Marked reductions in visual impairment due to diabetic retinopathy achieved by efficient screening and timely treatment.

Purpose: Diabetic retinopathy (DR) is the most common complication of diabetes and needs to be diagnosed early to prevent severe sight-threatening retinopathy. Digital photography with telemedicine connections is a novel way to deliver cost-effective, accessible screening to remote areas. Screening for DR in a mobile eye examination unit (EyeMo) is compared to traditional service models (i.

Postprandial hyperglycemia and insulin response are affected by sea buckthorn (Hippophaë rhamnoides ssp. turkestanica) berry and its ethanol-soluble metabolites.

Background/objectives: Repeated postprandial hyperglycemia and subsequent mild, late hypoglycemia as well as high postprandial insulin response lead to metabolic events that may eventually develop into type 2 diabetes. The aim of this study was to assess how sea buckthorn berries as well as two sea buckthorn extraction residues modulate the postprandial metabolism after a high-glucose meal.

Subjects/methods: Ten healthy normal-weight male volunteers consumed four study breakfasts, one control (A) and three sea buckthorn meals on four distinct study days.

Digital imaging and microtexture analysis of the nerve fiber layer.

Purpose: To describe the design of a digital retinal nerve fiber layer (RNFL) imaging techniques and present a new approach to measure the differences in RNFL patterns.

Methods: A digital camera body is connected to a wide-angle camera to obtain images of the RNFL, which are displayed in workstations throughout the clinic. In the on-line archive, images in Joint Photographics Experts Group (JPEG) format (100 KB per frame) are used.

The application of teleophthalmology in examining patients with glaucoma: a pilot study.

Purpose: To test the feasibility of teleophthalmology applications in examining patients with glaucoma, test its use for training purposes in an ophthalmology residency program and as a consultation link between primary healthcare unit and university eye clinic, and to introduce a preliminary model for economic assessment of telemedicine application in ophthalmology.

Methods: A video slit-lamp, an automated perimeter, a nonmydriatic fundus camera and a videoconferencing system were installed in a healthcare center in a rural area. Twenty-nine patients with glaucoma were examined in the rural healthcare center instead of the university eye clinic.

Fluorometry of the crystalline lens for correcting blue-on-yellow perimetry results.

Purpose: Optical and neural sources of short wavelength sensitivity should be separated in the assessment of the results of blue-on-yellow (B/Y) perimetry. It has been shown previously that lens autofluorescence is related directly to lens yellowing and age. The aim of this study was to find out if B/Y perimetry results can be better corrected by using lens fluorometry than by age.

Interobserver variation in the measurements of peripapillary atrophy in glaucoma.

Purpose: The purpose of this retrospective study is to compare the measurements of intrapapillary and peripapillary parameters between two observers and test the usefulness of measuring different types of crescents.

Methods: Optic disc photographs of 23 eyes of 23 patients with glaucoma and 23 age-matched normal eyes were measured in Oulu and in Erlangen using manual planimetric techniques. The authors measured the following magnification corrected intrapapillary and peripapillary areas: optic disc, neuroretinal rim, cup: disc area ratio, scleral ring, central (zone beta), and peripheral peripapillary atrophy (zone alpha).

Neuroretinal rim area measurements by configuration and by pallor in ocular hypertension and glaucoma.

Purpose: The purpose of this study is to examine the differences between measurements of neuroretinal rim area of the optic disc defined by configuration and by pallor.

Methods: One hundred seventy-one patients were studied (59 with glaucoma, 96 ocular hypertensive patients, and 16 controls). The magnification-corrected neuroretinal rim area was measured from black-and-white stereoscopic paper prints.

Rate and pattern of neuroretinal rim area decrease in ocular hypertension and glaucoma.

The neuroretinal rim areas of 123 eyes (from five normal subjects, 75 patients with ocular hypertension, and 43 patients with glaucoma) were measured to determine the rate and pattern of rim area change during 5 to 15 years (mean, 10 years) of follow-up. Fifty-seven percent of the patients with ocular hypertension and 79% of those with glaucoma showed a statistically significant slope of rim area decrease, a high rate of loss being associated with a high initial rim area. Ninety percent of the variation of rim area loss was accounted for by variables other than the ones measured herein, however (age, disc area, initial rim area, and intraocular pressure).

Neuroretinal rim area in low tension glaucoma: effect of nifedipine and acetazolamide compared to no treatment.

The purpose of this study was to measure the change of neuroretinal rim area in patients with low tension glaucoma on- and off-treatment. Thirty-two patients were followed up for a mean of 2.6 years.

Lens autofluorescence in healthy individuals.

We measured blue-green autofluorescence (AF, 495 nm/520 nm) of the lens in 43 random eyes of 43 healthy volunteers aged 6-86 years, five in each decade, using an instrument designed by one of us (HN). The instrument generates an autofluorescence profile, which consists of anterior and posterior juxtacortical peaks and a central plateau. The height of the anterior peak was taken as a maximum autofluorescence value and the square root of the ratio between the posterior and the anterior peak was used as a lens transmission index.

Retinal nerve fiber layer abnormalities and high-pass resolution perimetry.

The purpose of this study was to compare high-pass resolution perimetry (HRP) test results with clinical optic disc measurements and semi-quantitative retinal nerve fiber layer (RNFL) estimates. HRP reflects the separation of functional ganglion cells in the retina, and estimates a 'Functional Channel Fraction (FCF)' index that expresses the number of functional ganglion cells relative to average normal. FCF was statistically highly significantly correlated both with the overall and diffuse RNFL score (r = -0.

Laser trabeculoplasty versus medication treatment as primary therapy for glaucoma.

The first-year results of a 5-year prospective randomized follow-up study on 39 glaucoma patients, of whom 19 patients received laser trabeculoplasty and 20 patients medication therapy as primary treatment of their newly detected open-angle glaucoma, are presented. The optic disc changes were recorded by measuring the magnification corrected neuroretinal rim area from stereoscopic optic disc photographs and the visual field changes with an automated perimeter. There were no statistically significant differences in success rate, intraocular pressure reduction, and optic disc or visual field changes between the two groups during the first year of follow-up.

Prevalence of exfoliation syndrome in Finland.

Three separate investigations are reported, covering a total of 795 patients from different parts of Finland, two of them consisting of inmates of old people's homes in two towns (N = 205 and 262) and one a randomly selected population from a rural commune (N = 328). They show the mean prevalence of exfoliation syndrome (PS) to be 14.2% in age group 60 less than or equal to 69 years, 21.

A controlled five-year follow-up study of laser trabeculoplasty as primary therapy for open-angle glaucoma.

We followed up 32 eyes of 32 patients with early glaucoma (22 with capsular glaucoma and ten with simple glaucoma) who received laser trabeculoplasty as a primary therapy. These eyes were compared with a matched control group of 32 eyes treated with medication initially. The success rate (intraocular pressure below 22 mm Hg with laser alone or medication alone) at five years was 50% (16 of 32 eyes) in the laser-treated group and 22% (seven of 32 eyes) in the control group (P less than .

Characteristics of corneal endothelial cells in Fuchs' heterochromic cyclitis.

We studied the corneal endothelial cells in 14 patients (6 men and 8 women, ranging in age from 15 to 70 years) with unilateral Fuchs' heterochromic cyclitis (FHC) by means of specular microscopy. The healthy fellow eyes of the patients served as control material. Two affected eyes had undergone an intracapsular cataract extraction before specular microscopy.

Dislocated intraocular lens after biodegradation of fixation loops. A case report.

A boy aged 3 years had a Worst Medallion intraocular lens with loops made of nylon 6 implanted in his right eye after aspiration of traumatic cataract. Post-operatively, the eye was irritated and showed increased tendency to secondary membrane formation. The patient was lost to follow-up 3 months post-operatively.

Clinical electro-oculography.

Electro-oculography (EOG), a retinal function test, indirectly records slow, light-induced changes in the potential difference between the anterior and posterior poles of the eye. EOG is a valuable clinical tool in diagnosis of tapetoretinal degenerations, vitelliform foveal dystrophy including the carriers of this disease, retinal intoxications and in differential diagnosis of choroidal malignant melanomas. EOG is not an alternative to electroretinography but yields additional information on the function of the retinal pigment epithelium.

Effects of topical timolol on corneal endothelial cell morphology in vivo.

To determine the effect of topical timolol on corneal endothelial cell morphology in a randomized, controlled, double-masked study of 40 healthy human eyes, we photographed the central corneal endothelium with a contact specular microscope before and after two weeks of treatment with placebo (20 eyes), with 0.5% timolol with 0.01% benzalkonium chloride (ten eyes), or with 0.

Microcomputer analysis for corneal endothelial cell morphology.

A method for individual endothelial cell analysis using modern microcomputer hardware and the program package "ENDO", developed specially for this purpose, is described. To determine the areas and perimeters of individual cells the coordinates of cell apices are recorded directly from specular photomicrographs with a manual digitizer. To digitize 100 cells with this method takes an average of 16 min.

Vascular effects of timolol and pilocarpine in the iris. A simultaneous bilateral fluorescein angiographic study.

Simultaneous bilateral fluorescein angiography of the iris vessels (SIFA) was performed on 2 groups of patients. One group comprised previously untreated patients with elevated intraocular pressure who underwent a SIFA both before and after a 3 days' timolol treatment in one eye and pilocarpine treatment in the other eye. The other group consisted of glaucomatous patients treated with timolol for 4 to 24 (mean 11) months before the angiography.

Effect of retinal nerve fibre loss on the optic nerve head configuration in early glaucoma.

Twenty-nine ocular hypertensive patients with an optic disc haemorrhage, normal optic discs and normal visual fields were followed in this partly retrospective study by means of sequential optic disc stereophotographs and retinal nerve fibre layer (RNFL) photographs for a period of up to 14 years (mean 5.2). During this time early structural glaucoma damage developed in 11 patients (12 eyes).

Pseudoinflammatory fundus dystrophy with autosomal recessive inheritance.

A family in southwest Finland with bilateral hemorrhagic degeneration of the retina and choroid was followed up for more than 16 years. The maculas showed subretinal hemorrhages, glial cicatrization of the outer retinal layers, and profound choroidal atrophy, particularly in the advanced stages of the disease. Fluorescein angiography demonstrated leakage through the pigment layer in the retinal tissue.

Sensitivity of the electronic subtraction method in evaluation of simulated optic disc changes.

Electronic subtraction method can be used in evaluation of glaucomatous optic disc changes from sequential fundus photographs. To determine the resolving power of the subtraction method, minute changes in the diameter of the model optic cup of known dimensions were simulated by changing the magnification, i.e.

Changes in optic disc drusen. Demonstration by stereophotographs and electronic subtraction.

As a part of more comprehensive examination of 180 patients with optic disc drusen, fundus photographs of 159 cases were evaluated. There were 70 patients whose optic discs were photographed two or more times during the years from 1967 to 1981. Four patients were selected to present the changes which can take place in optic discs with drusen and the alterations are demonstrated by autofluorescence pictures, stereophotographs, and electronic subtraction method.