Humphrey SITA and Octopus TOP Perimetry on Normal Korean Subjects

PURPOSE: To evaluate and compare the inter-individual variability and normal limits of Humphrey SITA and Octopus TOP which were recently developed for shortening test time and decreasing the patient's fatigue. METHODS: Humphrey SITA and Octopus TOP tests were performed on 100 normal Korean subjects and their test results were analyzed. RESULTS: The average test duration was 294.02+/-29.61 seconds in SITA and 147.93+/-9.78 seconds in TOP. There was no significant difference between the two perimetric tests in MD (mean deviation), but PSD (pattern standard deviation) of TOP program was significantly higher than that of SITA (P< 0.01). Mean sensitivity of SITA was 30.15+/-1.00 dB and that of TOP was 26.79+/-1.11 dB, so mean sensitivity of SITA was about 3 dB higher than that of TOP. In topographical map, averaged threshold sensitivity decreased with the eccentricity in both perimetries. Topographically, SITA showed the more regularly increasing standard deviation of threshold sensitivity toward periphery of visual field, but TOP showed the irregular pattern of distribution of the standard deviation. Most of the subjects (88.8%) replied that they were more comfortable with the TOP than the SITA program because of the shorter test time. CONCLUSION: Inter-individual variability in the normal Korean subjects was smaller in Humphrey SITA than Octopus TOP program, but Octopus TOP had the advantage of shorter duration of the test and lower fatigue.

Intravenous Thrombus Formation in Branch Retina Vein Occlusion

PURPOSE: It is very rare to observe the thrombus formation next to the ateriovenous crossing(AV crossing) in branch retinal vein occlusion(BRVO). We investigated two cases with the thrombus in BRVO. MATERIALS AND METHODS: Two of 347 cases with BRVO to perform the fluorescein angiography(FAG) were observed to form the intravascular thrombus next to the AV crossing. RESULTS: The vascular wall in the area of thrombus was hyperfluorescent in FAG. The fluorescence was visible in the early arteriovenous phase and it increased in the mid-phase of the angiogram. Investigatons for systemic hypertension and hyperlipidemia in two cases were positive. The vascular wall in the area of thrombus in one case revealed as hyperfluorescence exaggeratedly in length by forward and backward movement of the thrombus during performing FAG. And the leakage of fluorescein from the venule next to the AV crossing was not observed. In the other case, the vascular wall in the area of thrombus revealed the small hyperfluorescent spot and the leakage of fluorescein. CONCLUSIONS: The pathogenesis of thrombus formation in the retinal vein resulting in retinal vein occlusion is not well understood. Although poststenotic turbulence of blood flow after an AV crossing or a preexisting vessel wall alteration combined with alterations of blood fluidity may induce thrombus formation, it was uncertain in our cases whether or not the thrombus formation was associated with hyperlipidemia, systemic hypertension, and hypercoaguable states.

Vascular Occlusions Associated with Antiphospholipid Antibodies in Systemic Lupus Erythematosus

Antiphospholipid antibodies are found in association with collagen-vascular diseases including systemic lupus erythematosus[SLE]. As the laboratory tests suggest impaired coagulation, the patients having antiphospholipid Ab have been reported to be prone to develop thrombosis. The authors present three patients with antiphospholipid antibodies in SLE who had suffered from retinal vascular occlusions. Case 1 with central retinal vein occlusion who had both lupus anticoagulant and anticardiolipin Ab resulted in visual loss. Case 2 with branch retinal vein occlusion who was positive for only lupus anticoagulant experienced moderate visual disturbance. Case 3 with branch retinal artery occlusion who was positive for both lupus anticoagulant and anticardiolipin Ab died without ocular follow-up examination. We consider that SLE patients with the antiphospholipid Ab may be at high risk to develop disturbances in vision due to thromboembolism from a hypercoagulable state.