Numerous cicatrizing and granulomatous diseases that simultaneously involve choroid, retina and their intervening Bruch's membrane may cause choroidoretinal vascular anastomoses. Anastomoses at capillary level and in neovascular granulomatous tissue are probably not uncommon under these and related circumstances, but choroidal connections to large-caliber segments of otherwise normal retinal arterioles and venules are unusual. We retrospectively studied 44 eyes of 44 patients with choroidal ruptures after blunt trauma. Of 44 choroidal ruptures, three patients had chorioretinal ruptures and choroidoretinal vascular anastomoses. This report describes three cases of large-caliber choroidoretinal anastomoses after chorioretinal ruptures.

Computerized image analysis of simultaneous stereoscopic videographic images has been used to study structural parameters of the optic nerv head. Although these instruments are of great interest as research tools, the current economic climate and the great cost make their utility for the average ophthalmologist unlikely. Seventy unselected optic nerve heads of 44 normal subjects(22 men, 22 women, mean age 45.8) were evaluated by magnification-corrected morphometry of optic disc photographs. The radius and angle were measured by a computer graphic program(Adobe Photoshop(TM)). The mean disc area(2.48 +/- 0.46 mm2), the mean cup area(0.59 +/- 0.25mm2), and the mean rim area(1.90 +/- 0.35mm2) were evaluated. The coefficients of variation of intraobserver determination were as follows: vertical disc diameter 0.92%. horizontal disc diameter 1.40%, vertical cup diameter 3.64, horizontal cup diameter 3.14%, disc area 1.33%, cup area 3.28%, and neuroretinal rim area 1.82%. The median interobserver percentage differences were as follows: vertical disc diameter 0.80%, horizontal disc diameter 0.83%. vertical cup diameter 3.75%, horizontal cup diameter 1.59%, disc area 1.57%. cup area 3.03%, and neuroretinal rim area 2.53%. While it is similar to the method of measuring the manual planimetry. the measuring of optic nerve head can be done directly on the monitor of personal computer by scanning the photograph. This method of measurement can be used clinically since it has a high reproducibility.
Climate ; Computer Graphics* ; Female ; Head ; Humans ; Male ; Microcomputers ; Optic Disk ; Radius

PURPOSE: To determine whether acute or subacute attack influences the peripapillary atrophy in patients with primary angle-closure glaucoma (PACG). METHODS: Thirty-three eyes with PACG that had an acute or subacute attack (symptomatic PACG group) and 30 eyes with chronic PACG that had no attack (asymptomatic chronic PACG group) were studied. The rim/disc area ratio were matched in both groups. There were no statistically significant differences in the age, sex, refractive error, optic disc area, and visual field mean deviation between the two groups. RESULTS: Nineteen of 33 eyes (57.6%) with symptomatic PACG group and 20 of 30 eyes (66.7%) with asymptomatic chronic PACG group had zone beta. The mean zone beta/disc area ratio was 0.31 in symptomatic PACG group and was 0.52 in asymptomatic chronic PACG group. There were no statistically significant differences regarding the prevalence of zone beta (P=0.63) and the zone beta/disc area ratio (P=0.09) between the two groups. CONCLUSIONS: These findings suggest that the peripapillary atrophy in PACG is almost independent of acute or subacute attack.
Atrophy* ; Glaucoma, Angle-Closure* ; Humans ; Prevalence ; Refractive Errors ; Visual Fields

PURPOSE: To determine the characteristics of visual field defects in acute primary angle-closure glaucoma and identify risk factors affecting such field defects. METHODS: Automated static perimetry was performed in 60 patients at least 3 months after remission of the acute attack. Glaucomatous visual field defects were defined as 3 or more contiguous points on the pattern deviation plot depressed at p<5% level and one point depressed at a p<1% level. RESULTS: Visual field defects were seen in 40 (67%) of 60 patients. The upper nasal area was most frequently and more severely affected. Only 2 cases (5%) presented a localized type defect. The multiple logistic regression showed that sex (odds ratio=23.1, 95% confidence interval [CI]=3.2 ~ 168.6, p=0.002) and vertical cup to disc ratio (odds ratio=5.5, 95% CI=1.2 ~ 24.8, p=0.03) were significant risk factors for visual field defects. Duration of the acute attack was a marginally significant risk factor (odds ratio=5.2, 95% CI=0.8 ~ 31.8, p=0.08). CONCLUSIONS: The upper nasal visual field was affected most frequently and more severely. The localized defect was rare. Women and the large vertical cup to disc ratio were associated with increased risk for visual field defects. A longer duration of the acute attack seems to more likely develop visual field damage.
Female ; Glaucoma, Angle-Closure* ; Humans ; Logistic Models ; Risk Factors* ; Visual Field Tests ; Visual Fields*

PURPOSE: To identify the risk factors associated with false negative findings of optical coherence tomography (Stratus OCT) in patients with photographic localized retinal nerve fiber layer (RNFL) defects. METHODS: Twenty-four patients with preperimetric glaucoma and 173 patients with perimetric glaucoma, all with localized RNFL defects were included in the present study. The patients were divided into 2 groups according to the presence or absence of detection of photographic defects by OCT. Gender, age, refractive error, diabetes, hypertension, central corneal thickness, type of glaucoma, mean deviation, pattern standard deviation, average RNFL thickness, disc area, and photographic RNFL defect related variables (location, number, and angular width) were compared between the 2 groups. Each variable was initially evaluated by univariate analysis and significant variables (p < 0.1) were included in the logistic regression analysis. RESULTS: Photographic RNFL defects were not detected by OCT in 51 (25.9%) of the 197 eyes. The angular locations and widths of RNFL defects by OCT were significantly correlated with those of RNFL defects by red-free RNFL photographs (Pearson correlation coefficient R = 0.98 and 0.64, respectively). Logistic regression analysis revealed the risk factors for false negative findings of OCT included average RNFL thickness (odds ratio = 1.106, 95% confidence interval [CI] = 1.057-1.156, p < 0.001) and angular width of defect (odds ratio = 0.929, 95% CI = 0.884-0.977, p = 0.004). CONCLUSIONS: This present study suggests that false negative findings of OCT in patients with photographic localized RNFL defects were associated with thicker RNFL thickness and smaller angular width of RNFL defect.
Eye ; Glaucoma ; Humans ; Hypertension ; Logistic Models ; Nerve Fibers ; Refractive Errors ; Retinaldehyde ; Risk Factors ; Tomography, Optical Coherence

Generalized narrowing of the retinal vessels has been recognized for glaucomatous and nonglaucomatous optic neuropathies. To evaluate how closely peripapillary retinal vessel diameters were related to functional and structural optic nerve damage in primary open-angle glaucoma, the data of the vessel diameters were correlated with intra- and peripapillary morphometric parameters and visual field indices. The diameters of the superior temporal and inferior temporal retinal artery and vein were measured at the opticdisc border from optic disc photographs of 234 eyes of 141 patients with primary open-angle glaucoma and 139 eyes of 86 normal subjects. Only one eye per patient and subject was taken for statistical analysis. The diameters of the inferior temporal and superior temporal retinal artery were significantly correlated with the intrapapillary parameters, the peripapillary parameters and the visual field indices. The correlation coefficients were highest for the neuroretinal rim data (r>0.37, p=0.0001), followed by mean deviation, vertical cup to disc ratios, whereas total peripapillary atrophy data, zone beta and zone alpha data were relatively low. Concerning the vessel diameter, the highest correlation coefficients were calculated for the inferior temporal artery, followed by the superior temporal artery. No correlation was found with age and refraction. The results indicate that, in primary open-angle glaucoma, the vessel diameter redduces with decreasing area of the neuroretinal rim, increasing visual field defects and increasing peripapillary atrophy. Its evaluation can be helpful for the diagnosis of glaucoma and possibly also for follow-up.
Atrophy ; Diagnosis ; Glaucoma ; Glaucoma, Open-Angle ; Humans ; Optic Nerve Diseases ; Optic Nerve* ; Retinal Artery ; Retinal Vessels* ; Retinaldehyde* ; Temporal Arteries ; Veins ; Visual Fields

Narrowing of the retinal vessels in chronic glaucoma has been recognized only recently. We performed this study to evaluate the vessel diameter in normal and glaucoma eyes, addressing whether the retinal vessel diameters differ with the degree of glaucomatous optic nerve damage. The diameters of the superior temporal and inferior temporal retinal artery and vein were measured at the optic disc border from optic disc photographs of 234 eyes of 141 patients with primary open-angle glaucoma and 139 eyes of 86 normal subjects. The photographic magnification was corrected according to Littmanns method. Only one eye per patient and subject was taken for statistical analysis. According to the neuroretinal rim/disc area ratio, the glaucoma group was divided into four stages(early; more than 0.61, medium; 0.60~0.41, advanced; 0.40~0.21, far advanced; less than 0.20). In the normal group the diameter of the inferior temporal vein(0.130+/-0.020mm) was the largest, followed by the superior temporal vein(0.117+/-0.017mm), the inferior temporal artery(0.102+/-0.016mm), finally the superior temporal artery(0.093+/-0.012mm). The retinal vessel diameter decreased significantly with decreasing of the neuroretinal rim/disc area ratio. In the glaucomatous eyes as compared to the normal eyes, the diameters of the inferior temporal and superior temporal retinal artery were significantly smaller at the early and medium stages(p<0.03, p<0.02, respectively). Whereas both inferior temporal and superior temporal retinal vein diameters were significantly samller at the far advanced stage(p=0.01, p=0.005, respectively). The results indicate that generalized reduction of the retinal vessel diameter throughout the retina is related to the severity of glaucoma. From a diagnostic point of view, evaluation of artery diameter rather than vein diameter may be helpful for the differentiation between normal and glaucomatous eyes.
Arteries ; Glaucoma* ; Glaucoma, Open-Angle ; Humans ; Optic Nerve ; Retina ; Retinal Artery ; Retinal Vein ; Retinal Vessels* ; Retinaldehyde* ; Veins

The relationship between quantitative structual measurements of the optic nerve head and visual field defects was studied in 150 eyes of 150 patients with primary open-angle glaucoma(POAG). The radius and angle of the optic disc and cup were measured every 30 degrees to obtain rim area, rim area to disc area ratio, cup area, and cup to disc ratio with a computer graphic program(Adobe PhotoshopTM) and the photographic magnification was corrected according to Littmann`s method. The visual field indices including mean deviation(MD) and corrected pattern standard deviation(CPSD), using a Humphrey Field Analyzer(C 302) were obtained. Each intrapapillary parameter showed statistically significant linear correlation with MD. And those disc parameters also significantly correlated with CPSD, although this correlation was relatively lower than that of intrapapillary parameter with MD. Rim area to disc area ratio and MD were most highly correlated(r=0.712, p=0.0001), and correlation of rim are with MD followed next(r=0.670, p=0.0001). These findings suggest that intrapapillary parameters in POAG were more correlated with the overall visual field depression(MD) than the localized visual field change(CPSD). The rim area to disc area ratio rather than the rim area itself, was more related to the diffuse visual field defects.
Computer Graphics ; Glaucoma, Open-Angle* ; Humans ; Optic Disk ; Radius ; Visual Fields*

This study was undertaken to evaluate how closely peripapillary atrophy(PPA) is related to structual and functional optic nerve damage in primary open-angle glaucoma. Magnification-corrected morphometry of photographs using computer graphic program and automated static threshold perimetry were performed on 234 eyes of 141 patients with primary open-angle glaucoma and 139 eyes of 86 normal subjects(control). For the data analysis, only one eye of each patient was randomly selected. Both groups did not differ significantly in age, refractive error and disc area. PPA differentiated into two different zone(alpha and beta). The area of zone alpha, zone beta and the total PPA enlarged significantly)P=0.0001) with a decreasing rim/disc area ratio(r=0.36, r=0.46, r=0.50, respectively), rim area(r=-0.27, r=-0.44, r=-0.43, respectively) and mean deviation(r=-0.30, r=-0.34, r=-0.39, respectively). They enlarged significantly(P=0.0001) with an increasing vertical(r=0.35, r=0.42, r=0.46, respectively) and horizontal cup to disc ratio(r=0.31, r=0.37, r=0.41, respectively) and cup area(r=0.36, r=0.41, r=0.46, respectively). Concerning peripapillary parameters, the correlation coefficients were generally lowest for zone beta and the highest for total PPA. The peripapillary atrophy showed a spatial relation to neuroretinal rim loss. These results indicate that enlargement of PPA is related to the severity of the glaucomatous optic nerve damage and visual field defects.
Atrophy* ; Computer Graphics ; Glaucoma, Open-Angle ; Humans ; Optic Nerve* ; Refractive Errors ; Statistics as Topic ; Visual Field Tests ; Visual Fields

The aim of this study was to compare optic disc size obtained using the two methods Color polaroid photographs of optic disc of 130 normal subjects and 174 patients with glaucoma were evaluated by means of computeraided morphometry. In the first method, the optic disc size were calculated by applying the modified formula of an ellipse, where area=pi/4xthe horizontal diameterxthe vertical diameter. In the second method, we obtained optic disc size [] using the twelve radii that were measured every 30 degrees. Magnification effects of the eye and camera were corrected in the two methods. The measurements of the optic disc area(2.49mm2), cup area(1.01mm2) and neuroretinal rim area (1.49mm2) by the first method were significantly(P<0.003, Wilcoxon signed -rank test) different from the measurements by the second method(2.48mm2, 1.03mm2, 1.45mm2, respectively) (the average difference; 0.05+/-0.05mm2, 0.05+/-0.05mm2, 0.07+/-0.06mm2,respectively). The mean error for the neuroretinal rim area was 4.2+/-3.3% in the normal group and 7.5+/-8.5% in the glaucoma group(P=0.005). It increased with decreasing neuroretinal rim area and increasing visual field defects. Thus the magnification corrected measurements of the horizontal and vertical diameters and the modified formula of an ellipse can be used for a quick approximate estimation of the optic disc size, but cannot replace more accurate method of optic disc measurements using twelve radii.
Glaucoma ; Humans ; Visual Fields