Glaucoma ; diagnosis ; therapy ; Humans ; Research

The method of observation for quantitative evaluation of disc pattern in early diagnosis of simple glaucoma was discussed in view of necessity of quantitative analysis of disc pattern, outline of quantitative disc pattern, judgement of quantitative disc pattern, type of glaucomatous cupping and classification of grade for glaucoma etc. At this attempt, authors observed vertical cup and disc ratio of physiologic cupping, prior to the investigation of variations of glaucomatous changes of optic disc. The associated factors with this study were briefly mentioned for further study.
Classification ; Early Diagnosis* ; Evaluation Studies as Topic* ; Glaucoma ; Glaucoma, Open-Angle*

The Humphrey Visual Field Analyzer and The Octopus Visual Field Analyzer in Early Primary Open Angle Glaucoma Visual field measurements are useful tool not only for diagnosis but also for management ealuation of early glaucoma. To know the relationship between the results of visual field which were performed by the Humphrey and the Octopus, the 25 disc data which have shown the general reduction of sensitivity on two continuous separate sessions in Humphrey viual field analyzer were transmitted into the Peridata Standard Printout Mode of GIX program on the Octopus 1-2-3. We compared the aspect of Bebie curve of Octopus 1-2-3 and the difference of the global indices between Humphrey and Octopus in the basically input data of age related standard sensitivity of visual field. The general reduction of sensitivity in Humphrey visual field analyzer showed the sensitivity loss in Bebie curve of Octopus 1-2-3(p<5%). In the statistical analysis of Global indices between the two field analyzers there were no differences in the MD and PSD(p>0.05) but were difference the CPSD and SF(p<0.05). In the comparison of the correlation on global indices between the two field analysis. MD and PSD were closely correlated r=0.657, PSD r=0.697, p<0.001), CPSD and SF were statistically correlated(p<0.001) but had lower correlation coefficients(CPSD r=0.478, SF r=0.389). Thus we conclude that there are little differences between the results of two field analyzers.
Diagnosis ; Glaucoma ; Glaucoma, Open-Angle* ; Octopodiformes* ; Visual Fields*

PURPOSE: To evaluate and compare the characteristics of patients whose nerve fiber layer (NFL) photographs showing diffuse or focal nerve fiber layer defects. METHODS: Patients with diffuse NFL defect were selected by comparing upper and lower half of a NFL photo, and we included the patients only when one part of it showed NFL defect. Patients with focal NFL defect were selected only when one eye had a wedge-shape NFL defect. RESULTS: There were no significant differences between the two groups in visual field index, nor in the results of glaucoma hemifield test. However, patients with diffuse NFL defect (13 eyes, 13 patients) mostly had primary open-angle glaucoma (POAG) (62%), and patients with focal NFL defect (13 eyes, 13 patients) mostly had normal- tension glaucoma (NTG) (62%) (p=0.048, chi-square test). CONCLUSIONS: We found significant differences in the diagnosis of glaucoma between the diffuse and focal NFL loss groups. Our results suggest that the characteristics of NFL loss in POAG and NTG may be different.
Diagnosis ; Glaucoma* ; Glaucoma, Open-Angle ; Humans ; Nerve Fibers* ; Visual Fields

OBJECTIVE: In order to study the mechanism of the aqueous humor circulation and its relationship to the glaucoma macroscopically with engineering methods. METHODS: A dynamistic model was presented, which can be used to simulate the situation and the treatment of the primary open angle glaucoma (POAG). The frame of the model was built based on the ophthalmically accepted feedback mechanism between the aqueous humor circulation and the intraocular pressure (IOP). The transfer functions and the parameters were educed from the analysis of physiological theories, the basic elements of hydrodynamics, and the clinical parameters. The relation between the parameters of the system and the episode mechanism of POAG was discussed. A digital method was used to simulate the Challenge test and some medicines' treatment of POAG, and the results were consistent with clinical observations. RESULTS: The results of simulation illuminate that the model can simulate the mechanism of the aqueous humor circulation and the curative mechanism of some medicines under the physiological condition and the pathological condition of the POAG. CONCLUSION: A few parameters which can hardly be captured with clinical method could be obtained from the model. These parameters can be helpful for the diagnosis and prediction of the curative effect.
Aqueous Humor* ; Diagnosis ; Glaucoma ; Glaucoma, Open-Angle* ; Hydrodynamics ; Intraocular Pressure

PURPOSE: To evaluate the ability of qualitative signs for glaucoma diagnosis, both alone and in combination, to discriminate between eyes with and without glaucomatous visual field damage. Furthermore, we investigated whether the characteristic optic disc changes in primary angle-closure glaucoma (PACG) differ from those in primary open-angle glaucoma (POAG). METHODS: Using color polaroid optic disc photographs, we examined 10 qualitative signs in 177 patients with PACG, 184 patients with POAG, and 181 normal subjects. RESULTS: Rim notches and rim shape alteration were found more frequently in patients with POAG than in those with PACG (p<0.05). Disc hemorrhage was not found in any eye in the PACG group. In the early stage (mean deviation >-6 dB) of the PACG and POAG groups, the best qualitative sign was rim shape alteration, and area under the receiver operating characteristic (ROC) curve was 0.696 and 0.768, respectively. The area under the ROC curve for the combination of qualitative signs was 0.802 and 0.918, respectively. CONCLUSIONS: These results suggest that glaucomatous disc damage was less pronounced in the PACG eyes than in the POAG eyes with similar visual field damage. A combination of the qualitative signs of optic disc using multiple logistic regression modelling improved the diagnostic ability.
Diagnosis ; Glaucoma ; Glaucoma, Angle-Closure* ; Glaucoma, Open-Angle* ; Hemorrhage ; Humans ; Logistic Models ; ROC Curve ; Visual Fields

Objective: In previous decades, glaucoma has been primarily attributed to elevated intraocular pressure (IOP), but this has gradually been replaced by the development of optic neuropathy as the central concept of glaucoma in developed countries. However, there still remain strong controversies in the definition of glaucoma in China. In this current review, we are going to discuss these controversies and elaborate on the historical transitions of the definition of glaucoma both in China and developed countries. Furthermore, we will briefly describe the "ocular-cranial pressure gradient" theory and discuss the relationship between glaucoma and degenerative diseases of the central nervous system (CNS) in order to show the complex pathogenesis of glaucoma and the importance for the modification to the definition of glaucoma. Data Sources: We performed a comprehensive search in both PubMed and SinoMed using the following keywords: (a) "primary glaucoma" and "guideline," (b) "ocular-cranial pressure gradient," and (c) "glaucoma," "Alzheimer's disease," and "Parkinson's disease." The literature search included the related articles with no restrictions on publication date. Study Selection: The primary references were Chinese and English articles including (a) original guidelines and expert consensuses of primary glaucoma, (b) reviews focusing on the differences between various versions of these guidelines and consensuses, and (c) papers about ocular-cranial pressure gradient theory and the relationship between glaucoma and CNS degenerative diseases. Results: The definitions and classifications of both primary open-angle glaucoma and primary angle-closure glaucoma differ between Chinese glaucoma consensuses and international primary glaucoma guidelines. Chinese definitions and classifications put more emphasis on the IOP, while international guidelines put more emphasis on the presence of optic neuropathy. The ocular-cranial pressure gradient theory and the research on the relationship between glaucoma and CNS degenerative diseases have provided new directions for exploring the pathogenesis of glaucoma. Conclusions As regards the definition and classification of primary glaucoma, we find that there are still some discrepancies between Chinese expert consensuses and international guidelines. Glaucoma is a disease with complex etiologies, while its common characteristic is a specific optic neuropathy. The current definition and understanding of glaucoma is an ongoing and evolving process, reflecting our latest available evidence on its pathogenesis. Chinese ophthalmology community may need to update our guidelines, accommodating these latest developments.
China ; Glaucoma ; diagnosis ; physiopathology ; Glaucoma, Angle-Closure ; diagnosis ; physiopathology ; Glaucoma, Open-Angle ; diagnosis ; physiopathology ; Humans ; Intraocular Pressure ; physiology ; Ophthalmology ; methods

Many visual field indices have been used for the rapid, precise evaluation of the Humphrey automated visual field. The clinical usefulness of Pericecal Index(PI), the mean sensitivity of 11 test points around the blind spot, was studied in the diagnosis of early glaucoma. PI was calculated in 60 eyes with low tension glaucoma(LTG)[mean defect<10dB], 60 eyes with early visual field change[general reduction of sensitivity(GRS)] and in 60 normal eyes. The difference between glaucomatolls eyes and normal eyes was statistically significant(p<0.01). And also compared PI with the mean sensitivity of 11 control points, located at same eccentricity in lower field and used this as the Control Area(CA). More over, the mean sensitivity of these points in glaucomatous and normal eyes was compared. The difference between PI and CI was only statistically significant in glaucomatolls eyes. On the other hand, We found a significant difference between normal and glaucomatolls control points. Thus we concluded that PI can be the useful visual field indix for the diagnosis of early glaucoma.
Diagnosis ; Glaucoma* ; Hand ; Optic Disk ; Visual Fields*

BACKGROUND: Fundus photographs performed during health check-up were reviewed to determine the usefulness in mass screening. METHODS: Subjects consistine of 3017 people who had undergone physical health check up at the Health Clinic, Dong-Eui Medical Center in 1997 and whose fundus photographs of both eyes were taken showing clearly visible posterior pole and optic disc were chosen as subjects. Medical records which included cases of reported close exam and causes, actual cases of close exam and final diagnoses. RESULTS: Of the 3017 people, reported close exam was performed in 665 (22.0%). Among them glaucoma was suspected in 460 retinal hemorrhagic lesion in 63, retinal degenerative lesion in 67 and others in 75. There were 187 actual cases(28.1%) of close exam including glaucoma suspect in 79, retinal hemorrhagic lesion 47, retinal degenerative lesion 34 and others 27. Among 187 actual cases of close exam, 140 people (1.3%) were eventually diagnosed as glaucoma suspect (60), retinal hemorrhagic lesion (38), retinal degenerative lesion (21) and others (21). CONCLUSIONS: Fundus photographs are useful in mass screening, but performing close exam to enhance the usefulness of the fundus photographs is necessary.
Diagnosis ; Glaucoma ; Mass Screening* ; Medical Records ; Retinaldehyde

Visual field measurements are useful tool for diagnosis and management of glaucoma, and for evaluation of prognosis. But it has intratest and intertest variability, which interfere the precise interpretation of visual field changes. To examine the long term fluctuation, we conducted visual field measurements on three separate sessions in 44 glaucomatous eyes using Humphrey visual field analyzer. Each visual field results were compared with that of the following results. The long term fluctuation of visual field measurem-ent was between 1.85 and 8.81dB and in average 4.36 +/- 1.56dB. If one retinal location shows variaton greater than 8.81dB, automated visual fields must be interpreted cautiously and require confirmation and assessment of other clinical factors.
Diagnosis ; Glaucoma* ; Humans ; Prognosis ; Retinaldehyde ; Visual Fields*