Visual Field Changes Research Articles

Sex-Specific Effect of BDNF Val66Met Genotypes on the Progression of Open-Angle Glaucoma.

To investigate whether the brain-derived neurotrophic factor (BDNF) Val66Met genotype is associated with the rate of progression of open-angle glaucoma (OAG). In this retrospective cohort study, 148 OAG patients (292 eyes) were enrolled with a median follow-up period of 5.3 (range, 1.1-8.6) years. All participants had undergone regular clinical examinations by using spectral-domain optical coherence tomography (SD-OCT) scans and Humphrey (SITA) visual field tests. BDNF Val66Met polymorphisms were genotyped in all participants. Longitudinal visual field and retinal nerve fiber layer (RNFL) changes were compared between Met carriers (n = 68, 135 eyes) and Val homozygotes (n = 80, 157 eyes) by using the generalized estimating equations (GEE) model and Kaplan-Meier survival analysis. There was no significant difference in mean rates of progression for the two genotypes. However, there was a significant association between the Val66Met genotypes and slower OAG progression, as suggested by a higher rate of global RNFL loss in Val/Val homozygotes (P = 0.008) in the long-term survival analysis. The effect demonstrated a degree of sex specificity, with the significant difference present only in females (P = 0.016) but not males. Similar sexual dimorphism was presented in superior (P = 0.005 in females, P = 0.38 in males) and inferior (P = 0.004 in females, P = 0.41 in males) RNFL loss. No significant difference was observed in visual field parameters. Our results suggested that carriage of Met allele reduces the rate of long-term OAG progression. However, the fact that this effect is observed only in females indicates BDNF Val66Met influences the progression rate of OAG in a sex-specific manner.

Delay of cone degeneration in retinitis pigmentosa using a 12-month treatment with Lycium barbarum supplement

Ethnopharmacological relevanceLycium barbarum L. (also known as “Goji berry”), a traditional Chinese herbal medicine, has been a common herb in the traditional Chinese pharmacopoeia for centuries. The main active component is the Lycium barbarum polysaccharides and its antioxidative effect has been widely shown to provide neuroprotection to the eye, and it would, therefore, be interesting to determine if Lycium barbarum help delay vision deterioration in patients with retinitis pigmentosa. Aim of the studyCone rescue is a potential method for delaying deterioration of visual function in Retinitis pigmentosa (RP). This study aimed to investigate the treatment effect of Lycium barbarum L. (LB) supplement on retinal functions and structure in RP patients after a 12-month intervention trial. MethodsThe investigation was a double-masked and placebo-controlled clinical study. Each of forty-two RP subjects who completed the 12-month intervention (23 and 19 in the treatment and placebo groups respectively) received a daily supply of LB or placebo granules for oral administration. The primary outcome was change of best corrected visual acuity (VA) (90% and 10% contrast) from the baseline to the end of treatment. The secondary outcomes were sensitivity changes of the central visual field, amplitude of full-field electroretinogram (ffERG) (including scotopic maximal response and photopic cone response), and average macular thickness. ResultsThe compliance rates for both groups exceeded 80%. There were no deteriorations of either 90% or 10% contrast VA in the LB group compared with the placebo group (p = 0.001). A thinning of macular layer was observed in the placebo group, which was not observed in the LB group (p = 0.008). However, no significant differences were found in the sensitivity of visual field or in any parameters of ffERG between the two groups. No significant adverse effects were reported in the treatment group. ConclusionsLB supplement provides a neuroprotective effect for the retina and could help delay or minimize cone degeneration in RP. ClassificationsClinical Studies (1.05). Trial registrationclinicaltrials.gov Identifier NCT02244996.

Clinical Efficacy of Pinhole Soft Contact Lenses for the Correction of Presbyopia

ABSTRACTWe investigated the clinical efficacy of pinhole soft contact lenses for presbyopia correction. Twenty participants with presbyopia wore pinhole soft contact lenses in the non-dominant eye for 2 weeks. Manifest refraction, Goldmann binocular visual field tests, contrast sensitivity tests, and biomicroscopic examinations were performed along with evaluations of questionnaire responses and the binocular corrected distance visual acuity (CDVA), distance-corrected near visual acuity (DCNVA), distance-corrected intermediate visual acuity (DCIVA), and depth of focus, both before and after 2 weeks of lens wear. DCNVA at 33 and 40 cm and DCIVA at 50 and 70 cm showed significant improvements after pinhole lens wear (P-value: <0.001, <0.001, <0.001, and 0.046, respectively), with no changes in the binocular visual field and binocular CDVA. Contrast sensitivities under photopic and mesopic conditions decreased at some frequencies; however, visual function questionnaire scores significantly improved (all P-values <0.001). These findings suggest that pinhole contact lenses effectively correct presbyopia.

Normal tension vs high tension glaucoma: an - overview.

The study provides an up-to-date overview of pathogenesis, functional and structural changes in normal tension glaucoma (NTG) and its differences from high tension glaucomas (HTG). The authors point to less known facts which make both diagnostic groups different. First of all, there are electrophysiological findings that verify pathology in the complete visual pathway in HTG in contrast to NTG where the retinal ganglion cell response is relatively normal but the abnormalities are in the visual pathway. This corresponds to the findings of functional magnetic resonance imaging of the brain with asignificant decrease in activity in HTG compared to NTG. We found ahigher decrease in activity in HTG following application of the colour paradigm compared to NTG where we did not see asimilar difference. We also investigated the central corneal thickness (CCT) in both diagnostic groups. We did not find astatistically significant difference. However, we found the effect of CCT on progression of the changes in visual fields in HTG. In relation to suspicion of abnormally low cerebrospinal pressure and apossible cerebrovascular fluid flow disturbance in NTG, we examined the optic nerve thickness (OND) and optic nerve sheath diameter (OSD) at adistance of 4, 8, 16 and 20mm from the posterior pole of the eye. In the comparison with the healthy population, we did not find any abnormalities except for the width of the optic chiasma that was markedly lower in NTG. In relation to apossible impairment of cerebral perfusion we determined the degrees of cerebral atrophy using magnetic resonance imaging by measuring the bicaudate ratio (BCR) and white matter lesions using the Fazekas scale. We did not find adifference between HTG and NTG in BCR. We found statistically significant changes in BCR which correlated with the changes in visual fields. The higher values of the pattern defect were associated with increased brain atrophy (BCR). We did not detect similar relations in the Fazekas scale. We found asignificant difference in this parameter among NTG, HTG and acontrol group. We found the most advanced changes in the patients with HTG. Conclusion: In HTG, impairment of retinal ganglion cells and subsequently also their axons, including visual cortex occurs because of ahigh intraocular pressure. In NTG, the retinal ganglion cells are relatively normal like the visual cortex, but alteration occurs in their axons. The cause is not ahigh intraocular pressure but most probably ischemia.

The effect of mirtogenol towards the changes in retinal nerve fiber layer thickness and visual field in primary open angle glaucoma

&#x0D; &#x0D; &#x0D; Objective: To evaluate the effect of Mirtogenol towards the changes in retinal nerve fiber layer (RNFL) thickness and visual field in patients with primary open angle glaucoma (POAG) with controlled IOP. Methods: This is a prospective, double blind, randomized study. Forty one POAG patients with IOP ≤ 18 mmHg were randomly assigned to receive either Mirtogenol or placebo. Changes in RNFL thickness and mean deviation of visual fields were evaluated before the treatment, as well as 4 weeks and 8 weeks after the treatment. Patients were asked for any side effects during the treatment period. &#x0D; Result: The average RNFL thickness in the Mirtogenol group decreased -0.70±1.63 μm from 87.29±19.39 μm before the treatment to 86.58±19.43 μm after 8 weeks of treatment, however the change was not significant (p=0.121). The average RNFL thickness in the placebo group decreased -1.74±1.79 μm from 97.14±17.19 μm before the treatment to 95.40±18.56 μm after 8 weeks of treatment, the change was statistically significant (p&lt; 0.001). The average MD of visual field in the Mirtogenol group increased 0.542±1.93 dB after 8 weeks of treatment while the MD of visual field in the placebo group decreased -0.083±1.36 dB after 8 weeks of treatment. Hoewever the changes in MD of visual field was not significant (p&gt;0.05). No side effect was found throughout the study. &#x0D; Conclusion: Mirtogenol seemed to maintain retinal nerve fiber layer thickness and increased mean deviation of visual fields. &#x0D; &#x0D; &#x0D;

Improving the Feasibility of Glaucoma Clinical Trials Using Trend-Based Visual Field Progression End Points

There have been concerns that short-term clinical trials for evaluating new treatments in glaucoma would require prohibitively large sample sizes when using visual field endpoints, given that glaucoma is often a slowly progressive disease. This study sought to determine the required sample size for such trials using event-based analyses, and whether it can be reduced using trend-based analyses. Longitudinal, observational study. 321 eyes of 240 glaucoma participants followed under routine clinical care using 242 visual field for an average of 10 years. Sample size requirements were derived using computer simulations that reconstructed "real-world" visual fields by combining estimates of point-wise variability according to different threshold levels and rates of change obtained from the clinical glaucoma cohort. A clinical trial lasting 2 years with testing every 3 months was simulated, assuming that the new treatment halted visual field change in various percentages of participants (or "responders"). Treatment efficacy was evaluated by: (a) Difference in incidence of point-wise event-based progression (similar to the commercially available Guided Progression Analysis), and (b) Difference in rate of visual field mean deviation (MD) change between groups using linear mixed models (LMMs). Sample size to detect a statistically significance difference between groups. Between-group trend-based analyses using LMMs reduced sample size requirements by 85-90% across the range of new treatment effects when compared to the conventional point-wise event-based analysis. To detect the effect of a new treatment that halted progression in 30% of the participants under routine clinical care (equal to a 30% reduction in average rate of MD change) with 90% power, for example, 1924 participants would be required per group using event-based analysis, but only 277 participants per group if LMMs were used. The feasibility of future glaucoma clinical trials can be substantially improved by evaluating differences in the rate of visual field change between groups.

Visual field defects and changes in central retinal artery occlusion.

ObjectivesTo investigate the characteristics and temporal changes in visual field defects (VFDs) in eyes with acute central retinal artery occlusion (CRAO).DesignRetrospective, observational case seriesMethodsA total of 119 patients diagnosed with acute non-arteritic CRAO through examination with Goldmann perimetry were included among the patients who visited Seoul National University Bundang Hospital between January 2009 and December 2016. They were treated with either conservative treatments or intra-arterial thrombolysis (IAT). The baseline features and temporal changes of visual field examination results and the association with clinical parameters including visual acuity, optical coherence tomography (OCT) findings, and the CRAO stages.ResultsAll of the 119 patients showed visual field defect and suffered unilateral acute CRAO. We observed five characteristic VFDs: peripheral constriction only (8%), paracentral scotoma (3%), central and cecocentral scotoma (19%), temporal island (59%), and no visual field (10%). Severe VFDs were associated with severe CRAO stages, poor baseline BCVA, delayed retinal arterial perfusion, and severe retinal morphologic changes on OCT. We found improvements in the visual field in 39% of all cases during the follow-up periods. Mild CRAO stages, good baseline BCVA, mild retinal morphologic changes, and mild initial VFDs were significantly associated with visual field improvement.ConclusionsThe five characteristic types of VFDs and their improvement in eyes with CRAO are associated with baseline features related to the severity of retinal ischemia. We suggest that the underlying mechanisms of VFDs involve the balance between the retinal arterial perfusion and the ischemic vulnerability of each retinal area.

Correlation between visual field changes and retinal nerve fiber layer thickness measured by optical coherence tomography in open-angle glaucoma patients

Purpose The aim of this study was to evaluate the retinal nerve fiber layer thickness (RNFLT) as measured by optical coherence tomography (OCT), in patients with primary open-angle glaucoma and to correlate it with the visual field (VF) changes in these patients.Patients and methods This was a prospective observational study done on 60 eyes of 30 patients with primary open-angle glaucoma. All participants underwent VF assessment and OCT assessment of the retinal nerve fiber layer.Results There was a statistically significant correlation when comparing age with mean deviation (r=−0.565), pattern standard deviation (r=0.179), and total deviation average (r=−0.414). In addition, there was a statistically significant correlation when comparing mean deviation, pattern standard deviation, and retinal thickness average (G), with peripapillary RNFLT sectors.Conclusion Correlation between the global indices of the Humphrey VF and the parameters of the OCT showed that there was a relation between the changes in the thickness of the retina, RNFLT, and the changes and defects in the results of Humphrey VF.

Superior segmental optic hypoplasia as a differential diagnosis of glaucoma

Superior segmental optic hypoplasia (SSOH) is a congenital anomaly affecting the optic nerve head and retina. Although the conventional characterization of SSOH emphasizes the relatively superior entrance of the central retinal artery, the pallor of the superior optic disc, a superior peripapillary halo, and thinning of the superior nerve fiber layer, we encounter many cases with rim thinning in the superior nasal region that corresponds to a nerve fiber layer defect and an inferior wedge-shaped visual field defect connecting to the blind spot. However, among Asians, such cases usually lack pallor of the superior optic disc and more resemble glaucomatous optic neuropathy. We found the prevalence of SSOH to be 0.2%/eye and 0.3%/case among Japanese. We also noted that approximately half of all SSOH eyes show visual field changes. SSOH is an important differential diagnosis of glaucoma, especially normal-tension glaucoma, in Asian populations.

Visual Field Changes after Internal Limiting Membrane Peeling in Glaucoma Patients with Epiretinal Membrane

Visual Field Changes after Internal Limiting Membrane Peeling in Glaucoma Patients with Epiretinal Membrane

PANRETINAL PHOTOCOAGULATION VERSUS RANIBIZUMAB FOR PROLIFERATIVE DIABETIC RETINOPATHY: Comparison of Peripapillary Retinal Nerve Fiber Layer Thickness in a Randomized Clinical Trial.

Compare changes in retinal nerve fiber layer (RNFL) thickness between eyes assigned to intravitreous ranibizumab or panretinal photocoagulation and assess correlations between changes in RNFL and visual field sensitivity and central subfield thickness. Eyes with proliferative diabetic retinopathy were randomly assigned to ranibizumab or panretinal photocoagulation. Baseline and annual follow-up spectral domain optical coherence tomography RNFL imaging, optical coherence tomography macular imaging, and automated static perimetry (Humphrey visual field 60-4 algorithm) were performed. One hundred forty-six eyes from 120 participants were analyzed. At 2 years, for the ranibizumab (N = 74) and panretinal photocoagulation (N = 66) groups, respectively, mean change in average RNFL thickness was -10.9 ± 11.7 μm and -4.3 ± 11.6 μm (difference, -4.9 μm; 95% confidence interval [-7.2 μm to -2.6 μm]; P < 0.001); the correlation between change in RNFL thickness and 60-4 Humphrey visual field mean deviation was -0.27 (P = 0.07) and +0.33 (P = 0.035); the correlation between change in RNFL thickness and central subfield thickness was +0.63 (P < 0.001) and +0.34 (P = 0.005), respectively. At 2 years, eyes treated with ranibizumab had greater RNFL thinning than eyes treated with panretinal photocoagulation. Correlations between changes in RNFL thickness, visual field, and central subfield thickness suggest that the decrease in RNFL thickness with ranibizumab is likely due to decreased edema rather than loss of axons.

A study for the assessment of central corneal thickness and visual field defects in patients of primary open-angle glaucoma

Purpose: The aim of this study is to assess the central corneal thickness (CCT) and visual field (VF) changes in patients of primary open-angle glaucoma (POAG) and the influence of CCT on glaucomatous damage in glaucoma clinic of Dr. R. P. G. M. C Kangra at Tanda. Materials and Methods: This cross-sectional study conducted on 103 eyes of 58 patients of POAG- >40 years. All patients underwent a complete eye examination including Goldmann applanation tonometry, CCT measurement through ultrasonic pachymeter, stereoscopic disc photography, retinal nerve fiber layer (RNFL) photography, and automated perimetry. Correlation of CCT with age, gender, intraocular pressure (IOP), advanced glaucoma intervention study (AGIS) score, VF parameters (mean deviation, pattern standard deviation [PSD]), vertical cup-disc ratio, average RNFL, and number of antiglaucoma medications was analyzed. The patients were divided into two groups – thin and thick CCT taking a reference range of 529 μm derived from a previous study done in same area with larger sample size. Pearson correlation was used for correlation coefficient and a value of P < 0.05 was considered statistically significant. Results: Thin CCT was significantly correlated with IOP (r = 0.28, P = 0.004). Thin CCT was also significantly associated with worsened PSD of VF (r = 0.25, P = 0.02). The mean AGIS score was more (8.07 ± 5.52) in patients with thin CCT (<529 μm) in comparison (5.96 ± 6.10) to patients with thick CCT (>529 μm) which was statistically significant (P < 0.05). Conclusion: CCT is a significant risk factor for glaucomatous VF loss. Patients with thinner CCT are more likely to have advanced VF defects in comparison to patients with thick CCT.

A Method to Measure the Rate of Glaucomatous Visual Field Change.

PurposeTo develop a method to measure the rate of glaucomatous visual field (VF) deterioration and to identify fast progressors.MethodsRetrospective, longitudinal, observational study of 8486 eyes of 4610 glaucomatous patients with ≥6 VFs and ≥3 years of follow-up. A Glaucoma Rate Index (GRI) was calculated. VF locations were partitioned into exponential decay or exponential improvement models. A pointwise rate of change (PRC) was estimated with an exponential fit and expressed as the percent/year change of the age- and location-matched normal perimetric range, presented as a spatially conserved VF map. PRCs were summed and normalized with boundary rates set by simulated decaying and improving VF series on a scale of −100 to +100, respectively.ResultsA total of 89,704 VF examinations with 425,039 test location series was used. Median follow-up and number of VFs/eye were 9.7 years and 9 VFs, respectively. Initial and final mean deviations (±SD) were −4.2 (±5.2) and −5.7 (±6.4) dB. The proportions of test locations designated as decayed, improved, and unchanged were 13%, 4%, and 83%, respectively. Mean PRCs for decay, improvement, and no change were −3.7 (±4.7)%/y, 2.5 (±2.6)%/y, and −0.5 (±2.1)%/y, respectively. The number of eyes with negative and positive GRIs was 5802 (68%) and 2390 eyes (28%), respectively. The proportion of eyes defined as fast progressors was 6.8%.ConclusionsGRI provides a robust measure of glaucomatous VF change, operates without discontinuity over the entire perimetric range, and can be used to identify fast progressors.Translational RelevanceThis study describes a novel method that can help the clinician to determine VF progression.

Low-grade \u201cbenign\u201d birdshot retinochoroiditis: prevalence and characteristics

PurposeTo establish the prevalence, morphologic and functional characteristics and evolution of mild birdshot retinochoroiditis (BRC).MethodsRetrospective review of all BRC cases treated at the Centre for Ophthalmic Specialized Care, Lausanne, Switzerland, with at least 3 years of follow-up since the initial symptoms. Sub-Tenon’s injection of triamcinolone was the first line of treatment if visual field changes were unilateral, with no additional treatment if visual field returned to normal. The percentage of patients who did not need systemic therapy was established, and the following parameters were evaluated: demographic characteristics, best-corrected visual acuity (BCVA), fundus photographs, fluorescein angiography (FA) and indocyanine green (ICGA) angiography frames and perimetry evaluation from initial visit to last follow-up.ResultsTwenty cases of BRC were included in this study. Three of these patients (15%) received only local periocular therapy and qualified as mild BRC, with a mean follow-up of 9.3 years. The BCVA was 0.89 ± 0.25 at presentation and 1.0 ± 0.39 at last follow-up. Average visual field mean defect was 5.05 ± 3.27 at presentation and 1.78 ± 0.95 at last follow-up. Depigmented fundus lesions remained stable from presentation to last follow-up. Choroidal inflammatory activity monitored by ICGA decreased from 11.66 ± 3.44 at presentation to 4.25 ± 2.87 at last follow-up. FA revealed mild retinal vasculitis (2.25 ± 3.20) which remained stable (2.00 ± 4.00).ConclusionsIn our setting, 15% of BRC cases had a benign course, controlled with periocular treatment. It is important to identify such cases in order not to overtreat, exposing patients needlessly to potential side effects of aggressive and prolonged immunosuppressive treatment.

Clinical profile, visual field changes and progression in patients with NTG

Clinical profile, visual field changes and progression in patients with NTG

Assessment of Optic Disc Perfusion in Open Angle Glaucoma (OAG) Using Optical Coherence Tomography Angiography (OCTA)

Background: glaucoma is a major disease that potentially results in irreversible blindness, some prospective studies demonstrated that in primary open-angle glaucoma (POAG), blood flow is diminished in the ophthalmic, retinal, choroid and retro-bulbar circulations. Aim of the Work: this study aimed to compare Optic disc perfusion in normal healthy persons with that of Open Angle Glaucoma (OAG) patients by using Optical Coherence Tomography Angiography (OCTA) and to see if a correlation exists between optic disc perfusion, visual field changes and retinal nerve fiber layer thickness in normal healthy persons and in OAG patients. Patients and Methods: we did an analysis of optic disc perfusion in two groups of normal healthy persons and primary open angle glaucoma patients who were previously diagnosed and attended follow up in outpatient clinic in Sayed Galal University Hospital located in Cairo. In our study we included 22 eyes of 12 people, (10 normal eyes and 12 Open angle glaucoma patients eyes) aged between 20 and 78 years old. Results: there was a statistically significant relationship between optic disc perfusion and glaucoma group in comparison with normal group, thus in normal group the optic disc perfusion indicated good optic disc perfusion which was significantly lower in glaucoma group. Also we discovered that there was a statistically significant correlation between optic disc perfusion with (Visual field changes and RNFL thickness). Conclusion: optic disc perfusion assessment by using OCT angiography could be beneficial in evaluation of glaucoma and assessment of disease progression and it’s follow up together with Visual Field assessment and clinical examination.

Are Patient Self-Reported Outcome Measures Sensitive Enough to Be Used as End Points in Clinical Trials?: Evidence from the United Kingdom Glaucoma Treatment Study

The United Kingdom Glaucoma Treatment Study (UKGTS) demonstrated the effectiveness of an intraocular pressure-lowering drug in patients with glaucoma using visual field progression as a primary outcome. The present study tested the hypothesis that responses on patient-reported outcome measures (PROMs; secondary outcome measure) differ between patients receiving a topical prostaglandin analog (latanoprost) or placebo eye drops in UKGTS. Multicenter, randomized, triple-masked, placebo-controlled trial. Newly diagnosed glaucoma patients in the UKGTS with baseline and exit PROMs (n= 182 and n= 168 patients from the treatment and placebo groups, respectively). In the UKGTS (trial registration number, ISRCTN96423140), patients with open-angle glaucoma were allocated to receive latanoprost (treatment) or placebo; the observation period was 24months. Patients completed general health PROMs (European Quality of Life in 5 Dimensions [EQ-5D] and 36-item Short Form [SF-36]) and PROMs specific to glaucoma (15-item Glaucoma Quality of Life [GQL-15] and 9-item Glaucoma Activity Limitation [GAL-9]) at baseline and exit from the trial. Percentage changes between measurement on PROMs were calculated for each patient and compared between treatment arms. In addition, differences between stable patients (n= 272) and those with glaucomatous progression (n=78), as determined by visual field change (primary outcome), were assessed. PROMs on health-related and vision-related quality of life. Average percentage change on PROMs was similar for patients in both arms of the trial, with no statistically significant differences between treatment and placebo groups (EQ-5D, P= 0.98; EQ-5D visual analog scale, P= 0.88; SF-36, P= 0.94, GQL-15, P= 0.66; GAL-9, P= 0.87). There were statistically significant differences between stable and progressing patients on glaucoma-specific PROMs (GQL-15, P= 0.02; GAL-9, P= 0.02), but not on general health PROMs (EQ-5D, P= 0.62; EQ-5D visual analog scale, P= 0.23; SF-36, P= 0.65). Average change in PROMs on health-related and vision-related quality of life was similar forthe treatment and placebo groups in the UKGTS. The PROMs used may not be sensitive enough to functionasprimary end points in clinical trials when participants have newly diagnosed early-stage glaucoma.

The role of cystoid macular edema as a marker in the progression of non-paraneoplastic autoimmune retinopathy.

To determine the relationship between cystoid macular edema (CME) and disease severity and progression in non-paraneoplastic autoimmune retinopathy (npAIR). A retrospective study was conducted on patients seen between 2008 and 2016 with npAIR as defined by electroretinogram (ERG) dysfunction, visual field changes, presence of antiretinal antibodies, a negative malignancy workup, and no other apparent cause for visual dysfunction. Optical coherence tomography (OCT) scans were reviewed for each patient. A minimum follow-up of 1year was necessary for study inclusion. The presence or absence of CME and the length of the preserved EZ on the centermost line scan of the SD-OCT images was recorded at each visit. The main outcome measure assessed was the rate of EZ loss (EZ final - EZ initial/days follow-up) over time, a marker for disease progression. Thirty-two eyes (16 patients) were included with an average follow-up of 42months. Twenty-one eyes (66%) had CME on initial presentation and final follow-up (group 1), eight eyes (25%) did not have CME on presentation or final follow-up (group 2), and three eyes (9%) did not have CME on presentation but developed CME during follow-up (group 3). Group 1 eyes had a lower maximal a-wave amplitude (59.0 vs. 220.9mV, p = 0.012) and lower maximal b-wave amplitude (88.1 vs 256.9mV, p = 0.017) on baseline ERG compared to Group 2 eyes. The rate of EZ loss over time was significantly greater for group 1 with CME compared to group 2 without CME both at 12months (- 1.26μm/day vs. - 0.26μm/day, p = 0.022) and at final follow-up (- 1.03μm/day vs. - 0.08μm/day, p = 0.012). CME was associated with decreased ERG amplitudes and greater velocity of EZ loss, suggesting that CME is a useful biomarker of more severe and more progressive disease in npAIR.

Evaluation of Iron Deficiency Anemia Frequency as a Risk Factor in Glaucoma.

Purpose Iron deficiency anemia is an important public health problem. Also it is considered to be a risk factor for many diseases. The study demonstrates the iron deficiency anemia frequency in glaucoma patients and compares with the normal subjects. We aimed to determine the iron deficiency anemia frequency in glaucoma patients. Methods Prospective, controlled study in a single university hospital setting. A total of 130 normal subjects (Group 1) and 131 glaucoma patients (Group 2) were included. The erythrocytes parameters, hemoglobin, red blood cell, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration, mean corpuscular hemoglobin, and red blood cell distribution width, and iron status indicators, Fe (iron), total iron binding capacity, and ferritin of the cases, in normal subjects and glaucoma patients were compared. Results There was no statistically significant difference for the erythrocyte parameters between the groups (p≥0.05). The number of the patients with iron deficiency anemia in both groups was similar. No statistically significant difference was found in the comparison of erythrocyte parameters and iron status indicators values according to the number of antiglaucomatous agents and visual field changes according to the presence of anemia in Group 2 (p≥0.05). A statistically significant difference was found only in MCH when the erythrocyte parameters and iron status indicators values of the cases in glaucoma patients were compared with the glaucoma duration (p<0.05). Conclusion The iron deficiency anemia frequency was like the normal population in glaucoma patients.

Correction to: Central 10-degree visual field change following non-penetrating deep sclerectomy in severe and end-stage glaucoma: preliminary results.

The published online version contain mistake in the author list. The correct presentation is also given above.