No abstract available.
Chronic Disease ; Cryopyrin-Associated Periodic Syndromes/*complications/diagnosis ; Gonioscopy ; Humans ; *Intraocular Pressure ; Male ; Microscopy, Acoustic ; Middle Aged ; Ocular Hypertension/diagnosis/*etiology/physiopathology ; Rare Diseases

PURPOSE: To describe the clinical course of congenital aniridia and to evaluate prognostic factors for visual outcome after long-term follow-up. METHODS: The medical records of 120 eyes from 60 patients with congenital aniridia were retrospectively reviewed. The prevalence and clinical course of ophthalmic characteristics, systemic disease, refractive errors, and visual acuity were assessed. Prognostic factors for final visual outcomes were analyzed. RESULTS: Aniridic keratopathy developed in 82 (69%) of 119 eyes. Macular hypoplasia was observed in 70 eyes of 35 patients (91%). Cataract was observed in 63 of 120 eyes (53%). Nystagmus was present in 41 patients (68% of 60 patients) at the initial visit but decreased in five patients (8% of 60 patients). Ocular hypertension was detected in 19 eyes (20% of 93 eyes), six (32% of 19 eyes) of which developed secondarily after cataract surgery. The mean changes in spherical equivalent and astigmatism during the follow-up period were -1.10 and 1.53 diopter, respectively. The mean final visual acuity was 1.028 logarithm of minimal angle of resolution. Nystagmus and ocular hypertension were identified as prognostic factors for poor visual outcome. CONCLUSIONS: Identification of nystagmus and ocular hypertension was important to predict final visual outcome. Based on the high rate of secondary ocular hypertension after cataract surgery, careful management is needed.
Adolescent ; Adult ; Aniridia/*diagnosis/physiopathology ; Cataract/diagnosis ; Child ; Child, Preschool ; Corneal Diseases/diagnosis ; Eye Abnormalities/diagnosis ; Eye Diseases/*diagnosis/physiopathology ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Nystagmus, Pathologic/diagnosis ; Ocular Hypertension/diagnosis ; Prognosis ; Retina/abnormalities ; Retrospective Studies ; Visual Acuity/*physiology ; Young Adult

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 report a case of bilateral spontaneous anterior lens dislocation associated with retinitis pigmentosa (RP). METHODS: A 45-year-old male with RP presented with elevated intraocular pressure (IOP) in the right eye and was treated with laser iridotomy (LI). After LI, complete crystalline lens dislocation into the anterior chamber occurred. Surgical intervention, including anterior vitrectomy, intracapsular cataract extraction (ICCE), and IOL scleral fixation was performed. Two years later, the same episode occurred in his left eye and a similar treatment was done. RESULTS: Surgery was successful in both eyes. CONCLUSIONS: This is the first report of bilateral spontaneous anterior lens dislocation in a RP patient.
*Anterior Chamber ; Cataract/complications/diagnosis ; Cataract Extraction ; Electroretinography ; Follow-Up Studies ; Humans ; Iris/surgery ; Laser Therapy/adverse effects ; Lens Implantation, Intraocular/methods ; Lens Subluxation/diagnosis/*etiology/surgery ; Male ; Middle Aged ; Ocular Hypertension/complications/physiopathology/surgery ; Retinitis Pigmentosa/*complications/diagnosis/surgery ; Sclera/surgery ; Suture Techniques ; Visual Fields ; Vitrectomy

This study was performed to evaluate optic disc appearance, retinal nerve fiber layer (RNFL) thickness, and macular thickness in normal, ocular hypertensive (OHT) and glaucomatous eyes using optical coherence tomography (OCT) 3000. One hundred fifty-eight eyes of 167 consecutive subjects were enrolled: 60 normal, 53 OHT, and 54 glaucomatous. OCT topographic parameters of cup diameter, cup area, rim area, and cup/disc area ratio were significantly less in OHT eyes than in normal eyes and were significantly less in glaucomatous eyes than in normal and OHT eyes. RNFL was significantly thinner in OHT eyes than in normal eyes in the inferior quadrant, and in glaucomatous eyes than in OHT and normal eyes in the mean and for all four quadrants. Macular thickness was significantly thinner in glaucomatous eyes than in OHT and normal eyes throughout all subdivisions. Optic disc parameters, and RNFL and macular thickness measurements made with OCT may be useful in the clinical assessment of glaucoma.
Adult ; Comparative Study ; Female ; Glaucoma/*diagnosis ; Humans ; Male ; Middle Aged ; Nerve Fibers/*pathology ; Ocular Hypertension/diagnosis ; Optic Disk/*pathology ; Optic Nerve Diseases/*diagnosis ; Research Support, Non-U.S. Gov't ; Retinal Ganglion Cells/*pathology ; Tomography, Optical Coherence/*methods

PURPOSE: To evaluate the pressure-lowering effects of selective trabeculoplasty versus these of Argon laser trabeculoplasty. METHODS: Fifteen eyes of 15 patients with primary open-angle glaucoma and ocular hypertension, all with IOPs over 30 mm Hg received SLT and 30 eyes of 30 patients with the same diagnosis were treated with ALT. Patients were evaluated after laser treatments at 1 hour, 1 day, 1 week, 1 month, and 3 months using slit lamp examinations and Goldmann applanation tonometry. RESULTS: At 3 months postoperative, the SLT group had a mean IOP of 16.9+/-4.2 mmHg with a mean reduction of 31.2+/-20.1%, while the ALT group had a mean IOP of 17.9+/-5.4 mmHg with a mean reduction of 26.3+/-23.3%. CONCLUSIONS: Selective trabeculoplasty and Argon laser trabeculoplasty are equally effective statistically in lowering IOP over a 3-month period (p=0.47). SLT has been shown to be safe and effective in lowering IOP.
Argon* ; Diagnosis ; Glaucoma, Open-Angle* ; Humans ; Manometry ; Ocular Hypertension ; Trabeculectomy*

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

We investigated the ability of the GDx-Nerve Fiber Analyzer (NFA) to discriminate between normal and early glaucomatous eyes among Korean individuals by reviewing the medical records of 217 consecutive subjects: 61 early glaucoma patients, 68 ocular hypertensive patients, and 88 normal subjects. GDx parameters were compared using ANOVA. The Receiver Operating Characteristics (ROC) curve for each GDx-NFA variable was used to diagnose each parameter, and Pearson correlation coefficients were calculated to assess the association between GDx-NFA parameters and visual field indices in early glaucoma. The best GDx parameters to discriminate between early glaucomatous and normal subjects were the number, maximum modulation, ellipse modulation and inferior ratio (i.e. area under the ROC curve > 0.8). A value for the Number of equal to or greater than 27 was optimal for detecting early glaucoma, with a sensitivity of 80.3% and specificity of 80.7%. In addition, symmetry was positively correlated with the corrected pattern standard deviation (CPSD) among visual field indices in early glaucoma.
*Diagnostic Techniques, Ophthalmological ; Female ; Glaucoma, Open-Angle/*diagnosis/ethnology ; Humans ; Intraocular Pressure ; Korea/epidemiology ; Male ; Middle Aged ; Nerve Fibers/*pathology ; Ocular Hypertension/diagnosis/ethnology ; Optic Nerve Diseases/*diagnosis/ethnology ; ROC Curve ; Retinal Ganglion Cells/*pathology ; Retrospective Studies ; Sensitivity and Specificity ; Visual Fields

PURPOSE: To determine the effect of central corneal thickness (CCT) on the measurement of intraocular pressure (IOP) and diagnosis of glaucoma on the resultant reclassification of patients as having primary open-angle glaucoma (POAG), normal tension glaucoma (NTG), or ocular hypertension (OHT). METHODS: Intraocular pressure (Goldmann applanation tonometry) and visual field test (Humphrey 24-2) were measured in 22 eyes of 23 patients with OHT, 20 eyes of 20 patients with POAG, 31 eyes of 31 patients with NTG, 27 eyes of 27 control subjects. CCT was measured and used to obtain a corrected value for the IOP and to reclassify the type of glaucoma. RESULTS: There was no significant difference in CCT between controls and patients with POAG, but the CCT in the group with NTG was significantly lower than that in the control group (p=0.012), and the CCT in the group with OHT was significantly higher than in controls (p=0.002). Correcting IOP for corneal thickness, 22.58% of patients with NTG could be reclassified as having POAG, and 56.52% of the patients with OHT as normal. CONCLUSIONS: Underestimation of the IOP in patients with POAG who have thin cornea may lead to a misdiagnosis of NTG, while overestimation of the IOP in normal subjects who have thick cornea may lead to a misdiagnosis of OHT. We suggest that CCT must be considered in diagnosis of glaucoma.
Cornea ; Diagnosis* ; Diagnostic Errors ; Glaucoma* ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Low Tension Glaucoma ; Ocular Hypertension ; Visual Field Tests

PURPOSE: To evaluate the clinical manifestations and the factors associated with prognosis of the traumatic cyclodialysis patients who underwent direct cyclopexy. METHODS: The authors retrospectively analyzed the data of 23 eyes of 22 patients who underwent consecutive direct cyclopexy for the hypotonous cyclodialysis between 1997 and 2002 at the authors' institution. Perioperative A-scan and ultrabiomicroscopy were performed to evalaute correlation between the parameters and postoperative visual prognosis. RESULTS: Postoperatively, the mean increase of intraocular pressure was 11.1mmHg and the mean improvement of visual acuity was four lines of Han's Korean visual acuity chart. As the preoperative hypotony period was shorter, postoperative visual prognosis was better (p<0.05). Anterior chamber depth (p<0.0001), axial length (p<0.01), spherical equivalent (p<0.05), and intraocular pressure (p<0.0001) were increased, whereas lens thickness (p<0.0001) was decreased postoperatively. Transient postoperative ocular hypertension was controlled by adequate medication, and the patients' intraocular pressure were controlled below 20 mmHg without medications at the average of 19 days after the cyclopexy. Post-operative visual acuity was not significantly correlated with pre-operative intraocular pressure, pre-operative visual acuity, age, or sex. Preoperative extent of cyclodialysis was not significantly correlated with visual prognosis, postoperative development of cataract, intraocular pressure, or the cause of trauma. CONCLUSIONS: Direct cyclopexy is one of a successful method for the treatment of the hypotonous cyclodialysis cleft, and the early diagnosis and treatment are thought to be necessary for the improvement of visual prognosis.
Anterior Chamber ; Cataract ; Early Diagnosis ; Humans ; Intraocular Pressure ; Ocular Hypertension ; Prognosis ; Retrospective Studies ; Visual Acuity