Статті в журналах: "Glaucome – Diagnostic"

1

Bresson, H., X. Zanlonghi, S. Bodet, J. P. Moisan, and F. Gerson. "473 Le glaucome : bases moléculaires et diagnostic génétique en France." Journal Français d'Ophtalmologie 28 (March 2005): 282. http://dx.doi.org/10.1016/s0181-5512(05)73593-2.

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2

Perossini, M., M. Romagnoli, T. Perossini, M. Figus, S. Benedetti, L. Corucci, and M. Nardi. "279 Le diagnostic précoce du glaucome : comparaison entre différentes techniques." Journal Français d'Ophtalmologie 28 (March 2005): 228–29. http://dx.doi.org/10.1016/s0181-5512(05)74676-3.

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3

Wroten, Chris. "Nouveautés et thérapies ´émergentes pour le glaucome." Canadian Journal of Optometry 80, no. 2 (June 1, 2018): 55–59. http://dx.doi.org/10.15353/cjo.80.271.

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On ne sait au juste quand la neuropathie optique progressive qu’est le glaucome a été découverte, mais elle est décrite dans la documentation médicale depuis les temps anciens. Hippocrate a évoqué la c´écité des personnes âgées qu’il a appelée « glaykoseis ». Bien plus tard, un ophtalmologue anglais, Richard Banister,a été le premier à constater un rapport de corrélation avec une pression intraoculaire (PIO) élevée. L’invention de l’ophtalmoscope par Hermann von Helmholtz au milieu des années 1800 a permis une première visualisation in vivo des changements glaucomateux du nerf optique et, en 1862, Franciscus Donders a inventé le terme « Glaukoma simplex » pour décrire la cécité résultant d’une PIO élevée. Peu après, l’invention du tonomètre, le développement de la périmétrie et l’utilisation de la cocaïne comme anesthésique ont fait progresser le diagnostic du glaucome.

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4

Biton, C., J. P. Lemoal, J. P. Djoumegan, T. Khuc, and M. Bonsch. "510 Diagnostic échographique anténatal d’un glaucome congénital bilatéral : à propos d’un cas." Journal Français d'Ophtalmologie 28 (March 2005): 291. http://dx.doi.org/10.1016/s0181-5512(05)73630-5.

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5

Promelle, V., C. Iscar, M. Grenot, C. Gondry-Jouet, and S. Milazzo. "Les anomalies congénitales de la papille : un diagnostic différentiel du glaucome congénital." Journal Français d'Ophtalmologie 40, no. 1 (January 2017): e35-e36. http://dx.doi.org/10.1016/j.jfo.2016.08.014.

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6

Bohere, E., N. Franquet, F. Delanoy, A. Scheffer, and G. Laverdure. "504 Intérêt de l’imagerie cérébrale dans le diagnostic de glaucome à pression normale." Journal Français d'Ophtalmologie 32 (April 2009): 1S155. http://dx.doi.org/10.1016/s0181-5512(09)73628-9.

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7

Cuvier, Marion. "Examens complémentaires dans le cadre d’un diagnostic de glaucome : Mme L., une configuration particulière." Revue Francophone d'Orthoptie 6, no. 3 (July 2013): 114–18. http://dx.doi.org/10.1016/j.rfo.2013.08.001.

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8

Almárcegui Lafita, C., J. Fernandez Tirado, B. Melcon Sanchez Friera, P. Uclés Moreno, JR Valdizán Usón, and FM Honrubia López. "Étude des composants de l'électrorétinogramme par inversion de damier dans le diagnostic précoce du glaucome." Neurophysiologie Clinique/Clinical Neurophysiology 27, no. 2 (April 1997): 109–15. http://dx.doi.org/10.1016/s0987-7053(97)85663-8.

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9

Rixon, Andrew J., Rebecca A. Wenig, and Brittany N. Rigdon. "Un cas de glaucome à angle ouvert consécutif au syndrome de Posner-Schlossman." Canadian Journal of Optometry 81, no. 3 (September 4, 2019): 39–48. http://dx.doi.org/10.15353/cjo.v81i3.1561.

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Cette observation clinique présente le diagnostic et la prise en charge appropriés du syndrome de Posner-Schlossman (SPS) et de ses séquelles possibles. Le SPS se caractérise par des poussées unilatérales et récurrentes de pression intraoculaire fortement accrue. Bien que l’étiologie et la pathophysiologie de cette maladie chronique demeurent incertaines, sa durée est directement corrélée au risque de développer un glaucome secondaire à angle ouvert. Le patient et l’optométriste responsable doivent être conscients de la nécessité d’une intervention en temps opportun pendant les poussées aiguës, ainsi que du respect des soins longitudinaux pour préserver la fonction et la qualité de vie. Cette observation clinique et cet examen de cas soulignent l’impact de cette maladie.

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10

Gheck, L., P. Koskas, S. N’ghiem-Buffet, and G. Chaine. "523 Apports de l’échographie Doppler couleur orbitaire dans le diagnostic étiologique d’un glaucome néovasculaire : à propos d’un cas." Journal Français d'Ophtalmologie 28 (March 2005): 294. http://dx.doi.org/10.1016/s0181-5512(05)73643-3.

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11

Mocanu, C., and M. Mocanu. "401 Soutien informatique aux processus de prise de décision en ophtalmologie : une étude de cas dans le diagnostic et le suivi du glaucome." Journal Français d'Ophtalmologie 31 (April 2008): 134. http://dx.doi.org/10.1016/s0181-5512(08)70999-9.

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12

Sharvadze, N. R., A. L. Shtilerman, D. P. Skachkov, and Y. A. Drovnyak. "Modern methods for assessing morphometric and functional indicators in primary glaucoma." Modern technologies in ophtalmology, no. 1 (May 29, 2021): 83–87. http://dx.doi.org/10.25276/2312-4911-2021-1-83-87.

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In the article are presented analytical review of scientific articles devoted to the study of modern methods of diagnostics of primary glaucoma. On the basis of scientific articles, a review material was collected and systematized on diagnostic methods for studying morphometric and functional changes in primary glaucoma, which are used in modern ophthalmic practice. In recent years, the improvement and implementation of new high-tech modern diagnostic methods open up new opportunities for researchers and clinicians. Optical coherence tomography, OCT angiography, static perimetry make it possible, by comparing morphometric and functional parameters, to give a more complete, comprehensive assessment of pathological changes in the optic nerve head, in the macular region and at the level of the choriocapillaries. Prevention of glaucoma blindness largely depends on its early diagnosis based on the use of modern organizational and medical technologies. Key words: glaucoma, open-angle glaucoma, intraocular pressure, glaucomatous optic neuropathy, diagnostic methods.

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13

Kiseleva, O. A., N. V. Balatskaya, A. M. Bessmertny, and V. I. Kotelin. "Facilities of diagnosis and monitoring of optic neuropathy in primary open-angle glaucoma. Part 1." Russian Ophthalmological Journal 12, no. 2 (June 12, 2019): 74–82. http://dx.doi.org/10.21516/2072-0076-2019-12-2-74-82.

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The review is focused on modern methods of instrumental diagnostics of primary open-angle glaucoma. Diagnostic possibilities and informativeness of objective measurable parameters are discussed with regard to special criteria, called clinical endpoints.

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14

Geimer, Sabina Andersson. "Glaucoma diagnostics." Acta Ophthalmologica 91, esis1 (February 2013): 1–32. http://dx.doi.org/10.1111/aos.12072.

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15

Andersson Geimer, Sabina. "Glaucoma diagnostics." Acta Ophthalmologica 91, no. 4 (April 20, 2013): 390–91. http://dx.doi.org/10.1111/aos.12099.

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16

Tan, Nicholas Y. Q., Chelvin C. A. Sng, Jost B. Jonas, Tien Yin Wong, Nomdo M. Jansonius, and Marcus Ang. "Glaucoma in myopia: diagnostic dilemmas." British Journal of Ophthalmology 103, no. 10 (April 30, 2019): 1347–55. http://dx.doi.org/10.1136/bjophthalmol-2018-313530.

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Myopic eyes have an increased risk of glaucoma. However, glaucomatous changes in a myopic eye are often difficult to detect. Classic structural and functional investigations to diagnose glaucoma may be confounded by myopia. Here, we identify some of the common pitfalls in interpreting these structural parameters, and the possible solutions that could be taken to overcome them. For instance, in myopic eyes, we discuss the limitations and potential sources of error when using neuroretinal rim parameters, and retinal nerve fibre layer and ganglion cell-inner plexiform layer thickness measurements. In addition, we also review new developments and potential adjuncts in structural imaging such as the assessment of the retinal nerve fibre layer texture, and the examination of the microcirculation of the optic nerve head using optical coherence tomography angiography. For the functional assessment of glaucoma, we discuss perimetric strategies that may aid in detecting characteristic visual field defects in myopic glaucoma. Ultimately, the evaluation of glaucoma in myopia requires a multimodal approach, to allow correlation between structural and functional assessments. This review provides overview on how to navigate this diagnostic dilemma.

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17

Kiseleva, O. A., N. V. Balatskaya, A. M. Bessmertny, L. V. Yakubova, and V. I. Kotelin. "Facilities of diagnosis and monitoring of optic neuropathy in primary open-angle glaucoma. Part 2." Russian Ophthalmological Journal 13, no. 1 (March 15, 2020): 85–93. http://dx.doi.org/10.21516/2072-0076-2020-13-1-85-93.

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The first part of the review was focused on modern methods of instrumental diagnostics of primary open-angle glaucoma [1]. Diagnostic possibilities and informativeness of objective measurable parameters were discussed with regard to special criteria, called clinical endpoints. The second part of the review is dedicated to finding methods of early diagnosis and criteria of the progression of glaucomatous optic neuropathy.

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18

Lindbohm, Nina M., Eija Vesti, Päivi Puska, Teemu Mäkitie, Kalevi Friberg, and Mika Harju. "Diagnostic Accuracy of Glaucoma Tests in Everyday Practice." Ophthalmology @ Point of Care 1, no. 1 (January 2017): oapoc.0000020. http://dx.doi.org/10.5301/oapoc.0000020.

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Purpose To evaluate the performance of various tests with automated and subjective evaluation for primary diagnostics of glaucoma in a normal clinical setting. Methods Subjects referred because of suspicion of glaucoma were recruited. All subjects had full ophthalmologic evaluation with stereophotography of the optic nerve head (ONH), red-free retinal nerve fiber layer (RNFL) photography, scanning laser polarimetry (SLP), optical coherence tomography (OCT), and standard automated perimetry (SAP). Analysis of all results was made jointly by 5 glaucoma specialists, with a consensus for each eye as healthy, glaucomatous, or glaucoma suspect. Results from each method were evaluated against this consensus, followed by a subjective evaluation of each method by a glaucoma specialist, comparing this with automated classification by the devices. Results Of the 101 subjects and 202 eyes examined, 23 eyes were by consensus glaucomatous, and 23 were glaucoma suspect. Sensitivity was best with ONH photos and worst with SAP, while SLP had a better sensitivity but poorer specificity than did RNFL photographs and OCT. Subjective evaluation of SLP, OCT, and SAP data gave better sensitivity and specificity than did classification by numeric values from the devices only, with OCT performing better in automatic classification than did SLP or SAP. Conclusions None of the current methods is superior to others in diagnosing glaucoma, and the accuracy of automated tests was better when subjectively evaluated by an experienced ophthalmologist. Diagnosis of glaucoma should be based on a combination of test results interpreted by a clinician.

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19

Mulak, Małgorzata. "Extended glaucoma diagnostics." OphthaTherapy. Therapies in Ophthalmology 6, no. 2 (June 30, 2019): 71–77. http://dx.doi.org/10.24292/01.ot.300619.02.

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20

Chukhraiev, A. M., N. M. Agarkov, D. A. Konyaev, E. V. Popova, M. M. Yablokov, and A. S. Kulabukhov. "Infiornativity lacrimal fluid interleukins in diagnostics and development of angle-closure glaucoma in elderly subjects." Russian Journal of Infection and Immunity 10, no. 4 (November 27, 2020): 755–61. http://dx.doi.org/10.15789/2220-7619-iit-1247.

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An increased percentage of the elderly subjects in pattern of contemporary society, along with other causes and risk factors, is accompanied by rise in the incidence of glaucoma. By 2020, according to international studies it is expected that prevalence of glaucoma patients in the world would increase up to 80 million subjects. Among the elderly, glaucoma is a common pathology, which development is associated with local disturbances in interleukin profile. However, the features of the latter in patients with primary closed-angle glaucoma in the elderly were poorly examined. Studies of local interleukin status were conducted mainly in patients with suspected or initial manifestations of primary open-angle glaucoma. The features of lacrimal fluid interleukin shift in a target group of elderly patients suffering from stage II primary closed-angle glaucoma virtually gained no attention. In addition, a limited range of local interleukins in patients with such pathology in previous studies was examined. In addition, informativity of lacrimal fluid interleukins in elderly glaucoma patients was not assessed too based on objective methods. The aim of the current study was to outline features and informativity of local interleukin profile indicators in 58 elderly patients with primary closed-angle glaucoma stage II, aged 60—74 years (main group) and 27 age-matched elderly subjects lacking such pathology. The level of interleukins in the lacrimal fluid was determined with the enzyme immunoassay “Multiscan” analyzer (Finland) by using sandwich ELISA (R&D Diagnostic Inc., USA). Informativity of measuring various interleukins was calculated according to the generally accepted formula. It was found that local interleukin profile in elderly patients with primary closed-angle glaucoma was mainly featured with increased amount of IL-2, IL-17, IL-8, but decreased IL-10. Hence, such local interleukins displayed peak informativity. The data obtained should be used in the diagnostics and treatment of such pathology, as well as of applied importance to unveil novel mechanisms behind development, diagnostics and corroboration for selective immuno-tropic therapy of primary closed-angle glaucoma.

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21

Sidorova, A. V., A. V. Starostina, K. A. Stefankova, E. S. Mustafaeva, M. S. Jereshtieva, and A. A. Aydinyan. "Modern methods of visualization of the angle of the anterior chamber of the eye in the diagnosis and treatment of glaucoma." Fyodorov journal of ophthalmic surgery, no. 2 (June 17, 2022): 67–76. http://dx.doi.org/10.25276/0235-4160-2022-2-67-76.

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Purpose. To analyze the literature reflecting the main modern methods of visualizing the angle of the anterior chamber of the eye, which are used in patients with glaucoma. Material and methods. To perform the review, a search was carried out for literature sources on the Pubmed, Scopus and Elibrary reference databases for the period up to 2022 inclusive using the following keywords: anterior camera angle, gonioscopy, electronic gonioscopy, optical coherence tomography, ultrasound biomicroscopy and the same phrases in Russian. Results. The variety of clinical and morphological forms of glaucoma, the wide prevalence, frequency of occurrence and steady growth of this disease require timely diagnostics, as well as dynamic monitoring of the results of conservative and surgical treatment in patients with glaucoma. Despite the importance of such a diagnostic method as gonioscopy, ophtalmologists still do not use it sufficiently, the frequency of its application during the first visit to the doctor for glaucoma varies from 17.96 to 45.9%. There are also additional instrumental methods of examination of patients with glaucoma that allow an objective assessment of the structures of the eye anterior segment: automated gonioscopy, optical coherence tomography of the eye anterior segment and ultrasound biomicroscopy. These methods can be used both for the primary diagnosis of glaucoma and its dynamic observation, as well as for choosing surgical treatment tactics and monitoring its results thanks to high-precision visualisation and image documentation. Each of them has its own characteristics, advantages and disadvantages, depending on the specifics of the disease and the presence of concomitant ocular pathology, which are described in this article. Conclusion. Taking into account the variety of clinical forms of glaucoma and the insufficient equipment of medical institutions, especially primary care, it can be concluded that it is necessary to improve diagnostic algorithms. Methods such as electronic gonioscopy, optical coherence tomography of the eye anterior segment and ultrasound biomicroscopy will make the diagnostic process more accurate and informative, help to correctly diagnose and determine treatment tactics for both primary care physicians and surgeons. The possibility of documenting the results obtained and creating a system for their analysis can contribute to the founding of a generalized database, which will greatly simplify and accelerate the process of providing care to patients with glaucoma. Key words: glaucoma, anterior chamber angle, gonioscopy, electronic gonioscopy, optical coherence tomography, ultrasound biomicroscopy

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22

Choi, Ji Ho, and Tae Eun Lee. "Changes in the Glaucoma Diagnosis during the Last 10 years: Health Insurance Review and Assessment Service Data 2010-2019." Journal of the Korean Ophthalmological Society 62, no. 9 (September 15, 2021): 1259–68. http://dx.doi.org/10.3341/jkos.2021.62.9.1259.

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Purpose: We determined the current status of glaucoma diagnoses in Korea and trends in the change over the past 10 years using data from the Health Insurance Review and Assessment Service. Methods: The glaucoma diagnostic code was collected from the disease subclass statistics of the medical statistical information disclosed in the Healthcare Bigdata open system, and the number of health insurance patients who were billed for medical care benefit costs from 2010 to 2019 with the glaucoma diagnosis code was collected. Data were collected for each diagnostic code by dividing it by year, age group, and gender, and then changes in the current status of glaucoma diagnosis per 100,000 people were analyzed by age group. A joinpoint regression analysis was used to determine the increasing and decreasing trends for each diagnostic code and whether the trend changed during the study period. Results: The number of health insurance patients who received treatment with the glaucoma diagnostic code in 2019 compared to 2010 increased by 120.3% and 109.5% per 100,000 people covered by medical care. This increasing trend has slowed as of 2015. Suspected glaucoma, primary open-angle glaucoma, and primary angle-closure glaucoma showed an increasing trend, while glaucoma secondary to eye trauma and glaucoma secondary to drugs declined markedly. No significant trend in glaucoma secondary to eye inflammation was detected, and glaucoma secondary to other eye disorders and unspecified glaucoma tended to increase. Other glaucoma diagnoses decreased from 2010 to 2012 and then increased. Conclusions: The number of patients who underwent glaucoma treatment among all health insurance patients increased significantly from 2010 to 2019. Despite the overall increasing trend, eye trauma and drug-induced secondary glaucoma have markedly decreased.

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23

Kim, Ko Eun, Joon Mo Kim, Ji Eun Song, Changwon Kee, Jong Chul Han, and Seung Hyup Hyun. "Development and Validation of a Deep Learning System for Diagnosing Glaucoma Using Optical Coherence Tomography." Journal of Clinical Medicine 9, no. 7 (July 9, 2020): 2167. http://dx.doi.org/10.3390/jcm9072167.

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This study aimed to develop and validate a deep learning system for diagnosing glaucoma using optical coherence tomography (OCT). A training set of 1822 eyes (332 control, 1490 glaucoma) with 7288 OCT images, an internal validation set of 425 eyes (104 control, 321 glaucoma) with 1700 images, and an external validation set of 355 eyes (108 control, 247 glaucoma) with 1420 images were included. Deviation and thickness maps of retinal nerve fiber layer (RNFL) and ganglion cell–inner plexiform layer (GCIPL) analyses were used to develop the deep learning system for glaucoma diagnosis based on the visual geometry group deep convolutional neural network (VGG-19) model. The diagnostic abilities of deep learning models using different OCT maps were evaluated, and the best model was compared with the diagnostic results produced by two glaucoma specialists. The glaucoma-diagnostic ability was highest when the deep learning system used the RNFL thickness map alone (area under the receiver operating characteristic curve (AUROC) 0.987), followed by the RNFL deviation map (AUROC 0.974), the GCIPL thickness map (AUROC 0.966), and the GCIPL deviation map (AUROC 0.903). Among combination sets, use of the RNFL and GCIPL deviation map showed the highest diagnostic ability, showing similar results when tested via an external validation dataset. The inclusion of the axial length did not significantly affect the diagnostic performance of the deep learning system. The location of glaucomatous damage showed generally high level of agreement between the heatmap and the diagnosis of glaucoma specialists, with 90.0% agreement when using the RNFL thickness map and 88.0% when using the GCIPL thickness map. In conclusion, our deep learning system showed high glaucoma-diagnostic abilities using OCT thickness and deviation maps. It also showed detection patterns similar to those of glaucoma specialists, showing promising results for future clinical application as an interpretable computer-aided diagnosis.

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24

Kiseleva, Olga A., Srbui M. Kosakyan, Liya V. Yakubova, Alexander M. Bessmertny, and Lubov’ V. Vasilenkova. "Pathophysiological features of development, clinical features and treatment of malignant glaucoma." Ophthalmology journal 12, no. 3 (December 16, 2019): 59–65. http://dx.doi.org/10.17816/ov15379.

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Malignant glaucoma is a difficult task for an ophthalmologist in the treatment process. This is a multifactorial condition that occurs in anatomically predisposed eyes. Malignant glaucoma remains one of the most severe clinical forms of glaucoma requiring timely diagnosis and immediate treatment. Diagnostic issues, pathophysiological mechanisms of development and methods of treatment are still controversial. The diagnosis of malignant glaucoma is often late due to similarity with some other pathological conditions. In many cases malignant glaucoma is resistant to medication and laser treatment. Surgical treatment of malignant glaucoma is complex and not always effective. The review discusses the possible pathophysiological mechanisms of development, diagnostic methods of research, as well as the applied conservative, laser and surgical methods of treatment of malignant glaucoma.

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25

Medvedovskaya, Nataliia, and Zoriana Povch. "Risk Factors for Development of Glaucoma in the Practice of Family Doctor." Family Medicine, no. 5 (December 30, 2016): 52–54. http://dx.doi.org/10.30841/2307-5112.5.2016.248660.

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The objective: studying of risk factors of developing of glaucoma for formation of risk groups in daily practice of the family doctor, in particular timely identification of an ocular hypertension, the prevention of establishment for the first time of the diagnosis in her late stage became a research objective. Patients and methods. Outpatient and polyclinic offices of five healthcare institutions of the city of Kiev in which primary help by the principles of the general medical practice – family medicine is given became scientific base of a research. Forms of account № 12 «The report on the diseases registered at patients who live in the area of service of treatment and prevention facility» and questionnaires of a sociological research of risk factors of glaucoma (820 questionnaires) were primary material. Achievement of goals of a research demanded use of a complex of methods of a research, a basis for which was a system approach, namely: bibliosemantic, sociological (questionnaire), medico-statistical methods. Results. Оf a research it is proved that relevance of a problem of the prevention of a blindness and a low vision owing to glaucoma increases in Ukraine over the years. Modern risk factors of development of glaucoma which have the proved influence on formation of an ocular hypertension, and are studied later and glaucomas, knowledge of which will help physicians of primary contact with the patient to form actively risk groups on glaucoma that, in turn, allows to individualize at the same time preventively – improving, medical and diagnostic medical care in each case and to objectify assessment of its results in dynamics. Conclusion. Knowledge the doctor of the general practice the family doctor of modern risk factors of development of glaucoma is necessary for her effective prevention as it is proved that timely diagnosis of a disease (at an early stage) does possible correction of the existing risk factors of emergence and progressing of glaucoma that is very important in daily practice of the doctor of the general practice – the family doctor.

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26

Tur, E. V., T. Y. Kozhevnikova, and A. O. Nevstrueva. "Case report of complex diagnostics of early glaucoma." Reflection, no. 1 (June 7, 2022): 121–27. http://dx.doi.org/10.25276/2686-6986-2022-1-121-127.

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Aim. To present a clinical case of early primary open-angle glaucoma diagnosing using modern examination methods and individual risk factors of glaucoma. Clinical case. A 72-year-old patient came to the clinic with complaints of a feeling of heaviness and blurred vision for several months. During the examination, both standard examinations such as visometry, tonometry, biomicroophthalmoscopy, computer static threshold perimetry were carried out, as well as evaluation of the biomechanical properties of the cornea, optical coherence tomography of the macula and the optic nerve, pattern electroretinography for diagnosis and subsequent evaluation of the effectiveness of prescribed antihypertensive therapy. Key words: primary open-angle glaucoma; early diagnosis of glaucoma.

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27

Cherednichenko, Nina L., Sergey M. Karpov, Vladimir A. Baturin, and Yuliana A. Barbos. "Antibodies to myelin basic protein as a diagnostic marker of primary open-angle glaucoma." Ophthalmology journal 11, no. 1 (March 15, 2018): 19–24. http://dx.doi.org/10.17816/ov11119-24.

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Recently, many authors resort to immunomolecular diagnostics of glaucoma. We found conflicting information about the concentration of antibodies to the myelin basic protein (AB to MBP) in primary open-angle glaucoma in the literature. Aim: to determine the concentration of antibodies to the myelin basic protein in the serum of patients with primary open-angle glaucoma to assess the diagnostic significance of the test. Materials and methods. We included 48 people aged from 42 to 79 years: fourteen people had the diagnosis of the first stage of primary open-angle glaucoma (POAG), 10 people had the second (advanced) stage of POAG, 8 people had the III (far-gone) stage of POAG, and 16 subjects made the control group. Exclusion criteria: mature or almost mature cataract, age-related macular degeneration, severe concomitant ophthalmologic, neurological pathology, oncological and autoimmune diseases, glucocorticoid or immunosuppressive therapy, exacerbation of any acute and subacute respiratory infection, chronic inflammatory processes and craniocerebral trauma. The serum level of AB to MBP was determined by enzyme immunoassay method (ELISA). Results. The concentration of AB to MBP was significantly higher in patients with first and second stages of POAG (177.5 ± 63.93 μg/ml and 262.63 ± 34.78 μg/ml, respectively) than in the control group (38.69 ± 11.77 micron/ml, p < 0.05). To establish the diagnosis of POAG in at risk patients it is appropriate to use the level of IgG to MBP > 60 μg/ml; the sensitivity of the method is 78% and its specificity is 87%. (For citation: Cherednichenko NL, Karpov SM, Baturin VA, Barbos YuA. Antibodies to myelin basic protein as a diagnostic marker of primary open-angle glaucoma. Ophthalmology Journal. 2018;11(1):19-24. doi: 10.17816/OV11119-24).

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28

Paycha, F., G. Nepoux, O. Roche, P. Dureau, Y. Uteza, and J. L. Dufier. "Diagnostic et traitement des glaucomes." Journal Français d'Ophtalmologie 28, no. 4 (April 2005): 396–400. http://dx.doi.org/10.1016/s0181-5512(05)81071-x.

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29

Thimons, J. J. "Advances in glaucoma diagnostic technology." Clinical Eye and Vision Care 9, no. 3 (September 1997): 139–47. http://dx.doi.org/10.1016/s0953-4431(97)10012-1.

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30

Muñoz-Negrete, Francisco J., Inés Contreras, Noelia Oblanca, M. Dolores Pinazo-Durán, and Gema Rebolleda. "Diagnostic Accuracy of Nonmydriatic Fundus Photography for the Detection of Glaucoma in Diabetic Patients." BioMed Research International 2015 (2015): 1–8. http://dx.doi.org/10.1155/2015/892174.

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Purpose.To determine the diagnostic accuracy for glaucoma of a set of criteria with nonmydriatic monoscopic fundus photography (NMFP) in diabetics.Methods.Diabetics recruited from a screening program for diabetic retinopathy and diabetic glaucoma patients recruited from our glaucoma unit were included. Any patient with evidence of diabetic retinopathy was excluded. Diabetic patients had to have no visual field defects to be included as controls. Glaucoma patients had to have a glaucomatous field defect in at least one eye to be included. One NMFP was taken per eye for all subjects. These photographs were evaluated by two masked glaucoma specialists for the presence of the following: bilateral cup to disc (C/D) ratio ≥0.6, notching or thinning of the neuroretinal rim, disc hemorrhages, and asymmetry in the C/D ratio between both eyes ≥0.2. This evaluation led to a dichotomous classification: if any of the above criteria was present, the patient was classified as glaucoma. If none were present, the patient was classified as normal.Results.72 control subjects and 72 glaucoma patients were included. Evaluation of NMFP had a sensitivity of 79.17% and a specificity of 80.56% for specialist 1 and a sensitivity of 72.22% and a specificity of 88.88% for specialist 2 for the detection of glaucoma. The overall accuracy was 79.83% and 80.55%, respectively.Discussion.NMFP evaluation by a glaucoma specialist may be useful for the detection of glaucoma in diabetics.

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Kita, Yoshiyuki, Gábor Hollό, and Ritsuko Kita. "Can diagnostic accuracy for early glaucoma be improved in Japanese? A trial with a potential new parameter of the RTVue OCT." Modeling and Artificial Intelligence in Ophthalmology 1, no. 1 (February 24, 2016): 21–36. http://dx.doi.org/10.35119/maio.v1i1.1.

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Aim: To evaluate the diagnostic accuracy of the ratio of circumpapillary retinal nerve fiber layer thickness (cpRNFLT) to macular outer retinal thickness (R/O ratio) and the ratio of ganglion cell complex (GCC) thickness to outer retinal thickness (G/O ratio) measured with the RTVue-100 Fourier-domain optical coherence tomograph for detecting early glaucoma in Japanese eyes.Methods: Forty-seven healthy control, 31 preperimetric and 70 early perimetric glaucoma eyes. We used cpRNFLT and macular retinal thickness measurements to calculate new ratio parameters, and to compare their diagnostic accuracy to those of the manufacturer-provided parameters of the RTVue-100. The ability of each parameter to diagnose glaucoma was examined by comparing the area under the receiver-operating characteristics curve (AUROC).Results: AUROC values for the healthy vs. preperimetric glaucoma comparison were 0.842, 0.859, and 0.925 for average cpRNFLT, average R/O ratio, and average G/O ratio, respectively. For the healthy vs. early perimetric glaucoma comparison the AUROC values were 0.927, 0.933, and 0.979 for cpRNFLT, R/O ratio, and G/O ratio, respectively. Diagnostic accuracy of the R/O ratio and cpRNFLT did not differ significantly (P > 0.05). Diagnostic accuracy for the G/O ratio was significantly greater than the cpRNFLT in early glaucoma (P < 0.05).Conclusions: Use of the G/O ratio is recommended for the detection of early glaucoma in Japanese eyes.

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Фролов, М. А., К. А. Казакова, Г. Н. Душина, А. М. Фролов та П. А. Гончар. "Непереносимость консервантосодержащих глазных капель при глаукоме: трудности диагностики, сложности лечения". Phylogenetic Analysis, № 1;2020 (26 січня 2020): 94–97. http://dx.doi.org/10.24075/vrgmu.2020.005.

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В клинику поступил пациент с диагнозом OD о/у глаукома 1a. OS оперированная о/у глаукома IIа. Состояние глазной поверхности расценено как токсико-аллергический конъюнктивит на фоне применения бримонидина 0,15%. Проведена замена бримонидина 0,15% на неселективный β-блокатор 0,5% и назначены стероиды местно. На фоне отмены стероидов было отмечено частичное возобновление симптомов в виде умеренно выраженных гиперемии и отека конъюнктивы, что было расценено уже как непереносимость консерванта. Было решено заменить β-блокатор на бесконсервантную форму под регулярным контролем уровня ВГД, дополнительно рекомендованы слезозаменители, не содержащие консервантов. При следующем визите отмечено повышение ВГД выше толерантного, назначена безконсервантная форма комбинированного гипотензивного средства (аналог простагландина 0,005% с неселективным β-блокатором 0,5%) под контролем уровня ВГД. Неправильная постановка диагноза вначале лечения усугубила состояние глазной поверхности. Применение препаратов без консерванта благоприятно влияет на поверхность роговицы и повышает комплаентность пациентов.

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Ittarat, Mantapond, Rath Itthipanichpong, Anita Manassakorn, Visanee Tantisevi, Sunee Chansangpetch, and Prin Rojanapongpun. "Capability of Ophthalmology Residents to Detect Glaucoma Using High-Dynamic-Range Concept versus Color Optic Disc Photography." Journal of Ophthalmology 2017 (2017): 1–7. http://dx.doi.org/10.1155/2017/8209270.

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Background. Assessment of color disc photograph (C-DP) is affected by image quality, which decreases the ability to detect glaucoma. High-dynamic-range (HDR) imaging provides a greater range of luminosity. Therefore, the objective of this study was to evaluate the capability of ophthalmology residents to detect glaucoma using HDR-concept disc photography (HDR-DP) compared to C-DP. Design. Cross-sectional study. Methods. Twenty subjects were classified by 3 glaucoma specialists as either glaucoma, glaucoma suspect, or control. All C-DPs were converted to HDR-DPs and randomly presented and assessed by 10 first-year ophthalmology residents. Sensitivity and specificity of glaucoma detection were compared. Results. The mean ± SD of averaged retinal nerve fiber layer (RNFL) thickness was 74.0 ± 6.1 μm, 100.2 ± 9.6 μm, and 105.8 ± 17.2 μm for glaucoma, glaucoma suspect, and controls, respectively. The diagnostic sensitivity of HDR-DP was higher than that of C-DP (87% versus 68%, mean difference: 19.0, 95% CI: 4.91 to 33.1; p=0.014). Regarding diagnostic specificity, HDR-DP and C-DP yielded 46% and 75% (mean difference: 29.0, 95% CI: 13.4 to 44.6; p=0.002). Conclusions. HDR-DP statistically increased diagnostic sensitivity but not specificity. HDR-DP may be a screening tool for nonexpert ophthalmologists.

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Avdeev, R. V., A. S. Alexandrov, M. U. Arapiev, N. A. Bakunina, A. S. Basinskiy, D. A. Belaya, A. Y. Brezhnev, et al. "Suspected glaucoma and early stage glaucoma: differential diagnostic criteria." Russian Ophthalmological Journal 10, no. 4 (2017): 5–15. http://dx.doi.org/10.21516/2072-0076-2017-10-4-5-15.

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Moreno-Montañés, Javier, Ana García-Nieva, Indira Aristeguieta Osio, Adriano Guarnieri, Antonio Morilla-Grasa, Marta García-Granero, and Alfonso Antón. "Evaluation of RETICs Glaucoma Diagnostic Calculators in Preperimetric Glaucoma." Translational Vision Science & Technology 7, no. 6 (November 30, 2018): 13. http://dx.doi.org/10.1167/tvst.7.6.13.

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Zheng, Feihui, Marco Yu, and Christopher Kai-Shun Leung. "Diagnostic criteria for detection of retinal nerve fibre layer thickness and neuroretinal rim width abnormalities in glaucoma." British Journal of Ophthalmology 104, no. 2 (May 30, 2019): 270–75. http://dx.doi.org/10.1136/bjophthalmol-2018-313581.

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Background/aimsAlthough measurements of the Bruch’s membrane opening minimum rim width (BMO-MRW) and retinal nerve fibre layer thickness (RNFLT) with optical coherence tomography (OCT) have been widely adopted in the diagnostic evaluation of glaucoma, there is no consensus on the diagnostic criteria to define BMO-MRW and RNFLT abnormalities. This study investigated the sensitivities and specificities of different diagnostic criteria based on the OCT classification reports for detection of glaucoma.Methods340 eyes of 137 patients with glaucoma and 87 healthy individuals, all with axial length ≤26mm, had global and sectoral BMO-MRW and RNFLT measured with Spectralis OCT (Heidelberg Engineering). Six diagnostic criteria were examined: global measurement below the fifth or the first percentile; ≥1 sector measurement below the fifth or the first percentile; superotemporal and/or inferotemporal measurement below the fifth or the first percentile. The sensitivities and specificities of BMO-MRW/RNFLT assessment for detection of glaucoma (eyes with visual field (VF) defects) were compared.ResultsAmong the six criteria examined, superotemporal and/or inferotemporal measurement below the fifth percentile showed the highest sensitivities and specificities for glaucoma detection. Abnormal superotemporal and/or inferotemporal RNFLT attained a higher sensitivity than abnormal superotemporal and/or inferotemporal BMO-MRW to detect mild glaucoma (mean VF MD: −3.32±1.59 dB) (97.9% and 88.4%, respectively, p=0.006), and glaucoma (mean VF MD: −9.36±8.31 dB) (98.4% and 93.6%, respectively, p=0.006), at the same specificity (96.1%).ConclusionsSuperotemporal and/or inferotemporal RNFLT/MRW below the fifth percentile yield the best diagnostic performance for glaucoma detection with RNFLT attains higher sensitivities than MRW at the same specificity in eyes without high myopia.

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Rebolleda, Gema, Ane Pérez-Sarriegui, Victoria De Juan, Sara Ortiz-Toquero, and Francisco J. Muñoz-Negrete. "A comparison of two optical coherence tomography–angiography devices in pseudoexfoliation glaucoma versus primary open-angle glaucoma and healthy subjects." European Journal of Ophthalmology 29, no. 6 (October 14, 2018): 636–44. http://dx.doi.org/10.1177/1120672118805882.

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Purpose: To compare peripapillary vascular parameters derived from two optical coherence tomography angiography devices in pseudoexfoliation glaucoma, primary open-angle glaucoma, and healthy controls and to evaluate their diagnostic accuracy. Methods: Observational, cross-sectional study. In total, 20 eyes with pseudoexfoliation glaucoma, 20 primary open-angle glaucoma eyes matched by peripapillary retinal nerve fiber layer thickness, and 20 control eyes were recruited. Participants underwent standard automated perimetry and peripapillary retinal nerve fiber layer analysis by Optovue and Cirrus optical coherence tomography. Vascular parameters provided by Angiovue and Angioplex optical coherence tomography angiography were compared. Their diagnostic accuracy and correlation with structural and functional parameters were assessed. Results: All peripapillary optical coherence tomography angiography vascular parameters were significantly different among groups (all p < 0.05). The whole image capillary density and peripapillary capillary density by Angiovue were significantly lower in pseudoexfoliation glaucoma compared with primary open-angle glaucoma (p = 0.009 and p = 0.001, respectively). Conversely, vascular parameters by Angioplex were not statistically different between primary open-angle glaucoma and pseudoexfoliation glaucoma. A good correlation was found using Angiovue between whole image capillary density and visual field mean deviation (0.758, p < 0.001), peripapillary capillary density and visual field mean deviation (0.729, p = 0.001), and peripapillary capillary density and peripapillary retinal nerve fiber layer thickness in eyes with pseudoexfoliation glaucoma (0.716, p = 0.001). Angiovue parameters showed higher area under the receiver operating characteristic curves than Angioplex to discriminate among groups. Conclusion: Only Angiovue detected a significantly lower capillary density in pseudoexfoliation glaucoma compared to primary open-angle glaucoma at similar glaucoma damage. Both, Angiovue and Angioplex demonstrated a decreased capillary density in glaucoma eyes compared to healthy eyes. Furthermore, Angiovue-derived vascular parameters showed better correlation with functional and structural parameters and a higher diagnostic capacity to discriminate among groups compared to Angioplex.

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Medvedovskaya, Nataliia, and Zoreslava Povch. "Timely Detection of Glaucoma in General Practice as a Means Prevent Late Diagnosis." Family Medicine, no. 4 (December 30, 2016): 143–45. http://dx.doi.org/10.30841/2307-5112.4.2016.248593.

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The objective: justification of need of the organization of introduction of measures for timely identification of an ophthalmic hypertension in practice of the family doctor for timely diagnosis of glaucoma, the prevention of development of her terminal stage became a research objective. Patients and methods. Outpatient and polyclinic units of five healthcare institutions of the city of Kiev in which primary help by the principles of the general medical practice – family medicine is given became scientific base of a research. Forms of account No. 12 «The report on the diseases registered at patients who live in the district of service of treatment and prevention facility» and questionnaires of a sociological research of risk factors of glaucoma (820 questionnaires) were primary material. Achievement of goals of a research demanded use of a complex of methods of a research, a basis for which was a systemic approach, namely: bibliosemantic, sociological, medico-statistical methods. Results. Of a research it has turned out that prevalence of glaucoma continues to increase enough in high gear (for 14,9% from 2010 to 2014) that proves relevance of a problem of the prevention of a blindness and a low vision because of glaucoma in Ukraine and in the near future. Owning knowledge of modern risk factors which has the proved influence on formation of an oftalmogipertenziya, and over time and glaucomas, physicians of primary contact can actively form risk groups on glaucoma that will allow to unify and to individualize at the same time preventively – improving, medical and diagnostic medical care in each case and to objectify assessment of her results in dynamics. Conclusion. Interaction in form of cooperation of the family doctor and ophthalmologist within the competences allows to perform effective long accounting of patients, preventing loss of visual functions by them for the account, first of all timely diagnosis of a disease (at an early stage), possible correction of the available risk factors of origin and progressing of glaucoma.

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Jain, Ritu, and Nupur Choudhary. "Comparative study of retinal nerve fibre layer thickness in normal and glaucomatous human eyes as measured by optical coherence tomography." International Journal of Research in Medical Sciences 8, no. 4 (March 26, 2020): 1375. http://dx.doi.org/10.18203/2320-6012.ijrms20201328.

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Background: Glaucoma is a disease primarily associated with damage to the Retinal Ganglion Cell (RGC) bodies and axons, which causes characteristic patterns of Visual Field (VF) and changes in the appearance of the Optic Nerve Head (ONH). This Study Compares Nerve Fibre layer thickness in normal and Glaucomatous Human Eye.Methods: It is a case control observational study carried out in 100 patients in a tertiary eye care hospital in the department of ophthalmology in the period from 1st January 2019 to 30th June 2019.Results: The diagnostic ability for distinguishing between normal and glaucoma patients were same when authors consider average RNFL thickness and average GCC thickness. Diagnostic accuracy increases when authors consider both RNFL and GCC thickness. There was a significant difference in both RNFL and GCC thickness between normal and glaucoma patient (p<0.001). The mean deviation shows a significant correlation with all the parameters in eyes with glaucoma (<0.001).Conclusions: RNFL thickness as measured by OCT showed statistically significant correlation with glaucoma. RNFL seems to have higher sensitivity and specificity for the detection of early glaucoma. Diagnostic accuracy increases when we include other parameters like RNFL and visual fields.

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Wu, Zhichao, Jayme R. Vianna, Alexandre S. C. Reis, Zane Z. Zemborain, Seung H. Lee, Abinaya Thenappan, Denis S. D. Weng, et al. "Qualitative evaluation of neuroretinal rim and retinal nerve fibre layer on optical coherence tomography to detect glaucomatous damage." British Journal of Ophthalmology 104, no. 7 (October 29, 2019): 980–84. http://dx.doi.org/10.1136/bjophthalmol-2019-314611.

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PurposeTo understand the added value of Bruch’s membrane opening-minimum rim width (BMO-MRW) measurements to conventional circumpapillary retinal nerve fibre layer (cpRNFL) thickness measurements on optical coherence tomography (OCT) imaging for discriminating between perimetric glaucoma and healthy eyes, evaluated through a qualitative evaluation.Methods384 healthy eyes and 188 glaucoma eyes were evaluated, and glaucoma eyes were categorised as perimetric (n=107) based on a history of ≥3 consecutive abnormal 24–2 visual field tests or suspected glaucoma if they did not (n=81). OCT-derived BMO-MRW and cpRNFL reports were qualitatively evaluated by two experienced graders in isolation at first, and then by using both reports combined. The diagnostic performance (sensitivity at 95% specificity, total and partial area under the receiver operating characteristic curve) of detecting perimetric glaucoma with each method were compared.ResultsAll diagnostic performance measures for detecting perimetric glaucoma eyes were not significantly different when using either the cpRNFL or BMO-MRW reports alone compared with using both reports combined (p≥0.190), nor when comparing the use of each report in isolation (p≥0.500).ConclusionsExperienced graders exhibited no difference in discriminating between perimetric glaucoma and healthy eyes when using a cpRNFL report alone, the BMO-MRW report alone or the two reports combined. Therefore, either OCT imaging report of the neuroretinal tissue could be used effectively for detecting perimetric glaucoma, but further studies are needed to determine whether there are specific advantages of each method, or the combination of both, when evaluating eyes that have a greater degree of diagnostic uncertainty.

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Talks, S. J., M. Tsaloumas, G. P. Misson, and J. M. Gibson. "Angle closure glaucoma and diagnostic mydriasis." Lancet 342, no. 8885 (December 1993): 1493–94. http://dx.doi.org/10.1016/0140-6736(93)92977-2.

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Douglas, Gordon R. "Diagnostic concepts in open-angle glaucoma." Current Opinion in Ophthalmology 3, no. 2 (April 1992): 141–69. http://dx.doi.org/10.1097/00055735-199204000-00006.

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Zanzmera, Paresh, Tinkal Patel, and Vinay Shah. "Diagnostic dilemma: Sturge-Weber syndrome, without facial nevus." Journal of Neurosciences in Rural Practice 6, no. 01 (January 2015): 105–7. http://dx.doi.org/10.4103/0976-3147.143215.

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ABSTRACTSturge-Weber syndrome (SWS), a rare sporadic neurocutaneous disease, is characterized by a congenital unilateral port-wine nevus affecting the area innervated by V1, ipsilateral leptomeningeal angiomatosis, and calcification in the occipital or frontoparietal region and glaucoma/vascular eye abnormality. Three types of SWS have been described in literature: Type I (classic) demonstrates facial and leptomeningeal angioma, often with glaucoma; type II has facial angioma and glaucoma, with no evidence of intracranial lesions; and type III (rarest) presents with only leptomeningeal angioma. Only a few cases of type III SWS have been reported. Here, we report a case of a seven-year-old boy with focal complex partial seizure, who was diagnosed with SWS without facial nevus. Recognition of this type of SWS is important, as our patient had been misdiagnosed and received inappropriate antiepileptic drugs for six years. We suggest that in the appropriate clinical scenario, the diagnosis of SWS without facial nevus should be considered before labelling idiopathic or cryptogenic localization-related epilepsy, and gadolinium-enhanced magnetic resonance imaging (MRI) should be done in clinically suspicious cases of SWS, without facial nevus.

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Krajčíková, Kristína, Miriama Skirková, Monika Moravská, Anna Birková, and Vladimíra Tomečková. "Native fluorescence of tear fluid as a tool for diagnostics of glaucoma." RSC Advances 11, no. 18 (2021): 10842–46. http://dx.doi.org/10.1039/d1ra00473e.

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Tear fluid native fluorescence differs among patients with primary open-angle glaucoma, suspected glaucoma, ocular hypertension, and healthy subjects and could serve as a diagnostic or screening tool in future.

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Koh, Anelisa. "Comparison of intraocular pressure peak and fluctuations among Filipino patients with non-glaucomatous eyes and glaucoma suspects using water drinking test and diurnal intraocular pressure." International Journal of Ophthalmology 14, no. 11 (November 18, 2021): 1729–34. http://dx.doi.org/10.18240/ijo.2021.11.12.

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AIM: To compare the intraocular pressure (IOP) peaks and fluctuations using water drinking tests (WDTs) and mean diurnal IOP among Filipino patients with normal eyes and glaucoma suspects METHODS: This prospective study included normal and glaucoma suspect patients. Each patient underwent both WDT and mean diurnal examination on separate visits. For mean diurnal examination, IOP was recorded every 2h for 8h while in WDT, IOP was recorded prior to WDT, and post-WDT at 5, 15, 30, 45, and 60min. IOP peak was recorded as the highest IOP for both methods, and IOP fluctuation was recorded as highest IOP minus lowest IOP. RESULTS: With the comparison of diagnostic tests, both normal eyes and glaucoma suspect groups, the peak IOP was caught at 15min. Comparative analysis of both groups also showed that the peak IOP measurements were statistically higher for the WDT compared to mean diurnal IOP (P=0.039, P=0.048 under normal group and P=0.032 and P=0.031 under glaucoma suspect group). Similarly, the WDT had a statistically higher mean IOP fluctuation score than the mean diurnal IOP method in both groups (P=0.003, P=0.011 under normal group; P=0.002 and P=0.005 under glaucoma suspect group). CONCLUSION: This study shows that WDT is a comparable diagnostic exam in predicting IOP fluctuations than mean diurnal measurement. WDT is a promising diagnostic procedure for risk assessment in glaucoma.

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Azuara-Blanco, Augusto, Katie Banister, Charles Boachie, Peter McMeekin, Joanne Gray, Jennifer Burr, Rupert Bourne, et al. "Automated imaging technologies for the diagnosis of glaucoma: a comparative diagnostic study for the evaluation of the diagnostic accuracy, performance as triage tests and cost-effectiveness (GATE study)." Health Technology Assessment 20, no. 8 (January 2016): 1–168. http://dx.doi.org/10.3310/hta20080.

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BackgroundMany glaucoma referrals from the community to hospital eye services are unnecessary. Imaging technologies can potentially be useful to triage this population.ObjectivesTo assess the diagnostic performance and cost-effectiveness of imaging technologies as triage tests for identifying people with glaucoma.DesignWithin-patient comparative diagnostic accuracy study. Markov economic model comparing the cost-effectiveness of a triage test with usual care.SettingSecondary care.ParticipantsAdults referred from the community to hospital eye services for possible glaucoma.InterventionsHeidelberg Retinal Tomography (HRT), including two diagnostic algorithms, glaucoma probability score (HRT-GPS) and Moorfields regression analysis (HRT-MRA); scanning laser polarimetry [glaucoma diagnostics (GDx)]; and optical coherence tomography (OCT). The reference standard was clinical examination by a consultant ophthalmologist with glaucoma expertise including visual field testing and intraocular pressure (IOP) measurement.Main outcome measures(1) Diagnostic performance of imaging, using data from the eye with most severe disease. (2) Composite triage test performance (imaging test, IOP measurement and visual acuity measurement), using data from both eyes, in correctly identifying clinical management decisions, that is ‘discharge’ or ‘do not discharge’. Outcome measures were sensitivity, specificity and incremental cost per quality-adjusted life-year (QALY).ResultsData from 943 of 955 participants were included in the analysis. The average age was 60.5 years (standard deviation 13.8 years) and 51.1% were females. Glaucoma was diagnosed by the clinician in at least one eye in 16.8% of participants; 37.9% of participants were discharged after the first visit. Regarding diagnosing glaucoma, HRT-MRA had the highest sensitivity [87.0%, 95% confidence interval (CI) 80.2% to 92.1%] but the lowest specificity (63.9%, 95% CI 60.2% to 67.4%) and GDx had the lowest sensitivity (35.1%, 95% CI 27.0% to 43.8%) but the highest specificity (97.2%, 95% CI 95.6% to 98.3%). HRT-GPS had sensitivity of 81.5% (95% CI 73.9% to 87.6%) and specificity of 67.7% (95% CI 64.2% to 71.2%) and OCT had sensitivity of 76.9% (95% CI 69.2% to 83.4%) and specificity of 78.5% (95% CI 75.4% to 81.4%). Regarding triage accuracy, triage using HRT-GPS had the highest sensitivity (86.0%, 95% CI 82.8% to 88.7%) but the lowest specificity (39.1%, 95% CI 34.0% to 44.5%), GDx had the lowest sensitivity (64.7%, 95% CI 60.7% to 68.7%) but the highest specificity (53.6%, 95% CI 48.2% to 58.9%). Introducing a composite triage station into the referral pathway to identify appropriate referrals was cost-effective. All triage strategies resulted in a cost reduction compared with standard care (consultant-led diagnosis) but with an associated reduction in effectiveness. GDx was the least costly and least effective strategy. OCT and HRT-GPS were not cost-effective. Compared with GDx, the cost per QALY gained for HRT-MRA is £22,904. The cost per QALY gained with current practice is £156,985 compared with HRT-MRA. Large savings could be made by implementing HRT-MRA but some benefit to patients will be forgone. The results were sensitive to the triage costs.ConclusionsAutomated imaging can be effective to aid glaucoma diagnosis among individuals referred from the community to hospital eye services. A model of care using a triage composite test appears to be cost-effective.Future workThere are uncertainties about glaucoma progression under routine care and the cost of providing health care. The acceptability of implementing a triage test needs to be explored.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Boyle-Walker, Megan, Leo P. Semes, Olivio J. Clay, Lei Liu, and Patti Fuhr. "Sleep Apnea Syndrome Represents a Risk for Glaucoma in a Veterans' Affairs Population." ISRN Ophthalmology 2011 (November 17, 2011): 1–5. http://dx.doi.org/10.5402/2011/920767.

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Purpose. To determine whether the diagnosis of sleep apnea syndrome (SAS) represents a risk-factor for glaucoma. Design. Retrospective records review. Methods. Records in an electronic database which exists at the Birmingham, Alabama Veterans' Affairs Medical Center (BVAMC) permit data retrieval and sorting based on diagnostic and procedural codes. Deidentified data of those having had an eye examination and a diagnostic code (ICD-9) for either sleep apnea or glaucoma were included. Statistical Analyses. SPSS version 19 was used to produce crosstabs and to conduct a bivariate logistic regression that examined the relationship between SAS and glaucoma. Results. A total of 70,960 unique records were included for analysis. Of the 2,725 patients with a diagnosis of sleep apnea, 228 (8.37%) also had a diagnosis of glaucoma. Diagnosis of glaucoma was present in 3,410 patients among 68,235 patients (5.00%) without sleep apnea. Bivariate logistic regression analysis yielded an odds ratio of 1.736 () suggesting that individuals with SAS are more likely to have a coexisting diagnosis of glaucoma than individuals without SAS. Conclusions. Results of this investigation suggest that SAS may represent a significant risk factor for glaucoma and this should be considered when managing patients who report that diagnosis.

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Anton, Alfonso, Karen Nolivos, Marta Pazos, Gianluca Fatti, Miriam Eleonora Ayala, Elena Martínez-Prats, Oscar Peral, et al. "Diagnostic Accuracy and Detection Rate of Glaucoma Screening with Optic Disk Photos, Optical Coherence Tomography Images, and Telemedicine." Journal of Clinical Medicine 11, no. 1 (December 31, 2021): 216. http://dx.doi.org/10.3390/jcm11010216.

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Purpose: The aim of this study was to evaluate the diagnostic accuracy of optical coherence tomography (OCT) and retinography in the detection of glaucoma through a telemedicine program. Methods: A population-based sample of 4113 persons was randomly selected. The screening examination included a fundus photograph and OCT images. Images were evaluated on a deferred basis. All participants were then invited to a complete glaucoma examination, including gonioscopy, visual field, and dilated fundus examination. The detection rate, sensitivity, specificity, and positive and negative predictive values were calculated. Results: We screened 1006 persons. Of these, 201 (19.9%) were classified as glaucoma suspects; 20.4% were identified only by retinographs, 11.9% only by OCT images, and 46.3% by both. On ophthalmic examination at the hospital (n = 481), confirmed glaucoma was found in 58 (12.1%), probable glaucoma in 76 (15.8%), and ocular hypertension in 10 (2.1%), and no evidence of glaucoma was found in 337 (70.0%). The detection rate for confirmed or probable glaucoma was 9.2%. Sensitivity ranged from 69.4% to 86.2% and specificity from 82.1% to 97.4%, depending on the definition applied. Conclusions: The combination of OCT images and fundus photographs yielded a detection rate of 9.2% in a population-based screening program with moderate sensitivity, high specificity, and predictive values of 84–96%.

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Yousef, N. Yu, E. E. Kazaryan, A. A. Rafaelyan, D. M. Safonova, N. Yu Shkolyarenko, and A. G. Matyuschenko. "The Effect of Age on the Indicator of Individual Norm of Intraocular Pressure." Ophthalmology in Russia 16, no. 3 (October 2, 2019): 355–59. http://dx.doi.org/10.18008/1816-5095-2019-3-355-359.

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The screening method for determination of individual norm of IOP proved the efficiency for early glaucoma diagnosis and for the treatment and monitoring of a disease. Purpose: definition of compliance of IOP to individual norm or tolerant IOP (TIOP) in different age groups Patients and methods. 4212 women (65.6%) and 2205 men (34.4%) aged from 22 up to 80 years participated in a research. In total 12820 examinations were analyzed. At each patient the result of compliance of settlement TIOP to the available real oftalmotonus was estimated. Patients with excess of an oftalmotonus concerning TVGD up to 15% were carried to group with low risk of disease developing, with excess from 15 to 25% — with average risk, by more than 25% — with high risk of glaucoma development. All patients were divided into 3 groups depending on age: younger 40 years, with average age of 35 years (620 eyes); from 40 to 60 years, with middle age 54 years (2724 eyes); 60 years, with middle age are more senior 73 years. Results. The regularity consisting in decrease in an indicator of lack of risk of glaucoma with age and in increase in high risk of a disease in the senior age groups was revealed. For patients who entered into risk group, morfofunctional monitoring for the glaucoma exception, dynamic observation with the subsequent analysis of the received results through certain time was recommended. The obtained data confirm decrease in hemodynamic parameters of eyes with increase in age, and assessment of indicators of microcirculation of an eye with calculation of TIOP can be one of important diagnostic criteria for glaucoma diagnostics and monitoring.

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50

Lever, Mael, Christian Halfwassen, Jan Darius Unterlauft, Nikolaos E. Bechrakis, Anke Manthey, and Michael R. R. Böhm. "The Paediatric Glaucoma Diagnostic Ability of Optical Coherence Tomography: A Comparison of Macular Segmentation and Peripapillary Retinal Nerve Fibre Layer Thickness." Biology 10, no. 4 (March 25, 2021): 260. http://dx.doi.org/10.3390/biology10040260.

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Paediatric glaucoma leads to a decreased thickness of the peripapillary retinal nerve fibre layer (pRNFL) and of the macula. These changes can be precisely quantified using spectral domain-optical coherence tomography (SD-OCT). Despite abundant reports in adults, studies on the diagnostic capacity of macular SD-OCT in paediatric glaucoma are rare. The aim of this study was to compare the glaucoma discriminative ability of pRNFL and macular segment thickness in paediatric glaucoma patients and healthy children. Data of 72 children aged 5–17 years (glaucoma: 19 (26.4%), healthy: 53 (73.6%)) examined with SD-OCT (SPECTRALIS®, Heidelberg Engineering) were analysed retrospectively. The thickness of pRNFL sectors and of macular segment subfields were compared between diseased and healthy participants. Areas under the receiver-operating characteristic curves (AUC), sensitivity, and specificity from logistic regression were used to evaluate the glaucoma discriminative capacity of single and combined pRNFL and macular segments’ thickness. The results revealed a reduced thickness of the pRNFL and of the three inner macular layers in glaucoma patients, which correlates highly with the presence of glaucoma. The highest glaucoma discriminative ability was observed for the combination of pRNFL sectors or inner macular segments (AUC: 0.83 and 0.85, respectively), although sensitivity remained moderate (both 63% at 95% specificity). In conclusion, while confirmation from investigations in larger cohorts is required, SD-OCT-derived pRNFL and macular thickness measurements seem highly valuable for the diagnosis of paediatric glaucoma.

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