Asunto(s)
Enfermedad de Fabry/complicaciones , Neuropatía Óptica Isquémica/etiología , Adulto , Angiografía con Fluoresceína , Glucocorticoides/administración & dosificación , Humanos , Masculino , Metilprednisolona/administración & dosificación , Neuropatía Óptica Isquémica/diagnóstico , Neuropatía Óptica Isquémica/tratamiento farmacológico , Quimioterapia por Pulso , Pruebas del Campo Visual , Campos VisualesRESUMEN
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.
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Algoritmos , Glaucoma de Ángulo Abierto/fisiopatología , Pruebas del Campo Visual/métodos , Campos Visuales/fisiología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sensibilidad y EspecificidadRESUMEN
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.
Asunto(s)
Diabetes Mellitus/fisiopatología , Hiperglucemia/fisiopatología , Presión Intraocular/fisiología , Enfermedad Crónica , Estudios Transversales , Femenino , Hemoglobina Glucada/análisis , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Tonometría OcularRESUMEN
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.
Asunto(s)
Oclusión de la Vena Retiniana/patología , Anciano , Membrana Basal/ultraestructura , Endotelio Vascular/ultraestructura , Eritrocitos/ultraestructura , Humanos , MasculinoRESUMEN
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.
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Aterosclerosis/patología , Hipertensión/patología , Vasos Retinianos/ultraestructura , Anciano , Anciano de 80 o más Años , Cadáver , Preescolar , Resultado Fatal , Humanos , Masculino , Microscopía Electrónica de Rastreo , Microscopía Electrónica de Transmisión , Persona de Mediana Edad , Oftalmoscopía , Índice de Severidad de la EnfermedadAsunto(s)
Glaucoma/diagnóstico , Presión Intraocular , Pruebas del Campo Visual , Adulto , Femenino , Glaucoma/fisiopatología , Humanos , Agudeza Visual , Campos VisualesRESUMEN
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.
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Potenciales Evocados Visuales/fisiología , Neuritis Óptica/fisiopatología , Visión Binocular/fisiología , Corteza Visual/fisiología , Adolescente , Adulto , Edad de Inicio , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reconocimiento Visual de Modelos/fisiología , Tiempo de Reacción , Agudeza Visual/fisiologíaRESUMEN
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.
Asunto(s)
Isquemia Encefálica/diagnóstico , Infarto Cerebral/diagnóstico , Cuerpos Geniculados/irrigación sanguínea , Hemianopsia/etiología , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Axones/patología , Mapeo Encefálico , Coroides/irrigación sanguínea , Coroides/patología , Diagnóstico Diferencial , Dominancia Cerebral/fisiología , Femenino , Cuerpos Geniculados/patología , Hemianopsia/diagnóstico , Humanos , Persona de Mediana Edad , Núcleos Talámicos Posteriores/irrigación sanguínea , Núcleos Talámicos Posteriores/patología , Retina/patología , Pruebas del Campo Visual , Vías Visuales/patologíaRESUMEN
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.
Asunto(s)
Glaucoma de Ángulo Cerrado/psicología , Glaucoma de Ángulo Abierto/psicología , Retinitis Pigmentosa/psicología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Determinación de la Personalidad , Pruebas de Personalidad , Agudeza Visual , Campos VisualesRESUMEN
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.
Asunto(s)
Glaucoma/diagnóstico , Trastornos de la Visión/diagnóstico , Pruebas del Campo Visual/métodos , Campos Visuales , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Programas InformáticosRESUMEN
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.
Asunto(s)
Citidina Difosfato Colina/metabolismo , Nootrópicos/metabolismo , Células Ganglionares de la Retina/efectos de los fármacos , Células Ganglionares de la Retina/metabolismo , Animales , Técnicas de Cultivo , Citidina Difosfato Colina/farmacología , Etiquetado Corte-Fin in Situ , Ratones , Ratones Endogámicos C57BL , Regeneración Nerviosa/efectos de los fármacos , Neuritas/metabolismo , Nootrópicos/farmacologíaRESUMEN
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.
Asunto(s)
Catarata/fisiopatología , Potenciales Evocados Visuales/fisiología , Glaucoma de Ángulo Abierto/fisiopatología , Implantación de Lentes Intraoculares , Facoemulsificación , Agudeza Visual/fisiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Catarata/complicaciones , Glaucoma de Ángulo Abierto/complicaciones , Humanos , Persona de Mediana Edad , Periodo PosoperatorioRESUMEN
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.