Lene Martin

A 5‐year follow‐up study of disease incidence in men with an abnormal hormone pattern

Abstract Rosmond R, Wallerius S, Wanger P, Martin L, Holm G, Björntorp P (The Cardiovascular Institute, Sahlgrenska University Hospital, Göteborg; and Huddinge University Hospital, Huddinge; Sweden). A 5‐year follow‐up study of disease incidence in men with an abnormal hormone pattern. J Intern Med 2003; 254: 386–390.

Early detection of macular changes in patients with diabetes using Rarebit Fovea Test and optical coherence tomography

Aim: To evaluate central retinal thickness and foveal function using optical coherence tomography (OCT) and the Rarebit Fovea Test (RFT) in patients with diabetes without previously known retinopathy or maculopathy. Method: Forty-two patients with diabetes mellitus (DM) were selected from the screening records at St Erik Eye Hospital. Inclusion criteria were absence of macular or other retinal changes at previous screening examination and best corrected visual acuity ⩾1.0. These patients and 42 healthy controls were examined with the recently developed RFT, and retinal thickness was measured using OCT. Lens thickness and light scatter were evaluated by Scheimpflug photography. Results: Significantly more DM subjects (12/42) had a subnormal RFT result compared with the controls (2/42) (p = 0.007). None of the 12 DM subjects had maculopathy, one had mild non proliferative diabetic retinopathy, and five had minimal non-proliferative diabetic retinopathy. The retinal thickness in the pericentral zone was significantly (p<0.05) thinner in DM patients with subnormal RFT compared with the controls. Conclusion: Decreased RT and subnormal RFT results were found in a subgroup of diabetes patients, despite normal screening results. Prospective studies are under way to evaluate the prognostic implications.

Visual and cerebral sequelae of very low birth weight in adolescents

Objective: To describe the visual functions and relate them to MRI findings and the intellectual level in adolescents born with very low birth weight (VLBW). Design: Population-based case–control study. Patients: 59 15-year-old VLBW adolescents and 55 sex and age-matched controls with normal birth weight. Main outcome measures: Objective clinical findings (visual acuity, stereo acuity and cycloplegic refraction) were recorded. Structured history taking was used to identify visual difficulties. The intellectual level was assessed with the Wechsler Intelligence Scale for Children (WISC). All VLBW adolescents underwent MRI of the brain. Results: Significant differences were found between the VLBW adolescents and controls regarding visual acuity (median −0.11 and −0.2, respectively; p = 0.004), stereo acuity (median 60″ and 30″, respectively; p<0.001), prevalence of astigmatism (11/58 and 0/55, respectively; p<0.001) and in full-scale IQ (mean IQ 85 and 97, respectively; p<0.001) and performance IQ (mean 87 and 99, respectively; p = 0.002). The structured history also revealed a borderline significant difference between the groups (mean problems 0.46 and 0.15 respectively; p = 0.051). 30% (17/57) of the VLBW adolescents had abnormal MRI findings and performed worse in all tests, compared with both the VLBW adolescents without MRI pathology and the normal controls. Conclusion: This study confirms previous observations that VLBW adolescents are at a disadvantage regarding visual outcome compared with those with normal birth weight. In 47%, visual dysfunction was associated with abnormal MRI findings and in 33% with learning disabilities. The adolescents with abnormal MRI findings had more pronounced visual and cognitive dysfunction. The findings indicate a cerebral causative component for the visual dysfunction seen in the present study.

Peripheral and central visual fields in 11-year-old children who had been born prematurely and at term.

PURPOSE To examine the peripheral and central visual fields in children who had been born prematurely and at term. METHODS Four groups of 11-year-old children were examined: group 1 included 24 children who had been born at term (control group); group 2 included 20 children who had been born prematurely without ROP; group 3 included 22 children who had been born prematurely with untreated ROP (stages 2 and 3); and group 4 included 21 children who had been born prematurely and underwent cryotreatment for severe ROP. Their peripheral visual fields were examined with Goldmann perimetry. Static high-pass resolution perimetry was used to evaluate their central visual fields within 30 degrees. RESULTS The peripheral visual fields were constricted in children who had undergone cryotreatment (group 4), as compared with the other groups (1 to 3). We found no difference between the groups of children who had been born prematurely with or without ROP (groups 2 and 3) and the control group. The function of the central visual fields, expressed as neural capacity, was reduced in the children who had been born prematurely compared with the controls, significantly in their left eyes only. The children who underwent cryotreament did not differ from the other children who had been born prematurely in this respect. CONCLUSIONS The peripheral visual fields were constricted in children who had undergone cryotreatment. It is uncertain whether this was caused by the treatment or by severe ROP. The central visual fields showed a tendency of reduced neural capacity in the children who had been born prematurely, reflecting a reduced density of retinocortical neural channels. However, this was not related to ROP or cryotreatment.

New perimetric techniques: a comparison between rarebit and frequency doubling technology perimetry in normal subjects and glaucoma patients.

Purpose:To compare rarebit microdot perimetry (RB) with frequency doubling technology (FDT) perimetry in normal subjects and a group of patients with ocular hypertension or glaucoma, with age-matched controls. Materials and Methods:Eighty-one subjects (age 17–88 years) were examined. Twenty-seven of these were patients, aged 50 to 88 years, with ocular hypertension or suspected/manifest glaucoma in at least one eye. All subjects were examined with the RB and FDT perimetry, using the standard procedures, recommended by the respective manufacturer. Results:All patients were able to perform the RB perimetry, but three patients could not perceive the strongest FDT stimulus. The concordance in RB and FDT classifications as normal/outside normal limits was 96% (Cohens kappa = 0.90). A curvilinear (quadratic) relationship (Rsq = 0.75) was found between RB hit rate and FDT MD. All patients, who could perform both examinations, preferred the RB perimetry. Conclusion:In the current study, the information from the RB and FDT perimetry was almost completely equivalent. However, RB perimetry was preferred by the patients and seemed to have a larger dynamic range than FDT. The RB hit rate is apparently a straightforward and efficient measure of visual field function.

Automated quality evaluation of digital fundus photographs

Purpose:  Retinal images acquired by means of digital photography are often used for evaluation and documentation of the ocular fundus, especially in patients with diabetes, glaucoma or age‐related macular degeneration. The clinical usefulness of an image is highly dependent on its quality. We set out to develop and evaluate an automatic method of evaluating the quality of digital fundus photographs.

Comparison of rebound and applanation tonometry in the management of patients treated for glaucoma or ocular hypertension.

Aim:  To compare intraocular pressure (IOP) values obtained with the iCare rebound tonometer (RBT) with values obtained with the Goldmann applanation tonometer (GAT) in patients with glaucoma and ocular hypertension, and to evaluate the impact of possible differences on management decisions.

Macular changes in diabetic patients with no or mild retinopathy

Aim: To evaluate central retinal thickness and foveal function using optical coherence tomography (OCT) and the Rarebit Fovea Test (RFT) in patients with diabetes without previously known retinopathy or maculopathy. Method: Forty-two patients with diabetes mellitus (DM) were selected from the screening records at St Erik Eye Hospital. Inclusion criteria were absence of macular or other retinal changes at previous screening examination and best corrected visual acuity ⩾1.0. These patients and 42 healthy controls were examined with the recently developed RFT, and retinal thickness was measured using OCT. Lens thickness and light scatter were evaluated by Scheimpflug photography. Results: Significantly more DM subjects (12/42) had a subnormal RFT result compared with the controls (2/42) (p = 0.007). None of the 12 DM subjects had maculopathy, one had mild non proliferative diabetic retinopathy, and five had minimal non-proliferative diabetic retinopathy. The retinal thickness in the pericentral zone was significantly (p<0.05) thinner in DM patients with subnormal RFT compared with the controls. Conclusion: Decreased RT and subnormal RFT results were found in a subgroup of diabetes patients, despite normal screening results. Prospective studies are under way to evaluate the prognostic implications.

Concordance of high-pass resolution perimetry and frequency-doubling technology perimetry results in glaucoma : no support for selective ganglion cell damage.

PurposeTo compare the results of frequency-doubling technology perimetry (FDT), assumed to test the magnocellular visual pathway, and high-pass resolution perimetry (HRP), assumed to test the parvocellular visual pathway, in patients with ocular hypertension or glaucoma. Patients and MethodsForty-eight consecutive patients with glaucoma or ocular hypertension, covering the entire range of optic nerve function from normal to severely damaged, were examined on the same day using FDT and HRP. ResultsThere was a linear correlation between both global and local indices in FDT and HRP (r = −0.84 P <0.0001 and r = 0.8 P <0.001, respectively). The HRP and FDT classifications agreed in 32 of the 48 (67%) eyes (Cohen &kgr; = 0.5). There was no significant difference between the ability of the different techniques to detect abnormality. ConclusionThe observations in the present study indicate either that both cell populations are similarly affected by glaucomatous damage or that both methods measure activity in the same cell populations.

Measurement of optic disc parameters on digital fundus photographs: algorithm development and evaluation

Purpose:  To develop and evaluate a simple and rapid algorithm for optic disc measurements on digital fundus photographs, relying on the macula–disc centre distance as a reference when converting length expressed in pixels to metric distance.