Improvement of central retinal sensitivity six months after topical isopropyl unoprostone in patients with retinitis pigmentosa.

Aims: Isopropyl unoprostone (IU), a maxi-K channel activator, is used topically to treat glaucoma, and has been reported to have neuroprotective effects on retinal neurons in vitro and in vivo. The purpose of this non-comparative pilot study was to determine whether topical IU will alter the sensitivity of the central retina in patients with retinitis pigmentosa (RP). Settings and Design: Non-comparative pilot study. Materials and Methods: IU was given topically twice a day for 6 months to both eyes of 30 patients with typical RP. The visual acuity was measured with a Japanese Snellen chart, and the mean retinal sensitivities were obtained by fundus-related microperimetry (MP-1). The mean deviation (MD) of the visual field was determined with a Humphrey field analyzer (HFA). All measurements were made before and 6 months after the treatment. Statistical Analysis Used: Wilcoxon and the Mann-Whitney U tests (SPSS, SPSS Inc., Chicago, IL). Results: After the treatment, the mean retinal sensitivity within the central 2° and 10° improved significantly from 12.3 ± 4.8 dB to 14.7 ± 5.5 dB (P = 0.001) and from 9.1 ± 5.4 dB to 11.0 ± 6.2 dB (P = 0.001), respectively. Conclusions: These short-term results suggest topical IU can improve the central retinal sensitivity in RP patients. It will be necessary to examine longer treatment periods in a controlled study to determine the effectiveness of topical IU in RP patients.

Acupuncture Stimulation Effects to the Sensitivity Threshold of the Retina / 全日本鍼灸学会雑誌

[Objectives] Acupuncture has shown to be beneficial for pseudomyopia and asthenopia patients through the improvement of hypermyotonia of the masculus ciliaris. Since acupuncture leads to visual acuity improvement and increases the retinal blood-flow volume, we wished to examine whether acupuncture results in higher retinal sensitivity.<BR>[Methods] Eleven healthy adults were recruited for this study. They received acupuncture (leaving needle) of LI4 (Hegu), Taiyang, and shang-jingming on both sides for 10 minutes in the supine position. Ten minutes of supine position with rest was used as a control. Retinal sensitivity before and after acupuncture, was measured using the blue-on-yellow program of the Humphrey Field Analyzer (HFA). The increase of mean deviation parameter (MD), foveal sensitivity, and examination time were analyzed.<BR>[Results] Acupuncture did not influence the MD or foveal sensitivity in this study. However, examination time was significantly prolonged in the control (p< 0.05), but this was suppressed by acupuncture. The number of volunteers with a shorter examination time was significantly larger than the control (p< 0.05).<BR>[Conclusions] A significant improvement in healthy volunteers was not detected by HFA. However, acupuncture may influence both the improvement of asthenopia and the concentration of the volunteers, leading to shortened examination times.

A Comparison of Frequency Doubling Technology N-30 and Humphrey Field Analyzer Central 30-2

To evaluate the validity of FDT as a field analyzer by comparing to Humphrey perimetry with global indeces.FDT is known as a easy to use and convenient device, and there is restriction in pupil size and refractive error within 7 diopters. Forty-two glaucoma patients[79 eyes]were included in this study. All subjects performed FDT N-30 and HFA C30-2 apart 15 minutes on same day.Mean age of subjects were 48.18 +/-16.46years[from sixteen to seventy four years].Twenty-five men and seventeen women were included in this study. Test duration was 4.92 +/-1.08 minutes with FDT N-30 and 13.79 +/-3.32 minutes with HFA C30-2.In global index mean deviation was 14.63 +/-9.52 decibel with HFA C30-2 and 10.33 +/-6 .8 3 decibel with FDT.There was a significant correlation with coefficient correlation 0.940 between two tests[p<0.01]. Pattern standard deviation was 7.89 +/-3 .8 5 decibel in HFA C30-2 and 7.80 +/-3.13 in FDT.There was a significant correlation with coefficient correlation 0.702 between FDT PSD and HFA C30-2 PSD, and 0.691 between FDT PSD and HFA C30-2 CPSD, too[P<0.01].In diagnosing glaucoma, sensitivity and specificity of FDT was 86% and 70% respectively. FDT is thought to be convenient and effective screening tool in glaucoma patients for with a high correlation with HFA C30-2.

Visual Fields in Normal Korean Measured with Humphrey Field Analyzer

Central 30-2 threshold tests were performed in 124 eyes of 62 normal subjects with Humphrey Field Analyzer. The average value of foveal threshold, mean deviation(MD), pattern standard deviation(PSD), shor-term fluctuation(SF) and corrected pattern standard deviation(CPSD) were 34.3+/-2.6dB, -1.96+/-1.31dB, 2.25+/-0.88dB, 1.38+/-0.52dB and 1.41+/-1.10dB, respectively. The frequency of abnormal value on automated perimetry(p<5%) was 25.5% in foveal threshold and 19.1% in MD, which was higher than fundamental data of perimetry. As the age increased, foveal threshold decreased (r=-0.729), PSD and CPSD increased (r=0.422) and 0.385, respectively) ; these are statistically significant correlations(p<0.05). This study has the limitation that test was performed on single session and had small study group. Therefore, further study is needed with comparative analysis following repeated test and larger group of visual field examination.

Preservation of retinal sensitivity in central visual field after panretinal photocoagulation in diabetics

Changes in retinal sensitivity within central 30 degrees following panretinal photocoagulation (PRP) for more severe diabetic retinopathy were investigated. Twenty-five eyes with visual acuity of 0.4 or better and minimal maculopathy were studied prospectively. All underwent PRP in two sittings, and Humphrey field analyzer 30-2 threshold test was done before and 1 week, 1 and 3 months after the treatment. The mean retinal sensitivity threshold was obtained from each hemifield between 15 and 30 degrees and from the central 15 degree area, and the changes in the values were analyzed. Mean sensitivity threshold in the upper visual field at pre-PRP, post-PRP 1 week, 1, 3 months were 15.62, 13.81, 14.31, 14.85, respectively. Values in the lower field were 18.71, 17.25, 17.10, 18.17. Difference between pre-PRP and post-PRP was statistically significant at 1 week but no longer thereafter. Retinal sensitivity within the central 15 degrees remained stable. The data show that retinal sensitivity decreases significantly 1 week after PRP but recovers upto 95% of pre-PRP level over the following 3 months.

Detection of Glaucomatous Visual Field Defect by Screening Program of Humphrey Field Analyzer

We have experienced automated and computerized perimetry using a Humphrey Field Analyzer in our Glaucoma Services. To evaluate its clinical efficacy, we report the results of the Armaly central field screening test in comparison with those of central 30-2 threshold test of the Humphrey Field Analyzer. One hundred fortythree eyes of 83 cases of normotensives, ocular hypertensives and glaucoma patients with open-angle or narrow-angle were enrolled in this study. Fiftyfour out of 61 patients (88.5%) and 73 out of 81 eyes (90.1 %) with visual field defect were detected by the screening test of the Humphrey Field Analyzer. Eight out of 81 eyes (9.9%) with visual field defect detected by the screening test were confirmed as false positive. All points of false positive were solitary, which tended to occur more frequently on superior vusual field. False negative of 8 eyes (12.9%) detected by the screening test were confirmed by the threshold test. The point of false negative was more frequent on superior field and showed to locate more peripherally from the fixation point. There was no significant difference in either central sensitivity or age of the false ring.

Detection of glaucomatous visual field defect using a screening program of Humphrey Field Analyzer

To evaluate its clinical efficacy, we report the results of Armaly central field screening test in comparison with those of central 30-2 threshold test of Humphrey Field Analyzer. In 83 cases of normotensives, ocular hypertensives, and glaucoma patients with open-angle or narrow-angle enrolled in this study, a total of 143 eyes were examined. Fifty-four out of 61 patients (88.5%) and 73 out of 81 eyes (90.1%) with visual field defects were detected by the Humphrey Field Analyzer screening test. Eight eyes out of 81(9.9%) with visual field defects detected by the screening test were confirmed as false positive. All points of false positive were solitary, which tended to occur more frequently on superior visual field. A false negative of eight eyes out of 62 (12.9%) detected by the screening test was confirmed by the threshold test, which was more frequent on superior field and shown to be located more peripherally from the fixation point. There was no significant difference in either central sensitivity or age of the false positive and negative.