1
|
Swanson WH, King BJ, Alluwimi MS, Malik R. Predicting perimetric defects from en face maps of retinal nerve fibre layer reflectance. Ophthalmic Physiol Opt 2024; 44:613-625. [PMID: 38404167 PMCID: PMC10999345 DOI: 10.1111/opo.13289] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 02/27/2024]
Abstract
PURPOSE To develop criteria to predict visual hemifields with deep perimetric defects based on retinal nerve fibre layer (RNFL) reflectance, in a transparent process whose components can be assessed by independent laboratories analysing data from their own small groups. METHODS The analysis was carried out in four stages, using three independent groups of patients-30, 33 and 62 participants-with glaucoma and age-similar controls. The first stage used Group 1 to develop a criterion for RNFL reflectance images at 24, 36 or 48 μm below the inner limiting membrane (ILM). The second stage evaluated the criterion using Group 2. The third stage developed a second criterion to improve performance for Groups 1 and 2 combined. The fourth stage evaluated the second criterion with Group 3. Confidence intervals for sensitivity and specificity were then computed by combining results from all three groups. RESULTS The first criterion identified all hemifields with deep defects and no hemifields from controls, using a within-eye reference for healthy RNFL. For Group 2, specificity remained high but sensitivity was reduced. The second criterion improved sensitivity by using location-specific reference values. For Group 3, sensitivity remained high but reduced specificity was found. Confidence intervals showed substantial overlap for the two criteria. CONCLUSIONS We developed two criteria to identify patients with deep perimetric defects with high specificity and sensitivity. Several improvements are warranted: automated identification of the fovea-disc angle and optic disc locations, evaluation of normal variation in patterns of RNFL thickness, improved segmentation of ILM and major vasculature, reduction of within-eye variability in RNFL reflectance of healthy eyes, assessment of effects of image quality, assessment of effects of comorbidity and effectiveness of other devices.
Collapse
Affiliation(s)
| | - Brett J King
- Indiana University School of Optometry, Bloomington, Indiana, USA
| | - Muhammed S Alluwimi
- Department of Optometry, College of Applied Medical Sciences, Qassim University, Buraidah, Saudi Arabia
| | - Rizwan Malik
- Department of Surgery, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
- King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| |
Collapse
|
2
|
Kaarniranta K, Pawlikowska-Łagód K, Jääskeläinen JE, Grzybowski AE. Acta Ophthalmologica 100 years-Overview of selected articles during Acta Ophthalmologica history. Acta Ophthalmol 2024; 102:367-373. [PMID: 38233882 DOI: 10.1111/aos.16628] [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: 11/16/2023] [Accepted: 01/05/2024] [Indexed: 01/19/2024]
Abstract
We selected and discussed 10 articles in Acta Ophthalmologica since 1923 that changed clinical ophthalmology and treatment protocols, or provided novel findings and perspectives. We are aware that the selection of articles may be debatable and we invite readers to suggest other significant Acta articles. For historians, the article archive of Acta Ophthalmologica is located in Copenhagen.
Collapse
Affiliation(s)
- Kai Kaarniranta
- Department of Ophthalmology, University of Eastern Finland, Kuopio, Finland
- Department of Ophthalmology, Kuopio University Hospital, Kuopio, Finland
- Department of Molecular Genetics, University of Lodz, Lodz, Poland
| | | | - Juha E Jääskeläinen
- Department of Ophthalmology, Kuopio University Hospital, Kuopio, Finland
- Department of Neurosurgery, University of Eastern Finland, Kuopio, Finland
| | - Andrzej E Grzybowski
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznań, Poland
| |
Collapse
|
3
|
Andrews JP, Cummins DD, Morshed RA, Kinde B, Aghi MK, McDermott MW, Berger MS, Theodosopoulos PV. Intraventricular meningioma resection and visual outcomes. J Neurosurg 2024; 140:1001-1007. [PMID: 37877997 DOI: 10.3171/2023.7.jns23680] [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: 03/27/2023] [Accepted: 07/20/2023] [Indexed: 10/26/2023]
Abstract
OBJECTIVE Intraventricular meningiomas (IVMs) of the lateral ventricle are rare tumors that present surgical challenges because of their deep location. Visual field deficits (VFDs) are one risk associated with these tumors and their treatment. VFDs may be present preoperatively due to the tumor and mass effect (tumor VFDs) or may develop postoperatively due to the surgical approach (surgical VFDs). This institutional series aimed to review surgical outcomes following resection of IVMs, with a focus on VFDs. METHODS Patients who received IVM resection at one academic institution between the years 1996 and 2021 were retrospectively reviewed. Diffusion tensor imaging (DTI) reconstructions of the optic radiations around the tumor were performed from preoperative IVM imaging. The VFD course and resolution were documented. RESULTS Thirty-two adult patients underwent IVM resection, with gross-total resection in 30 patients (93.8%). Preoperatively, tumor VFDs were present in 6 patients, resolving after surgery in 5 patients. Five other patients (without preoperative VFD) had new persistent surgical VFDs postoperatively (5/32, 15.6%) that persisted to the most recent follow-up. Of the 5 patients with persistent surgical VFDs, 4 received a transtemporal approach and 1 received a transparietal approach, and all these deficits occurred prior to regular use of DTI in preoperative imaging. CONCLUSIONS New surgical VFDs are a common neurological deficit after IVM resection. Preoperative DTI may demonstrate distortion of the optic radiations around the tumor, thus revealing safe operative corridors to prevent surgical VFDs.
Collapse
Affiliation(s)
| | | | | | - Benyam Kinde
- 2Ophthalmology, University of California, San Francisco, California
| | | | | | | | | |
Collapse
|
4
|
Kalloniatis M, Wang H, Phu J, Tong J, Armitage J. Optical coherence tomography angiography in the diagnosis of ocular disease. Clin Exp Optom 2024:1-17. [PMID: 38452795 DOI: 10.1080/08164622.2024.2323603] [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: 12/07/2023] [Accepted: 02/21/2024] [Indexed: 03/09/2024] Open
Abstract
Clinical imaging provided by optical coherence tomography (OCT) and its variant, OCT-angiography (OCT-A), has revolutionised eyecare practice. The imaging techniques allow for the identification and quantification of ocular structures, supporting the diagnosis and prognosis of eye disease. In this review, an overview of the usefulness of OCT-A imaging in the diagnosis and management of a range of ocular conditions is provided when used in isolation or in combination with other imaging modalities and measures of visual function (visual field results). OCT-A imaging has the capacity to identify and quantify ocular vasculature non-invasively, thereby assisting the clinician in the diagnosis or to determine the efficacy of intervention in ocular conditions impacting retinal vasculature. Thus, additional clinically useful information can be obtained in eye diseases involving conditions such as those impacting retinal vessel occlusion, in diabetic retinopathy, inherited retinal dystrophy, age-related macular degeneration, choroidal neovascularisation and optic nerve disorders. Through a clinical case series, various ocular conditions are reviewed, and the impact of OCT-A imaging is discussed. Although OCT-A imaging has great promise and is already used in clinical management, there is a lack of set standards to characterise altered vascular features in disease and consequently for prognostication, primarily due to a lack of large-scale clinical trials and variability in OCT-A algorithms when generating quantitative parameters.
Collapse
Affiliation(s)
- Michael Kalloniatis
- School of Medicine (Optometry), Deakin University, Waurn Ponds, VIC, Australia
- School of Optometry and Vision Science, University of New South Wales, Kensington, NSW, Australia
| | - Henrietta Wang
- School of Optometry and Vision Science, University of New South Wales, Kensington, NSW, Australia
- Centre for Eye Health, University of New South Wales, Kensington, NSW, Australia
| | - Jack Phu
- School of Medicine (Optometry), Deakin University, Waurn Ponds, VIC, Australia
- School of Optometry and Vision Science, University of New South Wales, Kensington, NSW, Australia
| | - Janelle Tong
- School of Optometry and Vision Science, University of New South Wales, Kensington, NSW, Australia
- Centre for Eye Health, University of New South Wales, Kensington, NSW, Australia
| | - James Armitage
- School of Medicine (Optometry), Deakin University, Waurn Ponds, VIC, Australia
| |
Collapse
|
5
|
Maniarasu P, Shasane PH, Pai VH, Kuzhuppilly NIR, Ve RS, Ballae Ganeshrao S. Does the sampling frequency of an eye tracker affect the detection of glaucomatous visual field loss? Ophthalmic Physiol Opt 2024; 44:378-387. [PMID: 38149468 DOI: 10.1111/opo.13267] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 12/28/2023]
Abstract
PURPOSE Evidence suggests that eye movements have potential as a tool for detecting glaucomatous visual field defects. This study evaluated the influence of sampling frequency on eye movement parameters in detecting glaucomatous visual field defects during a free-viewing task. METHODS We investigated eye movements in two sets of experiments: (a) young adults with and without simulated visual field defects and (b) glaucoma patients and age-matched controls. In Experiment 1, we recruited 30 healthy volunteers. Among these, 10 performed the task with a gaze-contingent superior arcuate (SARC) scotoma, 10 performed the task with a gaze-contingent biarcuate (BARC) scotoma and 10 performed the task without a simulated scotoma (NoSim). The experimental task involved participants freely exploring 100 images, each for 4 s. Eye movements were recorded using the LiveTrack Lightning eye-tracker (500 Hz). In Experiment 2, we recruited 20 glaucoma patients and 16 age-matched controls. All participants underwent similar experimental tasks as in Experiment 1, except only 37 images were shown for exploration. To analyse the effect of sampling frequency, data were downsampled to 250, 120 and 60 Hz. Eye movement parameters, such as the number of fixations, fixation duration, saccadic amplitude and bivariate contour ellipse area (BCEA), were computed across various sampling frequencies. RESULTS Two-way ANOVA revealed no significant effects of sampling frequency on fixation duration (simulation, p = 0.37; glaucoma patients, p = 0.95) and BCEA (simulation, p = 0.84; glaucoma patients: p = 0.91). BCEA showed good distinguishability in differentiating groups across different sampling frequencies, whereas fixation duration failed to distinguish between glaucoma patients and controls. Number of fixations and saccade amplitude showed variations with sampling frequency in both simulations and glaucoma patients. CONCLUSION In both simulations and glaucoma patients, BCEA consistently differentiated them from controls across various sampling frequencies.
Collapse
Affiliation(s)
- Priyanka Maniarasu
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Prathamesh Harshad Shasane
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Vijaya H Pai
- Department of Ophthalmology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Neetha I R Kuzhuppilly
- Department of Ophthalmology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Ramesh S Ve
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Shonraj Ballae Ganeshrao
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| |
Collapse
|
6
|
Bengtsson B, Villalba C, Peters D, Aspberg J. Comparison of disease severity in glaucoma patients identified by screening in the 1990s and in routine clinical care in the 2010s in Sweden. Acta Ophthalmol 2024; 102:238-245. [PMID: 37786298 DOI: 10.1111/aos.15777] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 09/08/2023] [Accepted: 09/18/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND AND PURPOSE In a previous study comparing the amount of visual field damage at presentation in patients having open-angle glaucoma (OAG) identified through screening and in patients diagnosed in routine clinical practice in the 1990s, the damage was considerably worse in the clinically diagnosed patients. In the present study we compare visual field damage at presentation in the same 402 screened patients with that seen in 281 newly detected previously untreated patients clinically diagnosed in the 2010s. METHODS The perimetric visual field index mean deviation (MD) was compared in the two groups of patients. RESULTS In the clinical patients diagnosed with bilateral visual field damage the median MD was -5.1 dB in the better eye and -13.0 dB in the worse eye. In the screened patients the median MD in the better eye was -6.5 dB and -11.5 dB in the worse eye. The differences between the clinical and screened patients were non-significant, p = 0.28 and p = 0.67 respectively. More clinical patients had severe visual field loss, defined as MD less than -20 dB, in the worse eye than in the screened patients, 18.5% versus 12.7% respectively, p = 0.037. CONCLUSION The visual field damage at presentation in clinically diagnosed OAG patients has improved in the past 20 years, but the proportion of patients with severe visual field loss in at least one eye, almost 20%, is still unacceptably high considering that severe visual field damage at presentation is the most important risk factor for later development of glaucoma blindness.
Collapse
Affiliation(s)
- B Bengtsson
- Department of Clinical Sciences, Ophthalmology in Malmö, Lund University, Lund, Sweden
| | - C Villalba
- Department of Clinical Sciences, Ophthalmology in Malmö, Lund University, Lund, Sweden
| | - D Peters
- Department of Clinical Sciences, Ophthalmology in Malmö, Lund University, Lund, Sweden
- Department of Ophthalmology, Skåne University Hospital, Lund, Sweden
| | - J Aspberg
- Department of Clinical Sciences, Ophthalmology in Malmö, Lund University, Lund, Sweden
- Department of Ophthalmology, Skåne University Hospital, Lund, Sweden
| |
Collapse
|
7
|
Ayala M. Risk Factors and Frequency of Examinations for Detecting Visual Field Deterioration in Patients with Newly Diagnosed Exfoliation Glaucoma in Sweden. J Glaucoma 2024; 33:168-175. [PMID: 37853670 PMCID: PMC10901225 DOI: 10.1097/ijg.0000000000002319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 10/09/2023] [Indexed: 10/20/2023]
Abstract
PRCIS The study identified risk factors for exfoliation glaucoma and recommended re-evaluating target intraocular pressure (IOP) after 5 visual fields to slow disease progression. PURPOSE This study aimed to establish risk factors for exfoliation glaucoma and determine the earliest time points for estimating disease progression. PATIENTS A total of 96 patients with newly diagnosed exfoliation glaucoma were included. Included patients were required to perform at least 7 visual field tests within a 3-year period (±3 months). All patients were treated at inclusion. METHODS This was a nonrandomized, prospective cohort study. The predictors measured included IOP, mean deviation (MD), and visual field index (VFI). Progression was assessed using the rate of progression based on MD, VFI, and "Guided Progression Analysis." Linear or logistic regression models were developed based on the variables studied. An analysis of variance was used to establish the earliest time point. At the earliest time point, the models were retested. The area under the receiver operating characteristic curve was calculated. RESULTS The general rate of progression of the cohort was -3.84 (±2.61) dB for the MD values and 9.66 (±6.25) % for the VFI values over 3 years. The IOP, MD, and VFI values at diagnosis were predictors of progression for both linear and logistic regression. Analysis of variance and post hoc Tukey test showed significant values at 24 months for MD and VFI. The area under the curve at 24 months showed significant values for MD and VFI. CONCLUSIONS The predictors studied (IOP, MD, and VFI) showed moderate accuracy at baseline but excellent predictive capacity at 24 months postdiagnosis. Re-evaluating the target IOP at 24 months can effectively slow down disease progression.
Collapse
|
8
|
Stoddard-Bennett T, Yu F, Spiegel SJ, Perez C, Coleman A, Repka MX, Pineles SL. Pediatric Optic Pathway Gliomas Resource Utilization and Prevalence in the OptumLabs Data Warehouse. J Neuroophthalmol 2024; 44:10-15. [PMID: 37505911 PMCID: PMC10822016 DOI: 10.1097/wno.0000000000001960] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
BACKGROUND Although significant progress has been made in improving the rate of survival for pediatric optic pathway gliomas (OPGs), data describing the methods of diagnosis and treatment for OPGs are limited in the modern era. This retrospective study aims to provide an epidemiological overview in the pediatric population and an update on eye care resource utilization in OPG patients using big data analysis. METHODS Using the OptumLabs Data Warehouse, 9-11 million children from 2016 to 2021 assessed the presence of an OPG claim. This data set was analyzed for demographic distribution data and clinical data including average ages for computed tomography (CT), MRI, strabismus, and related treatment (surgery, chemotherapy, and radiation), as well as yearly rates for optical coherence tomography (OCT) and visual field (VF) examinations. RESULTS Five hundred fifty-one unique patients ranging in age from 0 to 17 years had an OPG claim, with an estimated prevalence of 4.6-6.1 per 100k. Among the 476 OPG patients with at least 6 months of follow-up, 88.9% had at least one MRI and 15.3% had at least one CT. Annual rates for OCT and VF testing were similar (1.26 vs 1.35 per year), although OCT was ordered for younger patients (mean age = 9.2 vs 11.7 years, respectively). During the study period, 14.1% of OPG patients had chemotherapy, 6.1% had either surgery or radiation, and 81.7% had no treatment. CONCLUSIONS This study updates OPG demographics for the modern era and characterizes the burden of the treatment course for pediatric OPG patients using big data analysis of a commercial claims database. OPGs had a prevalence of about 0.005% occurring equally in boys and girls. Most did not receive treatment, and the average child had at least one claim for OCT or VF per year for clinical monitoring. This study is limited to only commercially insured children, who represent approximately half of the general child population.
Collapse
Affiliation(s)
- Theo Stoddard-Bennett
- Department of Ophthalmology, Stein Eye Institute, University of California, Los Angeles, CA, USA
| | - Fei Yu
- Department of Ophthalmology, Stein Eye Institute, University of California, Los Angeles, CA, USA
- Department of Biostatistics, University of California Los Angeles Fielding School of Public Health, Los Angeles, CA, USA
| | - Samuel J Spiegel
- Department of Ophthalmology, Gavin Herbert Eye Institute, University of California Irvine, Irvine, CA, USA
| | - Claudia Perez
- Department of Medicine Statistics Core, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Anne Coleman
- Department of Ophthalmology, Stein Eye Institute, University of California, Los Angeles, CA, USA
| | - Michael X Repka
- Department of Ophthalmology, Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Stacy L Pineles
- Department of Ophthalmology, Stein Eye Institute, University of California, Los Angeles, CA, USA
| |
Collapse
|
9
|
Sheth V, McLean RJ, Tu Z, Ather S, Gottlob I, Proudlock FA. Visual Field Deficits in Albinism in Comparison to Idiopathic Infantile Nystagmus. Invest Ophthalmol Vis Sci 2024; 65:13. [PMID: 38319668 PMCID: PMC10854418 DOI: 10.1167/iovs.65.2.13] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 01/08/2024] [Indexed: 02/07/2024] Open
Abstract
Purpose This is the first systematic comparison of visual field (VF) deficits in people with albinism (PwA) and idiopathic infantile nystagmus (PwIIN) using static perimetry. We also compare best-corrected visual acuity (BCVA) and optical coherence tomography measures of the fovea, parafovea, and circumpapillary retinal nerve fiber layer in PwA. Methods VF testing was performed on 62 PwA and 36 PwIIN using a Humphrey Field Analyzer (SITA FAST 24-2). Mean detection thresholds for each eye were calculated, along with quadrants and central measures. Retinal layers were manually segmented in the macular region. Results Mean detection thresholds were significantly lower than normative values for PwA (-3.10 ± 1.67 dB, P << 0.0001) and PwIIN (-1.70 ± 1.54 dB, P < 0.0001). Mean detection thresholds were significantly lower in PwA compared to PwIIN (P < 0.0001) and significantly worse for left compared to right eyes in PwA (P = 0.0002) but not in PwIIN (P = 0.37). In PwA, the superior nasal VF was significantly worse than other quadrants (P < 0.05). PwIIN appeared to show a mild relative arcuate scotoma. In PwA, central detection thresholds were correlated with foveal changes in the inner and outer retina. VF was strongly correlated to BCVA in both groups. Conclusions Clear peripheral and central VF deficits exist in PwA and PwIIN, and static VF results need to be interpreted with caution clinically. Since PwA exhibit considerably lower detection thresholds compared to PwIIN, VF defects are unlikely to be due to nystagmus in PwA. In addition to horizontal VF asymmetry, PwA exhibit both vertical and interocular asymmetries, which needs further exploration.
Collapse
Affiliation(s)
- Viral Sheth
- Health Sciences School, University of Sheffield, Sheffield, Yorkshire, United Kingdom
- The University of Leicester Ulverscroft Eye Unit, Psychology and Vision Sciences, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester, United Kingdom
| | - Rebecca J. McLean
- The University of Leicester Ulverscroft Eye Unit, Psychology and Vision Sciences, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester, United Kingdom
| | - Zhanhan Tu
- The University of Leicester Ulverscroft Eye Unit, Psychology and Vision Sciences, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester, United Kingdom
| | - Sarim Ather
- Oxford University Hospitals NHS Foundation Trust, Headley Way, Headington, Oxfordshire, United Kingdom
| | - Irene Gottlob
- The University of Leicester Ulverscroft Eye Unit, Psychology and Vision Sciences, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester, United Kingdom
- Department of Neurology, Cooper University Health Care, Cooper Medical School of Rowan University, Camden, New Jersey, United States
| | - Frank A. Proudlock
- The University of Leicester Ulverscroft Eye Unit, Psychology and Vision Sciences, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester, United Kingdom
| |
Collapse
|
10
|
Stalin A, Narayan A, Labreche T, Khan S, Stanberry A, Christian LWT, Leat SJ. Status of Vision and Eye Care Among Patients in Rehabilitation Hospital Units: A Cross-Sectional Study. J Am Med Dir Assoc 2024; 25:361-367.e1. [PMID: 38052415 DOI: 10.1016/j.jamda.2023.10.030] [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: 06/14/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 12/07/2023]
Abstract
OBJECTIVES The prevalence of vision disorders is high among geriatric and hospital inpatient populations, yet they often go undetected, resulting in consequences such as falls or prolonged recovery time. A needs assessment study was conducted to investigate levels of vision and the potential prevalence of unmanaged/undiagnosed ocular disorders among adult inpatients in a hospital-based rehabilitation unit. DESIGN Cross-sectional study. SETTING & PARTICIPANTS Inpatient rehabilitation units of an acute care hospital system in Ontario, Canada. Adults (n = 112) in a hospital inpatient rehabilitation unit participated from October 2018 to February 2019. METHODS Participants were surveyed regarding their demographic, ocular, and medical data and spectacle wear. Visual acuity, contrast sensitivity, visual fields, and stereoacuity plus the spectacle condition were directly assessed. RESULTS The majority (75%) were found to have reduced habitual vision while in hospital. Nearly 60% of participants reported at least some difficulty reading a newspaper or distinguishing a face or were "not happy with their vision." This was despite 80% of participants reporting that they had an eye care practitioner and 70% that they had an eye examination within the last 2 years. More than half (51.8%) of the participants received the recommendation to follow up with their eye care practitioner on discharge from the hospital. CONCLUSIONS AND IMPLICATIONS Reduced vision and vision disorders has a high prevalence among hospital patients in rehabilitation units and should be evaluated at or soon after hospital intake. By incorporating vision screening tools, necessary precautions may be taken to avoid possible falls and promote recovery.
Collapse
Affiliation(s)
- Amritha Stalin
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada.
| | | | - Tammy Labreche
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Shamrozé Khan
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Andre Stanberry
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Lisa W T Christian
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Susan J Leat
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| |
Collapse
|
11
|
Albadr FB, Alhatlani AH, Alhelal NS, Albakri AA, Alhumidi AA, Alshwieer MA. Calcified Pituitary Adenoma Mimicking Craniopharyngioma: A Case Report. Cureus 2024; 16:e54352. [PMID: 38500912 PMCID: PMC10946292 DOI: 10.7759/cureus.54352] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2024] [Indexed: 03/20/2024] Open
Abstract
A 60-year-old woman presented with a history of a previously diagnosed sellar mass and a recent onset of severe headache, vision loss, and dizziness. The patient was found to have a large mass with curvilinear calcification on imaging. Histopathology confirmed the presence of a pituitary adenoma with abnormal acini, consistent with adenoma, and moderate amounts of granular eosinophilic cytoplasm. A detailed analysis of the patterns of calcification and the radiological morphology is crucial to distinguishing between pituitary adenoma and craniopharyngioma. Recognition of these patterns can aid in distinguishing between these conditions, providing a more accurate diagnosis and an effective treatment plan.
Collapse
Affiliation(s)
- Fahad B Albadr
- Radiology and Medical Imaging/Neuroradiology, King Saud University Medical City, Riyadh, SAU
| | | | | | | | | | | |
Collapse
|
12
|
Nasim P, Ve RS, Kuzhuppilly NIR, Naik P, Ballae Ganeshrao S, Artes PH. Visual Field Evaluation Using Zippy Adaptive Threshold Algorithm (ZATA) Standard and ZATA Fast in Patients With Glaucoma and Healthy Individuals. Transl Vis Sci Technol 2024; 13:28. [PMID: 38289611 PMCID: PMC10833053 DOI: 10.1167/tvst.13.1.28] [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: 04/04/2023] [Accepted: 11/27/2023] [Indexed: 02/01/2024] Open
Abstract
Purpose To evaluate visual fields obtained with Zippy Adaptive Threshold Algorithm (ZATA) Standard and ZATA Fast from patients with glaucoma and healthy individuals. Methods Fifty-five patients with glaucoma (median mean deviation [MD], -7.6 dB; interquartile range [IQR], -15.3 to -2.6 dB) and 22 healthy participants (median MD, -0.6 dB; IQR, -1.7 to 0.2 dB) performed ZATA Standard and ZATA Fast tests on a Henson 9000 perimeter and Swedish Interactive Thresholding Algorithm (SITA) Standard and SITA Fast tests on a Humphrey Field Analyzer. Tests were repeated within 90 days (median, 14 days; range, 7-26 days) to evaluate the test-retest variability. Results The mean difference between the MD of the ZATA Standard and SITA Standard tests was 1.7 dB (95% confidence interval [CI], 0.9-2.4). Between ZATA Fast and SITA Fast, it was 0.9 dB (95% CI, 0.2-1.5 dB). Although there were systematic differences between the distributions of sensitivity estimates with ZATA and SITA, they did not affect the overall representation of damage by these tests. ZATA Standard and ZATA Fast were approximately 30% and 6% faster, respectively, than the corresponding SITA tests. Conclusions ZATA Standard and ZATA Fast are suitable for clinical practice. However, differences between ZATA and SITA tests suggest that they should not be used interchangeably when patients with glaucoma are followed over time. Translational Relevance This study examined the characteristics of ZATA visual field tests in a clinical population, and it supports the adoption of these tests for assessing patients with glaucoma.
Collapse
Affiliation(s)
- Pinaz Nasim
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ramesh S. Ve
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Neetha I. R. Kuzhuppilly
- Department of Ophthalmology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Preethi Naik
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shonraj Ballae Ganeshrao
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Paul H. Artes
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Faculty of Health, University of Plymouth, Plymouth, UK
| |
Collapse
|
13
|
McLaughlin DE, Savatovsky EJ, O’Brien RC, Vanner EA, Munshi HK, Pham AH, Grajewski AL. Reliability of Visual Field Testing in a Telehealth Setting Using a Head-Mounted Device: A Pilot Study. J Glaucoma 2024; 33:15-23. [PMID: 37647317 PMCID: PMC10713003 DOI: 10.1097/ijg.0000000000002290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 07/16/2023] [Indexed: 09/01/2023]
Abstract
PRCIS Monitoring visual fields (VFs) through virtual reality devices proved to have good inter-test and test-retest reliability, as well as easy usability, when self-administered by individuals with and without VF defects in a remote setting. PURPOSE To assess the reliability of remote, self-administered VF monitoring using a virtual reality VF (VRVF) device in individuals without ocular disease and with stable VF defects. MATERIALS AND METHODS Individuals without ocular disease and with stable defects were recruited. All participants had a baseline standard automated perimetry (SAP) test. Participants tested remotely on a VRVF device for 4 weeks (examinations V 1 , V 2 , V 3 , and V 4 ), with the last 3 unassisted. The mean sensitivities of VRVF results were compared with each other and to SAP results for reliability. RESULTS A total of 42 eyes from 21 participants were tested on the VRVF device. Participants tested consistently although external factors impacted outcomes. VRVF results were in reasonable agreement with the baseline SAP. Examinations performed by the cohort with stable defects evinced better agreement with SAP examinations (V2, P = 0.79; V3, P = 0.39; V4, P = 0.35) than those reported by the cohort without ocular disease (V2, P = 0.02; V3, P = 0.15; V4, P = 0.22), where the null hypothesis is that the instruments agree. Fixation losses were high and variable in VRVF examinations compared with those of SAP, particularly in certain test takers. Participants considered the device comfortable and easy to use. CONCLUSIONS Self-administered, remote VF tests on a VRVF device showed satisfactory test-retest reliability, good inter-test agreement with SAP, and acceptability by its users. External factors may impact at-home testing and age and visual impairment may hinder fixation. Future studies to expand the sample size and understand inconsistencies in fixation losses are recommended.
Collapse
|
14
|
Robitaille JM. Long-Term Visual Outcomes in Prematurely Born Children. J Binocul Vis Ocul Motil 2024; 74:1-8. [PMID: 38078812] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
PURPOSE Prematurely born children are at risk of numerous complications that affect the visual system. Retinopathy of prematurity (ROP) and cerebral visual impairment (CVI) are among two major causes of childhood blindness and visual impairment in industrialized nations, and large countries with emerging economies are seeing increasing childhood blindness from ROP alone, adding to the burden of disease worldwide. The purpose of this paper is to review the long-term impacts of prematurity, ROP and CVI on vision in children who were born preterm. METHOD The topics in this review of the literature include the burden of vision loss in prematurely born children world-wide, a description of ROP and CVI, effects on visual acuity, refractive errors, strabismus and binocularity, visual fields and contrast sensitivity, and risk factors for visual complications. RESULTS Children who are most at risk of visual complications are those with the smallest gestational age at birth and birth weight in general. Although ROP severity and the presence of neurological impairments including CVI play a large role in the development of poor visual outcomes, premature birth alone without CVI or severe ROP increases the risk of future visual complications. Awareness of signs and symptoms of CVI are important in the management of affected children. CONCLUSION Children born preterm are at increased risk of reduced visual acuity, refractive errors, strabismus and amblyopia, complications of ROP, CVI, visual field abnormalities and reduced contrast sensitivity. Awareness of risk factors warranting close monitoring and signs and symptoms of CVI are critical to optimize the visual outcomes and overall development.
Collapse
Affiliation(s)
- Johane M Robitaille
- Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| |
Collapse
|
15
|
Triantafyllopoulos GI, Karabatsas CH, Pateras E, Chandrinos A, Kapralos D, Georgiou I, Tsiogka A, Kourkoutas D. The Effect of Yellow Filter Use on Standard Automated Perimetry and Contrast Sensitivity in Healthy Individuals. Cureus 2024; 16:e51912. [PMID: 38333490 PMCID: PMC10850819 DOI: 10.7759/cureus.51912] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2024] [Indexed: 02/10/2024] Open
Abstract
Purpose The purpose of this study is to investigate the effect of two yellow filters (category 1: visible light transmission {VLT} from 80% to 43%) of Essilor (Kiros® and Lumior®) on standard automated perimetry (SAP) indices and Pelli-Robson (PR) contrast sensitivity (CS) testing in healthy individuals. Materials and methods This study is a prospective comparative study of 31 eyes of 31 healthy individuals aged 32.14 (8.13) years (14 males and 17 females). All participants underwent a series of three visual field (VF) examinations (24-2, Swedish Interactive Thresholding Algorithm {SITA} standard) with the Humphrey field analyzer (HFA II 740, Carl Zeiss Meditec, Jena, Germany) and three CS examinations with the PR chart (Precision Vision, Inc., Woodstock, IL). VF and CS examinations were carried out as follows: (a) no filter (NF), (b) with the yellow filter Kiros® (KIROS), and (c) with the yellow-orange filter Lumior® (LUMIOR). The effect of the two yellow filters on global VF indices (glaucoma hemifield test {GHT}, mean deviation {MD}, pattern standard deviation {PSD}, and visual field index {VFI}) and on CS score was evaluated and compared. Results When comparing the three pairs NF-KIROS, NF-LUMIOR, and KIROS-LUMIOR, no difference was presented on the global VF indices. However, a statistically significant difference was detected in the CS scores for all three pairs, favoring KIROS. It is important to note that while this difference was statistically significant, it did not reach clinical significance. Conclusions The use of yellow filters (category 1: VLT of 75% and 65%) does not affect the global VF indices and the CS of healthy individuals but significantly improves their CS score. Further studies are required to explore the clinical significance of these findings.
Collapse
Affiliation(s)
- George I Triantafyllopoulos
- Department of Biomedical Sciences, Faculty of Health Sciences, University of West Attica, Athens, GRC
- Department of Ophthalmology, 401 General Military Hospital of Athens, Athens, GRC
| | - Costas H Karabatsas
- Department of Biomedical Sciences, Faculty of Health Sciences, University of West Attica, Athens, GRC
| | - Evangelos Pateras
- Department of Biomedical Sciences, Faculty of Health Sciences, University of West Attica, Athens, GRC
| | - Aristeidis Chandrinos
- Department of Biomedical Sciences, Faculty of Health Sciences, University of West Attica, Athens, GRC
| | - Dimitrios Kapralos
- Department of Ophthalmology, 401 General Military Hospital of Athens, Athens, GRC
| | - Iordanis Georgiou
- Department of Ophthalmology, 401 General Military Hospital of Athens, Athens, GRC
| | - Anastasia Tsiogka
- Department of Ophthalmology, General Hospital of Athens "G. Gennimatas", Athens, GRC
| | - Dimitrios Kourkoutas
- Department of Ophthalmology, 401 General Military Hospital of Athens, Athens, GRC
| |
Collapse
|
16
|
Philip J, Huurneman B, Jansonius NM, Cillessen AHN, Boonstra FN. Childhood cerebral visual impairment subtype classification based on an extensive versus a limited test battery. Front Neurosci 2023; 17:1266201. [PMID: 37954874 PMCID: PMC10637406 DOI: 10.3389/fnins.2023.1266201] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/06/2023] [Indexed: 11/14/2023] Open
Abstract
Purpose To classify CVI subtypes and compare the added value of an extensive test battery over a limited test battery in subtype classification of cerebral visual impairment (CVI) in children. Methods Seventy-five children with a clinical diagnosis of CVI (median [IQR] age: 9 [7-12] years) were identified from the medical records. The extensive test battery included visual acuity, contrast sensitivity, ocular alignment, eye movement analysis, visual field analysis, optic nerve head evaluation, and evaluation of visual perception. The limited test battery included visual acuity, contrast sensitivity, ocular alignment, and evaluation of visual perception. Principal component analysis (PCA) followed by cluster analysis was done, for both test batteries separately, to determine the optimum subtype classification for CVI. Results Fifty-one participants with an extensive test battery with mild to moderate visual impairment were included in the main analysis. This resulted in four CVI subtypes for the extensive test battery (subtle characteristics, higher-level visual function deficits, lower-level visual function deficits, and higher- and lower- level visual function deficits) and three CVI subtypes for the limited test battery (subtle characteristics, higher-level visual function deficits, and higher- and lower- level visual function deficits). There were significant differences between the subtypes for 9 out of 10 measures of the extensive and all 4 measures of the limited test battery (p < 0.05). The subtle characteristics subtype (extensive n = 19, limited n = 15) showed near normal lower and higher-level visual functions in both test batteries. The higher-level visual function deficits subtype (extensive n = 18, limited n = 24) showed near normal visual acuity combined with significant visual perceptual deficits in both test batteries; accompanied by visual pathways defects and abnormal eye movement behavior in the extensive test battery. The higher- and lower- level visual function deficits subtype (extensive n = 4, limited n = 12) showed both higher and lower-level visual function deficits in both test batteries, but application of the extensive test battery revealed additional visual pathways defects and abnormal eye movement behavior. The lower-level visual function deficits CVI subtype (extensive n = 10) was a new subtype identified by the extensive test battery. This subtype showed lower-level visual function deficits together with abnormal eye movement measures. Conclusion This data-driven study has provided meaningful CVI subtype classifications based on the outcomes of various key functional and structural measures in CVI diagnosis. Comparison of the extensive test battery to the limited test battery revealed the added value of an extensive test battery in classifying CVI. The outcomes of this study, therefore, have provided a new direction in the area of CVI classification.
Collapse
Affiliation(s)
- Jannet Philip
- Royal Dutch Visio, National Foundation for the Visually Impaired and Blind, Huizen, Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Bianca Huurneman
- Royal Dutch Visio, National Foundation for the Visually Impaired and Blind, Huizen, Netherlands
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Nomdo M. Jansonius
- Department of Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Graduate School of Medical Science, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | | | - Frouke N. Boonstra
- Royal Dutch Visio, National Foundation for the Visually Impaired and Blind, Huizen, Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, Netherlands
| |
Collapse
|
17
|
Zahavi A, Weinberger Y, Geffen N, Gabbay I, Mimouni M, Gal-Or O, Stiebel-Kalish H, Gaton DD. Optical Coherence Tomography Angiography for the Differentiation of Glaucoma from Pituitary Macroadenoma Related Optic Disc Measurements. Semin Ophthalmol 2023; 38:625-629. [PMID: 36762773 DOI: 10.1080/08820538.2023.2177116] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 01/26/2023] [Accepted: 01/26/2023] [Indexed: 02/11/2023]
Abstract
OBJECTIVE To determine the potential of optical coherence tomography (OCT) and OCT angiography (OCTA) to distinguish between glaucoma and pituitary macroadenoma by optic disc appearance. METHODS This prospective case-control study comprised 31 patients: 23 with glaucoma (18 male, 5 female) and 8 with pituitary macroadenoma and chiasmatic compression (3 male, 5 female). The corresponding mean ages were 72.8 years (range 58-90) and 60.7 years (range 43-73). All participants underwent complete ophthalmological examination, spectral domain OCT and OCTA, and visual field testing. Clinical, imaging, and visual field results were compared between the groups. RESULTS On OCT analysis, the glaucoma group had relatively lower peripapillary retinal nerve fiber layer (RNFL) thickness (65.79 ± 15.46, 86.0 ± 11.37, respectively, P = .002) and lower rim area (1.00 ± 0.22 mm2 and 1.2 ± 0.15 mm2, respectively, P = .005). On OCTA, peripapillary vessel density was significantly lower in all quadrants in the glaucoma group. The significance of these between-group differences was maintained when patients were stratified by visual field mean deviation. CONCLUSIONS This is the first comparative analysis of optic disc morphology between glaucoma and pituitary macroadenoma using combined OCT and OCTA. The results yielded lower peripapillary RNFL thickness, lower rim area, and lower peripapillary vessel density in the glaucoma group. These parameters may aid in the initial differentiation between these two optic neuropathies.
Collapse
Affiliation(s)
- Alon Zahavi
- Department of Ophthalmology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Laboratory of Eye Research, Felsenstein Medical Research Center, Petach Tikva, Israel
| | - Yehonatan Weinberger
- Department of Ophthalmology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Noa Geffen
- Department of Ophthalmology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Itay Gabbay
- Department of Ophthalmology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michael Mimouni
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel
- Technion-Israel Institute of Technology, Haifa, Israel
| | - Orly Gal-Or
- Department of Ophthalmology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hadas Stiebel-Kalish
- Department of Ophthalmology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Laboratory of Eye Research, Felsenstein Medical Research Center, Petach Tikva, Israel
| | - Dan D Gaton
- Department of Ophthalmology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
18
|
Cantlay JC, Martin GR, McClelland SC, Potier S, O'Brien MF, Fernández-Juricic E, Bond AL, Portugal SJ. Binocular vision and foraging in ducks, geese and swans (Anatidae). Proc Biol Sci 2023; 290:20231213. [PMID: 37670586 PMCID: PMC10510447 DOI: 10.1098/rspb.2023.1213] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/02/2023] [Indexed: 09/07/2023] Open
Abstract
Wide variation in visual field configuration across avian species is hypothesized to be driven primarily by foraging ecology and predator detection. While some studies of selected taxa have identified relationships between foraging ecology and binocular field characteristics in particular species, few have accounted for the relevance of shared ancestry. We conducted a large-scale, comparative analysis across 39 Anatidae species to investigate the relationship between the foraging ecology traits of diet or behaviour and binocular field parameters, while controlling for phylogeny. We used phylogenetic models to examine correlations between traits and binocular field characteristics, using unidimensional and morphometric approaches. We found that foraging behaviour influenced three parameters of binocular field size: maximum binocular field width, vertical binocular field extent, and angular separation between the eye-bill projection and the direction of maximum binocular field width. Foraging behaviour and body mass each influenced two descriptors of binocular field shape. Phylogenetic relatedness had minimal influence on binocular field size and shape, apart from vertical binocular field extent. Binocular field differences are associated with specific foraging behaviours, as related to the perceptual challenges of obtaining different food items from aquatic and terrestrial environments.
Collapse
Affiliation(s)
- Jennifer C. Cantlay
- Department of Biological Sciences, School of Life and Environmental Sciences, Royal Holloway University of London, Egham, Surrey TW20 0EX, UK
| | - Graham R. Martin
- School of Biosciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Stephanie C. McClelland
- Department of Biological Sciences, School of Life and Environmental Sciences, Royal Holloway University of London, Egham, Surrey TW20 0EX, UK
| | - Simon Potier
- Department of Biology, Faculty of Science, Lund University, Sölvegatan 35, 223 62 Lund, Sweden
| | | | | | - Alexander L. Bond
- Bird Group, Department of Life Sciences, The Natural History Museum, Akeman Street, Tring, Hertfordshire HP23 6AP, UK
| | - Steven J. Portugal
- Department of Biological Sciences, School of Life and Environmental Sciences, Royal Holloway University of London, Egham, Surrey TW20 0EX, UK
- Bird Group, Department of Life Sciences, The Natural History Museum, Akeman Street, Tring, Hertfordshire HP23 6AP, UK
| |
Collapse
|
19
|
Kawali A, Shroff S, Sanjay S, Bhakti Mishra S, Mohan A, Mahendradas P, Shetty R. Visual Fields in Epidemic Retinitis. Ocul Immunol Inflamm 2023; 31:1473-1478. [PMID: 35708453 DOI: 10.1080/09273948.2022.2084422] [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: 02/24/2022] [Revised: 05/18/2022] [Accepted: 05/26/2022] [Indexed: 10/18/2022]
Abstract
AIM The aim of the study is to analyze visual fields defects (VFDs) in epidemic retinitis (ER). METHODS Patients with ER and Humphrey's visual field (HFA) 30-2 performed after resolution were studied. VFD severity grading was performed. Patients treated with oral doxycycline (Group-A) versus doxycycline-steroids (group-B) were compared. RESULTS Thirty-five eyes of 25 patients were studied. Nasal, inferior, temporal and central VFD were seen in 19 (54.2%), 13 (37.1%), 7 (20%) and 6 (17.1%) eyes, respectively. Grade 0, 1, 2 and 3 VFDs were seen in 4 (11.4%), 15 (42.8%), 12 (34.2%) and 4 (11.4%) eyes respectively. Seven eyes with ≥1 year of follow-up post-resolution also showed grade 0-3 scotomas. Mean severity of scotoma was grade 1.15 (Median: 1) and 1.42 (Median: 1.5) in groups A (n = 13) and B (n = 14), respectively (p = .637). CONCLUSION ER can cause VFD persisting long after resolution. Treatment with oral doxycycline without steroids was non-inferior to combined treatment with respect to VFD.
Collapse
Affiliation(s)
- Ankush Kawali
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | - Sujani Shroff
- Department of Glaucoma, Narayana Nethralaya, Bangalore, India
| | - Srinivasan Sanjay
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | - Sai Bhakti Mishra
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | - Ashwin Mohan
- Department of Retina, Narayana Nethralaya, Bangalore, India
| | | | - Rohit Shetty
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, India
| |
Collapse
|
20
|
Rafla D, Khuu SK, Kashyap S, Kalloniatis M, Phu J. Visualising structural and functional characteristics distinguishing between newly diagnosed high-tension and low-tension glaucoma patients. Ophthalmic Physiol Opt 2023; 43:771-787. [PMID: 36964934 PMCID: PMC10946885 DOI: 10.1111/opo.13129] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 03/03/2023] [Accepted: 03/07/2023] [Indexed: 03/27/2023]
Abstract
PURPOSE To determine whether there are quantifiable structural or functional differences that can distinguish between high-tension glaucoma (HTG; intraocular pressure [IOP] > 21 mm Hg) and low-tension glaucoma (LTG; IOP ≤ 21 mm Hg) at diagnosis. METHOD This was a retrospective, cross-sectional study. Clinical results of one eye from 90 newly diagnosed HTG and 319 newly diagnosed LTG patients (117 with very-low-tension glaucoma [vLTG; ≤15 mm Hg] and 202 with middling LTG [mLTG; >15 mm Hg, ≤21 mm Hg]) were extracted, which included relevant demographic covariates of glaucoma, quantitative optical coherence tomography (including the optic nerve head, retinal nerve fibre layer and ganglion cell-inner plexiform layer) measurements and standard automated perimetry global metrics. We used binary logistic regression analysis to identify statistically significant clinical parameters distinguishing between phenotypic groups for inclusion in principal component (PC) (factor) analysis (PCA). The separability between each centroid for each cohort was calculated using the Euclidean distance (d(x,y)). RESULTS The binary logistic regression comparing HTG and all LTG identified eight statistically significant clinical parameters. Subsequent PCA results included three PCs with an eigenvalue >1. PCs 1 and 2 accounted for 21.2% and 20.2% of the model, respectively, with a d(x,y) = 0.468, indicating low separability between HTG and LTG. The analysis comparing vLTG, mLTG and HTG identified 15 significant clinical parameters, which were subsequently grouped into five PCs. PCs 1 and 2 accounted for 24.1% and 17.8%, respectively. The largest separation was observed between vLTG and HTG (d(x,y) = 0.581), followed by vLTG and mLTG (d(x,y) = 0.435) and lastly mLTG and HTG (d(x,y) = 0.210). CONCLUSION Conventional quantitative structural or functional parameters could not distinguish between pressure-defined glaucoma phenotypes at the point of diagnosis and are therefore not contributory to separating cohorts. The overlap in findings highlights the heterogeneity of the primary open-angle glaucoma clinical presentations among pressure-defined groups at the cohort level.
Collapse
Affiliation(s)
- Daniel Rafla
- Centre for Eye HealthThe University of New South WalesSydneyNew South WalesAustralia
- School of Optometry and Vision ScienceThe University of New South WalesSydneyNew South WalesAustralia
| | - Sieu K. Khuu
- Centre for Eye HealthThe University of New South WalesSydneyNew South WalesAustralia
| | - Sahana Kashyap
- Centre for Eye HealthThe University of New South WalesSydneyNew South WalesAustralia
- School of Optometry and Vision ScienceThe University of New South WalesSydneyNew South WalesAustralia
| | - Michael Kalloniatis
- Centre for Eye HealthThe University of New South WalesSydneyNew South WalesAustralia
- School of Optometry and Vision ScienceThe University of New South WalesSydneyNew South WalesAustralia
- School of Medicine (Optometry)Deakin UniversityVictoriaGeelongAustralia
| | - Jack Phu
- Centre for Eye HealthThe University of New South WalesSydneyNew South WalesAustralia
- School of Optometry and Vision ScienceThe University of New South WalesSydneyNew South WalesAustralia
- Faculty of Medicine and HealthUniversity of SydneyNew South WalesCamperdownAustralia
- Concord Clinical SchoolConcord Repatriation General HospitalNew South WalesConcordAustralia
| |
Collapse
|
21
|
Fang CEH, Hakim MT, Siddiqui MM, Armstrong D, Shankar V. A retrospective study to assess visual field improvement following augmented trabeculectomy. Indian J Ophthalmol 2023; 71:1953-1959. [PMID: 37203064 PMCID: PMC10391496 DOI: 10.4103/ijo.ijo_2071_22] [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] [Indexed: 05/20/2023] Open
Abstract
Purpose To explore the visual field (VF) changes two years following augmented trabeculectomy. Methods A retrospective study of patients who underwent augmented trabeculectomy surgery with mitomycin C by a single surgeon at East Lancashire Teaching Hospitals NHS Trust over 3 years. Patients with a minimum of two years postoperative follow-up were included. Baseline characteristics, intraocular pressure (IOP), VF, number of glaucoma medications, and complications were recorded. Results In total, 206 eyes were included, 97 (47%) patients were female, and the mean age was 73.8 ± 10.3 (range 43 to 93) years. One hundred thirty-one (63.6%) eyes were pseudophakic before trabeculectomy. The patients were divided into three outcome groups according to VF outcome. Seventy-seven (37.4%) patients had stable VF, 35 (17.0%) patients showed VF improvement, and 94 (45.6%) had VF deterioration. The overall mean preoperative IOP was 22.7 ± 8.0 mmHg and postoperative IOP 10.4 ± 4.2 mmHg, with a reduction of 50.2% (P < 0.001). In total, 84.5% of postoperative patients did not require glaucoma medications. A higher number of patients with postoperative IOP ≥15 mmHg had deteriorating VF (P < 0.001). Based on preoperative MD distribution, VF improvement or stability was more achievable with patients with a preoperative VF defect up to -12 dB (n = 41, 59.4%) and in those with greater than -24 dB (n = 25, 64.1%). Conclusion Trabeculectomy continues to be an effective means of lowering IOP in patients with uncontrolled glaucoma and is important in stabilizing or improving visual fields. We recommend early trabeculectomy to prevent further VF deterioration. This may help in maintaining VF for driving status and, thus, quality of life.
Collapse
Affiliation(s)
- Clarissa E H Fang
- Ophthalmology Department, East Lancashire Hospitals NHS Trust, Burnley, United Kingdom
| | - Mohamad T Hakim
- Ophthalmology Department, East Lancashire Hospitals NHS Trust, Burnley, United Kingdom
| | - Muhammad M Siddiqui
- Ophthalmology Department, East Lancashire Hospitals NHS Trust, Burnley, United Kingdom
| | - Deborah Armstrong
- Ophthalmology Department, East Lancashire Hospitals NHS Trust, Burnley, United Kingdom
| | - Vikas Shankar
- Ophthalmology Department, East Lancashire Hospitals NHS Trust, Burnley, United Kingdom
| |
Collapse
|
22
|
Abstract
BACKGROUND Recovery from amblyopia in adulthood after fellow eye (FE) vision loss is a well-known phenomenon. Incidence of recovery varies widely following different FE pathologies, and the rate of recovery after FE ischemic optic neuropathy (ION) has not been examined. We aimed to determine the frequency and degree of improvement in amblyopic eye (AE) visual function after ION in the FE. METHODS We performed a retrospective chart review of patients between 2007 and 2021 confirmed to have amblyopia and ischemic optic neuropathy in different eyes. Patients with unstable ocular pathology potentially limiting vision were excluded. We compared the best-corrected visual acuity (VA) in each eye before and after FE ION over time. For patients with available data, we examined change in perimetric performance over time. RESULTS Among the 12 patients who met the inclusion criteria (mean age 67 ± 8 years), 9 (75%) improved ≥1 line and 2 (17%) improved ≥3 lines. The median time from ION symptom onset to maximal improvement was 6 months (range: 2-101 months). Reliable perimetric data were available for 6 patients. Mean sensitivity improved in the AE for all patients, with mean improvement of 1.9 ± 1.1 dB. There was no correspondence between foci of ION-related field loss and gains in field sensitivity in the AE. CONCLUSIONS A high proportion of patients with amblyopia and contralateral ION experience improvement in AEVA. Modest gains in perimetric sensitivity in the AE may accompany FE ION. These findings support the view that residual plasticity in the adult visual cortex can be tapped to support functional improvement in amblyopia.
Collapse
Affiliation(s)
- Hannah H Resnick
- Department of Ophthalmology (HHR, EDG), Harvard Medical School, Boston, Massachusetts; Department of Ophthalmology (HHR, EDG), Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; Picower Institute for Learning and Memory (MFB, EDG), Massachusetts Institute of Technology, Cambridge, Massachusetts; and Department of Ophthalmology (EDG), Boston Children's Hospital, Boston, Massachusetts
| | | | | |
Collapse
|
23
|
Fea AM, Ricardi F, Novarese C, Cimorosi F, Vallino V, Boscia G. Precision Medicine in Glaucoma: Artificial Intelligence, Biomarkers, Genetics and Redox State. Int J Mol Sci 2023; 24. [PMID: 36769127 DOI: 10.3390/ijms24032814] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/07/2023] [Accepted: 01/18/2023] [Indexed: 02/05/2023] Open
Abstract
Glaucoma is a multifactorial neurodegenerative illness requiring early diagnosis and strict monitoring of the disease progression. Current exams for diagnosis and prognosis are based on clinical examination, intraocular pressure (IOP) measurements, visual field tests, and optical coherence tomography (OCT). In this scenario, there is a critical unmet demand for glaucoma-related biomarkers to enhance clinical testing for early diagnosis and tracking of the disease's development. The introduction of validated biomarkers would allow for prompt intervention in the clinic to help with prognosis prediction and treatment response monitoring. This review aims to report the latest acquisitions on biomarkers in glaucoma, from imaging analysis to genetics and metabolic markers.
Collapse
|
24
|
Misawa M, Pyatova Y, Sen A, Markowitz M, Markowitz SN, Reber M, Daibert-Nido M. Innovative vision rehabilitation method for hemianopsia: Comparing pre- and post audio-luminous biofeedback training for ocular motility improving visual functions and quality of life. Front Neurol 2023; 14:1151736. [PMID: 37114220 PMCID: PMC10126773 DOI: 10.3389/fneur.2023.1151736] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 03/22/2023] [Indexed: 04/29/2023] Open
Abstract
Background Homonymous hemianopsia (HH) corresponds to vision loss in one hemi-field secondary to retro-chiasmal injury. Patients with HH experience difficulties in scanning and orientation in their environment. Near vision daily activities such as reading can also be impaired. There is an unmet need for standardized vision rehabilitation protocols for HH. We investigated the effectiveness of biofeedback training (BT), used for vision rehabilitation in patients with central vision loss, in individuals with HH. Methods In this prospective pilot pre/post study, 12 participants, with HH consecutive to brain injury, performed 5 weekly BT sessions for 20 min each under supervision using the Macular Integrity Assessment microperimeter. BT consisted of relocation of the retinal locus 1-4° toward the blind hemi-field. Outcomes measured post-BT were paracentral retinal sensitivity, visual acuity (near vision), fixation stability, contrast sensitivity, reading speed, and visual functioning questionnaire. Statistical analysis was performed using Bayesian paired t-tests. Results Paracentral retinal sensitivity significantly increased by 2.7 ± 0.9 dB in the treated eye in 9/11 of the participants. Significant improvements with medium-to-large effect size were observed for fixation stability (8/12 participants), contrast sensitivity (6/12 participants) and near vision visual acuity (10/12 participants). Reading speed increased by 32.5 ± 32.4 words per minute in 10/11 participants. Quality of vision scores improved significantly with large effect size for visual ability, visual information and mobility. Conclusion BT led to encouraging improvements in visual functions and functional vision in individuals with HH. Further confirmation with larger trials is required.
Collapse
Affiliation(s)
- Mariana Misawa
- Toronto Western Hospital, University Health Network, Toronto, ON, Canada
- Department of Ophthalmology and Vision Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Yulia Pyatova
- Department of Ophthalmology and Vision Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Atri Sen
- Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Michelle Markowitz
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Samuel N. Markowitz
- Toronto Western Hospital, University Health Network, Toronto, ON, Canada
- Department of Ophthalmology and Vision Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Donald K. Johnson Eye Institute, Krembil Research Institute, University Health Network, Toronto, ON, Canada
| | - Michael Reber
- Department of Ophthalmology and Vision Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Donald K. Johnson Eye Institute, Krembil Research Institute, University Health Network, Toronto, ON, Canada
| | - Monica Daibert-Nido
- Toronto Western Hospital, University Health Network, Toronto, ON, Canada
- Department of Ophthalmology and Vision Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- *Correspondence: Monica Daibert-Nido,
| |
Collapse
|
25
|
Dincer A, Herendeen J, Oster J, Kryzanski J. Resection of an occipital lobe epileptogenic network resulting in improvement of a visual field deficit: illustrative case. J Neurosurg Case Lessons 2022; 4:CASE22210. [PMID: 36254354 PMCID: PMC9576032 DOI: 10.3171/case22210] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/28/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Drug-resistant epilepsy leads to significant morbidity and mortality. Epilepsy surgery for resection of seizure foci is underused, particularly when a seizure focus is located in eloquent cortex. Epileptogenic networks may lead to neurological deficits out of proportion to a causative lesion. Disruption of the network may lead not only to seizure freedom but also reversal of a neurological deficit. OBSERVATIONS A 32-year-old male with new-onset generalized tonic-clonic seizure was found to have an occipital lobe cavernous malformation. On visual field testing, he was found to have a right-sided hemianopsia. He did not tolerate antiepileptic drugs and had a significant decline in quality of life. Resection was planned using intraoperative electrocorticography to remove the cavernous malformation and disrupt the epileptogenic network. Immediate and delayed postoperative visual field testing demonstrated improvement of the visual field deficit, with near resolution of the deficit 6 weeks postoperatively. LESSONS Epilepsy networks in eloquent cortex may cause deficits that improve after the causative lesion is resected and the network disrupted, a concept that is underreported in the literature. A subset of patients with frequent epileptiform activity and preoperative deficits may experience postoperative neurological improvement along with relief of seizures.
Collapse
Affiliation(s)
| | | | - Joel Oster
- Neurology, Tufts Medical Center, Boston, Massachusetts
| | | |
Collapse
|
26
|
Lambiri DW, Levin LA. Modeling Reactive Oxygen Species-Induced Axonal Loss in Leber Hereditary Optic Neuropathy. Biomolecules 2022; 12:biom12101411. [PMID: 36291620 PMCID: PMC9599876 DOI: 10.3390/biom12101411] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 11/17/2022] Open
Abstract
Leber hereditary optic neuropathy (LHON) is a rare syndrome that results in vision loss. A necessary but not sufficient condition for its onset is the existence of known mitochondrial DNA mutations that affect complex I biomolecular structure. Cybrids with LHON mutations generate higher rates of reactive oxygen species (ROS). This study models how ROS, particularly H2O2, could signal and execute the axonal degeneration process that underlies LHON. We modeled and explored several hypotheses regarding the influence of H2O2 on the dynamics of propagation of axonal degeneration in LHON. Zonal oxidative stress, corresponding to H2O2 gradients, correlated with the morphology of injury exhibited in the LHON pathology. If the axonal membrane is highly permeable to H2O2 and oxidative stress induces larger production of H2O2, small injuries could trigger cascading failures of neighboring axons. The cellular interdependence created by H2O2 diffusion, and the gradients created by tissue variations in H2O2 production and scavenging, result in injury patterns and surviving axonal loss distributions similar to LHON tissue samples. Specifically, axonal degeneration starts in the temporal optic nerve, where larger groups of small diameter fibers are located and propagates from that region. These findings correlate well with clinical observations of central loss of visual field, visual acuity, and color vision in LHON, and may serve as an in silico platform for modeling the mechanism of action for new therapeutics.
Collapse
Affiliation(s)
- Darius W. Lambiri
- Department of Physiology, McGill University, Montreal, QC H3G 1Y6, Canada
| | - Leonard A. Levin
- Department of Ophthalmology and Visual Sciences, McGill University, Montreal, QC H4A 3S5, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC H3A 2B4, Canada
- Correspondence:
| |
Collapse
|
27
|
Gomes MLS, Mansur-Pantuzzo ER, Lagos AAR, Corrêa H, Duarte D, Frasson M. Evaluating vision-specific quality of life and functional vision in a Brazilian population with Stargardt disease. Eur J Ophthalmol 2022; 33:11206721221121023. [PMID: 35975566 DOI: 10.1177/11206721221121023] [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] [Indexed: 11/15/2022]
Abstract
PURPOSE To compare the vision-specific quality of life (QoL) of individuals with Stargardt disease (STGD) with that of healthy individuals and to investigate the association between vision-specific QoL and functional vision. METHODS This cross-sectional study included 41 patients with STGD and 46 healthy volunteers matched by age and gender. Best corrected visual acuity (BCVA) was used to calculate the Functional Acuity Score (FAS) and Goldmann perimetry the Functional Field Score (FFS). These scores were combined to obtain the Functional Vision Score (FVS). Vision-specific QoL was assessed using the 25-item version of the National Eye Institute Visual Function Questionnaire (NEI VFQ-25). RESULTS The groups had similar sociodemographic and clinical characteristics. There were significant differences in BCVA, vision-specific QoL assessed by the NEI VFQ-25, and FVS (p < 0.001) between individuals with STGD and controls. The final total score and all the subscales of the NEI VQF-25 questionnaire were significantly lower in the STGD group (p < 0.001), except for the subscales general health, color vision, and ocular pain. NEI VFQ-25 results in the STGD group were positively correlated with family income, FVS, and FFS. FVS was the score best correlated with the NEI VFQ-25 total score. CONCLUSIONS Individuals with STGD had significant impairment of vision-specific QoL and functional vision compared with controls and the FVS was the objective evaluation method most correlated with vision-specific QoL in this population.
Collapse
Affiliation(s)
- Mirela L S Gomes
- Department of Ophthalmology, 219764Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Esther R Mansur-Pantuzzo
- Department of Ophthalmology, 219764Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Angel A R Lagos
- Department of Medical Tecnology, 28088San Sebastian University, Santiago, Chile
| | - Humberto Corrêa
- Department of Psychiatry, 28114Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Dante Duarte
- Spaulding Neuromodulation Center, 1811Harvard Medical School, Boston, MA, USA
| | - Maria Frasson
- Department of Ophthalmology, 219764Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| |
Collapse
|
28
|
Prea SM, Vingrys AJ, Kong GYX. Test Reliability and Compliance to a Twelve-Month Visual Field Telemedicine Study in Glaucoma Patients. J Clin Med 2022; 11. [PMID: 35893408 DOI: 10.3390/jcm11154317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 06/13/2022] [Revised: 07/18/2022] [Accepted: 07/19/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Our primary aim is to quantify test reliability and compliance of glaucoma patients to a weekly visual field telemedicine (VFTM) schedule. A secondary aim is to determine concordance of the VFTM results to in-clinic outcomes. Methods: Participants with stable glaucoma in one eye were recruited for a 12 month VFTM trial using the Melbourne Rapid Fields (MRF-home, MRFh) iPad application. Participants attended routine 6 month clinical reviews and were tasked with weekly home monitoring with the MRFh over this period. We determined compliance to weekly VFTM (7 + 1 days) and test reliability (false positives (FPs) and fixation loss (FL) <33%). A secondary aim considered concordance to in-clinic measures of visual field (MRF-clinic (MRFc) and the Humphrey Field Analyzer (HFA)) in active participants (≥10 home examinations and 5 reliable HFA examinations). The linear trend in the MRFh mean deviation (MD) was compared to the HFA guided progression analysis (GPA) using Bland−Altman methods. Data are shown as the mean ± standard deviation. Results: Forty-seven participants with a mean age of 64 ± 14.6 years were recruited for the trial. The VFTM uptake was 85% and compliance to weekly home monitoring was 75% in the presence of weekly text reminders in the analysed group (n = 20). The analysed group was composed of test subjects with five reliable in-clinic HFA examinations (GPA analysis available) and who submitted a minimum of 10 MRFh examinations from home. Of the 757 home examinations returned, approximately two-thirds were reliable, which was significantly lower than the test reliability of the HFA in-clinic (MRFh: 65% vs. HFA: 85%, p < 0.001). The HFA-GPA analysis gave little bias from the MRFh slope (bias: 0.05 dB/yr, p > 0.05). Two eyes were found to have clinical progression during the 12 month period, and both were detected by VFTM. Conclusions: VFTM over 12 months returned good compliance (75%) to weekly testing with good concordance to in-clinic assays. VFTM is a viable option for monitoring patients with glaucoma for visual field progression in between clinical visits.
Collapse
|
29
|
Harper RA, Parkes JA, Dickinson CM. Driving and exceptional cases: Supporting relicensing evaluation in patients whose visual fields fail to meet standards. Ophthalmic Physiol Opt 2022; 42:1009-1014. [PMID: 35687309 PMCID: PMC9543539 DOI: 10.1111/opo.13015] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/20/2022] [Accepted: 05/20/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE The UK Driver and Vehicle Licensing Agency's (DVLA) visual field criteria mean that homonymous defects close to fixation are not usually acceptable for driving. Here, we illustrate cases where patients with field defects failing to meet standards had their licences revoked but subsequently were permitted to drive again through exceptional case provisions. METHODS Clinical assessment of two patients with homonymous loss: a 62-year-old man (PWT) with a dense left upper homonymous quadrantanopia secondary to a right occipital lobe stroke and a 48-year-old woman (JC), only aware of right upper homonymous quadrantanopia following routine primary care assessment and subsequently attributed to left middle cerebral artery stroke from perinatal intracranial haemorrhage. RESULTS PWT's Esterman test showed a significant central defect failing to meet the standard. His subsequent ophthalmic examination was otherwise unremarkable with excellent visual functions. Clinical evidence was provided supporting his relicensing application, and in time, a practical DVLA driving assessment indicated adaptation had been successful, and his licence was restored. JC's defect also failed to meet the standard, and her licence was revoked. Her ophthalmic examination was otherwise unremarkable, and her condition was attributed to a nonprogressive, isolated perinatal event. The DVLA accepted supporting clinical evidence; her subsequent practical driving assessment demonstrated successful adaptation and her licence was also restored. CONCLUSIONS Conventional visual field tests are not necessarily predictive of real-world driving performance, with drivers' adaptive strategies not being accommodated. In the UK, individuals with visual field loss failing to meet the standard may be eligible for relicensing as exceptional cases if specific criteria can be met. For exceptional cases potentially licensable under these criteria, the DVLA requires clinician support and a satisfactory practical driving assessment. Similar provisions exist internationally. Clinicians need to be aware of the role they may play in such scenarios.
Collapse
Affiliation(s)
- Robert A Harper
- Manchester Royal Eye Hospital and Manchester Academic Health Sciences Centre, Manchester University NHS Foundation Trust Manchester, Manchester, UK.,Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Jeremy A Parkes
- Manchester Royal Eye Hospital and Manchester Academic Health Sciences Centre, Manchester University NHS Foundation Trust Manchester, Manchester, UK
| | - Christine M Dickinson
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| |
Collapse
|
30
|
Tong J, Alonso-Caneiro D, Kalloniatis M, Zangerl B. Prediction of visual field defects from macular optical coherence tomography in glaucoma using cluster analysis. Ophthalmic Physiol Opt 2022; 42:948-964. [PMID: 35598146 PMCID: PMC9544890 DOI: 10.1111/opo.12997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 02/21/2022] [Revised: 04/19/2022] [Accepted: 04/20/2022] [Indexed: 11/30/2022]
Abstract
Purpose To assess the accuracy of cluster analysis‐based models in predicting visual field (VF) defects from macular ganglion cell‐inner plexiform layer (GCIPL) measurements in glaucomatous and healthy cohorts. Methods GCIPL measurements were extracted from posterior pole optical coherence tomography (OCT), from locations corresponding to central VF test grids. Models incorporating cluster analysis methods and corrections for age and fovea to optic disc tilt were developed from 493 healthy participants, and 5th and 1st percentile limits of GCIPL thickness were derived. These limits were compared with pointwise 5th and 1st percentile limits by calculating sensitivities and specificities in an additional 40 normal and 37 glaucomatous participants, as well as applying receiver operating characteristic (ROC) curve analyses to assess the accuracy of predicting VF results from co‐localised GCIPL measurements. Results Clustered models demonstrated globally low sensitivity, but high specificity in the glaucoma cohort (0.28–0.53 and 0.77–0.91, respectively), and high specificity in the healthy cohort (0.91–0.98). Clustered models showed similar sensitivities and superior specificities compared with pointwise methods (0.41–0.65 and 0.71–0.98, respectively). There were significant differences in accuracy between clusters, with relatively poor accuracy at peripheral macular locations (p < 0.0001 for all comparisons). Conclusions Cluster analysis‐based models incorporating age correction and holistic consideration of fovea to optic disc tilt demonstrated superior performance in predicting VF results to pointwise methods in both glaucomatous and healthy eyes. However, relatively low sensitivity and poorer performance at the peripheral macula indicate that OCT in isolation may be insufficient to predict visual function across the macula accurately. With modifications to criteria for abnormality, the concepts suggested by the described normative models may guide prioritisation of VF assessment requirements, with the potential to limit excessive VF testing.
Collapse
Affiliation(s)
- Janelle Tong
- Centre for Eye Health, University of New South Wales (UNSW), Sydney, New South Wales, Australia.,School of Optometry and Vision Science, University of New South Wales (UNSW), Sydney, New South Wales, Australia
| | - David Alonso-Caneiro
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Michael Kalloniatis
- Centre for Eye Health, University of New South Wales (UNSW), Sydney, New South Wales, Australia.,School of Optometry and Vision Science, University of New South Wales (UNSW), Sydney, New South Wales, Australia
| | - Barbara Zangerl
- School of Optometry and Vision Science, University of New South Wales (UNSW), Sydney, New South Wales, Australia.,Coronary Care Unit, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| |
Collapse
|
31
|
Critelli K, Demiris V, Klatt BN, Crane B, Anson ER. Facemasks Block Lower Visual Field in Youth Ice Hockey. Front Sports Act Living 2021; 3:787182. [PMID: 34939030 PMCID: PMC8685261 DOI: 10.3389/fspor.2021.787182] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/11/2021] [Indexed: 11/13/2022] Open
Abstract
Wearing a facemask (FM) reduces the spread of COVID-19, but it also blocks a person's lower visual field. Many new public safety rules were created in response to COVID-19, including mandated FM wearing in some youth sports like youth ice hockey. We hypothesized that FM wearing in youth hockey players obstructs the lower field of view and may impact safety. Youth hockey players (n = 33) aged 12.03 (1.6) years button press when they saw an LED on the floor turn on in two conditions (wearing FM or no FM) in random order. An interleaved one-up/one-down two-alternative-forced-choice adaptive staircase design was used. Visual thresholds were calculated for each condition and participant. The visual angle threshold (VAT) was determined using standing eye height and the linear distance from the tip of the skates to the visual threshold. Paired t-tests determined whether mask wearing changed the VAT. We modeled the probability a player could see the puck on their stick in four distinct scenarios to estimate the potential impact of FM wearing during hockey play. The average unmasked VAT (11.4 degrees) was significantly closer to the skates than the masked VAT (20.3 degrees) (p < 0.001). Our model indicated a significant reduction in ability to visualize the puck using peripheral vision when more upright while wearing a FM. FM wearing compromised their lower visual field, suggesting a downward head tilt may be necessary to see the puck. Playing ice hockey while wearing a FM may lead to unsafe on-ice playing conditions due to downward head tilt to see the puck.
Collapse
Affiliation(s)
- Kyle Critelli
- Department of Otolaryngology, University of Rochester, Rochester, NY, United States
| | - Victoria Demiris
- Physical Therapy Department, University of Rochester, Rochester, NY, United States
| | - Brooke N Klatt
- Physical Therapy Department, University of Pittsburgh, Pittsburgh, PA, United States
| | - Benjamin Crane
- Department of Otolaryngology, University of Rochester, Rochester, NY, United States.,Department of Neuroscience, University of Rochester, Rochester, NY, United States.,Department of Biomedical Engineering, University of Rochester, Rochester, NY, United States
| | - Eric R Anson
- Department of Otolaryngology, University of Rochester, Rochester, NY, United States.,Physical Therapy Department, University of Rochester, Rochester, NY, United States.,Department of Neuroscience, University of Rochester, Rochester, NY, United States
| |
Collapse
|
32
|
Trinh M, Kalloniatis M, Nivison-Smith L. Should clinical automated perimetry be considered for routine functional assessment of early/intermediate age-related macular degeneration (AMD)? A systematic review of current literature. Ophthalmic Physiol Opt 2021; 42:161-177. [PMID: 34843120 PMCID: PMC9300202 DOI: 10.1111/opo.12919] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 10/19/2021] [Accepted: 10/19/2021] [Indexed: 11/30/2022]
Abstract
Purpose There is growing interest in functional testing for early/intermediate age‐related macular degeneration (iAMD). However, systematic evaluation of existing clinical functional tests is lacking. This systematic review examines evidence for using clinical automated perimetry in routine assessment of early/iAMD. Recent findings PubMed, Web of Science Core Collection, and Embase were searched from inception to October 2020 to answer, is there evidence of visual field defects in early/iAMD, and if so, are early/iAMD visual field defects linked to real‐world patient outcomes? Articles using clinical automated perimetry (commercially accessible and non‐modified devices/protocols) were included. Microperimetry was excluded as this has yet to be incorporated into clinical guidelines. The primary outcome was global visual field indices including mean deviation (MD), pattern standard deviation (PSD), mean sensitivity (MS) and frequency of defects. The secondary outcome was any real‐world patient outcome including quality of life and/or activities of daily living indices. Twenty‐six studies were eligible for inclusion and all studies were observational. There was consistent evidence of worsened MD, PSD, MS and frequency of defects for early/iAMD compared to normal eyes under photopic, low‐photopic and scotopic conditions. Meta‐analysis of studies using standard automated perimetry (SAP) under photopic conditions revealed worsened MD (−1.52dB [−2.27, −0.78 dB]) and MS (−1.47dB [−2, −0.94 dB]) in early/iAMD compared to normal eyes, representing large statistical effect sizes but non‐clinically meaningful reductions. There was insufficient data for meta‐analyses regarding other clinical automated perimetry protocols. Only one study assessed a real‐world patient outcome (on‐road driving performance), with no significant link to visual field outcomes in early/iAMD. Summary Significant reduction of global visual field indices is present in early/iAMD, but not clinically meaningful using SAP under photopic conditions. Translational relevance of visual field outcomes to patient outcomes in early/iAMD remains unclear. Thus, SAP under photopic conditions is unlikely to be useful for routine assessment of early/iAMD.
Collapse
Affiliation(s)
- Matt Trinh
- Centre for Eye Health, University of New South Wales, Sydney, New South Wales, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Michael Kalloniatis
- Centre for Eye Health, University of New South Wales, Sydney, New South Wales, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Lisa Nivison-Smith
- Centre for Eye Health, University of New South Wales, Sydney, New South Wales, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| |
Collapse
|
33
|
Erdinest N, London N, Lavy I, Morad Y, Levinger N. Vision through Healthy Aging Eyes. Vision (Basel) 2021; 5:46. [PMID: 34698313 DOI: 10.3390/vision5040046] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 07/23/2021] [Revised: 09/20/2021] [Accepted: 09/23/2021] [Indexed: 01/04/2023] Open
Abstract
As life expectancy grows, so too will the number of people adversely affected by age. Although it is acknowledged that many conditions and diseases are associated with age, this mini-review will present a current update of the various visual changes that generally occur in healthy individuals disregarding the possible effects of illness. These alterations influence how the world is perceived and in turn can affect efficiency or the ability to perform ordinary daily tasks such as driving or reading. The most common physical developments include a decreased pupil size and retinal luminance as well as changes both in intercellular and intracellular connections within the retina along the pathway to the visual cortex and within the visual cortex. The quantity and the physical location of retinal cells including photoreceptors, ganglion and bipolar retinal cells are modified. The clarity of intraocular organs, such as the intraocular lens, decreases. These all result in common visual manifestations that include reduced visual acuity, dry eyes, motility changes, a contraction of the visual field, presbyopia, reduced contrast sensitivity, slow dark adaptation, recovery from glare, variation in color vision and a decreased visual processing speed. Highlighting these prevalent issues as well as current and possible future innovations will assist providers to formulate treatments and thereby conserve maximum independence and mobility in the modern mature population.
Collapse
|
34
|
Xu L, Wu Z, Guymer RH, Anderson AJ. Investigating the discrepancy between MAIA and MP-1 microperimetry results. Ophthalmic Physiol Opt 2021; 41:1231-1240. [PMID: 34459022 DOI: 10.1111/opo.12877] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 08/07/2020] [Revised: 07/09/2021] [Accepted: 07/12/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Previous work has suggested that sensitivities measured on the iCare MAIA and Nidek MP-1 microperimeters differ systematically, although it is unclear whether one or both devices are inaccurate. Here, we assess the discrepancy between these two instruments as well as with a rigorous reference standard. METHODS Fifteen healthy participants underwent visual field testing on the MAIA and MP-1 microperimeters. Results were compared to a reference measure of increment thresholds on a laboratory-based, calibrated computer monitor system using the same background luminance and target size. Discrepancies were assessed as a function of eccentricity along the vertical meridian. Differences in decibels (dB) due to differences in the maximum stimulus luminance between devices were accounted for mathematically. RESULTS The mean sensitivity measured with the MAIA was <1 dB lower than laboratory-based measures, which was statistically significant but of limited clinical importance. In contrast, the mean sensitivity measured with the MP-1 was >8 dB lower than the laboratory measures. The difference was greater for an eccentric superior retinal location, in contrast to what would be predicted if the discrepancy was due to a ceiling effect caused by the MP-1's limited dynamic range. CONCLUSIONS While MAIA measurements showed low bias compared with our rigorously determined reference standard, the MP-1 showed large discrepancies that could not be explained purely by the limited dynamic range of the instrument. MAIA and MP-1 sensitivity values cannot be compared directly, and caution is advised when assessing absolute sensitivities or eccentricity effects in the extensive MP-1 literature.
Collapse
Affiliation(s)
- Lixing Xu
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Zhichao Wu
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Robyn H Guymer
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Andrew J Anderson
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| |
Collapse
|
35
|
Souto FMS, Missaka RFBG, Lavezzo MM, Mayumi Sakata V, Oyamada MK, Hirata CE, Yamamoto JH. Associations between functional and structural measurements in non-acute Vogt-Koyanagi-Harada disease. Acta Ophthalmol 2021; 99:e715-e723. [PMID: 33124155 DOI: 10.1111/aos.14646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/12/2020] [Revised: 09/11/2020] [Accepted: 09/17/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate associations between functional and structural measurements in patients with non-acute VKHD. METHODS In this cross-sectional study, 16 non-acute VKHD patients (32 eyes; 14 female) were evaluated with multifocal electroretinogram (mfERG), standardized automated perimetry (SAP) and optical coherence tomography (OCT)examinations. All included patients had a minimum 12 months of follow-up from acute onset and were participants of an ongoing prospective study since acute phase with systematic clinical imaging evaluations and electroretinogram examinations within a predefined treatment. Age- and gender-matched controls were included. Main outcomes were functional and structural abnormalities and their correlation; secondary outcome was correlation of these findings with clinical characteristics, including fundus abnormalities. RESULTS SAP and mfERG parameters were significantly worse in patients than in controls. Fourteen eyes (43.7%) had disrupted ellipsoid zone (EZ); visual acuity (VA) was similar between eyes with intact or disrupted EZ. Eyes with intact and disrupted EZ differed significantly concerning N1 and P1 amplitudes and N1 peak time values on mfERG and mean sensitivity (MS), central sensitivity (CS), foveal threshold, visual field index, mean deviation (MD) and pattern standard deviation values on SAP. The area under the curve on receiver operating curves for P1 amplitude was 0.81 (cut-off value = 34.7 nV/deg2 ) and for MD value was 0.84 (cut-off value = -5.2 dB). Central retinal thickness (CRT) significantly correlated with N1 and P1 amplitudes and P1 peak time values on mfERG (r = 0.354, r = 0.442 and r = -0.405, respectively) and MD, MS, CS and fovea threshold (log values) on SAP (r = 0.372, r = 0.406, r = 0.431 and r = 0.414, respectively). Statistically significant associations were found with the presence of peripapillary atrophy and recurrent anterior uveitis with a worse MD value (p = 0.004 and p < 0.001, respectively). CONCLUSION In non-acute VKHD, disrupted EZ and reduced CRT were correlated with impaired mfERG and SAP parameters, even in patients with good VA.
Collapse
Affiliation(s)
- Fernanda Maria Silveira Souto
- Department of Ophthalmology LIM‐33 Hospital das Clinicas HCFMUSP Faculdade de Medicina Universidade de Sao Paulo Sao Paulo Brazil
| | | | - Marcelo Mendes Lavezzo
- Department of Ophthalmology LIM‐33 Hospital das Clinicas HCFMUSP Faculdade de Medicina Universidade de Sao Paulo Sao Paulo Brazil
| | - Viviane Mayumi Sakata
- Department of Ophthalmology LIM‐33 Hospital das Clinicas HCFMUSP Faculdade de Medicina Universidade de Sao Paulo Sao Paulo Brazil
- Department of Ophthalmology Universidade Federal do Paraná Curitiba Brazil
| | - Maria Kiyoko Oyamada
- Department of Ophthalmology LIM‐33 Hospital das Clinicas HCFMUSP Faculdade de Medicina Universidade de Sao Paulo Sao Paulo Brazil
| | - Carlos Eduardo Hirata
- Department of Ophthalmology LIM‐33 Hospital das Clinicas HCFMUSP Faculdade de Medicina Universidade de Sao Paulo Sao Paulo Brazil
| | - Joyce Hisae Yamamoto
- Department of Ophthalmology LIM‐33 Hospital das Clinicas HCFMUSP Faculdade de Medicina Universidade de Sao Paulo Sao Paulo Brazil
| |
Collapse
|
36
|
Wadikhaye R, Alugolu R, Mudumba VS. A 270-Degree Decompression of Optic Nerve in Refractory Idiopathic Intracranial Hypertension Using an Ultrasonic Aspirator - A Prospective Institutional Study. Neurol India 2021; 69:49-55. [PMID: 33642270 DOI: 10.4103/0028-3886.310080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Although the nonsurgical treatment for idiopathic intracranial hypertension (IIH) involves weight loss, diuretics, and steroids, surgical intervention is required if there is a worsening of symptoms or visual deterioration. Objective To determine the efficacy and complications of transcranial optic nerve sheath fenestration (ONSF) using an ultrasonic aspirator as an adjunct in the treatment of refractory IIH. Material and Methods This prospective study included all patients with medically refractory IIH with visual deterioration from November 2017 to June 2019. Pterional craniotomy was followed by extradural clinoidectomy and optic foramen bony decompression using an ultrasonic aspirator. All the cases were followed up for changes in visual acuity and field and surgical outcomes. Results A total of 21 consecutive patients who underwent ONSF in the study period were included for analysis. Improvement in visual acuity was noted in 19/21 (90.47%) patients. Improvement in visual fields was noted in 17/21 (80.95%). Headache improved in 66.67% of patients. Improvement in the fundus picture was noted in 90.47%. Symptoms < 6 months showed better results compared to > 6 months symptom, although statistically nonsignificant (P = 0.2556). A 270-degree optic canal decompression was achieved in all the cases. Conclusion Transcranial optic nerve sheath decompression with a bone ultrasonic aspirator is a safe and direct decompression of the optic nerve in malignant/refractory cases of IIH.
Collapse
Affiliation(s)
- Rohit Wadikhaye
- Department of Neurosurgery, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana State, India
| | - Rajesh Alugolu
- Department of Neurosurgery, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana State, India
| | - Vijaya Saradhi Mudumba
- Department of Neurosurgery, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana State, India
| |
Collapse
|
37
|
Saeedi O, Boland MV, D'Acunto L, Swamy R, Hegde V, Gupta S, Venjara A, Tsai J, Myers JS, Wellik SR, DeMoraes G, Pasquale LR, Shen LQ, Li Y, Elze T. Development and Comparison of Machine Learning Algorithms to Determine Visual Field Progression. Transl Vis Sci Technol 2021; 10:27. [PMID: 34157101 PMCID: PMC8237084 DOI: 10.1167/tvst.10.7.27] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 04/17/2021] [Indexed: 12/23/2022] Open
Abstract
Purpose To develop and test machine learning classifiers (MLCs) for determining visual field progression. Methods In total, 90,713 visual fields from 13,156 eyes were included. Six different progression algorithms (linear regression of mean deviation, linear regression of the visual field index, Advanced Glaucoma Intervention Study algorithm, Collaborative Initial Glaucoma Treatment Study algorithm, pointwise linear regression [PLR], and permutation of PLR) were applied to classify each eye as progressing or stable. Six MLCs were applied (logistic regression, random forest, extreme gradient boosting, support vector classifier, convolutional neural network, fully connected neural network) using a training and testing set. For MLC input, visual fields for a given eye were divided into the first and second half and each location averaged over time within each half. Each algorithm was tested for accuracy, sensitivity, positive predictive value, and class bias with a subset of visual fields labeled by a panel of three experts from 161 eyes. Results MLCs had similar performance metrics as some of the conventional algorithms and ranged from 87% to 91% accurate with sensitivity ranging from 0.83 to 0.88 and specificity from 0.92 to 0.96. All conventional algorithms showed significant class bias, meaning each individual algorithm was more likely to grade uncertain cases as either progressing or stable (P ≤ 0.01). Conversely, all MLCs were balanced, meaning they were equally likely to grade uncertain cases as either progressing or stable (P ≥ 0.08). Conclusions MLCs showed a moderate to high level of accuracy, sensitivity, and specificity and were more balanced than conventional algorithms. Translational Relevance MLCs may help to determine visual field progression.
Collapse
Affiliation(s)
- Osamah Saeedi
- University of Maryland Department of Ophthalmology and Visual Sciences, Baltimore, MD, USA
| | | | | | - Ramya Swamy
- University of Maryland Department of Ophthalmology and Visual Sciences, Baltimore, MD, USA
| | | | | | | | - Joby Tsai
- University of Maryland Department of Ophthalmology and Visual Sciences, Baltimore, MD, USA
| | | | - Sarah R. Wellik
- Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, FL, USA
| | | | - Louis R. Pasquale
- Icahn School of Medicine at Mount Sinai, Department of Ophthalmology, New York, NY, USA
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Yangjiani Li
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Tobias Elze
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
38
|
Öhnell HM, Heijl A, Bengtsson B. Ageing and glaucoma progression of the retinal nerve fibre layer using spectral-domain optical coherence tomography analysis. Acta Ophthalmol 2021; 99:260-268. [PMID: 33945669 DOI: 10.1111/aos.14553] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 11/28/2019] [Accepted: 06/20/2020] [Indexed: 01/23/2023]
Abstract
PURPOSE To compare the effects of ageing and glaucoma progression on the thickness of the circumpapillary retinal nerve fibre layer (cpRNFL) and to evaluate the performance of a set of optical coherence tomography (OCT) progression analyses. METHODS The cpRNFL was measured twice by OCT at each of two visits made 10 years apart in 69 healthy individuals and 49 glaucoma patients. Both visits also included Humphrey 24-2 SITA standard testing. The change in cpRNFL thickness was analysed by linear regression, and a sub-analysis was performed on glaucoma patients with a perimetric mean deviation better than -10 dB at the first visit. The proportion of individuals whose OCT progression analyses indicated progression was also evaluated for the same groups. RESULTS The average cpRNFL thickness deteriorated by a mean of -0.16 μm/year in the healthy cohort, increased by 0.03 μm/year in the glaucoma cohort, and deteriorated by -0.24 μm/year in eyes with less severe glaucoma; there were no statistically significant differences between the groups. For 17 (30%) of 56 healthy individuals, at least one of the three different OCT progression analyses incorrectly indicated progression. CONCLUSIONS No significant differences in change of cpRNFL thickness between visits were found when comparing healthy subjects with glaucoma patients. Also, further cpRNFL thinning was not observed in glaucomatous eyes in which at least one-third of the visual field had been lost. The OCT progression analyses generated a relatively high proportion of false positives. Using OCT for glaucoma follow-up may not be entirely straightforward.
Collapse
Affiliation(s)
- Hanna Maria Öhnell
- Ophthalmology Department of Clinical Sciences in Malmö Skåne University Hospital Lund University Malmö Sweden
| | - Anders Heijl
- Ophthalmology Department of Clinical Sciences in Malmö Skåne University Hospital Lund University Malmö Sweden
| | - Boel Bengtsson
- Ophthalmology Department of Clinical Sciences in Malmö Lund University Malmö Sweden
| |
Collapse
|
39
|
Abstract
Identifying progression is of fundamental importance to the management of glaucoma. It is also a challenge. The most sophisticated, and probably the most useful, commercially available clinical tool for identifying progression is the Guided Progression Analysis (GPA), which was initially developed to identify progression using 24-2 visual field tests. More recently, it has been extended to retinal nerve fiber layer (RNFL) and ganglion cell+inner plexiform layer thicknesses measured with optical coherence tomography (OCT). However, the OCT GPA requires a minimum of 3 tests to determine "possible loss (progression)" and a minimum of 4 tests to determine if the patient shows "likely loss (progression)." Thus, it is not designed to answer a fundamental question asked by both the clinician and the patient, namely: Did damage progress since the last visit? Some clinicians use changes in summary statistics, such as global/average circumpapillary RNFL thickness. However, these statistics have poor sensitivity and specificity due to segmentation and alignment errors. Instead of relying on the GPA analysis or summary statistics, one needs to evaluate RNFL and ganglion cell+inner plexiform layer probability maps and circumpapillary OCT B-scan images. In addition, we argue that the clinician can make a better decision about suspected progression between 2 test days by topographically comparing the changes in the different OCT maps and images, in addition to topographically comparing the changes in the visual field with the changes in OCT probability maps.
Collapse
Affiliation(s)
- Donald C. Hood
- Department of Psychology, Columbia University, New York City, NY, USA
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York
| | - Bruna Melchior
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Emmanouil Tsamis
- Department of Psychology, Columbia University, New York City, NY, USA
| | - Jeffrey M. Liebmann
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York
| | - C. Gustavo De Moraes
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York
| |
Collapse
|
40
|
Abstract
CLINICAL RELEVANCE Tinted lenses may adversely affect colour discrimination. Before recommending tinted lenses to patients, practitioners should bear in mind any effects on colour discrimination. The effects of 'blue-blocking' spectacle lenses with high luminous transmittance on colour vision is not a concern. BACKGROUND Blue-blocking lenses have been widely promoted by manufacturers and practitioners. The more blue-blocking lenses are known to affect colour vision significantly but there has been no study of the effects of 'blue-blocking' spectacle lenses. METHODS The transmittances of commercially available lenses were measured and the three lenses with the lowest blue light transmittance were selected. Subjects undertook the following computer-based colour vision tests: Colour Assessment and Diagnosis; the Cambridge Colour Test; and the Farnsworth-Munsell 100 Hue Test. RESULTS Blue and luminous transmittances of lenses were documented. The reduction in blue transmittance varied from 12 to 40 per cent (two to 30 per cent compared with an untinted lens). The lenses were found to have no significant, statistical or possibly practical, effect on the results of the three colour vision tests (t-test, analysis of variance, Mann-Whitney, Kruskal-Wallis). CONCLUSION The modest blue light transmittance reduction of the 'blue-blocking' spectacle lenses examined was not sufficient to have a statistically significant effect on colour vision.
Collapse
Affiliation(s)
- Manon Baldasso
- School of Optometry and Vision Science, The University of New South Wales , Sydney, Australia
| | - Maitreyee Roy
- School of Optometry and Vision Science, The University of New South Wales , Sydney, Australia
| | - Mei-Ying Boon
- School of Optometry and Vision Science, The University of New South Wales , Sydney, Australia
| | - Stephen J Dain
- School of Optometry and Vision Science, The University of New South Wales , Sydney, Australia
| |
Collapse
|
41
|
Räty S, Sallinen H, Virtanen P, Haapaniemi E, Wu TY, Putaala J, Meretoja A, Tatlisumak T, Strbian D. Occipital intracerebral hemorrhage-clinical characteristics, outcome, and post-ICH epilepsy. Acta Neurol Scand 2021; 143:71-77. [PMID: 32602110 DOI: 10.1111/ane.13303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 04/08/2020] [Revised: 06/09/2020] [Accepted: 06/21/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Posterior location affects the clinical presentation and outcome of ischemic stroke, but little is known about occipital intracerebral hemorrhage (ICH). We studied non-traumatic occipital ICH phenotype, outcome, and post-ICH epilepsy. MATERIALS AND METHODS Occipital ICH patients were retrospectively identified from the Helsinki ICH Study registry of 1013 consecutive ICH patients treated in our tertiary center in 2005-2010. They were compared to non-occipital ICH patients to evaluate the effect of location on functional outcome at discharge (dichotomized modified Rankin Scale, mRS), 3- and 12-month mortality, and incidence of epilepsy. RESULTS We found 19 occipital ICH patients (5.3% of lobar and 1.9% of all ICH). Compared to non-occipital lobar ICHs, they were younger (median age 63 vs 71 years, P = .007) and had lower National Institutes of Health Stroke Scale on admission (1 vs 8, P < .001), smaller hematoma volume (6.3 vs 17.7 ML, P = .008), and more frequently structural etiology underlying the ICH (26% vs 7%, P = .01). Mortality at both 3 and 12 months was 6%, whereas 84% reached favorable outcome (mRS 0-2) at discharge. Occipital location was associated with favorable outcome at discharge in lobar ICH (OR 11.02, 95% CI 1.55-78.20). Incidence of post-ICH epilepsy (median follow-up 2.7 years) was 18%, equaling to that of non-occipital lobar ICH. CONCLUSIONS Occipital ICH patients are younger, have less severe clinical presentation, smaller hematoma volume, more often structural etiology, and better outcome than other ICH patients. They exhibit a similar risk of epilepsy as non-occipital ICHs.
Collapse
Affiliation(s)
- Silja Räty
- Neurology, HUS Neurocenter University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Hanne Sallinen
- Neurology, HUS Neurocenter University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Pekka Virtanen
- Radiology, HUS Medical Imaging Center University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Elena Haapaniemi
- Neurology, HUS Neurocenter University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Teddy Y Wu
- Department of Neurology, Christchurch Hospital New Zealand Brain Research Institute Christchurch New Zealand
| | - Jukka Putaala
- Neurology, HUS Neurocenter University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Atte Meretoja
- Neurology, HUS Neurocenter University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Turgut Tatlisumak
- Department of Clinical Neurosciences/Neurology, Institute of Neurosciences and Physiology Sahlgrenska Academy at University of Gothenburg Gothenburg Sweden
- Department of Neurology Sahlgrenska University Hospital Gothenburg Sweden
| | - Daniel Strbian
- Neurology, HUS Neurocenter University of Helsinki and Helsinki University Hospital Helsinki Finland
| |
Collapse
|
42
|
Sternfeld A, Bialer OY, Keidar D, Megiddo E, Budnik I, Stiebel-Kalish H, Livnat T. A Single Low-Dose of Methylphenidate Improves Abnormal Visual Field Testing. Curr Eye Res 2020; 46:1232-1239. [PMID: 33342320 DOI: 10.1080/02713683.2020.1858430] [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] [Indexed: 10/22/2022]
Abstract
PURPOSE To evaluate the effect of methylphenidate on visual field testing in healthy adults with abnormal visual field results. METHODS This prospective, randomized, controlled interventional clinical trial comprised all patients who had abnormal visual field test results and normal eye examination and ophthalmic history. Eligible patients were randomly assigned to either the study group or the control group. All patients repeated their visual field testing. Study group patients received a single dose of 10 mg methylphenidate prior to that. The main outcome measures were the percent difference in mean deviation and pattern standard deviation between the second and first visual fields. RESULTS The methylphenidate group had greater improvement in all parameters. Mean deviation improved by median 68% (IQR 19%-78%) in the methylphenidate group vs. 27% [-5% to 55%] in the controls. However, this was not statistically significant (p = .83). Pattern standard deviation improved by median 49% (22%-59%) vs. 7% [-9% to 45%], respectively (p = .012). The visual fields were also reviewed by 3 masked experienced ophthalmologists. They indicated that the second visual field improved in 76.2% of the methylphenidate group vs. 48.5% of the controls (p = .04). A normal repeat visual field occurred in 57.7% vs. 21.2%, respectively. A subgroup analysis of patients with prior experience in visual field testing yielded an even more striking improvement in the methylphenidate group vs. controls. CONCLUSIONS A single low dose of methylphenidate can improve visual field testing in subjects without ocular pathology, and even more in those with prior experience in perimetry.
Collapse
Affiliation(s)
- Amir Sternfeld
- Department of Ophthalmology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Omer Y Bialer
- Department of Ophthalmology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dotan Keidar
- Ramat-Hen Psychiatric Clinic, Clalit Health Services, Ramat Gan, Israel
| | - Elinor Megiddo
- Department of Ophthalmology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
| | - Ivan Budnik
- Department of Pathophysiology, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Hadas Stiebel-Kalish
- Department of Ophthalmology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tami Livnat
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Israeli National Hemophilia Center and the Amalia Biron Thrombosis Research Institute, Sheba Medical Center, Tel Hashomer, Israel.,Laboratory of Eye Research, Felsenstein Medical Research Center, Petach Tikva, Israel
| |
Collapse
|
43
|
Muthusamy V, Turpin A, Walland MJ, Nguyen BN, McKendrick AM. Increasing the Spatial Resolution of Visual Field Tests Without Increasing Test Duration: An Evaluation of ARREST. Transl Vis Sci Technol 2020; 9:24. [PMID: 33364079 PMCID: PMC7745600 DOI: 10.1167/tvst.9.13.24] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 08/11/2020] [Accepted: 10/25/2020] [Indexed: 12/02/2022] Open
Abstract
Purpose The Australian Reduced Range Extended Spatial Test (ARREST) approach was designed to improve visual field spatial resolution while maintaining a similar test duration to clinically used testing algorithms. ARREST does not completely threshold visual field locations with sensitivity < 17 dB, and uses the presentations saved to test new locations in areas of steep gradient within the visual field. Previous assessments of ARREST's performance have used computer simulation. In this study, we cross-sectionally assessed the performance of ARREST in people with visual field loss. Methods We tested 23 people with glaucoma (mean age: 71 ± 8 years) with established visual field loss. Three visual field procedures were performed using the Open Perimetry Interface: cZEST and ARREST on the Octopus 900 perimeter (Haag-Streit AG, Switzerland), and a reference standard (best available estimate [BAE]) on the Compass perimeter (CenterVue SpA, Italy). ARREST was compared against the cZEST and the BAE. Results On average, ARREST added seven new locations (range = 0–15) to a visual field test. There was no significant difference in the number of stimulus presentations between procedures (mean = 259 ± 25 [ARREST] vs. 261 ± 25 [cZEST], P = 0.78). In classifying threshold values < 17 dB, ARREST performed similarly when compared against BAE. Conclusions This study provides empirical evidence to support conclusions from previous computer simulations that ARREST can be used to increase spatial sampling in regions of interest without increasing test time. Translational Relevance ARREST is a new approach that augments current visual field testing procedures to provide better spatial description of visual field defects without increasing test duration.
Collapse
Affiliation(s)
- Vasanth Muthusamy
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Andrew Turpin
- School of Computing and Information Systems, The University of Melbourne, Parkville, Victoria, Australia
| | - Mark J Walland
- Department of Medical Education (St. Vincent's Hospital Clinical School), The University of Melbourne, Parkville, Victoria, Australia
| | - Bao N Nguyen
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Allison M McKendrick
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| |
Collapse
|
44
|
Ahmed OM, Waisbourd M, Spaeth GL, Katz LJ. Improvement in structure and visual function in patients with glaucoma: the possible key to better treatment? Surv Ophthalmol 2020; 66:644-652. [PMID: 33316283 DOI: 10.1016/j.survophthal.2020.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 08/03/2020] [Revised: 12/01/2020] [Accepted: 12/07/2020] [Indexed: 11/26/2022]
Abstract
Glaucoma is characterized by retinal ganglion cell loss that can lead to permanent visual loss. Current clinical management practice assumes that glaucomatous visual loss is irreversible; however, there is increasing evidence that permanent vision loss and cell death are preceded by reversible functional and structural changes. We propose that these changes should be considered by glaucoma specialists when treating their patients. We discuss the neurobiological basis of this phenomenon and provide clinical evidence of reversibility in both structure and function. Specifically, we review the findings of visual field testing, contrast sensitivity, electroretinography, and imaging of the optic nerve and their correlation with functional changes. We then discuss the clinical value of these observations in helping guide approaches toward the diagnosis and treatment of patients with glaucoma.
Collapse
Affiliation(s)
- Osama M Ahmed
- Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA, USA; Yale University School of Medicine, New Haven, CT, USA
| | - Michael Waisbourd
- Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA, USA; Department of Ophthalmology, Tel Aviv Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - George L Spaeth
- Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA, USA
| | - L Jay Katz
- Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA, USA.
| |
Collapse
|
45
|
Vergmann AS, Grauslund J. Changes of visual fields in treatment of proliferative diabetic retinopathy: a systematic review. Acta Ophthalmol 2020; 98:763-773. [PMID: 32421255 DOI: 10.1111/aos.14474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 06/19/2019] [Accepted: 04/24/2020] [Indexed: 01/20/2023]
Abstract
The aim of this systematic review was to compare certain side-effects [visual fields (VF), dark adaptation, colour vision (CV) and contrast sensitivity (CS)] of conventional panretinal photocoagulation (PRP) with those of other treatments in proliferative diabetic retinopathy (PDR). A systematic literature search was conducted on 30 November 2018 in PubMed and Embase. The search comprised the keywords 'proliferative diabetic retinopathy', 'laser', 'treatment' and 'anti-vegf'. We included prospective studies and randomized controlled trials that investigated certain side-effects (VF, dark adaptation, CV, CS) in treatment of PDR (primary outcome). In total, 1867 articles were screened, and 10 studies were included (2176 eyes of 2086 patients examined in the VF studies and 1360 eyes of 1360 patients examined in the CV and CS studies). Visual fields (VF) were investigated in 10 studies, CV in one study and CS in one study. Treatment modalities included conventional PRP, other modalities of laser treatment and vascular endothelial growth factor (VEGF) inhibitors. Four studies demonstrated a worse VF impact of PRP than VEGF inhibitors. Seven studies reported of an overall worsening in VF after laser with no differences between different laser approaches. No differences were found in CV or CS. Overall, we found a trend, confirmed in four large studies, towards VEGF inhibitors causing less harm to VF compared to conventional PRP. Whilst VF was generally depressed after laser, it did not differ between different treatment approaches. Furthermore, it was not possible to make certain conclusions of CV or CS, with only one study in each field.
Collapse
Affiliation(s)
- Anna Stage Vergmann
- Department of Ophthalmology Odense University Hospital Odense Denmark
- Research Unit of Ophthalmology Department of Clinical Research Faculty of Health Science University of Southern Denmark Odense Denmark
| | - Jakob Grauslund
- Department of Ophthalmology Odense University Hospital Odense Denmark
- Research Unit of Ophthalmology Department of Clinical Research Faculty of Health Science University of Southern Denmark Odense Denmark
- Steno Diabetes Center Odense Odense Denmark
| |
Collapse
|
46
|
Chen X, Di H, Hong Y, Zhang C. Late-stage sequela of an isolated optic neuropathy after acute magnesium valproate overdose: A case report. Eur J Ophthalmol 2020; 32:1120672120974943. [PMID: 33222509 DOI: 10.1177/1120672120974943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Magnesium valproate is a valproic acid (VPA) derivative that is widely used for the treatment of epilepsy and bipolar disorders. Acute overdose of VPA may cause complicated systemic syndromes; however, the reports of ocular sequelae caused by toxic optic neuropathy (TON) are rare. CASE PRESENTATION We present a case of a 19-year-old female with bilateral damage to visual function after acute VPA overdose. She was comatose and received systemic treatments for 1 month, during which she suffered a substantial loss of visual function without any evident neurological sequelae. The first recorded visual acuity was no light perception in the right eye (OD) and hand motion in the left eye (OS). Her best-corrected visual acuity improved to 20/100 OS after 4 months of hyperbaric oxygen therapy and neurotrophic treatments. Her visual field was limited to an inferior nasal area OS. Therefore, a diagnosis of TON was made. Her visual function remained stable in the left eye, but did not recover in the right eye during the 5-month follow-up. We found damage to the optic nerve pathway during ophthalmic examinations. CONCLUSION We report a rare case of TON caused by acute VPA overdose. Hyperbaric oxygen therapy, and neuroprotective and neurotrophic treatments might be effective at the early stage but cannot fully reverse the damage to the optic nerve. The present case indicates the potential neurotoxicity of VPA. It is crucial to determine the severity of an isolated optic nerve sequela caused by VPA overdose, though it might be rare as observed in previous reports. Further confirmation of the likelihood of its causation and its pathophysiology is needed in the future.
Collapse
Affiliation(s)
- Xuhao Chen
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Haohao Di
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
- Department of Ophthalmology, Zhengzhou Second Hospital, Henan, China
| | - Ying Hong
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Chun Zhang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| |
Collapse
|
47
|
Lee SU, Lee J, Yoon JE, Kim HJ, Choi JY, Yun CH, Kim JS. Transient Homonymous Superior Quadrantanopsia in Nonketotic Hyperglycemia: A Case Report and Systematic Review. J Clin Neurol 2020; 16:599-604. [PMID: 33029966 PMCID: PMC7541982 DOI: 10.3988/jcn.2020.16.4.599] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 03/10/2020] [Revised: 05/28/2020] [Accepted: 05/29/2020] [Indexed: 11/23/2022] Open
Abstract
Background and Purpose Nonketotic hyperglycemia often causes transient visual field defects, but only scattered anecdotes are available in the literature. Methods We report a patient with homonymous superior quadrantanopsia due to nonketotic hyperglycemia and provide a systematic literature review of the clinical features of 40 previously reported patients (41 in total, including our case) with homonymous visual field defects in association with nonketotic hyperglycemia. Results The typical visual field defect was congruous (84.6%), homonymous hemianopsia (87.8%) with macular splitting (61.5%) or sparing (38.5%). It was transient and repetitive in 54.5% of the patients, but it developed as a persistent form in the remainder. Positive visual symptoms such as hallucinations and phosphenes developed in 73.2% of patients. Brain MRI revealed corresponding abnormalities in most patients (84.8%), characterized by a low-intensity white-matter signal or a high-intensity gray-matter signal on T2-weighted or fluid-attenuated inversion recovery images with diffusion restriction or gadolinium enhancement. Most (97.0%) patients recovered completely, with 48.5% treated by glycemic control alone and the remainder also receiving antiepileptic agents. Conclusions Nonketotic hyperglycemia should be considered a possible cause of transient visual field defects, especially when it is associated with repetitive positive visual symptoms and typical MRI findings in hyperglycemic patients.
Collapse
Affiliation(s)
- Sun Uk Lee
- Department of Neurology, Korea University Medical Center, Seoul, Korea.,Department of Neurology, Seoul National University College of Medicine, Seoul, Korea
| | - Jungyeun Lee
- Department of Neurology, Korea University Medical Center, Seoul, Korea
| | - Jee Eun Yoon
- Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyo Jung Kim
- Research Administration Team, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jeong Yoon Choi
- Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea.
| | - Chang Ho Yun
- Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ji Soo Kim
- Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.,Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea
| |
Collapse
|
48
|
Chen XD, Gardner TW. A critical review: Psychophysical assessments of diabetic retinopathy. Surv Ophthalmol 2021; 66:213-30. [PMID: 32866468 DOI: 10.1016/j.survophthal.2020.08.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 08/23/2020] [Accepted: 08/24/2020] [Indexed: 02/08/2023]
Abstract
Diabetic retinal disease remains a leading cause of vision loss despite currently available screening methods, ocular treatments, and efforts to control metabolic dysfunction. It is now understood that diabetes damages the entire retina and the cellular components of the neurovascular unit. Multiple studies have demonstrated impairment of various aspects of retinal function across the spectrum of retinopathy severity. Here we review these tests, the principles underlying their use, clinical data from multiple publications, the strengths and limitations of the studies, and prospects for their application to understand the pathophysiology of diabetic retinal disease and monitor its response to therapy. We focus on visual acuity, contrast sensitivity, color vision, visual field, and dark adaptation and their use to understand the pathophysiology of diabetic retinopathy and as potential endpoints for clinical trials.
Collapse
|
49
|
Abstract
CLINICAL RELEVANCE There is a significant unintended consequences of blue-blocking lenses on visual behaviour, particularly for the detection of colour. Optometrists need to be mindful of this when prescribing the appropriate blue-blocking lenses for individuals who work in environments in which blue light is prevalent. BACKGROUND The selective reduction in visible wavelengths transmitted through commercially available blue-blocking lenses is known to influence object appearance and luminance contrast, and also potentially object colour contrast. The present study investigated the effect of a number of commercially available blue-blocking lenses on colour contrast sensitivity in normal individuals under low and high contrast stimulus conditions. METHODS Five healthy participants (one man and four women), aged between 23 and 39-years, were recruited for this study. Crizal Prevencia (Essilor), Blue Guardian (Opticare), and Blu-OLP (GenOp) lenses were examined in this study in comparison to a control lens (clear lens without blue-filtering coating). In Experiment 1, colour contrast thresholds were measured using a visual search colour detection task in which the colour (CIE Lu'v' red, green, blue and yellow) of the target circle stimulus (randomly located in an annulus of achromatic circles) was systematically reduced using a staircase procedure. As blue-blocking lenses selectively block blue light, in Experiment 2, colour contrast thresholds were specifically quantified for a range of short wavelengths near the attenuation transmittance range of the blue-blocking lenses tested. RESULTS Experiments 1 and 2 showed that colour contrast was impaired only for blue colours, and this was most evident at low contrasts. Additionally, the blue-blocking lenses with lower transmittance profiles led to greater reductions in colour contrast sensitivity and shown to affect colour contrast thresholds. CONCLUSION Our results suggest that while reducing blue light potentially minimises the harmful effect of blue hazard light, blue-blocking lenses can unintentionally reduce colour contrast sensitivity, particularly at low light levels.
Collapse
Affiliation(s)
- Hind Saeed Alzahran
- School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia.,Department of Physics, Taif University, Ta'if, Saudi Arabia
| | - Maitreyee Roy
- School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
| | - Vanessa Honson
- School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
| | - Sieu K Khuu
- School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
| |
Collapse
|
50
|
Abstract
Glaucoma is typically defined as a progressive optic neuropathy characterized by a specific (arcuate) pattern of visual field (VF) and anatomic changes. Therefore, we should be comparing arcuate patterns of damage seen on VFs with those seen on optical coherence tomography (OCT) maps. Instead, clinicians often use summary metrics such as VF pattern standard deviation, OCT retinal nerve fiber (RNF) global thickness, etc. There are 2 major impediments to topographically comparing patterns of damage on VF and OCT maps. First, until recently, it was not easy to make these comparisons with commercial reports. While recent reports do make it easier to compare VF and OCT maps, they have shortcomings. In particular, the 24-2 VF covers a larger retinal region than the commercial OCT scans, and, further, it is not easy to understand the topographical relationship among the different maps/plots within the current OCT reports. Here we show how a model of RNF bundles can overcome these problems. The second major impediment is the lack of a quantitative, and automated, method for comparing patterns of damage seen on VF and OCT maps. However, it is now possible to objectively and automatically quantify this agreement. Together, the RNF bundle model and the automated structure-function method should improve the power of topographical methods for detecting glaucoma and its progression. This should prove useful in clinical studies and trials, as well as for training and validating artificial intelligence/deep learning approaches for these purposes.
Collapse
Affiliation(s)
- Donald C. Hood
- Department of Psychology, Columbia University, New York City, NY, USA
- Department of Ophthalmology, Columbia University Medical Center, New York City, New York, USA
| | - Zane Z. Zemborain
- Department of Psychology, Columbia University, New York City, NY, USA
| | - Emmanouil Tsamis
- Department of Psychology, Columbia University, New York City, NY, USA
| | - C. Gustavo De Moraes
- Department of Ophthalmology, Columbia University Medical Center, New York City, New York, USA
| |
Collapse
|