A pilot study was undertaken using data from a population based screening program.The study aimed to determine the reliability of the frequency doubling technology using the Octopus 101 as the gold standard. 38 test eyes underwent frequency of doubling and octopus perimetry.Frequency doubling perimetry results were then correlated with Octopus perimetry results.Twenty-one out of the thirty-eight test results had a positive correlation.Test results showed a high sensitivity (76%) as compared with a lower (48%) specificity of the frequency-doubling perimeter for detecting visual field abnormalities
Human ; PERIMETRY

PURPOSE: To evaluate and compare correlations between structural and functional loss in glaucoma as assessed by optical coherence tomography (OCT), scanning laser polarimetry (GDx VCC, as this was the model used in this study), standard automated perimetry (SAP), and the Humphrey Matrix (Matrix). METHODS: Ninety glaucomatous eyes identified with SAP and 112 eyes diagnosed using Matrix were independently classified into six subgroups, either S1/M1 (MD>-6dB), S2/M2 (-12 Adult ; Aged ; Automation ; Female ; Glaucoma/*diagnosis ; Humans ; Male ; Middle Aged ; Nerve Fibers/pathology ; *Perimetry ; Retina/pathology ; *Scanning Laser Polarimetry ; *Tomography, Optical Coherence

We investigated the relationship between the circumferential extent of peripheral anterior synechiae (PAS) and the severity of visual field defects in primary angle-closure glaucoma (PACG). Correlations between visual field defects and the extent of PAS were analyzed in 73 eyes; 28 with and 45 without acute attacks. Spearman's correlation coefficient between the severity of visual field defects and the extent of PAS was 0.348 (P = 0.003) in all subjects (n = 73), 0.377 (P = 0.012) in the PACG eyes without acute attacks (n = 45), and 0.338 (P = 0.079) in the eyes with acute attacks (n = 28). Our results showed a statistically significant correlation between the extent of PAS and the severity of visual field damage in PACGoverall, and especially in PACG patients without a history of acute attacks.
Aged ; Comparative Study ; Female ; Glaucoma, Angle-Closure/*etiology/physiopathology ; Humans ; Intraocular Pressure ; Iris Diseases/*complications/physiopathology ; Male ; Middle Aged ; Perimetry ; Scotoma/*etiology/physiopathology ; *Visual Fields

We conducted an investigation of the relation between RNFL thickness and optic disc size along with an interocular comparison of optic disc size, RNFL thickness, and RNFL density in healthy subjects. A total of 64 normal eyes from 32 Korean volunteers were enrolled in this study. A GDx Nerve Fiber Analyzer with software version 2.0.09 was used to image all subjects. Optic disc size was measured by pi x (horizontal radius) x (vertical radius). The RNFL density of each quadrant was calculated by dividing each quadrant integral by the total integral. Optic disc size was positively correlated with the total RNFL thickness (r = 0.615, p < 0.01). Optic disc size and RNFL density were inversely related in the superior quadrant (r = -0.248, p < 0.05). There was a significant positive correlation between optic disc size and RNFL density in the nasal quadrant (r = 0.439, p < 0.01) and the temporal quadrant to a certain degree. A significant positive correlation was found between the right and left eyes in terms of total RNFL thickness in and that of each quadrant. Interocular RNFL density was positively correlated in both the temporal and nasal quadrants. These findings must be considered when one evaluates and compares RNFL measurements between two eyes as is often the case where both eyes are usually affected in the course of glaucomatous RNFL damage.
Adult ; Comparative Study ; Female ; Human ; Lasers/diagnostic use ; Male ; *Nerve Fibers ; Optic Disk/*anatomy & histology ; Optic Nerve/*anatomy & histology ; Perimetry ; Weights and Measures

To estimate the rate of visual field progression in primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG), we reviewed the medical records of POAG and PACG patients who had a minimum of 5-year longitudinal Goldmann visual field data. I4e and I2e isopters were quantified using grid systems. The rate of change was calculated from the slope of a linear fit to a series of average visual field scores. Twenty-three eyes of POAG patients and 25 of PACG patients were studied. The rate of visual field score change was -2.00 +/- 2.0% per year in the PACG group, and -0.81 +/- 1.0% per year inthe POAG group. In these two patient groups, who were on conventional treatment at two referral hospitals, better visual field on initial presentation yielded faster progression in the POAG group, while the higher average of highest intraocular pressure in each year during follow-up was related to faster progression in the PACG group.
Adult ; Aged ; Comparative Study ; Disease Progression ; Female ; Glaucoma, Angle-Closure/*physiopathology ; Glaucoma, Open-Angle/*physiopathology ; Humans ; Intraocular Pressure ; Male ; Middle Aged ; Perimetry/methods ; Retrospective Studies ; Vision Disorders/etiology/*physiopathology ; *Visual Fields

The aim of this study was to determine the relationship between the frequency doubling technology (FDT) screening algorithm and parapapillary retinal nerve fiber layer (RNFL) thickness in the eyes of glaucoma suspects and patients with open angle glaucoma. FDT C20-1 screening program and a scanning laser polarimetry (SLP) system (GDx-NFA) was used to assess 53 glaucomatous eyes, 53 glaucoma suspects and 36 normal control eyes. In glaucomatous eyes, there were correlations between the FDT the screening algorithm and RNFL retardation values in several polarimetric indices, most significantly "inferior thickness" (r = -0.321, P = 0.029). In the eyes of glaucoma suspects, however, we observed no correlation between the FDT results and RNFL retardation values (r = 0.080, P > 0.05, "inferior thickness"). In glaucomatous eyes, the abnormal scores obtained with FDT screening program correlated negatively with RNFL retardation values, as measured by SLP. Despite poor correlation between the FDT abnormal score and RNFL retardation value in glaucoma suspects, detection of abnormality using the FDT screening protocol may aid in the assessment of early glaucomatous structural damage.
Comparative Study ; Glaucoma, Open-Angle/*diagnosis/physiopathology ; Humans ; Intraocular Pressure ; Lasers/diagnostic use ; Microscopy, Confocal ; Middle Aged ; Nerve Fibers/*pathology ; Ocular Hypertension/diagnosis/physiopathology ; Optic Nerve/*pathology ; Perimetry/*methods ; Retinal Ganglion Cells/*pathology

PURPOSE: To evaluate the relationship between optic disc and retinal nerve fiber layer (RNFL) measurements obtained with the optical coherence tomography (OCT) and the Heidelberg retina topography (HRT) in normal, normal tension glaucoma (NTG), and high tension glaucoma (HTG). METHODS: Normal, NTG and HTG subjects who met inclusion and exclusion criteria were evaluated retrospectively. One hundred seventy eyes of 170 patients (30 normal, 40 NTG, and 100 HTG) were enrolled. Complete ophthalmologic examination, HRT, OCT, and automated perimetry were evaluated. RESULTS: Disc area, cup area and cup/disc area ratio measured with HRT were significantly different between NTG and HTG (all p<0.05). Mean RNFL thickness measured by OCT with ascanning diameter of 3.4 mm was larger in NTG than HTG (84.97+/-24.20 micrometer vs. 73.53+/-27.17 micrometer, p=0.037). Four quadrant RNFL thickness measurements were not significantly different between NTG and HTG (all p>0.05). Mean deviation and corrected pattern standard deviation measured by automated perimetry was significantly correlated with mean and inferior RNFL thickness in both NTG and HTG (Pearson's r, p<0.05). Mean RNFL thickness/disc area ratio was significantly larger in HTG than NTG (35.21+/-18.92 vs. 31.30+/-10.91, p=0.004). CONCLUSIONS: These findings suggest that optic disc and RNFL damage pattern in NTG may be different from those of HTG.
Adult ; Aged ; Axons/*pathology ; *Diagnostic Techniques, Ophthalmological ; Female ; Glaucoma, Open-Angle/*diagnosis ; Humans ; Male ; Middle Aged ; Ocular Hypertension/diagnosis ; Optic Disk/*pathology ; Optic Nerve Diseases/*diagnosis ; Perimetry ; Retinal Ganglion Cells/*pathology ; Retrospective Studies ; *Tomography, Optical Coherence ; Visual Fields

PURPOSE: To compare quantitative polarimetric measurements in eyes with NTG and HTG using GDx-VCC. Both groups were matched by age and glaucoma stage based on the Humphrey visual field test. METHODS: We retrospectively reviewed the records of 146 patients who underwent Humphrey field analysis (HFA) and GDx-VCC. We compared outcomes of retinal nerve fiber layer (RNFL) parameters among the three groups by ANOVA and between each pair of groups using the Tukey-Kramer Post-Hoc test. We also evaluated the sensitivity and specificity of GDx-VCC in detecting glaucoma in each group. RESULTS: The mean age and HFA mean deviation (MD) were 55.6+/-9.5 years and -0.8+/-1.5 dB in 47 control patients, 59.4+/-9.0 years and -5.77+/-4.38 dB in 49 NTG patients, and 59.4+/-11.7 years and -8.09+/-6.77 dB in 51 HTG patients, respectively. All thickness parameters were lower in HTG patients compared to NTG patients, but there were no significant differences in ratio parameters between age-matched early HTG and NTG patients. The sensitivity of GDx-VCC was significantly higher in both early and total HTG patients compared to the respective groups of NTG patients. CONCLUSIONS: Compared to eyes with NTG, eyes with HTG showed reduced RNFL thickness and ratio parameters when patients were age and visual field matched. GDx-VCC appeared to be more sensitive in detecting RNFL damage in HTG patients.
Visual Fields ; Severity of Illness Index ; Retrospective Studies ; Retinal Ganglion Cells/*pathology ; Perimetry/*methods ; Nerve Fibers/*pathology ; Middle Aged ; Lasers/*diagnostic use ; Intraocular Pressure/*physiology ; Humans ; Glaucoma, Open-Angle/*pathology/physiopathology ; Follow-Up Studies ; Aged

A 21-year-old woman presented with bilateral optic neuritis, combined with central retinal vein occlusion. General physical examination and neurologic consultation revealed no other findings. Laboratory investigation yielded an elevated erythrocyte sedimentation rate, positive LE preparation, elevated ANA titer, and elevated blood urea nitrogen and creatinine levels. Diagnosis of systemic lupus erythematosus (SLE) was made. Renal failure developed quickly and she was treated with hemodialysis, transfusion and subsequently systemic corticosteroid. Anti-phospholipid antibody was positive to lupus anti-coagulant and the titer was normalized after 2-month steroid therapy at which time the visual outcome differed between the eyes. The right eye showed improvement in visual acuity and visual field, but the left eye was not improved and retained a central scotoma. SLE needs to be considered in young women with optic neuritis when other causes of optic neuritis have been excluded, and serologic tests including anti-phospholipid antibody should be conducted.
Adult ; Case Report ; Female ; Fluorescein Angiography ; Human ; Lupus Erythematosus, Systemic/complications/*diagnosis/drug therapy ; Optic Neuritis/*diagnosis/drug therapy/etiology ; Perimetry ; Prednisolone/*therapeutic use ; Treatment Outcome ; Visual Acuity ; Visual Fields

PURPOSE: To evaluate retinal nerve fiber layer (RNFL) defect by a new scoring system for RNFL photography using the Heidelberg Retina Angiograph 1 (HRA1). METHODS: This retrospective study included 128 healthy eyes and 836 primary open-angle glaucoma eyes. The RNFL photography using HRA1 was interpreted using a new scoring system, and correlated with visual field indices of standard automated perimetry (SAP). Using the presence of RNFL defect, darkness, width, and location, we established the new scoring system of RNFL photos. RESULTS: The mean RNFL defect score I in the early, moderate, severe, and control groups were 7.3, 9.2, 10.4, and 3.6, respectively. The mean RNFL defect score II in the early, moderate, severe, and control groups were 14.5, 28.5, 43.4, and 3.4, respectively. Correlations between the RNFL defect score II and the mean deviation of SAP was the strongest of the various combinations (r=-0.675, P<.001). CONCLUSIONS: Using a new scoring system, we propose a method for semi-quantitative interpretation of RNFL photographs. This scoring system may be helpful to distinguish between normal and glaucomatous eyes, and the score is associated with the severity of visual field loss.
Equipment Design ; Female ; Fluorescein Angiography/*instrumentation ; Fundus Oculi ; Glaucoma, Open-Angle/*classification/pathology/physiopathology ; Humans ; Male ; Middle Aged ; Nerve Fibers/*pathology ; Perimetry ; Photography/*instrumentation ; Reproducibility of Results ; Research Design/*statistics & numerical data ; Retinal Ganglion Cells/*pathology ; Retrospective Studies ; Severity of Illness Index ; Visual Fields