The Pattern of Optic Nerve Fiber Loss in Anterior Ischemic Optic Neuropathy

Quigley, Harry A.; Miller, Neil R.; Green, W R

doi:10.1016/s0002-9394(14)73365-3

Cited by 64 publications

(28 citation statements)

References 11 publications

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“…In contrast to the typical VF defects below or above the horizontal meridian, paracentral VF loss frequently occurs in glaucoma patients with abnormal ocular blood flow (Anctil & Anderson 1984;Lee et al 2012;Hood et al 2013). Moreover, papillomacular fibres that correspond to central VFs have increased vulnerability to ischaemic insult (Quigley et al 1985;Zhang et al 2010). Taken together, these results suggest that abnormal ocular blood flow may play a role in the pathogenesis of NTG, particularly with paracentral VF loss.…”

Section: Introductionmentioning

confidence: 97%

Difference in the posterior pole profiles associated with the initial location of visual field defect in early‐stage normal tension glaucoma

Choi

Park

2014

Acta Ophthalmologica

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ABSTRACT.Purpose: To identify the differences in posterior pole profiles between early normal tension glaucoma (NTG) patients with an initial central visual field (VF) loss and those with a peripheral VF loss. Methods: Normal tension glaucoma patients with parafoveal scotoma (PFS; within a central 10°of fixation; superior, n = 47; inferior, n = 24) and peripheral nasal step (PNS; VF defect in the nasal meridian outside 10°of fixation; superior, n = 27; inferior, n = 32) in either hemifield were enrolled, if their mean deviation was greater than À10 decibels (dB). Disc tilt (tilt ratio), disc torsion, area of peripapillary atrophy and disc-foveal angle (angle between a horizontal line through the disc centre and the line connecting the fovea and the disc centre) were analysed from red-free fundus photographs. Results: The mean disc-foveal angles (shortest diameter) in PNS and PFS groups were 6.2 AE 4.5 and 7.7 AE 4.0°, respectively. In multivariate analysis, eyes with PFS were associated with a greater disc-foveal angle, compared with PNS (p = 0.042). In subgroup analysis, superior PFS group showed greater discfoveal angle compared with inferior PFS group (p = 0.018). In the PNS group, the direction of disc torsion was associated with superior and inferior hemifield defects (p = 0.004). Conclusions: The posterior pole profiles were different in NTG patients according to their location of damage. Disc-foveal angle was the major determinant of the VF location in patients with VF loss at the central region and disc torsion in patients with loss at the peripheral region.

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Section: Introductionmentioning

confidence: 97%

Difference in the posterior pole profiles associated with the initial location of visual field defect in early‐stage normal tension glaucoma

Choi

Park

2014

Acta Ophthalmologica

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“…Clinically, glaucomatous optic neuropathy is characterized by a preferential loss of RNFL in the superior and inferior ONH poles (ISNT rule), with relative sparing of the temporal and nasal sectors [55]. Thus, the strongest correlations are expected to be between the 11- and 12-o'clock OCT segments, corresponding to the superior ONH pole, and between the 6-, 7- and 8-o'clock OCT segments, corresponding to the inferior ONH pole.…”

Section: Discussionmentioning

confidence: 99%

Structure-Function Relationship between Frequency-Doubling Technology Perimetry and Optical Coherence Tomography in Glaucoma

et al. 2014

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Purpose: To assess the relationship between the retinal nerve fibre layer (RNFL) thickness and the frequency-doubling technology perimetry (FDT) outcome. Methods: Sixty-two healthy individuals and 72 glaucoma patients were prospectively selected. All participants underwent a reliable FDT and optical coherence tomography (OCT). Pearson correlations were calculated between the unlogged threshold values of FDT and RNFL thicknesses measured by OCT. Results: Mild to moderate correlations were found between a few points from FDT and RNFL thicknesses in the vertical axis. The nasal superior area of FDT and the RNFL thickness at the 7-o'clock position had the strongest correlation (0.434, p < 0.001). Conclusions: The poor agreementbetween FDT and OCT parameters suggests that both instruments assess different characteristics of glaucomatous optic neuropathy. The map obtained validates previously reported clinical findings and contributes to a better understanding of the structure-function relationship in glaucoma.

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“…Splinter hemorrhages around the optic disc may be present [165] . Visual defects most commonly occur in the inferior half of the visual field [145,166,167] . PION PION is the most common type of ION after spine surgery and is the most common cause of POVL associated with spine surgery [139,141,162] .…”

Section: Ionmentioning

confidence: 99%

Positioning patients for spine surgery: Avoiding uncommon position-related complications

Kamel

Barnette

2014

WJO

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Positioning patients for spine surgery is pivotal for optimal operating conditions and operative-site exposure. During spine surgery, patients are placed in positions that are not physiologic and may lead to complications. Perioperative peripheral nerve injury (PPNI) and postoperative visual loss (POVL) are rare complications related to patient positioning during spine surgery that result in significant patient disability and functional loss. PPNI is usually due to stretch or compression of the peripheral nerve. PPNI may present as a brachial plexus injury or as an isolated injury of single nerve, most commonly the ulnar nerve. Understanding the etiology, mechanism and pattern of injury with each type of nerve injury is important for the prevention of PPNI. Intraoperative neuromonitoring has been used to detect peripheral nerve conduction abnormalities indicating peripheral nerve stress under general anesthesia and to guide modification of the upper extremity position to prevent PPNI. POVL usually results in permanent visual loss. Most cases are associated with prolonged spine procedures in the prone position under general anesthesia. The most common causes of POVL after spine surgery are ischemic optic neuropathy and central retinal artery occlusion. Posterior ischemic optic neuropathy is the most common cause of POVL after spine surgery. It is important for spine surgeons to be aware of POVL and to participate in safe, collaborative perioperative care of spine patients. Proper education of perioperative staff, combined with clear communication and collaboration while positioning patients in the operating room is the best and safest approach. The prevention of uncommon complications of spine surgery depends primarily on identifying high-risk patients, proper positioning and optimal intraoperative management of physiological parameters. Modification of risk factors extrinsic to the patient may help reduce the incidence of PPNI and POVL. It is important for spine surgeons to be aware of PPNI and POVL to participate in safe, collaborative perioperative care of spine patients. Proper education of perioperative staff, combined with clear communication and collaboration while positioning patients in the operating room is the best and safest approach. The prevention of uncommon complications of spine surgery depends primarily on identifying high-risk patients, proper positioning and optimal intraoperative management of physiological parameters.Kamel I, Barnette R. Positioning patients for spine surgery: Avoiding uncommon position-related complications. World J Orthop

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The Pattern of Optic Nerve Fiber Loss in Anterior Ischemic Optic Neuropathy

Cited by 64 publications

References 11 publications

Difference in the posterior pole profiles associated with the initial location of visual field defect in early‐stage normal tension glaucoma

Difference in the posterior pole profiles associated with the initial location of visual field defect in early‐stage normal tension glaucoma

Structure-Function Relationship between Frequency-Doubling Technology Perimetry and Optical Coherence Tomography in Glaucoma

Positioning patients for spine surgery: Avoiding uncommon position-related complications

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