PURPOSE: To report a case of non-glaucomatous retinal nerve fiber layer (RNFL) defect associated with paravascular inner retinal defect (PIRD) in a patient with idiopathic epiretinal membrane (ERM).CASE SUMMARY: A 70-year-old male who was diagnosed with ERM in his right eye and pseudoexfoliative glaucoma in his left eye visited our clinic. His intraocular pressure was 14 mmHg in both eyes while using topical hypotensive medications in both eyes. His right eye showed no glaucomatous change of the optic disc head, and also no glaucomatous visual field defect on standard automated perimetry. Red-free fundus photography and swept-source optical coherence tomography showed an ERM and wedge-shaped RNFL defect starting from the PIRD, not the optic disc head. He was diagnosed with non-glaucomatous RNFL defect in the right eye and was told to stop using topical hypotensive medication for the right eye. After 2 years of discontinuing the medication, the IOP was within the normal range, the RNFL defect showed no progression, and the visual field remained stationary.CONCLUSIONS: A non-glaucomatous RNFL defect can develop in association with PIRD in patients with idiopathic ERM. Examinations for PIRD as well as evaluation of the optic disc head are therefore necessary in patients with ERM and RNFL defect.
Aged ; Epiretinal Membrane ; Glaucoma ; Head ; Humans ; Intraocular Pressure ; Male ; Nerve Fibers ; Photography ; Reference Values ; Retinaldehyde ; Tomography, Optical Coherence ; Visual Field Tests ; Visual Fields

optical coherence tomography guided progression analysis, with respect to the peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL).METHODS: One hundred sixty-four eyes with primary open-angle glaucoma were studied. The structural progression pattern evaluated by optical coherence tomography guided progression analysis was classified using hierarchical cluster analysis. The clinical parameters, patterns of structural progression, and visual field (VF) changes were compared among the groups.RESULTS: Three groups were included: stable, progressive peripapillary RNFL thinning without macular GCIPL involvement, and progressive thinning of both the peripapillary RNFL and macular GCIPL. The third group, those with progressive peripapillary RNFL and macular GCIPL thinning, showed more progressive peripapillary RNFL thinning in the inferotemporal area and VF progression in the parafoveal area. Conversely, the 12 and 6 o'clock areas were the most common locations of progressive peripapillary RNFL thinning in the group without macular GCIPL involvement.CONCLUSIONS: Structural progression patterns of glaucoma can be categorized into three groups. The location of progressive peripapillary RNFL thinning is associated with progressive macular GCIPL thinning and pattern of VF changes in the affected area. Our results indicate that the use of only macular GCIPL analysis is inadequate for analyzing the structural progression of glaucoma.]]>
Cluster Analysis ; Ganglion Cysts ; Glaucoma ; Glaucoma, Open-Angle ; Machine Learning ; Nerve Fibers ; Retinaldehyde ; Tomography, Optical Coherence ; Visual Fields

PURPOSE: This study aimed to develop a multi-channel near-infrared spectroscopy (NIRS) and ultrasonography (USG) fusion imaging system for imaging prostate cancer and to verify its diagnostic capability by applying the hybrid imaging system to a prostate cancer phantom. METHODS: A multi-channel NIRS system using the near-infrared 785-nm wavelength with 12 channels and four detectors was developed. After arranging the optical fibers around a USG transducer, we performed NIRS imaging and grayscale USG imaging simultaneously. Fusion imaging was obtained by processing incoming signals and the spatial reconstruction of NIRS, which corresponded with grayscale USG acquired at the same time. The NIRS-USG hybrid system was applied to a silicone-based optical phantom of the prostate gland containing prostate cancer to verify its diagnostic capability qualitatively. RESULTS: The NIRS-USG hybrid imaging system for prostate cancer imaging simultaneously provided anatomical and optical information with 2-dimensional registration. The hybrid imaging system showed more NIR attenuation over the prostate cancer model than over the model of normal prostate tissue. Its diagnostic capability to discriminate a focal area mimicking the optical properties of prostate cancer from the surrounding background mimicking the optical properties of normal prostate tissue was verified by applying the hybrid system to a silicone-based optical phantom of prostate cancer. CONCLUSION: This study successfully demonstrated that the NIRS-USG hybrid system may serve as a new imaging method for improving the diagnostic accuracy of prostate cancer, with potential utility for future clinical applications.
Diagnosis ; Methods ; Optical Fibers ; Prostate ; Prostatic Neoplasms ; Spectroscopy, Near-Infrared ; Transducers ; Ultrasonography

PURPOSE: To measure the thicknesses of the circumpapillary retinal nerve fiber layer (RNFL) and macular retinal ganglion cell-inner plexiform layer (GCIPL) by optical coherence tomography (OCT) in healthy Korean children and adolescents. METHODS: Circumpapillary RNFL and macular GCIPL thicknesses were measured by OCT in 352 healthy eyes of 352 children and adolescents (child-adolescent group) aged 5–17 years and in 159 healthy eyes of 159 adults (adult group) aged 18-75 years. The difference in RNFL and GCIPL thicknesses between the groups and the effects of age and refractive errors on the measurements were evaluated. RESULTS: The mean age of the children and adults were 9.7 ± 3.6 and 44.7 ± 15.7 years, respectively. The mean of the average RNFL and GCIPL thicknesses were 103.1 ± 9.2 and 85.7 ± 4.6 µm, respectively, in the children group and 97.8 ± 8.2 and 82.9 ± 4.4 µm, respectively, in the adult group. The child-adolescent group had greater RNFL and GCIPL thicknesses compared to the adult group in all areas (p < 0.05) with the exception of the RNFL thickness in the temporal quadrant (p = 0.555). A thinner RNFL and thinner GCIPL were significantly associated with older age and greater myopia (p < 0.001). CONCLUSIONS: The mean RNFL and GCIPL thicknesses measured by OCT in the healthy eyes of children and adolescents were 103.1 and 85.7 µm, respectively. Children and adolescents had a thicker RNFL and GCIPL compared to adults.
Adolescent ; Adult ; Child ; Ganglion Cysts ; Humans ; Myopia ; Nerve Fibers ; Refractive Errors ; Retinal Ganglion Cells ; Retinaldehyde ; Tomography, Optical Coherence

PURPOSE: To report the results of ganglion cell analysis in a patient with optic tract syndrome who was previously diagnosed with glaucoma. CASE SUMMARY: A 32-year-old male, who had been diagnosed with glaucoma 12 years ago, but had not visited an ophthalmology clinic since then, came to our clinic for evaluation of his glaucoma. Both eyes showed an increased cup-to-disc ratio and temporal pallor of the disc. Retinal nerve fiber layer (RNFL) optical coherence tomography showed thinning of the superior, inferior, and temporal peripapillary RNFL in both eyes. On ganglion cell analysis (GCA), ganglion cell layer thinning in the nasal region of the right eye and in the temporal region of the left eye was observed. The visual field test showed right incongruous homonymous hemianopsia. After the atrophic change of the left optic tract was confirmed by orbit magnetic resonance imaging, he was diagnosed with left optic tract syndrome. CONCLUSIONS: We report the results of GCA in a case of optic tract syndrome, previously diagnosed as glaucoma. GCA can be useful when diagnosing optic tract syndrome.
Adult ; Ganglion Cysts ; Glaucoma ; Hemianopsia ; Humans ; Magnetic Resonance Imaging ; Male ; Nerve Fibers ; Ophthalmology ; Optic Nerve ; Optic Tract ; Orbit ; Pallor ; Retinaldehyde ; Temporal Lobe ; Tomography, Optical Coherence ; Visual Field Tests

PURPOSE: Horizontal visual field defects are generally caused by lesions before the optic chiasm, but we report a case with bilateral inferior altitudinal defects secondary to bilateral occipital lobe infarction. CASE SUMMARY: A 57-year-old male with a history of diabetes and hypertension presented with a month of blurring in the inferior visual field. His corrected visual acuity was 1.0 in the right eye and 0.63 in the left eye, and the intraocular pressure was normal in each eye. Pupillary response, ocular movement, and color vision tests were normal in both eyes. There was no specific finding of the optic disc and macula on fundus examination. Visual field examination revealed an inferior congruous homonymous hemianopia with horizontal meridian sparing and a left incongruous homonymous quadrantanopia. Optical coherence tomography for peripapillary retinal nerve fiber layer thickness revealed a mild decrease in the inferior disc of both eyes. Brain magnetic resonance imaging confirmed the presence of an acute infarction confined with upper medial calcarine fissures of bilateral occipital lobe and the right splenium of the corpus callosum, which were consistent with inferior altitudinal hemianopia and left superior incongruous quadrantanopia, respectively. Brain magnetic resonance angiography showed multiple stenosis of bilateral posterior cerebral arteries. CONCLUSIONS: The altitudinal visual field defects could be caused by the occipital lesion medial to the calcarine fissure, and unusual visual defects could be due to a combination of multiple lesions.
Brain ; Color Vision ; Constriction, Pathologic ; Corpus Callosum ; Hemianopsia ; Humans ; Hypertension ; Infarction ; Infarction, Posterior Cerebral Artery ; Intraocular Pressure ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Nerve Fibers ; Occipital Lobe ; Optic Chiasm ; Posterior Cerebral Artery ; Retinaldehyde ; Tomography, Optical Coherence ; Visual Acuity ; Visual Fields

PURPOSE: We analyzed and compared retinal ganglion cell damage between patients with glaucoma and those with branched retinal vein occlusion (BRVO). We performed two types of visual field examinations. METHODS: We retrospectively reviewed the medical records of 40 glaucoma eyes and 40 BRVO eyes. We compared the median deviation (MD), the pattern standard deviation (PSD), and sensitivity of damaged visual hemifield from frequency-doubling technology (FDT) C24-2 and standard automated perimetry (SAP) C24-2 visual field tests evaluation. We sought correlations between the MDs and retinal nerve fiber layer thickness as revealed by optical coherence tomography. RESULTS: MDs did not differ between the groups. PSD value was higher in glaucoma patients with FDT C24-2 test (p = 0.022), but no difference between two groups with SAP C24-2 test (p = 0.144). In terms of the sensitivity of the damaged visual hemifield, glaucoma patients had larger areas of damage in the FDT C24-2 test (p < 0.01). In regression analyses, the log R2 values of both tests were higher in glaucoma patients. CONCLUSIONS: Glaucoma patients had a greater damaged visual field area in the FDT C24-2 test than the SAP C24-2 test. The BRVO patients exhibited similar extents of damage in both tests. Thus, the subtypes and distributions of damaged retinal ganglion cells may differ between the conditions, facilitating differential diagnosis.
Diagnosis, Differential ; Glaucoma ; Humans ; Medical Records ; Nerve Fibers ; Retinal Ganglion Cells ; Retinal Vein Occlusion ; Retinal Vein ; Retinaldehyde ; Retrospective Studies ; Tomography, Optical Coherence ; Visual Field Tests ; Visual Fields

PURPOSE: To explore the progressive change and associated factors of optic disc tilt in young myopic glaucomatous eyes by analyzing long-term follow-up data.METHODS: Optic disc images were obtained from spectral-domain optical coherence tomography enhanced depth imaging from at least five different visits. At each visit, the disc tilt angle (DTA), defined as the angle between the Bruch's membrane opening plane and the optic canal plane, was estimated at the central frame that passes through the optic disc. Glaucoma progression was assessed on the basis of changes noted on serial optic disc and retinal nerve fiber layer photographs or changes in the visual field (VF). A linear mixed effect model was used to assess the influence of parameters (age, sex, baseline and follow-up intraocular pressure, retinal nerve fiber layer thickness, VF mean deviation, axial length, central corneal thickness), and presence of glaucomatous progression upon DTA change.RESULTS: A total of 26 eyes of 26 young myopic primary open-angle glaucoma patients (axial length >24.0 mm; mean age, 25.1 ± 4.0 years; mean follow-up, 3.3 ± 0.9 years) were included. DTA was 7.0 ± 3.4 degrees at baseline and 8.3 ± 3.8 degrees at last visit, which represents a significant difference (p < 0.001). Worse VF mean deviation (p < 0.001) and longer axial length (p = 0.006) were significantly associated with DTA increase.CONCLUSIONS: Young myopic glaucomatous eyes showed progressive optic disc tilting. Progressive optic disc tilting in young myopic glaucomatous eyes may be related to either continuous axial myopic shift or glaucomatous structural change.
Bruch Membrane ; Follow-Up Studies ; Glaucoma ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Myopia ; Nerve Fibers ; Optic Disk ; Retinaldehyde ; Tomography, Optical Coherence ; Visual Fields

PURPOSE: We detected retinal nerve fiber layer (RNFL) defects using a confocal scanning laser ophthalmoscopy (CSLO) with both blue and green laser sources and evaluated image quality based on laser wavelength. METHODS: This was a retrospective observational case study. Blue and green CSLO images of 181 eyes with suspected glaucoma were evaluated and compared. Three independent observers identified the presence of RNFL defects and determined which CSLO imaging source provided superior visibility of the defect. After assessing the defect imaging by laser source, demographics and image quality indices of optical coherence tomography between blue better and green better groups were analyzed. RESULTS: Both blue and green CSLO showed high discriminating ability for RNFL defects. The discriminating ability of blue CSLO was significantly greater than that of green CSLO (p = 0.004). Among eyes with a detectable RNFL defect, 61.8% were better visualized with the blue laser compared to the green laser. Compared with the blue better group, the green better group was significantly older (p = 0.009), had a greater proportion of females (p = 0.005), had poorer best-corrected visual acuity (p = 0.001), more severe cataracts (p = 0.001), lower signal strength (p = 0.003), and poor image quality indices (p = 0.001). CONCLUSIONS: Both blue and green CSLO imaging was useful for detecting RNFL defects, but blue CSLO was superior to green CSLO in quality of RNFL defect imaging in most patients with clear media.
Cataract ; Demography ; Female ; Glaucoma ; Humans ; Nerve Fibers ; Ophthalmoscopes ; Ophthalmoscopy ; Retinaldehyde ; Retrospective Studies ; Tomography, Optical Coherence ; Visual Acuity

PURPOSE: To assess the clinical efficacy for early detection of glaucoma using custom-built image software visualizing translucent retinal nerve fiber layer thickness (RNFLT) that is graphed based on a normative database. METHODS: This prospective study was conducted using a normative database constructed with RNFLT data of 151 healthy Korean eyes. The reference lines of the mean, the lower 5%, and the lower 1% limit were visualized as a translucent RNFLT graph produced by our software after inputting each subject's major retinal artery position and overlaying the results onto the RNFLT measurements. Fifty-eight additional healthy control and 79 early-glaucoma eyes were collected for the validation group. If a subject's RNFLT graph was outside the reference line of the lower 1% limit, the graph was defined as abnormal. The lower 1% limit, which was generated by three criteria (criterion 1, built-in software; criterion 2, axial-length data; criterion 3, major retinal artery data), was used to address the difference of agreement with a standard answer. RESULTS: For criteria 1, 2, and 3, the accuracy of our custom-built software was significantly higher than that of the manufacturer's database (kappa of 0.475 vs. 0.852 vs. 0.940; sensitivity of 62.0% vs. 91.1% vs. 97.5%, respectively) maintaining high specificity (87.9% vs. 94.8% vs. 96.6%, respectively). CONCLUSIONS: The custom-built imaging software with the constructed RNFLT normative database showed high clinical efficiency for early detection of glaucoma with negligible user-related variability.
Glaucoma ; Nerve Fibers ; Prospective Studies ; Retinal Artery ; Retinaldehyde ; Sensitivity and Specificity ; Tomography, Optical Coherence ; Treatment Outcome