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Purpose. Study the thickness of periapillary retina, ganglion cell complex and optic disc parameters in patients with nonarteritised anterior ischemic optic neuropathy using the spectral OCT angiography. Material and Methods. We examined 17 people (17 eyes) with unilateral non-arteritised anterior ischemic optic neuropathy (no more than 30 days from the appearance of complaints), the average age was 64.1±8.1 years. The control group consisted of 37 volunteers. All the subjects were treated with spectral OCT angiography on RTVue XR Avanti device (Optovue Inc., USA). Results. In patients with non-arteritised anterior ischemic optic neuropathy, compared to the control group, there was a statistically significant increase in the average thickness of periapillary retina nerve fiber layer from 136 to 403 µm, an increase in optic disc area and neuroretinal belt (p < 0.0001) and the absence of cupping (Cup Volume = 0). A decrease in average thickness of ganglion cell complex was found in 8 out of 17 patients, while all patients showed increases in FLV (p=0.008) and GLV (p=0.036). A direct correlation relationship between FLV (r=0.64; p

Objective: Evaluation of efficacy of the application of artificial intelligence technology and neural networks in the analysis of the condition of the optic disc and the peripapillary retina in healthy individuals.Methods: Prospective analysis of the condition of visual organs in 54 patients aged from 49 to 71 years (100 eyes) was conducted. The examination included autorefractometry, visometry, tonometry, automated perimetry, spectral domain optical coherence tomography, Heidelberg retina tomography. A pre-trained neural network evaluated only a photograph of the optic nerve disc and the peripapillary retina.Results: Neural network identified twelve images with suspected glaucoma, five of which were selected by medical experts. The comparison of all study groups has demonstrated the presence of statistically significant differences between them according to a range of visiometric indicators.Conclusions: The study results showed high efficiency of artificial intelligence and the prospects of its use for the diagnosis of glaucoma.

PURPOSE: We studied effects of age and horizontal duction on deformation of the optic nerve (ON) head and peripapillary retina as reflected by displacement of vascular landmarks to explore the influence of adduction tethering. DESIGN: Cross-sectional study. METHODS: Setting: University. Study Population: Single eyes of 20 healthy young adults (average age 23.9±3.9 SD) years were compared to 20 older subjects (average age 61.4±9.3) years. Observational Procedure: The disc and peripapillary retina were imaged by scanning laser ophthalmoscopy in central gaze, and 35° abd- and adduction. Main Outcome Measure: Deformations of the disc and adjacent PPR were measured by comparing positions of epipapillary and epiretinal blood vessels. RESULTS: Vessels within the ONH of younger subjects shifted temporally during adduction and nasally during abduction. Displacement of the nasal hemi-disc in adduction was greater at 38.5±1.7μm (SEM) than the temporal half at 4.1±2.1μm (P

Correction of automated retinal layer segmentation in the peripapillary retina led to significant differences in perfusion density measured with optical coherence tomography angiography in the retinal plexuses. Segmentation accuracy should be checked prior to interpretation.

This study describes the optical coherence tomography and optical coherence tomography angiography features of three eyes of three patients affected by contractile morning glory syndrome. Optical coherence tomography angiography scans of the peripapillary retina revealed a dense microvascular network without any vascular difference between the superficial vascular plexus and the deep vascular plexus around the optic nerve. These optical coherence tomography angiography findings confirm that the contractile movement could be due to the presence of an autonomic cholinergic muscular mechanism in the posterior part of the globe. In fact in our cases, the contractile movement seemed to be induced by massage of the eyeball. Optical coherence tomography angiography is a valid, non-invasive, dyeless, and reliable method that could shed light on the pathogenesis of this rare disease of the optic disk.

Introduction. Reliable detection of papilledema is essential for establishing the diagnosis of idiopathic intracranial hypertension (IIH). The ophtalmoscopic fundus examination of the optic nerve head (ONH) is a subjective measurement, limited by the examiner’s experience, the patient’s degree of collaboration and the optics of the ophthalmoscope, making it often unreliable in detecting early edema and in assessing initial improvements or worsening. The objective of the study was to assess the role of optical coherence tomography (OCT) in diagnosing and monitoring papilledema in IIH. Materials and methods. The study period consisted of 3 years (October 2014- October 2017) in which we evaluated how OCT parameters correlated with the clinical grading of the optic nerve head (ONH) edema according to the Frisén’s scale. We included 11 patients (6 adults and 5 adolescents aged 15 years and above) with recently diagnosed IIH in the University Emergency Eye Hospital and ‘Prof. Dr. Al. Obregia Psychiatry Hospital, Bucharest, Romania. Patients underwent clinical evaluation and OCT examination in the Retina Clinic, Bucharest, Romania. The measurements were compared to a group of 13 subjects with demographic characteristics similar to the study lot, without IIH (7 adults and 6 adolescents over 15 years). Results. The average retinal nerve fiber layer (RNFL) thickness in the study lot was 165.8 μm, (95% CI ± 33 μm) compared to 116 μm (95% CI, ± 4.3 μm) in the control group, P= 0.001. We demonstrated a significant difference between the average RNFL thickness correlated to papilledema severity (r=0.967, N=22, p = 0.001), with an average value of 117 μm (95% CI, ± 16μm) in case of mild edema, 165 μm (95% CI, ± 89μm), in moderate cases and 269 μm (95% CI, ± 31 μm) in severe cases. Conclusions. Fundal photographs and optical coherence tomography can be used with clinical assessment and other visual tests for the diagnosis of papilledema. Frisén grade determined by direct fundus examination was significantly correlated with OCT parameters reflecting optic nerve head edema. Following the peripapillary RNFL thickness over different check-ups provides a quantitative and sensitive measurement of changes in the papilledema.

Purpose of review Optical coherence tomography angiography (OCTA) studies have demonstrated reduced microcirculation in the superficial optic nerve, peripapillary retina, and the macula of glaucoma patients. The scope of this review is to outline recent studies using OCTA in glaucoma and highlight how OCTA may help improve diagnosis and follow-up in glaucoma patients. Recent findings OCTA studies have provided evidence of vascular changes in the optic nerve head, peripapillary, and macula region in glaucoma in comparison to glaucoma suspects and normal eyes. Additionally, OCTA can detect longitudinal reduction of peripapillary and macula vessel density in glaucoma patients. It remains unclear whether the reduced microcirculation in glaucoma patients induces the neuronal damage or arises through reduced circulation requirements in damaged tissue. Summary OCTA is a novel imaging modality that has great potential to enhance our understanding of glaucoma and to improve our ability to detect and treat it.

PURPOSE: To determine the prevalence and factors associated with the presence of choroidal microvascular dropout (CMvD) in primary angle-closure glaucoma (PACG) eyes compared to primary open-angle glaucoma (POAG) eyes.DESIGN: Cross-sectional study.METHODS: Thirty-six POAG eyes (36 patients) and 28 PACG eyes (28 patients) underwent optical coherence tomography angiography (OCTA). Presence of CMvD was evaluated on choroidal OCTA slabs. Visual field (VF) defects in the glaucoma eyes were classified into initial nasal defect (IND), initial parafoveal scotoma (IPFS), and combined nasal and parafoveal defect, and the association between type of VF defect and CMvD was evaluated.RESULTS: CMvD was detected in 21 POAG (58.3%) and 10 PACG (35.7%) eyes (P = .07). CMvD in POAG eyes was associated with pretreatment intraocular pressure (odds ratio [OR] = 0.91/mm Hg higher intraocular pressure, P = .06), VF mean deviation (MD, OR = 0.75/dB higher MD, P = .007), retinal nerve fiber layer thickness (OR = 0.92/mu m increase in thickness, P = .02), and peripapillary vessel density (OR = 0.80/ unit increase in density, P = .01). CMvD in PACG eyes was associated only with VF MD (OR = 0.90/dB higher MD, P = .05). When analyzed in the entire cohort of glaucoma patients (64 eyes), CMvD was significantly associated with POAG (OR > 3.5, P CONCLUSIONS: Prevalence of CMvD was significantly lower in PACG compared to POAG. As in POAG, CMvD in PACG was associated with advanced VF damage and with IPFS on VF. (C) 2018 Elsevier Inc. All rights reserved.

In the last years optical coherence tomography imaging of the optic nerve head and the peripapillary retina became a part of the routine clinical practice worldwide. Unfortunately, performing optic nerve head imaging routinely does not mean that all acquired images are technically correct and clinically informative. Imaging artifacts are common, and in many cases, they remain undetected due to the users’ insufficient knowledge on the relevant technical aspects. Unrecognized imaging artifacts and lack of detailed clinical evaluation of the disc lead to incorrect medical decisions, which have clinically significant influence on the patients’ management. In this chapter the most common optic nerve head and peripapillary area imaging artifacts and errors, and their effects on medical decision making are summarized in a comprehensive manner.

Optical coherence tomography angiography (OCTA) is a novel imaging modality that provides visualization and, in some machines, quantification of microcirculation in the superficial optic nerve, peripapillary retina, and the macula of glaucoma patients in a noninvasive fashion. Among commercially available OCTA devices, the AngioVue® (Optovue Inc., Fremont, CA), Swept-Source OCT Angio® (Topcon Corporation, Tokyo, Japan), and Spectralis angiography module (Heidelberg Engineering, Germany) are based on amplitude-derived algorithms [1]. The Angioplex® and PlexElite® (Zeiss Meditec Inc., Dublin, CA) employ a combination of amplitude and phase-variance techniques [2]. High intra-visit repeatability and inter-visit reproducibility have been demonstrated [3, 4].

ЦЕЛЬ. Провести подробный индивидуальный анализ патологических параметров диска зрительного нерва, перипапиллярной сетчатки и комплекса ганглиозных клеток макулярной области сетчатки в группах глаз с различными стадиями глаукомы с площадью диска 1,63-2,43 мм2 . МАТЕРИАЛЫ И МЕТОДЫ. Обследовано 76 глаз у 64 пациентов (35 мужчин и 29 женщин; средний возраст 63,3±8,7 года); среди них 35 глаз с I стадией глаукомы; 21 глаз — со II стадией и 20 глаз — с III стадией. Ретинотомографические исследования параметров были проведены с помощью оптической когерентной томографии (ОКТ) и гейдельбергской лазерной ретинотомографии (HRT) с использованием модифицированной программы В.А. Мачехина, с учетом индивидуальной величины диска, регрессионного анализа и цветной кодировки патологических параметров диска и перипапиллярной сетчатки. РЕЗУЛЬТАТЫ. Были выделены 3 подгруппы патологических аналогичных параметров, показавших различные взаимоотношения между результатами ретинотомографии: а) с равнозначными результатами по данным обоих методов, б) с преимуществом метода HRT и в) с преимуществом метода ОКТ. ВЫВОДЫ. Методы HRT и ОКТ при исследовании параметров ДЗН и прилежащей сетчатки при глаукоме, взаимно дополняя друг друга, позволяют лучше понять процессы, происходящие при глаукоме., PURPOSE: To perform a detailed individual analysis of pathological parameters of the optic disc, peripapillary retina and macular ganglion cell complex in eyes with the disc area of 1.63–2.43 mm2 and different stages of glaucoma. MATERIALS AND METHODS: The study included 64 patients (76 eyes) aged 63.3±8.7 years, among them 35 male and 29 female patients with stage I (35 eyes), stage II (21 eyes) and stage III (20 eyes) glaucoma. Tomographic parameters of the retina were measured with optical coherence tomography (OCT) and Heidelberg laser retinal tomography (HRT) using a modified program by V.A. Machekhin, with consideration of the individual disc size, regression analysis and color coding of pathological parameters of the optic disc and peripapillary retina. RESULTS: Pathologically similar parameters that showed different relations between the tomographic results were divided into 3 subgroups: a) with equivalent results according to both methods; b) with the advantage of HRT method; c) with the advantage of OCT method. CONCLUSIONS: Examination of the optic disc parameters and adjacent retina using both HRT and OCT methods complementing each other can help improve the understanding of the glaucomatous processes., Национальный журнал глаукома, Выпуск 4 2020

PURPOSE: To investigate the association of the severity of obstructive sleep apnea syndrome (OSAS) with peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GC-IPL). MATERIALS AND METHODS: In this cross-sectional study, 145 patients with OSAS and 40 healthy subjects were enrolled. OSAS patients were further divided into mild (n=50), moderate (n=36), and severe (n=59) OSAS groups according to their apnea–hypopnea index (AHI) values. Spectral-domain optical coherence tomography was used to measure the peripapillary RNFL and GC-IPL thicknesses. RESULTS: There was no statistical difference between the RNFL thickness in OSAS and control groups (P>0.05). Both average GC-IPL and minimum GC-IPL thicknesses were significantly lower in severe OSAS group than in healthy controls (P

The term optical coherence tomography angiography (OCTA) comprises different OCT-based technologies which all allow noninvasive assessment of retinal perfusion, based on moving red blood cells. The main areas where OCTA is currently used are investigation of perfusion and vascular structure of the macular retina (e.g., in macular degenerations and diabetic macular diseases) and the disk and peripapillary retina (in glaucoma and other optic disk diseases). The current editorial provides a brief overview on the potential of OCTA and its use to measure perfusion in the peripapillary retina in glaucoma. How to cite this article Holló G. Optical Coherence Tomography Angiography to Better understand Glaucoma. J Curr Glaucoma Pract 2017;11(2):35-37.

В сообщении приведены данные, выявленные при проведении оптической когерентной томографии (ОКТ) у больных с разными стадиями кератоконуса. Наиболее изучены и подробно описаны морфометрические изменения на глазном дне при первичной открытоугольной глаукоме. Однако абсолютно не использованы возможности ОКТ для исследования головки зрительного нерва (ГЗН) и перипапиллярной сетчатки у больных с кератоконусом, что определяет научную новизну и актуальность настоящего исследования. ЦЕЛЬ. Изучение морфометрических изменений головки зрительного нерва и перипапиллярной области сетчатой оболочки у больных с кератоконусом с помощью ОКТ. МЕТОДЫ. Все пациенты с кератоконусом прошли через комплексное стандартное офтальмологическое обследование. Морфометрические параметры ГЗН и толщину нервных волокон сетчатки (СНВС) в перипапиллярной области исследовали с помощью ОКТ. Кроме того, проводилась компьютерная кератотопография, ОКТ роговой оболочки, ультразвуковая биомикроскопия, эндотелиальная (зеркальная) микроскопия и другие методы исследования. РЕЗУЛЬТАТЫ. Средний возраст обследованных больных с кератоконусом составил 28,43±0,89 года. Острота зрения без коррекции – 0,39±0,04 (ϭ=0,33), с коррекцией повысилась до 0,58±0,04. Среднее значение толщины роговой оболочки было 459,19±4,55 мкм, что в 1,1-1,2 раза меньше нормальных значений. Истинное внутриглазное давление (ВГД) составило 11,35±0,07 мм рт.ст. Толщина СНВС при кератоконусе была более чем в 3 раза меньше, чем у здоровых лиц аналогичного возраста. При всех стадиях кератоконуса экскавация ГЗН была большой – до 0,73 диаметра ГЗН, что позволило предположить, что кератоконус развивается у лиц, страдающих недифференцированной дисплазией соединительной ткани (НДСТ). Изменения со стороны сердца выявлены у 22 из 31 обследованных с помощью эхокардиографии больных с кератоконусом, что составило 70,9%. При триплексном сканировании артерий экстракраниального отдела брахиоцефальной системы с помощью УЗИ-сканера ACUSON S2000 сосудистые изменения были выявлены у 13 (41,9%) из 31 больных. Выявленные при кератоконусе изменения на глазном дне, похожие на глаукомные, мы расценили как проявления псевдоглаукомной оптической нейроретинопатии, развившейся на фоне системной неполноценности соединительной ткани, что послужило основой для нового понимания патогенеза кератоконуса и изменения диагностической и лечебной тактики. ЗАКЛЮЧЕНИЕ. С помощью ОКТ были обнаружены морфометрические изменения головки зрительного нерва, нервных волокон перипапиллярной зоны сетчатой оболочки у больных с разными стадиями кератоконуса, что определяет научную новизну и актуальность настоящего сообщения и меняет представление о кератоконусе как патологии переднего отдела глаза. Полагаем, что изменения корнеосклеральной капсулы глаза при кератоконусе являются только «вершиной айсберга». В патологический процесс вовлекаются глубокие структуры глаза – сетчатая оболочка и зрительный нерв., The article contains optical coherence tomography (OCT) assessment of patients with different stages of keratoconus. OCT method has previously been successfully used for diagnostics and monitoring of the optic nerve head (ONH) and retina condition in glaucoma. The morphometric changes of the eye fundus in primary open-angle glaucoma have been studied and described in detail. However, the potential of OCT assessment of ONH and peripapillary retina in keratoconus patients has not been previously realized, which defines the scientific novelty and relevance of the present study. PURPOSE: To study morphometric changes of ONH, peripapillary retina and ganglion cells complex (GCC) in keratoconus patients by means of optical coherence tomography. METHODS: All keratoconus patients underwent standard ophthalmological examination. Morphometric parameters of the ONH and peripapillary thickness of the retinal nerve fiber layer (RNFL) were studied by means of OCT. The complex examination also included computer assisted corneal topography, corneal OCT, ultrasound biomicroscopy, endothelial microscopy and other research methods. RESULTS: The average age of the surveyed keratoconus patients was 28.43±0.89 years. Non-corrected visual acuity (NCVA) amounted to 0.39±0.04 (ϭ=0.33), best corrected visual acuity (BCVA) – 0.58±0.04. The average value of the corneal thickness was 459.19±4.55 µm, which is 1.1-1.2 times less than normal values. The true intraocular pressure equaled 11.35±0.07 mm Hg. RNFL thickness in keratoconus patients was more than 3 times lower than in healthy individuals of similar age. Keratoconus patients of all stages manifested with optic nerve cup enlargement up to 0.73 which allowed suggesting that keratoconus occurs in people suffering from undifferentiated connective tissue dysplasia. Echocardiography revealed heart indices changes in 70.9% (22 of 31) of surveyed keratoconus patients. Triplex scanning of the extracranial parts of the brachiocephalic arteries (ACUSON S2000 ultrasound scanner) found vascular changes in 41.9% (13 out of 31) of keratoconus patients. Fundus changes similar to those found in glaucoma patients were regarded as manifestations of pseudoglaucomatous optic neuropathy development due to a systemic connective tissue deficiency. These findings led to a new understanding of keratoconus pathogenesis and changes in diagnostic and treatment tactics. CONCLUSION: OCT helped reveal morphometric changes of the ONH and peripapillary retinal nerve fiber layer in patients with different keratoconus stages, which define the scientific novelty of this research and change the idea of keratoconus as a pathology constrained to the anterior eye segment. We believe that corneoscleral changes in keratoconus eyes are only “the tip of the iceberg”, while the pathological process actually involves deeper structures – retina and the optic nerve., №3 (2018)

To investigate optic nerve head involvement in patients with Fuchs uveitis syndrome (FUS). Optic nerve head of 43 FUS eyes without clinical optic disc edema and 37 unaffected fellow eyes were evaluated using optical coherence tomography (OCT) of peripapillary retina and retinal nerve fiber layer (RNFL) and fundus fluorescein angiography. Seventy-one percent of FUS eyes showed optic nerve head hyperfluorescence. The mean average RNFL thickness in FUS eyes was 115.0 ± 11.9 μm, which was thicker than unaffected eyes (103.0 ± 10.7 μm, p

Optical coherence tomography (OCT) has led to a paradigm-shift in ophthalmic imaging. With the tremendous increase in OCT’s scanning speed and resolution, this technology is now able to provide data on the vascular supply of the ocular tissues. OCT angiography (OCTA) can measure the blood supply alterations in different ocular tissues, including the optic disc, peripapillary retina and macula. Importantly, OCTA is non-invasive, injection-free, rapid and highly convenient. There is early evidence that some vascular changes may precede structural and functional alterations in at least a subset of glaucoma patients. This chapter provides an overview of OCTA and its potential application in glaucoma diagnosis and management.

Purpose: To evaluate the effects of age, race, and ethnicity on the optic nerve and peripapillary retina using spectral-domain optical coherence tomography (SD-OCT) three-dimensional (3D) volume scans in normal subjects. Methods: This is a cross-sectional study performed at a single institution in Boston. All patients received retinal nerve fiber layer (RNFL) scans and an optic nerve 3D volume scan. The SD-OCT software calculated peripapillary RNFL thickness, retinal thickness (RT), and retinal volume (RV). Custom-designed software calculated neuroretinal rim minimum distance band (MDB) thickness and area. Results: There were 272 normal subjects, including 175 whites, 40 blacks, 40 Asians, and 17 Hispanics. Rates of age-related decline were 2.3%, 2.0%, 1.7%, 3.3%, and 4.3% per decade for RNFL, RT, RV, MDB neuroretinal rim thickness, and MDB area, respectively. The RNFL was most affected by racial and ethnic variations, with Asians having thicker global, superior, and inferior RNFL, Hispanics having thicker inferior RNFL, and blacks having thinner temporal RNFL, compared to whites. For MDB thickness and area, Asians had smaller nasal values and blacks had smaller temporal values. Peripapillary RT and RV parameters were not influenced by race and ethnicity. Conclusions: All of the parameters exhibited age-related declines. RNFL, MDB thickness, and MDB area demonstrated racial and ethnic variations, while peripapillary RT and RV did not. Translational Relevance: This study demonstrates that both normal aging and ethnicity affect several novel 3D OCT parameters used to diagnose and monitor glaucoma (i.e., RT, RV, and MDB), and this should be factored in when making clinical decisions based on these parameters. © 2018 The Authors.

Purpose: To evaluate the effects of age, race, and ethnicity on the optic nerve and peripapillary retina using spectral-domain optical coherence tomography (SD-OCT) three-dimensional (3D) volume scans in normal subjects. Methods: This is a cross-sectional study performed at a single institution in Boston. All patients received retinal nerve fiber layer (RNFL) scans and an optic nerve 3D volume scan. The SD-OCT software calculated peripapillary RNFL thickness, retinal thickness (RT), and retinal volume (RV). Custom-designed software calculated neuroretinal rim minimum distance band (MDB) thickness and area. Results: There were 272 normal subjects, including 175 whites, 40 blacks, 40 Asians, and 17 Hispanics. Rates of age-related decline were 2.3%, 2.0%, 1.7%, 3.3%, and 4.3% per decade for RNFL, RT, RV, MDB neuroretinal rim thickness, and MDB area, respectively. The RNFL was most affected by racial and ethnic variations, with Asians having thicker global, superior, and inferior RNFL, Hispanics having thicker inferior RNFL, and blacks having thinner temporal RNFL, compared to whites. For MDB thickness and area, Asians had smaller nasal values and blacks had smaller temporal values. Peripapillary RT and RV parameters were not influenced by race and ethnicity. Conclusions: All of the parameters exhibited age-related declines. RNFL, MDB thickness, and MDB area demonstrated racial and ethnic variations, while peripapillary RT and RV did not. Translational Relevance: This study demonstrates that both normal aging and ethnicity affect several novel 3D OCT parameters used to diagnose and monitor glaucoma (i.e., RT, RV, and MDB), and this should be factored in when making clinical decisions based on these parameters.

Peripapillar and nerve head vessel density (VD) was measured in 10 patients affected by Dominant optic atrophy (DOA) using optical coherence tomography angiography (OCT-A) and compared to the measurements of 15 age- and gender-matched controls. DOA patients showed VD reduction, mostly in the temporal and inferotemporal peripapillary sectors, according to the preferential involvement of the papillomacular bundle. Despite poor best-corrected visual acuity (BCVA), OCT-A revealed good repeatability. VD correlated with functional (mean deviation of visual field and BCVA) and structural (retinal nerve fiber layer thickness) parameters and could be a non-invasive, quantitative tool for the monitoring of the disease and of the therapeutic approaches.

Purpose With advanced in accuracy and reproducibility of spectral domain optical coherent tomography, It issuggested that the serial changes of retinal nerve fiber layer (RNFL) thickness could reflect the progression of glaucoma. But, patient may have accompany disease that affect retinal structure such as diabetes, venular occlusive diasese and macular degenerative diasese. So, we investigated the factors that influence the measurement of RNFL and peripapillaryretina. Methods In this retrospective controlled case series, we reviewed the eyes with macular edema. Analyzed factorsassociated RNFL thickness and peripapillary retina ranging from 3 mm and 5 mm of optic disc included age, IOP, visualacuity, central macular thickness (CMT), central macular thickness changes and kinds comorbid diasese. All themeasured values were obtained at initial presentation and the presentation when macular edema was relieved. The RNFL thickness and peripapillary retinal thickness were measured by SD-OCT (Spectralis OCT). Results The measured value RNFL thickness and peripapillary retina were significantly fluctuate with the macularedema. The initial CMT, CMT changes were quantitively correlated with RNFL thickness alteration (p

Because increasing evidence indicates that there is a close relationship between glaucoma and myopia, we hypothesized that conformational changes around the optic disc and axial elongation may biomechanically stress the optic nerve and increase the susceptibility of the lamina cribrosa to intraocular pressure. The area has a unique appearance, including the shape of the disc, an enlarged area of peripapillary atrophy, and nasal elevation with temporal flattening of the disc. These signs potentiality result from stretching of the posterior ocular wall and oblique insertion of the optic nerve, and investigators are expecting to find the key to the pathogenesis of glaucoma. Moreover, recent advances in imaging technologies are enabling visualization of the deep structural characteristics. This chapter reviews the morphologic and histologic changes in the peripapillary area in highly myopic eyes and addresses the underlying mechanism of glaucoma.

Purpose: The aim of this article is to study peripapillary retinal blood flow in patients with progressive and stable exfoliation glaucoma (ExG). Methods: Fifty-eight eyes with ExG were included; 25 of them had progressive and 33 stable glaucoma. Retinal blood flow in the peripapillary retina was measured with scanning laser Doppler flowmetry. Acquired flow maps were analysed with the automatic full-field perfusion image analyser. Multiple logistic regression was used to model progression of glaucoma. Results: Mean retinal flow (MF; correlation coefficient, P-value; R = 0.36, P = 0.006) and retinal minimum diastolic flow (R = 0.33, P = 0.011) were positively correlated with visual field mean defect (MD). Factors associated with progressive glaucoma were mean intraocular pressure (OR = 1.198 for each mmHg; P = 0.050) and visual field MD (OR = 1.134 for each dB; P = 0.013). Age (P = 0.35), MF (P = 0.58), or presence of cardiovascular disease (P = 0.17) were not associated with glaucoma progression. Conclusion: No difference in peripapillary retinal blood flow between progressive and stable ExG could be found.

Bietti's crystalline corneal-retinal dystrophy is characterized by deposits of crystals in the marginal cornea and the paracentral and peripapillary retina. To date, only three cases with long term follow-up have been reported. The case of another patient, who has been observed for 16 years, is reported here. The most striking morphologic feature during the period of examination was the diminution of the retinal crystals, an optical phenomenon that appears to be due to the advanced atrophy of the retinal pigment epithelium. The progressive course is documented photographically.

Asperger disorder is a complex behavioral disorder that may be related to autism. We examined a 49-year-old man with Asperger disorder who had multiple neuro-ophthalmologic abnormalities, including colobomatous defects involving the optic discs and peripapillary retina, and abnormal ocular motility with an oculocephalic dyskinesia. Asperger disorder may be associated with a variety of neuro-ophthalmologic disturbances.

In their case report in the April 1993 issue of theArchives, Dailey et al 1 misinterpret the morning glory disc anomaly shown in Figure 1 as an optic disc coloboma. The stereoscopic photograph shows a large optic disc surrounded by an annular zone of retinal depigmentation, an elevated glial tuft overlying the center of the disc, and anomalous retinal vessels that arise from the periphery of the optic disc and extend radially over the peripapillary retina. These typical features of the morning glory disc anomaly differ from those of the optic disc coloboma in which there is a discrete, focal, glistening white, bowl-shaped excavation decentered inferiorly within an enlarged optic disc, and minimal, if any, pigmentary disturbance surrounding the disc. 2 The importance of this distinction lies in the fact that optic disc colobomas are often familial, often accompanied by retinochoroidal or iris colobomas, and commonly associated with congenital

A 14-year-old Iranian girl was referred for evaluation of bilateral elevation of the peripapillary retina. Fluorescein angiography was consistent with bilateral peripapillary exophytic retinal hemangioblastomas as seen in angiomatosis retinae (von Hippel's disease). Argon laser photocoagulation of the more severely affected left eye was performed with minimal effect upon the tumor.

An eye that had the clinical appearance of a tumour of the nerve head was found on histological examination to have a congenitally large scleral canal with secondary buckling of the overlying retina.

Computerized topographic mapping of 10 repeated fundus images of one eye each in 10 healthy subjects and in 10 subjects with elevated intraocular pressures (IOPs) was performed with the Humphrey Retinal Analyzer. The variability of depth measurements at 400 to 650 individual locations in the optic nerve head and peripapillary retina was evaluated. The average size of the 95% confidence intervals for individual depth measurements for healthy subjects and those with elevated IOPs were 166 and 232 microns in the optic nerve head and 205 and 261 microns in the peripapillary retina, respectively. Variability was significantly less for healthy subjects than for those with elevated IOPs. Variability was significantly greater for depth measurements in the peripapillary retina than for measurements in the optic head. Knowledge about variability of individual depth measurements is useful for proper interpretation of computerized topographic mapping to detect retinal nerve fiber damage.