Glaucoma and obstructive sleep apnoea syndrome.

Glaucoma is increasingly recognized as a manifestation of both ocular and systemic risk factors. A number of disorders associated with reduced blood flow and ischaemia, collectively termed vascular risk factors, such as migraine, Raynaud's phenomenon, atrial fibrillation and reduced nocturnal blood pressure, lead to decreased ocular perfusion pressure. During sleep, alterations occur in cardiovascular physiology that are balanced by autoregulation to maintain homeostasis.

Horizontal central ridge of the lamina cribrosa and regional differences in laminar insertion in healthy subjects.

Purpose: To assess the general morphology and position of the lamina cribrosa (LC) in healthy subjects using enhanced depth imaging-optical coherence tomography (EDI-OCT).

Methods: Serial horizontal and vertical B-scans of the optic nerve head (interval between images, approximately 30 μm) were prospectively obtained using EDI-OCT for both eyes of each healthy subject. After delineation of the anterior laminar surface, mean and maximum LC depths were measured in 11 equally spaced horizontal B-scans, and the depth of the anterior LC insertion was measured at 32 points along its circumference (reference plane, Bruch's membrane edges) for one randomly selected eye of each subject.

In vivo evaluation of focal lamina cribrosa defects in glaucoma.

Objectives: To assess focal lamina cribrosa (LC) defects in glaucoma using enhanced depth imaging optical coherence tomography and to investigate their spatial relationships with neuroretinal rim and visual field loss.

Methods: Serial horizontal and vertical enhanced depth imaging optical coherence tomographic images of the optic nerve head were obtained from healthy subjects and those with glaucoma. Focal LC defects defined as anterior laminar surface irregularity (diameter, >100 μm;depth, >30 μm) that violates the normal smooth curvilinear contour were investigated regarding their configurations and locations.

Combined Baerveldt glaucoma implant and scleral buckling surgery for patients with retinal detachment and coexisting glaucoma.

Purpose: To report on the usefulness of combined Baerveldt glaucoma implantation (BGI) and scleral buckling surgery for patients with glaucoma requiring a scleral buckle for retinal detachment repair.

Methods: Retrospective, consecutive, noncomparative, and interventional case series of 30 eyes (30 patients) that underwent simultaneous scleral buckle and BGI surgery, using a staged (group 1, n=21 patients) or nonstaged (group 2, n=9 patients) approach to BGI implantation. Successful intraocular pressure (IOP) control was defined as 6 mm Hg≤IOP≤18 mm Hg.

Enhanced depth imaging optical coherence tomography of deep optic nerve complex structures in glaucoma.

Objective: To assess the usefulness of enhanced depth imaging (EDI) optical coherence tomography (OCT) for evaluating deep structures of the optic nerve complex (ONC; optic nerve head and peripapillary structures) in glaucoma.

Design: Prospective, observational study.

Participants: Seventy-three established glaucoma patients (139 eyes) with a range of glaucomatous damage.

Visual field progression outcomes in glaucoma subtypes.

Purpose: To determine whether glaucoma subtype is an independent risk factor for visual field (VF) progression.

Methods: We reviewed the charts of glaucoma suspects and glaucoma patients seen in a referral practice between 1999 and 2009. Automated pointwise linear regression analysis determined the rates of VF change.

High resolution in vivo imaging of the lamina cribrosa.

The lamina cribrosa (LC) is considered to be the principal site of retinal ganglion cell axon injury in glaucoma. Imaging technology has steadily improved in recent years, allowing greater resolution of fine details of laminar structure. Histological studies have elucidated the details of LC structure, both in normal and glaucomatous eyes, but such studies are limited by smaller sample size, greater difficulty of conducting prospective studies, and possibility of altered tissue architecture during histologic processing.

Short-duration transient visual evoked potential for objective measurement of refractive errors.

This study examined effects of uncorrected refractive errors (RE) in a short-duration transient visual evoked potential (SD t-VEP) system and investigated their role for objective measurement of RE. Refractive errors were induced by means of trial lenses in 35 emmetropic subjects. A synchronized single-channel EEG was recorded for emmetropia, and each simulated refractive state to generate 21 VEP responses for each subject.

Corneal hysteresis and Beta-zone parapapillary atrophy.

Purpose: To evaluate the relationship between β-zone parapapillary atrophy (βPPA) and corneal hysteresis (CH) in patients with glaucoma.

Design: Prospective, cross-sectional study.

Methods: Glaucoma patients aged 18 to 90 years with disc photographs within 12 months of the study visit were consecutively enrolled.

Examination of the performance of different pointwise linear regression progression criteria to detect glaucomatous visual field change.

Background: We aimed to investigate the performance of five different trend analysis criteria for the detection of glaucomatous progression and to determine the most frequently and rapidly progressing locations of the visual field.

Design: Retrospective cohort.

Participants Or Samples: Treated glaucoma patients with ≥ 8 Swedish Interactive Thresholding Algorithm (SITA)-standard 24-2 visual field tests.

The region of largest β-zone parapapillary atrophy area predicts the location of most rapid visual field progression.

Purpose: To determine if visual field (VF) progression occurs most rapidly in the region of largest β-zone parapapillary atrophy (PPA).

Design: Retrospective cohort.

Participants: One hundred twenty-five patients from the New York Glaucoma Progression Study with both β-zone PPA and VF progression.

Beta-zone parapapillary atrophy and multifocal visual evoked potentials in eyes with glaucomatous optic neuropathy.

We investigated changes in multifocal visual evoked potential (mfVEP) responses due to beta-zone parapapillary atrophy (ßPPA). Patients with glaucomatous optic neuropathy (GON) with or without standard achromatic perimetry (SAP) abnormalities were referred for mfVEP testing during a 2-year period. Eyes with good quality optic disc stereophotographs and reliable SAP results were included.

Visual recovery in a patient with total hyphema, neovascular glaucoma, long-standing retinal detachment and no light perception vision: a case report.

Introduction: We report the case of a patient with total hyphema, neovascular glaucoma, long-standing retinal detachment and no light perception vision, who regained counting fingers vision with complete regression of neovascularization following anterior chamber washout, intravitreal bevacizumab, pars plana vitrectomy, and silicone oil placement. This represents a rare case in which a patient with no light perception vision was able to regain functional vision.

Case Presentation: A 63-year-old Caucasian man with a 55-year history of long-standing retinal detachment after trauma presented to our facility with pain and redness, a total hyphema, no light perception vision and an intraocular pressure of 60 mmHg (right eye).

Lower corneal hysteresis is associated with more rapid glaucomatous visual field progression.

Aim: We investigated the correlation between central corneal thickness (CCT) and corneal hysteresis (CH) and their relationship with the rate of visual field (VF) change.

Methods: Glaucoma patients who underwent complete ophthalmic examination and tonometry using both the Goldmann applanation tonometer and the Ocular Response Analyzer were prospectively enrolled. Only eyes with ≥5 SITA Standard 24-2 VF tests were included.

Use of amniotic membrane graft in glaucoma shunt surgery.

Background And Objective: To determine the safety and efficacy of amniotic membrane graft in glaucoma drainage device surgery.

Patients And Methods: Institutional retrospective case series of 44 patients undergoing glaucoma drainage device implantation with use of 300-μm thick amniotic membrane as a patch graft. Endpoints assessed were tube exposure, graft thinning, graft clarity, graft-related infection, and inflammation.

Short duration transient visual evoked potentials in glaucomatous eyes.

Purpose: To investigate the correlation between structural and functional damage in patients with asymmetric glaucoma using a newly developed short duration transient visual evoked potential (SD-tVEP) device.

Methods: Twenty-five patients with visual acuity ≥20/30 and asymmetric visual field (VF) loss [inter-eye difference in mean deviation index (MD) of at least 3 dB] were enrolled. Patients underwent optical coherence tomography (OCT) for macular thickness measurement, scanning laser polarimetry with variable corneal compensation for retinal nerve fiber layer measurement, and SD-tVEP (10% and 85% Michelson contrast, acquisition time of 20 s) in both eyes within 2 months.

Risk factors for visual field progression in treated glaucoma.

Objective: To determine intraocular pressure (IOP)-dependent and IOP-independent variables associated with visual field (VF) progression in treated glaucoma.

Design: Retrospective cohort of the Glaucoma Progression Study.

Methods: Consecutive, treated glaucoma patients with repeatable VF loss who had 8 or more VF examinations of either eye, using the Swedish Interactive Threshold Algorithm (24-2 SITA-Standard, Humphrey Field Analyzer II; Carl Zeiss Meditec, Inc, Dublin, California), during the period between January 1999 and September 2009 were included.

Comparison of stereo disc photographs and alternation flicker using a novel matching technology for detecting glaucoma progression.

Background And Objective: To compare agreement of automated alternation flicker and serial stereophotograph inspection for detection of progressive glaucoma.

Patients And Methods: Serial photographs of patients with glaucoma with at least 36 months of follow-up and perimetry every 4 months were assessed by four graders using predefined criteria with both flicker and stereophotography. The main outcome measure was progressive neuroretinal rim deterioration as identified by each technique.

In-vivo microstructural anatomy of beta-zone parapapillary atrophy in glaucoma.

Purpose: To assess the microstructural anatomy of clinical β-zone parapapillary atrophy (βPPA) by using Fourier-domain optical coherence tomography (FD-OCT).

Methods: Color photographs and horizontal cross-sectional FD-OCT images of the optic disc and parapapillary retina were obtained in 24 eyes (24 patients with glaucoma or suspected glaucoma) with βPPA. The distances between the temporal disc margin and parapapillary landmarks (clinical βPPA margin and the edges of the retinal pigment epithelium [RPE], Bruch's membrane [BM], and the photoreceptor inner/outer segment [IS/OS] junction) were measured in 5 equally spaced horizontal meridians (total, 120 meridians).

Iridocorneal endothelial syndrome in a 16-year-old.

We report iridocorneal endothelial syndrome in a male who presented at the age of 16 years with a 3-year history of complaints of blurred vision, altered pupillary shape, and monocular diplopia OD. The examination was notable for unilateral effacement of the iris architecture, stretch holes, corectopia, and localized ectropion uveae. Intraocular pressures were 41 mm Hg OD and 10 mm Hg OS.

Corneal hysteresis and visual field asymmetry in open angle glaucoma.

Purpose: To investigate the association between corneal biomechanical parameters and asymmetric primary open angle glaucoma (POAG) using the Ocular Response Analyzer (ORA).

Methods: In a prospective cross-sectional study, ORA parameters were measured in 117 POAG patients with asymmetric visual fields (VF). The asymmetry in VF was defined as a five point difference between the eyes using the Advanced Glaucoma Intervention Study (AGIS) scoring system.

Modified visual field trend analysis.

Purpose: Visual field trend analysis can be influenced by outlying values that may disproportionately affect estimation of the rate of change. We tested a modified approach to visual field trend analysis to minimize this problem.

Methods: Automated pointwise linear regression (PLR) was used in glaucoma patients with ≥13 SITA-Standard 24-2 VF tests in either eye.

Intravitreal triamcinolone and bevacizumab therapy for combined papillophlebitis and central retinal artery occlusion.

Purpose: To report a case of an idiopathic, unilateral combined central retinal artery and vein occlusion in a young, healthy patient successfully treated with combined intravitreal triamcinolone and bevacizumab injection.

Methods: Interventional case report. A 38-year-old man presented with a 2-hour history of acute painless loss of vision in his right eye.

Pigment dispersion syndrome patients do not have larger-than-normal irides.

Purpose: To compare iris cross-sectional area and thickness in the accommodated and unaccommodated states in controls versus patients with pigment dispersion syndrome (PDS) and to quantify short-term response of the iris to accommodation.

Patients And Methods: Thirty-three patients with PDS and 17 control subjects were examined with ultrasound biomicroscopy. A radial image of the iris and ciliary body was taken at the temporal quadrant before and after accommodation with the patient looking at a standardized target.