This study reports the influence of miotics (pilocarpine) on the visual field by comparing two visual fields, one at the miotic state and the other at normal pupil size. The measurements from the Goldmann perimetry test of 10 ocular hypertensive eyes (7 patients) and 10 glaucomatous eyes (8 patients) were used. The visual field was analyzed using an Esterman grid for functional estimation and section paper for gross evaluation. The results were as follows; 1. A decrease in pupillary size eaused not only a decrease in the gross visual field but also a reduction in the functional visual field. 2. The pupillary size did not influence absolute scotoma.
Glaucoma/drug therapy ; Humans ; Pilocarpine/*pharmacology/therapeutic use ; Visual Fields/*drug effects

We quantitatively analyzed the changes of the (retinal) threshold sensitivities between normal status and dilated emmetropic status, and between dilated emmetropic status and -1.0D induced myopic status. Three consecutive visual field examinations by Humphrey Field Analyzer C-30-2 threshold test and STATPAC program were performed in 36 eyes of 21 normal subjects who ranged in age from 23 to 40 years. The results were as follows: 1) There was a statistically significant decrease (0.87 +/- 0.91dB)in the mean threshold sensitivity within the central 30 degrees at the dilated emmetropic status (27.90dB) as compared with the normal status (28.77dB)(p = 0.0001). 2) There was a statistically significant decrease(0.99 +/- 0.61dB) at -1.0D induced myopic status(26.91dB) as compared with the dilated emmetropic status(27.90dB)(p = 0.0001). 3) After dilation, the mean threshold sensitivity between 20 and 30 degrees of field showed statistically significant decrease as compared with those within the central 20 degrees of visual field(p < 0.05). In case of -1.0D induced myopia, there were uniform decreases in the mean threshold sensitivities within the central 30 degrees of visual field (p > 0.05). Therefore, we emphasize the importance of consistent pupillary size and correct refractive state in performing the serial automated visual field tests.
Adult ; Female ; Humans ; Male ; Myopia/etiology/*physiopathology ; Pupil/drug effects ; Pupil Disorders/chemically induced/*physiopathology ; Retina/physiology ; Sensory Thresholds/*physiology ; Tropicamide/pharmacology ; Visual Field Tests ; Visual Fields/*physiology

To evaluate the effect of chlorogenic acid supplementation in patients with retinitis pigmentosa, we evaluated objective change in visual function with multifocal electroretinography, along with visual acuity, visual field, standard electroretinography, and contrast sensitivity. Eighteen patients diagnosed with retinitis pigmentosa were enrolled in this prospective, non-comparative, single-arm study. Multifocal electroretinography, best-corrected visual acuity in Early Treatment Diabetic Retinopathy Study letters, total point score on visual field examination with Humphrey Field Analyzer II, electroretinography, and contrast sensitivity were measured and repeated after 3 months supplementation with chlorogenic acid. The amplitude of ring 5 was significantly higher on multifocal electroretinography after 3 months of chlorogenic acid supplementation (7.2 +/- 9.5 vs 8.3 +/- 10.8 nV/deg2, mean +/- standard deviation, P = 0.022). There were no significant changes in the best-corrected visual acuity, total point score on Humphrey Field Analyzer, 30 Hz flicker amplitude on standard electroretinography, or contrast sensitivity. Chlorogenic acid may have a beneficial effect on the peripheral area at the margins of retinal degeneration, and should be considered as an anti-oxidant for the management of retinitis pigmentosa.
Adult ; Antioxidants/adverse effects/therapeutic use ; Chlorogenic Acid/adverse effects/*therapeutic use ; Dietary Supplements/adverse effects ; Electroretinography/*drug effects ; Female ; Humans ; Male ; Middle Aged ; Oxidative Stress/drug effects ; Prospective Studies ; Retina/physiopathology ; Retinitis Pigmentosa/*drug therapy ; Vision, Ocular/*drug effects ; Visual Acuity/*drug effects ; Visual Fields/drug effects ; Young Adult

We studied the prevalence, type and severity of vigabatrin (VGB)-attributed visual field defects (VFDs), and used these data to assess the associated risk factors in pediatric patients. Medical records were retrospectively reviewed for 67 pediatric patients who received VGB alone or in combination with other antiepileptic drugs, and who had undergone visual field examinations using a Humphrey visual field analyzer. Of the 67 patients, 15 had VGB-attributed VFDs: 13 had nasal arcuate type, 1 had nasal and temporal constricted type and 1 had nasal constricted type. In terms of severity, 7 patients had Grade I VGB-attributed VFDs, 5 had Grade II, 2 had Grade III, and 1 had Grade IV. Although there were no significant differences between the VFD and non-VFD groups with regards to all tested parameters, there were no cases of VGB-attributed VFDs in patients with total treatment durations <2 yr and cumulative doses <10 g/kg. In conclusion, the prevalence of VGB-attributed VFDs in VGB-treated pediatric epilepsy patients was 22%. The high frequency of VGB-attributed VFDs indicates that physicians should inform all patients of this risk prior to VGB treatment and perform periodic visual field examinations.
Visual Fields/drug effects ; Vision Disorders/*chemically induced ; Vigabatrin/adverse effects/*therapeutic use ; Time Factors ; Risk Factors ; Retrospective Studies ; Male ; Humans ; Female ; Epilepsy/*drug therapy ; Drug Therapy, Combination ; Drug Monitoring/statistics & numerical data ; Child ; Anticonvulsants/adverse effects/*therapeutic use ; Adult

PURPOSE: To compare the efficacy and safety of latanoprost, bimatoprost, travoprost and timolol in reducing intraocular pressure (IOP) in patients with primary open angle glaucoma. METHODS: This was a prospective study conducted at a tertiary-care centre. One hundred and forty patients with newly diagnosed primary open angle glaucoma were randomly assigned to treatment with latanoprost (0.005%), bimatoprost (0.03%), travoprost (0.004%) or timolol gel (0.5%); 35 patients were assigned to each group. All patients were followed for 2, 6, and 12 weeks. The main outcome measure studied was the change in IOP at week 12 from the baseline values. Safety measures included recording of adverse events. RESULTS: The mean IOP reduction from baseline at week 12 was significantly more with bimatoprost (8.8 mmHg, 35.9%) than with latanoprost (7.3 mmHg, 29.9%), travoprost (7.6 mmHg, 30.8%) or timolol (6.7 mmHg, 26.6%) (ANOVA and Student's t-tests, p < 0.001). Among the prostaglandins studied, bimatoprost produced a maximum reduction in IOP (-2.71; 95% confidence interval [CI], -2.25 to -3.18) followed by travoprost (-1.27; 95% CI, -0.81 to -1.27) and latanoprost (-1.25; 95% CI, -0.79 to -1.71); these values were significant when compared to timolol at week 12 (Bonferroni test, p < 0.001). Latanoprost and travoprost were comparable in their ability to reduce IOP at each patient visit. Ocular adverse-events were found in almost equal proportion in patients treated with bimatoprost (41.3%) and travoprost (41.9%), with a higher incidence of conjunctival hyperemia (24.1%) seen in the bimatoprost group. Timolol produced a significant drop in heart rate (p < 0.001) at week 12 when compared to the baseline measurements. CONCLUSIONS: Bimatoprost showed greater efficacy when compared to the other prostaglandins, and timolol was the most efficacious at lowering the IOP. Conjunctional hyperemia was mainly seen with bimatoprost. However, the drug was tolerated well and found to be safe.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antihypertensive Agents/adverse effects/*therapeutic use ; Bimatoprost/adverse effects/therapeutic use ; Blood Pressure/drug effects ; Female ; Glaucoma, Open-Angle/*drug therapy/physiopathology ; Heart Rate/drug effects ; Humans ; Intraocular Pressure/drug effects ; Male ; Middle Aged ; Prostaglandins F, Synthetic/adverse effects/therapeutic use ; Timolol/adverse effects/therapeutic use ; Tonometry, Ocular ; Travoprost/adverse effects/therapeutic use ; Treatment Outcome ; Visual Acuity/drug effects ; Visual Field Tests ; Visual Fields/drug effects

We describe two cases of branch retinal artery occlusion (BRAO) after carotid artery (CA) stenting. Case 1: A 57-year-old man diagnosed with left neovascular glaucoma was admitted to our department for trabeculectomy (He had complained of decreased visual acuity (VA) in the left eye for a month). A preoperative neck angio CT scan showed bilateral CA stenosis. After CA stenting, he contracted visual defects on the right superior area of his right eye. Upon examination, VA with correction was found to be 1.0 (OD), but right fundoscopy revealed ischemic retina whitening along the inferior temporal arcade. Case 2: A 64-year-old man received left CA stenting for severe stenosis in the Department of Neurology. The next day, he was referred to us for acute onset of a left naso-inferior visual field defect. Upon initial examination, his VA with correction was 0.8/0.16 (OD/OS) and fundoscopy revealed ischemic retina whitening at the superior posterior pole in the left eye. It was not necessary to treat the BRAO in these cases because the foveal capillary network was not invaded at 2 month follow ups, VA was preserved in both cases. In conclusion, ophthalmic evaluation is important after CA stenting because of a possible embolic occlusion of the retinal artery.
Angiography ; Carotid Stenosis/radiography/*surgery ; Fibrinolytic Agents/therapeutic use ; Fluorescein Angiography ; Follow-Up Studies ; Fundus Oculi ; Humans ; Male ; Middle Aged ; Retinal Artery Occlusion/diagnosis/drug therapy/*etiology ; Stents/*adverse effects ; Visual Acuity ; Visual Fields

Atorvastatin is one of the most widely prescribed medications for dyslipidemia treatment. In Korea, post combined therapy with ezetimibe, a 73-year-old woman was reported by a community pharmacy to have experienced visual field defect, which recovered after drug discontinuation. She had never experienced this symptom before, and several studies have reported an association between use of statins and visual disorders such as blurred vision, diplopia, and cataract. Blockage of cholesterol accumulation, oxidative stress, or myopathy is expected to be a cause of this symptom. Naranjo scale, Korean causality assessment algorithm (Ver.2), and World Health Organization-Uppsala Monitoring Center (WHO-UMC) criteria were the three tools used to determine causality between the visual disorder and atorvastatin. The results represent ‘probable’, ‘certain’, and ‘probable/likely’ causality, respectively. Our results, in combination with a review of literature, indicate that ocular adverse effects are highly likely related to atorvastatin.
Aged ; Atorvastatin Calcium ; Cataract ; Cholesterol ; Diplopia ; Drug-Related Side Effects and Adverse Reactions ; Dyslipidemias ; Ezetimibe ; Female ; Global Health ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Korea ; Muscular Diseases ; Oxidative Stress ; Pharmacies ; Vision Disorders ; Visual Fields

PURPOSE: Based on the vascular theory of glaucoma pathogenesis, we wanted to evaluate the effect of Ginkgo biloba extract (GBE) on peripapillary blood flow in patients with normal tension glaucoma (NTG). METHODS: Thirty patients with NTG were randomly placed in the GBE-treated or control groups. The GBE-treated group received 80 mg GBE orally, twice a day for four weeks, and the control group received a placebo twice a day for four weeks. Complete ocular examinations including visual field, Heidelberg retina flowmeter, and systemic examinations were performed on the first study day and on the day treatment was completed. RESULTS: After GBE treatment, the mean blood flow, volume, and velocity increased at almost all points, and there was a statistically significant increase in blood flow at almost all points, in comparison to the placebo. Blood volume significantly increased only in the superior nasal and superior temporal neuroretinal rim areas. GBE also significantly increased blood velocity in areas of the inferior temporal neuroretinal rim and superior temporal peripapillary area. CONCLUSIONS: GBE administration appears to have desirable effect on ocular blood flow in NTG patients.
Aged ; Double-Blind Method ; Female ; *Ginkgo biloba ; Humans ; Laser-Doppler Flowmetry ; Low Tension Glaucoma/*drug therapy/physiopathology ; Male ; Optic Disk/blood supply ; Phytotherapy/*methods ; Plant Extracts/*therapeutic use ; Regional Blood Flow/*drug effects ; Retina/*physiopathology ; Retrospective Studies ; Time Factors ; Visual Fields

PURPOSE: Based on the vascular theory of glaucoma pathogenesis, we wanted to evaluate the effect of Ginkgo biloba extract (GBE) on peripapillary blood flow in patients with normal tension glaucoma (NTG). METHODS: Thirty patients with NTG were randomly placed in the GBE-treated or control groups. The GBE-treated group received 80 mg GBE orally, twice a day for four weeks, and the control group received a placebo twice a day for four weeks. Complete ocular examinations including visual field, Heidelberg retina flowmeter, and systemic examinations were performed on the first study day and on the day treatment was completed. RESULTS: After GBE treatment, the mean blood flow, volume, and velocity increased at almost all points, and there was a statistically significant increase in blood flow at almost all points, in comparison to the placebo. Blood volume significantly increased only in the superior nasal and superior temporal neuroretinal rim areas. GBE also significantly increased blood velocity in areas of the inferior temporal neuroretinal rim and superior temporal peripapillary area. CONCLUSIONS: GBE administration appears to have desirable effect on ocular blood flow in NTG patients.
Aged ; Double-Blind Method ; Female ; *Ginkgo biloba ; Humans ; Laser-Doppler Flowmetry ; Low Tension Glaucoma/*drug therapy/physiopathology ; Male ; Optic Disk/blood supply ; Phytotherapy/*methods ; Plant Extracts/*therapeutic use ; Regional Blood Flow/*drug effects ; Retina/*physiopathology ; Retrospective Studies ; Time Factors ; Visual Fields