversible changes in cup area, cup/disc area ratio, rim area, cup volume, rim volume, mean cup depth, and maximum cup depth were associated with decrease in IOP. During the follow up period from 6 month to 2 years, IOP did not change significantly, and MD was used as a measure of progression of glaucoma. During this period, only cup shape measure among HRT parameters showed significant association with subsequent change in MD. CONCLUSION: Disc area should be taken into account when using HRT to compare patients. Any effect of change in IOP should be also taken into account when using HRT in follow up. Cup shape measure is a promising indicator of progression of glaucomatous damage.

Age Factors↗
PubMed1992

Prediction of cerebral ischemia by ophthalmoscopy after carotid occlusion in gerbils.

BACKGROUND AND PURPOSE: The Mongolian gerbil provides a unique model of unilateral focal cerebral ischemia because of the lack of posterior communicating arteries in all gerbils as well as an absence of an anterior communicating artery in approximately 20% of the gerbil population. It is unclear how to identify unequivocably the subpopulation of animals that would suffer a severe focal cerebral ischemia after unilateral carotid occlusion. METHODS: Ninety-three male gerbils were exposed to unilateral occlusion of the right common carotid artery. The severity of neuronal loss was evaluated histologically in gerbils selected as having significant focal ischemia based on either behavioral criteria (i.e., the demonstration of stereotypical behavior within 1 hour after occlusion) or ophthalmoscopic criteria (i.e., interruption of the retinal arterial perfusion within 10 minutes of carotid ligation as assessed with an ophthalmoscope). After 3 hours of unilateral carotid occlusion, cerebral blood flow was reinstated for 24 hours before fixation for histological analysis. The viability of the CA1 region of the hippocampus, lateral cortex, and medial cortex was scored on a scale of 0-4 based on the percentage of apparent neuronal loss (e.g., 0, no damage; 4, > 75% damage (the Viability Index). RESULTS: Twenty-eight percent of the gerbils met the behavioral selection criteria, and 17% met the ophthalmoscopic criteria. In the specimens selected by behavioral criteria (n = 7), 30% demonstrated no evidence of postischemic neuronal loss; the mean +/- SEM Viability Index scores for CA1, lateral cortex, and medial cortex were 1.6 +/- 0.6, 1.0 +/- 0.3, and 0.3 +/- 0.2, respectively. Of the animals selected by ophthalmoscopic criteria (n = 12), 100% had severe ischemic tissue damage to the ipsilateral hemisphere; the Viability Index scores for CA1, lateral cortex, and medial cortex were 3.5 +/- 0.1, 3.1 +/- 0.2, and 1.2 +/- 0.2, respectively; all scores were significantly larger than those observed in the behaviorally selected group. CONCLUSIONS: Selection of animals by ophthalmoscopic criteria provides a reliable, consistent method to predict animals with severe focal cerebral ischemia.

Animals↗
PubMed2004

Confocal scanning laser ophthalmoscopy classifiers and stereophotograph evaluation for prediction of visual field abnormalities in glaucoma-suspect eyes.

PURPOSE: To determine whether Heidelberg Retina Tomograph (HRT; Heidelberg Engineering, Dossenheim, Germany) classification techniques and investigational support vector machine (SVM) analyses can detect optic disc abnormalities in glaucoma-suspect eyes before the development of visual field abnormalities. METHODS: Glaucoma-suspect eyes (n = 226) were classified as converts or nonconverts based on the development of repeatable (either two or three consecutive) standard automated perimetry (SAP)-detected abnormalities over the course of the study (mean follow-up, approximately 4.5 years). Hazard ratios for development of SAP abnormalities were calculated based on baseline classification results, follow-up time, and end point status (convert, nonconvert). Classification techniques applied were HRT classification (HRTC), Moorfields Regression Analysis, forward-selection optimized SVM (SVM fwd) and backward elimination-optimized SVM (SVM back) analysis of HRT data, and stereophotograph assessment. RESULTS: Univariate analyses indicated that all classification techniques were predictors of the development of two repeatable abnormal SAP results, with hazards ratios (95% confidence interval [CI]) ranging from 1.32 (1.00-1.75) for HRTC to 2.0 (1.48-2.76) for stereophotograph assessment (all P < or = 0.05). Only SVM (SVM fwd and SVM back) analysis of HRT data and stereophotograph assessment were univariate predictors of the development of three repeatable abnormal SAP results, with hazard ratios (95% CI) ranging from 1.73 (1.16-2.82) for SVM fwd to 1.82 (1.19-3.12) for SVM back (both P < 0.007). Multivariate analyses including each classification technique individually in a model with age, baseline SAP pattern standard deviation [PSD], and baseline IOP indicated that all classification techniques except HRTC (P = 0.06) were predictors of the development of two repeatable abnormal SAP results with hazards ratios ranging from 1.30 (0.99, 1.73) for HRTC to 1.90 (1.37, 2.69) for stereophotograph assessment. Only SVM (SVM fwd and SVM back) analysis of HRT data and stereophotograph assessment were significant predictors of the development of three repeatable abnormal SAP results in multivariate analyses; hazard ratios of 1.57 (1.03, 2.59) and 1.70 (1.18, 2.51), respectively. SAP PSD was a significant predictor of two repeatable abnormal SAP results in multivariate models with all classification techniques, with hazard ratios ranging from 3.31 (1.39, 7.89) to 4.70 (2.02, 10.93) per 1-dB increase. CONCLUSIONS: HRT classifications techniques and stereophotograph assessment can detect optic disc topography abnormalities in glaucoma-suspect eyes before the development of SAP abnormalities. These data support strongly the importance of optic disc examination for early glaucoma diagnosis.

Adult↗
PubMed2006

Structure-function relationships using confocal scanning laser ophthalmoscopy, optical coherence tomography, and scanning laser polarimetry.

PURPOSE: To assess the strength of the association between retinal nerve fiber layer (RNFL) thickness and optic disc topography measured with confocal retinal tomography (HRT II; Heidelberg Engineering, Dossenheim, Germany), optical coherence tomography (StratusOCT; Carl Zeiss Meditec, Inc., Dublin, CA), and scanning laser polarimetry (GDx with variable corneal compensator, VCC; Carl Zeiss Meditec, Inc.), and visual field (VF) sensitivity and to determine whether this association is better expressed as a linear or nonlinear function. METHODS: One hundred twenty-seven patients with glaucoma or suspected glaucoma and 127 healthy eyes from enrollees in the Diagnostic Innovations in Glaucoma Study (DIGS) were tested on HRT II, StratusOCT, GDx VCC, and standard automated perimetry (SAP, with the Swedish Interactive Thresholding Algorithm [SITA]) within 3 months of each other. Linear and logarithmic associations between RNFL thickness (HRT II, StratusOCT, and GDx VCC) and neuroretinal rim area (HRT II) and SAP sensitivity expressed in decibels were determined globally and for six RNFL/optic disc regions (inferonasal, inferotemporal, temporal, superotemporal, superonasal, and nasal) and six corresponding VF regions (superior, superonasal, nasal, inferonasal, inferior, and temporal). RESULTS: The associations (R2) between global and regional RNFL/optic disc measurements and VF sensitivity ranged from <0.01 (temporal RNFL, nasal VF, and nasal RNFL, temporal VF; linear and logarithmic associations) to 0.26 (inferotemporal RNFL, superonasal VF; logarithmic association) for HRT II; from 0.02 (temporal RNFL, nasal VF; linear association) to 0.38 (inferotemporal RNFL, superonasal VF; logarithmic association) for OCT; and from 0.03 (temporal RNFL, nasal VF; linear association) to 0.21 (inferotemporal RNFL, superonasal VF; logarithmic association) for GDx. Structure-function relationships generally were strongest between the inferotemporal RNFL-optic disc sector and the superonasal visual field and were significantly stronger for StratusOCT RNFL thickness than for other instruments in this region. Global associations (linear and logarithmic) were significantly stronger using OCT compared with HRT. In most cases, logarithmic fits were not significantly better than linear fits when visual sensitivity was expressed in log units (i.e., decibels). CONCLUSIONS: These results suggest that structure-function associations are strongest with StratusOCT measurements and are similar between HRT II and GDx VCC and these associations are generally no better expressed logarithmically than linearly when healthy, suspect, and glaucomatous eyes are considered.

Female↗
PubMed1998

Direct ophthalmoscopy versus slit lamp biomicroscopy in diagnosis of the acute red eye.

The causes of red eye range from trivial to life-threatening, and many general practitioners are uncertain of their ability to diagnose them with the aid of an ophthalmoscope. We tested the hypothesis that, in the assessment of a patient with red eye, a doctor using a slit lamp biomicroscope would not differ in diagnostic accuracy from a doctor using a direct ophthalmoscope. A cross-over study was conducted in 98 patients newly attending an eye casualty department. 71% of diagnoses agreed exactly, and all potentially sight-threatening lesions were either diagnosed correctly or managed appropriately by doctors using an ophthalmoscope. We conclude that the initial diagnosis and management of patients with an acute red eye is not prejudiced by the lack of a slit lamp biomicroscope.

Acute Disease↗