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Journal of Glaucoma Oct 2022Using optical coherence tomography angiography, we found an increase in the blood flow in regional macular without significant changes in the optic disk in patients with...
PRCIS
Using optical coherence tomography angiography, we found an increase in the blood flow in regional macular without significant changes in the optic disk in patients with glaucoma after a moderate exercise regime.
PURPOSE
To investigate the effect of moderate exercise on optic nerve and macular perfusion in glaucoma patients.
METHODS
Overall, 25 eyes of 25 patients with primary open angle glaucoma and 22 eyes of 22 normal subjects were included in the glaucoma and control groups, respectively. Foveal avascular zone parameters, whole and regional vessel density (VD) in the superficial layer of macula, VDs in the radial peripapillary capillary layer of the optic nerve head, intraocular pressure, and cardiovascular parameters were measured using optical coherence tomography angiography before, immediately after, and 30 minutes after a 20-minute run at moderate speed.
RESULTS
In the glaucoma group, macular superficial VD of the whole image, parafovea, and superior and nasal regions were higher after 30 minutes of rest (44.049±5.704, 47.238±5.741, 48.692±6.648, and 47.852±5.078) than immediately after exercise (43.229±5.867, 46.334±5.984, 47.840±6.895, 46.793±5.238, P <0.05). The VD in the temporal and nasal regions was higher 30 minutes after exercise (45.105±5.512 and 47.852±5.078) than before exercise (44.265±5.803 and 46.750±5.639, P <0.05). The intraocular pressure decreased immediately after exercise (14.20±2.51 and 14.51±2.96 mmHg for glaucoma and controls, respectively) but was restored after 30 minutes of rest (15.84±3.57 mmHg for glaucoma and 16.50±2.25 mmHg for controls) in both groups ( P <0.001). Cardiovascular parameters were similar in both groups.
CONCLUSION
Moderate physical exercise for 20 minutes increased blood flow in the macula region without significant change to the optic nerve and lowered intraocular pressure in glaucoma and normal subjects. The benefit of these findings to glaucoma patients needs further study.
Topics: Exercise; Fluorescein Angiography; Glaucoma; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Optic Disk; Perfusion; Retinal Vessels; Tomography, Optical Coherence
PubMed: 35882036
DOI: 10.1097/IJG.0000000000002082 -
Ophthalmology Jun 2021To review the literature on the efficacy and safety of medical and surgical interventions for indirect traumatic optic neuropathy (TON), defined as injury to the nerve... (Review)
Review
PURPOSE
To review the literature on the efficacy and safety of medical and surgical interventions for indirect traumatic optic neuropathy (TON), defined as injury to the nerve that occurs distal to the optic nerve head.
METHODS
A literature search was conducted on October 22, 2019, and updated on April 8, 2020, in the PubMed database for English language original research that assessed the effect of various interventions for indirect TON. One hundred seventy-two articles were identified; 41 met the inclusion criteria outlined for assessment and were selected for full-text review and abstraction. On full-text review, a total of 32 studies met all of the study criteria and were included in the analysis.
RESULTS
No study met criteria for level I evidence. Seven studies (1 level II study and 6 level III studies) explored corticosteroid therapy that did not have uniformly better outcomes than observation. Twenty studies (3 level II studies and 17 level III studies) assessed optic canal decompression and the use of corticosteroids. Although visual improvement was noted after decompression, studies that directly compared surgery with medical therapy did not report uniformly improved outcomes after decompression. Four studies (1 level II study and 3 level III studies) evaluated the use of erythropoietin. Although initial studies demonstrated benefit, a direct comparison of its use with observation and corticosteroids failed to confirm the usefulness of this medication. One study (level II) documented visual improvement with levodopa plus carbidopa. Complication rates were variable with all of these interventions. Pharmacologic interventions generally were associated with few complications, whereas optical canal decompression carried risks of serious side effects, including hemorrhages and cerebrospinal fluid leakage.
CONCLUSIONS
Despite reports of visual improvement with corticosteroids, optic canal decompression, and medical therapy for indirect TON, the weight of published evidence does not demonstrate a consistent benefit for any of these interventions. In summary, no consensus exists from studies published to date on a preferred treatment for TON. Treatment strategies should be customized for each individual patient. More definitive treatment trials will be needed to identify optimal treatment strategies for indirect TON.
Topics: Academies and Institutes; Consensus; Decompression, Surgical; Humans; Ophthalmology; Optic Disk; Optic Nerve Injuries; Visual Fields
PubMed: 33161071
DOI: 10.1016/j.ophtha.2020.10.038 -
Die Ophthalmologie Nov 2023Glaucoma is not a rare entity but because very few symptoms occur and visual field defects are frequently first recognized at a late stage, a large proportion of... (Review)
Review
BACKGROUND
Glaucoma is not a rare entity but because very few symptoms occur and visual field defects are frequently first recognized at a late stage, a large proportion of glaucoma diseases remain undetected. The aim of this study was to identify the proportion of undiagnosed glaucoma in German population-based cohort studies and to contextualize them in the context of the literature.
MATERIAL AND METHODS
The prevalence of glaucoma in the Gutenberg Health Study (GHS) and the age-related investigations on health of the University of Regensburg (AugUR) was evaluated based on visual field examinations and optic disc color photography according to the ISGEO criteria. Furthermore, the self-reported glaucoma diagnoses were collected and the proportion of undiagnosed glaucoma was determined.
RESULTS
The proportion of undiagnosed glaucoma was 55% in the GHS, and 53% in the AugUR study. The results correlate with results from previous studies from other countries in which the proportion of unrecognized glaucoma ranged from 33% to 78%. In the GHS and the AugUR study the proportion of undiagnosed glaucoma was higher in younger age groups and in women.
DISCUSSION
Roughly every second case of glaucoma is undetected. As the symptoms are often nonspecific or take a long time to appear, there is a risk of advanced glaucomatous visual field defects or blindness due to a lack of glaucoma awareness. Studies have shown that a systematic screening can halve this risk.
Topics: Humans; Female; Intraocular Pressure; Glaucoma; Visual Field Tests; Visual Fields; Optic Disk; Vision Disorders
PubMed: 37847376
DOI: 10.1007/s00347-023-01943-0 -
Current Opinion in Neurology Feb 2021Optic nerve head elevation can be associated with vision loss. This review provides an update regarding key features of optic disc drusen (ODD) compared with papilledema... (Review)
Review
PURPOSE OF REVIEW
Optic nerve head elevation can be associated with vision loss. This review provides an update regarding key features of optic disc drusen (ODD) compared with papilledema from increased intracranial pressure and optic disc edema from other causes.
RECENT FINDINGS
Clinical history and funduscopic examination are not sufficient to correctly diagnose different causes of optic nerve head elevation. Multimodal ophthalmic imaging is noninvasive and should be used as first-line diagnostic testing to distinguish optic disc edema or papilledema from pseudoedema. Advanced ophthalmic imaging, including enhanced depth imaging optical coherence tomography (EDI-OCT) and autofluorescence imaging, can visualize ODD at high resolution and determine whether there is optic disc edema. OCT angiography does not require contrast and can rapidly visualize papillary, peripapillary, and macular microvasculature and identify important vascular biomarker of ischemia and, potentially, visual prognosis.
SUMMARY
Multimodal ophthalmic imaging can help in the diagnosis of ODD and optic disc edema and identify patients at high risk of vision loss and neurological issues in order to ensure appropriate diagnosis and treatment.
Topics: Blindness; Diagnostic Techniques, Ophthalmological; Humans; Intracranial Hypertension; Multimodal Imaging; Ophthalmoscopy; Optic Disk; Optic Disk Drusen; Papilledema; Retinal Ganglion Cells; Tomography, Optical Coherence
PubMed: 33278141
DOI: 10.1097/WCO.0000000000000881 -
Journal of Glaucoma Aug 2019PRéCIS:: Eyes with glaucoma have tauter optic nerves compared with normal eyes, which may exert more force on the optic nerve head tissues during eye movements.
UNLABELLED
PRéCIS:: Eyes with glaucoma have tauter optic nerves compared with normal eyes, which may exert more force on the optic nerve head tissues during eye movements.
PURPOSE
The purpose of this study was to assess the difference in optic nerve tortuosity during eye movements and globe proptosis between primary open angle glaucoma and normal subjects using orbital magnetic resonance imaging (MRI).
METHODS
Ten Chinese subjects matched for ethnicity and refractive errors were recruited, including 5 normal controls and 5 patients with primary open angle glaucoma. All subjects underwent MRI to assess their optic nerves and globes for 3 eye positions: primary gaze, adduction, and abduction. Optic nerve tortuosity (optic nerve length divided by the distance between 2 ends) and globe proptosis (maximum distance between the cornea and interzygomatic line) were measured from MRI images.
RESULTS
In adduction, the tortuosity of normal eyes was significantly larger than that of the glaucomatous eyes. Optic nerve tortuosity in adduction in the control and glaucoma groups were 1.004±0.003 (mean±SD) and 1.001±0.001, respectively (P=0.037). Globe proptosis (primary gaze) in glaucoma subjects (19.14±2.11 mm) was significantly higher than that in control subjects (15.32±2.79 mm; P=0.046).
CONCLUSIONS
In this sample, subjects with glaucoma exhibited tauter optic nerves and more protruding eye globes compared with normal eyes. This may impact optic nerve head deformations in anatomically predisposed patients.
Topics: Aged; Aged, 80 and over; Asian People; Case-Control Studies; Exophthalmos; Eye Movements; Female; Fixation, Ocular; Glaucoma; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Optic Disk; Optic Nerve
PubMed: 31045951
DOI: 10.1097/IJG.0000000000001270 -
Indian Journal of Ophthalmology Mar 2020
Topics: Adult; Diagnosis, Differential; Female; Humans; Myopia; Optic Disk; Optic Nerve Diseases
PubMed: 32057022
DOI: 10.4103/ijo.IJO_1103_19 -
Current Opinion in Ophthalmology Nov 2022The purpose of this review is to provide an overview of the ophthalmic findings associated with peripapillary hyperreflective ovoid mass-like structures (PHOMS) in both... (Review)
Review
PURPOSE OF REVIEW
The purpose of this review is to provide an overview of the ophthalmic findings associated with peripapillary hyperreflective ovoid mass-like structures (PHOMS) in both adult and pediatric patients.
RECENT FINDINGS
PHOMS have recently been identified in a number of different ophthalmic disease entities ranging from nonpathologic to pathologic, including but not limited to anatomic abnormalities (tilting in myopia), optic nerve head drusen, optic disc edema from inflammation (optic neuritis, white dot syndromes), vascular insults (ischemic optic neuropathy, retinal vascular occlusion), and papilledema. The mechanism underlying the formation of PHOMS has not been fully elucidated although it has been hypothesized that PHOMS occur secondary to axoplasmic stasis from crowding at the optic nerve head.
SUMMARY
Although the clinical significance of the presence of PHOMS remains unclear, PHOMS are associated with several disease processes. Understanding the mechanism behind their formation and their impact on optic nerve head structure and visual function may be relevant in patients with optic nerve head pathology. The presence of PHOMS may also correlate with disease severity and duration. Future studies to evaluate whether the formation of PHOMS may be useful as an early indicator of disease or a prognostic tool are warranted.
Topics: Adult; Child; Humans; Optic Disk; Optic Disk Drusen; Optic Neuritis; Papilledema; Tomography, Optical Coherence
PubMed: 36094020
DOI: 10.1097/ICU.0000000000000897 -
Indian Journal of Ophthalmology Mar 2023Several characteristic vascular changes can be observed in the glaucomatous eyes, including changes in the vessel configuration and caliber, presence of collateral...
BACKGROUND
Several characteristic vascular changes can be observed in the glaucomatous eyes, including changes in the vessel configuration and caliber, presence of collateral vessel on disk, and disk hemorrhage.
PURPOSE
This video describes characteristic vascular changes in the optic nerve head, which can be observed on clinical examination in the glaucomatous eyes, and useful teaching points to identify the same.
SYNOPSIS
In glaucoma, as the optic cup enlarges, the normal pattern and course of retinal vessels on the optic disk are altered and show characteristic changes. Identification of these changes provides a clue to the presence of cupping.
HIGHLIGHTS
In this video, the vascular changes and its identification in the glaucomatous disc are described, which would be useful to the residents.
VIDEO LINK
https://youtu.be/2eINumBx33E.
Topics: Humans; Glaucoma; Optic Disk; Physical Examination; Retinal Vessels
PubMed: 36872755
DOI: 10.4103/ijo.IJO_2621_22 -
Journal of Biophotonics Sep 2022Multispectral imaging is used in various applications including astronomy, industry and agriculture. In retinal imaging, the single-shot multispectral image stack is...
Multispectral imaging is used in various applications including astronomy, industry and agriculture. In retinal imaging, the single-shot multispectral image stack is typically acquired and analyzed. This multispectral analysis can provide information on various structural or metabolic properties. This paper describes the multispectral improvement of a video-ophthalmoscope, which can acquire retinal video sequences of the optic nerve head and peripapillary area using various spectral light illumination. The description of the multispectral video imaging is provided and several applications are described. These applications include multispectral retinal photoplethysmography, visualization of spontaneous vein pulsation and multispectral RGB image generation.
Topics: Fiber Optic Technology; Lighting; Ophthalmoscopes; Ophthalmoscopy; Optic Disk; Retina
PubMed: 35604408
DOI: 10.1002/jbio.202200094 -
Arquivos Brasileiros de Oftalmologia 2020This study aimed to evaluate optic nerve head parameters and inner retinal layer thicknesses in obese children and adolescents.
PURPOSE
This study aimed to evaluate optic nerve head parameters and inner retinal layer thicknesses in obese children and adolescents.
METHODS
Forty-one eyes of 41 pediatric obese participants and 41 eyes of 41 age- and sex-matched healthy controls were included in this study. Body mass index was calculated, based on sex and age, using body weight and height measurements. Blood lipid values (i.e., cholesterol, low-density lipoprotein, high-density lipoprotein, and triglyceride) were measured in obese participants. Optical coherence tomography was used to examine optic nerve head parameters, including rim area, disc area, cup-to-disc ratio, and cup volume, as well as the thicknesses of retinal nerve fiber layers and macular ganglion cell-inner plexiform layers.
RESULTS
Optic disc parameters were similar in obese and healthy children (p>0.05). The percentage of binocular retinal nerve fiber layer thickness symmetry was significantly different between obese and control groups (p=0.003). Compared to the control group, participants in the obese group exhibited thinner retinal nerve fiber layers in the superior quadrants (p=0.04) and thinner ganglion cell-inner plexiform layers in the superior-temporal sectors (p=0.04). There were no statistically significant correlations between the ocular parameters and lipid blood test values assessed in this study (p>0.05). Body mass index was significantly negatively correlated with the mean retinal nerve fiber layer thickness (r=-0.33, p=0.03) in the obese group. There was no significant correlation between intraocular pressure and body mass index (r=0.05, p=0.74).
CONCLUSION
Compared to healthy children, obese children had greater binocular retinal nerve fiber layer thickness asymmetry and thinner retinal nerve fiber and ganglion cell-inner plexiform layers in several sectors. Blood lipid levels were not associated with retinal thickness or optic disc parameters in obese children.
Topics: Adolescent; Child; Humans; Nerve Fibers; Obesity; Optic Disk; Retina; Retinal Ganglion Cells; Tomography, Optical Coherence
PubMed: 33084815
DOI: 10.5935/0004-2749.20200047