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Alluwimi MS, Swanson WH, King BJ. A Novel Stimulus to Improve Perimetric Sampling within the Macula in Patients with Glaucoma. Optom Vis Sci 2021; 98:374-383. [PMID: 33828040 PMCID: PMC8046738 DOI: 10.1097/opx.0000000000001677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 12/23/2020] [Indexed: 11/25/2022] Open
Abstract
SIGNIFICANCE Identifying glaucomatous damage to the macula has become important for diagnosing and managing patients with glaucoma. In this study, we presented an approach that provides better perimetric sampling for the macular region, by testing four locations, with a good structure-function agreement. PURPOSE We previously presented a basis for customizing perimetric locations within the macula. In this study, we aimed to improve perimetric sampling within the macula by presenting a stimulus at four locations, with maintaining a good structure-function agreement. METHODS We tested one eye each of 30 patients (aged 50 to 88 years). Patients were selected based on observed structural damage to the macula, whereas perimetric defect (using 24-2) did not reflect the locations and extent of this damage. We used en face images to visualize retinal nerve fiber bundle defects. To measure perimetric sensitivities, we used a blob stimulus (standard deviation of 0.25°) at the 10-2 locations. A perimetric defect for a location was defined as any value equal to or deeper than -4, -5, and -6 dB below the mean sensitivity for 37 age-similar controls (aged 47 to 78 years). We also presented an elongated sinusoidal stimulus for 20 patients at four locations within the macula, in which we defined a perimetric defect as any value below the 2.5th percentile from controls. RESULTS The -4, -5, and -6 dB criteria identified perimetric defects in 14, 13, and 11 patients, respectively. When testing with the elongated stimulus, 18 patients were identified with perimetric defect. The perimetric defects were consistent with the structural damage. CONCLUSIONS The elongated stimulus showed a good structure-function agreement with only four testing locations as compared with 68 locations used with the blob stimulus. This demonstrates a clinical potential for this new stimulus in the next generation of perimetry.
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Affiliation(s)
- Muhammed S. Alluwimi
- Department of Optometry, College of Applied Medical Sciences, Qassim University, Buraidah, AlQassim, Saudi Arabia
| | | | - Brett J. King
- Indiana University School of Optometry, Bloomington, Indiana
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Mohammadzadeh V, Fatehi N, Yarmohammadi A, Lee JW, Sharifipour F, Daneshvar R, Caprioli J, Nouri-Mahdavi K. Macular imaging with optical coherence tomography in glaucoma. Surv Ophthalmol 2020; 65:597-638. [PMID: 32199939 DOI: 10.1016/j.survophthal.2020.03.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 03/10/2020] [Accepted: 03/12/2020] [Indexed: 02/07/2023]
Abstract
With the advent of spectral-domain optical coherence tomography, imaging of the posterior segment of the eye can be carried out rapidly at multiple anatomical locations, including the optic nerve head, circumpapillary retinal nerve fiber layer, and macula. There is now ample evidence to support the role of spectral-domain optical coherence tomography imaging of the macula for detection of early glaucoma. Macular spectral-domain optical coherence tomography measurements demonstrate high reproducibility, and evidence on its utility for detection of glaucoma progression is accumulating. We present a comprehensive review of macular spectral-domain optical coherence tomography imaging emerging as an essential diagnostic tool in glaucoma.
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Affiliation(s)
- Vahid Mohammadzadeh
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA
| | - Nima Fatehi
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA; Saint Mary Medical Center - Dignity Health, Long Beach, California, USA
| | - Adeleh Yarmohammadi
- Shiley Eye Institute, University of California, San Diego, La Jolla, California, United States
| | - Ji Woong Lee
- Department of Ophthalmology, Pusan National University College of Medicine, Busan, Korea
| | - Farideh Sharifipour
- Department of Ophthalmology, Shahid Beheshti university of Medical Sciences, Tehran, Iran
| | - Ramin Daneshvar
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Joseph Caprioli
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA
| | - Kouros Nouri-Mahdavi
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA.
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Firan AM, Iancu RC, Bujor IA, Ciuluvică RC, Tudosescu R, Ungureanu E, Pașca IG, Voinea L, Istrate S. The role of Visual Evoked Potential (VEP) in monitoring the progression and in guiding the treatment of glaucoma patients with poor compliance. Rom J Ophthalmol 2020; 64:205-212. [PMID: 32685788 PMCID: PMC7339685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objectives: The objectives of the present study were to analyze the possibility of using pattern VEPs (VEP of pattern type) in glaucoma patients and their role in the follow-up and coordination/ management of anti-glaucoma treatment. Patients and Methods: This is a prospective study on 54 eyes of 30 consecutive glaucoma patients, whose compliance capacity did not allow automatic perimetry and OCT scan to be carried out. The patients were divided into two groups: group A - the study group and group B - the control group. All patients underwent FO exam and pachymetry, plus VEP exam for group A patients. Patients were analyzed at the initial visit and at 1 month, 3, 6, 12 months. Statistical analysis was made using t-test, ANOVA, Fisher test and Pearson correlation coefficient. Results: These participants presented a positive correlation between C/ D ratio and the latency of the P100 wave at 1 degree and a negative correlation between C/ D ratio and the amplitude of the P100 wave both at 1 degree (60 arc minutes) and at 0.25 degrees (15 arc minutes). During the study, the values of the latent P100 changed statistically at 6 months and at 1 year. Using all the data, the authors of the study considered it necessary to modify the treatment for 2 patients out of 13 in group B and for 9 patients out of 16 in group A (p = 0,02892). Conclusions: VEP supplies additional/ further data that significantly help guiding the treatment and monitoring the progression, therefore, it should be part of the routine examination for these patients. Further studies are necessary to deepen our understanding of the visual evoked potentials utility.
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Affiliation(s)
| | | | - Inna Adriana Bujor
- Department of Ophthalmology, University Emergency Hospital, Bucharest, Romania
| | | | - Ruxandra Tudosescu
- Department of Ophthalmology, “Regina Maria” Private Health Care, Bucharest, Romania
| | - Emil Ungureanu
- Department of Ophthalmology, University Emergency Hospital, Bucharest, Romania
| | | | - Liliana Voinea
- Department of Ophthalmology, University Emergency Hospital, Bucharest, Romania
| | - Sînziana Istrate
- Department of Ophthalmology, “Regina Maria” Private Health Care, Bucharest, Romania
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Majoor JEA, Vermeer KA, Andrinopoulou ER, Lemij HG. Contrast-to-Noise Ratios for Assessing the Detection of Progression in the Various Stages of Glaucoma. Transl Vis Sci Technol 2019; 8:8. [PMID: 31114714 PMCID: PMC6504842 DOI: 10.1167/tvst.8.3.8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 01/29/2019] [Indexed: 11/24/2022] Open
Abstract
Purpose We determine the contrast-to-noise ratios (CNRs) of structural and functional measurements to assess their sensitivity to detect progression in the various stages of glaucoma. Methods We calculated the CNRs for the mean peripapillary retinal nerve fiber layer (RNFL) thickness measured by spectral domain optical coherence tomography, and the mean deviation (MD) and visual field index (VFI) determined by standard automated perimetry for the transitions between five stages. Longitudinal data from healthy and glaucomatous eyes from a prospective study were used. Contrast was defined as the change in the mean value of the parameter between two successive stages. Noise was defined as the variability of the parameter and calculated from the residuals of linear regression on the data from five subsequent visits per eye. Results We studied 205 eyes from 125 participants (46% men, 54% women). CNRs for different parameters varied considerably across the range of disease severity (0.8–12.2). The RNFL thickness had a higher CNR in the transition from normal to mild glaucoma (12.2) compared to the CNRs of the functional measures (MD 4.1, VFI 4.5). The CNRs for the functional measures were higher in the transition from moderate to advanced (MD 5.2, VFI 5.8) and advanced to severe glaucoma (MD 7.2, VFI 5.8) compared to the RNFL thickness (CNR 0.8 and 3.2, respectively). Conclusions The RNFL thickness is more sensitive for detecting glaucomatous progression at the onset of glaucoma compared to the functional measures, while the latter are more sensitive for detecting progression in the later stages of glaucoma. Translational Relevance The CNR method can be used to determine which measurement is most sensitive for detecting progression in glaucoma, differentiated for the severity of the disease. Furthermore, it creates a basic toolset for determining the most sensitive measurement in detecting progression not only in glaucoma, but other (ophthalmic) diseases as well.
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Affiliation(s)
- Juleke E A Majoor
- Rotterdam Ophthalmic Institute, The Rotterdam Eye Hospital, PO Box 70030, 3000 LM Rotterdam, The Netherlands
| | - Koenraad A Vermeer
- Rotterdam Ophthalmic Institute, The Rotterdam Eye Hospital, PO Box 70030, 3000 LM Rotterdam, The Netherlands
| | | | - Hans G Lemij
- Glaucoma Service, The Rotterdam Eye Hospital, PO Box 70030, 3000 LM Rotterdam, The Netherlands
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Abstract
SIGNIFICANCE Measurements of the macula have been increasingly used to diagnose and manage patients with glaucoma. Asymmetry analysis was clinically introduced to assess damage to the macular ganglion cells in patients with glaucoma, but its effectiveness is limited by high normal between-subject variability. PURPOSE We aimed to reduce the high normal between-subject variability and improve the potential of asymmetry analysis to identify glaucomatous damage to the macula. METHODS Twenty patients with glaucoma (aged 57 to 85 years) and 30 age-similar control subjects (aged 53 to 89 years) were recruited from a longitudinal glaucoma study. Participants were imaged with the Spectralis OCT using the posterior pole protocol; measurements of the averaged retinal thickness and ganglion cell layer (GCL) thickness were obtained. We established three zones per hemifield within the central ±9°, based on the lowest between-subject variability that we previously found and the course of retinal nerve fiber layer projections. The criteria for flagging abnormality were at least two contiguous zones when P < 5% or one zone when P < 1% with two-tailed tests. RESULTS Between-subject variability of the asymmetry analysis for both retinal and GCL thicknesses remained lower than that of the average thickness across each zone in control subjects (F > 2.52, P < .01). Asymmetry analysis of retinal and GCL thicknesses flagged 16 and 18 of 20 patients, respectively. CONCLUSIONS Between-subject variability was reduced in control subjects using the three zones; our criteria identified glaucomatous damage to the macula in most of the patients. We used high-density B-scans to confirm the patterns of the glaucomatous damage we found in this study.
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Mapping the Structure-Function Relationship in Glaucoma and Healthy Patients Measured with Spectralis OCT and Humphrey Perimetry. J Ophthalmol 2018; 2018:1345409. [PMID: 29850196 PMCID: PMC5932487 DOI: 10.1155/2018/1345409] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 02/15/2018] [Accepted: 03/01/2018] [Indexed: 11/23/2022] Open
Abstract
Purpose To study the structure-function relationship in glaucoma and healthy patients assessed with Spectralis OCT and Humphrey perimetry using new statistical approaches. Materials and Methods Eighty-five eyes were prospectively selected and divided into 2 groups: glaucoma (44) and healthy patients (41). Three different statistical approaches were carried out: (1) factor analysis of the threshold sensitivities (dB) (automated perimetry) and the macular thickness (μm) (Spectralis OCT), subsequently applying Pearson's correlation to the obtained regions, (2) nonparametric regression analysis relating the values in each pair of regions that showed significant correlation, and (3) nonparametric spatial regressions using three models designed for the purpose of this study. Results In the glaucoma group, a map that relates structural and functional damage was drawn. The strongest correlation with visual fields was observed in the peripheral nasal region of both superior and inferior hemigrids (r = 0.602 and r = 0.458, resp.). The estimated functions obtained with the nonparametric regressions provided the mean sensitivity that corresponds to each given macular thickness. These functions allowed for accurate characterization of the structure-function relationship. Conclusions Both maps and point-to-point functions obtained linking structure and function damage contribute to a better understanding of this relationship and may help in the future to improve glaucoma diagnosis.
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Alluwimi MS, Swanson WH, Malinovsky VE, King BJ. A basis for customising perimetric locations within the macula in glaucoma. Ophthalmic Physiol Opt 2018; 38:164-173. [PMID: 29315706 PMCID: PMC5887979 DOI: 10.1111/opo.12435] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 11/23/2017] [Indexed: 11/27/2022]
Abstract
PURPOSE It has been recognised that the 24-2 grid used for perimetry may poorly sample the macula, which has been recently identified as a critical region for diagnosing and managing patients with glaucoma. We compared data derived from patients and controls to investigate the efficacy of a basis for customising perimetric locations within the macula, guided by en face images of retinal nerve fibre layer (RNFL) bundles. METHODS We used SD-OCT en face montages (www.heidelbergengineering.com) of the RNFL in 10 patients with glaucoma (ages 56-80 years, median 67.5 years) and 30 age-similar controls (ages 47-77, median 58). These patients were selected because of either the absence of perimetric defect while glaucomatous damage to the RNFL bundles was observed, or because of perimetric defect that did not reflect the extent and locations of the glaucomatous damage that appeared in the RNFL images. We used a customised blob stimulus for perimetric testing (a Gaussian blob with 0.25° standard deviation) at 10-2 grid locations, to assess the correspondence between perimetric defects and damaged RNFL bundles observed on en face images and perimetric defects. Data from the age-similar controls were used to compute total deviation (TD) and pattern deviation (PD) values at each location; a perimetric defect for a location was defined as a TD or PD value of -0.5 log unit or deeper. A McNemar's test was used to compare the proportions of locations with perimetric defects that fell outside the damaged RNFL bundles, with and without accounting for displacement of ganglion cell bodies. RESULTS All patients but one had perimetric defects that were consistent with the patterns of damaged RNFL bundles observed on the en face images. We found six abnormal perimetric locations of 2040 tested in controls and 132 abnormal perimetric locations of 680 tested in patients. The proportions of abnormal locations that fell outside the damaged RNFL bundles, with and without accounting for displacement of the ganglion cell bodies were 0.08 and 0.07, respectively. The difference between the two proportions did not reach statistical significance (p = 0.5 for a one-tailed test). CONCLUSIONS We demonstrated that it is effective to customise perimetric locations within the macula, guided by en face images of the RNFL bundles. The perimetric losses found with a 10-2 grid demonstrated similar patterns as the damaged RNFL bundles observed on the en face images.
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Affiliation(s)
| | | | | | - Brett J King
- School of Optometry, Indiana University, Bloomington, USA
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Comparing the Rates of Retinal Nerve Fiber Layer and Ganglion Cell-Inner Plexiform Layer Loss in Healthy Eyes and in Glaucoma Eyes. Am J Ophthalmol 2017; 178:38-50. [PMID: 28315655 DOI: 10.1016/j.ajo.2017.03.008] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 03/03/2017] [Accepted: 03/06/2017] [Indexed: 12/11/2022]
Abstract
PURPOSE To compare the rates of circumpapillary retinal nerve fiber layer (RNFL) and macular retinal ganglion cell-inner plexiform layer (GCIPL) change over time in healthy and glaucoma eyes. DESIGN Cohort study. METHODS The rates of circumpapillary RNFL and macular GCIPL loss in 28 healthy subjects and 97 glaucoma subjects from the Diagnostic Innovations in Glaucoma Study (DIGS) were compared using mixed-effects models. RESULTS The median follow-up time and number of visits were 1.7 years and 6 visits and 3.2 years and 7 visits for healthy and glaucoma eyes, respectively. Significant rates of loss of both global circumpapillary RNFL and average macular GCIPL thickness were detectable in early and moderate glaucoma eyes; in severe glaucoma eyes, rates of average macular GCIPL loss were significant, but rates of global circumpapillary RNFL loss were not. In glaucoma eyes, mean rates of global circumpapillary RNFL thickness change (-0.98 μm/year [95% confidence interval (CI), -1.20 to -0.76]) and normalized global circumpapillary RNFL change (-1.7%/year [95% CI, -2.1 to -1.3]) were significantly faster than average macular GCIPL change (-0.57 μm/year [(95% CI, -0.73 to -0.41]) and normalized macular GCIPL change (-1.3%/year [95% CI, -1.7 to -0.9]). The rates of global and inferior RNFL change were weakly correlated with global and inferior macular GCIPL change (r ranges from 0.16 to 0.23, all P < .05). CONCLUSIONS In this cohort, the rate of circumpapillary RNFL thickness change was faster than macular GCIPL change for glaucoma eyes. Global circumpapillary RNFL thickness loss was detectable in early and moderate glaucoma, and average macular GCIPL thickness loss was detectable in early, moderate, and severe glaucoma, suggesting that structural changes can be detected in severe glaucoma.
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Waisbourd M, Gensure RH, Aminlari A, Shah SB, Khanna N, Sood N, Molineaux J, Gonzalez A, Myers JS, Katz LJ. Short-duration transient visual evoked potentials and color reflectivity discretization analysis in glaucoma patients and suspects. Int J Ophthalmol 2017; 10:254-261. [PMID: 28251085 DOI: 10.18240/ijo.2017.02.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 10/21/2016] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate the use of short-duration transient visual evoked potentials (VEP) and color reflectivity discretization analysis (CORDA) in glaucomatous eyes, eyes suspected of having glaucoma, and healthy eyes. METHODS The study included 136 eyes from 136 subjects: 49 eyes with glaucoma, 45 glaucoma suspect eyes, and 42 healthy eyes. Subjects underwent Humphrey visual field (VF) testing, VEP testing, as well as peripapillary retinal nerve fiber layer optical coherence tomography imaging studies with post-acquisition CORDA applied. Statistical analysis was performed using means and ranges, ANOVA, post-hoc comparisons using Turkey's adjustment, Fisher's Exact test, area under the curve, and Spearman correlation coefficients. RESULTS Parameters from VEP and CORDA correlated significantly with VF mean deviation (MD) (P<0.05). In distinguishing glaucomatous eyes from controls, VEP demonstrated area under the curve (AUC) values of 0.64-0.75 for amplitude and 0.67-0.81 for latency. The CORDA HR1 parameter was highly discriminative for glaucomatous eyes vs controls (AUC=0.94). CONCLUSION Significant correlations are found between MD and parameters of short-duration transient VEP and CORDA, diagnostic modalities which warrant further consideration in identifying glaucoma characteristics.
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Affiliation(s)
- Michael Waisbourd
- Wills EyeHospital Glaucoma Research Center, Philadelphia, PA 19107, USA
| | - Rebekah H Gensure
- Wills EyeHospital Glaucoma Research Center, Philadelphia, PA 19107, USA
| | - Ardalan Aminlari
- Wills EyeHospital Glaucoma Research Center, Philadelphia, PA 19107, USA
| | - Sonya B Shah
- Wills EyeHospital Glaucoma Research Center, Philadelphia, PA 19107, USA
| | - Nitasha Khanna
- Wills EyeHospital Glaucoma Research Center, Philadelphia, PA 19107, USA
| | - Neil Sood
- Wills EyeHospital Glaucoma Research Center, Philadelphia, PA 19107, USA
| | - Jeanne Molineaux
- Wills EyeHospital Glaucoma Research Center, Philadelphia, PA 19107, USA
| | | | - Jonathan S Myers
- Wills EyeHospital Glaucoma Research Center, Philadelphia, PA 19107, USA
| | - L Jay Katz
- Wills EyeHospital Glaucoma Research Center, Philadelphia, PA 19107, USA
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FALLAHI MOTLAGH B, SADEGHI A. Correlation between Macular Thickness and Visual Field in Early Open Angle Glaucoma: A Cross-Sectional Study. MEDICAL HYPOTHESIS, DISCOVERY & INNOVATION OPHTHALMOLOGY JOURNAL 2017; 6:56-62. [PMID: 29367936 PMCID: PMC5776503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/29/2022]
Abstract
The aim of this study was to correlate macular thickness and visual field parameters in early glaucoma. A total of 104 eyes affected with early glaucoma were examined in a cross-sectional, prospective study. Visual field testing using both standard automated perimetry (SAP) and shortwave automated perimetry (SWAP) was performed. Global visual field parameters, including mean deviation (MD) and pattern standard deviation (PSD), were recorded and correlated with spectral domain optical coherence tomography (SD-OCT)-measured macular thickness and asymmetry. Average macular thickness correlated significantly with all measures of visual field including MD-SWAP (r = 0.42), MD-SAP (r = 0.41), PSD-SWAP (r = -0.23), and PSD-SAP (r = -0.21), with P-values <0.001 for all correlations. The mean MD scores (using both SWAP and SAP) were significantly higher in the eyes with thin than in those with intermediate average macular thickness. Intraeye (superior macula thickness - inferior macula thickness) asymmetries correlated significantly with both PSD-SWAP (r = 0.63, P < 0.001) and PSD-SAP (r = 0.26, P = 0.01) scores. This study revealed a significant correlation between macular thickness and visual field parameters in early glaucoma. The results of this study should make macular thickness measurements even more meaningful to glaucoma specialists.
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Affiliation(s)
| | - Ali SADEGHI
- Ophthalmology Department, Tabriz University of Medical Science, Tabriz, Iran
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Rosenberg R, Marill AF, Fenolland JR, El Chehab H, Delbarre M, Maréchal M, Mouinga Abayi A, Giraud JM, Renard JP. [Evaluation of the new Canon HS-100 SD-OCT: Reproducibility of macular ganglion cell complex (GCC) thickness measurement in normal, hypertensive and glaucomatous eyes]. J Fr Ophtalmol 2015; 38:832-43. [PMID: 26494495 DOI: 10.1016/j.jfo.2015.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 03/01/2015] [Accepted: 03/09/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE To evaluate intra- and interobserver reproducibility of macular GCC thickness measurement by automated segmentation on the Canon HS-100 SD-OCT (Tokyo, Japan) in normal (N), hypertensive (OHT) and glaucomatous eyes. METHODS A total of 179 eyes of 93 patients were included: 90 N, 28 OHT and 36 early glaucoma and 25 advanced glaucoma. All patients underwent a complete ophthalmologic exam, central corneal thickness and 24-2 standard automated perimetry (HFA SITA standard). Each of two observers performed three macular acquisitions with the Canon OCT HS-100. Acquisitions were analyzed with the Glaucoma 3D mode, which estimated the macular GCC thickness in global, superior and inferior hemisectors, and in eight separate macular areas. Reproducibility was assessed by intraclass correlation coefficient (ICC), coefficient of variation (CV) and test-retest variability (TRTV) calculated as 1.96 times the standard deviation. RESULTS Mean GCC thickness was respectively 92.4 μm, 89.0 μm, 80.7 μm and 71.2 μm in N, OHT, early and advanced glaucomatous eyes. In all groups, intra- and interobserver reproducibility ranged respectively for ICC from 89.8 to 99.8% and from 90.2 to 99.4%, for CV from 0.43 to 1.95% and from 0.58 to 2.16% and for TRTV from 0.8 to 3.22 μm and from 1.04 to 3.53 μm. GCC thickness measurements using the new HS-100 SD-OCT were highly reproducible. However, in the advanced glaucoma group, while the reproducibility of GCC thickness measurement is good in the average, superior and inferior hemisectors of the macula, it was slightly less for the paracentral sectors, especially inferior. These sectors correspond generally to the areas most affected by glaucoma. CONCLUSION The reproducibility of GCC thickness measurements using the new Canon HS-100 SD-OCT is high for normal, OHT, and glaucomatous eyes. It is thus a reliable and reproducible ancillary test available to the clinician for the examination of glaucomatous optic neuropathies.
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Affiliation(s)
- R Rosenberg
- Service d'ophtalmologie, hôpital d'instruction des armées du Val-de-Grâce, 74, boulevard de Port-Royal, 75005 Paris, France.
| | - A-F Marill
- Service d'ophtalmologie, hôpital d'instruction des armées du Val-de-Grâce, 74, boulevard de Port-Royal, 75005 Paris, France
| | - J-R Fenolland
- Service d'ophtalmologie, hôpital d'instruction des armées du Val-de-Grâce, 74, boulevard de Port-Royal, 75005 Paris, France
| | - H El Chehab
- Service d'ophtalmologie, hôpital d'instruction des armées Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
| | - M Delbarre
- Service d'ophtalmologie, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France
| | - M Maréchal
- Service d'ophtalmologie, hôpital d'instruction des armées du Val-de-Grâce, 74, boulevard de Port-Royal, 75005 Paris, France
| | - A Mouinga Abayi
- Service d'ophtalmologie, hôpital d'instruction des armées du Val-de-Grâce, 74, boulevard de Port-Royal, 75005 Paris, France
| | - J-M Giraud
- Service d'ophtalmologie, hôpital d'instruction des armées du Val-de-Grâce, 74, boulevard de Port-Royal, 75005 Paris, France
| | - J-P Renard
- Service d'ophtalmologie, hôpital d'instruction des armées du Val-de-Grâce, 74, boulevard de Port-Royal, 75005 Paris, France
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Gao E, Chen B, Yang J, Shi F, Zhu W, Xiang D, Chen H, Zhang M, Chen X. Comparison of Retinal Thickness Measurements between the Topcon Algorithm and a Graph-Based Algorithm in Normal and Glaucoma Eyes. PLoS One 2015; 10:e0128925. [PMID: 26042671 PMCID: PMC4456408 DOI: 10.1371/journal.pone.0128925] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Accepted: 05/01/2015] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To assess the correlation and agreement between the Topcon built-in algorithm and our graph-based algorithm in measuring the total and regional macular thickness for normal and glaucoma subjects. METHODS A total of 228 normal eyes and 93 glaucomatous eyes were enrolled in our study. All patients underwent comprehensive ophthalmic examination and Topcon 3D-OCT 2000 scan. One eye was randomly selected for each subject. The thickness of each layer and the total and regional macular thickness on an Early Treatment of Diabetic Retinopathy Study (ETDRS) chart were measured using the Topcon algorithm and our three-dimensional graph-based algorithm. Correlation and agreement analyses between these two algorithms were performed. RESULTS Our graph search algorithm exhibited a strong correlation with Topcon algorithm. The macular GCC thickness values for normal and glaucoma subjects ranged from 0.86 to 0.91 and from 0.78 to 0.90, and the regional macular thickness values ranged from 0.79 to 0.96 and 0.70 to 0.95, respectively. Small differences were observed between the Topcon algorithm and our graph-based algorithm. The span of 95% limits of agreement of macular GCC thickness was less than 28 μm in both normal and glaucoma subjects, respectively. These limits of total and regional macular thickness were 15.5 μm and 23.1 μm for normal subjects and 29.1 μm and 46.4 μm for glaucoma subjects, respectively. CONCLUSION Our graph-based algorithm exhibited a high degree of agreement with the Topcon algorithm with respect to thickness measurements in normal and glaucoma subjects. Moreover, our graph-based algorithm can segment the retina into more layers than the Topcon algorithm does.
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Affiliation(s)
- Enting Gao
- School of Electronic and Information Engineering, Soochow University, Suzhou, China
- School of Electronic and Information Engineering, Suzhou University of Science and Technology, Suzhou, China
| | - Binyao Chen
- Joint Shantou International Eye Center, Shantou University and the Chinese University of Hong Kong, Shantou, China
| | - Jianling Yang
- Joint Shantou International Eye Center, Shantou University and the Chinese University of Hong Kong, Shantou, China
| | - Fei Shi
- School of Electronic and Information Engineering, Soochow University, Suzhou, China
| | - Weifang Zhu
- School of Electronic and Information Engineering, Soochow University, Suzhou, China
| | - Dehui Xiang
- School of Electronic and Information Engineering, Soochow University, Suzhou, China
| | - Haoyu Chen
- Joint Shantou International Eye Center, Shantou University and the Chinese University of Hong Kong, Shantou, China
| | - Mingzhi Zhang
- Joint Shantou International Eye Center, Shantou University and the Chinese University of Hong Kong, Shantou, China
- * E-mail:
| | - Xinjian Chen
- School of Electronic and Information Engineering, Soochow University, Suzhou, China
- * E-mail:
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Ledolter AA, Monhart M, Schoetzau A, Todorova MG, Palmowski-Wolfe AM. Structural and functional changes in glaucoma: comparing the two-flash multifocal electroretinogram to optical coherence tomography and visual fields. Doc Ophthalmol 2015; 130:197-209. [PMID: 25616700 DOI: 10.1007/s10633-015-9482-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 01/15/2015] [Indexed: 01/05/2023]
Abstract
PURPOSE To correlate multifocal electroretinogram (mfERG) findings in the macular area of glaucoma patients with automated perimetry (visual fields) and with optical coherence tomography (OCT). METHODS A two-global flash mfERG (VERIS™) was recorded in 20 eyes with primary open-angle glaucoma. The root mean square was calculated, and three response epochs were analysed: the direct component (15-45 ms) and two induced components (IC-1 at 45-75 ms and IC-2 at 75-105 ms). The central 10° of the mfERG was compared to the central 10° of the OCT and of the visual field. Responses grouped in a superior and in an inferior semicircle, extending between 10° and 20°, were also compared to the corresponding areas of the OCT and of the visual fields. In addition, the area of the papillomacular bundle was also analysed separately. RESULTS In glaucoma patients, mfERG responses showed a significant positive association with retinal thickness in the central 10° for IC2 (p = 0.001) and a trend for IC1 (p = 0.066). A significant association was found between the central IC1 and IC2 of the mfERG and corresponding perimetric sensitivities expressed in linear units (p < 0.01). The OCT showed a positive association with visual field sensitivities (p < 0.05) in all areas examined (p < 0.05). Separation of the papillomacular bundle area did not improve structure-function association further. CONCLUSIONS In our study, mfERG showed a statistically significant correlation with perimetric sensitivity measured in linear units and with structural macular changes detected with time-domain OCT.
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Affiliation(s)
- Anna A Ledolter
- Department of Ophthalmology, University of Basel, Basel, Switzerland,
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Rates and Patterns of Macular and Circumpapillary Retinal Nerve Fiber Layer Thinning in Preperimetric and Perimetric Glaucomatous Eyes. J Glaucoma 2015; 24:278-85. [DOI: 10.1097/ijg.0000000000000046] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
PURPOSE To elucidate the relationship between macular retinal thickness and corresponding superior or inferior visual hemifield defects in glaucoma patients. METHODS Thirty-nine eyes of 39 patients with open-angle glaucoma showed superior or inferior hemifield defects (superior hemifield defects, 27 eyes; inferior hemifield defects, 12 eyes). We measured the retinal thickness of the parafovea and fovea centralis corresponding to a defect or an apparently normal hemifield by spectral domain optical coherence tomography. We then analyzed the relationship between the retinal thickness corresponding to an apparently normal hemifield and the severity of the glaucomatous visual field defect on the other side of the same eye. RESULTS We found that the retinal thickness of the parafovea and fovea centralis significantly decreased, as the hemifield defect increased. The retinal thickness of the parafovea, the inner sector, outer sector, and inner and outer sectors, corresponding to the apparently normal hemifields significantly decreased with the progression of the hemifield defect on the other side. The mean±SD age of patients was 66.5±9.1 years and the refraction was -1.3±2.4 D. CONCLUSIONS Macular retinal thickness decreases with a corresponding visual hemifield defect in glaucoma patients. Retinal structural changes precede the loss of the visual field in the apparently normal side.
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Kulkarni SV, Coupland SG, Stitt DM, Hamilton J, Brownstein JJ, Damji KF. Efficacy of SLO-Microperimetry and Humphrey for evaluating macular sensitivity changes in advanced glaucoma. Can J Ophthalmol 2014; 48:406-12. [PMID: 24093188 DOI: 10.1016/j.jcjo.2013.08.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 07/30/2013] [Accepted: 08/08/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To compare the efficacy of scanning laser ophthalmoscope microperimetry (SLO-MP) and Humphrey visual fields in detecting macular sensitivity changes in advanced glaucoma. DESIGN Prospective cohort study. PARTICIPANTS 25 patients with advanced primary open angle glaucoma and 2 consecutive abnormal Humphrey 10-2 SITA Standard visual field tests. METHODS Thirty-six eyes of 25 patients with 2 consecutive abnormal Humphrey 10-2 SITA Standard (H10) visual fields were retested with a modified 10-2 SLO-MP within 3 months of the last reliable H10. A standardized grid was used to mark the macula. Primary outcome was change in mean macular sensitivity (dB; H10 and SLO-MP) in relation to mean macular retinal nerve fibre layer (RNFL) thickness (µm) by SLO- optical coherence tomography (SLO-OCT). Secondary outcome was comparison of reliability indices for both tests. Linear regression was used for analysis. RESULTS Mean macular sensitivity was significantly lower in SLO-MP (9.33 ± 3.37 dB) than H10 (18.83 ± 6.46 dB; p < 0.0001). Mean macular RNFL thickness correlated significantly with retinal sensitivity by both SLO-MP (r = 0.39, p < 0.02) and H10 (r = 0.37, p < 0.03). Fixation losses were better controlled in SLO-MP (0.38 ± 1.1) than H10 (4.28 ± 7.9; p = 0.008). False-positive responses were similar (SLO-MP: 2.25 ± 4.53, H10: 1.78 ± 3.33; p = 0.80). A statistically significant difference was noted in the false-negative responses (SLO-MP: 26.87 ± 25.24, H10: 5.33 ± 9.70; p < 0.0001). CONCLUSIONS Macular sensitivity determined by both H10 and SLO-MP correlates significantly with mean macular RNFL thickness measured by SLO-OCT. Precise localization of the macula in SLO-MP results in lower fixation losses. Detection of denser field defects by SLO-MP results in higher false-negative responses. A larger sample size is needed to further study the value of this diagnostic tool.
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Affiliation(s)
- Sadhana V Kulkarni
- University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Ont.
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Sharma A, Agarwal P, Sathyan P, Saini VK. Macular Thickness Variability in Primary Open Angle Glaucoma Patients using Optical Coherence Tomography. J Curr Glaucoma Pract 2014; 8:10-4. [PMID: 26997801 PMCID: PMC4741156 DOI: 10.5005/jp-journals-10008-1154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 10/06/2013] [Indexed: 11/23/2022] Open
Abstract
Aim: To compare the difference of retinal macular thickness and macular volume using optical coherence tomography (OCT) in primary open angle glaucoma (POAG) patients with the normal subjects. Materials and methods: This observational case control study included primary open angle glaucoma (POAG) patients (n = 124 eyes) and healthy subjects in the control group (n = 124 eyes). All subjects underwent detailed history, general and systemic exami -nation. Complete ocular examination included best corrected visual acuity (BCVA), slit lamp examination, intraocular pressure (IOP), central corneal thickness, gonioscopy, dilated fundus biomicroscopy. Field analysis was done by white on white Humphrey Field Analyzer (Carl Zeiss). Optical coherence tomography imaging of macular area was performed using Stratus OCT (OCT 3, Version 4, Carl Zeiss Inc, Dublin, California, USA). In both these groups, parameters analyzed were macular thickness, inner macular thicknesses (IMT), outer macular thicknesses (OMT), central macular thick ness (CMT) and total macular volume (TMV). Results: The POAG group had significantly decreased values of TMV, OMT and IMT, compared to control group, while there was no difference in CMT, presumably due to absence of ganglion cells in the central part. Thus, macular thickness and volume parameters may be used for making the diagnosis of glaucoma especially in patients with abnormalities of disc. Conclusion: Macular thickness parameters correlated well with the diagnosis of glaucoma. How to cite this article: Sharma A, Agarwal P, Sathyan P, Saini VK. Macular Thickness Variability in Primary Open Angle Glaucoma Patients using Optical Coherence Tomography. J Current Glau Prac 2014;8(1):10-14.
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Affiliation(s)
- Anjali Sharma
- Assistant Professor, Department of Ophthalmology, People's College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India
| | - Prakashchand Agarwal
- Assistant Professor, Department of Ophthalmology, People's College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India
| | - P Sathyan
- Professor and Head, Department of Ophthalmology, Sathyan Eye Care Hospital and Coimbatore Glaucoma Foundation, Coimbatore, Tamil Nadu, India
| | - V K Saini
- Professor and Head, Department of Ophthalmology, People's College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India
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Structural and functional assessment by hemispheric asymmetry testing of the macular region in preperimetric glaucoma. Jpn J Ophthalmol 2013; 58:197-204. [PMID: 24318011 DOI: 10.1007/s10384-013-0293-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 11/01/2013] [Indexed: 10/25/2022]
Abstract
PURPOSE To investigate structural measurements of the macular area in preperimetric glaucoma (PG) patients using spectral domain optical coherence tomography with two functional measurements [10-2 Humphrey visual field (HFA) and 10-2 Microperimeter-1 (MP-1)] and by macular symmetry testing. METHODS Fifteen eyes of 15 PG subjects with a retinal nerve fiber layer defect in the inferior hemisphere and 15 eyes of 15 normal control subjects were enrolled. Macular symmetry testing was performed between the superior and inferior zones by comparing zone thickness in each hemisphere. Perimetric sensitivity asymmetry was calculated with two functional measurements. Structure-function relationships between macular symmetry testing and the mean retinal sensitivity of the corresponding hemifield or perimetric sensitivity asymmetry were calculated using Spearman's rank correlation and linear regression. RESULTS Macular zone thickness in the abnormal hemispheres was significantly less than that in normal hemispheres in PG eyes and the corresponding hemispheres in control eyes (P < 0.001). Macular symmetry testing was significantly lower in PG eyes compared to control eyes (P < 0.001). HFA (10-2) and MP-1 (10-2) correlated significantly (rs = 0.81, P < 0.0001). Macular symmetry testing values were significantly correlated with perimetric sensitivity and perimetric sensitivity asymmetry with two functional measurements (rs = 0.61, P = 0.02; HFA and rs = 0.68, P = 0.006; MP-1). CONCLUSIONS Our results suggest that macular asymmetry analysis can reveal the structure-functional relationship in PG eyes.
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Francoz M, Fenolland JR, Giraud JM, El Chehab H, Sendon D, May F, Renard JP. Reproducibility of macular ganglion cell–inner plexiform layer thickness measurement with cirrus HD-OCT in normal, hypertensive and glaucomatous eyes. Br J Ophthalmol 2013; 98:322-8. [DOI: 10.1136/bjophthalmol-2012-302242] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Agrawal S, Singh V, Bhasker SK, Sharma B. Correlation of visual functions with macular thickness in primary open angle glaucoma. Oman J Ophthalmol 2013; 6:96-8. [PMID: 24082667 PMCID: PMC3779423 DOI: 10.4103/0974-620x.116640] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Aim: The aim of this study was to establish a correlation between macular thickness on optical coherence tomography (OCT) and 2 visual functions (visual acuity and contrast sensitivity [CS]) in established cases of primary open angle glaucoma (POAG). Materials and Methods: A total of 50 consecutive patients of established POAG between 40 years and 70 years of age attending the glaucoma clinic of a tertiary care eye center in North India were enrolled for this cross-sectional study. Best corrected visual acuity (BCVA), CS and macular thickness by spectral-domain-OCT (Cirrus HD-OCT, CarlZeiss, Germany) were evaluated. Statistical Analysis: The groups were compared together by one factor analysis of variance and the significance of mean difference between the groups was done by Newman-Keuls test. Results: Newman-Keuls test revealed a direct relationship of macular thickness to BCVA and CS (P < 0.05). Conclusion: BCVA and CS are directly related to the macular thickness on OCT.
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Affiliation(s)
- Siddharth Agrawal
- Department of Ophthalmology, King Georges' Medical University, Lucknow, Uttar Pradesh, India
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The 2-global flash mfERG in glaucoma: attempting to increase sensitivity by reducing the focal flash luminance and changing filter settings. Doc Ophthalmol 2012. [DOI: 10.1007/s10633-012-9360-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
PURPOSE To investigate the correlation between structural and functional damage in patients with asymmetric glaucoma using a newly developed short duration transient visual evoked potential (SD-tVEP) device. METHODS Twenty-five patients with visual acuity ≥20/30 and asymmetric visual field (VF) loss [inter-eye difference in mean deviation index (MD) of at least 3 dB] were enrolled. Patients underwent optical coherence tomography (OCT) for macular thickness measurement, scanning laser polarimetry with variable corneal compensation for retinal nerve fiber layer measurement, and SD-tVEP (10% and 85% Michelson contrast, acquisition time of 20 s) in both eyes within 2 months. We correlated VF MD and structural test results with SD-tVEP P100 latency and Delta Amplitude (N75-P100). RESULTS Using 10% contrast, there was a significant difference in SD-tVEP latency and amplitude between eyes with better and worse VF MD (P<0.001). MD correlated significantly with both SD-tVEP parameters (r>0.33, P≤0.01). When using 85% contrast, SD-tVEP amplitude differed between eyes (P=0.01) and MD values correlated significantly with amplitude results (r=0.32, P=0.01), but not with latency (P=0.46). In eyes with more advanced VF loss, there was a positive and significant correlation between SD-tVEP amplitude (85% contrast) and macular thickness on OCT (r=0.47, P=0.01), but not with retinal nerve fiber layer measured with polarimetry (P=0.26). CONCLUSIONS In cases of asymmetric glaucoma, SD-tVEP results correlate significantly with the level of VF damage as measured by MD. In the eyes with more advanced VF loss, reduced SD-tVEP amplitude was associated with decreased macular thickness on OCT. These findings suggest that SD-tVEP may be a fast and objective method to assess or screen for functional damage in glaucomatous eyes.
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Adhi M, Aziz S, Muhammad K, Adhi MI. Macular thickness by age and gender in healthy eyes using spectral domain optical coherence tomography. PLoS One 2012; 7:e37638. [PMID: 22629435 PMCID: PMC3357395 DOI: 10.1371/journal.pone.0037638] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Accepted: 04/26/2012] [Indexed: 11/21/2022] Open
Abstract
Purpose To determine normal macular thickness and its variation by age and gender in healthy eyes using spectral-domain optical coherence tomography (SD-OCT). Methods In this cross-sectional analysis, two hundred and twenty eyes of 220 healthy subjects underwent raster scanning using Topcon SD-OCT system, at the Department of Ophthalmology, Dow University of Health Sciences and Civil Hospital Karachi, Pakistan. Macular thickness from all 9 regions of the ETDRS map was documented for each subject. Variations in macular thickness measurements by age and gender were determined. Results The 220 subjects had a mean age of 45.3 years (16–80 years). Using the ETDRS map, foveal thickness for all subjects was measured to be 229±20.46 µm. Mean macular thickness for all subjects was 262.8±13.34 µm. Male gender was associated with greater foveal (p<0.0001) and mean macular (p<0.0001) thickness compared to females. There was no association of mean macular thickness (r2 = 0.01; p>0.05) and foveal thickness (r2 = 0.00004; p>0.05) with age. Conclusion We have provided normative data for macular thickness using Topcon SD-OCT system. Our results are comparable to some and vary from other reports using the similar OCT system. Our results suggest that male gender is associated with greater macular thickness, while macular thickness has no association with age in healthy eyes. This is the first normative data for macular thickness from Pakistan; benchmark for diagnosing and monitoring macular pathologies. The values obtained in this study may be useful for comparison with other populations, other SD-OCT systems and future imaging technologies.
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Affiliation(s)
- Mehreen Adhi
- Department of Ophthalmology, Dow University of Health Sciences and Civil Hospital, Karachi, Pakistan
- New England Eye Center, Tufts Medical Center, Boston, Massachusetts, United States of America
| | - Sumbul Aziz
- Department of Ophthalmology, Dow University of Health Sciences and Civil Hospital, Karachi, Pakistan
| | - Kashif Muhammad
- Department of Ophthalmology, Dow University of Health Sciences and Civil Hospital, Karachi, Pakistan
| | - Mohammad I. Adhi
- Department of Ophthalmology, Dow University of Health Sciences and Civil Hospital, Karachi, Pakistan
- * E-mail:
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Detection of progressive macular thickness loss using optical coherence tomography in glaucoma suspect and glaucomatous eyes. Eye (Lond) 2012; 26:983-91. [PMID: 22576828 DOI: 10.1038/eye.2012.76] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
AIMS To examine the rate of macular thickness loss using time-domain optical coherence tomography (OCT) in functionally progressing versus non-progressing eyes, determined by standard automated perimetry (SAP). METHODS Glaucoma suspects (GS) and glaucomatous (G) eyes underwent SAP and OCT imaging every 6 months. Functional progression was determined using pointwise linear regression, defined as 2 contiguous locations losing ≥1.0 dB/year at P<1.0% in the same hemifield. The annual rate of macular thickness loss was calculated from inner and outer regions of the macular map. RESULTS 72 eyes (43 GS and 29G) with ≥30 months of follow-up were enrolled. Fourteen eyes demonstrated SAP progression. The annual rate of macular thickness loss (μm/year) in progressing eyes was faster (all P<0.05) than non-progressing eyes in temporal outer (-1.90±2.97 vs 0.33±2.77), nasal inner (-1.70±2.66 vs 0.14±2.76), superior inner (-2.15±4.57 vs 0.51±2.99), temporal inner quadrants (-2.58±5.05 vs -0.38±2.34), and the average of inner macular quadrants (-1.84±2.90 vs 0.03±2.10). The rate of loss in the nasal inner (P=0.02) and temporal outer (P=0.02) macular regions was associated with optic disc haemorrhage. CONCLUSIONS Eyes with SAP progression have significantly greater rates of macular thickness loss consistent with glaucomatous retinal ganglion cell atrophy, as compared with non-progressing eyes.
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Raza AS, Cho J, de Moraes CGV, Wang M, Zhang X, Kardon RH, Liebmann JM, Ritch R, Hood DC. Retinal ganglion cell layer thickness and local visual field sensitivity in glaucoma. ACTA ACUST UNITED AC 2012; 129:1529-36. [PMID: 22159673 DOI: 10.1001/archophthalmol.2011.352] [Citation(s) in RCA: 149] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To compare loss in sensitivity measured using standard automated perimetry (SAP) with local retinal ganglion cell layer (RGC) thickness measured using frequency-domain optical coherence tomography in the macula of patients with glaucoma. METHODS To compare corresponding locations of RGC thickness with total deviation (TD) of 10-2 SAP for 14 patients with glaucoma and 19 controls, an experienced operator hand-corrected automatic segmentation of the combined RGC and inner plexiform layer (RGC+IPL) of 128 horizontal B-scans. To account for displacement of the RGC bodies around the fovea, the location of the SAP test points was adjusted to correspond to the location of the RGC bodies rather than to the photoreceptors, based on published histological findings. For analysis, RGC+IPL thickness vs SAP (TD) data were grouped into 5 eccentricities, from 3.4° to 9.7° radius on the retina with respect to the fovea. RESULTS The RGC+IPL thickness correlated well with SAP loss within approximately 7.2° of the fovea (Spearman ρ = 0.71-0.74). Agreement was worse (0.53-0.65) beyond 7.2°, where the normal RGC layer is relatively thin. A linear model relating RGC+IPL thickness to linear SAP loss provided a reasonable fit for eccentricities within 7.2°. CONCLUSION In the central 7.2°, local RGC+IPL thickness correlated well with local sensitivity loss in glaucoma when the data were adjusted for RGC displacement.
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Affiliation(s)
- Ali S Raza
- Department of Psychology, Columbia University, 1190 Amsterdam Ave, 405 Schermerhorn Hall, Room 301, New York, NY 10027-7004, USA
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Na JH, Kook MS, Lee Y, Yu SJ, Choi J. Detection of macular and circumpapillary structural loss in normal hemifield areas of glaucomatous eyes with localized visual field defects using spectral-domain optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 2011; 250:595-602. [DOI: 10.1007/s00417-011-1864-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Revised: 11/02/2011] [Accepted: 11/08/2011] [Indexed: 11/25/2022] Open
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Use of microperimetry to compare macular light sensitivity in eyes with open-angle and angle-closure glaucoma. Jpn J Ophthalmol 2011; 56:138-44. [PMID: 22160406 DOI: 10.1007/s10384-011-0111-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Accepted: 11/02/2011] [Indexed: 10/14/2022]
Abstract
PURPOSE Use of microperimetry to compare macular light sensitivity in early and moderate primary open-angle glaucoma (POAG), chronic angle-closure glaucoma (CACG), and normal controls. PATIENTS AND METHODS A cross-sectional, case-control, comparative study. A total of 126 eyes from 126 subjects, 53 normal eyes, 50 POAG eyes, and 23 CACG eyes were studied. A macular 10° program was performed with MP-1 microperimetry. The mean sensitivities (MS) of the central 2°, 6°, and 10° visual fields were compared among the POAG, CACG, and normal controls. The mean light sensitivities of the four quadrants in the central 6° were also analyzed in each group. RESULTS The MS of the central 2°, 6°, 10°, and total macular areas in the POAG patients were significantly reduced compared with those for the normal controls (all P < 0.05). The MS of the central 6°, 10°, and total areas, except those at the central 2°, in the CACG patients were significantly reduced. In the central 6°, more severe loss of MS was observed in the inferotemporal quadrant in the POAG group. In the CACG group, the reduction in the MS among the four quadrants was not significantly different (P = 0.623). CONCLUSIONS Different patterns of macular function damage were identified in both early and moderate stage POAG and in CACG patients.
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Mwanza JC, Oakley JD, Budenz DL, Chang RT, Knight OJ, Feuer WJ. Macular ganglion cell-inner plexiform layer: automated detection and thickness reproducibility with spectral domain-optical coherence tomography in glaucoma. Invest Ophthalmol Vis Sci 2011; 52:8323-9. [PMID: 21917932 DOI: 10.1167/iovs.11-7962] [Citation(s) in RCA: 311] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To demonstrate the capability of SD-OCT to measure macular retinal ganglion cell-inner plexiform layer (GCIPL) thickness and to assess its reproducibility in glaucomatous eyes. METHODS Fifty-one glaucomatous eyes (26 mild, 11 moderate, 14 severe) of 51 patients underwent macular scanning using the Cirrus HD-OCT (Carl Zeiss Meditec, Dublin, CA) macula 200×200 acquisition protocol. Five scans were obtained on 5 days within 2 months. The ganglion cell analysis (GCA) algorithm was used to detect the macular GCIPL and to measure the thickness of the overall average, minimum, superotemporal, superior, superonasal, inferonasal, inferior, and inferotemporal GCIPL. The reproducibility of the measurements was evaluated with intraclass correlation coefficients (ICCs), coefficients of variation (COVs), and test-retest standard deviations (TRTSDs). RESULTS Segmentation and measurement of GCIPL thickness were successful in 50 of 51 subjects. All ICCs ranged between 0.94 and 0.98, but ICCs for average and superior GCIPL parameters (0.97-0.98) were slightly higher than for inferior GCIPL parameters (0.94-0.97). All COVs were <5%, with 1.8% for average GCIPL and COVs for superior GCIPL parameters (2.2%-3.0%) slightly lower than those for inferior GCIPL parameters (2.5%-3.6%). The TRTSD was lowest for average GCIPL (1.16 μm) and varied from 1.43 to 2.15 μm for sectoral GCIPL CONCLUSIONS: The Cirrus HD-OCT GCA algorithm can successfully segment macular GCIPL and measure GCIPL thickness with excellent intervisit reproducibility. Longitudinal monitoring of GCIPL thickness may be possible with Cirrus HD-OCT for assessing glaucoma progression.
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Affiliation(s)
- Jean-Claude Mwanza
- Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Florida, USA
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Hood DC, Raza AS, de Moraes CGV, Odel JG, Greenstein VC, Liebmann JM, Ritch R. Initial arcuate defects within the central 10 degrees in glaucoma. Invest Ophthalmol Vis Sci 2011; 52:940-6. [PMID: 20881293 DOI: 10.1167/iovs.10-5803] [Citation(s) in RCA: 130] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To better understand the relationship between the spatial patterns of functional (visual field [VF] loss) and structural (axon loss) abnormalities in patients with glaucomatous arcuate defects largely confined to the central 10° on achromatic perimetry. METHODS Eleven eyes (9 patients) with arcuate glaucomatous VF defects largely confined to the macula were selected from a larger group of patients with both 10-2 and 24-2 VF tests. Eyes were included if their 10-2 VF had an arcuate defect and if the 24-2 test was normal outside the central 10° (i.e., did not have a cluster of three contiguous points within a hemifield). For the structural analysis, plots of retinal nerve fiber layer (RNFL) thickness of the macula were obtained with frequency-domain optical coherence tomography (fdOCT). The optic disc locations of the RNFL defects were identified on peripapillary fdOCT scans. RESULTS The VF arcuate defects extended to within 1° of fixation on the 10-2 test and were present in the superior hemifield in 10 of the 11 eyes. The arcuate RNFL damage, seen in the macular fdOCT scans of all 11 eyes, involved the temporal and inferior temporal portions of the disc on the peripapillary scans. CONCLUSIONS Glaucomatous arcuate defects of the macula's RNFL meet the disc temporal to the peak of the main arcuate bundles and produce a range of macular VF defects from clear arcuate scotomas to a papillofoveal horizontal step ("pistol barrel scotoma"). If RGC displacement is taken into consideration, the RNFL and VF defects can be compared directly.
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Affiliation(s)
- Donald C Hood
- Departments of Psychology, Columbia University, New York, NY 10027, USA.
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Wittström E, Schatz P, Lövestam-Adrian M, Ponjavic V, Bergström A, Andréasson S. Improved retinal function after trabeculectomy in glaucoma patients. Graefes Arch Clin Exp Ophthalmol 2009; 248:485-95. [PMID: 19865823 DOI: 10.1007/s00417-009-1220-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2009] [Accepted: 10/05/2009] [Indexed: 10/20/2022] Open
Abstract
PURPOSE To investigate retinal function after reduction of intraocular pressure (IOP) by filtration surgery in patients with medically uncontrolled glaucoma. METHODS Eleven patients (11 eyes) with medically uncontrolled glaucoma underwent trabeculectomy. Clinical investigation, visual field (testing with standard automated perimetry (SAP-Humphrey), optical coherence tomography (OCT), full-field electroretinography (full-field ERG) and multifocal electroretinography (mfERG) were performed preoperatively as well as 2 and 6 months after surgery. DESIGN Interventional prospective, consecutive case series. RESULTS No significant reduction was seen in mean log MAR visual acuity 2 or 6 months after filtration surgery. The mean preoperative intraocular pressure of 27.1 (+/-6.2) mmHg decreased to 19.0(+/-6.1) mmHg 2 months after surgery and to 17.1 (+/- 3.4) mmHg 6 months after surgery (both p = 0.001). The reduction in IOP significantly decreased the number of anti-glaucoma agents used, from 3.7 +/- 1.6 at baseline to 0.8 +/- 0.9 2 months after surgery and to 1.3 +/- 1.2 6 months after surgery (p = 0.004 and p = 0.008 respectively). The results of SAP, OCT and full-field ERG did not show any significant difference between pre- and postoperative values at any point in time. No significant improvement was found with regard to the first positive peak (P(1)) amplitudes in the macular retina (area 1) or in the perimacular retina/periphery (area 2) when measured with mfERG 2 months after surgery. The mfERG examinations revealed significantly improved P(1) amplitudes 6 months after surgery in both area 1 and area 2, compared with the preoperative values (p = 0.042 and p = 0.014 respectively). The implicit time of P(1) decreased significantly 6 months after surgery in area 2 compared with the preoperative values (p = 0.023). CONCLUSION A significant lowering of IOP seems to improve the function of the central retina, as demonstrated by increased amplitudes and reduced implicit times assessed with mfERG.
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Wang M, Hood DC, Cho JS, Ghadiali Q, De Moraes CG, De Moraes GV, Zhang X, Ritch R, Liebmann JM. Measurement of local retinal ganglion cell layer thickness in patients with glaucoma using frequency-domain optical coherence tomography. ACTA ACUST UNITED AC 2009; 127:875-81. [PMID: 19597108 DOI: 10.1001/archophthalmol.2009.145] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To explore the feasibility of obtaining a local measurement of the thickness of the retinal ganglion cell layer in patients with glaucoma using frequency-domain optical coherence tomography (fdOCT) and a computer-aided manual segmentation procedure. METHODS The fdOCT scans were obtained from the horizontal midline for 1 eye of 26 patients with glaucoma and 20 control subjects. The thickness of various layers was measured with a manual segmentation procedure aided by a computer program. The patients were divided into low- and high-sensitivity groups based on their foveal sensitivity on standard automated perimetry. RESULTS The RGC plus inner plexiform and the retinal nerve fiber layers of the low-sensitivity group were significantly thinner than those of the high-sensitivity group. While these layers were thinner in the patients than the controls, the thicknesses of inner nuclear layer and receptor layer were similar in all 3 groups. Further, the thinning of the retinal ganglion cell plus inner plexiform layer in 1 glaucoma-affected eye showed qualitative correspondence to the loss in 10-2 visual field sensitivity. CONCLUSIONS Local measures of RGC layer thickness can be obtained from fdOCT scans using a manual segmentation procedure, and these measures show qualitative agreement with visual field sensitivity.
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Affiliation(s)
- Min Wang
- Department of Psychology, Columbia University, New York, NY 10027, USA
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Moon SW, Kim ES, Kim YG, Yoo SY, Kwak HW. The Comparison of Macular Thickness Measurements and Repeatabilities Between Time Domain and Spectral Domain OCT. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2009. [DOI: 10.3341/jkos.2009.50.7.1050] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Sung Woon Moon
- Department of Ophthalmology, Medical College of Kyung Hee University, Seoul, Korea
| | - Eung Suk Kim
- Department of Ophthalmology, Medical College of Chung-Ang University, Seoul, Korea
| | - Young Gyun Kim
- Department of Ophthalmology, Medical College of Kyung Hee University, Seoul, Korea
| | - Seung Young Yoo
- Department of Ophthalmology, Medical College of Kyung Hee University, Seoul, Korea
| | - Hyung Woo Kwak
- Department of Ophthalmology, Medical College of Kyung Hee University, Seoul, Korea
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Abstract
PURPOSE The relationship between race and macular thickness remains unknown. This relationship may be important for early and accurate diagnosis of macular disease and glaucoma, and may also provide insight into disease mechanisms. In this study, we compared macular thickness in healthy eyes of black and white subjects using optical coherence tomography (Stratus OCT). METHODS This study used a matched, cross-sectional design. Subjects underwent OCT macular thickness map scanning in each eye, four-field, 45-degree digital retinal imaging in each eye, and blood pressure measurement. Retinal images were evaluated for absence of posterior pole disorders, including macular and optic nerve disease. Retinal thickness was evaluated in the central fovea, and in rings placed at 1, 3, and 6 mm from fixation. RESULTS Compared with whites (n = 7), blacks (n = 7) had significantly thinner total foveal thickness (TFT, retinal thickness in the central 1 mm diameter area; OD: p < 0.03; OS: p < 0.02; OU average: p < 0.02), and thinner total macular thickness (TMT, retinal thickness in 6mm diameter area excluding central foveal thickness; OS: p < 0.02; OU average: p < 0.03). There was a trend for central foveal thickness (retinal thickness at fixation) to be thinner in blacks than whites (OD: p = 0.12; OS: p = 0.08). There was no significant difference in macular thickness between right and left eyes. CONCLUSIONS Retinal thickness as measured by Stratus OCT in the fovea and macula is significantly thinner in blacks compared with age-matched whites. Larger multiracial prospective studies are needed to confirm these results and to evaluate the need for race-specific normative values.
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Chen J, Lee L. Clinical applications and new developments of optical coherence tomography: an evidence-based review. Clin Exp Optom 2008; 90:317-35. [PMID: 17697178 DOI: 10.1111/j.1444-0938.2007.00151.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Optical coherence tomography (OCT) is a new imaging modality that has increasingly become an indispensable tool in clinical practice for the diagnosis and management of ocular diseases involving the macula, optic nerve and anterior segment. The instrument is an advanced imaging technique that provides unprecedented high resolution and cross-sectional tomographic images of the ocular microstructure in situ, and in real time. Since its introduction about four years ago, a multitude of advantages has made OCT an essential instrument in ophthalmic imaging. The technique has fast image acquisition speed and non-contact, non-invasive applicability, allowing a non-excisional 'optical biopsy' to be performed. The purpose of this paper is to provide an evidence-based review of the increasing role of OCT in the diagnosis and management of ocular disorders, particularly in age-related macular degeneration, diabetic macular oedema, macular hole, epiretinal membrane and glaucoma. Being one of the first users of OCT in Australia, our clinical experiences will be highlighted and clinical examples of various conditions will be presented to provide an overview of the immense implications of OCT in practice. The latest developments of the OCT revolution, in relation to combining OCT with fundus photography and scanning laser ophthalmoscopy, will also be described. New developments of three-dimensional visualisation of tissue morphology with future models of ultra-high speed, ultra-high resolution OCT may further enhance the early diagnosis, monitoring of disease progression and assessment of treatment efficacy, facilitated by this powerful technology.
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Affiliation(s)
- Jennifer Chen
- City Eye Centre, School of Optometry and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
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Zeimer R. Nature is teaching us to be humble in our quest to measure structure and function in glaucoma. Br J Ophthalmol 2006; 91:2-3. [PMID: 17179118 PMCID: PMC1857555 DOI: 10.1136/bjo.2006.104356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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