- 标题
- 摘要
- 关键词
- 实验方案
- 产品
-
Comparison between broadband and monochromatic photopic negative response in full-field electroretinogram in controls and subjects with primary open-angle glaucoma
摘要： Purpose A prospective, cross-sectional, case–control study was conducted to investigate the role of broadband and monochromatic photopic negative response (PhNR) of the full-field flash electroretinogram (ERG) in the evaluation of ganglion cell damage in primary open-angle glaucoma (POAG) subjects. Methods Subjects with POAG and age-matched normal subjects were recruited from the outpatient department of a tertiary eye care center in South India. A total of 25 patients with POAG and 50 age-matched normal subjects were recruited. ERG was recorded using broadband (3.5 cd.s/m2 white stimulus on 10 cd/m2 white background) and monochromatic (3.5 cd.s/m2 red stimulus on 10 cd/m2 blue background and 1 cd.s/m2 blue stimulus on 10 cd/m2 yellow background) stimuli. Results The reduction in PhNR amplitude in POAG compared to normal individuals was higher in red-on-blue PhNR [26.37 μV; p < 0.001, confidence interval (CI) 19.34 to 33.4] as compared to broadband stimuli (16.41 μV; p < 0.001, CI 8.68 to 24.13), and blue on yellow (21.96 μV; p < 0.001, CI 10.12 to 33.8). Red-on-blue PhNR amplitudes correlated better with mean deviation (MD; r = -0.66, p < 0.05), pattern standard deviation (PSD; r = -0.4, p = 0.04), visual field index (VFI; r = -0.58, p < 0.05), and retinal nerve fiber layer thickness (r = -0.67, p < 0.05) in comparison with broadband and monochromatic blue-on-yellow PhNR. Receiver operating characteristic curve revealed largest area under the curve (0.89) in red-on-blue PhNR compared to broadband (0.76) and blue on yellow (0.74). The sensitivity and specificity was also higher in red-on-blue PhNR (72% and 80%, respectively) as compared to the other stimuli (sensitivity and specificity of broadband 0.68 and 0.7, blue on yellow 0.64 and 0.7, respectively). Conclusion Correlation of PhNR with Humphrey visual field parameters and retinal nerve fiber layer thickness showed that red-on-blue PhNR can be a useful additional tool for clinical assessment of retinal ganglion cell dysfunction in glaucoma patients. Red-on-blue PhNR was more sensitive as compared to white-on-white and blue-on-yellow PhNR in identifying ganglion cell dysfunction and correlates well with other structural and functional tests for glaucoma such as MD, PSD, VFI, and RNFL thickness.
关键词： Primary open-angle glaucoma,Photopic negative response,Broadband ERG,Full-field electroretinogram,Monochromatic ERG
更新于2025-09-23 15:23:52
-
Selective Laser Trabeculoplasty Protects Glaucoma Progression in the Initial Primary Open-Angle Glaucoma and Angle-Closure Glaucoma after Laser Peripheral Iridotomy in the Long Term
摘要： Purpose. To compare the ability of SLT in preventing glaucoma progression in the initial primary angle-closure glaucoma (PACG) after laser peripheral iridotomy and primary open-angle glaucoma (POAG) in the long term. Methods. 60 patients with the initial stage of PACG after laser peripheral iridotomy and 64 initial POAG patients were recruited in a prospective study. Complete success of selective laser trabeculoplasty (SLT) was de?ned as a 20% intraocular pressure (IOP) reduction with topical hypotensive medications without any hypotensive intervention. Pre-SLT rate of progression and post-SLT rate of progression (ROP) was detected in the both groups by means of the trend and the event analysis of perimetry, the Guided Progression Analysis, and the optical coherence tomography- (OCT-) based negative trend for either the thickness of the peripapillary retinal nerve ?ber layer (RNFL) or ganglion cell complex (GCC). Results. IOP decreased signi?cantly after SLT in both the groups. 30% in PACG and 19% in POAG had the progression according to perimetry and 49% in PACG and 40% in POAG had the progression, respectively, according to OCT. After SLT, ROP was reduced from ? 0.14 ± 0.39 dB/year to ? 0.08 ± 0.48 dB/year, p ? 0.034, in PACG and from ? 0.09 ± 0.36 dB/year to ? 0.04 ± 0.43 dB/year, p ? 0.021, in POAG. According to RNFL trend analysis, ROP was reduced from ? 1.86 ± 2.9 μm/year to ? 1.38 ± 2.2 μm/year, p ? 0.039, and from ? 1.24 ± 2.23 μm/year to ? 0.76 ± 1.73 μm/year, p ? 0.037, in PACG and POAG, and according to GCC, ROP was reduced from ? 1.88 ± 2.9 μm/year to ? 1.34 ± 2.0 μm/year, p ? 0.040, and from ? 1.35 ± 2.16 μm/year to ? 0.91 ± 1.86 μm/year, p ? 0.040, in PACG and POAG, respectively. ROP was signi?cantly faster in PACD than in POAG between 2 and 6 years after SLT: ? 0.15 ± 0.46 dB/year and 0.02 ± 0.38 dB/year (p ? 0.042). However, it did not di?er signi?cantly according to OCT. Conclusion. SLT is an e?ective treatment for initial PACG after LPI and POAG that can prevent functional and structural deterioration in the long term.
关键词： Ganglion Cell Complex,Laser Peripheral Iridotomy,Optical Coherence Tomography,Primary Angle-Closure Glaucoma,Selective Laser Trabeculoplasty,Intraocular Pressure,Retinal Nerve Fiber Layer,Primary Open-Angle Glaucoma,Glaucoma Progression
更新于2025-09-16 10:30:52
-
Inner Retinal Changes in Primary Open-Angle Glaucoma Revealed Through Adaptive Optics-Optical Coherence Tomography
摘要： To examine the microstructural changes in the inner nuclear layer (INL) and ganglion cell layer (GCL) in a primary open-angle glaucoma (POAG) subject at 2 timepoints, 4 months apart. This case-control study (1 POAG subject and 1 normal control) used the single cell, 3-dimensional volumetric imaging capability of an adaptive optics-optical coherence tomography-scanning laser ophthalmoscopy system to examine the inner retina. At the area of greatest glaucomatous change in the POAG subject [3-degrees temporal (T), 3-degrees inferior (I), right eye], the GCL was greatly thinned at both timepoints, yet retinal ganglion cell soma remained visible amid a meshwork of capillaries. Microcystic lesions in the INL were visible at both timepoints, ranging in diameter from 8 to 43 μm on day 1 to 11 to 64 μm at 4 months, with an average diameter increase of ～124%. Small hyperre?ective features (not seen in the contralateral eye or control subject) at a depth midway through the INL seemed correlated to the development of microcysts. We demonstrate the ability to image microcystic lesions early in their development and have quanti?ed longitudinal changes. The presence of small hyperre?ective structures at a layer midway through the INL seems to be a precursor to their formation and is a potential biomarker for assessing POAG severity and progression. The adaptive optics imaging system is also able to visualize retinal ganglion cells in this subject, despite severe thinning of the GCL.
关键词： optical coherence tomography,adaptive optics,retinal ganglion cells,microcysts,primary open-angle glaucoma
更新于2025-09-16 10:30:52
-
CO2 Laser-assisted Deep Sclerectomy Combined With Phacoemulsification in Patients With Primary Open-angle Glaucoma and Cataract
摘要： To assess the safety and efficacy of CO2 laser-assisted sclerectomy surgery (CLASS) combined with phacoemulsification in patients with primary open-angle glaucoma (POAG) and visually significant cataracts. This was a prospective, uncontrolled, interventional case series. Seventeen patients (17 eyes) diagnosed with POAG and cataracts were enrolled starting from November 2015. All subjects underwent CLASS combined with phacoemulsification surgery by the same surgeon. After the surgery, all patients were followed for 12 months. The preoperative to postoperative changes in intraocular pressure (IOP), glaucoma medication requirements, best-corrected visual acuity and adverse events were recorded. The results of 17 eyes of 17 patients were included in the statistical analysis. The baseline mean IOP was 23.94 ± 8.57 mm Hg (mean ± SD), and patients used 2.18 ± 0.88 types of antiglaucoma medication. At 12 months postsurgery, the mean IOP was 14.67 ± 2.97 mm Hg, and patients used 0.59 ± 0.87 types of antiglaucoma medication (both P < 0.001). The logarithm of the minimal angle of resolution of the best-corrected visual acuity improved from 0.77 ± 0.42 preoperatively to 0.33 ± 0.47 postoperatively (P < 0.05). Two patients experienced intraoperative perforation accompanied by iris prolapse. One patient exhibited postoperative choroidal detachment. CLASS with phacoemulsification may become a safe and effective intervention for patients with POAG and visually significant cataracts.
关键词： cataract,primary open-angle glaucoma,phacoemulsification,CLASS,laser surgery
更新于2025-09-16 10:30:52
-
Comparison of Central Corneal Thickness using Anterior Segment Optical Coherence Tomography Versus Ultrasound Pachymetry
摘要： Introduction: Corneal thickness is an important and sensitive indicator of corneal health. It is useful in monitoring corneal diseases such as corneal oedema and keratoconus, and selecting patients for refractive surgery. Central Corneal Thickness (CCT) is a risk factor for Primary Open-Angle Glaucoma (POAG). Aim: To compare CCT using ultrasound pachymetry and Anterior Segment Optical Coherence Tomography (AS-OCT), and also to find out the reproducibility of AS–OCT readings for both central and pericentral corneal areas. Materials and Methods: This prospective cross-sectional study was conducted on 120 patients above 40 years of age, and with clinically normal corneas, who underwent CCT measurements by both ultrasound and AS-OCT. Both the eyes were analysed. Two measurements by AS-OCT and 25 measurements by ultrasound pachymetry were taken. The readings were averaged and compared by paired t-test. Repeatability of the OCT pachymetry map sector averages, was assessed by pooled standard deviation, obtained from the two measurements taken from each eye. Results: The CCT in right eye by OCT and ultrasound was 516.28±29.76 μm and 532.42±29.71 μm, respectively. The CCT in left eye by OCT and ultrasound was 515.82±29.88 μm and 532.36±29.83 μm, respectively. The difference in CCT measurement by AS-OCT and ultrasound was statistically significant (p<0.001); mean ultrasound CCT being 16.14 μm and 16.54 μm greater than the mean AS-OCT, CCT in right eye and left eye respectively. For AS-OCT, intra-session repeatability was measured. Repeatability of the OCT mapping was 0.01 μm to 1.6 μm and 0.01 μm to 1.9 μm in the right eye and left eye respectively. Conclusion: The CCT measurement by ultrasound pachymetry gives higher values compared to AS-OCT measurement. Hence, they cannot be interchangeably used in clinical practice. The AS- OCT provides highly repeatable pachymetry map measurements both centrally and pericentrally.
关键词： Primary open-angle glaucoma,Reproducibility,2-mm pachymetry map
更新于2025-09-09 09:28:46
-
Optic disc topography in Malay patients with normal-tension glaucoma and primary open-angle glaucoma
摘要： Background: There are limited data concerning the optic disc topography in normal-tension glaucoma (NTG) and primary open-angle glaucoma (POAG) patients living in Southeast Asian countries. This study aims to compare optic disc parameters in patients with NTG and POAG in Malaysia and to discuss the results in comparison with studies of NTG and POAG in other Asian countries. Methods: This prospective cross-sectional study was performed in two hospitals with glaucoma service in Malaysia from 2010 to 2012. Seventy-seven patients of Malay ethnicity were enrolled in this study, including 32 NTG patients and 45 POAG patients. Using the Heidelberg Retinal Tomograph III, we measured optic disc area, cup area, rim area, cup volume, rim volume, cup-to-disc area ratio, mean cup depth, maximum cup depth, cup shape measure, height variation contour, mean retinal nerve fiber layer thickness, and retinal nerve fiber layer cross-sectional area. Results: The eyes for NTG patients had significantly larger optic disc areas (2.65 [standard deviation, 0.41] vs 2.40 [standard deviation, 0.36] mm2, respectively; P=0.006) and cup areas (1.54 [standard deviation, 0.43] vs 1.32 [standard deviation, 0.40] mm2, respectively; P=0.027) compared with the eyes of POAG patients. Comparison of the other parameters between the two groups revealed no significant difference (P0.050). The moderate and severe NTG patients showed significantly deeper cups and larger disc and cup areas when compared with the moderate and severe POAG patients (P0.050). Conclusion: The NTG patients in this study have notably larger optic disc and cup areas than the POAG patients. Our observations are consistent with those reported in studies of NTG and POAG patients in Korea. The deeper cups and larger disc and cup areas may serve as indicators of severity when comparing NTG with POAG. However, these findings require verification with IOP and visual field results.
关键词： optic disc topography,primary open-angle glaucoma,Heidelberg Retina Topography III,Malay ethnicity,normal-tension glaucoma
更新于2025-09-04 15:30:14