Purpose: To determine if an increased cup-to-disc ratio (CDR) and retinal nerve fiber layer (RNFL) loss occur after acute primary angle closure (APAC).
Design: Prospective, observational case series.
Participants: Twenty participants with unilateral APAC provided 20 affected eyes and 20 fellow eyes (controls) for analysis.
Methods: After initial presentation, participants attended 3 further assessments over a 12-month period (visit 2, within 2 weeks; visit 3, 2-3 months; and visit 4, 6-12 months), in which they underwent the following investigations: Heidelberg Retinal Tomography (Heidelberg Engineering, Dossenheim, Germany), optical coherence tomography of the RNFL and macula, and automated perimetry.
Main Outcome Measures: Cup-to-disc ratio, optic cup area, neuroretinal rim area, RNFL thickness, macular thickness, and volume.
Results: There was no change from visits 2 to 4 in CDR (0.46 ± 0.17 vs. 0.47 ± 0.20; P = 0.94), neuroretinal rim area (1.64 ± 0.55 vs. 1.64 ± 0.57; P = 0.96), or other optic nerve head parameters analyzed in eyes with APAC. The mean overall RNFL thickness decreased from 106.6 ± 17.9 μm to 92.9 ± 18.3 μm between visits 2 and 3 (P<0.01) in affected eyes. The superior quadrant RNFL thickness decreased from 134.8 ± 25.9 μm to 113 ± 25.7 μm (P<0.01), and the inferior quadrant RNFL thickness decreased from 139.1 ± 28.4 μm to 115.6 ± 24.9 μm (P<0.01). There was no significant change in macular thickness or volume.
Conclusions: This study demonstrated that an increase in CDR does not occur after APAC that is treated promptly, although RNFL loss does occur.
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http://dx.doi.org/10.1016/j.ophtha.2010.06.026 | DOI Listing |
PLoS One
January 2025
Department of Ophthalmology, University of Washington, Seattle, WA, United States of America.
To investigate macula and optic nerve head (ONH) mitochondrial metabolic activity using flavoprotein fluorescence (FPF) in normal, glaucoma suspect (GS), and open-angle glaucoma (OAG) eyes we performed a cross-sectional, observational study of FPF in normal, GS, and OAG eyes. The macula and ONH of each eye was scanned and analyzed with a commercially available FPF measuring device (OcuMet Beacon, OcuSciences Inc., Ann Arbor, MI).
View Article and Find Full Text PDFActa Neuropathol Commun
January 2025
Ophthalmology, Novartis Biomedical Research, Cambridge, MA, USA.
Neurodegeneration in glaucoma patients is clinically identified through longitudinal assessment of structure-function changes, including intraocular pressure, cup-to-disc ratios from fundus images, and optical coherence tomography imaging of the retinal nerve fiber layer. Use of human post-mortem ocular tissue for basic research is rising in the glaucoma field, yet there are challenges in assessing disease stage and severity, since tissue donations with informed consent are often unaccompanied by detailed pre-mortem clinical information. Further, the interpretation of disease severity based solely on anatomical and morphological assessments by histology can be affected by differences in death-to-preservation time and tissue processing.
View Article and Find Full Text PDFFront Ophthalmol (Lausanne)
December 2024
Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Purpose: Compare cup-to-disc ratio (CDR) measured by clinical assessment and optical coherence tomography (OCT) in pediatric eyes being monitored as glaucoma suspects for suspicious optic disc appearance.
Design: Retrospective cross-sectional study.
Methods: An institutional study following 221 eyes from 122 unique pediatric glaucoma suspects being monitored due to increased or asymmetric appearance of CDR.
Clin Exp Optom
December 2024
Consultant, Carlsbad, CA, USA.
Clinical Relevance: Clinical evaluation of the optic nerve using 3-D stereo disc photographs is considered the gold standard for estimating vertical cup-to-disc ratios. Ultra-widefield retinal imaging has gained increasing popularity to document and screen the health of the retina and optic nerve.
Background: Glaucoma is often first identified or suspected based on initial optic nerve assessment.
BMJ Case Rep
December 2024
Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
Non-arteritic anterior ischaemic optic neuropathy (NAION) is typically characterised by non-pallid optic disc oedema and a contralateral small optic nerve head. Typically, the optic cup is absent or small with a cup-to-disc ratio of less than 0.3 termed 'disc at risk'.
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