RESUMO
PURPOSE: To determine the sensitivity of manufacturer supported normative algorithms in Heidelberg retinal tomography (HRT) and Stratus optical coherence tomography (OCT) in detecting advanced primary open angle glaucoma. METHODS: A total of 157 subjects with advanced primary open angle glaucoma were recruited. The eye with the more severe glaucoma, as judged by mean deviation on Humphrey visual field, was imaged. The total number of optic disc sectors classified as being outside normal limits on Moorfields Regression Analysis (MRA) from the HRT II and HRT 3 software or from the sector and quadrant averages analysis of the Retinal Nerve Fiber Layer OCT scans was compared using the Wilcoxon signed ranks test. RESULTS: At least one segment in each eye was identified as being outside normal limits by the OCT sector Retinal Nerve Fiber Layer analysis (100% sensitivity). Five eyes were classified as being within normal limits on the OCT quadrant average analysis (96.8% sensitivity). Four eyes were found to be either completely within normal limits or borderline on the HRT II MRA (97.5% sensitivity), of which one was subsequently identified as being outside normal limits by the HRT 3 MRA. The total number of segments classified as being outside normal limits was greater on HRT 3 MRA than HRT II MRA (P < 0.001). CONCLUSION: Automated optic nerve imaging devices rarely produce a totally normal result in the presence of advanced primary open angle glaucoma. The Stratus OCT Retinal Nerve Fiber Layer clock hour normative database performs better than other modalities studied. These findings are important in considering the utility of these algorithms for community screening.
Assuntos
Glaucoma de Ângulo Aberto/diagnóstico , Lasers , Oftalmoscopia , Tomografia de Coerência Óptica , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Técnicas de Diagnóstico Oftalmológico/instrumentação , Progressão da Doença , Feminino , Glaucoma de Ângulo Aberto/complicações , Humanos , Masculino , Programas de Rastreamento , Disco Óptico/patologia , Doenças do Nervo Óptico/diagnóstico , Doenças do Nervo Óptico/etiologia , Sensibilidade e Especificidade , Campos VisuaisAssuntos
Neoplasias da Túnica Conjuntiva/diagnóstico , Córnea/inervação , Neoplasia Endócrina Múltipla Tipo 2b/diagnóstico , Neuroma/diagnóstico , Nervo Oftálmico/patologia , Adulto , Humanos , Masculino , Neoplasia Endócrina Múltipla Tipo 2b/genética , Mutação , Proteínas Proto-Oncogênicas c-ret/genéticaRESUMO
Idiopathic intracranial hypertension can cause severe optic nerve damage with irreversible visual loss. Heidelberg retina tomography is a sensitive and reproducible tool that can be used in the monitoring of optic disc swelling due to IIH. We demonstrate that the three-dimensional images produced are easy to interpret, indicate progression or resolution and improve the timing of intervention in multidisciplinary settings by facilitating communication between specialists.
Assuntos
Hipertensão Intracraniana/complicações , Microscopia Confocal , Oftalmoscopia , Papiledema/diagnóstico , Papiledema/etiologia , Adulto , Progressão da Doença , Feminino , Humanos , Imageamento Tridimensional , Hipertensão Intracraniana/cirurgiaRESUMO
The most effective dose of mitomycin C (MMC) in the treatment of primary acquired melanosis (PAM) with atypia of the conjunctiva and cornea has yet to be established. This case report describes successful treatment of PAM with atypia with a single four day cycle of 0.02% MMC.
