Metabolic changes in the visual cortex are linked to retinal nerve fiber layer thinning in multiple sclerosis.

OBJECTIVE: To investigate the damage to the retinal nerve fiber layer as part of the anterior visual pathway as well as an impairment of the neuronal and axonal integrity in the visual cortex as part of the posterior visual pathway with complementary neuroimaging techniques, and to correlate our results to patients' clinical symptoms concerning the visual pathway. DESIGN, SUBJECTS AND METHODS: Survey of 86 patients with relapsing-remitting multiple sclerosis that were subjected to retinal nerve fiber layer thickness (RNFLT) measurement by optical coherence tomography, to a routine MRI scan including the calculation of the brain parenchymal fraction (BPF), and to magnetic resonance spectroscopy at 3 tesla, quantifying N-acetyl aspartate (NAA) concentrations in the visual cortex and normal-appearing white matter. RESULTS: RNFLT correlated significantly with BPF and visual cortex NAA, but not with normal-appearing white matter NAA. This was connected with the patients' history of a previous optic neuritis. In a combined model, both BPF and visual cortex NAA were independently associated with RNFLT. CONCLUSIONS: Our data suggest the existence of functional pathway-specific damage patterns exceeding global neurodegeneration. They suggest a strong interrelationship between damage to the anterior and the posterior visual pathway.

Evaluation of the impedance tonometers TGDc-01 and iCare according to the international ocular tonometer standards ISO 8612.

BACKGROUND: Two new tonometers have been introduced that are based on the impedance principle. Both the TGDc-01 (transpalpebral measurement) and the iCare (corneal measurement) do not require corneal anaesthesia. The present work presents an evaluation of both devices. METHODS: Comparative measurements using one of the new tonometers and applanation tonometry were performed by one investigator according to the international standard for ocular tonometer (ISO 8612). Measurements were performed on 445 eyes without corneal pathology from 243 patients. Six measurements were performed for iCare and 3 for TGDc, immediately followed by 3 applanation tonometry measurements. RESULTS: The correlation coefficient with respect to applanation tonometry was 0.81 for TGDc and 0.95 for iCare. TGDc-01 measurements showed an average deviation of 3.1 +/- 2.6 mmHg to those of Perkins applanation tonometry. The maximum difference was 28.7 mmHg below and 9.8 mmHg above the results of applanation tonometry. iCare showed an average deviation of 2.5 +/- 1.1 mmHg to Goldmann tonometry. The maximum difference was 14.5 mmHg below and 9.8 mmHg above. CONCLUSIONS: The results of both new tonometers showed a good correlation with the reference applanation tonometric methods, but the strict requirements of ISO 8612 are not fulfilled by either tonometer at present. Additionally, transpalpebral measurements with the TGDc-01 showed unacceptably high variability.

[Standards for the measuring check of eye tonometers--comparative measurements with 50 test apparatuses]. / Normale für die messtechnischen Kontrollen von Augentonometern - Vergleichsmessungen an 50 Prüfeinrichtungen.

Different eye tonometers are available for the measurement of intraocular pressure. These devices must be checked in Germany by control measurements every 2 years. For this test, special apparatuses were developed by the "Physikalisch-Technische Bundesanstalt" which are checked by comparative measurements during seminars of this institute or during educational events of the "Deutsche Akademie für Metrologie". 50 test apparatuses were compared during a seminar of the "Physikalisch-Technische Bundesanstalt". The measurements of these investigations show the suitability of these devices for the performance of measuring checks of eye tonometers.