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Chong Lee - One of the best experts on this subject based on the ideXlab platform.
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relative sensitivity and specificity of 10 2 Visual Fields multifocal electroretinography and spectral domain optical coherence tomography in detecting hydroxychloroquine and chloroquine retinopathy
Clinical Ophthalmology, 2014Co-Authors: David J Browning, Chong LeeAbstract:BACKGROUND The purpose of this study was to determine the relative sensitivity and specificity of 10-2 Visual Fields (10-2 VFs), multifocal electroretinography (mfERG), and spectral domain optical coherence tomography (SD-OCT) in detecting hydroxychloroquine retinopathy. METHODS A total of 121 patients taking hydroxychloroquine (n=119) or chloroquine (n=2) with 10-2 VF, mfERG, and SD-OCT tests were retrospectively reviewed. Rates of test abnormality were determined. RESULTS Retinopathy was present in 14 and absent in 107. Eleven of 14 (78.6%) patients with retinopathy were overdosed. Twelve (85.7%) had cumulative dosing greater than 1,000 g. The sensitivities of 10-2 VF, mfERG, and SD-OCT in detecting retinopathy were 85.7%, 92.9%, and 78.6%, respectively. The specificities of 10-2 VF, mfERG, and SD-OCT in detecting retinopathy were 92.5%, 86.9%, and 98.1%, respectively. Positive predictive values of 10-2 VF, mfERG, and SD-OCT in detecting retinopathy were less than 30% for all estimates of hydroxychloroquine retinopathy prevalence. Negative predictive values were >99% for all tests. CONCLUSION Based on published estimates of hydroxychloroquine retinopathy prevalence, all three tests are most reliable when negative, allowing confident exclusion of retinopathy in patients taking ≤6.5 mg/kg/day. Each test is less useful in allowing a confident diagnosis of retinopathy when positive, especially in patients taking ≤6.5 mg/kg/day.
Wudunn D. - One of the best experts on this subject based on the ideXlab platform.
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Bilateral sequential nonarteritic anterior ischemic optic neuropathy: a comparison of Visual outcomes in fellow eyes using quantitative analysis of goldmann Visual Fields.
'American Medical Association (AMA)', 2012Co-Authors: Mercado J.l., Purvin V.a., Kawasaki A., Wudunn D.Abstract:OBJECTIVE To better define the concordance of Visual loss in patients with nonarteritic anterior ischemic optic neuropathy (NAION). METHODS The medical records of 86 patients with bilateral sequential NAION were reviewed retrospectively, and Visual function was assessed using Visual acuity, Goldmann Visual Fields, color vision, and relative afferent papillary defect. A quantitative total Visual field score and score per quadrant were analyzed for each eye using the numerical Goldmann Visual field scoring method. RESULTS Outcome measures were Visual acuity, Visual field, color vision, and relative afferent papillary defect. A statistically significant correlation was found between fellow eyes for multiple parameters, including logMAR Visual acuity (P = .01), global Visual field (P < .001), superior Visual field (P < .001), and inferior Visual field (P < .001). The mean deviation of total (P < .001) and pattern (P < .001) deviation analyses was significantly less between fellow eyes than between first and second eyes of different patients. CONCLUSIONS Visual function between fellow eyes showed a fair to moderate correlation that was statistically significant. The pattern of vision loss was also more similar in fellow eyes than between eyes of different patients. These results may help allow better prediction of Visual outcome for the second eye in patients with NAION
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Bilateral Sequential NAION: A Comparison of Visual Outcomes in Fellow Eyes Using Quantitative Analysis of Goldmann Visual Fields
2011Co-Authors: Mercado J.l., Purvin V.a., Kawasaki A., Wudunn D.Abstract:Purpose: Previous studies of the Visual outcome in bilateral non-arteritic anterior ischemic optic neuropathy (NAION) have yielded conflicting results, specifically regarding congruity between fellow eyes. Prior studies have used measures of acuity and computerized perimetry but none has compared Goldmann Visual field outcomes between fellow eyes. In order to better define the concordance of Visual loss in this condition, we reviewed our cases of bilateral sequential NAION, including measures of Visual acuity, pupillary function and both pattern and severity of Visual field loss.Methods: We performed a retrospective chart review of 102 patients with a diagnosis of bilateral sequential NAION. Of the 102 patients, 86 were included in the study for analysis of final Visual outcome between the affected eyes. Visual function was assessed using Visual acuity, Goldmann Visual Fields, color vision and RAPD. A quantitative total Visual field score and score per quadrant was analyzed for each eye using the numerical Goldmann Visual field scoring method previously described by Esterman and colleagues. Based upon these scores, we calculated the total deviation and pattern deviation between fellow eyes and between eyes of different patients. Statistical significance was determined using nonparametric tests.Results: A statistically significant correlation was found between fellow eyes for multiple parameters, including logMAR Visual acuity (P = 0.0101), global Visual field (P = 0.0001), superior Visual field (P = 0.0001), and inferior Visual field (P = 0.0001). In addition, the mean deviation of both total (P = 0.0000000007) and pattern (P = 0.000000004) deviation analyses was significantly less between fellow eyes ("intra"-eyes) than between eyes of different patients ("inter"-eyes).Conclusions: Visual function between fellow eyes showed a fair to moderate correlation that was statistically significant. The pattern of vision loss was also more similar in fellow eyes than between eyes of different patients. These results may help allow better prediction of Visual outcome for the second eye in patients with NAION. These findings may also be useful for evaluating efficacy of therapeutic interventions
Philip L Custer - One of the best experts on this subject based on the ideXlab platform.
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optic nerve sheath decompression for glaucomatous optic neuropathy with normal intraocular pressure
Archives of Ophthalmology, 1993Co-Authors: Martin B Wax, Debra A Barrett, William M Hart, Philip L CusterAbstract:Objective: To report our therapeutic experience with optic nerve sheath decompression in patients with normal-pressure glaucoma. Design: A case series of seven eyes from six patients with glaucoma and normal intraocular pressures who continued to have progressive Visual field loss despite conventional therapy. Setting: A hospital-based, referral glaucoma service. Patients: Three men (67, 67, and 72 years of age) and three women (58, 61, and 70 years of age). Interventions: Optic nerve sheath decompression. Main Outcome Measures: Visual field data and Visual acuity measurements were obtained at regular intervals during the postoperative periods (range, 3 to 18 months). Results: Two of seven eyes from six patients appear to have enjoyed an inital significant improvement in their Visual Fields with improved Visual acuity in one eye of one patient. The Visual Fields, however, appear to have deteriorated 18 months after the initial procedure in these two patients. In the remaining four patients, no further improvement or deterioration was observed within a limited follow-up period. Conclusions: The transient improvement in the Visual Fields of one eye from each of two patients documents an intial successful use of optic nerve sheath decompression in patients with nerve fiber bundle damage in the absence of optic nerve head swelling. However, the long-term potential of optic nerve sheath decompression in these patients may be of limited value.
Bradley K. Farris - One of the best experts on this subject based on the ideXlab platform.
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pseudotumor cerebri and optic nerve sheath decompression
Ophthalmology, 2000Co-Authors: James T Banta, Bradley K. FarrisAbstract:Abstract Objective To determine the efficacy and safety of optic nerve sheath decompression in a large population of patients with pseudotumor cerebri with Visual loss despite medical treatment and to suggest a treatment algorithm on the basis of these data. Design Retrospective, noncomparative, interventional case series. Participants One hundred fifty-eight eyes in 86 patients with pseudotumor cerebri. Intervention Optic nerve sheath decompression. Main outcome measures Visual acuity, Visual Fields, and surgical complications. Results After optic nerve sheath decompression for pseudotumor cerebri, Visual acuity stabilized or improved in 148 of 158 (94%) eyes, and Visual Fields stabilized or improved in 71 of 81 (88%) eyes. Surgical complications, most of which were transient and benign, were seen in 39 of 86 patients. Only one eye in one patient had permanent severe Visual loss secondary to an operative complication. Conclusions In patients with pseudotumor cerebri with progressive Visual loss despite maximum medical therapy, optic nerve sheath decompression is a safe and effective means of stabilizing Visual acuity and the Visual Fields of those tested.
Nagahisa Yoshimura - One of the best experts on this subject based on the ideXlab platform.
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frequency doubling technology and retinal measurements with spectral domain optical coherence tomography in preperimetric glaucoma
Graefes Archive for Clinical and Experimental Ophthalmology, 2013Co-Authors: Takafumi Hirashima, Masanori Hangai, Masayuki Nukada, Noriko Nakano, Satoshi Morooka, Tadamichi Akagi, Atsushi Nonaka, Nagahisa YoshimuraAbstract:Background To determine the relationship between Visual Fields and retinal structures measured with spectral-domain optical coherence tomography in preperimetric glaucoma (PPG).
