Purpose: The aim of the study was to compare optic nerve function in eyes with brinzolamide-reduced intraocular pressure (IOP) and the fellow eyes of patients with optic disk drusen (ODD). Methods: The study comprised 34 patients with bilateral ODD but no signs of any other ocular disease. The eyes with more advanced optic neuropathy were selected for treatment with an IOP-lowering drug, carbonic anhydrase inhibitor (brinzolamide); the fellow eyes served as the control. Static perimetry, pattern electroretinography (PERG), pattern visual-evoked potentials (PVEP), and retinal nerve fiber layer (RNFL) thickness were analyzed. The observation period was 12 months. Results: The eyes with brinzolamide-reduced IOP exhibited a statistically significant decrease in the mean defect index of static visual field (p = 0.03), an increase in PERG N95 amplitude (from 2.94 to 4.41 µV; p = 0.0047), and RNFL thickness stabilization. A statistically significant decrease in RNFL thickness (from 83.21 to 79.85 µm; p = 0.0017) was found in the control eyes. Conclusions: A decrease in IOP in eyes with ODD results in improvement of retinal ganglion cell function and delays the progression of optic neuropathy. PERG should be performed in patients with ODD as it is a sensitive test for monitoring optic neuropathy.
Purpose Evaluation of influence of the drusen on optic nerve function. Comparison of various diagnostic methods.
Methods 27 patients (54 eyes) with optic nerve drusen (average age: 33 years) and 15 healthy patients (30 eyes; average age: 32 years) have been examined. By all patients full ophthalmological examination, static perimetry (Octopus 301, Zeiss), contrast sensitivity with the sine wave contrast test (SWCT) as well as pattern electroretinography (PERG) and pattern visual evoked potentials (PVEP; Reti‐Port, Roland Consult) were conducted. Statistical analysis was based on Mann‐Whitney U Test and Spearman Test.
Results Best Corrected Visual Acuity in all eyes amounted to 0.0 logMAR. In PVEP examination, the eyes with optic nerve drusen have revealed a statistically significantly lower P100 wave amplitude at 1 check size (p = 0,0004) and at 15’ (p = 0,046) as well as longer P100 wave latency at 15’ check size (p = 0,046) than healthy eyes. In PERG the amplitude of N95 wave was statistically significantly lower for eyes with optic nerve drusen than for healthy eyes. Statistically significant, negative correlation between the amplitude of N95 wave PERG and the value of MD factor of static visual field (r = ‐ 0,1003) has been found. No significant differences in degrees of contrast sensitivity have been identified.
Conclusion Presence of drusen disturbs optic nerve function. Electrophysiological examinations are a sensitive test in identifying visual neuropathy.
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