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Hanai K, Hashimoto M, Nakamura H. Tuberculum meningioma with recovery of glaucoma-like visual field defects after chiasmal decompression: a case report. BMC Ophthalmol 2024; 24:68. [PMID: 38355425 PMCID: PMC10868030 DOI: 10.1186/s12886-024-03332-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 01/29/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND To report a case of tuberculum meningioma with recovery of glaucoma-like visual field defects after chiasmal decompression. CASE PRESENTATION A 39-year-old woman presenting with headache was found to have bilateral arcuate retinal nerve fiber layer (RNFL) thinning on optical coherence tomography (OCT) with a corresponding arcuate scotomas consistent with glaucomatous change. However a suprasellar tumor compressing the anterior chiasm from below was found on magnetic resonance imaging of the brain. After resection of the mass, which was diagnosed as meningothelial meningioma by the pathological examination, the glaucoma-like visual field defects resolved despite the RNFL thinning on the OCT showing no improvement. CONCLUSIONS Chiasmal compression may mimic glaucoma and produce arcuate scotoma rather than temporal visual field loss. There is a possibility that the development of chiasmal compression somehow converted preperimetric glaucoma into a more advanced form accompanied by visual field defects and that the glaucoma reverted to the preperimetric state after chiasmal decompression.
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Affiliation(s)
- Kaori Hanai
- Department of Ophthalmology, Nakamura Memorial Hospital, S-1, W-14, Chuo-ku, 060-8570, Sapporo, Japan.
| | - Masato Hashimoto
- Department of Ophthalmology, Nakamura Memorial Hospital, S-1, W-14, Chuo-ku, 060-8570, Sapporo, Japan
| | - Hirohiko Nakamura
- Department of Neurosurgery, Nakamura Memorial Hospital, S-1, W-14, Chuo-ku, Sapporo, Japan
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Mehta B, Ranjan S, Sharma V, Singh N, Raghav N, Dholakia A, Bhargava R, Reddy PLS, Bargujar P. The Discriminatory Ability of Ganglion Cell Inner Plexiform Layer Complex Thickness in Patients with Preperimetric Glaucoma. J Curr Ophthalmol 2023; 35:231-237. [PMID: 38681693 PMCID: PMC11047817 DOI: 10.4103/joco.joco_124_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 05/01/2024] Open
Abstract
Purpose To evaluate diagnostic performance of ganglion cell inner plexiform layer (GCIPL) and retinal nerve fiber layer (RNFL) parameters measured with Cirrus high-definition optical coherence tomography (OCT) in patients with preperimetric glaucoma. Methods In this multicenter cross-sectional study, 150 eyes of 83 patients with preperimetric glaucoma were compared with 200 eyes of age and sex matched healthy subjects. All patients had visual field testing and OCT scanning of GCIPL and RNFL in all quadrants. The independent Samples t-test was used to determine if a difference exists between the means of two independent groups on a continuous dependent variable. The area under the receiver operating characteristic (ROC) curve (AUC) of each parameter was calculated for discriminatory ability between normal controls and preperimetric glaucoma. The sensitivity and specificity were estimated by point coordinates on ROC curve. Results The best parameters for distinguishing preperimetric glaucoma from healthy eyes were the combined average GCIPL + average RNFL, followed by average RNFL + GCIPL (inferotemporal), and average RNFL + GCIPL (minimum). The GCIPL parameters with the highest to lowest AUC (in decreasing order) were inferotemporal, followed by average, minimum, superior, inferior, superonasal, inferonasal, superotemporal, and quadrants. The RNFL parameters with the highest to lowest AUC (in decreasing order) were average, followed by nasal, temporal, superior, and inferior quadrants. The sensitivity of combined GCIPL + RNFL parameters ranged 85%-88% and the specificity ranged 76%-88%. The sensitivity for RNFL parameters ranged 80%-90% and the specificity ranged 64%-88%. Conclusion GCIPL and RNFL have good discriminatory ability; the sensitivity and specificity increase when both parameters are combined for early detection of glaucoma.
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Affiliation(s)
- Bhavya Mehta
- Department of Ophthalmology, GS Medical College and Hospital, Hapur, Uttar Pradesh, India
| | - Somesh Ranjan
- Department of Ophthalmology, Santosh Medical College, Ghaziabad, Uttar Pradesh, India
| | - Vinod Sharma
- Department of Ophthalmology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
| | - Neha Singh
- Department of Ophthalmology, GS Medical College and Hospital, Hapur, Uttar Pradesh, India
| | - Nidhi Raghav
- Department of Ophthalmology, Santosh Medical College, Ghaziabad, Uttar Pradesh, India
| | - Acid Dholakia
- Department of Ophthalmology, Santosh Medical College, Ghaziabad, Uttar Pradesh, India
| | - Rahul Bhargava
- Department of Ophthalmology, GS Medical College and Hospital, Hapur, Uttar Pradesh, India
| | | | - Pooja Bargujar
- Department of Ophthalmology, GS Medical College and Hospital, Hapur, Uttar Pradesh, India
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Cennamo G, Malvone E, Marotta M, Breve MA, Costagliola C. Study of choroidal vasculature in open angle glaucoma patients. Photodiagnosis Photodyn Ther 2022; 40:103182. [PMID: 36368450 DOI: 10.1016/j.pdpdt.2022.103182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/27/2022] [Accepted: 10/28/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE To investigate the vessel density (VD) of the choriocapillary (CC) plexus in patients affected by preperimetric glaucoma (PPG), advanced glaucoma (AG) and in a healthy control group using Optical Coherence Tomography Angiography (OCTA) in order to clarify the pathogenetic mechanisms of this disease. METHODS In this prospective observational study, 19 eyes from 19 patients affected by preperimetric glaucoma (PPG) and 18 eyes from 18 patients affected by advanced glaucoma were studied from January 2022 to May 2022 at the University of Naples "Federico II". These patients had been compared with 20 eyes of 20 healthy subjects that represented the control group. All subjects underwent EDI-OCT to assess the subfoveal choroidal thickness (SFCT). OCTA was used to evaluate the vessel density (VD) of the CC in whole image in the studies groups. RESULTS The PPG and AG groups showed a statistically significant reduction in CC vessel density parameters with respect to controls (p < 0.001). Regarding EDI OCT results AG patients exhibited a statistically significant increase in the SFCT compared to healthy controls (p < 0.001). Whereas,no statistically significant difference was between the PPG groups and to healthy controls (p 0.851). CONCLUSIONS CC vessel density could represent a helpful and sensible biomarker to identify early choroidal microvascular changes in PPG and MCI in order to better understand the vascular pathophysiological mechanisms involved in glaucoma diseases.
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Affiliation(s)
- Gilda Cennamo
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy; Department of Public Health, University of Naples Federico II, Via S. Pansini 5, Naples 80133, Italy.
| | - Emanuele Malvone
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Maddalena Marotta
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy; Department of Public Health, University of Naples Federico II, Via S. Pansini 5, Naples 80133, Italy
| | - Maria Angelica Breve
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Ciro Costagliola
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
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Montorio D, Criscuolo C, Breve MA, Lanzillo R, Salvatore E, Morra VB, Cennamo G. Radial peripapillary vessel density as early biomarker in preperimetric glaucoma and amnestic mild cognitive impairment. Graefes Arch Clin Exp Ophthalmol 2022; 260:2321-8. [PMID: 35064364 DOI: 10.1007/s00417-022-05561-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 12/08/2021] [Accepted: 01/11/2022] [Indexed: 01/15/2023] Open
Abstract
PURPOSE To investigate the vessel density (VD) of the radial peripapillary capillary (RPC) plexus in patients affected by preperimetric glaucoma (PPG), amnestic mild cognitive impairment (aMCI) and in a healthy control group using optical coherence tomography angiography (OCTA) in order to clarify the pathogenetic mechanisms of these neurodegenerative diseases. METHODS In this prospective study, we studied 54 eyes of 54 patients with PPG, 54 eyes of 54 patients with aMCI and 54 healthy controls. All subjects underwent structural spectral domain optical coherence tomography (SD)-OCT to assess the ganglion cell complex (GCC) and the retinal nerve fibre layer (RNFL). OCTA was used to evaluate the VD of the RPC in different regions (whole image, inside disc and peripapillary). RESULTS The PPG and aMCI groups showed a statistically significant reduction in SD-OCT and parameters with respect to controls (p < 0.001). No statistically significant difference was found in GCC and RNFL parameters between the two study groups (p > 0.05). At OCTA examination, PPG and aMCI patients exhibited a statistically significant reduction in the VD of the RPC in whole image, inside and peripapillary regions compared to healthy controls (p < 0.001). When comparing the two study groups, the OCTA parameters were significantly impaired in PPG with respect to aMCI patients. Significant correlations were found between structural OCT and OCTA parameters in PPG and aMCI groups (p < 0.05). CONCLUSIONS RPC vessel density could represent a helpful and sensible biomarker to identify early retinal microvascular changes in PPG and MCI in order to better understand the vascular pathophysiological mechanisms involved in these neurodegenerative diseases.
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Chen MJ, Yang HY, Chang YF, Hsu CC, Ko YC, Liu CJL. Diagnostic ability of macular ganglion cell asymmetry in Preperimetric Glaucoma. BMC Ophthalmol 2019; 19:12. [PMID: 30621639 PMCID: PMC6325869 DOI: 10.1186/s12886-018-1019-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 12/26/2018] [Indexed: 11/21/2022] Open
Abstract
Background To evaluate the diagnostic ability of macular ganglion cell asymmetry to diagnose preperimetric glaucoma (PPG), using Cirrus spectral domain optical coherence tomography (OCT). Methods This prospective study included 67 eyes of 67 patients with PPG and 67 eyes of 67 age- and refractive error-matched controls. We measured circumpapillary RNFL (cpRNFL) thickness, macular ganglion cell-inner plexiform layer (GCIPL) thickness and optic nerve head (ONH) parameters using OCT. Macular ganglion cell asymmetries were expressed as absolute difference and ratios between inferior hemisphere and superior hemisphere, inferotemporal (IT) and superotemporal (ST), IT and superonasal (SN), IT and inferonasal (IN), ST and IN as well as temporal and nasal. An asymmetry index was assigned by taking the absolute value of log10 of the ratio. The area under the receiver operating characteristics curve (AUROC), partial AUROC (pAUROC) ≥ specificities 90 and 95%, cutoff values and sensitivities at specificities 90 and 95% was analyzed. Results Parameters with largest AUROCs were IT GCIPL thickness (0.784), average RNFL thickness (0.767), and average C/D (0.746). For macular asymmetry parameters, log IT/SN index had the largest AUROC (0.734), followed by log IT/IN index (0.725), and absolute difference of IT−SN GCIPL thickness (0.715). Performance was comparable between the best measures of asymmetry analysis (log IT/SN index) and those of cpRNFL, GCIPL, and ONH parameters (all P > 0.05). The IT/SN asymmetry index not only had the largest pAUROC based on the pAUROCs ≥90 and 95% specificity (0.044 and 0.019) but also had the highest diagnostic sensitivity at 90 and 95% specificities (52.2 and 46.3%). Conclusions GCIPL asymmetry measurements have diagnostic ability comparable to cpRNFL, GCIPL, and ONH analysis for PPG. The best macular ganglion cell asymmetry parameter was IT/SN asymmetry index, which could be a new parameter to detect early structural changes in PPG. Electronic supplementary material The online version of this article (10.1186/s12886-018-1019-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mei-Ju Chen
- Department of Ophthalmology, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei, 11217, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Hsin-Yu Yang
- Department of Ophthalmology, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei, 11217, Taiwan
| | - Yu-Fan Chang
- Department of Ophthalmology, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei, 11217, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chih-Chien Hsu
- Department of Ophthalmology, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei, 11217, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Chieh Ko
- Department of Ophthalmology, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei, 11217, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Catherine Jui-Ling Liu
- Department of Ophthalmology, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei, 11217, Taiwan. .,School of Medicine, National Yang-Ming University, Taipei, Taiwan.
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Abstract
Purpose: To present a revised interpretation of the work-up data that enabled diagnosis of preperimetric glaucoma (PPG) at the first examination. Methods: a) Literature analysis on PPG; b) 6-year follow-up of a glaucoma-suspect patient. Results: Two new concepts may be adapted: (a) the objective finding of retinal nerve fiber layer (RNFL) thinning below the normal border in the opposing typical glaucoma locations, the inferior and superior quadrants, and in a non-diffuse pattern, appears asymptomatically and simultaneously only in glaucoma; and (b) the imaging-related RNFL thickness may be considered the reference glaucoma standard, whereas the suspicious early glaucomatous optic neuropathy, having a potential diagnostic inaccuracy, would serve as a complementary revealing finding. That approach enabled, in retrospect, a first-visit diagnosis of low-tension PPG in the patient. Diagnosis was confirmed after 6 years, when cecocentral scotoma and further RNFL thinning emerged despite treatment. Conclusions: A revised approach enabled PPG diagnosis during the first visit.
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Affiliation(s)
- Avinoam Ophir
- Division of Ophthalmology, Hillel-Yaffe Medical Centre, Hadera and The Ruth and Bruce Rappaport Faculty of Medicine, The Technion, Haifa, Israel
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