Optic Disc Parameters Research Articles

Challenges and difficulties in diagnosis of normal-tension glaucoma

Aim The aim of this study is to clinically investigate the challenges and pitfalls of normal-tension glaucoma (NTG) diagnostic methods by ophthalmic clinical and investigative examinations. Setting This study was conducted at Al-Agouza Police Authority Hospital and Badr University Hospital. Methods A cross-sectional comparative study between the diagnosis of normal nonglaucoma patients and NTG. It included 40 normal nonglaucoma patients’ eyes as controls and 40 NTG patients’ eyes who met inclusion criteria. They were assessed by a complete ophthalmic exam., visual field (VF), and optical coherence tomography (OCT) variables between January 2022 and September 2022. Results The median age of the control group was 38 years old, while that of glaucomatous patients was 41 years old. The mean intraocular pressure (IOP) for the normal group was 15.53 mmHg (±1.935), while that for the glaucomatous group was 16.85 mmHg (±1.703). The intraocular pressure was considerably higher in the NTG group compared with the control (P = 0.0017). The mean deviation (MD) in dB of VF loss was considerably higher in the NTG group compared with the control (P = 0.0001). Also, the mean standard deviation (MSD) was considerably varied between the two groups (P < 0.0001). The average Retinal Nerve Fiber Layer (RNFL) in the NTG group, with a mean of 72.3 JOURNAL/jeos/04.03/01735167-202316030-00002/inline-graphic1/v/2023-09-27T140929Z/r/image-jpeg (±10.239) was significantly lower than in the control group with a mean of 102.025 JOURNAL/jeos/04.03/01735167-202316030-00002/inline-graphic2/v/2023-09-27T140929Z/r/image-jpeg (±7.454), P = 0.0001. Optic Disc Parameters: The Cup Area (mm2) was significantly wider in the NTG group with a mean of 1.62 (±0.476) than in the control with a mean of 1.297 (±0.44), P = 0.0024. Also, the Rim Area was significantly smaller in the NTG group with a mean of 0.614 (±0.342) than in the control with a mean of 1.135 (±0.319), P = 0.0024. The Cup/disc ratio was significantly larger in the NTG group than in the control group (P < 0.0001). The average Ganglion cell complex (GCC) was considerably thinner in the NTG patients in comparison to the controls (P = 0.0001). Conclusion The effects of NTG on VF and optic nerve seems to be more intensive. More focal notches and disc hemorrhage were noted in NTG. In the NTG group, the Cup Area was potentially wider, the rim area was significantly thinner, and the Cup/disc ratio was significantly larger.

Quantitative study of peripapillary retinal nerve fiber layer thickness and peripapillary vessel density in patients with different stages of Parkinson's disease.

To observe the changes in the thickness of peripapillary retinal nerve fiber layer (pRNFL) and peripapillary vessel density (pVD) in patients with different stages of Parkinson's disease (PD). Totally 47 patients (47 eyes) with primary PD were divided into the mild group and the moderate-to-severe group according to Hoehn & Yahr (H&Y) stage. Among them, there were 27 cases (27 eyes) in mild group and 20 cases (20 eyes) in moderate-to-severe group. And 20 cases (20 eyes) who were included in the control group were healthy people who came to our hospital for health screening at the same time. All participants underwent optical coherence tomography angiography (OCTA) examinations. The pRNFL thickness, total vessel density (tVD) and capillary vessel density (cVD) of the optic disc in average, superior half, inferior half, superior nasal (SN), nasal superior (NS), nasal inferior (NI), inferior nasal (IN), inferior temporal (IT), temporal inferior (TI), temporal superior (TS), and superior temporal (ST) were measured. One-way ANOVA was used to compare the differences of optic disc parameters among the three groups, and Pearson and Spearman correlations were used to analyze the correlation between pRNFL, pVD and the disease duration, H&Y stage and UPDRS-III score in patients with PD, respectively. There were significant differences in pRNFL thickness in average, superior half, inferior half, SN, NS, IN, IT and ST quadrants among the three groups (P<0.05). In PD group, the pRNFL thickness in average, superior half, inferior half, NS and IT quadrants were negatively correlated with H&Y stage and UPDRS-III score, respectively (P<0.05). There were statistically significant differences in the cVD of whole image, inferior half, NI and TS quadrants, the tVD of the whole image, inferior half, and peripapillary among the three groups (P<0.05). In PD group, the tVD of whole image and the cVD of NI and TS quadrants were negatively correlated with the H&Y stage, respectively (P<0.05); the cVD of TS quadrant was negatively correlated with UPDRS-III score (P<0.05). The thickness of pRNFL in PD patients is significantly decreased, and it is negatively correlated with H&Y stage and UPDRS-III score. With the increase of the severity of the disease, the pVD parameters in PD patients increase at first in the mild group, and then decrease in the moderate-to-severe group, and negatively correlate with H&Y stage and UPDRS-III score.

Value of optical coherence tomography measurement of macular thickness and optic disc parameters for glaucoma screening in patients with high myopia

The basic method of glaucoma diagnosis is visual field examination, however, in patients with high myopia, the diagnosis of glaucoma is difficult. To explore the value of optical coherence tomography (OCT) for measuring optic disc parameters and macular thickness as a screening tool for glaucoma in patients with high myopia. Visual values (contrast sensitivity, color vision, and best-corrected visual acuity) in three groups, patients with high myopia in Group A, patients with high myopia and glaucoma in Group B, and patients with high myopia suspicious for glaucoma in Group C, were compared. Optic disc parameters, retinal nerve fiber layer (RNFL) thickness, and ganglion cell layer (GCC) thickness were measured using OCT technology and used to compare the peri-optic disc vascular density of the patients and generate receiver operator characteristic (ROC) test performance curves of the RNFL and GCC for high myopia and glaucoma. Of a total of 98 patients admitted to our hospital from May 2018 to March 2022, totaling 196 eyes in the study, 30 patients with 60 eyes were included in Group A, 33 patients with 66 eyes were included in Group B, and 35 patients with 70 eyes were included in Group C. Data were processed for Groups A and B to analyze the efficacy of RNFL and GCC measures in distinguishing high myopia from high myopia with glaucoma. The area under the ROC curve was greater than 0.7, indicating an acceptable diagnostic value. The value of OCT measurement of RNFL and GCC thickness in diagnosing glaucoma in patients with high myopia and suspected glaucoma is worthy of development for clinical use.

Longitudinal evaluation of RTVue optical coherence tomography in patients with glaucoma and suspected glaucoma and stable visual fields.

To longitudinally compare isolated structural parameters obtained using RTVue optical coherence tomography in patients with glaucoma and suspected glaucoma with stable visual fields. All patients were required to have a reliable SITA Standard 24-2 Humphrey Visual Field test. Visual field stability was defined as having <5 points with p<5% and/or having no points with p<1% and/or p<0.05% in the glaucoma progression analysis comparison graph. Furthermore, the glaucoma assessment strategy was used in optical coherence tomography. The study included 75 eyes from 75 patients, 43 of which had glaucoma and 32 had suspected glaucoma. The mean visual field intervals were 29.57 ± 9.65 months between the first and third tests. No visual field parameter variations (mean deviation, pattern standard deviation, and visual field index) and no retinal nerve fiber layer or optic disk parameter variations between the first and third tests were observed (p>0.05 for all), and no retinal nerve fiber layer parameter variations throughout the study were observed, except for optic disk parameters presenting with cup volume changes (p=0.004). However, ganglion complex cells presented a progressively decreased average ganglion cell complex parameter, with a variability of -0.98% ± 3.71% (p=0.04) between the first and third tests. By contrast, the global loss volume progressively increased throughout the study, with a variability of 14.71% ± 44.52% (p=0.04) between the first and third tests. The inferior ganglion cell complex parameter was significantly decreased between the first and third tests (p=0.02). The present findings suggest that patients with glaucoma or suspected glaucoma with stable visual fields may present structural ganglion complex cell progression as assessed using RTVue optical coherence tomography.

Do Choroidal Melanocytes Affect Choroidal Thickness in Patients with Newly Diagnosed Vitiligo?

Aim: Vitiligo is a chronic skin disease and considered to be an autoimmune, neural, and autocytotoxic&#x0D; pathophysiology in which mainly the melanocytes in the epidermis are focused and destroyed.&#x0D; Therefore, alterations in the choroid and retinal pigment epithelium are expected, and there are very&#x0D; few publications using modern technology in research of this subject.&#x0D; This study aimed to examine the optic disc, retinal nerve fiber layer (RNFL), and choroidal thickness&#x0D; in patients with vitiligo by spectral-domain optical coherence tomography (SD-OCT) as a prospective&#x0D; observational study.&#x0D; Material and Methods: This single-center prospective cross-sectional study included 40 eyes of 40&#x0D; patients with vitiligo and 42 eyes of 42 healthy individuals. The RNFL thickness, choroidal thickness,&#x0D; and optic disc parameters (rim area, disc area, and cup volume) were compared between the two&#x0D; groups.&#x0D; Results: The study consisted of 21 female and 19 male in the vitiligo group, and 21 female and 21&#x0D; male in controls; no difference was found in gender distribution between two groups (p=0.836). Vitiligo&#x0D; and control groups had similar optic disc parameters, and RNFL and choroidal thicknesses; so the&#x0D; differences in the mentioned parameters did not differ statistically (p&gt;0.05 for all).&#x0D; Conclusion: Vitiligo patients’ optic disc parameters, and RNFL and choroidal thicknesses did not differ&#x0D; from those in healthy individuals. Based on unknown pathogenesis, the melanocytes at the choroidal&#x0D; region may have compensatory mechanisms in vitiligo.

Assessment of changes in optic disc parameters and peripapillary retinal nerve fiber layer thickness in myopic patients and its correlation with axial length and degree of myopia.

The present study aimed to assess the changes in optic disc and peripapillary retinal nerve fiber layer (RNFL) parameters in myopic patients and its correlation with axial length (AL) and spherical equivalent (SE) using optical coherence tomography (OCT). This was a cross-sectional study carried out from August 2019 to September 2021 in the ophthalmology department of a tertiary care hospital in eastern India. Myopic patients in the age group of 20-40 years and SE between - 0.5 to - 10 Diopters (D) were included in the study. Patients were divided into two groups on the basis of degree of myopia and AL. Appropriate statistical analysis was done at the end of the study period. The study included 307 eyes of 307 myopic patients. There were 181 females (58.96%) and 126 males (41.04%). The mean age of the patients enrolled for the study was 28.78 ± 5.76 years. Statistically significant difference (P < 0.001) was found between SE and AL in between the subgroups of A and B. With every 1 D increase in SE, the average peripapillary RNFL thickness decreased by 0.61 μ while with every 1 mm increase in AL, the average peripapillary RNFL thickness was found to reduce by 1.03 μ. Analysis of optic nerve head parameters and RNFL thickness by OCT for the diagnosis should be compared with a normative control group that has been matched for refractive error and AL instead of comparison with a normative database that has only been age matched.

Research on diagnostic value of OCT measurement of optic disc and macular parameters in early primary open angle glaucoma

Research on diagnostic value of OCT measurement of optic disc and macular parameters in early primary open angle glaucoma

Analysis of retinal nerve fibre layer thickness and optic disc parameters in patients of iron deficiency anaemia

Background: To evaluate peripapillary retinal nerve fibre layer (RNFL) thickness and optic disc parameters in iron deficiency anaemia (IDA) patients and its correlation with various blood parameters of age and sex matched healthy controls with the help of spectral domain optical coherence tomography (SD-OCT). Materials and methods: Cross sectional, hospital based study was done on patients with IDA and healthy patients attending departments of Ophthalmology and haematology of a tertiary referral hospital in Eastern India from June 2020 to January 2021. Comprehensive ophthalmic examination was done in all patients. Peripapillary RNFL thickness was measured using SD-OCT. Blood analysis for all patients included blood haemoglobin, serum iron binding capacity, Serum Ferritin, total iron binding capacity (TIBC), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin Concentration (MCHC). Results: Twenty five patients with IDA and 25 age and sex matched healthy patients constituted the study and control groups respectively. Mean age of study and control groups was 40.44±5.51 and 39.12±11.60 years respectively. Strong positive correlation was noted between mean RNFL thickness and haemoglobin, serum ferritin, serum iron and serum transferrin levels. Negative correlation was noted between mean RNFL thickness and total iron binding capacity. Conclusion: Patients with IDA in Eastern India have decreased mean peripapillary RNFL thickness. Mean RNFL thickness in different quadrants may not only be dependent on iron parameters but might also be influenced by dietary and geographical factors.

The different structure-function correlation as measured by OCT and octopus perimetry cluster analysis in intracranial tumor and glaucoma patients.

BackgroundTo explore the correlation between visual field (VF) defect values and retinal nerve fiber layer (RNFL) thickness for intracranial tumor and glaucoma patients.MethodsRetrospective analysis is performed for the intracranial and glaucoma patients, whose VF defect values were measured with Octopus perimeter cluster analysis, RNFL thickness, ganglion cell layer (GCL) thickness, and optic disk parameters measured with swept-source OCT. The differences between VF and RNFL (including the data of optic disc) are calculated. The correlation between VF defect values and RNFL and GCL thickness are explored.ResultsIn total 43 eyes of 29 patients with intracranial tumor and 31 eyes of 19 patients with glaucoma were enrolled. The thickness of RNFL not only for the whole (360°), but also for the four quadrants was thinner in the glaucoma group than those of the intracranial tumor group (p<0.05), and similar to the thickness of GCL without significance (p>). There is no significant difference in VF for those two groups except glaucoma having lower sLV (p<0.05). A stronger correlation for mean deviations (MD)s of VF ten clusters and RNFL thickness of OCT twelve sectors is found in the glaucoma patients, but few in the intracranial tumor patients. Logistic regression also shows the loss of RNFL or increasing of vertical CDR and cup volume tending to the diagnosis of glaucoma and the irregular VF damage is inclined to the diagnosis of intracranial tumor.ConclusionsIntracranial tumor has a weak correlation between the RNFL thickness and Octopus VF MD, compared with that of glaucoma. OCT and Octopus VF might provide more helpful information for the differential diagnosis of intracranial tumor and glaucoma.

Short-term progression of optic disc and macular changes in optic nerve head drusen

PurposeTo quantify in patients with optic nerve head drusen (ONHD)changes after 1-year observation in: (i) optic disc and (ii) macular optical coherence tomography (OCT) parameters and (iii) the effect of age at enrolment in the study.DesignProspective, cross-sectional observational study using Spectral Domain-OCT (Copernicus; OPTOPOL Technology S.A., Zawiercie, Poland) imaging was carried out in 35 patients with ONHD (age–42.8 ± 19.9 years; males = 15; females = 20) at baseline and after 12 months follow-up.ResultsPatients with ONHD had significant thinning of the surface nerve fibre layer in the central (p = 0.03), superior (p = 0.05) and inferior (p = 0.04) areas; mean ppRNFL thinning (p = 0.0 4) and ppRNFL thinning in the nasal segment (p = 0.028). Retinal thinning in the central (p = 0.001), inner (p = 0.01) and outer (p = 0.002) temporal, outer superior (p = 0.03) and inferior (p = 0.02) areas; borderline ganglion cell layer thinning (p = 0.051) and outer nuclear layer (p = 0.03) thinning in the central retina and outer segment layer thinning nasally (p = 0.01) between the first and the second visit in macula. Correlation of the difference in optic disc and macular parameters with the age at enrolment did not reveal any significance.ConclusionsStatistically detectable thinning of the optic nerve and macula structures occurred already after 12 months. The proximity of optic nerve changes to the vascular arcades can possibly be explained by involvement of retinal vessels in the pathophysiology of ONHD.

The Relationship Between Fetal Growth and Retinal Nerve Fiber Layer Thickness in a Cohort of Young Adults.

PurposeTo explore relationships between patterns of fetal anthropometric growth, as reflective of fetal wellbeing, and global retinal nerve fiber layer (RNFL) thickness measured in young adulthood.MethodsParticipants (n = 481) from within a Western Australian pregnancy cohort study underwent five serial ultrasound scans during gestation, with fetal biometry measured at each scan. Optic disc parameters were measured via spectral-domain optical coherence tomography imaging at a 20-year follow-up eye examination. Generalized estimating equations were used to evaluate differences in global RNFL thickness between groups of participants who had undergone similar growth trajectories based on fetal head circumference (FHC), abdominal circumference (FAC), femur length (FFL), and estimated fetal weight (EFW).ResultsParticipants with consistently large FHCs throughout gestation had significantly thicker global RNFLs than those with any other pattern of FHC growth (P = 0.023), even after adjustment for potential confounders (P = 0.037). Based on model fit statistics, FHC growth trajectory was a better predictor of global RNFL thickness than birth weight or head circumference at birth. RNFL thickness did not vary significantly between groups of participants with different growth trajectories based on FAC, FFL, or EFW.ConclusionsFHC growth is associated with RNFL thickness in young adulthood and, moreover, is a better predictor than either birth weight or head circumference at birth.Translational RelevanceThis research demonstrates an association between intrauterine growth and long-term optic nerve health, providing a basis for further exploring the extent of the influence of fetal wellbeing on clinical conditions linked to RNFL thinning.

Macular and Optic Disc Parameters in Children with Amblyopic and Nonamblyopic Eyes under Optical Coherence Tomography Fundus Images.

The aim of this study was to investigate the characteristics of macular and optic disc parameters in children with amblyopic and nonamblyopic eyes, using fundus images under optical coherence tomography (OCT). 36 patients with anisometropic amblyopia were selected in the experimental group, and another 36 healthy volunteers were selected in the control group, OCT examinations were performed in all groups, and the mean diopter, mean corrected visual acuity (CVA), mean axial length, mean optic disc retinal nerve fiber layer (RNFL) thickness, and mean macular fovea thickness were recorded in the two groups. The results found that the average diopter of the patients in the control group and the experimental group was +2.30 ± 2.54 D and +5.51 ± 1.76 D, respectively. The average CVA was 0.86 ± 0.07 and 0.22 ± 0.16, respectively; the average eye axial length was 22.41 ± 1.20 mm and 21.11 ± 0.78 mm, respectively. As P < 0.05, the differences were statistically significant in the three indicators between the two groups. There was no significant difference between the two groups in the average thickness of the RNFL of the optic disc and the average thickness of the central fovea of macula (P > 0.05). There was some correlation among CVA, diopter, eye axial length, RNFL thickness, and average thickness of macular fovea, but the correlation was not significant. It was suggested that there were certain differences in the macular and optic disc parameters between amblyopic and nonamblyopic children, but the difference is little. Thereout, a certain objective basis was provided for the early detection and treatment of amblyopia.

Bioinformatic Prioritization and Functional Annotation of GWAS-Based Candidate Genes for Primary Open-Angle Glaucoma.

Background: Primary open-angle glaucoma (POAG) is the most prevalent glaucoma subtype, but its exact etiology is still unknown. In this study, we aimed to prioritize the most likely ‘causal’ genes and identify functional characteristics and underlying biological pathways of POAG candidate genes. Methods: We used the results of a large POAG genome-wide association analysis study from GERA and UK Biobank cohorts. First, we performed systematic gene-prioritization analyses based on: (i) nearest genes; (ii) nonsynonymous single-nucleotide polymorphisms; (iii) co-regulation analysis; (iv) transcriptome-wide association studies; and (v) epigenomic data. Next, we performed functional enrichment analyses to find overrepresented functional pathways and tissues. Results: We identified 142 prioritized genes, of which 64 were novel for POAG. BICC1, AFAP1, and ABCA1 were the most highly prioritized genes based on four or more lines of evidence. The most significant pathways were related to extracellular matrix turnover, transforming growth factor-β, blood vessel development, and retinoic acid receptor signaling. Ocular tissues such as sclera and trabecular meshwork showed enrichment in prioritized gene expression (>1.5 fold). We found pleiotropy of POAG with intraocular pressure and optic-disc parameters, as well as genetic correlation with hypertension and diabetes-related eye disease. Conclusions: Our findings contribute to a better understanding of the molecular mechanisms underlying glaucoma pathogenesis and have prioritized many novel candidate genes for functional follow-up studies.

Peripapillary Vascular Density Measurement in Pediatric Renal and Liver Transplant.

Noninvasive monitorization of retinal structures of the eye could be a predictor for systemic microvasculature dysfunction in transplant recipients. In this study, our purpose was to determine the optic disc and peripapillary microvascular changes in pediatric patients who had undergone liver or renal transplant surgery. The study was performed at Başkent University. The medical records were reviewed, and patients who had liver or renal transplant in the last 10 years and were between 4 and 18 years old were included in the study. The optic disc and peripapillary vascular density parameters were obtained by optical coherence tomography angiography (Avanti RTVue XR). The results were compared with the results from age-matched, sex-matched, and spherical equivalent-matched healthy subjects. Our study included 32 eyes of 16 liver transplant patients, 20 eyes of 10 renal transplant patients, and 64 eyes of 32 healthy participants (control). Whole image peripapillary, inside disc, peripapillary, superior and inferior hemisphere, and superior, inferior, temporal, and nasal quadrant peripapillary vascular densities were evaluated. No statistically significant differences in any parameter were noted between the healthy control group and the patient groups (P > .05 for all parameters). Peripapillary vascular density measurements were not affected in pediatric renal and liver transplant patients.

Joint segmentation of optic cup and optic disc using deep convolutional generative adversarial network

Glaucoma, as one of the three major blinding ophthalmic diseases in the world, is usually accompanied by changes in the structure of the patient’s optic disc, such as optic disc atrophy and depression. Clinical ophthalmologists tend to use the cup-disc ratio as an evaluation index to realize the screening and diagnosis of glaucoma. Therefore, the accurate measurement of optic cup (OC), optic disc (OD) and other parameters is of great clinical significance for early screening of glaucoma. Inspired by game theory, this paper combines deep convolutional neural networks (DCNN) with generative adversarial networks (GAN), and proposes a model for the joint segmentation of OC and OD. Specifically, the generator is composed of a deep convolutional encoder-decoder network to jointly segment the OC and OD, and the discriminator is composed of an eight layer full convolutional neural network. The discrimination results adjust the parameters in the structure of the generator and discriminator network through back propagation to achieve the effect of autonomous learning and optimization of the model. When the proposed network and the existing networks are evaluated on the public dataset Drishti-GS1, the research results demonstrate that the proposed network can achieve a significant improvement in the overall performance.

The correlation of acoustic and morphometric parameters of the optic nerve and anthropometric data in healthy young people

Purpose: to study the correlation between the acoustic and morphometric parameters of the optic nerve (ON) and anthropometric data in healthy young people.Material and methods. The research involved 24 healthy volunteers (48 eyes), including 9 men and 15 women, the average age was 25.0 ± 1.9 years. Anthropometry included measurements of height, weight, and body mass index (BMI). Ultrasound examination of the retrobulbar part of the ON included measurement of the thickness of the ON with and without sheath, echodensitometry of the ON, and ocular biometry. Using optical coherence tomography, we measured the intraocular part of the ON, including the registration of Bruch's membrane opening and ovality index.Results. The average ON thickness with the sheath was 4.6 ± 0.3 mm, and without sheath, 2.6 ± 0.2 mm. In men, ON with the sheath was thicker than in women (p = 0.001). The acoustic density of the parenchyma of the orbital part of ON was 101.2 ± 11.4 r.u. in women, the mean acoustic density of the ON was significantly higher than that in men. Correlation analysis revealed a statistically significant correlation between the height and the thickness of the ON with the sheath (r = 0.480). The strongest reliable correlation was established between the index of the ON thickness and body weight (r = 0.712) and BMI (r = 0.509) (p &lt; 0.05). No statistically significant correlation was found between the morphometric parameters of the optic disc, anthropometry data and acoustic parameters of the ON.Conclusion. Studying the acoustic and morphometric characteristics of the intraocular and intraorbital parts of the ON in healthy young people, which included anthropometric data and gender characteristics, will contribute to the development more accurate diagnostic criteria of ON state evaluations.

Efficacy of Nimodipine Combined with Latanoprost in Treating Open-Angle Glaucoma and Its Influence on Ocular Hemodynamics and Visual Field Defects.

BackgroundOpen-angle glaucoma is a common ophthalmic disease, which has a great impact on the vision of middle-aged and elderly people. Medication plays an important role in the treatment of glaucoma, so finding effective drug treatment is of great significance to improve the quality of life of glaucoma patients.ObjectiveTo explore the curative effect of nimodipine combined with latanoprost in the treatment of open-angle glaucoma and its effect on ocular hemodynamics and visual field defects.MethodsThis study retrospectively analyzed the clinical data of 87 patients with open-angle glaucoma who came to the Shanxi Province Fenyang Hospital and The First Affiliated Hospital of Shanxi Datong University for treatment from January 2019 to January 2021. According to different treatment plans, the patients were divided into two groups: an observation group (n = 46) treated with nimodipine combined with latanoprost, and a control group (n = 41) treated by latanoprost monotherapy. Treatment efficacy, hemodynamics, visual field defects, 24-hour peak intraocular pressure, binocular optic disc parameters, adverse reactions and quality of life were recorded and compared between two groups of patients.ResultsThe overall therapeutic effect of the observation group was significantly better than that in the control group. After treatment, ocular hemodynamics, visual field defects, 24-hour peak intraocular pressure, binocular optic disc parameters and life quality of both groups were obviously improved compared to those before treatment, with more significant improvements in the observation group. In addition, there was no significant difference in the incidence of adverse reactions between the two groups.ConclusionNimodipine combined with latanoprost eye drops is effective in the treatment of primary open-angle glaucoma, which could effectively improve the ocular hemodynamics and visual field defects of patients with fewer adverse reactions and higher safety. Therefore, it can be further promoted and used in clinical practice.

The alterations of retinal vasculature detected on optical coherence tomography angiography associated with chronic obstructive pulmonary disease.

ObjectivesThis study aimed to evaluate the retinal vasculature of the macula and optic disc in patients with chronic obstructive pulmonary disease (COPD) by optical coherence tomography angiography (OCTA).MethodsThe right eyes of 70 COPD patients and 71 healthy individuals were evaluated. These patients had moderate airflow limitation and mean PO2 of 60 mmHg, and their average age was less than 60 years. Superficial and deep capillary plexus vascular densities, foveal avascular zone (FAZ) width, and optic disc parameters were measured with OCTA. In addition, the correlation between the PO2 level in COPD patients and superficial, deep, and peripapillary vascular densities and FAZ was examined in the study.ResultsThe COPD group had a significant decrease in the vascular density in the superficial (fovea [p = 0.019]; parafovea [p = 0.013]; and perifovea [p = 0.001]) and deep capillary plexus (fovea [p = 0.028]; parafovea [p = 0.005]; and perifovea [p = 0.002]). Also, the enlargement of the FAZ (p = 0.002) and a decrease in the peripapillary vascular density (p = 0.006) were observed in the COPD group. There was a positive correlation between PO2 level and superficial, deep, and peripapillary vascular densities in COPD patients and a negative correlation with FAZ (r = 0.559–0.900).ConclusionHypercapnia, respiratory acidosis, and chronic hypoxia associated with COPD may affect the macula and optic nerve, resulting in a serious decrease in vascular density, and OCTA can be a very important tool in the follow‐up and treatment of these patients.

Retinal nerve fiber layer thickness evaluation in iron deficiency anemia patients using optical coherence tomography

Background Anemia is a widespread public health problem. Iron deficiency is the most common cause of anemia. Hemoglobin (Hb) concentration was supposed to affect the retinal nerve fiber layer thickness (RNFLT).Objective The aim of this study was to evaluate the influence of iron deficiency anemia (IDA) on the peripapillary RNFLT using optical coherence tomography (OCT).Patients and methods A total of 30 patients with IDA with Hb less than 12 g/dl were enrolled in the study. Optic disk and RNFL parameters obtained by Topcon OCT in these patients were compared with those of age-matched and sex-matched nonanemic 30 individuals. The anemia group was also divided according to the Hb concentration into three groups: mild, moderate, and severe.Results The average age of the IDA cases and the controls was 23.38±9.06 years (range=15–30 years), and 25.37±7.64 years (range=15–30 years), respectively (P=0.09). The average right eye RNFLT in IDA patients was 98.20±10.98 µm compared with 106.30±14.05 µm in the control group (P=0.001), while in the left eye, it was 98.87±12.24 µm in the IDA group, and 105.30±6.59 µm in the control group (P=0.015). The average nasal and inferior RNFLT of the IDA group were thinner than the control group in the right eye (P=0.003 and 0.045, respectively) and in the left eye (P=0.016 and 0.038, respectively). There was a positive association between average RNFLT and Hb concentration in the right eye (r=0.554) and in the left eye (r=0.561), which was statistically significant (P=0.001). In addition, there was a positive correlation between nasal and inferior RNFLT and Hb concentration in the right eye (P=0.002 and 0.001, respectively) and in the left eye (P=0.001 and 0.002, respectively). The degree of thinning was related to the severity of anemia as the RNFL thinning was significantly more in severe anemia cases than in mild and moderate ones.Conclusions The peripapillary RNFLT measured by OCT was significantly thinner in the IDA patients in the average, inferior, and nasal quadrants, with more thinning in the severe than in mild and moderate groups. This finding may have a significant effect, as these pseudoglaucomatous changes could be misdiagnosed as glaucoma or other neuro-ophthalmological disorders.

Evaluation of Retinal Changes in Varicocele Patients With Optical Coherence Tomography Angiography.

Objective: To evaluate the macula and optic disc in varicocele patients with optical coherence tomography angiography (OCTA).Methods: The right eyes of 30 patients with varicocele and 30 healthy volunteers were evaluated. Superficial and deep capillary plexus vascular densities, foveal avascular zone (FAZ) width, and optic disc parameters were measured with OCTA.Results: There was a significant decrease in vascular density in the superficial and deep capillary plexus in the varicocele group compared to the control group, but no difference was found in FAZ and optic disc parameters.Conclusion: Patients with varicocele have reduced microvascular density in the retina; therefore, it may be beneficial to perform a detailed eye examination with OCTA in these patients.