PURPOSE: The aim of this study was to compare changes in the conventionally undiagnosed distal nasal visual field with RNFL in patients with early primary open-angle glaucoma (POAG). MATERIAL AND METHODS: 59 eyes of 32 patients (18 women, 14 men) with early stage POAG were included. All eyes were found to have a normal visual field (fast threshold program of 50 degrees nasally and 22 degrees temporally) with the Medmont M700. Visual acuity was 1.0 (with a possible correction ±3 D), and they had no other ocular pathology except glaucoma. The visual field was subsequently examined with the same instrument by moving the fixation point 40 degrees temporally (spatially adaptive program) and simultaneously turning the head 10 degrees nasally. A total of 89 examination points were included using flicker stimuli in a range of 0-120 degrees nasally. Nerve fiber layer (RNFL) and vessel density (VD) was measured using the in-built software of the Avanti RTVue XR instrument. Using Pearson's correlation coefficient, the results of visual field examination with RNFL without and after correction (by subtracting VD from total RNFL value) in the superior-nasal (SN-5) and inferior-nasal (IN-8) segments were compared. RESULTS: In all eyes, changes were found in the distal periphery of the nasal part of the visual field. No correlation was noted by comparison with RNFL. After adjusting RNFL for VD, we observed no correlation in the SN segment (5) (r=-0.03) and a very weak correlation in the IN segment (8) (r=-0.16). CONCLUSION: With a normal visual field tested by the rapid threshold glaucoma program, changes in the distal part of the nasal periphery of the visual field were found in the entire cohort and did not correlate with the RNFL and RNFL results after correction from VD.
- Publikační typ
- časopisecké články MeSH
Cíl: Cílem práce bylo zjistit hranice vzdálené nasální části zorného pole u pacientů s fyziologickým očním nálezem. Materiál a metody: Vyšetření zorného pole bylo provedeno u 15 zdravých osob (30 očí). U devíti žen ve věku 20–43 let a šesti mužů ve věku 22–35 let. U všech očí byl zjištěn fyziologický oční nález a zraková ostrost 1,0 s korekcí menší nebo rovnou 3 dioptrie. Zorné pole bylo vyšetřeno přístrojem Medmont M700 posunutím fixačního bodu o 40 stupňů temporálně a současného stočení hlavy nasálně, programem prostorové přizpůsobivosti. Celkem bylo zahrnuto 89 vyšetřovaných bodů pomocí flicker podnětů. Výsledky: Vzdálená nasální hranice zorného pole dosáhla u 13,3 % očí 100°, u 20 % očí 105° a u 66,7 % očí až 110°. Závěr: Hranice vzdálené nasální části zorného pole dosahovala 100–110 stupňů (při eliminaci stínění kořenem nosu).
Aims: The aim of the study was to determine the limits of the far nasal part of the visual field. Material and Methods: Visual field examination was performed in 15 healthy subjects (30 eyes), specifically nine women aged 20–43 years and six men aged 22–35 years. All eyes were found to have physiological ocular findings and visual acuity of 1.0 with correction less than or equal to 3 diopters. The visual field was examined with a Medmont M700 instrument by shifting the fixation point 40 degrees temporally and simultaneously turning the head nasally, with a spatial accommodation program. A total of 89 examination points were included using flicker stimuli. Results: The far nasal limit of the visual field reached 100° in 13.3% of eyes, 105° in 20% of eyes and up to 110° in 66.7% of eyes. Conclusion: The limit of the far nasal part of the field of vision reached 100–110 degrees (when nose shielding was eliminated).
- MeSH
- dospělí MeSH
- lidé MeSH
- testy zrakového pole metody MeSH
- zraková ostrost MeSH
- zraková pole * fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
Cíl: Cílem této studie bylo ověřit možné změny konvenčně nediagnostikované nasální části zorného pole u pacientů s diagnózou včasného primárního glaukomu s otevřeným úhlem (PGOÚ) s vysokou tenzí. Materiál a metody: Vyšetření vzdálené nasální části zorného pole bylo provedeno u 30 nemocných (60 očí) s počínajícím PGOÚ (preperimetrické stadium změn). Soubor tvořilo 16 žen (průměrného věku 46,5 let) a 14 mužů (průměrného věku 44,7 let). U všech očí bylo zjištěno glaukomovým programem (rychlý prahový program v rozsahu 50 stupňů nasálně a 22 stupňů temporálně) přístrojem Medmont M700 fyziologické zorné pole. Zraková ostrost byla 1,0 s případnou korekcí menší nebo rovnou ±3 dioptrie, a kromě glaukomového onemocnění neměli jinou oční vadu. Zorné pole bylo následně vyšetřeno stejným přístrojem posunutím fixačního bodu o 40 stupňů temporálně (prostorově adaptabilní program) a současným otočením hlavy o 10 stupňů nasálně. Celkem bylo zahrnuto 89 vyšetřovacích bodů s použitím flicker podnětů a rozsahem 0–120 stupňů nasálně. Výsledky: U všech očí byla zjištěna deprese vzdálené periferie nasální části zorného pole v rozsahu od 50 do 95 stupňů, při normální zorném poli vyšetřeným glaukomovým programem. Závěr: Při normálním zorném poli vyšetřeném rychlým prahovým glaukomovým programem byly u všech nemocných PGOÚ zjištěny změny v distální části nasální periferie zorného pole.
Aim: The aim of this study was to examine possible changes in the conventionally undiagnosed nasal visual field in patients diagnosed with early primary open angle glaucoma. Material and Methods: Examination of the far nasal part of the visual field was performed in 30 patients (60 eyes) with early stage of primary open angle glaucoma (preperimetric stage of changes). The cohort consisted of 16 women (mean age 46.5 years) and 14 men (mean age 44.7 years). In all eyes, the glaucoma program (rapid threshold program of 50 degrees nasally and 22 degrees temporally) was performed with the Medmont M700 instrument to determine the physiological visual field. Visual acuity was 1.0 with a possible correction less than or equal to ±3 diopters and they had no other ocular defect except glaucoma disease. The visual field was subsequently examined with the same instrument by moving the fixation point 40 degrees temporally (spatially adaptive program) and simultaneously turning the head 10 degrees nasally. A total of 89 examination points were included using flicker stimuli and a range of 0–120 degrees nasally. Results: The far nasal limit of the visual field reached 100° in 13.33% of eyes, 105° in 20% of eyes and up to 110° in 66.67% of eyes. Conclusion: In all eyes, depression of the distal periphery of the nasal part of the visual field was found to range from 50 to 95 degrees, with a normal visual field examined by the glaucoma program.
- MeSH
- časná diagnóza MeSH
- glaukom s otevřeným úhlem diagnóza MeSH
- glaukom * diagnóza MeSH
- lidé MeSH
- optická koherentní tomografie MeSH
- testy zrakového pole metody MeSH
- zraková pole MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- klinická studie MeSH
The present article describes a case of a 24-year-old patient who suffered from acute pancreatitis. The patient simultaneously developed visual acuity loss and changes in the visual field. When examined, the finding was physiological, including the fundoscopy. Neither fluorescein angiography or optical coherence tomography demonstrated any retinal abnormalities; electroretinography was physiological as well. The visual evoked potentials (VEP) showed abnormalities in amplitudes. Patient's visual field was reduced to 40 ̊. The follow-up examination 13 months after the first symptoms proved a progression of changes in the visual field and prolonged latency of P100 peak in VEP. The retinal nerve fibre layer stayed unchanged, but the vessel density on the optic nerve head decreased. Magnetic resonance brain imaging showed non-specific subcortical and paraventricular focuses in the white matter of both hemispheres. There were no other abnormalities detected by magnetic resonance imaging. Neurological examination was normal. In conclusion, the present study verified this decrease of visual functions as a lesion in the visual pathway using VEP, which was also confirmed by magnetic resonance brain imaging.
- Publikační typ
- kazuistiky MeSH
BACKGROUND: The authors present a case study which describes the development of bilateral optic neuropathy as a complication of allogeneic hematopoietic stem cell transplantation (HSCT) in a patient who underwent a transplant for B-cell acute lymphoblastic leukemia (B-ALL). The patient, who was in remission with regard to the underlying hematological disease, developed edema of both optic discs and maculas three months after transplantation. The morphological finding regressed after treatment with corticoids and comprehensive systemic anti-infective therapy. However, the loss of function was not entirely restored. CASE REPORT: One year after the healing, the atrophy of the optic discs persisted, with corresponding findings in vessel density (VD), retinal nerve fibre layer (RNFL) and visual field changes. Electrophysiological examination by pattern electroretinogram (PERG) showed an alteration in retinal ganglion cells in the left eye, but with significant damage to nerve fibres on both sides. Visual evoked potential (VEP) verified bilateral non-inflammatory neurogenic lesions. This finding was also confirmed by functional magnetic resonance imaging (fMRI). Examination by structural magnetic resonance imaging (MRI) showed inflammatory changes in the optic nerve sheaths over time and a consequent marked narrowing of them. CONCLUSION: The authors believe that edema of the optic discs and maculas was caused by a combination of several factors. Firstly, MRI showed inflammatory changes in the optic nerve sheaths, which led to a blockade of axoplasmic transport. Another factor that may have played a part in the outcome was endothelial damage to blood vessels with impaired microcirculation supplying the optic nerve fibres, which contributed to the occurrence of macular edema.
PURPOSE: A case report of a 40-year-old patient with tuberculosis treated with ethambutol is described. Within six months of starting treatment, there was a painless sudden decline in visual function. Despite the known complications of ethambutol treatment, it was discontinued after another three months. METHODS: In the case report, we highlight the damage to the dominantly peripheral visual pathways. Using electrophysiological examinations, we showed a significant alteration in the optic nerves. Optical Coherence Tomography (OCT) showed progressive loss of vessel density and nerve fibre layer of retinal ganglion cells. Perimetric examination showed both a central decrease in sensitivity and mainly scotomas in the temporal parts of the visual fields. Although there was improvement in visual fields over time, OCT findings indicated progression of ethambutol-induced optic neuropathy (EON). Magnetic Resonance Imaging confirmed the alteration in the peripheral part of the visual pathway (intraorbital, intracranial parts of optic nerves, chiasma, and optic tracts). CONCLUSION: Even though EON is not an unknown complication, new cases still occur and, unfortunately, with an irreversible course. Therefore, it is important to draw attention constantly to this complication and to consider it not only in ophthalmologists' surgeries.
- MeSH
- antituberkulotika škodlivé účinky MeSH
- dospělí MeSH
- ethambutol škodlivé účinky MeSH
- lidé MeSH
- nemoci zrakového nervu * chemicky indukované diagnóza patologie MeSH
- nervus opticus diagnostické zobrazování patologie MeSH
- optická koherentní tomografie metody MeSH
- tuberkulóza * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- kazuistiky MeSH
The present study aimed to determine how the vascular density (VD) in each segment peripapillary influences the retinal nerve fiber layer (RNFL) and to eliminate its contribution to RNFL in pathological intraocular pressure (IOP). In a cohort of 69 subjects (mean age, 45±6 years old) with untreated ocular hypertension (122 eyes in total) enrolled in this study, Ocular Response Analyser IOP was measured during routine outpatient care. Its value was >21 (range, 21-36) mmHg in all eyes. Furthermore, peripapillary VD and RNFL were measured using optical coherence tomography in the following eight segments: Inferior temporal (segment 1); temporal inferior (segment 2); temporal superior (segment 3); superior temporal (segment 4); superior nasal (segment 5); nasal superior (segment 6); nasal inferior (segment 7); and inferior nasal (segment 8). The visual field examination was performed with the fast threshold glaucoma program using the Medmont M 700. The overall defect was evaluated. Person's correlation coefficient was used to assess the correlation between VD and IOP. The largest changes were observed in peripapillary segments 1, 4, 5, 6, 7 and 8. The second part of the work was to eliminate the contribution of VD to RNFL. The partial correlation coefficient r was used to adjust RNFL from VD to assess the dependence between the selected parameters. The largest changes in RNFL were in segments 5 and 8 after they had been 'cleaned' of peripapillary VD. In conclusion, the present study revealed that the largest changes in RNFL after VD adjustment were observed for the incipient hypertensive glaucoma in segments 5 and 8.
- Publikační typ
- časopisecké články MeSH
The aim of this study was to determine whether the values of vessel density (VD) and perfusion parameters in the ophthalmic artery (OA) and central retinal artery (CRA) of the same eye differ in patients with hypertensive glaucoma (HTG) from patients with normotensive glaucoma (NTG). The first group consisted of 20 HTG patients (40 eyes). Patients with HTG were verified to have primary open-angle glaucoma (POAG). The second group consisted of 20 HTG patients (40 eyes). VD was used to determine the Avanti RTVue XR from Optovue (USA). Peak systolic velocity (PSV), end-diastolic velocity (EDV) and resistance index (RI) were measured in both the central retinal artery (CRA) and ophthalmic artery (OA) using Doppler sonography on the Affinity 70G from Philips (USA). The visual field (VF) was examined by a fast threshold glaucoma program using a Medmont M700 (Australia). We showed no differences in VF, VD, PSV-OA and EDV-CRA between the two groups. Statistically significant differences between the two groups were observed in PSV in CRA (p = 0.04), EDV in OA (p = 0.009) and in RI in both CRA and OA. Other values were without significant differences in both groups. In both HTG and NTG, we observed in PSV-CRA, EDV-OA, RI-CRA and RI-OA.
- Publikační typ
- časopisecké články MeSH
PURPOSE: The aim of this study was to investigate whether the retinal nerve fibre layer (RNFL) in some segments of the optic nerve disc in pathological intraocular pressure is more damaged in eyes without antiglaucoma treatment. PATIENTS AND METHODS: The cohort consisted of 69 subjects (122 eyes), 32 males (6x one, 26x both eyes) aged 21 to 76 years and 37 females (4x one and 30x both eyes) aged 22 to 75 years, who were measured to have IOP greater than 21 mmHg (21-36) in routine ambulatory care. Measurements were performed using the Ocular Response Analyser, taking into account corneal hysteresis. RNFL thickness was measured using the Avanti RTVue XR and was assessed in 8 segments (1-IT, 2-TI, 3-TS, 4-ST, 5-SN, 6-NS, 7-NI, 8-IN). The visual field was examined with a fast threshold glaucoma program using the Medmont M700. The overall defect (OD) was evaluated. Pearson's correlation coefficient r was used to assess the dependence between the selected parameters. RESULTS: The largest peripapillary changes in RNFL were observed in segments 1, 4, 5 and 8. It should be emphasized that segments 1 and 4 have been temporarily shifted. Segments 5 and 8 then corresponded to the upper (at no. 12) and lower (at no. 6) sectors. CONCLUSION: The most important result of this study is the finding that the greatest changes in the RNFL layer were observed in pathological IOP at segment 5 (r=-0.3) and 8 (r=-0.28), at the point where the fibres of the magnocellular retinal ganglion cells enter the retina.
- Publikační typ
- časopisecké články MeSH
