Clinical significance of optic disc progression by topographic change analysis maps in glaucoma: an 8-year follow-up study.

Aim. To investigate the ability of Heidelberg Retina Tomograph (HRT3) Topographic Change Analysis (TCA) map to predict the subsequent development of clinical change, in patients with glaucoma. Materials. 61 eyes of 61 patients, which, from a retrospective review were defined as stable on optic nerve head (ONH) stereophotographs and visual field (VF), were enrolled in a prospective study. Eyes were classified as TCA-stable or TCA-progressed based on the TCA map. All patients underwent HRT3, VF, and ONH stereophotography at 9-12 months intervals. Clinical glaucoma progression was determined by masked assessment of ONH stereophotographs and VF Guided Progression Analysis. Results. The median (IQR) total HRT follow-up period was 8.1 (7.3, 9.1) years, which included a median retrospective and prospective follow-up time of 3.9 (3.1, 5.0) and 4.0 (3.5, 4.7) years, respectively. In the TCA-stable eyes, VF and/or photographic progression occurred in 5/13 (38.4%) eyes compared to 11/48 (22.9%) of the TCA-progressed eyes. There was no statistically significant association between TCA progression and clinically relevant (photographic and/or VF) progression (hazard ratio, 1.18; P = 0.762). The observed median time to clinical progression from enrollment was significantly shorter in the TCA-progressed group compared to the TCA-stable group (P = 0.04). Conclusion. Our results indicate that the commercially available TCA progression criteria do not adequately predict subsequent photographic and/or VF progression.

Glaucoma risk assessment using a non-linear multivariable regression method.

The present research investigates the relationship between the central corneal thickness (CCT), Heidelberg Retina Tomograph II (HRTII) structural measurements and intraocular pressure (IOP) using an innovative non-linear multivariable regression method in order to define the risk factors in future glaucoma development and patient management. The method is implemented to data from ninety-three open angle glaucoma eyes. The results show that in established glaucoma, CCT is significantly associated with HRTII structural measurements (maximum contour depression, cup volume inferotemporally) and IOP. They are also compared to those obtained from the application of standard linear regression methods, improving the coefficient determination R(2) by 35%, exhibiting thus the performance of the proposed methodology.

Multifocal visual evoked potentials in amblyopia due to anisometropia.

PURPOSE: To investigate multifocal visual evoked potentials (mfVEP) of the amblyopic and fellow eye in amblyopia due to anisometropia. METHODS: We recorded mfVEP in both eyes of 15 anisometropic amblyopic patients and 15 normal control subjects. The responses from the central 7.0 degrees arc of the visual field were measured, and changes in latency and amplitude were compared between the amblyopic, fellow, and normal control eyes. RESULTS: There was a significant difference in the latency and amplitude of mfVEP between the amblyopic and fellow eyes. The responses in the central region of the visual field (rings 1 and 2) had a longer latency and smaller amplitude in the amblyopic eye. In contrast, there was no difference in mfVEP latency or amplitude between the fellow eye and normal control eyes. CONCLUSION: These results suggest that mfVEP may be used as an alternative objective method for diagnosis and monitoring of anisometropic amblyopia.

The prognostic value of visual evoked response latency in the treatment of amblyopia caused by strabismus.

Visual evoked response alterations and especially P100 latency were studied in 60 patents with amblyopia caused by strabismus. Patients were divided in two groups according to the mode of fixation of the strabismic eye. Group A included patients with eccentric fixation, and group B, patients with central fixation of the strabismic eye. In all cases visual evoked responses were recorded before and after a 6-month period during which the patients had full-time occlusion of the sound eye. In cases with eccentric fixation of the strabismic eye, P100 latency was more abnormal than in cases with central fixation. In cases where latencies are clearly abnormal before treatment, the prognosis is poor and the results after occlusion of the sound eye are unstable. In contrast, in the cases with normal or nearly normal visual evoked response latencies, the prognosis is better, and these eyes show satisfactory improvement of visual acuity.

The necessary resection of the levator muscle of the upper eyelid in the operation for congenital blepharoptosis.

The authors comment on the excellent postoperative results obtained in 22 eyes operated on according to the Blaskovics method for congenital blepharoptosis. They discuss the length of the resected part of the levator muscle of the upper lid, the length depending in each case on the degree of the ptosis and on the functional ability of the levator muscle. They arrive at the conclusion that the shortening of the levator muscle must be considerably greater than heretofore advocated by the classical view.