Purpose: To investigate the correlation of a structural measure of the macular area (optical coherence tomography (OCT)) with two functional measures (10-2 Humphrey visual field (HVF) and multifocal visual evoked potential (mfVEP)) of macular function. Methods: 55 eyes with open-angle glaucoma were enrolled. The 10-2 HVF was defined as abnormal if clusters of >3 points with p,5%, one of which had p,1%, were present. The mfVEP was abnormal if probability plots had >2 adjacent points with p,1%, or >3 adjacent points with p,5% and at least one of these points with p,1%. Two criteria were used for the macular OCT: (I) >2 sectors with p,5% or 1 sector with p,1% and (II) 1 sector with p,5%. Results: 54 of the 55 eyes showed an abnormal 10-2 HVF and 50 had central mfVEP defects. The two OCT criteria resulted in sensitivities of 85% and 91%. When both functional tests showed a defect (in 49 eyes), the OCT was abnormal in 45. For the OCT the outer and inner inferior regions were the most likely to be abnormal, and both functional techniques were most abnormal in the superior hemifield. Conclusions: Good agreement exists between macular thickness and functional defects in patients with glaucoma. Study of the macular region may provide a quantitative measure for disease staging and monitoring.
Contrary to previous reports, prolonged VEP delays were present in a minority of patients with glaucoma. Either a delayed VEP is not a good indicator of damaged, as opposed to dead, retinal ganglion cells, or there are relatively few patients who exhibit evidence of damaged ganglion cells.
The OCT RNFL test accurately detects abnormal hemifields confirmed on both subjective and objective functional tests. Identifying abnormal hemifields with a criterion of 1 red (1%) or 2 yellow (5%) clock hours may prove useful in clinical practice.
To identify differences in anterior chamber anatomy among patients with asymmetric pigment dispersion syndrome and no other discernible cause for the asymmetry. Methods: Ultrasound biomicroscopy and A-scan biometry were performed on both eyes of 13 patients with asymmetric pigment dispersion syndrome without a known cause for asymmetric involvement. A radial perpendicular image in the horizontal temporal meridian detailing the scleral spur, angle anatomy, and iris configuration was obtained for each eye by 2 examiners. Results: There were no differences in lens thickness (P=.33), refractive error (P=.84), or axial length (P=.99) between more and less affected eyes. However, the mean ± SD iris concavity (PϽ.001), iris-lens contact distance (P=.02), and distance from the scleral spur to the iris insertion (0.42 ± 0.11 vs 0.29 ± 0.06 mm) (P = .002) were greater in the more affected eye of each patient. Conclusion: A more posterior iris insertion predisposes to the phenotypic expression of pigment dispersion syndrome.
SUMMARY OBJECTIVES To bring summarized information about what has been published so far regarding Covid-19, facilitating the access to information and a better understanding of this pandemic, and to contribute to the medical community in the decision-making against this virus. METHODS This review article brings collected information from different articles published since the beginning of the pandemic of the 2019 novel coronavirus. KEY RESULTS This paper aggregates and consolidates some epidemiological parameters and clinical knowledge about the novel coronavirus and brings what is new in the search for pandemic control. MAJOR CONCLUSIONS Governments and health authorities are under increased pressure to control the COVID-19 spreading. In this scenario, the scientific community is working hard to produce relevant papers which will help in the next steps against coronavirus. Our review summarized the latest news about SARS-CoV2, evidencing what we know about COVID-19 until now.
PURPOSE
To determine the effect of optic disc drusen on the latency of the pattern-reversal checkerboard visual evoked potentials (VEPs) and multifocal (mf)VEPs and to better understand the pathophysiology of the condition.
METHODS
Eighteen eyes with optic disc drusen (10 patients) and 38 control eyes (19 subjects) underwent VEP, mfVEP, and visual field testing. Only one eye of each individual, the one with the more affected visual field, was used in the analyses. The VEPs were recorded with a 15′ and 60′ reversing checkerboard pattern, and the mfVEPs were elicited by a 60-sector dartboard display.
RESULTS
Unlike the VEP results, the mfVEP revealed a significant increase in the average monocular latency of the optic disc drusen group compared with that of the control group. The average mfVEP relative latency for the optic disc drusen group (4.1 ms) was greater than that (0.8 ms) in the control group. For monocular and interocular analyses, the average percentage of points delayed in the drusen group was significantly greater than that in the control group.
CONCLUSIONS
Optic disc drusen produced significant latency delays on the mfVEP test but not on the VEP test, presumably due to the mfVEP’s ability to detect the effects of local changes. The results are consistent with the hypothesis that local mechanical compression by optic disc drusen leads to abnormal retinal ganglion cell activity.
Précis:
Our results suggest gonioscopy-assisted transluminal trabeculotomy (GATT) as an effective and safe option for the surgical management of open-angle glaucoma (OAG). Older age was the only risk factor for failure in our analysis.
Purpose:
To report 12-month clinical outcomes, safety profile and success predictors of GATT in patients with OAG.
Patients and Methods:
A retrospective study of patients (18 y old and above) with medically uncontrolled OAG who underwent GATT as a solo procedure or combined with phacoemulsification (PHACO-GATT) between January 2018 and January 2020. Success at 12 months (primary outcome) was defined as intraocular pressure (IOP) <15 mm Hg, with an IOP reduction of at least 20%, OR a reduction of at least 2 glaucoma medications, compared with baseline. Secondary outcomes were success predictors and safety parameters.
Results:
A total of 73 eyes (GATT=38; PHACO-GATT=35) from 58 patients with a mean age of 54.8±11.6 years were included. Overall, after 12 months of follow-up, the mean IOP was reduced from 24.9±8.5 to 12.1±2.1 mm Hg (P<0.001). The mean number of glaucoma medications was reduced from 3.5±0.7 to 1.2±1.2 (P<0.001). The success rate was 87% at 12 months, with no significant differences between GATT (85%) and PHACO-GATT (91%) eyes (P=0.330). Age was the only factor significantly associated with surgical success (hazard ratio=1.35; P=0.012; after adjusting for preoperative IOP and number of glaucoma medications). Patients older than 60 years had a significant greater chance of failure (hazard ratio=10.96; P=0.026) compared with those younger than 60 years. The most common postoperative complication was transient hyphema (39%; median duration, 5 d). No sight-threatening adverse event was documented.
Conclusions:
GATT was effective and safe at lowering IOP with or without cataract extraction in OAG. Patients 60 years or older had a higher risk of failure compared with those younger in age.
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