Comparison of a five-degree visual field between two programs of different testing field range.

PURPOSE: A five-degree visual field with two programs of different testing field size was studied, and the visual fields between them were compared. DESIGN: Observational study. METHODS: Forty-six patients with open-angle glaucoma were tested by Humphrey field analyzer (Carl Zeiss Meditec, Inc, Dublin, California, USA) programs 30-2 full threshold and 10-2 full threshold. Forty reliable results with both programs were analyzed. RESULTS: Sensitivity of the same position within a five-degree field was significantly higher with the 10-2 program than with the 30-2 program. Higher sensitivity within a five-degree field with the 10-2 program significantly correlated with that with the 30-2 program. CONCLUSIONS: Visual field determined by automated perimetry was influenced by testing field size.

Effect of chronic hyperglycemia on intraocular pressure in patients with diabetes.

PURPOSE: To investigate the effect of chronic hyperglycemia on intraocular pressure (IOP) in patients with diabetes. DESIGN: Cross-sectional study. METHODS: We prospectively measured the IOP by Goldmann applanation tonometry in patients with diabetes with mild hyperglycemia (glycosylated hemoglobin A1c (HbA1c) < or = 6.5%), moderate hyperglycemia (6.5% < HbA1c < 8.0), and severe hyperglycemia (HbA1c > or = 8.0%). None of the patients with diabetes had diabetic retinopathy, secondary glaucoma, ocular or laser therapy, or history of glaucoma. The HbA1c level determined within three months of the IOP measurement was used. Statistical analysis was performed by Mann-Whitney U test. P < .05 was considered significant. RESULTS: The mean IOP in the mild group (n = 58) was 15.5 +/- 2.5 mm Hg, which was statistically significantly lower than that of the severe group (16.6 +/- 2.4 mm Hg; P = .013; n = 60). CONCLUSIONS: Chronic hyperglycemia is associated with increased IOP in patients with diabetes.

Histopathological study of a case with branch retinal vein occlusion.

A retinal specimen from a 68-year-old patient with glaucoma and branch retinal vein occlusion was examined by light and electron microscopy. The venous and arterial lumina were filled with erythrocytes, and many erythrocytes extravasated into the venous wall. We suggest that constant rubbing of endothelial cells of the occluded vein results in damage and erythrocyte extravasation was caused by diapedesis.

Light and electron microscopic studies on human retinal blood vessels of patients with sclerosis and hypertension.

PURPOSE: To correlate the ophthalmoscopic and histological findings on human retinal blood vessels of patients with sclerosis and hypertension, respectively. METHODS: Ophthalmoscopy, light microscopy, and transmission and scanning electron microscopy with histochemical staining were performed on eyes obtained from patients with a malignant orbital tumor, with absolute glaucoma, or with hypertensive retinopathy. RESULTS: The retinal arteries in aged patients with ophthalmoscopic sclerotic blood vessels had walls in which the smooth muscle cells had been replaced by collagen fibers, proteoglycan filaments, and ruthenium red-positive materials. The venous blood columns were hidden by numerous swollen nerve fibers and extending Müller cell processes. In a patient with accelerated hypertensive retinopathy, some of the muscle cells in the arteriolar walls were edematous. Focal and generalized narrowing of the retinal arteries appeared to be caused by a true functional constriction of the smooth muscle cells in the walls. CONCLUSIONS: The ophthalmoscopic signs, such as reflection of the retinal arterial blood column and crossing phenomena, were supported by sclerotic manifestations clearly visible upon histological examination. There were some organic changes in the retinal arteries in a patient with accelerated hypertensive retinopathy, but the ophthalmoscopic narrowings appeared to result from a functional constriction of the smooth muscle cells in these vessels.

Binocular summation in visual evoked cortical potential in patients who have significantly different P100 peak latencies in their two eyes.

PURPOSE: To determine whether binocular summation in visual evoked cortical potential (VEP) is present in patients who have significantly different P100 peak latencies in their two eyes. METHODS: Twelve patients with unilateral optic neuritis (ON) and 11 normal controls were studied. All of them had visual acuity of > or = 20/20 in both two eyes and good stereoacuity. Transient and steady-state VEPs were recorded with monocular and binocular pattern-reversal stimulation. RESULTS: In normal controls, the binocular summation ratio was 1.05 with transient stimulation and 1.21 with steady-state stimulation, and in ON patients it was 1.19 and 1.30, respectively. In ON patients, the peak latency of P100 components was delayed significantly when the affected eye was stimulated, but with binocular stimulation the waveform was very similar to that when the fellow eye was stimulated. CONCLUSION: Binocular summation of VECP is not present in ON cases with large differences in the peak latency between the two eyes even if they have good stereoacuity. Binocular summation may not be correlated with stereopsis in adults whose binocular function has already matured.

MR demonstration of partial lesions of the lateral geniculate body and its functional intra-nuclear topography.

Two rare cases with a partial lesion of the lateral geniculate body (LGB) presumably due to ischemia are demonstrated on high resolution MR imaging. A 62-year-old woman (case 1) presented with left homonymous superior quadrantanopia on Goldmann perimetry. Heavily T2 weighted MR images showed a localized lesion at the lateral portion of the LGB. The visual field defect was macular and horizontal meridian sparing and persisted for 9 years. A 49-year-old woman (case 2) presented with a sudden onset of left homonymous horizontal sectoranopia on Humphrey automated perimetry and heavily T2 weighted images demonstrated a lesion localized at the more medial part of the right LGB. Axons originating from inferior, central and superior retina are essentially located laterally, centrally and medially, respectively, in the LGB, based on the electrophysiological studies of animal experiments and this observation has been applied to humans. This study radiologically shows that a discrete lateral lesion of the LGB produced homonymous upper quadrantanopia in case 1, whereas a more medially located lesion produced homonymous sectoranopia in case 2, and reveals that the axons originating from inferior retina are located more laterally than those from central retina in the human LGB.

Comparison of Yatabe-Guilford personality test results in retinitis pigmentosa and glaucoma patients.

PURPOSE: To determine the psychological state and personality traits of patients with retinitis pigmentosa (RP) or glaucoma so that a closer and better relationship can be developed with the patients. METHODS: The Yatabe-Guilford personality test was administered to 75 RP patients and 42 glaucoma patients. The latter group included 29 cases of primary open-angle glaucoma, 6 of primary angle-closure glaucoma, and 7 of normal-tension glaucoma. The patients were being treated at the Department of Ophthalmology, Chiba University Hospital. As controls, 47 age-matched volunteers were tested. RESULTS: A comparison of these three groups showed that the proportions of patients with cyclic tendency, rhathymia, and lack of cooperativeness traits were significantly higher in the RP group than in the glaucoma group. The lack of cooperativeness value was especially higher in the RP than in the glaucoma group and the control group (Fisher exact test, P <.05). On the other hand, the nervousness value was significantly higher in the glaucoma group than in the RP group and than in controls (Fisher exact test, P <.05). Factors of sex, age, type of disease, corrected visual acuity, and central visual fields did not influence the profiles of the RP and glaucoma groups. CONCLUSION: RP patients had relatively well-stabilized personalities and were optimistic, while glaucoma patients tended toward nervousness in comparison with RP patients and controls.

Visual field indexes for version 3.0 of frequency doubling perimetry in patients with glaucoma.

PURPOSE: A new version of frequency doubling perimetry was compared to a former version in patients with glaucoma. DESIGN: Prospective observational study. METHOD: Thirty-two patients with glaucoma were examined twice sequentially in one eye with threshold c-20 of frequency doubling perimetry version 2.6. Within 3 months, the same eye was again examined twice sequentially, this time using the new version 3.0. Mean deviation, pattern standard deviation, short-term fluctuation, intraocular pressure at examination, and test duration were compared between versions. RESULTS: No significant difference was found in mean deviation, pattern standard deviation, intraocular pressure, or short-term fluctuation between versions. CONCLUSIONS: Version 3.0 took less time to perform the threshold test than did version 2.6. Version 3.0 of the frequency doubling perimetry program took less time to perform and showed similar values of visual field indexes when compared with version 2.6.

Citicoline has a protective effect on damaged retinal ganglion cells in mouse culture retina.

Some clinical reports indicate that exogenous CDP-choline (citicoline) may have a therapeutic effect in patients with glaucoma. However, the precise effect of citicoline on damaged retinal ganglion cells (RGCs) remains to be explained. We performed tissue culture of mouse retinal explants and investigated the effect of citicoline on damaged RGCs by the quantitative analysis of TdT-dUTP terminal nick-end labeling (TUNEL) staining and the assessment of the number of regenerating neurites. The TUNEL-positive ratio in 0.1-10 micromol/l citicoline-treated retina was very low, and the number of regenerating neurites increased more than in control retina. Our findings suggest that citicoline has a protective effect on damaged RGCs in tissue culture of retina.

Pattern visual evoked cortical potentials predict postoperative visual acuity after cataract surgery in patients with glaucoma.

Visual acuity after cataract surgery in patients with glaucoma cannot be predicted accurately. We studied preoperative recordings of pattern visual evoked cortical potentials (PVECPs) to evaluate postoperative vision in patients with glaucoma and cataract. Fifty patients with glaucoma and no cataract and 31 patients with glaucoma and cataract who underwent phacoemulsification were included in this study. Age and P100 component significantly correlated with postoperative visual acuity with multiple linear regression analysis. A significantly greater number of patients with glaucoma, cataract, and a P100 component preoperatively showed a visual acuity of 0.7 or better postoperatively, as compared to those without a P100 component. PVECP before cataract surgery was able to predict postoperative good visual acuity in patients with glaucoma and cataract.

Learning effect for frequency doubling perimetry in patients with glaucoma.

PURPOSE: We studied the results obtained by repeated frequency doubling perimetry in patients with glaucoma and demonstrated a learning effect. METHODS: Prospective observational study. Thirty-three patients who had glaucoma and had never experienced frequency doubling perimetry participated in this study. The patients were examined by frequency doubling perimetry three times within 6 months. Mean deviation, pattern standard deviation, and intraocular pressure at examination were compared among three results. RESULTS: On frequency doubling perimetry, the mean deviation results of the first, second, and third tests were -7.96 dB, -7.29 dB, and -7.36 dB, respectively. The first and second results and the first and third results were significantly different (P = 0.029 and P = 0.049, respectively). No significant differences with regard to pattern standard deviation and intraocular pressure were noted. CONCLUSION: A positive learning effect was found for frequency doubling perimetry in the first and second mean deviation results of patients with glaucoma.