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1.
J Vis ; 22(10): 7, 2022 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-36074477

RESUMO

Artificial orthographies have long been used in studies of verbal learning and reading. These orthographies, also known as pseudo or false fonts, are designed to match the letters of an existing alphabet on a range of visual features, isolating effects of orthography from those owing to lexical processing. In a parallel line of research, there has been much interest in the design of optotypes for measuring visual acuity that have good properties in terms of character complexity and graceful degradation under blur. Here we merge these two traditions by designing a fully scalable pseudofont, "PseudoSloan," that is based on the design rubric of the widely used Sloan optotypes. The font includes 26 Latin letters as well as two sets of letter-like symbols matching the Latin alphabet on a letter-by-letter basis. Quantitative matching of the pairs of Sloan and PseudoSloan glyphs is done on the basis of ink area and perimetric complexity. We provide the installable PseudoSloan font in TrueType and OpenType formats, plus a large number of PseudoSloan glyphs in .svg format that vary over wide ranges in their perimetric complexity and ink area (https://osf.io/qhj2b/).


Assuntos
Leitura , Visão Ocular , Humanos , Reconhecimento Visual de Modelos , Acuidade Visual , Testes de Campo Visual
2.
Medicine (Baltimore) ; 101(34): e30132, 2022 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-36042601

RESUMO

RATIONALE: Benign optic nerve gliomas were rarely found in adults, and total resection of these lesions seems impossible. We aimed to share a rare clinical case with an unusual and instructive treatment process. PATIENT CONCERNS: A 52-year-old woman complained of a 4-month history of visual disturbance. Automated perimetry revealed visual field defect in her both eyes. DIAGNOSIS: This patient was diagnosed with optic nerve glioma. We found its pathological features consistent with the pilocytic astrocytomas (WHO grade I). INTERVENTIONS: A total resection of the tumor was smoothly performed. OUTCOMES: Repeat MRI 3 months after the surgery demonstrated no recurrence of the lesion. Two years of postoperative telephone follow-up showed a stable status of improved vision. LESSONS: We reported this interesting case to show a rare kind of condition regarding optic nerve gliomas in adults, which might help neurosurgeons like us to diagnose and treat these "invisible" tumors.


Assuntos
Astrocitoma , Glioma do Nervo Óptico , Adulto , Astrocitoma/patologia , Feminino , Humanos , Imageamento por Ressonância Magnética/efeitos adversos , Pessoa de Meia-Idade , Glioma do Nervo Óptico/complicações , Glioma do Nervo Óptico/diagnóstico , Glioma do Nervo Óptico/cirurgia , Transtornos da Visão/etiologia , Testes de Campo Visual
3.
J Vis ; 22(9): 7, 2022 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-35998063

RESUMO

To this day, the most popular method of choice for testing visual field defects (VFDs) is subjective standard automated perimetry. However, a need has arisen for an objective, and less time-consuming method. Pupil perimetry (PP), which uses pupil responses to onsets of bright stimuli as indications of visual sensitivity, fulfills these requirements. It is currently unclear which PP method most accurately detects VFDs. Hence, the purpose of this study is to compare three PP methods for measuring pupil responsiveness. Unifocal (UPP), flicker (FPP), and multifocal PP (MPP) were compared by monocularly testing the inner 60 degrees of vision at 44 wedge-shaped locations. The visual field (VF) sensitivity of 18 healthy adult participants (mean age and SD 23.7 ± 3.0 years) was assessed, each under three different artificially simulated scotomas for approximately 4.5 minutes each (i.e. stimulus was not or only partially present) conditions: quadrantanopia, a 20-, and 10-degree diameter scotoma. Stimuli that were fully present on the screen evoked strongest, partially present stimuli evoked weaker, and absent stimuli evoked the weakest pupil responses in all methods. However, the pupil responses in FPP showed stronger discriminative power for present versus absent trials (median d-prime = 6.26 ± 2.49, area under the curve [AUC] = 1.0 ± 0) and MPP performed better for fully present versus partially present trials (median d-prime = 1.19 ± 0.62, AUC = 0.80 ± 0.11). We conducted the first in-depth comparison of three PP methods. Gaze-contingent FPP had best discriminative power for large (absolute) scotomas, whereas MPP performed slightly better with small (relative) scotomas.


Assuntos
Pupila , Testes de Campo Visual , Adulto , Humanos , Pupila/fisiologia , Escotoma , Transtornos da Visão/diagnóstico , Testes de Campo Visual/métodos , Campos Visuais
4.
Ophthalmic Surg Lasers Imaging Retina ; 53(8): 430-438, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35951718

RESUMO

BACKGROUND AND OBJECTIVE: To explore the association between best-corrected visual acuity (BCVA) improvement and changes in microperimetry (MP) and color vision in patients with nonexudative age-related macular degeneration following administration of two 1.0-mg intravitreal doses of risuteganib. PATIENTS AND METHODS: In a phase 2a, prospective, double-masked, sham-controlled study, eyes with nonexudative age-related macular degeneration and Early Treatment Diabetic Retinopathy Study BCVA between 20/40 and 20/200 were randomized to intravitreal risuteganib (1.0 mg) or sham injection. The risuteganib group received a second 1.0-mg dose, and patients in the sham group crossed over to receive 1.0 mg of risuteganib at week 16. Exploratory endpoints included changes in color vision and mesopic MP. RESULTS: Thirty-nine patients (risuteganib, n = 25; sham, n = 14) completed the study. There was a significant (P < .05) correlation between BCVA and the total error score (TES) for both Lanthony and Hue Style. Confusion index was close to the criterion for significance (P = .056) in the risuteganib group. All color vision metrics demonstrated a trend toward improvement in risuteganib responders (BCVA letter gain ≥8 letters) and no change in the nonresponders, with significant differences seen in confusion index between the risuteganib and control group (P = .0493) and between responders and nonresponders (P = .0478). MP showed that risuteganib responders improved in mean sensitivity and change in number of loci ≤11 dB and ≤0 dB, whereas nonresponders worsened. CONCLUSION: All color vision and MP parameters tested trended toward improvement in risuteganib-treated patients and risuteganib responders. Statistically significant improvement was evident in two metrics: confusion index (in risuteganib-treated patients and responders) and number of loci with decreased sensitivity (in responders). A significant correlation between BCVA and both TES Lanthony and TES Hue Style in risuteganib patients provides concurrent evidence of objective and subjective improvement of retinal function. [Ophthalmic Surg Lasers Imaging Retina 2022;53:430-438.].


Assuntos
Visão de Cores , Atrofia Geográfica , Inibidores da Angiogênese , Método Duplo-Cego , Atrofia Geográfica/tratamento farmacológico , Humanos , Injeções Intravítreas , Peptídeos , Estudos Prospectivos , Resultado do Tratamento , Acuidade Visual , Testes de Campo Visual
5.
BMC Ophthalmol ; 22(1): 339, 2022 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-35948955

RESUMO

BACKGROUND: Optical coherence tomography angiography (OCTA) is a novel technology that provides a noninvasive, dye-less method to visualize the blood vessels of the retina. In the present study, we investigate macular microvascular density and the correlation of ocular and demographic factors using OCTA in Posner-Schlossman syndrome (PSS) patients. METHODS: This is a prospective observational study. All PSS patients and age- and sex-matched healthy subjects underwent complete ophthalmologic examination, and RE, BCVA, IOP, CCT, AL, CMT, GCIPI, RNFL, C/D ratio were recorded. The whole-image vessel density (wiVD) and whole-image perfusion density (wiPD), three-circle (1 mm central ring, 3 mm inner ring, 6 mm outer ring), and four-quadrant segmental VD and PD were calculated. RESULTS: Seventeen PSS patients and 17 healthy subjects were enrolled in this study. The mean age was 42.65 ± 11.22 years in PSS patients and 42.71 ± 10.50 years in healthy controls. IOP, CCT, and C/D ratio were higher in PSS-attacked eyes, and BCVA, OPP and RNFL thickness was lower than those in the fellow eyes (p < 0.05). BCVA and OPP were improved in the PSS-attacked eyes in intermittent period (p < 0.05). The wiVD and wiPD were lower in the PSS-affected eyes than in the fellow eyes and in the control eyes in the PSS-attacked period (p < 0.05). All segmental VD and PD was lower in the PSS affected eyes than in the healthy control eyes (p < 0.05). In intermittent period, the wiVD and wiPD were lower in the PSS-affected eyes than in the fellow eyes (p < 0.05). Age, CCT, and SSI were associated with macular wiVD and wiPD in PSS attacked period. Age and CCT were associated with macular wiVD and wiPD in PSS intermittent period. CONCLUSION: Decreased macular superficial VD and PD was found in patients with Posner-Schlossman syndrome in attacked period and in remission. Macular wiVD and wiPD were associated with age, CCT and SSI in PSS patients.


Assuntos
Glaucoma de Ângulo Aberto , Disco Óptico , Adulto , Angiofluoresceinografia/métodos , Glaucoma de Ângulo Aberto/diagnóstico , Humanos , Pressão Intraocular , Densidade Microvascular , Pessoa de Meia-Idade , Fibras Nervosas , Disco Óptico/irrigação sanguínea , Células Ganglionares da Retina , Vasos Retinianos/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Testes de Campo Visual , Campos Visuais
6.
Optom Vis Sci ; 99(8): 645-651, 2022 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-35930259

RESUMO

SIGNIFICANCE: There is a clinical need for a quantitative test to objectively diagnose negative dysphotopsia, especially because the diagnosis is generally assessed using patients' subjective descriptions. In the search of a clinical test to objectify the shadow experienced in negative dysphotopsia, this study excludes static perimetry as suitable evaluation method. PURPOSE: This study aimed to evaluate the value of static perimetry in the objective assessment and follow-up of negative dysphotopsia. METHODS: Peripheral 60-4 full-threshold visual field tests were performed in 27 patients with negative dysphotopsia and 33 pseudophakic controls. In addition, 11 patients with negative dysphotopsia repeated the test after an intraocular lens exchange. Both the total peripheral visual field and the averaged peripheral visual field from 50 to 60° eccentricity were compared between patients and controls, and pre-operatively and post-operatively in patients who had an intraocular lens exchange. RESULTS: The peripheral visual fields from 30 to 60° did not show significant differences between patients with negative dysphotopsia and pseudophakic controls. Analysis of the peripheral visual field from 50 to 60° showed a median [Q1, Q3] of 20.0 [17.1, 22.5] dB in the negative dysphotopsia group compared with 20.1 [15.5, 21.3] dB in the control group (P = .43). Although 82% of patients treated with an intraocular lens exchange subjectively reported improvement of their negative dysphotopsia complaints post-operatively, there were no significant differences in their total peripheral visual field or averaged peripheral visual field from 50 to 60° (P = .92). CONCLUSIONS: Full-threshold static perimetry with a Goldmann size III stimulus up to 60° eccentricity does not show significant differences between patients with negative dysphotopsia and pseudophakic controls or between measurements before and after intraocular lens exchange. Therefore, this type of static perimetry cannot be used as a quantitative objective test for diagnosis or follow-up of patients with negative dysphotopsia.


Assuntos
Lentes Intraoculares , Testes de Campo Visual , Seguimentos , Humanos , Implante de Lente Intraocular/efeitos adversos , Implante de Lente Intraocular/métodos , Lentes Intraoculares/efeitos adversos , Transtornos da Visão/diagnóstico , Transtornos da Visão/etiologia
7.
Sci Rep ; 12(1): 14778, 2022 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-36042337

RESUMO

In this study, we investigated the patterns of visual field (VF) defects and the diagnostic abilities of VF tests using different strategies in Asian patients with hydroxychloroquine retinopathy. Patients screened for hydroxychloroquine retinopathy using optical coherence tomography, fundus autofluorescence, VF, and/or multifocal electroretinography were included. The VF was performed using the Humphrey 30-2 and/or 10-2 strategy, and 2,107 eyes of 1,078 patients with reliable results, including 136 eyes of 68 patients with hydroxychloroquine retinopathy, were analyzed. The characteristics of VF findings were evaluated and the sensitivity and specificity were compared between the 30-2 and 10-2 tests in subgroups of retinopathy severity and pattern. The most common VF defect pattern was partial- or full-ring scotoma in both the 10-2 and 30-2 tests. Among the eyes with hydroxychloroquine retinopathy that underwent both tests, 14.2% showed a disparity between the two tests, almost all at the early stage. In overall and early pericentral retinopathy, the sensitivity of the 30-2 test was significantly higher than that of the 10-2 test (95.7% vs. 77.1% and 90.6% vs. 53.1%, respectively; P < 0.05). However, the specificity of the 10-2 test was significantly higher than that of the 30-2 test (89.6% vs. 84.8%, P < 0.001). Therefore, the pattern of retinopathy should be carefully considered when choosing a VF strategy for better detection of hydroxychloroquine retinopathy.


Assuntos
Antirreumáticos , Doenças Retinianas , Antirreumáticos/efeitos adversos , Eletrorretinografia , Angiofluoresceinografia , Humanos , Hidroxicloroquina/efeitos adversos , Doenças Retinianas/induzido quimicamente , Doenças Retinianas/diagnóstico , Tomografia de Coerência Óptica , Transtornos da Visão/diagnóstico , Testes de Campo Visual , Campos Visuais
8.
Transl Vis Sci Technol ; 11(8): 3, 2022 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-35917137

RESUMO

Purpose: Test-retest variability in perimetry consists of short-term and long-term components, both of which impede assessment of progression. By minimizing and quantifying the algorithm-dependent short-term variability, we can quantify the algorithm-independent long-term variability that reflects true fluctuations in sensitivity between visits. We do this at locations with sensitivity both < 28 dB (when the stimulus is smaller than Ricco's area and complete spatial summation can be assumed) and > 28 dB (when partial summation occurs). Methods: Frequency-of-seeing curves were measured at four locations of 35 participants with glaucoma. The standard deviation of cumulative Gaussian fits to those curves was modeled for a given sensitivity and used to simulate the expected short-term variability of a 30-presentation algorithm. A separate group of 137 participants was tested twice with that algorithm, 6 months apart. Long-term variance at different sensitivities was calculated as the LOESS fit of observed test-retest variance minus the LOESS fit of simulated short-term variance. Results: Below 28 dB, short-term variability increased approximately linearly with increasing loss. Long-term variability also increased with damage below this point, attaining a maximum standard deviation of 2.4 dB at sensitivity 21 dB, before decreasing due to the floor effect of the algorithm. Above 30 dB, the observed test-retest variance was slightly smaller than the simulated short-term variance. Conclusions: Long-term and short-term variability both increase with damage for perimetric stimuli smaller than Ricco's area. Above 28 dB, long-term variability constitutes a negligible proportion of test-retest variability. Translational Relevance: Fluctuations in true sensitivity increase in glaucoma, even after accounting for increased short-term variability. This long-term variability cannot be reduced by altering testing algorithms alone.


Assuntos
Glaucoma , Testes de Campo Visual , Algoritmos , Feminino , Glaucoma/diagnóstico , Humanos , Distribuição Normal , Gravidez , Convulsões , Campos Visuais
9.
Sci Rep ; 12(1): 14080, 2022 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-35982106

RESUMO

Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness worldwide. Although deep learning methods have been proposed to diagnose POAG, it remains challenging to develop a robust and explainable algorithm to automatically facilitate the downstream diagnostic tasks. In this study, we present an automated classification algorithm, GlaucomaNet, to identify POAG using variable fundus photographs from different populations and settings. GlaucomaNet consists of two convolutional neural networks to simulate the human grading process: learning the discriminative features and fusing the features for grading. We evaluated GlaucomaNet on two datasets: Ocular Hypertension Treatment Study (OHTS) participants and the Large-scale Attention-based Glaucoma (LAG) dataset. GlaucomaNet achieved the highest AUC of 0.904 and 0.997 for POAG diagnosis on OHTS and LAG datasets. An ensemble of network architectures further improved diagnostic accuracy. By simulating the human grading process, GlaucomaNet demonstrated high accuracy with increased transparency in POAG diagnosis (comprehensiveness scores of 97% and 36%). These methods also address two well-known challenges in the field: the need for increased image data diversity and relying heavily on perimetry for POAG diagnosis. These results highlight the potential of deep learning to assist and enhance clinical POAG diagnosis. GlaucomaNet is publicly available on https://github.com/bionlplab/GlaucomaNet .


Assuntos
Aprendizado Profundo , Glaucoma de Ângulo Aberto , Glaucoma , Hipertensão Ocular , Glaucoma/complicações , Glaucoma de Ângulo Aberto/diagnóstico por imagem , Glaucoma de Ângulo Aberto/etiologia , Humanos , Pressão Intraocular , Hipertensão Ocular/complicações , Testes de Campo Visual
10.
Jpn J Ophthalmol ; 66(5): 413-424, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35972588

RESUMO

PURPOSE: To compare the ability of imo binocular random single-eye test (BRSET) to detect visual field (VF) defects due to chiasmal and postchiasmal lesions (C/PCLs) with a Humphrey Field Analyzer (HFA) monocular test. STUDY DESIGN: Prospective multicenter study METHODS: This study enrolled 40 patients with C/PCLs and measured their VFs using both imo BRSET and HFA monocular test. The VFs were classified into three groups using the cluster criterion: 1) bitemporal group, 2) homonymous group, and 3) others. The agreement and correlation of VF results between imo and HFA were analyzed using the Bland-Altman plot and Spearman correlation coefficient. RESULTS: The VFs of 34 patients were analyzed and classified. There were 13 patients in the bitemporal, 6 in the homonymous, and 15 in the others group. BRSET showed a significantly shorter test duration than HFA. The imo systematically yielded a lower sensitivity than HFA. The average sensitivity at each test location correlated well between the perimeters in all groups, with the correlation coefficients ranging from 0.89 to 0.98. Bland-Altman plots showed wider limits of agreement in the affected quadrants compared to the unaffected quadrants in the bitemporal and homonymous groups. The fixation loss rate did not differ between the perimeters, but there were significant differences in the false positive and false negative rates between perimeters. CONCLUSION: BRSET detected VF defects due to C/PCLs as accurately as the HFA monocular test with a shorter test duration.


Assuntos
Testes de Campo Visual , Campos Visuais , Humanos , Estudos Prospectivos , Transtornos da Visão/diagnóstico , Testes de Campo Visual/métodos
11.
Front Endocrinol (Lausanne) ; 13: 938952, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35966105

RESUMO

Background: To explore the correlation between visual field (VF) defect values and retinal nerve fiber layer (RNFL) thickness for intracranial tumor and glaucoma patients. Methods: Retrospective analysis is performed for the intracranial and glaucoma patients, whose VF defect values were measured with Octopus perimeter cluster analysis, RNFL thickness, ganglion cell layer (GCL) thickness, and optic disk parameters measured with swept-source OCT. The differences between VF and RNFL (including the data of optic disc) are calculated. The correlation between VF defect values and RNFL and GCL thickness are explored. Results: In total 43 eyes of 29 patients with intracranial tumor and 31 eyes of 19 patients with glaucoma were enrolled. The thickness of RNFL not only for the whole (360°), but also for the four quadrants was thinner in the glaucoma group than those of the intracranial tumor group (p<0.05), and similar to the thickness of GCL without significance (p>). There is no significant difference in VF for those two groups except glaucoma having lower sLV (p<0.05). A stronger correlation for mean deviations (MD)s of VF ten clusters and RNFL thickness of OCT twelve sectors is found in the glaucoma patients, but few in the intracranial tumor patients. Logistic regression also shows the loss of RNFL or increasing of vertical CDR and cup volume tending to the diagnosis of glaucoma and the irregular VF damage is inclined to the diagnosis of intracranial tumor. Conclusions: Intracranial tumor has a weak correlation between the RNFL thickness and Octopus VF MD, compared with that of glaucoma. OCT and Octopus VF might provide more helpful information for the differential diagnosis of intracranial tumor and glaucoma.


Assuntos
Neoplasias Encefálicas , Glaucoma , Octopodiformes , Animais , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/patologia , Análise por Conglomerados , Glaucoma/diagnóstico , Glaucoma/patologia , Humanos , Fibras Nervosas/patologia , Células Ganglionares da Retina/patologia , Estudos Retrospectivos , Tomografia de Coerência Óptica , Transtornos da Visão/patologia , Testes de Campo Visual , Campos Visuais
12.
Sci Rep ; 12(1): 11809, 2022 07 12.
Artigo em Inglês | MEDLINE | ID: mdl-35821509

RESUMO

In this study, we investigated the clock-hour topographic characteristics and extent of photoreceptor and retinal pigment epithelium (RPE) damage and correlated the extent with functional defects in eyes with hydroxychloroquine retinopathy. A total of 146 eyes of 75 patients diagnosed with hydroxychloroquine retinopathy were included. The clock-hour topographic characteristics (relative to the fovea) and extent of the photoreceptor and RPE defects in the parafoveal and pericentral areas were evaluated by reviewing the radial-scan optical coherence tomography (OCT) and wide-field fundus autofluorescence (FAF) images. The extent of outer retinal damage in the parafoveal and pericentral areas were correlated with the perimetric parameters of the Humphrey 10-2 and 30-2 tests, respectively. Although the photoreceptor damage was most commonly noted at the temporal to inferior locations in both parafoveal and pericentral areas, the RPE damage in the pericentral eyes was most commonly noted in the nasal area and showed topographic discrepancies with photoreceptor damage. The extent of RPE damage was almost identical between OCT and FAF images, whereas photoreceptor defect extent was significantly greater on OCT images. The extent of parafoveal and pericentral photoreceptor damage on OCT images was significantly correlated with perimetric parameters of the 10-2 and 30-2 tests, respectively (all P < 0.05). Our findings on the detailed topographic characteristics using a clock-hour-based system and significant correlation between the structural extent and perimetric parameters suggest that this evaluation may facilitate more comprehensive descriptions of structural damage extent and predictions of visual function.


Assuntos
Antirreumáticos , Doenças Retinianas , Antirreumáticos/efeitos adversos , Humanos , Hidroxicloroquina/efeitos adversos , Doenças Retinianas/induzido quimicamente , Doenças Retinianas/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Testes de Campo Visual
13.
Sci Rep ; 12(1): 12109, 2022 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-35840610

RESUMO

This study investigated the progression detection capabilities of circumpapillary and macular vessel density (cpVD and mVD) in advanced primary open angle glaucoma (POAG) eyes using the rates of change in VD (trend-based analysis) and variability limits derived from healthy eyes. (event-based analysis) This study included 75 POAG eyes [visual field (VF) mean deviation < - 10 decibels, mean follow-up; 2.3 years] and 33 healthy eyes. Of 75 POAG eyes, 17 (22.7 %) and 58 eyes (77.3 %) were classified into the VF progression and stable groups, respectively. The VF progression group showed significantly faster VD loss than the stable group. (cpVD; - 1.76 vs. - 0.84 %/year, mVD; - 1.10 vs. - 0.47 %/year, P < 0.05) However, the rates of change in circumpapillary retinal nerve fiber layer and macular ganglion cell complex thickness were similar between the groups. (cpRNFLT; - 0.67 vs. - 0.53 [Formula: see text]m/year, GCCT; - 0.48 vs. - 0.12 [Formula: see text]m/year, P > 0.05) Event-based analysis showed stronger agreement between VD and VF progression (cpVD; kappa value (k) = 0.630, mVD; k = 0.667, P < 0.05) than that between structure and VF progression. (cpRNFLT; k = 0.111, GCCT; k = 0.194, P > 0.05). In conclusion, VD loss showed better progression detection capabilities than structural loss in advanced POAG eyes. Detection of cpVD and mVD loss may be useful for detecting progression in the advanced stages of POAG to complement other reference standard strategies.


Assuntos
Glaucoma de Ângulo Aberto , Glaucoma , Disco Óptico , Glaucoma de Ângulo Aberto/diagnóstico , Humanos , Pressão Intraocular , Fibras Nervosas , Células Ganglionares da Retina , Vasos Retinianos/diagnóstico por imagem , Tomografia de Coerência Óptica , Testes de Campo Visual
14.
Sci Rep ; 12(1): 11263, 2022 07 04.
Artigo em Inglês | MEDLINE | ID: mdl-35788149

RESUMO

The risks of misdiagnosing a healthy individual as glaucomatous or vice versa may be high in a population with a large majority of highly myopic individuals, due to considerable morphologic variability in high myopic fundus. This study aims to compare the diagnostic ability of the regular and long axial length databases in the RS-3000 Advance SD-OCT (Nidek) device to correctly diagnose glaucoma with high myopia. Patients with high myopia (axial length ≥ 26.0 mm) in Chang Gung Memorial Hospital, Taiwan between 2015 and 2020 were included. Glaucoma was diagnosed based on glaucomatous discs, visual field defects and corresponding retinal nerve fiber layer defects. The sensitivity, specificity, diagnostic accuracy and likelihood ratios of diagnosing glaucoma via mGCC thickness in both superior/inferior and GChart mapping using the regular and long axial length normative databases. The specificity and diagnostic accuracy of mGCC thickness for distinguishing glaucomatous eyes from nonglaucomatous eyes among highly myopic eyes were significantly improved using the long axial length database (p = 0.046). There were also significant proportion changes in S/I mapping as well as GChart mapping (37.3% and 48.0%, respectively; p < 0.01) from abnormal to normal in the myopic normal eye group when using the long axial length normative database. The study revealed that clinicians could utilize a long axial length database to effectively decrease the number of false-positive diagnoses or to correctly identify highly myopic normal eyes misdiagnosed as glaucomatous eyes.


Assuntos
Glaucoma , Miopia , Disco Óptico , Glaucoma/diagnóstico por imagem , Humanos , Miopia/diagnóstico por imagem , Disco Óptico/diagnóstico por imagem , Células Ganglionares da Retina , Testes de Campo Visual
15.
Sci Rep ; 12(1): 11705, 2022 07 09.
Artigo em Inglês | MEDLINE | ID: mdl-35810182

RESUMO

The frequency-doubling technology (FDT) screening test (FDT-C-20-1) has adopted in many recent population-based glaucoma surveys, but factors associated with false-positive (FP) responses to FDT-C-20-1 in normal eyes and false-negative (FN) responses in glaucoma eyes were not known. These factors were investigated in a population-based setting using the data from 3805 normal eyes (2381 subjects) and 272 eyes with definite glaucoma (215 subjects) in the Kumejima Study participants with reliable FDT-C-20-1 results. Considering the presence of at least one abnormal test point (P < 0.01) as abnormal, the specificity and sensitivity of FDT-C-20-1 for glaucoma were 91.8% (95% confidence interval, 91.1 ~ 92.5) and 56.3% (47.0 ~ 62.5), respectively. Multivariate linear mixed-model logistic regression analysis showed correlations with older age, worse visual acuity, greater ß-peripapillary area (P < 0.001 for all comparisons) and more myopic refraction (P = 0.030) with the FP responses in normal eyes, and normal-tension glaucoma (P = 0.043), a better mean deviation value of Humphrey perimetry (P = 0.001), larger rim area (P = 0.041), and absence of disc hemorrhage (P = 0.015) with the FN responses in glaucoma eyes. In a population-based setting, abnormal responses to FDT-C-20-1 indicate the presence of a risk factor for glaucoma in normal eyes and risk factors for more rapid progression in glaucoma eyes.


Assuntos
Glaucoma , Testes de Campo Visual , Glaucoma/diagnóstico , Humanos , Reprodutibilidade dos Testes , Fatores de Risco , Sensibilidade e Especificidade , Tecnologia , Transtornos da Visão/diagnóstico , Testes de Campo Visual/métodos
16.
Invest Ophthalmol Vis Sci ; 63(8): 4, 2022 07 08.
Artigo em Inglês | MEDLINE | ID: mdl-35816046

RESUMO

Purpose: In choroideremia (CHM) carriers, scotopic sensitivity was assessed by dark adapted chromatic perimetry (DACP) and outer retinal structure was evaluated by multimodal imaging. Methods: Nine carriers (18 eyes) and 13 healthy controls (13 eyes) underwent DACP testing with cyan and red stimuli. Analysis addressed peripapillary (4 test locations closest to the optic disc), macular (52 locations), and peripheral (60 locations outside the macula) regions. Responses were considered to be rod-mediated when cyan relative to red sensitivity was >5 dB. Fundus imaging included spectral domain optical coherence tomography (SD-OCT), short-wavelength (SW-AF), near-infrared (NIR-AF), ultrawide-field (200 degrees) pseudocolor fundus imaging, and quantitative (qAF) fundus autofluorescence. Results: Detection of the cyan stimulus was rod mediated in essentially all test locations (99.7%). In the macular and peripheral areas, DACP sensitivity values were not significantly different from healthy eyes. In the peripapillary area, sensitivities were significantly decreased (P < 0.05). SD-OCT imaging ranged from hyper-reflective lesions and discontinuities of the outer retinal bands to hypertransmission of signal. SW-AF and NIR-AF images presented with peripapillary atrophy in seven patients (14 eyes). Mosaicism was detectable in SW-AF images in seven patients and in NIR-AF images in five patients. Frank hypo-autofluorescence was visible in eight patients with distinct chorioretinopathy in seven patients. The qAF values were below the 95% confidence interval (CI) of healthy age-matched individuals in 12 eyes. Conclusions: Rod mediated scotopic sensitivity was comparable to that in control eyes in macular and peripheral areas but was decreased in the peripapillary area where changes in retinal structure were also most severe.


Assuntos
Coroideremia , Coroideremia/diagnóstico , Coroideremia/patologia , Angiofluoresceinografia/métodos , Fundo de Olho , Humanos , Retina/diagnóstico por imagem , Retina/patologia , Tomografia de Coerência Óptica/métodos , Testes de Campo Visual
17.
Biomed Res Int ; 2022: 7204954, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35872870

RESUMO

We reviewed medical records of 121 patients/235 eyes of typical retinitis pigmentosa (RP) patients who could be followed up for at least 5 years with the aim of investigating the long-term course of visual function progression at each RP stage and appropriate assessment methods. Patients were classified into three groups: mild RP (baseline mean deviation (MD) ≥ -5), moderate RP (-25 < baseline MD < -5), and late RP (baseline MD ≤ -25). Linear mixed-effect models were used to follow MD, the average retinal sensitivity of the central four points of the Humphrey field analyzer 10-2 program (S4), and visual acuity (VA) with increasing time. The associations among factors (baseline MD group, sex, hereditary form) and the interaction between each factor and time were also investigated. The mean reduction of the MD, S4, and VA for all patients was -0.37 dB/year, -0.25 dB/year, and 0.018/year, respectively. The moderate RP group had a faster progression than other groups in MD (-0.43 dB/year, p < 0.05). The moderate (-0.31 dB/year, p = 0.01) and late RP groups (-0.25 dB/year, p < 0.01) had faster progression than the mild RP group in S4. The late RP group had faster progression in VA than the other groups (0.03/year, p < 0.05). Females had a slower progression of the S4 (-0.15 dB/year, p = 0.02) and VA (0.01/year, p < 0.001) than males. The autosomal dominant group had a slower progression than the sporadic group in MD (-0.22 dB/year, p = 0.02); the autosomal dominant and autosomal recessive groups had a slower VA decline than the sporadic group (0.01/year, p = 0.03; 0.01/year, p = 0.04). Because the progression rates of VA and visual field test differed as per the RP stage, S4 and VA can also be useful assessment methods depending on the stage. Inheritance form and sex may affect the progression rate.


Assuntos
Retinite Pigmentosa , Campos Visuais , Feminino , Humanos , Masculino , Retina , Retinite Pigmentosa/genética , Acuidade Visual , Testes de Campo Visual
18.
JAMA Ophthalmol ; 140(8): 800-806, 2022 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-35771529

RESUMO

Importance: Faster structural changes may be associated with worse vision-related quality of life in patients with glaucoma. Objectives: To evaluate the association between the rate of ganglion cell complex thinning and the Vision Function Questionnaire in glaucoma. Design, Setting, and Participants: This retrospective analysis of a longitudinal cohort was designed in October 2021. Patients were enrolled from the Diagnostic Innovations in Glaucoma Study and the African Descent and Glaucoma Evaluation Study. Two hundred thirty-six eyes of 118 patients with diagnosed or suspected glaucoma were followed up with imaging for a mean of 4.1 years from September 2014 to March 2020. Main Outcomes and Measures: The Vision Function Questionnaire was evaluated using the 25-item National Eye Institute Visual Function at the last follow-up visit. Ganglion cell complex thickness was derived from macular optical coherence tomography scans and averaged within 3 circular areas (3.4°, 5.6°, and 6.8° from the fovea) and superior and inferior hemiregions. Linear mixed-effects models were used to investigate the association between the rate of ganglion cell complex thinning and Rasch-calibrated Vision Function Questionnaire score. Results: The mean (SD) age was 73.2 (8.7) years, 65 participants (55.1%) were female, and 53 participants (44.9%) were African American. Race was self-reported by the participants. Mean composite Rasch-calibrated National Eye Institute Visual Function Questionnaire score was 50.3 (95% CI, 45.9-54.6). A faster annual rate of global ganglion cell complex thinning in the better eye was associated with a higher disability reflected by the composite National Eye Institute Visual Function Questionnaire score (-15.0 [95% CI, -28.4 to -1.7] per 1 µm faster; P = .03). When stratified by degrees from the fovea, the 5.6° and 6.8° areas were associated with the composite National Eye Institute Visual Function Questionnaire Rasch-calibrated score (-14.5 [95% CI, -27.0 to -2.0] per 1 µm faster; R2 = 0.201; P = .03; and -23.7 [95% CI, -45.5 to -1.9] per 1 µm faster; R2 = 0.196; P = .02, respectively), and -8.0 (95% CI, -16.8 to 0.8) per 1 µm faster for the 3.4° area (R2 = 0.184; P = .07) after adjusting for confounding factors. Conclusions and Relevance: These findings suggest that faster and sectoral central location of ganglion cell complex thinning provides useful information in determining the risk of vision-related quality of life in glaucoma. Monitoring macular structure may be useful for determining the risk of functional impairment in glaucoma.


Assuntos
Glaucoma , Qualidade de Vida , Idoso , Feminino , Glaucoma/diagnóstico , Humanos , Pressão Intraocular , Masculino , Células Ganglionares da Retina , Estudos Retrospectivos , Tomografia de Coerência Óptica , Testes de Campo Visual , Campos Visuais
19.
J Glaucoma ; 31(9): 734-743, 2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-35654344

RESUMO

PRCIS: Both macular superficial vessel density and ganglion cell complex (GCC) thickness measurement are significantly associated with regional and global 10-degree central visual field (VF) sensitivity in advanced glaucoma. PURPOSE: The purpose of this study was to evaluate the regional and global structure-function relationships between macular vessel density (MVD) assessed by optical coherence tomography angiography (OCTA) and 10-2 VF sensitivity in advanced open angle glaucoma eyes. METHODS: Macular OCTA and 10-2 VF sensitivity of 44 patients [mean deviation (MD) <-10 dB] were evaluated. Regional and global VF mean sensitivity (MS) was calculated from total deviation plots. Superficial and deep MVD were obtained from 3 × 3 and 6×6 mm 2 OCTA scans using 2 sectoral definitions. Spectral-domain optical coherence tomography macular GCC thickness was obtained simultaneously from the same scan as the MVD measurements. Linear regression models were used to assess the associations ( R2 ). RESULTS: Lower MS was significantly associated with a reduction in superficial MVD and GCC in each region of both scan sizes for both maps. Associations were weaker in the individual sectors of the whole image grid than the Early Treatment Diabetic Retinopathy Study map. Deep-layer MVD was not associated with central MS. Although 6×6 mm 2 and perifoveal vessel density had better associations with central 10-degree MS compared with GCC thickness (eg, R2 from 25.7 to 48.1 µm and 7.8% to 32.5%, respectively), GCC associations were stronger than MVD associations in the central 5-degree MS. CONCLUSIONS: Given a stronger MVD-central 10-degree VF association compared with GCC, as well as stronger GCC-central 5-degree VF association compared with MVD, MVD and GCC are complementary measurements in eyes with advanced glaucoma. A longitudinal analysis is needed to determine the relative utility of the GCC and MVD measurements.


Assuntos
Glaucoma de Ângulo Aberto , Glaucoma , Glaucoma de Ângulo Aberto/diagnóstico , Humanos , Pressão Intraocular , Fibras Nervosas , Células Ganglionares da Retina , Vasos Retinianos , Tomografia de Coerência Óptica/métodos , Testes de Campo Visual , Campos Visuais
20.
Semin Ophthalmol ; 37(6): 699-706, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35666653

RESUMO

OBJECTIVE: Strabismic amblyopia is a motor and sensory deficit produced by unilateral constant strabismus and binocular imbalance. The aim of this study was to analyse the retinal fixation pattern using microperimetry in subjects with strabismus with and without amblyopia associated, and to compare the results with those obtained in normal subjects. METHODS: Prospective comparative study conducted at the Optometric Clinic of the University of Valencia and Oftalvist Alicante (Spain) including 46 eyes with ages from 3 to 16 years. Three groups were differentiated: patients with persistent strabismic amblyopia after occlusion and active therapy (group 1, 7 patients, 30.4%), strabismic patients without amblyopia (group 2, 8 patients, 34.8%) and a control group (8 patients, 34.8%). Microperimetric analysis was performed with the Macular Integrity Assessment (MAIA) system (Centervue, Padova, Italy) and using the following parameters: P1% and P2% fixation indexes, and the ellipse areas (BCEA) for 95% and 63% of points for the first 10 seconds, 30 seconds, 60 seconds, and the total examination time. RESULTS: Significant differences were found between groups for dominant eyes in P2 calculated at 30 (p = .04) and 60 seconds (p = .03). However, these differences between groups in non-dominant eyes were close to statistical significance (p = .07 and p = .08). Specifically, P2 was significantly lower in group 1 compared to control group (p = .01). Best corrected visual acuity was found to be significantly correlated (p ≤ .04) with total P1 (dominant eye, r = -0.51; non-dominant eye, r = -0.50), total P2 (dominant eye, r = -0.50; non-dominant eye, r = -0.50), and BCEA63 (dominant eye, r = 0.50; non-dominant eye, r = 0.40) and BCEA95 (dominant eye, r = 0.50; non-dominant eye, r = 0.40) measured at 10 seconds. CONCLUSIONS: The preliminary results of this study seem to indicate that subjects with strabismus have fixation instability regardless of the presence or absence of amblyopia.


Assuntos
Ambliopia , Estrabismo , Adolescente , Criança , Pré-Escolar , Humanos , Projetos Piloto , Estudos Prospectivos , Retina , Acuidade Visual , Testes de Campo Visual
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