Short-wavelength Automated Perimetry Research Articles

Short Wavelength Automated Perimetry, Standard Automated Perimetry, and Optical Coherence Tomography in Dominant Optic Atrophy.

Background: Blue-yellow axis dyschromatopsia is well-known in Autosomal Dominant Optic Atrophy (ADOA) patients, but there were no data on the correlation between retinal structure and short-wavelength automated perimetry (SWAP) values in this pathology. Methods: In this cross-sectional case-control study, we assessed the correlation between best corrected visual acuity (BCVA), standard automated perimetry (SAP), SWAP, and optical coherence tomography (OCT) parameters of 9 ADOA patients compared with healthy controls. Correlation analysis was performed between BCVA, mean deviation, pattern standard deviation (PSD), and fovea sensitivity (FS) values and the OCT thickness of each retinal layer and the peripapillary retinal nerve fiber layer (pRNFL). Results: The following significant and strong correlations were found: between BCVA and ganglion cell layer (GCL) and the global (G) pRNFL thicknesses; between SAP FS and GCL and the G-pRNFL thicknesses; between SWAP PSD and total retina, GCL, inner plexiform layer, inner nuclear layer, inner retinal layer and the temporal pRNFL thicknesses. We found a constant shorter duration of the SITA-SWAP compared with the SITA-STANDARD strategy. Conclusions: SWAP, SAP, and BCVA values provided relevant clinical information about retinal involvement in our ADOA patients. The perimetric functional parameters that seemed to correlate better with structure involvement were FS on SAP and PSD on SWAP.

MODERN METHODS FOR DIAGNOSTICS OF GLAUCOMA

Glaucoma is a chronic optical neuropathy characterized by loss of ganglion cells with the development of specific changes in the optic nerve head (ONH) and retinal nerve fiber layer (RNFL). Early detection of the disease plays an important role in preventing the development structural abnormalities and irreversible vision loss. Diagnosis of glaucoma is based on assessing the safety of optic nerve structures and visual functions results clinical examination of the optic disc and RNFL are subjective and vary greatly. In connection with this, research in recent years has been aimed at developing additional objective methods for diagnosing glaucoma. The possibility of using confocal scanning laser ophthalmoscopy, scanning laser perimetry and optical coherence tomography to assess the condition of the optic disc. In order to ensure early detection of visual field defects options are currently being considered replacing standard automated perimetry (SAP) with selective, which includes short-wavelength automated perimetry (SWAP) and perimetry with the illusion of spatial doubling frequencies (frequency-doubling technology perimetry, FDT). The article is an overview modern method for diagnosing glaucoma in the context of their use in clinical practice.

Correlation between standard automated Perimetry, short wavelength Perimetry, and optic coherence tomography parameters in ADOA patients

AbstractPurpose: To assess the correlation between white‐on‐white standard automated perimetry (SAP), short‐wavelength automated perimetry (SWAP), and spectral‐domain optical coherence tomography (SD‐OCT) parameters of patients with Autosomal Dominant Optic Atrophy (ADOA) genetically confirmed by the presence of the OPA1 gene mutation.Methods: In this observational, cross‐sectional study 25 eyes of 13 patients with a genetic diagnosis of ADOA were included. All participants performed 24‐2C SAP and 24‐2C SWAP in a randomized order. They also underwent a “Posterior Pole” and “peripapillary RNFL (pRNFL)” scanning protocol using SD‐OCT. The thickness of the ETDRS sectors of each retinal layer and pRNFL was obtained and measured. Mean deviation (MD), pattern standard deviation (PSD), and fovea sensitivity values were obtained from SAP and SWAP. Correlation analysis was performed to evaluate the association between the mean thickness of each retinal layer and visual field parameters.Results: A moderate correlation was found between SAP MD and RPE thickness on the ETDRS grid. A moderate correlation was found between SWAP MD and whole retina, INL, ORL thicknesses on the ETDRS grid. A strong correlation was found between SWAP PSD and whole retina, GCL, IPL, INL, IRL thicknesses on the ETDRS grid. A strong correlation was also found between SWAP PSD and the temporal sector and PMB values on pRNFL. A strong correlation was found between SAP fovea sensitivity and GCL thickness on the ETDRS grid. A strong correlation was also found between SAP fovea sensitivity and the global pRNFL value.Conclusions: Both SAP and SWAP parameters can provide relevant clinical information on retinal involvement in ADOA patients. The most important function parameters that seem to correlate better with structure involvement were PSD on SWAP and foveal sensitivity on SAP.

Comparing retinal sensitivities on blue-on-yellow and green-on-yellow perimetry in glaucoma suspects.

To compare the retinal sensitivities between the blue-on-yellow perimetry (BYP)/short-wavelength automated perimetry (SWAP) and green-on-yellow perimetry (GYP) among patients with and without nuclear sclerosis among glaucoma suspects. After ophthalmic examination, patients were subjected to two perimetric tests: BYP and GYP. The visual field (VF) parameters were compared between the two perimeters (p < 0.05 was considered significant). Fifty-five eyes of 39 patients with a mean age of 60.53 ± 9.70 years were included in the study. Twenty-one eyes had clear lens or pseudophakia. Twenty-six eyes had lower grades of nuclear sclerosis (NO2NC2, NO3NC3) and eight eyes had higher grades of cataract (NO4NC4, NO5NC5). The mean retinal sensitivity (RS) in BYP was 22.08 ± 5.02 (dB) and in GYP was 23.84 ± 5.50 (dB) (p = 0.08). The mean defect in BYP was -2.56 ± 4.40 (dB) and in GYP was -3.24 ± 5.05 (dB), pattern standard deviation (PSD) in BYP was 3.65 ± 1.91 (dB) and in GYP was 3.83 ± 1.99 (dB), and foveal threshold (FT) was 24.20 ± 4.32 (dB) in BYP and 28.10 ± 4.50 (dB) in GYP. The two perimeters showed good agreement by the Bland-Altman plot for all parameters. Fourteen eyes showed perimetric changes suggestive of glaucoma by BYP. In these, GYP had a sensitivity of 92.86% (95% CI of 66.13% to 99.82%) and specificity of 95.12% (95% CI of 83.47% to 99.40%). BYP and GYP show good agreement. They are comparable in clear media as well as in different grades of nuclear sclerosis. GYP showed good sensitivity and specificity compared to BYP.

SHORT-WAVELENGTH AUTOMATED PERIMETRY IN DIABETIC PATIENTS WITHOUT RETINOPATHY.

To compare the results of short-wavelength automated perimetry (SWAP) in diabetic patients without retinopathy and healthy subjects and show if it is possible to detect an abnormal function of the retina in diabetic patients before vascular changes on the retina develop. Further, the effect of diabetes duration and long-term glycaemic control on the visual field was examined. The study group included 22 patients with diabetes type 1 or 2, without any signs of retinopathy. The control group consisted of 21 healthy subjects. Short-wavelength automated perimetry was performed on the Humphrey Field Analyzer (HFA 860, Carl Zeiss Meditec), SITA SWAP, 24-2 test. In diabetic patients, the duration of diabetes and the level of glycohemoglobin (HbA1c) was registered. The visual field indices MD (mean deviation) and PSD (pattern standard deviation) were compared between both groups by the Mann-Whitney test. The correlation between the visual field indices, HbA1c and duration of diabetes was assessed by the Spearman correlation coefficient. The mean value of MD in the study and control group was -3.64±3.66 dB and -1.48±2.12 dB respectively, the values in the study group were significantly lower (p &lt; 0.05). Mean PSD in the study group was 2.92±1.04 dB and 2.23±0.33 dB in the control group, again the difference was statistically significant (p &lt; 0.05). Patients in the study group suffered from diabetes for 17±9.4 years in average. The mean value of HbA1c in the study group was 60.64±16.63 mmol/mol. A significant correlation was found only for PSD and HbA1c (p &gt; 0.05). The duration of diabetes had no effect on either of the visual field indices. Short-wavelength sensitivity of retina seems to be affected in diabetic patients without clinically significant retinopathy suggesting a neuroretinal impairment at early stages of the retinopathy. We found no association between the visual field and the control or duration of diabetes.

Influence of ACPA-positive rheumatoid arthritis on visual field testing in patients with arterial hypertension: A comparative cross-sectional study.

PurposeTo evaluate a possible influence of anti‐cyclic citrullinated peptide autoantibodies (ACPA) ‐ positive rheumatoid arthritis (RA) on visual field (VF) testing in patients with arterial hypertension (aHT).MethodsWe conducted an observational cross‐sectional study comparing patients with ACPA‐positive RA and aHT, patients with aHT and healthy subjects. Further inclusion criteria were visual acuity (VA) of 0.8 or better and age between 40 and 60 years. VF testing was performed with standard automated achromatic perimetry (SAP), short wavelength automated perimetry (SWAP) (Octopus 300®) and flicker perimetry (Pulsar®). Results were analysed for a possible correlation with blood pressure or RA‐activity.ResultsTwenty subjects with RA and aHT, 26 patients with aHT and 22 healthy participants were examined. Significant differences were found for mean sensitivity (MS) in SWAP comparing RA‐patients with healthy participants (ΔMS −3.06, p = 0.001) and with hypertensive patients (ΔMS −2.32, p = 0.007). In SAP we observed a significant difference between patients with RA and healthy subjects regarding loss variance (LV) (ΔLV = +9.77, p = 0.004). Flicker perimetry did not demonstrate significant differences between groups. A correlation of VF changes with blood pressure level or RA‐activity was not observed.ConclusionPatients with ACPA‐positive RA and aHT showed significant impairment of VF performance in SWAP compared to patients with aHT alone and healthy subjects. SAP also revealed a significant difference of LV between RA‐patients and healthy subjects. aHT does not seem to induce functional changes in VF testing alone.

Cerebral trauma-induced dyschromatopsia in the left hemifield: case presentation

BackgroundAcquired color anomalies caused by cerebral trauma are classified as either achromatopsias or dyschromatopsias (Zeki, Brain 113:1721–1777, 1990). The three main brain regions stimulated by color are V1, the lingual gyrus, which was designated as human V4 (hV4), and the fusiform gyrus, designated as V4α. (Zeki, Brain 113:1721–1777, 1990). An acquired cerebral color anomaly is often accompanied by visual field loss (hemi- and quadrantanopia), facial agnosia, prosopagnosia, visual agnosia, and anosognosia depending on the underlying pathology (Bartels and Zeki, Eur J Neurosci 12:172–193, 2000), (Meadows, Brain 97:615–632, 1974), (Pearman et al., Ann Neurol 5:253–261, 1979). The purpose of this study was to determine the characteristics of a patient who developed dyschromatopsia following a traumatic injury to her brain.Case presentationThe patient was a 24-year-old woman who had a contusion to her right anterior temporal lobe. After the injury, she noticed color distortion and that blue objects appeared green in the left half of the visual field. Although conventional color vision tests did not detect any color vision abnormalities, short wavelength automated perimetry (SWAP) showed a decrease in sensitivity consistent with a left hemi-dyschromatopsia. Magnetic resonance imaging (MRI) detected abnormalities in the right fusiform gyrus, a part of the anterior temporal lobe. At follow-up 14 months later, subjective symptoms had disappeared, but the SWAP abnormalities persisted and a thinning of the sectorial ganglion cell complex (GCC) was detected.ConclusionThe results indicate that although the subjective symptoms resolved early, a reduced sensitivity of SWAP remained and the optical coherence tomography (OCT) showed GCC thinning. We conclude that local abnormalities in the anterior section of fusiform gyrus can cause mild cerebral dyschromatopsia without other symptoms. These findings indicate that it is important to listen to the symptoms of the patient and perform appropriate tests including the SWAP and OCT at the early stage to objectively prove the presence of acquired cerebral color anomaly.

Comparison of diagnostic ability of standard automated perimetry, short wavelength automated perimetry, retinal nerve fiber layer thickness analysis and ganglion cell layer thickness analysis in early detection of glaucoma.

Purpose:The aim of this study was to compare the diagnostic ability of macular ganglion cell layer (GCL) analysis using spectral domain optical coherence tomography against retinal nerve fiber layer analysis (RNFL), short-wavelength automated perimetry (SWAP), and standard automated perimetry (SAP) in early detection of glaucoma.Methods:Participants fulfilling the inclusion criteria were consecutively enrolled from the glaucoma clinic of tertiary care eye hospital in Western India from November 2015 to October 2016. The subjects underwent a detailed evaluation by trained glaucoma specialists. On suspicion of glaucoma, the patients underwent SAP, SWAP, and SD-OCT for GCL and RNFL analysis.Results:There were 91 patients in total of which experts classified 54 eyes into GON and 37 eyes into nonglaucomatous group. Sensitivity of SAP (42.59%) was significantly lower (P < 0.05) than that of average GCL thickness (79.63%) and average RNFL thickness (72.22%). Specificity and positive LR of SWAP (97.3% and 19.19, respectively) and SAP (94.6% and 7.88, respectively) were greater than those of GCL (81.08% and 4.21) and RNFL (67.57% and 2.23) parameters. Negative LR of average GCL thickness (0.25) was superior to that of average RNFL thickness (0.411), SWAP (0.495), and SAP (0.607).Conclusion:Macular GCL parameters perform better than RNFL parameters in patients with early glaucomatous damage. There is superior ability of SWAP over SAP in detecting glaucomatous changes in glaucoma suspect group. GCL thickness analysis has higher sensitivity and negative likelihood ratio, whereas SWAP had higher specificity and positive likelihood ratio. Thus, combining both tests can lead to better diagnostic ability for early glaucomatous damage.

Correlation of SWAP (short wavelength automated perimetry) with OCT (optical coherence tomography in pre perimetric glaucoma

Purpose: To find out correlation of swap and OCT in preperimetric glaucoma patient coming to Dhiraj general hospital. Materials and Methods: A complete ophthalmological examination will be done including uncorrected and best corrected visual acuity, slit lamp examination, central corneal thickness measurement by pachymetry, applanation tonometry, gonioscopy and dilated fundus examination and Humphrey perimetry followed by SWAP and FDT. Result: In the present study a total of 50 patients were screened. Out of this 22 patients had a CDR of 0.5 with healthy neuro-retinal rim (HNRR) in both the eyes. One patient had 0.5 CDR with inferior thinning in both the eyes. 8 patients had a CDR of 0.6 with HNRR and 1 had 0.6 CDR with inferior thinning. 2 patients had a large cup to disc ratio of 0.7 CDR but the neuro retinal rim on clinical examination appeared to be healthy. 14 patients had a large cup to disc ratio of 0.7 in both the eyes. Out of this 8 had inferior thinning of the neuro-retinal rim and 6 had superior thinning of the neuro retinal rim. 2 patients included in this study had 0.8 CDR with one having superior thinning and one having inferior thinning of the neuro retinal rim. The accuracy of OCT in detecting even the smallest nerve fiber layer defect was much higher than seen on SWAP. About 52% showed normal OCT as compared to perimetry group which was 60% and about 48% of patients showed affected nerve fiber layer thinning as compared to perimetry where visual field changes were 40%. Conclusion: In this study it was concluded that SD-OCT is better in detection very early stages of glaucoma where SAP or SWAP modality of perimetry does not detect. The sensitivity of OCT is much higher than perimetry and can help in detecting the suspects of glaucoma. Patients at with high risk (family history, smokers, large cup to disc ratio etc) should be screen for both OCT and SWAP. This will help us for manage patients better as they will be detected at a very early stage. Key

Short wavelength automated perimetry and standard automated perimetry in central serous chorioretinopathy

Short wavelength automated perimetry (SWAP) is known for detecting the early reduction of retinal sensitivity (RS) in glaucoma. It’s application in retinal diseases have also been discussed previously. We investigated the difference in RS measured between standard white-on-white automated perimetry (WW) and blue-on-yellow SWAP in central serous chorioretinopathy (CSC). The overall RS (W-RS, S-RS) as well as the RS inside and outside of the serous retinal detachment (SRD) region were investigated in 26 eyes of 26 CSC patients using WW and SWAP. The central retinal thickness, central choroidal thickness, SRD area (SRDa), and SRD height at the fovea were measured using optic coherence tomography. RS inside the SRD region was lower than that of outside for both perimetries (both p < 0.001). The difference between RS inside and outside of the SRD region was greater in SWAP compared to WW (p < 0.001). Univariate analysis revealed significant correlations between SRDa and both W-RS and S-RS (both p < 0.001); moreover, multivariate analysis indicated that only S-RS was selected as the optimal model for SRDa. Our study demonstrated that SWAP was detected the decrease in RS more accurately than WW in CSC. These results may suggest the usefulness of SWAP for detecting change of retinal function in CSC.

Blue-yellow deficiencies in young moderate smokers

PurposeTo evaluate whether tobacco affects color vision in young moderate smokers. MethodsChromatic mechanisms of 13 moderate smokers (10–20 cigarettes/day and at least 5 years smoking) and 17 non-smokers in the 18–35 age range were assessed with the Farnsworth-Munsell 100-hue (FM100h) test and short wavelength automated perimetry (SWAP). ResultsFM100h Total Error Scores (TES) were higher for smokers, and although differences were not significant (p = 0.14), a linear model with principal component analysis was able to explain 95% of the variance in TES and red-green partial error scores, though not in blue-yellow partial error scores (p = 0.07), using the number of years as smokers and the number of cigarettes/day as predictors. SWAP sensitivity values were globally worse (p = 0.002) for smokers (25.7 + 6.2 dB) than for non-smokers (26.7 + 6.2 dB). In the upper visual hemifield sensitivity, total deviation and pattern deviation values were worse for smokers (p < 0.001). Differences in mean defect and pattern standard deviation were not significant (p > 0.05 in both cases). The number of out-of-limits points in the total difference and pattern difference map were significantly larger for smokers. After correcting for multiple comparisons, only the differences in the upper visual hemifield were significant. ConclusionsThis pilot study suggests that even young moderate smokers show small sensitivity loss in the blue-yellow mechanism, it is statistically significant, restricted to the upper visual hemifield. This corresponds to a retinal region where literature reports a lower density of retinal ganglion cells and where, therefore, the chromatic mechanisms would be more fragile.

Characteristics of Normal-tension Glaucoma Patients with Temporal Retinal Nerve Fibre Defects

Glaucomatous visual field (VF) damage usually involves in the Bjerrum area, which refers to outside the central 10° region. However, some reports suggest that structural damage to the macula occurs even in the early stages of glaucoma. We investigated the characteristics of normal tension glaucoma (NTG) patients with temporal retinal nerve fibre layer (RNFL) defects. Ninety eyes from 90 subjects including 30 normal eyes, 30 eyes of 30 patients with normal-tension glaucoma with temporal RNFL defects, and 30 eyes of 30 patients with normal-tension glaucoma with inferotemporal or superotemporal RNFL defects were enrolled. The best-corrected visual acuity (BCVA) decreased significantly in glaucomatous eyes with temporal RNFL defects as compared with in controls and glaucomatous eyes with inferotemporal or superotemporal RNFL defects. VF tests showed more frequent central or cecocentral VF defects involving the central 10° region in glaucomatous eyes with temporal RNFL defects. VF defects were more frequently detected on short-wavelength automated perimetry (SWAP). Eyes with temporal RNFL defects had generally reduced ganglion cell-inner plexiform layer (GCIPL) thickness. In addition, the BCVA, GCIPL thicknesses, and SWAP findings were significantly different in glaucoma patients with temporal RNFL defects according to their colour vision deficiency, not RNFL thickness or standard automated perimetry (SAP) results.

Long-term Effect of Continuous Positive Air Pressure Therapy on Intraocular Pressure in Patients with Primary Open-angle Glaucoma with Obstructive Sleep Apnea.

ABSTRACTPurposePrevalence of glaucoma is higher in obstructive sleep apnea (OSA) patients. The gold standard technique to treat OSA is continuous positive airway pressure (CPAP) therapy. The influence of long-term CPAP therapy on intraocular pressure (IOP), blood pressure, ocular perfusion pressure (OPP), and glaucoma progression in primary open-angle glaucoma (POAG) patients was evaluated.DesignProspective study.Materials and methodsIn this study, we enrolled 12 eyes from six POAG patients aged >35 years, with newly diagnosed OSA and with indication for CPAP therapy. The CPAP was performed for 12 months. We monitored the IOP every 3 months. Visual field was determined at baseline and 12 months.ResultsThe mean IOP after CPAP therapy for 12 months was significantly higher than the mean baseline IOP (average IOP 3 months before CPAP therapy) (19.08 ± 3.47 vs 17.83 ± 2.88 mm Hg; p = 0.006). The IOP rising rate was 0.69 ± 0.47/years (p = 0.138) before CPAP therapy and increased to 1.13 ± 0.47/years (p = 0.016) after CPAP therapy. The OPP after 12 months of CPAP was significantly lower than the baseline (42.21 ± 5.29 vs 45.24 ± 7.09 mm Hg; p = 0.06). Results showed that the pattern standard deviation (PSD) value of 24-2 short wavelength automated perimetry (SWAP) visual field was reduced from 5.34 ± 3.92 to 4.77 ± 3.73 (p = 0.025). Antiglaucoma medication was administered to a patient due to increased IOP without glaucoma progression evidence.ConclusionThe POAG and OSA patients demonstrated significant IOP rising after CPAP therapy but did not show progression of glaucomatous damage. Mean deviation (MD), PSD, and visual field index (VFI) were not significantly different after CPAP therapy.PrécisProspective study of POAG and OSA patients demonstrated significant IOP rising after CPAP therapy for a year. The study did not show progression of glaucomatous damage.How to cite this articleHirunpatravong P, Kasemsup T, Ayudhya WN, et al. Long-term Effect of Continuous Positive Air Pressure Therapy on Intraocular Pressure in Patients with Primary Open-angle Glaucoma with Obstructive Sleep Apnea. J Curr Glaucoma Pract 2019;13(3):94–98.

Disorganization of Retinal Inner Layers (DRIL) and Neuroretinal Dysfunction in Early Diabetic Retinopathy.

PurposeTo elucidate the relationship between disorganization of retinal inner layers (DRILs) and retinal function in diabetic patients without diabetic retinopathy (DR) and with nonproliferative DR, but without diabetic macular edema (DME).MethodsFifty-seven participants with diabetes mellitus (DM) and 18 healthy controls underwent comprehensive ophthalmic examination, fundus photography, and spectral-domain optical coherence tomography. Scans of the fovea were evaluated for the presence of DRIL. Retinal function was evaluated using Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity, the quick contrast sensitivity function (qCSF) on the AST Sentio Platform, short-wavelength automated perimetry (SWAP), standard automated perimetry (SAP), and frequency doubling perimetry (FDP). ANOVA and Kruskal-Wallis were used to compare retinal function in subjects with and without DRIL. Tukey-Kramer test and Wilcoxon were used for post hoc analysis.ResultsDRIL was identified in 9 of 57 diabetic subjects. DRIL subjects had higher body mass index and longer diabetes duration compared to diabetic subjects without DRIL (P = 0.03 and P = 0.009, respectively). Subjects with DRIL had reduced ETDRS visual acuity (P = 0.003), contrast sensitivity function (P = 0.0003), and SAP performance (PSD, P < 0.0001) compared to controls and diabetic subjects without DRIL. Structural analysis revealed inner retinal thinning, and some outer retinal thinning, associated with DRIL.ConclusionsDiabetic subjects with DRIL have reduced retinal function compared to those without DRIL, and defective retinal lamination may be an early cellular consequence of diabetes responsible for this in some patients. Following further longitudinal studies, DRIL may be a readily available and reliable structural biomarker for reduced retinal function in early diabetic neuroretinal disease.

No blue-yellow color vision impairment after acute ethanol ingestion.

Several studies showed that chronic ethanol exposure can cause color vision deficiencies. There has been no agreement about the axis of color defects due to alcohol misuse since changes in the red-green and the blue-yellow axis have been described in literature. The acute influence of alcohol on the blue-yellow color vision has not been studied as well. The aim of this study was to determine the effect of acute alcohol ingestion on blue-yellow color vision by using short wavelength automated perimetry (SWAP) and anomaloscopy with the Moreland equation. This is the first study evaluating that question by using SWAP and anomaloscopy. Sixteen healthy subjects without a history of alcohol-related and ophthalmological problems were examined by SWAP and anomaloscopy (Moreland equation) before and after alcohol ingestion. Mean sensitivity (MS), mean deviation (MD), loss of variance (LV), reliability factor (RF), and duration of examination were assessed for perimetry and match midpoint (MP), matching range (MR), and duration of examination for anomaloscopy. Blood alcohol concentrations (BAC) were determined by gas chromatography and phosphatidylethanol concentrations (marker of an alcohol misuse) by liquid-chromatography tandem-mass spectrometry in venous blood samples from a cubital vein. Mean blood BAC was 0.86±0.20g/kg while performing perimetry and 0.84±0.20g/kg while performing anomaloscopy (BAC: 0.1g/kg≈0.01g/dL). MS, MD, RF, MP, MR, and duration of perimetry examination were not altered significantly after alcohol intake. LV showed a significant increase. The duration of anomaloscope testing was shortened significantly under the influence of alcohol. The subjects also revealed a significantly narrower matching range after alcohol intake. In the range of 0.8g/kg BAC, no blue-yellow vision deficiencies could be demonstrated. In further studies, the effect of higher BAC on blue-yellow vision should be investigated by different methods.

Multidimensional Functional and Structural Evaluation Reveals Neuroretinal Impairment in Early Diabetic Retinopathy.

PurposeTo test whether quantitative functional tests and optical coherence tomography (OCT)-defined structure can serve as effective tools to diagnose and monitor early diabetic neuroretinal disease.MethodsFifty-seven subjects with diabetes (23 without diabetic retinopathy [no DR], 19 with mild nonproliferative diabetic retinopathy [mild NPDR], 15 with moderate to severe [moderate NPDR]), and 18 controls underwent full ophthalmic examination, fundus photography, spectral-domain optical coherence tomography (SD-OCT), e-ETDRS (Early Treatment Diabetic Retinopathy Study) acuity, and the quick contrast sensitivity function (qCSF) method. Perimetry testing included short-wavelength automated perimetry (SWAP), standard automated perimetry (SAP), frequency doubling perimetry (FDP), and rarebit perimetry (RBP).ResultsETDRS acuity and RBP were not sensitive for functional differences among subjects with diabetes. AULCSF, a metric of qCSF, was reduced in diabetics with moderate compared to mild NPDR (P = 0.03), and in subjects with no DR compared to controls (P = 0.04). SWAP and SAP mean deviation (MD) and foveal threshold (FT) were reduced in moderate compared to mild NPDR (SWAP, MD P = 0.002, FT P = 0.0006; SAP, MD P = 0.02, FT P = 0.007). FDP 10-2 showed reduced MD in moderate compared to mild NPDR (P = 0.02), and FDP 24-2 revealed reduced pattern standard deviation (PSD) in mild NPDR compared to no DR (P = 0.02). Structural analysis revealed thinning of the ganglion cell layer and inner plexiform layer (GCL+IPL) of moderate NPDR subjects compared to controls. The thinner GCL+IPL correlated with impaired retinal function.ConclusionsThis multimodal testing analysis reveals insights into disruption of the neuroretina in diabetes and may accelerate the testing of novel therapies.

Psychophysical assessment of koniocellular pathway in patients with schizophrenia versus healthy controls

This study was designed to perform psychophysical assessment of koniocellular pathway in patients with schizophrenia versus healthy controls. A total of 26 patients diagnosed with schizophrenia and 15 healthy controls were included. Snellen Visual Acuity Chart scores and Short Wavelength Automated Perimetry (SWAP) visual field testing including global visual field indices [mean deviation (MD), pattern standard deviation (PSD), test time (min)], reliability parameters [false negative responses (%), false positive responses (%) and fixed losses (%)] and average threshold sensitivity [central (parafovea), peripheral area, and four quadrants] were recorded in both groups. Significantly lower MD scores, higher PSD scores and lower average threshold sensitivity at each location across the visual field were noted in schizophrenia relative to control group. In conclusion, our findings revealed a deficit in koniocellular pathway with impaired SWAP global indices and lower threshold sensitivity at each location across the visual field among chronic schizophrenic patients as compared with control subjects. Our findings emphasize potential application of SWAP outside its original intended purpose as a glaucoma test, to provide deeper understanding of the specific contribution of lateral geniculate nucleus to the visual and cognitive disturbances of schizophrenia.

The Relation of White-on-White Standard Automated Perimetry, Short Wavelength Perimetry, and Optic Coherence Tomography Parameters in Ocular Hypertension.

The purpose of this study is to examine the demographics, clinical properties, and the relation between white-on-white standard automated perimetry (SAP), short wavelength automated perimetry (SWAP), and optical coherence tomographic (OCT) parameters of patients with ocular hypertension. Sixty-one eyes of 61 patients diagnosed with ocular hypertension in the Ankara Numune Education and Research Hospital ophthalmology unit between January 2010 and January 2011 were included in this study. All patients underwent SAP and SWAP tests with the Humphrey visual field analyser using the 30.2 full-threshold test. Retinal nerve fiber layers (RNFL) and optic nerve heads of patients were evaluated with Stratus OCT. Positive correlation was detected between SAP pattern standard deviation value and average intraocular pressure (P=0.017), maximum intraocular pressure (P=0.009), and vertical cup to disc (C/D) ratio (P=0.009). Positive correlation between SWAP median deviation value with inferior (P=0.032), nasal (P=0.005), 6 o'clock quadrant RNFL thickness (P=0.028), and Imax/Tavg ratio (P=0.023) and negative correlation with Smax/Navg ratio (P=0.005) were detected. There was no correlation between central corneal thickness and peripapillary RNFL thicknesses (P>0.05). There was no relation between SAP median deviation, pattern standard deviation values and RNFL thicknesses and optic disc parameters of the OCT. By contrast significant correlation between several SWAP parameters and OCT parameters were detected. SWAP appeared to outperform achromatic SAP when the same 30-2 method was used.

POOR PROGNOSTIC FACTORS IN PATIENTS WITH BIRDSHOT RETINOCHOROIDOPATHY.

To identify prognostic factors for poor visual outcome in patients with birdshot retinochoroidopathy. A case-control study of 98 patients with birdshot retinochoroidopathy (196 eyes) was evaluated with a follow-up period of at least 12 months. After exclusion of glaucoma, optic atrophy, and macular scar, the remaining eligible patients were categorized into two groups: poor visual outcomes and good visual outcomes. Poor visual outcome was defined as less than -6 mean deviation score on Swedish interactive threshold algorithm (SITA) short-wavelength automated perimetry (SWAP) test and abnormality (amplitude or implicit time) of 30 Hz flicker electroretinogram at 4-year follow-up and at the most recent visit for separate analysis. Potential factors between both groups were statistically analyzed by Chi-square test and logistic regression model. After the aforementioned exclusion, the remaining 77 patients with an average follow-up period of 52 ± 29 months (335 person-years, 36% with follow-up of more than 5 years) were divided into two groups. Sixteen patients were categorized as having poor visual outcome. Univariate analysis identified significant association of abnormal 30 Hz flicker electroretinogram amplitude (P = 0.004), implicit time (P = 0.002), and SITA SWAP mean deviation at the initial visit (P < 0.001) in the poor visual outcome group. Multivariate logistic regression analysis identified only SITA SWAP mean deviation to be associated with poor visual outcome (adjusted odds ratio, 32.50; 95% confidence interval [3.84-275.32]; P = 0.001) at the initial visit. To verify the model validity, an analysis of 42 patients at 4-year follow-up was performed and the outcome was confirmed (adjusted odds ratio, 8.80; 95% confidence interval [1.58-49.16]; P = 0.013). Worse SITA SWAP mean deviation at the initial visit is a predictor of poor visual outcome in patients with birdshot retinochoroidopathy, and may serve as a proxy marker for delayed effective steroid sparing therapy in patients with birdshot retinochoroidopathy.

Baseline factors predicting the risk of conversion from ocular hypertension to primary open-angle glaucoma during a 10-year follow-up.

PurposeTo evaluate the ability of baseline clinical, morphological, and functional factors to predict the conversion to primary open-angle glaucoma (POAG) in ocular hypertensive (OHT) patients.MethodsThis single-center prospective longitudinal observational study included 116 eyes of 116 OHT patients followed for a 10-year period. All patients had intraocular pressure (IOP) ≥24 mm Hg in one eye and >21 mm Hg in the other eye, normal visual fields (VFs) and normal optic disc (OD) appearance in both eyes at baseline. All OHT patients were untreated at baseline with subsequent treatment upon need according to clinical judgement. Only one eye per subject was randomly selected. Patient age, gender, IOP, central corneal thickness (CCT), and ibopamine test results were collected at baseline. All patients underwent standard automated perimetry, short-wavelength automated perimetry (SWAP), frequency-doubling technology, confocal scanning laser ophthalmoscopy (CSLO), and scanning laser polarimetry (SLP) at baseline and every 6 months thereafter. Main outcome measure was the conversion to POAG, defined as the development of reproducible VF and/or OD abnormalities attributable to glaucoma. Cox proportional hazards models were used to identify the baseline factors predictive of POAG conversion.ResultsDuring the 10-year follow-up, 25% of eyes converted to POAG. In multivariate Cox models, baseline factors that were significant predictors of POAG development included: older age (hazard ratio (HR) 1.0, 99% confidence intervals (CIs) 1.0-1.2, per 1 year older); SWAP Glaucoma Hemifield test 'outside normal limits' (HR 4.3, 99% CIs 1.2-17.9); greater SLP 'Inter-eye Symmetry' (HR 1.1, 99% CIs 0.4-3.0, per 1 unit lower); lower CSLO Rim Volume (HR 1.1, 99% CIs 0.3-3.2, per 0.1 mm(3) lower); and greater CSLO cup-to-disc ratio (HR 6.0, 99% CIs 3.6-16.8, per 0.1 unit greater).ConclusionsThe baseline parameters that proved to be useful in assessing the likelihood of an OHT patient to develop POAG included age, functional variables provided by SWAP, and structural variables provided by SLP and CSLO. In this cohort of patients, baseline IOP, CCT, and ibopamine provocative test results were not significant predictors of POAG conversion.