The rate of structural change: the confocal scanning laser ophthalmoscopy ancillary study to the ocular hypertension treatment study.

Purpose: To compare rates of topographic change in ocular hypertensive eyes that develop primary open-angle glaucoma (POAG) compared to eyes that do not, and to identify factors that influence the rate of change.

Design: Longitudinal, randomized clinical trial.

Methods: Four hundred forty-one participants (832 eyes) in the Confocal Scanning Laser Ophthalmoscopy Ancillary Study to the Ocular Hypertension Treatment Study were included.

Predicting the onset of glaucoma: the confocal scanning laser ophthalmoscopy ancillary study to theOcular Hypertension Treatment Study.

Objective: To evaluate the predictive ability of baseline confocal scanning laser ophthalmoscopy (CSLO) Glaucoma Probability Score (GPS) for the development of primary open-angle glaucoma (POAG) and to compare it with the Moorfields regression analysis (MRA) classification, other topographic optic disc parameters, and stereophotograph-based cup-to-disc ratio.

Design: Longitudinal, randomized clinical trial.

Participants: We included 857 eyes of 438 participants in the CSLO Ancillary Study to the Ocular Hypertension Treatment Study (OHTS) with good quality baseline CSLO images.

MRI retinovascular studies in humans: research in patients with diabetes.

Purpose: To review existing applications of MRI for detecting blood-retinal barrier (BRB) damage and retinal oxygenation response abnormalities in patients with diabetes and highlight new information available from such applications.

Methods: BRB studies were accomplished using dynamic contrast-enhanced MRI, and the retinal oxygenation response studies were accomplished by monitoring changes in the MRI signal associated with hyperoxic provocation. Participants were patients with diabetes and macular edema, with either no detectable or mild to moderate background retinopathy, as well as non-diabetic individuals of similar age (controls).

A new method for eyelid elevation in glaucoma patients with ptosis during automated perimetry testing.

Purpose: Ptosis is a well-recognized confounding factor when interpreting superior visual field defects. As the current technique for eyelid elevation during automated perimetry is cumbersome and inconsistent, we developed a new technique. To evaluate its efficacy and feasibility, we studied a group of glaucoma patients with ptosis and superior visual field defects that had been attributed to nerve fiber layer defects.

Advances in imaging of the optic disc and retinal nerve fiber layer.

In the past decade, three technologies for imaging the optic disc and retinal nerve fiber layer have become commercially available: 1) confocal scanning laser tomography with the Heidelberg retinal tomograph; 2) confocal scanning laser polarimetry with the GDx VCC; and 3) optical coherence tomography with the Stratus OCT. Each uses different principles of physics. Understanding the merits and limitations of each of these technologies requires familiarity with the principles of operation of each device.

Early supernormal retinal oxygenation response in patients with diabetes.

Purpose: To determine whether the human retinal oxygenation response (deltaPO2) to a hyperoxic provocation is abnormal in patients with type I diabetes.

Methods: Magnetic resonance imaging (MRI) was used to measure deltaPO2 during 100% oxygen breathing in patients with type I diabetes who had either no clinically detectable retinopathy (n = 5) or mild to moderate background diabetic retinopathy (BDR; n = 5) and in age-matched healthy control subjects (n = 7).

Results: Both the patients with diabetes and the control subjects exhibited a significant (P < 0.

A multicenter, retrospective pilot study of resource use and costs associated with severity of disease in glaucoma.

Objective: To examine resource consumption and the direct costs of treating glaucoma at different disease severity levels.

Design: Observational, retrospective cohort study based on medical record review.

Participants: One hundred fifty-one records of patients with primary open-angle or normal-tension glaucoma, glaucoma suspect, or ocular hypertension (age > or =18 years) were randomly selected from 12 sites in the United States and stratified according to severity based on International Classification of Diseases, Ninth Revision, Clinical Modification codes.

Dynamic contrast enhanced MRI in patients with diabetic macular edema: initial results.

To assess the ability of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) to detect blood retinal barrier (BRB) damage in patients with diabetic macular edema (DME). DCE-MRI with 0.1 mmol Gd-DTPA was used to measure BRB permeability in 10 healthy and visually normal subjects and eight patients with DME, including five patients with non-clinically significant (NCS) DME and three patients with clinically significant (CS) DME.

Retinal oxygenation response and retinopathy.

Oxygen supply and demand of the retina, one of the most metabolically active tissues in the body, must be dynamically balanced to insure the health of the tissue. The integrity of such active regulation can be assessed by measuring retinal oxygenation response (ROR) to a hyperoxic provocation. Over the last decade, we have developed an MRI-based technique to measure ROR as a change in vitreal oxygen level from room air breathing to a new hyperoxic condition (DeltaPO2).

Beyond visual acuity: new and complementary tests of visual function.

Visual acuity is an essential component of the routine ophthalmic examination and the most common measure of visual function. There is increasing recognition, however, of the need to evaluate visual function beyond the limited extent afforded by visual acuity. The primary objective of this article is to introduce a variety of new and lesser-used techniques for measuring visual function that complement visual acuity assessment, each of which has been shown to detect visual dysfunction in patients with normal visual acuity.