Objective To assess the in vivo dynamic blood flow features of posterior optic nerve head (ONH) in rat model of nonarteritic anterior ischemic optic neuropathy (rNAION). Methods rNAION was established with Rose Bengal and argon green laser in Sprague-Dawley rats. Fundus photography and fundus fluorescein angiography (FFA) were performed to assess the dynamic changes of optic disc in morphology in 90 days and in blood perfusion in 3 hours after the induction of disease. Histological examinations were performed to evaluate the success of modeling. The dynamic blood flow kinetics of posterior ONH in rNAION were measured by Laser Doppler Flowmetry (LDF) on the day 3, 7, 14, 21, and 40 after the disease induction. One-way ANOVA, Student's t-test and Bonferroni adjustment were used for multiple comparisons of kinetic measurements of blood flow. Results Optic disc edema and subsequent resolution associated with the development of optic disc pallor were observed in rNAION. FFA showed that the optic disc was hypofluorescence in the early phase and hyperfluorescence in the late phase. Histological studies suggested edema and loosened tissues of ONH, loss of retinal ganglion cells (RGCs), optic nerve substance and gliosis. Compared to the naive rats, the blood flow kinetics of posterior ONH in rNAION significant reduced at each time point after modeling (F=175.06, P<0.0001). The reductions were specifically remarkable in 14 days after the disease induction (All P<0.01). Conclusions Continuous blood perfusion reduction was found in rNAION, with significant alteration in 14 days after disease induction. Our results provided important information for understanding the hemodynamic changes in rNAION.
Animals ; Disease Models, Animal ; Fluorescein Angiography ; Hemodynamics ; physiology ; Humans ; Male ; Optic Disk ; pathology ; physiopathology ; Optic Neuropathy, Ischemic ; pathology ; physiopathology ; Rats ; Rats, Sprague-Dawley ; Retinal Ganglion Cells ; physiology

A 32-year-old man with blurred vision in the right eye and headache presented with anterior uveitis, an intraocular pressure (IOP) of 60 mmHg, an open angle, no visual field defects, and normal optic nerve. He had a history of five previous similar attacks. In each of the previous instances, his anterior uveitis and high IOP were controlled with antiglaucoma medications and topical steroids. However, at the fifth attack, his optic disc was pale and a superior paracentral visual field defect was shown. Brain magnetic resonance image studies were normal. This case represents that a recurrent Posner-Schlossman syndrome (PSS)-induced optic disc atrophy likely due to ocular ischemia caused by a recurrent, high IOP. Although PSS is a self-limiting syndrome, we should manage high IOP and prevent ischemia of the optic nerve head by treating with ocular antihypertensive medications.
Atrophy/diagnosis/etiology ; Diagnosis, Differential ; Glaucoma, Open-Angle/*complications/diagnosis/physiopathology ; Humans ; *Intraocular Pressure ; Male ; Optic Disk/*pathology ; Optic Nerve Diseases/diagnosis/*etiology/physiopathology ; Syndrome ; Young Adult

Because the optic disc in myopic eyes is different from a normal optic disc, there are many difficulties in examining the optic discs of myopic eyes. To study optic disc change due to myopia, we performed a morphometrical study of stereophotographs of 61 men, 109 eyes, who had no glaucoma history. The range of refractive error was from +0.75 diopter to -12.75 diopter, and all subjects had intraocular pressure below or equal to 21 mmHg. According to the increase in the myopic degree, the temporal slope of the disc cup was significantly decreased, but the ratio of the vertical disc diameter (VDD) to the horizontal disc diameter and the ratio of the width of peripapillary atrophy (PPA) to the VDD were significantly increased. The above results suggests that in high myopia the optic disc was tilted and the rim-cup border was indistinct and there are some problems in the estimation of the morphometric parameters. Also in evaluation of the PPA of myopic glaucoma patients, there may be some difficulty in deciding whether it is due to myopic change or glaucomatous damage.
Adolescent ; Adult ; Anthropometry ; Female ; Fundus Oculi ; Humans ; Image Processing, Computer-Assisted ; Male ; Myopia/*pathology/*physiopathology ; Optic Disk/*pathology ; Photography ; Refractive Errors/*physiopathology

BACKGROUNDMorphological changes of the vasculature system in patients with myopia have been observed by Doppler ultrasound and fundus fluorescein angiography (FFA); however, these studies have limitations. Doppler ultrasound provides low-resolution images which are mainly obtained from visualized large vessels, and FFA is an invasive examination. Optic coherence tomography (OCT) angiography is a noninvasive, high-resolution measurement for vascular density. The purpose of this study was to investigate the change of vascular density in myopic eyes using OCT angiography.

METHODSThis cross-sectional study includes a total of 91 eyes from 47 participants including control, moderate, and high myopia that were evaluated by OCT angiography. Patients with myopia were recruited from the Refractive Department, Shenzhen Aier Eye Hospital, from August 5, 2015 to April 1, 2016. Emmetropic eyes were from healthy volunteers. The vascular density at macula and optic disc regions, ganglion cell complex (GCC) thickness, and retinal nerve fiber layer (RNFL) thickness were measured. Their relationships with axial length (AL) and refractive error were analyzed. One-way analysis of variance (ANOVA), Pearson's correlation, and generalized estimating equation were used for statistical analysis.

RESULTSBoth superficial and deep macular vascular density were highest in control (25.64% ± 3.76% and 37.12% ± 3.66%, respectively), then in moderate myopia (21.15% ± 5.33% and 35.35% ± 5.50%, respectively), and lowest in high myopia group (19.64% ± 3.87% and 32.81% ± 6.29%, respectively) (F = 13.74 and 4.57, respectively; both P < 0.001). Both superficial (β = -0.850 and 0.460, respectively) and deep (β = -0.766 and 0.396, respectively) macular vascular density were associated with AL and spherical equivalent (all P < 0.001). Superficial macular vascular density was associated with GCC thickness (β = 0.244, P = 0.040), independent of spherical equivalent. The vascular density in optic disc region had no difference among the three groups, and it was not associated with AL, spherical equivalent, or RNFL thickness.

CONCLUSIONOur results suggested that with the increase of myopia, the vascular density decreased in macular region, but not in optic disc region.

Adult ; Cross-Sectional Studies ; Eye ; blood supply ; Female ; Fluorescein Angiography ; Humans ; Macula Lutea ; pathology ; physiopathology ; Male ; Middle Aged ; Myopia ; pathology ; physiopathology ; Optic Disk ; pathology ; physiopathology ; Prospective Studies ; Retina ; pathology ; physiopathology ; Retinal Ganglion Cells ; pathology ; Tomography, Optical Coherence ; Young Adult

To know the pattern of visual field (VF) defect of low tension glaucoma (LTG), its diffuse and localized VF defects were compared using the significance values (p-value) of mean deviation (MD) and corrected pattern standard deviation (CPSD), which are calculated with STATPAC in Humphrey Visual Field Analyser. Sixteen eyes of LTG were enrolled and 34 eyes of primary open angle glaucoma (POAG) were used as controls. The degree of VF defects in LTG and POAG was relatively mild with the p-value of MD equal to or greater than 1%. Neither mean MD nor mean CPSD of LTG was significantly different from each of POAG (p > 0.8 and p > 0.2, respectively). Comparing the p-values of MD and CPSD, many patients showed more significant p-value of MD in LTG and POAG (62.5% and 61.8%, respectively). However, relatively more severe defect of CPSD tended to occur more frequently in LTG than in POAG (25% and 5.9%, respectively, chi-square = 4.964, p < 0.09). The relation between p-values of MD and CPSD was not significantly influenced by the intraocular pressure, MD or vertical cup to disc ratio in either LTG or POAG.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Glaucoma, Open-Angle/*pathology/physiopathology ; Humans ; *Intraocular Pressure ; Male ; Middle Aged ; Optic Disk/*pathology ; Probability ; Vision Disorders/*pathology ; *Visual Fields

PURPOSE: We analyzed the effect of the changes of the optic disc area (ODA) caused by the axial length and the refractive error, and the consequent changes of the distance from the optic disc margin to the circular scan (OD-CS) of Optical coherence tomography (OCT) on the measurement of the retinal nerve fiber layer thickness(RNFLT) were examined. METHODS: One hundred two eyes of 51 children (age range 4 to 15 years) were measured using OCT including the RNFLT. For the ODA and the OD-CS, the relative area formed by the ODA and the circular scan was obtained. In addition, the correlation of the refractive error and the axial length to the optic disc factors was assessed. RESULTS: As hyperopia progresses to myopia, the axial length became longer, the ODA became smaller (r=-0.442, p=0.000) and the OD-CS showed a tendency to increase (r=0.471, p=0.000). As the OD-CS became longer, the measured average RNFLT decreased significantly (r=-0.248, p=0.012), and the ODA and the OD-CS showed a significant correlation to the RNFL thickness that was measured in the nasal and inferior areas, the S2, N2 and N3 areas and the I1 area. CONCLUSIONS: As ODA becomes smaller and the OD-CS becomes longer, the RNFLT measured in the nasal and inferior areas, the S2, N2, N3, I1 area has a tendency to be thinner. Hence, consideration of the disc area is required when interpreting the RNFLT of these eyes.
Adolescent ; Aging/physiology ; Child ; Child, Preschool ; Female ; Glaucoma/diagnosis ; Humans ; Male ; Nerve Fibers/*pathology ; Optic Disk/*pathology ; Optic Nerve Diseases/*physiopathology ; Refraction, Ocular ; Refractive Errors/*physiopathology ; Retinal Ganglion Cells/*pathology ; Tomography, Optical Coherence ; Visual Acuity

To investigate the correlation between optic nerve head configuration and visual field defects, optie nerve head analysis using confocal scanning laser tomography (Heidelberg Retina Tomograph, HRT) and automated static threshold perimetry using a Humphrey Field Analyzer (program C3O-2) were performed on 81 eyes of 44 primary open-angle glaucoma (POAG) patients. The optic nerve head parameters-rim area, rim volume, mean retinal nerve fiber layer thickness, height variation contour, and third moment in contour were measured by HRT and were analyzed for correlation with visual field indices-mean deviation, and corrected pattern standard deviation. All optic nerve hend parameters except HVC correlated significantly with the visual field indices; the highest correlation was between rim area and mean deviation (r = 0.6172, p < 0.O0001). The rim area of the superior and inferior quadrants correlated significantly with the visual field defects in corresponding sectors. Structural optic disc measurements by HRT correlated significantly with funetional optic nerve head damage in POAG
Female ; Glaucoma, Open-Angle/*pathology/physiopathology ; Humans ; Male ; Middle Aged ; Nerve Fibers/pathology ; Optic Disk/*pathology/physiopathology ; Retina/pathology ; Tomography/*methods ; Vision Disorders/*pathology/physiopathology ; Visual Field Tests ; *Visual Fields

In the early stages of glaucoma, the disc changes prior to visual field loss, so assessment of the optic disc is very important for the evaluation of the glaucoma patient. The aim of this study is to assess the glaucomatous disc and to look for the features of the optic disc that are commonly associated with early visual field loss. Forty-three eyes of 28 patients were included in this investigation. The criteria for inclusion were a cup/disc(C/D) ratio of more than 0.4 by direct ophthalmoscopy, no visual field defect with Goldmann perimetry, and open anterior chamber angle. Each optic disc was photographed with a Canon fundus camera with Polaroid 600 Plus film. Each photographic set was then examined stereoscopically for morphologic parameters: 1) comparison of vertical versus horizontal C/D ratio; 2) presence of nasal cupping; 3) presence of overpassing vessels; 4) presence of baring of circumlinear vessels; 5) presence of peripapillary atrophy; 6) ratio of the thinnest neuroretinal rim(NRR) width in the vertical sectors of the NRR width of the temporal sector. All subject's central visual fields were examined with an automated static perimeter, Humphrey program C30-2 with STATPAC. The C/D ratio estimated by direct ophthalmoscopy consistently showed a smaller C/D ratio than that found by the stereophotographic method. The parameter with the highest probability value to differentiate between the optic disc of the early visual field loss and the optic disc of normal subjects was "Ratio of the thinnest NRR width in the vertical sectors to the NRR width of the temporal sector < or = 85%". Although it has less resolving power than slide film, a stereo disc photograph with Polaroid film is a quick and simple method of recording changes, and the ratio of the thinnest NRR width in the vertical sectors to the temporal sector is a good predictive parameter for detection of early visual field loss.
Adolescent ; Adult ; Aged ; Child ; Female ; Fundus Oculi ; Glaucoma, Open-Angle/*pathology/physiopathology ; Humans ; Male ; Middle Aged ; Ocular Hypertension/*pathology/physiopathology ; Optic Disk/*pathology ; Photography ; Visual Field Tests ; *Visual Fields

OBJECTIVETo explore the relationship between neuroretinal rim area (RA) /retinal nerve fiber layer (RNFL) thickness and differential light sensitivity (DLS) in visual field in primary open angle glaucoma (POAG).

METHODSFifty-one eyes of 51 patients with POAG were examined with HRT II, GDx VCC, and Octopus 101 for RA, RNFL thickness, and DLS. Their correlations were evaluated with linear and logarithmic regression models globally and for individual sectors.

RESULTSIn all the considered patients, visual field DLS was significantly correlated with neuroretinal RA or RNFL thickness globally and in individual sectors. Logarithmic fits were significantly better than linear fits for the global data and in most sectors. In preperimetric glaucoma, such correlations were weak and linear (R2 = 0.01-0.26). However, in perimetric glaucoma, the correlations were much stronger and curvilinear model gave the better fit (R2 = 0.15-0.84). Neuroretinal RA and RNFL thickness were linearly correlated.

CONCLUSIONNeuroretinal RA, RNFL thickness, and DLS in visual field were well correlated in POAG.

Adult ; Aged ; Aged, 80 and over ; Female ; Glaucoma, Open-Angle ; pathology ; physiopathology ; Humans ; Male ; Middle Aged ; Nerve Fibers ; pathology ; Optic Disk ; pathology ; Photophobia ; etiology ; Regression Analysis ; Retina ; pathology ; Visual Fields ; physiology ; Young Adult

PURPOSE: To document the clinical features of disc hemorrhage in patients with branch retinal vein occlusion (BRVO) and normal tension glaucoma (NTG), and to evaluate the relationship between BRVO and NTG with disc hemorrhages. METHODS: From July 2001 to May 2006, sixteen patients with both NTG and BRVO in different eyes were successively collected from outpatient population of Seoul National University Hospital in this observational case series. The frequency and location of disc hemorrhages, history of associated systemic diseases, and the order of the time of diagnosis between NTG and BRVO were studied. RESULTS: All patients had unilateral BRVO, and their mean age was 63.3+/-10.6 years. Disc hemorrhages were detected in eight patients (50%) during the mean follow-up of 26.8 months (range, 3-96 months). Six patients (75%) had disc hemorrhages in the non-BRVO eyes and two patients (25%) in BRVO eyes. Five hemorrhages (62.5%) were located at inferior-temporal quadrant of the optic disc. History of systemic hypertension was identified in 12 patients (75.0%). In 11 patients (68.8%), NTG was diagnosed at the same time as BRVO. CONCLUSIONS: A higher frequency of disc hemorrhages was identified in patients with both BRVO and NTG. Therefore, some cases of NTG, especially with disc hemorrhages, may share a common vascular pathophysiology with BRVO.
Adult ; Aged ; Eye Hemorrhage/*etiology/pathology/physiopathology ; Female ; Fluorescein Angiography ; Follow-Up Studies ; Fundus Oculi ; Glaucoma, Open-Angle/*complications/pathology/physiopathology ; Humans ; Intraocular Pressure ; Male ; Middle Aged ; Optic Disk/*pathology ; Optic Nerve Diseases/*etiology/pathology/physiopathology ; Retinal Vein Occlusion/*complications/pathology ; Retrospective Studies ; Severity of Illness Index ; Visual Acuity