Pattern Standard Deviation Values Research Articles

Evaluation of lamina cribrosa curvature index in different types of glaucoma.

The aim of this study was to evaluate the lamina cribrosa curvature index in different types of glaucoma in comparison with clinical findings and conventional measurement methods. Patients older than 18years who were followed up in Glaucoma Unit of Department of Ophthalmology at Fırat University Faculty of Medicine, whose disease had been under control at least for 1year, who had at least three reliable visual fields, whose refractive error was between - 6 and + 5 diopter and who did not have any disease other than glaucoma that would affect the visual field, were included in the study. Clinical and demographic characteristics, visual field, optical coherence tomography and lamina cribrosa curvature index (LCCI) results were evaluated. The study patients were divided into six groups: early-stage primary open-angle glaucoma (POAG) as group 1 and intermediate-advanced stage POAG as group 2, pseudo-exfoliation glaucoma (PEXG) as group 3, normal tension glaucoma (NTG) as group 4, ocular hypertension patients whom subsequently developed POAG as group 5 and healthy control as group 6. A total of 189 eyes of 101 patients were included in our study. Forty-seven patients were male (46.5%) and 54 were female (53.5%). The mean age was 62.43 ± 1.49years. LCCI, mean deviation (MD), visual field index (VFI), pattern standard deviation (PSD) and retinal nerve fiber layer thickness (RNFL) values were analyzed in all groups and Pearson correlation analysis showed statistically significant correlation between PSD and RNFL measurements with LCCI values in all groups. MD value was correlated with LCCI in groups 2, 3 and 4, while VFI value was correlated with LCCI in all groups except group 5. When the groups were compared with each other according to the Post-Hoc Tamhane test, LCCI measurement showed statistically significant results in accordance with MD, VFI, PSD and RNFL values. The LCCI assessment is mostly consistent with conventional tests. In this study, in which different types of glaucoma and healthy subjects were examined simultaneously, LCCI shows promise as a detailed and reliable assessment method.

Evaluation of effect of covıd-19 pandemic on anatomical and functional changes and vision-related quality of life in patients with glaucoma

BackgroundTo evaluate anatomical and functional changes and vision-related quality of life in patients whose glaucoma follow-up was disrupted by the COVID-19 restrictions. MethodsThis retrospective observational study included 100 patients who were followed up at the glaucoma unit. For the patients whose follow-up evaluations were postponed due to COVID-19 restrictions, visual acuity (VA), intraocular pressure (IOP), retinal nerve fiber layer (RNFL) thickness, visual field parameters [mean deviation (MD), pattern standard deviation (PSD), and visual field index (VFI)], and the National Institute of Ophthalmology Visual Function Scale-25 (NEI-VFQ-25) score were evaluated based on the measurements performed at the last visit before COVID-19 (V1) and at the first visit after the removal of COVID-19 restrictions (V2). ResultsThe mean age of the patients was 61.1 ± 13.4 years, the mean follow-up time was 11.4 ± 4.2 months, and the mean interval between the last two visits was 7.2 ± 2.7 months. In the evaluation of the last two visits, VA was lower and IOP was higher at V2, and there was progression in the MD, PSD, and VFI values (p<0.05, for all). RNFL thickness progression was seen in 13–23% of the patients. According to the NEI-VFQ-25 evaluation, except for peripheral vision and near vision, all the remaining subscale scores and the total score were lower at V2 (p<0.05, for all). ConclusionsThis study demonstrates the devastating impact of the COVID-19 pandemic on the anatomical and functional changes and vision-related quality of life together in patients with glaucoma.

Comparative Analysis of 10-2 Test on Advanced Vision Analyzer and Humphrey Perimeter in Glaucoma.

To evaluate diagnostic precision and prove equivalence of 2 devices, Advanced vision analyzer (AVA, Elisar Vision Technology) and Humphrey field analyzer (HFA, Zeiss) for the detection of glaucoma on 10-2 program. Prospective, cross-sectional, observational study. Threshold estimates of 1 eye each of 66 patients with glaucoma, 36 control participants, and 10 glaucoma suspects were analyzed on 10-2 test with AVA and HFA. Mean sensitivity (MS) values of 68 points and central 16 test points were calculated and compared. Intraclass correlation (ICC), Bland-Altman (BA) plots, linear regression of MS, mean deviation (MD), and pattern standard deviation (PSD) were computed to assess the 10-2 threshold estimate of the devices. Receiver operating characteristic curves were generated for MS and MD values, and the area under the curve (AUC) was compared with assessing diagnostic precision. Mean sensitivity values of 68 points and central 16 points, AUC for MS and MD values, ICC values, BA plots, and linear-regression analysis. Bland-Altman plot showed significant correlation for MS, MD, and PSD values for both devices. For MS, the overall ICC value was 0.96 (P < 0.001) with a mean bias of 0.0 dB and limits of agreement range of 7.59. The difference in MS values between both devices was-0.4760 ± 1.95 (P > 0.05). The AUC for MS values for AVA was 0.89 and for HFA was 0.92 (P= 0.188); whereas it was similar at 0.88 for MD values (P= 0.799). Advanced vision analyzer and HFA identically discriminated between healthy and patients with glaucoma (P < 0.001), although HFA denoted marginally greater ability (P > 0.05). Statistical results denote adequate equivalence between AVA and HFA because threshold estimates of AVA strongly correlate with HFA for 10-2 program. Proprietary or commercial disclosure may be found after the references.

Corneal Ectasia detection by epithelium pattern standard deviation from optical coherence tomography.

To test the ability of the corneal epithelial pattern standard deviation to distinguish between normal and cases with corneal ectatic condition. Instituto de Olhos Renato Ambrósio, Rio de janeiro, Brazil. Cross-sectional retrospective study. Patients were stratified into four groups based on clinical data and. (Groups 1 and 2 comprised one eye randomly selected from 105 patients with normal corneas (N) and 86 patients with bilateral keratoconus (KC). Groups 3 and 4, respectively comprised 11 ectatic eyes with no surgical treatment for keratoconus (VAE-E) from patients whose fellow eyes (61) presented with normal topographic patterns (VAE-NT). Corneas were scanned using an OCT system (RT Vue) and Scheimpflug corneal tomography (Pentacam), and also had biomechanical assessment through the Corvis ST. Corneal epithelial thickness maps were analyzed and the pattern standard deviation (PSD) value was calculated. The area under the ROC curve analysis was used to evaluate the diagnostic accuracy of the indices. Epithelial PSD was significantly different across the four groups (p<0.0001). The pairwise comparison revealed that the normal group presented significantly lower values than both ectasia groups (KC and VAE-E, p<0.0001) and the VAE-NT group (p=0.0008). There was no significant difference between KC and VAE-E (p=0.4284), while they were significantly higher than the VAE-NT group (p<0.0001 and p=0.0004). Epithelial PSD can be used to detect abnormal epithelial thickness patterns. Corneal epithelial thickness changes could be detected accurately in keratoconus patients, even in the form fruste of the disease.

Ocular pulse amplitude and visual field changes in patients diagnosed with aortic regurgitation.

To examine whether there is a relationship between ocular pulse amplitude (OPA), intraocular pressure (IOP), and visual field (VF) deterioration among the patients diagnosed with aortic regurgitation (AR). Twenty-nine patients (average age of 62.06 ± 13.27years) with AR diagnosis without glaucoma history as AR group and 32 healthy participants (average age 63.81 ± 6.42years) as control group were included in the study. Routine ophthalmologic examination including VF test [mean deviation (MD), pattern standard deviation (PSD) and VF index (VFI) values were recorded], diurnal IOP and OPA measurements with Pascal dynamic contour tonometry (DCT) was conducted on the patients. VF deficits were classified by Glaucoma Staging System 2 (GSS 2) score. Sixteen (50.0%) of 32 healthy subjects and 14 (48.3%) of 29 AR patients were female (p = 1.000). The measurement conducted at 15:30 among the diurnal IOP measurements performed with the Pascal DCT was found to be statistically significantly higher in the AR group (p = 0.009). While the MD and PSD values of the group diagnosed with AR were determined to be statistically significantly high, the VFI value was found to be significantly low. When the healthy cases and the patients diagnosed with AR were compared, it was observed that there was a statistically significant positive correlation in terms of the significant GSS 2 stage (p < 0.001). Although there was no significant increase in IOP, VF deficits were detected in patients with AR. These VF pathologies may be due to the ocular perfusion disorder in AR. However, additional comprehensive studies that also examine perfusion are needed to further confirm this.

Optical Coherence Tomography Angiography Findings in Primary Open-Angle and Pseudoexfoliation Glaucoma.

Objectives:To compare the optical disc and macular vascular density values of patients with glaucoma and healthy individuals by using optical coherence tomography angiography and evaluate the relationship between structural and functional test results and vascular density.Materials and Methods:The study included 128 eyes in total: 31 with pseudoexfoliation glaucoma (PEG), 55 with primary open-angle glaucoma (POAG) and similar visual field defects, and 42 healthy eyes. Whole image peripapillary vessel density (wpVD), intradisc vessel density (idVD), peripapillary vessel density (pVD), whole image macular vessel density (wmVD), and parafoveal vessel density (pfVD) values were compared between the groups. Correlations between visual field findings, retinal nerve fiber layer (RNFL) and optic nerve head measurements and peripapillary and macular vascular density were analyzed.Results:In the PEG and POAG groups, wpVD, idVD, wmVD, and pfVD values were significantly lower in than the control group. In the PEG group, wpVD was found to be significantly lower than the POAG group (p<0.001). There was no significant difference between the PEG and POAG groups in wmVD and pfVD except for nasal pfVD. There were strong positive correlations between RNFL thickness and pVD in the glaucoma groups (p<0.001). Significant correlations were found between visual field mean deviation and pattern standard deviation values and peripapillary and macular vessel density values in the glaucoma groups.Conclusion:Vascular density values were lower in glaucoma patients compared to normal individuals, and there is a strong correlation between structural and functional tests and vessel density values. The lower vascular density in the PEG group compared to the POAG group indicates that vascular damage may be more common in PEG patients.

Exploration of fluoroquinolone-induced retinal pigment epithelium layer changes in the pathogenesis of macular degeneration

PurposeFluoroquinolone toxicity studies in animals (cats, rabbits and mice) showed that acute retinal degenerations appear clinically related to phototoxicity. The aim of this study was to evaluate the association between the administration of oral fluoroquinolone and the onset of clinically or subclinically detectable acute retinal degeneration in humans. Material and MethodsThis study included patients that received oral fluoroquinolone treatment (ciprofloxacin, levofloxacin or moxifloxacin) for variable systemic diseases diagnosed by the Department of Urology and Infectious Diseases (study group, n=76), and age and sex matched otherwise healthy subjects (control group, n=50). All the subjects underwent a detailed ophthalmologic examination including tests for visual acuity, intraocular pressures, color vision, photostress recovery time and contrast sensitivity measurements, central foveal thickness, subfoveal choroidal thickness, ganglion cell complex thickness and 10/2 Humphrey visual field test. Color fundus and fundus autofluorescence photographs were also obtained. Examinations and tests were repeated at 1st week and 1st month in the study group. ResultsThere was no statistically significant difference among visual acuity, intraocular pressure, photostress recovery time, color vision, contrast sensitivity measurements, central foveal thickness, subfoveal choroidal thickness, average ganglion cell complex thickness, superior ganglion cell complex thickness, inferior ganglion cell complex thickness, focal loss volume, global loss volume, mean deviation, pattern standard deviation values in treatment group at baseline, 1st week and 1st month (p > 0.05, for the comparison of each parameters). There was not any alteration among color fundus and fundus autofluorescence photographs obtained at baseline, 1st week and 1st month in treatment group. All parameters within the study and control groups were similar throughout the study period (p > 0.05, for the comparison of each parameter). ConclusionThis study evaluated the association between the administration of oral fluoroquinolone and the onset of acute retinal degeneration. Preliminary results of this study showed that use of oral fluoroquinolone had no detectable impact on retinal degeneration at acute phase.

Comparison between frequency-doubling technology perimetry and standard automated perimetry in early glaucoma

This study aimed to find out the significance of the difference between frequency-doubling technology perimetry (FDT) and standard automated perimetry (SAP) in terms of the detected visual field (VF) damage, and evaluate associated factors to SAP–FDT difference in early glaucoma. Glaucoma patients in early stage (MD better than − 6.0 decibel, 96 eyes) were included in this cross-sectional study. We subtracted mean deviation (MD) and pattern standard deviation (PSD) of FDT from those of SAP, respectively. Additionally, we counted significantly depressed points of P < 5% and P < 1% on the pattern deviation probability plot of both FDT and SAP and defined eyes with significant SAP–FDT difference when the number of abnormal points were greater than 4 points on FDT. We measured lamina cribrosa depth (LCD) and lamina cribrosa curvature index (LCCI) for structural parameters of the optic nerve head from images using enhanced depth imaging of the optical coherence tomography (OCT). Peripapillary vessel density (VD) and presence of microvasculature dropout (MvD), the complete loss of choriocapillaris in localized regions of parapapillary atrophy, was evaluated using deep layer map of OCT angiography (OCT-A) for vascular parameters. Peripheral nasal step (PNS) group had an isolated glaucomatous VF defect within nasal periphery outside 10° of fixation. Parafoveal scotoma (PFS) group had an isolated glaucomatous VF defect within 12 points of a central 10˚ radius. Eyes with significant SAP–FDT difference showed higher detection of MvD on deep layer map of OCT-A, greater LCD, and greater LCCI (all P < 0.05, respectively). In logistic regression analysis, frequent presence of MvD, less presence of disc hemorrhage, and greater LCD were significantly associated with significant SAP–FDT difference. Sub-analysis was performed in eyes with PNS (50 eyes) and PFS (46 eyes). SAP–FDT difference of MD value showed positive association with peripapillary VD on deep layer of OCT-A, which was significant in eyes with PFS compared to eyes with PNS. SAP–FDT difference of PSD value showed negative association with LCCI and LCD, which was significant in eyes with PNS compared to eyes with PFS. Glaucomatous eyes classified by the difference of the detected VF damage on FDT versus SAP showed different clinical features. Greater SAP–FDT difference was significantly associated with structural parameters such as LCD and LCCI. Less SAP–FDT difference was associated with presence of disc hemorrhage and lower deep layer peripepillary VD. There is possibility to use the difference of SAP and FDT to identify associated risk factors in glaucoma patients.

Visual field changes in glaucoma patients during the coronavirus disease 2019 pandemic in a middle-income country

ABSTRACT Background To assess the possible effect of the coronavirus disease 2019 (COVID-19) pandemic on the progression of visual field in glaucoma patients attending a charity hospital in Sao Paulo, Brazil. Research design and methods This retrospective study included all glaucoma patients attending the Glaucoma Service Santa Casa of Sao Paulo from July 2019 to October 2021. Data retrieved from the charts included intraocular pressure (IOP), information about missing appointments and non-adherence to medical treatment, mean deviation (MD), and pattern standard deviation (PSD) of Humphrey visual field. Pre- and late in-pandemic data were compared with the Wilcoxon signed-rank test. Results There was no statistically significant difference between pre- and in-pandemic values of MD, and PSD values (all P > 0.05). Fifty eyes (27.9%) of 36 patients (36%) revealed an −2 dB decrease in the MD value. Conclusions The COVID-19 pandemic did not affect visual field progression in most of patients. However, about a third of patients presented a decrease in the MD value >-2 dB in at least one eye especially those with advanced disease. As a slowly progressive optic neuropathy, the two-year time of the pandemic was possibly not long enough to impact negatively on the glaucoma progression in most of patients.

Comparison of ZETA Fast (PTS) (Optopol Technology) and Humphrey SITA Fast (SFA) (Carl Zeiss Meditec) Perimetric Strategies.

Purpose To compare two threshold strategies for visual field assessment, ZETA Fast (Optopol Technology) and Humphrey SITA Fast (Carl Zeiss Meditec), in controls and subjects with glaucoma. Patients and Methods. A prospective case-control study was carried out in which the clinical practice study included 26 controls and 26 glaucoma subjects. Testing for each strategy was monocular. Quantitative comparisons of mean deviation (MD), pattern standard deviation (PSD), visual field index (VFI), and test duration were made using two one-sided t-tests and Wilcoxon signed-rank tests. Confusion matrices were constructed to assess Optopol's detection as a proxy for Zeiss's detection of early glaucomatous defects. Receiver operating characteristic (ROC) curves were used to assess MD and PSD's discriminability. Results The difference in MD values (Optopol-Zeiss) was within the margin for controls (difference = 0.36, p=0.06), but not for glaucomatous subjects (difference = 2.16, p=1.0). The Optopol strategy took longer than the Zeiss strategy in both controls (difference = 23 seconds, p=0.001) and glaucomatous subjects (difference = 49 seconds, p < 0.001). PSD values were higher and VFI values were lower from Optopol in glaucomatous subjects (p < 0.001 and p=0.002). Optopol was 92% sensitive in capturing early glaucomatous defects with MD <−2 when compared to Zeiss (p < 0.001). ROC analysis shows Optopol yields higher discriminability than Zeiss for MD/PSD indices. Conclusions Both strategies enable effective identification of glaucomatous defects within 6 minutes; they also offer high sensitivity with a high correlation in global indices between the two strategies. The Optopol strategy is an alternative to the Zeiss counterpart with the limitation of a marginally longer testing protocol but a higher sensitivity of detecting glaucomatous defects.

Comparison of the Effect of 1000mg and 500mg Oral Citicoline on Visual Field and Ganglion Cell Layer Thickness in Primary Open Angle Glaucoma

Purpose: To compare the effects of 1000 mg and 500 mg oral citicoline on the visual field, retinal nerve fiber layer and ganglion cells layer thickness in well controlled primary open angle glaucoma. Methods: A double blind randomized controlled trial was conducted on 50 subjects (75 eyes). The randomization divided the subjects into two groups, the 1000 mg group and the 500 mg group. The evaluations were performed after 30 days and 60 days intervention by assessing Mean Deviation (MD) and Pattern Standard Deviation (PSD) of Humphrey Visual field as well as retinal nerve fiber layer (RNFL) and Ganglion Cell-Inner Plexiform Layer (GCIPL) on ocular imaging. Results: After 60 days, there was no significant difference between both groups in the MD, PSD, RNFL, and GCIPL values. The median MD increased in the 1000 mg group from -9.96 dB at baseline to -5.0 dB after 60 days and from the intragroup analysis, there was a significant difference (p=0.008). Based on subgroup analysis, there was also significant difference before and after the intervention in the mild glaucoma receiving 500 mg citicoline and in moderate-severe glaucoma receiving 1000 mg citicoline. RNFL and GCIPL thickness in both groups were tended to be stable. A side effect of nausea was found in two subjects who each received a dose of 500 mg and 1000 mg citicoline. Conclusion: There was an improvement in the MD and PSD values in both groups after 60 days of oral citicoline administration, but a significant difference was found in mild glaucoma group receiving 500 mg citicoline and in moderate-severe glaucoma receiving 1000 mg citicoline. The thickness of RNFL and GCIPL in both groups did not decrease after 60 days of citicoline administration.

Visual field changes in glaucoma patients after blepharoptosis surgery.

To examine changes in parameters of the visual field test before and after blepharoptosis surgery in patients with glaucoma. Twenty-three eyes of 14 glaucoma patients who underwent blepharoptosis surgery at Toyama University Hospital between July 2015 and September 2020 were included in this study. Pre- and post-operative values for the mean deviation (MD), pattern standard deviation (PSD) and total deviation (TD) of the upper or lower hemi-visual field in the Humphrey visual field test, best-corrected visual acuity (BCVA), intraocular pressure (IOP), and margin reflex distance (MRD)-1 were compared. MRD-1 showed a significant improvement after blepharoptosis surgery (preoperative MRD-1: 1.0 ± 0.82 mm, postoperative MRD-1: 3.26 ± 0.66 mm, p < 0.001). There were no significant differences in BCVA, IOP, MD and PSD values before and after surgery. On the other hand, there was a significant improvement in the superior TD (preoperative: -11.29 ± 6.57 dB, postoperative: -9.88 ± 7.31 dB, p = 0.044) although no significant difference was detected in the inferior TD postoperatively. The preoperative parameters of 2 groups (improvement and non-improvement groups of postoperative superior TD) were compared. Preoperative MD and superior TD were significantly lower in the improvement group (p = 0.03, p = 0.004, respectively), although there was no significant difference in preoperative PSD and inferior TD between the two groups. In glaucoma patients, blepharoptosis may interfere with accurate visual field assessment, especially of superior TD.

Glaucoma Screening Using an iPad-Based Visual Field Test in a West African Population

To investigate the performance of the Melbourne Rapid Fields (MRF) for use in clinic-based visual field testing in a low-resource setting. Prospective cross-sectional study. One hundred and three participants (66 patients with glaucoma and 37 control participants) attending a clinical appointment at the Tema Eye Center, Tema, Ghana. Patients with glaucoma and control participants underwent MRF and Humphrey Field Analyzer (HFA) testing. Mean deviation (MD), pattern standard deviation (PSD), reliability parameters, sensitivity, specificity, and area under the receiver operating characteristic curve. Mean MD was less negative and mean PSD was more positive on the MRF than the HFA in both groups (all P < 0.001). False-positive and false-negative rates were comparable between methods (P= 0.09 and P= 0.35, respectively). In patients with glaucoma, MD and PSD from the 2 devices were correlated strongly (r= 0.84; P < 0.001) and moderately (r= 0.61; P < 0.001), respectively. Agreement analysis revealed that MRF tended to generate significantly higher MD (bias, 3.3 ± 4.1 dB; P= 0.03) and PSD (bias, 1.9 ± 2.8 dB; P= 0.03) with wide limits of agreement. For detecting moderate to advanced glaucoma, the sensitivity was 60.9% for the MRF and 78.3% for the HFA (P= 0.10); respective specificities were 86.5% and 83.8% (P= 0.76). The MRF underestimated MD and overestimated PSD values compared with the HFA. Agreement biases were significant, suggesting a weak agreement between the 2 devices. However, the MRF showed potential for screening in a low-resource setting, particularly for detecting moderate to advanced glaucoma.

Glaucoma Progressing Stage Estimated from Visual Field Test Data with Glaucoma Patient; and Zinc(Ⅱ) Induced Regenerative Ativity from Optic Nerve Damage

Glaucoma progressing stages (Stages 1～5) estimated from Visual Field Index (VFI); Mean Deviation (MD); and Pattern Standard Deviation (PSD) data has been elucidated; in which the glaucomatous pathology is in the proceeding stage 2-3 with T. Ishida's glaucoma patient compared with referring with VFI; MD; and PSD values to the literatures. Zinc(Ⅱ) induced VFI improvement should be taken into account when interpreting rates of VFI change over time that zinc promotes Retinal Ganglion Cells (RGCs) survival; in which zinc intake in RGCs survival may be zinc acetate 25-50 mg/day. Zinc(Ⅱ) induced recovery activity from optic nerve damage of the eye consists of four processes as follows. (1) Intraocular inflammatory stimulation process; Zinc concentrations 123-292 μg/g inhibit intraocular inflammation with atypical growth factor oncomodulin (Ocm) binding to its cognate receptor on RGCs. (2) RGC survival process; Zn2+ chelators enhance RGC survival and promote axon regeneration through the optic nerve. (3) Neural axon regeneration process; Zn2+ chelation promotes axon regeneration. Norepinephrine Transporters (Net) inhibitor promotes RGCs survival and axonal regeneration. (4) Eye to brain pathway process; Zn2+ chelator TPEN promotes both enduring RGC survival and considerable axon regeneration. Zinc induced recovery for NO production in RGCs that the NO conveys from the eye to the brain through the axons of RGCs; in which zinc concentration 100 μM may be suited for the optic nerve recovery. Accordingly; Zinc(Ⅱ) could enhance optic nerve damage recovery that Zn2+ may be bound with optic nerve damage proteins; in which Zn2+ ions may bind with intraocular protein; RGC survival protein; axonal protein; and optic nerve disorder proteins during recovery process by Zn2+ ions-centered tetrahedrally binding proteins molecular coordination pattern.

Agreement between Compass Fundus Perimeter New Grid and 10-2 Testing Protocols for Detecting Central Visual Field Defects

To evaluate the agreement between Compass New Grid (NG) and 10-2 test protocols for detecting early glaucomatous defects in the central 10 degrees of the visual field (CVFD). Cross-sectional study. A total of 123 eyes of 14 healthy individuals, 17 glaucoma suspects, and 32 glaucoma patients were enrolled. Subjects performed NG and 10-2 Compass automated perimetry testing within 1 week. For both test protocols, total deviation (TD) and pattern deviation (PD) plot CVFDs were defined by 3 contiguous points with probabilities of <5%, <2%, <2% or <5%, <1%, <1%. Cohen's Kappa statistic was used to assess agreement between NG and 10-2 for identifying CVFDs. The Spectralis GMPE Hood Glaucoma Report (investigational software version) macula deviation analysis obtained within 1 year was used for calculating sensitivities and specificities of test protocols. Protocols' agreement, sensitivity, and specificity. Fair to moderate agreement was observed between NG and 10-2 protocols for detecting presence of superior CVFDs on TD (k= 0.57) and PD (k= 0.26) plots and for detecting inferior CVFDs on TD (0.49) and PD (0.27) plots. With the use of OCT macula deviation maps, specificity for detecting CVFD was consistently higher with NG than 10-2 tests for TD plots of the superior hemifield (0.82 and 0.65), inferior hemifield (0.92 and 0.84), and PD plots of the superior hemifield (0.81 and 0.36) and inferior hemifield (0.86 and 0.52). Sensitivity of NG was consistently lower than TD plots of the superior hemifield (0.48 and 0.72), inferior hemifield (0.28 and 0.46), and PD plots of the superior hemifield (0.48 and 0.78) and inferior hemifield (0.20 and 0.52). By using pattern standard deviation (PSD) criterion, the mean PSD values for 10-2 and NG VF tests were 1.61 (95% confidence interval [CI], 1.26-1.96) and 1.81 (95% CI, 1.45-2.17) (P < 0.001), respectively. Although the Compass NG detected fewer CVFDs than the 10-2 test protocol, it did detect CVFDs that were not observed in the Compass 24-2 test in patients with early glaucoma. Therefore, NG may be particularly useful in clinical situations when higher specificity is desired or PSD criterion is used.

Analysis of factors affecting visual field recovery following surgery for pituitary adenoma.

To analyze the factors influencing visual field recovery in patients with pituitary adenoma following surgical treatment. We retrospectively reviewed 144 eyes of 72 patients with pituitary adenoma who had been followed up for more than 6 months following surgery between January 2016 and December 2019. Pre and postoperative visual acuity, visual field test and retinal nerve fiber layer (RNFL) thickness were investigated. We defined recovery of visual field defects as being an improvement in mean deviation (MD) of 2dB or more. The average age of the 72 patients (144 eyes) was 51.94 ± 14.69years, making for 37 patients in the recovery group and 35 patients in the non-recovery group. Preoperative MD, pattern standard deviation (PSD), and visual field indexes (VFI) were negatively correlated to postoperative MD, PSD and VFI changes and positively correlated to postoperative MD, PSD, and VFI values. Using multiple regression analysis, a shorter duration of symptoms (Odds ratio [OR], 0.990; p = 0.033), higher preoperative MD values (OR, 0.871; p = 0.025), and thicker temporal RNFL (OR, 1.068; p = 0.048) were associated with a visual field recovery following surgery. The prognosis for visual field recovery is favorable for patients who have a short period from symptom onset to surgery, a higher MD value of preoperative VF, and a thicker peripapillary temporal RNFL thickness. Therefore, the preoperative MD, temporal RNFL thickness, and the symptom period can be predictive variables affecting postoperative visual field recovery.

Qualitative Evaluation of the 10-2 and 24-2 Visual Field Tests for Detecting Central Visual Field Abnormalities in Glaucoma

To examine whether glaucomatous central visual field abnormalities can be more effectively detected using a qualitative, expert evaluation of the 10-2 test compared with the topographically corresponding central 12 locations of the 24-2 test (C24-2). Cross-sectional study. Eyes with a glaucomatous optic nerve appearance or ocular hypertension (n=523) and healthy eyes (n=107) were included as cases and control subjects, respectively. The 10-2 and C24-2 visual field results of all eyes were graded by 4 glaucoma specialists for the probability that central visual field abnormalities were present. The sensitivity of the 10-2 and C24-2 tests for detecting the cases at 95% specificity were not significantly different (e.g., 32.2% and 31.4%, respectively, for grader 1, P=.87; all graders P ≥ .25). At 95% specificity, the pattern standard deviation values from these tests had a similar sensitivity to the qualitative evaluation for the C24-2 test for all graders (P ≥ .083), but it had a significantly higher sensitivity than the qualitative evaluation for the 10-2 test for 3 graders (P ≤ .016). The similarity in performance of the 10-2 and C24-2 test suggests that the increased sampling density of the former does not significantly improve the detection of central visual field abnormalities, even when based on expert assessment. These findings should not be taken to mean that the 10-2 test is not useful, but it underscores the need for its utility to be clearly established before incorporating it as routine glaucoma standard of care.

Visual Field Indices Changes after Pterygium Surgery

Objectives:This study was a prospective evaluation of changes in the results of visual field tests taken before and after pterygium excision.Methods:This was a prospective, single-center study. Seventy-five eyes of 75 patients who had undergone pterygium excision with autograft implantation were enrolled. All of the patients had stage III pterygium according to the Johnston classification. The mean deviation (MD), pattern standard deviation (PSD), and visual field index (VFI) global index changes after pterygium excision were compared to evaluate the effect of pterygium on visual field analysis.Results:The mean preoperative MD value was -3.04±2.63 dB (range: -14.84–0.62 dB) and the mean postoperative MD value was -1.83±2.09 dB (range: -13.82–1.74 dB) (p<0.001). The mean preoperative PSD value was 2.59±1.92 dB (range: 1.16–12.76 dB) and the mean postoperative PSD value was 2.41±1.62 dB (1.15–13.29 dB) (p>0.05). The mean preoperative VFI value was 96.01±4.46% (range: 68–100%) and the mean postoperative VFI value was 96.28±4.18% (range: 70–100%) (p>0.05).Conclusion:After pterygium excision, the MD improved significantly. However, the PSD and VFI did not change significantly. The significant change in MD value was related to the reduction in corneal light scattering, contrast sensitivity, aberrations, and blockage on the optic axis.

Comparing isolated-check visual evoked potential, pattern visual evoked potential, and standard automated perimetry in dysthyroid optic neuropathy eyes

ObjectiveTo determine the diagnostic ability of isolated-check visual evoked potential (icVEP), pattern visual evoked potential (pVEP), and standard automated perimetry (SAP) between dysthyroid optic neuropathy (DON) and thyroid-associated ophthalmopathy (TAO) without DON (non-DON).MethodsThis is a case-control study, 49 bilateral patients (26 DON and 23 non-DON) were included. icVEP, pVEP, and SAP were conducted in all the subjects, icVEP parameters compared were signal-to-noise ratios (SNRs) under 8, 16, and 32% depth of modulation (DOM). pVEP parameters compared were amplitude and latency. SAP parameters were mean deviation (MD) and pattern standard deviation (PSD). The area under the receiver operating characteristic (ROC) curve (AUC), net reclassification index (NRI), integrated discrimination index (IDI), and decision curve analysis (DCA) were applied for analysis.ResultsIn icVEP, values of SNR in DON were significantly smaller than non-DON (p < 0.05). In pVEP, P100 latent time in DON was significantly larger than non-DON (p = 0.0026). In SAP, value of PSD in DON was larger than non-DON (p = 0.0006), and value of MD in DON was smaller (p = 0.0007). AUC, NRI, and IDI among the three tests were not significantly different. DCA showed that SNR of icVEP under 8% DOM was the farthest from the two extreme curves.ConclusionsicVEP, pVEP, and SAP have equal diagnostic capabilities to discern between DON and non-DON. In addition, icVEP may represent a significant ancillary diagnostic approach to DON detection, with more clinical benefit.

Associations between functional and structural measurements in non-acute Vogt-Koyanagi-Harada disease.

To evaluate associations between functional and structural measurements in patients with non-acute VKHD. In this cross-sectional study, 16 non-acute VKHD patients (32 eyes; 14 female) were evaluated with multifocal electroretinogram (mfERG), standardized automated perimetry (SAP) and optical coherence tomography (OCT)examinations. All included patients had a minimum 12months of follow-up from acute onset and were participants of an ongoing prospective study since acute phase with systematic clinical imaging evaluations and electroretinogram examinations within a predefined treatment. Age- and gender-matched controls were included. Main outcomes were functional and structural abnormalities and their correlation; secondary outcome was correlation of these findings with clinical characteristics, including fundus abnormalities. SAP and mfERG parameters were significantly worse in patients than in controls. Fourteen eyes (43.7%) had disrupted ellipsoid zone (EZ); visual acuity (VA) was similar between eyes with intact or disrupted EZ. Eyes with intact and disrupted EZ differed significantly concerning N1 and P1 amplitudes and N1 peak time values on mfERG and mean sensitivity (MS), central sensitivity (CS), foveal threshold, visual field index, mean deviation (MD) and pattern standard deviation values on SAP. The area under the curve on receiver operating curves for P1 amplitude was 0.81 (cut-off value=34.7 nV/deg2 ) and for MD value was 0.84 (cut-off value=-5.2dB). Central retinal thickness (CRT) significantly correlated with N1 and P1 amplitudes and P1 peak time values on mfERG (r=0.354, r=0.442 and r=-0.405, respectively) and MD, MS, CS and fovea threshold (log values) on SAP (r=0.372, r=0.406, r=0.431 and r=0.414, respectively). Statistically significant associations were found with the presence of peripapillary atrophy and recurrent anterior uveitis with a worse MD value (p=0.004 and p<0.001, respectively). In non-acute VKHD, disrupted EZ and reduced CRT were correlated with impaired mfERG and SAP parameters, even in patients with good VA.