Heidelberg Retina Tomography II parameters in evaluating high- and normal-pressure glaucoma progression.

BACKGROUND/AIM: Heidelberg retina tomography II (HRT II) haves been employed to quantitatively assess the topography of optic discs in eyes with high-pressure glaucoma (HPG) and normal-pressure glaucoma (NPG), in order to determine which of global and segmental optic disc parameters will prove to be most suitable for monitoring the progression of these two conditions. METHODS: The results of 73 eyes of 73 patients with HPG and NPG were analyzed in relation to age, refractive error, quality of HRT images and stereometric parameters. RESULTS: A statistically significant difference (p < 0.05) between the global baseline and follow-up results was found in: rim volume, maximum cup depth and cup shape measure (in the HPG group), and C/D ratio, cup volume, rim volume and cup shape measure (in the NPG group). The baseline and follow-up results of the retinal nerve fiber layer in the temporal and inferotemporal sectors show a significant difference in both groups. CONCLUSION: Several HRT stereometric parameters are useful for monitoring the progression of changes of the optic disc and local retina in eyes with HPG and NPG. Both segmental and global scanning is of importance in glaucoma progression analysis.

Retrobulbar hemodynamic parameters in men and women with open angle glaucoma.

BACKGROUND/AIM: Several factors may have influence on systemic circulation. Additionally, peripheral circulation also demonstrates sex differences, in young women presenting significantly lower finger blood flow in comparison to men of the same age, a finding that disappears in women after menopause. The aim of this study was to compare the retrobulbar hemodynamic parameters measured by means of color Doppler imaging in women and men with open-angle glaucoma and elevated intraocular pressure. METHODS: A total of 52 eyes from 52 open-angle glaucoma (OAG) patients, with elevated intraocular pressure (lOP), were included in this cross-sectional study. Peak-systolic velocity (PSV), end-diastolic velocity (EDV), and Pourcelot resistivity index (RI) were assessed in the ophtalmic artery (OA), central retinal artery (CRA), and posterior cilliary arteries (PCA). IOP was measured both with Goldmann Applanation tonometer (GAT) and with the dynamic contour tonometer (DCT), three times respectively. Ocular pulse amplitude (OPA) appeared during the DCT measurement. RESULTS: The retrobulbar hemodynamic parameters did not show any difference between men and post-menopausal women. CONCLUSION: The results of our study did not find any difference between sexes in patients with open-angle glaucoma and elevated intraocular pressure.

The role of confocal scanning laser ophthalmoscopy in stereometric differentiation of eye papilla in ocular hypertension, normal tension glaucoma and primary open-angle glaucoma.

BACKGROUND/AIM: Primary open angle glaucoma (POAG) and normal tension glaucoma (NTG) demonstrate the same structural changes in the optic disc along with visual field defects but only POAG includes an abnormal elevation of intraocular pressure. Heidelberg retina tomograph based on confocal scanning laser ophthalmoscopy (HRT) and Moorfields regression analysis (MRA) have been employed to quantitatively assess the topography of eye papilla. We measured stereographic parameters of eye papilla in patients with POAG, NTG, and ocular hypertension (OH) using an HRT in order to determine whether HRT topographic parameters can be used to differentiate those conditions. METHODS: The results of 145 eyes of 145 patients with OH, NTG and POAG were analyzed by age, refractive error, quality of HRT images, stereometric and MRA parameters. RESULTS: Significant differences were found between NTG and other two groups for a majority of the HRT parameters, and also no differences between OH and POAG patients for a majority of the investigated parameters, except thickness of retinal nerve fiber layer. By reading the MRA no differences were found in the distribution of mostly damaged and mostly preserved neuroretinal rim sectors between NTG and POAG patients, and also all sectors of the neuroretinal rim in OH patients were preserved. CONCLUSION: HRT stereometric parameters are useful to differentiate patients with OH and NTG, and also for differentiation between NTG and POAG patients, but most of parameters showed no difference between OH and POAG patients. MRA may serve to confirm the diagnosis of OH, but not for precise distinction between NTG and POAG.

Morphometric characteristics of optic disc in patients with myopia and primary open-angle glaucoma.

BACKGROUND/AIM: Primary open-angle glaucoma is a multifactorial and progressive neuropathy, characterised by the acquired loss of ganglion cells of the retina and their axons. One of the risk factors for primary open-angle glaucoma is myopia over 5 diopters (D). The aim of our work was to investigate two groups of patients with primary open-angle glaucoma and myopia by using confocal scanning laser ophthalmoscopy, and to find out if the size of refractive error influences optic disk morfometric characteristics. METHODS: One hundred eyes of one hundred patients with primary open-angle glaucoma and myopia were involved in our study. All the patients were classified into two groups, the first one with myopia < 5 D, and the second one with myopia > or = 5 D. The Heidelberg retina tomograph is a technique we used in our study. We analized morfometric parameters of patients optic discs, with the aim to find a correlation between the parameters in each group separeatly, and also to find differences between the same parameters from both groups. RESULTS: There were significant differences in disc area, cup area, rim area and mean RNFL thickness between the two groups. The size of damage of neuroretinal rim in the group with high myopia was 27%, and in the group with lower myopia 14%. The most frequently damaged segment of neuroretinal rim in the patients with high myopia was nasal segment and in the patients with low myopia infero-temporal one. The least frequently damaged segment of neuroretinal rim in both groups was temporal one. CONCLUSION: Optic discs of glaucomatous patients with high myopia have bigger diameter, also bigger and more irregularly distributed damaged zone of neuroretinal rim, and also thinner retinal nerve fiber layer compared to glaucomatous patients with lower myopia.