Correlation of the Intrapapillary Parameters to Visual Field Defects in Primary Open-Angle Glaucoma

The relationship between quantitative structual measurements of the optic nerve head and visual field defects was studied in 150 eyes of 150 patients with primary open-angle glaucoma(POAG). The radius and angle of the optic disc and cup were measured every 30 degrees to obtain rim area, rim area to disc area ratio, cup area, and cup to disc ratio with a computer graphic program(Adobe PhotoshopTM) and the photographic magnification was corrected according to Littmann`s method. The visual field indices including mean deviation(MD) and corrected pattern standard deviation(CPSD), using a Humphrey Field Analyzer(C 302) were obtained. Each intrapapillary parameter showed statistically significant linear correlation with MD. And those disc parameters also significantly correlated with CPSD, although this correlation was relatively lower than that of intrapapillary parameter with MD. Rim area to disc area ratio and MD were most highly correlated(r=0.712, p=0.0001), and correlation of rim are with MD followed next(r=0.670, p=0.0001). These findings suggest that intrapapillary parameters in POAG were more correlated with the overall visual field depression(MD) than the localized visual field change(CPSD). The rim area to disc area ratio rather than the rim area itself, was more related to the diffuse visual field defects.

Pattern of Glaucomatous Optic Disc Damage in Primary Open-Angle Glaucoma

To identify the pattern of glaucomatous changes of the optic disc, the rim area to disc area ratio (RA/DA ratio) of 149 eyes (149 cases) with primary open-angle glaucoma (POAG) were measured and compared with that of 88 eyes (88 cases) of normal individuals. At all stages of the disease, glaucomatous rim loss was present in all sectors of the optic disc. The location of the most pronounced rim loss changed depending on the severity of the disease. In the early (RA/DA ratio > 61%; mean deviation(MD): -6.43+/-3.32dB) and medium (RA/DA ratio=41~60%; MD: -7.54+/-5.65dB) glaucoma subgroups, rim loss was found predominantly at the inferior temporal and superior temporal disc region. In the advanced glaucoma subgroup (RA/DA ratio=40~21%; MD: -18.27+/-8.40dB), the temporal horizontal disc region showed relatively marked rim loss. In the far advanced glaucoma subgroup (RA/DA ratio=20~0%; MD: -25.91+/-5.40dB), the rim remnants were located mainly in the nasal disc sector, with a larger rim portion in the upper nasal region than in the lower nasal region. These results indicate that generally in POAG, the loss of neuroretinal rim was found to start predominantly in the inferior temporal and superior temporal disc region, and then the temporal horizontal, the inferior nasal, and the superior nasal disc sectors followed.

Detection of Eosinophil in Patient with Allergic Conjunctivitis by Impression Cytology

Allergic conjunctivitis is commonly encountered in the office parctice of ophthalmology. However, diagnosis is not easy because allergic conjunctivitis shows nonspecific ocular symptoms and signs. And for accurate diagnosis, conjunctival scraping for eosinophils, tear levels of specific IgE, skin testing to aeroallergens, and ocular challenge with allergens are available but these methods are much time and cost consuming. So we evaluate the usefulness of the detection of eosinophils by conjunctival impression cytology. Conjunctival impression cytology was done on 44 eyes of 44 patients who were diagnosed as allergic conjunctivitis. 7 eyes of 7 normal subjects and 14 eyes of 14 patients with epidemic keratoconjunctivits were used as control. Scoring system was defined according to the past history, symptom, sign, and slit lamp finding ranged from +1 to +5. Eyes of score +1 or +2 were defined as allergy suspect group, and eyes of score +3 to +5 defined as allergy group. The sensitivities of the impression dytology were 59% in allergy suspect group, 86% in definite allergy group and 72%in total, The specificity was 95%. According this study, we conclude that impression cytology is a simple, non-invasive and cheap method with high sensitivity and specificity for the diagnosis of allergic conjunctivitis.

Result of Excimer Laser Photorefractive Keratectomy Correction of Myopia: One and Two-Years Follow-up

To examine prospectively the efficacy and reliability of excimer laser photorefractive keratectomy for myopia. we treated 147 eyes of 86 patients with a VisX Twenty/Twenty excimer laser and followed them up for 1 year and follow up 48 eyes of 26 patients for 2 years. The patients were divided into two groups with preoperative myopia: group 1 with diopters between -1.50 and -6.00, group 2 with diopters between -6.01 and -10.00. At 1 year, the group 1 with a mean preoperative refractive error of -4.61D changed to -0.40D, the group 2 changed from -7.50D to -0.92D. At 2 years, the group 1 with a mean preoperative refractive error of -4.28D changed to -0.41D, the group 2 changed from -7.75D to -1.04D. At 1 yera, in group 1, 90.91% (70 of 77) of eyes and in group 2, 64.29%(45 of 70) of eyes were corrected within 1D of intended refraction,respectively. At 1 years, in group 1, 94.81% (73 of 77) of eyes and in group 2, 84.29%(59 of 70) of eyes achieved an uncorrected visual acuity of 0.5 or better. And at 2 years, in group 1, 81.82% (18 of 22)of eyes, and in group 2, 50.00% (13 of 26) of eyes were corrected within 1D of intended refraction, respectively. At 2 years, in group 1, 95.50% (21% of 22) of eyes and in group 2, 84.62%(22 of 26) of eyes achieved an uncorrected visual acuity of 0.5 or better.

Hypotony After Trabeculectomy with Mitomycin C

The purpose of this study is to evaluate the influence of clinical factors on the development of postoperative hypotony, and also to determine whether the occurrence of hypotony has any effect on the outcome of trabeculectomy with intraoperative mitomycin C. The authors retrospectively reviewed the outcome in 160 eyes of 112 patients who underwent tight scleral flap trabeculectomy with releasable sutures. Mitomycin C with 0.25 or 0.5mg/ml was applied for 3 or 5 minutes between the Tenon's capsule and the sclera. The mean follow-up period was 16.5 +/- 11.5 months. Success of the trabeculectomy was defined as intraocular pressure (IOP) 6-21 mmHg with or without medications. Hypotony(IOP