Visual field damage proximal to fixation in normal- and high-tension glaucoma eyes

To compare in more detail the central visual field damage in normal-tension glaucoma (NTG) and high-tension glaucoma (HTG) eyes, a pointwise inner-group comparison of the data obtained with the Humphrey 10-2 was carried out in 68 NTG cases with maximum intraocular pressure (IOP) of < or = 21 mmHg and 62 HTG cases with maximum IOP of > or = 25 mmHg. All eyes had the usual field defects, with a mean deviation of > or = -15 dB (MD, STATPAC). Age, refraction and MD were matched between the two groups. Total deviation (TD, STATPAC), the difference between the measured threshold and the age-corrected normal reference at each test point of the 10-2 program, was used for pointwise inter-group comparisons. The data were analyzed with Wilcoxon rank-sum test and logistic discriminant analysis. The latter method was also applied to the data of the 30-2 program to confirm the results obtained with the 10-2 program. The comparisons using the different methods and programs gave consistent results. For a given amount of overall visual field damage in the two types of glaucoma, a superior arcuate area extending down to the horizontal meridian just nasal to the fixation point was significantly more depressed and an area inferior to the horizontal meridian and inferior temporal to the fixation point significantly less depressed in NTG eyes. HTG eyes were significantly more diffusely damaged in the central 10-degree visual field. NTG and HTG may have unique patterns of central visual field damage. These differences may implications in following NTG patients and studying the pathogenesis of this glaucoma.     

Early detection of visual field progression in glaucoma: a comparison of PROGRESSOR and STATPAC 2

AIM: To compare the performance of PROGRESSOR (pointwise linear regression) and STATPAC 2 (comparison with baseline values) in detecting early deterioration in the visual fields of glaucoma patients. METHODS: Visual field series from 19 untreated normal tension glaucoma eyes which were deteriorating on clinical grounds were analysed by PROGRESSOR and STATPAC 2. Progression criteria for PROGRESSOR were (1) inner points: slope < -1 dB/year, p < 0.05 and (2) edge points: slope < -2 dB/year, p < 0.05. Criteria for STATPAC 2 were p < 0.05 change probability for any point on three consecutive fields. Detection time was defined as the time interval between the initial field and the first field in which at least one progressing point was identified. Detection times produced by the two techniques were compared. RESULTS: PROGRESSOR and STATPAC 2 agreed on progression in all 19 eyes. Mean detection time for PROGRESSOR was 1.077 (SD 0.985) years and for STATPAC 2 was 2.161 (1.357) years. PROGRESSOR detected progression sooner than STATPAC 2 in 18 eyes (p < 0.01), Wilcoxon matched pairs signed rank test). PROGRESSOR detected progression earlier by a mean of 1.085 (0.936) years. CONCLUSIONS: PROGRESSOR consistently detected progression earlier than STATPAC 2. The PROGRESSOR software is a useful tool for the early detection of visual field deterioration in glaucoma.     

Foveal dysfunction and central visual field loss in glaucoma

OBJECTIVE: To determine whether foveal function distal to the ganglion cell layer is an independent predictor of central visual field function in glaucoma. SETTING: University affiliated hospital and private practice. PARTICIPANTS: Twenty-seven eyes (27 patients) with normal-pressure glaucoma, 10 eyes (10 patients) with primary open-angle glaucoma, and 47 eyes of 47 matched normal volunteers. INTERVENTION AND MAIN OUTCOME MEASURES: Foveal cone electroretinogram (ERG) amplitude, relative optic cup to disc area and their relations to Humphrey full-threshold 30-2 visual field central 4-point mean total deviation (C4MTD) and pattern deviation (C4MPD). RESULTS: Foveal cone ERG amplitude was subnormal in 14 (37.8%) of the 37 glaucomatous eyes and lower in the glaucoma group compared with normal eyes (P<.01). The C4MTD and C4MPD were lower in glaucomatous eyes with subnormal amplitudes compared with those with normal amplitudes (P<.01 and P<.05, respectively). Amplitude was directly correlated with C4MTD (P<.01) and C4MPD (P<.01). Relative optic cup to disc area was inversely correlated with C4MTD (P<.001) and C4MPD (P<.001). Partial correlation analysis revealed that amplitude and relative optic cup to disc area were independent predictors of C4MTD and C4MPD. CONCLUSION: Foveal function distal to the ganglion cell layer and optic disc cupping independently predict central visual field function in glaucoma.     

Prevalence of primary chronic open-angle glaucoma in Ivory Coast

BACKGROUND: The aim of this study was to determine and analyze the rate of chronic open-angle glaucoma in C?te d'Ivoire. METHODS: The prevalence of chronic glaucoma (POAG) was retrospectively evaluated in a population of 33,000 patients attending a private clinic including 24,751 black subjects and 8,249 white subjects. Patients with a cup/disc superior to 0.5 and an abnormal Goldmann's kinetic perimetry, associated with (POAG with "elevated" pressure or not (POAG with normal pressure) with an intraocular hypertension (intra ocular pressure superior to 21 mmHg) were distinguished. RESULTS: Prevalence was from 2.1% for the black subjects and 0.75% for the white subjects. Mean age was 46.4 +/- 12.5 years for blacks subjects versus 52.8 +/- 12.2 years for white subjects. This prevalence increased with age in both populations. Out of 571 cases of POAG, 465 (81.4%) were previously known and 450 of them were treated; 38.5% of the POAG cases had normal pressure. CONCLUSION: Primary open-angle glaucoma is a major health care problem emphasizing the need for detection and prevention in C?te d'Ivoire.     

Family history in primary open-angle glaucoma

A family history of glaucoma was found in 50% of patients with primary open-angle glaucoma (POAG) and 43% of patients with ocular hypertension (OH). Positive family history was twice as prevalent in those with OH and either HLA-B7 or B12 antigens than in OH with neither antigen (P less than .01). Although POAG occurred equally in men and women, the prevalence of a positive family history of glaucoma on the maternal side of the family in POAG patients was six to seven times greater than on the paternal side (P less than .0005). However, in patients with OH, but no glaucomatous field loss, there was no difference in prevalence of maternal and paternal family history. Even in OH with HLA-B7 or B12 antigens, there was no predominance of maternal family history. The implication that offspring were more likely to develop POAG when their mother's side of the family rather than their father's side had the disease has provided an additional potentially useful risk factor in patients with OH. In addition, it has raised interesting questions as to possible maternal cytoplasmic factors in the transmission and pathogenesis of POAG.     

Gln368STOP myocilin mutation in families with late-onset primary open-angle glaucoma

PURPOSE: To examine families ascertained for late-onset primary open-angle glaucoma (POAG) to determine mutations in the gene coding for myocilin. METHODS: The diagnosis of late-onset POAG was defined as age at diagnosis more than 35 years, intraocular pressure (IOP) 22 mm Hg or more in both eyes or 19 mm Hg or more while the patient was taking two glaucoma medications, glaucomatous optic neuropathy in both eyes, and visual field loss consistent with optic nerve damage in at least one eye of the proband. Two of three criteria were required in other family members. DNA from all families was screened for polymorphisms in myocilin using single-strand conformation polymorphism analysis. All polymorphisms were sequenced for mutations. RESULTS: Eighty-three affected people in 29 families with late-onset POAG were screened for mutations. Three mutations, two novel missense (Thr377Met and Glu352Lys) and one nonsense (Gln368STOP), were identified. The missense mutations did not segregate with the disease phenotype in these families. The nonsense mutation was found in 3 of 29 unrelated families with POAG. All affected family members and 8 of 12 in whom glaucoma was suspected had the Gln368STOP mutation. All people with this mutation had elevated IOP, and 78% had POAG by age 70. CONCLUSIONS: Three mutations were identified in the gene coding for myocilin in families with late-onset POAG. Of these, the Gln368STOP mutation was highly associated with the development of glaucoma. All people with this mutation had glaucoma or elevated IOP by age 70. In the United States, the Gln368STOP mutation in myocilin is strongly associated with the development of late-onset POAG. However, factors in addition to the presence of this mutation seem to play a role in the development of ocular hypertension and glaucoma in these families.     

Neuroretinal rim width ratios in morphological glaucoma diagnosis

AIMS: To evaluate the inferior to temporal neuroretinal rim width ratio and superior to temporal rim width ratio as measures of rim shape for diagnosis of glaucoma. METHODS: Colour stereo optic disc photographs of 527 normal subjects, 100 ocular hypertensive individuals with normal visual fields, and 202 open angle glaucoma patients with a mean perimetric defect of less than 10 dB were morphometrically evaluated. Eyes with an optic cup area of < 0.2 mm2 were excluded. RESULTS: In the normal subjects, inferior to temporal rim width ratio (1.67 (SD 0.53)) was significantly (p < 0.0001) higher than superior to temporal rim width ratio (1.56 (0.49)). Both ratios were significantly (p < 0.0001) higher the more vertically the optic disc was configured. In the normal eyes, both ratios were statistically independent of disc size, rim area, refractive error, age, and sex. With the differences being more marked for the inferior to temporal ratio than for the superior to temporal ratio, both rim width ratios were significantly (p < 0.005) lower in the ocular hypertensive group than in the normal group. Despite the high significance of the differences, diagnostic power of the inferior ratio and the superior ratio was 59% and 58%, respectively, indicating a marked overlap between the groups. CONCLUSIONS: Abnormally low inferior to temporal and superior to temporal rim width ratios can indicate glaucomatous optic nerve damage in some ocular hypertensive eyes. Being independent of optic disc size and ocular magnification, the rim width ratios may be taken as one among other variables for the ophthalmoscopic optic disc evaluation, taking into account, however, a pronounced overlap between normal eyes and ocular hypertensive eyes.     

The evaluation of oscillatory potentials of the electroretinogram in the early diagnosis of the patients with primary open angle glaucoma

PURPOSE: To study the changes in the oscillatory potentials (OPs) of the electroretinogram in the earlier or early stage of primary open angle glaucoma. METHODS: OPs were recorded in thirty-three normal subjects (66 eyes) and 30 patients with primary open angle glaucoma (POAG) (58 eyes). The abnormal rates of OPs in the different stages of POAG were analyzed and the sensitivity and the specificity of OPs were also determined. RESULTS: The overall OPs amplitudes (sigma o) were reduced in the patients with POAG and the amounts of small wavelets were also decreased. The total abnormal rate of sigma o was 67.24%, and 42.86% in the earlier stage, 65.38% in the early stage and 76.00% in the advanced and late stage. The sensitivity and the specificity of OPs were 67.24% and 92.42%. OPs had correlation with C/D. CONCLUSION: OPs can be considered as an indicator of earlier or early diagnosis of patients with POAG before visual field loss is detected.     

Sensitivity and specificity of optic disc variables and analysis of a new variable (MP/D) for glaucoma diagnosis with the Glaucoma-Scope

AIM: In an attempt to use the quantitative optic disc measurements of the Glaucoma-Scope (OIS Sacramento, CA, USA) to distinguish glaucomatous from normal optic discs, a new variable was investigated, the mean disc corrected for the disc size by dividing by the disc area: MP/D. METHODS: Glaucoma-Scope disc evaluation was performed on 81 eyes of 51 patients split into the following groups based on Humphrey 24-2 visual field and clinical criteria of glaucoma: chronic glaucoma n = 27 (including only early, n = 17, and low tension glaucoma, n = 10), ocular hypertension n = 24, pseudoglaucomatous large discs, n = 12, and normal eyes, n = 18. Classic optic disc variables (the vertical and horizontal c/d ratios, and the c/d area) were compared with the new MP/D index calculating receiver operating characteristic curves. RESULTS: The MP/D ratio was able to identify the glaucomatous eyes more easily than other ratios. Areas under the curves were: 0.91 (MP/D); 0.87 (c/d area); 0.85 (c/d vertical); and 0.80 (c/d horizontal). The MP/D index was also correlated with the mean deviation (r = 0.466; p = 0.001). CONCLUSION: MP/D may prove useful in detecting glaucomatous optic nerve damage and could be an interesting screening tool for primary open angle glaucoma.     

Ultrastructural changes in the trabecular meshwork of human eyes treated with corticosteroids

OBJECTIVES: To study the ultrastructure of the trabecular meshwork in human eyes with corticosteroid-induced glaucoma and to determine whether the changes noted also occur in the eyes of patients with primary open-angle glaucoma (POAG) who have been treated with corticosteroids. METHODS: The trabecular meshwork from 5 patients in whom corticosteroid-induced glaucoma was diagnosed and from 6 patients with POAG who had been treated with systemic or topical corticosteroids for months to years was investigated with light and electron microscopy. None of the eyes with POAG were considered to have corticosteroid-induced elevation of the intraocular pressure. RESULTS: Eyes with corticosteroid-induced glaucoma had the accumulation of extracellular material distinct from the sheath-derived plaques typical of POAG. A finger-printlike arranged material resembling basement membranes (FBM material), considered characteristic of corticosteroid-induced glaucoma, was found in all eyes with corticosteroid-induced glaucoma. In addition, an abnormal accumulation of densely packed, fine fibrils immediately beneath the inner wall endothelium of Schlemm's canal was present. The findings were similar among patients receiving topical or systemic treatment and among patients of different ages. In the eyes from donors with POAG who had been treated with corticosteroids, the fine fibrillar material and FBM material were present in small amounts in 3 of 6 donors and were not found in the other 3 donors. CONCLUSIONS: The extracellular material that accumulates in eyes with corticosteroid-induced glaucoma differs from that seen in eyes with POAG. Eyes with POAG exposed to long-term corticosteroid treatment did not all respond with the formation of the abnormal extracellular materials characteristic of those found in eyes with corticosteroid-induced glaucoma.     

Frequency of asymmetric visual field defects in normal-tension and high-tension glaucoma

OBJECTIVE: The purpose of the study was to evaluate the frequency of asymmetric visual field loss at presentation in patients with normal-tension glaucoma (NTG) and high-tension glaucoma (HTG). DESIGN: A retrospective cross-sectional study design was used. PARTICIPANTS: Four hundred and three NTG patients and 337 consecutive HTG patients (consecutive diagnoses between 1986 and 1996). INTERVENTION: Analysis of the frequency of unilateral field loss presentations in NTG and HTG. The visual fields of fellow eyes were compared to determine the side of more severe field loss. For the NTG patients, the relationship between the side with greater field loss and corresponding intraocular pressure (IOP) was investigated. MAIN OUTCOME MEASURES: Humphrey field analyzer mean defect (MD) and mean diurnal IOP. RESULTS: In the NTG group, 101 (25%) patients presented with unilateral field loss. The proportion of cases with unilateral field loss decreased with increasing age of presentation (chi-square test for trend = 26.9; P < 0.0001). Sixty-four percent of the patients had unilateral field loss in the left eye. Sixty-eight percent of the cases with bilateral field loss had a higher MD in the left eye. The diurnal IOP was estimated as 0.23 +/- 0.068 mmHg (mean +/- SE) higher in the left eye (P = 0.001). In the HTG group, 104 (31%) patients presented with unilateral field loss. The proportion of cases with unilateral field loss decreased with increasing age of presentation (chi-square test for trend = 4.6; P = 0.03). Right and left eyes had an equal chance of having field loss in unilateral cases and of being the side of more advanced field damage in bilateral cases. CONCLUSIONS: The frequency of cases with unilateral field loss was similar in HTG and NTG patients. Patients with unilateral field loss at presentation were more likely to be at the younger end of the age range. In the NTG population we studied, the left eye was more frequently the side of onset of field loss and 2.1 times more likely to present with a greater field defect than the right eye. In HTG patients, right and left eyes showed an equal chance of being the side of onset of field damage and the more affected side.     

Analysis of depressive symptomatology in mood disorders

BACKGROUND: At this time little information is available about the relationship between glaucomatous visual field defects and impaired blood flow in the optic nerve head. The purpose of this study was to examine blood flow of the juxtapapillary retina and the rim area of the optic nerve head in primary open-angle glaucoma with a borderline visual defect. METHODS: Juxtapapillary retinal and neuroretinal rim area blood flow was measured by scanning laser Doppler flowmetry (SLDF). The visual field was evaluated by static perimetry (Octopus-G1). The optic nerve head was assessed on 15 degrees color stereo photographs. We examined 116 eyes of 91 patients with POAG with controlled IOP and 66 eyes of 44 healthy individuals. The POAG group was divided into eyes with a mean defect lower than 2 dB (POAG group I) and in eyes with a mean defect equal to or greater than 2 dB (POAG group II). The mean age of POAG group I and POAG group II was 55 +/- 11 years and 57 +/- 10 years, respectively. The mean age of the control group was 45 +/- 15 years. The eyes of POAG group I had an average C/D ratio of 0.71 +/- 0.18 with an average mean defect of the visual field of 0.97 +/- 0.68 dB; the eyes of POAG group II had an average C/D ratio of 0.80 +/- 0.17 with an average mean defect of the visual field of 8.2 +/- 6.0 dB. The intraocular pressure on the day of measurement in POAG group I was 18.2 +/- 3.7 mmHg, in POAG group II 17.6 +/- 4.0 mmHg, and in the control group 15.1 +/- 2.5 mmHg. For statistical analysis, age-matched groups of 32 normal eyes of 32 subjects (mean age 52 +/- 10 years) were compared to 18 glaucomatous eyes of 18 patients (POAG group I, mean age 55 +/- 11 years) and 59 glaucomatous eyes of 59 patients (POAG group II, mean age 55 +/- 10 years). RESULTS: In the eyes of POAG group I and POAG group II, both juxtapapillary retinal blood flow and neuroretinal rim area blood flow were significantly decreased compared to an age-matched control group: neuroretinal rim area "flow" POAG group I -65%, POAG group II -66%; juxtapapillary retina "flow" POAG group I -52%, POAG group II -44%. All eyes of the POAG group I (MD < 2 dB) and 56 of 61 eyes of the POAG group II (MD > = 2 dB) showed a retinal perfusion lower than the 90% percentile of normal blood flow. We found no correlation between reduction of juxtapapillary or papillary blood flow and mean defect in POAG eyes. CONCLUSION: Glaucomatous eyes with no defects or borderline visual field defects as well as glaucomatous eyes in an advanced disease stage show significantly decreased optic nerve head and juxtapapillary retinal capillary blood flow.     

Retroviral infection of Syrian hamster BHK cells depends on age and susceptibility toward sialidase

PURPOSE: To study the features of the motion perception (MP) and explore the worth of the clinical application of MP test in primary open angle glaucoma (POAG). METHODS: MPs were recorded from 41 patients (67 eyes) with POAG ang 56 normal subjects (112 eyes) by the MP software in PC compatible computer. Meanwhile, the MP ways and MP sites were analyzed and MP abnormal rate was compared to the clinical parameters and the visual function indices related to glaucoma. RESULTS: The results showed that the total abnormal rate of MP was 89.5% in POAG, and the abnormal rate was 81.6% in early stage of POAG, and MP abnormal degree had positive correlation with C/D, ocular tension and corrected loss variance (CLV), and negative correlation with visual acuity and mean sensitivity (MS), and no correlation with age and short-term fluctuation (SF) in the patients with POAG. CONCLUSION: These results suggest that the MP test provides a newly effective examination method in diagnosing the early POAG.     

Clinicopathological characteristics of skipping lymph node metastases in patients with colorectal cancer

We evaluated the optic disc in 77 eyes of 77 normal volunteers using a scanning laser tomograph (Heidelberg Retina Tomograph: HRT, version 1.11). Particular attention was paid to age, refractive error, and disc size. The topographic parameters included: cup area, C/D area ratio, rim area, cup volume, rim volume, mean cup depth, maximum cup depth, cup shape measure, height variation contour, mean RNFL thickness, and RNFL cross section area. There was a significant decline in mean RNFL thickness and RNFL cross section area with increase in age (p < 0.05). The mean and maximum cup depths were significantly deeper in myopic eyes (p < 0.05). Large discs had large values of cup area, C/D area ratio, rim area, cup volume, mean cup depth, cup shape measure (p < 0.01), and maximum cup depth (p < 0.05). Large discs had small values of mean RNFL thickness and RNFL cross section area. Rim volume was independent of age, refractive error, or disc area.     

Decrease of capsular opacification with adjunctive mitomycin C in combined glaucoma and cataract surgery

OBJECTIVE: The authors investigated the incidence of capsular opacification requiring YAG capsulotomy after primary trabeculectomy combined with phacoemulsification and implantation of all polymethylmethacrylate intraocular lenses. DESIGN: A prospective randomized study. PARTICIPANTS: One hundred seventy-four eyes of 174 nonselected patients with primary open-angle glaucoma (POAG) were randomized to either no adjunctive mitomycin C (MMC) control group of 93 eyes of 93 patients) or adjunctive subconjunctival MMC (MMC group of 81 eyes of 81 patients) during the primary glaucoma triple procedure (PGTP). INTERVENTION: Primary glaucoma triple procedure with and without MMC and YAG laser capsulotomy for posterior capsular opacification (PCO) was performed. MAIN OUTCOME MEASURES: The incidences of YAG capsulotomy for PCO were compared between the control and MMC groups and also between the control group and the MMC subgroups (1 minute, 3 minutes, and 5 minutes of MMC application) using Kaplan-Meier analysis with Mantel-Cox log-rank test. Cox proportional hazard regression analysis also was performed to identify significant factors affecting capsular opacification. RESULTS: The control and MMC groups were similar in preoperative characteristics. However, the probability of PCO requiring YAG capsulotomy was significantly lower in the MMC group than in the control group (P = 0.004). Among the MMC subgroups, MMC application for 3 minutes was most effective and significant when compared with that of the control group (P = 0.002). Although not as significant as the intraoperative use of MMC (P = 0.002), old age (P = 0.026) and presence of diabetes mellitus (P = 0.035) were also identified as significant beneficial factors for decreasing the incidence of YAG capsulotomy for PCO in Cox proportional hazard regression analysis. CONCLUSION: Intraoperative subconjunctival MMC application during combined glaucoma and cataract surgery has a beneficial effect of inhibiting PCO after combined surgery in patients with POAG. Thus, after intraoperative subconjunctival application of MMC at the concentration of 0.5 mg/ml for 3 minutes, the aqueous MMC level must have been great enough to inhibit the lens epithelial cell proliferation to result in a long-term decrease in PCO.     

An outcomes assessment of 15 years of patient care experiences in predoctoral pediatric dentistry

OBJECTIVE: To observe the features of the changes of color pattern electroretinogram (CP-ERG) in early primary open-angle glaucoma (POAG). METHOD: The detection and analyses of CP-ERGs in 29 patients (48 eyes) with POAG, 10 patients (16 eyes) with ocular hypertension and 33 age-matched normal volunteers (48 eyes) were made. RESULTS: The changes of CP-ERG in early POAG included reduction of amplitudes of P1 and N2 waves, prolongation of the peak times of red/black N2 and blue/black P1 waves. Part of the patients with ocular hypertension had the amplitude of N2 wave reduced. Five factors including the amplitude of blue/black N2 wave, the amplitudes of red/black P1 and N2 waves, the peak time of red/black N2 wave and the white/black P1 to N2 wave amplitude ratio from CP-ERG which are significantly correlated to the diagnosis of early POAG were selected by the multiple factor stepwise discriminatory analysis, and the stepwise discriminatory function was set up. CONCLUSIONS: CP-ERG is a useful method in detecting the retinal functions in early POAG, and is helpful to its early diagnosis.     

Complexation of okadaic acid: a preliminary study

BACKGROUND/AIMS: A photostress recovery test was designed to differentiate macular diseases from optic nerve disorders, but recently an abnormal recovery time was reported in glaucoma. The purpose of this study was to search for the difference in abnormality of the photostress recovery test between glaucoma and idiopathic central serous chorioretinopathy (ICSC). METHODS: This study involved 21 normal subjects, 14 patients, with ICSC and 10 patients with primary open angle glaucoma (POAG). A scanning laser ophthalmoscope (SLO) was used with microperimetry for bleaching the test point and measuring the recovery of sensitivity. Photostress recovery time (SLO-PSRT) could be measured at extrafoveal points outside and inside the affected area. The initial sensitivity change and the time constant of recovery after bleaching were calculated by fitting an exponential equation to the data. RESULTS: In normal subjects, neither the initial sensitivity change nor the time constant were correlated with the location of the test point. In 14 patients with ICSC, the initial sensitivity change in the detached area was significantly smaller than that in the unaffected area which was not significantly different from that in the age matched normal subjects. The time constant in the detached area was significantly longer than that in the unaffected area, which was not significantly different from that in the normal subjects. In 10 patients with POAG, the initial sensitivity change inside and outside the scotoma was not significantly different from that of age matched normal subjects. The time constant inside the scotoma was significantly longer than that outside the scotoma, which was not significantly different from that of the age matched normal subjects. CONCLUSION: Both ICSC and POAG showed a prolonged time constant of recovery, but the initial sensitivity change was reduced only in ICSC. The difference in our results between ICSC and POAG may be caused by the difference of the retinal pathology. Further, the SLO-PSRT is very useful when the lesion is located outside the fovea.     

Laser scanning laser ophthalmoscopy in diagnosis of juvenile glaucoma cases with myopia

The diagnosis of the open angle glaucoma in myopic eyes remains one of the major problems, as the changes of the optic head in myopia may be similar to glaucomatous changes. The aim of the study was to analyse biomorphometric parameters of the optic nerve head in myopic eyes with glaucoma with scanning laser ophthalmoscope from Laser Diagnostic Technologies Inc. There was 29 children examined and among them 12 children with glaucoma and myopia as a study group (I) and 17 children with myopia as a control group (II). RESULTS: TCA means values; group I: 1.994 +/- 0.158, group II:2.028 +/- 0.200 CD means values; group I; 0.315 +/- 0.072, group II: 0.247 +/- 0.057 Rim means values; group I: 1.366 +/- 0.164, group II: 1.511 +/- 0.136 Vol. A mean values; group I: +0.205 +/- 0.03, group II: +0.83 +/- 0.03 Vol. B mean values; group I: -0.159 +/- 1.608, group II: -0.117 +/- 0.08. Average values of the biomorphometric parameters of the optic nerve head were worse in group I than in group II, but there was not statistical significance between the differences. Scanning laser ophthalmoscopy may be used as very important additional examination in juvenile glaucoma cases with myopia.     

Prosthetic arteriovenous fistulas and venous anastomotic stenosis: influence of a high flow velocity on the development of intimal hyperplasia

OBJECTIVE: To search a sensitive parameter for the early diagnosis of primary open angle glaucoma (POAG). METHOD: A system of computerized image analysis was used to acquire images of the optic nerve head of patients with POAG, suspect glaucoma (SG) and of normal persons. Each of these groups contained 31 eyes of 31 cases. The mean relative depths of disc rim and cup at different areas in the optic nerve head were measured. All these patients were followed up for four to six months, and the changes of the mean depths of every sector were compared between each pair of the three groups with statistic analysis. RESULTS: The mean depth of the neural rim and cup of each sector and that of total rim and total cup of POAG and SG patients were all deeper than that of normal controls. The mean depths of neural rim of the superior sector, inferior sector and the total rim area of POAG were deeper than that of SG patients. Compared to their first measurements, the changes of mean depths of neural rim of superior sector and total neural rim area of POAG patients were more prominent than that of normal controls and SG. We also compared the relative depth of the total rim area in the different areas in the optic nerve head with other two dimensional optic disc parameters such as cup/disc ratio, etc. CONCLUSION: Our study suggests that three-dimensional stereoscopic measurement of the surface of optic nerve head and follow-up be of paramount importance in the early diagnosis of POAG patients.     

Isolation of the ALG5 locus encoding the UDP-glucose:dolichyl-phosphate glucosyltransferase from Saccharomyces cerevisiae

Cataract extraction and posterior chamber intraocular lens (PC-IOL) implantation was carried out in 45 glaucoma eyes that had undergone glaucoma filtering surgery (Group A), and in 47 glaucoma eyes in which intraocular pressure (IOP) was well controlled with medication (Group B). To analyze the effects of PC-IOL implantation on the control of IOP and the functioning of the filtering bleb, a life-table analysis using the Kaplan-Meier method was carried out. In Group A the probability that IOP control will not worsen at 2 years was 56 +/- 12 (SE)% in eyes where a functioning filtering bleb had existed preoperatively. The probability that the filtering bleb was not cicatrized at 2 years postoperatively was 44 +/- 11 (SE)%. In Group B the postoperative IOP on the first postoperative day was significantly higher than the preoperative level in primary open angle glaucoma (POAG) eyes, while no such difference was seen in primary angle closure glaucoma (PACG) eyes. The postoperative IOP was significantly lower than the preoperative level from 3 to 6 months postoperatively in POAG eyes and from 1 to 12 months postoperatively in PACG eyes. Medication did not differ significantly pre- and postoperatively. In 64 +/- 11 (SE)% of POAG and 63 +/- 15% of PACG eyes the IOP control did not worsen at 2 years. In 70% of the eyes the IOP control improved postoperatively, and was maintained for 2 years with the probability of 44 +/- 12 (SE)%.