Utilidad del nuevo software MultiColor de SPECTRALIS® en la identificación de defectos de la capa de fibras nerviosas de la retina / Use of the new MultiColour SPECTRALIS® software for identifying retinal nerve fibre layer defects

La fotografía de fibras clásica, usada tradicionalmente para identificar defectos en la capa de fibras nerviosas de la retina (CFNR), tiene un uso limitado debido a la necesidad de un equipo fotográfico específico y un técnico experto en la adquisición de esta clase de imágenes. El nuevo módulo MultiColor de la tomografía de coherencia óptica (OCT) SPECTRALIS®, utilizando 3 longitudes de onda diferentes simultáneamente, es capaz de proporcionar imágenes en las que se identifican las estructuras de la retina en diferente color según su profundidad. Nos propusimos realizar un pequeño estudio de concordancia para determinar la utilidad del nuevo software MultiColor frente a la fotografía de fibras tradicional en la identificación de defectos en la CFNR. La concordancia interobservador en la interpretación de imágenes MultiColor fue buena (κ=0,746; p<0,001); y se consiguieron identificar con MultiColor en torno al 70% de pacientes con glaucoma leve. Consideramos que el nuevo software MultiColor resulta útil en la evaluación de defectos de la CFNR, y es sencillo de realizar (AU)

The classical fibre photography traditionally used to identify defects in the retinal nerve fibre layer (RNFL), has been partially discontinued due to poor availability. The new MultiColour module of SPECTRALIS® Optical Coherence Tomography (OCT), using three different laser wavelengths simultaneously, can provide images that identify the structures of the retina in different colours according to their depth. A small concordance study was conducted to determine the usefulness of the new MultiColour software versus traditional fibre photography in identifying RNFL defects. The inter-observer agreement in the interpretation of MultiColour images was good (κ=.746; P<.001), as by using Multicolour they were able to identify around 70% of patients with mild glaucoma. It is believed that the new Multicolour software is useful in evaluating RNFL defects, and is easy to perform (AU)

Use of the new MultiColour SPECTRALIS® software for identifying retinal nerve fibre layer defects. / Utilidad del nuevo software MultiColor de SPECTRALIS® en la identificación de defectos de la capa de fibras nerviosas de la retina.

The classical fibre photography traditionally used to identify defects in the retinal nerve fibre layer (RNFL), has been partially discontinued due to poor availability. The new MultiColour module of SPECTRALIS® Optical Coherence Tomography (OCT), using three different laser wavelengths simultaneously, can provide images that identify the structures of the retina in different colours according to their depth. A small concordance study was conducted to determine the usefulness of the new MultiColour software versus traditional fibre photography in identifying RNFL defects. The inter-observer agreement in the interpretation of MultiColour images was good (κ=.746; P<.001), as by using Multicolour they were able to identify around 70% of patients with mild glaucoma. It is believed that the new Multicolour software is useful in evaluating RNFL defects, and is easy to perform.

[Functional relationship between retinal sensitivity threshold values assessed by standard automated perimetry in glaucoma]. / Relación funcional entre los puntos de sensibilidad retiniana de la perimetría automatizada en el glaucoma.

OBJECTIVE: To study the correlation between the sensitivity threshold values of the different points assessed by the Humphrey visual field analyzer (24-2 Swedish interactive threshold algorithm [SITA] standard strategy) in glaucoma patients. SUBJECTS, MATERIAL AND METHODS: Prospective cross-sectorial study. One-hundred and four eyes of 104 glaucoma patients, defined by the appearance of the optic nerve head, were evaluated. Retinal threshold sensitivity points of standard automated perimetry (SA) with SITA standard 24-2 program were obtained. The upper and the lower hemifields were studied separately. Pearson correlation coefficients were calculated between the mean threshold sensitivity value at each point of the visual hemifield and the rest of the threshold points in the same hemifield. RESULTS: Perimetric correlation maps between retinal threshold sensitivity values in the same hemifield were obtained. Most of the points showed moderate to high correlations (r≥0.65. P<0.001) with neighboring points and distant points in the same hemifield. CONCLUSIONS: There is a functional relationship between neighboring and distant points in Humphrey Visual Field Analyzer (SITA Standard 24-2) in glaucoma patients. This correlation is related to the anatomical arrangement of ganglion cell axons. This fact enables perimetric patterns of glaucoma defects to be obtained.

Relación funcional entre los puntos de sensibilidad retiniana de la perimetría automatizada en el glaucoma / Functional relationship between retinal sensitivity threshold values assessed by standard automated perimetry in glaucoma

Objetivo: Estudiar la interrelación entre los 52 valores de sensibilidad retiniana obtenidos en la perimetría automatizada convencional (PA) tipo Humphrey con la estrategia Swedish interactive threshold algorithm (SITA) estándar 24-2 en pacientes con glaucoma. Sujetos, material y métodos: Estudio prospectivo transversal en el que se incluyeron 104 ojos de 104 pacientes glaucomatosos diagnosticados por la apariencia de la cabeza del nervio óptico. Se recogió el valor de sensibilidad umbral de cada uno de los puntos de la PA SITA Standard 24-2, considerando cada hemicampo por separado. Se aplicó la prueba de Kolmogorov-Smirnov para demostrar la distribución normal de las variables, y se calcularon los coeficientes de correlación de Pearson entre los valores umbral de cada punto con todos los demás puntos del mismo hemicampo. Resultados: Se obtuvieron mapas de correlación perimétrica entre valores umbral de un mismo hemicampo. La mayoría de los puntos evaluados mostraron correlaciones significativas (r ≥ 0,65; p < 0,001) entre puntos vecinos, así como entre puntos distantes dentro del mismo hemicampo. Conclusiones: Existe una relación de dependencia funcional entre puntos vecinos y distantes en la PA de pacientes con glaucoma, en correspondencia con la distribución de los axones de las células ganglionares, que permite la obtención de patrones perimétricos del glaucoma (AU)

Objective: To study the correlation between the sensitivity threshold values of the different points assessed by the Humphrey visual field analyzer (24-2 Swedish interactive threshold algorithm [SITA] standard strategy) in glaucoma patients. Subjets, material and methods: Prospective cross-sectorial study. One-hundred and four eyes of 104 glaucoma patients, defined by the appearance of the optic nerve head, were evaluated. Retinal threshold sensitivity points of standard automated perimetry (SA) with SITA standard 24-2 program were obtained. The upper and the lower hemifields were studied separately. Pearson correlation coefficients were calculated between the mean threshold sensitivity value at each point of the visual hemifield and the rest of the threshold points in the same hemifield. Results: Perimetric correlation maps between retinal threshold sensitivity values in the same hemifield were obtained. Most of the points showed moderate to high correlations (r ≥ 0.65. P < 0.001) with neighboring points and distant points in the same hemifield. Conclusions: There is a functional relationship between neighboring and distant points in Humphrey Visual Field Analyzer (SITA Standard 24-2) in glaucoma patients. This correlation is related to the anatomical arrangement of ganglion cell axons. This fact enables perimetric patterns of glaucoma defects to be obtained (AU)

Axonal loss and cognitive deficits in term infants with normal umbilical artery Doppler born small-for-gestational age.

OBJECTIVE: To assess cognitive outcomes and structural changes in the central nervous system, the latter using a novel approach to examine changes in neuronal integrity of the optic nerve, in children at 5-6½ years of age who were born small-for-gestational age (SGA) at term having shown normal umbilical artery (UA) Doppler. METHODS: We compared neuronal damage, cognitive deficits and visuospatial perception in two cohorts of infants, one born SGA (n = 40) and one born appropriate-for-gestational age (AGA) (n = 39) in weight. Neuronal damage was evaluated using optical coherence tomography (OCT) of the optic nerve. Cognitive deficits were assessed with the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) test. Visuospatial perception was evaluated with Rey-Osterreich Complex Figure (ROCF) tasks. RESULTS: Children from the SGA group had a significantly thinner average retinal nerve fiber layer (RNFL) compared with those from the AGA group (98.2 vs 104.5 µm, P = 0.012). Children from the SGA group exhibited impaired performance in copy tasks on the ROCF (3.27 vs 3.56, P = 0.036) and a higher rate of suboptimal WPPSI test performance intelligence quotient scores (15% vs 0%; P = 0.025) compared with those from the AGA group. CONCLUSION: Term infants with normal UA Doppler born SGA are at increased risk for cognitive deficits and axonal loss in the RNFL at the age of 5-6½ years.