Shino Sato

Evaluation of peripapillary choroidal thickness in patients with normal-tension glaucoma

BackgroundTo compare peripapillary choroidal thickness measurements between normal and normal-tension glaucoma eyes.MethodsCross-sectional comparative study. 50 normal and 52 normal-tension glaucoma subjects were enrolled in the study. Peripapillary choroidal thickness was measured with spectral-domain optical coherence tomography and enhanced depth imaging. After obtaining circular B-scans around the disc, choroidal thicknesses were calculated based on the exported segmentation values. Visual fields were measured using automated perimetry. Difference in peripapillary choroidal thickness between the normal subjects and the patients with normal-tension glaucoma was analyzed.ResultsThere were no significant differences in age, axial length, or refraction between the two groups. Peripapillary choroidal thickness was inversely correlated with age in both the normal (r = −0.287, P = 0.04) and normal and normal-tension glaucoma (r = −0.322, P = 0.02) groups. Peripapillary choroidal thickness of inferonasal (125 vs 148 μm, P < 0.05), inferior (101 vs 122 μm, P < 0.05), or inferotemporal (100 vs 127 μm, P < 0.05) regions were significantly thinner in the normal-tension glaucoma group as compared to normal subjects. Superior visual hemifield defect was significantly worse than inferior visual hemifield defect in normal and normal-tension glaucoma patients.ConclusionAs compared to normal subjects, peripapillary choroidal thickness was significantly thinner in the normal and normal-tension glaucoma patients, at least in some locations.

Correlation between the ganglion cell-inner plexiform layer thickness measured with cirrus HD-OCT and macular visual field sensitivity measured with microperimetry

PURPOSE To evaluate relationships between the macular visual field (VF) mean sensitivity and the ganglion cell and inner plexiform layer (GCA) thicknesses. METHODS Seventy-one glaucoma patients and 29 healthy subjects were included in this cross-sectional study. At each visit, GCA thicknesses were measured by Cirrus HD-OCT and static threshold perimetry was performed using Macular Integrity Assessment (MAIA). The relationship between the VF sensitivity and GCA thickness was examined globally, and in the superior hemiretina, inferior hemiretina, and six VF sectors with both VF and optical coherence tomography (OCT) in retinal view. Regression analysis was used to investigate the relationship between the GCA thickness and macular sensitivity. RESULTS Macular VF sensitivity (dB) and GCA thickness relationships were statistically significant in each sector (R = 0.365-0.706, all P < 0.001). The highest correlation observed was between the inferotemporal average mean sensitivity and the inferotemporal average GCA thickness (R = 0.706) with both VF and OCT in retinal view. Strength of the structure-function relationship for each of the corresponding inferior sectors was higher than those for the corresponding superior sectors. The strength of the structure-function relationship of the temporal sector was higher than that of the nasal sector. CONCLUSIONS GCA thickness measured by Cirrus HD-OCT showed statistically significant structure-function associations with central VF. Inferotemporal central VF had the strongest association.

Correlation between retinal nerve fibre layer thickness and retinal sensitivity

Purpose:  To evaluate the relationship between retinal nerve fibre layer (RNFL) thickness measured by optical coherence tomography (OCT) and light threshold values obtained with the Micro Perimeter 1 (MP1).

Comparison of optic nerve head parameters using Heidelberg Retina Tomograph 3 and spectral-domain optical coherence tomography

Background:  To assess the agreement between the Heidelberg Retina Tomograph and Cirrus spectral‐domain optical coherence tomography (Cirrus HD‐OCT [Carl Zeiss Meditec, Dublin, CA, USA]) when measuring optic disc parameters.

Comparison of Macular Integrity Assessment (MAIA ™), MP-3, and the Humphrey Field Analyzer in the Evaluation of the Relationship between the Structure and Function of the Macula.

Purpose This study was conducted in order to compare relationships between the macular visual field (VF) mean sensitivity measured by MAIATM (Macular Integrity Assessment), MP-3, or Humphry field analyzer (HFA) and the ganglion cell and inner plexiform layer (GCA) thicknesses. Methods This cross-sectional study examined 73 glaucoma patients and 19 normal subjects. All subjects underwent measurements for GCA thickness by Cirrus HD-OCT and static threshold perimetry using MAIATM, MP-3, or HFA. VF and OCT in the retinal view were used to examine both the global relationship between the VF sensitivity and GCA thickness, and the superior hemiretina and inferior hemiretina. The relationship between the GCA thickness and macular sensitivity was examined by Spearman correlation analysis. Results For each instrument, statistically significant macular VF sensitivity (dB) and GCA thickness relationships were observed using the decibel scale (R = 0.547–0.687, all P < 0.001). The highest correlation for the global (R = 0.682) and the superior hemiretina (R = 0.594) GCA thickness-VF mean sensitivity was observed by the HFA. The highest correlation for the inferior hemiretina (R = 0.687) GCA thickness-VF mean sensitivity was observed by the MP-3. Among the three VF measurement instruments, however, no significant differences were found for the structure-function relationships. Conclusions All three VF measurement instruments found similar structure-function relationships in the central VF.

The Relationship Between Vision-related Quality of Life and Visual Function in Glaucoma Patients.

Purpose:To evaluate the relationship between vision-related quality of life (QOL) as measured by the short-form 11-item Japanese version of the Visual Function Questionnaire (VFQ-J11) and the severity of visual field (VF) defects in patients with glaucoma. Methods:The study included 134 glaucoma patients and 30 normal subjects. VF testing using the Humphrey Field Analyzer was performed to obtain both the VF index (VFI) and MD in both eyes of each glaucoma patient. Binocular integrated VF was constructed for each patient by merging corresponding sensitivity values from monocular VFs, and the correlation between visual function and vision-related QOL was then assessed. Results:A significant relationship was found between QOL and VF in 6 of 7 subscales on the VFQ-J11, and between the composite scores in both the better eye and the worse eye in glaucoma patients. The relationship was stronger in the worse eye than in the better eye. Overall, correlation coefficients of the VFI were higher than those of MD and slightly higher than those of integrated VF in the worse eye. Conclusions:The VFI showed a marginally better correlation than MD. Assessment of VFI in the worse eye may provide useful information regarding vision-related QOL in glaucoma patients.

Efficacy and Safety of Switching from Topical Latanoprost to Bimatoprost in Patients with Normal-Tension Glaucoma

PURPOSE The aim of this study was to evaluate the efficacy and safety of bimatoprost in Japanese patients with normal-tension glaucoma (NTG) who showed insufficient response to latanoprost. METHODS A prospective, nonrandomized study was conducted in patients with NTG, with ≤20% intraocular pressure (IOP) decrease from pretreatment baseline with latanoprost monotherapy who had been switched to bimatoprost. The IOP was measured at 4, 8, and 12 weeks after the switch to bimatoprost. In 12 weeks after the switch to bimatoprost, efficacy and safety were evaluated. RESULTS Postswitch to bimatoprost, IOP was significantly reduced at every visit. Bimatoprost produced significantly greater mean% IOP reduction rate from pretreatment than that of latanoprost at week 12 (P<0.01). There was a significant correlation between% IOP reduction of bimatoprost and that of latanoprost (Pearson r(2)=0.374; P=0.007). No significant difference was observed in the mean scores of conjunctival hyperemia and corneal epithelial disorder between bimatoprost-treated eyes and latanoprost-treated eyes. CONCLUSIONS Significant additional IOP lowering was achieved by switching to bimatoprost in Japanese patients with NTG with insufficient response to latanoprost. Bimatoprost treatment was safe and well tolerated.

Retinal oxygen saturation before and after glaucoma surgery

This study compared retinal vessel oxygen saturation before and after glaucoma surgery.

Influence of Disc Size on the Diagnostic Accuracy of Cirrus Spectral-Domain Optical Coherence Tomography in Glaucoma

Purpose To examine the influence of optic disc size on the diagnostic accuracy of optic nerve head (ONH) parameters determined by Cirrus spectral-domain optical coherence tomography (Cirrus HD-OCT). Methods A total of 51 eyes of 51 normal participants and 71 eyes of 71 glaucoma patients were examined. ONH imaging was obtained by Cirrus HD-OCT. Sensitivity at a fixed 90% specificity along with the area under the receiver operating characteristic curve (AUC) for continuous parameters were analyzed. We also examined the coefficients of variation (CoV) for sensitivity estimates, as these have been used to test and quantify the influence of optic disc size on diagnostic accuracy. The influence of optic disc size on the glaucoma diagnosis was assessed by the likelihood ratio chi-square test. Results Among the continuous parameters, the best diagnostic accuracy was seen for the average rim area, which had an AUC of 0.96. The most reliable factor across the disc size groups was the rim area (CoV, 2.8%). The diagnostic accuracy of the rim area did not appear to be influenced by optic disc size (P = 0.17). Conclusions The high diagnostic accuracy of the rim area demonstrated by Cirrus HD-OCT for the quantitative assessment of the ONH was not significantly affected by disc size in this study.

Correlation between Intraocular Pressure Fluctuation with Postural Change and Postoperative Intraocular Pressure in Relation to the Time Course after Trabeculectomy

Background. To investigate the correlation between intraocular pressure (IOP) fluctuation with postural change and IOP in relation to the time course after trabeculectomy. Methods. A total of 29 patients who had previously undergone primary trabeculectomy with mitomycin C were examined. IOP was obtained at 1, 2, 3, 6, and 12 months and then every 6 months postoperatively. Results. The postural IOP difference before surgery was 3.0 ± 1.8 mmHg, which was reduced to 0.9 ± 1.1 mmHg at 1 month, 1.0 ± 1.0 mmHg at 2 months, 1.3 ± 2.0 mmHg at 3 months, 1.3 ± 1.4 mmHg at 6 months, 1.4 ± 1.5 mmHg at 12 months, and 1.1 ± 0.7 mmHg at 18 months after trabeculectomy (P < 0.01 each visit). The filtering surgery failed in 7 out of 29 eyes. Postural IOP changes were less than 3 mmHg in those patients who did not require needle revision at every visit. However, in patients who did require needle revision, the increase in the posture-induced IOP was greater than 3 mmHg prior to the increase in the sitting position IOP. Conclusions. Assessment of postural IOP changes after trabeculectomy might be potentially useful for predicting IOP changes after trabeculectomy.