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Purpose: To evaluate the effectiveness of a new modification of the vacuum-perimeter test (VPT) by V.V. Volkov in the early diagnosis of glaucoma in comparison with the results of the original test and its known modification — vacuum-compression automated test (VCAT) in an open comparative clinical research. Patients and Methods. The study involved 26 patients (47 eyes) (average age 52.9 ± 8.5 years) with suspected open-angle glaucoma (OAG). Patients were divided into three groups: 1-st — 19 eyes with preglaucoma, 2-nd — 18 eyes with the early stage of OAG, 3-rd — 10 eyes of five patients with unconfirmed glaucoma. The control group (4-th) included 20 eyes of 10 healthy people (average age 56.4 ± 4.4 years). Along with the standard ophthalmological examination, all patients underwent perimetry on Humphrey Visual Field Analyzer II 745i (Germany-USA), our modification of Frequency Doubling Technology (FDT) perimetry, evaluation of the optic nerve head (ONH) on Heidelberg Retina Tomograph (HRT 3, Germany) and three stress tests: VPT, VCAT and our modification — vacuum-contrast-frequency test (VCFT). VCFT was created on the base of FDT perimetry with the aim of increasing the sensitivity of the original test (VPT) for detection of preglaucoma through the use of non-standard stimulus and increasing the number of investigated points of central visual field. Results. According to the National classification (1975) the diagnosis of preglaucoma was determined on the basis of a positive result of at least one of three stress tests, taking into account the risk factors for the development of glaucoma in patients. The early stage of OAG was established on the base of International standards for structural and functional assessment of the ONH (2003). The specificity of all three compared stress tests was 100 %, which confirmed their negative results in all patients (10 eyes) from the 3-rd group. However, the sensitivity of VCFT (75 %) was significantly higher than VPT (21.05 %) and VCAT (21.05 %), which is due, we believe, to the specific nature of VCFT stimulus. Conclusion. According to the obtained data, the developed new modification of VPT — VCFT on the specificity of the results was not worse, and the sensitivity was better than the original VPT and VCAT in the diagnosis of preglaucoma. VCFT is quickly performed and comfortable for patients.

Purpose There is a limited understanding of factors that influence the efficacy of topical glaucoma medication. Our study is a long-term, case-control analysis of how systemic antihypertensive (anti-HTN) medications influence the change in IOP after initiating prostaglandin (PG) drop therapy. Materials and methods A retrospective chart review of 3,781 patients was performed on patients with a diagnosis of glaucoma suspect that progressed to primary open-angle glaucoma (POAG) by ICD-9 codes over a 10-year period. Inclusion criteria consisted of the following: 1) progression from preglaucoma to glaucoma diagnosis in a time span of ≥6 months; 2) two visual fields recorded between these dates; 3) initial average IOP of both eyes of ≥21 mmHg; and 4) initiation of topical PG therapy alone. IOP (in mmHg) was measured at initiation of PG drops and at next visit. Results One hundred eleven patients were qualified for analysis. Patients not on anti-HTN agents had an average IOP decrease of 6.38±0.56 mmHg. Comparatively, patients on anti-HTN agents had an average IOP decrease of 6.66±0.48 mmHg (P=0.61). In addition, there was no statistical difference between IOP decrease between patients on single vs multiple systemic anti-HTN agents (P=0.85). There were eight nonresponders to PGs on no anti-HTN medications and 12 nonresponders on anti-HTN medication (P=0.55). Conclusion Systemic anti-HTN medication use did not significantly impact IOP reduction after topical PG initiation for POAG. Additionally, nonresponse to PG therapy was not correlated to systemic anti-HTN use.

To detect changes in the compliance and baseline position (position at the baseline time point of a compliance test) of the monkey optic disc after the onset of chronic experimental glaucoma.Sixty-six compliance tests were performed on 26 eyes of 13 monkeys. Longitudinal Study. In seven normal monkeys, compliance tests were performed three times in one eye (study eye) and once in the contralateral eye. In the study eye of five of these monkeys, chronic experimental glaucoma was then induced and compliance tests were performed at some or all of the following postglaucoma testing intervals: 1 to 2 weeks, 3 to 4 weeks, 5 to 8 weeks, 9 to 12 weeks, 13 to 18 weeks, and more than 18 weeks after the onset of elevated intraocular pressure (IOP). In the study eye of the remaining two monkeys, the optic nerve was transected, and compliance was tested at 5, 9, and 13 weeks after transection. An analysis of variance (ANOVA) was performed to detect an increase (hypercompliance) or decrease (rigidity) in the compliance of the glaucomatous eyes at each testing interval. A second ANOVA was performed to detect the onset of chronic posterior deformation of the baseline position of each disc. Cross-Sectional Study. In six additional monkeys with pre-existing experimental glaucoma, the glaucomatous study eye was compliance tested at one of the postglaucoma testing intervals used in the longitudinal study. The contralateral normal eye was compliance tested once. These data were then added to the data from the five longitudinally studied monkeys at the appropriate preglaucoma and postglaucoma testing intervals. A third ANOVA was done to compare the compliance of the expanded group of glaucomatous eyes at each postintervention testing interval with the compliance of the 13 normal contralateral eyes.Compliance. In the longitudinally (PrF = 0.0005) and cross-sectionally (PrF = 0.0001) studied glaucomatous eyes, optic disc compliance increased significantly by 1 to 2 weeks and then returned to a level statistically indistinguishable from normal within 13 to 18 weeks after the onset of glaucoma. In the transection eyes, the optic discs were significantly less compliant (more rigid) at 5 and 9 weeks after transection compared with the discs in either the normal or the glaucomatous eyes (PrF0.05). Baseline Optic Disc Position. Chronic posterior deformation of the disc was detected in one of three eyes tested 1 to 2 weeks and three of four eyes tested 3 to 4 weeks after the onset of glaucoma (PrF0.05). Chronic posterior deformation was not detected in the discs of either of the transection eyes at any of the post-transection testing intervals.Changes in optic disc compliance and surface position were detected by digitized image analysis within 2 to 4 weeks of the onset of experimental glaucoma in the monkey eye. These findings are unlikely to be due to axon loss alone, because they did not occur in optic nerve transection eyes (which constitute a model of axon loss in which intraocular pressures remain normal). The results suggest that IOP-related damage to the load-bearing connective tissues of the optic nerve head may occur early in the course of experimental glaucoma.

Aubert1in 1862 was the first to call attention to studies of dark adaptation as evidence of the sensitivity of the retinal elements. Since then numerous observers have tried to associate ocular disease with the abnormal course of dark adaptation. Notable among these have been Kleckowski,2Jess,3Shindler,4Tschenow5and Derby and co-workers.6Other investigators have studied the problem of dark adaptation, using either an apparatus of their own design, the Nagel adaptometer, or modifications of the latter. A review of these instruments has been given by Derby, Chandler and Sloan in their article on "A Portable Adaptometer."7 The subject becomes of greater importance in view of the fact that attention has been called to the value of dark adaptation as an aid in early diagnosis in cases of so-called "preglaucoma" (one eye normal and the other affected with glaucoma), in cases

Records from the United States Air Force glaucoma screening and management program for flying personnel were surveyed to obtain long-term followup information and age-specific prevalences for this population. Untreated ocular hypertensives with tensions of 22-29 with no visual field loss were labeled 'preglaucoma'; ocular hypertensives without field loss and treated with epinephrine (for tensions above 29 or for other reasons) were labeled 'glaucoma. ' Those requiring other drugs and those with field loss were disqualified from flying. Questionnaires to ophthalmologists caring for retired men indicated that 1 of the 39 preglaucomas followed 8 years and 2 of the 27 glaucomas followed 7 years had lost visual field. Among ocular hypertensives screened from 15,804 men, ages 40-54, in 1970, only 5 had visual field loss presumed glaucomatous.

The level of catecholamines was determined in the lacrimal fluid since it may serve as an index of the activity of the sympatho-adrenal system. 86 persons aged between 35 and 65 years were studied. Of these, 49 were glaucoma patients, 16 patients had preglaucoma, and 21 practically healthy subjects served as a control. The results of the study showed that dopa and catecholamines: dopamine, noradrenaline and adrenaline can be determined in the lacrimal fluid of healthy people. Preglaucoma patients were found to have a reduced level of dopamine and its precursor dopa. Glaucoma patients were found to have reduced levels of dopa and noradrenaline. Determination of the level of catecholamine and dopa is considered to be an immediate index of the state of the sympathoadrenal system in the initial glaucoma. Determination of catecholamines and dopa in the lacrimal fluid can serve as a test in glaucoma diagnosis.