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70th AIOC Proceedings, Cochin 2012We conclude from present study that PSV is better in PACG than POAG. OnceIOP is controlled then following up these patients through OBF might indicatethat a patient is likely to progress and subsequently there is a need for furtherintervention.REFERENCES1. Kerr J, Nelson P, O’Brien C. A comparison of ocular blood flow in untreated primaryopen-angle glaucoma and ocular hypertension. Am J Ophthalmol. 1998;126:42–51.2. Flammer J, Orgul S, Costa VP, et al.The impact of ocular blood flow in glaucoma.Prog Retin Eye Res 2002;21:359-93.3. Butt Z, O’Brien C, McKillop G, Aspinall P, Allan P. Color Doppler imagingin untreated high- and normal-pressure glaucoma. Invest Ophthalmol Vis Sci.1997;38:690–6.4. Nicolela MT, Hnik P, Drance SM. Scanning laser Doppler flowmeter study of retinaland optic disc blood flow in glaucomatous patients. Am J Ophthalmol 1996;122:775–83.5. Schwartz B, Rieser JC, Fishbein SL. Fluorescein angiographic defects of the opticdisc in glaucoma. Arch Ophthalmol 1977;95:1961–74.6. Cioffi GA, Alm A. Measurement of ocular blood flow. J Glaucoma 2001;10:S62–4.7. Januleviˇciene I, Ehrlich R, Siesky B, Nedzelskien˙e I, Harris A. Evaluation ofhemodynamic Parameters as Predictors of Glaucoma Progression. J Ophthalmol2011;12:1-9.8. Kaiser HJ, Schoetzau A, Stumpfig D, Flammer J. Blood flow velocities of theextraocular vessels in patients with high tension and normal tension primaryopen angle glaucoma. Am J Ophthalmol. 1997;123:320-7.9. Hafez AS, Bizzarro RLG, Lesk MR, “Evaluation of optic nerve head andperipapillary retinal blood flow in glaucoma patients, ocular hypertensives, andnormal subjects,” Am J Ophthalmol 2003;136:1031.Peripapillary Microperimetry Vs Retinal Sensitivityin GlaucomaDr. Ulka Srivastava, Dr. Pushpa Varma, Dr. Latika Khare, Dr. Mema JoshiGlaucoma is an optic neuropathy characterized by a specific andprogressive injury to the optic nerve head (ONH) and retinal nerve fiberlayer (RNFL), resulting in progressive loss of vision. Conventional automatedperimetry is generally an accepted method for the diagnosis and follow-up ofa patient with glaucoma. It is probable that conventional visual field tests candetect abnormalities only after a substantial number of nerve fibers have beendefinitely lost.312
Glaucoma Free PapersMicroperimetry is a procedure in which retinal sensitivity is assessed whilethe fundus of the eye is directly examined and it enables an exact correlationbetween pathology and corresponding functional defects.OCT is a non contact, non invasive diagnostic technique that allows themeasurement of RNFL (retinal nerve fiber layer) thickness with goodreproducibility. Early detection and prevention of RNFL glaucomatousdamage is essential because RNFL injury is largely irreversible. OCT computesRNFL thickness measurements from high-resolution cross-sectional images ofthe retina and is able to identify diffuse and focal RNFL defects that occur inglaucoma. Both macular and peripapillary NFL thicknesses, as measured byOCT, show statistically significant correlation with glaucoma, the peripapillaryRNFL thickness turns out to be the best marker in glaucoma assessment.Purpose of the study is to determine peripapillary threshold sensitivity usingmicroperimetry and correlate it with retinal nerve fiber layer thicknessmeasured by OCT.MATERIALS AND METHODSTotal 45 eyes including 10 POAG (gp-1), 23 glaucoma suspects (gp-2) and 10age match control (gp 3) were enrolled in this prospective case control study.All attended the OPD of upgraded dept. of ophthalmology, MGMMC andMYH, Indore. Subjects with glaucoma were diagnosed on the basis of raisedintraocular pressure, optic disc changes and visual field changes and openangle in gonioscopy. Glaucoma suspects were the patients with optic nervehead changes suggestive of glaucoma but without a raised IOP or visual fieldchanges. Controls were patients without any history of ocular or systemicdiseases, other than refractive error.Exclusion criteria: myopia>5D, any corneal, retinal, optic nerve (other thanglaucoma), or neurologic pathology associated with visual field defects andany other optic disc abnormality (tilted disc, optic disc drusen, optic discpit,optic disc coloboma) that would affect the evaluation of optic disc. Allstudy subjects underwent complete ophthalmic examination including bestcorrected visual acuity, slit lamp biomicroscopy, intraocular pressure check,fundoscopy, perimetry with SLO –MP using standard peripapillary grid andRNFL thickness measeared with OCT using fast RNFL thickness protocol (3.4mm).The testing protocol included Goldmann IV stimuli, fixation target: cross 1*, astimulus presentation time of 200 ms, background illumination (1.27 cd/m2)with attenuation of stimulus intensity 16 db. A 4-2-1 staircase strategy wasused. The MP tested 12 locations with peripapillary grid. Test was performedwith pupillary semidilatation.313
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