Structure-Function Relationship of Changes in Visual Field Indices with Quadrant and Average Retinal Nerve Fiber Layer Thickness in the Eyes with Exfoliation

Abstract

The progressive nature of glaucoma suggests it should be possible to detect structural changes such as retinal nerve fiber layer (RNFL) thickness loss before the condition becomes clinically apparent with visual field (VF) impairment. Therefore, the aim was to analyze RNFL thickness and VF changes in study groups with unilateral exfoliation syndrome (XFS), bilateral XFS and bilateral exfoliative glaucoma (XFG), and compare it with controls. The study included 114 subjects (228 eyes) divided into 4 groups according to the presence of exfoliation: 30 subjects with unilateral XFS (30 with clinically visible XFS and 30 fellow eyes), 24 subjects (48 eyes) with bilateral XFS, 28 (56 eyes) subjects with bilateral XFG, and control group (32 subjects). All subjects underwent VF and RNFL measurements after ophthalmologic examination. Both eyes of unilateral XFS (clinically -visible and fellow eye) showed positive correlation between Mean Defect (MD) and square root of Loss of Variance (sLV) and between MD and inferior quadrant RNFL thickness. In bilateral XFS and XFG, there was negative correlation between MD and inferior quadrant RNFL thickness. Inferior, superior and nasal quadrant RNFL thickness was lower in XFG group than in other groups. In bilateral XFS group, the inferior quadrant RNFL thickness was lower as compared with unilateral XFS group (in both eyes). The mean RNFL thickness negatively correlated with MD in bilateral XFS and XFG groups. In conclusion, structural changes before VF impairment have an important role in early detection of glaucoma in subjects at risk.

Risk factors for anxiety and depression among pregnant women during the COVID-19 pandemic

“…[ 7 – 10 ] Untreated perinatal depression may result in adverse obstetric outcomes and is a risk factor for poor maternal health, inadequate prenatal care, and postnatal depression. [ 10 , 11 ] In addition to the potential negative impact on pregnancy outcomes, perinatal depression is associated with disrupted maternal-infant bonding, increased irritability, and decreased activity. Children born to depressed mothers are at risk for delayed cognitive and language development, lower IQ, and increased prevalence of psychiatric and emotional problems.…”

Cortisol and DHEA-S levels in pregnant women with severe anxiety

“…The term ‘anxiety’ may encompass a wide variety of constructs ranging from clinical diagnosis to self-report measures of symptoms to more general measures of stress [ 1 ]. Elevated symptoms of anxiety have been reported in 15–16% of pregnant women and in 8–9% of postpartum women [ 2 ]. Other reports have shown that the prevalence of prenatal anxiety has been estimated in 25% during the first trimester and 21% during the third trimester of pregnancy [ 3 ].…”

Prevalence and risk factors of postpartum depression, general depressive symptoms, anxiety and stress (PODSAS) among mothers during their 4-week postnatal follow-up in five public health clinics in Perak: A study protocol for a cross-sectional study

“…22 A study in Croatia reported 17% prevalence of high anxiety occurring immediately after childbirth, 20% at 6 weeks post partum and the comorbidity of anxiety and PPD was 75%. 25 Characteristics of anxiety include excessive worry that lasts, accompanied by restlessness, fatigue, poor concentration, muscle tension and sleep disturbance. 9 Other symptoms include excessive worry, feeling nervous or on the edge, inability to stop or control worrying, having troubles relaxing, feeling easily irritable or annoyed and feeling awful as if something bad is going to happen.…”

“…Sociodemographic information and possible risk factors of the participants will be captured via a set of validated questionnaires, postpartum depression (PPD) will be measured using the Edinburgh Postpartum Depression Scale questionnaire and general depressive symptoms, anxiety and stress will be measured using the 21-item Depression, Anxiety and Stress Scale. Data analysis will be conducted using SPSS V. 25.0 (IBM). Besides descriptive statistics, multivariable regression analyses will be done to identify possible risk factors and their independent associations with depression (PPD and general depressive symptoms, combined and separately), anxiety and stress.…”