Retinal blood flow indices in patients infected with human immunodeficiency virus.

AIMS/BACKGROUND: Abnormal blood flow dynamics are believed to contribute to the development of retinal microvascular disease in patients infected with human immunodeficiency virus (HIV). In this study, the scanning laser ophthalmoscope (SLO) was used, combined with fluorescein angiography, to measure retinal blood flow indices in HIV seropositive patients. METHODS: Arteriovenous passage time (AVP) and perifoveal capillary blood flow velocity (CFV) were measured in 23 HIV infected patients and 23 control subjects with SLO fluorescein angiography. RESULTS: No significant difference in AVP was found between the two groups. However, CFV was significantly reduced in HIV infected patients (p = 0.013). CONCLUSION: Patients infected with HIV show abnormal haemodynamics at the level of the perifoveal capillaries.

Recurrent neuroretinitis.

OBJECTIVE: To characterize a distinct disorder of the optic nerve that manifests as recurrent episodes of acute, monocular disc edema and macular star formation. DESIGN: Description of the clinical features and laboratory findings in a group of patients with this disorder. SETTING: Referral center. PATIENTS: Seven patients (average age, 27 years) who experienced from two to seven attacks of neuroretinitis at intervals ranging from 1 to 10 years (average interval, 2.7 years). INTERVENTIONS: Treatment with corticosteroids (oral in seven patients; intravenous in two patients) and azathioprine sodium (one patient). MAIN OUTCOME MEASURES: Visual acuity, color vision, Goldmann perimetry, and fundus photography. RESULTS: Visual loss manifested as disc-related field defects with variable loss of acuity. Regardless of treatment, patients did not experience significant improvement of optic nerve function following each episode. Results of tests for specific inflammatory origins were normal. CONCLUSIONS: The presence of disc-related field defects, poor recovery, and tendency to recur distinguish this disorder from the typical benign form of idiopathic neuroretinitis previously described.

Analysis of electro-oculographic artifact during vertical saccadic eye movements.

The analysis of vertical saccades by electrooculography (EOG) is limited by the presence of waveform artifacts that occur with both upward and downward saccades. The artifacts have been shown to increase the calculated velocities of upward saccades. For better evaluation of the nature of these artifacts, voluntary vertical saccades were recorded by EOG and magnetic search coil in five normal subjects and by EOG only in two patients who had previously undergone enucleation. All subjects demonstrated peaked EOG artifacts during vertical saccades. The amplitude of these artifacts was decreased but not completely eliminated by eyelid or eyeball fixation during the attempted saccade. Peak saccadic velocities were also decreased by eyelid fixation, but EOG measurements were generally less accurate than those obtained by search coil. There is evidence that these artifacts may be the result of a combination of eyelid electrical activity and resistance effects.

Red-green mixture thresholds in congenital and acquired color defects.

A color television display was used to measure thresholds for mixtures of red and green on a white background; red and green components could be either incremental, decremental or zero. Ellipses are fitted to a plot of green contrast as a function of red contrast, and it is argued that the length of the ellipse is a measure of red-green color discrimination and the width of the ellipse is a measure of luminance discrimination. It is shown that the technique reliably distinguishes normals from congenital color defectives and also protan from deutan subjects. For some cases of acquired color defects (e.g. optic neuritis), there is a roughly equal loss of color and luminance discrimination whereas, in other cases (e.g., hereditary optic atrophies), the loss of color discrimination is much greater than the loss of luminance discrimination.

Color mixture thresholds measured on a color television--a new method for analysis, classification and diagnosis of neuro-ophthalmic disease.

A color television display can be used to determine color and brightness discrimination thresholds using identical adaptation conditions and experimental technique. The color discrimination threshold is measured by using an equiluminous test spot--i.e. one which differs in color from the surrounding screen but has the same luminance. Because there is no brightness clue, the subject is forced to detect such a spot by using color discrimination. It is shown how color and brightness thresholds may be determined from threshold measurements of different color-mixtures even though it is not known beforehand which stimulus will be equiluminous for the subject. Results are shown for normal subjects, congenital color defectives and for two patients having optic nerve disease who show respectively non-selective and selective loss of color discrimination compared to brightness discrimination. Normal control data are presented, illustrating the effect of eccentricity, optical blur, viewing distance, pupil size and age. It is concluded that the technique is relatively insensitive to moderate variations in these factors and that it is more sensitive in detecting selective color loss than a spectral sensitivity technique which has been described previously.

Pseudoisochromatic plate design--Macbeth or tungsten illumination?

Three sets of pseudoisochromatic plates were evaluated by photometry and colorimetry. The luminance contrast between the figure and background was measured and compared with a contrast detection threshold. The chromaticity coordinates of the figure and background were evaluated on the basis of how closely they approached a dichromatic line of confusion. The separation of the coordinates of the figure and background are a measure of the severity of the defect for which the plate tests. The plates were evaluated under both Macbeth (C) and tungsten (A) illuminants; two sets of plates were found to be better designed for tungsten illumination.