Structure-Function Relationship Between the Bruch Membrane Opening-based Minimum Rim Width and Visual Field Defects in Advanced Glaucoma.

PURPOSE: To investigate the relationship between the Bruch membrane opening-minimum rim width (BMO-MRW) (global and temporal) parameters with spectral-domain optical coherence tomography (SD-OCT) and visual field (VF) sensitivity on the 10-2 test in patients with advanced glaucoma. MATERIALS AND METHODS: This cross-sectional, observational study included a total of 33 eyes of 29 patients. To evaluate VF sensitivity, automated white-on-white perimetry was performed using a Humphrey field analyzer. The mean deviation (MD) and pattern SD values were used to characterize the degree of functional damage. BMO-MRW and peripapillary retinal nerve fiber layer thickness were obtained with SD-OCT. According to the Garway-Heath map and fovea and BMO axis, the 90 degrees temporal sector of the optic disc corresponding to the central VF was divided into upper and lower parts. RESULTS: The upper and lower temporal BMO-MRW parameters showed stronger correlations with the MD parameters of their corresponding VFs when compared with both global and temporal MRW parameters. Global and temporal retinal nerve fiber layer thickness parameters were also correlated with global MD parameters. CONCLUSIONS: BMO-MRW measurements in the upper and lower parts of the 90 degrees temporal sector of the optic nerve head by SD-OCT and their corresponding VF sensitivity on the 10-2 test were found highly correlated. These BMO-MRW measurements could offer a means of predicting the status of visual hemifields in patients who are unable to undergo VF testing. Further longitudinal studies with larger series evaluating BMO-MRW parameters with SD-OCT are also needed to monitor progression in advanced glaucoma.

Surgical outcomes of patients with iridocorneal endothelial syndrome: a case series.

The purpose of this study is to report the intermediate-term surgical outcomes of patients with iridocorneal endothelial syndrome-related glaucoma. The medical records of four patients (five eyes) surgery (Ahmed glaucoma valve implantation surgery and EX-PRESS mini shunt) were retrospectively reviewed. Median follow-up after glaucoma surgery was 24 (15-36) months. The preoperative intraocular pressure was significantly reduced from a median of 33 (22.5-36) mmHg on a median of 4 (4-5) glaucoma medications to a median of 12 (10.5-14.5) mmHg on a median of 2 (0-2) medications at last follow-up after surgery (p = 0.043 for IOP and p = 0.042 for glaucoma medications). Median preoperative visual acuity [0.016 (0.008-0.1)] did not change significantly when compared to median visual acuity at last follow-up [0.016 (0.004-0.5)] (p = 0.59). Intraocular pressure control in patients with iridocorneal endothelial syndrome is challenging and may require multiple operations and revisions. Some modifications during glaucoma drainage implant surgery and use of EX-PRESS mini shunt in certain cases could offer an advantage in these patients.

In vivo biometric evaluation of Schlemm's canal with spectral-domain optical coherence tomography in pseuduexfoliation glaucoma.

PURPOSE: To perform in vivo imaging of the Schlemm's canal (SC) with anterior segment spectral-domain optical coherence tomography [AS-spectral-domain (SD)-OCT] and also to measure its biometric parameters including the SC length and SC area in patients with pseudoexfoliation (PEX) glaucoma. METHODS: Forty-one consecutive patients with PEX glaucoma and 41 age- and sex-matched normal subjects were enrolled. All subjects underwent imaging with SD-OCT. The SC length and SC area were examined in the temporal sections and measured with customized software. RESULTS: The percentages of the temporal sections in which SC was observable were similar between the two groups. Mean SC length was found significantly shorter, and mean SC area was found significantly smaller in patients with PEX glaucoma than in controls (p = 0.044 and p = 0.036, respectively). Mean intra-ocular pressure (IOP) values were also similar between two groups. No significant correlations were found between SC measurements and IOP. CONCLUSIONS: Anterior segment spectral-domain optical coherence tomography offers non-invasive, in vivo measurement of the SC, and it could be used for investigating the SC changes in patients with PEX glaucoma.