A characteristic optic disc appearance associated with myopia in subjects with Graves' ophthalmopathy and in subjects with primary open-angle glaucoma.

PURPOSE: To determine if qualitatively defining the appearance of optic disc change was a valid characteristic of myopia in subjects with Graves' ophthalmopathy (GO) or primary open-angle glaucoma (POAG). METHODS: WE DEFINED TYPICAL TILT APPEARANCE AS THE SIMULTANEOUS PRESENCE OF THE FOLLOWING: an elliptical optic disc, a crescent, unequal sharpness of the cupping margin (horizontally), and nasally displaced vessels in the optic cup. Ninety-two eyes from 92 subjects each with GO or with POAG and no severe complications were included in the study after matching for spherical refractive errors. Using our definition of tilt appearance, two independent observers subjectively judged optic disc photographs. One observer repeated judgments in 70 randomly selected eyes and judgment reproducibility was assessed using kappa statistics. Tilt ratio was used as a quantitative parameter. RESULTS: The numbers of eyes judged as having a typical tilt appearance in the GO group and in the POAG group were 25 (27.2%) and 39 (42.4%), respectively, by one observer (P = 0.0297), and 12 (13%) and 44 (47.8%), respectively, by another observer (P < 0.0001). Intra- and interobserver reproducibility of tilt judgment were very good (kappa = 0.93) and good (kappa = 0.65), respectively. Tilt ratio did not significantly differ between the two groups. Analytical results including background factors were essentially the same for the two observers: multivariate logistic regression for one observer's judgment showed that the presence of the typical tilt appearance was associated with belonging to the glaucoma group (odds ratio [OR], 6.25; P = 0.0054), tilt ratio (OR per 0.01, 0.77; P < 0.0001), and spherical refractive error (OR per diopter, 0.80; P < 0.003). CONCLUSION: The optic disc feature we designated as typical tilt was associated with myopia, and its frequency was higher in subjects with POAG compared to those with GO.

[Anderson criteria in early glaucomatous visual field defects with the SITA Standard].

PURPOSE: We evaluated the positive rate of the Anderson criteria of suspected early glaucomatous visual field defects (GVFDs). SUBJECTS AND METHODS: Ninety-six eyes of 96 patients, who had suspected primary open-angle glaucoma with apparent glaucomatous optic disc changes and who had more than -6.0 dB of mean deviation (MD) with Swedish Interactive Thresholding Algorithm Standard (SITA-S) Central 30-2 program in the Humphrey Field Analyzer, were selected. We applied the Anderson criteria and calculated the positive rates for these criteria and for three elements pattern deviation probability plots (PD plots), glaucoma hemifield test (GHT), pattern standard deviation (PSD). RESULTS: The positive rate of the Anderson criteria was 78.1% and the PD plots (77.1%) were significantly higher rate than the GHT (62.5%) or the PSD (63.5%). The positive rate of the Anderson criteria was 100% in the MD of less than -3.0 dB and was 65.6% even in the MD of more than -3 dB (p < 0.0001). On the other hand, 57.9% of the eyes with an MD between -2 dB and -1 dB showed positive in all elements. At more than -1.0 dB of MD, the PD plots (50.0%) were significantly higher than the PSD (18.8%) or the GHT (21.9%) (PSD: p = 0.0085, GHT : p = 0.0190). CONCLUSION: Using the SITA-S, the Anderson criteria showed a high positive rate in eyes with suspected early GVFDs.

Effects of switching to SofZia-preserved travoprost in patients who presented with superficial punctate keratopathy while under treatment with latanoprost.

PURPOSE: To investigate the effects of switching to SofZia-preserved travoprost (TRV) on superficial punctate keratopathy (SPK) observed in patients using benzalkonium chloride (BAC)-preserved latanoprost (LAT). METHODS: Patients with either primary open-angle glaucoma or ocular hypertension treated with LAT for at least 1 month who presented with SPK participated in this prospective, multicenter, open-label uncontrolled study. After the switch from LAT to TRV, patients were monitored at 2 weeks and at 1, 2, and 3 months. The use of concomitantly employed ophthalmic solutions was continued during the observation period. The intensity of SPK in each of five areas defined on the cornea was scored on a standard scale. Repeated measurements were tested with a linear mixed model. RESULTS: Of the 48 patients enrolled, 45 patients completed the study. After the switch to TRV, the mean SPK score in the whole cornea decreased significantly at every observation point (P < 0.0001 at each point) while intraocular pressure did not change significantly. Throughout the observation period, the SPK score tended to be higher in patients using a larger number of concomitant medications that contained BAC. CONCLUSION: Switching to TRV improved SPK observed in a population using LAT, likely because of a decrease in exposure to BAC.