PURPOSE: To investigate the effects of a delay in finger temperature recovery rate on the hand cold provocation test (HCPT) and a nocturnal dip greater than 10% (dipper) on the progression of glaucomatous visual field (VF) defects in open-angle glaucoma patients when the intraocular pressure (IOP) was well controlled lower than the target pressure. METHODS: 30 patients (58 eyes) with normal tension glaucoma (NTG) and 13 patients (24 eyes) with primary open angle glaucoma, and 12 normal controls (24 eyes) were retrospectively enrolled in this study. We performed HCPT, 24 hour ambulatory blood pressure monitoring (24-hr ABPM), Goldmann applanation tonometer measurements, and VF tests on all subjects. The delay in finger temperature recovery rate was defined as a delay longer than 15% of the mean finger temperature of normal controls over 2 intervals among 5, 10, 15, and 20 minutes after the immersion of cold water. We examined the relationships among the delay in finger temperature recovery rate, dipper, and the progression of glaucomatous VF defects. RESULTS: The finger temperature recovery rate in NTG patients was significantly delayed more than that of normal controls at 5, 10, and 15 minutes after the immersion. The delay in finger temperature recovery rate significantly correlated with dipper in NTG patients. Glaucomatous VF defects were significantly progressed in the presence of dipper in NTG patients. Delay in finger temperature recovery rate was significantly related to the progression of glaucomatous VF defects in NTG patients. In the binary logistic regression test, delay in finger temperature recovery rate was the only factor that was strongly related to the progression of glaucomatous visual field in NTG patients. CONCLUSIONS: When glaucomatous VF defects progressed despite the IOP being well controlled, 24-hr ABPM and HCPT for detecting vascular dysregulation might be helpful for diagnosis and treatment of glaucoma.
Blood Pressure Monitoring, Ambulatory ; Diagnosis ; Fingers* ; Glaucoma* ; Glaucoma, Open-Angle ; Hand ; Humans ; Immersion ; Intraocular Pressure ; Logistic Models ; Low Tension Glaucoma ; Retrospective Studies ; Visual Fields ; Water

PURPOSE: To compare the macular choroidal thickness, ganglion cell complex thickness, peripapillary choroidal thickness and retinal nerve fiber layer thickness among normal, primary open angle glaucoma (POAG) and normal tension glaucoma (NTG) patients using RTVue (Fourier-domain optical coherence tomography; Optovue, Fremont, CA, USA). METHODS: A retrospective analysis of 32 normal controls, 32 POAG and 52 NTG patients was performed. Choroidal thickness, ganglion cell complex thickness and retinal nerve fiber layer thickness were compared among normal controls, POAG and NTG subjects. Additionally, the factors influencing choroidal thickness (age, axial length, spherical equivalent, central corneal thickness, mean deviation, nocturnal dip, blood pressure variability) were analyzed. RESULTS: A total of 32 normal controls, 32 POAG and 52 NTG patients were enrolled in this study. Macular and peripapillary choroidal thicknesses were significantly thinner in the NTG patients. In NTG subjects, the significant influencing factors associated with macular and peripapillary choroidal thicknesses were age, axial length, nocturnal dip (diastolic blood pressure), diastolic blood pressure variability and ganglion cell complex thickness. In POAG patients, significant influencing factors associated with macular and peripapillary choroidal thicknesses were age and axial length. CONCLUSIONS: Choroidal thickness was significantly thinner in NTG patients compared with normal controls and POAG patients. Factors influencing choroidal thickness in NTG patients were age, axial length, nocturnal dip (diastolic blood pressure), diastolic blood pressure variability and ganglion cell complex thickness. In POAG patients, significant factors influencing choroidal thickness were age and axial length.
Blood Pressure ; Choroid* ; Ganglion Cysts ; Glaucoma, Open-Angle* ; Humans ; Low Tension Glaucoma ; Nerve Fibers ; Retinaldehyde ; Retrospective Studies ; Tomography, Optical Coherence

PURPOSE: To compare the macular choroidal thickness, ganglion cell complex thickness, peripapillary choroidal thickness and retinal nerve fiber layer thickness among normal, primary open angle glaucoma (POAG) and normal tension glaucoma (NTG) patients using RTVue (Fourier-domain optical coherence tomography; Optovue, Fremont, CA, USA). METHODS: A retrospective analysis of 32 normal controls, 32 POAG and 52 NTG patients was performed. Choroidal thickness, ganglion cell complex thickness and retinal nerve fiber layer thickness were compared among normal controls, POAG and NTG subjects. Additionally, the factors influencing choroidal thickness (age, axial length, spherical equivalent, central corneal thickness, mean deviation, nocturnal dip, blood pressure variability) were analyzed. RESULTS: A total of 32 normal controls, 32 POAG and 52 NTG patients were enrolled in this study. Macular and peripapillary choroidal thicknesses were significantly thinner in the NTG patients. In NTG subjects, the significant influencing factors associated with macular and peripapillary choroidal thicknesses were age, axial length, nocturnal dip (diastolic blood pressure), diastolic blood pressure variability and ganglion cell complex thickness. In POAG patients, significant influencing factors associated with macular and peripapillary choroidal thicknesses were age and axial length. CONCLUSIONS: Choroidal thickness was significantly thinner in NTG patients compared with normal controls and POAG patients. Factors influencing choroidal thickness in NTG patients were age, axial length, nocturnal dip (diastolic blood pressure), diastolic blood pressure variability and ganglion cell complex thickness. In POAG patients, significant factors influencing choroidal thickness were age and axial length.
Blood Pressure ; Choroid* ; Ganglion Cysts ; Glaucoma, Open-Angle* ; Humans ; Low Tension Glaucoma ; Nerve Fibers ; Retinaldehyde ; Retrospective Studies ; Tomography, Optical Coherence

PURPOSE: To investigate the influence of water-shed zone (WSZ) and nocturnal dip (ND) on the progression of the glaucomatous visual field (V/F) defects in open-angle glaucoma (OAG) patients when the intraocular pressure (IOP) was maintained under the target pressure. METHODS: We performed fluorescence angiography (FAG), 24-hour ambulatory blood pressure monitoring (24-hr ABPM), and V/F tests. We examined the relationships among WSZ in early-FAG, ND over 10% (dip), and the progression of the glaucomatous V/F defects using chi-square, Fisher's exact, and multivariate logistic regression tests. A p-value < 0.05 was considered statistically significant. RESULTS: When considering the correlation between WSZ and dip, statistical significance was found in OAG (p = 0.024, odds ratio (OR) = 3.308) and normal tension glaucoma (NTG) (p = 0.029, OR = 4.364) patients. In patients with dip, glaucomatous V/F defects significantly progressed (OAG: p = 0.003, OR = 5.938, NTG: p = 0.005, OR = 13.929). In patients with WSZ, the glaucomatous V/F defects progressed in all groups (OAG: p = 0.002, OR = 5.156, NTG: p = 0.024, OR = 4.750, primary open angle glaucoma (POAG): p = 0.021, OR = 8.750). In the patients with WSZ involving optic nerve head, the glaucomatous V/F defects had progressed in OAG (p = 0.004, OR = 5.958) and NTG (p = 0.009, OR = 8.333) groups. Based on binary logistic regression analysis, dip (p = 0.010, OR = 6.227) significantly affected V/F progression only in OAG patients. CONCLUSIONS: In the OAG and NTG groups, ND over 10% influenced the progression of the glaucomatous V/F defects. The patients with WSZ tended to have ND over 10% in OAG and NTG groups and glaucomatous V/F defects progressed in all patients. Therefore, performing early FAG and 24-hr ambulatory blood pressure monitoring may be helpful for glaucoma patients with progressing glaucomatous V/F defects even when the IOP was maintained under the target pressure.
Blood Pressure Monitoring, Ambulatory ; Fluorescein Angiography ; Glaucoma ; Glaucoma, Open-Angle* ; Humans ; Intraocular Pressure ; Logistic Models ; Low Tension Glaucoma ; Odds Ratio ; Optic Disk ; Visual Fields*

PURPOSE: We evaluated the thickness of RNFL and optic nerve head parameters with age in normal eyes using Spectral-Domain Optical Coherence Tomography (SD-OCT). METHODS: A total of 128 normal Korean volunteers in different age groups were recruited (age range, 20-70 years). RESULTS: A significant negative correlation in average RNFL thickness with increasing age was found. The inferior areas (130.31 +/- 3.33 micrometer) were significantly thicker than other areas (superior area 119.05 +/- 2.12 micrometer, nasal area 71.80 +/- 0.57 micrometer, temporal area 77.72 +/- 0.16 micrometer). The average C/D ratios (mean 0.38 +/- 0.14) and vertical C/D ratios (mean 0.35 +/- 0.11) both showed significant increases with age, and the vertical C/D ratio correlation coefficient was higher (average C/D ratio r = 0.249, vertical C/D ratio r = 0.537). However, rim area, disc area, and cup volume were not correlated with age. CONCLUSIONS: From these findings, we conclude that, in normal Koreans, the mean RNFL thickness decreases and the C/D ratio increases with age, with the increase in the vertical C/D ratio being greater.
Eye ; Humans ; Optic Disk ; Tomography, Optical Coherence

PURPOSE: To investigate the effect of nocturnal dip, carotid artery blood flow, and brain ischemic change on the progression of glaucomatous visual field defect in open-angle glaucoma (OAG) when IOP is less than the target pressure. METHODS: We classified OAG patients (74 patients, 148 eyes) who maintained IOP less than the target pressure as normal tension glaucoma (NTG; 52 patients, 104 eyes) or primary OAG (POAG; 22 patients, 44 eyes). Additionally, we performed 24-hr ambulatory blood pressure monitoring (24-hr ABPM), carotid artery color Doppler U/S (CAD), brain MRI, and visual field (V/F) tests on the patients. Nocturnal dips less than 10% were classified as non-dippers, and dips greater than 10% as dippers. The relationships among nocturnal dip, carotid artery blood flow, brain ischemic change, and progression of glaucomatous V/F defect were examined. RESULTS: In the case of dippers, glaucomatous V/F defects were aggravated, with a relative risk of approximately 1.74 (NTG) and 2.91 (POAG) times that of non-dippers. In NTG, decreased carotid artery blood flow and brain ischemic change furthered glaucomatous V/F defects, with a relative risk of approximately 2.40 and 2.54 times that of normal carotid artery blood flow and brain MRI findings, respectively. However, in POAG, decreased carotid artery blood flow and brain ischemic change were not influenced by the progression of glaucomatous V/F defects. CONCLUSIONS: In dippers, decreased carotid artery blood flow and brain ischemic change caused a progression of glaucomatous V/F defects in NTG and POAG patients. Thus, performing 24-hr ABPM, CAD, and brain MRI should be helpful for glaucoma patients with progression of glaucomatous V/F defects even when the IOP is less than the target pressure. In addition, this analysis provides useful information regarding glaucoma diagnosis and treatment.
Blood Pressure Monitoring, Ambulatory ; Brain ; Brain Ischemia ; Carotid Arteries ; Glaucoma ; Glaucoma, Open-Angle ; Humans ; Low Tension Glaucoma ; Salicylates ; Visual Fields

PURPOSE: To evaluate the clinical efficacy and histopathological tolerance of 2-octyl cyanoacrylate versus conventional suture materials for eyelid wound closure in rabbits. METHODS: We performed an experimental study on 16 eyes of eight New Zealand albino rabbits. Eyelid incisions of 15 mm were done 4mm from the upper eyelid margin in both eyes. The eyes of the rabbits were divided into two groups: eyelid incisions of the right eye were closed by a 2-octyl cyanoacrylate adhesive (group A) and eyelid incisions of the left eye were closed by 7-0 nylon sutures (group B). At 1, 2, 4, and 8 weeks after surgery, the rabbits were macroscopically examined and then sacrificed. The specimens of their eyelid tissues were stained by a hematoxylin and eosin stain and Masson-trichrome stain, and were observed under microscope. RESULTS: Both eyelid surgical closure methods were found to be equally efficacious in fixing the eyelids of groups A and B, and their clinical efficacy was similar. Histopathological findings of the hematoxylin and eosin stain of group A showed less inflammatory infiltration than group B at 2 weeks. There were no significant histopathological differences between the two groups at 1, 4, and 8 weeks. The degree of fibrosis of the Masson-trichrome stain was similar between the two groups at 8 weeks. CONCLUSIONS: The 2-octyl cyanoacrylate adhesive proved to be an effective eyelid closure method and was very well tolerated by the skin surface. 2-Octyl cyanoacrylate could be used as an alternative tissue adhesive for eyelid wound closure along with conventional suture materials.
Animals ; Blepharoplasty/*methods ; Cyanoacrylates/*pharmacology ; Disease Models, Animal ; Eyelid Diseases/pathology/*surgery ; Eyelids/*surgery ; Rabbits ; Suture Techniques/*instrumentation ; *Sutures ; Tissue Adhesives/*pharmacology ; Treatment Outcome ; Wound Healing

PURPOSE: To evaluate the changes in break-up time (BUT) and corneal sensitivity following LASIK surgery for refractive error correction with presbyopia in patients older than 45 years. METHODS: The authors of the present study measured the BUT and corneal sensitivity of 92 eyes that received LASIK surgery for correcting refractive error with presbyopia. The eyes were divided into groups according to gender and preoperative refractive error before surgery and 1, 3, 6 and 12 months after LASIK. RESULTS: The mean age of patients was 52.01 +/- 5.51 years, and the male to female eye distribution was 31:61. The value of BUT before surgery and 1, 3, 6, and 12 months postoperative was 5.31 +/- 2.03 sec, 4.47 +/- 1.67 sec, 4.04 +/- 1.58 sec, 4.53 +/- 1.51 sec, and 4.87 +/- 1.46 sec, respectively; corneal sensitivity was 56.35 +/- 5.94 mm, 40.07 +/- 14.21 mm, 46.42 +/- 10.41 mm, 50.75 +/- 8.04 mm, and 52.92 +/- 7.51 mm, respectively. BUT was not significantly different relative to refractive error and was significantly shorter in the female group than the male group at 1 month postoperative. Corneal sensation of myopia at 12 months postoperative was statistically higher than at other time points; however, there was no difference between genders. BUT and corneal sensitivity at 12 months postoperative recovered to 91.6% and 93.9% of the preoperative value, respectively. CONCLUSIONS: BUT and corneal sensitivity after LASIK for presbyopia were decreased until 12 months postoperative and recovered slowly, but did not return to preoperative levels.
Eye ; Female ; Humans ; Keratomileusis, Laser In Situ ; Male ; Middle Aged ; Myopia ; Presbyopia ; Refractive Errors ; Sensation ; Tears

PURPOSE: To investigate the effect of nocturnal dip influence on the progression of glaucomatous visual field defect. METHODS: We performed 24hr ABPM and V/F tests on patients diagnosed with NTG (140 patients, 280 eyes) and POAG (84 patients, 168 eyes). Nocturnal dips below 10% were classified as non-dippers, and those above 10% were noted as dippers. The correlations among nocturnal dip, progression of glaucomatous visual field defect, and hypertension treatment were examined. RESULTS: In NTG, dippers in both systolic and diastolic blood pressure furthered glaucomatous visual field defects, with a relative risk of approximately three times that of non-dippers. Hypertension treatment was not influenced by the progression of glaucomatous visual field defect but was influenced by dips in the systolic and diastolic pressures in NTG and in diastolic pressure in POAG. Nocturnal dips were more frequent in the group with progression of the visual field compared to those in the group with non-progression of the visual field in NTG. CONCLUSIONS: Dipper caused a progression of glaucomatous visual field defects in NTG and was influenced by hypertension treatment in NTG and POAG. Performing 24hr ABPM should be helpful for glaucoma patients with progression of a glaucomatous visual field defect even when the IOP is less than the target pressure. In addition, hypertension treatment should be considered an important factor in the treatment of glaucoma.
Blood Pressure ; Glaucoma ; Humans ; Hypertension ; Salicylates ; Visual Fields

PURPOSE: To compare dynamic contour tonometry (DCT) and Goldmann applanation tonometry (GAT) and investigate the influence of central corneal thickness (CCT) onintraocular pressure. METHODS: In a prospective study of 165 eyes with glaucoma (135 eyes), glaucoma suspect (14 eyes), and ocular hypertension (16 eyes), intraocularpressure was measured with DCT and GAT, and followed by measurement of the CCT with ultrasound pachymetry. Statistical analysis were performed with simple linear regression analysis and t-test using SPSS (Statistical software, ver. 10; SPSS Inc., Chicago, IL). RESULTS: A clear correlation between DCT and GAT was found (r=0.733, p<0.001). The average intraocular pressure was 14.92+/-2.28 mmHg with DCT and 13.97+/-3.12 mmHg with GAT, and the intraocular pressure with DCT was 0.95+/-2.49 mmHg higher than with GAT. A meaningful correlation was shown between GAT and CCT (r2=0.145, p<0.001), but was not demonstrated between DCT and CCT (r2=0.012, p=0.081). In addition, the difference of intraocular pressure between GAT and DCT (GAT-DCT) showed a significant correlation with CCT (r2=0.145, p<0.001). CONCLUSIONS: DCT appears to be a reliable method for intraocular pressure measurement, which is not influenced by CCT, unlike GAT.
Chicago ; Eye ; Glaucoma ; Intraocular Pressure ; Linear Models ; Manometry ; Ocular Hypertension ; Peptides ; Prospective Studies