Correlation between central corneal thickness and intraocular pressure peak and fluctuation during the water drinking test in glaucoma patients

OBJECTIVE: To investigate the correlation between central corneal thickness and outflow facility assessed by intraocular pressure peak and fluctuation during the water drinking test. METHODS: Fifty-five newly diagnosed primary open-angle glaucoma patients submitted to central corneal thickness measurements and water drinking test were enrolled in this retrospective study.;. Patients were divided into three groups according to their central corneal thickness. Pearson's Correlation test was performed in the groups with lower and higher pachymetric values. RESULTS: The mean age was 65,65 ± 28,28 years; 63,63% were female and 52,72% were caucasian. The mean central corneal thickness was 544,32 ± 36,86 µm, and the mean baseline intraocular pressure was 23,36 ± 6,26 mmHg. During the water drinking test, the mean intraocular pressure peak and mean intraocular pressure fluctuation were 30,43 ± 8,13 mmHg and 31,46 ± 18,46%, respectively. No relevant correlation was detected between the central corneal thickness and the intraocular pressure peak (r² = 0,021) or between the central corneal thickness and the intraocular pressure fluctuation (r² = 0,011). Group 1 presented a mean central corneal thickness of 505,81 ± 13,86 µm, and Group 3 was 583,55 ± 27,87 µm (p = 0,001). The mean intraocular pressure peak was 31,05 ± 9,05 mmHg and 27,83 ± 4,92 mmHg in Group 1 and in Group 3, respectively (p = 0,193). The difference of intraocular pressure fluctuation was not statistically significant between Group 1 (mean 28,47±16,25%) and Group3 (mean 33,27 ± 21,27%) (p = 0,43). CONCLUSION: In our case series, no correlation was found between central corneal thickness and water drinkingtest results

Analysis of neuroretinal rim distribution and vascular pattern in eyes with presumed large physiological cupping: a comparative study

Background: To investigate possible differences in neuroretinal rim distribution, vascular pattern, and peripapillary region appearance between eyes with presumed large physiological optic disc cupping (pLPC) and eyes with minimal optic disc excavation.Methods: We prospectively enrolled consecutive subjects with pLPC and individuals with minimal excavation (optic disc excavation within normal limits; control group). All eyes had normal visual fields and untreated intraocular pressure (IOP) = 0.6 and >= 30 months of follow-up with no evidence of glaucomatous neuropathy. for controls, VCDR was limited to <= 0.5. We compared ocular signs and characteristics related to the neuroretinal rim distribution, vascular pattern, peripapillary region appearance and disc size between groups. Whenever both eyes were eligible, one was randomly selected for analysis.Results: A total of 74 patients (mean age, 45.6 +/- 14.9 years) with pLPC and 45 controls (mean age, 44.8 +/- 11.6 years) were enrolled (p = 0.76). Median disc size and VCDR was significantly larger in eyes with pLPC compared to controls (p < 0.01). the proportion of eyes with violation of the ISNT rule, laminar dot sign, nasal shifting of the central vessels, nasal excavation and baring of circumlinear vessel was significantly greater in the eyes with pLPC compared to controls (p < 0.01). There were no significant differences regarding the proportions of eyes with peripapillary atrophy between groups (p < 0.09). Finally, disc size was significantly associated with VCDR (r(2) = 0.47, p < 0.01), with an increase of 0.21 in VCDR for each 1 mm(2) in disc area.Conclusion: Compared to normal controls, eyes with pLPC may present a higher proportion of optic nerve head findings frequently observed in glaucomatous eyes. This seems to be explained in part by the larger discs found in these eyes. We believe care should be taken while classifying them as glaucomatous or not based solely on these characteristics.Universidade Federal de São Paulo, Dept Ophthalmol, BR-04021001 São Paulo, BrazilHosp Med Olhos, Glaucoma Unit, BR-06018180 Osasco, SP, BrazilMayo Clin, Dept Ophthalmol, Jacksonville, FL 32224 USAUniversidade Federal de São Paulo, Dept Ophthalmol, BR-04021001 São Paulo, BrazilWeb of Scienc

Estudo da correlação entre estrutura e função no glaucoma por meio da ultrassonografia de alta-resolução e ressonância magnética com a tomografia de coerência óptica e as perimetrias computadorizadas padrão e de frequência duplicada

Purpose: To evaluate the correlation between 20 MHz high-resolution ultrasonography (US) and currently available structural tests for glaucoma in assessing the cup-to-disc ratio (CDR) of the optic nerve head. Further, we aimed to analyze the correlation between structural characteristics of intraorbital optic nerve (ION) and lateral geniculate nucleus (LGN) measured by 3-Tesla magnetic resonance imaging (MRI), and the extent of glaucoma damage, assessed by functional or ocular structural tests. Methods: This was a cross-sectional study. All participants underwent US, MRI, ocular structural testing [optic disc stereophotograph, spectral-domain optical coherence tomography (OCT) and confocal scanning laser ophthalmoscopy] and functional evaluation (standard automated perimetry and frequency doubling technology). Generalized estimating equations, bootstrap resampling method for clustered data, area under receiving operator characteristics curve (AUC) and Bland-Altman plots were used in statistical analysis. Results: We included 41 glaucoma patients and 12 age- and sexmatched healthy volunteers; 54.7% were female. When glaucoma diagnosis was determined by functional damage, the AUC for US vertical CDR in the right eye was 0.882 (95% CI, 0.792 ? 0.972), whereas for stereophotograph it was 0.982 (95% CI, 0.945 ? 1.0). The mean difference of vertical CDR between stereophotograph and US was 0.46 (95% CI, 0.425 ? 0.488), as US tended to underestimate CDR measurements greater than 0.8 on stereophotographs. Regarding MRI results, there were significant differences of ION parameters and LGN height between glaucoma and control groups. All ION segments correlated with functional parameters and OCT rim area. In addition, ION distal segments correlated with the OCT average retinal nerve fiber layer thickness, and ION segment at 15 mm behind the globe correlated with the optic nerve head rim area measured on stereophotographs. LGN measurements were not correlated with any ocular structural or functional parameter. Conclusion: 20 MHz high-resolution US may provide a useful quantitative assessment of the optic nerve head in glaucoma. This may be advantageous mainly in eyes with media opacity, in which clear optic media-based exams might not provide reliable information. However, we observed that US tended to underestimate greater CDR measurements and overestimate smaller ones in comparison with other structural tests for evaluation of the optic nerve head. Moreover, MRI may be a promising tool for objective analysis of glaucomatous damage in the central nervous system. ION correlated with functional parameters, and its distal portions correlated better with ocular structural parameters. However, LGN parameters were not associated with functional or ocular structural evaluation.Objetivo: Avaliar a correlação entre a ultrassonografia de alta resolução com transdutor de 20 MHz (US) e testes estruturais realizados na prática clínica em determinar a razão escavação/disco (E/D) da cabeça do nervo óptico no glaucoma. Além disso, nós quisemos analisar a correlação entre as características do nervo óptico intraorbitário (NOI) e do corpo geniculado lateral (CGL) medidas pela ressonância magnética de 3 Teslas (RM), e a extensão do dano glaucomatoso, determinada por exames funcionais e estruturais oculares. Métodos: Este foi um estudo com desenho transversal. Os participantes foram submetidos a US, RM, exames estruturais oculares [estereofotografia do disco óptico, tomografia de coerência óptica de domínio espectral (OCT) e oftalmoscopia confocal de varredura a laser] e avaliação funcional (perimetria computadorizada padrão e perimetria de frequência duplicada). Equações de estimativas generalizadas, método de reamostragem bootstrap para dados agrupados, áreas sob as curvas características de operação do receptor (AUC) e análise de concordância pelo método de Bland-Altman foram utilizados na análise estatística. Resultados: Foram incluídos 41 pacientes com glaucoma e 12 indivíduos controles; 54,7% mulheres. Quando o diagnóstico de glaucoma foi determinado pelo dano funcional, a AUC para a E/D vertical para a US no olho direito foi 0,882 (IC 95%, 0,792 ? 0,972), enquanto que, para a estereofotografia, foi de 0,982 (IC 95%, 0,945 ? 1,0). A diferença média da E/D vertical entre a estereofotografia e a US foi 0,46 (IC 95%, 0,425 ? 0,488), e a US tendeu a hipoestimar os resultados da E/D quando valores maiores que 0,8 da E/D foram obtidos pela estereofotografia. Com relação aos resultados da RM, houve diferenças significativas dos parâmetros do NOI e da altura do CGL entre os grupos glaucoma e controle. Todos os segmentos do NOI analisados correlacionaram-se com a avaliação funcional e com a área da rima neural medida pela OCT. Ainda, os segmentos distais do NOI correlacionaram-se com a espessura média da camada de fibras nervosas da retina peripapilar da OCT, e o segmento do NOI a 15 mm do globo ocular correlacionou-se com a área da rima neural obtida pela estereofotografia. O CGL não apresentou correlação com nenhum parâmetro funcional ou estrutural. Conclusões: A US pode ser útil na avaliação quantitativa da cabeça do nervo óptico no glaucoma. Isto pode ser conveniente principalmente em olhos com opacidade de meios, nos quais exames baseados em princípios ópticos podem não fornecer informações precisas. No entanto, a US tendeu a hipoestimar altos valores da E/D e hiperestimar valores menores desta em comparação com testes estruturais da cabeça do nervo óptico. Adicionalmente, a RM parece ser uma ferramenta promissora na avaliação das alterações glaucomatosas no sistema nervoso central. O NOI correlacionou-se com os parâmetros funcionais, e suas porções distais correlacionaram-se melhor com parâmetros estruturais oculares. Contudo, não houve associação dos parâmetros do CGL com nenhum parâmetro funcional ou estrutural ocular.Dados abertos - Sucupira - Teses e dissertações (2013 a 2016

Guide des professions de santé : concours d'entrée, formations, diplômes / Françoise Thiebault-Roger ; [illustrations de Cécile Gallou et Florence Pinel]

Collection : Guides VuibertContient une table des matièresAvec mode text

Severities of visual field damage in both eyes of glaucoma subjects according to standard automated perimetry results and subgroup classification.

<p>Severities of visual field damage in both eyes of glaucoma subjects according to standard automated perimetry results and subgroup classification.</p

Structure-function relationship between 3-Tesla magnetic resonance imaging findings of the intraorbital optic nerve and frequency doubling technology outcomes.

<p>Structure-function relationship between 3-Tesla magnetic resonance imaging findings of the intraorbital optic nerve and frequency doubling technology outcomes.</p

Structure-function relationship between 3-Tesla magnetic resonance imaging findings of the intraorbital optic nerve and standard automated perimetry outcomes.

<p>Structure-function relationship between 3-Tesla magnetic resonance imaging findings of the intraorbital optic nerve and standard automated perimetry outcomes.</p

Relationship between 3-Tesla magnetic resonance imaging findings of the intraorbital optic nerve and spectral-domain optical coherence tomography outcomes.

<p>Relationship between 3-Tesla magnetic resonance imaging findings of the intraorbital optic nerve and spectral-domain optical coherence tomography outcomes.</p

Receiver operating characteristic curves for the best-performing parameters of the different devices used in the study to discriminate glaucomatous from healthy eyes.

<p>MRI = magnetic resonance imaging; ION = intraorbital optic nerve; HRT = confocal scanning laser ophthalmoscopy;OCT = spectral-domain optical coherence tomography.</p